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Nutrition/behavior population and nutrition, griffith/miller

Protective intakes for Stage 2 and 3 atherosclerosis Fiber, folate, vitamin K, and antioxidants
Intake factors that slow progression at stage 2 and 3 atherosclerosis decreasing blood pressure (moderate sodium chloride, adequate potassium, calcium and magnesium)
Protective intake for stage 4 atherosclerosis Fish
Mechanisms that contribute to vascular disease LDL and lipoproteins, homocysteine, vascular damage due to hypertension, diabetes or vitamin K deficiency,
Mechanisms that contribute to vascular disease thrombosis increased platelet aggregation due to decreased fish and low fruit/vegetable intake, hypercoagulation with high fat intake and obesity
Typical progression of atherosclerosis begins with tears or fatty streaks in the intima of blood vessels attract monocytes and stimulate the cellular immune response
First step in cardiovascular disease prevention Risk assessment
Age for premature coronary heart risk Female- under 65, male- under 55
Source of fatty acids Dietary fat (not carbs, proteins or alcohol)
Bodily uses of fatty acids Build membranes, precursor for complex lipids,precursor for eicosanoides (important for inflammatory response and platelet aggregation), energy
Complex proteins are transported as lipoproteins
Atherogenic lipoproteins chylomicron remnants,LDLs and VLDL remnants
Non-atherogenic lipoproteins chylomicrons, HDLs, VLDLs
All lipoproteins contain cholesterol, cholesterol esters, triglycerides (three fatty acids and glycerol), phospholipids, and apolipoproteins
Chylomicrons are lipoproteins that transport fat soluble compounds from the intestines to other organs
Chylomicrons are cleared in a two step process. What is it? 1. Hydrolysis of triglycerides by lipoprotein lipase in the bloodstream 2. Receptor mediated uptake of the residual lipoproteins
Lipoprotein lipase is activated by Apolipoprotein CII
What determines the amount of chylomicron remnants in the blood Genetic predisposition and dietary habits
Increase in triglycerides after a meal is mainly due to Chylomicrons
Lipoprotein lipase (LPL) Releases fatty acids from chylomicrons in small arterioles and capillaries
Chylomicrons carrying dietary fat are absorbed into the circulation and first enter the (organ?) Lungs
Chylomicron remnants are taken up by Liver
VLDL transports what? From where? Trigs, Vitamin E and cholesterol from the liver
Catabolism of VLDLs 1. Lipoprotein lipase cleaves trigs and generates VLDL remnants 2. Half of the remnants are taken up by a receptor mediated process and half are converted to LDL in the liver
VLDLs are produced in the Liver
Chylomicrons are produced in the small intestinal mucosa
Which lipoprotein mediates the transport of cholesterol from arterial walls to the liver HDLs (thats why they are good!!)
LDLs are derived from VLDLs
LDLs carry most of the Vitamin E and cholesterol in the blood
In a low cholesterol diet, (more/less) receptors are expressed in liver cells MORE
Cells with highest LDL receptor activity Adrenal cells
The liver converts LDL into Bile acids
Lifestyle changes can reduce LDL concentration by 20-40%
Boosting viscous fiber does what to LDL Lowers it significantly
Increasing myristic and palmitic fatty acid intakes increases LDLs
Increasing intake of linoleic fatty acid lowers LDLs
LDL receptor activity which is down-regulated by High cholesterol and high dietary fat
Polyunsaturated fats are susceptible to peroxidation
Oxidized lipids are (more/less)atherogenic More
LDLs are most susceptible to peroxidation because of their high PUFA levels and long circulation time
When free radicals attack LDLs, what happens The apoB is fragmented, changing the structure and making it difficult to bind to its receptor.
What role does the scavenger receptor play in atherosclerosis? The scavenger receptor allows modified LDLs to be taken up by macrophages which promotes atherosclerosis
The longer LDL stays in the bloodstream, the (more/less) it becomes oxidized more
Foam cells Macrophages that are full of lipids (specifically LDLs)
Where do dying foam cells deposit their cholesterol Vascular endothelium
Modified LDLs promote secretions from endothelial cells that lead to smooth muscle proliferation, attracts macrophages and increases the inflammatory response
Defense mechanisms against free radicals 1. protective cellular enzymes inactivate free radicals 2. Fat soluble antioxidants protect membranes, lipid rich organelles and lipoprotiens (ex. alpha-tocopherol) 3. Proteins and metabolites protect aqueous environments within and outside of cells
Free radicals, oxidized lipids and lipoproteins can interfere with Nitric oxide signalling in Smooth muscle which increases arterial pressure
Rate limiting step of cholesterol synthesis conversion of HMG-CoA to mevalonate
Conversion of HMG-CoA to mevalonate is catalyzed by HMG-CoA reductase
The activity of HMG-CoA reductase, the rate-limiting enzyme in cholesterol biosynthesis, (decreases/increases) with high dietary cholesterol intake. Decreases
Suggested HDL level over 40 mg/dl
Main functions of HDL Take up phopholipids and cholesterol from VLDLs, take up cholesterol from LDLs, remove cholesterol from peripheral tissues, transfer apoCII and apoE to chylomicrons and VLDLs to regulate their metabolism
The main benefit of HDLs is its ability to transport cholesterol from arteries to the liver
Central organ for cholesterol excretion liver
Can cholesterol be excreted in bile? Yes
Alcohol consumption does what to HDLs Increases
Women have (higher/lower) HDL concentrations than men Higher
HDLs originate from Liver and small intestines
Be sure to mention a ____ when referring to CV discease Stroke
Desirable polyunsaturated fat to saturated fat ratio 1.0
Saturated and transaturated fat should be what percent of daily calorie intake less that 8%
Daily Cholesterol intake should be less than 300 mg per day
Limit salt intake to less than 6g or 2300 mg of sodium per day
Recommended servings of fruits and vegetables per day 4 and 4
Recommended grain servings per day 6
Recommended servings of fish per week 2
Desirable cholesterol levels Under 200
Desirable LDL levels under 100
Desirable HDL leves over 40
Normal Trig levels 150
Obese is considered a BMI over 30
Nearly 1 in _ kids are considered obese 6
Obesity contributes to 4 of the top 10 causes of death in the US. What are they Heart disease, cancer, cerebrovascular disease and diabetes
Central obesity "apple shape", increases health risks significantly
The most commonly used tool to identify obesity BMI
BMI compares Weight in Kg to height in m^2 (weight/height^2)
Weight circumference measure intra-abdominal fat
Weight circumference that is considered obese Men- >40inches, Women-> 35 inches
Normal BMI 18.5-24.9
Carb supplies are depleted how quickly with fasting? a single day
Increased circulating insulin favors the storage of Trigs in adipose tissue
The release of free fatty acids promote an increase in lipoprotein production and insulin resistance
Glucagon promotes Free fatty acid release
Insulin promotes Free fatty acid storage
Modest changes in adipose tissue fat effect VLDL production
The inhibition of hormone sensitive lipase by insulin (speeds up,slows down)the release of free fatty acids from adipose tissue. Slows down
Hormone sensitive lipase causes the breakdown of stored triglycerides to free fatty acids and glycerol
Three keys for a healthy diet Moderation, variety, balance
Steps to a successful weight management Assess, Provide, Plan
Exercise enhances Hormone sensitive lipase
Total energy expenditure includes Physical activity, basal energy expenditure, thermal effect of food, and growth
Thermic effect of food is approximately 10% of total energy expenditure
Primary determinant of basal energy expenditure Body weight, specifically fat-free mass
Energy needed for growth between ages 1-18 is <2% of daily energy requirements
The most variable component of total energy expenditure in healthy people Physical activity
Regulates hunger and satiety Hypothalamus
Neurotransmitter released during a meal CCK from duodenum
Neurotransmitter released soon after a meal Peptide YY from colon
Neurotransmitter released to signal hunger Ghrelin from stomach
A reduction in leptin is caused by A reduction in fat stores
Orexigenic neurons cause a Increase in appetite
Estimated energy requirements (increase,decrease) with age Decrease
Energy expenditure is directly related to muscle mass
A diet assessment should provide information about the patient's intake with regards to food choices, calorie level, variety, adequacy, portion sizes, potential excesses or deficiencies, and dietary supplement use
The basic food groups are Grains, vegetables, fruits, oils, dairy, protein
Important target for obesity treatment and prevention Portion control
Healthy eating emphasized choosing nutrient dense foods
Factors describing physical activity Frequency, intensity, type and time (FITT)
Recommended daily activity 30-60 minutes a day
In children, how much sedentary time is too much 2 hours
Motivational interviewing a patient centered approach designed to effect behavior change
Motivational interviewing elements Feedback, Responsibility, Advice, Menu, Empathy, Self-efficacy (FRAMES)
2 Major points of dietary guidelines for Americans 1. Maintain calorie balance over time to achieve and sustain a healthy body weight 2. Focus on consuming nutrient-dense foods and beverages
Focus of Myplate.gov Eat more fruits and vegetables!
6 classification of nutrients Carbohydrates, Fat, Protein, Vitamins, Minerals, Water
Energy-yielding nutrients Carbohydrates, Fat and Proteins
Monosaccharides Glucose, Fructose, Galactose
Disaccharides Sucrose
Polysaccharides Starch
Fiber Indigestible Carbohydrate, soluble or insoluble fiber
Which is easier to get, a structure/function claim or a food label health claim A structure/function claim
Enriched wheat flour and multi-grain flours are refinded and do not have the same nutrient value and fiber as whole grain wheat flour
Government guideline for using "natural" on label NONE
What makes up a protein 20 amino acids in any order
Complete protein contains All 9 essential amino acids in proportions needed by the body
Conditions of Aerobic exercise Continuous, Rhythmic, Uses Large muscles, 3 days a week or more, 20 continuous minutes or more, at or above target Exercise Heart Rate (aka increasing oxygen consumption)
Exercise recommendation for adults 150 minutes of moderate activity or 75 minutes of vigorous activity/ 2 strength trainings a week
Most common exercise risks Heart attack, muscle/joint injuries, heat disorders
Created by: mcasto