Question

Since heart problems only seem to occur in people of middle age and older, a child need not be so concerned with fat and cholesterol intake. A. Strongly agree B. Agree C. No opinion D. Disagree E. Strongly Disagree

Lipids - 4
Heart Disease, Risk Factors, Prevention and Treatment Strategies

Road to a Heart Attack

Review
Food for thought story from the text and in this learning module!

Cardiovascular Disease
Cross-section of (a) a normal artery and (b) a partially blocked artery.

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Atherosclerosis

Formation of an Atherosclerotic Lesion

Blood vessel

Risk Factors for Heart Disease

Non-Modifiable: Can Not Change

Lumen blood flowing

Monocyte/White Blood Cell LDL Endothelial cells Sub-endothelial space Lipid oxidation
Antioxidants block this step

Inflammation
Lesion Scavenger cell Foam Cell Fatty Streak

Modifiable: Can Change

Smooth muscles surrounding blood vessel

Recommendations for Fat Intake Heart Disease Prevention No RDA - AMDR 20-35% AHA recommendations
20-30% of total kcal from fat 7-10% can come from saturated/trans fat 200-300 mg cholesterol/day

Strategies to Decrease Risk

Good Blood Lipid Profile - < 200 mg/dL Lower LDL-C - < 100 mg/dL Reduce dietary saturated fat and cholesterol Increase MUFA and PUFA Increase dietary fiber (soluble) Lowering Blood TG - most diet-responsive blood lipid Avoid overeating Limit alcohol Limit simple sugars Small frequent meals Include fish in the diet Raise HDL exercise, moderate alcohol - >40 mg/dL

Average U.S. intake:

33% of total kcal from fat 13% of kcal from saturated fat 180-320 mg cholesterol/day

Strategies to Decrease Risk

Good Blood Lipid Profile Target Cholesterol Biosynthesis prescription medications, statins Absorption, reuse pathways Fibers Benecol and Take Control margarines, Plant stanol/sterol esters - Decrease absorption of cholesterol Prescription Medication - Ezetimibe Protect Blood Lipids Antioxidants Fruits and Vegetables: phytochemicals, nutrient Hypertension and diabetes can promote blood lipid oxidation so treat

Strategies to Decrease Risk

Decrease Inflammation and potential blood vessel injury
Stop Smoking Obesity, hypertension and diabetes Omega-3 fatty acids

Decrease potential for blood to clot in arteries

Low dose aspirin Omega-3 fatty acids Anticoagulant therapy prescription medication vitamin K analogs

Making Platelets less sticky!

Resources
American Heart Association
Warning signs Diet and Nutrition

National Cholesterol Education Program

Excessive Platelet Stickiness and aggregation can trigger blood clotting -low dose aspirin and omega-3 fatty acids help prevent this

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