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11 Cards in this Set

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Effect of inflammation on heart disease
C-reactive protein (CRP) is a protein found in the
blood(synthesised in the liver), the levels of which rise in
response to inflammation
• The erythrocyte sedimentation rate (ESR), is the rate at
which red blood cells precipitate in a period of one hour. It is
a non-specific measure of inflammation
• The serum arachidonic acid:eicosapentaenoic acid (AA:EPA)
ratio is a biochemical marker of coronary artery disease (CAD)
risk, as well as a tool to measure omega-3 fatty acid
supplementation response
• Triglycerides/HDL ratio is an indicator of LDL particle size
What does excercise do to circulating levels of CRP in diseased populations?
It reduces it.
Salt recommended levels
Infants:6-25 millimoles 0.1-0.6 grams
• Children:14-100 millimoles 0.3-2.3gms
• Adults:40-100 millimoles 0.9-2.3 grams
(around 6gm of table salt
Recall Oats: beta glucans and fibre and dose
Beta –glucans increase bile acid synthesis and thus
decrease serum cholesterol
• Fibre binds to cholesterol preventing absorption.
• Dose: 75gm dried oatmeal daily or 6gm of
concentrated oat beta-glucan daily
Phytosterols: What they do and dose?
Phytosterols are cholesterol-like molecules found in
all plant foods, with the highest concentrations
occurring in vegetable oils. They are absorbed only in
trace amounts but inhibit the absorption of intestinal
cholesterol including recirculating endogenous
biliary cholesterol, a key step in cholesterol
elimination.
• A dose of 2 g/day as the ester reduces low density
lipoprotein cholesterol by 10% which usually equates
to around 20g of margarine daily.
Policasonil; what is it and effect on LDL?
Derived from the waxy coating of stems and
leaves of Cuban sugar cane.
• Cuban studies shows lowering of LDL by
13%(Kassis et al 2007) however many
negative clinical findings since then make this
product controversial.
Phytonutrients: role of carotenoids
Carotenoids
 lutein,lycopene, β carotene (diet): lower incidence of CV disease
• inhibition of LDL oxidation, inhibition of cellular lipid peroxidation and
consequently attenuation of cell-mediated oxidation of LDL (Aviram M et al
Handb Exp Pharmacol. 2005;(170):263-300)
• but: avoid synthetic β carotene (MRC/BHF Heart Protection study:Violi F et al Lancet.
2002 Nov 30;360(9347):1782-3
Phytonutrients: role of flavonoids
Red Wine
• proanthocyanidins: antioxidants; decrease platelet aggregation,
increase platelet-derived NO release, decreases superoxide production
Phytonutrient: dark chocolate, tea, resveratrol
Dark Chocolate – contains polyphenol epicatechin- lowers
CRP,blood pressure,platelet reactivity, reduces stroke risk.
• South Med J 2008;12(101):1203–12004
• Tea-contains polyphenol epigallocatechin gallate (EGCG)-
cohort study of 40,530 Japanese-study suggest the
association of green tea consumption with lower rates of
cardiovascular disease and stroke.
• The Ohsaki Study. JAMA 2006;296:1255–1265.
• Resveratrol – the active ingrediant in red wine –may reduce
the risk of CV disease.
• Eur Heart J 2007;28:1683–93.
Why is resistance training type of exercise so useful in preventative CV health?
Resistance training reduces circulating levels of CRP in
diseased populations.
• A 2007 American study found support for the use of
combined aerobic/resistance training as a modality to
decrease serum CRP concentration in healthy humans.
• Resistance training assists the body in expending calories
via an increase in lean body mass and basal metabolism.
Thus, resistance training exercise is strongly recommended
for implementation in primary and secondary
cardiovascular disease–prevention programs.
SALT and detrimental effects on health..
What does a 5g difference in salt diet associated with?
Systematic review and meta-analysis of
prospective studies published 1966-2008
• Conclusions High salt intake is associated with
significantly increased risk of stroke and total
cardiovascular disease.
• A difference of 5 g a day in habitual salt intake is
associated with a 23% difference in the rate of
stroke and 17% difference in the rate of total
cardiovascular disease
• BMJ