Metabolic Syndrome & Cardiovascular Disease

Nutrition, Dietetics, And Food Science 254 with J.ross at University of Vermont

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By: Shira Levien
Created: 2011-05-04
Size: 32 flashcards
Views: 0

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Causes of Metabolic Syndrome

Increased calorie intake, increased refined CHO, physical inactivity, abdominal obesity

Development of Metabolic Syndrome

-genetic predisposition

-central obesity

- diabetes melitus

- high fat diets

- aging

-medications

-physical inactivity

- polycystic ovary disease

-low birth weight

Criteria for Metabolic Syndrome

at least 3 of:

- abdominal obesity in men >40in waist, women >35in waist

- triglycerides = or > 150 mg/dl

- HDL cholesterol <40 in men and <50 in women

- blood pressure = or >130/85 mmHG

- fasting glucose = or >110mg/dl

Risk Factors for Metabolic Syndrome

- Atherogenic dyslipidemia

- Glucose intolerance

- Hypertension

- proinflammatory state

- prothrombotic state

Atherogenic dyslipidemia

High TGL, VLDL-C, non-HDL-C, and low HDL-C, LDL-C particle size

glucose intolerance

high fasting glucose, HBA1c, impaired glucose tolerance

Hypertension

High BP

Proinflammatory state

High WBC, hs-CRP, IL-6

Prothrombotic state

High fibrinogen, vWF, PAI-1

Management ABC's of Metabolic Syndrome

A- assessment/ aspirin

B- BP control

C- cholesterol management, LDL, non HDL, HDL

D - diabetes prevention/ diet

E- exercise

Diet considerations for Metabolic syndrome

- weight loss reduces oxidative stress

- more refined CHO lead to insulin resistance, metabolic syndrome, diabetes

- hight GI diets lead to decreased CVD especially in obese women

- low GI diets lead to high HDL, low TGL in 6 months

- omega-3 and other USFA, natural antioxidants, fiber - decrease inflammation

- mediterranean diet - lowers insulin resistance and proinflammatory cytokines

CVD prevalence

- leading cause of death in US

- US ranks 13th for women and 17th for men in world incidence

- incidence increases with age, especially in women

- african americans have highest rate, asians lowest

- death rates have declined due to prevention, behavior, and better treatment

CVD includes...

hypertension, coronary heart disease (CHD), stroke, rheumatic heart disease, congestive heart failure

Coronary heart disease pathology

results from ischemia or lack of blood flow to the heart, specifically through coronary arteries

underlying cause of decreased blood flow is atherosclerosis

complicated by hypertension

how long can atherosclerosis take to develop

decades

progression of atherosclerosis

endothelial dysfunction > less nitric oxide (vasodilator) > constriction of artery> artery permeable to LDL > LDL + macrophages = foam cells > fatty streaks > fibrous plaque (LDL, calcium, fibrin) > acute lesions > plaques imbed blood flow to heart

cause of atherosclerosis progression

LDL infiltrates intimat of arteriol wall, modified by oxidation and enzymes which cause release of leukocytes which leads to inflammatory proteins (cytokines, TNF, IL-6, C-reactive protein)

atherosclerosis treatment

reversible by diet

inflammation

response to injury/infection, nonspecific stress response, capillaries become more permeable to allow phagocytes to destroy.

Catecholamines

norepinephrine and epinephrine, increase metabolic rate, glycogen breakdown in liver and muscle, glucose production from amino acids, release of fatty acids from adipose tissue, glucagon secretion from pancreas.

Glucagon

glycogen breakdown in liver, glucose production from amino acids, release of fatty acids from adipose tissue.

Cortisol

protein degradation, enhancement of glucagons action on liver glycogen, glucose production from amino acids, release of fatty acids from adipose tissue.

Aldosterone

hormone involved in retention of stodium

antidiuretic hormone

hormone involved in retention of water

additional immune response to atherosclerosis

T cells patrol arteries for antigens, if found produce cytokines for inflammation. promote atherosclerosis in response to infection.

C-Reactive protein

acute phase protein produced by liver and increased in systemic infection. may be additional test for CVD risk. highly sensitive in increased risk of heart attack, sudden death, peripheral artery disease.

Test suggestions for CRP using global risk assessment

<10% no test

10-20% test

>20% should be treated anyway

hsCRP levels

<1mg/l - low risk

1-3mg/l - average risk

>3mg/l- high risk

factors effecting CRP levels

weight loss, exercise, diabetes, smoking cessation, BP, reducing alcohol, stress, genetics.

suggested foods to reduce CRP

fish oil, ginger, tumeric, aspirin, coenzyme Q

factors increasing release of chemicals and activation of immune cells

cigarette smoking, hypertension, atherogenic lipoproteins, hyperglycemia, all give rise to variety of noxious stimuli that cause release of chemicals and activation of cells involved in inflammatory process which can cause formation of plague and clots causing CHD.

Modifiable Risk Factors in CVD

markers in blood, lipoprotein profile, inflammatory markers, lifestyle risk factors, related diseases.

About this deck

By: Shira Levien
Created: 2011-05-04
Size: 32 flashcards
Views: 0

About StudyBlue

“I have been getting MUCH better grades on all my tests for school. Flash cards, notes, and quizzes are great on here. Thanks!”
Kathy