Chapter 5   Lipids   Lecture and Animation PowerPoint   Copyright © The McGraw-Hill Companies, Inc. Permission required fo...
Lipids <ul><li>Do not readily dissolve in water </li></ul><ul><li>Types of lipids: </li></ul><ul><ul><li>Triglycerides </l...
Chemical Forms of Common Lipids
Fatty Acids <ul><li>Found in our body and foods </li></ul><ul><ul><li>In triglycerides  </li></ul></ul><ul><li>Saturated f...
Cis and Trans Fatty Acids
Fatty Acid Structure  <ul><li>omega end alpha end </li></ul><ul><li>Degree of saturation </li></ul>H  H  H  H  H  H  H  H ...
Saturated Fatty Acid Structure <ul><li>omega end alpha end </li></ul><ul><li>Degree of saturation: single carbon bond </li...
Monounsaturated Fatty Acid Structure <ul><li>omega end alpha end </li></ul><ul><li>One double bond </li></ul>H  H  H  H  H...
Polyunsaturated Fatty Acid Structure <ul><li>omega end alpha end </li></ul><ul><li>>  2 double bonds </li></ul>H  H  H  H ...
Composition of Common Fats / Oils
Essential Fatty Acids <ul><li>Omega-3 fatty acid (alpha-linolenic acid) </li></ul><ul><li>Omega-6 fatty acid (linoleic aci...
Triglycerides <ul><li>Most common form of fats and oils </li></ul><ul><li>Fatty acids attached to a glycerol </li></ul>
Triglycerides  <ul><li>Glycerol  +  3 FA ’s  Triglyceride + </li></ul><ul><li>  3 H 2 0 </li></ul>
Phospholipids <ul><li>Built on a glycerol backbone </li></ul><ul><li>Contains phosphorus compound(s) </li></ul><ul><li>Fou...
Functions of Phospholipids <ul><li>Component of cell membrane </li></ul><ul><li>Emulsifier </li></ul><ul><ul><li>Bile acid...
Sterols <ul><li>Multi-ringed structure </li></ul><ul><li>Do not have a glycerol backbone </li></ul><ul><li>Cholesterol is ...
Functions of Cholesterol <ul><li>Essential component of cell membrane </li></ul><ul><li>Produced by the liver </li></ul><u...
Chemical Forms of Common Lipids
Lipids in Foods
Emulsifiers
Hidden Fat <ul><li>Look on the Nutrition Facts labels </li></ul><ul><li>Look on the lists of ingredients </li></ul><ul><li...
Reduced-Fat Foods <ul><li>Calorie content is about the same </li></ul><ul><li>Sugar is commonly added in place of fat </li...
Fat Substitutes <ul><li>Water  </li></ul><ul><ul><li>Diet margarine </li></ul></ul><ul><li>Z-trim  </li></ul><ul><ul><li>S...
Rancidity <ul><li>Decomposed oils </li></ul><ul><li>Breakdown of the C=C bonds by UV light, and/or O 2 </li></ul><ul><li>U...
Prevention of Rancidity <ul><li>Hydrogenation </li></ul><ul><li>Addition of vitamin E </li></ul><ul><li>Addition of Butyla...
Hydrogenation of Fatty Acids <ul><li>Process used to solidify an oil </li></ul><ul><li>Addition of H to C=C double bonds <...
Hydrogenation
Cis and  Trans  Fatty Acid
Excessive  Trans  Fatty Acid Intake <ul><li>Raises LDL </li></ul><ul><li>Lowers HDL </li></ul><ul><li>Increases risk for c...
Minimize Intake of  Trans  Fat <ul><li>Limit use of hydrogenated fats </li></ul><ul><li>Limit deep-fried foods </li></ul><...
Trans  Fat-free Foods
Main Sources of Fatty Acids
Digestion of Fats and Oils
Digestion of Fat in the Stomach <ul><li>Gastric lipase   </li></ul><ul><ul><li>Activated by an acidic environment  </li></...
Digestion of Fat in the Small Intestine <ul><li>Primary site of fat digestion </li></ul><ul><li>Hormone Cholecystokinin (C...
 
Digestion of Phospholipids <ul><li>Enzymes released </li></ul><ul><ul><li>From pancreas </li></ul></ul><ul><ul><li>From ce...
Digestion of Cholesterol <ul><li>Enzymes released </li></ul><ul><ul><li>From pancreas </li></ul></ul><ul><li>Cholesterol i...
Absorption of Fat <ul><li>95% of dietary fat is absorbed </li></ul><ul><li>Diffused into the absorptive cells </li></ul><u...
Carrying Fat in the Bloodstream <ul><li>Water (blood) and oil (fat) are incompatible </li></ul><ul><li>Unique system of fa...
Transportation of Absorbed Fatty Acids <ul><li>Re-formed into triglycerides </li></ul><ul><li>Packaged into chylomicrons <...
Composition and Roles of Lipoproteins
Transportation of Synthesized Fat <ul><li>Made primarily by the liver </li></ul><ul><li>Very-Low-Density Lipoprotein (VLDL...
Lipoproteins
High-Density Lipoprotein (HDL) <ul><li>Synthesized by liver and intestine </li></ul><ul><li>High proportion of protein  </...
Benefits of (a high) HDL (level) <ul><li>Removes cholesterol from the bloodstream </li></ul><ul><li>HDL may block oxidatio...
<ul><li>Scavenger WBC removes (oxidized) LDL from circulation </li></ul><ul><li>Build-up of plaque on walls of the blood v...
Antioxidant <ul><li>Reduces oxidation </li></ul><ul><li>Slows LDL uptake by scavenger cells </li></ul>
Functions of Essential Fatty Acids
Essential Fatty Acid- Omega-3 (alpha-linolenic acid) <ul><li>omega end alpha end </li></ul><ul><li>1st double bond is loca...
Omega-3 Fatty Acid <ul><li>Primarily from fish oil </li></ul><ul><li>Also found in canola, walnuts, flax seeds, mussels, c...
Essential Fatty Acid- Omega-6 (alpha-linoleic acid) <ul><li>omega end alpha end </li></ul><ul><li>1st double bond is locat...
Omega-6 Fatty Acid <ul><li>Found in vegetable oils </li></ul><ul><li>Only need ~ 2-4 tablespoons a day </li></ul>
Essential Fatty Acids
Health-related Effects <ul><li>Archidonic acid (Omega-6 ) </li></ul><ul><ul><li>Increases blood clotting </li></ul></ul><u...
Signs and Symptoms of Essential Fatty Acids Deficiency <ul><li>Flaky, itchy skin </li></ul><ul><li>Diarrhea </li></ul><ul>...
Functions of Fatty Acids  <ul><li>Provide energy </li></ul><ul><li>Efficient storage of energy </li></ul><ul><li>Insulatio...
Recommendations for Fat Intake <ul><li>No RDA  </li></ul><ul><li>AHA recommendations </li></ul><ul><ul><li>20-30% of total...
AHA Goals
AHA Recommendations
Advice from National Cholesterol Education Program and Food and Nutrition Board  <ul><li>Up to 35% of total kcal from fat ...
Other Recommendations <ul><li>Fat intake can be higher as long as saturated and  trans  fatty acid are minimal </li></ul><...
Cutting the Fat
Road to a Heart Attack
Cardiovascular Disease <ul><li>Myocardial infarction </li></ul><ul><li>Cerebrovascular disease </li></ul>
Risk Factors <ul><li>Total blood cholesterol > 200 mg/dl </li></ul><ul><li>Smoking  </li></ul><ul><ul><li>Increases clotti...
Other Risk Factors <ul><li>Low HDL (< 40 mg/dl) </li></ul><ul><li>Age </li></ul><ul><li>Family history </li></ul><ul><li>B...
Signs of a Heart Attack <ul><li>Intense, prolong chest pain </li></ul><ul><li>Shortness of breath </li></ul><ul><li>Sweati...
Medical Intervention  <ul><li>For those who experience a heart attack </li></ul><ul><ul><li>Or have CVD or diabetes </li><...
Lowering LDL <ul><li>See your doctor to assess for other conditions </li></ul><ul><li>Reduce dietary saturated fat and cho...
Lowering Blood TG <ul><li>Is the most diet-responsive blood lipid </li></ul><ul><li>Avoid overeating </li></ul><ul><li>Lim...
Other Possible Methods <ul><li>Benecol  and  Take Control  margarines </li></ul><ul><ul><li>Plant stanol/sterol esters </l...
Raising HDL <ul><li>Physical activity </li></ul><ul><li>At least 45 min/day, 4 days a week </li></ul><ul><li>Don ’t smoke ...
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Ch5 Lipids

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Ch5 Lipids

  1. 1. Chapter 5 Lipids Lecture and Animation PowerPoint Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. To run the animations you must be in Slideshow View . Use the buttons on the animation to play, pause, and turn audio/text on or off. Please Note : Once you have used any of the animation controls , you must click in the white background before advancing to the next slide.
  2. 2. Lipids <ul><li>Do not readily dissolve in water </li></ul><ul><li>Types of lipids: </li></ul><ul><ul><li>Triglycerides </li></ul></ul><ul><ul><li>Phospholipids </li></ul></ul><ul><ul><li>Sterols (Cholesterol) </li></ul></ul><ul><li>Fats (solid) and oils (liquid) </li></ul><ul><ul><li>9 kcal /gm </li></ul></ul>
  3. 3. Chemical Forms of Common Lipids
  4. 4. Fatty Acids <ul><li>Found in our body and foods </li></ul><ul><ul><li>In triglycerides </li></ul></ul><ul><li>Saturated fatty acids </li></ul><ul><ul><li>Solid form </li></ul></ul><ul><li>Unsaturated fatty acids </li></ul><ul><ul><li>Liquid form </li></ul></ul><ul><ul><li>Cis and Trans </li></ul></ul><ul><li>Fats are composed of both saturated and unsaturated </li></ul>
  5. 5. Cis and Trans Fatty Acids
  6. 6. Fatty Acid Structure <ul><li>omega end alpha end </li></ul><ul><li>Degree of saturation </li></ul>H H H H H H H H H H H H H H H H H O H-C--C--C--C--C--C--C--C--C--C--C--C--C--C--C--C--C-C-OH H H H H H H H H H H H H H H H H H
  7. 7. Saturated Fatty Acid Structure <ul><li>omega end alpha end </li></ul><ul><li>Degree of saturation: single carbon bond </li></ul>H H H H H H H H H H H H H H H H H O H-C--C--C--C--C--C--C--C--C--C--C--C--C--C--C--C--C-C-OH H H H H H H H H H H H H H H H H H
  8. 8. Monounsaturated Fatty Acid Structure <ul><li>omega end alpha end </li></ul><ul><li>One double bond </li></ul>H H H H H H H H H H H H H H H O H-C--C--C--C--C--C--C--C--C=C--C--C--C--C--C--C--C--C-OH H H H H H H H H H H H H H H H H H
  9. 9. Polyunsaturated Fatty Acid Structure <ul><li>omega end alpha end </li></ul><ul><li>> 2 double bonds </li></ul>H H H H H H H H H H H H H O H-C--C--C--C--C--C=C--C--C=C--C--C--C--C--C--C--C--C-OH H H H H H H H H H H H H H H H H H
  10. 10. Composition of Common Fats / Oils
  11. 11. Essential Fatty Acids <ul><li>Omega-3 fatty acid (alpha-linolenic acid) </li></ul><ul><li>Omega-6 fatty acid (linoleic acid) </li></ul><ul><li>Body can only make double bonds after the 9th carbon from the omega end </li></ul><ul><li>Functions </li></ul><ul><ul><li>Immune function, vision, cell membrane, and production of hormone-like compounds </li></ul></ul>
  12. 12. Triglycerides <ul><li>Most common form of fats and oils </li></ul><ul><li>Fatty acids attached to a glycerol </li></ul>
  13. 13. Triglycerides <ul><li>Glycerol + 3 FA ’s Triglyceride + </li></ul><ul><li> 3 H 2 0 </li></ul>
  14. 14. Phospholipids <ul><li>Built on a glycerol backbone </li></ul><ul><li>Contains phosphorus compound(s) </li></ul><ul><li>Found in body </li></ul><ul><li>Synthesized by the body as needed </li></ul>
  15. 15. Functions of Phospholipids <ul><li>Component of cell membrane </li></ul><ul><li>Emulsifier </li></ul><ul><ul><li>Bile acids </li></ul></ul><ul><ul><li>Lecithins </li></ul></ul><ul><ul><li>Improves food products </li></ul></ul><ul><li>Found in wheat germ, peanuts, yolks, soy beans, organ meat </li></ul>
  16. 16. Sterols <ul><li>Multi-ringed structure </li></ul><ul><li>Do not have a glycerol backbone </li></ul><ul><li>Cholesterol is a sterol </li></ul><ul><li>Waxy substance </li></ul><ul><li>Do not readily dissolve in water </li></ul><ul><li>Found in animal foods </li></ul>
  17. 17. Functions of Cholesterol <ul><li>Essential component of cell membrane </li></ul><ul><li>Produced by the liver </li></ul><ul><li>Found only in animal products </li></ul><ul><li>Forms important hormones </li></ul><ul><ul><li>Estrogen, testosterone, vitamin D </li></ul></ul><ul><li>Precursor to bile acids </li></ul>
  18. 18. Chemical Forms of Common Lipids
  19. 19. Lipids in Foods
  20. 20. Emulsifiers
  21. 21. Hidden Fat <ul><li>Look on the Nutrition Facts labels </li></ul><ul><li>Look on the lists of ingredients </li></ul><ul><li>Control portion size </li></ul>
  22. 22. Reduced-Fat Foods <ul><li>Calorie content is about the same </li></ul><ul><li>Sugar is commonly added in place of fat </li></ul>
  23. 23. Fat Substitutes <ul><li>Water </li></ul><ul><ul><li>Diet margarine </li></ul></ul><ul><li>Z-trim </li></ul><ul><ul><li>Starch derivative that binds with water </li></ul></ul><ul><li>Fiber cellulose </li></ul><ul><ul><li>Maltrin, Stellar, Oatrim </li></ul></ul><ul><li>Dairy-Lo </li></ul><ul><ul><li>Protein globules </li></ul></ul><ul><li>Olestra or Olean (links fatty acid to sucrose) </li></ul><ul><ul><li>Not digested </li></ul></ul><ul><ul><li>FDA approved for fried snack foods </li></ul></ul><ul><ul><li>Fat-soluble vitamins issue </li></ul></ul><ul><li>Salatrim or Benefat </li></ul><ul><ul><li>Fat and sucrose </li></ul></ul><ul><ul><li>Not digested and/or absorbed well </li></ul></ul>
  24. 24. Rancidity <ul><li>Decomposed oils </li></ul><ul><li>Breakdown of the C=C bonds by UV light, and/or O 2 </li></ul><ul><li>Unpleasant odor and flavor </li></ul><ul><li>PUFA more susceptible </li></ul><ul><li>Limited shelf life </li></ul>
  25. 25. Prevention of Rancidity <ul><li>Hydrogenation </li></ul><ul><li>Addition of vitamin E </li></ul><ul><li>Addition of Butylated hydroxyanisol (BHA) and Butylated hydroxytolune (BHT) </li></ul>
  26. 26. Hydrogenation of Fatty Acids <ul><li>Process used to solidify an oil </li></ul><ul><li>Addition of H to C=C double bonds </li></ul><ul><li>Increases shelf life </li></ul><ul><li>Formation of trans fatty acid </li></ul><ul><ul><li>(similar to shape of saturated fatty acid) </li></ul></ul>
  27. 27. Hydrogenation
  28. 28. Cis and Trans Fatty Acid
  29. 29. Excessive Trans Fatty Acid Intake <ul><li>Raises LDL </li></ul><ul><li>Lowers HDL </li></ul><ul><li>Increases risk for cardiovascular disease </li></ul><ul><li>Current intake is 3%-4% of total kcal </li></ul><ul><li>Added to food labels Jan. ‘06 </li></ul>
  30. 30. Minimize Intake of Trans Fat <ul><li>Limit use of hydrogenated fats </li></ul><ul><li>Limit deep-fried foods </li></ul><ul><li>Limit high-fat baked goods </li></ul><ul><li>Limit use of non-dairy creamers </li></ul>
  31. 31. Trans Fat-free Foods
  32. 32. Main Sources of Fatty Acids
  33. 33. Digestion of Fats and Oils
  34. 34. Digestion of Fat in the Stomach <ul><li>Gastric lipase </li></ul><ul><ul><li>Activated by an acidic environment </li></ul></ul><ul><ul><li>Acts on triglycerides containing short- and medium-chain fatty acids </li></ul></ul>
  35. 35. Digestion of Fat in the Small Intestine <ul><li>Primary site of fat digestion </li></ul><ul><li>Hormone Cholecystokinin (CCK) </li></ul><ul><ul><li>Stimulates release of pancreatic lipase </li></ul></ul><ul><li>Bile acid released </li></ul><ul><ul><li>Emulsifies digested fat </li></ul></ul><ul><li>Fat is broken down </li></ul><ul><ul><li>To monoglycerides and fatty acids </li></ul></ul>
  36. 37. Digestion of Phospholipids <ul><li>Enzymes released </li></ul><ul><ul><li>From pancreas </li></ul></ul><ul><ul><li>From cells of the small intestine </li></ul></ul><ul><li>Broken down to </li></ul><ul><ul><li>Glycerol </li></ul></ul><ul><ul><li>Fatty acids </li></ul></ul><ul><ul><li>Remaining parts </li></ul></ul>
  37. 38. Digestion of Cholesterol <ul><li>Enzymes released </li></ul><ul><ul><li>From pancreas </li></ul></ul><ul><li>Cholesterol is absorbed </li></ul>
  38. 39. Absorption of Fat <ul><li>95% of dietary fat is absorbed </li></ul><ul><li>Diffused into the absorptive cells </li></ul><ul><li>Short- and medium-chain (<12 C) fatty acids </li></ul><ul><ul><li>Are water soluble </li></ul></ul><ul><ul><li>Enter the portal system </li></ul></ul><ul><li>Long-chain fatty acids re-form into triglycerides </li></ul><ul><ul><li>Not water soluble </li></ul></ul><ul><ul><li>Enter the lymphatic system </li></ul></ul>
  39. 40. Carrying Fat in the Bloodstream <ul><li>Water (blood) and oil (fat) are incompatible </li></ul><ul><li>Unique system of fat transportation is needed </li></ul>
  40. 41. Transportation of Absorbed Fatty Acids <ul><li>Re-formed into triglycerides </li></ul><ul><li>Packaged into chylomicrons </li></ul><ul><li>Lipoprotein lipase </li></ul><ul><ul><li>Breaks down triglycerides in the chylomicrons </li></ul></ul><ul><li>Chylomicron remnant </li></ul><ul><ul><li>Delivered to the liver </li></ul></ul>
  41. 42. Composition and Roles of Lipoproteins
  42. 43. Transportation of Synthesized Fat <ul><li>Made primarily by the liver </li></ul><ul><li>Very-Low-Density Lipoprotein (VLDL) </li></ul><ul><li>Low-Density Lipoprotein (LDL) </li></ul><ul><li>High-Density Lipoprotein (HDL) </li></ul>
  43. 44. Lipoproteins
  44. 45. High-Density Lipoprotein (HDL) <ul><li>Synthesized by liver and intestine </li></ul><ul><li>High proportion of protein </li></ul><ul><li>Picks up cholesterol from dying cells and other sources </li></ul><ul><li>Transfers cholesterol to other lipoproteins </li></ul><ul><li>Transfers cholesterol directly back to the liver </li></ul>
  45. 46. Benefits of (a high) HDL (level) <ul><li>Removes cholesterol from the bloodstream </li></ul><ul><li>HDL may block oxidation of LDL </li></ul><ul><li>Reduces risk of cardiovascular disease </li></ul><ul><li>Pre-menopausal women have higher HDL </li></ul>
  46. 47. <ul><li>Scavenger WBC removes (oxidized) LDL from circulation </li></ul><ul><li>Build-up of plaque on walls of the blood vessels </li></ul><ul><li>Development of atherosclerosis </li></ul><ul><li>Vessel damage caused by: </li></ul><ul><ul><li>Smoking, diabetes, hypertension, homocysteine, high LDL, infection </li></ul></ul>Scavenger Cells
  47. 48. Antioxidant <ul><li>Reduces oxidation </li></ul><ul><li>Slows LDL uptake by scavenger cells </li></ul>
  48. 49. Functions of Essential Fatty Acids
  49. 50. Essential Fatty Acid- Omega-3 (alpha-linolenic acid) <ul><li>omega end alpha end </li></ul><ul><li>1st double bond is located on the 3rd carbon from the omega end </li></ul>H H H H H H H H H H H H H H H H H O H-C--C--C=C--C--C =C--C--C=C--C--C--C--C--C--C--C--C-OH H H H H H H H H H H H
  50. 51. Omega-3 Fatty Acid <ul><li>Primarily from fish oil </li></ul><ul><li>Also found in canola, walnuts, flax seeds, mussels, crab, shrimp, and soybean oil </li></ul><ul><li>Recommended intake of ~2 servings of fish per week </li></ul>
  51. 52. Essential Fatty Acid- Omega-6 (alpha-linoleic acid) <ul><li>omega end alpha end </li></ul><ul><li>1st double bond is located on the 6th carbon from the omega end </li></ul>H H H H H H H H H H H H H O H-C--C--C--C-- C--C =C--C--C=C--C--C--C--C--C--C--C--C-OH H H H H H H H H H H H H H H H H H
  52. 53. Omega-6 Fatty Acid <ul><li>Found in vegetable oils </li></ul><ul><li>Only need ~ 2-4 tablespoons a day </li></ul>
  53. 54. Essential Fatty Acids
  54. 55. Health-related Effects <ul><li>Archidonic acid (Omega-6 ) </li></ul><ul><ul><li>Increases blood clotting </li></ul></ul><ul><ul><li>Increases inflammatory responses </li></ul></ul><ul><li>DHA, EPA (Omega-3) </li></ul><ul><ul><li>Decrease blood clotting </li></ul></ul><ul><ul><li>Reduce heart attack </li></ul></ul><ul><ul><li>Decrease inflammation </li></ul></ul><ul><ul><li>Excess may cause hemorrhagic stroke </li></ul></ul><ul><ul><li>Other possible uses: Lower triglycerides, rheumatoid arthritis, behavioral disorders </li></ul></ul>
  55. 56. Signs and Symptoms of Essential Fatty Acids Deficiency <ul><li>Flaky, itchy skin </li></ul><ul><li>Diarrhea </li></ul><ul><li>Infections </li></ul><ul><li>Retarded growth and wound healing </li></ul>
  56. 57. Functions of Fatty Acids <ul><li>Provide energy </li></ul><ul><li>Efficient storage of energy </li></ul><ul><li>Insulation </li></ul><ul><li>Protection </li></ul><ul><li>Transport fat-soluble vitamins </li></ul><ul><li>Some satiety </li></ul><ul><li>Flavor and mouth feel </li></ul>
  57. 58. Recommendations for Fat Intake <ul><li>No RDA </li></ul><ul><li>AHA recommendations </li></ul><ul><ul><li>20-30% of total kcal from fat </li></ul></ul><ul><ul><li>7-10% can come from saturated/ trans fat </li></ul></ul><ul><ul><li>200-300 mg cholesterol/day </li></ul></ul><ul><li>Average U.S. intake: </li></ul><ul><ul><li>33% of total kcal from fat </li></ul></ul><ul><ul><li>13% of kcal from saturated fat </li></ul></ul><ul><ul><li>180-320 mg cholesterol/day </li></ul></ul>
  58. 59. AHA Goals
  59. 60. AHA Recommendations
  60. 61. Advice from National Cholesterol Education Program and Food and Nutrition Board <ul><li>Up to 35% of total kcal from fat </li></ul><ul><li>Keep saturated fat, cholesterol, and trans fat to a minimum </li></ul>
  61. 62. Other Recommendations <ul><li>Fat intake can be higher as long as saturated and trans fatty acid are minimal </li></ul><ul><li>Eat plenty of fruits and vegetables </li></ul><ul><li>Cut down on red meats </li></ul><ul><li>Cut down on simple sugars and refined carbohydrate </li></ul><ul><li>Promote healthy weight </li></ul><ul><li>Be active </li></ul>
  62. 63. Cutting the Fat
  63. 64. Road to a Heart Attack
  64. 65. Cardiovascular Disease <ul><li>Myocardial infarction </li></ul><ul><li>Cerebrovascular disease </li></ul>
  65. 66. Risk Factors <ul><li>Total blood cholesterol > 200 mg/dl </li></ul><ul><li>Smoking </li></ul><ul><ul><li>Increases clotting </li></ul></ul><ul><ul><li>Increases expression of genetic link </li></ul></ul><ul><li>Hypertension (> 139/89) </li></ul><ul><li>Diabetes </li></ul><ul><ul><li>Insulin increases cholesterol synthesis </li></ul></ul><ul><ul><li>Guarantees development of cardiovascular disease </li></ul></ul>
  66. 67. Other Risk Factors <ul><li>Low HDL (< 40 mg/dl) </li></ul><ul><li>Age </li></ul><ul><li>Family history </li></ul><ul><li>Blood triglycerides > 200 mg/dl </li></ul><ul><li>Obesity </li></ul><ul><ul><li>Fat around the waist </li></ul></ul><ul><ul><li>Insulin resistance </li></ul></ul><ul><li>Inactivity </li></ul>
  67. 68. Signs of a Heart Attack <ul><li>Intense, prolong chest pain </li></ul><ul><li>Shortness of breath </li></ul><ul><li>Sweating </li></ul><ul><li>Nausea and vomiting </li></ul><ul><li>Dizziness </li></ul><ul><li>Weakness </li></ul><ul><li>Jaw, neck, shoulder pain </li></ul><ul><li>Irregular heartbeat </li></ul>
  68. 69. Medical Intervention <ul><li>For those who experience a heart attack </li></ul><ul><ul><li>Or have CVD or diabetes </li></ul></ul><ul><li>www.nhlbi.nih.gov/ </li></ul><ul><li>Medication to lower LDL </li></ul><ul><ul><li>Reduce cholesterol synthesis (Statins, “Lipitor”) </li></ul></ul><ul><ul><li>Binds to bile acids for elimination </li></ul></ul><ul><li>Medication to lower blood triglycerides </li></ul><ul><ul><li>Reduce triglyceride synthesis </li></ul></ul>
  69. 70. Lowering LDL <ul><li>See your doctor to assess for other conditions </li></ul><ul><li>Reduce dietary saturated fat and cholesterol </li></ul><ul><li>Increase MUFA and PUFA </li></ul><ul><li>Increase dietary fiber (soluble) </li></ul>
  70. 71. Lowering Blood TG <ul><li>Is the most diet-responsive blood lipid </li></ul><ul><li>Avoid overeating </li></ul><ul><li>Limit alcohol </li></ul><ul><li>Limit simple sugars </li></ul><ul><li>Small frequent meals </li></ul><ul><li>Include fish in the diet </li></ul>
  71. 72. Other Possible Methods <ul><li>Benecol and Take Control margarines </li></ul><ul><ul><li>Plant stanol/sterol esters </li></ul></ul><ul><ul><li>Cholesterol-lowering effects </li></ul></ul><ul><ul><li>Decrease absorption of cholesterol and lower amount returning via enterohepatic circulation </li></ul></ul><ul><ul><li>Liver takes up more cholesterol from the blood </li></ul></ul>
  72. 73. Raising HDL <ul><li>Physical activity </li></ul><ul><li>At least 45 min/day, 4 days a week </li></ul><ul><li>Don ’t smoke </li></ul><ul><li>Eat regularly </li></ul><ul><li>Eat less total fat </li></ul><ul><li>Moderate intake of alcohol increases HDL </li></ul>

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