Fats are lipids that provide energy, cushion organs, and carry fat-soluble vitamins. They include triglycerides, phospholipids, and cholesterol. Triglycerides are the main form of fat stored in the body and are composed of a glycerol molecule bonded to three fatty acids. Phospholipids are components of cell membranes. Cholesterol is a precursor for hormones and vitamin D. Fats are broken down into fatty acids and other compounds that have important functions in the body.
You obtain fats as a sort of nutrition from your food. While eating some fats is necessary, eating too much can be harmful. Your body gets the energy it needs to function correctly from the fats you consume. Your body burns calories from the carbs you’ve consumed while you workout.
You obtain fats as a sort of nutrition from your food. While eating some fats is necessary, eating too much can be harmful. Your body gets the energy it needs to function correctly from the fats you consume. Your body burns calories from the carbs you’ve consumed while you workout.
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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2 Case Reports of Gastric Ultrasound
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
2. Introduction
⚫Fatsare best known membersof a chemical group
called the lipids.
⚫The term lipid is applied to a group of naturally
occurring substancescharacterized by their
insolubility in water, greasy feel and solubility in
organic solvents likeether, chloroform, benzeneor
other fatsolvents.
⚫The term lipid was first used by the German
biochemist Bloor in 1943
3. Introduction
⚫In normal human subjects, fatsconstitutes between
10-15 % of bodyweight.
⚫Mostof the body fat(99%) is stored in the adipose
tissues.
⚫Fat present in the diet or in human body are in the
formof fattyacids, triglycerides, phospholipidsand
cholesterol.
⚫Each fat molecule is made upof fourcompounds, one
alcohol and three fattyacids.
4.
5.
6. Functions of Fats
1) Insulationand Padding:
⚫ Fatsaredeposited in adipose tissue, subcutaneous tissue
and abdominal cavity
⚫ Fats surrounds theorgans and laced throughout muscle
tissue
⚫ Fats functions like insulating material againstcold
⚫ Fats protects vital organs against physical injuries by
forming a padding around them
7. Functions of Fats cont…
2. Energy:
⚫ The primary function of fat is to supplyenergy.
⚫ It isaveryconcentrated source of energy.
⚫ Each gram of fat when oxidized yields approximately 9
kcal, twice as much energyas one gram of carbohydrate or
protein.
⚫ Fat specially supplyenergy in between the meals and
during starvation.
8. Functions of Fats cont…
3. Carriersof fat solublevitamins:
⚫ Dietary fat isacarrierof the fat solublevitamins-A,D,E
and Vitamin K
⚫ Fat is also necessary fortheabsorption of Vitamin A and
its precursor, carotene.
9. Functions of Fats cont…
4. Satiety function:
⚫ Fats improves the palatabilityof thediet.
⚫It slows digestion--resulting in satiety (a sense of
fullness and satisfaction aftereating).
⚫In theabsence of fats the food become non palatable.
10. Functions of Fats cont…
5. Fats provide essential fattyacidswhich the
bodycan’t manufacture.
6. Fatsare theconstituentsof cell membrane
and regulates the membrane permeability.
7. Fatsarealso function as cellular metabolic
regulators in the form of prostaglandins and
steroid hormones.
11. Sources of dietary FATS
Fatsof animal origin : Ghee, butter, milk, cheese, eggs
and fatof meatand fish
Fatsof plantsorigin: Groundnutoil, Coconutoil,
Palm oil, Mustard oil, Canola
oil, Sesameoil, Corn oil
Other Sources: Cereals, Pulses, Oil seeds (Sunflower,
Safflower, Soyabean, Cottonseeds), rice
bran and Leafy green vegetables
13. Bio chemical classification of fats
A. Simple Lipids:
Simple lipids are defined as those which yield only
oneor more fattyacids and an alcohol on hydrolysis.
Example: 1) Fatsand Oils, also known as triglycerides
2) Waxes
14. Bio chemical classification of fats cont….
B. Compound Lipids:
Compounds lipids are those lipids which contain in
addition to fattyacids and glycerol, someotherorganic
compoundssuch as phosphoricacid, nitrogenous
base, sugars and Proteins.
Example:
Phospholipids, Sphingolipids, Glycolipids,
Sulpholipidsand lipoproteins
15. Bio chemical classification of fats cont….
C. Derived Lipids:
Theseare thederivativesobtained on the hydrolysis
of simple and compound lipids which possess the
characteristics of lipids.
Example:
Fattyacids, monoand diacylglycerols, lipid soluble
vitamins, steroid hormonesand ketone bodies
17. Digestion of Fats
Fivedifferent phases:
⚫ Hydrolysis of triglycerides (TG) to free fattyacids (FFA)
and monoacylglycerols
⚫Solubilization of FFA and monoacylglycerols by
detergents (bileacids) and transportation from the
intestinal lumen toward thecell surface
⚫Uptakeof FFA and monoacylglycerols into thecell and
resynthesis to triglyceride
⚫Packaging of TG’s intochylomicrons
⚫Exocytosis of chylomicrons into lymph
18. Enzymes Involved in Digestion of Lipids
⚫lingual lipase: Hydrolyze short and medium chain
fattyacids.
⚫Gastric Lipase: Hydrolyze Long, medium and short
chain fatty acids.
⚫Pancreatic lipase: majorenzymeaffecting
triglyceride hydrolysis
⚫Colipase: protein anchoring lipase to the lipid
⚫lipid esterase: secreted by pancreas, acts on
cholestrol esters, activated by bile
⚫phospholipases: cleavephospholipids, activated
by trypsin
25. Saturated fattyacids continues..
Saturated fats are considered as harmful fats
because they increases total cholesterol level and
TGs level.
Sources :
Animal foods such as meat, poultry and full-fat
dairy products
Tropical oils such as palm and coconut
RDA: Less than 10% of total energy intake perday.
26. Unsaturated fatty acids
Fattyacid with one or more points of Unsaturation.
Unsaturated fats are found in foods from both plantand
animal sources.
27. Monounsaturated fatty acids
⚫Fattyacid containing one pointof Unsaturation.
⚫Theyareconsidered as beneficial for human health.
⚫Replacing SFA with MUFA reduces LDL cholesterol
concentrationand total cholesterol / HDL cholesterol
ratio.
⚫Replacing carbohydratewith MUFAs increases HDL
cholesterol concentration.
⚫Sources: vegetableoils such as olive, canola, and peanut.
⚫RDA: Bydifference
29. Cis- unsaturated fatty acids
Natural unsaturated fatty acids have Cis- double bonds.
The unsaturated fatty acids can’t bunch tightly together.
The bend helps the fat stay liquid rather than solid.
Significance –
⚫Decreases total cholesterol and TGs level.
⚫Increases HDL level.
30. Trans unsaturated fatty acids
Unsaturated fatty acids (MUFAs and PUFAs) containing
one or moredouble bonds in trans configuration arecalled
trans fattyacids (TFAs).
Hydrogen atoms areon theoppositesides of the molecule.
31. Trans fatty acids cont….
Produced during partial hydrogenation of vegetableoils.
Partially hydrogenation of vegetable oil results in longer
shelf lifeof a product. less rancidity and oxidationwhen
exposed to heatand light.
Alsodeveloped in vegetableoils during frying and heating.
Sources:
“Formationof trans fattyacids in edible oils during the frying and heating
process” (Vol.123, No.4, 15Dec.2010, pp 976-982, doi:
10.1016/j.foodchem.2010.05.048)
32. Why trans fatty acids are harmful …
Trans fatty acids are much more linear than cis fatty acids,
so their melting points are higher and studies have shown
that trans fats mayact similarly to saturated fats.
Increases the ratio of total cholesterol to HDL cholesterol,
a powerful predictorof the risk of CHD
A recent study suggests trans fats harm the cardiovascular
system by triggering inflammation in blood vessels.
In addition, trans fat may increase risk forcancers of the
breast and prostate.
33. Trans fatty acids cont….
Sources:
1. Spreads: Butter, margarine
2. Package foods: Cake mixes, Biscuits
3. Soups: Plain soups, Noodlesoups
4. Fast foods: Deep fried Fish and Chicken, Pancakes
5. Frozen foods: Frozen pies, pot pies, wafers
6. Backed foods: Cakes, doughnuts
7. Chipsand Crackers: Potatochips
8. Cookiesand Candy: Choc0late bars, Cream filled
cookies
34. RDA for Trans fatty acid
The American Heart Association recommends limiting
total trans fat intake to less than 1 percentof our total daily
calories, which means less than 2 grams per day for many
people.
Since mostof us get that much from naturallyoccurring
trans fat in red meat and dairy, we need to cut trans fat
from other foods to zero.
That meanschecking every ingredient listand bypassing
foods that declare any hydrogenated oils or partially
hydrogenated oils, even if it states "trans fat 0 g" on the
nutrition panel.
35. Polyunsaturated fatty acids
Polyunsaturated fatty acids are those fatty acids where
Unsaturation occur more than two points.
They possess protective role on human health. considered as
beneficial for consumption.
36. ⚫Increase esterification process of cholesterol & prevents its
absorption.
⚫By increasing the synthesis of eicosanoids, acts as an anti
platelet aggregating factor, so decreases the chances of clot
formation.
⚫Decreases the synthesis of the precursor of VLDLAND TGs.
⚫Increases clearance of LDL cholesterol.
Polyunsaturated fatty acids cont…
37. Polyunsaturated fatty acids cont…
Sources:
Found in nuts and vegetableoils such as safflower,
sunflower, and soybean, and in fatty fish.
RDA: 6-10% of total energy intake per day.
38. Essential Fatty Acids:
There are two PUFAs which cannot be synthesized in
the body and required in the preformed state in diet
forgrowth and maintenanceof normal skin.
Thesearecalled Essential fattyacids and include
linoleicacid and linolenicacid.
The term essential fattyacid was introduced by Burr
and Burr.
39. Essential Fatty Acids cont…..
⚫Sourcesof linoleicacid:
⚫Leafyvegetables, nuts, vegetableoils (seasame, corn oil,
sunflower, soybean), poultry fat
⚫Sourceso f linolenicacid:
⚫Nuts, seeds (soybean, walnuts, flaxseed) and oils
(soybean, canola)
⚫ RDA: Minimum intake levels foressential fattyacids
estimated to be 2.5% E LA and 0.5% EALA
40. Omega 6 Fatty Acid- Linoleic acid
RDA: 5-8% of total energy intake perday
Sources:
Saff loweroil
Sunf loweroil
Corn oil
Soybeanoil
Pros:
- helps lower LDLcholesterol; thereby lowering ourrisk of
heartdisease
- helps makeour blood "sticky" so it isable toclot
- supportskin health
41. Omega 6 Fatty Acid (continued)
Butwhenomega-6saren't balanced with sufficientamountsof
omega-3s…
Cons:
- Excessiveamounts increase the inflammatory response in
ourbodies
- Can exacerbateconditions likearthritis, lupusand perhaps
somecancers
- When blood is too 'sticky,' itpromotes clot formation―
increasing the risk of heartattack and stroke
42. Omega 3 Family of Fatty Acids
ALA (alpha linolenicacid)
RDA: 1-2 % of total energy
intake perday
Sources:
Flaxseed
Walnuts
Canolaoil
Soybean oil
Dark green vegetables
(Mint,Watercress,Parsley)
43. Omega 3 Family of Fatty Acids (continued)
ALA can converttootheromega 3 fattyacids—DHA and
EPA (atavery low percentage)
DHA = Docosahexaenoicacid
EPA = Eicosapentaenoic acid
Sources:
Fish
Mother’s milk
44. Specific Functions of Each
⚫ DHA:
- importantfor maintaining neurotransmitterfunctionand a
calming effecton the nervoussystem
- anti-inflammatory effect in the joints, blood stream and
tissues
- support retinal and brain development in fetusand infants
⚫ EPA:
- fights inflammation by bolstering the immunesystem
- preventsclotting thus helping topreventcardiovascular
events
- preventssome heartarrhythmias
45. Health Benefits of Omega 3 Fatty acids
⚫ Reduces the risk of coronary heartdisease:
- Stimulates blood circulation
- Increases the breakdown of fibrin-thus lowering theclot
formation
- Lower triglycerides
- Acts asan anti-inf lammatoryagent
- Lowers blood pressures (a little)
⚫ Promotes nervoussystem’s healthand development
46. 2.Triglycerides
⚫Structure
⚫Glycerol + 3 fattyacids
⚫Functions
⚫Energy source
⚫ 9 kcals pergram
⚫ Formof stored energy in adipose tissue
⚫Insulation and protection
⚫Carrierof fat-solublevitamins
⚫Sensory properties in food
47. 3.Phospholipids
⚫Structure
⚫Glycerol + 2 fattyacids + phosphategroup
⚫Functions
⚫Componentof cell membranes
⚫Provides lipid transport, as partof lipoproteins
⚫Emulsifiers
⚫Food Sources: Mostabundant in egg yolks, liver,
soybeans, and peanuts
48. 4.Sterols: Cholesterol
⚫Functions
⚫Component of cell membranes
⚫Precursor to othersubstances
⚫ Sterol hormones
⚫ Vitamin D
⚫ Bileacids
⚫Synthesis
⚫Made mainly in the liver
⚫Food Sources: Highest in organ meats like beef
kidney, beef liver, and beef brain, egg yolks, and
breast milk
49. Total Cholesterol
⚫Direct, positive association between TC and CHD
risk
⚫Diets high in saturated fats raise total cholesterol
and CHD incidenceand mortality
⚫ATP-III Guidelines: lowering total cholesterol and
LDL-C reduces CHD risk
⚫10% reduction in TC decreases CHD risk byabout
30%
50. 5.Eicosanoids
Thesecompoundsare derived from long chain poly
unsaturated fattyacids
⚫Prostaglandins.
⚫Prostacyclines,
⚫Thromboxanes
⚫Leukotrienes
They have roles in:
Inflammation
Fever
Regulation of blood pressure
Blood viscosity
Blood clotting
Tissue growth
Bronchocostriction
Asthma.
53. Chylomicrons
⚫Largest particles
⚫Transport dietary fatand cholesterol from thesmall
intestine to the liver
⚫In the bloodstream, triglycerides are hydrolyzed by
lipoprotein lipase (LPL) in muscleand adipose tissue
⚫When 90% of triglyceride is hydrolyzed, released into
blood as a remnant
⚫Liver metabolizes remnants, but some delivercholesterol
to thearterial wall
54. VLDL:- rich in CE and TGs-
Surface
Monolayer
Phospholipids
(12%)
Free Cholesterol
(14%)
Protein (4%)
Transport
endogenous
cholesterol
Hydrophobic Core
Triglyceride (65%)
Cholesterol Esters
(8%)
55. Very-Low-Density-Lipoproteins
⚫Manufactured in the liver to transport
endogenous triglycerideand cholesterol
⚫60% is triglyceride
⚫LargeVLDL may be non atherogenic
⚫VLDL remnantsor IDL appearto be atherogenic
⚫Notroutinely measured, butTG in them is
measured in total triglyceride
56. LDL:- cholesterol rich.
Surface Monolayer
Phospholipids
(25%)
Free Cholesterol
(15%)
Protein (22%)
Synthesized
from VLDLin
blood
circulation.
Transports
cholesterol from
liver and delivers
to other tissues.
57. Intermediate-Density Lipoprotein
⚫Formed with catabolismof VLDL, a precursorof LDL
⚫Rich in cholesterol and apo E
⚫High concentrations of IDL and VLDL remnants
directly related to lesion progression and coronary
events
⚫Notroutinely measured, thoughcomponentscan be
58. Low-Density Lipoprotein
⚫Primary cholesterol carrier in blood
⚫Total cholesterol and LDL-cholesterol are strongly correlat
⚫LDL is formed in VLDL catabolism, 60% is taken up by LDL
receptors in liver, adrenals, other tissues; rest is metabolized
viaalternative pathways
⚫Numberand activityof receptors determines LDL
cholesterol levels in the blood
59. LDL-Cholesterol
⚫Particles heterogeneous in size, density, lipid
components
⚫PhenotypeA: large particles, notassociated with
disease risk
⚫Phenotype B typified by small, dense LDL particles;
triglyceriderich, cholesterol depleted; predictiveof
CHD risk in men and women
60. High density lipoprotein-
Surface Monolayer
Phospholipids (25%)
Free Cholesterol (7%)
Protein (45%)
Promotes re-
esterification process
of cholesterol.
Reversecholesterol
transport
61. High Density Lipoproteins (HDL)
⚫Contain more protein than theother
lipoproteins
⚫Apo A-1 is involved in tissue
cholesterol removal
⚫High HDL isassociated with low
levelsof Chylomicrons, VLDL
remnants, and small, dense LDL
64. 1.Cardiovascular disease
⚫The Prevalenceof Coronary Heart Disease (CHD)
“ HEART ATTACK” is rapidly increasing in India
⚫It has becomean “ EPIDEMIC”.
⚫It is a majorcontributor for mortality and
morbidity.
65. Cardiovascular disease cont…
⚫ Cardiovascular disease will account for 33.5% of
total deaths by the year 2015, would replace
infectiousdiseases, as the numberone killer in the
Indian Population.
⚫It is expected that deaths due to HEART ATTACK
will double in the next 10 years
⚫Thedeath ratedue to heart attack will be 295 per
1,00,000 population in theyear 2015.
66. Unchangeable Risk Factors
⚫Age- theolderyou get, thegreater thechance.
⚫Sex- males havea greater rateeven afterwomen pass
menopause.
⚫Family history- if family members have had CHD,
there is a greaterchance.
⚫Personal Medical History- otherdiseasessuch as
Diabetes Mellituscan increase chances.
68. Primary Prevention of CHD
⚫Knowyourrisk factors
⚫Makedietarychanges
⚫Start/continueexercise
⚫Stop smoking
⚫Stress reduction
⚫Use medication if necessary
69. Risk Factors for CHD cont..
⚫High Total Blood Cholesterol
⚫>200 mg/dl: borderline high risk
⚫>240 mg/dl: high risk
⚫High LDL-C
⚫>130 mg/dl: borderline high
⚫>160 mg/dl: high risk
72. Risk Factors for CHD cont..
⚫Low HDL-C
⚫< 40mg/dl : high risk
⚫> 60mg/dl : protective
73. Increasing your HDL-C
⚫Aerobicexercise for 30 min aday
⚫Loosing weight
⚫Restrict trans fats in thediet
⚫By taking diet rich in wholegrains, Nuts,
legumes, fruits, vegetablesand fish
74. 2.Obesity
It is defined as abnormal increase in the bodyweight
due toexcessive fatdeposition
Obesity is a stateof excess adipose tissue mass
Man & Women are considerobese if theirweightdue
to fat (in adipose tissue) respectively, exceeds more
than 20% and 25% of bodyweight.
75. Nutritional basis for Obesity
Obesity is basicallya disorderof excess calorie intake, in
simple language –overeating.
Every 7 calorieof excess consumption leads to 1 gm fat
depositand increase in bodyweight.
Overeating coupled with lack of physical exercise
furthercontributetoobesity.
76. Indices for Obesity measurement clinicaly
A) Body Mass Index-BMI
Clinicalyobesity is represented by BMI
BMI is calculated as theweight in kg divided by the
Height in metersquare
77. Body mass index cont……
Classification of weight status and risk of disease
Category BMI (Kg/M sq.) Obesity Class Risk of disease
Under weight < 18.5 Nil ---------
Healthy weight 18.5 to 24.9 Nil ---------
Over weight 25 to 29.9 Nil Increased
Obesity 30 to 34.9 Class I obesity High
Obesity 35 to 39.9 Class II obesity Very high
Extreme Obesity 40 or >40 Class III obesity Extremely high
78. Indices for Obesity measurement clinicaly cont…
B) Ratio between waistand hip size:-
The distribution of adipose tissue in different anatomic
depots has substandard implication for morbidity.
Intra abdominal and abdominal subcutaneous fat have
more significance than subcutaneous fat present in the
buttocksand lowerextremities
79. Indices for Obesity measurement clinicaly cont…
This distribution is measured clinically bydetermining
thewaist to hip ratio.
With a ratio More than 0.9 in womenand more than
1.0 in Men is considered abnormal.
Manyof the most importantcomplicationof obesity ,
such as insulin resistance, diabetes, hypertension and
hyperlipidemia are linked more strongly to intra
abdominal and/or upper body fat than over all
adiposity.
80. Genetical aspect of obesity
Onegene namely Obgene, expressed in adipocytes (of
white adipose tissues) producing a protein called
leptin is closelyassociated with obesity.
Leptin is regarded as bodyweightregulatory
hormone.
It binds toa specific receptor in brain and functionas
a lipostat.
81. Genetical aspect of obesity cont…
When the fat store in theadipose tissueareadequate,
leptin levelsare high.
This signals torestrict the feeding behaviourand limit
fatdeposition.
Anygeneticdefect in leptin or its receptorwill lead to
extremeovereating and massive Obesity.
82. Pathologic consequences of obesity
Obesity is associated with an increase in mortality ,
with a 50-100% increased risk of death from all causes
compared to normal weight individuals, mostlydue to
cardiovascularcauses.
Life expectancyof a moderatelyobese individual
could be shorted by 2 to 5 years.
A 20 to 30 yearold malewith a BMI >45 may lose 13
yearsof life.
83. Pathologic consequences of obesity cont..
Obesitycauses insulin resistancewhich leads to type 2
DM
Obesitycausescardiovasculardiseases:-
“ The Framingham study revealed thatobesitywas an
independent risk factor for the 26 year incidence of
cardiovasculardiseases in man and women.”
84. Diet therapy for obesity
The primary focusof diet therapy is to reduceoverall
calorieconsumption
The NHLBI recommended initiating treatmentwith a
calorie deficit of 500-1000 Kcal/day compared to
patients habitual diet.
This reduction is consistwith agoal of loosing
approximately 1-2 Ib perweek.
85. Diet therapy for obesity cont..
This caloriedeficit can beaccomplished bysuggesting
substitutionsoralternatives todiet.
Example:-
Choosing small portion sizesof meal
Eating more fruit and vegetables
Consuming morewhole grain cereals
Selecting skimmed dairy products
Reducing fried foods and otheradded fats and oils
Drinking water instead of calorie beverages
86. Recommendations for dietary Fats
(FAO/WHO expert consultation on fats in human nutrition, Geneva,2008)
Recommendations fordietary fatsaredirected
towards:-
⚫Meeting the requirementof optimal foetal and infant
growthand development
⚫Maternal health
⚫Forcombating chronic energy deficiency in children
and adults
⚫Diet related non-communicablediseases in adults
87. Recommendations for dietary Fat intake for Indians (ICMR-2010)
25 10 15
Age/Gender/Ph
ysiological
groups
Physical
activity
Minimum level
of Total fat
(%E)
Fats from foods
other than visible
fats (%E)
Visible
(%E)
Fat
gm/day
Adult Man Sedentary 25
Moderate 20 10 10 30
Heavy 40
Adult Women Sedentary 25
Moderate 20 10 10 30
Heavy 40
Pregnant 20 10 10 30
Lactating 20 10 10 30
Infants 0-6 months 40-60 Fat present in Human M ilk
07-24 months 35 10 25 25
Children 3-6 years 25
7-9 years 30
Boys 10-12 years
13-15 years
16-17 years
35
45
50
Girls 10-12 years
13-15 years
35
40
88. Recommendations for visible fats
⚫Thequantityand fattyacid composition of both visible fat
and fat from all other foods (invisible fats) contribute to
the intakeof various fattyacids in the total diet.
⚫The data on fatty acid intake in Indian adults determined
by taking into account the contribution of various fatty
acids from all foods (invisible fat) & visible fats ( in dietsof
eitherrural or urban population respectively) shows thata
complete dependence on just one vegetable oil does not
ensure the recommended intake of fatty acids for optimal
health and prevention of DR-NCD
89. Recommendations for visible fats cont..
A long term(in home) study with oil combinations
(which increase ALA) showed improvement of LC n-3
PUFA nutritional status in adults
Therefore, to ensure optimal fat quality, the use of
correct combination of vegetable oils is recommended
90. Recommendations for visible fats cont..
1) Usecorrectcombination / blend of 2 or morevegetable
oils (1:1)
(a) Oil containing LA + oil containing both LA and ALA
Example:
Groundnut / Sesame / Rice bran / Cottonseed + Mustard/ Rapeseed
Groundnut /Sesame / Rice bran / Cottonseed + Canola
Groundnut / Sesame / Rice bran/ Cottonseed + Soyabean
Palmolein+ Soyabean
Safflower / Sunflower + Palm oil/ Palmolein + Mustard/ Rapeseed