Atherosclerosis is a disease where plaque builds up in the arteries, limiting blood flow. It is caused by chronic inflammation and is the leading cause of heart attacks and strokes. Lifestyle changes like a healthy diet, exercise, weight control, and avoiding tobacco can help prevent and manage atherosclerosis. Functional foods rich in antioxidants, omega-3 fatty acids, fiber and other nutrients may also help reduce the risk and progression of atherosclerosis. These include fish, nuts, citrus fruits, soy, tea, coffee, and cocoa. Proper diagnosis and medical treatment of risk factors like high cholesterol, hypertension, and diabetes are also important to treat atherosclerosis.

1. Atheros
clerosis
Presented by:
Jyoti Pachisia
Guest Lecturer,
Department: Nutrition and Dietetic
IMS Mukundpur, Kolkata

2. • Lifestyles of populations across the world
have changed dramatically in the 21st
century. These changes (collectively
termed as epidemiological transition)
have been brought about by a number of
developments in science and technology
that now affect every facet of human
existence.
• Most human societies have moved from
agrarian diets and active lives to fast
foods and sedentary habits. Combined
with increasing tobacco use, these changes
have fuelled the epidemic of obesity,
diabetes, hypertension, dyslipidemia and
cardiovascular diseases (CVD).

3. Figure 1:
Source: World Health Organization Report profile, 2017

4. • Coronary heart disease (CHD) is the most
common form of Cardiovascular diseases
(CVD) and caused by atherosclerosis in the
large and medium sized arteries that supply
the heart muscle with oxygen and nutrients.
• Also called as coronary artery disease (CAD)
• In developed nations the rise in the burden of
CVD occurred over several decades due to a
long period of epidemiological transition.
• In India, perhaps because of the rapid pace of
economic development, epidemiological
changes have spanned a much shorter time. As
a consequence, cardiovascular disease (CVD)
has emerged as the leading cause of death all
over India, with coronary heart disease (CHD)
affecting Indians at least 5-6 years earlier than
their western counterparts.

7. • Atherosclerosis (also known as arteriosclerotic
vascular disease or ASVD) is a special form of
arteriosclerosis in which an artery wall thickens
as a result of invasion and accumulation of
WBCs.
• Atherosclerosis is a syndrome affecting arterial
blood vessels due to a chronic inflammatory
response of WBCs in the walls of arteries. This
is promoted by low-density lipoproteins (LDL,
plasma proteins that carry cholesterol and
triglycerides) without adequate removal of fats
and cholesterol from the macrophages by
functional high-density lipoproteins (HDL). It is
commonly referred to as a "hardening" or
furring of the arteries. It is caused by the
formation of multiple atheromatous plaques
within the arteries.
• Atherosclerosis is a chronic disease that remains
asymptomatic for decades.
• The incidence of atherosclerosis is difficult to
determine since it mainly an asymptomatic
condition. The pathological process begins in
childhood and continues throughout the life. In
the United Kingdom, the frequency of clinical
manifestations of atherosclerosis is high,
especially in the West of Scotland.

11. Age
Gender
Family
history
Unmodifible risk factors

12. Modifiable risk factors
Hyperlipidemia
Hypertension
Diabetes mellitus
Cigarette smoking
Metabolic syndrome
High- saturated fat, high cholesterol diet
Physical inactivity
Elevated low-density
lipoprotein cholesterol
Hormonal factors
High altitude and cold
Acute-life event stress
Work- related stress
Alcohol
Oral Contraceptive pill

13. Newer novel risk factors
Elevated
homocysteine
levels
Elevated
lipoprotein (a)
levels
Elevated
triglycerides
levels
Oxidative
stress
Fibrinogen
High sensitive
C-reactive
protein

15. • Angina pectoris
• Myocardial infarction
• Calcification of the artery walls
• Ulceration and rupture
• Superimposed thrombosis
• Hemorrhage into the plaque
• Aneurysmal dilation
• Transient ischaemic attack
• Permanent neurological damage.
• Peripheral Arterial disease
• Tendon xanthomas
• Premature xanthelasma
• Hypertension
• Abnormal heart sounds
• Increased heart rate
• Central abdominal pain following a meal (post
prandial mesentric angina)
Peripheral arterial disease (affects
the legs)
Tendon xanthomas affecting hands,
eye, face, back and buttocks.

16. ANGINA
PECTORIS
MYOCARDIAL
INFARCTION

18. • Cardiac remodeling may be defined as genome expression, molecular, cellular and interstitial
changes that are manifested clinically as changes in size, shape and function of the heart after
cardiac injury.
• It occurs after myocardial infarction, pressure overload (aortic stenosis, hypertension),
inflammatory heart muscle (myocarditis), idiopathic dilated cardiomyopathy or volume
overload (valvular regurgitation).
• The process of cardiac modeling is mainly influenced by hemodynamic load and
neurohormonal activation.
• The myocyte is the major cardiac cell involved in the remodeling process. Other components
involved include the interstitium, fibroblasts, collagen and coronary vasculture; relevant
processes also include ischemia, cell necrosis and apoptosis.

20. • Blood tests
• Electrocardiogram
• Chest X-ray
• Ankle/ Brachial Index
• Echocardiography
• Magnetic Resonance
imaging (MRI)
• Position emission
tomography (PET)

22. Maintaining a healthy
weight
Preventing
hypertension
Effectively controlling
blood glucose levels
Avoiding Cigarette
smoking

23. • HMG-CoA Reductase
inhibitors
• Fibric acid derivatives
• Niacin
• Bile acid sequestrants
• Cholesterol Absorption
inhibitors
• Combination therapies.
• Nitrates, beta-blockers
and calcium antagonists

25. 1
• Maintenance of good
nutrition
2
• Acceptability of the
programme
3
• Proper rest to the heart

26.  Cardiac prudent diet
 Diet should be low in saturated fats, Trans fats as well as cholesterol.
 20kcal/kg body weight is recommended for obese patients in bed and 25kcal/kg body
weight for those near ideal body weight.
 Fats should be 15-20% of total calories
 Carbohydrate intake should be limited to 50-60 per cent of total energy in patients
with metabolic syndrome.
 Normal allowances of protein are recommended (1gram/kg body weight).
 Mega doses of niacin have been known to be an effective treatment of dyslipdemia
 Diet should be rich in dietary fibre, MUFA and PUFA.
 Vitamin B6, B12, and folic acid supplementation decreases the risk of cardiovascular
disease related to homocysteine risk factor.
 200-300mg of Vitamin C reduces cholesterol
 A restriction of sodium of 1600-2300 mg is satisfactory among patients with
atherosclerosis
 Potassium helps to maintain cell fluid balance and plays a role in muscle contraction.
Low levels of this mineral have been associated with high blood pressure.
 Magnesium helps muscles relax, affects the muscle tone of blood vessels and keeps
heart rhythm steady.
 Low glycaemic index diets may preserve HDL cholesterol and thus have a potentially
positive effect in reducing CHD risk.

27. • A functional food is any food that has a
positive effect on a person’s health,
physical performance or state of mind.
• Reduces the risk of chronic diseases and
physiological benefits when eaten on a
regular basis in adequate amounts.
• Foods rich in antioxidants,
hypocholesterolemic agents and
phytochemicals protect from Coronary
Heart diseases.
• Antioxidants including Vitamin C, E β-
carotene have potential health benefits of
reducing cardiovascular diseases.

28. FUNCTIONAL FOODS IDEAL FOR ATHEROSCLEROSIS

29. FUNCTIONAL FOOD: FISH
• Rich in Selenium and Omega-3 Fatty
acids
• The American Heart Association has
recommended that people eat fish rich in
unsaturated fats at least twice a week.
The unsaturated fats in fish are called
omega-3 fatty acids. Omega-3 fatty acids
and other nutrients in fish may benefit
heart health and reduce the risk of dying
of heart disease.
• Surmai is the one containing lean protein
and reduces the risk of condition
• Ways to incorporate: Baked, Grilled
form or less spicy maacher jhol

30. FUNCTIONAL FOOD: MASOOR DAL
The goodness of dietary fibre in
masoor dal helps to diminish
bad cholesterol (LDL) and total
cholesterol levels in the body.
This improves blood circulation
and prevents the deposit of
plaque in the blood vessels,
thereby lowers the risk of
atherosclerosis, optimise
cardiac muscle functions and
boost heart health.

31. FUNCTIONAL FOOD: GINGER AND GARLIC
• Garlic and ginger contain powerful
anti-inflammatory plant compounds
that may help inhibit pro-
inflammatory proteins associated with
chronic inflammation.
• Garlic and ginger may help reduce
markers of oxidative stress and may
help boost antioxidant defences.

32. FUNCTIONAL FOOD: MILLETS
• Millets are diverse types of grains that are
produced across the world
• They are recognized to be highly packed
with nutritional content like proteins,
minerals – calcium, iron, potassium,
magnesium, zinc, and vitamins
• It is found that consumption of different
millets cuts down the risk of developing
cardiovascular diseases
• They help in lowering total cholesterol,
triglycerides, BMI, and even blood pressure
• It can be consumed in various ways- dosas,
pulao, upma, porridge, poha, and other
delicious recipes.

33. FUNCTIONAL FOOD: CITRUS FRUITS
• Eating citrus can reduce cholesterol
plaque in clogged arteries and help
reverse atherosclerosis, a leading cause
of heart attacks and strokes
• A variety of flavonoids from fruits could
not only reduce cholesterol transport,
but also enhanced the immune function
by regulating the level of intracellular
inflammatory factors

34. FUNCTIONAL FOOD:
NUTS AND OILSEEDS
• Nuts are rich sources of mono and
polyunsaturated fatty acids, arginine, soluble
fibre and various antioxidant polyphenols and
these active components contribute to cholesterol
lowering effects
• Almonds, macadamia nuts, hazelnuts and pecans
also appear to be quite heart healthy. Even
peanuts — though they are technically not a nut,
but a legume, like beans. It's best to choose
unsalted or unsweetened nuts. Adding salt or
sugar to nuts may cancel out their heart-healthy
benefits.

35. FUNCTIONAL FOOD: COFFEE, TEAAND COCOA
• Coffee and tea, the most popularly consumed beverages after water, are the chief source of
caffeine. Diterpenes such as kahweol and cafestol are suspected to be behind the cardio-
protective effect of coffee.
• Cocoa is the main ingredient in chocolate manufacturing; it is a rich source of flavonoid and it
has been lately evaluated for its plausible role. The protective effect of chocolate is attributed to
the decrease of blood cholesterols levels, substantial increase of high density lipoprotein
including marked decrease of oxidised low density lipoprotein

36. FUNCTIONAL FOOD: SOY PROTEIN
• Rich source of polyunsaturated fatty
acids, dietary fibre, micronutrients, low
saturated fat content and isoflavones
• Isoflavones prevent the oxidation of low
density lipoprotein and reduces the risk
of atherosclerosis

37. Atherosclerosis is the cause of more than 50% mortality in industrial countries.
Atherosclerosis is a disease in which plaque builds up inside your arteries. Over
time, plaque hardens and narrows your arteries, limiting the flow of oxygen-rich
blood. This can lead to serious problems. Atherosclerosis is a disease in which
plaque builds up inside your arteries. Over time, plaque hardens and narrows
your arteries, limiting the flow of oxygen-rich blood. This can lead to serious
problems Atherosclerosis usually doesn't cause symptoms until it severely narrows
or totally blocks an artery. Many people don't know they have the disease until
they have a medical emergency. When symptoms do happen, they are specific to
the arteries affected by atherosclerosis. A physical examination, imaging, and other
diagnostic tests can tell if the patient have this disease. Treatments include
medicines, and medical procedures or surgery. Lifestyle changes can also help.
These include following a healthy diet, getting regular exercise, maintaining a
healthy weight, and quitting smoking.

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