Download Marywood University Weigh To Go

Marywood University
Weigh To Go
November 3, 2010
Cholesterol Quiz
• Only adults need to have their cholesterol checked.
Children can’t have high cholesterol?
• All I really need to know about my cholesterol
levels is my total blood cholesterol number?
• If I have high cholesterol the only thing I can do
about it is take medication?
• High cholesterol levels put me at risk for
atherosclerosis?
• Thin people don’t have to worry about high
cholesterol?
Cholesterol
• Approximately 1 in every 6 adults—16.3% of the
U.S. adult population—has high total cholesterol.
The level defined as high total cholesterol is 240
mg/dL and above.
• People with high total cholesterol have
approximately twice the risk of heart disease as
people with optimal levels. A desirable level is
lower than 200 mg/dL.
• For adult Americans, the average level is about
200 mg/dL, which is borderline high risk.
• More women than men have high cholesterol in
the United States.
Cardiovascular Disease (CVD)
• CVD has been the leading cause of death in the
United States for every year since 1900, except 1918
– More than 71 million Americans have at least one form of
CVD (e.g., hypertension, CHD, stroke, or congestive heart
failure)
• Includes deaths from CHD and stroke
– Atherosclerosis most common cause of CHD
• One third of deaths occur before age 65
– Prevalence doubles from 35-44 years to 65-74 years
• Risk reduction; major breakthroughs in prevention
and treatment
Natural Progression of Atherosclerosis
Blood Markers for CHD
• Lipoprotein profile
– Total cholesterol >200 mg/dl
– LDL cholesterol >130 mg/dl
– HDL cholesterol <40 mg/dl
– Triglycerides >150 mg/dl
Lifestyle Risk Factors
• Tobacco use – influences acute coronary events
(thrombus formation, plaque instability and
arrhythmias)
• Physical inactivity – same risk as high blood
cholesterol, HTN or smoking
• Poor diet
• Stress – type A personality shows increased risk
• Alcohol consumption – above moderate
consumption raises BP, TG and HDL
AHA Diet Recommendations for CVD Risk Reduction
• Balance calorie intake and physical activity to achieve or maintain a
healthy body weight.
• Consume a diet rich in vegetables and fruits.
• Choose whole grain, high-fiber foods.
• Consume fish, especially oily fish, at least twice a week.
• Limit intake of saturated fat to <7% of energy, trans-fat to <1% of
energy, and cholesterol to <300 mg/day by:
– Choosing lean meats and vegetable alternatives.
– Selecting fat-free (skim), 1%-fat, and low-fat dairy products.
– Minimizing intake of partially hydrogenated fats.
• Minimize your intake of beverages and foods with added sugars.
• Choose and prepare foods with little or no salt.
• When consuming alcohol, do so in moderation.
• When eating food that is prepared outside of the home, follow the
American Heart Association Diet and Lifestyle Recommendations.
Nutrient Composition of the Heart Healthy Diet
Nutrient
Recommended Intake
Saturated fat*
Less than 7% of total calories
Polyunsaturated fat
Up to 10% of total calories
Monounsaturated fat Up to 20% of total calories
Total fat
25%-35% of total calories
Carbohydrate†
50% to 60% of total calories
Fiber
25-30 g/day
Protein
Approximately 15% of total calories
Cholesterol
Less than 200 mg/day
Total calories
(energy) ‡
Balance energy intake and expenditure to
maintain desirable body weight/prevent weight
gain
Foods with Fat
Saturated Fats
• Saturated fats
– Meats, Organ meats, Egg
yolk, Whole milk cheese,
Whole milk, Cream, Butter,
Lard, Palm oil, Coconut oil
• Trans fatty acids
– Cookies, Crackers, Cakes,
Fried Foods, Donuts
Unsaturated
• Monounsaturated
– Olive oil, Olives, Canola
oil, Peanut oil, Avocados
• Polyunsaturated
– Safflower oil, Sunflower
oil, Corn oil, Sesame oil,
Nuts, Seeds
Food Examples
• Peanut Butter
• Serving Size – 2
tablespoons
• Calories – 190
• Fat – 16 g
• Saturated fat – 3 g (16%)
• Carbohydrate – 6 g
• Cholesterol – 0 mg
• Protein – 8 g
• Fiber – 2 g
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•
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•
•
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Whole Milk
Serving Size – 1 cup
Calories – 150
Fat – 8 g
Saturated fat – 5 g (23%)
Carbohydrate – 13 g
Cholesterol – 25 mg
Protein – 8 g
Fiber – 0 g
Dietary Factors
• Saturated fatty acids – most potent effect on LDL
chol
• Monounsaturated fatty acids – when used to
replace SFA they lower total chol, LDL & TG; may
increase HDL
• Trans fatty acids – raise LDL chol
• Polyunsaturated fatty acids - when used to replace
SFA they lower LDL & HDL
• Omega-3 fatty acids – decreased CVD risk with fatty
fish 2 times/week
• Amount of dietary fat – low fat diets (<25% of kcals)
raise TG and lower HDL
Dietary Factors–cont’d
• Dietary cholesterol – raise total chol and LDL
• Fiber – soluble fibers (pectins, gums, mucilages)
lower LDL
• Antioxidants – affect oxidative potential of LDL
• Soy protein – large intakes of soy may decrease LDL
• Stanols and sterols – lower total chol and LDL
• Weight loss - improves endothelial function
References
• American Heart Association: americanheart.org
• Centers for Disease Control and Prevention:
cdc.org
• Mahan, L.K., & Escott-Stump, S. (2008). Krause's
food & nutrition therapy (11th ed.). St. Louis, MO:
Saunders.
• Calorie King: calorieking.com