I What is atherosclerosis A Thickening of arterial walls causing decreased blood flow 1 primarily affects arteries Atherosclerosis http www youtube com watch v F0Y5hss1tZQ feature related II Atherosclerotic Plaque Formation A Endothelial damage 1 Endothelium B C Aggregation of platelets monocytes t lymphocytes 1 Macrophages take up LDLs 2 Growth factors released from platelets and macrophages 3 Growth factors stimulate smooth muscle cell growth and attract more macrophages 4 Smooth muscle cells D Arterial narrowing E Vessels compensate by vasodilation F Increased pressure causes cracks in plaque more endothelial damage G Platelet aggregation 1 continued narrowing of vessels 2 if loose blood clot can get stuck in narrowed vessels H Total blockage by plaque 1 myocardial infarction 2 stroke 3 poor circulation in lower extremities fatty streaks early plaque formation arterial narrowing localized slowing of blood flow cracks in plaque platelet recruitment 1 III Possible causes of endothelial damage 1 foam cells erupt 2 oxidized LDLs 3 high blood pressure 4 increased endothelial cell death accelerates atherosclerotic lesion formation IV Serum Cholesterol A Total Cholesterol 1 tells value of all cholesterol in blood 2 Recommendation B LDL recommendation C HDL recommendation D Total HDL ratio F How to modify cholesterol 1 HDL increase by 2 LDL want to decrease a Fat intake 1 saturated 2 polyunsaturated 3 monounsaturated V Dietary Approaches A decrease saturated fat B decrease trans fats C increase fiber E role of antioxidants A Replace SFA in diet with CHO no decreased risk of CHD PUFA reduction in CHD MUFA reduction in blood cholesterol B Decrease Trans fats 1 Trans fats will LDLs and HDLs 2 Sources a Naturally occurring meats and dairy products b Chemical processing cis to trans configuration during hydrogenation 3 Labeling laws 2006 Trans fats must be included on label rounded to nearest 0 5g if less than 5g to nearest g if trans fat is above 5g if total fat is less than 0 5g can state 0g of trans fat 2 C Fiber 1 Fermented in colon short chain fatty acids E Antioxidants 1 Reactive Oxygen Species more ROS Acetic acid Butyric acid Propionic acid a Functions of short chain FAs 1 stimulate water and sodium absorption into mucosal cells 2 provide colonocytes with energy 3 enhanced immune function stimulates immune cells stimulates good bacteria production 2 Excreted as fecal matter b carries bile with it 2 Oxidation metabolic complexes of ETC and MEOS lipoxygenase and cyclooxygenase pathways increased deposition of cholesterol to vascular system 3 Oxidation of 4 Antioxidants Vitamins E C Carotenoids 3
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