营养与心血管疾病.pptVIP

Chapter 13 Nutrition and Cardiovascular Disease Magnitude of the Burden— The Leading Causes of Death Coronary heart diseaseThe problem of atherosclerosis Arteriosclerosis动脉硬化: arteries become thick and hard making the passage of blood difficult and sometimes impossible. Atherosclerosis动脉粥样硬化: affects inner lining of arteries where deposits of cholesterol, fats, and other substances accumulate over time, thickening and weakening artery walls. Deposits are called plaque斑块. Normal arterial wall Development of Atherosclerotic Plaques Risk Factors for CHD Modifiable Dyslipidemia Raised LDL Low HDL Raised TGs Smoking Hypertension Diabetes mellitus Obesity Dietary factors Thrombogenic factors Sedentary lifestyle Non-modifiable Family history of premature CHD Age Sex Dyslipidemia： 患病率 18.6%，人数1.6亿 城乡差别不大，中、老年相近 Obesity：明显上升 Adult:超重率 22.8%(2.0亿） 肥胖率7.1% （6000多万） In big city, Adult 超重率 30.0%,肥胖率12.3% 儿童肥胖率8.1% Hypertension Relationship between Cholesterol and CHD risk: The Framingham Study Cholesterol—a Modifiable Risk Factor 10% reduction in TC = 15% reduction in CHD mortality LDL-C is the primary target to prevent CHD Strongly associated with atherosclerosis and CHD events 10% increase results in a 20% increase in CHD risk1 HDL cholesterol Elevated HDL cholesterol has a protective effect for risk of atherosclerosis and CHD The lower the HDL cholesterol level the higher the risk for atherosclerosis and CHD Relationship of diet to risk factor 膳食脂类 : Amount of fat: Limit fat kcal to 20-30% of total kcal Kind of fat: 脂肪酸: 饱和脂肪酸高的食物可导致血胆固醇水平升高，但对甘油三酯的影响不一 短链（C6:0~C10:0）和硬脂酸（C18:0）对血胆固醇影响很小 月桂酸（C12:0）豆蔻酸（C14:0）棕榈酸(C16:0) :血脂升高 单不饱和脂肪酸（MUFA）:橄榄油、茶油 降低血清总胆固醇和LDL，且不降低HDL 多不饱和脂肪酸（PUFA）分n-6系列和n-3系列 n-3 系列的EPA（C20:5）和DHA(C22:6)具有明显降低甘油三酯的作用 n-3 系列多不饱和脂肪酸抗动脉硬化的有效作用： 减少血小板的凝聚作用，增加抗血凝作用 在早期血管硬化时，能减少动脉内壁损伤面的血小板凝聚与血小板栓塞 能在血管的损伤面加强白细胞的作用，从而降低炎症反应 增加血浆的溶解纤维作用