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Lect 18 CVD Part 2

Acid linoleic acid 182 oleic acid acid 181

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Unformatted text preview: acid acid (18:1) Eicosapentaenoic acid (20:5) Cyclooxygenase Lipoxygenase Prostanoids Leukotrienes AntiAnti-inflammatory Arachidonic acid (20:4) Cyclooxygenase Lipoxygenase Prostanoids Leukotrienes Eicosatrienoic acid (20:3) • Eicosanoids are produced from fatty acid metabolites from fatty acid metabolites by enzymes associated with macrophages • Omega-3 fatty acids from diet or supplements can decrease production of proinflammatory eicosandoid compounds, and increase production of lessinflammatory products ProPro-inflammatory 23 24 Soluble Fiber Mechanism Of Action • Fiber binds bile salts in the GI tract bi bil th GI • Cholesterol removed from serum for bile acid synthesis in an effort to restore bile acid pool synthesis in an effort to restore bile acid pool • Promotes synthesis of short chain fatty acids via fermentation in the colon. SCFA inhibit via fermentation in the colon. SCFA’s inhibit hepatic cholesterol synthesis • Tendency towards lower fat diets 25 Soluble Fiber Recommendations Fiber Recommendations • Encourage patients to consume plenty of: – – – – – – – Legumes Beans Peas/Corn Oatmeal Cereal grains (oats and barley) grains (oats and barle Citrus fruits Apples 26 Plant Sterols/Stanols/Stanol Esters Sterols/Stanols/Stanol Esters Stanols & Stanol Esters Stanol Esters Sitosterol Sitostanol HO hydrogenation HO esterification O C-O Sitostanol fatty acid ester (PSE) 27 Phytosterols: Plant Sterols/Stanols Plant Sterols/Stanols Stigmastserol, -sitosterol, campesterol Mechanism of action: cholesterol cholesterol absorption from gut Plant Stanol Esters Block entry of most cholesterol into micelle • Dietary Cholesterol • Biliary Cholesterol • Blocked cholesterol and plant stanol are eliminated from body Efficacy: ~5-10% Efficacy: ~5-10% esters/d /d plasma plasma lipids at intake of 1-3 g ster...
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