Role Of Diet In Cardiovascular Disease

Improper eating habits accompanied by the lack of exercise increase the risk of gaining excess weight, a major risk factor for heart disease, high blood pressure, and diabetes (14). Diet also affects plasma cholesterol levels. Cholesterol is carried in the blood associated with two major types of lipoproteins; LDL and HDL. LDL cholesterol has been

Table 7. Major Risk Factors for Cardiovascular Disease

• Increasing age

• High blood cholesterol levels

• Physical inactivity

Diabetes mellitus

• High blood pressure

Obesity and overweight

correlated with increased risk of cardiovascular disease. For many years it has been recognized that dietary cholesterol has only a limited effect on plasma cholesterol levels (17). Absorption of ingested cholesterol is poor, and part of the cholesterol in plasma is synthesized in the liver.

Total lipid intake, and the type of fat consumed, have more effect in raising plasma cholesterol than does dietary cholesterol (17,20). Saturated fatty acids were found to raise cholesterol, polyunsaturated fatty acids lowered plasma cholesterol, and monounsaturated fatty acids had an intermediate effect. In the classic seven-country prospective study where lipid intake was correlated with CHD (21,22), the disease incidence was also related to the intake of saturated fat. Most dietary prevention trials have reduced total fat, saturated fat, and cholesterol intakes along with moderately increased polyunsaturated fat levels.

Similar recommendations are also inclusive in many of the guidelines for health in the United States. Recent research indicates that monounsaturated fatty acids such as oleic acid, which were thought to be neutral, have, in fact, a substantial cholesterol lowering effect (23). Trans fatty acids formed during hydrogenation of certain edible oils may, perhaps, increase LDL cholesterol and decrease HDL cholesterol (24). A high fish intake has been associated with beneficial effects on the prevention of CHD. Fish oils contain DHA (docosahexaenoic acid), which has a plasma triglyceride-lowering effect (25).

High levels of dietary carbohydrate, especially complex carbohydrate, are associated with a decreased risk of cardiovascular disease (17). A recent study found rice bran as well as oat bran to have a hypocholesterolemic effect (26). Increasing intakes of a number of vitamins have also been shown to be protective toward cardiovascular disease. These include vitamins Be, C, E, and folate. Vitamin C and E are antioxidants and have been hypothesized as preventing damage to coronary arteries. Elevated serum vitamin C has also been correlated with increased HDL cholesterol levels in women (27). Increased consumption of folate and vitamin Be have also been shown to reduce risk of CHD in women (28). Current dietary recommendations (Table 3) incorporate many of these proven relationships between diet and health.

The Mediterranean Diet Meltdown

The Mediterranean Diet Meltdown

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