NUR 242 Nutrition

Study Guide for Ch21 Heart, Blood Vessels

Elevator speeches:
What to tell someone with high LDLs/total cholesterol?
How to follow the DASH diet?
Most important dietary changes for someone with high triglycerides?

Vocab: plaque, atherosclerosis, myocardial infarction (know common name for

this, too), stroke, cardiac cachexia

VLDL LDL HDL (see pages in textbook for a refresher)(5th ed: pgs 48-50)(6th ed:
pgs 50-52)
Roles of each, what do they principally carry?
Which are atherogenic?

Classic risk factors for CHD? (list 4)

Table 21-3 Reducing risk of CHD with Therapeutic Lifestyle Changes

(useful for elevator speech for how to reduce LDLs)

Limiting which dietary fat has the strongest influence on blood cholesterol?

Effect of nicotinic acid (form of niacin) on lipid profile

Am Heart Assoc recommendations for fish consumption:

Healthy fats are:

Fats to avoid are:

Dietary changes to lower LDLs:

Replace saturated fat with____________
Limit saturated fat to _____% of total kcals
Main sources of saturated fat in US diet: (5th ed: pg 598)(6th ed: pg 589)
How do soluble fibers decrease LDLs?
Good sources of soluble fibers are:
 Sterols and stanols are compounds found in plants. They are widely
distributed in whole grains, fruits and veggies. Can be added to various foods (i.e.
margarine, OJ). Help lower LDLs. Work with statin drugs for an even bigger
reduction than either alone.

Triglycerides--see nutrition therapy summary under Metabolic Syndrome.

Dietary and lifestyle changes to increase HDL

Exercise and wt loss
Low HDL and high triglycerides often go together, and the recommendations for
TG usually improve HDL, too.

Note that several of these nutrition therapies are counter-intuitive.

To lower LDLs (which carry cholesterol) the most important thing is to replace
saturated fats with mono- and poly-unsaturated fats. It is not to eat less
cholesterol.
To lower triglycerides, which are fats, the most important thing is to reduce the
amount of simple sugars. It is not to eat less fat.

Hypertension
Risk factors (5th ed: pg 609)(6th ed: pg 598)
DASH diet (Dietary Approaches to Stop Hypertension)
—summarize the major features, servings per day for 2000 kcal/day
Very high fruits&veggies—
Lowfat/skim milk—
Lean meat or fish—
Grains--
Nuts/seeds/legumes--
Fats and oils--
Sweets—

DASH diet by itself does not limit sodium, so adding a low sodium restriction to it
enhances the BP drop.

Foods high in potassium: (be able to list at least 5)(5th ed: pg 635)(6th ed: pg 624)
Heart failure
Nutrition therapy usually includes sodium levels around ____________ and
_______________ restriction.
If constipated, add _______________.

Cardiac cachexia is:

Potassium and blood pressure meds

Salt substitutes usually have potassium in them, replacing the sodium. So people
with potassium sparing diuretics (i.e. spironolactone) should not use them and
should avoid supplemental potassium.
Furosemide (Lasix) is a potassium wasting diuretic, so pts should be encouraged to
increase potassium intake. (p 606).

Updated SS2019