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Diet jantung

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Fat
• Dietary fats:
– Polyunsaturated fatty acids
– Monounsaturated fatty acids
– Saturated fatty acids
• Cholesterol
– It is recommended that dietary saturated fat
intake be <7% of energy to reduce CHD risk
Fat
• Dietary fats and cholesterol play a major role
in CHD development
• Saturated fatty acids: contain no double bonds
and generally vary in chain length from 12 to
18 carbons.
• Major sources of saturated fat in diet: dairy,
beef, pork, poultry, and lamb products
Saturated Fatty Acids
• Saturated fatty acids increase LDL-cholesterol
concentrations by decreasing LDL receptor–
mediated catabolism
• This effect is mediated both by decreased LDL
receptor messenger RNA (mRNA) expression and
decreased membrane fluidity
• This latter effect causes less receptor recycling
across the cell membrane.
• It is recommended that dietary saturated fat
intake be <7% of energy to reduce CHD risk
Monounsaturated fatty acids

• The major monounsaturated fatty acid in the diet


is oleic acid, which contains one double bond at
the number 9 carbon
• Monounsaturated fatty acids, as compared with
dietary carbohydrates, were neutral with respect
to their effects on plasma total cholesterol
concentrations
• When substituted for dietary saturated fatty
acids, monounsaturated fatty acids have a
hypocholesterolemic effect
Monounsaturated fatty acids

• Monounsaturated fats do not lower LDL or


HDL cholesterol relative to saturated fat as
much as does polyunsaturated fat
• Food sources: olive oil, peanut oil, margarine,
chicken fat
Trans Fatty Acids
• Trans Fatty acids are formed during the
hydrogenation process, a process that
converts vegetable oils to a semisolid state
• Major sources: baked products, processed
foods, and margarines
• Increases plasma concentrations of
lipoprotein(a), an independent risk factor for
CHD
Polyunsaturated fatty acids

• Subclassified: n−6 and n−3


• The major n−6 fatty acid in the diet is α-
linoleic acid, the precursor for arachidonic acid
(20:4n−6)
• α-Linoleic acid is not synthesized by the body
and is therefore an essential fatty acid.
• Food sources: vegetables and vegetable oils
(corn, soybean, safflower, and sunflower),
with the exception of coconut and palm oils
Ω-3 fatty acid
• linolenic acid (18:3n−3)
• hypocholesterolemic effect: reducing both LDL-
and HDL-cholesterol concentrations, lower
platelet aggregation, lower immune response,
and lower blood pressure
• fish oil, especially eicosapentaenoic acid, lower
triacylglycerol concentrations significantly
• recommended that the polyunsaturated fat
intake be <10% of energy
• An optimal ratio of n−6 to n−3 fatty acids in the
diet is believed to be ≈4:1.
Cholesterol
• 1.3 egg yolks/d containing 272 mg cholesterol
• increases LDL cholesterol
• Cholesterol with saturated fat, should be
restricted in the diet to ≤200 mg/d to
decrease CHD risk
National Cholesterol Education Program coronary heart disease
(CHD) risk factors- NCEP
in addition to diabetes and elevated LDL cholesterol1

1Subtractone risk factor for HDL cholesterol ≥ 1.6 mmol/L (60 mg/dL). Diabetes has
been defined as a CHD risk equivalent.
2Defined as CHD in a male first-degree relative aged <55 y or a female first-degree
relative aged <65 y.
1) Male ≥45 y
2) Female ≥55 y
3) Family history of premature CHD2
4) Hypertension
5) Cigarette smoking
6) HDL cholesterol <1.0 mmol/L (40 mg/dL)
National Cholesterol Education Program guidelines on dietary therapy
(Am J Clin Nutr February 2002 vol. 75 no. 2 191-212)

Therapeutic lifestyle
Nutrient Average US diet2 changes

Saturated fat (% of energy) 12 <7

Monounsaturated fat (% of
energy) 13 <20

Polyunsaturated fat (% of
energy) 7 <10
Cholesterol (mg/d) 270 <200

To achieve and maintain a


Total energy — desirable body weight

Carbohydrate (% of energy) 51 50–60

Protein (% of energy) 15 15
Hypertension
• Calcium, potassium, magnesium, phosphorus,
and fiber that would be included in a diet
containing adequate amounts of dairy
products and fruit and vegetables.
• Reduce salt intake (< 5 g/day)
• Maintenance body weight