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 LDLcholesterol concentrations by decreasing LDL
receptormediated 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: n6 and n3
The major n6 fatty acid in the diet is linoleic acid, the precursor for arachidonic
acid (20:4n6)
-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

-3 fatty acid
linolenic acid (18:3n3)
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 n6 to n3 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
Subtract one risk factor for HDL cholesterol 1.6 mmol/L (60
mg/dL). Diabetes has been defined as a CHD risk equivalent.
1

Defined as CHD in a male first-degree relative aged <55 y or a

female first-degree relative aged <65 y.
2

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)

Nutrient

Therapeutic lifestyle
changes

Average US diet2

Saturated fat (% of
energy)

12

<7

Monounsaturated fat
(% of energy)

13

<20

<10

Polyunsaturated fat
(% of energy)
Cholesterol (mg/d)

270

<200

Total energy

To achieve and maintain

a desirable body weight

Carbohydrate (% of
energy)

51

5060

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