Blood lipid levels disease risk

Cardiovascular diseases are a major cause of death in developed countries, making prevention a priority for public health policy. Research evidence over years has shown that cardiovascular diseases can be managed and even prevented by healthful eating practices involving a resveratrol-enriched diet of whole plant foods such as offered by superfruits. For more than fifty years, research has shown that a healthful, active lifestyle combined with the dietary benefit of high fruit and vegetable intake may lower blood lipid levels, blood pressure, and risk of coronary heart disease and stroke. 

Increased weight increases cardiovascular risk factors, including hypertension, diabetes, and alterations in blood lipid levels. It also increases the risk for respiratory problems, gallbladder disease, and certain types of cancer. 

In addition to diabetes mellitus, Mr. Applebod has a hyperlipidemia (high blood lipid level—elevated cholesterol and triacylglycerols), another risk factor for cardiovascular disease. A genetic basis for Mr. Applebod s disorder is inferred from a positive family history of hypercholesterolemia and premature coronary artery disease in a brother. 

Clinical coronary heart disease usually appears at least two or three decades after the onset of pathological lesions of coronary atherosclerosis. Epidemiological studies emphasize that hyperlipidemia, especially hypercholesterolemia, is a primary risk factor which should be construed as a warning sign. Normalization of high blood-lipid levels could start, therefore, long before the acute phases of coronary heart disease are manifest. 

There is supporting evidence that apples and apple components upregulate the composition and the activity of the gut microbiota and may improve biomarkers related to cardiometabohc disease. Data from animal studies represent a stronger evidence base compared with more limited data from human studies which are scarce and often inconsistent. Beneficial effects on key CVD risk markers such as blood pressure and vascular function are limited, whereas evidence for antiinflammatory activities and beneficial effects of apples and apple components on glucose and insulin levels has been mainly derived from in vitro and animal studies. The strongest effects are related to blood lipid levels where a frequent apple consumption of approximately three apples per day has been... 

Today, the dietary "culprit" is fat. An estimated 35 million Americans are considered to be obese. Obesity is connected with a higher incidence of diabetes, hypertension, osteoarthritis, gallbladder disease, and some types of cancer. Additionally, high blood lipid levels are a major risk factor for heart disease. So, convenience and fast-food menus currently reflect consumer concern about the amount and type of dietary fat they are eating. For example, McDonald s "McLean Deluxe" is a low-fat ground beef patty that is 91% fat free, and contains only 310 calories and 1 0 grams of fat. 

Insulin resistance occurs when the normal response to a given amount of insulin is reduced. Resistance of liver to the effects of insulin results in inadequate suppression of hepatic glucose production insulin resistance of skeletal muscle reduces the amount of glucose taken out of the circulation into skeletal muscle for storage and insulin resistance of adipose tissue results in impaired suppression of lipolysis and increased levels of free fatty acids. Therefore, insulin resistance is associated with a cluster of metabolic abnormalities including elevated blood glucose levels, abnormal blood lipid profile (dyslipidemia), hypertension, and increased expression of inflammatory markers (inflammation). Insulin resistance and this cluster of metabolic abnormalities is strongly associated with obesity, predominantly abdominal (visceral) obesity, and physical inactivity and increased risk for type 2 diabetes, cardiovascular and renal disease, as well as some forms of cancer. In addition to obesity, other situations in which insulin resistance occurs includes... 

Until 1993 apolipoprotein E was best known for its central role in plasma lipoproteins and cholesterol transport (Fig. 21-1). However, one of the three common alleles of the apoE gene confers a significant risk of development of Alzheimer disease.12171218 A high blood cholesterol level is also correlated with increased risk.12191220 Membrane abnormalities in mitochondria have been associated with Alzheimer disease.1221 Also related to membranes and lipid metabolism, vitamin E appears to combat Alzheimer disease.843 1218... 

The clinical manifestations of PAD are associated with reduction in functional capacity and quality of life, but because of the systemic nature of the atherosclerotic process there is a strong association with coronary and carotid artery disease. Consequently, patients with PAD have an increased risk of cardiovascular and cerebrovascular ischemic events [myocardial infarction (Ml), ischemic stroke, and death] compared to the general population (4,5). In addition, these cardiovascular ischemic events are more frequent than ischemic limb events in any lower extremity PAD cohort, whether individuals present without symptoms or with atypical leg pain, classic claudication, or critical limb ischemia (6). Therefore, aggressive treatment of known risk factors for progression of atherosclerosis is warranted. In addition to tobacco cessation, encouragement of daily exercise and use of a low cholesterol, low salt diet, PAD patients should be offered therapies to reduce lipid levels, control blood pressure, control blood glucose in patients with diabetes mellitus, and offer other effective antiatherosclerotic strategies. A recent position paper... 

A better indication of a person s riidi of heart disease comes from a measurement of blood lipoprotein levels. Lipoproteins arc romfdex mol ecules with both lipid and protein parts that transport lipids through the body. They can be divided into four types ucconbiig to density as shown in 6tble 27.4. People with a high serum level high-density lipoproteins 4 HDL s) seem to have a decreased risk of heart disease. Asa rule of thumb, u person s risk drops about for each increase of 5 mg/dl.. in HDL con-... 

Alpha-tocopherol acetate (vitamin E) has no effect on lipid levels but is a powerful antioxidant. Considerable evidence points to oxidation of LDL as an essential step in the development of atheroma, and therefore interest has centred on the role of either endogenous or therapeutic vitamin E in prevention of atheroma. Reduced concentrations of vitamin E in both blood and fat (vitamin E is a fat soluble vitamin) are found in inhabitants of countries with a high prevalence of ischaemic heart disease, and (within these countries) in patients who develop ischaemic heart disease. A high dose reduced by half the risk of myocardial infarction in 2000 patients with angina and positive coronary angiogram. However most other studies have failed to confirm this finding and there is no indication at present for routine prescribing of a-tocopherol in the treatment or prevention of atherosclerosis. 

In laboratory experiments, prune extracts inhibit cholesterol synthesis and oxidation of lipids and thus might serve to lower the risk of chronic vascular diseases. A limited study by nutritionists at the University of California, Davis, examining men with high blood cholesterol provided evidence for this effect, showing that eating twelve prunes a day for eight weeks reduced overall blood cholesterol levels. 

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