Coronary Heart Disease

Definition

Coronary Heart Disease (CHD), also known as Coronary Artery Disease, is a condition characterized by reduced blood flow to the heart muscle due to the build-up of plaque (a combination of cholesterol, other fats, calcium, and other substances) in the coronary arteries. This plaque buildup can lead to angina (chest pain) and heart attacks, and is a leading cause of death worldwide.

Significance of Lipoproteins

Lipoproteins are complexes that transport cholesterol and other fats through the bloodstream. There are two main types relevant to CHD:

High-Density Lipoproteins (HDL)

Often termed 'good cholesterol,' HDL helps transport cholesterol away from artery walls and back to the liver for processing and elimination. High levels of HDL are associated with a lower risk of CHD.

Low-Density Lipoproteins (LDL)

Known as 'bad cholesterol,' LDL can deposit cholesterol on artery walls, forming plaques and contributing to atherosclerosis. Elevated LDL levels increase the risk of CHD.

Dietary Factors and Coronary Heart Disease

Diet plays a crucial role in the development and prevention of CHD. The interrelationship of dietary components with CHD risk factors is significant.

Dietary Excesses Contributing to CHD

• Saturated and Trans Fats: Found in red meat, dairy products, and processed foods, these fats raise LDL levels.
• Cholesterol: Present in animal-based foods; excessive intake can increase blood cholesterol.
• Salt (Sodium Chloride): High intake can lead to hypertension, a risk factor for CHD.
• Sugar: Excessive sugar, especially refined sugar, can contribute to obesity and diabetes, both risk factors for CHD.

Dietary Deficiencies and CHD

• Fiber: A low intake of dietary fiber, found in fruits, vegetables, and whole grains, can lead to elevated cholesterol levels.
• Omega-3 Fatty Acids: Found in fatty fish like salmon, these fats have a protective effect against CHD but are often lacking in Western diets.
• Antioxidants and Vitamins: Diets low in antioxidants (found in colorful fruits and vegetables) and essential vitamins can contribute to the development of CHD.

Specific Dietary Requirements for CHD Management

• Reduced Saturated Fat Intake: Replace with monounsaturated and polyunsaturated fats (found in olive oil, avocados, nuts, and seeds).
• Increased Fiber Consumption: Aim for a diet rich in fruits, vegetables, and whole grains.
• Controlled Salt Intake: Limit processed and high-sodium foods.
• Moderate Alcohol Consumption: Excessive alcohol can raise blood pressure and triglyceride levels.
• Balanced Diet: Emphasize a Mediterranean-style diet, rich in fruits, vegetables, whole grains, lean protein, and healthy fats.

Additional Points

• Physical Activity: Regular exercise complements dietary changes in reducing CHD risk.
• Stress Management: Chronic stress can contribute to heart disease; stress management techniques are beneficial.
• Regular Health Check-ups: Monitoring cholesterol levels, blood pressure, and blood sugar can help in early detection and management of CHD.

Example Exam Questions and Answers

Define Coronary Heart Disease and explain the roles of HDL and LDL in its development.

Coronary Heart Disease is a condition where the blood supply to the heart muscle is restricted due to plaque buildup in the coronary arteries. High-Density Lipoproteins (HDL) are beneficial as they transport cholesterol away from the arteries to the liver for removal. In contrast, Low-Density Lipoproteins (LDL) contribute to plaque formation by depositing cholesterol on the artery walls, increasing the risk of CHD.

Discuss the dietary changes recommended for a person diagnosed with CHD.

For CHD management, a diet low in saturated and trans fats, cholesterol, and salt is recommended. This involves limiting red meat, full-fat dairy, and processed foods while increasing intake of fruits, vegetables, whole grains, and sources of omega-3 fatty acids like fatty fish. A Mediterranean-style diet, rich in antioxidants, vitamins, and healthy fats, is also beneficial.

Explain how excessive sugar consumption can increase the risk of CHD.

Excessive sugar intake can lead to obesity and the development of Type 2 Diabetes, both of which are risk factors for CHD. High sugar consumption can also contribute to elevated triglyceride levels in the blood, another risk factor for CHD.