Atherosclerosis

Atherosclerosis is the major cause of all cardiovascular diseases. It is the hardening of the inner walls of the arteries resulting in a loss of elasticity. It is also known as Arteriosclerotic Vascular Disease or ASVD. Fat including cholesterol deposits in the arteries and the walls become narrower to disturb the blood flow. A complete blockage leads to heart attack. The arterial lesion of atherosclerosis is characterized by patchy thickening of fat and layers of collagen like fibers. There is a gradual build up of plaque or thickening of the walls of the artery causing decreased blood flow and oxygen supply to the vital organs and extremities. A heart attack may occur if oxygenated blood flow is reduced to the heart. A stroke may occur if the oxygenated blood is cut off to the brain. Gangrene may occur if the oxygenated blood supply is reduced to the arms and legs.

The following diagram shows how a plaque is formed.

The goals of Nutritional management are to reduce weight in overweight or obese patients; reduce total fat, saturated fat and cholesterol; provide medications to control or lower lipid levels and BP and bring about lifestyle changes such as increase physical activity, moderate alcohol intake and cessation of smoking.

The dietary modification for atherosclerosis will include calories to maintain Ideal Body Weight i.e. Low-moderate calories, Low fat, Low cholesterol, Moderate Carbohydrates and normal protein diet. Vitamin and mineral requirements remain the same. Sodium is restricted in cases of hypertension.

The dietary treatment for atherosclerosis requires that the patient should maintain slightly lower than the standard body weight. The diet should be rich in fibre by including foods like raw salads, fruits, green leafy vegetables and whole grains. Five servings of fruit and vegetables should be included in the diet not only to meet the nutritional requirement but also to meet anti-oxidants and fibre requirements.

Inclusion of fish in the diet is beneficial as they contain omega-3-fatty acids. 

Vegetable oils rich in PUFA like sunflower oil should be included in the diet. Concentrated foods like sweets, chocolates, cakes, pastries, ice creams and fried foods should be restricted or preferably avoided. Foods giving only empty calories like carbonated beverages, alcohol, sugar and sago are totally avoided. Small quantities of almonds can be consumed to bring down the cholesterol levels. High amounts of nuts and oil seeds increase the calories and fat content in the diet.  

Egg yolk contains cholesterol, hence egg white is preferable. Cholesterol containing foods should be limited in the diet. Coconut should be avoided in the diet as it contains high amount of saturated fatty acids and it is a concentrated source of energy.

Coffee and tea can be taken in moderation as excess amount of caffeine increases the heart rate. To restrict sugar intake, artificial sweetener can included in the diet.

Animal foods like meat and pork which contain high amount of saturated fat should be avoided. Shrimps and crabs have less amount of fat and can be included in the diet. All the sea foods are rich in sodium; hence hypertensive patients should avoid these foods.

Constipation should be avoided by including plenty of water and fibre in the diet. Foods that have hypocholesteromic effects like soya bean, fenugreek, garlic, onion and turmeric should be included in the diet.

Read more about Fats in the Nutri-knowhow column.

Post by Faiz Lahori