Insert logo. Linda Main, Dietetic Adviser

Size: px

Start display at page:

Download "Insert logo. Linda Main, Dietetic Adviser"

Elwin Griffin
5 years ago
Views:

1 Insert logo Linda Main, Dietetic Adviser

2 HEART UK The Cholesterol Charity Our Vision: To prevent avoidable and early deaths caused by high cholesterol. We want the majority of UK adults to know their cholesterol levels, understand the impact and to be taking any necessary action. Providing expert support, guidance & education

3 National Cholesterol Month October

Figure 7 Burden of disease attributable to 20 leading risk factors for both sexes in 2010, expressed as a percentage of UK disabilityadjusted life-years Alcohol use Diet low in fruits High total

4 Figure 7 Burden of disease attributable to 20 leading risk factors for both sexes in 2010, expressed as a percentage of UK disabilityadjusted life-years Alcohol use Diet low in fruits High total cholesterol Diet low in nuts and seeds Diet high in sodium Diet low in veg Diet high in processed meat Diet low in seafood omega 3 fatty acid Diet low in fibre Diet Diet low low in wholegrains Diet Diet low low in polyunsaturated in polyunsaturated fatty fats acids The Lancet 2013; 381: (DOI: /S (13) )

5 Cardiovascular Disease - UK Responsible for more than 1 in 4 deaths Kills someone every 3 minutes 7 million people in the UK living with CVD 41,000 people die prematurely of CVD each year Coronary Heart Disease - UK Heart disease is the nation s biggest single killer About half of all heart attacks are caused by abnormal blood fats 4 out of every 5 heart attacks could be avoided by improving diet and lifestyle

6 The Heavyweights of Modifiable Cardiovascular Disease (CVD) Risk Factors Hypertension Cholesterol Diabetes Smoking LDL HDL CVD Risk

7 More than half of all adults have raised cholesterol population LDL by 5% - prevent 64,000 cases of CVD BMJ d4044 population LDL by 1mmol/l reduce CHD by 19% Lancet 2005; 366:

8 Inherited high cholesterol Over 90 different genes affect cholesterol control POLYgenic Single gene

Familial Hypercholesterolaemia (FH) The most common

single altered gene (heterozygous) resulting in a

know they have it Early and unexpected heart disease in

9 Familial Hypercholesterolaemia (FH) The most common genetic condition (1 in ) caused by inheriting a single altered gene (heterozygous) resulting in a doubling of cholesterol 80-90% of people with FH don t know they have it Early and unexpected heart disease in their 20 s, 30 s and 40 s Diagnosed ~ Simon Broome criteria/genetic testing

10 Is obesity a driver for cholesterol? It s not so much how much fat but where and how it is stored Focus on waist loss not weight loss

11 Features of the metabolic syndrome High triglycerides Low HDL cholesterol Small dense LDL particles High apolipoprotein B Inflammatory profile Insulin resistance Increased insulin levels Glucose intolerance Impaired clotting Endothelial dysfunction Raised blood pressure

12 Are we achieving nutritional targets? Nutrient Target/day Is the UK achieving the targets? Do healthy eaters achieve? Do plant based eaters achieve? Total fat < 35% food energy Saturated fat < 11% food energy X Fibre (NSP) 18g/day X X Fruit and vegetables 5 or more portions X Whole grains 3+ portions X X Oily Fish 1 serve/week X?? Red meat <70g/day women Sugars <11% food energy NMES X Trans fat < 2% food energy Salt <6g day X??

13 Ultimate Cholesterol Lowering Plan

14 Nutrient Convincing evidence of effect on blood cholesterol levels Saturated fat Polyunsaturated fat omega 6 Polyunsaturated fats omega 3 (Fish oils DHA and EPA) Health effect LDL cholesterol Total : HDL ratio LDL cholesterol Total : HDL ratio Decrease risk of CHD events Monounsaturated fats LDL cholesterol Total: HDL Ratio HDL cholesterol Trans fats LDL Cholesterol Total : HDL ratio HDL cholesterol Stearic acid (cocoa beans) No effect Reference: FAO/WHO 2008

15 Dietary potential to lower cholesterol kg weight loss 5% sat fat reduction 2.5g plant sterols 30g nuts 15-25g soya protein 3g beta-glucan Sanders, T. (2003). Dietary methods to help control blood cholesterol - what works?. In Nutrition & Health Current Topics 3. (pp ). Antwerp: Garant Publishers.

16 Ultimate Cholesterol Lowering Plan Scientifically grounded Flexible UCLP Realistic Practical

17 Ultimate Cholesterol Lowering Plan Step 1 Motivational Interviewing Step 2 Heart healthy foundation diet Step 3 Soya foods Nuts Sterol & stanol fortified foods Soluble fibre

Ultimate Cholesterol Lowering Plan Consumer Resources Consumer leaflet Website 16 pages Factsheets 8 Patient tear off factsheet UCLP Store tour Health Professional

18 Ultimate Cholesterol Lowering Plan Consumer Resources Consumer leaflet Website 16 pages Factsheets 8 Patient tear off factsheet UCLP Store tour Health Professional Resources UCLP report Online training resource Patient education slides Patient advice pad

19 Thank you Any questions? Helpline

Latest Nutritional Guidelines: What s new for practice? Paul Pipe-Thomas Specialist Dietitian

+ Latest Nutritional Guidelines: What s new for practice? Paul Pipe-Thomas Specialist Dietitian + Evidence Based Guidelines Last nutritional guidelines published in 2003. New guidelines published in May