Hyperlipidemia چربي مفيد = (چربي با تراكم بالا)HDL چربي كمي مضر = Triglyceride چربي خيلي مضر =LDL (چربي با تراكم كم)

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Presentation transcript:

Hyperlipidemia چربي مفيد = (چربي با تراكم بالا)HDL چربي كمي مضر = Triglyceride چربي خيلي مضر =LDL (چربي با تراكم كم)

LDL

هر چه LDL كوچكتر باشد خطر آن بيشتر است

چربي مفيد

Dyslipidemia SCREENING The U.S. Preventive Services Task Force (USPSTF) strongly recommends screening men aged 35 and older for lipid disorders. Grade: A recommendation.A recommendation The USPSTF recommends screening men aged 20 to 35 for lipid disorders if they are at increased risk for coronary heart disease. Grade: B recommendation.B recommendation Women aged 45 and older for lipid disorders if they are at increased risk for coronary heart disease. Grade: A recommendation.A recommendation women aged 20 to 45 for lipid disorders if they are at increased risk for coronary heart disease.

مقادير طبيعي تري گليسريد : كمتر از 150 كلسترول : كمتر از 200 LDL : كمتر از 130 در گرفتاری کرونر قلبي و دیابت: كمتر از 100 HDL کمتر از 40 در هر دو جنس HDL محافظتی بیشتر از 60

علل کاهش HDL چاقی و اضافه وزن کم تحرکی مصرف زیاد کربوهیدرات (بیش از 60% انرژی) سیگار دیابت تری گلیسیرید بالا داروها: بتابلوکرها، استروئیدها، پروژست ژنتیک

راههای افزايش اچ دی ال ورزش قطع سيگار كاهش مصرف چربي اشباع مصرف ماهي (امگا تري ) خواب خوب! (افزايش هورمون رشد) گردو چایی سبز ؟ استاتین ها و اسید نیکوتینیک

مقایسه محتویات سه نوع غذا (در صد گرم) جو سبوس دار *** مرغ ( ران پخته شده )** گردو * محتویات گرمپروتئین 1707 گرمفیبر گرم 6 گرمچربی اشباع 034 mg0 کلسترول گرم Monounsaturated fat گرم Polyunsaturated fat 110 mg190 mg9 گرم Omega 3

جو سبوس دار *** مرغ ( ران پخته شده )** گردو * محتویات 12 گرم 38 Omega گرم کل چربی ضریب التهاب 3510 ضریب گلیسمیک 2.8 mg3.1 mg Zinc mg 2 mg Na

برخی غذاهاي پر چربی سرخ كرده ها پيتزا – اسنك بريان كله پاچه كره كباب غذاي رستوراني

برخی غذاهاي با فاکتور التهاب بالا (ضد التهاب) فلفل سس (بدون چربی) ادویه با سیر زنجبیل سیر روغن ماهی (به ویژه سالمون) پیاز – خردل اسفناج

برخی غذاهاي با فاکتور التهاب پایین (التهاب زا) قلب مرغ گوساله خوک گوسفند جگر مرغ آدامس قهوه کاکائو - چایی شیرین دسرها - برنج - عسل

کاهش کلسترول، کاهش چربی دور شکم کاهش درد و خشکی مفاصل، کاهش شانس سرطان پوست؟ افزایش جذب ویتامین ها و کلسیم، بهبود فعالیت سلول های مغز، کاهش حوادث قلبی – عروقی، اثر بر پوست

Hydrogenated Oils Dried Coconut Butter Meat Dark Chocolate

Cheese Nuts and Seeds Processed Meats Cream

Monounsaturate d Fat Sources Omega-6 Polyunsaturated Fat Sources Omega-3 Polyunsaturated Fat Sources Nuts Vegetable oils Canola oil Olive oil High oleic safflower oil Sunflower oil Avocado Soybean oil Corn oil Safflower oil Soybean oil Canola oil Walnuts Flaxseed Fish: trout, herring, and salmon

secondary tertiary primary

گوشت فوائد منبع پروتئین، آهن ، روی، منیزیوم ، کلسیم... کمک به رشد کودک مضرات افزایش بروز فشارخون سنگ کلیه سنگ صفرا میوم ؟ قساوت قلب ( خشونت )

نیاز به پروتئین بین 6%- 8% گرم بازای هر کیلو وزن بدن تعیین شده است ( در بارداری، شیردهی و کودکی نیاز بیشتر است ) یک فرد 60 کیلوئی با فعالیت مطلوب حدود 40 گرم پروتئین در روز نیاز دارد. در هفته = 280 گرم هر تخم مرغ 6 گرم پروتئین دارد گوشت قرمز از 20 تا 30 گرم بر حسب خالص بودن آن گوشت ماهی حدود 18 گرم 100 گرم گوشت تقریبا معادل 5 قطعه گوشت خورش است

Total protein needs Low biologic Wheat, …. Vegetable Cereals Fruits High biologic Milk, dairy, Egg Meat (Red, White)

Total protein needs 280 گرم Low biologic (140) Wheat, …. Vegetable (70) Cereals (70) High biologic (140) Milk, dairy, Egg (70) Meat (Red, White) (70)

130 گرم ماهی ( حاوی 24 گرم پروتئین ) ، 120 گرم مرغ ( حاوی 22 گرم ) 100 گرم گوشت قرمز ( حاوی 24 گرم ) جمع = 70

Clinical Identification of the Metabolic Syndrome* Risk Factor Defining Level Abdominal Obesity Waist Circumference† Men >102 cm (>40 in) Women >88 cm (>35 in) Triglycerides ≥150 mg/dL HDL cholesterol Men <40 mg/dL Women <50 mg/dL Blood pressure ≥130/85 mmHg Fasting glucose ≥110 mg/dL

The ATP III panel did not find adequate evidence to recommend routine measurement of insulin resistance (e.g., plasma insulin), proinflammatory state (e.g., high-sensitivity C-reactive protein), or prothrombotic state (e.g., fibrinogen or PAI-1) in the diagnosis of the metabolic syndrome

Assumptions Used in Cost-Effectiveness In Lipid treatment ■ Efficacy of drug therapy ■ Price of drugs (with or without wholesale discounts) ■ Lag time between institution of therapy and first benefit ■ Baseline risk of population ■ Impact of individual risk factors on CHD risk ■ Prior dietary therapy before initiation of drug therapy (lessening cost-effectiveness of drugs) ■ Prior treatment with less expensive drugs (e.g., nicotinic acid) before starting more expensive drugs (e.g., statins) (lessening cost-effectiveness of more expensive drugs) ■ Endpoints selected for cost-effectiveness analysis (e.g., morbidity reduction, life years gained, quality adjusted life years [QALY] gained)

Projections of efficacy of secondary prevention measures (to extend life) after failure of primary prevention ■ Coexisting primary and secondary prevention measures (e.g., aspirin prophylaxis) ■ Quality of life adjustments ■ Time discounting of benefits, risks and costs ■ Methods adjustments for quality of life years ■ Costs of treating new-onset CHD and sequelae ■ Projected morbidity and mortality outcomes after onset of CHD ■ Frequency and costs of physician visits for monitoring ■ Adherence/compliance characteristics of population ■ Thresholds for acceptable costs per year of life saved Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on. 2002