MEDICAL NUTRITION

THERAPY IN
CARDIOVASCULAR DISEASE
(2)

Nutrition Department
Medical Faculty
University of Methodist Indonesia
October 2010 (DKS)
HOMOCYSTEIN AND FOLIC
ACIDS
 Containing Sulphur
 Independent risk factor for CHD
 Methionine
 Suplement B, replace fat intake with
fruits and vegetables, and folic
supplementation lowered
homocystein
Tipe Rentangan Keterangan
mol/L
Rentangan risiko tinggi > 30 Berhubungan dengan defisiensi nutrisi
atau defek metabolisme homosistein

Rentangan risiko 12-30

menengah
Diperuntukkan bagi dewasa sehat,
Rentangan normal terkini 6-12 peningkatan homosistein sesuai umur
dan paska menopause

Rentangan normal Rentangan pada berbagai literatur

5-15
Kadar target Risiko minimal terjadinya PKV
<9
Kadar optimal Risiko terendah terjadinya PKV
<7
 CALCIUM
 Supplementation 
decreased LDL cholesterol
4.4% and increase HDL
cholesterol 4.1%
 Besides prevent
osteoporosis, lipid
lowering benefit
SOY PROTEIN

 Lowered total
cholesterol 9%, LDL
13%, and
triglycerides 11%
 Isoflavon 4-8%
hypercholesterolemi
a person
 POTASSIUM

 K+
 The major kation in intracelluler
 3.5-5 mEg/L
 Requirement 1600-2000 mg  to
prevent hypertension
 Defficiency potassium: rare
 Potassium
Bahan Makanan Mg
Kacang kedelai 1504
Kacang merah 1151
Kacang hijau 1132
Durian 601
Kelapa 555
Jambu monyet 420
Kacang tanah 421
Kentang 396
Singkong 395
Pisang 435
SODIUM

 Na+
 Major kation
intracelluler
 Increasing Na in diet:
oedema,
hypertension, and
osteoporosis
 ‘Fast Food’>>
 Sodium
Bahan Makanan Mg
Margarin 950
Teri kering 885
Mentega 780
Ragi 610
Roti putih 530
Roti coklat 500
Ginjal sapi 200
Hati sapi 110
Telur bebek 191
Telur ayam 158
 Sodium and potassium

Umur Berat badan (kg) Natrium (mg) Kalium (mg)

Bulan:
0-5 4,5 120 500
6-11 8,9 200 700
Tahun:
1 11,0 225 1000
2-5 16,0 300 1400
6-9 25,0 400 1600
10-18 50,0 500 2000
> 18 70,0 500 2000
OMEGA-3 FATTY ACIDS

 PUFA
 Alpha linoleic acids
 EPA
 DHA
 0,65-1.2 g per day
 Consuming 2-3
times fish
containing oil  1 g
per day
 Omega-3
Bahan makanan sumber Jumlah untuk memperoleh 1
gram omega-3 (EPA dan
DHA)
Ikan Herring 1,5 ounce
Ikan Salmon 2 ounce
Tiram 2,5 ounce
Ikan Trout 3,5 ounce
Ikan Tuna 4 ounce
Kepiting 9 ounce
Udang 11 ounce
Ikan Cod 12,5 ounce
PHYTOSTEROL/
STANOL
 Main sterol in plant
 Likely cholesterol different biological functions
 2-3 g per day  lowered cholesterol 9-20%
 Inhibit exogenous and endogenous cholesterol
 NCEP ATP III  2 grams per day
 Phytosterol sources
Bahan makanan sumber Kandungan sterol (mg) per 100
g bahan makanan sumber
Minyak bekatul 1.190
Minyak jagung 968
Biji wijen 714
Minyak safflower 444
Minyak biji kedelai 250
Minyak zaitun 221
Kacang 220
Jagung 178
Gandum 60 - 69
Minyak sawit 49 - 61
Oat bran 46
Bunga kol 40
Brokoli 39
Pisang 16
Wortel 12
Tomat 7
FAST FOOD
 Term fast food: 19 th
century start
industrial age
 High calories, high fat,
high sodium CHD
risk >>
 Characteristic:
– Require little time
– Very limited
– Finger food
– Silverware and plates
disposable
 Bad food or good
food?

 Cause obesity and

overweight CHD
risk
 Malnutrition and CHD

 Over weight and obesity cause CHD

 Under weight : malnutrition and
inflammation CHD
 Lowered albumin and BMI
inflammation CRP raised HDL
decreased easily oxidised LDL
Malnutrition-inflammation
Lipid accumulation