Question

Rafael’s father died of a heart attack at age 50. Rafael is worried about his own heart disease risk, so he makes an appointment with the physician. He fills out a questionnaire about his medical history, lifestyle and meets with a dietitian to evaluate his diet and has blood drawn for cholesterol analysis. The table below summarizes factors that may affect Rafael’s risk of developing heart disease:

Sex Male

Age 35

Family history Father had a heart attack at 50

Height/weight 5’8”/160lbs

Blood pressure 120/70

Stress level Moderate

Smoker Yes

Activity level Inactive

Blood values

Total cholesterol 210mg/100ml

HDL cholesterol 50mgs/100ml

Typical daily intake from 3-day food record

Percentage energy from fat 39, Percentage energy from saturated fat 17 ,Percentage energy from polyunsaturated fat 7, Cholesterol (mg) 350

Servings from food guide pyramid

Bread, cereal, pasta group 11

Vegetable 2 Fruit 1

Milk, yoghurt, cheese 2 Meat, egg, poultry, beans, nuts, fish 4

QUESTION : If Rafael were to replace all of the added fat in his diet with olive oil, would he reduce his risk of cardiovascular disease to the level found in Mediterranean countries? Why or why not?

Answer 1

Rafael's father had died of heart attack at the age of 50. The risk of Rafael developing cardiovascular disease is high as there is genetic predisposition . Genetic factors comes under non modifiable risk factors. You cannot change it but however you have to focus on modifiable risk factors thereby reducing the chances of heart diseases at young age.

When you look into the history, his age is 35. He is young and therefore he should start his lifestyle modifications at this stage itself.

By his height and weight - BMI is 24 which is normal range.

Blood pressure is in normal range.

He smokes which has to be cut down as smoking is major factor for atherosclerosis as nicotine causes hardening of arteries.

He leads a inactive lifestyle - Again sedentary lifestyle comes under modifiable risk factor and should include any physical activity of his choice like walking, jogging, swimming, playing outdoor games. This also helps in managing stress levels.

His cholesterol levels is on higher side with 210 mg/dl. and his diet consists of Meat , poultry and large amounts of dairy products like cheese. He should cut down the fats . Medditterian diet which includes lot of fresh fruits and vegetables, use of olive oil , seafood, red meat occasionally helps Rafael to lower his cholesterol levels which is good for cardiovascular health. This , to some extent can prevent heart diseases but not to the level found in Medditerean countries as Rafael as family history.  

Thank you..