lipídeos:lipídeos: –Ácidos graxos cadeias saturadas, mono ou poliinsaturadas –triglicerídeos...

• Lipídeos:Lipídeos:

– Ácidos graxos• Cadeias saturadas, mono ou poliinsaturadas

– Triglicerídeos• Forma de armazenamento

– Fosfolipídios• Constituintes estruturais de membrana

– Colesterol• Precursor de hormônios esteróides, ácidos biliares,

vitamina D, constituinte de membrana

Aspectos Gerais

FUNÇÕES DOS LIPÍDIOS

FONTE DE ENERGIA ISOLANTE TÉRMICO FUNÇÃO HORMONAL PROTEÇÃO MECÂNICA FUNÇÃO ESTRUTURAL LUBRIFICANTE FUNÇÃO IMPERMEABILIZANTE

Lipoproteins• Function: Transport of fat soluble substances

• Types: 1) Chylomicron

2) VLDL

3) LDL

4) HDL

ChylomicronTriglycerides

3 Fatty Acids Glycerol

Adipose Skeletal Heart Blood(storage) Muscle (energy)

(energy) Liver

Chylomicron Remnant

Liver

VLDL• = Very Low Density Lipoprotein• Made in: the liver from excess dietary carbohydrate

and protein along with the Chylomicron remnant• Secreted into: the bloodstream• Rich in: TGs• Function: Deliver TGs to body cells• Contains apo B100• Similar to Chylomicrons, but made by different tissues

LDL

• = Low Density Lipoprotein• Made in: the Liver as VLDL• Arise from: VLDL once it has lost a lot of its TG’s• Secreted into: the bloodstream• Rich in: Cholesterol• Function: Deliver cholesterol to all body cells

HDL

• = High Density Lipoprotein• Made in: the Liver and Small Intestine• Secreted into: the bloodstream• Function: Pick up cholesterol from body cells

and take it back to the liver = “reverse cholesterol transport”

• Potential to help reverse heart disease

Composition of the four major lipoprotein classes

9

Placa de AteromaAcumulo de lipídios modificados

Ativação das células endoteliais

Ativação das células inflamatórias

Proliferação e síntese da matriz

Formação da capa fibrosa

Ruptura da placa

Agregação das plaquetas

Trombose

Migração das células inflamatórias

Recrutamento das células musculares lisas

Cardiovascular Disease (CVD)• Main type of CVD is Atherosclerosis (AS)• Endothelial dysfunction is one of earliest

changes in AS• Mechanical, chemical, inflammatory mediators

can trigger endothelial dysfunction:– High blood pressure – Smoking (free radicals that oxidatively damage

endothelium)– Elevated homocysteine– Inflammatory stimuli– Hyperlipidemia

Endothelial Dysfunction( endothelial activation, impaired endothelial-dependent

vasodilation)

• endothelial synthesis of PGI2 (prostacylcin), & NO (nitric oxide)– PGI2 = vasodilator, platelet adhesion/aggregation– NO = vasodilator, platelet & WBC (monocyte) adhesion

• Adhesion of monocytes onto endothelium --> transmigration into subendothelial space (artery wall) --> change to macrophages

• Endothelial dysfunction --> increased flux of LDL into artery wall

Know Your Lipid Profile

Total Cholesterol < 200 mg/dl

LDL-Cholesterol < 100 mg/dl

HDL-Cholesterol ≥ 60 mg/dl

Triglycerides < 150 mg/dl

Fasting Blood Level Ideal, Healthy Level

Know Your Diabetes, Metabolic Risk

Blood Glucose < 110 mg/dl 110-125 mg/dl ≥ 126 mg/dl

2 hr GTT < 140 mg/dl 140-200 mg/dl > 200 mg/dl

Triglyceride < 150 mg/dl > 150 mg/dl Typically elevated

HDL ≥ 60 mg/dlM < 40 mg/dlF < 50 mg/dl

Typically low

Fasting Healthy Pre-Diabetes Diabetes (Metabolic Syndrome)

The Metabolic Syndrome

Abdominal Obesity Men Women

> 40 inch waist> 35 inch waist

Triglycerides ≥ 150 mg/dL

HDL cholesterol Men Women

< 40 mg/dL< 50 mg/dL

Blood Pressure ≥ 130/ 85 mm Hg

Fasting Blood Glucose 110-125 mg/dL

Prevalence of major risk factors in Great Britain/England

Plasma HDL-cholesterol in groups differing in level of habitual activity

4 VEZES NA SEMANA É MAIS EFETIVO DO QUE 3 VEZES NA SEMANA

COMBINAÇÃO DE ALTO VOLUME E ALTA INTENSIDADEMOSTRA MAIOR EFEITO SOBRE O PERFIL LIPIDICO

(at 60 % VO2max) or a high-intensity exercise group (at 80 % VO2max). Both exercising groups completed three 400 kcal sessions weekly for 24 weeks. By setting the session volume in calories, the overall training volume was controlled. Participants were instructed to maintain their dietary habits. It was reported that significant lipid profile improvements occurred only in the high-intensity group, with significant decreases (p\0.05) in total cholesterol (from 6.02 to 5.48 mmol/L), LDL cholesterol (from 4.04 to 3.52 mmol/L) and non-HDL cholesterol (from 4.58 to 4.04 mmol/L). The evidence suggests that a

O’Donovan G, Owen A, Bird S, et al.

Changes in cardiorespiratory fitness and coronary heart disease risk factors following 24 wk of moderate- or high-intensity exercise of equal energy cost. J Appl Physiol. 2005;98(5):1619–25.

EXERCÍCIOS AERÓBICOS

Triglyceride clearance at 72 h was significantly (p\0.05) greater following 50 % 1 RM (-14.6 mg/dL) and 75 % 1 RM (-10.7 mg/dL) than following 90 % 1 RM (?9.5 mg/dL) and 110 % 1 RM (?12.1 mg/dL). Further, increases in HDL cholesterol were significantly greater following 50 % 1 RM and 75 % 1 RM than following 110 % 1 RM (p = 0.004 and 0.03, respectively).

Lira F, Yamashita A, Uchida M, et al. Low and moderate, rather than high intensity strength exercise induces benefit regarding plasma lipid profile. Diabetol Metab Syndr. 2010;2:31.

EXERCÍCIOS DE RESISTÊNCIA MUSCULAR

Há efeitos agudos do exercício: 24 a 48 horas depois LDL HDL

ASSOCIAÇÃO DO EXERCÍCIO DE PERDA DE PESO CONTRIBUI MAIS COM O

CONTROLE LIPÍDICO

MECANISMOS PELO QUAL O EXERCÍCIO CONTRIBUI