Aspectos Gerais 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

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

Chylomicron Triglycerides 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 8

Agregação das plaquetas Placa de Ateroma Acumulo de lipídios modificados Ativação das células endoteliais Migração das células inflamatórias Ativação das células inflamatórias Recrutamento das células musculares lisas Proliferação e síntese da matriz Formação da capa fibrosa Ruptura da placa Agregação das plaquetas 9 Trombose

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) â endothelial synthesis of PGI2 (prostacylcin), & NO (nitric oxide) PGI2 = vasodilator, âplatelet adhesion/aggregation NO = vasodilator, âplatelet & WBC (monocyte) adhesion á 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 Fasting Blood Level Ideal, Healthy Level Total Cholesterol < 200 mg/dl LDL-Cholesterol < 100 mg/dl HDL-Cholesterol ≥ 60 mg/dl Triglycerides < 150 mg/dl

Know Your Diabetes, Metabolic Risk Fasting Healthy Pre-Diabetes Diabetes (Metabolic Syndrome) 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/dl M < 40 mg/dl F < 50 mg/dl Typically low

The Metabolic Syndrome Abdominal Obesity Men Women > 40 inch waist > 35 inch waist Triglycerides ≥ 150 mg/dL HDL cholesterol < 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 15

Plasma HDL-cholesterol in groups differing in level of habitual activity 16

4 VEZES NA SEMANA É MAIS EFETIVO DO QUE 3 VEZES NA COMBINAÇÃO DE ALTO VOLUME E ALTA INTENSIDADE MOSTRA MAIOR EFEITO SOBRE O PERFIL LIPIDICO

EXERCÍCIOS AERÓBICOS 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. (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

EXERCÍCIOS DE RESISTÊNCIA MUSCULAR 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. 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).

ASSOCIAÇÃO DO EXERCÍCIO DE PERDA DE PESO CONTRIBUI MAIS COM O HDL Há efeitos agudos do exercício: 24 a 48 horas depois LDL ASSOCIAÇÃO DO EXERCÍCIO DE PERDA DE PESO CONTRIBUI MAIS COM O CONTROLE LIPÍDICO

MECANISMOS PELO QUAL O EXERCÍCIO CONTRIBUI