Dietary Pattern among Hypercholesterolemia Patients with Cholesterol-Lowering Medication: The Adventist Health Study-2

By

[Name of the Author]

[Name of the Faculty]

[Department Name]

ACKNOWLEDGEMENT

I would like to take this chance for thanking my research facilitator, friends and family for the support they provided me and their belief in me, as well as the guidance that they provided me, without which I would have never been able to do this research. I would also like to express my gratitude for all my acquaintances at the Adventist Health Study-2 who have extended all their help in execution of this study. In the last, my special thanks to Mr. Vichuda L Matthews, Mr. Synnove F. Knutsen and Mr. Larry Beeson who have been provided my all the support during the course of this research project.

DECLARATION

I, (Your name), would like to declare that all contents included in this proposal stand for my individual work without any aid, and this proposal has not been submitted for any examination at academic as well as professional level, previously. It is also representing my very own views and not essentially those that are associated with university or Adventist Health Study-2.

Signed __________________ Date _________________

TABLE OF CONTENTS

ACKNOWLEDGEMENTii

DECLARATIONiii

TABLE OF CONTENTSiv

Chapter 1: Introduction1

Background of the Study1

Purpose of the Study2

Rationale of the Study2

Chapter 2: Literature Review4

Hypothetical Causes of Elevated Cholesterol (Research based evidence)4

Endothelial dysfunction4

LDL Oxidation and Oxidative Stress4

C-reactive protein, Lipoprotein A, inflammation and their effects on heart disease5

Homocystiene and its effect6

Other contri, buting factors7

Dietary Supplements and Hypercholesterolemia10

Omega-3 Fatty Acids10

Soy10

Red Yeast Rice11

Guggulipid12

Policosanol12

Garlic12

Plant Sterols13

Margarines13

Hypercholesterolemia and Treatment14

Lifestyle Modification14

Pharmacologic Therapy16

Nonstatin Therapy16

Statins16

Specific populations18

Chapter 3: Methodology22

Study population22

Adventist Health Studies22

Food Frequency Questionnaire (FFQ)23

Lifestyle Questionnaire23

Statistical Analysis24

Chapter 4: Results & Analysis25

Chapter 5: Discussion29

Chapter 6: Conclusion And Recommendation33

References34

Appendix39

Food Frequency Questionnaire44

Lifestyle Questionnaire45

CHAPTER 1: INTRODUCTION

Background of the Study

Coronary heart disease (CHD) is a most important cause of death as well as disability in developed nations. Even though, studies show a decline in mortailty rates caused by Coronary heart disease over the last 4 decades in USA, CHD continues to be primary reason for about 1/3 of all demises among individuals aged above 35 years (Rosamond et al, 2008; Lloyd-Jones, 2010). Nearly, fifty percent of all men in middle-aged group and thirthy three percent of all women in the same age group in USA will develop some demonstration of coronary heart disease (Lloyd-Jones et al, 1999).

Population-based epidemiologic data, for instance contri, bution made by Framingham Heart Study (in this context), offer the paramount risk appraisal of all factors that contri, bute to the expansion of CHD and to the way it develops, grows, and ceases since these data are less hampered by the inevitable selection bias of data gathered in clinical trials. Additionally, epidemiologic data offer vital information about the objectives for the prevention of CHD in subjects.

Coronary Heart Disease continued to be a main reason of untimely deaths regardless of the diminishing coronary heart disease (CHD) mortality rate, and inflicts high personal, social as well as economic costs. Blood cholesterol is a significant risk factor for heart disease patients. If we compare the statistics of US with countries ...