and Alternative Therapies Modulating Cardiometabolic Syndrome Risk Factors
V. Juturu, PhD, FACN
This manual (203 pgs) will enable you to:
- evaluate the role of risk factors in contributing to cardiovascular
- assess the associated complications of cardiometabolic syndrome
- explain lifestyle modifications as first-line therapy for CMS
- apply complementary and alternative therapy options to manage CMS
- discuss the effects of herbs containing stimulants on CMS risk factors
- evaluate adverse effects of complementary and alternative therapies
- recommend dietary supplements to manage CMS risk factors
- assess complementary therapies for CMS and its adverse effects in
health and disease
- discuss recommendations for bioactive food components for CMS
- recognize interactions of alternative therapies and cardiovascular
- utilize cardiovascular disease risk assessment methods
- implement American Heart Association Evidence Based Guidelines and
quality health care improvement and risk reduction strategies
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For RDs & DTRs: Suggested Learning Need Codes for the Prof. Dev.
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and Alternative Therapies
Modulating Cardiometabolic Syndrome Risk Factors
V. Juturu, PhD, FACN
© 2008 Wolf Rinke Associates, Inc. All rights reserved for this
self-directed accredited learning program. Reproduction in whole or
part without written permission, except for brief excerpts, is prohibited.
Beverly Kapple: "Quick, easy, geared to adult education &
Nancy Dell-Cannata "Up to date, interesting topic."
OVERVIEW AND INTRODUCTION
Welcome to Complementary and Alternative Therapies Modulating Cardiometabolic
Syndrome Risk Factors, a self-directed, accredited learning program.
When selecting complementary and alternative therapies, the nutrition
professional needs to evaluate all the possible options. Herbal remedies,
vitamins and minerals are each considered dietary supplements by the
FDA, they do not have the same rigorous testing and labeling process
as over-the-counter and prescription medications. Some of these substances,
including products labeled as "natural," a term with no government
approved definition, have drug-like effects that can be dangerous. Certain
vitamins and minerals can cause problems when taken in excessive amounts.
While some changes to federal labeling guidelines have helped protect
consumers by requiring manufacturers to evaluate the identity, purity,
strength, and composition of dietary supplements. healthcare providers
still need to carefully investigate potential benefits and side effects
before making recommendations to their patients.
This self-directed, accredited learning program will provide you with
detailed information that will enable you to evaluate the beneficial
effects and safety of complementary and alternative medicine (CAM) therapy
to reduce cardiometabolic syndrome (CMS) risk factors including:
Evaluating and assessing the modifiable and non-modifiable risk factors
Assessing the possible complications of CMS.
Evaluating the beneficial and safety effects of complementary therapies.
Planning, recommending and implementing CAM therapy to reduce risk factors
of CMS along with lifestyle modifications to maintain quality health
This learning program is designed to help you earn 16 continuing professional
education units (CPEUs). It is a category 2 Continuing Professional
Education (CPE) program, meaning that the reader has general knowledge
of the literature and professional experience within the area covered.
The focus of the program is to enhance knowledge and application.
To get the most out of this program, it is suggested that you follow
these four steps:
Step 1: Read the material presented in each of the chapters.
Step 2: When you come to an example, stop for a moment and work out
the answers using pen and paper.
Step 3: Assess what you have learned by completing the self-assessment
instrument contained at the end of the learning program.
Step 4: Compare your answers to the answer key contained at the end
of the learning program. If you score at least 80% correct, you have
completed this program and are ready to transfer your answers to the
CONTINUING PROFESSIONAL EDUCATION REPORTING FORM. If you scored less
than 80% correct, re-read the learning program until you score at least
After you have successfully completed the program complete the CPE CONTINUING
PROFESSIONAL EDUCATION REPORTING FORM and
Mail to: Wolf Rinke Associates, Inc., 13621 Gilbride Lane, Clarksville, MD
Or Fax to: (410) 531-9282,
Or submit On-line at www.easyCPEcredits.com
Once we receive your successfully completed CONTINUING PROFESSIONAL
EDUCATION REPORTING FORM we will send you a certificate of completion.
Vijaya Juturu., Ph.D., F.A.C.N.
GOAL AND OBJECTIVES
To provide you with practical information that will enable you to apply
complementary and alternative therapy options to manage cardiometabolic
syndrome modifiable risk factors.
Upon the completion of this accredited, self-directed learning program
you should be able to:
- Evaluate the role of risk factors in contributing to cardiovascular
- Assess the associated complications of cardiometabolic syndrome.
- Explain the importance of lifestyle modifications as first-line
therapy for cardiometabolic syndrome.
- Apply complementary and alternative therapy options to manage cardiometabolic
syndrome modifiable risk factors.
- Discuss the effects of herbs containing stimulants on cardiometabolic
- Evaluate potential adverse effects of complementary and alternative
- Recommend dietary supplements to manage cardiometabolic risk factors.
- Assess complementary therapies for cardiometabolic syndrome and
its adverse effects in health and disease.
- Discuss recommendations for bioactive food components for cardiometabolic
syndrome and its risk factors.
- Recognize potential interactions of alternative therapies and cardiovascular
- Utilize Cardiovascular Disease risk assessment methods.
- Implement American Heart Association Evidence Based Guidelines and
quality health care improvement and risk reduction strategies.
TABLE OF CONTENTS
Chapter I: Cardiometabolic Syndrome 1
Prevalence of Cardiometabolic Syndrome 2
Chapter II: Cardiometabolic Syndrome Risk Factors 5
Non-Modifiable Risk Factors 5
Family History 9
Modifiable Risk Factors 10
Body Mass Index 10
Intra Abdominal Obesity 12
Lipids and Lipoproteins 16
LDL Oxidation 17
Type 1 Diabetes Mellitus 22
Type 2 Diabetes Mellitus 22
Gestational Diabetes Mellitus 23
Other Specific Types of Diabetes 24
Polycystic Ovary Syndrome 25
Childhood Obesity 26
Adult Obesity/Abdominal Obesity 32
Blood Pressure 33
Vascular Endothelial Function 36
Coronary Circulation 37
Peripheral Circulation 37
C-Reactive Protein 38
Chapter III: Cardiometabolic Syndrome Associated Complications 43
Heart Rate Abnormalities 43
Hemostatic and Inflammatory Markers 43
von Willebrand Factor Antigen 45
Tissue Plasminogen Activator 46
Plasminogen activator inhibitor-1 46
Factor VII 48
Chapter IV: Complementary and Alternative Therapies 55
Whole Medical Systems 55
Homeopathic Medicine 57
Crataegus and Pumpan (Hawthorn) 57
Naturopathic Medicine 58
Traditional Chinese Medicine 58
Ayurvedic Medicine 61
Mind-Body Medicine 63
Transcendental Meditation 65
Tai Chi 68
Bioenergetics (Energy Medicine) 70
Biofield Therapies 73
Qi Gong 73
Healing and Therapeutic Touch 74
Distance Healing 74
Applied Kinesiology 75
Vibrational Medicine 77
Manipulative and Body Based Therapies 78
Osteopathic Manipulation 80
Biologically Based Medicines 80
Omega-3 Fatty Acids/Fish Oils 80
Plant Sterols and Stanols, Soy Protein and Isoflavones 88
Herbal Nutrients 98
Hawthorn Berry Fruit Extract 103
Gymnema Sylvestre 106
Gotu Kola 107
Dietary Supplements 108
Vitamin E 111
Other Plants 113
Weight Control Substances 113
Polyphenols and Dietary flavonoids 114
Coenzyme Q 10 115
Chapter V: Cardiovascular Disease Risk Assessment 117
Framingham Risk Score Assessment Tool 117
The Reynolds Risk Score 121
Chapter VI: AHA Evidence-Based Guidelines 125
Quality Health Care: CMS Improvement and Risk Reduction in Men and
For Your Continued Learning 153
List of Abbreviations 159
Self-Assessment Questions 173
Answer Key 195
Explanation of Answers 197
About The Author 205
About Wolf Rinke Associates, Inc 207
ABOUT THE AUTHOR
Dr. Vijaya Juturu is currently working as Director of Scientific Affairs
at Nutrition 21, Inc. in Purchase, NY. Dr. Juturu has a Doctoral degree
in Clinical Nutrition (Cardiovascular Nutrition) from S.V. University
in India (1996) and completed her Post Doctoral Research in Cardiovascular
Nutrition at Penn State University (1997-2000). Her main research interests
include cardiometabolic syndrome, diabetes, obesity, coronary heart
disease, phytoestrogens, functional foods, cardiovascular physiology,
lipid metabolism, insulin signaling transduction, vascular biology and
nutraceuticals. She is the recipient of the 2008 Dr. Mark Bieber Award
from the American College of Nutrition-a distinguished award given for
accomplishments in nutrition; the 2008 Dr. Tinsley R. Harrison Award
from The Society of Clinical Investigation (SSCI) and the American Journal
of Medical Sciences; the Young Scientist Award given by the Indian Society
of Atherosclerosis Research in 1995; and the Indian Medical Scientist
Award in Nutritional Sciences, given by the Indian Council of Medical
Research in 1997. She received the Diabetes Education Stipend Award
in 2005 and the Diabetes Care Education and Professional Excellance
Award in 2007 from the Nutrition in Complementary Care DPGs of the American
Dietetic Association (ADA). She is the author of several publications
including patents, book chapters, and submissions of qualified health
claims. She is an invited author, reviewer and editorial board member
for several reputed journals. She was nominated as Resources and Development
Chair for the Medical Nutrition Practice Group of ADA, is working as
an EAL analyst for ADA, and is involved in a women's working group committee
of the American Diabetes Association. Dr. Juturu is a member of numerous
professional organizations including the American Diabetes Association,
AHA, American Society for Nutritional Sciences, American College of
Nutrition, and the American Oil Chemists Society. She is a consultant
of the United Soy Bean Board, and a Fellow of the American College of
Nutrition (F.A.C.N.). She resides in New York with her husband and daughter.
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