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Nutritional Guide to Lowering Cholesterol: A Comprehensive Approach to Heart Health
Elaine B. Trujillo, MS, RD

C216 12 CPEUs HARD COPY
Discontinued

(Manual, 114 pgs) It will provide you the tools to assess and counsel your heart disease patients. After applying the concepts presented in this program you will have a greater understanding of cholesterol basics, modifiable lifestyle factors that affect cardiac disease, and specific nutrients and foods which impact cardiac disease risk. You will also be able to:

  • Differentiate between the types of fatty acids in the diet and how they impact cardiovascular disease risk
  • Predict which lipid profiles are associated with cardiovascular disease
  • Formulate plans to manage hypercholesterolemia
  • Explain the rationale for diet interventions for hypertension
  • Assess risk factors and recommend treatment for metabolic syndrome

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Approved by CDR, CBDM

RDs & DTRs: Suggested Learning Need Codes for the Prof. Dev. Portfolio
2000, 2010, 2020, 2050, 2070, 2090, 3,000, 3005, 3010, 3020, 3060, 3070, 3080, 3090, 3100, 4000, 4030, 4040, 4050, 4060, 4090, 4120, 4150, 4160, 4170, 4180, 5000, 5150, 5160, 5190, 5260, 5370, 5410 5420

Nutritional Guide to Lowering Cholesterol:
A Comprehensive Approach to Heart Health

Elaine B. Trujillo, MS, RD

Copyright 2011 Wolf Rinke Associates, Inc. All rights reserved for this self-directed, accredited learning program. Reproduction in whole or part without written permission from the publisher is prohibited.

CUSTOMER COMMENTS

Lynn Hull: “Best CPE Program I have ever used. Good Length, very helpful.”

Jennifer Rosario: “Super course! I loved all the recommendations summarized from current studies. Would have liked a page of those recommendations for diet change on one page so it is easier to communicate with clients.”

Virginia Harmon: "Excellent service--fast delivery. Interesting and thorough programs."

INTRODUCTION AND INSTRUCTIONS

This self-directed learning program will provide you the tools necessary to assess and guide your heart disease patients. After reading this CPE program, you will have a greater understanding of cholesterol basics, modifiable lifestyle factors that affect cardiac disease, and specific nutrients and foods which impact cardiac disease risk.
Although the title focuses on cholesterol, there are many other factors that are involved in heart disease risk which are reviewed here. This CPE program is intended to provide the full spectrum of evidence linking diet to heart health.
This self-directed learning program is a Level 2 Continuing Professional Education (CPE) program approved for 12 Continuing Professional Education Units (CPEUs), meaning that the reader has general knowledge of the literature and professional practice within the area covered. The focus of the program is to enhance knowledge and application.
To get the most benefit from this program, I suggest that you follow these four steps:
Step 1: Review the objectives for the program.
Step 2: Study each chapter. As you read, think of patients or clients from your own practice who fit the situation described.
Step 3: Assess what you have learned by completing the self-assessment instrument at the end of this program.
Step 4: Compare your answers to the answer key that has been provided. If you score at least 80% correct, you are ready to transfer your answers to the CONTINUING PROFESSIONAL EDUCATION (CPE) REPORTING FORM. If you scored less than 80% correct, re-read this learning program until you score at least 80% correct.
After you have successfully completed the program complete the CPEU REPORTING FORM and:
Mail to: Wolf Rinke Associates, Inc., 13621 Gilbride Lane, Clarksville, MD 21029,
Or fax to: (410) 531-9282,
Or submit on-line at www.easyCPEcredits.com.
We will email your Certificate of Completion.
When you submit your CPEU Reporting Form to us via mail, fax, or www.easyCPEcredits.com, be sure to write your correct email address in the space provided on the CPE Reporting Form. If writing by hand, be sure to print your email address clearly.

To ensure that our emails are delivered to your inbox (instead of your junk/spam folders), please add cpesupport@wolfrinke.com to your Address Book or Safe List of allowed email senders. Also, be sure to allow attachments from this email address.

HAPPY LEARNING!

GOALS AND OBJECTIVES


Goals
To understand the evidence behind the nutritional guidelines for nutrition and heart disease and to provide practical information that will assist you in providing appropriate nutritional care for optimal heart health.

Objectives
As a result of studying and applying the concepts presented in this accredited, self-directed learning program, you will be able to:

  • Identify the modifiable risk factors related to cardiovascular disease
  • Differentiate between the types of fatty acids in the diet and how they impact cardiovascular disease risk
  • Translate dietary intervention trials to practical application
  • Recommend nutrients and foods which may negatively and/or positively affect cardiovascular disease risk
  • Predict which lipid profiles are associated with cardiovascular disease risk
  • Provide sound nutritional advice to individuals with high cholesterol levels
  • Formulate plans to manage hypercholesterolemia based on biomarker levels
  • Identify the causes of hypercholesterolemia
  • Explain the rationale for the diet interventions for hypertension
  • Assess risk factors and recommend potential treatment plans for metabolic syndrome.

TABLE OF CONTENTS

Introduction 1
Chapter 1: Understanding Cholesterol 3
Cholesterol Basics 3
Cholesterol Absorption and Metabolism 4

Chapter 2: Markers for CHD Risk 7
Cholesterol as a Cause of CHD 7
Cholesterol Levels 7
Lipoprotein Particle Size 9
C-Reactive Protein 9
Triglycerides 10

Chapter 3: Risk Factors for CHD 13
Dietary Cholesterol Intake 13
Metabolic Syndrome 14

Chapter 4: Cholesterol Treatment 17
Therapeutic Lifestyle Changes 17
Lipid Lowering Agents 17
Weight Loss 20

Chapter 5 Childhood Cholesterol 23

Chapter 6 Dietary Fats 27
Understanding Fats 27
Saturated Fatty Acids 27
Trans Fatty Acids 29
Conjugated Linoleic Acids 31
Monounsaturated Fatty Acids 31
Polyunsaturated Fatty Acids 32
Omega-6 Fatty Acids 32
Omega-3 Fatty Acids 35
Omega-3 and Omega-6 Fatty Acid Balance 36

Chapter 7 Selected Foods, Nutrients and Compounds:
Association to CHD Risk. 39
Omega-3 Fatty Acids and Fish Oil 39
Omega-3 Fatty Acid and Fish Intake Recommendations 42
Mercury, Polychlorinated Biphenyls (PCBs), and Dioxins in Fish 45
Meats 47
Grass-Fed versus Grain-Fed Beef 48
Oats and Whole Grains 48
Plant Sterols, Stanols, and Stanol Esters 49
Nuts and Seeds 49
Soy 51
Eggs 53
Coffee and Tea 55
Coffee 55
Green and Black Tea 57
Red Wine and Resveratrol 58
Chocolate 59
Vitamins, Minerals, Antioxidants and Heart Health 59
Sodium and Salt 61
Combination Diets 62
DASH Diet 62
Portfolio Diet 64

References 67
List of Abbreviations 83
Glossary 85
For Your Continuing Learning 95
Resources 95
Self-Assessment Questions 97
Answer Key 107
Explanations to Questions 109
About the Author 113
About Wolf Rinke Associates, Inc 114

Tables

Table 1. Cholesterol Levels and Risk Categories 8
Table 2. Classification of Serum Triglyceride Levels 11
Table 3. Cholesterol Content of Selected Foods 14
Table 4. Clinical Identification of the Metabolic Syndrome 15
Table 5. Risk Categories, LDL Cholesterol Goals, and Therapy 18
Table 6. Cholesterol Guidelines for Children and Adolescents 2 to 19 Years Old 23
Table 7. Levels of Omega-3 Fatty Acids in Commonly Consumed Fish and Shellfish.43
Table 8. Omega-3 Fatty Acid and Fish Recommendations from Selected Organizations 44
Table 9. Classification of Blood Pressure 61

ABOUT THE AUTHOR

Elaine B. Trujillo, M.S., R.D., is a national leader in nutrition. Currently, she is a Nutritionist with the National Cancer Institute, National Institute of Health. For ten years, she was a Senior Clinical and Research Dietitian, Brigham and Women's Hospital, Harvard Medical School in Boston where she led patient investigation in metabolic and nutrition research. Ms. Trujillo holds a Bachelor of Science degree in Nutritional Science with a minor in Biology from the University of Delaware. At Texas Woman's University, she earned a Master of Science degree and completed a Dietetic Internship. Ms. Trujillo has published numerous scientific journal articles, book chapters and abstracts. In 2007, she was awarded the Huddleson Award by the American Dietetic Association for her article, Nutrigenomics, Proteomics, Metabolomics, and the Practice of Dietetics (J Am Diet Assoc 2006;106:403). She is the co-author of a nutrition cookbook, Eating for Lower Cholesterol: A Balanced Approach to Heart Health with Recipes Everyone will Love, Da Capo Press, 2005 and a textbook, Nutritional Support in the Care of the Critically Ill, 2nd Edition, Wolf Rinke Associates, Inc., 2007. She is a wife and a mother of two teenage children.

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