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Interpretation and Application of Advanced Cardiometabolic Testing
Mary McNeill, MS, RDN/LD, CDE, MBA

18 CPEUs
18 CPEUs

Course Expires: 5/31/2023

Manual with 1 Reporting Form, 133 pgs.
As leaders in the fight for improved health and prevention of disease, it is important for nutrition professionals to be up-to-date on the management of cardiometabolic disease biomarkers. This cutting edge CPE program will enable you to:

  • Interpret advanced cardiometabolic laboratory markers and apply it to MNT and lifestyle counseling.
  • Evaluate the role of lipoproteins and lipids in the pathogenesis of atherosclerotic and cardiometabolic disease.
  • Evaluate the hereditary predisposition as reflected in the genetic polymorphism markers for cardiometabolic disease and identify those at risk.
  • Explain the interplay of secondary causes of dyslipidemia  and their impact upon cardiometabolic risk.
  • Recommend nutrient modifications and assess their contribution to risk reduction for cardiometabolic disease.

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Approved/Accepted by CDR, NCBDE

For RDs/RDNs & DTRs/NDTRs for the Professional Development Portfolio

SUGGESTED Performance Indicators (PIs):
8.1.1, 8.1.2, 8.1.3, 8.1.4, 8.1.5, 8.3.1, 8.3.5, 8.3.6, 10.1.1, 10.1.2, 10.1.3, 10.2.1,10.2.2, 10.2.3, 10.2.4, 10.2.5, 10.2.6, 10.2.7, 10.2.8, 10.2.9, 10.2.10, 10.4.2, 10.4.3, 10.4.4, 12.4.6

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Interpretation and Application of Advanced Cardiometabolic Testing
Mary McNeill, MS, RDN/LD, CDE, MBA

Copyright 2016 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.


Julie Echols: "A very good review of the physiology of lipid formation and effects on body."

Andrea Young: "I loved this course. It was hard because I was not familiar with the advanced testing values. It took me 2 tries to pass the test. The information was valuable and I loved the case study format."

Stephanie Frantz: "More intense than I realized, liked the case studies. Very thankful for the explanation to the test questions. Helped me retain the info overall."

Donna McNeill: "Extremely complex material that I can use as a reference. This course should be at least 25 hours of credit."

Cholesterol has been maligned as a significant contributor to heart disease–the major cause of mortality in the United States. But is it that simple? In one study, half of all individuals who were admitted to the hospital for a heart attack had normal total serum cholesterol levels. One third of the participants in the same study had normal low-density lipoprotein cholesterol (LDL-C) levels. This suggests that there is something we are missing in assuming cholesterol is the driving force for heart attacks. Many other conditions influence the likelihood of cardiovascular disease. By understanding and acting upon risk factors, including smoking, elevated LDL-C levels, hypertension, diabetes, abdominal obesity, stress, low intake of fruit and vegetables and sedentary lifestyle, we can reduce the risk. Acting upon these risk factors does not, however, reduce the risk as completely as we would like. Advanced cardiometabolic testing is becoming the standard of care. Organizations such as the American Diabetes Association, in conjunction with the American College of Cardiology released a consensus statement recommending laboratory testing such as apolipoprotein-B (APO-B) or low-density lipoprotein particle (LDL-P) count to assess the residual risk of heart disease which is not evident by results of the traditional lipid panel. These advanced biomarkers indicate the number of LDL particles that carry cholesterol and other fats to the tissues or the size of the LDL particles.
Advanced cardiometabolic testing will have a major impact on nutritional professionals as Medical Nutrition Therapy (MNT) is, and will continue to be, an important part of the prevention and treatment for cardiometabolic disease. Increased testing will likely mean an increase in the number of individuals who will be referred for MNT. As leaders in the fight for improved health and prevention of disease, it is important for nutritional professionals to be up-to-date on the management of cardiometabolic disease biomarkers.

This self-directed learning program is a Level 2 Continuing Professional Education (CPE) program approved for 18 Continuing Professional Education Units (CPEUs). That means 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, we suggest you adhere to the following four steps:
Step 1: Review the objectives for the CPE program.
Step 2: Study each chapter. As you read, think of patients 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 CPE program.
Step 4: Compare your answers with the answer key that has been provided. If you score at least 80% correct (40 questions), transfer your answers to the Continuing Professional Education Reporting Form. If you scored less than 80% correct, re-read this CPE program until you are able to score at least 80% correct.
After you have successfully completed the program, complete the CPE REPORTING FORM and:
Submit on-line at www.easyCPEcredits.com,
Or fax to: (410) 531-9282,
Or mail to: Wolf Rinke Associates, 3801 Schuylkill Road, Spring City, PA 19475.

We will email your Certificate of Completion.

When you submit your CPE Reporting Form to us via www.easyCPEcredits.com, fax, or mail 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.

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

  • Interpret advanced cardiometabolic laboratory markers and apply this knowledge in MNT and lifestyle counseling to reduce risk of atherosclerosis and cardiometabolic disease.
  • Evaluate lipoproteins, factors that influence their synthesis, effectiveness and clearance, and their role in the pathogenesis of atherosclerotic disease.
  • Explain the role of lipids (cholesterol, phospholipids, triglycerides, and fat soluble vitamins) in the body, as well as their role in cardiometabolic disease.
  • Evaluate the hereditary predisposition as reflected in the genetic polymorphism markers for cardiometabolic disease and identify those at risk.
  • Explain the interplay of secondary causes of dyslipidemia (diabetes, renal disease, hepatic disease, thyroid disease) and the impact of these conditions upon cardiometabolic risk.
  • Interpret the expected outcomes from implementation of MNT and other lifestyle factors.
  • Recommend nutrient modifications, e.g. omega fatty acids and vitamins, and assess their contribution to risk reduction for cardiometabolic disease.

CHAPTER 1: Introduction
CHAPTER 2: Traditional Lipid Biomarkers
Total Cholesterol (TC)
Absorption vs. Synthesis
Low Density Lipoprotein (LDL)
High Density Lipoprotein (HDL)
Triglycerides (TG)
CHAPTER 3: Traditional Ratios That Predict Atherosclerotic Risk
Non-HDL-Cholesterol (NonHDL-C)
TC/HDL-C Ratio
CHAPTER 4: Lipoprotein Metabolism
Physiology of Lipoprotein Metabolism
Absorption and Synthesis
Exogenous Cholesterol Absorption and Lipoprotein Synthesis
Endogenous Lipoprotein Synthesis
Formation of VLDL, IDL and LDL
Formation of HDL
Action and Clearance
Atherogenic Potential
CHAPTER 5: Advanced Lipoprotein Testing
LDL Particle Properties
Apolipoprotein-B (Apo-B)
Low Density Lipoprotein–Particle Count (LDL-P)
Small Dense LDL (sdLDL)
Lipoprotein (a) [Lp(a)]
HDL Particle Properties
CHAPTER 6: Evaluating the Primary Causes of Dyslipidemia: Genetics
Familial Hypercholesterolemia (FH)

Other Genetic Predispositions To CVD
Apolipoprotein–E (APOE)
Genetic Predisposition to Thrombophilia
Factor V Leiden
Prothrombin Mutation
MTHFR 677 and MTHFR 1298
CHAPTER 7: Evaluating the Secondary Causes of Dyslipidemia: Acquired or Co-existing Thyroid, Insulin Resistance/Diabetes, Liver or Kidney Disease
Thyroid Dysfunction
Type 2 Diabetes
Hepatic Dysfunction
Renal Dysfunction
Other Acquired Conditions that Affect Lipids: HIV on HAART (Human Immunodeficiency Virus on Highly Active Anti-Retroviral Therapy)
CHAPTER 8: Inflammation
Measuring Systemic Inflammation
Role of Inflammation in Cardiometabolic Disease
Measuring Vascular Inflammation
The Importance of Dietary Choices in Inflammation
CHAPTER 9: The Role of Omega Fatty Acids
Omega-3 Fatty Acids
Omega-6 Fatty Acids
AA:EPA or EPA:AA Ratio
Other Omega Fatty Acids
CHAPTER 10: Special Circumstances
Weight Changes
CHAPTER 11: Wrapping it all Up

Mary McNeill MS, RDN/LD, CDE, MBA is dedicated to improving health for everyone along the healthcare continuum. As a Registered Dietitian/Nutritionist and Certified Diabetes Educator, she has seen the devastating impact disease has upon health, emotions, mental and spiritual health, as well as interpersonal relationships.
Mary has over 35 years of experience in dietetics and diabetes, in private practice, hospitals, physician clinics as well as the corporate world with wellness programs broadcast to multiple locations. She volunteers for the Dallas-Fort Worth Business Group on Health, and has developed and taught "Road Trip! A Journey to a Healthier You," an award-winning program. She works in advanced laboratory testing, teaching patients and providers about the laboratory values.

Wolf J. Rinke, PhD, RDN, CSP is the president and founder of Wolf Rinke Associates, Inc., a company that has provided high quality CPE programs to nutrition professionals since 1990.
He earned a BS dgreee at Drexel University, a MS at Iowa State University, a PhD in Continuing and Vocational Education (Adult Ed) at the University of Wisconsin, and interned at Walter Reed Army Medical Center. He participated in a test item writer workshop sponsored by the Commission on Dietetic Registration (CDR).
Wolf is a past Adjunct Associate Professor, Graduate School of Management & Technology, University of Maryland, and a former Adjunct Faculty Member, School of Continuing Studies, The Johns Hopkins University.
He is the past president of the DC Dietetic Association and has been honored by the Academy with the Award for Excellence in the practice of Management; the Outstanding Dietitian of the Year Award; the Outstanding Service Award; and has delivered the Lenna Frances Cooper Lecture.
At the Academy he has served in numerous leadership roles including Chair, Scholarship Committee, DBC; Chair, Communication Committee, CDR; Chair, Area Coordinating Committee, COE; Chair, COE, and member of Resource for Education Programs Committee; Honors Committee; CDR, Licensure Panel and Ethical Practices Task Force; CDR; House of Delegates and Board of Directors.
He is the author of more than 500 articles, numerous CPE home-study programs, several popular books, and the free monthly eNewsletter "Read and Grow Rich" written specifically for savvy Nutrition Professionals like YOU!
Subscribe now at www.easyCPEcredits.com--you'll be glad you did!

Special thanks to the following individuals for their careful review of this program:

Carol O'Neil, PhD, MPH, RD, LDN
Class of 1941 Alumni Professor
School of Nutrition and Food Sciences
Louisiana State University

Kim Slominsky, RD, LDN, CDE
Kim Smolinsky Nutrition
Tampa, FL

Angie Toll, RD, LD
Florence, AL

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