A 50 year old male patient presents to the clinic for routine checkup. He is a known case of hypertension and is under medication. Lab investigations reveal plasma cholesterol levels 5.8 mmol/L and RBS 180 mg/dl. Physician advised the patient about diet restriction to prevent arteriosclerosis. All of the following can lead to the said condition except:

**Core Concept:** Arteriosclerosis is a progressive thickening and hardening of the arterial walls due to the accumulation of lipids, calcium, and collagen, leading to decreased blood flow and increased risk of cardiovascular events. Dietary modifications, lifestyle changes, and medications are essential in preventing and managing arteriosclerosis.

**Why the Correct Answer is Right:**

The correct answer is **D**. The question asks about factors that do not contribute to arteriosclerosis. A high-sugar diet (Option B) can lead to increased triglyceride levels, leading to lipoprotein abnormalities and increased risk of arteriosclerosis. High-fat diet (Option A) can also contribute to atherogenesis, as it increases LDL cholesterol levels. High-sodium diet (Option C) can lead to hypertension, which is a risk factor for arteriosclerosis.

**Why Each Wrong Option is Incorrect:**

Option A (high-fat diet) contributes to arteriosclerosis because it raises LDL (bad) cholesterol levels, which can lead to the formation of atherosclerotic plaques in the arterial walls.

Option B (high-sugar diet) is incorrect because a high-sugar intake can lead to increased triglyceride levels, causing abnormalities in lipoprotein profile and increasing the risk of arteriosclerosis.

Option C (high-sodium diet) is incorrect because high sodium intake can cause hypertension, which is a significant risk factor for arteriosclerosis.

**Clinical Pearl:**

In the context of routine check-up, the physician should emphasize the importance of a balanced diet, including low-fat, low-sugar, and low-sodium intake, for preventing and managing arteriosclerosis. Additionally, ongoing monitoring of blood pressure, cholesterol levels, and lifestyle modifications, including regular exercise, are essential for maintaining cardiovascular health.

✓ Correct Answer: D. Low LDL:HDL cholesterol ratio