Download Diet, Diabetes, Fat and Heat Disease

Health Tips- Lifestyle, diet,
exercise and diabetes and heart
disease
Dr Bevan Hokin PhD
Director of Pathology
Sydney Adventist Hospital
Introduction to the food groups
– carbohydrates
– fats
– protein
– Vitamins and
minerals
– Water
– Fibre
energy source
energy source and storage
growth, repair and
reproduction
body regulators metabolic co-factors
Energy - body fuels
• Cannot be created or destroyed - but it can
change its form
• Body obtains its energy in the form of
chemical energy from the food we eat
• Food energy is measured in K Joules (used
to be calories: 1 calorie = 4.2 KJoules
Food sources of energy I
Food class
Calories/gm
• Carbohydrates:
• Proteins
• Fats
4
4
11
KJoules/gm
17
17
45
How much energy do I need each
day?? (K Joules for men by age grouping)
Desirable
weight
60 kg
20-39
40-59
60-79
9500-10200 9200-9400 7500-7900
70kg
11300-12100 10400-10600 8300-9000
80kg
13200-14000 11500-12100 9200-10000
How much energy is contained in
some common foods?
•
•
•
•
•
•
•
Apple pie
moderate serving
Baked beans 1 cup
Banana split with icecream
Hot cross bun with butter and jam
Cheese cheddar 1 slice (28 gm)
Cheese omelette (2 eggs)
KFC
average serving
1257
1173
2095
1264
460
1089
1173
How much energy is contained in
some common foods?
•
•
•
•
•
•
•
Asparagus
6 spears /serving
Weet-bix
1 biscuit
Cabbage
1 cup
Carrot
1 cup raw or boiled
Celery
6 large stalks
Fresh fruit salad -average serving
Green beans fresh or frozen 1 cup
75
209
126
188
63
377
63
Energy content of potato
• Plain boiled
1 medium
356
Energy content of potato
• Plain boiled 1 medium
• Mashed with milk and butter 1/2 cup
356
398
Energy content of potato
• Plain boiled 1 medium
• Mashed with milk and butter 1/2 cup
• Baked
1 medium
356
398
524
Energy content of potato
•
•
•
•
Plain boiled 1 medium
Mashed with milk and butter 1/2 cup
Baked
1 medium
Roasted
1 medium
356
398
524
922
Energy content of potato
•
•
•
•
•
Plain boiled 1 medium
Mashed with milk and butter 1/2 cup
Baked
1 medium
Roasted
1 medium
French fried 8 chips
356
398
524
922
943
Energy content of potato
• Plain boiled 1 medium
356
• Mashed with milk and butter 1/2 cup 398
• Baked
1 medium
524
• Roasted
1 medium
922
• French fried 8 chips
943
(and who eats only 8 chips at a sitting?!)
Food sources of energy II
The body can inter-convert carbohydrates,
fat and protein
CHOFatsProtein
So not only is what you eat important, but
how much you eat
CHOFatsProtein
• Energy cannot be created or destroyed…
• Consume more of ANY food than necessary
will result in the energy excess having to
go somewhere
• If it is not ‘burnt’ through exercise it will be
stored as fat
Food
consumed
Digested in stomach
Nutrients absorbed
through small intestine
Absorbed nutrients
transported to the liver
Interconversion of Fats,
carbohydrates and
protein occurs as the
body needs dictate
Nutrients released into
the blood stream for use
by body cells
Liver and pancreas
control blood glucose
levels. As glucose levels
increase, more insulin is
produced to force down
serum glucose levels.
Increased
exercise burns
excess energy
More energy
available than
needed?
Excess energy
stored as FAT
Diabetes
• Three types;
– Type 1 - Insulin dependent. Caused by the
pancreas not producing adequate functional
insulin
– Type 2 - Non-insulin dependent. Body produces
insulin, but it cannot be used due to resistance
caused by excess stored fat and/or ‘fatty liver’
– Type 3 - Gestational diabetes - a transient (but
significant) diabetes which occurs during
pregnancy
Type II Diabetes
• Lifestyle and diet related
– too much refined carbohydrate in diet
– too little exercise
– overweight
Why is diabetes so serious?
• Disease of glucose metabolism with risk of
hypo- and hyper-glycaemic attacks
• Glycosylation of proteins (including blood
cell surfaces) making them ‘sticky’
• Vascular diseases result: increased risk of:
–
–
–
–
heart disease
renal failure
blindness and deafness
stroke
Prevention of diabetes (Type II)
•
•
•
•
•
Consume the correct amount of KJoules (food, calories)
Focus on fresh fruits and vegetables
Avoid refined carbohydrates
Avoid fatty foods
Use whole grains where possible including wholemeal
bread
• Follow a high fibre low fat diet
• Engage in a regular exercise programme
• Maintain ideal weight
Treatment of diabetes (Type II )
• Loose weight
• Consume the correct amount of KJoules (food, calories) to
achieve then maintain your ideal weight
• Avoid refined carbohydrates esp. sugars
• Follow a high fibre low fat diet- lots of fruit and veges
• Use whole grains where possible including wholemeal
bread
• Engage in a regular exercise programme
• Follow your doctor’s advice - tablets can assist with
glucose control
Blood fats and heart
disease
Heart disease
• 1 person in 3 will die of heart disease
• A “Heart attack” and death will be the first
symptom for about a half of those affected
• A heat attack occurs when a blockage in
one of the coronary arteries causes
inadequate blood flow (and hence oxygen
supply) to part of the heart muscle and as a
result that part of the heart muscle dies.
Preventing sudden death from
heart attack
• Strategies to prevent heart attack:
– don’t allow the coronary arteries to become
occluded with fatty deposits. Control blood fats
and cholesterol
– prevent artery lining from becoming damaged
thus allowing debris to adhere (diabetes,
homocysteine)
– prevent blood clots from forming
Blood fats
• Two main types:
– Triglycerides
– Lipoproteins and Cholesterol
Triglycerides
G Fatty acid
L
Y
C
Fatty acid
E
R
O
L Fatty acid
Structure of fatty acids
H-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-COOH
Saturated fat
H-C-C-C-C-C-C=C-C-C-C-C-C-C-C-C-C-C-C-CO0H
Mono-unsaturated fat
H-C-C-C-C-C=C-C-C-C=C-C-C-C=C-C-C-C-COOH
Poly-unsaturated fat
Structure of fatty acids
H-C-C-C-C-C-C=C-C-C-C-C-C-C-C-C-C-C-C-CO0H
Omega-6 mono-unsaturated fat
H-C-C-C=C-C-C-C-C-C-C-C-C-C-C-C-C-C-COOH
Omega-3 mono-unsaturated fat
Lipoprotein
• Spherical molecules made up cholesterol
fats and protein in differing proportions:
– HDL
of
– LDL
– VLDL
high proportion of protein, low amount
cholesterol
Moderate amounts of both cholesterol
and protein
Small amounts of protein, large
amounts of cholesterol
• These are three of several combinations...
Food
consumed
Digested in stomach
Nutrients absorbed
through small intestine
Absorbed nutrients
transported to the liver
Interconversion of Fats,
carbohydrates and
protein occurs as the
body needs dictate
Nutrients released into
the blood stream for use
by body cells
Liver controls the
manufacture storage
and destruction of
all blood fats
Triglycerides available for cells to convert
into energy or store
Low density lipoproteins transported to cells
for utilisation eg manufacture or repair of
cell membranes
Some Cholesterol from low-density
lipoproteins sticks to artery walls
HDL Cholesterol is the transport
form of lipid/cholesterol that has
been removed from cells and
blood vessel walls – returned to
liver for destruction and
removal
Arteriosclerosis
• Thickening of the artery walls
• One important cause is the deposit of
cholesterol in the arterial wall
• This deposit is reinforced with calcium
salts
• Lumen of artery is occluded such that a
blockage would be more likely in the event
of a small clot or broken off piece of plaque.
Contributing factors to
arteriosclerosis formation
• Damage to vessel wall e.g. from elevated
homocysteine concentrations
• High blood pressure
• Diabetes
• Lack of exercise
• High levels of cholesterol
• Sex (gender)
• Smoking
How to prevent heart disease
• Maintain ideal weight through a healthy diet and
exercise programme
• Enjoy a healthy diet low in saturated fats
• Maintain a low cholesterol/HDL ratio (<4.5)
• Avoid diabetes. If too late, control it carefully
• Engage in a regular exercise programme
• Develop a low stress lifestyle through a deep faith
in God’s leading
Role of HDL
• So-called ‘good cholesterol’
• HDL is cholesterol that is being transported
back to the liver for destruction
• Ration of total cholesterol/HDL cholesterol
should be < 4.5 and preferably <4.0
• Can increase HDL by exercise
• I have never seen a vegetarian at or below
his ideal weight with abnormal blood lipids
If you have heart-disease risk
factors…..
• Control blood pressure
• Control diabetes
• Increase exercise (minimum of 3 hours/week on
non consecutive days)
• Healthy diet low in fats especially saturated fats
• Monitor cholesterol and keep low
• Consider medication…. E.g. low dose aspirin
• Lower homocysteine levels to <10 umol/L
Conclusions
• The Adventist Church-recommended diet most
closely complies with these recommendations
and when followed, does result in a reduced
incidence of diabetes and heart attack.
High fibre, low saturated fat, an abundance of fruit and vegetables, adequate protein, and micronutrients.
• A Vegetarian diet was for many years ridiculed. In
the 60’s vegetarianism started to be tolerated; in
the 80’s vegetarianism became accepted. Now
vegetarianism is acclaimed.
Question time
?