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Cardiovascular System
KNH 411
 Nutrition Therapy
 DASH – Dietary Approaches to Stop Hypertension
 Decrease sodium, saturated fat, alcohol
 1 drink per day for women
 2 drinks per day for men
 Increase calcium, potassium, fiber
 Fiber rich in fruits/veggies
 Lifestyle modifications
 Smoking
 exercise
 Weight loss
 Nutrition Therapy
 Sodium restriction controversial
 “salt sensitive” or “salt resistance”
 Limit processed & cured foods, no added salt during
preparation and cooking
 Limit to 2400 mg/day
 African Americans, older adults, and people with DM
 Can control HTN w/ decreasing salt
 Nutrition Therapy
 DASH-Dietary Approaches to Stopping Hypertension
 Decrease Sodium, saturated fat, alcohol
 Increase calcium, potassium, fiber
 Lifestyle Changes
 #1 concern w/ CAD and Stroke
 Etiology - risk factors cont.
Physical inactivity
Atherogenic diet- Western diet high fat, low fiber
Diabetes mellitus
Impaired fasting glucose/ metabolic syndrome
Cigarette smoke
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
 Nutrition Therapy
 Therapeutic Lifestyle Changes (TLC) developed as
component of ATP-III
 Modifications in fat, cholesterol
 Rich in fruits, vegetables, grains, fiber
 Limit sodium to 2400 mg
 Include stanol esters
 2 g/day
© 2007 Thomson - Wadsworth
 Nutrition Therapy - Fat Modifications
Total fat 25-35% of calories
Very-low-fat diets
Saturated fat < 7% of calories
Avoid trans fats
Increase intake of monounsaturated fats &
Polyunsaturated omega-6 fatty acids
Increase intake of omega-3 essential fatty acids
(cold water fish)
 Limit dietary cholesterol < 200 mg daily
 Nutrition Therapy - Other
 Increase sources of soluble fiber
 Ridding yourself of cholesterol
 Increase intake of plant sterols
 Weight loss – BMI 18.5-24.9
 Regular physical activity
 Nutrition Therapy Prescription
 Assessment of dietary fat intake, saturated fat intake
 MEDFICTS assessment tool
 Dietary CAGE questions
 Target weight calculated
 Prioritize nutrition problems
 Multiple planned visits with R.D.
Ischemic Heart Disease
 Most common in smokers or people with DM
 Nutrition Therapy
 Post MI
 Decrease oral intake
 Clear liquids, no caffeine
 Progress to soft, more frequent meals
 Individualized – use TLC recommendations
Heart Failure
 Nutrition Therapy Intervention
 Control signs and symptoms
 Promote overall nutritional status rehabilitation
 Monitor weight, fluid status, calories
 Sodium and fluid restriction
 2000 mg Na
 Fluid 1 mL/kcal or 35 mL/kg
 Correction of deficiencies
 Give calories, watch fluid intake
 Increase nutrient density
 Use Ensure suplement
 Enhance oral intake
Heart Failure
 Nutrition Therapy
 Assess drug-nutrient interactions
 Losses of water-soluble vitamins
 Supplementation may be warranted
 Consider arginine, carnitine and taurine in dietary regimen
 Aids in facilitaing tissue repair