Download File - Andrea Sigrist

Cardiovascular System
KNH 411
Hypertension
 Nutrition Therapy
 DASH – Dietary Approaches to Stop Hypertension
 Decrease sodium, saturated fat, alcohol
 Increase calcium, potassium, fiber
 Lifestyle modifications
 Weight loss
Hypertension
 Nutrition Therapy
 Sodium restriction controversial
 “salt sensitive” or “salt resistance”
 Only 5% of population is salt sensitive
 Limit processed & cured foods, no added salt during
preparation and cooking
 Limit to 2400 mg/day
 African Americans, older adults and people with diabetes
will benefit from salt restriction
Hypertension
 Nutrition Therapy
 DASH-Dietary Approaches to Stopping Hypertension
 Decrease Sodium, saturated fat, alcohol
 Increase calcium, potassium, fiber
 Lifestyle Changes
Atherosclerosis
 Etiology - risk factors cont.
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Physical inactivity
Atherogenic diet
Diabetes mellitus
Impaired fasting glucose/ metabolic syndrome
Cigarette smoke
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
Atherosclerosis
 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
© 2007 Thomson - Wadsworth
Atherosclerosis
 Nutrition Therapy - Fat Modifications
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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
Limit dietary cholesterol < 200 mg daily
Atherosclerosis
 Nutrition Therapy - Other
 Increase sources of soluble fiber
 Lowers cholesterol
 Increase intake of plant sterols
 Weight loss – BMI 18.5-24.9
 Regular physical activity
 Depends on what the patient is capable of
Atherosclerosis
 Nutrition Therapy Prescription
 Assessment of dietary fat intake, saturated fat intake
 MEDFICTS assessment tool (evaluating your diet for cholesterol
control)
 Dietary CAGE questions (Cheese, Animal fats, Got it away from
home, Eat high fat commercial products) –quick assessment of
diet
 REAP – rapid eating assessment for patients (what and how
often)
 Target weight calculated
 Prioritize nutrition problems
 Multiple planned visits with R.D.
Ischemic Heart Disease
 Nutrition Therapy
 Common in smokers and diabetics
 Post MI
 Decrease oral intake
 Clear liquids, no caffeine
 Progress to soft, more frequent meals
 Individualized – use TLC recommendations
Heart Failure
 Nutrition Therapy Intervention
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Control signs and symptoms
Promote overall nutritional status rehabilitation
Monitor weight, fluid, and sodium
Sodium and fluid restriction
 2000 mg Na
 Fluid 1 mL/kcal or 35 mL/kg
 250cc in 1 cup (8oz)
 Correction of deficiencies
 Increase nutrient density
 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