Download Nutritional Notes on Health Problems

NUTRITIONAL NOTES ON HEALTH PROBLEMS
You said that you have a health problem, X.
Whilst “Healthizme” in no way sets out to be your doctor or health care provider, it is interested
in helping to identify ways in which health problems related to food intake may be prevented or
minimized.
For you, it may be worth checking a few nutritional points.
OVERWEIGHT and OBESITY

With a BMI (Body Mass Index) of X, by WHO (World Health Organization) criteria you
would be regarded as [overweight/obese/healthy weight range/underweight].

However a measurement of abdominal girth with a tape measure tells much more about the
health risk of your BMI. If, mid-way between the lower border of the rib cage, and upper
part of the pelvis,
Tape measure
Rib cage and upper part of the pelvis
If the measurement is 100cm or more, you have “abdominal obesity”. The waist should be
narrower than hips in about 85% or less of the hip circumference.

One of the most important ways to keep the waist trim is to exercise regularly.

Some foods (like wholegrains, beans, and other vegetables) may make you distended for a
few hours, but not fat, around the middle - and this is not unhealthy.

Foods with a “low energy (calorie) density” - not many calories per gram of food, low in fat
and alcohol, and high in roughage (dietary fibre) and water - can help.

Smaller serving sizes of “high energy density” food can also help.

Abdominal fat also accumulates for psycho-social reasons, since by nerves and hormones it
is connected to the brain - so managing stress and relationships also helps.
DIABETES (and IMPAIRED GLUCOSE TOLERANCE, IGT)

In diabetes the blood glucose (sugar) is too high. Even if not as high as in diabetes, the blood
glucose can be abnormally high, and this is referred to as an “impaired” blood glucose state
(glycaemia). In both of these abnormal situations, or in people at risk of them for various
reasons:
 family history
 overweight
 physical inactivity
 large infrequent meals
Some important steps can be taken. These are:

exercise by walking and muscle strengthening activities (like gardening)

have small frequent nutritious meals - especially wholegrains and seeds and magnesium rich
(like greens which have chlorophyll, a magnesium containing molecule)

prefer “low glycaemic foods” which means ones which, for the same amount of food
carbohydrate, have less impact on blood glucose (eg. lentils)

avoid or reduce stress, which puts up blood glucose

have a wide variety of foods which protect against the complications of diabetes, notably
plant foods (herbs, spices, fruits and vegetables), and fish.
CORONARY HEART DISEASE (“CHD”)
The prevention of CHD can be achieved at several points between food ingestion and loss of
heart muscle through a reduced coronary artery blood flow. These are:

the blood fats as lipids (cholesterol in its different forms - “LDL Cholesterol” and “HDL
Cholesterol”, so-called “good” and “bad”, and triglycerides)

blood glucose (sugar)

blood pressure

the artery wall

the heart muscle, its metabolism, contraction and electrical activity

avoidance of damaging agents like cigarette smoke

protection against damaging substances and processes with antioxidants from food
(wholegrain cereals, fruits and vegetables)
Hence the nutritional steps to take to reduce the risk of CHD are:

have a wide variety of foods

have fish regularly - 2-4 times per week or if unable to do so, a plant food surrogate like
linseed, rapeseed (canola), certain wild vegetables like purslane, or sea plants (seaweed).
Although some animal-derived foods are high in cholesterol they are also high in the
protective n-3 (omega-3) fatty acids found in fish - brains, free-range eggs, crustaceans and
shell-fish - which in small quantities may confer overall nutritional benefit.

prefer lean meat and low fat milk and dairy products

avoid salty foods, to keep the sodium intake low - cured meats, packaged soups, breads
which are not wholegrain, soy sauce, salty fish, salty spreads

too much alcohol which damages heart muscle and puts up blood pressure and may push up
the blood fats known as triglycerides (even if the good cholesterol, HDL, may usefully
increase)

do those things which reduce the risk of * abdominal obesity and * diabetes , or
* impaired glucose tolerance
* Click these words
Regular physical activity always underpins healthy eating for almost all health problems because, amongst other reasons, we can eat more protective food without risk of becoming
overweight.
Walking improves health because
 it is relaxing
 it elevates mood
 it burns calories
 it maintains muscle mass and activity ( and this burns off calories between walks!)
 it helps appetite to be more appropriate for your needs
 it engages you with nature or the real world with its sensory (sound, smell, visual and
tactile) inputs, assisting your sense of well-being
 it allows you to walk alone, for reflection, or with others, to talk and solve problems.
STROKE (CEREBROVASCULAR DISEASE)
The nutritional steps to reduce * heart disease also work for stroke, but additional emphasis can
be placed on:
 Potassium-rich foods - fruits and wholegrains
 Low alcohol - even small amounts of alcohol increase blood pressure and risk of stroke
 Low salt (sodium) - to keep blood pressure down
* Click
COGNITIVE IMPAIRMENT, DEMENTIA, ALZHEIMER’S DISEASE
“Cognition” is how our brains gather information, sort and assemble it, and allow us to make
meaningful and rational responses. When it fails, we become demented; one kind of dementia,
which tends to occur, as we age, but earlier than expected is Alzheimer’s Disease (pre-senile
dementia). Dementia also occurs in association with cardiovascular disease when the blood flow
to the brain progressively decreases and nerve cells die or malfunction (as with progressive or
recurrent small strokes).
It should not surprise that life-long eating habits might affect brain function, since the nerve cells
(neurones) have vary special nutritional requirements as does the chemical transmission between
nerve cell by “neurotronsmitters”.
Some of the nutrients of great importance to the nervous system are:

omega-3 (n-3) polyunsaturated “long-chain” fatty acids (found particularly in fish and other
seafood, animal brains, lean muscle of land animals and in free-range eggs

iron - which is a key element for the developing brain and cognitive function in childhood, as
well as later in life

the vitamins folic acid, pyridoxine (B-6) and hydroxocobalamin (B-12) - which, among other
roles, keep the blood level down of a substance damaging to arteries, known as homocysteine

the vitamin K-2 (menaquinone), found in cheese, because of its role in the formation of
certain brain proteins

the substance “choline”, which is found in the phospholipid lecithin (often obtained from
eggs or soy) and which forms part of the neurotronsmitter, acetylcholine

the antioxidants, like glutathione, a small peptide or protein fragment, which may be formed
from proteins like whey from milk, but can occur as such in food as well

possibly anti-inflammatory compounds, like salicylates, found in same plants.
MOOD
Mood, hunger and satiety are often intertwined; but more than that, some food components can
alter mood status.


Carbohydrate (better if they are from intact plant foods like wholegrains, fruits or vegetables)
as small snacks
Fish (for the omega-3 fatty acids) - several times a week.
OSTEOPOROSIS - BONE HEALTH - FRACTURES
To avoid fractures:


reduce falls by being strong and having a good sense of balance (strength training and Taichi)
have healthy bones
Healthy bones are more likely where the diet provides adequate:






calcium (milk, dairy products; fish; greens; sesame seeds or paste - tahini)
vitamin D (especially when there is not enough sunlight to form it in the skin) (fish, liver,
eggs - unless fortified milk does not have much vitamin D!)
not too much protein
not too much salt (sodium) - causes loss of calcium in urine
plenty of potassium (plant foods) - helps retain calcium
soy and its products like tofu, tempeh, drinks and in breads - because it provides isoflavones,
which are phyto-estrogens of special value to bone
ARTHRITIS
All arthritis is not the same.
There is:
 GOUT (G) - with high blood uric acid (the gout factor!)
 OSTEOARTHRITIS (OA) - joint wear and tear, but other factors must also be involved
 RHEUMATOID ARTHRITIS (RA) and other INFLAMMATORY ARTHRITIDES (as in
psoriasis)
Depending on the kind of arthritis, foods, or nutritional status of interest may be different.
Tomatoes
G
OA
RA
?+
?+
+
NA
?
Favourable/To Have
Unfavourable/To Avoid
Not applicable
Possibly
n-3 fatty acids (fish)
(Hyper-link to
Fish/Linseed)
NA
NA
+
Avoiding obesity
+
+
?+
FRAILTY
One of the major health problems of older people is frailty - which represents a reduction in the
reserve capacity of various organs - muscle, joints, bone, heart, lungs, blood forming capacity,
immune system and brain and nervous system.
Regular physical activity, both aerobic and strength training, is the key to avoidance of frailty
when this is coupled with *nutritious (varied, nutrient-dense) food frailty is even less likely.
* Nutritious Food is
 Nutrient Dense - more essential nutrients per calorie of the food
 Varied - as in the Food Variety Score
IMMUNE SYSTEM
The immune system is made up principally of antibody producing cells (B lymphocyte), cells
that themselves specifically handle foreign agents and infections (T lymphocytes) and scavenger
cells which more generally and non-specifically clear the body of foreign or damaged matter
(neutrophilic leukocytes or white cells) and macrophages. The function of the immune system is
affected by past exposure to foreign agents, nutrition, exercise and stress (arising from
disordered relationships and social support).
Foods that help the immune system are:
 lean meat
 fish
 nuts (unless allergic!) and seeds
 berries
 Relationship

Movement

Food
FLASHING ICON
“Active Nourished People”
“People Active and Nourished” (PAN)
The PAN approach
SKIN
Skin is an organ most vulnerable to the environment, because of mechanical damage, actinic
(UV, ultraviolet) sun rays, natural background radiation, and chemical exposure. It is an organ
vital to protect underlying tissues and is required for temperature regulation, synthesis of
important substances (like vitamin D) and needs to have great healing or recovery potential upon
injury. Its nourishment, whether via the blood stream or topically, is critical.
The very least we can say about nutrition and the skin is that the following are important:

* protein

* vitamin C (ascorbic acid)

* zinc

* essential polyunsaturated fatty acid (n-3 and n-6)

* antioxidants (from a variety of plant foods)

** link to good sources
*
Click
** Lists of Good Sources of macro- and micronutrients - from “Use and Abuse of Vitamins”
CANCER
Cancer is the abnormal and excessive proliferation of body cells leading to a tumour, organ
enlargement or increase in blood cells (like the white cells in leukaemia). For a change in a gene
that regulates cell division and leads to a tumour ( a mutation) is required - but more than one
error is usually required because of a cell’s capacity to rectify a certain amount of error.
Mutation can be induced by radiation, toxic chemcials or viruses. Food can influence these cell
changes favourably or unfavourably.
For example, certain vegetables (green leafy and yellow) can reduce a smoker’s risk of lung
damage and cancer.
Foods or food factors which protect against cancer are:
Protective Foods/Factors
Fruits and Vegetables
Soy
Wheat Bran
Tea
Tomato products
Fish
Cancer
Lung, Large Bowel
Breast, Prostate
Large Bowel
General, Skin
Prostate, Large Bowel
Large Bowel
Cancer promoting food factors
Salt
Cancer
Gastric (stomach)
Nasopharyngeal (especially in Cantonese Chinese)
Gastric (stomach)
Breast
Larynx
Oesophagus
Primary (beginning in) Liver (Hepatoma)
Primary Liver (Hepatoma)
Nitrites (nitrosamines)
Alcohol
Alfatoxins (mycotoxins)
from mouldy foods
(rice, peanuts)
Fat (except n-3 fatty acids
especially from fish; and
except plant fats obtained
from the primary commodity Seeds, grains)
Large Bowel Cancer
FOOD AND NUTRITION SECURITY - QUANTITY AND QUALITY OF FOOD
For most of the world’s population, having enough food, and having it varied and safe is the
major nutritional issue.
Energy (or calorie) deficiency may be chronic * (CED) and is defined by WHO as a
* BMI < 18.5 kg.m-2 . With grades of CED (Chronic Energy Deficiency)
I
II
III
*
17 to < 18.5
16 to < 17.0
< 16.0
Click for explanation
* BMI is Body Mass Index
Weight (kg)
=
Height (metres)2
These state of malnutrition are associated with loss of muscle mass, a major protein store,
(known as “sarcopenia”) and of fat (energy undernutrition, since fat is the main energy store).
Food shortage through poverty, famine, adverse climate or conflict leads to CED. It can also be
seen with wasting diseases like cancer or severe heart or lung failure, with loss of appetite or
with disordered eating.
CED is commonly associated with a wide range of nutritional deficiencies of not only energy
and protein, but also essential fatty acids (n-3 and n-6) micronutrients (vitamins and mineral) and
* phytochemicals .
Foods that help people quickly and easily address general nutritional needs:
 Nuts
 Fresh fruit
 Dried fruits
 Vegetable soups (like minestrone)
 Wholegrain and multigrain breads
 Fish (eg. tinned)
 Liver
 Yeast (eg. Brewer’s yeast)
 Eggs
 Beans/Lentil