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Chapter 11 Nutrition and Health 1 Learning Objectives 1. List and describe three common forms of cardiovascular disease 2. Explain what atherosclerosis is and how it is related to cardiovascular diseases 3. List five risk factors for coronary heart disease 4. Distinguish between angina and a heart attack 5. Explain how a person’s risk for coronary heart disease is assessed Learning Objectives (cont’d) 6. Explain the two main ways to lower blood cholesterol levels 7. Explain how strokes occur 8. List five lifestyle modifications for hypertension control 9. List five menu-planning guidelines to lower cardiovascular risk 10. Define cancer Learning Objectives (cont’d) 11. Outline the American Cancer Society’s four guidelines to reduce cancer risk 12. Distinguish between type 1 and type 2 diabetes mellitus and understand the principles of planning meals for people with diabetes 13. Define osteoporosis and how to prevent/treat it 14. Discuss how to safely use botanicals including herbs 15. Analyze the pros and cons of biotechnology used to produce plants for food Leading Causes of Death in the U.S. Cardiovascular disease Coronary heart disease Stroke High blood pressure Cancer Diabetes 5 Risk Factors for Heart Disease Cigarette smoking and exposure to tobacco smoke High blood cholesterol High blood pressure Physical inactivity Obesity and overweight Diabetes Increasing age Male Family history of premature heart disease 6 Metabolic syndrome Excessive abdominal obesity High blood triglycerides Reduced HDL Elevated fasting glucose Raised blood pressure 7 What leads to most cardiovascular disease? Atherosclerosis (condition characterized by plaque buildup along artery walls – a silent process) High blood pressure 8 Coronary Heart Disease (CHD) CHD – Damage to or malfunction of the heart caused by narrowing or blockage of the coronary arteries Angina Heart attack (Myocardial infarction) 9 What Do Your Cholesterol Numbers Mean? Total cholesterol LDL (bad) cholesterol – the main source of cholesterol buildup and blockage in the arteries HDL (good) cholesterol – helps keep cholesterol from building up in the arteries Triglycerides – another form of fat in your blood 10 Total Cholesterol and LDL Total Cholesterol <200 mg/dL Desirable LDL 200 – 239 100 – 129 Borderline high 240 or more High <100 mg/dL Optimal 130 – 159 160 – 189 Above optimal Borderline high High 11 How to Lower Cholesterol Therapeutic lifestyle changes (TLC): TLC diet Physical activity Weight management Drug treatment (along with TLC if needed) 12 TLC Diet Low saturated fat (less than 7% of total kcalories) Low cholesterol (less than 200 mg/day) Only enough kcalories to maintain a desirable weight and avoid weight gain If LDL is not lowered enough, the amount of soluble fiber can be increased 13 Heart Disease Quiz (True/False) 1. 2. 3. 4. 5. High blood cholesterol is one of the risk factors for heart disease that you can do something about To lower your blood cholesterol level you must stop eating meat altogether Any blood cholesterol level below 240 mg/dL is desirable for adults To lower your blood cholesterol level you should eat less saturated fat, total fat, and cholesterol, and lose weight if you are overweight The main goal of cholesterol-lowering treatment is to lower LDL 14 Heart Disease Quiz (True/False) 6. 7. 8. 9. 10. Saturated fats raise your blood cholesterol level more than anything else in your diet All vegetable oils help lower blood cholesterol levels The TLC diet calls for less than 10% of kcalories from saturated fat and less than 300 mg of dietary cholesterol Women don't need to worry about high blood cholesterol and heart disease Reading food labels can help you eat the heart healthy way 15 Answers to Quiz 1. 2. 3. 4. 5. 6. True False False False True True 7. 8. 9. 10. False False False True 16 Stroke Damage to brain cells resulting from an interruption of blood flow to the brain Most are caused by blockages in the arteries that supply blood to the brain, a few are caused by a ruptured brain artery 17 Types of Strokes Ischemic strokes Hemorrhagic strokes 18 High Blood Pressure Greater than 120/80 Top number is called the systolic pressure Bottom number is called the diastolic pressure 19 Risk Factors for High Blood Pressure Obesity Eating too much sodium/salt Drinking too much alcohol Lack of physical exercise Race Heredity Increasing age Lifestyle Modification for High Blood Pressure Lose weight if overweight Adopt DASH diet (high in potassium, calcium, magnesium) Reduce sodium intake to <2400 mg/day Engage in regular aerobic physical activity Limit alcohol intake to no more than 2 drinks/day for men and 1/day for women 21 DASH Diet Based on a 2,000 calorie a day diet the DASH diet recommends the following number of servings from the listed food groups: *6-8 servings of grain and grain products *4-5 servings of vegetables *4-5 servings of fruits *2-3 servings of low-fat or nonfat dairy products *6 oz. or less of meat, poultry, or fish *4-5 servings of nuts, seeds and legumes per week *limited intake of fats and sweets 22 Menu Planning for CVD General Decrease or replace salt in recipes by using vegetables, herbs, spices, and flavorings Offer salt-free seasoning blends and lemon wedges 23 Menu Planning for CVD Breakfast Appetizers and Soups Salads Breads Entrees Side Dishes Desserts Beverages 24 Caffeine and Health Most common sources of caffeine in the diet: Coffee Tea Cola Cocoa Rapidly absorbed Withdrawal symptoms No longer considered a diuretic Moderate use does not seems to negatively affect heart health 25 Nutrition and Cancer 26 Guidelines from American Cancer Society Maintain a healthful weight throughout life Adopt a physically active lifestyle Eat a healthy diet with an emphasis on plant sources Limit alcohol to 2 drink/ day for men and 1 for women 27 Menu Planning to Lower Cancer Risk 1. 2. 3. 4. 5. 6. Offer lower-fat menu items. Offer more plant-based menu items Avoid salt-cured, smoked, and nitrite-cured foods. Offer high-fiber foods Include lots of fruits and vegetables (especially cruciferous vegetables) Offer foods that are good sources of beta-carotene, and vitamins C and E Offer alternatives to alcoholic drinks 28 Nutrition and Diabetes Mellitus Types Type 1 diabetes Type 2 diabetes Nearly 90% of people with diabetes Age of onset over 40 in most cases Most frequently occurs in overweight individuals Slow onset of symptoms Often improves with weight loss and/or changes in diet and exercise 29 Treatment for Diabetes Individualized diet to maintain good glucose control keep blood levels of fat and cholesterol in normal ranges maintain or get body weight within a desirable range Sugars are allowed in moderation. Kcaloric distribution Carbohydrates and monounsaturated fats: 60-70% Saturated fat: 10% or less 30 Exchange Lists for Meal Planning List Starch Meat Vegetable Fruit Milk Other Carb. Fat Typical Item 1 slice bread 1 ounce lean ½ cup cooked 1 small apple 1 cup nonfat 2 small cookies 1 teaspoon margarine Kcalories 80 kcal 55 kcal 25 kcal 60 kcal 90 kcal Varies 45 kcal 31 Osteoporosis A disease characterized by: Low bone mass Structural deterioration of bone tissue Fragile bones Increased susceptibility to fractures of hip, spine, and wrist 32 Osteoporosis Peak bone mass is attained during the early thirties. Bone is being constantly remodeled, and after the early thirties bone is broken down faster than it is deposited (especially during the five years after menopause for women due to estrogen decrease). 33 Risk Factors for Osteoporosis You can’t change these: Gender Age Body size Ethnicity Family history You can change these: A diet low in calcium and vitamin D Sedentary lifestyle Cigarette smoking Excessive use of alcohol 34 Prevention of Osteoporosis The best approach to osteoporosis is prevention – taking in the AI for calcium regular exercise consuming milk for adequate vitamin D consuming moderate amounts of alcohol avoiding smoking. Medications, such as Fosamax, can increase bone density. 35 Treatment of Osteoporosis Proper nutrition – calcium and vitamin D Exercise Safety practices to prevent falls Possibly medications 36 Food Facts: Botanicals & Herbs Botanical – plant or plant part valued for its medicinal or therapeutic properties, flavor, and/or scent Herbs – a category of botancials Hot Topic: Biotechnology Biotechnology Genetic Engineering Plant Applications Animal Applications Regulations Pros and Cons 38 Copyright ©2010 John Wiley & Sons, Inc. Clip art images may not be saved or downloaded and are only to be used for viewing purposes. 39