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Cardiovascular System
KNH 411
 Nutrition Therapy
 DASH – Dietary Approaches to Stop Hypertension
 Decrease sodium, saturated fat, alcohol
 Increase calcium, potassium, fiber
Lifestyle modifications- smoking, exercise (increase HDL)
Weight loss (everything comes back to normal)
Increase Ca, K, and Fiber
Decreased alcohol
 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
 Nutrition Therapy
 DASH-Dietary Approaches to Stopping Hypertension
 Decrease Sodium, saturated fat, alcohol
 Increase calcium, potassium, fiber
 Lifestyle Changes
 Hardest to change
 Etiology - risk factors cont./ typical profile
 Physical inactivity
 Atherogenic diet- or the Western diet, high in fat and low
in fiber
 Diabetes mellitus- highest risk of CAD, because they have
metabolic syndrome
 Impaired fasting glucose/ metabolic syndrome
 Cigarette smoke- decreasing vascular system, CAD, stroke
© 2007 Thomson - Wadsworth
© 2007 Thomson - Wadsworth
 Nutrition Therapy
 Therapeutic Lifestyle Changes (TLC) developed as
component of ATP-III
 Modifications in fat, cholesterol- more advance than the DASH
 Rich in fruits, vegetables, grains, fiber
 Limit sodium to 2400 mg
 Include stanol esters- up to 2 grams per 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, hopefully three times per week
 Limit dietary cholesterol < 200 mg daily
 Trying to lower LDL levels with this
 Nutrition Therapy - Other
 Increase sources of soluble fiber- legumes, oats, ridding of
cholesterol, and free radicals, lowering cholesterol, helpful
for HD, anti-inflammatory
 Increase intake of plant sterols
 Weight loss – BMI 18.5-24.9
 Regular physical activity
 What level can they maintain or take? Work with doctor,
trainer as well
 Nutrition Therapy Prescription
 Assessment of dietary fat intake, saturated fat intake
 MEDFICTS assessment tool- food frequency chart to be used
with individuals, comes out with a score that you can instruct
on, which clients to see first
 Dietary CAGE questions- even simpler, quick assessment of
what they are eating- cheese, animal fats, got it away form
home, eat (extra) high-fat commercial products- assessment of
saturated fats and cholesterol intake, just get them to cut
back as a starting point
 REAP- rapid, eating, assessment, plan, in between CAGE and
 Target weight calculated
 Prioritize nutrition problems
 Multiple planned visits with R.D.
Ischemic Heart Disease
 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
 Sodium and fluid restriction
 2000 mg Na
 Fluid 1 mL/kcal or 35 mL/kg
 Correction of deficiencies
 Increase nutrient density- coffee, or water- give ensure not
to waste calories
 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 regimenall aid in tissue repair