Download Chapter 11 Diet and Health

Chapter 11 Diet and Health
Chapter 11 Diet and Health
Heart Disease
 Atherosclerosis
 Hypertension
 Hypercholesterolemia
Health Risk Factors Associated with Heart Disease
Primary Controllable Risk Factors
 Cigarette smoking
affects 25% of adults
 Hypertension
affects 25% of adults
 Hypercholesterolemia
affects 20% of adults
 Physical inactivity
affects 75% of adults
 Obesity
affects 33% of adults
 Diabetes
affects 10% of adults
Non-controllable risk factors
 Genetics
 Male
 Age
Contributing risk factor
 stress
Atherosclerosis “scleros = “hard; “osis” = too much
 1 type of hardening of arteries caused by build up of plaque
o plaque consists of cholesterol (oxidized LDL), calcium, white blood cells, etc.
85% of all heart disease has atherosclerosis as underlying cause
Hypertension
Blood pressure is pressure exerted by blood against walls of blood vessels
 concern is in arteries
high blood pressure known as “Silent killer” 120/80 normal
 systolic vs diastolic
 140/90 high B.P.
B.P. tends to rise with age
 don’t except this
1 in 4 U.S. Americans
 1/3 not aware of it
 contributes to 700,000 deaths each yr.
Hypercholesterolemia
Functions of cholesterol
hypercholesterolemia - elevated blood cholesterol
 oxidized LDL’s main concern
Values (total cholesterol)
 *desirable < 200mg/dl
1 in 5 people;  with age
Primary risk factor for CHD
So What do I do Nutritionally to  Risk of These Diseases?
Prevent & Treatment of HBP
 Weight loss (if overweight, most important factor) or maintain appropriate weight
o apply diet for weight loss
 Reduce Na+ intake <2400 mg/day (some sensitive to Na+)
 read food labels (watch canned & processed foods)
  salt during cooking (use herbs & spices)
 limit foods with visible salt (chips, pretzels, nuts, etc)
 avoid putting salt on food
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Choose fresh fruits & vegetables (low Na+ & good K+)
Adequate magnesium
o most people are sub clinically def.
 whole grains & legumes
 Limit alcohol consumption
 Non-diet related factors
o Stop smoking
o Stress management
o Aerobic exercise
attacks problem, medications attack symptoms
What Can I Do to  Total Cholesterol & LDL?
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Maintain ideal body wt. or  body weight if overweight
 saturated fat & “trans-fatty acids”
o <10% of total calories
substitute monounsaturated fats (olive oil) for saturated
 dietary cholesterol?
o <300mg/day
 complex carbs & fibers
 anti-oxidants
oxidized LDL’s seem to be problem
vit. E, C, Beta-carotene, selenium (phytochemicals)
To  HDL’s
 Weight reduction & leanness
 most important factor IF overweight
 Moderate alcohol consumption?
 Aerobic exercise, >90 minutes/wk
 Smoking cessation
Additional Nutritional Information to Reduce Risk of Heart Disease
Follow guidelines
-55% carb (2/3 complex)
-<30% fat (**sat. fat)
-15% protein
-20-30 g of fiber
-*minimize eating away from home
-decrease sugar intake
 Antioxidants:  plant foods; insufficient evidence to support supplements (look for color)
B Vitamins: normal metabolism of homocysteine requires adequate supply of folate & other B
vitamins
 high homocysteine levels have been related to  risk for heart disease in most but not
all studies
Soy Protein: consumption of soy protein in place of animal protein tends to lower blood levels of
cholesterol, LDL’s, & triglycerides without affecting HDL
Omega-3 Fatty Acid: consumption of one fatty fish meal per day may have beneficial affect on
heart disease
Nutrition & Diabetes Mellitus
“There is a strong link b/t Type 2 diabetes & sedentary living. Greatest benefits occur in
those who incorporate regular physical activity into their lives”
What is Diabetes Mellitus?
Metabolic disease characterized by high blood glucose
Diabetes
Type I
5-10%, damaged pancreas
 “autoimmune disease”
 Prone to ketoacidosis (life-threatening)
-Usually starts in children, tend to be slim
-Need insulin injections
Type II
90-95%, - “insulin resistance syndrome”
Develops gradually
 used to be 45yrs, obese, sedentary, & family history
 Now seeing in younger pop.
Most do not need insulin
“syndrome X” – obesity, HBP, high insulin levels, & dislipidemia
Complications of Diabetes
$100 billion/yr in health care costs, 10th? leading cause of death
Heart disease death rates 2-4x’s > non-diabetics
 Risk of stroke is 2-4x’s > non-diabetics
 High blood pressure – 60-65% of diabetics
Blindness – leading cause of new blindness 20-74yrs of age
 Diabetic retinopathy
Kidney disease – leading cause of end renal stage
Nervous system disease – 60-70% (impaired sensation)
Amputations - >1/2 of lower limb amputations are diabetics
Pregnancy – 3-5% result in newborn deaths vs 1.5% in non-diabetics
Depression/anxiety are common due to emotional & social impact of diabetes & treatment
  risk for developing dementia such as Alzheimer’s
Type 2 Diabetes & Body Weight
Gaining just 10 lbs  risk of developing diabetes (2) 25%
 More frequent when weight is around abdomen (android)
Weight loss improves insulin resistance & glucose levels
Risk reduction for developing Type 2 diabetes who maintain ideal weight is 50-75%
compared to obese
 (most important prevention measure for Type 2 diabetes is to be active & maintain
ideal body weight)
Nutrition for Diabetics
Similar general guidelines
 need to follow guidelines for heart disease
 minimize high glycemic foods
 Carbs. 50-55%
 watch simple sugars
 Fiber intake 25-30 g/day
 Planning meals
 regular, exercise, meds.
Create caloric deficit if overweight
Exercise Benefits for Diabetics
**Improved insulin sensitivity
 During exercise or activity, insulin is NOT needed to move sugar (glucose) into body
cells
 caloric expenditure (weight control)
Reduce risk for other health issues
 Improved blood lipids
  blood pressure in hypertensives
  risk of cardiovascular disease
 Enhanced quality of life, improved self esteem
*will not fix problem for Type 1, may in Type 2
Nutrition and Cancer
Cancer
1 in 4 in U.S. will contract cancer
 20-50% attributable to diet
Suggested  in colon, prostate, pancreas, & breast cancer by 50% if all adopted healthy diet
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excessive fat, alcohol, & calories, and low fruit & vegetables are associated with
cancer
foods can be cancer causing?, cancer promoting, or protective
Development of Cancer
 exposure to carcinogen
 entry of carcinogen into cell
 initiation of cancer, possibly altering genetic material
 acceleration by promoters
 metastasis (spreading)
Nutrition and Cancer
What Can We Do?
Increase intake of green, red, orange & yellow fruits & vegetables
 probably most important due to phytochemicals and anti-oxidants;  high red
meat intake related to colon cancer??
 may be other related factors (high cals, high sat. fat, low fiber)
 High fiber diets may be protective
 due to excretion of bile & absorbing toxins
 may relate to  fruit & vegetables
Vitamin E, C, folate, & beta carotene (ANTIOXIDANTS) in diet may be protective
(phytochemicals)
Crucifers
Broccoli, Kale, Brussels Sprouts, Cabbage, Couliflower
Contains several phytochemicals including Indols
Eating 3-4 servings of broccoli or other crucifers per week may have a positive effect on cancer
risk reduction.
A serving equals approximately 1/2 cup of broccoli.
Nutrition and Cancer
Smoke from wood or charcoal settles on food
To minimize effect:
 Line grill with foil
 Don’t burn food
 Trim off fat or remove skin