Diet and Health: Whitney & Rolfes - Understanding Nutrition, 12 Edition

Diet and Health
Chapter 18
Whitney & Rolfes Understanding Nutrition, 12th Edition
Nutrition and Infectious Diseases

Nutrition cannot directly prevent or cure infectious diseases
Good nutrition can strengthen bodys defenses Poor nutrition weakens the immune system
The Immune System

Bodys first line of defense
Skin, mucous membranes, GI tract
Antigens
Examples
Two types of white blood cells

Phagocytes Lymphocytes
The Immune System

Phagocytes
Scavengers of immune system First to arrive at the scene of an invader Phagocytosis
Engulf and digest antigen
Secrete cytokines
The Immune System

Lymphocytes B-cells
Rapidly divide and produce antibodies
Travel through bloodstream to site of infection Stick to surfaces of antigens Make it easy for phagocytes to ingest
Antibodies react selectively

Retain a memory
The Immune System

Lymphocytes T-cells
Travel directly to invasion site Recognize antigens on surface of phagocyte cells
T-cells multiply in response Release chemicals to destroy antigen
Signal to slow down immune response Highly specific Organ transplants

Nutrition and Immunity

Immune system responds to subtle changes in nutrition status
Synergistic downward spiral
Protein energy malnutrition (PEM)

Impaired immunity
Vitamin and mineral deficiencies & excesses

Diminish immune response
Nutrition and Immunity
Effects of PEM on the Bodys Defense Systems
HIV/AIDS
Human immunodeficiency virus (HIV)
Develops into acquired immune deficiency syndrome (AIDS) Transmitted by direct contact with body fluids
No cure
Prevention is best course
Nutrition benefits for HIV/AIDS patients

Food safety is critical
Inflammation and Chronic Diseases

Immune system response to infection or injury
Acute inflammation
Phagocytes engulf microbes Release of oxidative products to kill microbes Inflammation fights off infection and promotes recovery
Chronic inflammation
Harmful
Nutrition and Chronic Diseases

Leading causes of death in U.S.
Relationship with diet
Chronic diseases
Interrelationships among chronic diseases Numerous disease associations with various nutrients Multiple risk factors for each chronic disease
Modifiable risk factors Nonmodifiable risk factors
Ten Leading Causes of Death in the U.S.
Interrelationships among Chronic Diseases
Risk Factors and Chronic Diseases
Cardiovascular Disease
Major causes of death around the world
Family history Lifestyle factors Coronary heart disease (CHD) is most common form
Usually caused by atherosclerosis
Atherosclerosis development
Accumulation of fatty streaks along inner arterial walls
Streaks enlarge and harden Encasement in fibrous connective tissue
Plaques stiffen arteries and narrow passages

Well-developed plaques by age 30
Dietary factors
Inflammation
Damage to cells lining the blood vessels elicits inflammatory response Immune system sends in macrophages LDL cholesterol becomes trapped and engulfed by macrophages Macrophages swell; eventually become cells of plaque
Inflammation
Aneurysm C-reactive protein (CRP) Lipoprotein-associated phospholipase A(2) or LP-PLA(2)
Plaques
Plaque stability rupture
Blood clots
Platelets and other factors form blood clots Prostaglandins and thromboxanes Omega-3 fatty acids
Blood pressure
Plaques increase pressure Atherosclerosis is a self-accelerating process
The results
Heart attack Transient ischemic attack (TIA)
Risk Factors for Coronary Heart Disease (CHD)

By middle age, most adults have at least one risk factor Regular screening and early detection

Age, gender, and family history
Nonmodifiable risk factors
Older vs. younger people Men vs. women Early CHD in immediate family members

High LDL and low HDL cholesterol
Total cholesterol LDL most atherogenic lipoproteins
Plaque instability Inflammatory process
HDL indicate a reduced risk of atherosclerosis
Standards for CHD Risk Factors

High blood pressure (hypertension)
Relationship with heart disease risk holds true for men, women, young, and old Injures artery walls Accelerates plaque formation
Diabetes
Increases risk of death from CHD

Obesity and physical inactivity
Increase risk for CHD
High LDL, low HDL, hypertension, & diabetes
Cigarette smoking
Smoking damages the heart directly Toxins in cigarette smoke damages vessels
Atherogenic diet
Elevates LDL cholesterol

Other risk factors
Elevated triglycerides
VLDL Measurement of triglycerides
Metabolic syndrome
Cluster of health risks Markers of inflammation and thrombosis
Recommendations for Reducing CHD Risk

Screening
Cholesterol screening
Total cholesterol, LDL, HDL, triglycerides Two measurements at least 1 week apart
Intervention
Lifestyle changes
Physical activity, dietary changes, lose weight, reduce exposure to cigarette smoke
Medications
Hypertension
Systolic and diastolic pressure with risk of death from CVD Physiological factors of hypertension
Cardiac output
Heart rate or blood volume increases
Peripheral resistance
Diameters of arterioles
Regulated by nervous system & hormones

Kidneys
Hypertension
Risk factors
Aging Genetics Obesity Salt sensitivity Alcohol
Treatment
Weight control Physical activity DASH diet Lowers LDL & total cholesterol Salt/sodium intake Drug therapy
Diabetes Mellitus
Incidence has risen dramatically
Prediabetes
Sixth among leading causes of death Underlies or contributes to several other major diseases
Heart disease is leading cause of diabetesrelated deaths
Prevalence of Diabetes among Adults in the United States
Diabetes Mellitus
Diabetes development
Characteristics
High blood glucose concentrations Disordered insulin metabolism
Two main types

Type 1 Type 2
Features of Type 1 and Type 2 Diabetes
Diabetes Mellitus
Type 1 diabetes
Less common type
Autoimmune disorder
Pancreas loses ability to synthesize insulin Commonly occurs in childhood & adolescence Energy metabolism changes
May threaten survival
Need insulin injections or external pump

Diabetes Mellitus
Type 2 diabetes
Most prevalent form of diabetes
Exact cause is unknown Risk factors
Insulin resistance
Hyperinsulinemia Amount of insulin is insufficient to compensate for diminished effect in cells
Chronic inflammation
Diabetes Mellitus
Complications
Acute Chronic
Conversion of glucose to sugar alcohols Loss of circulation and nerve function Infections Diseases of large blood vessels Diseases of small blood vessels Diseases of the nerves
Metabolic Consequences of Untreated Diabetes
Diabetes Mellitus
Recommendations for diabetes
Total carbohydrate intake Carbohydrate sources
Fiber and sugar Glycemic index
Dietary fat Protein

Kidney function
Diabetes Mellitus
Recommendations for diabetes
Alcohol
Moderation
Type 1 diabetes
Adjust insulin to accommodate meals, physical activity, and health status Nutrition therapy
Type 2 diabetes
Diet and regular moderate physical activity
Cancer
Second leading cause of death in U.S. Development of cancer carcinogenesis
Mutations in genes that control cell division
Effects of mutations
As tumor develops, a network of blood vessels develops Metastasis
Causes
Cancer Development
Normal cells Malignant cells Normal cells

Initiation Promotion Further tumor development
Mutagens alter the DNA in a cell and induce abnormal cell division.
Promoters enhance the development of abnormal cells, resulting in formation of a tumor.
The cancerous tumor releases cells into the bloodstream or lymphatic system (metastasis).
Stepped Art
Fig. 18-6, p. 626
Cancer
Development of cancer carcinogenesis
Environmental factors
Sun, water, air pollution, and smoking Obesity Exposure to estrogen
Cancer
Dietary factors cancer initiators
Alcohol and tobacco use Cooking meats at high temperatures Grilling meats Diets high in red meats & processed meats Presence of acrylamide
Cancer
Dietary factors cancer promoters
Types of fat in diet
Dietary factors antipromoters
Factors Associated with Cancer at Specific Sites
Cancer
Recommendations for reducing cancer risks
Fruit and vegetable intake
Phytochemical protective benefits
Rich sources of fiber

Fruits, vegetables, legumes, & whole grains
Maintenance of healthy body weight Physical activity
Recommendations for Chronic Diseases

Comparison with Dietary Guidelines for Americans Healthy Eating Pyramid
Links between diet and health
Weight control Diet Individualized recommendations

Human genome
Dietary Guidelines & Recommendations for Chronic Diseases Compared
The Healthy Eating Pyramid
Highlight 18
Complementary and Alternative Medicine
Defining Complementary and Alternative Medicine (CAM)

Insufficient evidence regarding safety Variety of approaches, philosophies, & treatments
Alternative Complementary
Integrative medicine
Sound Research, Loud Controversy

Scientific evidence is lacking
Safety and effectiveness
Sound research the questions

Does treatment offer better results than doing nothing or giving a placebo? Do the benefits clearly outweigh the risks?
Sound Research, Loud Controversy

Placebo effect
Placebo brings about healing effect in people who believe they are receiving the treatment
Risks versus benefits

Ideally, benefits with little or no risk
Some therapies are innocuous
Benefits with significant, unknown, or debatable risks

Nutrition-Related Alternative Therapies

Use of foods, vitamin and mineral supplements, and herbs to prevent & treat illness Foods
Examples
Vitamin and mineral supplements

Can be either conventional or alternative
Nutrition-Related Alternative Therapies

Herbal remedies
Beneficial compounds from wild species Herbal precautions
Natural does not mean safe or beneficial Not regulated or evaluated by the FDA Lack of consumer information regarding herbal preparations
The Consumers Perspective

Use of alternative therapies
In line with beliefs about health and life
Alternative therapies are most often used in addition to conventional therapies Important to inform physician of alternative therapy use

Diet and Health: Whitney & Rolfes - Understanding Nutrition, 12 Edition

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Diet and Health

Whitney & Rolfes Understanding Nutrition, 12th Edition

Nutrition and Infectious Diseases

Whitney & Rolfes Understanding Nutrition, 12th Edition

The Immune System

Two types of white blood cells

The Immune System

Whitney & Rolfes Understanding Nutrition, 12th Edition

The Immune System

Antibodies react selectively

The Immune System

Signal to slow down immune response Highly specific Organ transplants

Nutrition and Immunity

Protein energy malnutrition (PEM)

Vitamin and mineral deficiencies & excesses

Nutrition and Immunity

Whitney & Rolfes Understanding Nutrition, 12th Edition

Effects of PEM on the Bodys Defense Systems

Whitney & Rolfes Understanding Nutrition, 12th Edition

Nutrition benefits for HIV/AIDS patients

Food safety is critical

Inflammation and Chronic Diseases

Nutrition and Chronic Diseases

Whitney & Rolfes Understanding Nutrition, 12th Edition

Ten Leading Causes of Death in the U.S.

Whitney & Rolfes Understanding Nutrition, 12th Edition

Interrelationships among Chronic Diseases

Whitney & Rolfes Understanding Nutrition, 12th Edition

Risk Factors and Chronic Diseases

Whitney & Rolfes Understanding Nutrition, 12th Edition

Whitney & Rolfes Understanding Nutrition, 12th Edition

Plaques stiffen arteries and narrow passages

Whitney & Rolfes Understanding Nutrition, 12th Edition

Risk Factors for Coronary Heart Disease (CHD)

Whitney & Rolfes Understanding Nutrition, 12th Edition

Risk Factors for Coronary Heart Disease (CHD)

Whitney & Rolfes Understanding Nutrition, 12th Edition

Risk Factors for Coronary Heart Disease (CHD)

HDL indicate a reduced risk of atherosclerosis

Whitney & Rolfes Understanding Nutrition, 12th Edition

Standards for CHD Risk Factors

Whitney & Rolfes Understanding Nutrition, 12th Edition

Risk Factors for Coronary Heart Disease (CHD)

Whitney & Rolfes Understanding Nutrition, 12th Edition

Risk Factors for Coronary Heart Disease (CHD)

Risk Factors for Coronary Heart Disease (CHD)

Whitney & Rolfes Understanding Nutrition, 12th Edition

Recommendations for Reducing CHD Risk

Regulated by nervous system & hormones

Whitney & Rolfes Understanding Nutrition, 12th Edition

Whitney & Rolfes Understanding Nutrition, 12th Edition

Prevalence of Diabetes among Adults in the United States

Whitney & Rolfes Understanding Nutrition, 12th Edition

Two main types

Whitney & Rolfes Understanding Nutrition, 12th Edition

Features of Type 1 and Type 2 Diabetes

Whitney & Rolfes Understanding Nutrition, 12th Edition

Need insulin injections or external pump

Metabolic Consequences of Untreated Diabetes

Whitney & Rolfes Understanding Nutrition, 12th Edition

Dietary fat Protein

As tumor develops, a network of blood vessels develops Metastasis