Chapter 11

V. Chan MS, RD

Diet & Health

2 Types of Diseases:
Infectious- caused by bacteria, viruses, parasites, other microbes
Transmitted from person to person, air, water, food, contact, vector organisms (Ex) Polio, Small Pox, Tuberculosis

Chronic- Long duration degenerative diseases that deteriorate body organs

(Ex) Diabetes, Cancer, Heart Disease Multiple factors

Nutrient & Body Defense

Precautionary measures Supplements
Caution of toxicity

Leading Causes of Death

Nutrition & Immunity

Well nourished immune system provides the best defense Groups at risk
Elderly Children Hospitalized Malnourished
PEM Malnourished as result of other diseases

Concept of Risk Factors

Risk Factor- factors known to be related to (or correlated with) diseases but not proven to be casual Disease Risk Factors
Genetics Environment -Social Factors -Behaviors

Dietary Contribution to Disease Development

Cardiovascular Diseases
Disease affecting heart and blood vessels Symptoms of heart attack (pg 413) Minimizing risk
Stop smoking -Exercise Diet low in Na & saturated/ trans fat More whole grains, fruits, vegetables

Atherosclerosis
Hardening of arteries
Plaque building up on inner artery wall

Most common
Most have well developed plaque by age 30

How plaque forms

Damaging factors to vessel lining
Inflammation- white blood cells released Macrophages- engulfs oxidized LDL and attracts immune scavengers Mineralization- increase hardening of plaque.

Atherosclerosis
Plaque Rupture
Like an injury, blood begins to clot

Blood Clots
Abnormal blood clotting
Thrombosis Embolism Heart attack/ stroke

Omega 3 fatty acids

Blood Pressure
Hypertension Aneurysm
Aorta

Risk Factors for CVD

Age, Gender, Genetic Inheritance
Cannot be modified by lifestyle choices

Cholesterol Levels
LDL, HDL

LDL Oxidation
Promote plaque development Contribute to plaque instability

Risk Factors for CVD

Hypertension & Atherosclerosis
Worsen CVD and each other

Diabetes Lack of Physical Activity

Regular physical activity expands the hearts capacity to pump blood
Reduces number of heartbeats required and hearts workload

Smoking
Damages the heart with toxins and causes the blood pressure to increase Starves tissues for oxygen Damages platelets
Blood clots

Risk Factors for CVD

Atherogenic diet
DASH diet (ex pg 437)

Obesity & Metabolic Syndrome

Metabolic Syndrome:
Hyperglycemic/ Insulin Resistance (T2DM) Central Obesity -Hypertension Low HDL/ Elevated Triglycerides

Inflammation Thrombosis

Other risk factors

Elevated homocysteine Elevated triglycerides

Recommendations for Reducing CVD Risk

Increase physical activity Maintain health body weight Healthy varied diet Quit smoking/ avoid 2nd hand smoke

Recommendations for Reducing CVD Risk

Diet to Reduce CVD Risk
Reduce fat intake
Replace Saturated fat with Monounsaturated & Polyunsaturated fat

Limit refined starches and added sugars Eat fruits, vegetables, whole grains Diet rich in omega-3 fatty acids
Reduce inflammation, lowers triglycerides

Other Dietary Factors

Sterol Esters
Added in margarine, orange juice, etc

Soy Reduce stress

Nutrition & Hypertension

Most prevalent forms of CVD
No symptoms

Get tested
Self test machines often give inaccurate readings

Systolic Pressure
Top number, ventricular contraction

Diastolic Pressure
Lower number, number at rest

Prehypertension
Borderline blood pressure between 120/80 and 139/80 Hypertension most likely to develop

Nutrition and Hypertension

Blood pressure
Cardiac output
Amount of blood the heart pumps per minute Raised when heart rate/ blood pressure increase

Peripheral resistance
Resistance to pumped blood in the small arterial branches that carry blood to tissue Affected by diameter of arteries

Risk factors
Age -Genetics Salt intake -Obesity -Alcohol -Diet

Nutrition & Hypertension

Dash Diet (Dietary Approaches to Stop Hypertension)
Increase in potassium, calcium, magnesium Emphasizes legumes & fish over red meat

Maintaining healthy weight Physical Activity Decrease in salt

WHO estimates reduction in sodium could reduce the number of people needing medication & reduce deaths of CVD >2,300 mg/ day Those with hypertension, >1,500 mg/ day

Nutrition & Hypertension

Alcohol
Moderate doses reduces blood pressure
Women: 1 drink/ day Men: 2 drinks/ day

High doses raises blood pressure

Minerals & Vit C

Increased calcium Adequate potassium & magnesium Adequate Vit C

Nutrition & Cancer

Reducing cancer risk
Diet Physical activity Smoking Alcohol Environment

Nutrition & Cancer

How does cancer develop?
Arises in the genes DNA is damaged from carcinogen
Cellular repair or self destruct Cell loses ability to self destruct Replicate uncontrollably
Mass of abnormal tissue (tumor)

Nutrition & Cancer

Diet factors affecting cancer risk
Energy Intake
Caloric effect- drop in cancer cases seen when intake of calories are restricted
Only seen effective in preventative measures

Obesity
Influence depends on site and other factors

Physical Activity Alcohol Fatty Acids & Fat Intake

Nutrition & Cancer

Red Meat
Processed meat (smoked, cured, salted, added preservatives) contain nitrates, nitrogen- containing compounds that may be carcinogenic

Fiber Rich Food Folate and antioxidant vitamins

Folate may protect against esophagus & colon cancer Vit E, Vit C, beta carotene supplements have not been proven to cure

Calcium and Vit D Iron

Under study for links with colon cancer

Food phytochemicals
Fruits/ vegetables

The DASH Diet: Preventative Medicine

Focuses on unprocessed/ lightly processed foods Whole grains, fruits, vegetables Low fat/ fat free dairy products Poultry, fish, legumes, nuts over red meat Higher intakes of potassium, calcium, magnesium