1 DNT 200 NUTRITION FOR HEALTH SCIENCES DIET AND HEALTH.

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DNT 200NUTRITION FOR HEALTH

SCIENCES

DIET AND HEALTH

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DIET AND HEALTH

"There are people in the world so hungry, that God cannot appear to them except in the form of bread."

- Mahatma Gandhi (1869-1948)

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DIET AND HEALTHThe Ten Leading Causes of Death in the United States

Diet related

Alcohol related

Other causes

10 20 30 40 50 60 70 80 90 100 110 120 130 140 150

Homocide and legal intervention

Chronic liver disease and chirrosis

Heart Disease

Cancers

Strokes

Chronic obstructive lung disease

Deaths per 100,000 population

Motor vehicle accidents

Diabetes mellitus

Pneumonia and influenza

Suicide

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DIET AND HEALTH

Risk Factors and Recommendations• Risk factors are factors associated with an

elevated frequency of a disease but not proven to be causal

ILLNESS

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DIET AND HEALTHRisk Factors and Recommendations

• Risk factors for chronic diseases– Include genetic, behavioral, metabolic, and

environmental factors– Diet exerts its greatest influence on disease by

modifying these factors

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DIET AND HEALTHDIET/LIFESTYLE RISK FACTORS AND DEGENERATIVE DISEASES

Cancers X X X X X X X X X X X

Hypertension X X X X X X X X X X X

Diabetes (NIDDM) X X X X X

Osteoporosis X X X X X X X

Athersosclerosis X X X X X X X

Obesity X X X X

Stroke X X X X X X

Diverticulosis X X X X X X

Dental disease X X X X

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DIET AND HEALTHNutrition, Heart

Disease, And Strokes

• Cardiovascular disease is the leading single cause of U.S. deaths each year, mostly by heart attacks and strokes

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DIET AND HEALTHNutrition, Heart Disease, And Strokes

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• Risk Factors for cardiovascular disease– Total blood cholesterol (mg/dL) -- <200 is

desirable– LDL cholesterol (mg/L) -- <70 is goal for those

with risk factors of having a heart attack (7/04)– Triglycerides, fasting (mg/dL) -- <150 is normal– Obesity (BMI) -- 18.5 - 24.9 is desirable– Blood pressure (systolic and/or diastolic) -- <120-

129 and <80-84 is desirable)

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• Atherosclerosis– No one is free

• How far advanced is it

• What can be done to slow or reverse its progression

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• Atherosclerosis (con’t)

– Plaques are mounds of lipid mixed with smooth muscle cells and calcium that develop in the artery walls• Begin as fatty streaks, enlarge and become

hardened with minerals• Stiffen the arteries and narrow the passages

through them

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– Blood pressure rises because the arteries stiffened and hardened by plaques cannot expand, damaging the artery walls further

– As the arteries harden and blood flows less freely through the kidneys, they respond by raising the blood pressure further

– High blood pressure strains the heart

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• Atherosclerosis (con’t)– Blood clots form (a normal process) but

may stick to a plaque in an artery and gradually enlarge until it shuts off the blood supply to the portion of tissue supplied by that artery• A coronary thrombosis is the blockage of a

vessel that feeds the heart muscle• A cerebral thrombosis is the blockage of a

vessel that feeds the brain

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DIET AND HEALTHNutrition, Heart Disease,

And Strokes• Atherosclerosis (con’t)

• A clot can break loose, becoming an embolus, and travel along until it reaches an artery too small to allow its passage

– Such a clot lodged in an artery of the heart can cause sudden death of part of the heart muscle -- a heart attack

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– When the clot lodges in an artery in the brain, it kills a portion of brain tissue -- a stroke

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DIET AND HEALTH

Nutrition, Heart Disease, And Strokes• Recommendations for reducing

cardiovascular disease risk– Cholesterol screening– Population goals

• Maintain a healthy eating pattern

• Maintain a healthy body weight

• Maintain a desirable blood cholesterol and lipoprotein profile

• Maintain a desirable blood pressure

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DIET AND HEALTHNutrition, Heart Disease, And

Strokes• Additional recommendations for

reducing cardiovascular disease risk– Control weight– Reduce fat, especially saturated fat– Replace some of the saturated fat

with monounsaturated fat– Increase physical activity– Drug therapy -- lipid lowering drugs

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• Hypertension

– Blood pressure is vital to life -- it pushes blood through the large arteries, into the smaller ones, and finally into the capillaries enabling the cells to receive a constant supply of nutrients and oxygen and waste products are removed

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• Hypertension (con’t)– Strain on the heart’s pump, the left ventricle,

can enlarge and weaken it until it finally fails (heart failure)

– Excess pressure in the aorta may cause it to balloon out and burst (aneurysm)

– Excess pressure in the small arteries of the brain may make them burst and bleed (stroke)

– The kidneys sicken when the heart cannot adequately pump blood through them (kidney failure)

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• Hypertension (con’t)

– Categories (May, 2003)

• Normal -- less than 120/less than 80 mm Hg

• Prehypertension -- 120-139/80-89 mm Hg

• Stage I hypertension -- 140-159/90/99 mm Hg

• Stage II hypertension -- at or greater than 160/at or

greater than 100 mm Hg

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• Risk factors for hypertension– Smoking– High blood cholesterol; high LDL, low HDL or

both– Obesity (30% or more overweight)– Glucose intolerance (diabetes)– Lack of exercise– Heredity (history of CVD in family members

younger than 55 years old)– Gender (being male)– Race (prevalence differs between racial and ethnic

groups)

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DIET AND HEALTHNutrition, Heart Disease, And Strokes• Recommendations for reducing hypertension risk

– Achieve and maintain weight control– Be physically active– If you drink alcohol, limit consumption to one

to two drinks per day– If you are genetically sensitive, limit salt to no

more than 1 tsp. daily– Drug therapy

• Diuretics -- lower blood pressure by increasing fluid loss

• Antihypertensive agents

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DIET AND HEALTHNutrition and Cancer

• Steps in cancer development– Exposure to a carcinogen– Entry of the carcinogen into a cell– Initiation, probably by the carcinogen altering the

cellular DNA– Enhancement of cancer development by

promoters (factors that favor the development of cancer once the initiating event has taken place) probably involving several more steps before the cell begins to multiply out of control

– Tumor formation

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• Connections– Environmental factors -- incidence of cancer

varies by both geographic factors and racial groups

• Japanese people in Japan develop more stomach cancers and fewer colon cancers than people in the U.S.

• When Japanese people come to the U.S., their children develop both stomach and colon cancers at about the same rate as other U.S. populations

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• Connections (con’t)– Fat

• Appears to be a cancer promoter, not an initiator• Examples

– Causes the body to secrete more of certain hormones (e.g. estrogen), a favorable climate is created for the development of certain cancers (e.g. breast cancer)

– Promotes intestinal bile secretions -- organisms may then convert the bile into compounds that cause cancer

– Are incorporated into cell membranes and change them so that they offer less defense against cancer-causing invaders

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• Connections (con’t)– Fiber

• Might help protect against some types of cancer

• Hastens excretion of bile from the body

• Speeds up the transit time of all materials through the colon so that the colon walls are not exposed for long to carcinogens

• May also have an independent protective effect

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• Connections (con’t)– Promoters and anti-promoters

• Dietary fats act as promoters• Fibers and other factors may act as anti-promoters• Vegetarians have lower mortality rates from cancer than the

rest of the population• Plant foods (yellow and green fruits and vegetables) when

regularly eaten, result in fewer cancers than when these foods are rarely or never eaten

• Cancers of the head and neck correlate closely not with diet per se but with alcohol and tobacco consumption -- some dietary factors may be protective, particularly fruits and raw vegetables

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• Recommendations– Choose a diet rich in a variety of plant-based

foods– Maintain a healthy weight and by physically

active– Drink alcohol in moderation, if at all– Select foods low in fat and salt– Prepare and store foods safely– Do not smoke or use tobacco in any form– Vary your food choices

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DIET AND HEALTHNutrition and Diabetes Mellitus

Source: National Health and Nutrition Examination Survey III

Prevalence of Diabetes in Men and Women in the U.S. Population Aged 20 Years and Older

05

10152025

20-39 40-49 50-59 60-74 75+

Age Group

% of

pop

ulat

ion

Men

Women

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• Two main types– Insulin-dependent diabetes mellitus (IDDM)

• Less common• Person produces no insulin at all• Also known as type I

– Non-insulin-dependent diabetes mellitus (NIDDM)

• More common• Fat cells resist insulin• Also known as type II

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• Insulin Resistance– Reduced ability of insulin to regulate glucose

metabolism– Strong association with obesity– Acanthosis might reflect insulin resistance,

especially in children

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• Insulin Resistance

– Major causes

• Genetics

• Obesity

• Lack of exercise

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• Symptoms– Hyperglycemia -- abnormally high blood glucose

concentrations– Glucosuria (glycosuria) -- an abnormal amount of glucose in

the urine– Polyuria -- excessive urine production– Polydypsia -- excessive thirst– Ketonemia -- ketones in the blood– Acetone breath -- a distinctive fruity odor that can be detected

on the breath of a person who is experiencing ketosis– Ketonuria -- ketones in the urine– Diabetic coma -- a complication of uncontrolled diabetes

precipitated by ketosis– Polyphagia -- excessive eating

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• Complications -- can be minimized by keeping blood glucose normal– If uncontrolled, effects can be severe– Small arteries that feed tissues become blocked or

destroyed causing tissues to die from lack of nourishment– Resulting loss of circulation to the legs and feet sometimes

results in amputation– Loss of circulation to the heart sometimes results in heart

attacks or strokes– Loss of vision due to retinal degeneration– Loss of nerve function causing loss of sensation in the

limbs– Loss of kidney function sometimes requiring hospital care

or transplantation– Infections caused by bacteria that thrive on glucose-rich

blood

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DIET AND HEALTHNutrition and Diabetes Mellitus• Recommendations

– Balanced meals– Ample fiber– Provide consistent carbohydrate intake

spaced throughout the day -- amount is more important than the source

– Limited fat -- up to 35% fat energy imporve both blood glucose and lipid metabolism

– Regular physical activity

1 DNT 200 NUTRITION FOR HEALTH SCIENCES DIET AND HEALTH.

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