Note

Current omega 6 to omega 3 dietary ratio inWestern countries is 15-16.7 to 1

ideal ratio is < 4:1

links on 2105 webpage re obesity

CVD mortality relative to those who consumed 8% of daily calories from added sugar there is:

-roughly triple the CVD mortality for those who consumed 25% of daily calories from added sugar

-double the CVD mortality for those who consumed 21% of daily calories from added sugar

Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults Quanhe Yang, PhD1; Zefeng Zhang, MD, PhD1; Edward W. Gregg, PhD2; W. Dana Flanders, MD, ScD3; Robert Merritt, MA1; Frank B. Hu, MD, PhD4,5 JAMA Intern Med. Published online February 03, 2014. doi:10.1001/jamainternmed.2013.13563

CVD mortality These results remained significant after adjusting for conventional CVD risk factors, including total serum cholesterol and high blood pressure, as well as other factors, such as physical activity levels and body mass index.

American Heart Association recommends that women should consume no more than 100 calories (6 teaspoons) a day from added sugar, while men should consume no more than 150 calories (9 teaspoons) a day from added sugar.

WHO recommends that less than 10% of a person's total daily calorie intake should be from added sugar

US Institute of Medicine states that added sugar should make up no more than 25% of total daily calories.

AHA- tips to reduce added sugars in our diets•Purchase sugar-free or low-calorie beverages•Try cutting back on the amount of sugar personally added to food and drinks, such as pancakes, coffee and tea•Avoid fruit canned in syrup. Instead, go for fruit canned in water or natural juice•Add fresh fruit to cereal or oatmeal instead of sugar•Add spices such as ginger or cinnamon to enhance foods instead of using sugar•When baking cakes, cut the amount of sugar used by one third to one half•Try non-nutritive sweeteners- such as aspartame, sucralose or saccharin - in moderation.

NoteExam

Monday, 3 March at 12:50 in class

65 minutes, bring a calculator and answer in pen

-55 multiple choice questions-55 points-1 short answer question-10 points

-all Nutrition 2105 material to and inclusive of 10 February 2013-strong emphasis on online notes-review on 24 February

Lecture 6a 10 Feb. 2014 Hypertension 

PathologyNutritional InterventionNutraceutical Approaches

Group activity

Better to manage blood pressure with diet or drugs?

PATHOLOGY OF HYPERTENSION INVOLVES THESE FACTORS Water volume-volume to space ratioBlood viscosity-gooeyness of bloodVasodilation-blood vessel lumen expansionVasoconstriction-blood vessel lumen constriction

Pathology-Water volume

-affected by kidney function

-affected by blood salt concentration due to osmosis

Pathology- blood viscosity-salt in blood mildly increases blood viscosity -fat load-cells are more difficult to shove through tiny spaces if loaded with saturated fat and cholesterol- increased cellular saturated fat and cholesterol make the blood cells less pliable and thus blood is more viscous - as the cholesterol to phospholipid ratio goes up in cells they are less pliable and hence the blood is more viscous and are tougher to shove through tiny spaces

Pathology- Vasodilation- ability of artery to expand 

-important to overcome volume to space ratio -saturated fat makes walls stiffer and vasodilation more difficult -cholesterol influx makes vasodilation even more important since cholesterol can reduce lumen size

Pathology- Vasoconstriction

-occurs when cholesterol and other lipids infiltrate the arterial wall

-calcium follows causing stiffening of the arteries and a reduced ability of the arteries to vasodilate

What can be done nutritionally ?

Group discussion- what are the food groups that affect blood pressure- how?

What are the nutritional interventions ? Water volume 

Reduce dietary salt intake to 2000 mg Na/day (or x milligrammes of NaCl/day) –particularly in salt sensitive persons as this will: 

-reduce osmotic pressure 

-reduce blood pressure which can keep kidney able to regulate water volume

Nutritional interventions -Water viscosity 

-reduce salt load- overcomes the osmosis factor discussed above.

 -fat load-reduce saturated fat and cholesterol to encourage cell pliability via decreased saturated fat in the cell walls combined with a decreased cholesterol:phospholipid ratio in the cell walls

 -fat load reductions accomplished by table 6

 

Nutritional interventions -Vasodilation- ability of artery to expand 

-important to overcome volume to space ratio -reduce saturated fat and cholesterol and increase monounsaturated and polyunsaturated fat intakes -makes walls less stiff and vasodilation easier

-also diets rich in fruits, vegetables and low fat dairy products help in this regard

Nutritional interventions -Vasodilation-

-monounsaturated and polyunsaturated fats also displace saturated fats and reduce

cholesterol synthesis in the body 

-cholesterol influx makes vasodilation even more important since cholesterol can reduce lumen size

  -increase potassium intake as potassium helps

with vasodilation

Nutritional interventions -Vasoconstriction

-nutritional interventions as above

Nutraceuticals 

Class activity-better to use nutraceuticalsor drugs to combat blood pressure

Nutraceuticals-Water volume 

To improve kidney function reduce blood pressure -less chance of renal failure

No nutraceuticals have been proven to reduce water volume

 

Nutraceuticals -Water viscosity 

Gamma-linolenic and dihomogammalinolenic and alpha-linolenic and eicosapentaenoic acids are all polyunsaturated fatty acids and they displace saturated fatty acids in the cell membranes thus increasing cell membrane fluidity  Increases in cell membrane fluidity-reduced resistance posed by cells as they squeeze through tiny spaces

Nutraceuticals-Vasodilation- ability of artery to expand 

Gamma linolenic acid produces dihomogammalinolenic acid (DGLA) and DGLA produces prostaglandin I1 (PGI1)and prostaglandin E1(PGE1)

Alpha-linolenic acid produces eicosapentanenoic acid (EPA) and EPA produces prostaglandin I3 (PGI3) 

PGI1 and PGE1 and PGI3 are all vasodilatory eicosanoids

 

Nutraceuticals-Vasodilation- ability of artery to expand

Any of these fatty acids in the previous slide reduce the production of vasoconstrictory thromboxane A2 which is derived from arachidonic acid Such a reduction in TxA2 results from decreased availability of arachidonic acid

Garlic capsules increases vasodilatory nitric oxide

 Concept of reverse nutraceutical-avoid excessive alcohol

-excessive alcohol can raise triglycerides