Diet and Health

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Chapter 18

• Diet and Health

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Ten Leading Causes of Death in US

• Heart disease
• Cancer
• Stroke
• Chronic obstructive lung disease
• Unintentional injuries
• Pneumonia and influenza
• Diabetes mellitus
• HIV
• Suicide
• Homicide

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Leading Causes of Death
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Risk Factors in Chronic Disease
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I. Heart Disease and Stroke

• (cardiovascular disease CVD)
• A. Development of Atherosclerosis 1. Plaque
  development a. Damage to artery b.
  Platelets and cells migrate to site,
  cholesterol is deposited c. Fatty
  streaks form ? enlarge and harden d. Arteries
  stiffen and narrow 2. Blood pressure
  rises a. ? elasticity of blood vessels ? ?
  damage ? ? plaques

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Development of Atherosclerosis (cont)

• 3. Blood clots form (platelets respond to
  plaques) a. ? Plaques ? ? blood clots
• 4. Blockage of artery by clot a. Occurs in
  brain stroke b. Occurs in heart heart
  attack

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Atherosclerosis
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View from Inside an Artery
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Atherosclerosis and CHD
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Heart Disease and Stroke (cont)

• B. Risk Factors for Cardiovascular Disease
  (CVD)
• 1. ? LDL, ? HDL a. LDL (cholesterol
  linked to CVD) b. HDL (returns cholesterol to
  liver) 2. Men over 45 y/o ? risk a.
  LDL 3. Women over 55 y/o ? risk a.
  Menopause (? estrogen) 1. ? LDL, ? HDL
  2. Replace estrogen ? ? CVD

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Cholesterol and CHD
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HDL / LDL Ratio
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Heart Disease and Stroke (cont)

• 4. Hypertension (? blood pressure) a. ?
  damage to vessels ? plaques 5. Smoking a. ?
  HDL b. ? O2 ? damages platelets plaque
  formation 6. Diabetes a. ? HDL, ? LDL,
  HPT, obesity b. 80 die of some type of CVD

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Heart Disease and Stroke (cont)

• C. Recommendations for Reducing Risk for
  CVD 1. Know your blood pressure 2.
  Cholesterol screening a. HDL, LDL, TGs 3.
  Control weight a. Weight loss ? BP, ?
  cholesterol, ? TGs 4. Reduce fat, especially
  saturated fat Saturated fat ? ? cholesterol

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Heart Disease and Stroke (cont)

• 5. Other dietary interventions a. Two-step
  diet plan 1. Focus on reducing
  cholesterol a. ? saturated fat especially, ?
  total fat, ? cholesterol b. ? soluble
  dietary fiber (oat) 1. ? cholesterol c. ?
  antioxidant (Vitamin C, Vitamin E) d. Wine
  consumption 6. Physical activity a. ? HDL

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II. Hypertension (HPT)

• A. Blood Pressure Regulation 1. Closed
  system (heart and vasculature) 2.
  Kidneys, liver, hypothalamus, adrenal and
  pituitary glands B. Development of HPT 1.
  Etiology unknown 2. Kidney a.
  Atherosclerosis ? ? blood flow to kidney
  ? ? blood pressure ? ? burden on heart

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Development of HPT (cont)

• 3. Obesity a. ? insulin ? kidney retains Na
  ? ? BP 4. Result a Aneurysm (blood vessel
  ruptures) b. Heart failure c. Stroke d.
  Kidney disease

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Development of HPT (cont)

• C. Risk Factors for HPT 1. Age - arteries
  lose elasticity 2. Hereditary - ? risk 2-5
  fold 3. Obesity 4. Race - ? risk 2 fold in
  blacks

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Development of HPT (cont)

• D. Recommendations for Reducing HPT 1. ?
  weight 2. ? physical activity 3. ? Na 4. ?
  alcohol 5. Drug therapy a. Diuretics (?
  water loss)

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III. Cancer

• Initiation, promotion and progression A.
  Development 1. Initiation a. Genetic
  damage (critical gene) 1. Carcinogen 2.
  Hereditary 3. Free radicals produced in
  oxidation reactions

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Cancer (cont)

• 2. Promotion a. Initiated cells are
  stimulated to replicate 1. Dietary
  compounds 2. Environmental compounds 3.
  Hormones (estrogen) 3. Progression a.
  Metastasis 1. Cancer cells from the original
  tumor spread to other tissues

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Carcinogenesis
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Cancer (cont)

• B. Risk Factors 1. Genetic 2.
  Environmental 3. Diet - initiator a.
  Smoked meats, spices, barbecue, pickled 4.
  Diet - promoter a. Fats, calories 5. Diet
  - anti-promoter a. Fruits and
  vegetables 1. Fiber, antioxidants,
  phytochemicals

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IV. Diabetes Mellitus (DM)

• A. Insulin Dependent DM (IDDM) 1. Pancreas
  unable to synthesize insulin 2. 5-10 of
  diabetes 3. Autoimmune disease ? B.
  Non-Insulin Dependent DM (NIDDM) 1. 90-95 of
  diabetes 2. 90 are obese 3. Pancreas
  produces insulin but cells are resistant to
  the effects

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Metabolic Consequences of Diabetes
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Diabetes Mellitus (DM) (cont)

• C. Complications of Diabetes related to ?
  blood glucose 1. Disease of the large blood
  vessels a. Poor control of blood glucose ? ?
  TG, ?HDL ? atherosclerosis b. Poor
  circulation in extremities 2. Diseases of the
  small blood vessels a. Poor circulation 1.
  Degeneration of the retina 2. Impaired kidney
  function

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Diabetes Mellitus (DM) (cont)

• 3. Diseases of the nerves a. Nerve tissue
  degeneration 1. Loss of sensation
• D. Dietary Recommendations for IDDM 1.
  Consistent pattern of food intake,
  particularly CHO a. Stabilize blood glucose
  concentration 2. Consistent activity a.
  Stabilize blood glucose concentration

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Diabetes Mellitus (DM) (cont)

• E. Dietary recommendations for NIDDM 1.
  ? weight a. Dietary modification 1. ?
  caloric input b. ? Physical activity