Chapter
15 Diet and Health
Nutrition and Chronic Disease • Healthy People 2020 • Disease prevention/health promotion objectives • Increase the quality and years of healthy life • Eliminate health disparities
• Obesity and chronic disease • Physical inactivity and chronic disease
Reproduced from U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Healthy People 2020. Washington, DC. http://healthypeople.gov/2020/about/GenHealthAbout.aspx.
Genetics and Disease • Disease Risk Factors • Genetics, environment, nutrition, lifestyle
• Human Genome Project • International effort designed to help understand the genetics of diseases • Spearheaded by NIH
Genetics and Disease • The Workings of DNA and Genes • Genetic code for making proteins • Mutations: error in genetic code
• Nutritional Genomics • Influence of diet on gene expression
Cardiovascular Disease (CVD) • Leading cause of death in the United States and Canada
The Cardiovascular System and Cardiovascular Disease • What is atherosclerosis? • Coronary heart disease
• Cholesterol and Atherosclerosis • Hypercholesterolemia • Lipoprotein a [Lp(a)]
• Inflammation and Atherosclerosis • C-reactive protein (CRP)
Cardiovascular Disease • Risk Factors for Atherosclerosis • • • • • • • •
High blood pressure High blood cholesterol Cigarette smoking Diabetes Overweight Physical inactivity Age Family history
Cardiovascular Disease • Dietary and Lifestyle Factors for Reducing Atherosclerosis Risk • Balance calories and activity to achieve or maintain healthy body weight • Consume a diet rich in fruits and vegetables • Choose whole-grain, high-fiber foods • Consume fish, especially oily fish, at least twice a week
Cardiovascular Disease • Factors for Reducing Atherosclerosis Risk • Limit saturated and trans fat and cholesterol • Minimize intake of beverages and foods that contain added sugar • Choose and prepare foods with little or no salt
Cardiovascular Disease • If you consume alcohol, do so in moderation • When you eat food that is prepared outside of the home, follow the AHA’s Diet and Lifestyle recommendations • Other dietary factors • Soy
Cardiovascular Disease • Putting it all together • Healthy People 2020 objectives target reducing deaths from heart disease and stroke
Hypertension • • • •
“Silent killer” Blood pressure Hypertension Renin © Paul Maguire/ShutterStock, Inc.
Hypertension • Stress • Risk Factors • • • • • • •
Obesity Eating too much salt Lack of physical activity Drinking too much alcohol Race Age Heredity
Hypertension • Dietary and Lifestyle Factors for Reducing Hypertension • Sodium • Other dietary factors • The DASH Diet • Control diet • Fruit and vegetable diet • Combination diet
Cancer
Cancer • Dietary and Lifestyle Factors for Reducing Cancer Risk • Recommendations for Individual Lifestyle Choices • Maintain a healthful weight throughout life • Adopt a physically active lifestyle • Eat a healthy diet, with an emphasis on plant sources • If you drink alcoholic beverages, limit consumption
Cancer • Dietary and Lifestyle Factors for Reducing Cancer Risk • Fat • Vegetables and fruits • Whole grains and legumes
Diabetes Mellitus • Definition and types • Type 1 • Type 2 • Pre-diabetes • Gestational • Hypoglycemia • Risk factors
Diabetes Mellitus • Dietary and Lifestyle Factors for Reducing Diabetes Risk • Management • Diet • Physical activity • Medications
• Nutrition
Metabolic Syndrome • Cluster of three of the following risk factors: • • • • •
Abdominal obesity High fasting blood glucose High serum triglycerides Low HDL cholesterol Elevated blood pressure
Osteoporosis • Definition • “Porous bone”
• Risk factors • Reducing the risk • • • •
Calcium Vitamin D Vitamin A Exercise
Nutrition and Women’s Health • It is the position of the Academy of Nutrition and Dietetics (AND) and Dietitians of Canada (DC) that women have specific nutritional needs and vulnerabilities and, as such, are at unique risk for various nutrition-related diseases and conditions. • Therefore, AND and DC strongly support research, health promotion activities, health services, and advocacy efforts that will enable women to adopt desirable nutrition practices for optimal health.
The Role of Dietetics Professionals in Health Promotion and Disease Prevention • It is the position of the Academy of Nutrition and Dietetics that health promotion and disease prevention endeavors are the best population strategies for reducing the current burden of chronic disease. • Dietetics professionals should be actively involved in promoting optimal nutrition in community settings and should advocate for the inclusion of healthy eating, in addition to other health-promoting behaviors, in programs and policy initiatives at local, state, or federal levels.
Coronary Heart Disease • A number of studies have shown components of fruits and vegetables may reduce the risk of coronary heart disease (CHD). • A recent study proved that this is correct. • Those in the highest fruit and vegetable intake group (top 20% who averaged 9–10 servings per day) had significantly fewer CHD events compared to those in the lowest fruit and vegetable intake group (lowest 20% who averaged less than 3 servings per day).
Balancing Calorie Intake and Physical Activity • To avoid weight gain, calorie intake needs to match calorie output. Awareness of calorie content of foods and beverages along with control of portion sizes are major steps toward calorie control. • Current recommendations suggest engaging in a minimum of 30 minutes of moderateintensity activity on most days of the week; more activity would reduce heart disease risk further.
The Diet–Cancer Link • High-fat diets have been associated with an increase in the risk of cancers of the colon and rectum, prostate, and endometrium. • The association between high-fat diets and breast cancer appears to be much weaker. The Nurses’ Health Study followed more than 121,000 women for 14 years and found no evidence that higher total fat intake was associated with an increased risk of breast cancer. • High intake of red meat (beef, pork, lamb) and processed meat (bacon, sausage, hotdogs, lunchmeat) is associated with some types of colorectal cancer; longterm consumption of poultry and fish is associated with reduced risk.
Benefits of Weight Loss • Weight loss as modest as 5 to 15 percent of total body weight in a person who is overweight or obese reduces the risk factors for some diseases, particularly heart disease.
• Weight loss can result in lower blood pressure, lower blood sugar, and improved cholesterol levels.
Structure of DNA
Source: US Department of Energy Human Genome Program, http://www.ornl.gov/hgmis.
Hardy Hearts • By the end of a normal life span, the human heart has pumped more than 3 billion times. • Despite this heavy use, heart failures are usually caused by heart attacks or problems with blood vessels and valves; heart muscle itself rarely wears out.
Diabetes Prevention • According to the AND, structured programs that emphasize lifestyle changes, including education, reduced fat and energy intake, regular physical activity, and regular participant contact can produce long-term weight loss of 5– 7 percent of starting weight and reduce the risk for developing diabetes.