Cardiovascular System KNH 411
Hypertension Nutrition Therapy DASH – Dietary Approaches to Stop Hypertension Decrease sodium, saturated fat, alcohol Increase calcium, potassium, fiber Lifestyle modifications Weight loss #1 thing to do to see decrease in BP Less than 7% saturated fat, stay at bare minimum alc (1 drink women, 2 men)
Only about 5% of clients respond to lowering salt intake for lowering BP 5% salt sensitive 95% will not respond
Hypertension Nutrition Therapy Sodium restriction controversial “salt sensitive” or “salt resistance” Limit processed & cured foods, no added salt during preparation and cooking Limit to 2400 mg/day
Hypertension Nutrition Therapy DASH-Dietary Approaches to Stopping Hypertension Decrease Sodium, saturated fat, alcohol Increase calcium, potassium, fiber Lifestyle Changes
Weight reduction is number one treatment for hypertension
Look at cholesterol below 200 mg HDL concern if less than 40 mg—physical activity LDL less than 100 mg—consumption of fatty foods TG—simple sugar, weight, fatty foods
Atherosclerosis Etiology - risk factors cont. Physical inactivity Atherogenic diet Diabetes mellitus Impaired fasting glucose/ metabolic syndrome Cigarette smoke Atherogenic diet—high fat, low fiber—foods in exess CVD & Diabetes usually go hand in hand with adult onset Impaired fasting glucose/metabolic syndrome—highest risk—increased BMI, abdominal obesity (apple), insulin resistance, dyslipidemia, HTN, PT off (sticky blood) Smokers have increased cholesterol, TG, LDL, and low HDL—compromised lipid profile
© 2007 Thomson - Wadsworth
Adult treatment panel—ATP III Identify clinical status—risk factors Final step: what kind of therapy and LDL goal—TLC plan
© 2007 Thomson - Wadsworth
We would intervene if TG is above 150
Atherosclerosis Nutrition Therapy Therapeutic Lifestyle Changes (TLC) developed as component of ATP-III Modifications in fat, cholesterol Rich in fruits, vegetables, grains, fiber Limit sodium to 2400 mg Include stanol esters Margarines have stanols -inhibits endogenous cholesterol synthesis, may interrupt lipid absorption Take control or benecool
© 2007 Thomson - Wadsworth
Atherosclerosis Nutrition Therapy - Fat Modifications Total fat 25-35% of calories Very-low-fat diets Saturated fat < 7% of calories Avoid trans fats Increase intake of monounsaturated fats & Polyunsaturated omega-6 fatty acids Increase intake of omega-3 essential fatty acids Limit dietary cholesterol < 200 mg daily
Atherosclerosis Nutrition Therapy - Other Increase sources of soluble fiber Increase intake of plant sterols Weight loss – BMI 18.5-24.9 Regular physical activity
Atherosclerosis Nutrition Therapy Prescription Assessment of dietary fat intake, saturated fat intake MEDFICTS assessment tool Dietary CAGE questions REAP Target weight calculated Prioritize nutrition problems Multiple planned visits with R.D. These tools are online on niihka to address how much fat they are taking in
Ischemic Heart Disease Nutrition Therapy Post MI Decrease oral intake Clear liquids, no caffeine Progress to soft, more frequent meals Individualized – use TLC recommendations
Heart Failure Nutrition Therapy Intervention Control signs and symptoms Promote overall nutritional status rehabilitation Sodium and fluid restriction 2000 mg Na Fluid 1 mL/kcal or 35 mL/kg Correction of deficiencies Increase nutrient density Enhance oral intake
Heart Failure Nutrition Therapy Assess drug-nutrient interactions Losses of water-soluble vitamins Supplementation may be warranted Consider arginine, carnitine and taurine in dietary regimen