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

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 *Only about 5% of the time you hit the mark. One small component African Americans, older adults, and people with diabetes

Hypertension Nutrition Therapy DASH-Dietary Approaches to Stopping Hypertension Decrease Sodium, saturated fat, alcohol Increase calcium, potassium, fiber Lifestyle Changes

*Reduce alcohol and saturated fat *weight reduction -these decrease triglycerides

Atherosclerosis Etiology - risk factors cont. Physical inactivity Atherogenic diet - high in fat, low in fiber Diabetes mellitus: highest risk of CAD because of: Impaired fasting glucose/ metabolic syndrome Cigarette smoke TLC plan, CAD and stroke TLC plan CAD and stroke

© 2007 Thomson - Wadsworth

*pay attention to step 3 *pay attention to step 3

*step 6 is what we will do to take action © 2007 Thomson - Wadsworth

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

© 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.

Ischemic Heart Disease Nutrition Therapy Post MI Decrease oral intake Clear liquids, no caffeine Progress to soft, more frequent meals Individualized – use TLC recommendations These people may have lost some function, so have to alter

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 Just get enough calories to sustain them until they get transplant When calculating fluid CCs, keep in mind the amt. of water in foods (ex iceburg lettuce= 80% water)

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