1. DIET AND HEALTH RELATED TO DISEASE INCIDENCE

2. The Leading Causes of Death in the United States 1.*Heart disease 2.*Cancers 3.*Strokes 4.Chronic obstructive pulmonary disease 5.Unintentional injuries * Indicates diet related causes

3. The Leading Causes of Death in the United States {continued} Pneumonia and influenza *Diabetes mellitus Human immunodeficiency virus (HIV) Suicide *Chronic liver disease *Indicates diet related causes

4. Heart Disease Cardiovascular disease (CVD) refers to the general term for all diseases of heart and blood vessels. Atherosclerosis is a condition characterized by fatty plaques along the inner walls of the arteries.

5. Heart Disease {continued} Coronary heart disease (CHD) refers to the damage that occurs when the blood vessels carrying blood to the heart become narrow and occluded. Most common form of CVD usually involves atherosclerosis and hypertension.

6. How Atherosclerosis Develops 1.Plaques develop 2.Blood clots form 3.Blood pressure rises

7. Risk Factors For CVD Elevated LDL cholesterol Low HDL cholesterol Hypertension Diabetes Male, 45 years or older Female, 55 years or older, or with premature menopause and not on estrogen replacement therapy Smoking Family history

8. Blood Lipid Levels Total Cholesterol <200mg/dl– desirable 200-239mg/dl- borderline >240mg/dl- high LDL Cholesterol <130mg/dl- desirable 130-159mg/dl- borderline >160mg/dl- high

9. Blood Lipid Levels HDL Cholesterol <35mg/dl indicates risk LDL to HDL Ratio HDL/total cholesterol Men: >5 indicates risk Women: >4 indicates risk Triglycerides <150mg/dl- desirable 150-199mg/dl- borderline 200-499mg/dl- high >500mg/dl- very high

10. Reducing The Risk Of CVD Identification through cholesterol screening Treatment: Two-step diet plan- American heart association Control weight

11. Reducing The Risk Of CVD {continued} Reduce total fat, especially saturated fat & trans fat - Increase omega 3 fatty acids Increase fiber rich foods Physical activity Drug therapy Vitamin/mineral supplementation

12. Step 1 & 2 Diet NutrientStep 1 dietStep 2 diet Total fat<=30% kcalsSame Saturated8-10% kcals<7% kcals polyunsaturatedUp to 10% calsSame MonounsatUp to 15% calsSame Cholesterol<300mg/day<200 mg/day Carbohydrates50-60% kcalsSame Protein10-20% kcalsSame caloriesEnough to maintain DBWSame

13. Prevention: All Americans AHA Dietary Guidelines Healthy eating pattern Fruits, veggies, whole grains Fat free, low fat dairy, fish, legumes, poultry, lean meats Soy Protein-FDA passed health claim: foods with 6.25g of soy protein per svg can carry health claim for reduced risk Healthy Body Weight Desirable Blood Cholesterol and Lipoprotein Profile Desirable BP

14. Hypertension Higher than normal blood pressure Essential or primary- develops with out an identifiable cause Secondary- caused by a specific disorder such as kidney disease

15. Blood Pressure Regulation Arteries- the heart pushes the blood into the arteries, at the periphery the smallest arteries and capillaries resist its flow. Blood volume- volume in the vascular system depends on the number of dissolved particles the fluid contains.

16. Blood Pressure Regulation {continued} Kidneys- depend on blood pressure to filter the waste from the blood. They retain sodium and water, expanding the blood volume when pressure is elevated.

17. Risk Factors For Hypertension Smoking Obesity High blood lipid levels Diabetes Age Heredity Race-highest among African Americans

18. Recommendations For Reducing The Risk Weight control Physical activity Decrease alcohol consumption Decrease sodium/salt intake DASH diet- consuming ~10 servings of fruits and vegetable daily and reducing fat intake to < 30% Drug therapy

19. Metabolic Syndrome 3 of the following: Abdominal obesity : waist circumference >40 in (M) and >35 in (w) HDL <40 mg/dl (M) and <50 mg/dl (W) BP >= 130/85 Fasting blood sugar >110mg/dl Overeating and physical inactivity-role in development of metabolic syndrome 47 million have it

20. Cancer Diseases that result from unchecked growth of malignant tumors. Tumor/neoplasm- a new growth of tissue forming an abnormal mass with no function. Malignant- tumors that multiply out of control, threaten health, and require treatment.

21. Cancer {continued} Benign- tumors that stop growing without treatment, or could be removed surgically and pose no threat to health. Carcinogenic- cancer causing.

22. How Cancer Develops Develops from a mutation in the genes that regulate cell division Carcinogen>>Initiation>>Promotion>>Tumor Formation Genetic factors Immune factors Environmental factors Dietary factors

23. Dietary Factors Incidence of stomach cancer is high among those who consume heavily smoked, pickled or salt-cured foods in large quantities. This is due to carcinogenic nitrosamines. Breast cancer-negatively associated with sedentary lifestyle, high caloric intake, high alcohol consumption Pesticides? Cancers of head and neck associated with smoking & alcohol & decreased intakes of yellow and green fruits/veggies

24. Recommendations For Reducing Cancer Risk Increase fruit and vegetables, especially the deep yellow and dark green cruciferous vegetables for their phytochemical composition. *MOST IMPORTANT Phytochemicals- non-nutrient compounds that protect against cancer by acting as powerful antioxidants. Consume salt-cured, pickled, nitrite-cured, and smoked foods in moderation. Consume alcohol in moderation if at all.

25. Recommendations For Reducing Cancer Risk {Continued} Control weight and prevent obesity. Reduce fat consumption to 30% or less and saturated fat to 10% or less of total energy. Increase dietary fiber to 20-30 grams/day.

26. Diabetes Mellitus A metabolic disorder of carbohydrate metabolism characterized by altered glucose regulation and utilization, usually resulting from insufficient or ineffective insulin.

27. Diabetes Mellitis {continued} Type 1- the person produces no insulin at all. Also known as insulin dependent diabetes mellitus (IDDM) or juvenile onset. Type 2- insulin is produced, however the cells are resistant to it, also known as non- insulin dependent diabetes mellitus (NIDDM).

28. Complications of Diabetes Diseases of the large blood vessels-  CVD Diseases of the small blood vessels-  Loss of kidney function  Retinal degeneration Diseases of the nerves and loss of circulation

29. Dietary Recommendations- Type 1 Diabetes Therapy focuses on maintaining optimal nutritional status, controlling blood glucose, achieving a desirable lipid profile, controlling blood pressure, and preventing complications.

30. Dietary Recommendations- Type 1 Diabetes {continued} Diet must provide a fairly consistent carbohydrate intake from day to day and at each meal to minimize fluctuations in blood glucose Exchange lists for meal planning Carbohydrate counting

31. Dietary Recommendations- Type 2 Diabetes Therapy focuses on maintaining optimal nutritional status, controlling blood glucose, achieving a desirable lipid profile, controlling blood pressure, and preventing complications. Achieve desirable weight as weight loss can reverse insulin resistance. Exchange lists for meal planning