1. Cardiovascular System
KNH 411

2. 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)

3. Only about 5% of clients respond to lowering salt intake for lowering BP
5% salt sensitive
95% will not respond

4. 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

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

8. Weight reduction is number one treatment for hypertension

9. 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

10. 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

11. © 2007 Thomson - Wadsworth

12. Adult treatment panel—ATP III
Identify clinical status—risk factors
Final step: what kind of therapy and LDL goal—TLC plan

13. © 2007 Thomson - Wadsworth

14. We would intervene if TG is above 150

15. 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

16. © 2007 Thomson - Wadsworth

17. 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

19. Atherosclerosis Nutrition Therapy - Other
Increase sources of soluble fiber
Increase intake of plant sterols
Weight loss – BMI
Regular physical activity

20. 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

22. Ischemic Heart Disease
Nutrition Therapy
Post MI
Decrease oral intake
Clear liquids, no caffeine
Progress to soft, more frequent meals
Individualized – use TLC recommendations

23. 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

25. 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