1. Eating to Live…. Not Living to Eat Cooperative Extension Service University of Kentucky

2. Objectives Identify the leading causes of death in Kentucky and their relationship with diet. Explore nutrition attitudes & behaviors. Recognize common serving sizes. Identify the benefits of physical activity. Identify risk factors of chronic disease. Explore dietary interventions for chronic disease.

3. Leading Causes of Death

4. Risk Factors & Chronic Disease SOME CANCERS ATHEROSCLEROSIS STROKE & HEART ATTACK OBESITY HYPERTENSION GALLBLADDER DISEASE DIABETES

5. Diet Related Risk Factors Cancers Diabetes Atherosclerosis Obesity Stroke X X X X X X X X X X High Fat/Sat High Alcohol Low CHO/Fiber Low Vit or Min High Salt/Pickled Chronic Disease

6. Trends 2000 “I’m already doing it.” “I know I should, but…” “Don’t bother me.” -Nutrition & You: Trends 2000, ADA

7. Serving Savvy FoodServing SizeLooks Like…. Meat, chicken, fish3 ozDeck of cards Pasta or rice1 cupWalkman Vegetables½ cupTennis ball Cheese1 ozTwo saltines Ice cream or frozen yogurt ½ cupTennis ball

8. Recreational Activity 15 minutes Shovel snow Run 1½ mile Stair walk Jump rope 20 minutes Play basketball game Swim laps Reference: Eating Smart, 1996 30 minutes Rake leaves Walk 2 miles Push stroller 1½ mile Shoot basketball Bike 5 miles Dance fast Water aerobics 45 minutes Garden Play touch football

9. Potential Benefits of Activity Increased self- confidence Easier weight control More energy Less stress and anxiety Improved sleep Healthier appearance Lowered risk of heart disease Stronger bones Lowered risk of diabetes Lowered risk of hypertension Increased quality of life

10. Fat Cell Development in Obesity Reference: Understanding Nutrition, 2002

11. Healthy People 2010 HEART DISEASE & STROKES HYPERTENSION CANCER DIABETES

12. Heart Disease & Strokes Cardiovascular Disease (CVD) Coronary Heart Disease (CHD) Atherosclerosis Hypertension Heart Attack Stroke

13. Major Risk Factors for CHD High blood cholesterol Hypertension Diabetes (insulin resistance) Obesity Physical inactivity Smoking

14. Standards for CHD Risk Factors Risk FactorsDesirableBorderlineHigh Total blood cholesterol<200 mg/dL200-239>240 LDL<130 mg/dL130-159>160 Triglycerides, fasting<150 mg/dL150-499>500 Obesity (BMI)18.5-24.925-29.9>30 Systolic blood pressure Diastolic <120 <80 121-139 81-89 >140 >90

15. AHA Dietary Guidelines Healthy Eating Pattern Healthy Body Weight Desirable Blood Cholesterol & Lipoprotein Profile Desirable Blood Pressure

16. Other Dietary Interventions Dietary FactorProtection Soluble Fiber Lowers blood cholesterol Decreases risk of heart attack Improves LDL/HDL ratio Omega-3 Fatty Acids Limit clot formation Prevent irregular heart beat Lowers risk of heart attack Alcohol Raises HDL Prevents clot formation Folate, Vitamin B 6 & B 12 Reduce homocysteine Vitamin E Slows plaque formation Lowers risk of heart attack Limits LDL oxidation Soy Lowers blood cholesterol Raises HDL cholesterol Improves LDL/HDL ratio

17. Reduce Hypertension Risk Weight Control Aim for a healthy weight Physical Activity Increase physical activity Alcohol If you drink, do so moderately Sodium/Salt Intake (1 tsp salt = 2 g sodium) Choose and prepare foods with less salt The DASH Eating Plan Eat a variety of fruits and vegetables daily Drug Therapy

18. Daily Servings Comparison Food GroupDASHPyramid Grains7-86-11 Vegetables4-53-5 Fruits4-52-4 Milk(non-fat)2-42-3 Meat(lean)2 or less2-3 kCalories20001600-2800

19. Kentucky Cancer Burden 2002

20. Specific Cancer Relationships Based on Epidemiological Studies Cancer SitesIncidence Association PancreaticSmoking; possibly meat, cholesterol EsophagealAlcohol, tobacco & combined use StomachSalt-preserved foods; possibly bbq & grilling ColorectalFat; possibly eggs, grilling, sugar LiverHepatitis B or aflatoxins; alcohol LungSmoking; possibly alcohol, fat & cholesterol Breast Obesity; early puberty; alcohol; possibly meat & fat EndometrialObesity, estrogen therapy, fat CervicalFolate deficiency; smoking Bladder Smoking; possibly artificial sweeteners, coffee & alcohol ProstateHigh fat intake

21. Definition of Antioxidants Antioxidants are compounds typically found in foods that significantly decrease the adverse effect of oxidants on body functions. Oxidative stress is damage inflicted on cells in the body. Free radicals are unstable, highly reactive molecules that cause oxidative stress.

22. The Theory of Antioxidants & Disease Fatty acids, DNA, or cholesterol Oxygen free radical Vitamin E stops the chain reaction by changing the nature of the free radical. Vitamin E

23. Top Antioxidant Fruits & Vegetables Prunes Raisins Blueberries Blackberries Strawberries Raspberries Plums Oranges Red Grapes Cherries Kale Spinach Brussels sprouts Broccoli Beets Red bell pepper Onion Corn Eggplant

24. Dietary Recommendations Choose a diet rich in a variety of plant- based foods. Maintain a healthy weight and be physically active. Drink alcohol in moderation, if at all. Select foods low in fat and salt. Prepare and store foods safely. Do not smoke or use tobacco in any form!

25. Features of Diabetes Type 1 DiabetesType 2 Diabetes Other names Insulin-dependent diabetes mellitus (IDDM) Noninsulin-dependent diabetes mellitus (NIDDM) Juvenile-onset diabetesAdult-onset diabetes Ketosis-prone diabetesKetosis-resistant diabetes Brittle diabetesStable diabetes Onset average age <20 (mean age 12)10-19; >40 Insulin required? YesSometimes Insulin cell response NormalResistant Symptoms Relatively severeRelatively moderate Prevalence in diabetics 5-10%90-95%

26. Untreated Diabetes Consequences Type 1 No glucose enters cells Cells break down protein & fat Hunger Ketones are produced Diabetic acidosis Diabetic coma Weight loss Excessive eating Type 2 Some glucose enters cells slowly Hunger Excessive eating Weight gain Blood glucose rises Glycosuria Water moves into blood Polyuria Dehydration Excessive thirst

27. Diet & Health Recommendations Reduce total fat intake to <30% of total calories, saturated fats intake to less than 10% of total calories, & cholesterol intake <200 mg per day. Increase intake of complex carbohydrates. Maintain protein intake at moderate levels. Balance food intake and physical activity to maintain appropriate body weight. Limit consumption of alcoholic beverages. Limit total daily intake of sodium to <2 g. Maintain adequate calcium intake. Avoid taking dietary supplements in excess.

28. BALANCED DIET + PHYSICAL ACTIVITY = You are what you eat + You are how you move = You are how you feel…GREAT!