1. 1 Chapter 11 Nutrition and Health

2. 2 Leading Causes of Death in the U.S. Cardiovascular disease  Coronary heart disease  Strokes  High blood pressure Cancer

3. 3 Risk Factors for Heart Disease Cigarette smoking and exposure to tobacco smoke High blood cholesterol High blood pressure Physical inactivity Obesity and overweight Diabetes Increasing age Male Family history of premature heart disease

4. 4 Metabolic syndrome Excessive abdominal obesity High blood triglycerides and/or low HDL Poor blood sugar control Raised blood pressure

5. 5 What leads to most cardiovascular disease? Atherosclerosis (condition characterized by plaque buildup along artery walls – a silent process) High blood pressure

6. 6 Coronary Heart Disease (CHD) CHD - Damage to or malfunction of the heart caused by narrowing or blockage of the coronary arteries.  Angina  Heart attack (Myocardial infarction)

7. 7 What Do Your Cholesterol Numbers Mean?  Total cholesterol  LDL (bad) cholesterol--the main source of cholesterol buildup and blockage in the arteries  HDL (good) cholesterol--helps keep cholesterol from building up in the arteries  Triglycerides--another form of fat in your blood

8. 8 Total Cholesterol and LDL Total Cholesterol LDL <200 mg/dLDesirable<100 mg/dLOptimal 200 – 239Borderline high 100 - 129Above optimal 240 or moreHigh130 - 159Borderline high 160 - 189High

9. 9 How to Lower Cholesterol Therapeutic lifestyle changes (TLC):  TLC diet  Physical activity  Weight management Drug treatment (along with TLC if needed)

10. 10 TLC Diet Low saturated fat (less than 7% of total kcalories) Low cholesterol (less than 200 mg/day) Only enough kcalories to maintain a desirable weight and avoid weight gain If LDL is not lowered enough, the amount of soluble fiber can be increased

11. 11 Heart Disease Quiz (True/False) 1. High blood cholesterol is one of the risk factors for heart disease that you can do something about. 2. To lower your blood cholesterol level you must stop eating meat altogether. 3. Any blood cholesterol level below 240 mg/dL is desirable for adults. 4. To lower your blood cholesterol level you should eat less saturated fat, total fat, and cholesterol, and lose weight if you are overweight. 5. The main goal of cholesterol-lowering treatment is to lower LDL.

12. 12 Heart Disease Quiz (True/False) 6. Saturated fats raise your blood cholesterol level more than anything else in your diet. 7. All vegetable oils help lower blood cholesterol levels. 8. The TLC diet calls for less than 10% of kcalories from saturated fat and less than 300 mg of dietary cholesterol. 9. Women don't need to worry about high blood cholesterol and heart disease. 10. Reading food labels can help you eat the heart healthy way.

13. 13 Answers to Quiz 1. True 2. False 3. False 4. False 5. True 6. True 7. False 8. False 9. False 10. True

14. 14 Stroke Damage to brain cells resulting from an interruption of blood flow to the brain. Most are caused by blockages in the arteries that supply blood to the brain, a few are caused by a ruptured brain artery.

15. 15 Types of Strokes Ischemic strokes Hemorrhagic strokes

16. 16 High Blood Pressure Greater than 120/80 Top number is called the systolic pressure Bottom number is called the diastolic pressure

17. 17 Lifestyle Modification for High Blood Pressure Lose weight if overweight. Exercise regularly. Adopt DASH diet. (high in potassium, calcium, magnesium) Reduce sodium intake to <2400 mg/day. Limit alcohol intake to no more than 2 drinks/day for men and 1/day for women.

18. 18 DASH Diet  Based on a 2,000 calorie a day diet the DASH diet recommends the following number of servings from the listed food groups: *7-8 servings of grain and grain products *4-5 servings of vegetables *4-5 servings of fruits *2-3 servings of low-fat or nonfat dairy products *2 or fewer servings of meat, poultry, or fish *4-5 servings of nuts, seeds and legumes per week *limited intake of fats and sweets

19. 19 Menu Planning for CVD General  Decrease or replace salt in recipes by using vegetables, herbs, spices, and flavorings.  Offer salt-free seasoning blends and lemon wedges.

20. 20 Menu Planning for CVD Breakfast Appetizers and Soups Salads Breads Entrees Side Dishes Desserts Beverages

21. 21 Nutrition and Cancer

22. 22 Guidelines from American Cancer Society Eat a variety of healthful foods with an emphasis on plant sources. Adopt a physically active lifestyle. Maintain a healthful weight throughout life. If you drink alcoholic beverages, limit consumption.

23. 23 Menu Planning to Lower Cancer Risk 1. Offer lower-fat menu items. Offer more plant-based menu items. 2. Avoid salt-cured, smoked, and nitrite-cured foods. 3. Offer high-fiber foods. 4. Include lots of fruits and vegetables (especially cruciferous vegetables). 5. Offer foods that are good sources of beta-carotene, and vitamins C and E. 6. Offer alternatives to alcoholic drinks.

24. 24 Nutrition and Diabetes Mellitus Types  Type 1 diabetes (insulin-dependent)  Type 2 diabetes (non-insulin-dependent) Nearly 90% of people with diabetes Age of onset usually over 45 Most frequently occurs in overweight individuals Slow onset of symptoms Usually runs in families Easier to control

25. 25 Treatment for Diabetes Individualized diet to  maintain good glucose control  keep blood levels of fat and cholesterol in normal ranges  maintain or get body weight within a desirable range Sugars are allowed in moderation. Kcaloric distribution  Carbohydrates and monounsaturated fats: 60-70%  Saturated fat: 10% or less

26. 26 Exchange Lists for Meal Planning ListTypical ItemKcalories Starch1 slice bread80 kcal Meat1 ounce lean55 kcal Vegetable½ cup cooked25 kcal Fruit1 small apple60 kcal Milk1 cup nonfat90 kcal Other Carb.2 small cookiesVaries Fat1 teaspoon margarine 45 kcal

27. 27 Vegetarian Eating Lacto-ovo-vegetarians Lacto-vegetarians Vegans Pesco-vegetarians

28. 28 Potential Health Benefits of Vegetarian Eating Lower incidence of: Hypertension Coronary artery disease Colon and lung cancer Type 2 diabetes Diverticular disease of the colon

29. 29 Why Become Vegetarian?? Health benefits Ecology Economics Ethics Religious beliefs

30. 30 Nutritional Adequacy of Vegetarian Diets Can be nutritionally adequate when varied and adequate in kcalories (except for vegans who need vitamin B12). Nutrients that need special attention:  Vitamin B12  Vitamin D  Calcium  Iron  Zinc

31. 31 Vegetarian Food Pyramid

32. 32 Menu-Planning Guidelines for Vegetarians 1. Use a variety of plant protein sources at each meal. 2. Use a wide variety of vegetables. 3. Offer entrees that are acceptable to each type of vegetarian. 4. Choose low-fat and nonfat varieties of milk and milk products and limit eggs. 5. Offer dishes made with soybeans. 6. Provide foods that have nutrients of special importance: vitamins D and B12, calcium, iron, zinc, and alpha-linolenic acid.

33. 33 Food Facts: Caffeine Most common sources of caffeine in the diet:  Coffee  Tea  Cola  Cocoa Rapidly absorbed Withdrawal symptoms Risks No longer considered a diuretic

34. 34 Hot Topic: Biotechnology Biotechnology Genetic Engineering Plant Applications Animal Applications Regulations Pros and Cons

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