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
Hypertension
 Nutrition Therapy
 DASH-Dietary Approaches to Stopping Hypertension
 Decrease Sodium, saturated fat, alcohol
 Increase calcium, potassium, fiber
 Lifestyle Changes
Atherosclerosis
 Etiology - risk factors cont.
 Physical inactivity
 Atherogenic diet: the western diet. Not for the better.
Normally high in fat and low in fiber.
 Diabetes mellitus: more than 2-3 X as likely to develop CAD
 Impaired fasting glucose/ metabolic syndrome
 Cigarette smoke: inhaling smoke decreases vascular system
© 2007 Thomson - Wadsworth
© 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 -2 q.d
© 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
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Atherosclerosis
 Nutrition Therapy - Other
 Increase sources of soluble fiber
 Increase intake of plant sterols
 Weight loss – BMI 18.5-24.9
 Regular physical activity
 Nutrition Therapy Prescription
Atherosclerosis
 Assessment of dietary fat intake, saturated fat intake
 MEDFICTS assessment tool: food frequency chart you can use
with the individual
 Looks at weekly serving size and comes out with a score for
you
 Dietary CAGE questions
 Acronym for cheese animal fats, got it away from home, Eat
high fat commercial products
 Easy what to assess what sort of foods of concern to us
that they have been eating
 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
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
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