Nutrition and Cardiovascular disease
which includes coronary heart disease, stroke and other circulatory diseases. The major cardiovascular diseases affecting the developed world have at their core atherosclerosis and hypertension, both of which are profoundly affected by diet
.Dietary influences on cardiovascular disease have been established for many years.
These include
 saturated fat, which influences cholesterol and on thrombosis
 salt intake, which can increase blood pressure
 overall calorie intake, which can lead to weight gain.
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The aim of these nutrition guidelines is to help reduce the cardiovascular disease risk of
The four population goals
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A reduction in the intake of saturated fat and trans fat (less than 10% of dietary energy and a reduction in trans fat to less than 2% of energy)
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An increase in the consumption of fruit and vegetables
400grams a day (
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A reduction in the intake of salt) less than 6 grams a day (
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A reduction in body mass index (BMI((less than 25 kg/m2 )
Other recommendation :
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-Dietary cholesterol consumption should be restricted to less than 300 mg/d, mainly through the restriction of dairy fats
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Dietary intake of potassium lowers blood pressure and is protective against stroke and cardiac arrhythmias Potassium is found in meat, milk, vegetables, potatoes, fruit and fruit juices, bread, fish, nuts and seeds .
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Restricting daily salt (sodium chloride) intake to less than 5 g/d
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Fiber is protective against CHD and has also been used in blood pressure lowering diets.
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Fruits and vegetables contribute to cardiovascular health is recommended to reduce the risk of CHD, stroke and HBP
 Regular fish consumption, as consumed on a weekly basis is protective against
CHD and ischemic stroke
 Dietary intake of sodium, from all sources, influences blood pressure levels in populations and should be limited so as to reduce the risk of CHD and both forms of stroke
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Ensuring adequate amounts of calcium and magnesium in the diet is important to protect against high blood pressure (WHO/ISH, 1999). Sources of calcium include milk and dairy products, soft bones in canned fish, bread, pulses, green

vegetables, dried fruit, nuts and seeds. Foods containing magnesium include cereals and cereal products, meat, green vegetables, milk, potatoes, nuts and seeds .
Nutrition for Special Age Groups
A-Maternal Nutrition
A varied and balanced diet with adequate amounts of energy and nutrients is essential both before conception and during pregnancy. .
During pregnancy, extra servings are needed from the meat, fish and alternatives shelf and from the milk, cheese and yogurt group. For breastfeeding mothers, extra servings from the milk, cheese and yogurt group are required .Evidence indicates that the maternal diet influences the health of the baby
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An adequate intake of folic acid is essential in advance of conception and during the first 12 weeks of pregnancy. Ensuring a diet rich in folic acid can help to prevent neural tube defects such as spina bifida. To achieve the recommended intake of 400µg per day .Good food sources of folic acid include dark green vegetables and oranges as well as some fortified foods such as breakfast cereals and milk.
B-
Childhood Nutrition
The nutrition and dietary habits of children (2-18 years) are complex and these are discussed in detail in the World Health Organization and recommendations for the prevention of cardiovascular disease among adults are not suitable for children. The higher energy needs of children suggest a less restrictive threshold for fat intake (no more than 35%). Furthermore, as the child grows, energy requirements change, therefore three broad age-bands have been chosen namely, under two years,
1.
Under two years: milk is the first food and one half of the total energy requirement is met by the fat or lipid fraction of milk. Wherever possible, breastfeeding is to be recommended. As the infant is weaned and spoon feeds are introduced, the amount of energy derived from milk fat decreases.
However, breast milk or formula milk should remain the primary nutrient source for the first year and whole cows’ milk for the second
2.
Children between two and five years: a gradual reduction in fat intake to approximately 35% of energy requirements is to be recommended.
3.
Children older than five years: require a moderate intake of fat (no more than
35% of

Older People
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Older people, who are healthy and fit, have similar nutritional needs to the general
 population, but special attention needs to be given to fiber, calcium, salt and cholesterol
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Constipation can be a common complaint amongst older people, especially those with
 decreased mobility. A high fiber intake is very important to prevent constipation. The
 fiber found in fruit and vegetables, peas, beans, lentils and oats may also help to reduce
 cholesterol levels and control blood sugar levels. Foods such as fruit and vegetables ,
 whole meal breads, cereals should be included in the daily diet. It is very important to
 increase fibre intake gradually and to also increase fluid consumption. Fibre- rich foods
 also have a high satiety value and therefore help control weight .
 Calcium is needed for building and maintaining strong bones. It also helps the muscles ,heart and nervous function properly. Loss of calcium from the bones is part of ageing
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The risk of developing high blood pressure increases with age. Excess salt
(sodium) can increase blood pressure, which in turn can cause heart disease, stroke and kidney disease .
 . Foods rich in saturated fat should not be eaten regularly. On the other hand foods rich in polyunsaturated fats and monounsaturated fats can lower cholesterol levels when used in the diet instead of saturated fat
General recommendation for proper nutrition during all age groups
 Breast milk is preferred to infant formula where possible, as it contains many protective and immunological factors that benefit the baby’s development. Fruit juice is not recommended for babies under the age of six months.
 Solids should be introduced around six months of age to meet your baby’s increasing nutritional and developmental needs. However, breastfeeding should continue until twelve months of age and beyond, or for as long as the mother and child desire.
 Give your baby foods that are rich in iron and zinc, such as iron-enriched infant cereals, pureed meats and poultry dishes, cooked plain tofu and legumes/soy beans/lentils. Iron-enriched rice-based cereals are frequently recommended as the first food to be introduced, as there is the additional benefit of a lower risk of an allergic reaction.
 Do not add salt, sugar or honey to your baby’s food. It is unnecessary.

 Avoid cow’s milk as a drink in the first 12 months. Small amounts can be used in cereals and custards. All milk used should be pasteurized.
 Whole fruit is preferable to fruit juice. Avoid juices and sugar sweetened drinks.
 Avoid whole nuts, seeds or similar hard foods to reduce the risk of choking.
 Introduce foods one at a time. Offer new foods once every three to four days to avoid confusion and to rule out food allergy and sensitivity.
 Feed babies during any illness and feed up after illness. Give ample liquids if your baby has diarrhea.
 Occasional exposure of the skin to sunlight is usually enough to provide a baby’s vitamin D requirements, but this does vary from season to season and with skin color.
 If a child is gaining inappropriate weight for growth, limit energy-dense, nutrientpoor snack foods. Increase your child’s physical activity. You could also limit the amount of television watching.
 Tooth decay can be prevented with regular brushing and visits to the dentist. Avoid sugary foods and drinks, especially if sticky or acidic.
 Be aware of foods that may cause allergic reactions, including peanuts, shellfish and cow’s milk. Be particularly careful if there is a family history of food allergy.
 The extra energy required for growth and physical activity needs to be obtained from foods that also provide nutrients, instead of just ‘empty calories’.
 Takeaway and fast foods need to be balanced with nutrient-dense foods such as wholegrain breads and cereals, fruits, legumes, nuts, vegetables, fish and lean meats.
 Milk, yoghurt and cheese (mostly reduced fat) should be included to boost calcium intake – this is especially important for growing bones. Cheese should preferably be a lower salt variety.
 Adolescent girls should be particularly encouraged to consume milk and milk products
 For adult Make a deliberate effort to keep physically active.
 Limit alcohol intake.
 Reduce the amount of fats and salt in the daily diet.
 Be careful to include foods rich in iron and calcium.
 Establish healthy eating habits that will be carried on into later life.
 A pregnant woman should concentrate on increasing her nutrient intake, rather than her kilojoules intake, particularly in the first and second trimesters. In Australia, pregnant women are expected to gain about 10 to 13 kg during pregnancy.
However, this depends on the pre-pregnancy weight of the mother.
 Concentrate on diet quality rather than quantity.
 Nutrients for which there are increased requirements during pregnancy include folate, iron, vitamin B12 and iodine.
 Iron is required for oxygen transport in the body. Iron supplements can be advised by your doctor during pregnancy, but do not take them unless your doctor recommends them. Increasing vitamin C intake can help increase iron absorption from foods.

 Iodine is important for normal growth and development of the baby. Iodine supplements are often advised during pregnancy to meet the increased needs, as food sources (such as seafood, iodised salt and bread) are unlikely to provide enough iodine. Talk to your doctor about this.
 Do not smoke – both direct and passive smoking is associated with growth retardation, increased risk of spontaneous abortion, stillbirths, placental complications and low birth weight.
 Eat enough food – breastfeeding burns through extra kilojoules.
 Eat and drink regularly – breastfeeding may increase the risk of dehydration and cause constipation. fluid needs are approximately 750 – 1000 ml a day above basic needs.
 Women should continue to avoid drinking alcohol while breastfeeding.
 Many people eat less as they get older – this can make it harder to make sure your diet has enough variety to include all the nutrition you need.
 Be as active as possible to encourage your appetite and maintain muscle mass.
 FOR OLDER Remain healthy with well-balanced eating and regular exercise.Eat foods that are nutrient dense rather than energy dense, including eggs, lean meats, fish, liver, low-fat dairy foods, nuts and seeds, legumes, fruit and vegetables, wholegrain breads and cereals.
 FOR OLDER Limit foods that are high in energy and low in nutrients such as cakes, sweet biscuits and soft drinks.
 FOR OLDER Choose foods that are naturally high in fibre to encourage bowel health.
 Share mealtimes with family and friends.