Chapter 18
Diet & Health
Cardiovascular Disease
Hypertension
Cancer
Nutrition And Chronic Disease
Leading causes of death in the U.S.
Copyright 2005 Wadsworth Group, a division of Thomson Learning
Nutrition And
Chronic Disease
Copyright 2005 Wadsworth Group, a division of Thomson Learning
Cardiovascular Disease
• Heart/blood vessel disease, includes:
–Coronary heart disease (CHD)most common form of CVD
• Atherosclerosis of the coronary
arteries
–Hypertension (HTN)
–Heart failure
Atherosclerosis
• “Hardening of the arteries”- begins as
accumulation of fatty streaks along the inner
arterial walls that gradually enlarge & harden
• Fatty plaques in artery walls caused by:
1. Accumulation of lipids
2. Inflammatory response in response to
tissue damage from high LDL cholesterol,
HTN, toxins from cigarette smoking, elevated
homocysteine, infections
3. Platelets forming blood clots that cause a
thrombosis or embolism
Atherosclerosis
• Narrowing/Obstruction of blood flow results in:
1. High blood pressure – needed to
deliver blood to the tissues
2. High C-reactive protein – marker of
inflammation
3. Angina – pain & pressure when heart
muscle deprived of oxygen
4. Heart attack – area of the heart muscle dies
when blood flow is cut off
5. Stroke or transient ischemic attack –
restricted blood flow to the brain
Copyright 2005 Wadsworth Group, a division of Thomson Learning
Risk Factors For CHD
Copyright 2005 Wadsworth Group, a division of Thomson Learning
Diet Strategies to Prevent
& Treat CHD
• Four main goals:
1. A healthy eating pattern
2. A healthy body weight
3. A desirable blood cholesterol and
lipoprotein profile
4. A desirable blood pressure
A Healthy Eating Pattern
• Consume a variety of fruits,
vegetables, and whole grain products
to increase antioxidants, folate (to
decrease homocysteine levels) and
viscous fiber to 20-30 gm/day
• Include fat-free and low fat milk
products, fish, legumes, poultry, and
lean meats
A Healthy Body Weight
• Balance energy intake with energy needs
reduce total fat intake; a diet high
in fat is generally high in calories
• Achieve a level of physical activity that
either balances with energy needs (for
weight maintenance) or exceeds energy
needs (for weight reduction)
A Desirable Blood Cholesterol
and Lipoprotein Profile
• Decrease total fat to 25-35% of total
calories
• Decrease saturated fat intake to <10% of
total calories to lower LDL; dietary sources
include meat, poultry, butter, dairy
products, coconut oil, palm oil, cocoa
butter, hydrogenated oils; solid at room
temperature
A Desirable Blood Cholesterol
and Lipoprotein Profile
• Replace saturated fat with unsaturated fatty
acids; liquid at room temperature
Monounsaturated Fatty Acids – canola & olive
oils, avocados, peanuts, pecans;
Recommendation <20% of total calories to
lower LDL & raise HDL
Polyunsaturated Fatty Acids – corn,
sunflower, safflower & soybean oils
Recommendation <10% of total calories
Omega-3 fatty acids – fish & flaxseed oil lowers
LDL & HDL
A Desirable Blood Cholesterol
and Lipoprotein Profile
• Limit trans-fatty acids – hydrogenated
unsaturated fats (vegetable oils) raise
LDL;
Dietary sources include margarine, baked
goods, shortening, peanut butter
• Limit cholesterol intake to <250 mg/day;
Dietary sources include egg yolks, organ
& high-fat meats, butterfat
A Desirable Blood Cholesterol and
Lipoprotein Profile
• Moderate alcohol intake, if at all; may be
cardioprotective by raising HDL & preventing blood
clots but may raise triglycerides
• Phytosterols-compete
with cholesterol absorption;
added to margarines
• Physical activity
• Smoking cessation
• Drug therapy
Copyright 2005 Wadsworth Group, a division of Thomson Learning
A Desirable Blood Pressure
• Cause of high blood pressure unknown although
kidneys play a role
• Risk factors:
1. Age – increases after age 50
2. Heredity
3. Obesity/Diabetes
4. Race – higher among African-Americans
5.Smoking
6.Alcohol
7.High blood lipids
8.Gender
A Desirable Blood Pressure
• High blood pressure can result in:
1. Heart strain -> heart failure
2. Aneurysm
3. Accelerates atherosclerosis
4. Kidney failure
Recommendations for Reducing
Hypertension Risk
• Limit the intake of sodium to <2400 mg/day; limit
table salt and salted, smoked, canned, and
highly processed foods
• Limit alcohol consumption (no more than
1 drink/day for women and 2 drinks/day for men)
• Maintain a healthy body weight, especially
abdominal fat
• Increase physical activity
Recommendations for Reducing
Hypertension Risk
• Increase potassium, calcium, and magnesium
intake
DASH diet – Dietary Approaches to Stop
Hypertension; increase fruits, vegetables,
legumes, nonfat dairy products along with low
fat, low saturated fat, low cholesterol
diet
Potassium especially important if on
potassium wasting diuretic; 8-10 servings fruits
& vegetables/day
Copyright 2005 Wadsworth Group, a division of Thomson Learning
Cancer
• Cancer is not a single disorder but all
develop from mutations in the genes that
regulate cell division
• Tumor (neoplasm) – abnormal mass of
cells with no function
– Malignant tumors multiply out of control and
threaten health
– Benign tumors stop growing or can be
surgically removed
How Cancer Develops
• Genetic factors – inherited predisposition
• Immune factors – tumor cells not
recognized as foreign
• Environmental factors – exposure to
radiation and sun, water and air pollution,
smoking
• Dietary factors - Initiators
- Promoters
- Antipromoters
How Cancer Develops
Copyright 2005 Wadsworth Group, a division of Thomson Learning
Cancer Initiators
• Factors that cause mutations that give rise
to cancer
– Alcohol
– Pesticides
– Grilled food creates polycyclic aromatic
hydrocarbons
– Red meat
– Fried foods containing acrylamide
Cancer Promoters
• Factors that favor the development of
cancer once it has started
–High saturated and trans-fatty acid
diets
–High calorie diets
Cancer Antipromoters
• Factors that oppose the development of
cancer
– Omega-3 fatty acids
– Fiber
– Cruciferous vegetables containing
phytochemicals
– Antioxidant nutrients – beta-carotene, vitamin
C and Vitamin E
Recommendations For
Reducing Risk
• Eat a variety of healthful foods
– Emphasize plant sources
• Adopt a physically active lifestyle
• Maintain a healthful weight throughout life
• If you drink alcoholic beverages, limit
consumption
• Do not smoke or use tobacco in any form
Copyright 2005 Wadsworth Group, a division of Thomson Learning
Food Guide Pyramid for
Disease Prevention
Copyright 2005 Wadsworth Group, a division of Thomson Learning