chapter 11 diet and health

1. Chapter 11 DIET AND HEALTH If there is any deficiency in food or exercise, the body will fall sick. -Hippocrates, c 400 B.C.

3. FIGURE 11-1: LEADING CAUSES OF DEATH—UNITED STATES, 2001.a The causes identified with the red bars are related to nutrition; those with green bars are alcohol related. aRates are age adjusted to allow relative comparisons of mortality among groups and over time. bAccidents are the leading cause of death among people aged 15–24, followed by homicide, suicide, cancer, heart disease, birth defects, lung disease, pneumonia and influenza, and stroke. Alcohol contributes to about half of all accident fatalities; together, alcohol-related deaths amount to the third leading cause of mortality. See Controversy 3. FIGURE 11-1: LEADING CAUSES OF DEATH—UNITED STATES, 2001.a The causes identified with the red bars are related to nutrition; those with green bars are alcohol related. aRates are age adjusted to allow relative comparisons of mortality among groups and over time. bAccidents are the leading cause of death among people aged 15–24, followed by homicide, suicide, cancer, heart disease, birth defects, lung disease, pneumonia and influenza, and stroke. Alcohol contributes to about half of all accident fatalities; together, alcohol-related deaths amount to the third leading cause of mortality. See Controversy 3.

4. Leading Causes of Death Infectious diseases Antibiotics and vaccines have eradicated/cured infectious diseases, especially in “developed” countries. True or False?

5. Nutrition and Immunity Barriers to infection Skin and mucous membranes Immune cells and antibodies The proper functioning of these barriers is vital for prevention of or coping with infections.

6. Nutrition and Immunity Dietary deficiencies and toxicities that impair immunity Protein energy malnutrition (PEM) Vitamins A, D, E, F, B’s, and C deficiencies Iron, zinc, copper, magnesium, and selenium deficiencies Iron and zinc toxicities Malnutrition is especially harmful in the very thin, very young, very old, the poor, and those hospitalized or already suffering from chronic illness.

7. Degenerative Diseases Lifestyle choices and risk factors, fig 11.3a. Risk factor = circumstantial evidence Includes environmental, behavioral, social and genetic factors. Risk factors are additive Some diseases have more risk factors than others. *Interaction among diseases, fig 11.3b.

8. FIGURE 11-3: DIET/LIFESTYLES RISK FACTORS AND DEGENERATIVE DISEASES. This chart shows that the same risk factor can affect many degenerative diseases. Notice, for example, how many diseases have been linked to a sedentary lifestyle. The chart also shows that a particular disease, such as atherosclerosis, can have several risk factors. FIGURE 11-3: DIET/LIFESTYLES RISK FACTORS AND DEGENERATIVE DISEASES. This chart shows that the same risk factor can affect many degenerative diseases. Notice, for example, how many diseases have been linked to a sedentary lifestyle. The chart also shows that a particular disease, such as atherosclerosis, can have several risk factors.

9. FIGURE 11-3: DIET/LIFESTYLES RISK FACTORS AND DEGENERATIVE DISEASES. This flowchart shows that many of these conditions are themselves risk factors for other degenerative diseases. For example, a person with diabetes is likely to develop atherosclerosis and hypertension. These two conditions, in turn, worsen each other. Notice how all of these degenerative diseases are linked to obesity. FIGURE 11-3: DIET/LIFESTYLES RISK FACTORS AND DEGENERATIVE DISEASES. This flowchart shows that many of these conditions are themselves risk factors for other degenerative diseases. For example, a person with diabetes is likely to develop atherosclerosis and hypertension. These two conditions, in turn, worsen each other. Notice how all of these degenerative diseases are linked to obesity.

10. Degenerative Diseases Lifestyle choices and risk factors cont’d Poor dietary choices. Alcohol and tobacco abuse. Predisposition to diseases (genetics). These can often be reduced with reduction of other risk factors for that disease. ***Know your family history and start young eliminating risk factors you can control.

11. Nutrition and Atherosclerosis Cardiovascular disease (CVD) is a major cause of death worldwide. Atherosclerosis is the major cause of CVD. What is atherosclerosis? Begins as damage to artery wall. Damage causes an inflammatory response. LDLs are oxidized attracting other immune cells. Plaque formation.

12. FIGURE 11-4: THE FORMATION OF PLAQUES IN ATHEROSCLEROSIS. FIGURE 11-4: THE FORMATION OF PLAQUES IN ATHEROSCLEROSIS.

13. Nutrition and Atherosclerosis What is Atherosclerosis? Cont’d Plaques make arteries inelastic and narrow the passageway. Hypertension develops and further damages the arteries and may lead to an aneurysm (weakening of artery wall). Blood flow in arteries can be reduced by plaques or blood clots causing a heart attack or stroke. Stationary blood clot = thrombus, blood clot that breaks loose = embolus.

14. Nutrition and Atherosclerosis Major risk factors for CVD, Table 11.2. Assess your risks, Fig 11.6 and 11.7.

16. Nutrition and Atherosclerosis Risk Factors cont’d Diabetes: Metabolic syndrome:

17. Nutrition and Atherosclerosis Recommendations – CVD risks Reduce intake of saturated and trans fats. Increase activity and fiber intake. Avoid alcohol (moderate intake may be beneficial). Avoid tobacco. Vitamin E? Other dietary benefits, table 11.4.

18. Nutrition and Atherosclerosis Recommendations cont’d Control stress Treatment – drugs Statins that block production of cholesterol and/or cholesterol absorption blockers. Aspirin and other “blood thinners”.

19. Nutrition and Hypertension 1/3 of U.S. adults have hypertension, a major risk factor for strokes and heart attacks. Risk increases with age – as many as 90% of people over the age of 65 have hypertension. Risk increases with ongoing atherosclerosis.

20. Nutrition and Hypertension Hypertension has no symptoms until it is too late. **Measure your blood pressure Systolic (upper number) Diastolic (lower number) Normal – below 120/80 (now considered borderline hypertension).

21. Nutrition and Hypertension Blood Pressure Varies directly with cardiac output (blood volume) and resistance to blood flow in the arteries. It is necessary to push blood through the arteries to the tissues.

22. Nutrition and Hypertension Role of the Kidneys Maintenance of blood pressure is necessary for filtration of blood in the kidneys. When blood pressure is low, the kidneys “sense” low blood volume and release hormones that: Constrict arteries and raise blood pressure. Increases absorption of sodium and water to increase blood volume.

23. Nutrition and Hypertension Blood Pressure Atherosclerosis sends a false signal to the kidneys that blood volume is low. Increased blood pressure damages arteries, increases atherosclerosis and increases the false signals to the kidneys.

24. Nutrition and Hypertension Risk Factors for Hypertension Diabetes, especially Type II Obesity Age (increased) Genetics Race – increased in African Americans?

25. Nutrition and Hypertension Prevention/control of Hypertension Decrease sodium intake, especially for “salt” sensitive individuals Control weight Decrease dietary fat and increase dietary fiber Increase physical activity Avoid alcohol and tobacco Adequate intake of calcium, potassium, magnesium and vitamin C

26. Nutrition and Hypertension Prevention/control of Hypertension Drugs Diuretics ACE inhibitors *Receptor blockers DASH diet, table 11.5.

28. Nutrition and Cancer Despite “cures”, cancer is now the #1 cause of death in the U.S. Probabilities of developing cancer: 1 in 2 men, 1 in 3 women. Risk factors: Genetics Viral infections Smoking

29. Nutrition and Cancer Risk factors cont’d Being overweight or obese is implicated in as many as 15% of cancers. Lack of physical activity implicated in colon and breast cancer. Poor diet implicated in 20-50% of cancers. Diets high in red meat and fats. Low fiber intake and alcohol abuse also implicated.

30. Nutrition and Cancer How does Cancer Develop? 6 Steps Exposure of cells to a carcinogen. Carcinogen enters cells. Carcinogen causes mutation of DNA. “Promoters” cause uncontrolled cell division in mutated cells causing a tumor, etc. Cells break loose and affect many organs = metastasis. Body functions are disrupted.

31. FIGURE 11-9: CANCER DEVELOPMENT. FIGURE 11-9: CANCER DEVELOPMENT.

32. Nutrition and Cancer Diet and Cancer – the bad Saturated and trans fats act as promoters - associated with breast cancers. Excess omega 6 fatty acids may promote cancer, omega 3 fatty acids may be protective. High calorie intake and obesity are linked to several cancers. Tobacco – linked to head, neck, lung and other cancers .

33. Nutrition and Cancer Diet and Cancer – the bad cont’d Alcohol – linked to mouth, throat, breast and liver cancers High heat cooking (blackening, Bar-B-Cue) – meats and carbohydrate rich foods. Increases carcinogens in air and on foods. Iron overload – associated with colon cancer.

34. Nutrition and Cancer Diet and Cancer – the bad cont’d Lack of fluids (& alcohol abuse) – associated with bladder cancer. Folate deficiency is associated with cervical cancer. ?Other vitamin deficiencies.

35. Nutrition and Cancer Diet and Cancer – the good Fruits and veges: vitamins (antioxidants) and fiber. Folate enriched foods. Calcium and other minerals. Phytochemicals and cruciferous veges.

36. Other Cautions Herbal medicine and alternative therapies **Oral contraceptives Caffeine Illicit drugs Stress

37. FIGURE 11-11: PROPER NUTRITION SHIELDS AGAINST DISEASES. A well-chosesn diet can protect your health. FIGURE 11-11: PROPER NUTRITION SHIELDS AGAINST DISEASES. A well-chosesn diet can protect your health.