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Chapter 18. Diet and Health. Ten Leading Causes of Death in US. Heart disease Cancer Stroke Chronic obstructive lung disease Unintentional injuries Pneumonia and influenza Diabetes mellitus HIV Suicide Homicide. Leading Causes of Death. Risk Factors in Chronic Disease.

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Chapter 18

Diet and Health

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Ten Leading Causes of Death in US

Heart disease



Chronic obstructive lung disease

Unintentional injuries

Pneumonia and influenza

Diabetes mellitus




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I. Heart Disease and Stroke

(cardiovascular disease CVD)

A. Development of Atherosclerosis 1. Plaque development a. Damage to artery b. Platelets and cells migrate to site, cholesterol is deposited c. Fatty streaks form  enlarge and harden d. Arteries stiffen and narrow 2. Blood pressure risesa.  elasticity of blood vessels   damage  plaques

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Development of Atherosclerosis (cont)

3. Blood clots form (platelets respond to plaques)a.  Plaques  blood clots

4. Blockage of artery by clota. Occurs in brain = stroke b. Occurs in heart = heart attack

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Heart Disease and Stroke (cont)

B. Risk Factors for Cardiovascular Disease (CVD)

1.  LDL,  HDLa. LDL (cholesterol linked to CVD) b. HDL (returns cholesterol to liver) 2. Men over 45 y/o  risk a. LDL 3. Women over 55 y/o  riska. Menopause ( estrogen) 1.  LDL,  HDL 2. Replace estrogen  CVD

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Heart Disease and Stroke (cont)

4. Hypertension ( blood pressure)a.  damage to vessels  plaques 5. Smokinga.  HDL b.  O2 damages platelets plaque formation 6. Diabetesa.  HDL,  LDL, HPT, obesity b. 80% die of some type of CVD

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Heart Disease and Stroke (cont)

C. Recommendations for Reducing Risk for CVD 1. Know your blood pressure 2. Cholesterol screeninga. HDL, LDL, TG’s 3. Control weighta. Weight loss  BP,  cholesterol,  TG’s 4. Reduce fat, especially saturated fat Saturated fat cholesterol

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Heart Disease and Stroke (cont)

5. Other dietary interventionsa. Two-step diet plan 1. Focus on reducing cholesterol a.  saturated fat especially,  total fat,  cholesterol b.  soluble dietary fiber (oat) 1.  cholesterol c.  antioxidant (Vitamin C, Vitamin E) d. Wine consumption 6. Physical activitya.  HDL

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II. Hypertension (HPT)

A. Blood Pressure Regulation 1. Closed system (heart and vasculature) 2. Kidneys, liver, hypothalamus, adrenal and pituitary glandsB. Development of HPT 1. Etiology unknown 2. Kidneya. Atherosclerosis  blood flow to kidney  blood pressure  burden on heart

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Development of HPT (cont)

3. Obesitya.  insulin  kidney retains Na  BP 4. Resulta Aneurysm (blood vessel ruptures) b. Heart failure c. Stroke d. Kidney disease

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Development of HPT (cont)

C. Risk Factors for HPT 1. Age - arteries lose elasticity 2. Hereditary -  risk 2-5 fold 3. Obesity 4. Race -  risk 2 fold in blacks

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Development of HPT (cont)

D. Recommendations for Reducing HPT 1.  weight 2.  physical activity 3.  Na 4.  alcohol 5. Drug therapya. Diuretics ( water loss)

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III. Cancer

Initiation, promotion and progressionA. Development 1. Initiationa. Genetic damage (critical gene)1. Carcinogen 2. Hereditary 3. Free radicals produced in oxidation reactions

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Cancer (cont)

2. Promotiona. Initiated cells are stimulated to replicate 1. Dietary compounds 2. Environmental compounds 3. Hormones (estrogen) 3. Progressiona. Metastasis 1. Cancer cells from the original tumor spread to other tissues

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Cancer (cont)

B. Risk Factors 1. Genetic 2. Environmental 3. Diet - initiatora. Smoked meats, spices, barbecue, pickled 4. Diet - promotera. Fats, calories 5. Diet - anti-promotera. Fruits and vegetables 1. Fiber, antioxidants, phytochemicals

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IV. Diabetes Mellitus (DM)

A. Insulin Dependent DM (IDDM) 1. Pancreas unable to synthesize insulin 2. 5-10% of diabetes 3. Autoimmune disease ?B. Non-Insulin Dependent DM (NIDDM) 1. 90-95% of diabetes 2. 90% are obese 3. Pancreas produces insulin but cells are resistant to the effects

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Diabetes Mellitus (DM) (cont)

C. Complications of Diabetesrelated to  blood glucose 1. Disease of the large blood vessels a. Poor control of blood glucose  TG, HDL  atherosclerosis b. Poor circulation in extremities 2. Diseases of the small blood vesselsa. Poor circulation 1. Degeneration of the retina 2. Impaired kidney function

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Diabetes Mellitus (DM) (cont)

3. Diseases of the nervesa. Nerve tissue degeneration 1. Loss of sensation

D. Dietary Recommendations for IDDM1. Consistent pattern of food intake, particularly CHOa. Stabilize blood glucose concentration 2. Consistent activitya. Stabilize blood glucose concentration

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Diabetes Mellitus (DM) (cont)

E. Dietary recommendations for NIDDM 1.  weighta. Dietary modification 1.  caloric input b.  Physical activity