Nutrition 1: Nutrition in Health and Disease

Created by lcoghill 

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Healthy diet

results in absence of illness or discomfort, fitness, longevity, optimum health

Under-nutrition

low food intake

Specific deficiencies

imbalanced nutrient intake

Overweight/obesity

BMI > 25/>30

Malnutrition

under-nutrition, specific deficiencies, overweight/obesity

Key variables that influence nutritional demands and the incidence and presence of diseases with a nutritional basis

stage of development (fetus->elderly), level of inflammatory stress, previous nutritional exposure in utero (fetal origins of adult disease), genotype

Defense for exposure to pathogens and toxins

immune system, antioxidant defenses, detoxification systems (efficiency declines with age -> activity of enzymes involved in xenobiotic detoxification systems declines with age)

Whole body protein synthesis

rate significantly declines from infancy to elderly -> impacts on speed of wound healing and recovery from infection

Level of inflammatory stress

interaction between nutritional status and effective operation of the immune system -> malnutrition leads to increased chances of dying from infection -> due to malfunctioning immune system -> inflammation plays significant role in morbidity and mortality in chronic diseases with a nutritional basis

Hypertension

does not involve the immune system (this could be false) but is influenced by nutrition

Chronic diseases

most involve immune system and mostly all are influenced by nutrition

Microbes

we are surrounded by these and our physiology is designed to resist them

Immune system

normal function is to detect and destroy pathogens, removing damaged tissue and bringing about wound healing

IL-1, IL-6, TNF-alpha

Effects of pro-inflammatory cytokines and inflammation in health and disease -> many types of injury produce a similar inflammation

Typical response of the body to infection or injury

immune system activation -> pro-inflammatory cytokines -> oxidants -> pathogen killing and tissue damage -> nutrients are released from host tissues (appetite loss) -> glutamine and glucose consumed by T and B cells (immuno-nutrition)

Glutamine

along with sulfur amino acids cause glutathione synthesis -> antioxidant defenses are strengthened to reduce tissue damage

TWEAK/Fn14 system

tissue remodeling

Feedback systems

IL10, heat shock proteins

Influence of infections and injury on metabolic rate

major injury (burns) or infection increase significantly, under-nutrition can decrease (weight loss >10% of body weight)

Body weight loss during fasting and following injury and infections of various intensity

although weight loss provides nutrition for the immune system during infection and injury -> there is a limit to weight loss and survival

Body cell mass

Survival curves of patients with HIV infection according to rate of loss of body protein content -> % of patients surviving decreases significantly with BCM <30% of body weight

Serum albumin

negative acute phase reactants -> when it is reduced when levels of inflammatory stress become raised -> One of the first indications that the immune system had a role in mortality from chronic diseases

HDL

as serum albumin it is a negative acute phase reactant and is reduced when inflammatory stress levels are increased

Monocytes

take up cholesterol and damaged lipoproteins -> die and deposit fat under lining of endothelial cells of the arteries -> all due to inflammation

Anti-inflammatory changes in lifestyle

Heart disease is caused by chronic inflammation and therefore this should be the focus

Inflammation (stimulated by pathogens, environmental factors and damaged tissue)

key task is to kill pathogens -> too much of this can cause mortality and morbidity -> can also cause insulin insensitivity (diabetes mellitus), hyperlipidemia, atherosclerosis (MI)

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