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Nutrition (12) - Cardiovascular Disease (Overnutrition)

Terms in this set (56)

Obesity shortens life ?true or false?
True
Obesity increases the total mortality
in both men and women

Increases mortality is mainly from specific causes:-
1. Ischemic heart disease
2. Stroke
3. Diabetes
4. Cancers
5. Liver disease
Overweight and obesity increases
Mortality

particularly increase death from CVD and some cancers
Obesity markedly increases disease incidence
relative risk >3
1. dm type 2
2. Hypertension
3. Insulin resitance
4. dyslipidemia
5. breathlessness
6. Gall bladder disease
7. Sleepapnea


Relative Risk 2-3
1. Coronary heart disease
2. Osteoarthritis
3. Hyperuricemia - Gout
4. Pregnancy complications - eg. preclampsia
5. Cancer

Relative risk 1-2
1. Cancer, colorectal cancer
endometrium, kidney
2. Imparied intertinility, polycystic ovary syndrome
3. low back pain
4. increased risk during anaesthesia
5. fetal defects arising from maternal obesity
Benefits from 10kg weight loss
Mortality:
20 to 25 percent fall in total mortality

30-40 percent fall in diabetes related death

40-50 percent fall in obesity related cancer deaths



BP: fall of 10 mm hg systolic and diastolic blood pressure

Diabetes:
risk of developing diabetes reduced by 60 percent Fall of 30 to 50 percent fasting glucose
Fall of 15 percent in HbA1C (glycated hemoglobin)

Lipids:
fall of 10 percent in total cholestrol
fall of 15 pecent in LDL
Fall of 30 percent tags
increase 8 percent HDL
Obesity markedly increased risk of
early death and other diseases especilly CVD, and diabetes and cancers

Weight loss reduces all above risks
CVD and risk factors
CHD
Stroke
Hypertension
High blood cholestrol
What is CVD?
ATHEROSCLEROSIS (FOAL cells)

plaque rupture ---> thrombosis ---> ishemia arrhythmia

Obesity increases the formation of Atherosclerosis
two main risk of CVD
Increased blood pressure and Dyslipidemia


obesity increases both factors above
Obesity
elevates LDL levels, and falls HDL levels
what predict Coronary heart disease mortality
plasma total cholestrol


Total mortality and CHD mortality increases as increases in cholestrol levels
Plasma cholestrol is poor discriminator of CHD RISK within countries, so then what is better discriminator of CHD RISK?
Tags
Raised Tags leads to
Pro inflammation
Prothrombotic

Increase in small dense LDL

Intolerance of dietary fats

reduces Cardioprotective HDL
CVD involves multiple pathophysiolocial changes including
abnormal clotting
hypertension
dyslipidemia
inflammation
vascular endothelial dysfunction

CVD major cause of death in men and women - major obesity related disease

Hypertension, dyslipidemia and inflammation, important mechanims for CVD - ARE INCREASED by obesity


total cholestrol (plasma is poor discriminator within population)

Tags is an important measure of dyslipidemia and consequent CVD Risk
Major part of risk of CVD is modifiable by
diet and lifestyle (66 percent

lose weight, change diet, change lifestyle
CVD and Diet : the main risk factors
Salt (too much
Fat (too much and wront sort such as saturated)
Carbs: too much and wrong sort : radicals goes up
Fiber: not enough
Fruits,veg, nuts: not enough
Processed foods increase salt intakes and reduce
pottasium intakes
Excess salt / low potassium increases the risk of
hypertension

and reduced by fruit and vegetables
Fruits and unprocessed foods have
low Na and High K
Ishemia leads
to cell death and heart failure
Butter has the most
saturated fats
Olive oil and canola
are low in saturated fats
oilve oil has less ______ than canola oil
N-6 unsaturated fats
Cod liver oil has higher
very long chain N-3 pufa
Know the importance of N-6 AND N-3
Soybean and corn oil has high N-6 oils
soybean and corn oil should be replaced by
olive and fish oil, or canola oil --- lead to reduction in inflammatory responses
N-3 VLC (UFA)
REDUCES clotting , Tags, and inflammation
N-6
Increases clotting, inflammation, but reduces cholestrol
monosaturated
reduces cholestrol
saturated and transfats, cholestrol
all increases tags and cholestrol, (cholestrol only increases cholestrol)
Current advice about dietary fat
Target: Obesity - reduce total fat

Target: Heart disease:

A. atherogenesis:
1. LDL cholesterol /Tags/post prandial lipemia: - Reduce fat quality

Reduce SFA/Trans fats (increase pufa/mufa/increase n-3, with oily fish)


B. Clotting /inflammation

Improve eicosanoid balance (EPA/AA ratio)

increase N-2 With oily fish
What reduces the or lower the risk of CHD
PUFA and whole grain carbs
What increases the risk of CHD
refined starches/added sugars
Replacing 5 percent energy intake from SFA with PUFA/MUFA/ whole grain carbs
lowerst the ris of CHD by 25 percent - pufa

15 percent - mufa

9 percent - whole grain carbs
Unsaturated fats especially PUFAs, and high quality carbs can be used to replace SFA to reduce __________
CHD Risk
Fish oil is urged for which patients
Heart patients
patients who do not eat fish 2 to 3 portions of oily fish --- given supplements for up to
4 years
CVD and dietary carbohydrate
too much wrong sort

high glycemic index carbs
excess fructose
GI
Area under blood gluclose curve 50 g CHO/ corresponding area after equi carbs portion of white bread x 100


Ripe banana has higher GI than whole wheat
low Glycemic index (GI) diet improves?
blood lipids, especially Tags

and also lowers HDL, and increase LDL levels
Excess frutctose
metabliszed in liver and excess converted to tags -- -increases CVD risk

Fructose does not signal satiety like glucose

i.ie -- obesogenic


Moderate amounts of fructose in fruits is ok
Not enough fiBER Means
non starch polysachrides
Soluble fibers lowers
cholestrol
soluble fibers examples
psyllium, oat products, guar gum
Lower GI carbs, and increased fiber improves
dyslipidemia (lower cholestrol and tags)
High GI carbs, and low fibers increaes
cholestrol , tags etc
Inadequite fruit intake is linked to
low levels of dietary intake of antioxidants and potassium
Dietry antioxidants protect against
LDL Oxidations so therefore prevent atherosclerosis
Hypertension
excess Na (in procesed foods)
low K+ (fruit veg nprocessed foods)
Dyslipidemia
excess SFA/Trans fat/ dietary cholestrol

Low pufa/mufa/VLC/ n-pufa (oil fish)

High GI/GL carbs, excess fructose

low NSP, Low antixodiants in Fruits and vegetabtes (intake)
Increasd clotting and infammation
Excess N6 and low N3 especially oilly fish
Dietry advice to decrease CVD
Obesity - maintain healthy weight

Salt - decrease processed foods


Dietry fat - increase plant oil, oily fish, increase mufa, pufa, VLC N-3 , decrease animal fat, decrease SFA/Cholestrol
Dietary carbs and NSP
Decrease high fructose drinks, increase whole grains and pulses to decrease GI, GL, and increase NSP
Pottasium and antioxidants
increase fruits, vegetables, and nuts and oils
Diet and lifestyle changes result in
significant health benefits

Smoking cessation (35 percent

Physical activity

Moderate alcohol (less than <14 units a week)

Combined dietary changes


If these changes implemented --- 14 YEARS OF extra life, and 80 percent reduction in CVD mortality and 75 percent reduction in total mortality
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