Diet Related Diseases and CVD

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Questions and Answers

What is the primary dietary recommendation for cancer patients undergoing chemotherapy?

Low carbohydrate diet

Low protein and low calorie diet

Balanced diet with no restrictions

High protein and high calorie diet (correct)

What is a major nutritional concern for cancer patients receiving chemotherapy?

Excessive weight gain

High levels of energy

Increased appetite

Food aversion and anorexia (correct)

How much protein should malnourished cancer patients consume per kilogram of body weight?

1.3-2g (correct)

1-1.2g

2.5-3g

0.5-1g

What role do carbohydrates and fats play in the diet of cancer patients?

They spare proteins for building tissues and supporting the immune system Signup and view all the answers

Which of the following may help improve nutritional status during the recovery period between chemotherapy sessions?

Serving food in a familiar way and attractively Signup and view all the answers

What is nephrolithiasis more commonly known as?

Kidney Stones Signup and view all the answers

Which dietary substance is known to convert into a carcinogen during cooking?

Nitrates in smoked food Signup and view all the answers

Which of the following symptoms can indicate the presence of kidney stones?

Intense pain with stone movements Signup and view all the answers

What dietary change is recommended for patients with calcium oxalate stones?

Avoid excessive animal protein Signup and view all the answers

What is a common effect of untreated cancer on the body?

Anorexia and weight loss Signup and view all the answers

Which antioxidant is specifically noted to protect against stomach and esophagus cancer?

Vitamin C Signup and view all the answers

Which type of stones is associated with a hereditary metabolic disorder causing excess cystine?

Cystine Stones Signup and view all the answers

What is a key dietary feature of the alkaline-ash diet used in treating cystine stones?

High in vegetables Signup and view all the answers

How can high-fat diets influence cancer risk?

Contribute to prostate, breast, uterus, and colon cancers Signup and view all the answers

What is the term for severe malnutrition and body wasting caused by chronic disease?

Cachexia Signup and view all the answers

Struvite stones are often referred to as infection stones because they develop due to:

Urinary tract infections Signup and view all the answers

Which dietary choice should be limited to prevent uric acid stones?

Purine-rich foods Signup and view all the answers

What effect do radiation treatments typically have on taste and smell?

Change taste and smell senses Signup and view all the answers

A diet high in what type of food is considered protective against colorectal cancer?

High fiber Signup and view all the answers

Which of the following is NOT a common cause of kidney stones?

High fluid intake Signup and view all the answers

Which dietary factor can contribute to gallbladder cancer?

Excess calorie intake Signup and view all the answers

What is the primary goal of treatment for diabetes mellitus?

To prevent symptoms and delay complications Signup and view all the answers

What percentage of daily caloric intake from carbohydrates is recommended for Type II diabetes?

50 – 60 % Signup and view all the answers

What is the advised daily fiber intake for individuals with diabetes?

25 – 30 g/day Signup and view all the answers

What type of insulin is produced within the body?

Endogenous insulin Signup and view all the answers

Which component of diabetic management is specifically complicated by exercise in Type I diabetes?

Insulin therapy Signup and view all the answers

What must diabetic foods be calculated based on?

The total day's diet Signup and view all the answers

What health risk is associated with taking insulin without eating?

Hypoglycemic episodes Signup and view all the answers

What is an example of an alternative sweetener discussed?

Aspartame Signup and view all the answers

What is a key characteristic of atherosclerosis?

It reduces blood flow by forming plaque in arteries. Signup and view all the answers

Which of the following is considered a major risk factor for the development of atherosclerosis?

Hyperlipidemia. Signup and view all the answers

Which dietary modification is recommended to help manage hyperlipidemia?

Reduce the quantity and types of fats in the diet. Signup and view all the answers

What lifestyle change can potentially alleviate hypertension?

Weight loss. Signup and view all the answers

What is the primary function of HDL cholesterol in the body?

To transport cholesterol to liver for excretion. Signup and view all the answers

What effect does excessive sodium intake have on blood vessels?

It causes edema and increases pressure. Signup and view all the answers

Which of the following is NOT a risk factor contributing to hypertension?

Regular exercise. Signup and view all the answers

What is the consequence of ischemia in surrounding tissues?

Decreased blood flow and oxygen. Signup and view all the answers

What is a key focus of the DASH diet?

Limit intake of sodium and saturated fats Signup and view all the answers

Which symptom is directly associated with hyperglycemia?

Polydipsia Signup and view all the answers

Which of the following is NOT a classification of diabetes mellitus?

Type III Diabetes Signup and view all the answers

What is the primary cause of glycosuria?

Hyperglycemia exceeding renal threshold Signup and view all the answers

What dietary modifications are beneficial for controlling blood pressure?

Increase intake of fruits and vegetables Signup and view all the answers

Which condition is NOT typically associated with diabetes mellitus?

Thrombosis Signup and view all the answers

What is the recommended daily limit for sodium intake to help manage hypertension?

Less than 2400 mg/day Signup and view all the answers

Which factor is NOT considered a potential cause of diabetes mellitus?

Protein deficiency Signup and view all the answers

Study Notes

Medical Nutrition Therapy is a crucial aspect of managing diet-related diseases.

Diet and CVD

Cardiovascular Disease (CVD) affects the heart and blood vessels.
Myocardial infarction (MI), or heart attack, is caused by artery blockage.
Atherosclerosis is a condition where arteries harden, restricting blood flow.
Cholesterol, fats, and other substances accumulate in the arteries, forming plaque, which reduces the lumen size.
Reduced blood flow restricts nutrient and oxygen supply, causing ischemia in surrounding tissues.
Thrombus is a blood clot that forms within narrow arteries.

Risk Factors for Atherosclerosis

Major Risk:
- Hyperlipidemia: Elevated serum cholesterol levels.
  - Saturated fats increase cholesterol.
  - Monounsaturated fats reduce cholesterol.
  - LDL (low-density lipoprotein) carries cholesterol to cells (high levels contribute to atherosclerosis).
  - HDL (high-density lipoprotein) carries cholesterol from tissues to the liver (low levels contribute to atherosclerosis).
- Hypertension: High blood pressure.
Other Risks: Obesity, diabetes, male gender, heredity, personality (stress response), age, sedentary lifestyle.

MNT for Hyperlipidemia

Reduce the quantity and types of fat and total calories in the diet.
Weight loss reduces serum cholesterol levels.
Serum Cholesterol Levels:
- <200 mg/dL: Desirable level
- 200–239 mg/dL: Borderline high
- ≥240 mg/dL: High
Recommended Dietary Intake:
- <200 mg dietary cholesterol/day
- No more than 30% of calories from fat (7% saturated, 8% polyunsaturated, 15% monounsaturated)
- 50-55% of calories from carbohydrates
- 12-20% of calories from protein

Low-fat Diet (Dietary Changes)

Gradual lifestyle changes are essential for adhering to a low-fat diet.
Patient education is crucial to understand fat content in food and methods for low-fat cooking.
Limit foods high in cholesterol (animal products, organ meats).
Limit saturated fats (animal products, coconut oil, palm oil).
Increase water-soluble fiber (oats, legumes, fruits).
25-35% soluble fiber intake daily can reduce serum cholesterol by 15%.
Consider supplemental fat-soluble vitamins if limiting caloric intake to 1200 or less.
Drugs such as Lipitor or Zocor may be prescribed if diet is insufficient.

Hypertension

Hypertension is chronically high blood pressure (systolic >140/diastolic >90 mmHg).
Factors contributing to hypertension include heredity, obesity, smoking, stress, excessive salt intake.
Therapy:
- Weight loss
- Sodium-restricted diet with diuretics
- Limit sodium intake to <2400mg/day
- Increase potassium-rich fruits and vegetables (6-10 servings)
- Increase calcium and magnesium-rich foods
- DASH diet (a therapeutic diet) limiting sodium, cholesterol, saturated fat, red meat, and sugary foods. Focuses on whole grains, fruits, vegetables, and low-fat dairy.

Diabetes Mellitus

Diabetes mellitus is a group of serious and chronic disorders affecting carbohydrate metabolism.
Key features:
- Hyperglycemia (high blood sugar levels)
- Causes major health problems (death, blindness, heart and kidney disease, amputations)
- Involves the pancreas, insulin, and glucagon.

Diabetes Symptoms

Abnormal Glucose Concentration:
- Glycosuria: Glucose in the urine as the body attempts to excrete excess blood glucose.
- Polyuria: Excessive urination due to fluid shift from cells to blood.
- Polydipsia: Excessive thirst due to fluid loss through urination.
- Polyphagia: Excessive hunger due to cells not receiving glucose.
Fat Breakdown:
- Ketonemia: Ketones in blood.
- Ketonuria: Ketones in urine.
- Acidosis: Reduced blood pH due to ketone buildup
Other Symptoms:
- Diabetic coma
- Muscle waste, weight loss, weakness, fatigue.

Additional Diabetes Symptoms

Vascular System: Atherosclerosis
Retina: Retinal degeneration & retinopathy
Nerve Damage: Neuropathy

Etiology of Diabetes

Uncertain
Potential factors include heredity and environmental influences.

Diabetes Classification

Type I Diabetes Mellitus:
- Acute onset (ages 1-40)
- Pancreas produces little to no insulin
- Requires insulin therapy
Type II Diabetes Mellitus:
- Gradual onset (after age 40)
- Reduced insulin effectiveness
- Managed primarily through diet and exercise
Gestational Diabetes:
- During pregnancy
- May require insulin therapy

Normal Blood Glucose Control

Normal blood glucose regulation involves a balance between insulin (which lowers blood glucose) and glucagon (which raises blood glucose).
The pancreas plays a critical role in releasing these hormones.

Type I Diabetes

Muscle cells cannot use glucose due to insufficient insulin.
Glycogen and protein breakdown lead to ketoacidosis.
Insufficient insulin in blood vessels

Type II Diabetes

Insulin resistance develops in body cells
The pancreas produces sufficient to adequate insulin, but body cells are resistant to taking up glucose from blood
Glucose buildup in bloodstream.

Treatment of Diabetes Mellitus

Control blood sugar levels (70-110 mg/dL for fasting).
Provide optimal nutrition.
Prevent complications of disease and related symptoms.
Treatment usually begins when blood tests reveal hyperglycemia (excessive blood sugar).

Treatment of Diabetes Mellitus (Cont)

Normal fasting blood glucose levels: 70-110 mg/dL
HbA1c: indicator of blood sugar control over time
Dietary measures for managing blood glucose levels.

Nutritional Management of Diabetes Mellitus

Diet based on exchange system or carbohydrate counting.
- Type 1 patients require a balanced plan accounting for insulin requirements
- Type 2 patients management relies heavily on weight loss and exercise
Carbohydrate Intake: 50–60% (40–50% complex; 10–20% simple)
Fat Intake: 30% of total daily calories
Protein Intake: 15–20% of total daily calories

Miscellaneous Concerns

Fiber: 25-30 grams daily.
Alternative sweeteners (i.e. sucralose and aspartame).
Alcoholic beverages should be avoided.
Exercise is important but can complicate diabetes management (Type I).
Insulin therapy (exogenous and endogenous).
Hypoglycemic episodes require immediate glucose intervention (oral glucose or IV dextrose).

Kidney Stones

Nephrolithiasis: Stones in the kidneys.
Symptoms:
- Asymptomatic
- Hematuria (blood in urine)
- Infection
- Obstruction
- Intense pain during stone movement
Causes: Metabolic imbalances, patient immobilisation
Classification: Based on composition (calcium oxalate, uric acid, cystine, struvite).

Dietary Treatment of Renal Stones

All types: Drink plenty of fluids, particularly water, and eat a balanced diet.
Calcium Oxalate Stones:
- Avoid excessive animal protein.
- Avoid foods high in oxalate (beets, wheat bran, chocolate, tea, strawberries, spinach).
Uric Acid Stones:
- Limit purine-rich foods (meats, fish, poultry).
Cystine Stones:
- Increased fluids and alkaline-ash diet (limiting meat, poultry, cheese, grains, emphasizing fruits, vegetables, and milk).
Struvite Stones:
- Low-phosphorus diet (reducing milk and cola).

Cancer

Etiology is often unknown, could be related to heredity, viruses (Epstein Barr, hepatitis B, herpes simplex II), environmental carcinogens, or emotional stress.

Food and Cancer

Bad:
- Nitrates in processed meats converting to nitrosamines (stomach/esophagus cancers).
- High-fat diets
- Excess calories
- Smoking and alcohol
Good:
- Antioxidants (certain plant substances): protect cells against carcinogens
  - Vitamin C
  - Vitamin A and beta-carotene
  - Flavonoids, phenols, indoles, found in fruits and vegetables
- High-fiber diets are associated with decreased colorectal cancer risk.

Effects of Cancer

General Effects: Unexplained weight loss (due to increased metabolism and nutrient use by cancer cells); muscle loss (hypoalbumenia, low protein in blood); anemia; weakness, anorexia; altered senses of taste and smell due to nutrient deficiencies; early satiety due to decreased digestive secretions; delayed gastric emptying; and poor appetite.
- Specific Effects: depend on tumor site. Untreated cancer → anorexia → malnutrition → cachexia → death

Cancer Treatment

Medical Treatments Side Effects:
- Surgical removal: Can affect organ function
  - (example: stomach removal affecting digestion).
- Radiation: Can lead to altered taste and smell, dry mouth (xerostomia), difficulty swallowing, reduced ability of intestine to absorb nutrients, bowel obstruction and diarrhea.
- Chemotherapy: Can result in reduction of small intestine absorptive cells ability to regenerate, hemorrhagic colitis; reduced appetite, vomiting, nausea, and diarrhea
Combined therapy (chemo-radiation): Further aggravates medical treatment side effects.

Nutritional Care for Cancer Patients

High metabolic rate: High-calorie, high-protein diets
Sufficient calories and nutrients: Essential for survival.
Specific nutritional requirements: 40–50 kcal/kg body weight (high protein); 1–1.2 g protein/kg body weight for well-nourished clients; 1.3-2 g protein/kg body weight if malnourished.
Nutrient supplementation: Include multivitamins and minerals; use carbohydrates and fats to spare proteins needed for tissue building and immune function)
Hydration: Ensure adequate intake to support kidney function.
Anorexia: Common, manage by preparing familiar foods attractively, and offer soft foods.
Add sugar to fruit juices to improve taste. Avoid nausea with cold food/covering.

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Description

This quiz explores the relationship between diet and diet-related diseases, particularly focusing on cardiovascular disease (CVD). Learn about major risk factors like hyperlipidemia, the impact of cholesterol, and how dietary choices can influence the development of conditions such as atherosclerosis. Test your knowledge on medical nutrition therapy essential for disease management.