Diet Related Diseases PDF

DIET RELATED DISEASES Medical Nutrition Therapy Diet and CVD CVD  Cardiovascular Disease (CVD): Affect heart and blood vessels.  Myocardial infarction (MI): heart attack caused by blockage of an artery leading to the heart.  Atherosclerosis: a condition in which the arteries...

DIET RELATED DISEASES Medical Nutrition Therapy Diet and CVD CVD  Cardiovascular Disease (CVD): Affect heart and blood vessels.  Myocardial infarction (MI): heart attack caused by blockage of an artery leading to the heart.  Atherosclerosis: a condition in which the arteries become harden making the passage of blood become difficult. In this condition cholesterol, fats and other substances accumulate overtime and form a deposit in the inner lining of the arteries that is called plaque. plaque reduce the size of lumen and the blood flow Low blood flow reduce the supply of nutrient and oxygen and cause ischemia in surrounded tissue. Thrombus is a blood clot that forms within narrow arteries.  Risk factors for atherosclerosis  Risk factors for the development of atherosclerosis:  Major risk: Hyperlipidemia Saturated fat intake increase serum cholesterol Monounsaturated fat reduce serum cholesterol LDL a lipoprotein that carries cholesterol to the cells (high LDL contribute to atherosclerosis). HDL a lipoprotein that carries cholesterol from tissues to the liver for excretion (low HDL contribute to atherosclerosis). Hypertension Smoking.  Other risks: obesity, diabetes, being a male, heredity, personality (ability to handle stress), age, sedentary lifestyle.  Dietary control can: alleviate hypertension, reduce obesity & control diabetes.  Exercise can: help lose weight, lower blood pressure and increase HDL (good cholesterol).  MNT for Hyperlipidemia  Reduce the quantity and types of fat and total calories in the diet.  Weight loss can help reduce serum cholesterol levels  Serum cholesterol levels: 240mg/dl  high  Recommended dietary intake: 140/diastolic >90 mm Hg)  Hypertension (silent disease): can be asymptomatic and lead to heart attack, stroke, heart failure & kidney failure.  Factors that contribute to hypertension:  Heredity, obesity, smoking, stress, excessive use of table salt.  Excess sodium  edema  pressure on blood vessels.  Therapy:  Weight loss lower hypertension.  Sodium restricted-diet with diuretic used to alleviate edema and treat hypertension. Limit sodium to less than 2400mg/day  Increasing intake of high potassium fruits and vegetables (6-10 servings) help lower blood pressure.  Increase intake of Calcium and magnesium rich food (control blood pressure). 3H  Dash Diet: a therapeutics diet specifically developed to treat hypertension. eptilach Limits the intake of: sodium, cholesterol and saturated fat, red meat, and sugary food. Focus on the intake of: high in whole grains, fruits & vegetables & low fat dairy & nuts. IPerension Diabetes Mellitus Diabetes (to follow through) mellitus (honeyed)  Is the name for a group of serious and chronic disorders affecting the metabolism of carbohydrates.  Hyperglycemia  Is a major cause of death, blindness, heart and kidney disease, amputations.  Pancreas Insulin Glucagon Symptoms  The abnormal concentration of glucose in the blood draws water from the cell to the blood.  Glycosuria Glucose excreted in the urine. Occur when hyperglycemia exceeds the renal threshold.  Polyuria Excessive urination, due to loss of cellular fluids.  Polydipsia Excessive thirst.  Polyphagia  Excessive appetite cause the break down of body fat and protein.  Ketonemia (ketons in blood), Ketonuria (ketons in urine)  Break down of fat (ketones = CO2 + H2O) = acidosis low pH Diabetic coma  Muscle waste, weight loss, weakness, and fatigue. Additional symptoms  Vascular system  Atherosclerosis  Retinal degeneration  Retinopathy  Nerve damage  Neuropathy Etiology  Nott confirmed, but may be  Heredity  Environmental Classification  Insulin-dependent diabetes mellitus (type I)  Occur suddenly between ages 1 and 40  Pancreas secrets little or no insulin  Require insulin injection and carefully controlled diet.  Non-insulin-dependent diabetes mellitus (type II)  Occurs after age 40  Gradual onset with gradual insulin diminish.  Controlled by diet and exercise.  Gestational diabetes  Occur between the 16th and 20th week of pregnancy.  May require insulin injection if not responsive to diet and exercise. Normal blood glucose control Type I Diabetes TYPE II Diabetes Treatment of Diabetes Mellitus  Control blood sugar levels  Provide optimal nourishment for the client.  Prevent symptoms and thus delay the complications of the disease.  Treatment is typically begun when blood tests indicates hyperglycemia or related symptoms occur. Normal blood glucose levels FBS mmol 18 frommgto 70 – 110 mg/dl. bib 4y 8.8mmol  Nutritional Management of DM more flexable  Diets based on exchange system list and carbohydrates counting.  Type I  needs a nutritional plan that balances kcal and nutrient needs with insulin therapy and exercise.  Meals and snacks are composed of similar nutrients and kcal, eaten at regular times each day.  Type II  Weight loss and exercise. Carbohydrates 50 – 60 % 40 – 50 % complex (starch) 10 – 20% simple (sugar) Fat 30% of total kcal Protein 15 – 20 % of total kcal  Miscellaneous Concerns  Fiber  25 – 30 g/day  Alternative sweeteners  Sucralose (indigestible sugar) Aspartame (phynyl + aspartic acid)  Diebetic foods  Must be calculated in the total day’s diet. 15min Alcohol wait Podhtits   Not recommended. normal  Exercise his  Can complicate diet With type I. Insulin therapy treat Eats.it ÑÑ   Indogenous, insulin produce within the body go  Exogenous, is produced outside the body (injection) 8 now  Insulin reaction 155111  Hypoglycemic episodes, taking insulin without eating. Treated with glucose tablets or sugary beverages or intravenous with dextrose if patients is unconscious. in's glucagon a Kidney Stones Kidney Stones  Nephrolithiasis  Stones develop in the kidneys.  Symptoms  Sometimes asymptomatic  Hematuria (blood in urine).  Infection  Obstruction  Intense pain with stone movements Kidney Stones  What cause stones?  Metabolic disturbances  Patient immobilization  Stones classification (based on their composition) Calcium oxalate Uric acid Cystine (a nonessential amino acid) Magnesium ammonium phosphate (struvite) Dietary Treatment of Renal Stones  For all types:  Drink plenty of fluids especially water.  Eat a balanced diet.  Calcium Oxalate Stones  Most common type (~80%)  Studies did not support A low calcium diet theory! And higher calcium intake may decrease kidney stones.  Avoid excessive intake of animal protein because it is a risk factor.  Avoid diets rich in oxalate found in: Beets, wheat bran, chocolate, tea, strawberries, spinach.  Uric Acid Stones  Associated with: Gout. GI diseases that cause diarrhea. Malignant disease.  Limit the intake of purine-rich foods found in: all meats, fish, and poultry, organ meats, broth, anchovies, sardines, meat extract. Purines are the end products of nucleicprotein metabolism.  Dietary Treatment of Renal Stones  Cystine Stones  Cystine is an amino acid.  These stones develop due to a hereditary metabolic disorder that cause excess concentration of cystine in urine.  Treated with increased fluids and alkaline-ash diet. Alkaline-ash diet: mainly consist of fruits, vegetables, and milk with little meat, fish, eggs, cheese, and grains, that when catabolized leaves an alkaline residue to be excreted in the urine. Limiting meat, poultry, cheese, and grains in order to make the urine more alkaline (higher pH).  Struvite Stones (magnesium ammonium phosphate)  Called infection stones, develop following urinary tract infections.  Treated with a low phosphorus diet focus on eliminating milk and cola products. Cancer Causes of cancer!  The etiology is unknown, it could be related to:  Heredity  Viruses linked to cancer: Epstein Barr, hepatitis B, & herpes simplex II.  Environmental carcinogens  Emotional stress (could contribute to the development of disease)  FOOD & Cancer BAD:  Cretin substance in food are considered carcinogens (cancer causing substances)  Nitrtes in smoked food change to nitrosamines (carcinogen) during cooking. cause stomach & esophagus cancers.  High-fat diet  cause prostate, breast, uterus & colon cancers.  Excess calorie cause gallbladder cancer.  Smoking & alcohol cause mouth, pharynx, lung cancer.  Malnutrition: poor protein intake  decrease immune system may lead to cancer. GOOD:  certain substances found in plants are considered Antioxidants (anticarcinogenic agents that protect the cells from carcinogens).  Vitamin C  protect against stomach & esophagus cancer.  Vitamin A & Beta-carotene protect against lung, larynx & bladder cancer.  Flavonoids, phenols & indules are antioxidants that protect against cancer found in fruits and vegetables.  High fiber diet protect against colorectal cancer.  Legumes high in vitamins, minerals & fiber  protect against cancer.  Effects of Cancer  General effect:  Unexplained weight loss as nutrients utilized for cancer cell growth and increase metabolism. Mainly loss of muscle tissue, hypoalbuminemia (low protein in blood) that can lead to anemia.  Weakness  Anorexia  Abnormal sense of taste & smell mainly because of nutrient deficiency.  Early satiety due to decrease digestive secretions.  Abnormal insulin production (hyperglycemia)  delay stomach emptying poor appetite.  Specific effect:  Depends on tumor site.  Untreated cancer  anorexia & weight loss  malnutrition  cacheixa (severe malnutrition and body wasting caused by chronic disease) death.  Cancer Treatment  Medical treatment side effects:  Surgical removal Can affect the organ function (e.g. removing part of the stomach because of cancer affects digestion).  Radiation Change smell & taste senses especially with head & neck cancers. Decrease salivary secreation & cause dry mouth (xerostomia) & difficulty swallowing (dysphagia). Reduce the amount of absorptive tissue in small intestine Bowel obstruction or diarrhea.  Chemotherapy Reduce small intestine ability to regenerate absorptive cells hemorrhagic colitis  Or combination (chemo+radiation) Decrease appetite, cause vomiting, nausea, diarrhea.  Nutritional care for cancer patients  High metabolic rate  due to higher energy and nutrient requirement than usual in non- diseased state.  Sufficient calorie & nutrient are important for survival.  High protein/high calorie diet is prescribed during chemotherapy & radiation therapy  Patient on high-protein & high-calorie diet better tolerate the side-effect of therapy.  40-50Kcal/Kg body weight. &  Well nourished 1-1.2g protein/Kg body weight.  Malnourished 1.3-2g protein/Kg body weight.  Multivitamin & minerals tablet.  Carbohydrates & ft needed to spare proteins for building tissues & immune system.  Drinking fluid important to help kidneys eliminate metabolic wastes.  Anorexia: major problem in cancer patients (they develop food aversion because of chemotherapy). give foob  Usually client improve nutritional status between chemotherapy sessions during recovery period.  Favorite food prepared in familiar way & served attractively.  Soft diet for those with chewing problems.  Add sugar to fruit juices to overcome the bitter taste.  Serve food covered and cold to reduce nausea.