Chapter 22 Nutrition PDF

Cardiovascular disease (CVD) is a term that refers to heart and blood vessel conditions such as coronary heart disease (CHD), stroke, hypertension and heart failure (HF). Athererosclerotic cardiovascular disease (ASCVD) refers to cardiac conditions caused by atherosclerosis, a disease characterized...

Cardiovascular disease (CVD) is a term that refers to heart and blood vessel conditions such as coronary heart disease (CHD), stroke, hypertension and heart failure (HF). Athererosclerotic cardiovascular disease (ASCVD) refers to cardiac conditions caused by atherosclerosis, a disease characterized by buildup of plaque that can develop in the arteries that supply blood to the heart, brain, kidneys, and extremities. ASVCD is the leading cause of morbidity and mortality worldwide. A healthy lifestyle: eating pattern, physical activity, and avoidance of tobacco helps prevent ASCVD. Cardiovascular Health American Heart Association concept of cardiovascular health 7 metrics, Lifes Simple 7. These metrics include 4 health behaviors (diet quality, physical activity, tobacco use, body mass index) three factors blood cholesterol, blood pressure and blood glucose. Score improvement 1999-2000 and 2015-2016 for smoking, cholesterol, blood pressure, and physical activity, but declined in BMI and diabetes Ideal diet 2000 calories, and Dash type diet is defined by achieving 4 out of 5: >> ≥ 4.5 cups of fruits and vegetables/day ≥ 2 servings of fish/week < 1500 mg sodium/day < 36 oz sugar sweetened bev/week ≥ 3 servings of whole grains/day Secondary metrics ≥ 4 servings/week of nuts/legumes/seeds ≤ 2 servings/week of processed meats 7% total calories from saturated fat Animal fats (meat and dairy), coconut oil, palm oil and palm kernel are the biggest sources of saturated and fatty acids Life’s 7 Simple 7 uses DASH type diet as ideal but Mediterranean and plant based are helpful as well. Both patterns: ​ Emphasize the intake of fruits and vegetables, legumes, nuts, whole grains, vegetable oils, and fish ​ Limit the intake of red and processed meats, refined grains, added sugars, butter, high sodium foods, and commercial trans fat  ​ Are higher in fiber, vitamins, antioxidants, minerals, phytonutrients, and unsaturated fat and lower in glycemic index, glycemic load, salt and trans fat then the typical Western diet Mediterranean Style Pattern Arguably the healthiest and best studied eating pattern Is associated with lower risks of CVD. the protective effects were atrritbutable to olive oil, fruits, veggies, and legumes. Nutrition for Cardiovascular Disease Risks A heart healthy lifestlye is secondary prevention of ASCVD, hypertension, obesity and diabetes. Overweight and Obesity 5% loss of body weight may improve blood pressure, LDL-C, triglyceride levels and glucose levels A hypocaloric diet of 1200-1500cal/day for women and 1500-1800ca;/day for men Hypertension Is a major risk factor for CVD and stroke Ideal blood pressure is less than 120/80 Hypertension described as more than 130/80 Top 6 sources of sodium: bread and rolls, pizza, sandwiches, cold cuts and cured meats, soup, burritos and tacos More than 75% of sodium comes from processed foods Increase potassium intake. High potassium foods include: dried apricots, raisins and prunes, potatoes, both sweet and white (baked with skin on especially), leafy greens, lentils and legumes, certain fruit juices, prune juice, tomato puree or juice, carrot juice, orange juice, and vegetable juice, milk and yogurt, seafood, abstinence from alcohol Hypercholesterolemia Ideal cholesterol is less than 200 mg Optimal LDL is less than 100 mg Recommended HDL level is at least 40 mg for men and 50 mg for women Cholesterol should be as low as possible without compromising diet Dietary guidance focus on heart healthy eating patterns, such as DASH and Mediterranean, these are low in cholesterol Emphasis on fruits, veggies, legumes, whole grains, nontropical vegetable oils, low fat dairy, low fat poultry, fish seafood, and nuts Metabolic Syndrome Is a mutlicimponent risk factor for CVD and type 2 diabetes Consists of a cluster of metabloc abnormalities, elevated triglycerides, low HDL-C, high blood pressure, high fasting blood glucose levels, and central obesity. Mediterranean style preferred Secondary Prevention of Cardiovascular Diseases Goal is to prevent recurrent events, improve symptoms, and quality of life. Treatment is drug therapy, cardiac rehab, and lifestyle intervention, including healthy eating pattern. Medaterranean style preferred. Heart Failure Characterized by dyspnea, fatigue, fluid retention, that result from structural and functional impairment of the hearts ability to pump blood. Malnutrition may occur from decreased sensation of hunger, diet restriction, fatigue, shortness of breath, anxiety, or malabsorption HF treated with drug therapy and lifestyle modifications, including weight management, healthy eating, physical activity, and smoking cessation Mediterranean diet associated with lower risk of HF and mortality Sarcopenia: loss of skeletal muscle mass and strength, common in clients with HF Nutrition for HF Protein intake should be at least 1.1g of body weight. Clients malnourished may need 1.1 to 1.4g Sodium and fluid intake within 2000-3000 mg and 1 to 2 L fluid/day Cachexia: a wasting syndrome characterized by loss of lean tissue, muscle mass, and bone mass Culteral Considerations Soul food high in saturated fat and sodium. Heavy emphasis on veggies and complex carbs. Mexican Vegetarian and fruits, rice, dried peas and beans Cooking techniques rely on frying and stewing with oil or lard. Alternative saute or stew with canola or olive oil. High fat meats commonly used