Nutrition Concepts & Controversies 16th Edition Chapter 11 PDF

Chapter 11 Nutrition and Chronic Diseases Sizer/Whitney, Sizer/Whitney,Nutrition NutritionConcepts Concepts& Controversies, & Controversies,16th Edition...

Chapter 11 Nutrition and Chronic Diseases Sizer/Whitney, Sizer/Whitney,Nutrition NutritionConcepts Concepts& Controversies, & Controversies,16th Edition. © 2023 16th Edition. © Cengage. All RightsAll 2023 Cengage. Reserved. May not beMay Rights Reserved. scanned, copied not be or duplicated, scanned, copied oror posted to a publicly duplicated, accessible or posted website, to a publicly in whole or accessible in part. in whole or in part. website, 1  Icebreaker Do you believe that what you eat and drink really make that much difference in how well or how long you live? Why or why not? Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 2  Learning Objectives (1 of 2) At the end of this chapter, you should be able to: LO 11.1 Discuss the relationship between risk factors and chronic diseases. LO 11.2 Describe cardiovascular disease and identify its risk factors. LO 11.3 Summarize the causes, consequences, and management of type 2 diabetes. LO 11.4 Describe the relationship between diet and cancer. Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 3  Learning Objectives (2 of 2) At the end of this chapter, you should be able to: LO 11.5 Outline strategies for including sufficient fruit and vegetables in a diet. LO 11.6 Summarize the concerns surrounding nutrient and drug interactions. Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 4  Infectious vs. Chronic Diseases Infectious diseases- caused by specific pathogens (Pneumonia and Influenza) − Natural immunity (adequate nutrition), vaccines, sanitation Chronic diseases- degenerative conditions or illness that progress slowly − To a great extent, are preventable by good nutrition − Leading causes of death in the US Morbidity- a diseased condition or state; ill health Mortality- death Risk factors- correlated with diseases − Traits, conditions or lifestyle habits that increase chances of developing diseases Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 5  Chronic Diseases Sizer/Whitney, Sizer/Whitney,Nutrition NutritionConcepts Concepts& Controversies, & Controversies,16th Edition. © 2023 16th Edition. © Cengage. All RightsAll 2023 Cengage. Reserved. May not beMay Rights Reserved. scanned, copied not be or duplicated, scanned, copied oror posted to a publicly duplicated, accessible or posted website, to a publicly in whole or accessible in part. in whole or in part. website, 6 The Ten Leading Causes of Death Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 7  Chronic Disease Risk Factors (1 of 2) Of all of these risk factors, the first two are unalterable: you cannot change your age or heredity. The other risk factors have to do with your lifestyle choices and therefore are, to a great extent, under your control. Your choices can be powerful preventive measures against chronic diseases. DISEASES Atherosclerosis Hypertension Diabetes (type 2) Cancers Obesity Risk factors that cannot be modified: Advancing age X X X X Family history (heredity) X X X X X Modifiable risk factors other than diet: Excessive alcohol intake X X X X Physical inactivity X X X X X Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 8  Chronic Disease Risk Factors (2 of 2) DISEASES Atherosclerosis Hypertension Diabetes (type 2) Cancers Obesity Smoking/tobacco use X X X Diet and nutrition risk factors: Diet high in added sugars X Atherogenic diet (high in saturated and X X X X trans fat and low in vegetables, fruit, and whole grains.a Diet high in salty/pickled foods X X Diet low in vitamins and/or minerals X X X aAn atherogenic diet produces high blood LDL and VLDL and low blood HDL. Such a diet is a CVD risk factor, and these blood-lipid test results, themselves, are also considered risk factors (see Table 11–3, p. 402). Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 9 Interrelationships among Chronic Diseases Many chronic diseases are themselves risk factors for other chronic diseases, and all of them are linked to obesity. Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 10 Cardiovascular Diseases (CVD) Sizer/Whitney, Sizer/Whitney,Nutrition NutritionConcepts Concepts& Controversies, & Controversies,16th Edition. © 2023 16th Edition. © Cengage. All RightsAll 2023 Cengage. Reserved. May not beMay Rights Reserved. scanned, copied not be or duplicated, scanned, copied oror posted to a publicly duplicated, accessible or posted website, to a publicly in whole or accessible in part. in whole or in part. website, 11  Cardiovascular Diseases (CVD) Disease of the heart and blood vessels; “Heart Disease” Leading cause of death in the United States Includes hypertension, atherosclerosis, coronary heart disease, and stroke Atherosclerosis Hardening of the arteries No one is completely free of all signs of atherosclerosis Hypertension and atherosclerosis are interrelated and accelerate each other As most people age, atherosclerosis progresses steadily Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 12  Atherosclerosis Development involves: Plaque development- lipid material mixed with muscle cells and calcium Blood clot formation faster than they can dissolve Inflammation- produces free radicals Thrombus, embolism, aneurysm, hemorrhage − Cerebral (brain)- stroke − Coronary (heart)- heart attack Relationship with hypertension − Hardened and narrowed arteries increases blood pressure − High blood pressure damages the artery walls and accelerates atherosclerosis Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 13 The Formation of Plaque in Atherosclerosis Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 14  Major Risk Factors for Heart Disease Risk factors highlighted with a blue background have relationships with diet. Later figures provide standards by which to judge blood lipids and blood pressure. Page E at the back of the book displays BMI values. Risk factors that cannot be modified: Increasing age Male sex Family history (heredity) Risk factors that can be modified: High blood LDL cholesterol Low blood HDL cholesterol High blood triglyceride (VLDL) levels High blood pressure (hypertension) Diabetes (type 2) Obesity (especially central obesity) Physical inactivity Cigarette smoking Excessive alcohol consumption High intake of sodium An “atherogenic” diet (high in saturated fats and trans fats and low in vegetables, fruit, and whole grains) Sources: S. S. Virani and coauthors, Heart disease and stroke statistics—2020 update: A report from the American Heart Association, Circulation 141 (2020): e139– e596. Metabolic syndrome- (3 or more)- high blood glucose, central obesity, HTN, low blood LDL, High blood triglycerides Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 15  Discussion Question What is the relationship between hypertension and atherosclerosis? Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16  Discussion Question: Answer Atherosclerosis raises blood pressure and high blood pressure accelerates atherosclerosis. Plaques in arteries also promote and aggravate hypertension. Normally, arteries expand with each heartbeat, accommodating the pulses of blood that flow through them, but arteries hardened and narrowed by plaques cannot expand, so the blood pressure rises. High blood pressure then becomes a symptom of atherosclerosis. High blood pressure also worsens atherosclerosis. High pressure damages the artery walls, making fatalities more likely. And because plaques are most likely to form at damage sites, atherosclerosis progresses most rapidly at those sites. Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 17 Adult Standards for Blood Lipids Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 18  Recommendations to Reduce CVD Risk Treat existing Recognize a heart attack diseases/disorders Reduce salt/sodium intake Lose weight Increase potassium intake Be physically active Follow a healthy dietary Control alcohol intake pattern DASH, Mediterranean Don’t smoke CAM Know your family history Supplements, herbs, drugs Know your blood pressure Manage lifestyle changes Determine your risk Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 19 The Impact Diet Can Have on LDL Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 20  Diabetes Sizer/Whitney, Sizer/Whitney,Nutrition NutritionConcepts Concepts& Controversies, & Controversies,16th Edition. © 2023 16th Edition. © Cengage. All RightsAll 2023 Cengage. Reserved. May not beMay Rights Reserved. scanned, copied not be or duplicated, scanned, copied oror posted to a publicly duplicated, accessible or posted website, to a publicly in whole or accessible in part. in whole or in part. website, 21  Type 1 and Type 2 Diabetes Compared Table 11–7 Type 1 Type 2 Percentage of cases 5–10% 90–95%a Associated Autoimmune disease, viral Aging, overweight or obesity, family history, heart characteristics infections, family history disease, elevated blood lipids, hypertension, psychological depression, some medications Primary problems Destruction of insulin-producing Insulin resistance, insulin deficiency (relative to needs) cells of the pancreas, insulin deficiency Insulin secretion Little or none Varies; may be normal, increased, or decreased Requires insulin Always Sometimes aIncidence of type 2 diabetes is increasing in children and adolescents; in more than 90% of these cases, it is associated with overweight or obesity and a family history of type 2 diabetes. Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 22  How Type 2 Diabetes Develops Prediabetes- blood glucose is above normal, but not high enough to be diagnosed as diabetes; can be reversed Insulin resistance causes glucose and insulin to build up in the bloodstream Cells of the pancreas begin to fail and reduce their insulin output, while blood glucose soars farther out of control Symptoms- intense hunger, frequent urination, intense thirst Harms from diabetes Disease of the large blood vessels Impaired kidney, eye, and nerve function Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 23  Diabetes Test Standards Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 24  Diabetes Prevention and Management Know your family history and get tested Lose weight if overweight Be physically active Choose your diet with care Control carbohydrate intake Decreased saturated fats, increased omega-3 fatty acids Determine ideal protein intake Control alcohol intake Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 25 Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 26  Knowledge Check 1 Match these: With these: Pancreas loses ability to produce Type 1 diabetes insulin Type 2 diabetes Insulin resistance Less common Requires insulin Sometimes requires insulin Autoimmune disease Most common form Associated with aging Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 27  Knowledge Check 1: Answer Match these: Pancreas loses ability to produce insulin – Type 1 diabetes Insulin resistance – Type 2 diabetes Less common – Type 1 diabetes (5-10%) Requires insulin – Type 1 diabetes Sometimes requires insulin – Type 2 diabetes Autoimmune disease – Type 1 diabetes Most common form – Type 2 diabetes (90-95%) Associated with aging – Type 2 diabetes Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 28  Cancer Sizer/Whitney, Sizer/Whitney,Nutrition NutritionConcepts Concepts& Controversies, & Controversies,16th Edition. © 2023 16th Edition. © Cengage. All RightsAll 2023 Cengage. Reserved. May not beMay Rights Reserved. scanned, copied not be or duplicated, scanned, copied oror posted to a publicly duplicated, accessible or posted website, to a publicly in whole or accessible in part. in whole or in part. website, 29  Cancer Second leading cause of disability and death in the US Prevention is preferable to potential for cure For the majority of cancers, lifestyle choices and environmental exposures are the major risk factors Overweight/obesity may overtake smoking as the leading risk factor Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 30  The Cancer Disease Process Cancer arises in the genetic material inside a person’s cells- Carcinogenesis Begins when a cell’s genetic material sustains damage from a carcinogen. − Radiation, free radical, chemicals Damage occurs everyday and is repaired by the cell or the cell dies. When a damaged cell doesn’t die, the immune system destroys it. − If the immune system fails, the damaged cell reproduces uncontrollably (tumor) Life-threatening cancer begins with an event called initiation. − Promoters (hormones or environment) stimulate tumor growth. − Metastasis- movement of cancer cells from one body part to another Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 31  Cancer Development Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 32  Cancer Risk Factors Advancing age Alcohol with smoking Family history Carcinogens in red and processed meats Chronic inflammation Cooking methods Diet Iron Weakened immunity Fried foods Infections Environmental carcinogens Obesity and estrogen Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 33  Recommendations and Strategies for Reducing Cancer Risk (1 of 2) Table 11–9 Recommendations Strategies Body weight: Be a healthy weight. Keep your weight within the Follow the USDA Healthy US-Style Dietary Pattern for your healthy range and avoid weight gain in adulthood. appropriate energy level. Engage in regular physical activity. Processed foods: Limit consumption of “fast foods” and other Limit consumption of “fast foods,” many pre-prepared dishes, snacks, processed foods high in fat, starches, or sugars. Limiting these foods bakery foods and desserts, and candy. helps control energy intake and maintain a healthy weight. Sugar-sweetened beverages: Limit consumption of sugar- Do not consume sugar-sweetened beverages. sweetened beverages. Drink mostly water and unsweetened drinks. Physical activity: Be physically active. Be physically active as part Engage in at least 150 minutes of moderate-intensity physical activity of everyday life—walk more and sit less. or 75 minutes of vigorous-intensity activity or an equivalent combination throughout the week. Limit sedentary behaviors such as sitting, lying down, watching television, or other forms of screen-based recreation. Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 34  Recommendations and Strategies for Reducing Cancer Risk (2 of 2) Recommendations Strategies Plant foods: Eat a diet rich in whole grains, vegetables, fruit, Consume a diet that provides at least 30 grams of fiber per day from food and beans. Make whole grains, vegetables, fruit, and legumes a sources. major part of your usual daily diet. At most meals, include foods containing whole grains, non-starchy vegetables, fruit, and legumes such as lentils and beans. Eat a diet high in all types of plant foods including at least 5 servings of a variety of non-starchy vegetables and fruit every day. Alcoholic drinks: Limit alcohol consumption. For cancer prevention, it's best not to drink alcohol. Red and processed meats: Limit consumption of red and If you eat red meat, limit consumption to no more than about three portions processed meats. Eat no more than moderate amounts of red per week. Three portions is equivalent to about 12 to 18 ounces meat, such as beef, pork, and lamb. Eat little, if any processed cooked weight of red meat. Consume very little, if any, processed meat. meat. Dietary supplements: Do not use supplements for cancer High-dose supplements are not recommended for cancer prevention—aim to prevention. meet nutritional needs through diet alone. Source: World Cancer Research Fund, American Institute for Cancer Research, Diet, Nutrition, Physical Activity and Cancer: A Global Perspective, Continuous Update Project, A summary of the Third Expert Report, 2018, www.dietandcancerreport.org Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 35  Knowledge Check 2 Match these: With these: Toxic chemical Initiator Estrogen Promoter Radiation Obesity Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 36  Knowledge Check 2: Answer Match these: Toxic chemical - Initiator Estrogen - Promoter Radiation - Initiator Obesity - Promoter Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 37 The DASH Diet: Preventive Medicine Emphasizes fruits, vegetables, low fat dairy. Features fish, poultry, nuts instead of some of the red meat Fresh, unprocessed, or lightly processed foods that are lower in sodium “Knowing is not enough; we must apply. Willing is not enough, we must do.” Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 38 Nutrient-Drug Interactions Sizer/Whitney, Sizer/Whitney,Nutrition NutritionConcepts Concepts& Controversies, & Controversies,16th Edition. © 2023 16th Edition. © Cengage. All RightsAll 2023 Cengage. Reserved. May not beMay Rights Reserved. scanned, copied not be or duplicated, scanned, copied oror posted to a publicly duplicated, accessible or posted website, to a publicly in whole or accessible in part. in whole or in part. website, 39  Nutrient-Drug Interactions: Who Should Be Concerned? Potential for harm/unintended consequences Prescription drugs Over-the-counter (OTC) drugs Factors that make interactions likely Multiple drugs Long duration of taking medicines Alcohol consumption daily Herbs or supplements Poorly nourished Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 40 How Foods, Drugs, and Herbs Can Interact Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 41 Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 42  Summary Now that the lesson has ended, you should have learned: About the relationship between risk factors and chronic diseases. What the risk factors are for cardiovascular diseases (CVD). The causes, consequences, and management of type 2 diabetes. About the relationships between diet and cancer and the importance of including sufficient fruit and vegetables in a diet. How nutrients can interact with drugs. Sizer/Whitney, Nutrition Concepts & Controversies, 16th Edition. © 2023 Cengage. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 43