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DIET AND LIFESTYLE S. A. Udipi Professor & Head Dept. of Food Science and Nutrition, S.N.D.T. Womens University.

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Presentation on theme: "DIET AND LIFESTYLE S. A. Udipi Professor & Head Dept. of Food Science and Nutrition, S.N.D.T. Womens University."— Presentation transcript:

1 DIET AND LIFESTYLE S. A. Udipi Professor & Head Dept. of Food Science and Nutrition, S.N.D.T. Womens University

2 Food and Man Food occupies a central position in life. - beyond appeasement of hunger. - part of our value systems. - symbol of hospitality, pleasure, love, security. - symbolize status and power. - emotional connotations.

3 Indian modern society – a paradox One end of the spectrum – a scene of plenty, at the other end, food and nutritional security are unfulfilled dreams Nutrition a critical component of risk reduction and treatment India faces double burden of malnutrition Undernutrition in pregnancy – increased risk of NCDs?

4 Globalization Diet and Lifestyle Global markets Global trading system Cultural globalization Migration Cross-cultural interactionIncreasing world trade Increasing array of manufactured goods Widespread flow of information, ideas, lifestyles Product marketing Advertising Changing dietary and life style patterns Nutrition Transition

5 Globalization Nutrition transition towards diets with high proportions of salt, saturated fats, sugar Availability and use of drugs Consumption of alcohol and tobacco products Results in profound, complex changes in nature of society Brings new opportunities and risks

6 Frequency of Consumption of Foodstuffs by Call Center Employees (n=1400) Food itemsDaily2-3 x /week1x/week1 x/fortnight Fried snacks Pizza/burger 3.812.728.014.6 Icecream Chocolate 20.518.516.412.6 Mithai 6.910.916.711.6 Biscuits 32.418.715.210.8 Wafers/chips 26.920.617.012.8 Soft drinks 25.420.419.49.6 Juices 25.421.315.713.4 Alchohol/Beer Leafy vegetables 29.331.419.59.4 Fruits 41.724.316.18.8 Non vegetarian foods19.920.915.36.5

7 Consequences of Job on Eating Patterns Overeating - 35% Eat less than usual - 35.2% Irregular meal timings - 61.1% Skipping meals - 56.9% Eat out more - 61.8% Consume fried foods - 50.0% Consume tea/coffee - 53.5% Consume soft drinks - 40.1%

8 Percent Infants consuming various energy dense foods Foodstuff %Infants Chocolates 56.7 Marie biscuit 48.8 Glucose biscuit 47.0 Wafers/chips 43.9 Icecream 39.6 Cakes and pastries 33.5 Milk shakes 19.5 Soft drinks 16.5 Pizza 14.0 Imported fruit purees 12.8 Noodles 11.0 French fries 9.1 Pasta 8.5 Burger 7.3 Imported vegetable puree 7.3

9 Number of Feeds / week given to Infants FoodsUnderweight (n=2) Normal weight (n=83) Overweight (n=33) Obese ( n=46) Cereals 16.5 ± 0.419.2± 0.520.5± 0.622.1 ± 0.6 Halwa 0.02.0 ± 0.63.5 ± 0.44.6 ± 0.8 Vegetables 0.08.8± 0.58.4 ± 0.59.7 ± 0.6 Potato/sweet potato 7.0±0.05.3±0.36.2±0.27.3±0.3 Fruits 10.5±0.510.4±0.411.7±0.511.6±0.4 Fruit juices 0.05.3±0.24.5±0.39.7±0.5 Animal milk/Infant formula 14.0±1.020.0±0.924.0±1.126.8±0.9 Paneer and Cheese 0.04.9±0.36.6±0.49.0±0.5 Non-vegetarian foods 4.5±0.410.8±2.812.1±0.912.4±0.8 Energy dense foods 3.0±0.08.4±0.49.9±0.512.0±0.7 Biscuits 7.0±0.08.1±0.48.5±0.410.5±0.3

10 Diet Patterns of 2-5 yr old children 41-53% children offered food as a reward Foods offered – chocolates, pizzas, burgers 48-50% children watch television while eating, 4-6% study while eating 50-57% children 3-5 yrs of age eat out (1-3 x / week) Fast foods, carbonated drinks, milk shakes, ice cream, fruit juice, other sweetened beverage

11 Frequency of Consumption of various Foods ItemsDaily1-2 x /week Pulav/Biryani4.331.7 Cheese11.340.2 Paneer2.743.3 Potato, yam20.647.5 Banana, chickoo, custard apple35.845.3 Carbonated beverages2.416.1 Chips, wafers, farsan11.411.8 Fruit based beverages2.922.2 Pastries, cakes4.824.2 Chocolates18.646.7 Instant noodles4.444.4

12 Diet, Obesity, Diabetes and CVD Carbohydrate,glycemic load Dietary fat and fatty acids Fibre Sodium Western style vs Mediterranean, Paleolithic diets

13 Glycemic Index, Glycemic Load Higher glycemic load( incl. intake of starches with high GL ) glucose response Serum Insulin levels Urinary C- peptide Glycated Hb Blood pressure Impaired fibrinolysis, thrombosis hs- CRP( independent of BMI, total energy intake, other risk factors )

14 Mediterranean diets and Health Meta- analysis –mortality evaluated Total mortality 8 cohorts, 9 studies 514816 subjects, 33576 deaths Cardiovascular mortality 3 cohorts, 4 studies 404491 subjects, 3876 fatal events Cancer incidence/mortality 5 cohorts, 6 studies 521366 subjects, 10929 events Parkinsons, Alzheimers 2 cohorts, 3 studies 133626 subjects, 783 cases

15 Outcomes A 2-point increase in score significantly assoc with reduced risk of mortality from any cause Greater adherence risk of mortality from cardiovascular disease, neoplasm, reduced incidence of Parkinsons, Alzheimers Sofi et al. (2008) 337:1344-1351

16 Paleolithic diets - benefits In Type 2 diabetics(comparison with Diabetic diet for 3 months) - improved glycemic control, - lower HbA1c levels, - decline in insulin levels, - lower TAG levels( abdominal fat?) - lower body weight, WC, diastolic BP - Jonsson et al. (2009) Cardiovasc Diabetol 8:35-49

17 School age children, physical activity & sleep Negative correlation between : Total number of hours children sleep and BMI. Duration of walking and BMI, mode of transport to reach school. Total time spent in play and BMI. Attending tuition classes and BMI.

18 Physical activity Intensity (degree / extent of exertion -- % of heart rate or lung volume VO2 Duration ( length of time) Frequency ( # of times a given activity is performed)

19 Benefits of Exercise More effective fibrinolytic profile* Plasma fibrinogen (75% VO2 max for 30 mins)* Risk of thrombus formation* Long term exercise regimen (60% VO2 max, 30 mins)** Platelet adhesiveness, aggregability Tissue plasminogen activator, Plasminogen activator inhibitor-1 * El Sayed et al (1999) Thromb Res; 96:467-472. ** Wang et al (1995) Arterioscler Thromb Vasc Biol; 15:1668-1674.

20 Postmenopausal sedentary women Plasminogen activator Inhibitor (AU/mL) Tissue Plasminogen activator (U/mL) Sedentary14.5 ± 1.21.3 ± 0.1 Physically active6.5 ± 1.12.7 ± 0.4 Source: DeSouza et al (1998) Arterioscler Thromb Vasc Biol. 18:362-68 Physical Activity& Blood Coagulation

21 Exercise and Blood Pressure Rowland (2001) routine daily exercise throout life time systolic and diastolic in hypertensives & normotensives ( Adults n=1076) Izqueiredo- Porrera et al (2000) exercise rehabilitation 6 mos, 3 x Decrease in systolic BP, no change in diastolic ( older adults 54-84 yrs n=48 ) Jakes et al (2003) Increased time of TV viewing– increase in BP Increased level of vigorous activity – lower diastolic BP ( middle age & older adults 45-74 yrs, n= 15,515 ).

22 Physical Activity & Vascular remodelling Angiogenesis – growth of new capillaries from existing ones – increases perfusion in cardiovascular tissues & cells, reduces effects of ischemia. Vasculogenesis – formation of new blood vessels in original position and growth of endothelial progenitor cells (EPCs). Arteriogenesis – modification of pre-existing arterioles, affecting size, length & diameter of arterioles

23 Exercise and Vascular Remodelling Group Lumen diameter of femoral artery (mm) Arterial wall (intima- media) thickness (mm) Endurance trained 9.62 ± 0.124.6 ± 0.1 Sedentary 9.03 ± 0.134.7 ± 0.10 Dinenno et al (2001) J Physiol. 534:287-95.

24 Benefits of Exercise contd Miyachi et al (1998) -- Endurance training – arteriogenesis increased CSA (16%) of ascending aorta 24% CSA of abdominal aorta, 20% increase in blood flow Kleim et al (2002) -- Angiogenesis in rats Increased blood vessel density in caudal forelimb muscle facilitated better oxygen transport Decreased diffusion time Improved glucose uptake Laufs et al (2004) -- Elevated a subset of bone marrow derived EPCs enhanced angiogenesis

25 We may / may not consume more energy per se BUT The composition of what we eat is markedly different compared to the assumed hunter, gatherers on which human appetites and metabolism, physiology evolved Comparison of ED of diets: African diets - 450kJ/100g Average British Diet – 670kJ/100g Av. Fast food outlet -- 1100 kJ/100g More sedentary lifestyles Gardner and Rhodes (2009) Adv Exp Med Biol; 646:83-93. You are what you eat

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