Chapter 11 Diet and Health Nutrition: Concepts & Controversies, 12e Sizer/Whitney

Learning Objectives Describe relationships between immunity and nutrition, and explain how malnutrition and infection worsen each other. Compare and contrast the progression and the symptoms of heart disease in men and women. Describe what dietary and genetic factors may affect CVD risks and why higher LDL levels are a health concern.

Learning Objectives Develop a general eating plan for a person with prehypertension. Speculate about possible mechanisms by which a diet high in red meat might increase the risk of breast cancer or colorectal cancer.

Learning Objectives Develop a healthy eating plan that reduces the intake of trans fat and saturated fat but maintains sufficient intakes of essential nutrients. Describe some recent advances in nutritional genomics with regard to the health of the body through life.

Introduction Two types of diseases Nutrients and our body’s defenses Infectious and chronic Nutrients and our body’s defenses Hoaxes Leading causes of death Chronic diseases Mixture of factors

The Ten Leading Causes of Death in the United States

Nutrition and Immunity Well-nourished immune system Provides protection Susceptible groups PEM Malnutrition

Effects of Protein-Energy Malnutrition (PEM) on the Body’s Defense Systems

The Concept of Risk Factors Suspected contributors Show correlation with the disease Disease risk factors Genetic Environmental Behavioral Social Dietary contributions to disease

Risk Factors and Chronic Diseases

Interrelationships Among Chronic Diseases

The Concept of Risk Factors Estimating your risk Search family’s medical history Laboratory tests

Cardiovascular Diseases Disease of heart and blood vessels Symptoms of heart attack and stroke Minimizing risks Heart is one of the least regenerative organs Heart disease Men vs. women

U.S. Heart Disease Death Rates

Atherosclerosis Hardening of the arteries Everyone has signs How advanced is the disease Plaque formation Damaging factors to vessel linings Inflammation Macrophages Mineralization

The Formation of Plaques in Atherosclerosis

Atherosclerosis Plaque rupture Blood clots Blood pressure Abnormal blood clotting Omega-3 fatty acids Blood pressure

Risk Factors for CVD Age, gender, and genetic inheritance Nonmodifiable High LDL and low HDL cholesterol Higher the LDL the greater the risk Most atherogenic lipoproteins Higher HDL reduces risk LDL oxidation

LDL, HDL, and Risk of Heart Disease

Adults Standards for Blood Lipids, Body Mass Index (BMI) and Blood Pressure

Risk Factors for CVD Hypertension and atherosclerosis Diabetes Both worsen CVD Worsen each other Diabetes Physical inactivity Benefits of activity for heart health Smoking

Risk Factors for CVD Inflammation Increased risk of thrombosis Atherogenic diet DASH eating plan Obesity & metabolic syndrome Cluster of risk factors Inflammation Increased risk of thrombosis Other risk factors

Recommendations for Reducing CVD Risk Lifestyle changes Increase physical activity Lose weight Implement dietary changes Reduce exposure to tobacco smoke

Recommendations for Reducing CVD Risk Diet to reduce CVD risk Reduce fat intake Saturated and trans fats Limit refined starches and added sugars Eat fruits, vegetables, and whole grains Diet rich in omega-3 fatty acids Other dietary factors

Nutrition and Hypertension One of most prevalent forms of CVD No symptoms you can feel Two numbers Systolic pressure Diastolic pressure Prehypertension Blood pressure checks at regular intervals

Nutrition and Hypertension Blood pressure Cardiac output Factors causing an increase Peripheral resistance Risk factors Salt intake Alcohol

The Blood Pressure

Nutrition and Hypertension DASH diet Health benefits beyond blood pressure Weight control Physical activity Alteration of hormones Salt or sodium Alcohol Minerals and vitamin C

Lifestyle Modifications to Reduce Blood Pressure

Complementary and Alternative Medicine Complementary vs. alternative Integrative medicine National Center for Complementary and Alternative Medicine (NCCAM) http://nccam.nih.gov/ Accupuncture Herbal medicines

Selected Herbs: Claims, Evidence, and Risks

Selected Herbs: Claims, Evidence, and Risks

Nutrition and Cancer Prevention of cancer Risk factors Diet Lifestyle factors Environmental exposures Diet Dietary components Relation to cancer

How Does Cancer Develop? Cancer arises in the genes DNA is damaged by carcinogen Cellular repair or self-destruction Cell loses ability to self-destruct Replicates uncontrollably Mass of abnormal tissue Cancer prevention through tumor development

Cancer Development

Which Diet Factors Affect Cancer Risk? Energy intake Reduced caloric intakes Cancer prevention only Obesity Depends on site of cancer & other factors Physical activity Alcohol Fat and fatty acids

Which Diet Factors Affect Cancer Risk? Red meats and processed meats Cooking Smoking Fiber-rich foods Folate and antioxidant vitamins Calcium and vitamin D Iron Food phytochemicals

The DASH Diet: Preventive Medicine Emphasized foods Make only a few dietary changes at a time Start with fruits & vegetables

Nutritional Genomics: Can It Deliver on Its Promises? Controversy 11

Nutritional Genomics Research Genome Genetic profile DNA microarray technology DNA mutations SNPs Variation of a nucleotide

Epigenetics Epigenome Proteins and other molecules that regulate expression of genes Turning genes “on” and “off” Inherited or altered Regulation Histones Methyl groups

Two Epigenetic Factors and Gene Activity

Bioactive Food Components and Gene Expression

Epigenetics Future generation effects Modifying your epigenome Embryonic development Modifying your epigenome Health implications Bioactive constituents in whole foods

Genetic Testing Arguments Merits Demerits Nutritional genomics fraud

Genetic Testing: Pros and Cons