Cardiovascular System

KNH 411

Hypertension

Nutrition TherapyDASH – Dietary Approaches to Stop Hypertension

Decrease sodium, saturated fat, alcohol Increase calcium, potassium, fiber

Lifestyle modifications- smoking, exercise (increase HDL)

Weight loss (everything comes back to normal) Increase Ca, K, and FiberDecreased alcohol

Hypertension

Nutrition TherapySodium restriction controversial

“salt sensitive” or “salt resistance”

Limit processed & cured foods, no added salt during preparation and cooking

Limit to 2400 mg/day

Hypertension

Nutrition Therapy

DASH-Dietary Approaches to Stopping HypertensionDecrease Sodium, saturated fat, alcohol Increase calcium, potassium, fiber

Lifestyle Changes Hardest to change

Atherosclerosis

Etiology - risk factors cont./ typical profilePhysical inactivityAtherogenic diet- or the Western diet, high in fat and

low in fiberDiabetes mellitus- highest risk of CAD, because they

have metabolic syndrome Impaired fasting glucose/ metabolic syndromeCigarette smoke- decreasing vascular system, CAD,

stroke

© 2007 Thomson - Wadsworth

© 2007 Thomson - Wadsworth

Atherosclerosis

Nutrition TherapyTherapeutic Lifestyle Changes (TLC) developed as

component of ATP-III Modifications in fat, cholesterol- more advance than the

DASH Rich in fruits, vegetables, grains, fiber Limit sodium to 2400 mg Include stanol esters- up to 2 grams per day

© 2007 Thomson - Wadsworth

AtherosclerosisNutrition Therapy - Fat Modifications

Total fat 25-35% of caloriesVery-low-fat dietsSaturated fat < 7% of caloriesAvoid trans fatsIncrease intake of monounsaturated fats &

Polyunsaturated omega-6 fatty acidsIncrease intake of omega-3 essential fatty acids

Cold water fish, hopefully three times per weekLimit dietary cholesterol < 200 mg daily

Trying to lower LDL levels with this

Atherosclerosis

Nutrition Therapy - Other Increase sources of soluble fiber- legumes, oats,

ridding of cholesterol, and free radicals, lowering cholesterol, helpful for HD, anti-inflammatory

Increase intake of plant sterols

Weight loss – BMI 18.5-24.9Regular physical activity

What level can they maintain or take? Work with doctor, trainer as well

AtherosclerosisNutrition Therapy Prescription

Assessment of dietary fat intake, saturated fat intake MEDFICTS assessment tool- food frequency chart to be used with

individuals, comes out with a score that you can instruct on, which clients to see first

Dietary CAGE questions- even simpler, quick assessment of what they are eating- cheese, animal fats, got it away form home, eat (extra) high-fat commercial products- assessment of saturated fats and cholesterol intake, just get them to cut back as a starting point

REAP- rapid, eating, assessment, plan, in between CAGE and MEDFICTS plan

Target weight calculatedPrioritize nutrition problemsMultiple planned visits with R.D.

Ischemic Heart Disease

Nutrition TherapyPost MI

Decrease oral intake Clear liquids, no caffeine! Progress to soft, more frequent meals Individualized – use TLC recommendations

Heart FailureNutrition Therapy Intervention

Control signs and symptomsPromote overall nutritional status rehabilitation Sodium and fluid restriction

2000 mg Na Fluid 1 mL/kcal or 35 mL/kg

Correction of deficiencies Increase nutrient density- coffee, or water- give

ensure not to waste calories Enhance oral intake-

Heart FailureNutrition Therapy

Assess drug-nutrient interactions Losses of water-soluble vitamins

Supplementation may be warrantedConsider arginine, carnitine and taurine in dietary

regimen- all aid in tissue repair