hypertension, cardiovascular disease, diabetes. 34% of americans 36% of americans
TRANSCRIPT
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Hypertension, Cardiovascular
Disease, Diabetes
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34% ofAmericans
36% ofAmericans
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Video
http://www.youtube.com/watch?v=jvE6at_i_Tw&feature=related
Volume (Cardiac Output-CO) Sodium
Increased intake, increased volume Potassium
Balances high blood sodium, promotes kidney excretion of sodium
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Video
Rate-Resistance Effects heart muscle cells, rhythmic beating
Calcium Magnesium Potassium
Hypertension affects: Blood vessels Kidneys Eyes Brain
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Dash Diet
Adequate potassium, calcium, magnesium whole grains, 4-5 servings/day vegetables, 4-
5 servings/day fruits, 2-3 low-fat dairy 4-5 servings/week of nuts, seeds, legumes 2-3 servings soft margarine-oil/day (1 tsp) 5 or fewer servings sweets/added sugars/week
Moderate Sodium2400 → 1500 mg/day
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Atherosclerosis
• Plaque progression – Coronary Heart Disease
(CHD)
– Peripheral Vascular Disease (PVD)
– Carotid Artery Disease (CAD)
– Cerebral Vascular Disease (CVD)- strokes
• Chronic disease• Goal to stop or
prevent• 37% of Americans
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Nutrition Related Modifiable Risk Factors
Obesity Elevated LDL, Cholesterol, Triglycerides Low HDL Hypertension Diabetes
Smoking Family history
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Nutrition Recommendations
National Cholesterol Education Program- Adult Treatment Panel III Guidelines (NCEP-ATP III) www.nhlbi.nih.gov/guidelines/cholesterol/dskref.htm
Mediterranean Diet American Heart Association
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NCEP-ATP III Blood Lipid Goals
LDL (MOST IMPORTANT TO DECREASE) < 100 mg/dL if CHD < 130 mg/dL if 2+ risk factors, < 160 mg/dL if 0-1 risk factors
Cholesterol < 200 mg/dL
HDL < 40 - low; > 60 - high
Triglycerides < 150 mg/dL
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NCEP-ATP III Guidelines- TLC Diet
Saturated fat and trans fat < 7% of calories
Cholesterol < 200 mg/day
Increase soluble fiber Increase plant stanols/sterols
2 grams/day Weight Management Physical Activity
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Plant Stanols/Sterols
• Modified triglyceride that prevents fat/cholesterol absorption
• Margarine like product
• 2 servings a day
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American Heart Association
Weight loss Whole grains- ½ of grain intake Fatty Fish- 2 servings/week; 8 oz total Fat- 25-35% of total calories
Decrease saturated and trans fats Increase mono and polyunsaturated
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DietResponse to diet varies per individualResponse depends on patient
compliance6-8 weeks
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Impact on LDL and HDL
LDL Cholesterol HDL Cholesterol
Weight Loss ↓ ↑
High Saturated Fat ↑ ─
High Trans Fat ↑ ─
High Soluble Fiber ↓ ─
Smoking ─ ↓
Regular Exercise ─ ↑
Moderate Alcohol ─ ↑
Plant Sterols ↓ ─
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InsulinFrom pancreas or injection
CHO from diet, glycogen
Blood Glucose (blood sugar) + Insulin
Cells
Diabetes- Blood Glucose
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Hyperglycemia
Elevated fasting blood glucose (sugars) Labs
Normal- 70-110 mg/dL Pre-diabetes- 100-125 mg/dL Diabetes > 126 mg/dL fasting
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Pre-Diabetes
Weight loss Exercise
150 minutes/week
General Diet Guidelines ½ grain intake whole grains Increase fiber
25+ grams for women 38+ grams for men
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Type 1- Insulin Dependent Diabetes
Pancreas does not make insulin Carbohydrate (CHO) coincides with insulin therapy
@15 grams CHO: 1 unit insulin
Have a CHO intake pattern Count TOTAL grams of CHO Regular (scheduled) meals and snacks Eat more complex carbohydrates than refined
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Adult Onset-Type 2 Diabetes
Insulin does not get glucose to cells Insuline resistance
Weight loss Reverses insulin resistance Calorie control, exercise
Balanced Diet Moderate CHO intake Whole grains, limit sugar
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Diabetic Hypoglycemia
Low blood glucose < 70 mg/dL 15-15 rule
15 grams CHO, test 15 minutes later ½ cup juice, 1 tablespoon sugar, 1/3-1/2 cup
regular soda/pop Goal to ↑ 50-100 mg/dl in 15 minutes