Chapter 11 Nutrition and Chronic Diseases.pptx

Nutrition and Chronic Diseases

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

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. LO 12.9 Summarize the advantages and disadvantages of producing foods through bioengineering.

4. Chronic Diseases

5. Infectious vs. Chronic Diseases Infectious diseases vs. chronic diseases Nutrients and our body’ s defenses Top causes of death that are chronic diseases Heart disease Cancers Strokes Diabetes

6. Figure 11 – 1 The Ten Leading Causes of Death

7. Table 11 – 1 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

8. Table 11-1 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 trans fat and low in vegetables, fruit, and whole grains. a X X X X Diet high in salty/pickled foods X X Diet low in vitamins and/or minerals X X X a An 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).

9. Cardiovascular Diseases (CVD)

10. Table 11-2

11. Cardiovascular Diseases (CVD) Disease of the heart and blood vessels 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

12. Cardiovascular Diseases (CVD) Disease of the heart and blood vessels 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

13. Atherosclerosis Development involves: Plaque development Foam cells Blood clot formation Hypertension Inflammation Embolism, aneurysm, hemorrhage, heart attack Relationship with hypertension

14. Atherosclerosis Development involves: Plaque development Foam cells Blood clot formation Hypertension Inflammation Embolism, aneurysm, hemorrhage, heart attack Relationship with hypertension

15. Figure 11.3 The Formation of Plaque in Atherosclerosis

16. Table 11.3 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.

17. Figure 11-2 Interrelationships among Chronic Diseases

18. Discussion Question What is the relationship between hypertension and atherosclerosis?

19. 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.

20. Figure 11.5 Adult Standards for Blood Lipids

21. Table 11-4

22. Recommendations to Reduce CVD Risk Treat existing diseases/disorders Lose weight Be physically active Control alcohol intake Don’t smoke Know your family history Know your blood pressure Determine your risk Recognize a heart attack Reduce salt/sodium intake Increase potassium intake Follow a healthy dietary pattern DASH, Mediterranean Complementary and Alternative Medicines (CAM) Supplements, herbs, drugs Manage lifestyle changes

23. Table 11-5

24. Diabetes

25. Type 1 and Type 2 Diabetes Compared Table 11–7 Type 1 Type 2 Percentage of cases 5–10% 90–95% a Associated characteristics Autoimmune disease, viral infections, family history Aging, overweight or obesity, family history, heart disease, elevated blood lipids, hypertension, psychological depression, some medications Primary problems Destruction of insulin-producing cells of the pancreas, insulin deficiency Insulin resistance, insulin deficiency (relative to needs) Insulin secretion Little or none Varies; may be normal, increased, or decreased Requires insulin Always Sometimes a Incidence 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.

26. How Type 2 Diabetes Develops 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 Harms from diabetes Disease of the large blood vessels Impaired kidney, eye, and nerve function

27. Figure 11-8 Diabetes Test Standards

28. Table 11-8

29. Harm from Diabetes Diseases of the Large Blood Vessels? Impaired Kidney, Eye, and Nerve Function

30. 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

31. Knowledge Check 1 Match these: Pancreas loses ability to produce insulin Insulin resistance Less common Requires insulin Sometimes requires insulin Autoimmune disease Most common form Associated with aging With these: Type 1 diabetes Type 2 diabetes

32. 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 Requires insulin – Type 1 diabetes Sometimes requires insulin – Type 2 diabetes Autoimmune disease – Type 1 diabetes Most common form – Type 2 diabetes Associated with aging – Type 2 diabetes

33. Diabetes Summary Prediabetes silently threatens the health of tens of millions of people in the United States. Type 1 diabetes is an autoimmune disease that attacks the pancreas and abolishes its ability to produce insulin; it necessitates that insulin be provided from an external source. Type 2 diabetes, the predominant type, is closely linked with obesity. A primary characteristic of type 2 diabetes is insulin resistance—an inadequate response of the body’s cells to insulin.

34. Cancer

35. Figure 11- 9 Cancer Development

36. Cancer Risk Factors Advancing age Family history Chronic inflammation Diet Weakened immunity Infections Obesity and estrogen Carcinogens in red and processed meats Cooking methods Iron Fried foods Environmental carcinogens

37. Cancer Risk Factors Advancing age Family history Chronic inflammation Diet Weakened immunity Infections Obesity and estrogen Carcinogens in red and processed meats Cooking methods Iron Fried foods Environmental carcinogens

38. Cancer Risk Factors Advancing age Family history Chronic inflammation Diet Weakened immunity Infections Obesity and estrogen Carcinogens in red and processed meats Cooking methods Iron Fried foods Environmental carcinogens

39. Cancer Risk Factors Advancing age Family history Chronic inflammation Diet Weakened immunity Infections Obesity and estrogen Carcinogens in red and processed meats Cooking methods Iron Fried foods Environmental carcinogens

40. 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 healthy range and avoid weight gain in adulthood. Follow the USDA Healthy US-Style Dietary Pattern for your appropriate energy level. Engage in regular physical activity. Processed foods: Limit consumption of “fast foods” and other processed foods high in fat, starches, or sugars. Limiting these foods helps control energy intake and maintain a healthy weight. Limit consumption of “fast foods,” many pre-prepared dishes, snacks, bakery foods and desserts, and candy. Sugar-sweetened beverages: Limit consumption of sugar-sweetened beverages. Drink mostly water and unsweetened drinks. Do not consume sugar-sweetened beverages. Physical activity: Be physically active. Be physically active as part of everyday life—walk more and sit less. Engage in at least 150 minutes of moderate-intensity physical activity 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.

41. Recommendations and Strategies for Reducing Cancer Risk (2 of 2) Recommendations Strategies Plant foods: Eat a diet rich in whole grains, vegetables, fruit, and beans. Make whole grains, vegetables, fruit, and legumes a major part of your usual daily diet. Consume a diet that provides at least 30 grams of fiber per day from food sources. 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 processed meats. Eat no more than moderate amounts of red meat, such as beef, pork, and lamb. Eat little, if any processed meat. If you eat red meat, limit consumption to no more than about three portions per week. Three portions is equivalent to about 12 to 18 ounces cooked weight of red meat. Consume very little, if any, processed meat. Dietary supplements: Do not use supplements for cancer prevention. High-dose supplements are not recommended for cancer prevention—aim to 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

42. Figure 11-11

43. Dietary Guidelines and the DASH Diet DASH Diet Website: https://mydash.diet/ DASH Eating Plan: https://www.nhlbi.nih.gov/education/dash-eating-plan

44. Table 11-10

45. The Pros and Cons of Bioengineered Foods

46. Table C12-1

47. Table C12-2

48. Bioengineered Foods Most people consume foods that are products of bioengineering Recombinant DNA (rDNA) technology Selective breeding Positive outcomes Golden rice Mass production of insulin and rennin Greater crop yields Faster growing fish

49. Figure C12-3

50. Figure C12-2 Selective Breeding

51. Promises and Problems Bioengineered Foods Human Nutrition Molecules from Microbes

52. Figure C12-4

53. Promises and Problems Bioengineered Foods Greater Crop Yields A Faster Growing Fish

54. Figure C12-5

55. Concerns about GMOs Overdoses of nutrients or phytochemicals Accidental ingestion of drugs Pesticide residues Environmental effects Outcrossing Wildlife Ethical arguments

56. Concerns about GMOs Overdoses of nutrients or phytochemicals Accidental ingestion of drugs Pesticide residues Environmental effects Outcrossing Wildlife Ethical arguments

57. Concerns about GMOs Overdoses of nutrients or phytochemicals Accidental ingestion of drugs Pesticide residues Environmental effects Outcrossing Wildlife Ethical arguments

58. Table C12-3 (1 of 2)

59. Table C12-3 (2 of 2)

60. Figure C12-6

61. Nutrient-Drug Interactions

62. Nutrient-Drug Interactions: Who Should Be Concerned? Potential for harm Prescription drugs Over-the-counter (OTC) drugs Factors that make interactions likely Multiple drugs Alcohol Herbs or supplements

63. Figure C 11- 1 How Foods, Drugs, and Herbs Can Interact

64. Table C11-1

65. Table C11-2

66. Figure C11-2

67. Nicotine and Vaping

68. Health and Vaping

69. Health and Vaping Resource: Health Effects of Vaping (CDC) https://www.cdc.gov/tobacco/e-cigarettes/health-effects.html#cdc_generic_section_8-other-potential-harms-of-e-cigarettes Resource: e-Cigarette Use Among Adults https://www.cdc.gov/tobacco/e-cigarettes/adults.html Resource: Youth vaping - Mid North Coast Local Health District (nsw.gov.au)--Australia https://www.health.nsw.gov.au/tobacco/factsheets/vaping-factsheet-young.pdf

70. Table C11-3

71. 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. The debate around using bioengineering to produce foods.