emphasis on prevention of food and nutrition problem.ppt

University notes

1. An emphasis on prevention of
food and nutrition problem
Tayyaba ayub
Assistant professor

2. Learning Objectives
•Upon completion of this module,
the student will be able to:
1.Explain the severity of the worldwide
obesity epidemic
2.Identify how chronic diseases can be
prevented by proper nutrition and lifestyle
3.Identify what dietary regimens are
beneficial for chronic disease management
4.Explain why breastfeeding is the best choice
for infant feeding
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3. Chronic Disease
•A long-term condition
–e.g., obesity, diabetes, and cardiovascular disease
•May be prevented or delayed with lifestyle changes
–e.g., healthier eating and more physical activity
•According to the WHO
– “…by 2020, chronic diseases will account for almost
three-quarters of all deaths worldwide, and that 71% of
deaths due to ischaemic heart disease (IHD), 75% of deaths
due to stroke, and 70% of deaths due to diabetes will occur
in developing countries. The number of people in the
developing world with diabetes will increase by more than
2.5-fold, from 84 million in 1995 to 228 million in 2025. On a
global basis, 60% of the burden of chronic diseases will
occur in developing countries.”
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4. Nutrition for Chronic Disease
Prevention and Treatment
•Nutrition is a widely accepted tool for prevention
of chronic diseases
•Nutrition is also very important for management
and treatment of a chronic diseases
•This presentation will discuss cardiovascular
diseases (e.g., heart disease and stroke), obesity
and diabetes, and how they can be prevented and
treated with nutrition
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5. Classification BMI(kg/m )
�
Principal cut-off pointsAdditional cut-off points
Underweight <18.50 <18.50
     Severe thinness <16.00 <16.00
     Moderate thinness 16.00 - 16.99 16.00 - 16.99
     Mild thinness 17.00 - 18.49 17.00 - 18.49
Normal range 18.50 - 24.99
18.50 - 22.99
23.00 - 24.99
Overweight ≥25.00 ≥25.00
     Pre-obese 25.00 - 29.99
25.00 - 27.49
27.50 - 29.99
     Obese ≥30.00 ≥30.00
          Obese class I 30.00 - 34-99
30.00 - 32.49
32.50 - 34.99
          Obese class II 35.00 - 39.99
35.00 - 37.49
37.50 - 39.99
          Obese class III ≥40.00 ≥40.00
5http://apps.who.int/bmi/index.jsp?introPage=intro_3.html

6. 6

7. Value of waist circumference
•Location of excess fat is
important
•If excess fat is mainly around
midsection = more likely to
develop health problems than if
excess fat is mainly around hips
and thighs
•Apple vs. Pear shapes
•True even if BMI falls within the
normal range
•Women: waist measurement of
more than 35 inches (88 cm)
•Men: waist measurement of
more than 40 inches (102 cm)
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Higher risk body
shape
Lower risk body
shape

8. Use BMI and Waist
Circumference
•Use it with every patient visit
•Can identify those patients at risk for
chronic disease with confidence
•Should be incorporated into vital signs
and patient check-in procedures
•Quick, cheap, and easy to do!
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9. The role of genetics in body
weight
•Epidemiological evidence shows that
obesity, excess energy (Calorie) intake,
and sedentary lifestyle are primary
contributors to the chronic disease
epidemic
•40% of BMI is attributable to
independent genetic

influences
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10. Obesity and Nutrition
Transition
“Obesity in the developing world can be
seen as a result of a series of changes in
diet, physical activity, health and nutrition,
collectively known as the 'nutrition
transition.' As poor countries become more
prosperous, they acquire some of the
benefits along with some of the problems
of industrialized nations.”
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11. Worldwide Obesity Epidemic
•2.5 million deaths can be attributed to
overweight/obesity worldwide
•Nearly 70% of cases of CVD are associated with
obesity
•Worldwide, more than 1.1 billion overweight adults
•At least 312 million of them are clinically obese
•By the end of 2010, an estimated 43 million children under
five will be overweight
•Obesity levels range from 20-30% in European
countries, to over 70% in Polynesia
•By 2015, the worldwide obese population will reach
1.5 BILLION
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12. Diabetes
•Characterized by increased blood glucose (sugar)
levels
•Due to
1.a lack of insulin (a hormone), which controls
blood glucose levels
And/Or
2.an inability of the body’s tissues to respond
properly to insulin (a state called insulin
resistance)
•The most common type of diabetes is type 2
•Diabetes can benefit from good nutrition
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13. Types of Diabetes
–Type 1 diabetes
•an autoimmune condition resulting in the need for
lifelong insulin therapy
–Type 2 diabetes
•Progressive disease related to insulin resistance
•May be managed with just diet and exercise, or may
require oral medication and/or insulin injections
•Most commonly seen in overweight/obese people, but
can also develop in normal weight people
–Gestational Diabetes
•Diabetes that develops during pregnancy
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14. Nutrition for Diabetes
•Goal of nutrition therapy
–To help people with diabetes learn how to make
healthy food choices, which will optimize
glycemic control and prevent complications
–A healthy, well-balanced diet
–There is no one “diabetic diet”
•Healthy eating for diabetes includes whole grain
cereals, lean protein foods, fruits, generous portions of
non-starchy vegetables
•Ideally, a person with diabetes receives an
individualized meal plan from a nutritionist or dietitian
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15. Nutrition for Diabetes
–Questions to ask patients:
•What are the food-related factors that increase
one’s chance of developing diabetes?
–Answer: Obesity (in part due to excess food intake)
is the only food-related cause of diabetes. Eating too
much sugar does not cause diabetes.
•What are the factors that influence eating
habits?
–There are many factors that influence food choices
and eating habits. Economic and family situation,
geography and cultural all contribute to food choices.
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16. Nutrition for Diabetes
•Questions to ask patients:
–What types of foods do you normally eat?
•This allows identification of healthy vs. less healthy eating
patterns
–What types of foods do you eat after waking?
•Carbohydrate foods are less well-tolerated in the morning
hours during pregnancy
–Are you able to monitor your blood sugar?
•If patients have access to a glucometer and test strips,
monitoring post-meal blood sugars can be a useful tool in
assessing dietary factors
•Elevated post-meal blood sugars may indicate too much
carbohydrate is being consumed, or inadequate medication
or insulin is being provided
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17. Managing Type 2 Diabetes
•Glycemic Control
–Self-monitoring should only be considered
when the person with diabetes and their
health care team is prepared to learn the skill,
record the findings, understand the data, and
act appropriately on the data
–Desired plasma glucose levels are <6.0 mmol/l
(<110 mg/dl) before meals, and <7.8 mmol/l
(<140 mg/dl) 2 h after meals.
•Allow higher targets for patients on insulin or
sulfonylureas at risk for hypoglycemia
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18. The Plate Method
•Easy to teach
•Easy to understand
•Based on dividing
portions onto a
standard 9” plate
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19. 19
http://www.dlife.com/diabetes/information/inspiration_expert_advice/expert_columns/
PrescriptionSolutionsPlatePlannerEnglish_LetterSize_3-09.pdf

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21. Cardiovascular Disease
•Caused by disease of the blood vessels
(atherosclerosis) of the heart, usually
as part of the process which affects
blood vessels more generally
•Stroke and heart disease are the main
cardiovascular diseases
–Stroke is the main cardiovascular disease in many
east Asian countries
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22. Nutrition for Cardiovascular
Disease
•Eat a diet rich in fruits, vegetables and whole cereal
grains
–This provides potassium and fiber, both clearly
linked to reduced chronic disease risk
•Don’t add salt during food preparation
•Limit use of processed and pre-prepared food items
–They are typically very high in salt
•Cook with no or very minimal added fats and oils
–If fat or oil is used, unsaturated is healthiest option
(canola, olive, etc)
•Maintain a healthy body weight
•Control blood pressure and blood sugar
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23. Successful Long-term Weight
Control
•Long-term behavioral treatment,
whatever form it takes, encourages
patients to practice four key behaviors
1.Exercise regularly
2.Consume a lower-calorie diet
3.Monitor weight regularly
4.Record food intake and physical activity
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24. Preventing Chronic Diseases
•Maintain a healthy body weight
–The WHO goals are
•For an adult median BMI of 21 to 23 kg/m
2
•For individuals, the recommendation is to
maintain a BMI in the range 18.5 to 24.9 kg/m
2

and to avoid a weight gain greater than 5 kg
(11 pounds) during adult life
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25. Preventing Chronic Diseases:
Physical Activity
•Stay physically active
–The WHO goal is for all people to get
one hour per day on most days of the
week of moderate-intensity activity,
such as brisk walking
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26. Preventing Chronic Diseases:
Breastfeeding
•Infants should be breastfed for at least 6 months
•Breastfeeding is convenient
–Food is readily available for the infant, and
requires no special preparation or equipment
•Provides the best balance and quantity of nutrients
ideal for the human infant
•Both colostrum and breastmilk have anti-infective
constituents that help limit infectious disease
•Bottle feeding increases risk of infections from
contamination with pathogenic organisms in the milk,
the formula and the water used in preparation, as well
as in bottles, teats (bottle nipples) and other items
used for infant feeding
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27. Preventing Chronic Disease:
Breastfeeding
•More economical than bottle-feeding
–Bottle feeding involves costs for infant formula
the bottles and teats and the fuel necessary for
bottle sterilization
•Prolongs the duration of post-partum anovulation,
helping mothers to space their children
•Enhances bonding and relationship between mother
and infant
•Seems to reduce the risk of allergies, obesity and
certain other health problems
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28. Preventing Chronic Diseases:
Summary Points
•Chronic diseases can be prevented with
lifestyle changes
–Lifestyle changes include healthier eating, increasing
physical activity, and smoking cessation
•Very active populations with diets rich in
vegetables, legumes, fruits and whole
grains may have a total fat intake of up to
35% of total calories without the risk of
unhealthy weight gain. WHO, 2003
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