dietary changes in disease prevention

what is the main process that leads to CVD?

atherosclerosis

what risk factors for CVD can a poor diet contribute to?

- obesity

- hypertension

- hypertriglyceridaemia

- T2DM

what are the key points of how diet changes can prevent atherosclerosis?

- preventing accumulation of lipids

- changing composition of circulating and stored lipids

- reduce oxidation or glycation

- prevent hypertension

what are some dietary guidelines that should be followed to prevent CVD?

- total fat intake < 30% and saturated fats < 7%

- eat 5 portions of fruit and vegetables a day

- eat 2 portion of fish per week

- reduce sugar intake

- choose wholegrain varieties of starchy food

what nutrients are thought to have an association with the reduction of CVD incidence?

- vitamin C

- caretinoids

- vitamin E

what do oxidised LDLs do?

inhibit nitric oxide production - which usually vasodilates vessels

what does vitamin E do?

inhibits oxidisation

when is diet modification used in renal disease?

only in severe and end-stage disease

what are some areas of the diet that need to be controlled in renal disease? (5)

- protein intake

- energy intake

- potassium

- phosphate

- sodium and fluid

what is important about protein intake?

has to be adequate to avoid malnutrition

what is important about general energy intake?

has to be adequate to avoid weight loss

what is important about potassium intake?

needs to be restricted due to impairment in excretion ability of the damaged kidneys

what can hyperkalaemia lead to?

cardiac arrhythmias or arrest

what is potassium found in?

fresh fruit ad vegetables

what is important about phosphate intake?

hyperphosphataemia is common in renal impairment due to inability to excrete phosphate

which foods are high in phosphate?

foods high in protein - so difficult to avoid malnutrition and hyperphosphataemia

what drugs are often prescribed to combat hyperphosphataemia?

phosphate binders e.g. calcium carbonate

what is important about sodium and fluid intake?

sodium and fluid retention leads to oedema and htn

what is recommended for sodium and fluid intake in renal disease?

- no-added slat

- fluid restriction (500ml per day)

what is the key focus of dietary control in diabetes mellitus?

improving glycaemic control

what are the benefits of improving glycaemic control? (3)

- relieving acute and chronic symptoms of hyperglycaemia

- reduces risk of CVD and other complications

- achieving or maintaining ideal body weight

what is the general dietary advice for those with diabetes mellitus? (5)

- three regular meals per day - snacks if necessary to avoid hypos between meals

- complex carbs/starchy foods at each meal

- avoid sugar and sugary foods

- low in fat

- high fibre rich in fruit and veg