Diet and Health

Diet and Health Overview

  • Presenters: Caden Mitchell, MS, RD, CSCS

Nutrition and Chronic Disease

  • Importance of Nutrition:

    • Nutrition plays a critical role in health and well-being.

    • Food choices and lifestyle significantly affect chronic disease risk.

  • Definition of Health (WHO):

    • "A state of complete physical, mental and social well-being and not just the absence of disease or infirmity."

  • Compare and contrast:

    • Reducing risk via lifestyle modification vs. Inherited disease tendency.

Determinants of Health

  • Key Determinants:

    • Physical Environment

    • Social Environment

    • Health Services

    • Individual Behavior

    • Biology and Genetics

  • Health Outcomes:

    • Goals include:

    • Attaining high-quality, longer lives free of preventable diseases, disability, injury, and premature death.

    • Achieving health equity and eliminating disparities.

    • Creating health-promoting social and physical environments.

    • Promoting quality of life, healthy development, and healthy behaviors across all life stages.

Leading Causes of Death in the U.S.

  • Ten Leading Causes:

    1. Heart disease

    2. Cancers

    3. Chronic lung diseases

    4. Accidents

    5. Strokes

    6. Alzheimer\'s disease

    7. Diabetes mellitus

    8. Influenza and pneumonia

    9. Kidney diseases

    10. Suicide

  • Note: Motor vehicle accidents are the leading cause of death for ages 15-24.

  • Contribution of alcohol to accidental fatalities.

  • Mortality rate represented per 100,000 population.

Healthy People 2020

  • Objectives:

    • Comprehensive set for disease prevention and health promotion.

    • Enhance quality and years of healthy life.

    • Eliminate health disparities.

    • Create environments that support good health.

    • Promote healthy behaviors lifelong.

Body Weight & Chronic Disease

  • Public health crisis caused by body weight:

    • Risk factors include cardiovascular disease, hypertension, diabetes, metabolic syndrome.

    • Emphasis on weight loss and prevention of further gain.

    • Challenges of weight cycling and chronic dieting.

Physical Inactivity

  • Physical inactivity is a major risk factor for heart disease:

    • Comparable to high blood pressure, smoking, or high cholesterol.

    • Important for long-term weight management.

  • Recommendation: 30 minutes of activity per day; benefits outweigh risks.

Genetics and Disease

  • Genetic components in almost all diseases:

    • Interaction of genetics, environment, nutrition, and lifestyle affects disease outcomes.

    • Cardiovascular disease is the leading cause of death in the U.S.

  • Human Genome Project:

    • International initiative to understand disease genetics, led by NIH.

The Workings of DNA and Genes

  • Genetic code's function in protein creation.

  • Mutations: Errors in the genetic code affecting cell function.

  • Nutritional Genomics

    • Study of diet's influence on gene expression.

Nutritional Genomics

  • Concepts:

    • Nutrigenetics: Interaction between genes and diet.

    • Nutrigenomics: Study of how genes affect dietary responses.

    • Transcriptome: The full range of messenger RNA molecules expressed.

    • Gene-Diet Regulation: Mechanisms by which diet influences gene activity.

    • SNPs: Single nucleotide polymorphisms affecting nutritional metabolism.

Cardiovascular Disease (CVD)

  • Anatomy relevant to CVD:

    • Ascending aorta, Right atrium, Right coronary artery, Right ventricle, Aortic arch, Left pulmonary artery, Auricle of left atrium, Left coronary artery, Left ventricle, Descending aorta.

Atherosclerosis

  • Definition:

    • Slow progressive hardening and narrowing of arteries due to lipid deposits and cholesterol.

  • Consequences:

    • Coronary heart disease (CHD), myocardial infarction (MI), and stroke.

  • Risk Factors:

    • Elevated blood pressure

    • High blood cholesterol

    • Cigarette smoking

    • Diabetes

    • Overweight

    • Physical inactivity

    • Age

    • Family history of heart disease.

Standards for CHD Risk Factors

  • Classification of cholesterol levels (mg/dL):

    • Total blood cholesterol:

    • Desirable: <200

    • Borderline: 200-239

    • High Risk: ≥240

    • LDL cholesterol (mg/dL):

    • Desirable: <100

    • Borderline: 130-159

    • High Risk: 160-189

    • HDL cholesterol (mg/dL):

    • Desirable: ≥60

    • Borderline: 59-40

    • High Risk: <40

    • Triglycerides (mg/dL):

    • Desirable: <150

    • Borderline: 150-199

    • High Risk: 200-499

    • Body Mass Index (BMI):

    • Desirable: 18.5-24.9

    • Borderline: 25-29.9

    • High Risk: ≥30

    • Blood Pressure (in mm Hg):

    • Desirable: <120/<80

    • Borderline: 120-139/80-89

    • High Risk: ≥140/≥90

  • Classification aids in determining medical treatment.

Cholesterol and Atherosclerosis

  • Identify the risk factors established in the 60s:

    • Hypercholesterolemia, high blood pressure, smoking.

  • Importance of lipoproteins:

    • Certain LDL variants (Lp(a)) are more atherogenic.

  • Trend: Overall deaths from CHD have decreased over time.

  • Women aged 35-54 years see heightened risk due to obesity.

Inflammation and Atherosclerosis

  • C-reactive protein (CRP):

    • Protein indicative of injury, infection, or inflammation; used as a risk assessment tool.

Dietary and Lifestyle Factors for Reducing Atherosclerosis Risk

  1. Balance calories with physical activity.

  2. Eat a diet high in fruits and vegetables.

  3. Consume whole-grain, high-fiber foods (25-30g/day).

  4. Eat fish (especially oily types) at least twice weekly.

  5. Limit saturated and trans fats, cholesterol intake.

  6. Minimize consumption of added sugars.

  7. Choose foods low in sodium.

  8. Consume alcohol in moderation: 1 drink/day for women, 2 for men.

  9. Adhere to American Heart Association's diet recommendations when dining out.

Tips for Dining Out

  • Choose restaurants with healthy menu options; make special requests for low-saturated-fat selections.

  • Control portion sizes through side dishes or sharing meals.

  • Ask for sauces/dressings on the side to manage fat intake.

  • During pizza orders, opt for vegetable toppings or half/omit cheese.

  • Fast food strategies: salads, grilled proteins, moderate portions being key.

Hypertension

  • Blood Pressure Classifications for Adults (mm Hg):

    • Normal: <120 systolic and <80 diastolic

    • Prehypertension: 120-139 or 80-89

    • Stage 1 Hypertension: 140-159 or 90-99

    • Stage 2 Hypertension: ≥160 or ≥100

  • Source data by Chobanian et al., JAMA.

Risk Factors for Hypertension

  • Contributing factors include stress, “white-coat” syndrome, obesity, excessive salt intake, sedentary lifestyle, alcohol consumption, race, age, and heredity.

Dietary and Lifestyle Factors for Reducing Hypertension

  • Sodium Intake:

    • Limit to <2300mg daily.

  • Avoid tobacco and excessive alcohol use.

  • Maintain BMI < 25; a 10 lb weight loss can decrease BP.

  • Following the DASH diet is recommended.

Cancer

  • Dietary and Lifestyle Factors for Reducing Cancer Risk:

    1. Maintain a healthy weight.

    2. Engage in regular physical activity.

    3. Eat a diet rich in plant-based sources.

    4. Limit alcohol intake if consumed.

Specific Dietary Recommendations

  • Emphasize:

    • Healthy fats, vegetables, fruits, whole grains, and legumes.

Diabetes Mellitus

  • Type Definitions:

    • Type 1 Diabetes: Autoimmune destruction of insulin-producing cells.

    • Type 2 Diabetes: Insulin resistance and/or inadequate insulin secretion.

    • Pre-diabetes and Gestational Diabetes also discussed.

  • Risk Factors for Type 1 and Type 2 Diabetes:

    • Type 1: Family history (first-degree relative).

    • Type 2: Age ≥ 45, overweight (BMI ≥ 25), family history, sedentary lifestyle, ethnicity, history of pre-diabetes or gestational diabetes, hypertension, dyslipidemia, and polycystic ovary syndrome.

Prevalence of Diabetes in the U.S.

  • Observed increases in prevalence from 2004 to 2014.

  • Categories based on state data, illustrating rising diabetes rates.

Reducing Diabetes Risk

  • Management Strategies:

    • Focus on diet, physical activity, and medications.

Understanding Diabetes

  • Additional resources available via video link: https://www.youtube.com/watch?v=X9ivR4y03DE

Metabolic Syndrome

  • Definition: Cluster of 3 or more risk factors including:

    • Abdominal obesity (men ≥ 40 inches, women ≥ 35 inches).

    • High fasting blood glucose (≥ 100 mg/dL).

    • High serum triglycerides (≥ 150 mg/dL).

    • Low HDL cholesterol (< 40 mg/dL for men, < 50 mg/dL for women).

    • Elevated blood pressure (systolic ≥ 130, diastolic ≥ 85).

Summary Recap**:

  • Cardiovascular Disease: Leading cause of death in the U.S.

  • Hypertension: Link to sodium intake.

  • Diabetes: Differences in Type 1 and Type 2 diabetes understanding.

  • Cancer: Impact of diet and environmental factors.

  • Genetics' role in diseases.

Final Questions

  • Open floor for questions.