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Nutrition & Heart Disease
Transcript of Nutrition & Heart Disease
# 1 cause of death for both men & women
375,000 Americans die each year
Insulin resistance, diabetes, hypertension, unhealthy cholesterol levels, lack of exercise
Nutrition & Older Adults
NUTRITION = forefront
Underestimated importance of cardiovascular diseases in older populations
Effects of diet on diagnosis/prevention
What is CHD?
Nutrition & Heart Disease
Dietary Antioxidant Flavanoids
group of antioxidants
known to occur in vegetables, fruit, tea & wine
The Zutphen Elderly Study
Subjects: 805 65+ year old men
Longitudinal--followed for 5 years (1985-1990)
43 men died of coronary heart disease
Major sources of intake: tea, onions, apples
Methods: 1. Measured flavanoid contents in foods. 2. Measured intake of these foods in men. Trained dieticians interviewed the participants at home about consumption, food buying and preparation.
Info also taken on smoking, physical activity,
blood samples, BP, weight & height
Results & Conclusions
Significant inverse relationship between intake and CHD mortality.
Inverse relationship also with myocardial infarctions, however less significant.
Just living a healthy lifestyle?
The researchers conducted statistical analysis to eliminate the chance of r relationship due to other factors besides flavanoid intake.
Can Food Cure heart disease???
Zutphen Elderly Study
Subjects: 852 middle aged men without CHD
beginning at 40-60 years
ending at 60-80 years
Dietitians estimated quantities of fish intake based on an interview with the men and their spouses who reviewed their previous 6 months of eating habits
Results & Conclusion
Results: Death from CHD was 50% lower in those that consumed a minimum of 30 g of fish/day
Conclusion: 1 or 2 fish dishes/week may be preventive for reducing CHD risk.
Wine & Alcohol
: a fat-soluble antioxidant that prevents cell membrane damage from free radicals & atherogenesis
reactive atoms with unpaired electrons
caused by internal physiological processes or external (toxins, smoke, etc.)
damage cells, proteins & DNA by altering chemical structure
: fatty degeneration or fatty deposit in inner arterial wall lining
Subjects: 39,910 40-75 year old male health professionals free of CHD
Longitudinal study: 1986-1990
@ 4 year follow up 667 CHD cases
60 IU/day of vitamin E had a .64 relative risk of CHD after 10 years of supplementation as oppose to 1.0 when no use occurs.
60 IU/day of supplemental vitamin C shows .80 relative risk after 10 years, as oppose to 1.0 with no supplementation
Conclusion: vitamin E is associated with lower risk of CHD, but not vitamin C (carotene)
Foods with vitamin E?
green leafy vegetables (spinach, swiss chard, turnip greens)
Study: Wine, Alcohol, Platelets, & The French Paradox for Coronary Heart Disease
The French Paradox
: the mortality rate from CHD is much lower in France than in other industrialized countries such as the USA & UK; despite high intakes of saturated fat
"Two populations in the world with the greatest life expectancy--the Cretans and the Japanesse--both of whom consume moderate amounts of alcohol: the Cretans 20g per day mostly in the form of wine and the Japanese 28 g/day, primarily in the form of beer"
platelets: blood cells with the purpose to clot & stop bleeding
dairy fat is significantly related to mortality rate of CHD
moderate doses (20-30 g/day) can decrease risk of CHD up to 40%
alcohol is positively associated with HDL (high density lipoproteins, 'healthy' cholesterol)
In the USA, beer & wine show stronger inverse relationship with CHD than spirits in non smokers
moderate drinking--decrease in platelet activity
Vitamin D Deficiency
Elderly is in risk for Vitamin D Deficiency because of poor dietary Vitamin D intake and Exposure to sunlight
Vitamin D Deficiency increases the risk of cardiovascular disease and has a greater risk to coronary heart disease
Interaction between Vitamin D Deficiency and statins in skeletal muscle can be postulated by potentially causing decreased statin usage which is another possible means for Vitamin D Deficiency to increase CV risk
DASH is Dietary Approaches to Stop Hypertension
rich fruits and vegetables
high in protein
mono saturated fats
low saturated fats
low in red meat, sweets, and sugar containing beverages
rich in vitamins and minerals
rapid and sustained reductions in blood pressure
appears to be affective in high, intermediate and low levels of sodium
High consumption of monounsaturated fatty acids primary olives
Daily consumption of fruits, vegetables, nuts, whole grains, and low-fat diary products
Relatively low consumption of red meat
systolic blood pressure
cellular lipid levels
low density lipoproteins
high sensitivity C-reactive protein
Increased high density lipoproteins
Saturated Fat in the Diet
Replacing saturated fat with polyunsaturated fat modestly decreases Coronary Heart Disease risk with approximately 10% risk reduction for a 5% energy substitution
Fat as a dietary component is essential fatty acids and is important in the absorption of fat-soluble vitamins and essential nutrients
Trans fat from hydrogenated oils adversely affect multiple Cardiovascular risk factor and significantly contribute to CHD events
Age-related changes in body composition = slight decline in lean body mass.
Energy requirements decline about 100 kcal/day per decade.
Difficulty to meet daily micronutrients requirements
Leads to Malnourishment AKA heart healthy foods
Community Dwelling Older Populations
16% deficiency in protein
35% deficient in vitamins & minerals
Senior Hospitalized Patients
20-65% had vitamin & mineral deficits
30-60% prevalence of malnutrition in long-term care facilities
What causes these things?
(Ferrini) & (Nutrition)
(Ferrini) & (Nutrition)
Ages 65-69 = 15%
Ages 80-84 = 18%
23% of men and 38% of women with EKG evidence of myocardial infarction did not report it. Results suggest that prevalent disease estimates based only on self-report may underestimate the prevalence of cardiovascular diseases in older Americans.
Prevalence of Myocardial Infarction & Angina
(Wells & Dumbrell)