The week 4 signature Diet Analysis assignment has been designed for you to analyze and assess your own diet using the US Dietary Guidelines for Americans.
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Nnakwe_PPTS_CH10.pptxChapter 10 Adulthood: Special Health Issues
Adulthood: Special Health Issues
A chronic condition is an occurrence of a disease that is long term and extends over a period of time.
The risk factors of dietary practices are significant in several chronic diseases, including heart disease, stroke, cancer, obesity, and osteoporosis.
Healthy People 2010
The goal of Healthy People 2010 is to prevent and control chronic diseases such as heart disease, obesity, cancer, and osteoporosis.
Cardiovascular Disease
The cardiovascular system includes the heart, blood vessels, and the blood-forming organs.
Atherosclerosis
This hardening of the arteries occurs when fibrous plaques forms, which are composed mainly of cholesterol, build up in the arteries, especially at branch points.
The first sign of atherosclerosis is soft fatty streaks visible along the walls of the arteries.
Cardiovascular Disease Continued
This disease process interferes with the pumping of blood through the artery in two ways:
The deposits gradually narrow the opening.
The fibrosis makes it increasingly harder for the artery to constrict or dilate in response to the tissues’ need for oxygenated blood.
Coronary heart disease (CHD) is the most common form of cardiovascular disease.
It involves atherosclerosis and causes one-third of all deaths in both men and women.
Cardiovascular Disease Continued
Unmodifiable Risk Factors are risk factors that are not under the control of the individual such as age, gender, ethnicity, and family history.
Family History
A family history of premature CHD in a parent or sibling increases a person’s risk for the disease.
Premature CHD occurs in a male under the age of 50 or a female under age 60.
Cardiovascular Disease Continued
Modifiable Risk Factors: The major modifiable risk factors for CVD are hypertension, obesity, cigarette smoking, hypercholesterolemia, and diabetes.
Hypertension—there is a direct link between increase in blood pressure (BP) and CVD complications.
Cigarette smoking stresses the CVD system by depriving the heart of oxygen and raising the blood pressure.
Cardiovascular Disease Continued
Hypercholesterolemia is the total blood cholesterol level of over 200 mg/dl, especially at or over 240 mg/dl together with LDL cholesterol over 130 to 159 mg/dl, is associated with CVD.
The higher a person’s HDL levels, the lower the risk of coronary heart disease.
Obesity has increased over the past several decades, and has had a negative impact in reducing CVD morbidity and mortality.
Increase in the risk for CHD is observed in individuals with diabetes.
Cardiovascular Disease Continued
The National Cholesterol Education Program: The NCEP recommended several different strategies for identifying and managing individuals at risk for heart disease.
The strategies include either primary prevention for healthy individuals or secondary prevention for those at risk of heart disease.
Box 10-4 and Table 10-4 present the approaches for reducing the risk of heart disease and managing hypercholesterolemia.
Obesity
Obesity is due to the accumulation of excess body fat.
It increases the risk for:
high blood pressure
high blood cholesterol
type 2 diabetes
insulin resistance
coronary heart disease (CHD)
many other physical ailments
Obesity Continued
Defining Obesity and Overweight: Fat distributed around the hips and thighs (“pear shape”) or gynoid obesity is common in women.
Fat distributed around the abdomen (“apple” shape) or android obesity, found mainly in men, is linked to high blood lipids, glucose intolerance and insulin resistance, and high blood pressure.
Excess body fat at both locations has detrimental consequences for both men and women.
Obesity Continued
A waist circumference of larger than 40 inches in men or higher than 35 inches in women is a sign of increased health risk.
BMI is the recommended method for screening and monitoring the population’s body fat and for defining both overweight and obesity in a clinical setting.
For adults, a BMI of 25.0 to 29.9 is classified as overweight and a BMI of 30.0 or more is classified as obese.
Obesity Continued
Epidemiology of Obesity and Overweight: The second leading cause of preventable death in the United States is obesity.
It accounts for at least 112,000 deaths each year.
The National Center for Health Statistics reported that in 2003–2004 66 percent of U.S. adults were either overweight or obese.
Medical and Social Costs of Obesity: Direct healthcare costs refer to preventive, diagnostic, and treatment services related to overweight and obesity.
For example, physician’s office visits, hospital, and nursing home care
Obesity Continued
Medical and Social Costs of Obesity Continued
Indirect costs refer to the value of wages people lost when they were unable to work because of illness or disability.
Also includes the value of future earnings lost by premature death.
Overweight and obese individuals are at increased risk for many diseases and health conditions, including:
Type 2 diabetes
Coronary heart disease
Stroke
Obesity Continued
Sleep apnea
Respiratory problems
Some cancers
Complications during pregnancy
Complications during surgical procedures
Depression
Gallbladder disease
Osteoarthritis
Hypertension
Dyslipidemia
Obesity Continued
Determinants of Obesity: Size of the fat cells can decrease with weight loss, but the number of the cells does not decrease.
Other determinants include:
Genetics
Gender
Hypothyroidism
Cushing syndrome
Depression
Environmental: The term “obesogenic environments” includes costs, laws, policies, social and cultural attitudes, and values.
Obesity Continued
Obesity Prevention and Treatment Intervention includes the following:
Lifestyle modification
Dietary modification
Physical activity modification
Behavior modification
Public Health Policy for Addressing Global Obesity: In 2006, the Trust for America’s Health (TFAH) reported that national and state policies were inadequate for obesity control and reduction.
Obesity Continued
Obesity Prevention and Treatment Continued
Some important findings from the study include the following:
A lack of designated leadership and a bureaucratic tangle of involved agencies
Obesity and obesity-related disease rates increasing throughout the nation
All states on track to fail the national Healthy People 2010 goal of reducing the proportion of adults who are obese
Cancer
Its development involves damage to the DNA of cells.
The characteristics common to all types of cancer are uncontrolled growth and the ability to spread to distant sites (metastasize).
Link Between Cancer and Diet: It is estimated that 35 percent of the cancer mortality in the U.S. population is attributable to diet and about 80 percent to environmental factors.
Cancer Continued
Dietary components and cancer—the nutrients that may cause cancer include fat, calories, calcium, and vitamin D.
Table 10-5 presents the dietary components of cancer.
Protective Effects of Certain Food Components Against Cancer can be accomplished by eating a low-fat diet and by increasing the consumption of fruits, vegetables, and whole grains.
Cancer Continued
Fiber intake was related to the low incidence of colorectal cancer in Africans consuming high-fiber diets.
Fiber also plays a protective role in preventing breast and ovarian cancer.
Antioxidants—vitamin E, vitamin C, beta-carotene, and flavonoids are antioxidants that are active in the prevention of cancer in vitro.
Vitamins C and E and green tea can prevent the formation of carcinogenic nitrosamines and nitrosamides.
Tomatoes and tomato sauce may reduce the incidence of prostate and gastrointestinal cancers.
Cancer Continued
Physical Activity, Exercise, and Cancer: There is a direct relationship between physical activity and colon cancer.
Cancer Continued Dietary Guidelines for Americans
Reduce fat intake to less than or equal to 30 percent of calories.
Increase fiber intake to 20–30 g/day, with an upper limit of 35 g/day.
Include a variety of vegetables and fruits in the daily diet.
Avoid obesity.
Consume alcoholic beverages in moderation, if at all.
Reduce salt-cured, salt-pickled, or smoked foods, and high-fat meats intake.
Osteoporosis
Osteoporosis is porous bone due to reduction in bone mass.
An estimated 13–18 percent, or 4–6 million, women have osteoporosis.
37–50 percent, or 13–17 million, have reduced bone mineral density (BMD).
Normal Bone Development: There are both intrinsic and extrinsic factors that are determinants of normal bone mass.
Intrinsic factors include genetics, family history, and ethnicity.
Extrinsic factors include diet, hormones, specific illness, and exercise.
Osteoporosis Continued
Calcium intake seems to increase and maintain bone mass.
The recommended daily intake for men and women aged 51 years and older is 1,200 mg elemental calcium.
Estrogen helps to preserve bone mass in young women with anorexia nervosa (AN) by impairing osteoclast-mediated bone resorption.
Oral contraceptive use by these young women in a retrospective cross-sectional study was shown to be associated with a higher BMD.
Successful Community Strategies
Nutritionists at the department of nutrition and food science at the University of Maryland conducted a research study to enhance the antioxidant content of pizza dough by:
incorporating whole wheat flour in to the dough
increasing the fermentation process and baking conditions that increased antioxidant
Chemical reactions induced by yeast during the fermentation process release antioxidants that gather in the dough.
Successful Community Strategies
A team of healthcare professionals consisting of registered dietitians, faculty, and extension specialists collaborated and designed a community-based health education program.
They also formed partnerships and coalitions with individuals, communities, organizations, government agencies, and businesses to educate people about the prevention of osteoporosis.
The program was publicized by placing advertisements in the local newspaper and displaying posters in local businesses.
Successful Community Strategies Continued
The educational session emphasized prevention, risk factors, diagnosis, and treatment of osteoporosis.
These issues were incorporated into the educational session:
Knowledge of osteoporosis, the need for an optimal calcium intake and bioavailability
Food sources of calcium; parents as role models; weight concerns; lactose intolerance; vitamin D inadequacy; calcium retention; weight-bearing exercise; bone density scans; and avoidance of smoking and excessive alcohol intake
Topics for Discussion
What are the risk factors of cardiovascular diseases?
What are the health consequences of obesity?
What are the contributing factors to obesity?
What is the link between diet and cancer?
What are the contributing factors of osteoporosis?
What are the protective effects of certain food components against cancer?
