Nutri Cardio

8/13/2019 Nutri Cardio

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Nutritional Therapy for CardiovascularDisorder



CAD refers to a variety of pathologicconditions that cause narrowing orobstruction of the coronary arteries,resulting in decreased blood supply to the

myocardium. This results from a focalnarrowing of large and medium-sizedcoronary arteries due to intimal plaqueformation.



Cardiovascular Disease (CVD)

Coronary Heart Disease (CHD)-angina pectoris

-myocardial infarction

-sudden death

Stroke Other vasculardiseases



Insulin resistance

obesity

age

Sedentary

lifestyle

DIET

Causes and consequences of insulin resistance

Dyslipidaemia-high triglycerides

-low HDL

-high LDL-3

Increased coagulation

hyperglycaemia

hyperinsulinaemia

hypertension

genetics



Myocardial Infarction

The death or destruction of the of

myocardial cells from inadequate

oxygenation often caused by a suddencomplete blockage of

a coronary artery; characterized by

localized formation of necrosis

(tissue destruction) withsubsequent healing by

scar formation and fibrosis



Development of atherosclerosis



‘The Lipid Accumulation’ Hypothesis



The ‘Response to Injury’ Hypothesis

Glass and Witzum, 2001



Glass and Witzum, 2001

The ‘Response to Injury’ Hypothesis (contd)



CHD Pathology

cholesterol

Oxidative Status

Thrombosis &

fibrinolysis

Vascular tone

& BP

Plaque structure

Inflammation

homocysteine Adipose tissue mass/topography

triglycerides



Therapeutic Lifestyle Changes

Recommendations1. Reduce daily saturated fat intake to less

than 7%.

Example: Saturated fats are found in cold cuts, processedmeats,egg yolk, butter coconut, avocados,desserts,cakes ,pies and other similar snacks.

Low in saturated fats are fish, chicken and white turkey

without skin.



2. Reduce daily dietary cholesterol intake to less than200 mg.

Example: Dietary cholesterol is found in animal meatand animal by product such as milk, eggs, cheese andbutter.

Fruits, vegetable and grains do not contain cholesterol.



3. Include 2 gm. Of plant stanol/sterols per day.

Example: Flaxseeds, flaxseeds oil,walnuts,

oil,soybeans,canola oil.Research suggests that ALA ( alpha linoleic acid) may becardioprotective by having positive effects on theinflammatory process.



4. Include greater than 5-10 gm. Of viscous fiber per day.

Example: Oats , barley,legumes fruits and vegetables.

5. Include omega 3- fatty acids on the diet

Example: Fish shows cardioprotective effect includingreducing triglycerides , inflammation, and platelet

adhesion; inhibiting plaque formation, decreasingarrhythmias and decreasing blood pressure.



DASH diet ( Dietary Approaches to

Stop Hypertension)Low total and saturated fat diet

Fruits=(5 serving per day)

Vegetables=( 3 servings per day)Low fat dairy products=( 2 servings per day)

Whole grains and nuts

Poultry, fish and limited amounts of red meat and

sweets.



Diabetes and Diet Is a group of metabolic disorder characterized by

increased levels of glucose in the blood(hyperglycemia) resulting from defects in insulinsecretion, insulin action, or both.

Once the pancreas fails in its function to produceinsulin when it is needed or in the right proportionsneeded, the body’s blood sugar level becomes affectedby the intake of other foods containing glucose. Theimpairment leads to diabetes and diet now becomes acritical concern.



Below is a step-by-step description on how insulin

affects our diet intakes:

1. During and after each meal, carbohydrates andproteins are broken down into amino acids.

2. Immediately after each meal, the bloodstreamabsorbs glucose and amino acids where there is arazor-sharp rise in the glucose level.

3. The increase in the glucose level will signal the betacells in the pancreas to produce insulin in thebloodstream. This happens within 10 minutes aftereach meal when the glucose level is at its peak.



4. Insulin enables glucose and amino acids to enter themuscle and liver cells. Just like any hormones, it willregulate whether it will be used for energy or stored for

use in the future.5. In the absence of insulin that will enable glucose and

amino acids to enter the muscle and liver cells, there will be excessive blood sugar level known as

hyperglycemia.Due to the inability of the body to utilize sugar, glucose will be carried in the urine and will be dischargedinstead of being used as energy.



Classification of DM Type 1 Diabetes ( Juvenile Type)

Type 2 Diabetes ( Adult Onset)

Diabetes associated w/ other conditions Gestational Diabetes

IGT

Prediabetes



Risk Factors for DM Family history of DM

Obesity

Race/ Ethnicity

Age

Previously identified IFG or IGT

Hypertension

HDL cholesterol level Hx of GDM



Obesity-≥20% over desired BW or ≥ BMI 27 Kg/m2

Race- African Am.,Asian Am,Hispanic Am, Native Am,Pacific Is

Age- ≥45 yo HPN- ≥140/90 mmHg (0.90 mmol/L)

IFG/IGT - metabolic stage intermediate bet. N glucosehomeostasis and Diabetes

HDL- ≤ 35 mg/dL or triglyceride level ≥ 250 mg/dl(2.8mmol/L

GDM - or deliveries of babies over 9 lb



In relation to this, the following

dietary advice should be followed: 1. Eat plenty of fiber-rich foods like fruits, vegetables,

whole grains, nuts, legumes or seeds.

2. Consume in moderation foods with sugar.

3. Reduce the intake of foods high in cholesterol.

4. Reduce salt in the food.

5. Maintain a daily balanced diet with 10% to 20%

calories, fat of not more 30% and carbohydrates of upto 60%.

Nutri Cardio

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