Transcript 2101lecture 11 powerpoint

Student presentations results
Final exam
15 questions-short answer-point form
covering whole term
5 Q on diabetes and atherosclerosis
10 Q on blood pressure, stroke, and
kidney disease-10 points each- 3 hoursno choice on questions
PLEASE SEE EXAM REGULATIONS
ON: faculty.cbu.ca/ebarre
The
Lecture 11- 20 November 2012
Stroke
Outline of todays talk
I.
Pathology
II.
Socioeconomic factors contributing to stroke
III. Elementary nutritional approaches to be taken to
avoid and treat these diseases including foods
available to those at risk
IV.
First Nations and other Cape Breton individuals at
risk
V.
How is nutritional assessment made for blood
stroke?
VI.
How would one assess from a nutritional perspective
the socioeconomics, pathology and success of
nutritional interventions relative to stroke?
Stroke
I. Pathology
three types of stroke
hemorrhagic
thrombotic
embolic
all are cerebrovascular accidents
Stroke
I. Pathology
three types of stroke-defined
hemorrhagic-blood vessel rupture
thrombotic-rupture of plaque and
platelets aggregate
embolic-thrombus breaks off
and moves down stream
Stroke
I. Pathology
What are the risk factors?
hypertension and all contributing
factors to hypertension-explain
atherosclerosis and all contributing
factors to atherosclerosis-explain
Stroke
I. Pathology
What are the risk factors?
Diabetes types I and II and all
contributing factors to types I and II
diabetes-explain
End stage renal disease and all
contributing factors to end stage
renal disease-explain
Stroke
I. Pathology
What are the risk factors?
Old age-how would this contribute to
the pathology?
Smoking- how would this contribute to
the pathology?
Socioeconomic factors
Food and hence nutritional choices depend on:
Personal preference-protective
factors(preventative)-absence is a risk factor
consumption of fresh fruit
flavonoid consumption of greater than
4.7 cups green tea per day
fish consumption in white and black women
and black men
Socioeconomic factors
Food and hence nutritional choices depend on:
Habit
fattening foods bring on obesity
which increases blood pressure
which results in increased risk of all 3
types of types of stroke
Food and hence nutritional choices depend on:
Ethnic heritage or tradition
fish consumers-Japanese, Inuit
omega 3s EPA- effects of EPA
vitamin E consumption- sources of
vitamin E-who might consume
these- vegetable oils, nuts, seeds
Social interaction
relate social interaction to ethnic
heritage or tradition
Food and hence nutritional choices depend on:
Availability of food
availability of omega 3s and vitamin Ewho would have access to the omega 3s
and vitamin E
Convenience of food
some convenience foods do not have
omega 3s and vitamin E- list some of
these foods
Food and hence nutritional choices depend on:
Economy of food
consumption of fresh fruit
flavonoid consumption of greater than
4.7 cups green tea per day
fish consumption in white and black women
and black men
Food and hence nutritional choices depend on:
Positive and negative associations
consumption of fresh fruit
flavonoid consumption of greater than
4.7 cups green tea per day
fish consumption in white and black women
and black men
vitamin E
Food and hence nutritional choices depend on:
Emotional conflict
may induce eating
blood pressure elevated-what is the
relation of hypertension to food and
hence nutritional choices?
Food and hence nutritional choices depend on:
Values-how does this apply to:
consumption of fresh fruit
flavonoid consumption of greater than
4.7 cups green tea per day
fish consumption in white and black women
and black men
vitamin E
Food and hence nutritional choices depend on:
Body image
relationship to food and hence
nutritional choices- if one is too thin this
will not lead to stroke- if one accepts a
BMI of greater than 27 and the dietary
habits that support such a BMI then one
is at greater risk of stroke
Food and hence nutritional choices depend on:
Advertising-who is responsible for
encouraging or not encouraging
consumption of fresh fruit
flavonoid consumption of greater than
4.7 cups green tea per day
fish consumption in white and black women
and black men
vitamin E
BREAK
More on socioeconomic factors
Prestige
-occupationallower the occupation the greater the risk
of stroke-why?
low occupational fathers tend to have
low or lower occupational kids
could be a number of generations before
population stroke risk is reduced
More on socioeconomic factors
Prestige
-occupationalhigher the occupation the less the risk
of stroke-why?
high occupational fathers tend to have
high or higher occupational kids
could be a number of generations before
population stroke risk is increased
among descendants of initial high
occupational fathers
More on socioeconomic factors
Prestige
-societal perceptions-dictate ability of people
to change their social rankings
-education-eg university professors and
astronauts have a lot of sophisticated
education and they are rated highly-however
this is no guarantee that there is no risk of
stroke
More on socioeconomic factors
Power-based on societal perceptions to some extent
Income-also based on societal perceptions of the
importance of the job to society
More on socioeconomic factors
Wealth-based on education-lower classes tend to be
less well educated and therefore less able to take
advantage of the societal perceptions that improve
one’s socioeconomic status including wealth
Education- lower classes tend to be less well
educated and therefore less able to take advantage
of the societal perceptions that improve one’s
socioeconomic status including the benefits arising
from that education
More on socioeconomic factors
Social stratification
-ancestry-socioeconomic childhood
-gender-fish consumption in white and black
women and black men
-race- fish consumption in white and black
women and black men
-ethnicity-those consuming omega 3s and
vitamin E
More on socioeconomic factors
Social stratification
-mobility-effect on depression and food
choices
-mental and physical activitymental patients-may be marginalised by
society-what impact does this have on
the risk of stroke?
physical activity
More on socioeconomic factors
Social stratification
physical activity-stroke risk lowered by chronic
aerobic activity-caution with elevated blood
pressure- blood pressure increases during aerobic
exercise
- benefit with exercise comes after blood pressure is
lowered in rest and during exercise- this is a
training effect
More on socioeconomic factors
Class
-uppers
-lower uppers
-upper middles
-average middles
-working class
-lower class
How might each of these classes have an impact
risk or presence of stroke?
More on socioeconomic factors
Global economy-globalisation- impact on:
consumption of fresh fruit
flavonoid consumption of greater than
4.7 cups green tea per day
fish consumption in white and black women
and black men
Government-nutrition policies affect risk of
stroke-how?
More on socioeconomic factors
Business-promotion of globalisation-why would
business promote globalisation?
Psychology-susceptibility to business tactics such
as?- impact on the risk of stroke?
History-one’s habits and childhood socioeconomic
status
Elementary nutritional biochemistry of
nutritional approaches that use foods
available to those at risk
Planning a healthy diet
To do this bear in mind
Adequacy
Balance
Energy control
Nutrient density
Moderation
Variety
Elementary nutritional biochemistry of
nutritional approaches that use foods
available to those at risk
Prevention-eat foods in accordance with
low salt (if salt-sensitive)
and eat in accordance with keeping
blood plasma lipids and lipoproteins to
target levels specified to prevent
atherosclerosis, hypertension, type II
diabetes and end stage renal disease
Elementary nutritional biochemistry of
nutritional approaches that use foods
available to those at risk?
Prevention
increase fruits and vegetables and low
fat foods(DASH diet)-contain
antioxidants and other blood
pressure lowering chemicals
DASH-Dietary approaches to stop
hypertension
Elementary nutritional biochemistry of
nutritional approaches that use foods
available to those at risk
Post-onset-eat foods in accordance with
low salt (if salt-sensitive)
and eat in accordance with keeping
blood plasma lipids and lipoproteins to
target levels specified to prevent
atherosclerosis, hypertension, type II
diabetes and end stage renal disease
--antioxidant
vitamins and minerals
BREAK
IV. First nations and other Cape Breton
individuals at risk.
Aboriginals
Retired
Unemployed
Genetics
Others?
How is nutritional assessment made for
stroke-prevention and cure?
Nutrient intake analysis
salt intake
dietary lipids
-saturated fat
-trans-fatty acids
-cholesterol
-other dietary components adjusted in
accordance with recommendations made in
lectures on atherosclerosis, types I and II
diabetes and blood pressure
How is nutritional assessment made for
stroke- prevention and cure?
Daily food record/Diary
what are potential problems with
this approach regarding stroke?
How is nutritional assessment made for
stroke-prevention and cure?
Retrospective data
-24 hour recall
-food frequency questionnaire
both 24 hour recall and are used to
cross check one another-how would
this apply to stroke
How is nutritional assessment made for
hypertension--prevention and cure?
Anthropometry-focus on overweight and
obesity
skin folds
underwater weighing
bioimpedance
waist circumference
BMI
How is nutritional assessment made for
hypertension--prevention and cure?
Nutrition focussed physical exam:
•
•
•
body weight and height
direct blood pressure determination
anthropometric measures
waist circumference
BMI
How is nutritional assessment made for
stroke-prevention and cure?
Skin testing-not applicable
How is nutritional assessment made for
stroke-prevention and cure?
Biochemical analysis
blood lipids-which raise bp and
promote risk of
aneurysm/thrombosis/embolism
blood lipoproteins-which raise bp
and promote risk of
aneurysm/thrombosis/embolism
How is nutritional assessment made for
stroke--prevention and cure?
Biochemical analysis
blood sodium-raises bp and
promotes risk of
aneurysm/thrombosis/embolism
blood potassium-lowers bp and
reduces risk of
aneurysm/thrombosis/embolism
How is nutritional assessment made for
stroke--prevention and cure?
Biochemical analysis
blood calcium-lowers bp and risk of
aneurysm/thrombosis/embolism
blood magnesium-lowers bp and risk of
aneurysm/thrombosis/embolism
How is nutritional assessment made for
stroke--prevention and cure?
CLASSIFYING MALNUTRITION
obesity is the main issue here
thin individuals are much less at risk than
obese persons
VI. GROUP DISCUSSION-HOW WOULD
ONE ASSESS FROM NUTRITIONAL
PERSPECTIVE THE SOCIOECONOMICS,
PATHOLOGY AND SUCCESS OF
NUTRITIONAL INTERVENTIONS
RELATIVE TO STROKE ?