Transcript 2105Lecture 6a powerpoint

Note
Current omega 6 to omega 3 dietary ratio in
Western countries is 15-16.7 to 1
ideal ratio is < 4:1
links on 2105 webpage re obesity
CVD mortality
relative to those who consumed 8% of daily calories from
added sugar there is:
-roughly triple the CVD mortality for those who consumed
25% of daily calories from added sugar
-double the CVD mortality for those who consumed 21% of
daily calories from added sugar
Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults
Quanhe Yang, PhD1; Zefeng Zhang, MD, PhD1; Edward W. Gregg, PhD2; W.
Dana Flanders, MD, ScD3; Robert Merritt, MA1; Frank B. Hu, MD, PhD4,5
JAMA Intern Med. Published online February 03, 2014. doi:10.1001/jamainternmed.2013.13563
CVD mortality
These results remained significant after adjusting for conventional
CVD risk factors, including total serum cholesterol and high blood
pressure, as well as other factors, such as physical activity levels and
body mass index.
American Heart Association recommends that women should
consume no more than 100 calories (6 teaspoons) a day from added
sugar, while men should consume no more than 150 calories (9
teaspoons) a day from added sugar.
WHO recommends that less than 10% of a person's total daily calorie
intake should be from added sugar
US Institute of Medicine states that added sugar should make up no
more than 25% of total daily calories.
AHA- tips to reduce added sugars in our diets
•Purchase sugar-free or low-calorie beverages
•Try cutting back on the amount of sugar personally added to
food and drinks, such as pancakes, coffee and tea
•Avoid fruit canned in syrup. Instead, go for fruit canned in
water or natural juice
•Add fresh fruit to cereal or oatmeal instead of sugar
•Add spices such as ginger or cinnamon to enhance foods
instead of using sugar
•When baking cakes, cut the amount of sugar used by one third
to one half
•Try non-nutritive sweeteners- such as aspartame, sucralose or
saccharin - in moderation.
Note
Exam
Monday, 3 March at 12:50 in class
65 minutes, bring a calculator and answer in
pen
-55 multiple choice questions-55 points
-1 short answer question-10 points
-all Nutrition 2105 material to and inclusive of
10 February 2013-strong emphasis on online
notes-review on 24 February
Lecture 6a 10 Feb. 2014
Hypertension
Pathology
Nutritional Intervention
Nutraceutical Approaches
Group activity
Better to manage blood pressure with diet or
drugs?
PATHOLOGY OF HYPERTENSION INVOLVES
THESE FACTORS
Water volume-volume to space ratio
Blood viscosity-gooeyness of blood
Vasodilation-blood vessel lumen expansion
Vasoconstriction-blood vessel lumen constriction
Pathology-Water volume
-affected by kidney function
-affected by blood salt concentration due to osmosis
Pathology- blood viscosity
-salt in blood mildly increases blood viscosity
-fat load-cells are more difficult to shove through
tiny spaces if loaded with saturated fat and
cholesterol- increased cellular saturated fat and
cholesterol make the blood cells less pliable and
thus blood is more viscous
- as the cholesterol to phospholipid ratio goes up in
cells they are less pliable and hence the blood is
more viscous and are tougher to shove through tiny
spaces
Pathology- Vasodilation- ability of artery to expand
-important to overcome volume to space ratio
-saturated fat makes walls stiffer and
vasodilation more difficult
-cholesterol influx makes vasodilation even
more important since cholesterol can reduce
lumen size
Pathology- Vasoconstriction
-occurs when cholesterol and other lipids
infiltrate the arterial wall
-calcium follows causing stiffening of the
arteries and a reduced ability of the arteries
to vasodilate
What can be done nutritionally ?
Group discussion- what are the food groups that
affect blood pressure- how?
What are the nutritional interventions ?
Water volume
Reduce dietary salt intake to 2000 mg Na/day
(or x milligrammes of NaCl/day) –particularly
in salt sensitive persons as this will:
-reduce osmotic pressure
-reduce blood pressure which can keep
kidney able to regulate water volume
Nutritional interventions -Water viscosity
-reduce salt load- overcomes the
osmosis factor discussed above.
-fat load-reduce saturated fat and
cholesterol to encourage cell pliability
via decreased saturated fat in the cell
walls combined with a decreased
cholesterol:phospholipid ratio in the cell
walls
-fat load reductions accomplished by
table 6
Nutritional interventions -Vasodilation- ability of
artery to expand
-important to overcome volume to space ratio
-reduce saturated fat and cholesterol and
increase monounsaturated and
polyunsaturated fat intakes -makes walls less
stiff and vasodilation easier
-also diets rich in fruits, vegetables and
low fat dairy products help in this regard
Nutritional interventions -Vasodilation-
-monounsaturated and polyunsaturated fats
also displace saturated fats and reduce
cholesterol synthesis in the body
-cholesterol influx makes vasodilation even
more important since cholesterol can reduce
lumen size
-increase potassium intake as potassium helps
with vasodilation
Nutritional interventions -Vasoconstriction
-nutritional interventions as above
Nutraceuticals
Class activity-better to use nutraceuticals
or drugs to combat blood pressure
Nutraceuticals-Water volume
To improve kidney function reduce blood
pressure -less chance of renal failure
No nutraceuticals have been proven to
reduce water volume
Nutraceuticals -Water viscosity
Gamma-linolenic and dihomogammalinolenic
and alpha-linolenic and eicosapentaenoic
acids are all polyunsaturated fatty acids and
they displace saturated fatty acids in the cell
membranes thus increasing cell membrane
fluidity
Increases in cell membrane fluidity-reduced
resistance posed by cells as they squeeze
through tiny spaces
Nutraceuticals-Vasodilation- ability of
artery to expand
Gamma linolenic acid produces
dihomogammalinolenic acid (DGLA)
and DGLA produces prostaglandin I1
(PGI1)and prostaglandin E1(PGE1)
Alpha-linolenic acid produces
eicosapentanenoic acid (EPA) and EPA
produces prostaglandin I3 (PGI3)
PGI1 and PGE1 and PGI3 are all
vasodilatory eicosanoids
Nutraceuticals-Vasodilation- ability of
artery to expand
Any of these fatty acids in the previous slide
reduce the production of vasoconstrictory
thromboxane A2 which is derived from
arachidonic acid
Such a reduction in TxA2 results from
decreased availability of arachidonic acid
Garlic capsules increases vasodilatory nitric
oxide
Concept of reverse nutraceutical-avoid excessive
alcohol
-excessive alcohol can raise triglycerides