4 - Nutrition and Health Flashcards
What do I need to know?
- Appreciate the importance of the role of nutrition in health and disease
- Differentiate between the nutritional needs of individuals and populations
- Briefly outline the rational for EACH statement of the Eating and Activity Guidelines of the ADULT POPULATION
What are the biggest health problems affecting NZers and what influences these?
Chronic/non-communicable diseases. Usually arise due to certain lifestyles - nutrition especially influences risk of chronic diseases
What is nutrition?
Nutrition is the interaction between the individual and the environment mediated by food. It is the science of food and the substances the contain and their actions within the body
What is a diet?
The food/beverages one consumes. The quality of diet affects quality of life and risk of chronic diseases
Describe the interaction between food, diet and the body
The interaction between food, diet and body impact on nutrition
Environment/food includes
food... production distribution hygiene preparation labels meals
Agent/diet includes
carbs proteins vitamins minerals fats
Body includes
genetics
physiology
lifestyle
needs
What has the biggest influence on our food choice behaviors?
The food environment
- i.e. budget, easy access, nutrition
- some people don’t prioritise food in terms of nutrition
- when setting someone a nutrition plan need to consider the food environ, the food and the host. Can tell to eat fruit and veg but what if no provider in area? Too expensive? Culture? Genetics?
… and … have consequences on health
body weight and fitness
Nutrition impacts the … and …. of many ….
Nutrition impacts on the progression and treatment of many chronic diseases
What are the common dietary goals in disease prevention?
- maintain appropriate body weight
- minimally processed food
- more plant based food
- beneficial fats and oils
How has what we use to think about when considering nutrition and health/disease changed over the years
- When thinking about nutrition and its interaction with disease, was largely focused around MALNUTRITION and deficiencies i.e. not having enough of something (iodine) which was fixed by supplementing that specific nutrient
- NOW it is exposure to CERTAIN types of diets and lfiestyles over a LONG time period that is affecting disease i.e. rise in non-communicable diseases which are related to the ways people live
Chronic diseases are often … …
Inter-related and so have co-morbidities. For example patients will often have obesity, diabetes and cardiovascular disease where one causes increased risk of other diseases
How is health loss measured?
Number of years lost by burden of disease - disease measured by disability adjusted life years
What is the greatest cause of (preventable) health loss in NZ (meaning they can’t work, disability or mortality)?
Dietary risks are the greatest cause of health loss in NZ
Including high sugar and salt, low fruit and veg, high body weight causing cancers, diabetes and cardiovascular disease
How much of the total DALYs/health loss does dietary risks account for in NZers
12% of total health loss/burden of disease
After dietary risk what are the greatest causes of health loss?
high BMI
smoking
high BP
low physical activity
Why has there been a change to chronic diseases/dietary risk is contributing so much NOW to health loss?
Diet, lifestyle and environment has changed. Access to foods dense and high in energy has increased greatly., food outlets, sedentary lifestyle, technology
Although we live longer what we ARE dying of is chronic exposure to poor diets and lifestyles
What do the population guidelines aim to do?
Aim to reduce risk factors for non-communicable diseases and ensure adequate nutrient intake
What 4 things do the population guidelines need to be?
- Evidence based to show that at a population level the diet will increase the health of new zealanders (HARD as can’t do RCTs on entire diets - can on single nutrients)
- Include adequate nutrient intake
- optimise health
- safe to consume (low in contaminants and potentially harmful added substances)
NZ Eating and Activity Guideline Statements for Adults statement 1:
Enjoy a variety of nutritious foods everyday including
- Plenty of fruit and veg
- Plenty of breads and cereals especially whoegrain and those high in fibre
- Some milk and milk products
- Some legumes, nuts, seeds, fish, seafood, eggs, poultry, lean meat with fat removed
Why plenty of fruit and veg?
- many health benefits
- cancer, weight control, CVD
- vitamins C, A, K
- minerals
- fibre
- PHYTOchemicals/non-nutrients (i.e. polyphenols give colour and anti-oxidants)
Why plenty of grain foods especially high in fibre and whoegrain?
- refined/white grains have bran and germ removed
- BRAN - fibre, vitamin B and minerals
- GERM - vitamin B and minerals and PHYTOchemicals
- endosperm you eat has energy, carbs, protein, vitamin B
The bran and germ removed help towards cancer, weight control and CVD
Why some milk and milk products?
- recommend low/reduced fat (although problem is mainly in processed foods)
- abundant in NZ as main industry
- part of food culture
- calcium, protein, fat soluble vitamins (A and D)
> important as osteoporosis is the silent killed in women
Why some legumes, nuts, seeds, seafood, poultry, red meat
- protein to maintain lean body mass
- iron, zinc, healthy FAs, vit A and E, cancer, diabetes, CVD
NZ Eating and Activity Guideline Statements for Adults #2
Choose or prepare food and drinks…
- with minimal added fat especially saturated
- low in salt (iodine preferred)
- little/no added sugar
- mostly whole and less processed (know what is in)
What is food today more like?
more processed so is quick, available, doesn’t fill us up as is energy dense. Energy dense have a lot of calories in little food - easy to digest and so over eat rather than making self. Need to prepare, chew and digest
Where is 30% of all sugar intake from?
30% of sugar intake is from soft drinks
5 things that an increase in SALT causes?
- increase in BP > risk of CVD
- renal failure
- oxidative stress on blood vessels
- cardiac hypertrophy and dysfunction
- increased fibrosis and so decreased vascular elasticity > stiff > increase in blood pressure
NZ Eating and Activity Guideline Statements for Adults #3`
Make water your first choice in drink
NZ Eating and Activity Guideline Statements for Adults #4
Ensure a low intake of alcohol
NZ Eating and Activity Guideline Statements for Adults #5
Buy/gather, prepare, cook and store food to ensure it is safe to eat
Besides from eating guidelines what else is in the population guidelines and what does it say?
Body Weight Statement
Making good choices about what you eat and drink and being physically active are also important to achieve and maintain a healthy body weight
What are the 3 activity statements?
- Sit less move more
- Do at least 2.5 hrs moderate or 1.5 hrs vigorous exercise a week
- For extra health benefits - 5 hrs moderate and 3.5 vigorous
BMI for individuals vs pop
- individuals its accuracy and usefulness can vary i.e. athlete have high BMI due to high lean body mass does not possess the same health risks as an obese person
- is a good indicator of state of health at a population level
Describe the obesity epidemic
Obesity is one of the greatest health burdens. Since 1977 has increased from 9% to 30% of men in 2012
The population guidelines are trying to alter behaviour and lifestyles to change this
A lot of energy output we have lost in our lives is involuntary i..e walking upstairs or cleaning the car - now have machines
genes
may be diets that are suited to certain gene types
