Dietary Disorders Flashcards
What is CHD?
Occurs when 1 or more of the coronary arteries is narrowed or blocked by a build up of fatty deposits on its walls
This restricts blood flow through the arteries, causing damage to heart muscle (this is called atherosclerosis)
The heart has to work harder to pump blood around the body
How does a heart attack occur?
In a complete blockage, where blood cannot flow to the heart
Dietary risk factors for CHD
Hypertension High fat intake (esp sat fat) High salt intake Being overweight/obese Diabetes
Lifestyle risk factors for CHD
Excessive alcohol intake
Lack of physical activity
Smoking
How does hypertension increase the risk of CHD?
Can cause heart to become abnormally large and the pumping action may become less effective, increasing heart attack/stroke risk
How does a high fat intake increase the risk of CHD?
Increases blood cholesterol levels, which in turn, increases CHD risk
How does a high salt intake increase the risk of CHD?
Increases blood pressure levels, which in turn, increases CHD risk
How does being overweight increase the risk of CHD?
Increases risk of developing several serious and possibly life threatening medical conditions, including CHD and Type 2 diabetes
How does an excessive alcohol intake increase the risk of CHD?
Can cause…
- damage to heart muscle
- an increase in blood pressure
- weight gain
All of which increase CHD risk
How does a lack of physical activity increase the risk of CHD?
Heart muscle doesn’t get the exercise it needs to ensure that it functions properly
Inactive people are more likely to be overweight
How does smoking increase the risk of CHD?
- Almost doubles risk of heart attack
- Damages lining of arteries, increasing build up of fatty deposits
- CO decreases amount of O2 blood can carry to heart and body
- nicotine stimulates body to produce adrenaline, making heart beat faster and raises blood pressure
- makes blood more likely to clot
How does diabetes increase the risk of CHD?
High blood sugar levels may affect artery walls and increases likelihood of high cholesterol levels and HBP, which in turn, increases CHD risk
How to adapt the diet of someone with CHD
- Fruit and veg
- Reduce fat intake
- Eat 2 portions of fish weekly (at least 1 oily)
- Reduce salt intake
- Replace meat
- Increase physical activity
- Maintain safe blood pressure
- Avoid smoking
- Controlling Diabetes
- Maintain healthy weight
How does eating more fruit and veg help to lower CHD risk? Give an example.
Help lower risk of CHD
5 portions of fresh, frozen, dried, tinned or juiced fruit and veg a day
- replace sugary snacks between meals, like chocolate, with a piece of fruit, like an apple
How does reducing fat intake help to lower CHD risk? Give an example.
Help reduce cholesterol levels
Cut down on total fat and replace sat fat with unsat fat
- eat Flora instead of butter to reduce sat fat intake
How does eating 2 portions of fish weekly help to lower CHD risk? Give an example.
Oily fish (eg salmon, tuna) are rich in the essential fatty acid Omega 3, which can help protect against CHD)
- replace a portion of red meat with a portion of oily fish
How does reducing salt intake help to lower CHD risk?
Help keep blood pressure down
How does replacing meat help to lower CHD risk? Give an example.
Use veg, beans or pulses to decrease intake of sat fat and increase soluble NSP, which can help lower cholesterol
- veg curry instead of chicken curry
How does increasing physical activity help to lower CHD risk?
Help increase HDL cholesterol
How to maintain a safe blood pressure
Being physically active
Keeping a healthy weight
Reducing salt and alcohol intake
Eat more fruit and veg
How to limit total fat intake
Cut visible fat off meat/skin off chicken
Back bacon rather than streaky
Boil, bake, grill instead of frying
Choose tomato based sauces over creamy ones
What are the 2 types of cholesterol?
Low-density lipoprotein (LDL) is a harmful type of cholesterol.
High-density lipoprotein (HDL) is a protective type of cholesterol.
Having to much harmful cholesterol increases CHD risk.
Role of insulin
Insulin (a hormone that is produced in the pancreas) helps glucose enter the cells to be made into energy, and as this happens the level of sugar in the blood goes down.
Diabetes is a condition where…
The amount of glucose in the blood is too high
Type 1 diabetes
The body cannot make any insulin
Occurs more commonly in children, adolescents and young adults
Treated with insulin injections
Aka insulin dependent diabetes
Type 2 diabetes
Either not enough insulin produced or the insulin produced doesn’t work effectively
Occurs more commonly after the age of 40
Usually linked with obesity
Aka non-insulin dependent diabetes
How is type 1 caused?
Cause is unclear
Possible that insulin producing cells in the body have been destroyed - may have been triggered by a virus or other infection
More likely to develop if (close) relative has it
Risk factors for type 2
- risk increases as age increases
- being overweight/obese: risk increases if waist measurement is 31.5in or more for women, 35in or more for Asian men, and 37in or more for black/white men
- leading an inactive lifestyle can contribute to weight gain, increasing risk
- family history: the closer the relative, the greater the risk
- risk increases if you have any circulation problems, had a heart attack or stroke, or if you have HBP
Diet and lifestyle advice to manage diabetes
- eat a healthy balanced diet that is low in fat, sugar and salt and including lots of fruit and veg (also contain soluble NSP which helps lower cholesterol)
- take regular physical activity and keep weight under control (for type 2 weight loss may be suggested)
- with type 1, you must learn to count your carbohydrate intake so you can match the amount of insulin you take with it
- cut back on alcohol
How does tooth decay occur?
Tooth decay occurs when bacteria in the mouth feed on sugars in food and produce an acid.
The acid erodes the tooth enamel (if this is progressive holes may appear in the enamel).
If left untreated, this can lead to pain, tooth loss and infection in the gums and teeth.
Tooth decay is usually caused by a build up of plaque.
Plaque is a sticky substance (a mixture of food, bacteria and saliva) which clings to teeth.
Ages and stages most at risk of dental caries
Children and adolescents - the enamel is not so strong and therefore susceptible to acid attack
Ways to decrease risk of dental caries
Good oral hygiene:
- good electric toothbrush
- good fluoride toothpaste
- visit dentist every 6 months
- use dental floss
Diet:
- cut down on fizzy drinks
- avoid snacking between meals
- cut down on sugar intake
- drinking water increases saliva flow, which neutralises plaque acid
- drink lots of milk during developmental stages of teeth (calcium can help with good tooth development)
Fluoride (gives added protection against acid damage):
- in drinking water in some places (could lead to dental fluorosis, mottling)
- possibly fluoride supplements
Role of iron
Needed for formation of haemoglobin which is responsible for transporting oxygen around the body.
Symptoms of iron deficiency anaemia
(Caused by less oxygen being transported to the cells and tissues)
Weakness Faintness Dizziness Paleness Lethargy Inability to concentrate Sometimes headaches, palpitations and sore gums
Groups most at risk of iron deficiency anaemia
Growing children Adolescents (esp girls) Women Older people Pregnant women Vegetarians and vegans
Risk factors for iron deficiency anaemia
Poor absorption of iron by the body:
- can be caused by some medical conditions
- phytates in whole grain cereals
- tannins in tea
Pregnancy:
- developing foetus needs iron to form its own blood system and build up iron stores in the liver (no iron in milk - baby relies on iron stores built up during pregnancy)
Dietary factors:
- lack of iron or vitamin C
Plant sources of iron
Beans Nuts Dried fruit Fortified breakfast cereals Soybean flour Dark green leafy veg (watercress, kale) Whole grain foods
Animal sources of iron
Liver Beef Poultry Fish Meat Kidney Eggs (non-haem)
Why periods of rapid growth increase risk of iron deficiency anaemia: baby
Introducing cows milk into a baby’s diet before 12 months can lead to iron deficiency anaemia as cows milk is low in iron, needed for infant growth
Why periods of rapid growth increase risk of iron deficiency anaemia: children (ages 1-3)
- no longer consume iron-fortified formula milk and infant cereal
- don’t eat enough iron rich foods (possibly picky eaters)
- drink a lot of cows milk (low in iron)
Why periods of rapid growth increase risk of iron deficiency anaemia: boys
Boys are at risk during 1st stages of puberty, due to rapid growth
Why periods of rapid growth increase risk of iron deficiency anaemia: girls
Girls are a my a higher risk due to menstrual blood loss and smaller iron stores
Girls are more likely to adopt a vegetarian diet than boys of the same age
Diet and lifestyle advice to prevent/manage iron deficiency anaemia
- eat a wide range of iron rich foods
- eat plenty of foods rich in vitamin C
- breast milk or fortified infant milk are the only suitable main drinks for infants under 12 months (iron rich foods should be introduced during weaning after 6 months)
- careful meal planning is essential for vegetarians and vegans, since iron from plant sources is less readily absorbed by the body
- iron supplements (go to GP for diagnosis and treatment)
Iron sources
Liver Meat Beans Nuts Dried fruit (eg apricots) Wholegrain rice/bread Fortified breakfast cereals Soybean flour Dark green leafy veg (eg watercress, kale)
Vitamin C sources
Peppers Broccoli Brussel sprouts Sweet potatoes Oranges Kiwi fruit
Obesity definition
Abnormal or excessive fat accumulation that may impair health
OR
20% over the recommended weight for height and build
How does obesity occur?
Obesity happens when more calories are eaten than are burned off over a period of time - extra energy from food is stored as fat.
What is BMR?
Basal metabolic rate
The energy your body needs when resting
Risk factors for obesity
Family history
Genetic factors affecting appetite, metabolic rate and how the body stores fat
Overeating (portion sizes)
Irregular meals
Lack of daily physical activity
Medication that can cause weight gain
Excessive alcohol consumption
Diet high in fat and sugar (fast food, high calorie snacks)
Physical health problems associated with obesity
Respiratory problems Circulatory problems Joint pains Hypertension High cholesterol Type 2 diabetes Some types of cancer (bowel, breast) CHD, heart attack Gallstones Possibly skin conditions like acne
Mental health problems associated with obesity
Poor body image/low self esteem
Social anxiety (affecting social life and friendships)
Depression (comfort eating)
Metabolic rate
Dictates how quickly you burn off calories
Increases during periods of growth
Active people usually have a higher metabolic rate than those who are inactive
BMI
Body mass index
Calculated as weight (kg) divided by height squared (m)
Used by medical practitioners to diagnose obesity in adults
Diet advice to reduce obesity risk
Eat less sugary foods
Trim visible fat off meat
Choose low fat dairy products (use less butter - margarine has same amount of total fat, just unsat)
Increase starchy food intake rather than fatty intake
Increase fruit and veg intake (5 a day)
Lifestyle advice to reduce obesity risk
Physical activity:
- controls body weight
- controls appetite
- beneficial effects on the heart and blood which helps to prevent cardiovascular disease
Osteoporosis is characterised by…
Fragile bones and an increased risk of fracture due to a low bone mass
When and why does osteoporosis occur?
Occurs due to the natural aging process when, from around the age of 35 more bone cells are lost than are replaced.
Most common in post-menopausal women (drop in oestrogen).
Nutrients required for the growth, formation and maintenance of healthy bones
Calcium
Vitamin D
Phosphorus
Protein
The more of these nutrients that are deposited on the bones during childhood and adolescence, the stronger the bones will be in the long term - decreases osteoporosis risk.
Peak bone mass
If not enough calcium is taken in during the developmental stages of life then peak bone mass may be affected.
PBM reaches between ages 30-35
Symptoms of osteoporosis
Pain in bones
Bones that are brittle and break easily
Risk factors for osteoporosis
- increasing age
- women are at higher risk than men
- early menopause: breakdown of bone is quicker due to lack of oestrogen
- being underweight and having low BMI
- an inactive lifestyle (weight bearing exercise is important for strengthening bones)
- smoking and high alcohol intake: increases rate of bone loss
- genetic factors affecting bone health
- a diet low in calcium and vitamin D
- tannins in tea and phytates in wholegrain cereals reduce ability to deposit calcium on bones
Advice to reduce the risk of osteoporosis
- eat a diet rich in foods containing calcium and vitamin D (3 portions a day)
- weight-bearing exercise
- reduce alcohol intake
- no smoking
Calcium sources
Cheese (30g) Yoghurt (150g) Milk (250ml) Tinned fish with bones Some green leafy veg Dried fruit Fortified white bread
Vitamin D sources
Oily fish Eggs (esp yolk) Meat Cheese Fortified breakfast cereals Fortified margarine
The action of sunlight on the skin
Types of load bearing exercise
Jogging Aerobics Tennis Weight training Dancing Brisk walking
Dietary risk factors for HBP
High sodium (salt) intake Excessive alcohol intake Obesity
Lifestyle risk factors for HBP
Stress
Smoking
Lack of exercise
Other risk factors for HBP
Family history
Growing older
Dietary advice to avoid/manage HBP
Reduce salt intake (6g max for adults, less for children):
- low salt foods (eg fruit, veg, fresh meat)
- avoid processed meats (bacon, ham, sausages), ready meals, salty snacks, take a ways, veg/fish canned in brine (salted water)
- don’t add extra at the table
Limit/avoid alcohol (2-3 units a day for women, 3-4 for men)
Maintain healthy weight:
- ensure calorie intake is appropriate for age, stage and activity level
- reduce fat and sugar intake if necessary
Lifestyle advice to avoid/manage HBP
Learn to manage stress in a positive way (eg relaxation techniques, exercise, talking therapies)
Give up smoking/don’t start
Take part in regular, moderately intense physical activity to help maintain appropriate height
Other advice to avoid/manage HBP
Growing older and heredity cannot be altered so it’s important to make changes to diet and lifestyle to decrease HBP risk
