Dietary Patterns for Health Promotion Flashcards
Dietary Planning: Dietary Patterns for Health Promotion
Diets and Dietary Patterns
1. The Standard American Diet (Western Dietary Pattern) 2. The Mediterranean Diet 3. Vegetarian Dietary Patterns 4. Low Glycemic Index/Load Diet 5. DASH Diet 6. National Cholesterol Education Program, Adult Treatment Panel III (ATP III): TLC
KNOW
Dietary Planning: Dietary Patterns for Health Promotion
The SAD Diet = Standard American Diet
AKA. Western Dietary Pattern Virtually every dietary factor known to increase the risk of obesity, cancer, heart disease, stroke, intestinal disorders – almost any chronic disease – the standard American diet has them all: High in hydrogenated FATS Low in FIBER High in\_\_\_\_\_\_\_\_\_\_ foods Low in complex carbohydrates High in simple/refined carbohydrates Low in \_\_\_\_\_-\_\_\_\_\_\_\_\_ foods
processed
plant-based
Dietary Planning: Dietary Patterns for Health Promotion
Mediterranean Diet (Eating Pattern)
Some History:
• Ancel Keys, an American doctor stationed in Italy in the
40’s observed that, despite poverty and limited access to
medical care, rates of chronic disease in the region
surrounding the Mediterranean Sea were among the lowest in the world and life expectancy was among the highest.
• Most commonly-understood version of the Mediterranean diet presented by Dr. Walter Willett of Harvard University’s School of Public Health.
• Introduced classic Mediterranean Diet in ____ at a
conference in Cambridge, MA, with a Mediterranean Diet
Pyramid graphic to represent it visually
1993
Dietary Planning: Dietary Patterns for Health Promotion
Features of the Mediterranean Dietary Pattern:
• Emphasis on whole foods and plant foods
• Legumes
• Nuts & seeds
• Fresh fruits as dessert
• Whole grains
• ______________ as main source of dietary fats
• Cheese and yogurts as main dairy foods
• Moderate amounts of fish and poultry
– Fish favored over poultry
• Up to 7 eggs/week (Including use in baking)
• Small amounts of red meat
– Few times a month - choose lean versions
• Low/moderate amounts of wine
Olive oil (extra virgin)
Dietary Planning: Dietary Patterns for Health Promotion
Characteristics of the Mediterranean Dietary Pattern:
• ___________ dense
• High in monounsaturated fats
• High in ____________
• High in antioxidants including vitamins C and E
• High in fiber and folic acid
• Low in saturated fat ( 35% of energy
• Emphasis on a variety of minimally processed and,
wherever possible, seasonally fresh and locally grown
foods.
Increased telomere length has been found in response to adherence to this dietary pattern suggesting that it may promote ___________.
Nutrient
phytonutrients
longevity.
Dietary Planning: Dietary Patterns for Health Promotion
For the general population:
Adopting a Mediterranean diet has been shown to be more effective at reducing ___________ deaths then
statins (statins reduced heart attacks and strokes by 25%1; 30% reduction with Med diet2) – and more effective than a low fat diet.
Food for Thought
“Even the best available drugs, like statins, reduce heart disease by about 25%, which is in the same ballpark as the Mediterranean diet… but the statins increase the risk of ________, whereas this diet can help reduce the risk.”
cardiovascular
diabetes
What makes this dietary pattern so good?
- Anti-inflammatory
- Low GI/GL
- Plant-based
reduced blood pressure
improved lipid profile
diminished insulin resistance
Dietary Planning: Dietary Patterns for Health Promotion
Summary of observed benefits of adhering to a
Mediterranean dietary pattern:
Longer lifespan
Lower risk of dying from heart disease
Lower risk of dying from cancer
Lower risk of developing Type 2 diabetes
Lower risk of hypertension
Lower risk of raised cholesterol levels
Lower risk of becoming obese
Aid weight-loss and management efforts
Lower risk of dementia
Lower risk of developing Alzheimer’s disease
Lower risk of developing Parkinson’s disease
Improve rheumatoid arthritis
KNOW
Dietary Planning: Dietary Patterns for Health Promotion
Adherence to the traditional Mediterranean diet was
associated with a reduction of the concentrations of
inflammatory markers ________&_________.
For each unit of increasing adherence to the
Mediterranean diet score there was a reduction
of 3.1% in the average CRP and of 1.9% in the
average IL-6 levels after adjusting for centre, age,
sex, body mass index, physical activity, smoking
status, diabetes and medication intake
CRP and IL-6
Dietary Planning: Dietary Patterns for Health Promotion
OMEGA-3 EFA = Alpha-Linolenic Acid (ALA)
(e.g., green vegetables, walnuts, flaxseed oil)
OMEGA-6 FA = Linoleic Acid (LA)
(e.g., corn, safflower, sunflower oil, grains)
EPA/DHA
(e.g., fish oils) = Prostaglandin 3 (anti-inflammatory)
= leukotriene B5 (anti-inflammatory)
Arachidonic Acid (ArA)
(e.g., grain-fed meat) = PGE2 (pro-inflammatory)
= LTB4 (_____-_________)
pro-inflammatory
Dietary Planning: Dietary Patterns for Health Promotion
Examples of herbs and spices with
____-__________ properties
Cayenne Ginger Turmeric Garlic Onion Rosemary Cinnamon Oregano Parsley Cumin
anti-inflammatory
Dietary Planning: Dietary Patterns for Health Promotion
Low Glycemic Index / Load Eating Pattern
Glycemic Index (GI) of a food: Measure of how much its
ingestion raises blood glucose levels postprandially
– Measured as area under glucose curve
– Developed by Dr. David Jenkins et al. at University of Toronto in________.
________ _______ is believed to better predict the Glycemic impact of foods under real world conditions
1—Describes the amount of carbohydrate in a serving of food
2–Reflects both the GI of dietary carbohydrate AND the amount of carbohydrate ingested.
3–The lower a food’s glycemic index or glycemic load, the less it affects blood sugar and insulin levels.
4—The findings support the hypothesis that higher postprandial glycemia is a universal mechanism for disease progression.
5–A low-GI diet can improve glycemic control in ________.
1981
Glycemic Load
diabetes.
In studies comparing ad libitum LGI diets to conventional restricted energy low-fat diets, participants fared as well or better on the LGI diet, even though they could eat as much as desired!!
• Lowering the Glycemic load of the diet appears to be an effective method of promoting weight LOSS and improving LIPID profiles and can be simply incorporated into a person’s lifestyle
Dietary Planning: Dietary Patterns for Health Promotion
“High-glycemic index meals produce an initial period of high blood glucose and insulin levels, followed in many individuals by reactive ________, counterregulatory hormone secretion, and _______ serum free fatty acid
concentrations. These events may promote excessive food intake, beta cell dysfunction, dyslipidemia, and endothelial dysfunction.”
“Resting energy expenditure decreased LESS with the low-glycemic load diet than with the low-fat diet .
. . participants receiving the low-glycemic load diet reported _____ _________. . .”
“Insulin resistance, serum triglycerides, C-reactive protein, and blood pressure improved more with the low-glycemic
load diet.”
“…the low-glycemic load diet had beneficial effects on several obesity-related risk factors compared with a low-FAT diet”
hypoglycemia
elevated
less hunger
Dietary Planning: Dietary Patterns for Health Promotion
Vegetarian / Plant Based Dietary Patterns
“It is the position of the American Dietetic
Association that…well-planned vegetarian diets are
appropriate for individuals during all stages of the
life-cycle including pregnancy, lactation, infancy,
childhood and adolescence and for athletes.”
Increasing intake of plant based foods and fiber may
also offers additional benefits by helping re-establish
disturbed __________ balance in obesity
microbiota
Dietary Planning: Dietary Patterns for Health Promotion
_______: Excludes all foods with added animal products and those that involve animal processing & Include: fruits, vegetables, legumes, grains, seeds and nuts
___________:Local, allows seafood, limited consumption of nuts, seeds and fruit— Combines tenets of Zen Buddhism with a Western-style vegetarian diet – not merely a diet; way of life – about balance (yin-yang)
Vegan
Macrobiotic
Dietary Planning: Dietary Patterns for Health Promotion
________: Emphasizes fruit and botanically grown vegetables (tomatoes, eggplant, avocado, zucchini) and allows nuts and seed
___________:Consume only uncooked fruits and vegetables— Heating above ______ believed to destroy valuable nutrients/enzymes
Fruitarian
Raw Food
118F
Dietary Planning: Dietary Patterns for Health Promotion
_____________: Primarily follow a plant-based diet but occasionally eat small
amounts of meat, poultry or fish
_____________: Primarily follow a plant-based diet but occasionally eats fish
Flexitarians (Semi-vegetarians)
Pescaterian
Dietary Planning: Dietary Patterns for Health Promotion
Protein Intake
• Digestibility of vegetarian sources of protein are _____ than animal protein
• An approx. 15% - 25% increase in recommended daily protein intake
–approx 1.0 g/kg body weight
• Vegetarians adhering to strict vegan diets and exercising heavily may require additional ________
Up to 1.6 g/kg daily
—-Complete protein source:
• Provides all of the essential amino acids in adequate
amounts
—-Incomplete protein source:
• LOW in 1 or more of the essential amino acids
—-_________ Proteins:
• Two or more incomplete protein sources that together
provide adequate amounts of all essential amino acids
NOTE: Quinoa and Soy protein have been shown to be equal to proteins of animal origin (complete)
lower
protein
Complementary
NOTE: It was thought that complementary proteins
needed to be consumed at same meal for body to use
them together. Now, studies show that your body
can combine complementary proteins that are
eaten within the same day
Dietary Planning: Dietary Patterns for Health Promotion
Vitamin B12 Intake
• Even vegetarians who eat eggs and dairy products consume, on average, LESS than half the adult Recommended Dietary Allowance of ____ mcg
Clinical Considerations OF NO/LOW B12: Symptoms of a B12 deficiency may include: Feeling weak, tired, and lightheaded Pale skin Sore, red tongue or bleeding gums Sick to stomach and lose weight Diarrhea or constipation Prolonged shortages can result in: Numbness or tingling in fingers and toes A poor sense of balance Depression Dementia
2.4
Dietary Planning: Dietary Patterns for Health Promotion
Clinical Considerations OF Iron Intake
2 types of iron in foods: non-heme and heme iron
Non-heme: in _______
Heme: solely in ________ sources
***Heme iron is more readily absorbed by the body.
plants
animal
Dietary Planning: Dietary Patterns for Health Promotion
Dietary Approaches to Stop Hypertension (DASH)
Based on research findings: ______ ______ were reduced with an eating plan LOW in saturated fat, cholesterol, and total fat and that emphasizes fruits, vegetables, and fat-free or low-fat milk and milk products
• Research also showed that following the DASH diet reduces risk of stroke and heart disease, as well as kidney stones
• Can help lower __________, and with weight loss and exercise, can reduce insulin resistance
2 versions of DASH:
- Standard DASH diet
- Lower sodium DASH diet
Menus and recipes are given for two levels of daily sodium
consumption ____&_______ milligrams per day
blood pressures
cholesterol
2,300 and 1,500
Dietary Planning: Dietary Patterns for Health Promotion
National Cholesterol Education Program: ATP III Guidelines
Therapeutic Lifestyle Changes (TLC)
“Use lifestyle interventions first, then drug therapy for higher levels of BP or if insufficient response to lifestyle
modifications.”
Major Features
• TLC Diet
– Reduced intake of cholesterol-raising nutrients
• Saturated fats
200
Dietary Planning: Dietary Patterns for Health Promotion
Steps in Therapeutic Lifestyle Changes (TLC)
First Patient Visit
• Begin Therapeutic Lifestyle Changes
• Emphasize reduction in saturated fats and cholesterol
• Initiate moderate physical activity
• Consider referral to a _______(medical nutrition therapy)
• Return visit in about 6 weeks
Second Patient Visit
• Evaluate LDL response
• Intensify LDL-lowering therapy (if goal not achieved)
– Reinforce reduction in saturated fat and cholesterol
– Consider plant stanols/sterols
– Increase viscous (soluble) fiber
– Consider referral for medical nutrition therapy
• Return visit in about 6 weeks
Third Patient Visit
• Evaluate LDL response
• Continue lifestyle therapy (if LDL goal is achieved)
• Consider LDL-lowering drug (if LDL goal not achieved)
• Initiate management of metabolic syndrome
(if necessary)
– Intensify weight management and physical activity
• Consider referral to a dietitian
dietitian
Dietary Planning: Dietary Patterns for Health Promotion
Lifestyle Change and Chronic Disease Prevention
Adhering to 4 healthy lifestyle factors:
- Never ______
- Having a body mass index lower than _____
- Performing _____ h/wk or more of physical activity
- Adhering to healthy dietary principles: high intake of
fruits, vegetables, and whole-grain bread and low meat
consumption
Adhering to just 4 basic lifestyle factors translated into:
____% lower risk of developing a chronic disease
93% lower risk of developing diabetes
81% lower risk of developing myocardial infarction
50% lower risk of developing stroke
36% lower risk of developing cancer
smoking
30
3.5
78
