cardiovascular system knh 411. hypertension nutrition therapy dash – dietary approaches to stop...
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Cardiovascular System
KNH 411
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Hypertension
Nutrition TherapyDASH – Dietary Approaches to Stop Hypertension
Decrease sodium, saturated fat, alcohol Increase calcium, potassium, fiber
Lifestyle modifications- smoking, exercise (increase HDL)
Weight loss (everything comes back to normal) Increase Ca, K, and FiberDecreased alcohol
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Hypertension
Nutrition TherapySodium restriction controversial
“salt sensitive” or “salt resistance”
Limit processed & cured foods, no added salt during preparation and cooking
Limit to 2400 mg/day
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Hypertension
Nutrition Therapy
DASH-Dietary Approaches to Stopping HypertensionDecrease Sodium, saturated fat, alcohol Increase calcium, potassium, fiber
Lifestyle Changes Hardest to change
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Atherosclerosis
Etiology - risk factors cont./ typical profilePhysical inactivityAtherogenic diet- or the Western diet, high in fat and
low in fiberDiabetes mellitus- highest risk of CAD, because they
have metabolic syndrome Impaired fasting glucose/ metabolic syndromeCigarette smoke- decreasing vascular system, CAD,
stroke
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© 2007 Thomson - Wadsworth
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© 2007 Thomson - Wadsworth
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Atherosclerosis
Nutrition TherapyTherapeutic Lifestyle Changes (TLC) developed as
component of ATP-III Modifications in fat, cholesterol- more advance than the
DASH Rich in fruits, vegetables, grains, fiber Limit sodium to 2400 mg Include stanol esters- up to 2 grams per day
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© 2007 Thomson - Wadsworth
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AtherosclerosisNutrition Therapy - Fat Modifications
Total fat 25-35% of caloriesVery-low-fat dietsSaturated fat < 7% of caloriesAvoid trans fatsIncrease intake of monounsaturated fats &
Polyunsaturated omega-6 fatty acidsIncrease intake of omega-3 essential fatty acids
Cold water fish, hopefully three times per weekLimit dietary cholesterol < 200 mg daily
Trying to lower LDL levels with this
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Atherosclerosis
Nutrition Therapy - Other Increase sources of soluble fiber- legumes, oats,
ridding of cholesterol, and free radicals, lowering cholesterol, helpful for HD, anti-inflammatory
Increase intake of plant sterols
Weight loss – BMI 18.5-24.9Regular physical activity
What level can they maintain or take? Work with doctor, trainer as well
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AtherosclerosisNutrition Therapy Prescription
Assessment of dietary fat intake, saturated fat intake MEDFICTS assessment tool- food frequency chart to be used with
individuals, comes out with a score that you can instruct on, which clients to see first
Dietary CAGE questions- even simpler, quick assessment of what they are eating- cheese, animal fats, got it away form home, eat (extra) high-fat commercial products- assessment of saturated fats and cholesterol intake, just get them to cut back as a starting point
REAP- rapid, eating, assessment, plan, in between CAGE and MEDFICTS plan
Target weight calculatedPrioritize nutrition problemsMultiple planned visits with R.D.
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Ischemic Heart Disease
Nutrition TherapyPost MI
Decrease oral intake Clear liquids, no caffeine! Progress to soft, more frequent meals Individualized – use TLC recommendations
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Heart FailureNutrition Therapy Intervention
Control signs and symptomsPromote overall nutritional status rehabilitation Sodium and fluid restriction
2000 mg Na Fluid 1 mL/kcal or 35 mL/kg
Correction of deficiencies Increase nutrient density- coffee, or water- give
ensure not to waste calories Enhance oral intake-
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Heart FailureNutrition Therapy
Assess drug-nutrient interactions Losses of water-soluble vitamins
Supplementation may be warrantedConsider arginine, carnitine and taurine in dietary
regimen- all aid in tissue repair