the lecture 5- 8 october 2013 atherosclerosis 94/80
DESCRIPTION
Schedule for projects-22 October and 19 November groups or single, titles (any including eg cancer),order of presentation, marking Student presentations (2) each worth 10 % - 20% any nutritional assessment topic of your choice - PowerPoint PPT PresentationTRANSCRIPT
Schedule for projects-22 October and 19 November groups or single, titles (any including eg cancer),order of presentation, marking
Student presentations (2) each worth 10 % - 20% any nutritional assessment topic of your choice
20 minutes in length (includes 5 minutes for questions) 5 marks for each of: a) grammar, spelling, punctuation, expression and
presentation (presentation includes asking and answering questions)
b) logic
c) relating topic to material presented in class
d) conclusions
The new normal-Globe and Mail- 30 September 2012- parents do not recognise when they and/or others including kid(s) is/are overweight or obese
Fat is the new normal
The
Lecture 5- 8 October 2013
ATHEROSCLEROSIS
94/80
Outline of today’s talk
I. Pathology
II.Socioeconomic factors contributing to the diseases
III.Elementary nutritional approaches to be taken to avoid and treat these diseases including foods available to those at risk
I. PathologyMAIN PLAYERS
BLOOD PLASMA LIPIDSBLOOD PLASMA LIPOPROTEINSPLATELETSBLOOD PRESSUREOBESITYSMOKINGTYPE II DIABETESDIET
I. PathologyMAIN PLAYERS
BLOOD PLASMA LIPIDS
elevated cholesterolelevated triglycerideselevated free fatty acids
I. PathologyMAIN PLAYERS
BLOOD PLASMA LIPOPROTEINS
decreased high density lipoprotein (HDL) cholesterol
increased low density lipoprotein (LDL) cholesterol and small dense LDL, very low density lipoprotein (VLDL) cholesterol and chylomicrons (CM)
increased LDL oxidation
I. PathologyMAIN PLAYERS
PLATELETS
elevated platelet reactivity
I. PathologyMAIN PLAYERS
BLOOD PRESSURE
elevated blood pressure
both systolic and diastolic pressures
definition and significance of each of two types of pressure
I. PathologyMAIN PLAYERS
OBESITY
central obesity- apple versus pear shape waist
circumference 94/80 cm
BMI greater than 25- define BMI and its limitations
I. PathologyMAIN PLAYERS
SMOKING
CAUSES RISE IN BLOOD PRESSURE, LIPOPROTEIN OXIDATION
I. PathologyMAIN PLAYERS
TYPE 2 DIABETES obesity causes pro-atherosclerotic stance of triglycerides, free fatty acidsHDLc, LDL size, VLDL (triglycerides) and CM(triglycerides) and
blood pressure
Break
Food and hence nutritional choices depend on:Personal preference
acceptance of certain foods-saturated fats-lipids and
lipoproteins-high caloric intake-obesity-salty foods- blood pressure
Habitleads to acceptance of certain foods or is it acceptance of certain foods leads tohabit ?
Food and hence nutritional choices depend on:Ethnic heritage or tradition
which groups would prefer the offendingfoods?
Social interaction-may encourage consumption of certain
bad foods or overeating
Food and hence nutritional choices depend on:Availability of food
contrast atherosclerosis here withtraditional Japanese or Inuit dietwhy are there differences in rates ofatherosclerosis
Convenience of food
movement of Inuit, Japanese and Mik’maq to foods that require less effort to prepare- why would this occur?
Food and hence nutritional choices depend on:
Economy of food what are different definitions of
economy here and how do they impact positively or negatively on the risk of atherosclerosis?
Positive and negative associationspositive-health outcome (positive or negative)
negative-can can cause positive or negative health outcome- how is this possible?
Food and hence nutritional choices depend on:
Emotional conflictavoid discussion of comfort foodhow else might conflict affect diet intake?
Values-dietary restrictions- positive outcome in
India
-fasting may reduce post-prandial lipemic effects
-values that allow high caloric consumption or high saturated fat intake encourage atherosclerosis
Food and hence nutritional choices depend on:Body image
thin people
contrast this with belief that overweight is beautiful
Advertising
fast food companies and companies producing fast home preparation foods- impact on all factors affecting atherosclerosis
More on socioeconomic factors
Prestige-occupational
hypothesis-stress is eased in high prestige occupations-comment on this and on the impact of stress levels in high prestige occupations in terms of dietand the general impact of stress on atherosclerosis
-societal perceptions-perceptions of population about CEOs
of large food corporations
More on socioeconomic factors
Prestige
-education-relate this to aspects of Cape Breton economy- 30 % aged 15-24 are not in school- ramifications for heart disease
Unemployment rate among this age group in Cape Breton is 45 % and CBRM it is 26.5 %
Overall unemployment in CBRM is about 16 %(Halifax 7.2 %) – less heart disease in Halifax compared to CBRM
More on socioeconomic factors
Power-relate power or perceptions of power to
stress levels
Income-Cape Breton statistics-strong impact on
life expectancy compared to metroHalifax- implications for atherosclerosis?
More on socioeconomic factors
Wealth-Cape Breton statistics-strong impact of
income on life expectancy compared to metroHalifax- implications for wealth and atherosclerosis?
Education
impact of job loss on stress and dietary choices relative to type and level of education
More on socioeconomic factors
Social stratification-ancestry-relate this to Cape Breton and diet
-gender-Cape Breton statistics -hormonal protection against
atherosclerosis- mechanism involved
-men are much more affected in terms of effect of heart disease on life expectancy in metro Cape Breton than women –this gap narrows in rural Cape Breton
More on socioeconomic factors
Social stratification
-race
-ethnicity
More on socioeconomic factors
Social stratification
-mobility-ability to get to heart healthy foods
-mental and physical activity-impact of mental illness on atherosclerosis
physical activity-mechanisms of protection
More on socioeconomic factors
Class-income distribution in Cape Breton-uppers-lower uppers-upper middles-average middles-working class-lower class
More on socioeconomic factors
Average employment income in Cape Bretonis $19,000 and in 2 parent families it is $45,000-what is the significance of this for atherosclerosis?
Average hourly wage in CBRM is about the same as the rest of Nova Scotia- significance for atherosclerosis?
More on socioeconomic factors
Global economy-effect on Cape Breton and ondietary habits here
Government-impact of government policywhat approaches are taken to improve diet here in Cape Breton
More on socioeconomic factors
Business- what changes are taking place here in Cape
Breton?Psychology
-impact of Stephen Harper’s comment about Atlantic Canadians having a defeatist
attitude-how would this affect atherosclerosis rates?
History-history of government/private investment here in Cape Breton- how does that history impact atherosclerosis on the island?
Break
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Planning a healthy diet
To do this bear in mindAdequacy
BalanceEnergy controlNutrient densityModerationVariety
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Planning a healthy diet
To do this bear in mind
Adequacy-sufficient energy and enough of the nutrients
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Planning a healthy diet
To do this bear in mind
Balance-enough but not too muchof each food
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Planning a healthy diet
To do this bear in mind
Energy control-adequate, balanced diet without overeating
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Planning a healthy diet
To do this bear in mind
Nutrient density-select foods that deliver the most nutrients for the least food energy
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Planning a healthy diet
To do this bear in mind
Moderation-eat low nutrient densefoods rarely
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Planning a healthy diet
To do this bear in mind
Variety-select foodsin Canada’s 4 food groups each dayand vary those choices in each foodgroup from day to day
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Prevention
Lower saturated fat, total fat, carbohydrates
Increase polyunsaturated (especially omega 3) fatsWhy? Impact on lipids and lipoproteins including post-prandial lipemia, platelets and bp
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Prevention
Lower total calorie intake- why? relative to physical activity and impact on risk factors
Lower salt intake- why?
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Post-onset
Lower saturated fat, total fat, carbohydrates
Increase polyunsaturated (especially omega 3)Why? Impact on lipids and lipoproteins including post-prandial lipemia, platelets and bp
Elementary nutritional biochemistry of nutritional approaches that use foods available to those at risk
Post-onset
Lower total calorie intake- why? relative to physical activity and impact on risk factors
Lower salt intake- why?
Summary of lecture and lead into next lecture
IV. First Nations and other Cape Breton individuals at risk
Summary of lecture and lead into next lecture
V. How is nutritional assessment made relative to atherosclerosis?
Nutrient Intake Analysis Daily Food Record/Diary Retrospective Data 24 hour recall Anthropometry Nutrition focussed physical exam Skin Testing Biochemical analysis Classifying Malnutrition
Summary of lecture and lead into next lecture VI. How would one assess from a nutritional perspective the socioeconomics, pathology and success of nutritional interventions relative to atherosclerosis?