NS 210: Seminar 8Nutritional Assessment in

Disease Prevention

Overview

• Nutritional assessment in disease prevention

• Coronary heart disease

• Osteoporosis

Coronary Heart Disease

• Coronary Heart Disease (CHD)– Leading cause of death in the US despite

>26% decline in CHD death rates since 1988

– Associated with several risk factors• Elevated blood cholesterol

• High blood pressure

• Cigarette smoking

Coronary Heart Disease (CHD) Risk Factors

• Risk factors for CHD– Positive risk factors

• Cigarette smoking

• Hypertension (blood pressure >140/90)

• Low HDL cholesterol <40– Goals

» Women >55

» Men > 45

• Family history of premature CHD

• Age (men >45, women >55)

– Negative Risk Factors• HDL Cholesterol >60

– 10-year risk: http://hp2010.nhlbihin.net/atpiii/calculator.asp

Heart Attack Warning Signs

• Heart attack warning signs– Chest discomfort– Discomfort in other areas of the upper body

• Arm, back, neck, jaw

– Shortens of breath– Other signs

• Cold sweat, nausea, lightheadedness

CHD Risk – Elevated Cholesterol

• CHD risk is directly related to serum levels of total cholesterol and LDL cholesterol

• CHD risk is inversely related to levels of high HDL cholesterol

• National Cholesterol Education Program (NCEP) desirable levels of total cholesterol in adults– <200mg/dL

Atherosclerosis

How is CHD Diagnosed?

• Doctors will diagnosis CHD based on:– Your medical and family history– Risk factors– Results of a physical exam and diagnostic test

procedures• EKG (Electrocardiogram)• Stress Testing• Echocardiography• Chest X-Ray• Blood tests• Electron-Beam Computed Technology• Coronary Angiography and Cardiac Catheterization

How is CHD Treated?

• Lifestyle Changes– Reduce high blood pressure– Reduce high cholesterol

• Follow a Heart Healthy Eating Plan• Therapeutic Lifestyle Changes• DASH Diet• Increased Physical Activity• Maintain a Healthy Weight • Smoking Cessation• Stress Reduction• Medications• Cardiac Rehab

Dietary Factors and Cholesterol

• Factors that can influence cholesterol and lipoprotein levels– Saturated Fats & Cholesterol

• Raise LDL cholesterol

– Unsaturated Fats• Polyunsaturated Fats

– Lower LDL

• Monounsaturated Fats– Lower LDL

– Maintain HDL cholesterol

– Dietary Fiber– Sugar

CHD and Hypertension

• Hypertension is one of the most common risk factors for cardiovascular disease and renal disease– 1 in 4 Americans has hypertension or is taking

antihypertensive medications– Systolic >120mm HG and diastolic >80mmg HG increases

risk for cardiovascular disease

• Most important risk factors for hypertension– Sodium intake– Excessive energy consumption– Physical inactivity– obesity– Alcohol consumption– Inadequate potassium intake

Nutrition Assessment in Disease Prevention: Osteoporosis

• Osteoporosis– Bone mineral content is decrease– Resulting in great susceptibility to fracture– Common fracture sites - pelvis vertebrae, hip, distal

forearm, humorous

• Peak bone mass– Varies considerably among individuals because of

• Heredity

• Sex

• Race

• Environmental factors

Nutritional Assessment in Disease Prevention

• Osteoporosis– Cost

• In 2005– Osteoporosis-related fractures were responsible for an

estimated $19 billion in costs

• By 2025– Experts predict that these costs will rise to

approximately $25.3 billion

http://www.nof.org/osteoporosis/diseasefacts.htm#gender

Risk Factors for Osteoporosis

– Being female – Older age – Family history of osteoporosis or broken bones – Being small and thin – Certain race/ethnicities such as Caucasian, Asian, or

Hispanic/Latino although African Americans are also at risk – History of broken bones – Low sex hormones– Diet– Inactive lifestyle – Smoking – Alcohol abuse – Certain medications– Certain diseases and conditions

Prevention

http://www.girlshealth.gov/bones/

Bone Densitometry

• Bone densitometry– The measurement of bone mineral content– Important in early detection and treatment of

osteoporosis and monitoring progression and response to treatment

– Dual-energy X-Ray Absorptiometry (DEXA) is the most widely used technology for determining bone mineral density

• Quantitative Ultra-songoraphy (QUS)– Identify those persons likely to benefit from DEXA testing

Thank you

for attending the seminar!