nutrition & cardiovascular disease

Cardiovascular diseases

Dhuha Faisal Shamsaldeen

What is cardiovascular disease?

Cardiovascular disease (also called heart disease) is a class of diseases that involve the heart or

blood vessels 

The prevalence

According to World Health Organization statistics from Kuwait in 2008

CVD 46.8%Diabetes 14.6%respiratory disease 15%smoking 20.6%obesity 7%

Age and genders

Cardiovascular diseases

Angina:

Angina is : Chest pain

or discomfort

Medications: 1-statins

2-Nitroglycerin

3-ACE inhibitors

4-Ca channel blockers

5-beta blocker

6- aspirin

Manifestation:1-Shortness of breath when exercising 2-A fast heartbeat.3-Weakness, dizziness, and feeling sick to your stomach (nausea).4-Increased sweating.

Causes: 1- smoking

2-hypercholesterolemia

3-HTN

4-family history

MNT1. Control calories: eat just enough calories to achieve and maintain

a healthy weight.

2. Eat quality fats:

-use virgin olive oil and other unsaturated, low-cholesterol fats.

-eat foods that rich in omega-3 fatty acid.

3. Eat the right amount of fat, carbohydrates, and protein:

-limit your fat intake to 20 or 30 percent but don`t substitute simple carbohydrates for fat

-less than 7% of the day`s total calories from saturated fat.

-up to 10% of the day`s total calories from polyunsaturated fat.

-up to 20% of the day`s total calories from monounsaturated fat.

4. Avoid fad diet:

-eat a well-rounded diet instead.

-eat small, frequent meals.

-avoid large and heavy meals.

5. Limit cholesterol in diet : to less than 200 milligram a day.

6. Limit iron intake: too much iron can increase atherosclerosis.

7. Eat enough dietary fiber: whole grains are best.

8. Eat plenty of fresh fruits and vegetables.

9. Reduce salt in your diet:

Optimal: no more than 1,500 milligrams/day.

10. Check with your doctor about supplementing your diet with B vitamins:- Vitamin B1 [ Thiamine]- Vitamin B2 [ Riboflavin]- Vitamin B3 [Niacin]- Vitamin B5 [ Pantothenic acid]- Vitamin B6 [ Pyridoxine]- Vitamin B12 [ Cobalamin]

Cardiomyopathy is: disease of heart muscle

Causes : 1-HTN2-infection of the heart muscle3-certain toxins, such as cobalt4-certain drugs , such as cocaine and amphetamines

Cardiomyopathy

Manifestation:1-Breathlessness with exertion or even at rest2-Swelling of the legs, ankles and feet3-Bloating of the abdomen due to fluid buildup4-Fatigue

Medications: 1-ACE inhibitors2- ARBs 3- beta blockers4- digoxin5-Diuretics

MNT• Grains: 6-8 servings/day (half of those should be whole

grains)• Vegetables: 3-5 servings/day• Fruits: 4-5 servings/day• Fat-free or low-fat dairy: 2-3 servings/day• Lean meat, poultry, and seafood: 3-6 oz./day (about the

size of a deck of cards)• Fat and oils: 2-3 tbsp./day (use unsaturated fats such as

olive oil or canola oil)

• Nuts, seeds, and legumes: 3-5 servings/week• Sweets, or sugar: 5 or fewer servings/week [ the fewer

the better ]• Eating 2 servings of fatty fish ( such as salmon or lake

trout) per day• Holding sodium <2,400 mg/day or less• Omega-3 fatty acids 1-4 g/day• Folic acid 400 mcg/day• Vitamin B6 25-100 mcg/day• Vitamin B12 2-100 mcg/day

Hypertension

Hypertension is: vascular disorder characterized by

disrupted auto regulation of blood vessel leading to

insufficient blood supply

Causes: 1- smoking2-obesity3-stress4- high salt in diet5-genetics factors6-older age

Medications: 1-thiazide diuretics.2-beta blockers3-ACE4-Ca channel blocker5-renin inhibitor 6-capotine sublingual

Manifestation: 1-Severe headache2-Fatigue or confusion3-Vision problems4-Difficulty breathing5-Irregular heartbeat6-Blood in the urine7-Pounding in your chest, neck, or ears

MNT [Dash diet]

Daily nutrient goals used in the dash studies (for a 2000 calorie eating plan)

Total fat 27% of calories

Saturated fat 6% of calories

Protein 18% of calories

Carbohydrate 55% of calories

Cholesterol 150 mg

Sodium 2,300 mg (1,500 mg is better)

Potassium 4,700 mg

Calcium 1,250 mg

Magnesium 500 mg

fiber 30 g

Cardiac dysrhythmia

Cardiac dysrhythmia is:

abnormalities of heart rhythm

Medications: 1-amiodarone[cardarone]2-bepridil hydrochloride [vascor]3-disopyramide[norpace]4-sotalol [betapace]5-lidociane [xylocaine]6-flecainide [tambocor]

Causes: 1-heart attack2-blocked arteries in the heart3-HTN4-DM5-hyperthyrodisim

Manifestation: 1-Irregular heartbeats that feel rapid, pounding or fluttering2-Dizziness, lightheadedness and fainting

MNT

• High in fruits and vegetables (at least five servings a day) and in whole grain foods. It includes lean protein sources like fish, beans, saturated fats, trans-fats, and cholesterol.

• Omega-3: 2-4 g/day• Magnesium: 400-800 mg/day• Potassium: 500-1,000 mg/day• Vitamin C: 1,000 mg/day• Vitamin E: 200-300 mg/day

Peripheral artery disease [PAD]

Peripheral artery disease [PAD] is : disease of blood vessel that

supplies to arms and legs

Medications: 1-cholesterol-lowering medication2-HTN medication3-aspirin

Causes: 1-blood vessel inflammation2-injury to the limbs3-edema in hand and feet Manifestation 1-Painful

cramping in your hip, thigh or calf muscles after activity, such as walking or climbing stairs (intermittent claudication)2-Leg numbness or weakness3-Coldness in your lower leg or foot, especially when compared with the other side4-Shiny skin on your legs

MNT• Five portions, and ideally 7-9 portions, of a

variety of fruit and vegetables/day.• Should not eat much fatty food such as fatty

meats, cheeses, fatty-cream milk, fried food, butter, etc. Ideally, you should use low fat, mono-unsaturated or poly-unsaturated spreads.

• Try to include 2-3 portions of fish 1 week, at least one of which should be “oily”.

• If you eat meat, it is best to eat lean red meat or poultry such as chicken.

• If you do fry, choose a vegetables oil such as sunflower, rapeseed or olive.

• Try not to add salt to food, and limit foods which are salty.

PREVENTION

Eat more

1- Healthy fats: raw nuts, olive oil, fish oils, flax seeds, or avocados.2- Nutrients: colorful fruits and vegetables—fresh or frozen, prepared without butter.3- Fiber: cereals, breads, and pasta made from whole grains or legumes.4- Omega 3 and protein: fish and shellfish, poultry.5-Calcium and protein: Egg whites, egg substitutes, skim or 1% milk, low-fat or nonfat cheeses or yogurt.

Eat less

1- Trans fats from partially hydrogenated or deep-fried foods; saturated fats from whole-fat dairy or red meat.2- Packaged foods of any kind, especially those high in sodium.3- White or egg breads, granola-type cereals, refined pastas or rice.4- Red meat, bacon, sausage, fried chicken.5- Egg yolks, whole or 2 percent milk, whole milk products like cheese or yogurt.

low

Fat diet

Sodium diet

Cholesterol diet

• Reinforce reductionin saturated fat andcholesterol

• Consider addingplant stanols/sterols

• Increase fiber intake• Consider referral to

a dietitian

• Initiate Tx forMetabolicSyndrome

• Intensify weightmgt &physical activity

• Consider referral to a dietitian

6 wks 6 wks Q 4-6 mo

• Emphasizereduction insaturated fat &cholesterol

• Encouragemoderate physicalactivity

• Consider referral toa dietitian

Visit I

Begin LifestyleTherapies

Visit 2Evaluate LDLresponse

If LDL goal notachieved, intensifyLDL-Lowering Tx

Visit 3Evaluate LDLresponse

If LDL goal notachieved, consideradding drug Tx

Steps in Therapeutic Lifestyle Changes

MonitorAdherenceto TLC

Visit N

References

• Krause`s food, Nutrition and Diet Therapy. 2008. L. Kathleen Mahan MS RD CDE & Sylvia Escott-Stump MA RD LDN.

• http://www.euro.who.int/en/what-we-do/health-topics/noncommunicable-diseases/cardiovascular-diseases/definition

• http://www.heart.org• http://en.wikipedia.org• http://www.helpguide.org