ch 18

increases permeable phagocytes oxidative inflammation

Inflammation and Chronic Diseases • Immune system response to infection or injury - Blood supply to the site ____ - Vessels become _____ - _______ engulf microbes Release _______ molecules to kill microbes - Fights off infection and promotes recovery • Chronic ____ - Obesity - Harmful

subtle

Nutrition and Immunity • Immune system responds to _____ changes in nutrition status - Over or undernutrition • Immune response requires greater nutrients - Synthesis of antibodies, cytokines, cell multiplication - Infectious disease raises nutrient need and decreases food intake Synergistic downward spiral

inactivity ldl hdl hypertension diabetes smoking

Other Risk Factors • Obesity and physical____ - Increase risk for CHD High___, low ____, ______, and ______ - Benefits of weight loss and improving fitness • Cigarette _______ - Smoking directly damages heart - Toxins damage vessels

atherogenic

Other Risk Factors • ______ diet - Elevates LDL cholesterol - Metabolic syndrome Cluster of health risks o Abdominal obesity and insulin resistance - Markers of inflammation and thrombosis - Early treatment, focus on lifestyle changes

protein

Selected Nutrients in Immune Function Key Role(s) in Immune Function Maintains healthy skin and other epithelial tissues (barriers to infection); participates in the synthesis and function of the organs and cells of the immune system and antibody production. What nutrient???

Answer: 1. Similar; even; food lists 2. Glycemic; sugar; the same 3. Saturated fat, trans fat, omega 3s

1. To maintain near-normal blood glucose levels, the diet should deliver similar/different amounts of carbohydrates each day. The spacing of carbohydrates should be even/sporatic. People learn to count carbohydrates using ______ (2 words). 2. The ____ effect of food is influenced by fiber content and other variables. High fiber foods are recommended, _____ recommendations are the same/different for the general population. 3. People with diabetes should follow the Dietary Guidelines for Americans for these nutrients:

Selinium

Protects against oxidative

increased poor nutrition

Advances in medical science have _____ average life expectancy - Immunizations and antibiotics • Strong immune system depends on adequate nutrition - ______ weakens the immune system

age, gender, early chd, and genetics

Age, Gender, and Family History • Nonmodifiable risk factors are ___,___,____and____. - Age Significant factor at 45 for men, 55 for women - Gender Men have earlier onset of risk factors - Early CHD in immediate family members Greater risk the more family members are affected Greater risk the earlier age of onset - People with high genetic risk Improve odds by living healthy lifestyle

Vitamin B12 and folate

Assist in cell replication and specialization that support immune cell and antibody production

Answer: 1. Malignant 2. Carcinogenesis; mutations; death; tumor; metastasized 3. Environment

Cancer 1. The growth of ______ tissue, ranks just below cardiovascular disease as a cause of death in the United States. 2. _______ is the development of cancer. _______ in genes that control cell division promote cell replication and can prevent cell ____. The mass of cells grows and is called a _____. Some of those cells may travel to other parts of the body, meaning the growth has _______. 3. Most commonly, cancers are caused by interaction between genes and the _______.

Answer: 1. Blood vessels 2. Coronary heart disease (CHD); Explanation: Recall that dietary patterns high in saturated and trans fats contribute to the development of plaques, and atherosclerosis progression.atherosclerosis; lipids; cholesterol; plaques; inflammatory

Cardiovascular Disease 1. Cardiovascular disease, collectively are diseases of the heart and _______ (2 words). 2. ________ (3 words) is the most common form of cardiovascular disease. It is usually caused by _______. This is the accumulation of ______ and other materials in the arteries. This disease consists of fatty streaks that enlarge, fill with ______ and calcium, and become encased in fibrous tissues. This forms ______ that stiffen and narrow arteries. This disease is a complex ________ response to tissue damage.

Answer: 1. Lifestyle. Diet, physical inactivity, overweight, tobacco use, alcohol and drug abuse 2. Many 3. Genetics; heart Explanation: Nondietary factors include genetics, physical inactivity, and smoking.

Chronic Diseases 1. Many of the 10 leading causes of death reflect chronic diseases that develop in response to ______ factors. List at least 5: 2. Each chronic disease develops in response to one/many risk factors. 3. _____ and lifestyle often work synergistically. For example, cigarette smoking increases ____ disease in those predisposed to develop it.

alcohols a1c circulation nerve large small nerves

Complications of Diabetes Mellitus • Acute—see Figure 18-4 on next slide • Chronic - Conversion of glucose to sugar _____ - Changes in proteins (_____ test) - Loss of ______ and _____ function - Infections - Diseases of ____ blood vessels - Diseases of _____ blood vessels - Diseases of the ______

elevated seventh cardiovascular

Diabetes Mellitus • Incidence has risen dramatically - Prediabetes: _____ blood glucose • ____ among leading causes of death • Contributes to several other major diseases - _______ disease is leading cause of diabetes-related death

Answer: 1. One-third 2. Alcohol, tobacco, low intakes of fruits and vegetables 2. High 3. Grilling; foil, marinating 4. Processed; colon 5. Acrylamide

Dietary Factors—Cancer Initiators 1. Diet may be linked to ___-___ of all cancer cases. 2. Head and neck cancers correlate strongly with the use of: 3. Amino acids and creatine in meats react and form carcinogens when cooked at ____ temperatures. 4. The process of _____ causes fat to splash up and onto the food, introducing carcinogens. To avoid, wrap meat in ____. _____ meat prior to cooking helps reduce carcinogens as well. 5. Diets high in red meat and _______ meat are a cause of _____ cancer. 6. Fried foods, including french fries and potato chips, contain ______, a potential carcinogen.

obesity

Diets high in added sugars (beverages)

hypertension, cancer

Diets high in salty or pickled foods

cancer, diabetes, stroke, Athersclerosis, obesity,

Diets low in fruits, vegetables, and other foods rich in fiber and phytochemicals

cancers, hypertension, atherlsclerosis

Diets low in vitamins and/or minerals

sun pollution smoking obesity estrogen

Environmental Factors • Known environmental causes of cancer - Radiation and ___ - Water and air ______ - ______ • ______ and physical inactivity are risk factors • Hormones: ______ - Breast cancer risk after menopause - Excess fat

cancer, hypertension, stroke, Athersclerosis, obesity,

Excessive alcohol intake

omega three fatty acids

Help resolve inflammation when it is no longer needed for the immune response through production of lipid mediators known as resolvins and protectins, which also play a role in enhancing host defense. What nutrient?

zinc

Helps maintain an effective immune response; participates in antibody production

hypertension walls accelerates diabetes

High Blood Pressure (Hypertension) • Chronic ______ - Slightly elevated levels increase risk of heart disease • Injures artery ______ • _______ plaque formation - Increases blood pressure further • _______ - Increases risk of death from CHD

total LDL HDL not triglycerides

High LDL and Low HDL Cholesterol • ___ blood cholesterol - Strong correlation to atherosclerosis • _____: the most atherogenic lipoprotein - Plaque formation and instability - Inflammatory process • Adequate levels of _____ are beneficial - High HDL may or may ____ provided added benefit • High blood ______ - Promote atherosclerosis

aging, genetics, obesity, salt sensitivity, alcohol

Hypertension Risk Factors and Treatment • Risk factors ___,___,____,____,_____ • Treatment - Weight control - Salt/sodium intake DASH diet - Physical activity - Medications

Vitamin A

Maintains healthy skin and other epithelial tissues (barriers to infection); participates in the cell replication and specialization that supports immune-cell and antibody production and the anti-inflammatory response. What nutrient?

ldl hdl pressure inactivity smoking atherogenic

Major Risk Factors for CHD (modifiable) • High blood ____cholesterol • Low blood ____ cholesterol • High blood ____(hypertension) • Diabetes • Obesity (especially abdominal obesity) • Physical _____ • Cigarette_______ • An "________" diet (high in saturated fats and low in vegetables, fruits, and whole grains)

Answer: a c;f b a c b; e d d; g

Match these a) Diabetes mellitus b) Diabetes diagnosis c) Type 1 diabetes d) Type 2 diabetes With these a) Fasting plasma glucose, nonfasting A1C b) Pancreas loses ability to produce insulin c) Characterized by high blood glucose concentrations (hyperglycemia) d) Insulin resistance, eventually insulin production decreases e) Less common, autoimmune f) People may have insufficient insulin, ineffective insulin, or both g) Most common form, hyperinsulinemia as the pancreas tries to compensate

Answer: ac; f; h ba; e cb dg ed

Match these a) Inflammation b) Plaques c) Blood clots d) Blood pressure e) Results With these a) May be stable or unstable and may rupture b) Platelets cover injured or damaged area, may restrict blood vessel c) Damage increases permeability of blood vessel walls d) Heart attack, stroke, angina e) Composition rather than size predict rupture f) LDL cholesterol becomes trapped in blood vessel walls, are oxidized by free radicals, engulfed by macrophages, becoming part of the plaque g) When it is high, can provoke low-grade inflammation h) Favors the formation of blood clots

Answer: a b; c b a

Match these a) Promoter b) antipromoter With these a) Defend against cancer b) Accelerate cancer development c) Animal fats and colon cancer

Answer: 1. Intervention 2. Age, sex, race, total cholesterol, HDL, blood pressure, blood pressure medication, diabetes, smoking 3. Patient-centered; lifestyle. Diet, physical activity, smoking cessation.

Recommendations for Reducing CHD Risk 1. Screening and ______ is a recommendation to reduce cardiovascular disease. 2. List the risk factors included in the assessment: 3. Guidelines focus on _____-_____ care. Treatment plans, in addition to medications include major _____ changes including:

Answer: 1. Phytochemicals; oxidative; immune; fiber 2. Physical activity

Reducing Cancer Risks 1. A diet rich in fruits and vegetables contain nutrients and _____ with antioxidant activity. These may prevent and reduce ______ reactions that damage DNA. These may also enhance ____ function that is protective again cancer development. This diet pattern is also rich in ____, which is protective against cancer. 2. ________ (2 words) helps maintain a healthy body weight and reduce risk of some cancers.

Vitamin D

Regulates immune cell (T-cell) responses; participates in antibody production

age=cancer, genectics, hypertension, athersclerosis, stroke Enviromental contaminents=cancer genetics=cancer, genectics, hypertension, athersclerosis, obesity, stroke sedetary lifestyle=cancer, genectics, hypertension, athersclerosis, obesity, stroke Smoking and tobacco use=cancer, hypertension, atherosclerosis, stroke stress=hypertension, atherosclerosis, stroke

Risk Factors and Chronic Diseases age= Enviromental contaminents= genetics= sedetary lifestyle= Smoking and tobacco use= stress=

half

Risk Factors for Coronary Heart Disease (CHD) • Modifiable and non-modifiable risk factors •______of U.S. adults have at least one major risk factor by age 20 • Regular screening and early detection - Downward trend since 1960

age male premature

Risk Factors for Coronary Heart Disease (CHD) Major Risk Factors for CHD (not modifiable) • Increasing ____ • ____ gender • Family history of _______ heart disease

Answer: a c; d; h; i b b; e; g c a; f; h

The Immune System Match these a) Lymphocytes: T-cells b) Phagocytes c) Lymphocytes: B-cells With these a) Respond to infection by dividing rapidly b) First to arrive if foreign invader gains entry c) Recognize antigens and produce cytokines to destroy particles with foreign antigens d) Highly specific e) Engulf and digest via phagocytosis f) Produce antibodies, a class of proteins called immunoglobulins g) Neutrophils and macrophages h) Have a memory i) Participate in rejection of transplanted tissues

Answer: 1. Skin, mucous membranes, GI tract 2. Organs; antigens 3. Phagocytes and lymphocytes Explanation: Organs of the immune system include the spleen, lymph nodes, and thymus. Bacteria, viruses, toxins, and allergy-causing food proteins are examples of antigens.

The Immune System 1. The body's first lines of defence are: 2. If these fail, the cells and ____ of the immune system kick in. Foreign cells that elicit the immune response are called _____. 3. Name the two types of white blood cells that defend against infectious diseases:

hypertension

What is this describing?_____ • Underlying causes not fully understood • Physiological factors affecting blood pressure - Cardiac output Contractions in heart muscle, pumping blood - Peripheral resistance Diameters of arterioles - Nervous system - Hormones Kidneys

vitamins C and E

protect against oxidative damage

cancer, diabetes, hypertension, stroke, Athersclerosis, obesity,

diets high in saturated fats and trans fat

leading causes of death

heart disease cancer chronic lung disease accident stroke alzheimers diabetes influenza/pnuemonia kidney disease suicide

insulin weight loss activity

• Type 1 diabetes - Adjust _____ doses to accommodate meals, physical activity, and health status - Nutrition therapy • Type 2 diabetes - Moderate _____ - Regular physical _____