Module 9 Reading Assignment - Cardiovascular Diseases

Sodium

- mineral sodium is most often over-consumed in the American diet - does not have a direct link with atherosclerosis because it does not affect blood cholesterol levels - due to its effects on blood pressure, it can indirectly affect atherosclerosis - If a client has HTN or high risk for HTN, sodium should be restricted to 1,500mg of sodium daily.

Which of the following are risk factors for cardiovascular disease? Select all that apply. [mark all correct answers] a. Obesity b. Inactivity c. Smoking d. Low blood pressure e. High LDL cholesterol f. Diabetes g. Female in reproductive years

A,B,C,E,F

What lifestyle modifications are known to help reduce high blood pressure? Select ALL that apply [mark all correct answers] a. lowering body weight b. decreasing sodium intake c. increasing potassium intake d. reducing calcium intake e. including moderate alcohol in the diet f. including daily physical activity

A,B,C,F

Select all of the ways that exercise helps with cardiovascular disease. [mark all correct answers] a. Helps with weight loss b. Lowers blood pressure c. Lowers HDL cholesterol d. Improves insulin sensitivity e. Strengthens the heart

A,B,D,E

Which cooking oils would be best for a client with atherosclerosis? Select ALL that apply. [mark all correct answers] a. Safflower oil b. Sunflower oil c. Coconut oil d. Corn oil e. Canola oil

A,B,D,E

Which of the following are ways to reduce the risk of heart disease? Select all that apply. [mark all correct answers] a. Exercise b. Avoid stanols and sterols c. Good intake of B-vitamins d. Good intake of antioxidant nutrients e. Decrease sodium intake f. Avoid alcohol

A,C,D,E

Which of the following are potential serious consequences of CHF? Select ALL that apply. [mark all correct answers] a. Loss of bone mass b. Organ failure c. Malnutrition d. Hemorrhagic stroke e. Pulmonary edema f. Respiratory infections g. Weight gain

B,C,E,F

DASH diet

Dietary Approaches to Stop Hypertension - diet includes many (8-12) servings of fruits and vegetables, along with plenty of grain products, and 2-3 servings of low-fat dairy daily - Nuts, seeds, and legumes should also be consumed 3-4 times per week, while meats and poultry should be limited to 1-2 small servings per day. - sodium restriction is also recommended on the DASH diet - diet aims to provide a diet rich in potassium, magnesium, and calcium (milk contains all 3). It also reduces amounts of sodium and saturated and trans fat.

Risk Factors for CHD

Major Risk Factors for CHD (not modifiable): - Increasing age - Male gender - Family history of premature heart disease Major Risk Factors for CHD (modifiable): - High blood LDL cholesterol - Low blood HDL cholesterol - Hypertension (high blood pressure) - Diabetes - Obesity (especially abdominal obesity) - Physical inactivity - Cigarette smoking - An "atherogenic" diet (high in saturated fats and low in vegetables, fruits, and whole grains)

This recipe for Keto Coconut Shrimp calls for air-frying the shrimp for a crispy, lower fat alterntive. The nutrition facts were provided following this air-frier method. If a person with coronary heart disease would eat all six shrimp, would this be a good choice?

No, because the saturated fat would be 12 grams eating all six shrimp

Standards for CHD Risk Assessment

Refer to image attached

Increase HTN

high sodium

Trans fat

Trans fat has shown a strong correlation with increased LDL levels and a higher risk of cardiovascular disease. Trans fats have recently been removed from the American food supply and should no longer be a concern.

Overall,

We should eat a diet filled with complex carbohydrates from whole grains, legumes, and vegetables; unsaturated fats from nuts, seeds, oils, and fish; lean animal and dairy sources; and whole fruits to provide soluble fiber. *Whole is a term that refers to minimal processing.*

What is a symptom of CHF? a. fluid retention b. rapid weight loss c. excessive thirst d. chest pain

a. fluid retention

What health problem is most commonly associated with a diet high in saturated fat? a. high LDL cholesterol b. high blood pressure c. high blood sugars d. high ammonia

a. high LDL cholesterol

What is a likely complication of uncontrolled high blood pressure? a. kidney disease b. diabetes c. cancer d. gallstones

a. kidney disease

What is a primary characteristic of atherosclerosis? a. narrowing of arterial vessels due to plaque buildup b. weakness of blood vessels c. cholesterol buildup in the bloodstream d. abnormal heart rate

a. narrowing of arterial vessels due to plaque buildup

Nutrition prevention of stroke:

aimed at lowering cholesterol levels, weight loss in the overweight/obese, and reducing high blood pressure.

Increase HTN

alcohol consumption

The recommended maximum daily sodium intake for a person with hypertension is: a. 1,000mg b. 1,500mg c. 2,500mg d. 3,000mg

b. 1,500mg

What is the most important nutrient for lowering LDL on the food label to reduce risk of cardiovascular disease? a. Lowest amount of total fat b. Lowest amount of saturated fat c. Lowest amount of dietary cholesterol d. Lowest amount of sodium

b. Lowest amount of saturated fat

Which of the following meals is lowest in sodium for someone with CHF to consume? a. pancakes, sausage, and orange juice b. chicken breast, baked potato, and spinach c. spaghetti with tomato sauce, carrots, and dinner roll d. cheeseburger on a bun with lettuce, tomato and ketchup, and milkshake

b. chicken breast, baked potato, and spinach

What is included in a DASH diet? a. Less dairy products b. more fruits and vegetables c. restrict fatty fish d. avoidance of animal products

b. more fruits and vegetables

Which of the following can cause atherosclerosis? a. liver disease b. periodontal disease c. reflux disease d. irritable bowel syndrome

b. periodontal disease

You have been hired to help sandwich shop owner revise his "dinner specials" so they can be labeled "heart healthy." One popular "special" offers a 3 oz. cut of grilled salmon on a whole grain bun; and a salad that includes 1/2 tomato, lettuce leaf, and 1/2 Tbsp. blue cheese dressing. Which of the following would be the most effective revision to recommend for a heart health label? a. add cheese to the salad b. substitute olive oil for the salad dressing c. offer chicken breast instead of salmon d. eliminate the bun

b. substitute olive oil for the salad dressing

What are common distinct symptoms of stroke? a. fatigue and chest pains b. nausea and vomiting c. drooping face and slurred speech d. dizziness and passing out

c. drooping face and slurred speech

What is the main characteristic of congestive heart failure? a. a clot in the heart b. cell damage to the heart arteries c. inability of the heart to pump enough blood d. narrowing of the arterial walls

c. inability of the heart to pump enough blood

What can damage the blood vessels and lead to atherosclerosis? a. hypotension b. hypoglycemia c. smoking d. exercise

c. smoking

Which of the following statements suggests accurate recall of the diet instruction for lowering LDL (cholesterol) levels? a. "I should increase my alcohol consumption to raise my HDL". b. "I must eliminate red meat from my diet". c. "I must reduce my carbohydrate intake". d. "I should eat unsaturated fat instead of saturated fat foods".

d. "I should eat unsaturated fat instead of saturated fat foods".

What is a likely complication after a stroke, which can interfere with nutrition status? a. Rapid weight loss b. Malabsorption c. Food aversions d. Dysphagia

d. Dysphagia

Decrease HTN

exercise

Decreased risk of heart disease

exercise

Decreased risk of heart disease

garlic

Decreased risk of heart disease

high HDL

Increased risk of heart disease

high LDL

Increase HTN

low potassium intakes

Increased risk of heart disease

obesity

Increased risk of heart disease

saturated fat intake

Increased risk of heart disease

smoking

Decreased risk of heart disease

soy protein intakes

Increased risk of heart disease

trans fat intake

Decrease HTN

weight loss

Nutrition therapy: Fat

- Total fat should be kept below 30% of total kcalories per day, with the majority coming from unsaturated sources, especially omega-3 fatty acids - simply reducing total fat below 30% is not enough. The type of fat consumed is critical.

Cholesterol

- health care professionals continue to recommend intake below 300 mg per day - Cholesterol is primarily found in eggs, dairy (milk/cheese), shrimp, and lobster. - Blood levels of cholesterol refer to the amount of cholesterol within your blood that was either 1) consumed in dietary cholesterol or 2) made by your liver - body makes cholesterol easily from saturated fat, trans fat, and excess carbohydrate. - dietary cholesterol you eat has only minimal effect on your blood cholesterol. But, saturated fat, trans fat, and excess carbohydrate have a great risk for increasing blood LDL because your liver loves to make cholesterol and triglycerides with it - HDL is the good carrier of cholesterol and LDL is the bad carrier of cholesterol

Saturated fat food sources include:

- Butter. - Animal fat found in fatty meats. - Dairy fat such as whole milk and cheese. * plant fats found in coconut and palm kernel oil.

Plant-based

- Evidence shows us that plant-based diets are associated with a lower risk of cardiovascular disease (CVD), death from CVD, hypertension, stroke, high cholesterol, and death from all causes -Sterols are plant substances that can reduce blood cholesterol levels naturally by reducing the intestinal absorption of cholesterol - Sterols are sometimes added to food products such as margarine, cheese, salad dressings, and chewable supplements - Consuming at least 25 grams of soy protein daily can lower LDL cholesterol levels

Treatment for CHD

- Exercise: promote weight loss, raise good HDL blood cholesterol levels, lower blood pressure, and help control diabetes by improving insulin sensitivity - Quit smoking: Smoking is a leading risk factor for heart disease, so individuals should quit immediately or their condition will worsen. - Lose weight, if needed: A person should keep their BMI below 25. A 5-10% weight loss can significantly reduce an individual's risk for heart disease, with an even more significant risk reduction with additional weight loss. - Drug therapy: medications can be given to reduce the risk factors for heart disease. - Herbals: garlic may reduce cholesterol levels and lower blood pressure, although the results may be modest and short. Hawthorn is an herb that is sometimes prescribed because it can intensify blood pressure medications' action and, therefore, lower the amount of medication needed. Hibiscus tea can reduce blood pressure in individuals with stage 1 hypertension - Diet therapy: one of the most important ways to prevent or treat coronary heart disease

Unsturated Fats

- Unsaturated Fats are considered the 'good' fats - The omega-3 fatty acids: have reasonably good evidence of benefits in heart disease - a diet rich in omega-3 fatty acids may suppress the inflammatory response, reduce blood-clotting time, stabilize heart rhythm, and lower triglycerides - American Heart Association recommends eating two servings of fatty fish per week for CHD risk reduction - Plant sources of omega-3 fatty acids include flaxseed, walnuts, soybean, and canola oil - Our bodies have limited ability to convert the plant omega-3's. So, having a combination of plant-based sources with fatty fish is still considered best - omega-3 is a FAT. Lean fish is not a good source of omega-3's. We need to remove the idea that fat is always bad and lean is always better. Lean is better when there is no unsaturated fat replacement (like lean sources of meat, poultry, pork, and dairy) - Unsaturated fats are found primarily in plants such as nuts, seeds, and oils, in addition to fatty fish sources.

Vitamins and Minerals

- a diet with adequate calcium, magnesium, and potassium can help to lower blood pressure - sodium intake should be less than 2,300 mg per day and less than 1,500mg for high blood pressure - B-vitamins folic acid, vitamin B6, and vitamin B12 can help reduce elevated homocysteine levels - Taking megadoses of antioxidant vitamins such as vitamin E is not scientifically supported and can even cause harm - eating a diet that is rich in antioxidants is not harmful and may help prevent the oxidation of LDL.

Coronary Heart Disease (CHD)

- a disease that is defined by the inability of the arteries to carry enough blood to the heart - often the result of a build-up of plaque along the arterial walls, which is called atherosclerosis - Atherosclerosis can damage tissues and raise blood pressure - Usually the plaques start as lipids and cholesterol, and eventually they may harden. When a blood vessel in the heart becomes blocked, it will obstruct blood flow to the heart and cause a heart attack - If a blood clot travels to the brain, it leads to stroke.

Metabolic syndrome

- a group of disorders that can substantially increase the risk of developing cardiovascular disease, heart disease, and stroke - The metabolic syndrome is a cluster of at least 3 of the following: - Central Obesity (increased abdominal or visceral fat) - Insulin resistance (high blood sugars or diabetes) - High triglycerides - Low HDL cholesterol - Hypertension (high blood pressure) - The more conditions a person has, the higher the risk of developing type 2 diabetes - The majority of the conditions are linked to overweight or obesity, inactivity, and higher age. Ethnicity has been linked to metabolic syndrome - Hispanic women have the highest risk. - primarily treated with dietary and lifestyle changes

Cardiovascular disease (CVD)

- any disease affecting the heart or blood vessels - It is the leading cause of death in the United States - It includes atherosclerosis, coronary heart disease (CHD), myocardial infarction (MI, or heart attack), and stroke.

Hypertension

- chronic, elevated blood pressure, and is a leading risk factor for cardiovascular disease - called the "silent killer" because it often does not produce symptoms - Hypertension can occur as a result of another disorder, but most of the time the cause is unknown - Obese people seem to be at higher risk for hypertension - Constant high blood pressure can enlarge and weaken the heart, damage arterial walls, and cause arteries to burst, called an aneurysm - Uncontrolled hypertension can also lead to kidney disease and stroke - kidneys are the main organ that regulates blood pressure, and pre-existing kidney disease can cause hypertension - Normal blood pressure is 120/80 or less, blood pressure even slightly higher than 120/80 typically needs treatment.

Carbohydrates

- diet should include foods rich in whole grains and fiber while being low in refined carbohydrates and sugar - Processed carbohydrates can elevate blood sugar, triglycerides levels, and inflammation - high intakes of refined flours and sugar may increase the risk of heart disease as much as saturated fat - Fiber seems to help lower LDL cholesterol levels, while the minerals found in most high-fiber foods may help to lower blood pressure.

Nutriton therapy: Saturated fats

- have shown a high correlation with increased LDL levels - Since LDL is a significant factor in atherosclerosis, prevention is aimed at replacing saturated with unsaturated fats - When we reduce intake of one macronutrient (or type of macronutrient), it will be replaced with another macronutrient to maintain calories and satiety - If saturated fat is replaced with unsaturated fat, CHD risk declines.

Alcohol

- in moderation (one drink per day for women and two drinks per day for men) may reduce the risk of CHD by raising good HDL blood cholesterol and preventing blood clot formation - In excess, alcohol may have other damaging effects on the body, primarily by increasing blood pressure.

Treatment for Hypertension

- includes weight loss if needed, medications, exercise, and diet therapy - low sodium diet is prescribed, with less than 1,500 mg per day - Alcohol should be avoided because it increases blood pressure - commonly prescribed diet called the DASH (Dietary Approaches to Stop Hypertension) diet is guaranteed to lower high blood pressure if followed faithfully.

Congestive Heart Failure (CHF)

- is when the heart can no longer adequately pump blood through the circulatory system - usually develops gradually but can also occur suddenly after a heart attack - Risk factors include coronary heart disease (CHD), obesity, and hypertension. - CHF can reduce blood flow to the kidney and trigger massive fluid retention (edema) - Pulmonary edema can also occur, which increases the risk of respiratory infections - Disrupted blood flow limits the supply of nutrients and oxygen to the organs and tissues, leading to organ failure - Malnutrition and weight loss are common problems with CHF - Heart failure may affect either side of the heart. Depending on the side, the body will experience fluid overload in different parts of the body. - To treat CHF, diuretics would be necessary to reduce the edema, and fluids and sodium are often restricted. - Medications such as cardiac glycosides are given to increase the strength of the heart - Adequate fiber intake is essential to prevent constipation, leading to straining during defecation and possibly severe heart failure and death - Stool softeners are often given to people with CHF - person must frequently rest to prevent overexertion, and exercise is often not possible.

Stroke

- occurs anytime blood flow to the brain is blocked, and like a heart attack, may result in death - stroke can result in temporary or permanent problems that interfere with the person's ability to communicate - Paralysis may occur, which can interfere with the ability to prepare foods or to eat - Some stroke victims may develop severe dysphagia - Different consistency changes in food and liquids may be required - Assessing swallowing function is vital to prevent complications with aspiration - tube feeding may be necessary in severe cases

Heart Attacks

- often called myocardial infarctions (MI) and occur any time the blood supply to the heart is blocked - Once the person can eat, they will be given a liquid diet and then will progress to soft foods to prevent nausea and abdominal distention - Calories are restricted to lower the metabolic rate and therefore reduce the workload of the heart - Caffeine and temperature extremes of food are also avoided for the same reasons. - follow the same dietary recommendations to treat CHD and hypertension - They should eat slowly and avoid strenuous physical activity before and after meals

Several risk factors for stroke:

- risk factors include hypertension, smoking, diabetes, elevated LDL blood cholesterol, age, family history, ethnicity, drug use, and certain medications - In women, oral contraceptive use has been linked to an increase in stroke risk. Women who smoke should not take oral contraceptives for this reason

Three types of strokes:

- transient ischemic attack (TIA): which causes temporary reductions in blood flow to the brain - ischemic stroke: which results from the obstruction of blood flow to brain tissue - hemorrhagic stroke: which causes bleeding with the brain and can destroy or compress brain tissue.

Which of the following is a risk factor for developing hypertension? a. underweight b. Caucasian race c. low dietary intake of potassium d. high dietary intake of calcium

c. low dietary intake of potassium

Prior to feeding someone after a stroke, the health care professional should assess the client for: a. food intolerance. b. salt sensitivity. c. swallowing ability. d. hydration status.

c. swallowing ability

Decrease HTN

increase calcium intakes

Decreased risk of heart disease

moderate alcohol consumption

Decreased risk of heart disease

omega-3 fatty acid intakes

Increased risk of heart disease

periodontal disease

Decreased risk of heart disease

plant sterol intakes