Primary Prevention Strategies

Free Radicals and Antioxidants

"Free radicals and oxidants play a dual role as both toxic and beneficial compounds, since they can be either harmful or helpful to the body. They are produced either from normal cell metabolisms in situ or from external sources (pollution, cigarette smoke, radiation, medication). When an overload of free radicals cannot gradually be destroyed, their accumulation in the body generates a phenomenon called oxidative stress. This process plays a major part in the development of chronic and degenerative illness such as cancer, autoimmune disorders, aging, cataract, rheumatoid arthritis, cardiovascular and neurodegenerative diseases. The human body has several mechanisms to counteract oxidative stress by producing antioxidants, which are either naturally produced in situ, or externally supplied through foods and/or supplements." {Abstract}

dietary cholesterol

found in animal fats also raises total blood cholesterol and LDL cholesterol.

what are the hunger hormones?

ghrelin and leptin

Sodium Intake

•"The American Heart Association recommends no more than 2,300 milligrams (mgs) a day and an ideal limit of no more than 1,500 mg per day for most adults. •On average, Americans eat more than 3,400 milligrams of sodium each day. •Because the average American's sodium intake is so excessive, even cutting back by 1000 milligrams a day will significantly improve blood pressure and heart health. •More than 70 percent of the sodium Americans eat comes from some processed, prepackaged and restaurant foods - not from the salt shaker."

DASH Diet

•Dietary Approach to Stop Hypertension •Fruits, vegetables, low-fat dairy •Whole grains, low fat protein sources •Diet rich in minerals and fiber •Avoid processed foods •Promotes salt excretion •Acts like a diuretic ** Mediterranean diet also works

Cultural Issues and Health

•Exercise and activity habits •Food preferences •Attitudes towards health and healthcare practitioners (hospitals, physicians, etc) •Use of traditional medicines and practices, such as herbs •Appearance and cultural norms--> tell the pt to talk to her husband about how losing weight will help her knee feel better

Phytochemical Examples

•Flavonoids are plant chemicals found in fruits, vegetables, and grains. •Lycopene (tomatoes, red peppers, pink grapefruit) •Lignans (flaxseed and whole grains) •Isoflavones (soy products, garbanzo beans) •Quercetin (apples, onions, teas, red wine) •Carotenoids (carrots, yams, cantaloupe, squash, apricots)

role of potassium

•Helps control blood pressure by reducing the impact of sodium. Sodium is lost through the urine. •Reduces tension in blood vessel walls. *anti salt- helps keep sodium levels down

High Fat Hangover

•Reduced arterial oxygen carrying ability •Decreased muscle performance •Impaired cognition •Short and long term consequences •Research on rats fed a high fat diet

Food and Drug Interactions

-Alcohol and prescription medication might NOT mix. Check the warning labels!!!

Causes of Elevated Triglycerides

( ≥ 150 mg/dL) •Obesity and overweight •Physical inactivity •Cigarette smoking •Excess alcohol intake •High carbohydrate diets (greater than 60% of energy intake) •Several diseases (Type 2 Diabetes, Chronic Renal Failure, Nephrotic Syndrome) •Certain drugs (corticosteroids, estrogens, retinoids, higher doses of beta-blockers) •Various genetic dyslipidemias

Chronic Inflammation

-Although it is not proven that inflammation causes cardiovascular disease, inflammation is common for heart disease and stroke patients and is thought to be a sign or atherogenic response. -"The body perceives this plaque as abnormal and foreign — it does not belong in a healthy blood vessel," he said. "In response, the body tries to wall off the plaque from the flowing blood. However, under the wrong set of circumstances, that plaque may rupture, and its walled-off contents can come into contact with blood and trigger a blood clot formation." Bhatt added, "This combination of plaque and blood clots causes the majority of heart attacks and certain types of stroke, if the blood clot obstructs blood flow to the heart or brain." -Cholesterol-lowering medications called statins appear to reduce arterial inflammation, but whether that's from cholesterol reduction or something else is being debated -(cigarette smoking, high blood pressure and LDL [bad] cholesterol) that can lead to inflammation.

Ghrelin

-Appetite stimulator -Signals hunger to the brain -Sleep deprivation increases ghrelin levels

Leptin

-Appetite suppressor -Signals that the body has enough energy stores

Coenzyme Q10

-Coenzyme Q10 (CoQ10) is a substance that is naturally present in the human body, with the highest levels in the heart, liver, kidneys, and pancreas -CoQ10 has not been shown to be of value in treating cancer, but it may reduce the risk of heart damage caused by one type of cancer chemotherapy drug. Only a few studies have looked at whether CoQ10 might help prevent heart disease, and their results are inconclusive. Research on the effects of CoQ10 in heart failure is also inconclusive. However, there is evidence that CoQ10 may reduce the risk of some complications of heart surgery. Although results of individual studies have varied, the overall scientific evidence does not support the idea that CoQ10 can reduce muscle pain caused by the cholesterol-lowering drugs known as statins. The small amount of evidence currently available suggests that CoQ10 probably doesn't have a meaningful effect on blood pressure. Guidelines from the American Academy of Neurology and the American Headache Society say that CoQ10 is "possibly effective" in preventing migraines, but this conclusion is based on limited evidence. A major National Institutes of Health-funded study showed that CoQ10, even in higher-than-usual doses, didn't improve symptoms in patients with early Parkinson's disease. A 2017 evaluation of this study and several other, smaller studies concluded that CoQ10 is not helpful for Parkinson's symptoms. CoQ10 has also been studied for a variety of other conditions, including amyotrophic lateral sclerosis (Lou Gehrig's disease), Down syndrome, Huntington's disease, and male infertility, but the research is too limited for any conclusions to be drawn.

free radical generating substances

-fried food -alcohol -tobacco smoke -pesticides -air pollutants

The Anti-Inflammatory Diet

-healthy sweets such as plain dark chocolate (sparingly) -red wine no more than 1-2 glasses a day (optional) -supplements (daily) -tea (white, green, oolong) 2-4 cups a day -healthy herbs &spices such a sagrlic, ginger, tumeric,cinnamon (unlimited amounts) -other sources of protein (dairy-natural cheeases, yogurt) omega-3 enriched eggs, skinless poultry, lean meats (1-2 a week) -whole-soy foods edamame, soy nuts, soymilk,tofu, tempeh 1-2 a day -fish & shellfish such as wild alsakan salmon, black cod, sardines 2-6 a week -healthy fats such as extra virifin olive oil, nutes, walnutes avocados, seeds such as hemp seeds and flaxseeds -whole and cracked grains 3-5 a day -pasta 2-3 week -1-2 a day beans and legumes 1-2 a day vegetables (raw and cooked , organic ) 4-5 a day minimum -fruits 3-4 a day

The links between gum disease , heart disease, & stroke

-low grade periodontal disease--> low grade infection will promote inflammation in the body

resources to quit smoking

-quitlines -support groups -private programs (insurance can help with the cost -nicotine chewing gum )every one to two hours -nicotine patch--> 16-24 hours -nicotine spray(need prescritption) one or two times per hour -non-nicotine prescription Bupropion hydrochloride is a medicine for depression,Varenicline is a medicine that can help reduce the cravings for nicotine and its pleasurable effects on the brain.

how many times does it take people to quit smoking?

6-8 times

Red yeast

Some red yeast rice products contain substantial amounts of monacolin K, which is chemically identical to the active ingredient in the cholesterol-lowering drug lovastatin. These products may lower blood cholesterol levels and can cause the same types of side effects and drug interactions as lovastatin. Other red yeast rice products contain little or no monacolin K. It is not known whether these products have any effect on blood cholesterol levels. Consumers have no way of knowing how much monacolin K is present in most red yeast rice products. The labels on these products usually state only the amount of red yeast rice that they contain, not the amount of monacolin K. The U.S. Food and Drug Administration (FDA) has determined that red yeast rice products that contain more than trace amounts of monacolin K are unapproved new drugs and cannot be sold legally as dietary supplements. Some red yeast rice products contain a contaminant called citrinin, which can cause kidney failure. Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. -The same types of side effects that can occur in patients taking lovastatin as a drug can also occur in patients who take red yeast rice products that contain monacolin K. Potential side effects include myopathy (muscle symptoms such as pain and weakness), rhabdomyolysis (a condition in which muscle fibers break down, releasing substances into the bloodstream that can harm the kidneys), and liver toxicity. Each of these three side effects has been reported in people who were taking red yeast rice.

salt and hypertension

You cant live a salt free cause you will die - its processed food

what happens when you dont sleep?

it messes up leptin and ghrelin -ghrelin is the craving hormone that tells you to eat -you need 7-8 hours per night to increase leptin and keep ghrelin at bay

AHA recommendations of daily added sugar limit

men: 9 teaspoons 36 grams 150 calories women: 6 teaspoons 25 grams 100 calories

Trans Fatty Acids

•A fatty acid molecule consists of a chain of carbon atoms in carbon-carbon double bonds with hydrogen atoms attached. In nature most unsaturated fatty acids are cis fatty acids. This means that the hydrogen atoms are on the same side of the double carbon bond. In trans fatty acids the two hydrogen atoms are on opposite sides of the double bond. •Trans double bonds are also formed during the hydrogenation of either vegetable or fish oils. French fries, donuts, cookies, chips and other snack foods are high in trans fatty acids. Nearly all fried or baked goods have some trans fats. In addition, to help foods stay fresh on the shelf or to get a solid product, such as margarine, food manufacturers hydrogenate polyunsaturated oils. •In clinical studies, trans fatty acids or hydrogenated fats tend to raise total blood cholesterol levels and LDL ("bad") cholesterol and lower HDL ("good") cholesterol. This information has led to policy changes concerning food labeling.

Health Consequences of Sleep Deprivation and Sleep Disorders

•Cardiovascular Issues (Hypertension, Heart Attack, Heart Failure, Stroke) •Obesity, Appetite Hormone Disturbance, Diabetes •Depression and other Mood Disorders •Increased Risk of Substance Abuse •Mental Impairment, including Memory Deficits •Injuries from Accidents, including Driving and Occupational Situations •Increased Pain Complaints

Homocysteine

•Homocysteine, Folic Acid, and Cardiovascular Disease •Homocysteine is an amino acid in the blood. Too much homocysteine is related to a higher risk of coronary heart disease, stroke, and peripheral vascular disease. Other evidence suggests that homocysteine may promote atherosclerosis by damaging the inner lining of arteries and promoting blood clots. Folic acid and other B vitamins help break down homocysteine in the body. Homocysteine levels in the blood are strongly influenced by diet and genetic factors. The American Heart Association doesn't recommend the widespread use of folic acid and B vitamin supplements to reduce the risk of heart disease and stroke. The AHA advises a healthy, balanced diet that is rich in fruits and vegetables, whole grains, and fat-free or low-fat dairy products. For folic acid, the recommended daily value is 400 micrograms (mcg). Citrus fruits, tomatoes, vegetables, and grain products are good sources. Since January 1998, wheat flour has been fortified with folic acid to add an estimated 100 micrograms per day to the average diet. Supplements should only be used when the diet does not provide enough.

Serum Triglycerides

•In the blood, triglycerides are combined with proteins to form lipoproteins. The liver synthesizes lipoproteins to transport fats to other tissues, where they are a source of energy. Fat in adipose tissue is stored energy. Elevated triglycerides may cause low HDL cholesterol (less than 40 mg/dL).

Dietary Recommendations for Elevated Cholesterol

•Lower saturated fat •Reduce trans fatty acids •Lower dietary cholesterol •Plant stanols/sterols •Increase soluble fiber •Maintain desirable weight •Include moderate physical activity

General Nutrition

•Macronutrients -Protein (4 calories per gram) -Carbohydrate (4 calories per gram) -Fat (9 calories per gram) •Micronutrients -Vitamins -Minerals •Water -50% - 60% of body weight

Stop smoking and vaping

•Nicotine causes vasoconstriction -Smoking can increase your risk for cancer of the bladder, throat, mouth, kidneys, cervix and pancreas. Carbon monoxide is a harmful gas you inhale when you smoke. Once in your lungs, it's transferred to your bloodstream. Carbon monoxide decreases the amount of oxygen that is carried in the red blood cells. It also increases the amount of cholesterol that is deposited into the inner lining of the arteries which, over time, can cause the arteries to harden. This leads to heart disease, artery disease and possibly heart attack. Nicotine is a dangerous and highly addictive chemical. It can cause an increase in blood pressure, heart rate, flow of blood to the heart and a narrowing of the arteries (vessels that carry blood). Nicotine may also contribute to the hardening of the arterial walls, which in turn, may lead to a heart attack. This chemical can stay in your body for six to eight hours depending on how often you smoke. Also, as with most addictive substances, there are some side effects of withdrawal. And some e-cigarettes and newer tobacco products deliver even more nicotine than traditional cigarettes.

Primary Prevention Strategies

•Nutrition •Physical Activity •Quit Smoking •Weight Management •Stress Management

Omega-3 Fatty Acids

•Omega-3 fatty acids have been reported to reduce serum triglycerides and inhibit platelet aggregation and inflammation, which contributes to coronary artery blockage. -good for the heart

fats

•Saturated fatty acids •Monounsaturated fatty acids •Polyunsaturated fatty acids

Sitting Disease

•Sitting more than six hours a day greatly increases your risk of an early death •Promotes obesity •Drops HDL cholesterol •Increases risk of cardiovascular disease •Goal is to increase physical activity as much as possible throughout the day

Portion Size

•Tools to Help with Portion Control •Weighing and Measuring -Equipment -Keeping a Food Journal •Use of Technology -Apps -Websites

Saturated fatty acids

•have all the hydrogen the carbon atoms can hold. Saturated fats are usually solid at room temperature and are more stable. Saturated fatty acids raise blood cholesterol.

Polyunsaturated fatty acids

•have more than one unsaturated bond. Polyunsaturated oils, which contain mostly polyunsaturated fatty acids, are liquid at room temperature and in the refrigerator. They easily combine with oxygen in the air to become rancid. Polyunsaturated fatty acids help lower total blood cholesterol when substituted for saturated fats.

Monounsaturated fatty acids

•have only one unsaturated bond. Monounsaturated oils are liquid at room temperature but start to solidify at refrigerator temperatures. Monounsaturated fatty acids seem to lower blood cholesterol when substituted for saturated fats.