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Note Current omega 6 to omega 3 dietary ratio in Western countries is 15-16.7 to 1

Note Current omega 6 to omega 3 dietary ratio in Western countries is 15-16.7 to 1 ideal ratio is < 4:1 links on 2105 webpage re obesity. CVD mortality relative to those who consumed 8% of daily calories from added sugar there is:

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Note Current omega 6 to omega 3 dietary ratio in Western countries is 15-16.7 to 1

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  1. Note Current omega 6 to omega 3 dietary ratio in Western countries is 15-16.7 to 1 ideal ratio is < 4:1 links on 2105 webpage re obesity

  2. CVD mortality relative to those who consumed 8% of daily calories from added sugar there is: -roughly triple the CVD mortality for those who consumed 25% of daily calories from added sugar -double the CVD mortality for those who consumed 21% of daily calories from added sugar Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults Quanhe Yang, PhD1; Zefeng Zhang, MD, PhD1; Edward W. Gregg, PhD2; W. Dana Flanders, MD, ScD3; Robert Merritt, MA1; Frank B. Hu, MD, PhD4,5 JAMA Intern Med. Published online February 03, 2014. doi:10.1001/jamainternmed.2013.13563

  3. CVD mortality These results remained significant after adjusting for conventional CVD risk factors, including total serum cholesterol and high blood pressure, as well as other factors, such as physical activity levels and body mass index. American Heart Association recommends that women should consume no more than 100 calories (6 teaspoons) a day from added sugar, while men should consume no more than 150 calories (9 teaspoons) a day from added sugar. WHO recommends that less than 10% of a person's total daily calorie intake should be from added sugar US Institute of Medicine states that added sugar should make up no more than 25% of total daily calories.

  4. AHA- tips to reduce added sugars in our diets • Purchase sugar-free or low-calorie beverages • Try cutting back on the amount of sugar personally added to food and drinks, such as pancakes, coffee and tea • Avoid fruit canned in syrup. Instead, go for fruit canned in water or natural juice • Add fresh fruit to cereal or oatmeal instead of sugar • Add spices such as ginger or cinnamon to enhance foods instead of using sugar • When baking cakes, cut the amount of sugar used by one third to one half • Try non-nutritive sweeteners- such as aspartame, sucralose or saccharin - in moderation.

  5. Note Exam Monday, 3 March at 12:50 in class 65 minutes, bring a calculator and answer in pen -55 multiple choice questions-55 points -1 short answer question-10 points -all Nutrition 2105 material to and inclusive of 10 February 2013-strong emphasis on online notes-review on 24 February

  6. Lecture 6a 10 Feb. 2014 Hypertension Pathology Nutritional Intervention Nutraceutical Approaches

  7. Group activity Better to manage blood pressure with diet or drugs?

  8. PATHOLOGY OF HYPERTENSION INVOLVES THESE FACTORS Water volume-volume to space ratio Blood viscosity-gooeyness of blood Vasodilation-blood vessel lumen expansion Vasoconstriction-blood vessel lumen constriction

  9. Pathology-Water volume -affected by kidney function -affected by blood salt concentration due to osmosis

  10. Pathology- blood viscosity -salt in blood mildly increases blood viscosity -fat load-cells are more difficult to shove through tiny spaces if loaded with saturated fat and cholesterol- increased cellular saturated fat and cholesterol make the blood cells less pliable and thus blood is more viscous - as the cholesterol to phospholipid ratio goes up in cells they are less pliable and hence the blood is more viscous and are tougher to shove through tiny spaces

  11. Pathology- Vasodilation- ability of artery to expand -important to overcome volume to space ratio -saturated fat makes walls stiffer and vasodilation more difficult -cholesterol influx makes vasodilation even more important since cholesterol can reduce lumen size

  12. Pathology- Vasoconstriction -occurs when cholesterol and other lipids infiltrate the arterial wall -calcium follows causing stiffening of the arteries and a reduced ability of the arteries to vasodilate

  13. What can be done nutritionally ? Group discussion- what are the food groups that affect blood pressure- how?

  14. What are the nutritional interventions ? Water volume Reduce dietary salt intake to 2000 mg Na/day (or x milligrammes of NaCl/day) –particularly in salt sensitive persons as this will: -reduce osmotic pressure -reduce blood pressure which can keep kidney able to regulate water volume

  15. Nutritional interventions -Water viscosity -reduce salt load- overcomes the osmosis factor discussed above. -fat load-reduce saturated fat and cholesterol to encourage cell pliability via decreased saturated fat in the cell walls combined with a decreased cholesterol:phospholipid ratio in the cell walls -fat load reductions accomplished by table 6

  16. Nutritional interventions -Vasodilation- ability of artery to expand -important to overcome volume to space ratio -reduce saturated fat and cholesterol and increase monounsaturated and polyunsaturated fat intakes -makes walls less stiff and vasodilation easier -also diets rich in fruits, vegetables and low fat dairy products help in this regard

  17. Nutritional interventions -Vasodilation- -monounsaturated and polyunsaturated fats also displace saturated fats and reduce cholesterol synthesis in the body -cholesterol influx makes vasodilation even more important since cholesterol can reduce lumen size -increase potassium intake as potassium helps with vasodilation

  18. Nutritional interventions -Vasoconstriction -nutritional interventions as above

  19. Nutraceuticals Class activity-better to use nutraceuticals or drugs to combat blood pressure

  20. Nutraceuticals-Water volume To improve kidney function reduce blood pressure -less chance of renal failure No nutraceuticals have been proven to reduce water volume

  21. Nutraceuticals -Water viscosity Gamma-linolenic and dihomogammalinolenic and alpha-linolenic and eicosapentaenoic acids are all polyunsaturated fatty acids and they displace saturated fatty acids in the cell membranes thus increasing cell membrane fluidity Increases in cell membrane fluidity-reduced resistance posed by cells as they squeeze through tiny spaces

  22. Nutraceuticals-Vasodilation- ability of artery to expand Gamma linolenic acid produces dihomogammalinolenic acid (DGLA) and DGLA produces prostaglandin I1 (PGI1)and prostaglandin E1(PGE1) Alpha-linolenic acid produces eicosapentanenoic acid (EPA) and EPA produces prostaglandin I3 (PGI3) PGI1 and PGE1 and PGI3 are all vasodilatory eicosanoids

  23. Nutraceuticals-Vasodilation- ability of artery to expand Any of these fatty acids in the previous slide reduce the production of vasoconstrictory thromboxane A2 which is derived from arachidonic acid Such a reduction in TxA2 results from decreased availability of arachidonic acid Garlic capsules increases vasodilatory nitric oxide

  24. Concept of reverse nutraceutical-avoid excessive alcohol -excessive alcohol can raise triglycerides

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