Lec 8 nutrition for health promotion and disease prevention 2

Improving diets and increasing levels of physical activity
in adults and older people will reduce chronic disease
risks for death and disability (WHO).
Community and Public Health
Nutrition
lec. 8-Nutrition for Health Promotion
and Disease Prevention 2
Nutrition and the chronic diseases
Prepared by
Dr. Siham Gritly
Dr. Siham M.O.Gritly 1

glossary
• chronic diseases: diseases characterized by a slow
progression and long duration. Examples include heart
disease, cancer, and diabetes.
• risk factor: a condition or behavior associated with
an elevated frequency of a disease but not proved to be
causal. Leading risk factors for chronic diseases include
obesity, cigarette smoking, high blood pressure, high
blood cholesterol, physical inactivity, and a diet high in
saturated fats and low in vegetables, fruits, and
wholegrains.

• Diabetes Mellitus; a disorder of carbohydrate
metabolism due to disturbances in production
or utilization of insulin, results in high blood
glucose levels and loss of sugar in urine

Nutrition and the chronic diseases
• Chronic diseases; are diseases of long duration
and generally slow progression.
• Chronic diseases, such as
• heart disease, stroke,
• cancer,
• chronic respiratory diseases
• diabetes,
• Disorders of the GI Tract

Ref World Health Organization, 2002
• chronic disease was related to dietary and lifestyle
• Chronic diseases are largely preventable diseases
• Diet has been known for many years to play a key
role as a risk factor for chronic diseases
• In many developing countries, food policies
remain focused only on undernutrition and are not
addressing the prevention of chronic disease.

Lifestyle and The biological risk factors that
contribute to the development of chronic
diseases:
• WHO suggested that;
• Unhealthy diets,
• physical inactivity
• and smoking are confirmed risk behaviours for chronic
diseases.
• The biological risk factors such as
• hypertension,
• obesity
• and lipidaemia are risk factors for coronary heart disease,
stroke and diabetes.

Vegetables rich in fiber, phytochemicals, and the
antioxidant nutrients (beta-carotene, vitamin C, and
vitamin E) help to protect against chronic diseases
Ref Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition,
Twelfth Edition. 2011, 2008 Wadsworth, Cengage Learning

For diet, recommendations for communities and
individuals should include the following
Diet, nutrition, and the prevention of chronic diseases. Report of a WHO Study Group.
Geneva, World Health Organization, 1990(WHO Technical Report Series, No. 797).
• achieve energy balance and a healthy weight
• limit energy intake from total fats and shift fat consumption
away from saturated fats to unsaturated fats
• the elimination of trans-fatty acids
• increase consumption of fruits and vegetables, and legumes,
whole grains and nuts
• limit the intake of free sugars limit salt (sodium)
consumption from all sources and ensure that salt is iodized

• These recommendations need to be considered
when preparing national policies and dietary
guidelines, taking into account the local situation
(WHO).
• Improving dietary habits is a societal, not just an
individual problem.
• Therefore it demands a population-based,
multisectoral, multi-disciplinary, and culturally
relevant approach.

Nutritional factors in selected diseases
• -Cardiovascular disease,
• -Diabetes,
• -Cancer
• -Obesity and weight management
• -Disorders of the GI Tract
• -nutritional anemia

Nutrition and Cardiovascular disease
• The heart is a four-chambered
organ consisting of right and left halves.
• Two of the chambers, the left and right atria,
are entry-points into the heart, while the other
two chambers, the left and right ventricles, are
responsible for contractions that send the blood
through the circulation.
• The circulation is split into the pulmonary and
systematic circulation

.
The role of the right ventricle is to pump deoxygenated
blood to the lungs through the pulmonary trunk and
pulmonary arteries. The role of the left ventricle is to
pump newly oxygenated blood to the body through the
aorta

Cardiovascular Disease (atherosclerosis)
• The major causes of death ,are diseases of the
heart and blood vessels, collectively known as
cardiovascular disease (CVD).
• Coronary heart disease (CHD) is the most
common form of cardiovascular disease and is
usually caused by atherosclerosis in the
coronary arteries that supply blood to the heart
muscle.
• Atherosclerosis is the accumulation of lipids and
other materials in the arteries

Atherosclerosis : a type of artery disease
characterized by plaques (accumulations of lipid-containing
material) on the inner walls of the
arteries

Atherosclerosis is a process in which blood, fats such
as cholesterol, and other substances build up on
artery walls. deposits called plaques.
As atherosclerosis
progresses, plaque
thickens over time,
causing arteries to
harden, narrow, and
become less elastic

Heart Attacks and Strokes
• The deposits may narrow or block arteries. These
plaques can also rupture, causing a blood clot.
• The Result: Heart Attacks and Strokes When
atherosclerosis in the coronary arteries becomes
severe enough to restrict blood flow and deprive
the heart muscle of oxygen, CHD develops.
• The person with CHD often experiences pain and
pressure in the area around the heart (angina). A
heart attack occurs.

• when blood flow to the heart is cut off and
that area of the heart muscle dies. Restricted
blood flow to the brain causes a transient
ischemic attack (TIA) or stroke.

Risk Factors for Coronary Heart Disease
• High blood LDL cholesterol
• Low blood HDL cholesterol
• High blood pressure (hypertension)
• Diabetes
• Obesity (especially abdominal obesity)
• Physical inactivity
• Cigarette smoking
• An “atherogenic” diet (high in saturated fats and
low in vegetables, fruits, and whole grains

High blood LDL cholesterol
Major lipoproteins in the blood
• Lipoproteins; clusters of lipids associated
with proteins that serve as transporter for lipids
in the lymph and blood
• The body makes four main types of
lipoproteins, distinguished by their size and
density.* Each type contains different kinds
and amounts of lipids and proteins

four main types of lipoproteins
• chylomicrons, Chylomicrons the class of
lipoproteins that transport lipids from the
intestinal cells to the rest of the body
• very-low-density lipoproteins VLDL
• low-density lipoproteins LDL
• high-density lipoproteins (HDLs).

Major lipoproteins in the blood

The body makes four main types of lipoproteins, distinguished
by their size and density.
Each type contains different kinds and amounts of lipids and
proteins

very-low-density lipoproteins
• VLDL; in the liver the most active site of lipid
synthesis—cells are making;-
• cholesterol,
• fatty acids,
• and other lipid compounds.
• the lipids made in the liver and those collected from
chylomicron remnants are packaged with proteins as
VLDL (very-low-density lipoproteins) and shipped to
other parts of the body

• As the VLDL travel through the body, cells
remove triglycerides, causing the VLDL to shrink.
• As VLDL lose triglycerides, Cholesterol becomes
the predominant lipid, and the lipoprotein density
increases. The VLDL becomes LDL (low-density
lipoprotein).
• * This transformation explains why LDL
contain few triglycerides but are loaded with
cholesterol

low-density lipoproteins LDL
• The LDL circulate throughout the body, making their
contents available to the cells of all tissues—muscles
(including the heart muscle), fat stores, the mammary
glands, and others.
• The cells take triglycerides, cholesterol, and
phospholipids to build new membranes, make
hormones or other compounds, or store for later use.
• Special LDL receptors on the liver cells play a crucial
role in the control of blood cholesterol concentrations
by removing LDL from circulation.

High-density lipoproteins(HDLs).
• The liver makes HDL to remove cholesterol
from the cells and carry it back to the liver for
recycling or disposal.
• In addition, HDL have anti-inflammatory
properties that seem to keep atherosclerotic
plaque from breaking apart and causing heart
attacks.

Health Implications
Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition, Twelfth
Edition. 2011, 2008 Wadsworth, Cengage Learning
• The distinction between LDL (bad) and HDL (good) has
implications for the health of the heart and blood
vessels.
• The blood cholesterol linked to heart disease is LDL
cholesterol.
• HDL also carry cholesterol, but elevated HDL represent
cholesterol returning from the rest of the body to the
liver for breakdown and excretion.
• High LDL cholesterol is associated with a high risk of
heart attack, whereas high HDL cholesterol seems to
have a protective effect.

• the cholesterol itself is the same in LDL and
HDL, and that the differences between LDL
and HDL reflect the proportions and types of
lipids and proteins within them—not the type
of cholesterol.
• numerous genes influence how the body
handles the synthesis, transport, and
degradation of lipids and lipoproteins

Dietary Strategies to Reduce Risk of
CHD
Energy: Balance energy intake and physical activity
to prevent weight gain and to achieve or maintain
a healthy body weight.
Saturated fat, trans fat, and cholesterol: Choose
lean meats, vegetables, and low-fat milk products;
minimize intake of hydrogenated fats. Limit
saturated fats to less than 7 percent of total
kcalories, trans fat to less than 1 percent of total
kcalories, and cholesterol to less than 300
milligrams a day

Soluble fibers:
a diet rich in vegetables, fruits, whole grains,
and other foods high in soluble fibers.
Potassium and sodium:
a diet high in potassium-rich fruits and
vegetables, low-fat milk products, nuts, and
whole grains.
• with little or no salt (limit sodium intake to
2300 milligrams per day).

adapted from; Ellie Whitney and Sharon Rady Rolfes; Under standing
Nutrition (2008),
Added sugars: Minimize intake of beverages and foods
with added sugars.
Fish and omega-3 fatty acids: Consume fatty fish rich in
omega-3 fatty acids (salmon, tuna, sardines) at least
twice a week.
Soy: Consume soy foods to replace animal and dairy
products that contain saturated fat and cholesterol.
Alcohol: If alcohol is consumed, limit it to one drink
daily for women and two drinks daily for men.

• Lifestyle Choices Strategies to Reduce Risk
of CHD
• Physical activity: Participate in at least 30
minutes of moderate-intensity endurance
activity on most days of the week.
• Smoking cessation (end): Minimize exposure
to any form of tobacco or tobacco smoke

High Blood Pressure (hypertension)
• hypertension: higher-than-normal blood
pressure. Two types;
• Essential or primary hypertension;
Hypertension that develops without an
identifiable cause
• Secondary hypertension; hypertension that is
caused by a specific disorder such as kidney
disease

• The high blood pressure is above normal, the
risk of death from CVD.
• Low blood pressure, on the other hand, is
generally a sign of long life expectancy and
low heart disease risk.
• The high blood pressure contributes to more
than a million heart attacks and half a million
strokes each year.

Arterial Blood Pressure
Expressed as systolic/diastolic
• The Cardiac Cycle or Arterial Blood Pressure :
includes all of the events between two
consecutive cycles;-
1 -Systole: contraction phase;-systolic pressure-the
blood pressure in the arteries when the heart is
contracting and pumping blood (the pressure at
which a sound of heart beat heard)
2 -Diastole: relaxation phase;-diastolic pressure-the
blood pressure in the arteries when the heart is
at rest between beats (the pressure at which the
sound disappears)

if the resting blood pressure is above normal, the
reading should be repeated before confirming the
diagnosis of hypertension
Sphygmomanometer

Classification of blood pressure for
adults (WHO)
category Systolic(mmHg) Diastolic
(mmHg)
Normal < 120 < 80
Pre-hypertension 120-139 80-89
Hypertension
*Stage one
*Stage two
140-159
> 160
90-99
> 100

Dietary Strategies to Stop Hypertension
(DASH) ,
• The following dietary plans based on;-
• USDA (United States Department of
Agriculture)
• the American Heart Association Dietary
Strategies to Stop Hypertension (DASH) ,

Dietary Strategies to Stop
Hypertension (DASH)
• The Dietary Strategies to Stop Hypertension
(DASH) recommended that;-
• diet rich in fruits, vegetables, nuts, and low-fat
milk products and low in total fat and
saturated fat have positive effect on blood
pressure.

• the DASH diet lowers total cholesterol and
LDL cholesterol.
• Compared to the typical American diet, the
DASH eating plan provides more fiber,
potassium, magnesium, and calcium and less
red meat, sweets, and sugar-containing
beverages

The DASH Eating Plan
and the USDA Food Guide
These diet plans are based on 2000 kcalories per day
Food Group DASH USDA
Grains 6–8 oz 6 oz
Vegetables 2–2 c 2 c
Fruits 2–2 c 3 c
Milk (fat-free/low-fat
2–3 c 2 c
Lean meats, poultry,
fish
6 oz or less 5. oz
Nuts, seeds,
legumes
4–5 oz per week combines nuts,
seeds, and legumes
with meat, poultry,
and fish.

• Salt/Sodium Intake control;
• The combination of the DASH diet with a limited
intake of sodium, however, improves blood pressure
better than either strategy
• the lower the sodium intake, the greater the drop in
blood pressure.
• Dietary Guidelines for Americans recommended no
more than 1500 mg of sodium per day and to meet the
potassium recommendation

• Weight Control to reduce high blood
pressure
• Weight loss alone is one of the most effective
nondrug treatments for hypertension.
• Physical activity helps with weight control,
but moderate aerobic activity, such as 30 to 60
minutes of brisk walking most days, also helps
to lower blood pressure directly.

Lifestyle Modifications to Reduce Blood
Pressure
adapted from; Ellie Whitney and Sharon Rady Rolfes; Under standing
Nutrition (2008),
Modifi cation Recommendation Expected Reduction
in Systolic Blood prssure
Weight
reduction
Maintain healthy body weight
(BMI below 25).
5–20 mm Hg/10
kg lost
DASH eating Adopt a diet rich in fruits,
vegetables, and 8–14 mmHg
low-fat milk products with
reduced saturated fat intake.
8–14 mm Hg
Sodium
restriction
Reduce dietary sodium intake
to less than 2–8 mm Hg 2400
milligrams sodium (less than 6
grams salt) per day.
2–8 mm Hg

Risk Factors for Coronary
Heart Disease
overweight and obesity
• Obesity is a disease of multiple etiologies
characterized by an excess accumulation of
adipose tissue (more than 20% of the desirable
weight) and due to
• enlargement of fat cell size (hypertrophic
obesity) or
• an increase in fat cell number (hyperplastic
obesity) or
• a combination of both.

• Body mass index (BMI) is a simple index of
weight-for-height that is commonly used to
classify overweight and obesity for both sexes
and for all ages of adults.

components of body composition
• A two-component of body composition divides
the body into;
• 1-fat component
• 2-fat-free component (Lean body mass)

Fat component
• Body fat is the most variable constituent of the body.
The total amount of body fat consists of essential fat
and storage fat.
• Fats, the energy reserve of body stored as triglycerides
in adipose tissue and under the skin and around internal
organs (bone marrow, lung, liver, spleen, kidneys,
intestine, heart and lipid rich tissues in nervous system)
• Adipose tissue is located under the skin (storage fat)
• Triglycerides are the main fat depot

• visceral fat: fat stored within the abdominal
cavity in association with the internal
abdominal organs; also called intra-abdominal
fat
• Visceral fat that is stored around the organs
of the abdomen is referred to as central
obesity or upper-body fat.

Abdominal Fat
In overweight
people, excess
abdominal fat
increases the
risks of diseases.
In healthy-weight people, some
fat is stored around the organs
of the abdomen

Apple and Pear
Body Shapes
Lower-body fat is
more common in
women than in
men and is not
usually associated
with chronic
diseases.
central obesity is
associated with
increased risks of
heart disease, stroke,
diabetes, insulin
resistance,
hypertension,
gallstones, and some
types of cancer.
Upper-body fat is more common in men than in
women and is closely associated with heart
disease, stroke, diabetes, hypertension, and
some types of cancer.

Causes of Obesity
• Genetic factors
• Psychological factors
• Hormonal imbalance
• Sedentary lifestyle
• Excess consumption of calorie rich foods.
• If a person is obese it is very essential to know
the hazardous consequences of obesity

Health Consequences of Obesity
www.cdc.gov/chronicdisease/resources/publications/aag/obesity.htm
• Obesity increases the risk of many health conditions,
including the following:
• Coronary heart disease, stroke, and high blood pressure.
• Type 2 diabetes.
• Cancers, such as breast, and colon cancer.
• High total cholesterol or high levels of triglycerides.
• Liver and gallbladder disease.
• respiratory problems.
• Degeneration of cartilage and underlying bone within a joint
(osteoarthritis).
• Reproductive health complications such as infertility.
• Mental health conditions.

five target areas identified by CDC for
preventing and reducing obesity
• Increase consumption of fruits and vegetables.
• Increase physical activity.
• Increase breastfeeding
• Decrease consumption of sugar drinks.
• Decrease consumption of high-energy-dense
foods, which are high in calories.

Management of obesity
• There are three basic components for the
reduction of weight:
• Diet
• Exercise
• Behavior modification

What is diabetes?
• Diabetes is a chronic disease that occurs either
when the pancreas does not produce enough
insulin or when the body cannot effectively use
the insulin it produces.
• Hyperglycaemia, or raised blood sugar, is a
common effect of uncontrolled diabetes and over
time leads to serious damage to many of the
body's systems, especially the nerves and blood
vessels.

• WHO projects stated that diabetes will be the
7th leading cause of death in 2030
• Healthy diet, regular physical activity,
maintaining a normal body weight and
avoiding tobacco use can prevent or delay the
onset of type 2 diabetes

• diabetes mellitus are of two types either;
• 1- Type 1 DM; (insulin-dependent, juvenile or childhood-onset)
people cannot produce insulin.
it results from the body's failure to produce insulin, and
presently requires the person to inject insulin.
Symptoms include excessive excretion of urine (polyuria),
thirst (polydipsia), constant hunger, weight loss, vision
changes and fatigue. These symptoms may occur
suddenly.

• 2- Type 2 DM; (non-insulin-dependent or adult-onset)
the insulin they produce is ineffective in
stimulating the uptake of blood sugar (glucose)
into the body's cells.
• Symptoms may be similar to those of Type 1
diabetes, but are often less marked. As a result,
the disease may be diagnosed several years after
onset, once complications have already arisen.
• Until recently, this type of diabetes was seen only
in adults but it is now also occurring in children.

Hypothalamus
Response of hypothalamus to blood glucose
level
If the sugar levels in the
blood fall far below their
usual range, the brain
(hypothalamus) responds
by stimulating;
*the adrenal glands,
*the pancreas and
* the pituitary gland

Response of hypothalamus to blood glucose
level
• the brain (hypothalamus) responds by
stimulating;
• *the adrenal glands to release, 1-adrenaline
or norepinephrine, 2-epinephrine and 3-
cortisol,
• 1-adrenalin or norepinephrine, increase energy in
the form of glucose and free fatty acids mainly
during activities or exercise

• 2-Epinephrine stimulate the liver to release
glucose and accelerates the use of glycogen in
the muscle
• 3-cortisol, release of amino acids from muscle
tissue to provide substrate to liver for
gluconeogenesis

The Adrenal Gland
adrenalin, epinephrine and cortisol

the pancreas
the endocrine pancreas, secretes hormones called
insulin and glucagon.These hormones regulate
the level of glucose in the blood.
These hormones have
competing functions;
-insulin stimulates glucose
uptake by body tissues,
- glucagon increase the rate
of gluconeogenesis in the
liver and help to increase
blood glucose levels

insulin a hormone secreted by special cells in the pancreas in
response to (among other things) increased blood glucose
concentration. The primary role of insulin is to control the transport of
glucose from the bloodstream into the muscle and fat cells.

glucagon: a hormone that is secreted by special cells in the
pancreas in response to low blood glucose concentration and
elicits release of glucose from liver glycogen stores.

the pituitary gland
hypothalamus stimulate
the pituitary gland to
release growth hormone,
all of which cause the
liver to regulate glucose
into the blood

• Gestational diabetes
• Gestational diabetes is hyperglycaemia with
onset or first recognition during pregnancy.
• Symptoms of gestational diabetes are similar
to Type 2 diabetes.
• Gestational diabetes is most often diagnosed
through prenatal screening, rather than
reported symptoms.

• Impaired glucose tolerance (IGT) and
impaired fasting glycaemia (IFG)
• Impaired glucose tolerance (IGT) and impaired
fasting glycaemia (IFG) are intermediate
conditions in the transition between normality
and diabetes. People with IGT or IFG are at
high risk of progressing to type 2 diabetes,
although this is not inevitable.

What are common consequences of diabetes?
• Over time, diabetes can damage the heart, blood
vessels, eyes, kidneys, and nerves.
• Diabetes increases the risk of heart disease and
stroke.
• Combined with reduced blood flow, neuropathy
(nerve damage) in the feet increases the chance of
foot ulcers, infection and eventual need for limb
amputation.

• Diabetic retinopathy is an important cause of
blindness, and occurs as a result of long-term
accumulated damage to the small blood vessels in
the retina.
• Diabetes is among the leading causes of kidney
failure
• The overall risk of dying among people with
diabetes is at least double the risk of their peers
without diabetes.

Nutrition and Diabetes
• Goals of nutritional therapy
• Achieve physiologic blood glucose levels
• Maintain desirable plasma lipid levels
• Reduce complications of diabetes mellitus
• Retard development of atherosclerosis
• Provide optimal selection of nutrients

• Attain and maintain desirable body weight
• Individualize to preferences and food
available.
• Address special requirements (such as
pregnancy)
• Tailor for therapeutic needs (such as renal
failure

Calorie Requirement Based on Weight/age.
• Ref Advances in Diet Therapy by VIMLA
• An excessive calorie intake results in weight
gain and obesity
• See page 160

• Carbohydrates
• The present recommendation is to provide
generous amounts of complex carbohydrates
and fibre and restricted fat.
• Carbohydrates should provide 50 – 60 per cent of
energy
• Complex carbohydrates should account for
approximately 2/3 of total carbohydrate. Among
this,
• 60 – 70% should be complex carbohydrate
• 30 – 40% should be simple carbohydrate

Glycemic index
• Glycemic index represents a ranking system
relative to the effect that consumption of 50
grams of particular carbohydrates that influence
blood glucose within 2 hours.
• The values that used to rank glycemic index of
food as follows;-
*70 or more------high GI
*69-55------------medium GI foods
*55 or less--------low GI foods
A glycemic index GI value tells only how rapidly a
particular carbohydrate turns into sugar

• Protein
• Protein should provide 12 – 20% of energy intake
• An additional 30 g may be necessary during
pregnancy and lactation
• Protein requirement is increased in malnutrition,
surgery or wound healing.
• In insulin dependent diabetics adequate dietary
protein (1 – 1.5g/kg body weight) is necessary for
growth and development.
• Protein from vegetable source is preferable to that
from animal sources

• Fat
• Diabetes of all types have a greater incidence
of hyperlipidemia and atherosclerosis than do
the nondiabetics.
• High fat diets offer short term benefits for
glycomic control

The Healthy Eating Pyramid

Cancer
ref WHO Fact sheet N°297. Reviewed January 2013
• Cancer is a leading cause of death worldwide,
accounting for 7.6 million deaths (around 13%
of all deaths) in 2008.
• Lung, stomach, liver, colon and breast cancer
cause the most cancer deaths each year.
• The most frequent types of cancer differ
between men and women.

• About 30% of cancer deaths are due to the five
leading behavioral and dietary risks:
• high body mass index,
• low fruit and vegetable intake,
• lack of physical activity,
• tobacco use,
• alcohol use.

What is cancer
• Cancer is a generic term for a large group of diseases
that can affect any part of the body. Other terms used
are malignant tumours and neoplasms.
• cancer is the rapid formation of abnormal cells that
grow beyond their usual boundaries, and which can
then invade adjoining parts of the body and spread to
other organs.
• This process is referred to as metastasis. Metastases is
the spread of cancer from one part of the body to
another
• Metastases are the major cause of death from cancer.

What causes cancer?
• Cancer arises from one single cell. The
transformation from a normal cell into a
tumour cell is a multistage process, typically a
progression from a pre-cancerous lesion to
malignant tumours.
• These changes are the result of the interaction
between a person's genetic factors and three
categories of external agents, including:

• 1-physical carcinogens, such as ultraviolet
and ionizing radiation;
• 2-chemical carcinogens, such as asbestos,
components of tobacco smoke, aflatoxin (a
food contaminant) and other food containing
carcinogens; and
• 3-biological carcinogens, such as infections
from certain viruses, bacteria or parasites.

Nutrition and Cancer
Cruciferous vegetables,
such as cauliflower,
broccoli, and brussels
sprouts, contain
nutrients and
phytochemicals that
may inhibit cancer
development.

Recommendations for Reducing Cancer
Risk
• Body fatness: normal range of body weight.
• Physical activity: Be physically active as
part of everyday life.
• Limit consumption of energy-dense foods and
avoid sugary drinks. Consume energy-dense
foods (>225 kcalories/100 grams food),

• Plant foods: Eat mostly foods of plant origin.
Eat at least five servings of a variety of non
starchy vegetables and fruits every day. Eat
relatively unprocessed grains and/or legumes with
every meal. Limit refined starchy foods
• Animal foods: Limit intake of red meat and
avoid processed meat. Eat no more than 18
ounces of red meat a week, very little if any of
which is processed.
• Alcoholic drinks: Limit alcoholic drinks

• Preservation, processing, preparation:
Limit consumption of salt and avoid moldy
grains or legumes.
• Avoid salt-preserved, salted, or salty foods.
• Limit consumption of processed foods with
added salt to ensure an intake of less than 6
grams of salt (2.4 grams of sodium) a day.
• Do not eat moldy grains or legumes

• Dietary supplements: Aim to meet
nutritional needs through diet.
• Dietary supplements are not recommended for
cancer prevention.

• To minimize carcinogen formation during
cooking:
• • Roast or bake meats in the oven.
• • When grilling, line the grill with foil, or wrap
the food in foil.
• • Take care not to burn foods.
• • Marinate meats beforehand.

Disorders of the GI Tract
nutrition

the upper GI tract
Upper GI tract —
mouth, pharynx,
esophagus and
stomach. The stomach
leads to the small
intestine

the lower GI tract
Lower GI tract — intestines
(bowel) and the anus. The
bowel is made up of two
sections:
Small intestine — the
duodenum, jejunum and ileum
Large intestine — the rectum
(where the appendix is
attached), colon and rectum
In addition, the liver, pancreas
and gallbladder

the lower GI tract
Common Intestinal
Problems;
Intestinal gas or flatulence
Constipation
Diarrhea
Steatorrhea

Diseases of Small Intestine
• Celiac disease
• Caused by inappropriate autoimmune reaction to
gliadin (found in gluten) Results in damage to
villi of intestinal mucosa – atrophy, flattening
• Brush border enzyme deficiencies; Deficiency
of brush border disaccharidases, Lack of sucrase,
isomaltase, lactase in newborns
• Inflammatory Bowel Disease such as Crohn’s
disease May involve any part of GI,
Inflammation, ulceration, abcesses, fistulas

Diseases of Large Intestine
• Irritable Bowel Syndrome; Abdominal pain,
bloating, abnormal bowel movements,
irregular diarrhea, constipation
• Diverticular Disease; Sac-like herniations or
outpouches of the colon wall
• Colon Cancer

references
• http://www.webmd.com/hiv-aids/guide/nutrition-hiv-aids-enhancing-quality-
life
• Key TJ. The effect of diet on risk of cancer. Lancet, 2002, 360:861-868.
• Sareen Gropper, Jack Smith and James Groff, Advanced Nutrition and
Human Metabolism, fifth ed. WADSWORTH
• Melvin H Williams 2010; Nutrition for Health, Fitness and Sport. 9th ed,
McGraw Hill
• World Cancer Research Fund/American Institute for Cancer Research,
Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global
Perspective (Washington, D.C.: AICR, 2007), pp. 373–390.
• Heymsfield, SB.; Baumgartner N.; Richard and Sheau-Fang P. 1999.
Modern Nutrition in Health and Disease; Shils E Maurice, Olson A.
James, Shike Moshe and Ross A. Catharine eds. 9th edition
• Guyton, C. Arthur. 1985. Textbook of Medical Physiology. 6th edition,
W.B. Company

• Ellie Whitney and Sharon Rady Rolfes; Under standing Nutrition, Twelfth
Edition. 2011, 2008 Wadsworth, Cengage Learning
• http://www.livestrong.com/article/354549-the-effect-of-exercise-on-the-cardiorespiratory-
system/#ixzz2UUaL51TH
• http://www.mayoclinic.com/health/medical/IM00642
• Scott K. Powers & Edward T. Howley; Theory and Application to Fitness
and Performance, 6th edition. EXERCISE PHYSIOLOGY
• Sports Fitness Advisor: The Cardiovascular System and Exercise
• Read more: http://www.livestrong.com/article/192489-immediate-effects-of-
exercise-on-the-cardiovascular-system/#ixzz1miWxuYrs
• Diastolic Blood Pressure During Exercise | eHow.com
• Lactate Theshold Training. Len Kravitz, and Lance Dalleck,

Lec 8 nutrition for health promotion and disease prevention 2

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (17)

Similar to Lec 8 nutrition for health promotion and disease prevention 2

Similar to Lec 8 nutrition for health promotion and disease prevention 2 (20)

More from Siham Gritly

More from Siham Gritly (20)

Lec 8 nutrition for health promotion and disease prevention 2

Editor's Notes