01.06 Nutrition-related Diseases

This lesson is going to cover nutrition related diseases. One thing to think about with obesity is hunger vs. appetite. Hunger is more of an internal or physiological drive to find and eat food.  Appetite is more of an external, or psychological cues that encourage us to eat, often in the absence of hunger.  That’s why it’s easy to find room for dessert even when we think we are full after a meal.  One key part of appetite regulation is satiety.  It is the state of fullness.  This occurs after the meal and is how long before you feel hungry again.  Macronutrient have a different impact on satiety.  And a big part of that is with hormones.  One of the hormones is insulin and that is released in response to carbohydrate intake.  Cholecystokinin or CCK slows down the emptying of the stomach and it’s influenced by fat and protein intake.  Ghrelin is called the hunger hormone and it is impacted by carbohydrate as well as protein intake. Palatable food is food described as acceptable or very pleasant to taste. Some common ingredients include fat, sugar and salt.  These can override hunger/satiety signals – lead to overeating of these types of foods. With Type 2 Diabetes, there isn’t one diet that works for everyone.  Striving toward maintaining a healthy weight can improve the disease management.  While macronutrient distribution can still be in the ranges of the AMDR, adjustments can be made based on blood sugar regulation.  Individual assessment of eating patterns, preferences and metabolic goals. 

The Mediterranean Diet is one diet that can be used with Type 2 diabetes. And if think about the Mediterranean, it is a really broad term because it is a large region with a lot of countries in it.  And the diet isn’t just about eating a certain type of food or a couple types of food but it’s really more a lifestyle.  So it’s also about enjoying food with friends and family as well as being physically active.  Emphasis is on fruits, vegetables, whole grains, beans, nuts and seeds.  And it’s considered to be what’s called a plant-based diet.  And that means it is centered around plant foods instead of meat products.  Healthy fats are also an emphasis.  And one big source of them is olive oil due to its high monounsaturated fat content.  And also nuts and seeds are a great source of the monounsaturated fats.  And fatty fish which contains those great omega -3 fatty acids.  The fats that are avoided are trans fats and saturated fats.  Dairy products, eggs, fish and poultry are consumed in low to moderate amounts, and very little red meat is eaten.  Wine preferably red, is consumed in low to moderate amounts.  And that’s one part of the diet that seems to get a lot of attention.  Other foods that are avoided include added sugars, processed meats, refined grains and refined oils.

Similar to other chronic diseases, obesity increases the risk of hypertension/cardiovascular disease.  It can either be either be prevented, improved or reduced when a healthy weight is maintained or, if overweight, if even a modest weight loss occurs.  In addition to the Mediterranean diet, there’s also the DASH diet.  Which stands for Dietary Approaches to Stop Hypertension.

It is rich in fruits, vegetables, low fat or nonfat dairy. It also includes mostly whole grains; lean meats, fish and poultry; nuts and beans.  If you’re thinking about 2,000 calories a day diet, the number of servings for whole grains would be 6-8 oz a day, fruits would be 4-5 servings and vegetables would also be 4-5 servings a week.  Dairy both being low-fat and non-fat would be 2-3 servings, And for the lean meat and poultry, it’s no more than about 6 oz. And the nuts, seeds and legumes for the 2,000 calorie a day diet would be somewhere about 4 to 5 servings a week. 

So how do fats and oils play a role with the DASH diet?  It’s recommended that no more than 30 percent of daily calories is There’s also an emphasis on those healthy monounsaturated fats.  And trans fats and saturated fats are also limited in addition to sugar, sweets and alcohol.

With cancer, there is the impact of the disease itself which can lead to both weight loss as well as Then there’s also the side effects that can happen with the treatment.  Some of the side effects impact both the intake of food and beverage.  There can be some things such as fatigue, nausea and/or vomiting, dry mouth or mouth sores, changes in swallowing, there can also be changes in taste/smell.  So with maintaining a healthy weight with cancer, instead of weight loss, it can be more about weight maintenance or even putting on a little weight.   Part of the recommendations are for really energy and nutrient dense foods.  Because there can be a decrease in appetite, getting the most out of the foods they can take in is important.  And there are a lot of recommendations but each person is a little bit different so it can take a little experimenting to see what works best

So, what’s an important goal with osteoporosis?  It’s to prevent further loss in bone density.  And so part of a balanced diet needs to included optimal calcium and vitamin D intake because those are critical for bone health.  A few other nutrients that play a big role are Mg, K, and vitamin C as a few examples. There’s actually some things in diet can interfere with calcium absorption. One of those is phytic acid that’s found in some beans, seeds, and grains.  And oxalic acid that’s in spinach, and other leafy green vegetables.  High levels of sodium can interfere with calcium retention and alcohol, when consumed in larger amounts, can also increase bone loss. 

So, let’s sum it up.  A healthy weight is important with the management of chronic diseases.  A few diets that can be helpful are the Mediterranean as well as the DASH diet.  Cancer has an impact not only because of the disease but also with the side effects.  And key nutrients for bone health are key with osteoporosis. 

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