Stress, diet & disease
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Stress, diet & disease

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This ppt covers the role of diet in various diseases and the effects of excessive stress and gives an overview of the optimal diet in various non-communicable diseases....

This ppt covers the role of diet in various diseases and the effects of excessive stress and gives an overview of the optimal diet in various non-communicable diseases.
Dr B Ravinder Reddy
Care Hospital, Hyderabad, India

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Stress, diet & disease Stress, diet & disease Presentation Transcript

  • Dr B Ravinder Reddy
    MBBS, MS, FRCS (Edinburgh), FRCS (Glasgow)
    Consultant Gastrointestinal & General Surgeon
    Chief – Division of Clinical Nutrition
    Care Hospitals
    Hyderabad
    bravinderreddy@doctor.com
  • Dept. of Surgical Gastroenterology &
    Division of Clinical Nutrition
    Greetings From Care Hospital, Hyderabad
    www.carehospitals.com
  • Diet & Disease
    Nutrition is of interest to Everyone!
    Impoverished
    Scientists
    Community Worker
    Over Nourished
    Under Nourished Pts
    Food Industry (FF&N)
    Aesthetic & Cosmesis
    Clinicians & Nutritionists
  • Diet & Disease
    Diet related diseases are spreading throughout the world across all age barriers, affecting many children as well as adults
    Recent WHO statistics:
    One Billion Adults Are Overweight!
    300 Million Adults Are Obese!
    Puska P et al. WHO strategy on diet, physical activity and health.
    Data and Statistics. Geneva: WHO; 2007
  • Diabesity
  • Front Cover
  • Diet & Disease
    In the past two decades our understanding of food and nutrients that promote good health has grown substantially
    Owing to studies of molecular mechanisms of various diseases and the effects of various nutrients
  • Diet
    Will Not Keep The Stress Away!
  • Diet Helps To CopeWith Stress
    =
    +
    Lifestyle
    Dietary Factors
  • Diet & Disease
    A wrong diet can be a major cofactor
    in causing various diseases and
    aggravating the various stressors!
  • Diet & Disease
    After eating a calorie dense diet
    ↑Saturated Fats
    ↑ Refined CH
    ↑ Fibre
    Is Very Common!
  • Stress, Diet & Disease
    This diet is associated with
    Hyperglycemia
    Hypertriglyceridemia
    Increase in free radicals (pro-oxidant state)
    Increase in cytokines (pro-inflammatory state)
  • Stress, Diet & Disease
    This in turn is associated with:
    Endothelial dysfunction
    Increase in free radicals
    Increase in inflammation
  • Stress &
    Wrong Diet
    Insulin
    Resistance
    Inflammation
     ROS, TNF, IL6, IL18
    Obesity
    Visceral
    Metabolic Syndrome
    Type 2 Diabetes
    Atherosclerosis
  • Stress, Diet & Disease
    High Fat, Refined Carbohydrate Diet
    Insulin Resistance / Hyperinsulinemia
  • Diet & Disease
    High Fat, Refined Carbohydrate Diet
    Blood
    Insulin Resistance / Hyperinsulinemia
      IGF
     Free IGF
     Testosterone
     Estradiol
     Estradiol
  • Diet & Disease
    High Fat, Refined Carbohydrate Diet
    Blood
    Insulin Resistance / Hyperinsulinemia
      IGF
     Free IGF
     Testosterone
     Estradiol
     Estradiol
    Tumor Promotion
  • Correct Diet & Stress Management Can Prevent:
    Metabolic Syndrome
    Diabetes Mellitus
    Cardiovascular Disease
    Cancer
    Obesity
    Dyslipidemia
  • Diet & Disease: Preventive
    Diabetes Mellitus: 91% reduction*
    Cardiovascular Disease: 83% reduction*
    Cancer: 71% reduction (colon cancer)*
  • Stress, Diet & Disease: Therapeutic Roles
    Acute illness (critically ill, pancreatitis, MOF)
    Chronic diseases (MS, DM, HBP, CVD,)
    Inflammatory bowel diseases (UC & CD)
    Irritable bowel syndrome
    Autoimmune diseases
    Congenital & metabolic diseases (lactose intolerance, cystic fibrosis etc)
    HIV
  • Stress, Diet & Disease
    Can Appropriate Diet
    Prevent or Treat
    All Diseases?
    NO!
  • Diet & Disease
    A select few types of diets have shown
    to be effective as per their respective claim*
    *By scientific investigations & clinical trails
  • Diet & Disease
    Fibre (25 – 50 gms)
    Reduces Cardiovascular Diseases*
    Reduces LDL Cholesterol
    Provides SCFA
    Avoids Constipation
    *The first health claim allowed by US Government
    FDA, US Department of Health and Human Services
    FDA proposes health claim for oatmeal & oat bran. Jan 11, 1999
  • Diet & Disease
    Soy Protein(35 – 45 gms)
    Reduces Cardiovascular Diseases*
    Reduces LDL Cholesterol & Triglycerides
    Antioxidant, Antiproliferative, Antimigratory
    Reduces Atherosclerosis
    Phytoestrogens
    *Due to its amino acid profile which differs from animal protein
    FDA, US Department of Health and Human Services
    FDA proposes health claim for soy protein & hear disease.
    Oct 26, 1999
  • Diet & Disease
    Omega - 3 Fatty Acids
    The best known nutrient, has been extensively studied
    Ratified by US FDA & AHA to reduce CVD and for use of supplements of FO for CHD patients
  • Diet & Disease
    Omega - 3 Fatty Acids
    Reduces inflammation by inhibiting cytokines
    Inhibits mitogens
    Inhibits thrombosis
    Inhibits antherosclerosis
    Reduces TG
    Increases NO production
    Is beneficial in autoimmune diseases, IBD, RA
    Forms important aspect of nervous system
    1 to 2 gms
  • Diet & Disease
    Without Omega - 3 Fatty Acids
  • Diet & Disease
    Omega - 3 Fatty Acids
    Connor WE. Importance of n-3 fatty acids in health & disease. Am J Clin Nutr 2000;71
  • Diet & Disease
    Synbiotics
    Probiotics
    Are bacteria containing foods
    Alter the bacterial composition of gut by adding bacteria
    Prebiotics
    Act as substrate to the gut bacteria
    Alter the bacterial composition by changing the substrates
  • Diet & Disease
    Synbiotics
    Immunity of the gut largely depends on type of micro-organisms
    Alter the gut bacterial colonies
    Reduce permeability of harmful micro-organisms
  • Diet & Disease
    Synbiotics
    Strengthen intestinal immunity through IgA & inflammatory responses
    Decrease levels of enzymes, mutagens & 20 bile salts, thereby reducing the incidence of colon cancer
  • Diet & Disease
    Synbiotics
    Produce SCFA
    SCFA reduce pH of colon, increase proliferation of normal epithelium, suppressing abnormal cells, thereby reducing incidence of cancer
    SCFA also help in absorption of iron
  • Diet & Disease
    Synbiotics
    All these benefits are not JUST due to replacing the bacteria…
    Recent evidence suggests that it is the secondary products* produced by these probiotics that are responsible for the beneficial bioactivity
    *SCFA, Short Bioactive Peptides
    (cleaved from milk & other proteins)
  • Alcohol
  • Alcohol
    Beneficial effects within 2 weeks!
    “Moderate alcohol”:
    Men - 2 drinks per day
    Women – 1 drink per day
  • Alcohol
    One Drink?
  • Alcohol
    “One Drink*”
    *1 ounce = 30 mls
    Beer - 12 ounces* ( 360 mls)
    Wine - 5 ounces (150 mls)
    Spirits - 1.5 ounces (45 mls)
    2005 Dietary Guidelines Committee report. U.S. Department of Health & Human Services. http://www.health.gov/Dietary Guidelines/dga2005/report.
  • Alcohol
    Benefits
    Increases HDL
    Reduces CVD
    Anti-thrombotic (reduces fibrinogen & TPA)
    Side Effects
    1 gram = 7 calories
    1 drink = 21 grams
    30g/day  Triglycerides
    Cardiomyopathy, HBP
    CLD, AP, GERD
  • Nutrigenomics
    “Personalised Nutrition”
    This involves application of evidence based nutrition as per the person’s genetic makeup!
    Individualised nutritional intervention rather than the traditional or general approach to maintain good health appears to be more appropriate
  • Nutrigenomics
    “Personalised Nutrition”
    Nutrigenomics is promising!
    Is still in the early stages
    In due course of time, a more accurate and effective recommendations can be tailor made on individual basis!
  • Till nutrigenomics is available…
  • Let thy food be thy medicine…
    And the medicine be thy food!
  • Physical Activity, High Fibre, Low Fat
    Stress Reduction Methods
  • Diet & Disease
    9 to 11 servings per day
    25 gms dietary fibre
    Substituting soy for animal protein
  • Diet & Disease
    Fish 2 times a week
    Nuts 1 ounce / day
    Moderate alcohol 1-2 drinks / day
    Regular Physical Activity
    Lifestyle Changes
  • Stress, Diet & DiseaseStress Reduction Methods
  • Only
    Medicines Without Nutrition & Stress Reduction
  • “Futulis” Attempt of Danaides
    We Will Also Be Confronted With Such Futile
    Situations
  • “Futulis” Attempt of Danaides
    If We Do Not Control Our Stress &
    Supplement Our Diet With Correct Nutrients!
  • Stress
    Is the price we pay for becoming more civilised and sophisticated!!
    It is inevitable!!
  • PrescriptionsLifestyle, Stress ↓ & Diet
  • References
    www.teachhealth.com
    www.residentassistant.com
  • Many Many Thanks
    ?
    bravinderreddy@doctor.com