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.
Dr B Ravinder Reddy
Care Hospital, Hyderabad, India

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Stress, diet & disease

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

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