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Chronic Disease, it's mostly Diet.ppt
- 1. HEALTH??? Healthy Lifestyle Diet andNutrition Exercise and weight control Avoidance of Injuries Mental and Emotional Health MVA ALCOHOL SMOKING HYGIENE STRESS MANAGEMENT INTERPERSONAL RELATIONS OBESITY
- 2. Nutrition and Learning Obesityand chronic diseases • Paediatric malnutrition • Morning fasting(skipping breakfast) • Vitamins and Mineral deficiency • High sugar and ADHD?? • High sugar and Hypoglycemia and obesity • Obesity leading cause of death • Youth diet indiscretions and adult diseases • WHO...exponential increase in chronic diseases by 2050 • Parenting… most complex machine came with no MANUAL • USA… pull Junk from schools...restrict adverts to kids • Are we careful about the type gas and oil we put in our cars?!!
- 3. Malnutrition / Obesity TheProblem The Link The Evidence The Solution Dr. Clifton Reid
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- 5. Leading Causes ofDeath- 2001 0 500 1000 1500 2000 Stroke Heart Disease Diabetes Hypertension Other external cause Prostate Cancer HIV Pneumonia Other Cancers Lung Cancer Breast Cancer Cervix Cancer Registrar General’s Department
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- 8. GLOBE’S NEWEST EPIDEMIC •Figures shot up 50% over last 10 years • Growth Fastest Among Children • 200M kids in 1995 to 300M in 2003 • 1.7 Billion of the World’s 6.0 Billion People • It Affects:- 80% of World’s 176M Diabetics - 40% of Uterine Cancers - 25% of Kidney Cancers - 10% of Breast and Colon Cancers - 21% of Heart Disease
- 9. Latest Obesity Statistics •USA Obesity Rates Reach Epidemic Proportions • 58 Million Overweight; 40 Million Obese; 3 Million morbidly Obese • Eight out of 10 over 25's Overweight • 78% of American's not meeting basic activity level recommendations • 25% completely Sedentary • 76% increase in Type II diabetes in adults 30-40 yrs old since 1990
- 10. "Child Obesity isChild Abuse!" --Ron Jones, Child Health Advocate
- 11. Fat Distribution • Androidvs. gynoid • Visceral vs. subcutaneous • WHR > 1.0 men • WHR > 0.8 women • DEXA, CT, MRI, TBW etc
- 12. Measures of obesity •Body weight • Body Mass index • Skin fold measurements • Waist circumference
- 13. Measures of Obesity 2 m) in (Height kg in Weight BMI BMI and waist circumference are the best measures of obesity
- 14. BMI categories BMI Cut-offpoint Diagnosis <18.5 Chronic energy deficient/ Undernourished 18.5-24.9 Normal 25.0-29.9 Overweight 30.0-39.9 Obesity > 40 Morbid Obesity
- 15. Predictors of weightgain • Parental overweight • Lower socioeconomic status • Smoking cessation • low level of physical activity • Infancy and childhood overweight • Low metabolic rate (hypothyroidism) • Lack of parental knowledge of child’s sweet eating habits • Recent marriage • Multiple births
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- 18. Co-morbidities • Hypertension • Type2 diabetes • Dyslipidaemia • Coronary artery disease • Peripheral vascular disease • Obstructive sleep apnoea • Osteoarthritis • Gall stones • Stress incontinence • GERD • Cancer (uterus, breast, colon, prostrate) • Gout • Venous thrombo-embolism • Polycystic ovary syndrome • Benign intracranial HTN • Tobacco use (to lose weight) • Asthma • Type 1 diabetes • Slipped capital femoral epiphyses
- 19. Fat as theMacronutrient Culprit Adapted from WHO Consultation 1998 Protein Carbohydrat e Fat Energy content per g Ability to end eating Ability to suppress hunger Storage capacity Pathway to transfer excess to alternative compartment Ability to stimulate own oxidation 4 High High Low Yes Excellent 4 Moderate High Low Yes Excellent 9 Low Low High No Poor
- 20. Energy density isour enemy Patty 300-450 kcal 1 cookie 50 kcal Soda 150 kcal Candy bar 225 kcal Large fries 400 kcal Whopper 660 kcal
- 21. C Energy Balance: Intake vsExpenditure
- 22. Mean SBP byBMI and age group: 5062 men from ISHIB.
- 23. HTN & Obesity Prevalenceof Hypertension U n d e r n u t r i t i o n N o r m a l O v e r w e i g h t O b e s e 0 5 10 15 20 25 30 35 40 45 Male Female BMI %
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- 25. Medications Aging INSULIN RESISTANCE Atherosclerosis Genetics Obesity and inactivity Rare disorders PCOS Dyslipidemia Hypertension Type 2 diabetes InsulinResistance: Causes and Associated Conditions
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- 27. Man lives onone quarter of what he eats. On the other three quarters lives his doctor -inscription on an Egyptian Pyramid 3800 B.C.
- 28. Eat to Live! Live toEat! Energy intake
- 30. Health = NutrientDensity Caloric Density
- 31. • Phytonutrients • Vitamins •Minerals • fibres • Carbohydrates • fats • Proteins H = N C
- 32. Nutrients 1. Macronutrients • Fat •Protein • Carbohydrates 2. Micronutrients • Vitamins • Minerals • Phytonutrients • Fibre
- 33. Nutrients • Green Vegetables •Legumes and Beans Protein Fat Carbohydrates Slice 4 Protein Fat Carbohydrates Slice 4
- 34. Fat Oils Sweets Milk Meat Yogurt Poultry CheeseDry Bean Fish, Eggs Nuts Vegetables Fruits Breads, Cereals Rice, Pasta Official Food Guide Pyramid Use sparingly 2 – 3 servings daily 3 – 5 servings daily 6 - 11 servings daily 2 - 4 servings daily 2 - 3 servings daily
- 35. Fat Oils Sweets Eggs Poultry/Fish Low-Fat Dairy Beans, OtherLegumes Nuts & Seeds Whole Grains Brown Rice Fruits Bulgar, Quinoa Vegetables ½ raw and ½ cooked Healthy Diet Food Pyramid No more than 4 x monthly No more than 4x per week 1 – 2 servings daily OR 5% - 20% of calories 2 – 4 servings daily OR 15% - 30% of calories 4 – 6 servings daily OR 15% - 30% of calories 6 – 10 servings daily OR 30% - 60% of calories
- 36. Weight Loss More BulkMeans Fewer Calories 400 Cal of oil 400 Cal of chicken 400 Cal of calaloo, eggplant, and beans
- 37. Behavioral Modification • Associationof food with love, caring, and comfort • 3 steps: are you hungry, substitution for eating, repetition • Not every maladaptive behaviour needs to extinguished • Restraint • Technique of gradual change
- 38. Behavioral Modification • Goalsetting, family involvement • Self-monitoring • Eating cue should be true hunger • Identify habits or stimuli for eating • Slow eating rate - chewing time, utensils • Control impulses to eat when tired, bored, stress, reward, TV • Increase activity
- 40. Pacifying kids withsweets
- 41. What are fries???? = 400 Calories per serving+
- 42. Turn off the television Takethe kids outside to play
- 43. Forbid eating infront of the TV
- 44. …. and finally MakeHealthy Food choices… At The Supermarket
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- 46. Prevention better thancure... • promoting maintenance of a normal BMI from childhood is the only true treatment at a macro- economic level • increase physical activity • reduce TV watching • reduce sodas, fast food and vending machines • bans of food advertising to children • subsidies on healthy food