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Healthy Life Style - Modification
Healthy Life Style - Modification
in population
Medical sense: all factors, that influence health status and the
risk for disease development
1. Modifiable RFs
Factors of life styl: nutrition, smoking, low physical activity
2. Non-modifiable RFs
age (men over 45 y., postmenopausal women)
sex (male)
family history (mother below 65 y. and father below 55 y.)
personal history CVD
Strategy of CV prevention
psychomotoric stimulator
development of a tolerance is very quick
60 Coronary mortality
Cardiovascular mortality
50
Total mortality
40
30
20
/ age
10
0
<65 65-74 75-84 85+
Pozvte na kontroly,
pedevm v prvnch tdnech
Abstinuje: Kou:
Podpote v nekuctv, Pokuste se opt motivovat, vyut
pi dalch nvtvch zkuenosti (pro i v jak situaci si zaplil,
zdraznte vznam byla farmakoterapie adekvtn?) a podpote
abstinence. v dalm pokusu pestat kouit.
CHCE NECHCE
Opakujte relevantn
intervenci vetn zven
vych dvek a delho
trvn farmakoterapie.
Sympathetic nervous activity
and risk factors of AS
Smoking increased secretion of catecholamines
F.S. Facchini F.S. Lancet 1992
G. Grassi, Circulation 90, 1994
peristaltic obstipation
others
Physical activity
Energy intake
polysacharides 55-65%
proteins 15%
fat 20-30%
Diet energy intake
individual !
Polysacharides-
carbohydrates
Un-saturated FA
poly-unsaturated, mono-unsaturated FA
Lipids
Saturated FA < 7%
cholesterol below 200 mg/24 h
To add omega 3 FA
vegetable sterols
Relative Priority of Consumption
Omega-3 PUFA
Omega-3 PUFA
Some food sources are fatty fish and Omega-6PUFA
Omega-6 PUFA Mono- Saturated FA
Saturated FA
shellfish, flaxseed, walnuts, and Some sources are animal-based
canola oil. Some food sources are unsaturated foods such as cream, butter,
nuts, seeds and
Eicosapentaenoic
Eicosapentaenoicacid
acid(EPA)-fish
(EPA)-fish
vegetable oils such as
FA cheese, and fatty meats.
Lauric acid-coconut, palm oil
Docosahexaenoic
Docosahexaenoicacid
acid(DHA)-fish
(DHA)-fish
sunflower, safflower, corn Some food sources Myristic acid-dairy fat
-Linolenicacid
-Linolenic acid(ALA)-flax
(ALA)-flaxseed,
seed, and soybean oils. are canola oil and Palmitic acid-meat
walnuts
walnuts Stearic acid-meat
Linoleic
Linoleicacid-seeds
acid-seeds olive oil.
Stearidonic
Stearidonicacid
acid(STD)-canola,
(STD)-canola,fish Trans-Saturated FA
Trans-Saturated FA
fish Dihomo-gamma-
Dihomo-gamma- Oleic
Oleicacid-olive,
acid-olive,
Eicosatrienoic acid (ETE)-seafood Some food sources are margarine,
Eicosatrienoic acid (ETE)- linolenic acid-metabolic canolaoiloil
canola
Eicosatetraenoic acid (ETA)-seafood
linolenic acid- fried foods, baked goods and
seafood metabolic product
product Palmitoleic
Palmitoleicacid-
acid- processed foods.
Docosapentaenoic acid (DPA)-
Eicosatetraenoic acid (ETA)- vegetableoiloil
vegetable Elaidic acid-preservative
seafood Arachidonic
Arachidonicacid-
acid-
seafood Partially hyrdogenated plant and
metabolic
metabolic product
product vegetable oils
Docosapentaenoic acid (DPA)-
seafood
Most Harmful
Most Beneficial Promotes: Obesity
Cardioprotective Dyslipidemia
Does not promote obesity American Heart Association Atherosclerosis
Proteins
reduces wieght
reduces blood pressure
improves lipid profile
improves glucose level
reduces trend to coagulation
Diet heart hypothesis
Etc.
Nine-year multivariable-adjusted hazard
ratios (95% CI) for 3782 cases of metabolic
syndrome
Dietary pattern Quintile 1 Quintile 5 p for
trend
Western diet 1 1.18 (1.031.37) 0.03
Prudent diet 1 1.07 (0.951.20) 0.11
Individual foods
Meat 1 1.26 (1.111.43) <0.001
Dairy 1 0.87 (0.770.98) 0.006
Fruits and 1 1.10 (0.981.24) 0.09
vegetables
Whole grains 1 1.02 (0.921.14) 0.76
Refined grains 1 0.89 (0.781.01) 0.15
Lutsey PL et al. Circulation 2008; available at:
http://circ.ahajournals.org.
Odds ratioa for dyslipidemia indicatorb by % total energy from
added sugar in NHANES analysis
Low HDL-C 1.0 (0.81.4) 1.5 (1.21.9) 1.9 (1.52.6) 3.1 (2.34.3)c
High LDL-C
a. OR (95% CI) vs reference0.9 (0.71.2)
group 1.1added
(<5% energy from (0.91.3) 1.1
sugar, n=593); (0.91.5)
adjusted for age; sex;1.2 (0.91.7)
race/ethnicity;
poverty; body-mass index; waist circumference; weight change; physical activity; total energy intake; intake of
monounsaturated fatty acids, polyunsaturated fatty acids, saturated fatty acids, cholesterol, fiber, and other
carbohydrates; hypertension; cigarette smoking; and alcohol use
b. low and high levels as defined by NCEP-ATP III guidelines
c. p<0.05 for trend
ABUSUS
Binge drinking
Mild
consumption
Alcohol beverages
1 l beer
28-33 g alcohol
1 beer = 0,5 l
14 -16 g alcohol
Alcohol beverages
1 l wine
80 -100 g alcohol
2 dl wine
16 -20 g alcohol
Alcohol beverages
1 l destilate = 400 g
alcohol
5 cl = 20 g alcohol
Alcohol drinking and risk of atherotrombotic
events in primary prevention
CHD morbidity
Ischem. STR
RRR 40-70%
IM
Mortality
CVD, total
RR
0,5 0,75 1 1,5
I decided
to give up reading
Mild
Mark Twain (1835-1910) consumption
Abusus