Health: state of complete physical, mental, and social well being, not merely absence of disease or infirmityPublic health: what a society does to assure the conditions in which people can be healthyPrevent disease and promote health through organized community effortFocus is on prevention, not treatment or cureObjectives for the nationSet of goals and objectives with 10 year targetsTo guide national health promotion and disease preventionHealthy people 2020“Attain high quality, longer lives free of preventable disease”Create social and physical environments that promote good health for allPromote quality of life across all life stagesHealthy people 201075% of Americans will eat 2 or more servings of fruit50% of Americans will eat 3 or more servings of vegetables2010 CDC survey33% of Americans achieved goal for fruit27% of Americans achieved goal for vegetablesLevels of preventionPrimary: prevention of disease symptomsSecondary: early detection, diagnosis, interventionTertiary: treating and rehabilitating diagnosed patients to delay further disease progressionDiet and inactivity- great health challengesBehavior and lifestyle are the greatest contributing factors to mortalityOnly 12% of Americans eat a healthy dietIf Americans reduced their daily intake of saturated fat from 13% of calories to 10%, 2.3 million fewer Americans would have heart diseaseRisk factors for cardiovascular diseaseRisk factor: factor that increases the probability of developing a disease or health problemNon-behavioral/non-modifiable: cannot be changedGenderAgeFamily historyGeneticBehavioral/modifiable: can be changedSmokingHigh fat dietHeavy alcohol consumptionSedentary lifestyleUnder nutritionRelated to povertyWealth in the US is not distributed evenlyFood securityFood security: access by all members at all times to enough food for an active, healthy lifeAvailability of nutritionally adequate and safe foodsmeasured along a continuumfood securefood insecurehigh and very high food insecure14.9% of US households were food insecure at some time during 2011Food deserts: area with limited access to affordable and nutritious food, particularly an area composed of predominantly lower income neighborhoodsFood assistance programsEntitlement programsPersons qualify because meet eligibility requirementsMandatory fundsNon-entitlement programsLimited by spending capsDiscretionary fundsSupplemental Nutrition Assistance Program (SNAP)Largest food assistance programElectronic benefits transfer (EBT)Includes nutritional education componentOnly allow foods from food pyramid and seeds/plants that produce foodNational School Lunch ProgramFree lunches to children in households with incomes at/below 130% of povertyReduced price lunches to children in households with incomes 130-185% of povertyGuidelinesProvides free or reduced price lunchesMust provide 1/3 of RDA for protein, calcium, iron, vitamins A/CNo more than 30% of meal’s calories can come from fat, no more than 10% from saturated fatSpecial Supplemental Food Program for Women, Infants, and Children (WIC)ParticipantsPregnant/lactating womenInfants (0-12mths)Kids (1-5yrs)ProvidesSupplemental foodNutrition education referrals to health care serviceReferrals to health care serviceEffectsImproved dietsImproved healthFewer, lower birth weight babiesChronic disease: persistent, long term, recurring conditionRequires long term and systematic approach to treatmentCan be prevented or delayed with changes of diet and lifestyle patternsEx. Diabetes, Heart disease, Cancer, Osteoporosis, HypertensionFoods containing excess fats, cholesterol, salts, and sugars can promote chronic diseasesCardiovascular Disease (CVD)Disease of heart and blood vesselsLeading cause of disability and premature deaths in USTypesHeart attack (coronary disease-CHD, Myocardial Infarction-MI)Caused by cholesterolCongestive heart failure (CHF)Angina pectoris: chest painArrhythmia: irregular heartbeatStroke: cerebrovascular diseaseAtherosclerosis: hardening of arteriesRoot of most forms of CVDFree radical theoryFree radicals oxidize LDL-cholesterolOxidized cholesterol picked up by immune cells- now called foam cellsFoam cells lodge inside of arteries, beginning of plaquesAntioxidants- Vitamin C, E, b-caroteneMajor risk factorsModifiableElevated blood LDL-cholesterol and consumption of cholesterol/trans fatCigarette smoking (passive smoking)HypertensionDiabetesObesity and metabolic syndromePhysical inactivityNon-modifiableFamily history of premature CHDAge/gender (men ≥45, women ≥55)Strategies for preventionLimit consumption of fatDon’t smokeHypertensions- limit salt intakeControl diabetesKeep your weight normalExerciseRelaxHave your blood cholesterol/glucose and blood pressure checked regularlyLDL and HDL cholesterolLDL delivers cholesterol to the tissuesCholesterol in LDL is called “bad cholesterol”HDL carries “used” cholesterol back to the liver where it is degraded and excreted as bile saltsCholesterol in HDL is called “good cholesterol”Atherogenic diet: high in cholesterol, trans fat, saturated fat; low in vegetables, fruits, and whole grainsTrans fat vs saturated fatGood (HDL)Trans fat lowersSaturated fat risesBad (LDL)Trans fat risesSaturated fat risesRecommended cholesterol levels for adultsTotal blood cholesterol- <200 mg/dLLDL cholesterol- <100 mg/dLHDL cholesterol- ≥60 mg/dLNutrients affecting CVDAntioxidants (vitamin C, vitamin E, b-carotene, Se)Vitamin DOmega 3 fatty acidAnti-thrombogenicEskimos’ cold water fish dietMediterranean dietFolate, Vitamin B12, Vitamin B6 (related to homocystein)HypertensionMeasurement of blood pressureSystolic pressure: top of pulse pressure waveDiastolic pressure: bottom of pulse pressure waveNormal blood pressure is 120/80Consistent blood pressure of 140/90 or higher is considered hypertensionAge and nutrition related diseaseInfluencing factorsModifiableExcess consumption of sodiumLow potassium and magnesiumOverweightExerciseAlcohol consumptionNon-modifiableAgesFamily history of hypertensionAfrican American ancestryPreventionReduce sodium (2300 mg/day)Increase potassiumFollowing a healthy eating patternMore vegetablesDASH diet (Dietary Approaches to Stop Hypertension)Maintaining a healthy weightPhysically activeLimiting alcoholQuitting smokingCancerBenign cancer: human disease where abnormal cells divide without controlMalignant cancer: abnormal cells invade other tissues and spreadDevelopment- carcinogenesis is a multistage
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