Diet-Related Diseases

As adults grow older, they have a greater chance of developing certain diet-related diseases, such as hypertension (high blood pressure), heart disease, cancer, and/or osteoporosis. Older adults are more likely to require diet modification to control disease than younger adults, but the diet should still reflect the preferences of the older adult. For the elderly, the diet should fit the person rather than changing the person’s eating behavior. No food should be denied simply because a person is old.

Hypertension
It is estimated that 40 to 50% of the adults in the United States are “at risk” of developing high blood pressure. Untreated hypertension can lead to:

A high sodium intake is generally believed (but not proven) to increase the risk of having high blood pressure. In some people, other risk factors include:

Weight loss may help reduce an elevated blood pressure. Some people are able to lower their elevated blood pressure by restricting sodium consumption. Others may significantly decrease their blood pressure by increasing their calcium intake. African Americans and those who are salt sensitive appear to be especially responsive to an increase in calcium intake.

Certain drug-nutrient interactions may result in additional vitamin or mineral requirements of the older adult. For example, some people need to control hypertension with medication, which usually is a diuretic that also wastes potassium (decreases retention). Potassium is important for:

Although a physician may prescribe a potassium supplement, it is expensive and unpleasant tasting. The safest way to protect the body’s potassium, without supplying more sodium than the diet of a hypertensive patient would allow, is to include plenty of fruit and fruit juices in their diet. Fruits are the only foods which are rich in potassium and usually prepared and eaten without added sodium.

For more information concerning sodium and salt substitutes, see the discussion in the Dietary Guidelines section of ??????


Heart Disease
Heart attacks are the leading cause of death and illness in the United States. At the root of the cause for heart attacks is a disease called “arteriosclerosis,” which is the accumulation of “plaque” or “crud” (cholesterol, fatty deposits, and other substances) on the inner lining of artery walls. This buildup narrows arteries until they become so clogged, blood cannot flow through. This can result in death or damage to part of the heart muscle; a heart attack.

Many factors are associated with heart disease. For example, a smoker has a statistically greater chance of developing cardiovascular disease and dying of a heart attack or stroke than does a nonsmoker; thus, smoking is a “risk factor” for heart disease. Other factors associated with greater risk are:

The risk factors are powerful predictors of heart disease. Three risk factors have been most intensively studied: smoking, high blood pressure, and high blood cholesterol.

Millions of dollars have been spent and decades of research conducted to determine what exactly causes heart disease. Even though hundreds of researchers have demonstrated positive findings from risk factor research, it is still not possible to pinpoint the exact causes of heart disease. In short, although diet and nutrition are the focus of attention in heart disease, it is important to take a broad view of the problem. Nutrition is not the only factor involved.

In addition, there is recent evidence that arteriosclerosis begins in childhood. Some studies have shown that plaque buildup can slowly progress into coronary heart disease in adulthood.

Cholesterol
Cholesterol is made primarily in the liver and sent through the bloodstream to all parts of the body. Cholesterol is needed by the body to:

The liver also uses cholesterol to make bile acids needed for digesting fats. In a single day, the liver produces 1,000 milligrams of cholesterol to meet the body’s needs.

The typical American diet supplies approximately 600 milligrams of cholesterol a day over and above what is made by the liver. Even though this is a lot less than the liver makes on its own, it may exceed the body’s ability to hold down the amount of cholesterol circulating in the blood. Blood cholesterol levels, therefore, rise.

Cholesterol is carried through the bloodstream in packages called lipoproteins. High-density lipoproteins, or HDL’s are the “good” type; they carry cholesterol away from body cells and tissues to the liver for excretion from the body. Low-density lipoproteins, or LDL’s, are the “bad” type responsible for depositing cholesterol on artery walls.

The amount of cholesterol circulating in the body’s blood is affected by more than the amount of cholesterol consumed. It also is influenced by the amount and kinds of fats consumed. Specifically, diets rich in saturated fats tend to raise the level of blood cholesterol, while polyunsaturated fats and monosaturated fats help to lower it.

The more cholesterol there is in a person’s blood, the greater the likelihood that some will build up on the inner walls of the body’s arteries as “plaques.” These plaques become larger and larger. The blood vessel width becomes narrower until eventually the clot completely cuts off any blood flow through the artery. If the artery leads to the heart, a heart attack may result because the heart muscle did not receive the essential supply of oxygen it needed to do its work. If the artery leads to the brain, a stroke may result. Leg arteries also can become clogged; painful muscle spasms from the slightest exercise can result because the muscles are not receiving enough oxygen.

Studies have confirmed that the amounts and kind of fats and the amount of cholesterol consumed does directly influence a person’s risk of dying prematurely of coronary heart disease. There is some evidence that a reversal of arteriosclerosis can occur in people who reduce the amount of saturated fat and cholesterol.

Regular physical exercise can promote a healthier heart in two ways:

For more information on dietary fat ?????

Remember that fats and cholesterol are not the only dietary constituents that may influence a person’s risk of developing heart disease. Other factors implicated by research studies include:

It is not possible to point to a particular individual and predict what effect diet will have on that person’s chances of developing heart disease. An individual’s genetic predisposition influences the extent of damage the environment can do.

Cancer
The same high-fat diet associated with heart disease also may increase the risk of developing certain cancers, including two that frequently strike Americans:

Obesity is one risk factor associated with a high risk of developing breast and endometrial cancers. Chemical reactions in body fat result in the formation of substances that act similarly to female sex hormones; they may stimulate the growth of breast and endometrial cancers.

Among the Japanese, who eat little fat of any kind, breast and colon cancers are uncommon. Studies have shown that when a diet contains high amounts of fat and cholesterol, intestinal bacteria break down these foodstuffs into substances that can cause cancer directly or that promote the action of other cancer-causing chemicals. Since such diets usually contain little bulky, fibrous foods, the stool tends to be concentrated and to stay longer than usual in the colon; there is more exposure to carcinogens.

In addition, some of the substances produced from cholesterol by intestinal bacteria may imitate the action of female sex hormones. This may promote cancer growth in hormone-sensitive tissues, such as the breast and endometrium (the lining of the uterus).

Osteoporosis
Osteoporosis is one of the most common problems among older Americans. It is the primary cause of “shrinkage” in stature and bone fractures among the elderly. Starting in the 20’s for women and somewhat later for men, calcium is gradually lost from the bones. It results in a shortening and weakening of the long bones and greatly increases a woman’s susceptibility to fractures. This loss of calcium accelerates in women after menopause. Past 50 years of age, 25 to 30% of women and 15 to 20% of men suffer a shortening of the spinal column as a result of osteoporosis.

Osteoporosis afflicts one in four American women past menopause. It causes a loss of height with age because spinal vertebrae collapse, producing the characteristic “dowager’s hump.” Osteoporosis is the primary cause of debilitating hip and wrist fractures that commonly afflict older women. It also may be a factor in bone loss in the jaws; it leads ultimately to a loss of teeth through periodontal disease.

Women who are three to six years past menopause can help prevent bone loss by increasing their calcium intake in addition to getting plenty of exercise. While large amounts of calcium supplements are used by older women, the evidence shows that such supplements can prevent or stem the progress of osteoporosis in some people, but not all. Dietary calcium (calcium from foods) is much better absorbed and used by the body than supplements. However, no supplement can replace calcium already lost from bones; at best, it can slow down further deterioration. Thus, prevention is so important.

Fluoride also is important to bone strength. Osteoporosis is significantly less common in communities serviced by fluoridated water; this suggests that fluoride protects against the disease and the fractures that accompany it. Fluoride combines with the calcium in the bone and helps to prevent the loss of calcium common after mid-life.

Other factors, besides the amount of calcium consumed, influence how much of this mineral is absorbed by the body. The following is a partial list.

However, such binding is not thought to interfere seriously with the amounts of calcium the body obtains.

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