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Healthy Nutrition as an Intervention for Preventing and Treating Chronic Disease

April 08, 2014

Healthy Nutrition as an Intervention for Preventing and Treating Chronic Disease
By Bridgitte Broxton FNP-C, CDE, CWCN

National Nutrition Month reminds us to focus on the importance of being accountable for the foods we eat. As the saying goes, “we are what we eat”. Realistically speaking, most of us wait until there is a problem and we are told by a physician to modify our eating habits. So we start restricting salt when we are diagnosed with hypertension and start eating low fat when we are told our cholesterol levels are high. Yet studies have shown that following a nutritiously sound diet, consisting of a variety of nutrients can help to prevent chronic disease. This is true even when genetics seemingly paves the way for chronic disease such as heart disease and diabetes. Proper nutrition can alter the path by reducing risk factors for developing the disease.

Advances in modern medicine have allowed for the world population to live longer. However, medical problems remain a common concern for the older population. Cardiovascular disease (CVD) can be manifested in a variety of disorders of the heart and blood vessels. CVD is still the leading cause of death and disability in the United States. Clinical evidence shows that most cardiovascular disease can be helped by controlling blood pressure and body weight. If you are diagnosed with hypertension, your physician or practitioner may prescribe an anti- hypertensive medication. In addition, you will be advised to limit salt intake and lose weight. The American Heart Association advocates the “ DASH” diet (Dietary Approaches to Stop Hypertension), which is basically high in fruits and vegetables, as well as low- fat dairy foods. The National Heart, Lung and Blood Institute (NHIBI) has conducted multiple studies, which have demonstrated that “Blood pressures were reduced with an eating plan that is low in saturated fat, cholesterol, and total fat. It further emphasizes fruit, vegetables, and fat free or low fat milk products (NHIBI,2006). The DASH plan recommends that sodium be restricted to 1500 to 2300 mg per day, potassium should comprise 4700 mg, calcium 1250 mg and magnesium 500 mg, and fiber 30 grams (NHBI,2006). It is recommended that we read labels to determine what is in foods that we eat. While your physician may recommend the DASH diet, one should never stop taking blood pressure medication until told to do so by your provider. Additionally, combining the DASH meal plan with regular physical activity will enhance weight loss and blood pressure control. For specific details about the DASH meal plan you may contact the NHLBI Health Information Center at 301-592-8573 or email them at: nhlbiinfo@nhlbi.nih.gov. Tips to reduce salt and sodium include: rinsing canned foods such as tuna and beans to remove some of the sodium content, using spices instead of salts (herbs, lemon, lime, vinegar, or salt free seasoning blends), eliminating flavored rice and pasta, as well as cereal mixes, which usually have added salt.

According to the American Cancer Society, 76% of cancers are diagnosed in adults age 55 and older (American Cancer Society, 2004). Obesity is linked to increased risk of many cancers , such as breast and colon cancer. Recommendations from the American Cancer Society promote eating whole grains instead of processed grains and sugars, as well as reducing the consumption of meat, especially if it’s high in fat or processed (2004).

The American Diabetes Association states, ”More than 18 percent of people age 60 and older have diabetes (2004). Nutrition therapy goals for people with diabetes are to “maintain blood glucose levels as close to normal as possible, to achieve blood sugar, lipid profile and blood pressure levels that reduce the risk of cardiovascular disease, prevent and treat complications and improve general Health (ADA, 2004). ” Even weight loss of just 5 to 7 % of total body weight can delay the development of diabetes in those who are overweight and have impaired fasting glucose. Health care providers, such as Dietitians and Certified Diabetes Educators (CDEs) can provide guidance on the nutrition and lifestyle changes that are recommended to achieve established treatment goals.

Osteoporosis is a disease characterized by low bone mass, which seems to begin after the age of 30. It usually becomes advanced following menopause. According to Bales, Fischer, and Orenduff, risk factors for osteoporosis include having a low bone mass, advanced age, being female, having a family history, low calcium and vitamin D intakes, inactivity, having a small frame, smoking, excessive alcohol consumption, and the use of certain medications, such as corticosteroids. There is good evidence that increasing calcium and vitamin D through food and supplements can help prevent bone fractures and loss of bone mass. Your physician can order lab tests to determine if you are deficient in calcium and vitamin D. A Bone Mineral Density Test is needed to make the diagnosis of Osteoporosis or Osteopenia (bone loss of a lesser degree).

Chronic Obstructive Pulmonary Disease (COPD) refers to conditions that cause airflow blockage and breathing difficulties, such as emphysema, and chronic bronchitis. Tobacco use is a key factor in developing COPD. Often patients with COPD experience unintentional weight loss because they expend increased energy for metabolism. Nutritional goals in this case are to increase caloric intake to prevent further weight loss. They may need frequent snacks, high caloric drinks and liquid meal supplements. 

Nutritional strategies can be used to treat a variety of conditions. Often they may be used as an adjunct to medications prescribed by your provider to delay or prevent the most common age related disorders. This article attempts to summarize recommendations for the most common age related conditions. Yet it should be mentioned that due to the increasing prevalence of obesity, Americans are being diagnosed with these conditions, such as diabetes and heart disease prematurely. Proper nutrition can be an effective intervention for preventing chronic diseases before they develop. Your practitioner can recommend a nutritionist to provide more detailed information for any of these and many other medical conditions.

We contacted a Registered and Licensed Dietitian, Beth Morlang. We asked her: What suggestions do you have for someone who has hyperkalemia? Ms. Morlang stated “Avoiding common high potassium foods like bananas, oranges, orange juice, potatoes, tomatoes, avocados and melons are simple dietary changes that can help lower potassium. Also, constipation can cause hyperkalemia. Hyperkalemia is fairly rare and usually seen in 

Chronic Kidney Disease. Increasing dietary fiber including raw-low-potassium fruits and vegetables can help keep bowels moving and prevent constipation. If diet alone does not relieve constipation, patients should discuss the use of daily fiber supplements and/or stool softeners with their MD. She also stated that Magnesium also plays a role in the active transport of calcium and potassium ions across cell membranes a process that is
important to nerve impulse conduction, muscle contraction and normal heart rhythm. ”Ms. Morlang states that Phosphorus is essential to bone health, in conjunction with calcium. It is a very common element in many food. These include high protein foods, including beef, poultry, fish, pork and dairy. Some prepackaged foods also contain phosphorus additives used as natural preservatives.“ The kidneys regulate the excretion of both Magnesium
and Phosphorus. Unless a patient had Chronic Kidney disease or a disorder of calcium metabolism, phosphorus control is not needed. Magnesium supplements should be discussed with your MD before it is started.

Beth Morlang, RD, LD graduated from Cedar Crest College in Allentown PA. She is currently a consultant for Nephrology Associates and can be reached at: beth.morlang@davita.com


Bibliography References 

American Diabetes Association. (2004). Nutrition principles and recommendations in diabetes. Diabetes Care, 27, 36-46.
Bales, C. W., Fischer, J. G., & Orenduff, M. C. (2004). Nutritional
interventions for age-related chronic disease. Generations, 54
Brus, J., Schols, A., & Mesters, I. (2004). Dietary change, nutrition, education
and chronic obstructive pulmonary disease. Patient Education Counselor, 52,
Cancer facts and figures. (2004). Retrieved from www.cancer.org/downloads/
Diabetes statistics for seniors. (2004). Retrieved from www.diabetes.org/
National Diabetes Education Program. (2004). Guiding principles for diabetes
care for health care providers. Retrieved from www.ndep.nih.gov
National Heart, Lung and Blood Institute (2006). Your guide to lowering your
blood pressure with DASH. : NIH Publications, No. 06-4082


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