Advanced Clinical Nutrition - Research Paper Example

Advanced Clinical Nutrition QUESTION Inflammation and CVD Describe the relationship between inflammation andcardiovascular disease. There is no proof to show that inflammation causes cardiovascular disease. However, it has been found that in cardiovascular diseases like myocardial infarcts (heart attacks), inflammation plays an important role. Inflammation is the response of the body to injurious agents, foreign bodies or disease causing organisms. The response of the body is aimed at getting rid of these substances from the body. Research is ongoing to show how inflammation plays a role in cardiovascular diseases like heart attack and stroke. Many theories have been advanced to explain this analogy. But the most acceptable is as follows; the trigger in heart attacks and some forms of stroke is the accumulation of cholesterol rich plaques (atheromas) in blood vessels of the heart and brain. The body detects these plaques as foreign and unwanted in the body; hence, through the process of inflammation, the body tries to remove the plaques from the walls of blood vessels. However, as the body is trying to remove the foreign plaques from the walls of blood vessels, circumstances may go wrong in that the plaques may rupture causing aneurysms or it may trigger blood clot formation. These clots normally obstruct blood flow to vital organs of the body causing heart attacks or cerebral infarcts (strokes). 2) Choose a nutrient or food that is considered both “anti-inflammatory” and “heart healthy”. Provide evidence that supports that your nutrient/food is “heart healthy” using key studies from the literature (described sufficiently and referenced appropriately). Beans. Foods like beans are anti-inflammatory in the sense that they do not have triggers of inflammation which may predispose to cardiovascular diseases. Plaques that accumulate in blood vessels that may lead to cardiovascular infections normally contain LDL (bad) cholesterol. Such cholesterol is found in fatty foods like animal products e.g. red meat, eggs etc. Beans do not have this form of cholesterol, hence, are heart healthy. 3) What evidence exists that your nutrient/food may be “anti-inflammatory”? Use the 3-legged stool analogy as you look for supporting evidence (primary research articles). Beans are anti-inflammatory from many respects. Clinically, beans have been observed not to cause any heart conditions. Basically, beans do not have any cholesterol; hence, they do not trigger any inflammatory response in arteries of the heart. Epidemiologically, studies have revealed that incidences of heart conditions with plant products are rare, but animal products have been implicated. 4) Is the anti-inflammatory evidence clear? Why or why not? The anti-inflammatory response is clear in that there is no content of LDL cholesterol in beans and bean products. 5) Briefly, how would you design a study to provide information that would strengthen your case for the anti-inflammatory effects of your nutrient/food in humans? I would conduct biochemical tests on beans to ascertain that they do not have LDL cholesterol that triggers inflammation to cause cardiovascular diseases. QUESTION #2: Consider the National Cholesterol Education Program (NCEP), adult treatment panel III (ATP III) recommendations for reducing CVD risk. Discuss EITHER the dietary soluble fiber OR plant sterols/stanols recommendation and answer the following questions: 1) First, mechanistically speaking, how is that particular recommendation supposed to lower CVD risk? Be specific Introduction of soluble dietary fibers is a strategy for reducing cardiovascular disease. These foods have trace amounts of saturated and trans fats, hence, they reduce incidences of cardiovascular disease. The therapeutic lifestyle changes that are recommended to reduce cardiovascular disease risk are that fiber should be between 20 to 30 g per day. 2) Where did the recommendation itself come from? In other words, what research led to this recommendation? Discuss using appropriate studies for support (provide adequate details and appropriate citation). HINT: Consider using the 3 legged stool analogy when setting up this discussion. In 1988, the first National Cholesterol Education Program began and its aim was to come up with cholesterol levels based on risk assessment. From the program, a panel of experts drafted guidelines which were published as the Adult Treatment Panel (ATP). Subsequently, modifications were done, and these were the ATP II and ATP III. 3) Give specific examples of dietary modifications that someone can make to meet the recommendation Consumption of many fruits and vegetables, minimizing intake of beverages and foods with added sugars, moderating alcohol consumption, eating foods with little or no salt and consumption of fish. 4) Since the NCEP ATP recommendations are due for a revision soon, based on current health and nutrition trends, how do you think that these recommendations might be modified? Provide evidence to support your answer As there is an increasing incidence of cardiovascular diseases, recommendations should be in such a way that consumption of alcohol and smoking should be discouraged instead of advocating for their moderation. QUESTION #3: a) Define obesity and why it is considered a “chronic” disease. Obesity is a condition whereby the body has accumulated so much fat which may impact negatively on the health of an individual. A person is considered obese if his body weight is at least 20% more than it should be i.e. when one’s Body Mass Index is 30 or over. It is considered chronic because the patho-physiology takes a long time span. b) Identify two other chronic diseases that obesity is associated with and discuss why these relationships exist. Cardiovascular disease and diabetes mellitus type 2. Obesity is a risk factor for these chronic diseases. c) As mentioned in class, there exists a subpopulation of obese individuals termed the “Metabolically Healthy Obese.” First, define MHO and compare this to “typical” metabolic manifestations of obesity (provide evidence to support). Do these individuals have the same risk for chronic diseases? Why or why not? Be specific! MHO individuals are those individuals who are obese but they remain metabolically healthy i.e. they have normal blood glucose, blood pressure, blood lipids and cytokine profile. This accounts for about 25-30% of obese individuals. As a result of this, these individuals do not have the same risk for chronic diseases like the typical cases. d) Related to this topic, there are also “metabolically obese but normal weight’’ individuals. What type of health assessment would you give someone who fits into this category? Would this person be considered the same risk level as someone who is MHO? Explain (and support) your answer. These are people who are not obese on the basis of BMI but who like people with obesity are insulin –resistant, hyperinsulinemic and predisposed to diabetes mellitus type 2, hypertriglyceridemia and coronary heart disease. Their risk for chronic diseases is way than MHO individuals. QUESTION #4: You are asked to research the relationship between antioxidant nutrient “X” and cancer. You find that not all papers agree on whether the nutrient is beneficial or not. Answer the questions below. 1. What types of studies typically provide the strongest evidence? Why? Examples of studies include; laboratory evidence from cell culture, chemical and animal studies. These studies show would try to explain the fact that antioxidants prevent or reduce cancer development. 2. What are potentially “confounding” variables? Give an example. Variables for these studies include antioxidants like beta carotene, lycopene, vitamins C, E and A 3. What does “relative risk” mean? What factors should you consider when you see a high relative risk reported? Is it always clinically relevant? Provide conceptual examples to support your answer. Relative risk refers to the risk of one developing a disease relative to exposure. Relative risk compares risk of disease in two different types of people, i.e. between smokers and non smokers. It is clinically relevant to talk of relative risk in diseases since exposure to diseases differs between different groups. 4. Define what it means to say that a “U-shaped relationship” exists between antioxidant nutrient X and a particular type of cancer. Give a specific example of this. When these two are plotted against each other, one constant rises, and reaches a maximum then drops smoothly. When antioxidant X is introduced to a particular cancer, the cancer is reduced but when this rises up to a particular degree. Higher than this, there will be no effect on the cancer; instead it will be injurious to be body. 4. Discuss two ways in which antioxidant nutrients may be protective against cancer and provide examples (referenced) for each. Antioxidant nutrients are protective against cancer in that they stabilize free radicals that are unstable. These radicals move around cells looking for electrons to stabilize them. This destroys DNA of cells, which triggers cancers. By stabilizing these cells, cancer progression is reduced. Works Cited Arthur C. Guyton, John Edward Hall. Human physiology and mechanisms of disease. London: Taylor and Francis, 2009. Print Read More