STUDY - Technical - New Dacian's Medicine
Diet
Therapy (2)
Translation Draft
Let's continue with specific dietary treatments!
To type something on hypertension... Increased blood pressure increases the risk of cardiovascular disease and stroke. Although not all hypertensive patients are sensitive to salt intake, sodium in the diet should be reduced to 2,000 mg/ day. In addition, there is a need to decrease body weight in obese people, finding that modest reductions in body weight can decrease high blood pressure. Of course, to those exposed are "added" all the elements inserted in the previous post to cardiovascular diseases.
In the case of congestive heart failure, cardiac casexia is a class of malnutrition that occurs in such patients and is due to reduced heart rate, changes in the small intestine leading to malabsorption, anorexia and hypermetabolism secondary to increased respiratory exertion. Dietary consumption is limited due to fatigue and early satiety. Diet therapy tries to ensure adequate intake of calories and nutrients, as well as restriction of liquids (from 1 to 1.5 l/ day) and sodium (from 1,000 mg to 2,000 mg/ day).
In cancer, dietary factors influence survival rates in patients with certain malignancies, such as breast cancer. A possible link between diet and the risk of developing breast, colonic or prostate cancer was suggested, but it was difficult to demonstrate. For example, dietary factors that can increase the risk of cancer, such as fats, seem to vary inversely in proportion to the diet with protective factors, such as carotenoids. In addition, people with high-fat diets eat fewer vegetables and fruits, consuming smaller amounts of the protective factors contained in these foods. On the other hand, eating fats in the diet increases the risk of colon cancer, while fiber consumption decreases it (these nutrients have inverse concentrations in different foods).
In general there are some dietary recommendations that can reduce the carcinogenic risk but they are based on a "generally correct" diet, as follows: 1. increased consumption of fruits and vegetables, especially from the family of limes (crucifers), vegetables and fruits rich in vitamin C, as well as intensely pigmented, containing beta-carotene or other caretonims. It tends to reach at least 5 servings of vegetables and fruits daily, 2. increased consumption of high-fiber foods, such as whole grains, fruits and vegetables, with a daily intake of 20-30g, avoidance of obesity, body weight control through exercise and low energy intake, 4. decrease in fat intake to 30% or less of total energy consumed, 5. reducing salt consumption, nitrite-treated or smoking-treated foods (such as bacon, bacon, hot dogs), smoking cessation and 6. limiting or eliminating alcohol consumption. Weight loss in cancer has many causes.
The metabolic and energy requirements of the tumor can cause the weight loss of the host. Circulating factors (e.g. cytokines) from either the host or the tumour may be involved in weight loss, but decreased food intake, commonly associated with anorexia, plays a major role in most patients. Indeed, many patients with neoplasms show signs of malnutrition at the time of diagnosis, objectified by weight loss, asthenia, anemia, disorders of protide, lipid and carbohydrate metabolism.
However, in some forms of cancer (breast cancer, prostate, melanoma) weight loss occurs late in the course of the disease. The effects of chemotherapy, immunotherapy and radiotherapy on dietary intake and nutritional status include nausea and vomiting, diarrhoea, dry or painful mouth as well as dental problems. Surgical interventions can lead to chewing and swallowing disorders, "dumping" syndrome or malabsorption. Anorexia is the most common problem in cancer patients, and substances such as megestrol acetate, glucocorticoids, hydrazine sulfate or droneabinol may increase appetite to a certain level.
Some patients may have a distinct circadian rhythmicity of appetite and anorexia, which is identifiable by carefully assessing their culinary preferences and meal schedules. Dietary strategies to increase appetite or food intake include providing poor foods, nutrient-rich liquids (such as fruit juice), light snacks. Attractive meals and snacks should be provided when appetite is good (liquid supplements in food can be administered when appetite is lacking). Nausea and vomiting in neoplastic patients may be related to the primitive tumour (which would cause obstruction), metastatic disease (involving the central nervous system) or chemotherapy. In patients with reduced stomach capacity, diet based on relatively small and frequent meals can avoid early satiety and improve nutrition status.
One strategy that reduces both revulsion towards food and nausea during chemotherapy is to ensure a diet that contains little stimulating foods (i.e. odourless, colourless), served cold or at room temperature. Mucous inflammations and stomatitis of patients with head or neck cancers can be treated with diets that minimize local irritation and calm swallowing disorders. Similarly, diarrhea can be minimized by dietary changes.
Criteria for establishing nutritional support in cancer patients are progressive weight loss or risk of serious weight loss. Although such features of neoplastic cheesexia can be improved by parenteral or enteral nutrition, few studies document the restoration of body composition or the beneficial effect on the disease. An exception may be the case for patients who are operated on for cancer, because the risk of postoperative complications is increased in malnourished.
Diabetes mellitus occurs as a result of the absolute or relative absence of insulin, a hormone that regulates the key features of carbohydrate, lipid and protide metabolism. Diabetes is associated with accelerated atherogenesis and an increased incidence of cardiovascular disease. Approximately 10% of patients suffering from type I diabetes, characterized by severe endogenous insulin deficiency, while the majority of other diabetics suffer from type II diabetes, in which endogenous insulin is synthesized but is insufficient to overcome peripheral insulin resistance.
All patients with diabetes need dietary therapy, in combination with medication and physical exertion, to achieve an optimal contro of blood glucose and lipidemia. The aim of therapy is to prevent acute complications (primarily hypoglycaemia and hyperglycaemia) and to reduce the risk of long-term complications (such as diabetic ophthalmopathy, cardiovascular disease, diabetic neuropathy and renal failure). The most important discussions about the diet relate to the saddle: 1. the percentage with which carbohydrates, lipids or proteins participate in the caloric ration, 2. the impact with which carbohydrates and lipids in the diet have on the concentration of glucose and blood lipids, 3. reaching an optimal body weight (which for many patients means weight loss). Diabetes control improves even in the case of modest weight loss (4-9 kg) in overweight patients (with a body mass index greater than 30).
A moderate caloric restriction (250-500 kcal less than daily energy needs), associated with an increase in daily activity, seems to be the best strategy. Improved metabolic control in such a regimen appears to be due to the combination of low dietary intake, increased insulin sensitivity and return of liver gluconeogenesis to normal, even when optimal body weight has not been achieved. In patients with diabetes, 10-20% of energy intake should be protein, to ensure normal growth and development of the child and to maintain the normal protein reserves of the adult. This consumption corresponds to an intake of 14-18% of energy intake and is in line with the "recommended dietary limits" of 0.8g protein/ kg for adults.
Protein consumption can accelerate the progression of kidney failure, but a protein intake of 10% of caloric intake is tolerated by most diabetic patients. When nephropathy has progressed to the stage of terminal renal disease, low protein intake (e.g. 0.g/ kg body) may be necessary if the patient does not benefit from dialysis. Carbohydrates and lipids share the rest of their energy intake. Diabetic patients have dyslipidemia characterized by increased total triglycerides and reduced HDL-cholesterol levels. Hypertriglycerideemia is due to increased liver production of triglyceride-rich VLDL, which may associate increased circulatory levels of low-density lipoproteins (LDL).
Due to the association of cardiovascular disease with diabetes mellitus, traditional dietary recommendations emphasize the importance of a low-fat diet (especially low in saturated fats), high in carbohydrates, which could increase hypertriglycerideemia and decrease HDL-cholesterol. An alternative program recommends replacing saturated fats with monounsaturated lipids rather than carbohydrates. This approach tends to adjust carbohydrates and fats in the diet to achieve optimal serum concentrations of glucose and lipids, preferably compared to establishing a uniform, preconceived consumption. Sugars and flours have the same effect on serum glucose, and the diet should contain both types of carbohydrates.
Finally, diabetic diet therapy should be individualized according to lifestyle, traditional eating habits and patient motivation. An example of dietary therapy in diabetes mellitus would be: 1. keeping serum glucose levels as close to normal as possible by balancing dietary intake with medication (insulin or oral antidiabetics) and physical activity, 2. achieving optimal serum levels for lipids, 3. calorie insurance to achieve or maintain a reasonable weight in adults or to ensure recovery from catabolic disorders, encouraging weight loss in obese patients, 4. protein intake of 10-20% and saturated lipids of less than 10% of daily caloric requirements, 5. distribution of the remaining 60-70% of the daily caloric requirement between carbohydrates and fats, the ultimate goal being to achieve serum levels of glucose and lipids as close as possible to normal, encouraging the consumption of monounsaturated lipids compared to polyunsaturated ones, 6. sucrose and other "simple sugars" should be substituted for other carbohydrates, 7. as for the rest of the population, it tends to a fiber intake of 20-30g daily, 8. if hypertension is present, sodium is limited to less than 2,400 mg/ day, 9. the number of alcoholic beverages and 10 are limited. vitamin and mineral supplementation is not required for most patients.
We'll continue next time!
Let's continue with specific dietary treatments!
To type something on hypertension... Increased blood pressure increases the risk of cardiovascular disease and stroke. Although not all hypertensive patients are sensitive to salt intake, sodium in the diet should be reduced to 2,000 mg/ day. In addition, there is a need to decrease body weight in obese people, finding that modest reductions in body weight can decrease high blood pressure. Of course, to those exposed are "added" all the elements inserted in the previous post to cardiovascular diseases.
In the case of congestive heart failure, cardiac casexia is a class of malnutrition that occurs in such patients and is due to reduced heart rate, changes in the small intestine leading to malabsorption, anorexia and hypermetabolism secondary to increased respiratory exertion. Dietary consumption is limited due to fatigue and early satiety. Diet therapy tries to ensure adequate intake of calories and nutrients, as well as restriction of liquids (from 1 to 1.5 l/ day) and sodium (from 1,000 mg to 2,000 mg/ day).
In cancer, dietary factors influence survival rates in patients with certain malignancies, such as breast cancer. A possible link between diet and the risk of developing breast, colonic or prostate cancer was suggested, but it was difficult to demonstrate. For example, dietary factors that can increase the risk of cancer, such as fats, seem to vary inversely in proportion to the diet with protective factors, such as carotenoids. In addition, people with high-fat diets eat fewer vegetables and fruits, consuming smaller amounts of the protective factors contained in these foods. On the other hand, eating fats in the diet increases the risk of colon cancer, while fiber consumption decreases it (these nutrients have inverse concentrations in different foods).
In general there are some dietary recommendations that can reduce the carcinogenic risk but they are based on a "generally correct" diet, as follows: 1. increased consumption of fruits and vegetables, especially from the family of limes (crucifers), vegetables and fruits rich in vitamin C, as well as intensely pigmented, containing beta-carotene or other caretonims. It tends to reach at least 5 servings of vegetables and fruits daily, 2. increased consumption of high-fiber foods, such as whole grains, fruits and vegetables, with a daily intake of 20-30g, avoidance of obesity, body weight control through exercise and low energy intake, 4. decrease in fat intake to 30% or less of total energy consumed, 5. reducing salt consumption, nitrite-treated or smoking-treated foods (such as bacon, bacon, hot dogs), smoking cessation and 6. limiting or eliminating alcohol consumption. Weight loss in cancer has many causes.
The metabolic and energy requirements of the tumor can cause the weight loss of the host. Circulating factors (e.g. cytokines) from either the host or the tumour may be involved in weight loss, but decreased food intake, commonly associated with anorexia, plays a major role in most patients. Indeed, many patients with neoplasms show signs of malnutrition at the time of diagnosis, objectified by weight loss, asthenia, anemia, disorders of protide, lipid and carbohydrate metabolism.
However, in some forms of cancer (breast cancer, prostate, melanoma) weight loss occurs late in the course of the disease. The effects of chemotherapy, immunotherapy and radiotherapy on dietary intake and nutritional status include nausea and vomiting, diarrhoea, dry or painful mouth as well as dental problems. Surgical interventions can lead to chewing and swallowing disorders, "dumping" syndrome or malabsorption. Anorexia is the most common problem in cancer patients, and substances such as megestrol acetate, glucocorticoids, hydrazine sulfate or droneabinol may increase appetite to a certain level.
Some patients may have a distinct circadian rhythmicity of appetite and anorexia, which is identifiable by carefully assessing their culinary preferences and meal schedules. Dietary strategies to increase appetite or food intake include providing poor foods, nutrient-rich liquids (such as fruit juice), light snacks. Attractive meals and snacks should be provided when appetite is good (liquid supplements in food can be administered when appetite is lacking). Nausea and vomiting in neoplastic patients may be related to the primitive tumour (which would cause obstruction), metastatic disease (involving the central nervous system) or chemotherapy. In patients with reduced stomach capacity, diet based on relatively small and frequent meals can avoid early satiety and improve nutrition status.
One strategy that reduces both revulsion towards food and nausea during chemotherapy is to ensure a diet that contains little stimulating foods (i.e. odourless, colourless), served cold or at room temperature. Mucous inflammations and stomatitis of patients with head or neck cancers can be treated with diets that minimize local irritation and calm swallowing disorders. Similarly, diarrhea can be minimized by dietary changes.
Criteria for establishing nutritional support in cancer patients are progressive weight loss or risk of serious weight loss. Although such features of neoplastic cheesexia can be improved by parenteral or enteral nutrition, few studies document the restoration of body composition or the beneficial effect on the disease. An exception may be the case for patients who are operated on for cancer, because the risk of postoperative complications is increased in malnourished.
Diabetes mellitus occurs as a result of the absolute or relative absence of insulin, a hormone that regulates the key features of carbohydrate, lipid and protide metabolism. Diabetes is associated with accelerated atherogenesis and an increased incidence of cardiovascular disease. Approximately 10% of patients suffering from type I diabetes, characterized by severe endogenous insulin deficiency, while the majority of other diabetics suffer from type II diabetes, in which endogenous insulin is synthesized but is insufficient to overcome peripheral insulin resistance.
All patients with diabetes need dietary therapy, in combination with medication and physical exertion, to achieve an optimal contro of blood glucose and lipidemia. The aim of therapy is to prevent acute complications (primarily hypoglycaemia and hyperglycaemia) and to reduce the risk of long-term complications (such as diabetic ophthalmopathy, cardiovascular disease, diabetic neuropathy and renal failure). The most important discussions about the diet relate to the saddle: 1. the percentage with which carbohydrates, lipids or proteins participate in the caloric ration, 2. the impact with which carbohydrates and lipids in the diet have on the concentration of glucose and blood lipids, 3. reaching an optimal body weight (which for many patients means weight loss). Diabetes control improves even in the case of modest weight loss (4-9 kg) in overweight patients (with a body mass index greater than 30).
A moderate caloric restriction (250-500 kcal less than daily energy needs), associated with an increase in daily activity, seems to be the best strategy. Improved metabolic control in such a regimen appears to be due to the combination of low dietary intake, increased insulin sensitivity and return of liver gluconeogenesis to normal, even when optimal body weight has not been achieved. In patients with diabetes, 10-20% of energy intake should be protein, to ensure normal growth and development of the child and to maintain the normal protein reserves of the adult. This consumption corresponds to an intake of 14-18% of energy intake and is in line with the "recommended dietary limits" of 0.8g protein/ kg for adults.
Protein consumption can accelerate the progression of kidney failure, but a protein intake of 10% of caloric intake is tolerated by most diabetic patients. When nephropathy has progressed to the stage of terminal renal disease, low protein intake (e.g. 0.g/ kg body) may be necessary if the patient does not benefit from dialysis. Carbohydrates and lipids share the rest of their energy intake. Diabetic patients have dyslipidemia characterized by increased total triglycerides and reduced HDL-cholesterol levels. Hypertriglycerideemia is due to increased liver production of triglyceride-rich VLDL, which may associate increased circulatory levels of low-density lipoproteins (LDL).
Due to the association of cardiovascular disease with diabetes mellitus, traditional dietary recommendations emphasize the importance of a low-fat diet (especially low in saturated fats), high in carbohydrates, which could increase hypertriglycerideemia and decrease HDL-cholesterol. An alternative program recommends replacing saturated fats with monounsaturated lipids rather than carbohydrates. This approach tends to adjust carbohydrates and fats in the diet to achieve optimal serum concentrations of glucose and lipids, preferably compared to establishing a uniform, preconceived consumption. Sugars and flours have the same effect on serum glucose, and the diet should contain both types of carbohydrates.
Finally, diabetic diet therapy should be individualized according to lifestyle, traditional eating habits and patient motivation. An example of dietary therapy in diabetes mellitus would be: 1. keeping serum glucose levels as close to normal as possible by balancing dietary intake with medication (insulin or oral antidiabetics) and physical activity, 2. achieving optimal serum levels for lipids, 3. calorie insurance to achieve or maintain a reasonable weight in adults or to ensure recovery from catabolic disorders, encouraging weight loss in obese patients, 4. protein intake of 10-20% and saturated lipids of less than 10% of daily caloric requirements, 5. distribution of the remaining 60-70% of the daily caloric requirement between carbohydrates and fats, the ultimate goal being to achieve serum levels of glucose and lipids as close as possible to normal, encouraging the consumption of monounsaturated lipids compared to polyunsaturated ones, 6. sucrose and other "simple sugars" should be substituted for other carbohydrates, 7. as for the rest of the population, it tends to a fiber intake of 20-30g daily, 8. if hypertension is present, sodium is limited to less than 2,400 mg/ day, 9. the number of alcoholic beverages and 10 are limited. vitamin and mineral supplementation is not required for most patients.
We'll continue next time!
Understanding, Love and
Gratitude!!!
Dorin, Merticaru