AMSA GHI 2023

Nutrition and lifestyle affect these mechanisms which affect CVD

1. Cholesterol

2. Blood pressure

3. Oxidative stress and inflammation

4. Endothelium

5. Insulin and glucose control

6. Gut microbiome 

Cholesterol

• What nutrients elevate serum cholesterol, and what foods are they found?

  • Cholesterol

    • Only animal foods

    • Red and processed meat, chicken, dairy, eggs

  • Saturated fat → causes liver to make more cholesterol

    • Animal foods

    • Ultra processed foods

    • Palm oil, coconut products

  • Trans fat

    • Fried food

    • Donuts, cakes, pastries, biscuits

  • Fructose

    • Ultra processed foods

    • Table sugar

    • NOT fruit

• Foods that decrease cholesterol: dietary fibre

  • Whole grains 

  • Legumes

  • Vegetables

  • Soy foods

  • Fruit and berries

Blood pressure

• Nutrient associated with hypertension: sodium

  • Limit to 3g salt

  • Table salt, packaged foods, bread, cheese condiments

• Nutrients that reduce hypertension:

  • Potassium (bananas, potatoes)

  • Flax seeds

  • Hibiscus tea

Oxidative stress and inflammation

• What increases oxidative stress:

  • Oxidised cholesterol (from cooking cholesterol rich food, e.g. BBQ meat)

  • Haem iron (animal products)

  • Deep fried meet

• What increases inflammation:

  • Saturated fat

  • Endotoxins

  • AGEs (meat, processed foods, foods browned from cooking)

  • Arachidonic acid

  • Excess adipose tissue

  • Oxidative stress

• What decreases oxidative stress:

  • Antioxidants in plant foods

  • Especially dark coloured fruits and vegetables

  • Berries

  • Leafy green vegetables

  • Whole grains

Endothelium

• Produces nitric oxide → vasodilation, decreases BP, increase O2 and nutrient delivery

• What foods increase nitric oxide production?

  • Nitrate rich greens, e.g. kale, spinach, roquette, basil, silver beet

• What damages endothelium?

  • Saturated fat

  • Haem-iron rich foods, e.g. red and processed meat

Diet for cardiovascular health

• Avoid: animal foods, highly processed foods

  • High cholesterol, saturated fat, trans fat, fructose

  • Low/no fibre, phytonutrients, antioxidants

• Increase: whole, plant-based foods

  • High soluble fibre, vitamins, minerals, phytonutrients, antioxidants, nitrates

Barriers

• Motivation → transtheoretical model of behaviour change

• Taste → takes 30-90 days to re-sensitive taste preferences to natural foods and flavours

• Opportunity → convenient options include canned legumes, frozen vegetables, microwave rice or quinoa

• Time → batch cook

• Cost → legumes, wholegrains, potatoes are cheap

Tips for changing diet

• Food swaps

  • Refined grains → whole grains

  • Meat → legumes, or add can of legumes to meals

• Add vegetables to meals 

• Leafy greens with every meal

• Snack on fruit to crowd out unhealthy food

• Doctors for nutrition website

  • Information for students and clinicians

  • Food Vitals webinars

  • Free online course

  • The 4Leaf Survey

  • Recipes

  • 7 day meal plan

• Book: plant based nutrition in clinical practice

• Moving Medicine Forward MasterClass by Dr Michael Klaper

• ASLM website