Question

78 CHAPTER 4 Relationship Between Food and Disease 2. Your dad developed a BP of 170/90. Explain what that means to him and describe the DAS diet. Ate 3. New Yorkers will develop type 2 diabetes at epidemic levels. Describe a prevention prograo reduce our risk. DASHin Diet Fist Effects of a C-Rea Emuch, R The Ner Kas R. M ment for Asociati The Nationa 4. Your friend gets bloated afer eating flour and wheat. Describe a gluten-fe diet to hetal Ch

Answer 1

1.Blood pressure of 170/90 is considered as high BP.with one reading a person cant be diagnosed as a hypertensive.So , atleast 3 consecutive readings of blood pressure to be taken in lying and sitting positions at relaxed state to made up a conclusion.If the BP is still high noting more than 140/90 ,can be considered as Hypertension.

High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.

Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.

a person can have high blood pressure (hypertension) for years without any symptoms. Even without symptoms, damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.

High blood pressure generally develops over many years, and it affects nearly everyone eventually. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.

Dietary Approaches to Stop Hypertension, or DASH, is a diet recommended for people who want to prevent or treat hypertension — also known as high blood pressure — and reduce their risk of heart disease.

The DASH diet focuses on fruits, vegetables, whole grains and lean meats.

The diet was created after researchers noticed that high blood pressure was much less common in people who followed a plant-based diet, such as vegans and vegetarians (5, 6).

That’s why the DASH diet emphasizes fruits and vegetables while containing some lean proteinsources like chicken, fish and beans. The diet is low in red meat, salt, added sugars and fat.

Scientists believe that one of the main reasons people with high blood pressure can benefit from this diet is because it reduces salt intake.

The regular DASH diet program encourages no more than 1 teaspoon (2,300 mg) of sodium per day, which is in line with most national guidelines.

The lower-salt version recommends no more than 3/4 teaspoon (1,500 mg) of sodium per day.

2.Diabetes is epidemic in New York City. Diabetes prevalence has more than doubled over the past 10 years.

Physical inactivity and unhealthy eating may lead to overweight or obesity – increasing a person’s risk of developing diabetes.

Diabetes Prevention Program (DPP)

DPP Goal

The DPP looked at whether the DPP Lifestyle Change Program or taking metformin would delay or prevent type 2 diabetes.

DPP Results

After about 3 years, the DPP showed that participants in the DPP Lifestyle Change Program lowered their chances of developing type 2 diabetes by 58 percent compared with participants who took a placebo (a pill without medicine). The DPP Lifestyle Change Program was effective for all participating racial and ethnic groups and both men and women. The Program worked particularly well for participants ages 60 and older, lowering their chances of developing type 2 diabetes by 71 percent. About 5 percent of participants in the DPP Lifestyle Change Program developed diabetes each year during the study compared with 11 percent of participants who took a placebo.

Participants who took metformin lowered their chances of developing type 2 diabetes by 31 percent compared with participants who took a placebo. Metformin was effective for all participating racial and ethnic groups and both men and women. Metformin was most effective in women with a history of gestational diabetes, in people between the ages of 25 and 44, and in people with obesity who had a body mass index of 35 or higher.

DPP Study Design

The DPP was a randomized, controlled clinical trial conducted at 27 clinical centers around the United States from 1996 to 2001. The trial enrolled 3,234 participants; 55 percent were Caucasian, and 45 percent were from minority groups at high risk for the disease, including African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander. The trial also recruited other groups at high risk for type 2 diabetes, including people ages 60 and older, women with a history of gestational diabetes, and people with a parent, brother, sister, or child who had type 2 diabetes.

DPP participants were randomly assigned to one of the following groups:

• Lifestyle Change Group – Group participants joined a DPP Lifestyle Change Program that provided intensive training. Participants tried to lose 7 percent of their body weight and maintain that weight loss by eating less fat and fewer calories and exercising 150 minutes per week. Researchers met with participants individually at least 16 times in the first 24 weeks, and then every 2 months with at least 1 phone call between visits.
• Metformin Group – Group participants took 850 mg of metformin twice a day and were provided standard advice about diet and physical activity.
• Placebo Group – Group participants took a placebo twice a day instead of metformin and were provided standard advice about diet and physical activity.

DPP participants who developed diabetes remained in the study and received additional care from their own physicians if good blood glucose control could not be maintained.

After DPP ended all participants were provided a modified group version of the DPP’s Lifestyle Change program.

Diabetes Prevention Program Outcomes Study (DPPOS)

DPPOS Goal

The DPPOS is following DPP participants to see if participants who took part in the DPP Lifestyle Change Program or who are continuing to take metformin have a delay in the development of type 2 diabetes over time and if they experience fewer health problems such as cancer, cardiovascular diseases, nerve damage, kidney disease, eye disease, and age-related health problems such as trouble with physical function and difficulties with thinking or memory.

DPPOS Results

10-Year Findings

At the 10-year follow-up

• participants who took part in the DPP Lifestyle Change Program continued to have a delay in the development of diabetes by 34 percent—and developed diabetes about 4 years later—compared with participants who took a placebo. Participants from the DPP Lifestyle Change Program ages 60 and older had a delay in the development of diabetes by 49 percent.
• participants who continued to take metformin had a delay in the development of diabetes by 18 percent—and developed diabetes about 2 years later—compared with participants who took a placebo.
• participants from the DPP Lifestyle Change Program and participants who continued to take metformin or took a placebo all improved their risk factors for cardiovascular diseases, such as high blood pressure and cholesterol. However, the participants from the DPP Lifestyle Change Program achieved these results with fewer blood pressure and cholesterol-lowering medications.
• the DPP Lifestyle Change Program was shown to be cost-effective and metformin was shown to be cost-saving.

• DPPOS Study Design

  The DPPOS follow-up study started in 2002. All 3,149 surviving participants of DPP groups were eligible for the DPPOS, including those with and without diabetes. Of the 3,149 surviving participants, 2,776 (88 percent) joined the DPPOS. Similar proportions of each DPP group joined the DPPOS and remained in their original groups. There were some changes to the treatments each group received:

• Lifestyle Change Group –Group participants received quarterly group lifestyle change classes throughout the study and two group classes yearly to reinforce self-management behaviors for weight loss.
• Metformin Group – Group participants received quarterly group lifestyle change classes throughout the study. Participants continued to take metformin and were told that they were taking metformin.
• Placebo Group – Group participants received quarterly group lifestyle change classes throughout the study. Participants did not take a placebo pill.
• DPPOS participants who developed diabetes remained in the study and received additional care from their own physicians if good blood glucose control could not be maintained.

3. A gluten-free diet involves excluding foods that contain the protein gluten, including wheat, rye and barley.

luten is a family of proteins found in wheat, barley, rye and spelt.

Its name comes from the Latin word for “glue,” as it gives flour a sticky consistency when mixed with water.

This glue-like property helps gluten create a sticky network that gives bread the ability to rise when baked. It also gives bread a chewy and satisfying texture

Completely avoiding gluten can be challenging.

This is because it is found in many common ingredients that are added to foods.

These are the main sources of gluten in the diet:

• Wheat-based foods like wheat bran, wheat flour, spelt, durum, kamut and semolina
• Barley
• Rye
• Triticale
• Malt
• Brewer’s yeast

Below are some foods that may have ingredients containing gluten added to them:

• Bread. All wheat-based bread.
• Pasta. All wheat-based pasta.
• Cereals. Unless labeled gluten-free.
• Baked goods. Cakes, cookies, muffins, pizza, bread crumbs and pastries.
• Snack foods. Candy, muesli bars, crackers, pre-packaged convenience foods, roasted nuts, flavored chips and popcorn, pretzels.
• Sauces. Soy sauce, teriyaki sauce, hoisin sauce, marinades, salad dressings.
• Beverages. Beer, flavored alcoholic beverages.
• Other foods. Couscous, broth (unless labeled gluten-free).

The easiest way to avoid gluten is to eat unprocessed, single-ingredient foods. Otherwise, you should read the food labels of most foods you buy.

Oats are naturally gluten-free. However, they are often contaminated with gluten, as they might be processed in the same factory as wheat-based foods.Completely avoiding gluten can be challenging, as it’s found in many common foods. The best way to completely avoid it is to eat whole, single-ingredient foods.

Foods to Eat

There are plenty of gluten-free options that will allow you to enjoy healthy and delicious meals.

The following foods are naturally gluten-free:

• Meats and fish. All meats and fish, except battered or coated meats.
• Eggs. All types of eggs are naturally gluten-free.
• Dairy. Plain dairy products, such as plain milk, plain yogurt and cheeses. However, flavored dairy products may have added ingredients that contain gluten, so you will need to read the food labels.
• Fruits and vegetables. All fruits and vegetables are naturally free of gluten.
• Grains. Quinoa, rice, buckwheat, tapioca, sorghum, corn, millet, amaranth, arrowroot, teff and oats (if labeled gluten-free).
• Starches and flours. Potatoes, potato flour, corn, corn flour, chickpea flour, soy flour, almond meal/flour, coconut flour and tapioca flour.
• Nuts and seeds. All nuts and seeds.
• Spreads and oils. All vegetable oils and butter.
• Herbs and spices. All herbs and spices.
• Beverages. Most beverages, except for beer (unless labeled as gluten-free).

Health benefits of gluten free diet:

1. May Relieve Digestive Symptoms

2.Can Reduce Chronic Inflammation in Those With Celiac Disease

3.May Boost Energy

4. Can Help You Lose Weight

Disadvantages :

1. Risk of a Nutritional Deficiency

2. Constipation

3.Following a gluten-free diet can be difficult on a tight budget.