Prevention and Management of Cardiovascular and Metabolic Disease

Description:
Prevention and Management of Cardiovascular and Metabolic Disease

Provides accurate and well-documented information on the impact of diet and physical activity in the prevention and management of cardiovascular and metabolic diseases and healthy aging.

This authoritative textbook examines the independent and combined impact of diet and physical activity in the prevention and management of cardiovascular and metabolic diseases, with special emphasis on the elderly populations.

In this book the authors:

• Provide the latest data on the association between a suboptimal diet and physical inactivity and chronic disease.
• Examine the role of epigenetics on longevity.
• Discuss the fundamentals of healthy aging.
• Highlight the role of well-known dietary patterns such as the Mediterranean diet and the Nordic diet in favorable health outcomes, including cardiovascular, metabolic health, and healthy aging.
• Discuss the health outcomes of physical activity and healthy aging.
• Present the most recent evidence-based data on the independent and synergistic impact of diet and exercise on disease prevention and management including, heart disease, diabetes mellitus, hypertension, dyslipidemia, kidney failure, cancer and other conditions.

Prevention and Management of Cardiovascular and Metabolic Disease: Diet, Physical Activity and Healthy Aging is an excellent textbook for upper-level undergraduate and graduate students in medical and health-related disciplines and for health professionals, including dietitians and nutritionists, exercise physiologists, athletic trainers, nurses, physicians, geriatricians, and other health professionals with a special focus in older adults. This book is also a highly useful reference for health professionals interested in introducing diet and physical activity as an intervention for healthy aging as well as the prevention and management of cardiovascular and other metabolic diseases that are prevalent in aging populations.

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Preface

Approximately 2500 years ago, the Greek physician and father of medicine Hippocrates wrote: “If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.” In more recent years, a plethora of scientific evidence supports this concept.

In this book, we present strong scientific evidence that supports the important role of proper diet and physical activity on the prevention and management of cardio-metabolic diseases and mortality. Our focus is on older adults and healthy aging, as the aging population is increasing globally and is expected to nearly double by 2050. Millions of deaths worldwide are attributed to some of today’s most common diseases such as cardiovascular disease, obesity, type 2 diabetes mellitus, and others.

It is now well-accepted that individuals who follow a healthy lifestyle live longer and are in better health. Key health behaviors such as physical activity and healthy diet are among the factors that contribute to reducing the risk of chronic diseases, improving quality of life, and promoting healthy aging.

The main aim of this book is to provide health professionals, clinicians, and students in medical and health-related disciplines with the most recent scientific evidence on the impact of diet and physical activity in the prevention and management of several chronic diseases that are prevalent in aging populations. Our goal is to provide accurate and well-established knowledge and to identify gaps in our knowledge as well as new challenges for current and future health professionals in our quest to find the safest way to healthy aging via proper diet and physical activity.

This book can serve as a primer for all health-care professionals involved in the prevention and management of cardiovascular and metabolic conditions with a special focus on older adults, or in a research lab that studies some aspects of lifestyle in relation to healthy aging.

The book is divided into five units. In every chapter, readers are provided with the latest, in-depth scientific evidence in specific areas.

Unit 1: Diet and Physical Activity as Determinants of Human Health. In Unit 1, we discuss the dual role of lifestyle, e.g., the negative (unhealthy lifestyle) or positive (healthy lifestyle) effects on health. We first describe the link between a suboptimal diet and physical inactivity with non-communicable diseases. Next, we discuss the concept and mechanisms of epigenetics, presenting how lifestyle stimuli can change our gene expression. We finish this unit by describing the beneficial role of healthy/prudent diets on health.

Unit 2: Basic Concepts of Physical Activity and Fitness. Unit 2 begins with an introduction to the fundamental knowledge needed for both basic and more complex definitions of physical activity, exercise, and fitness. We then describe the implications and health benefits of physical activity in adults.

Unit 3: Determinants of Healthy Aging. In Unit 3, we begin with a discussion on aging and age-related disease (e.g., the definition of healthy aging, the interface between healthy aging, longevity, and disease, the physiological changes in multiple organ systems through aging, measuring and monitoring tools). Next, we emphasize the role of nutrients, foods, and healthy dietary patterns on aging. For example, we discuss in detail the Mediterranean dietary pattern, the Nordic diet, the Dietary Approaches to Stop Hypertension (DASH) diet, the vegetarian diet, and the Okinawan diet by presenting the latest evidence-based data on this topic. We finish this unit by including the applicability of metrics used in physical activity for older adults as well as mechanisms to reduce sarcopenia and frailty, common health issues in older adults. We hope that this section will be a useful guide in the hands of health professionals and clinicians who manage older-adult patients by acknowledging the instrumental role of diet and physical activity as determinants of healthy aging.

Unit 4: Cardiovascular Health, Diet, and Physical Activity. Unit 4 is devoted to specific cardiovascular diseases common in older adults, e.g., heart failure and atrial/flutter fibrillation as well as the loss of normal endothelial function as a hallmark of vascular diseases. We discuss the challenges faced in the assessment and management of these diseases in adults and older adults. We also present specific exercise training and dietary interventions for these populations.

Unit 5: Cardio-metabolic Health, Diet, and Physical Activity. In Unit 5, we describe the most common metabolic diseases, which include diabetes mellitus, hypertension, dyslipidemia, obesity, metabolic syndrome, obstructive sleep apnea, chronic kidney disease, and obesity-induced cancers. Most of these conditions require a weight-loss intervention as part of the strategy to prevent and manage the disease. We provide evidence on the impact of diet- or exercise-alone interventions on muscle physiology in these patients and older adults. We also discuss the synergistic effects of diet and physical activity in achieving optimal health. Some of the distinctive features of the book are:

1. Well-established knowledge related to cardiovascular and metabolic diseases that affect human health.

2. Applicability to those interested in studying or working with older-adult patients.

3. An easy-to-use and read format that can be used for undergraduate and graduate teaching.

4. The latest evidence-based data to describe some of the healthiest dietary patterns according to the 2015 Dietary

Guidelines for Americans: the Mediterranean-style eating pattern, the DASH diet, the Nordic dietary pattern, and the vegetarian-type dietary pattern.

5. Highlighted main messages (key points) at the end of each chapter.

6. Over 200 “Self-assessment Questions” and answers that offer readers the most comprehensive, and up-to-date coverage in relation to the material presented in the book.

7. Useful links and related bibliographies at the end of each chapter with patent-related information and services.

8. A collection of clinical “Case scenarios” at the end of each chapter in Units 4 and 5, for students and health professionals to enhance their knowledge and practice skills relevant to each clinical condition.

We hope that this book can serve as a valuable tool to students in medical and health-related disciplines and to health professionals, including dietitians and nutritionists, exercise physiologists, athletic trainers, nurses, physicians, geriatricians, and other health professionals. We hope that the information included in this book will advance the implementation of non-pharmacological strategies that include proper dietary and exercise interventions to better manage cardiovascular and metabolic diseases in adults and older adults, ultimately leading to healthy aging.

We are grateful to Ioanna Katsaroli MSc, Mara Alepoudea cMMedSci, Athanasia Kyrkili ΜSc, Alexandros Tsigkas MSc, Michael Georgoulis PhD, Natasha Kolomvotsou PhD, Eleftheria Papachristou MSc, Despoina Chaloutsi, and Alexandra

Foskolou PhD. These passionate young scientists contributed tremendously to completing this book with thorough literature reviews, drafting and editing chapters, and helping during the final stages of book editing. Last, but not least we would like to thank the Wiley team for their dedication and professionalism; Mandy Collison, Tom Marriott, Ranjith Kumar Thanigasalam, Anitha Jasmine Stanley, and Ada Hagan, PhD.

We would like also to thank our families for their continuous love and support.

Table of contents :
Cover
Title Page
Copyright Page
Contents
Preface
List of Contributors
UNIT 1 Diet and Physical Activity as Determinants of Human Health
CHAPTER 1 The Link between Sub-optimal Diet and Physical Inactivity with Non-communicable Diseases
Introduction
Sub-optimal Diet in Terms of Nutrients
Low Dietary Fiber Intake
High Dietary Sodium Intake
High Saturated Fatty Acid Intake
High Trans Fatty Acids Intake
Sub-optimal Diet in Terms of Foods and Food Groups
Low Consumption of Fruits and Vegetables
Low Consumption of Whole-grain Products
High Intake of Added/Free Sugar and Sweetened Beverages
Foods and Food Groups Rich in Saturated Fatty Acids
High Processed-meat Consumption
Sub-optimal Diet in Terms of Dietary Patterns
The Western Dietary Pattern
Physical Inactivity
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
Links
CHAPTER 2 Lifestyle and Epigenetics
Introduction
Epigenetics Overview
Epigenetics Definition
Epigenetic Mechanisms
Epigenetics and Disease Epidemiology
The Barker Hypothesis
Epigenetics in utero and Maternal Lifestyle
Maternal Undernutrition
Maternal Overnutrition
Dietary Pattern as an Epigenetic Mark
Epigenetics and Stress
Psychological Stress
Cigarette Smoking
Alcohol Consumption
Endocrine Disruptors
Physical Activity and Epigenetic Alterations
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
CHAPTER 3 Healthy/Prudent Diets and Health Benefits in Adults
Introduction
A Healthy/Prudent Diet Definition
Dietary Patterns that are Considered Healthy
The Mediterranean-type Dietary Pattern
Health Effects of the Mediterranean Diet
All-cause and Disease-specific Mortality
Cardiovascular Diseases
Hypertension
Type 2 Diabetes Mellitus
Dyslipidemia
Obesity/Metabolic syndrome
Cancer
Healthy Aging
The Dietary Approaches to Stop Hypertension (DASH) Dietary Pattern
Initial Dietary Approaches to Stop Hypertension (DASH) Trials
The Dietary Approaches to Stop Hypertension (DASH) Diet Characteristics
The Dietary Approaches to Stop Hypertension (DASH) Diet Health Effects
All-cause and Specific-cause Mortality
Obesity/Metabolic Syndrome
Type 2 Diabetes Mellitus/Hyperglycemia
Hyperlipidemia
Cancer
Chronic Kidney Disease
The Healthy Nordic Dietary Pattern
Health Effects of the Nordic Diet
Chronic Disease Risk
All-cause and Specific-cause Mortality
Inflammation
Physical Performance and Cognitive Health in Older Adults
The Healthy Vegetarian-type Dietary Pattern
Health Effects of the Healthy Vegetarian–type Dietary Pattern
CVD Risk and Mortality
Blood Pressure/Hypertension
Type 2 Diabetes
Metabolic Syndrome
Cancer
Considerations in Implementing a Healthy Vegetarian-type Dietary Pattern
The Healthy US-style Dietary Pattern
Effectiveness of Healthy/Prudent Dietary Patterns
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
Links
UNIT 2 Basic Concepts of Physical Activity and Fitness
CHAPTER 4 Definition of Fitness and Its Components
Definition of Physical Fitness
Aerobic and Anaerobic Fitness
Health-related Physical Fitness Components
Cardiovascular or Cardiorespiratory Fitness
Body Composition
Muscular Fitness
Muscular Strength
Muscular Endurance
Muscular Endurance Versus Aerobic Endurance
Flexibility
Skill-Related Physical Fitness Components
Speed, Agility, Balance, Reaction Time, Power
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
Links
CHAPTER 5 Defining Physical Activity and Exercise
Definition of Physical Activity and Exercise
Quantifying the Intensity of Physical Activity
Total Energy Expenditure
Physical Activity Level
Perceived Exertion (Borg Rating of Perceived Exertion Scale)
Metabolic Equivalents of Task
VO2max
Percent of Maximum Heart Rate
Heart Rate Reserve Method (Karvonen Method)
VO2 Reserve Method
Exercise Duration
Exercise Frequency
Exercise Volume
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
Links
CHAPTER 6 Implications and Health Benefits of Physical Activity in Adults
Introduction
Physical Activity and Inactivity Estimations Worldwide
Sedentary Behavior
Premature All-cause Mortality
Health Impact of Physical Activity
Physical Activity Guidelines
Interventions to Increase Physical Activity
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
Links
UNIT 3 Determinants of Healthy Aging
CHAPTER 7 Healthy Aging: Definition and Scope
Introduction
Overview of the Aging Process
Biology of Aging
Early Concepts of Healthy Aging
The Concept of Successful Aging
Healthy Aging
Definition
Life-course Approach to Healthy Aging
Special Considerations
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
CHAPTER 8 The Interface Between Healthy Aging, Longevity, and Disease
Introduction
Overview of Longevity
The Longevity Boom
Sex Differences
Geographical Longevity Clusters
Overview of the Concepts of Morbidity and Mortality
Longevity as a Healthy Aging Model
Are the Long Lived, Healthy Lived?
The Heritability of Longevity and Healthy Aging
Epigenetic Mechanisms and Longevity
How to Achieve a Healthy and Long Life Span
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
Links
CHAPTER 9 Physiological Changes in Multiple Organ Systems Through Aging: Measuring and Monitoring Aging
Introduction
Physiological Changes in Multiple Organ Systems Through Aging
Cardiovascular
Pulmonary
Immune System
Neurologic Function
Musculoskeletal System
Sarcopenia
Frailty
Measurements
Hand-grip Strength
Gait Speed
Balance Assessment
Timed Up-and-Go (TUG) Test
30-second Chair Stand
Four-stage Balance Test
Complex Balance Measures
Short Physical Performance Battery (SPPB)
Functionality Assessment Tools: Activities of Daily Living (ADLs) Assessment Tools
ADL Assessment Tool: Barthel Index
ADL Assessment Tool: Katz Index of Independence in Activities of Daily Living (ADL)
ADL Assessment Tool: Functional Independence Measure (FIM)
IADL Assessment Tool: ADL Profile Instrumental (IADL)
IADL Assessment Tool: Lawton Instrumental ADL Scale
IADL Assessment Tool: Performance Assessment of Self-care Skills (PASS)
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
Links
CHAPTER 10 The Role of Plant-based Diets on Healthy Aging
Introduction
The Role of Macronutrients in Healthy Aging
Protein
Carbohydrates
Fat Intake
Plant-based Diets
Plant Polyphenols
The Mediterranean Diet
The Nordic Diet
Dietary Approaches to Stop Hypertension (DASH) Diet
The Okinawan Diet
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
Links
CHAPTER 11 Physical Activity as a Determinant of Healthy Aging
Introduction
Physical Inactivity
Physical Activity as a Determinant of Healthy Aging
Cardiovascular Health
Immune System
Cognitive Function
Musculoskeletal Health
Physical Activity and Sarcopenia
Physical Activity and Frailty
The VIVIFRAIL Exercise Protocol
Physical Activity Recommendations for Older Adults
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
UNIT 4 Cardiovascular Health, Diet, and Physical Activity
CHAPTER 12 Heart Failure
Introduction
Definition
Classification
Prevalence
Clinical Conditions Associated with Heart Failure
Obesity
Obesity Paradox
Malnutrition and Sarcopenia Heart Failure Patients
Diabetes and Heart Failure
Heart Failure in Older Adults
Cognitive Impairment in Patients with Heart Failure
Therapeutic Management of Heart Failure
Lifestyle Factors and Heart Failure
Body Weight and Caloric Restriction
Nutrition and Dietary Approaches
Sodium Restriction
Fluid Restriction
Dietary Patterns
DASH Diet
Mediterranean Diet
Nutritional Supplements
Thiamine Supplementation
Iron Supplementation
Essential Amino Acids Supplementation
Omega-3 Poly-unsaturated Fatty Acid Supplementation
Physical Activity and Exercise for Heart Failure Prevention and Therapy
Physical Activity and Heart Failure
Physical Inactivity and Heart Failure
Exercise Training in Heart Failure
Intensity of Exercise in Patients with Heart Failure
Type of Exercise in Patients with Heart Failure
Tailored Exercise Advice in Patients with Heart Failure
Key Points
Self-assessment Questions
Case Scenario
References
Further Reading
Bibliography
Links
CHAPTER 13 Atrial/Flutter Fibrillation
Definition
Prevalence
Etiology
Complications
Management
Nutrition in Atrial Fibrillation
Physical Activity and Risk of Atrial Fibrillation
Exercise Training and Atrial Fibrillation Management
Physical Activity Recommendations
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
Links
CHAPTER 14 Endothelial Function
Introduction
Endothelial Dysfunction
Description
Assessment
Management
Nutrition and Endothelial Function
Obesity and Weight Loss
Nutrients and Foods
Dietary Patterns
Physical Activity and Endothelial Function
Exercise Training and Endothelial Function
Vasodilation
Oxidative Stress
Fibrinolysis
Angiogenesis
Inflammation
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
Link
UNIT 5 Cardio-metabolic Health, Diet, and Physical Activity
CHAPTER 15 Diabetes Mellitus
Definition
Epidemiology
Types of Diabetes
Diagnosis of Diabetes Mellitus
Prediabetes
Complications
Heart Disease and Stroke
High Blood Pressure
Diabetic Retinopathy
Diabetic Kidney Disease
Diabetic Neuropathy
Amputations
Dental Disease
Complications of Pregnancy
Other Complications
Physiology and Pathophysiology
Physical Inactivity/Sedentary Behavior and Diabetes Mellitus
Obesity, Diabetes Mellitus and Mortality
Prevention or Delay of Diabetes Mellitus
Non-pharmacological Management of Diabetes Mellitus
Nutrition-based Interventions
Nutrition Interventions for Older Adults with Diabetes
Physiology of Exercise in Type 1 Diabetes
Physiology of Exercise in Type 2 Diabetes
Benefits of Physical Activity
Benefits of Reducing Sedentary Time
Exercise-based Interventions
Nutrition and Exercise: Combined Interventions
Exercise Guidelines for Diabetes Mellitus Patients
Key Points
Self-assessment Questions
References
Further Reading
Bibliography
Links
CHAPTER 16 Hypertension
Introduction
Definition
Prevalence
Risk Factors
Unhealthy/Poor Diets
Sodium Intake
Alcohol Intake
Physical Inactivity
Body-Mass Index/Obesity
Co-morbidities and Complications
Lifestyle Modifications for the Prevention and Management of Hypertension
Treatment Goals for Patients with Hypertension
Dietary Strategies to Prevent and Manage Hypertension
Weight Loss
Sodium Restriction
Potassium Intake
Magnesium Intake
Calcium Intake
Omega-3 Fatty Acids
Caffeine
Alcohol
Dietary Patterns
DASH Diet
Mediterranean Diet
Vegetarian Diets
Nordic Diet
Physical Activity, Fitness, and Hypertension
Physical Activity Guidelines for Hypertension
Nutrition and Exercise: Combined Interventions
Other strategies
Key Points
Self-assessment Questions
Case Scenario
References
Further Reading
Bibliography
Links
CHAPTER 17 Dyslipidemia
Introduction
Epidemiology
Pathophysiology
Risk Factors
Cardiovascular Disease Risk Assessment
Preventing ASCVD
Management
Diet
DASH Diet
Mediterranean Diet
Physical Activity and Exercise Training Role on Blood Lipids
Physical-activity Recommendations
Total Cholesterol
Triglycerides
Low-density Lipoprotein-cholesterol
High-density Lipoprotein-cholesterol
Type of Exercise Training and Blood Lipids
Intensity of Training and Blood Lipids
Dyslipidemia in Older adults: The Role of Physical Activity and Diet
Key Points
Self-assessment Questions
Case Scenario
References
Further Reading
Bibliography
Links
CHAPTER 18 Obesity and Metabolic Syndrome
Introduction
Definition, Assessment, and Classification of Obesity
Epidemiology of Obesity
Pathogenesis of Obesity
Complications and Co-morbidities of Obesity
Obesity Paradox
Metabolically Healthy Obesity
Prevention of Obesity
Early Strategies
Healthy Weight
Dietary Sugar
Dietary Patterns
Physical Activity
Treatment of Obesity
Goals
Who Needs Weight Loss?
Dietary Strategies
Physical Activity and Obesity
Nutrition and Exercise: Combined Interventions
Pharmacotherapy and Bariatric Surgery
Lifestyle Modifications During Weight-loss Maintenance
Introduction to Metabolic Syndrome
Epidemiology of Metabolic Syndrome
Diagnosis of Metabolic Syndrome
Lifestyle and Risk of Metabolic Syndrome
Diet
Physical Activity
Management of Metabolic Syndrome
Diet
Physical Activity
Exercise and Nutrition: Combined Intervention
Recommendations
Key Points
Self-assessment Questions
Case Scenario
References
Further Reading
Bibliography
Links
CHAPTER 19 Obstructive Sleep Apnea
Introduction
Diagnosis
Prevalence
Pathophysiology and Risk Factors
Complications
Management
Nutrition in Obstructive Sleep Apnea
Diet as a Risk Factor for Obstructive Sleep Apnea Development and Progression
Dietary Modifications for Obstructive Sleep Apnea Management
Role of the Mediterranean Diet/Lifestyle in Obstructive Sleep Apnea
Physical Activity, Fitness, and Obstructive Sleep Apnea
Exercise Training and Obstructive Sleep Apnea Management
Key Points
Self-assessment Questions
Case Scenario
References
Further Reading
Bibliography
Links
CHAPTER 20 Chronic Kidney Disease
Introduction
Definition
Prevalence
Etiology
Complications
Management
Nutrition in Chronic Kidney Disease
Physical Activity, Fitness, and Chronic Kidney Disease
Physical Activity and Fitness Status of Chronic Kidney Disease Patients
Physical Activity, Fitness, and Risk of Chronic Kidney Disease
Physical Activity, Fitness, and Mortality Risk in Chronic Kidney Disease
Exercise Training and Chronic Kidney Disease Management
Physical Function
Disease Progression
Cardiovascular Risk
Physical Activity Recommendations
Key Points
Self-assessment Questions
Case Scenario
References
Further Reading
Bibliography
Links
CHAPTER 21 Cancer Introduction
Introduction
Risk Factors
Excess Body Fat
Alcohol
Red and Processed Meat
Dietary Fiber, Whole Grains, Fruits, and Vegetables
Calcium and Dairy Products
Sugar-Sweetened Drinks, Fast and Ultra-processed Foods
Dietary Patterns
Dietary Supplements
Sedentary Behavior
Physical Activity
Diet and Physical Activity Recommendations for Prevention
Nutrition and Physical Activity in Patients Living With or Beyond Cancer
Body Weight, Body Composition, and Physical Activity during Therapy
Role of Nutrition and Physical Activity during Therapy
Role in Prehabilitation for Surgery
Role in Long-term Survivorship
Key Points
Self-assessment Questions
Case Scenario
References
Further Reading
Bibliography
Links
APPENDIX Answers to Self-assessment Questions