Diet and Cardio Vascular Risk Factors

Technip World Health Day
November, 21 2013
Diet and Cardio Vascular Risk Factors

50% of the worlds population live in cities. The rise of Cardio Vascular Diseases (CVD) has been linked to progressive urbanization and the globalization of unhealthy lifestyles exacerbated by urban life. Today Technip will inform you on how to prevent CVD through simple life and dietary rules.
Dr Sabine Genty Technip Corporate Doctor

Diet and Cardio Vascular Risk Factors
The Health and Safety of our people is a core value and an absolute commitment. (Technip HSE Policy) While you may have heard many messages to keep us safe, we need to be also reminded that we need to stay healthy. Do we invest enough to be knowledgeable in these aspects to maintain our health? A healthy life style, a good work- life balance, sports and an appropriate diet are the key! This booklet has been compiled by the Medical Department to help us learn about how we can reduce the incidences of Cardio Vascular Diseases. It covers the food we should eat, the risk profile and other very interesting general information. Please find the time to study it. I found it useful and I am sure you will! Thank You Edgar Pushparatnam Group QHSE Director

Diet & Cardio Vascular Risk Factors
Contents
TEST YOUR KNOWLEDGE IN THE WORLD WHO campaign 2013 control your blood pressure WHAT ARE THE MAIN RISK FACTORS CARDIO VASCULAR DISEASES (CVD) Coronary & peripheral artery diseases Heart attacks Stroke disease CALCULATE WHAT YOUR RISK IS Body Mass Index (BMI) Framingham Score WOMEN & CARDIO VASCULAR DISEASES CARDIO VASCULAR-HEALTHY DIET Diet and Cardio Vascular disease 8 steps to prevent CVD TEST RESULTS INTERNET LINKS FOR MORE INFORMATION 4 6 7 8 10 10 11 12 14 14 15 16 17 17 18 22 24
The aim of this booklet is to improve understanding of an unhealthy diet as one of the most important Cardio-Vascular risk factors.
3 Technip World Health Day Diet & CVD risk factors
Test your knowledge

1. Which is not a type of cardiovascular disease A. Varicose veins B. High Blood pressure C. Cellulitis D. Stroke 2. Cardiovascular disease kills far more men and women than cancer A. True B. False 3. Risk factors and symptoms of cardiovascular disease are identical for men and women A. True B. False 4. Cardiovascular disease is hereditary and cannot be prevented A. True B. False 5. Skipping breakfast is a good way to lose weight A. True B. False 6. Which one is the bad cholesterol A. LDL cholesterol B. HDL cholesterol C. Total cholesterol 7. At what age should you start getting checked for CVD if you are healthy adult? A. 20 B. 30 C. 40 D. 50
Test your knowledge

8. Saturated fat can raise your cholesterol level and increase your risk of CVD. Which of these is a saturated fat? A. Olive oil B. Flax oil C. Butter D. Rapeseed Oil 9. Certain food help you burn fat A. True B. False 10. You dont need to worry about your childrens CVD risk until they are at least 18 A. True B. False 11. CVD is the number 1 health threat to postmenopausal women A. True B. False 12. Eating a diet that includes plenty of pasta, potatoes and white rice can reduce your risk of heart disease A. True B. False 13. How many glasses of alcoholic beverages harm your health? A. >3/day B. >5/day 14. The French enjoy a 42% lower incidence of heart disease than Americans because they drink red wine A. True B. False See answers page 22 and 23
In the World (1/2)

Cardio Vascular Diseases (CVDs) are the number ONE cause of death globally: more people die annually from CVDs than from any other cause An estimated 17.3 million people died from CVDs in 2008, representing 30% of all global deaths. Of these deaths, an estimated 7.3 million were due to coronary heart disease and 6.2 million were due to stroke
(source: World Health Organization 03/2013)
80% of CVD deaths take place in low- and middleincome countries The number of people who die from CVDs, mainly from heart disease and stroke, will increase to reach 23.3 million by 2030 CVDs and deaths occur almost equally in men and women. Younger women who have heart attack have higher mortality than men of the same age Most cardiovascular diseases are caused by risk factors that can be controlled, treated or modified such as unhealthy diet and obesity, raised lipids, physical inactivity, diabetes, high blood pressure and tobacco use
Most of Technip employees live and work in urban areas that may engender unhealthy lifestyles, a poor diet and a lack of physical activity
In the World (2/2)

WHO World Health Day 2013: Control your blood pressure
April 2, 2013 = High blood pressure contributes to more than 9 million deaths every year, including about half of all deaths due to heart disease and stroke. Cut your risk of developing high blood pressure by: cutting down on salt, eating a balanced diet, avoiding harmful use of alcohol, doing regular physical activity and avoiding tobacco use. These will also reduce your cardio vascular risk factors 40% of adults aged 25 and over have raised blood pressure (2008)
WHO Internet link = http://www.who.int/campaigns/worldhealth-day/2013/event/en/
What are the main risk factors ? (1/2)

The most important behavioral risk factors of heart and cerebrovascular diseases are:
An unhealthy diet increases the risk of cardio-vascular and noncommunicable diseases Physical inactivity: a sedentary lifestyle with no or irregular physical activity less than 1/2h walk/day Harmful use of alcohol: WHO definition is consumption of more than 3 glasses for men and 2 glasses for women per day Use of tobacco
What are the main risk factors ? (2/2)

Other risk factors can interconnected, such as:
High blood pressure is a
condition in which the pressure of the blood against your artery walls is high enough to cause possible CVDs
Blood pressure Normal If diabetic In mmHg 140/90 130/90
Blood pressure apparatus, to test blood pressure level
Diabetes is a condition
characterized by hyperglycemia resulting from the body's inability to regulate the blood glucose level
Normal Glucose blood level 126 mg/dl or 7,0 mmol/l
Glucometer to test glucose blood level
Age & gender Personal and family medical history & genetics Others: stress, sleep disorders, etc. Behavioral risk factors are responsible for about 80% of coronary heart and cerebrovascular disease
(source World Heart Organization)
Cardio Vascular Diseases

Coronary & peripheral artery diseases
Coronary artery and peripheral artery diseases are caused by atherosclerosis, that develops in the walls of blood vessels supplying the heart, brain and/or arms and legs over many years.
Atherosclerosis
Normal Artery Artery inner
What is it?
Long-term development, characterized by deposit of fatty material on the inner walls of arteries That cause, ischemia, the arteries narrow and blood flow is restricted artery vessel
Atherosclerosis
How does it happen?

Reduction in the flow of oxygen-rich blood to organs
Fatty deposit
What are the effects?

Potential blood clot in coronary artery (heart attack), brain (stroke) or limbs (necrosis)
Heart Attack
What is it?
Acute event due to atherosclerosis/clot in the coronary arteries
Coronary Artery Fatty deposit Blocked Blood flow
How does it happen?

The blood flow is cut off to a section of heart muscle
How to care?
Treatment is to dissolve the clot and re-open the artery
Dead Heart Muscle
Heart Attacks
Most common symptoms*
Pain or discomfort in the center of the chest Pain or discomfort in the arms, the left shoulder, elbows, jaw, or back Difficulty in breathing or shortness of breath Feeling sick or vomiting Feeling light-headed or faint Breaking into a cold sweat Becoming pale * Symptoms could occur one by one or together, intensity could differ
Risk factors are the same in men and women, but symptoms can be slightly different
(not exhaustive list of symptoms)
Men Chest discomfort Uncomfortable pressure Arm pain Shortness of breath
Women Nausea / vomiting Jaw and/or back pain Palpitations Flu-like symptoms Anxiety, fatigue, emotional stress
Stroke Disease (1/2)

Cerebro-vascular diseases are a group of disorders of blood vessels supplying the brain Stroke
Damaged brain area Blood vessel Blood clot
What is it?
Acute event, due to fatty deposits on the inner walls of the blood vessels
How does it happen?

It is caused by a blockage of the blood flow to a section of the brain
Different types of Stroke

Hemorrhagic = when a blood vessel ruptures and prevents blood flow to the brain (less common) Ischemic = when a clot obstructs the flow of blood to the brain generally caused by atherosclerosis Sometimes, the blockage is temporary = ministroke or Transcient Ischemic Attack (TIA) which can then become an ischemic stroke
Hemorrhagic Stroke
Blood vessel rupture
Ischemic Stroke
Blood leaks into brain tissue
Blood clots stop the flow of blood

Stroke disease (2)

Most common symptoms
Sudden weakness or numbness of the face, arm, and/or leg, most often on one side of the body Sudden confusion, trouble speaking or understanding Sudden trouble seeing in one or both eyes Sudden difficulty walking, dizziness, loss of balance or coordination; Sudden severe headache with no known cause Fainting or unconsciousness.
Remember F.A.S.T and act
Calculate what your risk is (1/2)

BMI = Body Mass Index To calculate your BMI
< 18.5 =Thinness >25 = Overweight
18.5 < Normal < 25 >30 = Obesity
Calculate what your risk is (2/2)

Framingham Score
The Framingham Score is a gender-specific algorithm used to estimate the 10-year cardiovascular risk of an individual Everybody can estimate their 10-year cardiovascular risk on the following web page: http://www.framinghamheartstudy.org/risk/coronary.html Framinghamheartstudy.org The only information you need before are the last blood test results (Total & HDL cholesterol ) and your blood pressure. Example of table above, you can enter you result in the last column. Calculate your score
Age Gender Total Cholesterol (or LDL) HDL Cholesterol Smoker Diabetes Blood Pressure Are you being treated for High Blood pressure
To define
years F M
Points
mmol/L ... mmol/L YES YES NO NO
mm Hg
YOUR SCORE
Do not hesitate to ask to your MD for more information Other web page are available: http://www.mdcalc.com/framingham-coronary-heart-disease-risk-score-siunits/
Women & Cardio Vascular Diseases

As the symptoms can be different, CVDs are underestimated in women. Women are under-diagnosed and under-treated. Studies show that younger women who have heart attacks have higher mortality than men of the same age. It is important to be aware that risk factors are the same for men and women.
Number 1 killer of women = 8.6 million/year
Women and CVD, the fact are:

Women in low- and middle-income countries who develop CVD are more likely to die from it than comparable women in industrialized nations Women with diabetes have higher CVD mortality rates than men with diabetes Women are more likely than men to become more disabled by stroke Educating women greatly increases their willingness and ability to take heart-protective action, for themselves and their families There are steps women can take to protect their hearts, these include: ensuring a healthy food intake maintaining a healthy weight engaging in physical exercise and stopping smoking
Cardio Vascular-Healthy Diet

Diet and cardiovascular disease
The role of diet is crucial in the development and prevention of cardiovascular disease. Diet is one of the key things you can change that will impact all other cardiovascular risk factors.
10 ways to protect your heart & brain from cardio vascular diseases:
1 2 3 4 5 6 7 8 9 10 Eat less salt Eat more fish Swap your snacks Have regular meals Think about drinks Be a savvy shopper Eat smart when eating out Keep an eye on portion sizes Eat 5 portions of fruit and vegetable a day Cut down on fat, especially saturated fat
Heart-Healthy Diet (1/4)

8 steps to prevent CVDs
Incorporate these 8 tips into your life Find that heart-healthy eating is both feasible and enjoyable
1. Limit unhealthy fats and cholesterol

Limiting saturated fats (<7% daily cal) & trans fats (<1% daily cal) = trimming fat off your meat or choosing lean cuts
Olive oil Canola oil Margarine free of trans fats Cholesterol-lowering margarine
Butter, lard, bacon fat, gravy, cream sauce and non diary creamer, margarine, cocoa butter, coconut, palm cottonseed & palm-kernel oils
2. Choose low-fat protein sources

Lean meat, poultry & fish, egg whites, fish rich in omega-3, fatty acids
Skim or low-fat milk, fat-free or low-fat dairy products, egg, fish, skinless poultry, legumes, soybeans & soy products
Full-fat milk, dairy products, offal, egg yolks, fatty and marbled meats, frankfurters, hotdogs & sausages, bacon, fried or crumbed meats

Incorporate these 8 tips into your life
Find that heart-healthy eating is both feasible and enjoyable
3. Eat more vegetables and fruits

Good source of vitamins and minerals Low in calories and rich in dietary fiber
Fresh or frozen vegetables and fruits, low-sodium canned vegetables, canned fruit packed in juice or water
Coconut, vegetables with creamy sauces, fried & crumbed vegetables, canned fruit packed in heavy syrup, frozen fruit with sugar added
4. Select whole grains

Good sources of fiber Good nutrients which help in regulating blood pressure
Whole-wheat flour, wholegrain bread, high-fiber cereal, whole grains (brown rice, barley & buckwheat (kasha), whole-grain pasta, oatmeal, ground flaxseed
White, refined flour, white bread, muffins, frozen waffles, com bread, quick breads, biscuits, cakes, pies, egg noodles, high-fat snack crackers

5. Reduce the sodium in your food

For healthy adults, sodium 2,3mg a day (a tea spoon) People 51yo and/or with High Blood Pressure, sodium 1,5mg a day
Herbs & spices, salt substitutes, reduced-salt canned soups or prepared meals, reduced-salt versions of condiments
Table salt Canned soups & prepared foods, such as frozen dinners
6. Control your portion size

Need to know how much you should eat Portions served in restaurant are often over-generous
Monitor serving sizes until you are comfortable with your judgment
Eating fast Eating until you feel full Dont overload your plate

7. Plan ahead: Create daily menus

Need to know how much you should eat Portions served in restaurant often more than anyone needs
Use the 6 strategies above & create daily menus, select vegetables, fruits & whole grains, add variety to your menus, watch your portion sizes
No diversification in your plate, same menus every day, only sugar, burgers and fatty meats, only potatoes, candies, pies, biscuits, etc.
8. Allow yourself an occasional treat

You know now what is healthy diet for your heart and corps
Exceptions are allowed, a balance must be found to maintain progress in the long term, healthy eating is enjoyable
Deviate from your hearthealthy diet too much: overindulgence should be the exception
Quiz Answers (1/2)

1. Which is not a type of cardiovascular disease
C. Cellulitis CVD is any condition that affects the heart (cardio) or the blood vessels (vascular). Varicose veins is indeed a type of CVD. Cellulitis is a bacterial infection of the skin, not related to CV
2. Cardiovascular disease kills far more men and women than cancer
A. True Although cancer is more common, CVD is the chief cause of death in most of the countries. CVD is the silent epidemic
3. Risk factors and symptoms of cardiovascular disease are identical for men and women
B. False Women's hearts, coronary arteries and other blood vessels are smaller than men's, which means it may take less plaque to block them. Men and women also experience heart attack symptoms differently. See more information in this booklet page 11 and 16
4. Cardiovascular disease is hereditary and cannot be prevented

B. False Even if there is heart disease in your family and even if you have high cholesterol, altering your diet and leading a healthy lifestyle can dramatically reduce your risk of heart attack and stroke.
5. Skipping breakfast is a good way to lose weight

B. False Skipping meals, especially breakfast, can make you feel tired and hungry and more likely to reach for high-fat, high-calorie snacks. In fact, people who eat breakfast are more likely to maintain a healthy weight than those who dont.
6. Which one is the bad cholesterol

A. LDL Cholesterol HDL cholesterol protects the arteries. Total cholesterol raises in parallel with LDL cholesterol
7. At what age should you start getting checked for CVD if youre healthy adult?
A. 20 American Heart Association guidelines recommend that your doctor begin assessing your risk of cardiovascular disease at age 20. Assessment includes lifestyle habits, family history, blood pressure and pulse check, body mass index and waist check.
Quiz Answers (2/2)

8. Saturated fat can raise your cholesterol level and increase your risk of CVD. Which of these is a saturated fat?
C. Butter Olive oil is monounsaturated fat, flax oil is a polyunsaturated fat with healthy omega-3 fatty acids, and rapeseed oil is a polyunsaturated fat. Saturated fat is commonly found in animal products. More information pages 18 to 21
9. Certain food help you burn fat B. False

No food can actually help you burn fat. The important thing is eating less calories (energy), rather than eating specific foods wrongly thought to have special properties
10. You dont need to worry about your childrens CVD risk until theyre at least 18
B. False Risk factors for cardiovascular disease are rising among adolescents and even younger children. As with adults, these risk factors are often related to unhealthy lifestyles (inactivity, obesity, diabetes, high blood pressure, etc.)
11. CVD is the number 1 health threat to postmenopausal women

A. True During and after menopause, as estrogen levels decrease, the risk of heart disease in women dramatically rises
12. Eating a diet that includes plenty of pasta, potatoes and white rice can reduce your risk of heart disease
B. False For years we were told that a heart-healthy diet included food low in fat and high in carbohydrates. Eating food with a high glycaemic index, such as cookies, cake, bagels, pasta, potato chips, raises blood sugar and insulin levels, and stimulates triglycerides production (risk factor of CVD)
13. How many glasses of alcoholic beverages harm your health?

A. >3 /day The WHO defines the threshold of excessive consumption at 21 glasses /week for men and 14 glasses/week for women. More information page 8
14. The French enjoy a 42% lower incidence of heart disease than Americans because they drink red wine
A. True While the French do eat a high-fat diet these includes high-fiber grains and red wine. Red wine raises the level of beneficial HDL cholesterol and lowers the risk of blood clots and heart attack. However, red wine must be consumed in moderation ! One glass a day is enough

Diet & Cardio Vascular Risk Factors
November, 21 2013
On line information
Tpnet Group Medical Technip World Health Day 2013 World Health Organization (WHO) = Cardiovascular diseases, non-communicable diseases, diet & unhealthy diet, physical activity, salt intake, fats, blood pressure, etc.
http://www.who.int/cardiovascular_diseases/en/ http://www.who.int/dietphysicalactivity/implementation/toolbox/en/index.html http://www.who.int/dietphysicalactivity/workplace/en/index.html
World Heart Federation = Cardiovascular & heart diseases, strokes, cardiovascular risk factors, etc.
http://www.world-heart-federation.org
BMI & Framingham calculate what your risk is

http://www.framinghamheartstudy.org/risk/gencardio.html https://www.cvdriskchecksecure.com/FraminghamRiskScore.aspx http://www.cdc.gov/healthyweight/assessing/bmi/
THANK YOU

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