11.2 Plan Nutritional Strategies to Impact Cardiovascular Wellness
4 min read•june 18, 2024
Alzheimer's disease wreaks havoc on the brain, causing protein buildup and neuronal damage. This leads to memory loss, cognitive decline, and eventually, complete dependence on caregivers. Understanding its mechanisms is crucial for developing effective treatments.
Diagnosis involves a mix of cognitive tests, brain scans, and biomarker analysis. While age and genetics play a role, lifestyle factors can influence risk. Early detection is key, as symptoms progress from mild forgetfulness to severe cognitive impairment.
Overview of Alzheimer's Disease
Mechanisms of Alzheimer's disease
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- Abnormal accumulation of proteins in the brain disrupts neuronal function
- Beta-amyloid plaques form sticky clusters between neurons interfering with cell communication and triggering inflammation
- Neurofibrillary tangles composed of twisted tau protein fibers accumulate inside neurons causing instability of microtubules and impairing transport of nutrients
- Neuronal dysfunction and loss leads to cognitive decline
- Synaptic dysfunction impairs communication between neurons due to beta-amyloid plaques and neurofibrillary tangles reducing neurotransmitter release and signaling
- Neuronal death causes progressive loss of neurons in affected brain regions resulting in brain atrophy and cognitive impairment
- Affected brain regions include the hippocampus and cerebral cortex
- Hippocampus plays a crucial role in learning and memory formation and is an early site of damage (short-term memory loss)
- Cerebral cortex responsible for higher cognitive functions such as reasoning and language is gradually affected as the disease progresses (difficulty with complex tasks, language, and decision-making)
Neurobiological factors in Alzheimer's disease
- Neurodegeneration: Progressive loss of structure or function of neurons, including death of neurons
- Cholinergic system: Impairment of this system, which uses acetylcholine as a neurotransmitter, contributes to memory and cognitive deficits
- Neurotransmitters: Imbalances in various neurotransmitter systems affect brain function and cognition
- Neuroplasticity: Reduced ability of the brain to form new neural connections and adapt to changes
- Blood-brain barrier: Alterations in this protective barrier may contribute to disease progression
- Neuroinflammation: Chronic inflammation in the brain exacerbates neuronal damage
- Oxidative stress: Increased cellular damage due to an imbalance between free radicals and antioxidants
Symptoms of Alzheimer's progression
- Early stage characterized by memory loss and mild cognitive impairment
- Difficulty remembering recent events or newly learned information often repeating questions or statements (forgetting appointments, misplacing items)
- Trouble with complex tasks, planning, and organizing as well as difficulty with problem-solving and decision-making (struggling to manage finances, getting lost in familiar places)
- Middle stage marked by worsening memory loss, language difficulties, and changes in mood and behavior
- Inability to recall personal history or recognize familiar people along with confusion about time, place, and events (forgetting names of family members, wandering)
- Struggling to find the right words or follow conversations with reduced vocabulary and impaired comprehension (using incorrect words, difficulty understanding instructions)
- Apathy, depression, or irritability as well as restlessness, agitation, or wandering (losing interest in hobbies, becoming easily upset, pacing)
- Late stage characterized by severe cognitive decline, physical deterioration, and complete dependence on caregivers
- Inability to communicate effectively or respond to the environment with loss of awareness of surroundings and recent experiences (unable to recognize loved ones, unresponsive to stimuli)
- Difficulty with mobility, balance, and coordination as well as incontinence and difficulty swallowing (bedridden, requiring assistance with feeding and personal care)
- Require assistance with all daily activities and increased susceptibility to infections and complications (pneumonia, pressure ulcers)
Causes and diagnosis of Alzheimer's
- Potential causes include age, genetic factors, and environmental and lifestyle factors
- Age is the greatest risk factor with prevalence increasing significantly after age 65
- Genetic factors include rare familial Alzheimer's disease caused by specific gene mutations inherited from a parent typically developing earlier in life (30s to 50s) and more common genetic risk factors such as APOE-e4 increasing likelihood of developing Alzheimer's without guaranteeing disease development
- Environmental and lifestyle factors such as head trauma, , and low education levels may increase risk while maintaining a healthy lifestyle (exercise, balanced diet) may reduce risk
- Diagnostic methods involve medical history, cognitive assessments, neuroimaging techniques, and biomarker analysis
- Evaluation of symptoms, family history, and overall health along with cognitive tests to assess memory, language, and problem-solving skills (Mini-Mental State Exam, Montreal Cognitive Assessment)
- Neuroimaging techniques such as Magnetic Resonance Imaging (MRI) to detect brain atrophy and structural changes helping rule out other conditions and Positron Emission Tomography (PET) using radioactive tracers to visualize abnormal protein accumulation (beta-amyloid and tau) and assess brain metabolism and function
- Biomarker analysis including cerebrospinal fluid (CSF) tests measuring levels of beta-amyloid and tau proteins (lower beta-amyloid and higher tau levels suggest Alzheimer's) and emerging blood tests potentially detecting Alzheimer's-related changes in blood biomarkers currently used in research settings with ongoing efforts to develop reliable clinical tests
Key Terms to Review (47)
Added Sugars: Added sugars refer to any sugars or caloric sweeteners that are added to foods or beverages during processing or preparation. These include white sugar, brown sugar, high-fructose corn syrup, and other sweeteners that contribute calories but lack the fiber, vitamins, and minerals found in naturally occurring sugars from fruits, vegetables, and dairy products.
Albumin: Albumin is a protein made by the liver that plays a crucial role in maintaining oncotic pressure and transporting various substances in the blood. It is essential for proper fluid distribution between body compartments.
Arrhythmias: Arrhythmias are abnormal heart rhythms that occur when the electrical signals that coordinate the heart's contractions are disrupted. These irregularities can affect the heart's ability to effectively pump blood throughout the body, and they are closely tied to the cardiovascular system's overall health and function.
Atherosclerosis: Atherosclerosis is a chronic, inflammatory condition characterized by the buildup of plaque within the arteries. This plaque is made up of cholesterol, fat, and other substances that accumulate on the inner walls of the blood vessels, gradually narrowing and hardening them over time.
Blood pressure: Blood pressure is the force exerted by circulating blood on the walls of blood vessels. It is a critical parameter in assessing cardiovascular health and can be influenced by nutrition, lifestyle, and various medical conditions.
BMI: BMI, or Body Mass Index, is a measure calculated using a person's weight and height. It is commonly used to categorize individuals into different weight statuses such as underweight, normal weight, overweight, and obesity.
Cardiovascular disease: Cardiovascular disease (CVD) encompasses a range of conditions affecting the heart and blood vessels. It includes coronary artery disease, hypertension, stroke, and heart failure, among others.
Cardiovascular Exercise: Cardiovascular exercise, also known as aerobic exercise, is physical activity that increases the heart rate and breathing rate for an extended period of time. It is a crucial component of maintaining cardiovascular wellness and overall health.
Cholesterol: Cholesterol is a waxy, fat-like substance found in all cells of the body. It is essential for producing hormones, vitamin D, and substances that help digest foods.
Cholesterol levels: Cholesterol levels refer to the amount of cholesterol present in the blood, which includes low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides. These levels are crucial indicators of cardiovascular health and can be influenced by diet, lifestyle, and genetics.
DASH Diet: The DASH (Dietary Approaches to Stop Hypertension) diet is a eating plan focused on reducing blood pressure and promoting overall cardiovascular health. It emphasizes the consumption of fruits, vegetables, whole grains, lean proteins, and low-fat dairy products, while limiting sodium, saturated fats, and added sugars.
DHA: DHA, or docosahexaenoic acid, is a long-chain omega-3 fatty acid that is essential for proper brain, eye, and nervous system development and function. It is a critical component of the phospholipids that make up cell membranes, particularly in the brain, retina, and heart.
Dietary Approaches to Stop Hypertension: Dietary Approaches to Stop Hypertension (DASH) is a dietary plan designed to reduce blood pressure and promote cardiovascular health. It emphasizes the consumption of fruits, vegetables, whole grains, lean proteins, and low-fat dairy while reducing sodium intake.
Disease prevention: Disease prevention involves strategies and actions aimed at preventing the onset of diseases, particularly chronic ones like cardiovascular diseases. It includes lifestyle changes, medical interventions, and public health policies to reduce risk factors.
Emotional Eating: Emotional eating is the practice of consuming food in response to feelings or emotions, rather than true physical hunger. It is a coping mechanism where individuals turn to food as a way to soothe, distract, or reward themselves during times of stress, boredom, or other negative emotional states.
EPA (Eicosapentaenoic Acid): EPA, or eicosapentaenoic acid, is a type of omega-3 fatty acid that is essential for human health. It is primarily found in fatty fish and fish oil supplements and plays a crucial role in various physiological processes, including the neurologic, cardiovascular, and musculoskeletal systems.
Fiber: Fiber is a type of carbohydrate that the body cannot digest. It helps regulate the body's use of sugars, keeping hunger and blood sugar in check.
Fiber: Fiber refers to the indigestible parts of plant-based foods that pass through the human digestive system without being broken down. It plays a crucial role in maintaining gut health, managing chronic conditions, and promoting overall wellness.
Food Deserts: Food deserts are geographic areas where access to affordable and nutritious food options is limited or nonexistent. These areas typically lack supermarkets, grocery stores, and other sources of healthy, fresh food, making it challenging for residents to maintain a balanced and nutritious diet.
Food Preferences: Food preferences refer to an individual's subjective liking or disliking of certain foods, which are influenced by a complex interplay of biological, psychological, and sociocultural factors. These preferences play a crucial role in shaping dietary choices and patterns, ultimately impacting cardiovascular wellness.
Food preparation: Food preparation involves the process of planning, selecting, and cooking food to ensure nutritional balance and safety. It is essential for maintaining cardiovascular health through appropriate dietary choices.
HDL Cholesterol: HDL (High-Density Lipoprotein) cholesterol is a type of cholesterol that is often referred to as the 'good' cholesterol. It plays a crucial role in maintaining cardiovascular health by helping to remove excess cholesterol from the body and transport it to the liver for processing and elimination.
High-density lipid (HDL) cholesterol: High-density lipoprotein (HDL) cholesterol is often termed 'good' cholesterol because it helps remove other forms of cholesterol from the bloodstream. Higher levels of HDL are associated with a lower risk of heart disease.
Hypertension: Hypertension, also known as high blood pressure, is a chronic medical condition characterized by consistently elevated blood pressure levels above the normal range. It significantly increases the risk of heart disease, stroke, and kidney failure.
Hypertension: Hypertension, also known as high blood pressure, is a chronic medical condition characterized by an elevated force of blood pushing against the walls of the arteries. It is a major risk factor for several cardiovascular diseases, including heart attack, stroke, and kidney disease. Understanding hypertension is crucial in the context of evidence-based practice, mineral intake, cardiovascular wellness, and the impact of nutrition across the lifespan and in chronic illnesses.
Hypoalbuminemia: Hypoalbuminemia is a condition characterized by abnormally low levels of albumin in the blood. Albumin is a protein made by the liver that helps maintain osmotic pressure and transport substances in the bloodstream.
Insulin Resistance: Insulin resistance is a physiological condition in which cells fail to respond normally to the hormone insulin. As a result, the body is unable to effectively use glucose from the bloodstream, leading to high blood sugar levels and an increased risk of various health issues, particularly those related to the endocrine system and cardiovascular health.
LDL Cholesterol: LDL (Low-Density Lipoprotein) cholesterol is a type of cholesterol that carries cholesterol particles from the liver to the body's cells. It is often referred to as the 'bad' cholesterol because high levels can contribute to the buildup of plaque in the arteries, increasing the risk of heart disease and stroke.
Lean Protein: Lean protein refers to protein-rich foods that are low in fat and calories. These high-quality protein sources provide essential amino acids without the excess saturated fat and calories that can contribute to cardiovascular disease risk factors.
Low-density lipid (LDL) cholesterol levels: Low-density lipoprotein (LDL) cholesterol levels indicate the amount of LDL cholesterol in the blood, often referred to as 'bad' cholesterol. High levels can lead to plaque buildup in arteries, increasing the risk of cardiovascular diseases.
Meal Planning: Meal planning is the process of organizing and preparing meals in advance to ensure a balanced, nutritious, and cost-effective diet. It involves selecting appropriate foods, determining portion sizes, and creating a schedule for meals and snacks to meet an individual's or family's dietary needs and preferences.
Mediterranean diet: The Mediterranean diet is a nutritional plan inspired by the traditional eating habits of countries bordering the Mediterranean Sea. It emphasizes whole foods, healthy fats, lean proteins, and abundant fruits and vegetables to promote overall health and well-being.
Mediterranean Diet: The Mediterranean diet is a plant-based eating pattern that emphasizes the consumption of whole, minimally processed foods commonly found in the countries surrounding the Mediterranean Sea. This diet is characterized by a high intake of fruits, vegetables, whole grains, legumes, nuts, and olive oil, along with moderate consumption of fish, poultry, and red wine. The Mediterranean diet has been extensively studied for its numerous health benefits, including its positive impact on evidence-based practice and nutrition, gut health, neurological wellness, endocrine wellness, hematological wellness, cardiovascular wellness, pulmonary wellness, and musculoskeletal and integumentary wellness.
Monounsaturated Fats: Monounsaturated fats are a type of dietary fat that contain one double bond in the fatty acid chain. They are considered a healthier alternative to saturated fats and can help improve cardiovascular wellness and reduce the risk of long-term cardiovascular illnesses when consumed in moderation as part of a balanced diet.
Omega-3 Fatty Acids: Omega-3 fatty acids are a type of polyunsaturated fatty acid that are essential for human health. They play a crucial role in various bodily functions, including the maintenance of the neurological, endocrine, cardiovascular, and pulmonary systems. Omega-3s are considered 'essential' because the body cannot produce them on its own, and they must be obtained through diet or supplementation.
Omega-6 Fatty Acids: Omega-6 fatty acids are a type of polyunsaturated fatty acid (PUFA) that are essential for human health. They play crucial roles in various physiological processes, including cardiovascular function, immune response, and skin health.
Phytochemicals: Phytochemicals are a diverse group of naturally occurring plant-based compounds that have been shown to provide various health benefits beyond basic nutrition. These compounds are found in fruits, vegetables, grains, and other plant-based foods, and they play a crucial role in human health and wellness across multiple areas, including nutrition, supplements, cardiovascular health, and musculoskeletal and integumentary wellness.
Polyunsaturated Fats: Polyunsaturated fats are a type of dietary fat that contain multiple double bonds in their carbon chain. These fats are considered 'healthy' fats and play a crucial role in maintaining cardiovascular wellness and managing long-term cardiovascular illnesses.
Portion Control: Portion control refers to the practice of managing the amount of food consumed at each meal or snack. It involves being mindful of serving sizes and making conscious decisions about the quantity of food intake to support overall health and wellness.
Saturated fat: Saturated fat is a type of dietary fat found in animal products and some plant oils. It is solid at room temperature and linked to increased levels of LDL cholesterol, which can impact cardiovascular health.
Saturated Fats: Saturated fats are a type of fat that is solid at room temperature and is primarily found in animal-based foods and some plant-based oils. These fats are characterized by the presence of single bonds between their carbon atoms, resulting in a straight and rigid molecular structure. Saturated fats play a crucial role in various aspects of nutrition and population health, the cardiovascular system, long-term cardiovascular illnesses, and gastrointestinal wellness across the lifespan.
Sodium: Sodium is an essential mineral that plays a critical role in maintaining fluid balance, nerve function, and muscle contraction. It is commonly consumed through salt (sodium chloride) in the diet.
Trans fats: Trans fats are a type of unsaturated fat that have been hydrogenated to be solid at room temperature. They are commonly found in processed foods and have been linked to negative health effects, particularly cardiovascular disease.
Trans Fats: Trans fats, or trans fatty acids, are a type of unsaturated fat that is created through an industrial process called hydrogenation. This process turns liquid vegetable oils into solid or semi-solid fats, resulting in a product that is more stable, has a longer shelf life, and can withstand repeated heating at high temperatures. Trans fats have been linked to numerous negative health effects, particularly in the context of cardiovascular and neurological diseases, as well as gastrointestinal wellness.
Triglycerides: Triglycerides are a type of fat found in the blood that the body uses for energy. They are the main storage form of fat in the body and play a crucial role in cardiovascular health, as well as in the overall metabolism and energy balance.
Unsaturated fats: Unsaturated fats are fats that have one or more double bonds in their fatty acid chains, which makes them liquid at room temperature. They are generally considered healthier than saturated fats and can positively impact cardiovascular health.
Whole Grains: Whole grains are cereal grains that have retained the entire grain kernel, including the bran, germ, and endosperm. This makes them a nutritious choice as they contain the full complement of vitamins, minerals, and fiber that are often stripped away during the refinement process.