12.2 Nutrition and Long-Term Cardiovascular Illnesses
3 min read•june 18, 2024
Multiple sclerosis is a complex autoimmune disorder that attacks the central nervous system. It causes demyelination, , and axonal damage, leading to a range of neurological symptoms that can significantly impact daily life.
Diagnosis involves a combination of clinical evaluation, MRI scans, and cerebrospinal fluid analysis. Treatment focuses on managing symptoms and slowing disease progression through immunomodulatory therapies, which aim to reduce relapses and disability.
Overview of Multiple Sclerosis
Mechanisms of multiple sclerosis
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- Autoimmune disorder involves the immune system mistakenly attacking the central nervous system (CNS)
- T-cells, a type of white blood cell, cross the blood-brain barrier and enter the CNS causing damage
- Demyelination occurs when T-cells attack and damage the myelin sheath, the protective covering around nerve fibers
- Damage to myelin disrupts the transmission of electrical signals along nerve fibers leading to impaired function
- Scarring (sclerosis) occurs in multiple areas where myelin is damaged resulting in hardened, scar-like tissue
- Axonal damage can occur as the disease progresses, where the nerve fibers (axons) themselves become damaged
- Axonal damage leads to permanent neurological deficits and disability due to irreversible nerve damage
- Inflammation in the CNS is caused by immune system activation
- Inflammatory chemicals contribute to further damage of myelin and nerve fibers exacerbating the condition
- Neuroplasticity, the brain's ability to form new neural connections, can help compensate for some damage
Signs and symptoms of multiple sclerosis
- Visual disturbances such as optic neuritis, an inflammation of the optic nerve
- Blurred vision, double vision, or complete loss of vision in one eye can occur
- Sensory symptoms include numbness, tingling, or burning sensations in the face, body, or extremities
- Paresthesia, abnormal sensations such as pins and needles, may be experienced
- Motor symptoms involve muscle weakness, especially in the legs
- Difficulty with coordination and balance can be present
- Spasticity, stiffness and involuntary muscle spasms, may occur
- Fatigue is an overwhelming tiredness that worsens as the day progresses
- May be exacerbated by heat exposure (Uhthoff's phenomenon)
- Cognitive changes such as difficulty with attention, concentration, and memory
- Slowed information processing speed can be observed
- Bowel and bladder dysfunction including urgency, frequency, or incontinence
- Constipation may also be experienced
- Sexual dysfunction such as decreased libido, erectile dysfunction, or reduced vaginal lubrication
- Other symptoms can include vertigo and dizziness
- Pain, including trigeminal neuralgia and dysesthetic pain, may be present
- Emotional changes, such as depression or mood swings, can occur
Factors and diagnosis of multiple sclerosis
- Risk factors for developing MS include genetic susceptibility, where certain genes increase the risk
- Environmental factors such as low vitamin D levels, smoking, and Epstein-Barr virus infection may play a role
- Geographic location, with higher prevalence in regions farther from the equator, is a contributing factor
- Age and gender, typically diagnosed between 20-40 years old and more common in women, are risk factors
- Diagnostic methods involve a neurological examination to assess signs and symptoms
- Magnetic Resonance Imaging (MRI) detects lesions in the brain and spinal cord and helps rule out other conditions
- Cerebrospinal fluid (CSF) analysis, obtained through a lumbar puncture, may show oligoclonal bands and elevated IgG index suggesting MS
- Evoked potential tests measure the electrical activity of the brain in response to stimuli and can detect subtle changes in nerve conduction
- McDonald Criteria are diagnostic guidelines that combine clinical presentation, MRI findings, and CSF analysis to confirm MS diagnosis and rule out other possible causes
- The Expanded Disability Status Scale (EDSS) is used to quantify disability in MS patients and monitor disease progression
Types and Treatment of Multiple Sclerosis
- Relapsing-remitting MS is characterized by periods of symptom flare-ups followed by periods of remission
- Progressive MS involves steady worsening of neurologic function over time without distinct relapses
- Immunomodulatory therapy is a primary treatment approach, using medications to modify the immune system's response
- These treatments aim to reduce the frequency and severity of relapses and slow disease progression
Key Terms to Review (34)
Abdominal Fat: Abdominal fat, also known as visceral fat or central obesity, refers to the accumulation of fat deposits around the abdomen, particularly within the abdominal cavity. This type of fat is associated with increased risk of various long-term cardiovascular illnesses.
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.
Blood Pressure Management: Blood pressure management refers to the strategies and interventions used to monitor, control, and maintain healthy blood pressure levels within the body. It is a critical aspect of cardiovascular health and long-term disease prevention.
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 Health: Cardiovascular health refers to the overall well-being and functioning of the heart, blood vessels, and the circulatory system. It encompasses the ability of the cardiovascular system to effectively pump blood, deliver oxygen and nutrients to tissues, and maintain proper blood pressure and blood flow throughout the body.
Coronary artery disease: Coronary artery disease (CAD) is a condition characterized by the narrowing or blockage of the coronary arteries due to plaque buildup. It can lead to reduced blood flow to the heart muscle, resulting in chest pain, heart attacks, and other cardiovascular issues.
Coronary Artery Disease: Coronary artery disease (CAD) is a condition in which the major blood vessels that supply the heart with blood, oxygen, and nutrients become damaged or diseased, usually due to a buildup of cholesterol-containing plaques. This impairs the heart's ability to function properly and can lead to serious complications like heart attack.
Dietary Patterns: Dietary patterns refer to the overall composition and combination of foods and beverages that an individual or population typically consumes. These patterns encompass the types, quantities, and frequency of different food groups and nutrients in a person's diet, providing a holistic view of eating behaviors and nutritional intake.
Fiber-Rich Foods: Fiber-rich foods are plant-based foods that contain high amounts of dietary fiber, a type of carbohydrate that the body cannot digest. These foods provide numerous health benefits, particularly in the context of long-term cardiovascular illnesses, by helping to regulate blood sugar levels, lower cholesterol, and promote healthy digestion.
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.
Heart attack: A heart attack, or myocardial infarction, occurs when blood flow to a part of the heart is blocked for a long enough period that part of the heart muscle is damaged or dies. It is often caused by a blockage in one or more coronary arteries due to plaque buildup.
Heart Disease: Heart disease is a broad term that encompasses a variety of conditions affecting the heart and blood vessels. It is a leading cause of morbidity and mortality worldwide, often resulting from the buildup of plaque in the arteries, which can restrict blood flow and increase the risk of heart attack, stroke, and other cardiovascular events.
High blood pressure: High blood pressure, or hypertension, is a condition where the force of the blood against artery walls is consistently too high. It can lead to severe health complications and increases the risk of heart disease, stroke, and sometimes death.
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.
Inflammation: Inflammation is the body's natural immune response to various stimuli, such as injury, infection, or irritation. It involves the activation of the body's defense mechanisms to remove harmful agents and initiate the healing process. Inflammation plays a crucial role in maintaining overall health and wellness across various bodily systems, including the endocrine, cardiovascular, pulmonary, gastrointestinal, musculoskeletal, and integumentary systems.
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 Proteins: Lean proteins are a type of protein that are low in fat and calories, making them a healthier choice for individuals looking to maintain a balanced diet, especially in the context of long-term cardiovascular illnesses. These proteins provide essential amino acids without the excess saturated fat and cholesterol often found in higher-fat protein sources.
Lipids: Lipids are a diverse group of hydrophobic molecules that include fats, oils, waxes, and steroids. They play key roles in energy storage, cell membrane structure, and signaling pathways.
Mediterranean Cuisine: Mediterranean cuisine refers to the traditional cooking styles and dietary patterns found in the countries surrounding the Mediterranean Sea. This plant-based, whole-food approach to eating is renowned for its health benefits, particularly in relation to long-term cardiovascular illnesses.
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.
Myocardial infarction: Myocardial infarction, commonly known as a heart attack, occurs when blood flow to a part of the heart is blocked for long enough to cause damage or death to the heart muscle. This blockage is usually caused by a buildup of fat, cholesterol, and other substances forming a plaque in the coronary arteries.
Nutrient-Dense Foods: Nutrient-dense foods are those that provide a high concentration of essential vitamins, minerals, and other beneficial nutrients relative to their calorie content. These foods are a crucial component in maintaining long-term cardiovascular health by supporting overall nutrition and reducing the risk of chronic conditions like heart disease and stroke.
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.
Plant-Based Protein: Plant-based protein refers to protein derived from non-animal sources, such as legumes, grains, nuts, seeds, and vegetables. These protein sources provide essential amino acids and are an important part of a healthy, balanced diet, particularly for individuals following vegetarian or vegan lifestyles.
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 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 Intake: Sodium intake refers to the amount of sodium, a vital mineral, that is consumed through the diet. Sodium plays a crucial role in various bodily functions, but excessive intake has been linked to long-term cardiovascular illnesses, making it an important consideration in the context of 12.2 Nutrition and Long-Term Cardiovascular Illnesses.
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 (lipid) found in your blood. They serve as a major form of energy storage in the body.
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.
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.