NUTRITION IN MEDICAL DISEASES
Chronic Non-Communicable Diseases(NCDs): Also known as chronic diseases, are usually of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors.NCDs are much more common in older age and up to 80% of people have at least one of these conditions before the age of 70. They disproportionately affect people in lower middle-income countries and are occurring at increasingly younger ages.The main types of NCDs are cardiovascular diseases (such as heart attacks and strokes), cancer, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes. Modifiable behaviors such as tobacco use, physical inactivity, unhealthy diet, and harmful alcohol consumption increase the risk of CVD. Metabolic risk factors contribute to four major metabolic changes that increase the risk of NCDs: high blood pressure, overweight and obesity, hyperglycemia (high blood glucose levels), and hyperlipidemia (elevated blood fat levels)..
Examples of chronic pathologies that we can treat at the Kuzmar Clinic: -
High Blood Pressure: We speak of hypertension when the blood pressure in our blood vessels is too high (140/90 mmHg or more). It is a common problem that can be serious if left untreated.Sometimes it causes no symptoms and the only way to detect it is to take your blood pressure.The risk of hypertension may increase in these cases:
Advanced age
Genetic causes
Overweight or obesity
Lack of physical activity
Eating too much salt
Drinking too much
Chronic Kidney Disease: Chronic kidney disease (CKD) is defined by the presence of renal lesions and/or a decrease in glomerular filtration rate (GFR) of more than 3 months and can be classified into five stages. A diagnosis of renal failure is established when the GFR is less than 60 ml/min/1.73 m2. This definition helps guide the management of each stage of the disease. Early detection of CKD is based on the determination of creatinine, GFR, and microalbuminuria in patients with risk factors for developing CKD.
Chronic heart failure: The inability of the heart to pump blood in adequate volumes to meet the body's needs; exertional dyspnea is the most common symptom, although it is very non-specific; other symptoms include orthopnea, paroxysmal nocturnal dyspnea, and lower limb edema. The most frequently associated comorbidities were hypertension, diabetes mellitus, chronic obstructive pulmonary disease, sleep-disordered breathing, renal dysfunction, anemia/ferropenia, depression, and cognitive impairment. Arrhythmias are also very common and worsen prognosis.
Diabetes: Nutritional therapy has been the cornerstone of diabetes prevention and treatment since the era of modern scientific medicine. Before the discovery of insulin, diabetes was treated with a starvation diet (Allen diet) with a very low calorie content (400-500 calories/day), with the later emergence of other diets with an extreme carbohydrate restriction of approximately 2% and a very high fat content of approximately 70%. Although there was no clear distinction between what is now known as type 1 and type 2 diabetes, these eccentric diets were remarkably successful in controlling diabetes and even in keeping patients with type 1 diabetes alive for some years. Diabetes is commonly defined as carbohydrate intolerance. After the discovery of insulin, the amount of carbohydrates in the diabetic diet increased to a maximum of 35-40% of the total daily caloric intake. In the late 1970s, there was a strong call for a reduction in total dietary fat and saturated fat intake owing to the increased incidence of cardiovascular death, particularly in patients with diabetes. Reducing fat intake by approximately 10% required a compensatory increase in other nutrients, in this case dietary carbohydrates, which rose to approximately 55–60%.
Although medical nutrition therapy is widely recognized by leading diabetes organizations worldwide, their dietary recommendations differ slightly. In principle, the main goal is to achieve and maintain optimal glycemic control and metabolic improvement through healthy food choices, considering patients' personal needs, preferences, and lifestyle patterns. Appropriate medical nutrition therapy has been shown to reduce HbA1c levels by 0.5% to 2% in patients with T2 diabetes and by 0.3% to 1% in patients with type 1 diabetes. Medical nutrition therapy has also been shown to be particularly beneficial after the initial diagnosis of diabetes, and in patients with poor glycemic control. At Kuzmar Clinic, we are medical researchers specializing in clinical nutrition with extensive national and international experience, and we can treat your disease very well to help you have a better quality of life.
Alzheimer's disease and other forms of dementia. Aging of the world's population is an unprecedented process in human history and a source of complexity for the provision of health and social care from a public health perspective. Increased longevity and survival have led to an increase in the prevalence of chronic diseases and increased morbidity in older age. Dementia is a common clinical syndrome in individuals aged 65 years and older, characterized by a persistent impairment of higher mental functions, leading to an alteration of the individual's ability to carry out activities of daily living in people who do not suffer from altered levels of consciousness.
Chronic Obstructive Pulmonary Disease (COPD) is a chronic degenerative disease that occurs in adults over 45 years of age, and is one of the leading causes of morbidity and mortality. Clinically, it is characterized by emphysema and chronic bronchitis, leading to airway obstruction. It is a common, preventable, and treatable disease characterized by persistent respiratory symptoms and airflow limitation due to airway or alveolar abnormalities caused by exposure to noxious particles or gases.
Dyslipidemia: Hypercholesterolemia is a highly prevalent risk factor for ischemic heart disease in patients with cardiovascular diseases. Patients with acute coronary syndrome often have intermediate low-density lipoprotein cholesterol values, reflecting the importance of interactions with other risk factors in increasing cardiovascular risk. However, statin therapy improves the prognosis of patients after ACS, especially intensive therapy, irrespective of low-density lipoprotein cholesterol levels, making this therapeutic strategy the best option for all such patients and, by extension, all patients with established cardiovascular disease.
Hyperuricemia and gout are pathological conditions characterized by overproduction or under-excretion of uric acid, a product of purine catabolism physiologically excreted in the urine. Both conditions are often associated with chronic diseases such as hypertension, diabetes mellitus, metabolic syndrome, renal and cardiovascular diseases. As a consequence, uricemia control is fundamental, as well as monitoring of uric acid levels over time.
References:
Hamdy, Osama et al.Nutrition in Diabetes. Endocrinology and Metabolism Clinics, 2016; 45(4) : 799 – 817
Boffa, J.-J., & Cartery, C. Insuficiencia renal crónica o enfermedad renal crónica. EMC - Tratado de Medicina, 2015; 19(3),:1–8. doi:10.1016/s1636-5410(15)72803-5
Robles Gamboa, C. Insuficiencia cardíaca crónica. Medicine - Programa de Formación Médica Continuada Acreditado, 2017; 12(35) : 2100–2115. doi:10.1016/j.med.2017.06.003
OMS. Enfermedades no transmisibles. 2023 Acceso el: 08.2024 Disponible en : https://www.who.int/es/news-room/fact-sheets/detail/noncommunicable-diseases
Garre-Olmo, J. Epidemiología de la enfermedad de Alzheimer y otras demencias. Rev Neurol, 2018; 66(11): 377-386.
Martínez Luna, M., Rojas Granados, A., Lázaro Pacheco, R. I., Meza Alvarado, J. E., Ubaldo Reyes, L., & Ángeles Castellanos, M. Enfermedad pulmonar obstructiva crónica (EPOC). Bases para el médico general. Revista de la Facultad de Medicina (México), 2020; 63(3): 28-35.
Cordero, A., & Fácila, L. Situación actual de la dislipemia en España: La visión del cardiólogo. Revista Española de Cardiología Suplementos, 2015;15: 2-7
Gliozzi, M., Malara, N., Muscoli, S., & Mollace, V. The treatment of hyperuricemia. International journal of cardiology, 2016; 213: 23-27.
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