Chapter 4 Special Diets

Chapter 4 Special Diets

Lactovegetarian Vegan Coronary heart disease Stroke Sodium Empty-calorie foods Dietary fibre/cellulose Obesity Coeliac disease Gluten Diabetes (type 1 and 2) Insulin 2

After completing this chapter and the homework, assignments and activities that accompany it, you should: Know what the different types of vegetarians are and be able to plan a menu for a day for a vegetarian (both lacto and vegan), taking account of suitable dietary guidelines. Understand the diet-related causes of the following health issues: coronary heart disease and strokes, obesity, coeliac disease and diabetes. Be able to suggest at least four dietary guidelines that should be followed by people at risk of or with the other related issues above. Be able to plan a suitable daily menu for each of the above. Understand the benefits of having a diet low in saturated fat, sugar and salt and be able to suggest at least four ways of reducing each of these in the diet. Understand the need to increase fibre in the diet and be able to plan a menu for a person who wants to improve this aspect of their lifestyle. 3

Vegetarianism Vegetarians don’t eat meat or fish. There are two types of vegetarian: Lactovegetarians don’t eat meat or fish but do eat animal products such as milk, cheese and eggs. Vegans, or strict vegetarians, eat only plant foods such as fruit, vegetables, nuts, cereals and soya milk. 4 Essentials for Living, 3rd Edition

Advantages of vegetarianism It is a healthy diet that is low in fat and high in fibre. It is easier to maintain a healthy weight. Vegetarians have to get enough iron and protein. Vegans usually take vitamin B supplements because this vitamin is not found in plant foods at all. 5 Essentials for Living, 3rd Edition

Suitable vegetarian dishes Various vegetable soups, such as carrot, mushroom or mixed vegetable Vegetarian pizza, quiche, risotto, lasagne, curry Various salads Stir-fries 6 Essentials for Living, 3rd Edition

Problem diets Most diet-related problems are linked to the following: Eating too much saturated fat Eating too much salt Eating too much sugar Eating too little fibre Drinking too much alcohol 7 Essentials for Living, 3rd Edition

Coronary heart disease and strokes Healthy artery A heart attack occurs when an artery becomes totally blocked by the fatty substance known as cholesterol. A stroke occurs if the blocked artery is in the brain. Unhealthy artery Ireland has the highest death rate from heart disease in people aged under 65 in the EU (see the bar chart below). cholesterol 8 Essentials for Living, 3rd Edition

Most heart attacks happen within a few hours of the symptoms first occurring and before the person reaches hospital. Prevention is therefore vitally important. • Heart disease is linked to: • A high-fat diet • Being overweight • Smoking • Drinking too much • A stressful lifestyle 9 Essentials for Living, 3rd Edition

Tips for a healthy heart Low-fat diet Low-salt diet Low-sugar diet High-fibre diet 10 Essentials for Living, 3rd Edition

Low-fat diet 11 Essentials for Living, 3rd Edition

Low-salt diet If everyone in Ireland reduced their salt intake by half a teaspoon (3 grams) per day, it would save 900 deaths per year from stroke and heart attack. Salt is the common name for a substance called sodium (Na). Adults need a maximum of 4–6g of sodium per day. Children should have less. Many of us, however, take up to 20g. Too much salt in the diet can cause high blood pressure, which can lead to heart attacks and strokes. 12 Essentials for Living, 3rd Edition

Reducing salt in the diet Reduce the amount of salt added during cooking or at the table. Use low-sodium alternatives. Flavour dishes with herbs, spices and pepper instead of salt. Choose fresh meat and vegetables. Avoid foods that are high in salt. If in doubt, look out for the words salt, sodium or Na on food labels. 13 Essentials for Living, 3rd Edition

Low-sugar diet Sugar is not needed in the diet. Sugar and sugary foods and drinks are often called empty-calorie foods. Many of us are encouraged to develop a sweet tooth as children. Too much sugar in the diet causes weight problems and tooth decay. 14

Avoid fizzy drinks, sweets, bars, sugary breakfast cereals, cakes, etc. Use artificial sweeteners, e.g. Canderel, for cooking. Snack on healthy foods such as fresh fruit and unsalted nuts. Be careful of ‘hidden sugars’. Read labels – glucose, fructose and sucrose are all sugar. Reducing sugar in the diet 15

High-fibre diet • Dietary fibre (cellulose) is found in plant foods such as cereals, fruit and vegetables. • Processed foods lose much of their fibre content. Therefore, wholesome, unprocessed foods should be eaten. • A high-fibre diet has many benefits. • Fibre absorbs large amounts of water when eaten, creating a feeling of fullness. • Fibre contains no calories, so fibre-rich foods are excellent to include in the diet for anyone trying to lose weight. • Fibre-rich foods include wholegrain breads and breakfast cereals, e.g. All-Bran, brown rice and pasta, fruit and vegetables, nuts and seeds. 16 Essentials for Living, 3rd Edition

Incidence of colon cancer worldwide What sort of food is traditionally eaten in countries with low/high incidence rates of colon cancer? 17 Essentials for Living, 3rd Edition

Obesity • Obesity means being 20% or more above the normal weight for your height and build. • In Ireland, 20% of men and 16% of women are obese. One in every 10 Irish children are now classified as obese. • The thyroid gland in the neck controls the rate at which we burn food. People who are naturally thin burn food quickly, but some people burn food more slowly and are therefore prone to put on weight. • Obesity can be caused by an unhealthy thyroid gland. More often, though, the cause is overeating and lack of exercise. 18 Essentials for Living, 3rd Edition

Watch A ticking time bomb – who is responsible for childhood obesity? (Part 1) on RTÉ: http://www.rte.ie/news/player/2014/0114/20505627-a-ticking-time-bomb-who-is-responsible-for-childhood-obesity-part-1/ Obesity video link 19

Problems caused by obesity Increased risk of: Chest infections Diabetes Fertility problems Heart attacks High blood pressure Low self-esteem Problems when under anaesthetic Strokes Varicose veins 20

Body mass index (BMI) Body mass index (BMI) is a measure of body fat based on height and weight that applies to both adult men and women. BMI = weight in kg OR weight in lb x 703 height in m2 height in inches2 BMI categories: Underweight = <18.5 Normal weight = 18.5–24.9 Overweight = 25–29.9 Obesity = BMI of 30 or greater 21

Guidelines for sensible weight loss Avoid crash or fad diets. Exercise more – at least three times per week. Plan your meals each day in advance. Always have healthy options easily available. Use a smaller plate and try to eat more slowly. Eat less butter, fatty meats, sugary foods and convenience foods. If you do buy biscuits, go for low-fat varieties and individually wrapped portions. Eat more fruit and vegetables, white fish and chicken. Eat bread, potatoes and nuts only in moderation. Drink more water – at least eight glasses per day. 22

(Higher Level only) Coeliac disease • During normal digestion, long protein chains are broken down into lots of tiny amino acid units. These single units pass easily through the walls of the small intestine and into the bloodstream. • Gluten is a type of protein found in wheat and some other cereals. A person suffering from coeliac disease cannot break gluten down. • The big undigested gluten molecules damage the walls of the intestine as they pass through. • The symptoms of the condition are pains in the abdomen, diarrhoea, failure to thrive and anaemia. • There is only one way of treating coeliac disease: avoid all foods containing gluten. 23

(Higher Level only) Foods to avoid • All wheat products: biscuits, bread, cakes, pasta, many breakfast cereals • Rye and barley • Processed meat products, such as sausages, and fish or anything else in batter or breadcrumbs • Packet soups and sauces, many snack foods 24

(Higher Level only) Gluten-free foods and foodsvery low in gluten • Fruit, vegetables, dairy products such as milk and cheese • Rice, soya products such as TVP • Plain meat and fish • Maize products such as cornflakes • Specially made gluten-free products such as bread and cakes 25

(Higher Level only) Diabetes • Diabetes is a disorder that occurs when the pancreas (a leaf-shaped organ under the stomach) does not produce any or enough insulin to meet the body’s needs or stops being able to use insulin, causing abnormally high levels of sugar in the blood. • Normally, digested carbohydrate (glucose sugar) is ‘unloaded’ into the body’s cells by insulin. • With diabetes, reduced or no insulin means sugar stays in the blood. • Body cells don’t get enough fuel to function properly and literally begin starving to death. If left untreated, diabetes can lead to heart disease, kidney disease, chronic infections or other life-threatening conditions. • While there is no cure for diabetes, it can be controlled. 26

(Higher Level only) There are two types of diabetes • Type 1 diabetes, also called insulin-dependent diabetes, occurs in about 0.5% of the general population. With type 1, the body produces little or no insulin, so insulin injections need to be taken daily. Type 1 may appear at any age but usually begins in childhood or early adulthood, most often among young people with a sibling or parent who also has the disease. • Type 2 diabetes, also called non-insulin-dependent diabetes, occurs in about 2–3% of the general population. You are most likely to develop the disease if you are obese, are over the age of 45 or have a family history of diabetes. While type 2 diabetes used to be practically unheard of in people under 30, it is becoming more common in younger people today. • Control of diabetes centres around three things: injections or tablets, diet and exercise. 27

(Higher Level only) Dietary guidelines for diabetics • Reach and maintain your ideal weight and take plenty of exercise. • Eat regularly – don’t skip meals. • Keep to a low-sugar diet. • Eat high-fibre carbohydrates such as brown bread and pasta. • Diabetic foods, such as diabetic chocolate, are available, but it is good to get out of the habit of eating sweet-tasting foods. 28

Name the two main types of vegetarianism. List three advantages to being a vegetarian. Describe three nutritional precautions that should be remembered by vegetarians who want to have a balanced diet. Name six dishes suitable for a lactovegetarian. List five factors associated with coronary heart disease. Suggest six ways of reducing fat in the diet. What is the scientific name for salt? What is the RDA for salt as recommended by the Irish Heart Foundation? Suggest five ways of reducing salt in the diet. Describe two problems associated with a high-sugar diet. Suggest four ways of reducing sugar in the diet. Describe two advantages of a high-fibre diet. Define obesity. 29

What percentage of Irish children are currently considered to be obese? What are the main causes of obesity? List six problems associated with obesity. What do the letters BMI stand for and what do they mean? List eight guidelines for sensible weight loss. What is coeliac disease? Name six foods that should be avoided by coeliacs. What is diabetes? Describe the two different types of diabetes. What are the main differences between them? List three ways diabetes is controlled. Describe three dietary guidelines for diabetics. (Questions 19–24 are Higher Level only) 30

Assignment 9 Now test yourself at www.eTest.ie. 31

Chapter 4 Special Diets