the risk of coronary heart disease; on the other hand, replacing saturated fat with refined carbohydrates has no benefit on the prevention of coronary heart disease and may even increase the corresponding risk.
Dairy products (e.g., yogurt and cheese) may have a neutral or even beneficial effect on CVD risk; in fact, it seems that CVD risk decreases from moderate dairy consumption.
TFA intake has been positively and robustly associated with increased risk of CHD and related mortality.
Dietary fiber has been associated with reduced all‐cause and cardiovascular‐related mortality, incidence of CHD, stroke incidence and mortality, T2DM, and colorectal cancer. The adequate daily intake of fiber is 14 g/1000 kcal, or 25 g/day for women and 38 g/day for men.
Overconsumption of calories and unhealthy dietary patterns, such as the Western dietary pattern, might be the main contributing factors for chronic diseases.
Western‐type diets are positively associated with chronic diseases by increasing ROS production, insulin secretion, and insulin resistance; promoting low‐grade inflammation and abnormal activation of the sympathetic nervous system and the renin‐angiotensin system; and leading to gut microbiota alterations.
Very‐high and very‐low carbohydrate diets have been associated with increased all‐cause mortality, with the lowest risk observed at 50–55% carbohydrate intake.
Physical inactivity can explain 6–10% of the main NCDs and 9% of premature mortality, while physical activity may increase quality of life and possibly life expectancy.
Obesity grades 2 and 3 (BMI > 35 kg/m2) may be a risk factor of NCD development, even in the absence of other major risk factors.
Tobacco use increases the incidence of a variety of chronic diseases, such as stroke, CHD, diabetes, respiratory problems, impaired immune function, and several types of cancer.
Excessive alcohol intake has been linked to the development of more than 200 major diseases.
Stress can trigger the inflammatory response in the circulatory system, mainly in the coronary arteries, which is thought to be one of the mechanisms mediating the development of CVD.
The term epigenetic mechanisms refers to the parameters involved in the modifications of gene regulation, including DNA methylation, histone modifications, and RNA‐based mechanisms.
Maternal health and lifestyle habits, as well as infants' early nutrition and exposure to environmental factors, are involved in the development of metabolic diseases later in life.
Self‐Assessment Questions
1 Which of the following sentences is correct?Excess caloric intake has favorable effects on insulin sensitivity.Overeating has been associated with increased aging rate.One week of hypercaloric feeding does not affect fasting plasma insulin.a and b
2 Fill in the blanks:The substitution of ________ for SFAs might reduce CHD risk.Replacing SFA _________ reduces CVD risk.Results from prospective studies show ________ in CVD risk from full‐fat dairy consumption.The highest degree of _________ is generated during the manufacturing process of hydrogenated vegetable and marine oils, such as margarines, confectionary fats, and fat spreads.Diets restricted in red meat may have ________ effect on cardiometabolic outcomes and cancer incidence and mortality._________ smoking can lead to important benefits in terms of longevity and mortality risk.Very‐high and very‐low carbohydrate diets have been associated with increased all‐cause mortality; the lowest risk is observed when_________ of daily energy comes from carbohydrate intake.
3 What is the recommended daily amount of fiber intake?
4 According to the World Cancer Research Fund, what is the recommendation of red meat consumption per week?
5 How much moderate‐ to vigorous‐intensity physical activity should children engage in?30 minutes or more per day60 minutes or more per day90 minutes or more per day150 minutes or more per day
6 What are the recommendations for physical activity for adults?
7 Tobacco use has been shown to have a positive relationship with:strokeCHDT2DMrespiratory problemsimpaired immune functionall of the above
8 Define the terms binge and heavy drinking.
9 How can stress affect CVD development?
10 What does the term epigenetic mechanisms refer to?
11 Briefly describe the effects of SFAs on health.
12 How can TFAs increase CVD risk?
13 Which of the following statements about Western‐type diets are correct?They are characterized by high intakes of meat, refined grains, fast food, eggs, high‐sugar drinks and sweets, as well as low intake of fruits and vegetables.They represent a major risk factor for hypertension due to their high salt content.They can induce low‐grade inflammation and oxidative stress and lead to an abnormal activation of the sympathetic nervous system.They seem to alter the structure of the microbiome even in the absence of obesity.All of the above
14 Fill in the blanks:Inactive adults have_________increased risk of all‐cause mortality, compared to those who engage in at least 150 minutes of moderate‐intensity PA per week._________is the leading risk factor of cancer‐specific deaths._________may be related to decreased all‐cause mortality, compared to body weight values in the normal BMI range._________ but not_________ TFAs are associated with increased risk of CHD.Changing our diet from:________‐based foods to_________‐based foods may result in better health outcomes.
15 Which of the following statements about TFAs are correct?TFA intake has been positively and robustly associated with increased risk of CHD and related mortality.TFAs are naturally present in foods, such as legumes and vegetable oils.Foods that commonly contain margarine, such as deep‐fried foods, baked goods, and snacks, are therefore high in TFAs.Naturally occurring TFAs are associated with increased risk of CVD.TFAs are not dangerous as long as total fat intake is low.
Bibliography
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2 American Psychological Association. (2017). Stress effects on the body. http://www.apa.org/helpcenter/stress‐body.aspx.
3 Azadbakht, L., Haghighatdoost, F., Keshteli, A.H. et al. (2017). Consumption of energy‐dense diets in relation to metabolic syndrome and inflammatory markers in Iranian female nurses. Public Health Nutr. 20 (5): 893–901.
4 Azais‐Braesco, V., Sluik, D., Maillot, M. et al. (2017). A review of total & added sugar intakes and dietary sources in Europe. Nutr. J. 16 (1): 6.
5 Bielemann, R.M., Silva, B.G., Coll Cde, V. et al. (2015). Burden of physical inactivity and hospitalization costs due to chronic diseases. Rev. Saude Publica 49: 75.
6 Briggs, M.A., Petersen, K.S., and Kris‐Etherton, P.M. (2017). Saturated fatty
