Dietary habits form the foundation for the causation, prevention, and treatment of most cardiovascular and metabolic diseases. Smoking and an inactive lifestyle further impact on poor cardiovascular health outcomes.
Nutritional factors present a major modifiable cause of both total deaths and deaths from cardiovascular disease. In South Africa, the exploding epidemic of obesity, diabetes, and coronary artery disease are a result of accelerating urbanisation, social-economic and behavioural change resulting immense cost to individuals and society.
Our metabolic systems have evolved over thousands of years in relation to diverse environmental and genetic factors. Our gastrointestinal tract has a large surface area, enabling optimal absorption of macromolecules that comprise our daily nutritional intake. These molecules are enzymatically transformed to soluble substrates, transportable by various proteins and modified lipids. The liver represents our metabolic powerhouse, containing a myriad of complex enzyme systems, central to protein, fat and carbohydrate metabolism. There are complex physiological interactions between the liver and other organs, such as our muscles and adipose (fat) tissue. Our thyroid gland is another important determinant of metabolic rate. As mentioned earlier our genetic and environmental factors determine the degree to which we store and utilise the energy we gain from our nutritional intake.
Our diet has also been gaining attention as a potential contributor to the increase in immune-mediated diseases. Modern, unhealthy diets are characterised by an over consumption of refined sugars, salt, and saturated fat. The impacts of artificial sweeteners, gluten, and genetically modified foods have also been highlighted as potentially harmful to our immune system. Defective dietary habits may even result in genetic changes at the level of our gastrointestinal system, potentially resulting in cancer. Poor diet and excessive energy intake may all lead to increased inflammation, and increased risk of allergy. Inflammation is also a known risk marker for heart disease, such as coronary artery disease. We know that excessive fat tissue releases chemicals that stimulate inflammation, creating the conditions for diseases of lifestyle (diabetes, hypertension and coronary artery disease).
Recent scientific developments in the area of nutritional medicine suggest that poor dietary habits may be inherited from generation to generation, from mother to her unborn fetus through gut bacterial changes in the setting of poor maternal nutrition. Sweet cravings may be inherited from the mother in simple terms. Genetic changes may even occur at the level of the father’s genetic complement due to a process called epigenetics, resulting in adverse outcomes for the fetus and their metabolic health.
Indeed, human nutrition has been the focus of rigorous research and conceptual development. Prior to any new dietary intervention, consult a healthcare provider with a focus on a comprehensive lifestyle assessment and a good clinical assessment including a lipid and glucose analysis.