miércoles, 26 de septiembre de 2007

DIETOTERAPIA EN ARTERIOSCLEROSIS




Se define como el endurecimiento de las arterias. Los productos grasos de la sangre, que casi siempre se encuentran en forma de una sustancia serosa, conocida como colesterol, se deposita en la pared interior de las arterias formando una placas ásperas que aumentan de tamaño con lentitud, este proceso provoca reducción del calibre de las arterias, donde corre la sangre, y ala larga puede quedar obstruida por completo, lo que impide que la sangre llegue al órgano que irriga dicho vaso, si la arteria alimenta el tejido cardiaco, el paciente desarrolla lo que se conoce como un ataque cardiaco, pero si obstruye una arteria que irriga una porción del cerebro de denominara un ataque apopletico. Por tal motivo un ataque cardiaco o una apoplejía, no son enfermedades primarias del corazón o del cerebro sino un padecimiento de los vasos sanguíneos

Es una enfermedad que ya no solo es de la edad adulta sino que ya comienza a ser generalizada.
Es multifactorial por varios factores de riesgo o causas: tabaquismo, hipertensión arterial, elevación de lípidos en la sangre, en especial el colesterol, y un factor indirecto es la obesidad que va muy de la mano también con diabetes, estos factores tienen efectos de adición y las posibilidades de tener arteriosclerosis disminuyen cuando se eliminan o se controla la multifactoriedad, el factor dietético es importante ya que los niveles sericos en la sangre debido a las comidas de zonas urbanizadas y el estilo de vida de el pasado siglo XX y el entrante siglo XXI.
El colesterol se produce en el organismo y también se encuentra en la dieta, el nivel sanguíneo se determinara por la disponibilidad de colesterol de estas fuentes (grasas saturadas), derivadas de carnes grasosas, productos lácteos y comidas preparadas con manteca, o aceites de origen no vegetal, tal es el caso que la dieta mexicana es una dieta muy condimentada, y muy grasosa, y se podría decir que las grasas saturadas son grasas duras, como es el caso de la manteca, y las grasas Monoinsaturadas no están blandas como es el caso de los aceites de origen vegetal, como el aceite de oliva.
Este (el colesterol) viaja por la sangre que esta ligado transportadores de proteínas de diversos tamaños, formados por lipoproteínas. Las lipoproteínas de baja densidad transportan la mayor parte del colesterol, y de hecho los niveles altos de colesterol, son los responsables del alto riesgo de desarrollar coronariopatias los estudios recientes han dado como resultados que las lipoproteínas de alta densidad protegen contra el desarrollo de enfermedad coronario. Por lo mismo cuando los niveles altos de colesterol en sangre pueden presagiar problemas es importante conocer los niveles de colesterol LBD, y LAD.


Complicaciones
El riesgo de aumentar enfermedad de arterias coronarias aumenta de manera progresiva con el aumento en nivel sanguíneo del colesterol sin importar cual sea dicho nivel, si se parte de igualdad de factores de riesgo, una persona que presente niveles de 300 mg por 100 ml de colesterol tendrá un riesgo mayor que aquella que tienen un nivel de 250 mg quien a su vez cuenta con un riesgo mas alto que el individuo que tiene un nivel de colesterol de 200 mg y así sucesivamente, ya que entre menos niveles de colesterol menor será el riesgo.


Los expertos están de acuerdo que los niveles altos de colesterol LBD, en particular cuando van acompañados de un nivel de bajos de colesterol LAD incrementan el riesgo de coronariopatias.
Recomendaciones
La reducción del colesterol alimentario, reduce solo parcialmente los niveles de colesterol sanguíneos de colesterol esto se debe a que a que el cuerpo responde con un mayor producción y la cantidad será distinta de una persona a otra, en lo que algunos expertos no están de acuerdo es en cuanto disminuye los niveles de colesterol al consumir una dieta baja en colesterol y grasas saturadas. Esto significa el consumo de alimentos que contengan menos grasas saturadas y colesterol de los que consumimos hasta el momento, hacer ejercicio, terminantemente abstenerse de fumar, y con ellos será posible evitar dos importantes riesgos de enfermedades cardiacas, obesidad y colesterol sanguíneo elevado. Con la ingestión de colesterol debe de ser inferior a menos de 300 mg al día.
Dietoterapia

Objetivo es reducir los niveles de colesterol a niveles aceptables, dieta de reducción de peso si el paciente es obeso
Proteínas : 1g /kg/día o 10-15% del valor energético total.
Incrementar proteína vegetal como Soya, ya que es reductora del colesterol.
H de carbono 50-60%: complejos ¾ (70%), simples ¼ (30%).
Grasas : máximo 30% del valor energético total: Monoinsaturadas 10-12% son cardioprotectoras, Poliinsaturadas: 10%, Saturadas 8% (son aterogenas), colesterol 300mg día.
Fibra dietaria 40-50 g/día.
Fibra soluble: pectinas, gomas y mucilagos: efecto reductor de lípidos, se incluyen las leguminosas.

Si con las modificaciones dietéticas y demás recomendaciones no se llegara a disminuir la hiperlipidemia, se dará tratamiento con fármacos hipolipemiantes.
Medidas preventivas:
MODIFICACIONES A LA DIETA HABITUAL PARA AYUDAR A PREVENIR AMINORAR O RETARDAR LA APARICION DE ENFERMEDADES CRONICO DEGENARATIVAS.

MODERAR EL CONSUMO DE ALIMENTOS DE ORIGEN ANIMAL, YA QUE CONTIENEN CANTIDADES ELEVADAS, DE ACIDOS GRASOS SATURADOS Y COLESTEROL.

PREFERIRE EL CONSUMO DE PESCADOS Y AVES POR EL CONTENIDO DE ACIDOS GRASOS OMEGA 3: SALMON ATUN EN AGUA, ARENQUE, MACARELA, TRUCHA.

PREFERIR PRODUCTOS ELABORADOS CON GRANO ENTERO (TORTILLAS DE NIXTAMAL, PAN INTEGRAL)

INCLUIR REGULARMENTE LEGUMINOSAS: FRIJOL, LENTEJA, GARBANZO,ARVEJON, POR SU CONTENIDO DE FIBRA SOLUBLE (REDUCTORA DE COLESTEROL)

DISMINUIR EL CONSUMO DE GRSASAS DE ORIGEN ANIMAL EN LA PREPARACION DE LOS ALIMENTOS, UTILIZAR PREFERENTEMENTE ACITES DE ORIGEN VEGETAL. (MAIZ, OLIVA, GIRASOL, CARTAMO)

AUMENTAR EL CONSUMO DE FIBRA DIETARIA, BETACAROTENOS, Y VITAMINA C ESTOS DOS ULTIMOS TIENEN FUNCIÓN ANTIOXIDANTE.INCREMENTAR TAMBIÉN EL CONSUMO DE VERDURAS CRUCIFERAS: COL COLIFLOR, BROCOLI, COLECITAS DE BRÚCELAS, LAS CUALES SE HAN COMPROBADO SON ALIMENTOS PROTECTORES CONTRA EL CÁNCER.

MODERAR EL CONSUMO DE AZUCAR, SAL ALCOHOL.

MODERAR EL CONSUMO DE PRODUCTOS ALIMENTARIOS INDUSTRIALIZADOS, YA QIUE ESTOS OCULTAN SU ALTO CONTENIDO DE AZUCAR, GRASA Y SAL.

MOERAR EL CONSUMO DE ALIMENTOS AHUMADOS Y CURADOS POR SU ELEVADO CONTENIDO DE NITRATOS Y NITRITOS, YA QUE SE CONSIDERAN SUBTANCIAS POTENCIALMENTE CANCERIGENAS.

Recomendaciones nutrimentales
Yemas de huevo no más de 2 a la semana
La clara de huevo consumase en cantidades ilimitadas
Todos los productos que no contengan grasas como frutas, vegetales, lácteos descremados, granos pueden consumirse sin restricción a menos que este en tratamiento de obesidad, en tal caso moderar ingesta de hidratos de carbono complejos.
A los alimentos es necesario añadir tres cucharadas para 170 g de carne de alguna grasa rica en enlaces no saturados, ya que aseguran una relación de 2 a 1 entre las grasas Poliinsaturadas y saturadas que ingerimos en la dieta.
Los postres deben de tener un bajo contenido de grasas, gelatina helado de fruta, yoghurt descremado.

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