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Key Topics
Requirement
PUBLIC HEALTH NUTRITION: POSSIBLE RISK REDUCTION IN STROKE
Solution
Introduction
Life expectancy in developed countries compared to under developed countries have shown a steady improvement in recent years (Hum et al., 2015). However, this improvement has not occurred consistently across all segments of the population. Inequalities in health exist between groups of the population and, in some countries, these inequalities are increasing. Inequalities in health are considered by all countries to be unacceptable. The inequalities could occur due to poverty for the health. In addition, poor countries tend to have worse health outcomes than better-off countries. Within countries, poor people have worse health outcomes than better off people. The association between poverty and ill health reflects causality running in both directions. Illness or excessively high fertility may have a substantial impact on household income (Bloom & Sachs, 1998) and may even make the difference between being above and being below the poverty line. The ill health is associated with substantial health care costs. Poor countries, and poor people within countries, suffer from a multiplicity of deprivations that translate into high levels of ill health. Among the cardiovascular diseases, stroke is accounted for 11.1% of all deaths globally, most occurring in low- and middle-income countries (Strong, Mathers & Bonita, 2007). Due to population growth and a delayed epidemiologic transition, the number of stroke deaths actually increased (Agyei-Mensah, & de-Graft Aikins, 2010). Diverse factors are contributing for stroke including, tobacco chewing, consumption of salt, healthy lifestyles, stress, socioeconomic policies and nutrition (Di Cesare et al., 2013).
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The present paper describes the features of health inequality, approaches of estimation, and conclusions followed by a survey related to the nutrition that influences stroke. The disease was selected as it is more prevalent and its mortality rate is high (Moran, et al., 2011). The individuals should know the risk of stroke. Therefore, the disease was selected for the current scenario. Hence, a systematic evaluation is carried out to assess the effect of diet, fruits and drinks in reducing a cardiovascular disease such as stroke.
Role of nutrition on stroke
Pathophysiology
Before assessing the role of nutrition on stroke, it is required to understand the Pathophysiology of the disease. The etiologic mechanisms include lack of sufficient blood flow to perfuse heart or cerebral tissue. The interruption of blood flow can lead to irreversible neuronal damage and thus stroke. The mechanisms of ischemia can be categorized into (i) thrombosis, (ii) embolism, (iii) systemic hypo-perfusion, (iv) arterial luminal obliteration, and (v) venous congestion (Woodruff et al., 2011).
Preventive measures: Role of diet
The major cause for the stroke is due to narrowing of blood vessels, high blood pressure, smoking or exposure to second hand smoke, diet with high cholesterol (Majno & Joris, 1995), diabetes, obstructive sleep apnea, heart failure, heart defects, heart infection or abnormal heart rhythm etc. A part from the physical needs, most of the causes associated with nutrition for example, diet with high salt contents and lipids. The following diet is recommended for the control of stroke
Diet with low fat and cholesterol
Diet with monounsaturated fat was associated with reduced risk of narrowing of blood vessels and thus ischemic stroke (Mozaffarian, Micha & Wallace, 2010)
Diet with polyunsaturated fatty acids
Antioxidant and vitamin C and E: The presence of these components in diet can reduce the oxidation of low-density lipoprotein thus narrowing of blood vessels (Bjelakovic et al., 2007)
Diet with low salt; high potassium (Delia et al., 2011) and low calcium (Larsson et al., 2011) are desired to reduce the risk of stroke
Reduction of risk: Possible mechanisms
As shown in preceding section, diet with adequate nutrients can reduce the risk substantially. The presence of antioxidant vitamins, enzymes, and some poly-phenolic compounds comprise the human's total antioxidant defence system (Niki, & Noguchi, 2002). The presence of potential protective components such as peridoxin, calcium, potassium, and riboflavin can reduce the risk of stroke by reducing the lipid peroxidation and decreasing the contractility of the vessels (Hariri et al., 2013) and possibly by decreasing the tendency of hypertension.
Methods
Literature search was carried out for the evidences pertaining to the investigation of diet effect on stroke. Online resources such as Pubmed, Sciencedirect, Wileyscience and Springer link were used for searching relevant sources.
Based on the available sources and methods, a study can be initiated utilizing on-line resources to update the health and wellbeing information. The individuals from a defined location can be enrolled and instructed for the procedures and to record the observations. The parameters pertaining to diet, fruits and drinks consumption for a month are recored. The recordings from each eligible individual can be pooled and collated in order to analyze for descriptive statistics.
Discussion
One study related to the investigation of effect of white rice-based foods (Liang et al., 2010) on risk of ischemic stroke. The results provide evidence of a positive association between habitual rice food consumption and the risk of ischemic stroke in the population studied. A comparative study was conducted for 3 months to determine the effectiveness of a community-based stroke prevention programme. The study aimed to improve knowledge about stroke, self-health-monitoring practice and maintain behavioural changes when adopting a healthy lifestyle for stroke prevention (Sit et al., 2007). The study found a three-month-sustained effect of positive changes in knowledge and skill from participants who undertook a nurse-led community-based stroke prevention programme. Lydia et al., (2003) described the scientific evidences and diet effects on cardiovascular disease such as stroke, hypertension, obesity, and type 2 diabetes mellitus. Another study (Larsson et al., 2013) describes about the estimation of relation between the bioactives containing compounds and stroke. The study reveals that there exists an inverse association of fruit and vegetable consumption with stroke risk. The evidences reveal that there is a significant reduction of risk potential for stroke with diet containing fruits. In a similar manner, a study was conducted to check the risk reduction for the stroke in a population with age 50 years and above. The population was selected based on the potential of occurrence of atherosclerosis and based on the interview i.e., one to one interaction. The outcome of the study was shown in Apendix-1. Such health check programmes are desired to bring awareness of the individuals towards health risk and 'inequity'. The programme is part of a longer-term vision to support people of all ages to gain greater control over their own health. The programmes also facilitate the government to understand the risk and implement strategies for mitigation of the risk. There exist certain limitations with the study as the studies are based on computer-assisted programs. Therefore, not all the individuals with more than 50 years of age may be adequately aware of the usage of computers and to record the data. The hindrances can be overcome by providing adequate staff members to support them. Else the individuals can be trained for the usage of computes in recording the responses.
Conclusions
The aspects of public health nutrition are discussed. The programmes are desired to understand the effect of food on cardiovascular disease such as stroke. The stroke can also occur to brain
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