Diet and chronic diseases

Every chronic illness requires a specific, precisely prescribed diet, and it is crucial that patients adhere to it. Proper nutrition will improve the immune system and the general condition of the body, as well as significantly reduce the risk of complications.

What are chronic diseases?

Chronic illnesses are all those that last for a longer period of time and can only be controlled with appropriate therapy. They can appear at the earliest age, but mostly develop in middle age. Most commonly, they last a lifetime. Unlike chronic diseases, acute illnesses occur suddenly, last for a short time and usually do not leave significant consequences on the body. For a chronic illness to be under control, it is important that the patient attends regular check-ups, takes their medication regularly, and adheres to the prescribed dietary plan. In this way, possible complications and further development of disease symptoms are prevented. Chronic illnesses arise from various factors, and we classify them into two groups:

• Metabolic risk factors are those that develop gradually within the body or can be hereditary. These include obesity, hypertension, hyperglycaemia, hyperlipidaemia, etc.;
• Environmental factors: poor diet, smoking, alcohol consumption, lack of physical activity, poor sleep quality, stress… It is also important to note that a poor diet is a cause of metabolic risk factors, such as obesity and hypertension.

Types of chronic illnesses

Chronic non-communicable diseases are a global health problem and are the cause of more than 40 million deaths a year. Most commonly, these are patients between 30 and 69 years of age. The most prevalent chronic diseases are:

• cardiovascular (hypertension, heart failure, ischaemic heart diseases, cardiomyopathies);
• diabetes;
• malignant diseases;
• kidney diseases;
• thyroid disorders;
• rheumatoid arthritis;
• osteoporosis;
• Anaemia;
• insulin resistance,
• others.

Proper nutrition and chronic diseases

If they adhere to their therapy, follow medical advice and eat healthily, patients with chronic illnesses can live a good quality of life. The world's top nutrition experts are focused on creating proper recommendations in order to halt the rise in the number of sufferers, as well as to reduce the mortality rate. Therefore, proper nutrition is one of the most important factors in the lives of all people suffering from chronic diseases. Depending on the type of disease, symptoms and the patient's condition, the doctor will create personalised nutrition plan. This dietary regime will encompass the intake of all necessary nutrients and healthy foods that will suit the individual. Research shows that diet affects the functioning of the immune system. A lack of minerals and micronutrients can weaken the immune system. A diet rich in antioxidants and omega-3 fatty acids can help reduce inflammatory processes. The highest amounts of antioxidants are found in berries, green leafy vegetables, legumes, nuts, and whole grains. The best sources of omega-3 fatty acids are oily fish (salmon, mackerel, trout), linseed oil, flaxseed and chia seeds, and walnuts. It is important for the patient to strictly adhere to the guidelines received from the doctor in order to halt the progression of the disease. Diet can help a great deal with that. We will set out the basics of diet for various chronic diseases, according to the advice of our Dr Tamara Šimić. However, please note that what your doctor says is the most important thing. Every organism is unique and only the doctor who monitors your condition and symptoms knows exactly which foods will be suitable for you.

Cardiovascular diseases

Cardiovascular diseases are the leading cause of mortality worldwide. Various studies have shown that unhealthy diets (saturated and trans fatty acids, high sodium intake, cholesterol), alcohol and obesity contribute to the development of cardiovascular diseases. In the prevention of cardiovascular diseases, as well as for diagnosed patients, the diet is based on the following: fish and fish oil, fruit and vegetables, unsalted seeds, whole grains, and dietary fibre. The diet should be rich in potassium, linolenic fatty acid, and folic acid.

Diabetes

Diabetes or diabetes mellitus occurs when the body does not secrete sufficient amounts of insulin. Insulin is a hormone produced in the pancreas. It is responsible for the proper metabolism of carbohydrates—sugars. When we do not have a sufficient amount of insulin, the sugar we consume does not pass from the bloodstream into the cells. This causes an increase in blood sugar. A condition is considered diabetes when the amount of sugar in the blood (after 10 hours of fasting) is greater than 7.0 mmol/L. There is type 1 diabetes (when the pancreas does not produce insulin) and type 2 diabetes (the pancreas does not produce enough insulin or it does not function effectively). Changes to lifestyle and an adapted, balanced diet are of key importance for patients suffering from diabetes. Alongside prescribed therapy, this reduces the risk of complications and other diseases, such as heart attack, kidney disease and stroke. The optimal blood sugar level is maintained through a healthy diet, as well as an active, healthy lifestyle. The diet includes vegetables, fruit in permitted quantities, whole grains, seeds, nuts, healthy oils, fish rich in omega-3 fatty acids, chicken meat, eggs, milk and dairy products.

Insulin resistance

Insulin resistance is a condition that involves increased levels of insulin in the blood, as well as cellular resistance to insulin. There is an increased level of glucose in the blood, because the cells do not respond properly to insulin. If not detected in time, insulin resistance can cause prediabetes, type 2 diabetes or gestational diabetes. In people with insulin resistance, the diet is based on an intake of foods with a low glycaemic index, rich in dietary fibre. For example, oats contain beta-glucan, swell in the digestive tract, provide a prolonged feeling of fullness, and are low in calories. A higher intake of red berries, seeds, nuts, and anti-inflammatory foods—such as fish, fish oil, freshly ground flaxseed, sweet potatoes, and leafy vegetables—is also recommended. The intake of dried fruit and fruit with a higher glycaemic index, such as bananas, watermelon, grapes, and pineapple, is restricted.

Thyroid disorders

The thyroid gland is a very important part of the endocrine system and is located on the front of the neck. It is a gland of internal secretion and secretes the hormones triiodothyronine (T3) and thyroxine (T4). These hormones help to regulate various bodily functions, including heart rate. The most common thyroid disorders are hypothyroidism – underactivity of the thyroid gland – and hyperthyroidism – overproduction of thyroid hormones. When a thyroid disorder occurs, symptoms can vary and affect almost all organ systems. The recommendation is to use wholegrain cereals. This includes wholemeal wheat bread, wholewheat pasta, brown rice. In addition, olive and linseed oil should be used in salads along with apple cider vinegar, low-fat dairy products, fresh fruit and vegetables, white lean fish, and lean meats: chicken, turkey, veal and beef.

Hashimoto's disease

Hashimoto's disease (Hashimoto's thyroiditis) is a condition where the immune system attacks the thyroid gland. This leads to a reduction in the function of this gland. The diet should include foods that will improve its function and prevent the progression of the disease. Foods treated with pesticides should be eliminated from the diet, as well as foods containing additives, preservatives, artificial colours, sweeteners and flavour enhancers. Some foods contain goitrogens, substances which in large amounts can affect thyroid function: cabbage, kale, Brussels sprouts, broccoli, cauliflower, radishes, soybeans and millet. In normal quantities, and especially when heat-treated, they are not a problem for most people, particularly with a sufficient iodine intake. Whether and how much they should be restricted is assessed by a doctor based on your test results and therapy. It is necessary to exclude soya from the diet, as it contains phytoestrogens – the isoflavones genistein and daidzein, which also inhibit TPO (thyroid peroxidase) and thereby reduce the synthesis of thyroid hormones. The intake of goitrogenic foods that slow down the absorption of iodine in the body is restricted. These are pears, grapefruit, strawberries, and peaches. For the normal functioning of the thyroid gland, carrots, apricots, avocados, bananas, sunflower seeds, sea fish, fish oil and wholegrain cereals are particularly important.

Anaemia

Anaemia or anaemia is a condition that occurs when the body does not have enough healthy red blood cells (erythrocytes) to carry oxygen to the tissues. Haematocrit and haemoglobin are also reduced. The percentage of iron in the body drops, leading to fatigue, headache, weakness, dizziness, chest pain, pale or yellowish skin, and an irregular heartbeat. The treatment of anaemia involves a diet that will enable the synthesis of haemoglobin. In addition to iron, it is necessary to consume vitamins C and B12, folic acid and other nutrients. The diet should be enriched my vitamin and trace elements. Vitamin C improves the absorption of iron from food and the mobilisation of iron from body reserves. The consumption of chokeberry juice, nettle tea, alongside foods rich in vitamin C, and more frequent consumption of red berries and beetroot is especially recommended.

Constipation

Constipation is a bowel disorder, specifically relating to bowel movements. Long-term constipation leads to bloating, stomach pain and other problems. The longer it lasts, the harder the treatment is. A frequent cause of constipation is an unhealthy diet, the intake of fatty, processed foods and simple sugars. For the treatment of constipation, it is crucial:

• higher dietary fibre intake, primarily fresh salads. Green leafy salad contains cellulose, a dietary fibre that is not digested in the digestive tract, cleanses the intestinal walls and speeds up peristalsis, while providing a prolonged feeling of fullness;
• higher fluid intake;
• intake of chia seeds and milled flaxseed which can also be added to salad along with olive oil and apple cider vinegar as a dressing;
• fruit snack at least 4-5 times a week. Do not consume fruit immediately before or after consuming other food, because fruit ferments first. Therefore, the ingested food can take significantly longer to digest and lead to a feeling of bloating. Fruit is always consumed as a separate meal, 3.5-4 hours after breakfast;
• porridge oats for breakfast with yoghurt and ground flaxseed;
• reduce the intake of cheese and teas with a diuretic effect (they can worsen constipation due to the elimination of water from the bowels). Milder teas such as chamomile and peppermint tea may be consumed.

Psoriasis

Psoriasis is a chronic skin condition and requires long-term treatment. It can appear at any age, both in childhood and in adulthood. Triggers are external factors, most commonly viral illnesses, bacterial infections or emotional stress. In order to alleviate the symptoms of psoriasis, it is necessary to introduce a balanced diet: foods rich in vitamins, primarily vitamins A and D, minerals, antioxidants and dietary fibre. Food rich in antioxidants, beta-carotene (carrots, apricots, green leafy vegetables), folic acid (broccoli, cabbage and green leafy vegetables), and omega-3 fatty acids (fish, flaxseed and chia seeds) is recommended. The intake of red meat and dairy products with a high percentage of milk fat is restricted. Folic acid is important in reducing the symptoms of psoriasis. It reduces inflammation and itching and thus contributes to skin recovery. Broccoli, cabbage and other green leafy vegetables contain the most folic acid. The intake of citrus fruits (lemon, orange, grapefruit, mandarin) is limited. Only diluted freshly squeezed juices may be consumed. Besides diet, proper skin care and the products we apply to it are very important for treating psoriasis. Read more about psoriasis psoriasis and treatment options.

Haemorrhoids

Haemorrhoids are swollen blood vessels in the region of the anal opening and the lower part of the rectum. Under pressure, these blood vessels become enlarged and swollen, and they can be external or internal. If not treated in time, haemorrhoids become very painful, prevent normal functioning and often the only solution can be a surgical procedure. A proper diet can alleviate haemorrhoids. It is important that the diet is varied and rich in dietary fibre, as well as that a sufficient amount of water is taken during the day. The diet should be abundant in fresh fruit, vegetables, and wholegrain cereals. Coffee intake should be reduced, carbonated drinks and alcohol (beer) should not be consumed, and salty and spicy food should be avoided. Such food retains fluid in the body, which can cause constipation and consequently worsen haemorrhoids. Also, it is necessary to avoid snacks, cut out white flour, and replace refined oil with olive oil.

Osteoporosis

Osteoporosis represents the progressive loss of bone mass. Bone density decreases, which makes them softer and more brittle. A lack of calcium in the diet can lead to the weakening of bones over time. The diet should be based on foods that are rich in calcium. Apart from dairy products, food that is rich in calcium includes broccoli, kale, white beans, sesame seeds, chia seeds, almonds, sardines, oranges as well as spices – dried parsley which should be added to every cooked dish. It is necessary to increase vitamin D intake, as it increases the body's ability to absorb calcium from food. The general recommendation for most adults is about 600 IU of vitamin D per day from food or supplements, and in cases of osteoporosis, the dose is determined by a doctor based on test results. Regular physical activity can slow down the progression osteoporosis.

Physical activity and chronic diseases

A healthy, active lifestyle and regular exercise are the best prevention for various diseases and one of the ways to prevent the further progression of illness. Walking at a brisk pace is recommended whenever you are able. It is best to be active in the morning, before breakfast, after drinking your morning detox, as this is when fat in the subcutaneous adipose tissue and visceral fat is burned most effectively. Hydration is essential during physical activity – carry water, tea or freshly squeezed juice with you, and always drink fluids in sips. Along with a healthy diet and exercise, quality sleep, avoiding stress, and spending time in nature in the fresh air are also important.