6 Nutrition - Common Ailments in Clinic Flashcards
Why is finding the root cause of disease paramount?
Treating symptoms suppresses underlying imbalances and drives disease deeper into the body
Given the right conditions, the body has the innate ability to heal.
What are questions a naturopathic practitioner should be asking?
Not what is the disease,
but why is it there, where did it come
from and, therefore, what is the cause?
What are fundamental factors to good health?
ie. what is the client including or excluding in their life
- Clean water
- Good nutrition
- Fresh air
- Exercise
- Sufficient rest/sleep
- Exposure to nature and natural light
- Goals in life
- Meaningful work
- Harmonious social life
- Spirituality
What are obstacles to health?
ie. what is the client including or excluding in their life
- Exposure to chemicals and pollutants
- Overly processed foods
- Sugar, Coffee, alcohol
- Smoking
- Medications, vaccinations, drugs
- Poor digestion
- High stress
- No fulfilment, no goals in life
How can a naturopath get to root cause?
- Always ask WHY. For example: Insomnia – why you not sleeping well? When did it start? Why is it not getting better?
- Naturopath’s must be inquisitive in order to ‘peel back the layers’ – use open questions and follow-up questions. E.g. ‘what do you think has caused this? Does anything else worsen the pain?’
What are predispositions and triggers?
Predisposition: A certain environment and history of an individual that can increase the likelihood of that individual manifesting disease.
Trigger: things that directly cause or worsen the problem
* Listen for words like “Since… I have…”
* Stressful life events
* Environmental toxin exposure
What naturopathic principles are applied when considering the whole person?
Take into account the client’s
* Predisposing factors to illness
* Triggering event/cause
Uncover the individual’s lifestyle factors:
* Sleeping and relaxation time
* Exercise and movement
* Nutrition/hydration
* Stress levels and relationships
Plot the information on a timeline:
* Birth…. Events …… Present
What are Aggravating and relieving factors
Things that makes symptoms better or worse
Identifying the aggravating and relieving factors can help to uncover the cause.
* Always ask: ‘What makes it better or worse?’
* Time of day, month, year, period (before, during or after)
* Eating, sleeping, exercising, drinking, relaxation, stress
* Specific foods or beverages
* Application of hot, cold or warm
* Application of remedy or drugs
How can the Chinese Body Clock direct towards possible cause?
Consider this alongside the rest of the knowledge gained during the consultation
Examples:
* Waking 1am – 3am -possible liver stress
* Asthma symptoms at 3am – 5am– may indicate lung imbalance
* Energy slumps at 5pm – 7pm, but after that time client starts to feel better - to be an issue with the kidneys
What should a Food diary contain?
- All snacks and meals consumed during the time-frame
- Portions of fruit and vegetables consumed
- All fluids, coffee, tea, alcohol, carbonated drinks
- Methods of food preparation (cooked, fried, bought)
- Symptoms following meals (identify triggers)
- Triggers for eating particular foods (mood, energy)
- Time of meals
- Supplements and medications taken each day
What can a Food diary show?
- Whether the diet is balanced (macro and micro-nutrients)
- If food is correctly combined
- Whether particular foods or combinations of foods cause symptoms
- Whether the individual is hydrated or dehydrated
- Frequency and time of meals– may indicate unstable blood glucose levels, emotional eating etc
- Inclusion of junk food that impacts well-being
What is Anxiety?
Feelings of worry, apprehension and fear, which can range in intensity from mild to severe
What are the causes and risk factors of anxiety disorders?
- Stressful life experiences
- Chronic stress
- Poor gut health (e.g. dysbiosis)
- Lack of essential nutrients
- Sugar and processed foods
- Caffeine
- Alcohol
What are general nutritional guidelines to help anxiety?
- Ensure a good intake of fresh fruit and vegetables, grains and legumes to supply essential nutrients
- Probiotic and prebiotic food/supplements – support microbiome
Maintain stable blood sugars:
* Include protein with every meal (to also support neurotransmitter production)
* Avoid refined carb/sugar and include complex carbs/low GI foods; e.g. beans, whole grains, vegetables etc.
* Chew well, eat mindfully, don’t over eat, three meals a day
How can Magnesium help with anxiety?
- Cofactor for GABA synthesis and in the serotonin–melatonin pathway
- Essential for nerve transmission, cell signalling and also muscle relaxation
- Low-levels increase anxiety risk
How can Tryptophan help with anxiety?
- Precursor for serotonin and melatonin synthesis
- Serotonin helps regulate mood. Low levels are common in anxiety
- Melatonin regulates the sleep-wake cycle and is a potent antioxidant
How can B complex vitamins help with anxiety?
- Play a role in energy production and healthy nervous system function
- B6 is especially important for the conversion of glutamate (excitatory) to GABA (inhibitory)
- B1 is required for metabolism of amino acids used in neurotransmitter production
How does Zinc help with anxiety?
- Essential for the synthesis of GABA
- Decreased zinc in the nerve synapse leads to increased NMDA receptors, which respond to glutamate (increases anxiety)
How does Vitamin C help with anxiety?
- Vitamin C is necessary for the production of cortisol (anxiety increases adrenal output)
- It is a cofactor in the synthesis of serotonin
- Shown to lower anxiety by reducing oxidative stress, a factor in anxiety
How can Theanin* help with anxiety?
Non-protein amino acid
- Blocks glutamate receptors, whilst increasing GABA activity (which has a calming effect)
- Increases alpha–brainwaves producing a calming, mood enhancing effect without drowsiness
- Increases serotonin and dopamine levels
Other naturopathic advice
- Regular exercise (Focus on calming exercise - Pilates, Yoga, tai chi, walking)
- Diaphragmatic breathing exercises to calm the SNS
- Include herbal teas with relaxant and anxiolytic properties e.g. passionflower (Passiflora incarnate), lemon balm (Melissa officinalis), chamomile (Matricaria recutita)
- Bach flowers, homoeopathy and acupressure (covered later)
What are the features of Anxiety?
- Anxiety is part of the body’s natural defence system and alerts to a threat, either real or perceived
- It functions to facilitate response to adverse or unexpected situations
- However, persistent or extreme anxiety that interferes with daily life is counter-productive, signifying an anxiety disorder
What are some Anxiety disorders?
- Generalised anxiety disorder (GAD)
- Panic disorder
- Social anxiety disorder
- Post-traumatic stress disorder (PTSD)
Explain why Chronic stress
affects anxiety
- Increases sympathetic nervous system (SNS) activity, adrenaline and cortisol release
- It decreases parasympathetic activity, impeding nutrient absorption (e.g. tryptophan)
Explain why poor gut health (e.g. dysbiosis) affects anxiety
Lactobacillus and Bifidobacterium have been shown to produce GABA
Explain why lack of essential nutrients affects anxiety
Lack of essential nutrients to support the production of inhibitory neurotransmitters (i.e. GABA) - vit C, B vitamins (esp B6), mag & zinc
Explain why sugar and processed foods affects anxiety
- Promotes inflammation and oxidation in neuronal cells
- Nutrient poor
- Cause fluctuations in blood glucose
- Hypoglycaemia (low blood sugar) triggers adrenaline release and promotes fatigue, worsening anxiety
Explain why caffeine affects anxiety
- Stimulant = taxes the adrenals
- Adenosine antagonist = negatively impacts sleep
- Depletes nutrients essential for mental well-being, in particular the B vitamins
Explain why alcohol affects anxiety
- Depletes the body of vital nutrients
- Fragments sleep and blocks the REM phase (sleep is less restorative)
- Regular consumption decreases serotonin levels affecting mood
What are Magnesium sources?
Magnesium: 500 - 1000 mg / day
Epsom salt bath
- Dark leafy greens
- Seeds
- Nuts
- Whole grains
- Legumes
What are sources of Tryptophan?
Tryptophan: 300 – 2000 mg / day
o Brown rice
o Quinoa
o Pumpkin seeds
o Bananas
o Oats
o Turkey
What are the sources of B complex vitamins?
o Whole grains
o Legumes
o Sunflower seeds
o Fish (especially salmon)
o Pistachios
o Eggs
What are sources of Zinc?
Zinc: 25 – 60 mg / per day)
o Pumpkin and hemp seeds
o Cashews
o Legumes
o Whole grains
o Oysters
o Sardines
*supplements can cause nausea on empty stomach
What are sources of Vitamin C?
Vitamins C: 500 mg / day
o Peppers
o Broccoli
o Kale
o Cauliflower
o Tomatoes
o Strawberries
o Kiwifruit
o Citrus
What are sources of Theanin?
Theanine: 50 – 200 mg / day
o Green tea .
o Black tea (lower amounts)
What is Type II Diabetes?
A metabolic condition whereby body cells become resistant to the effect of insulin, leading to hyperglycaemia
Why type of diet is considered a risk in diabetes ?
- High intake of refined carbohydrates, high GI (glycaemic index) and high GL (glycaemic load) foods
- Inadequate fibre (fibre can slow glucose absorption)
- Poor intake of antioxidant nutrients e.g. fruit and vegetables
- High intake of saturated fats and trans-fats
GI: how fast/much a food raises blood glucose; GL: GI + how much carbs
Why is weight considered a risk in T2D?
- Increased risk in those who are overweight and obese, in particular, central adiposity
- Adipose cells in visceral fat are metabolically active and secrete inflammatory mediators including TNF-a and interleukin-6.
- These mediators increase systemic inflammation and decrease insulin sensitivity
How does exercise help in T2D?
- Regular exercise modulates the expression of inflammatory mediators involved in insulin resistance
- Increases the release of anti-inflammatory proteins such as adiponectin*
- Increases GLUT4 protein expression, facilitating transport of glucose into the cell
- Supports healthy weight management and improves body composition (decreases adiposity, more lean muscle)
- Improve cardiovascular health
* protein hormone that improves insulin sensitivity
How is the microbiome implicated in T2D?
- Dysbiosis drives insulin resistance
- Plant-based, fibre-rich diet increases insulin sensitivity
- Diet rich in animal food increases inflammatory mediators that can drive insulin resistance
- Stress (cortisol increases blood sugars)
- Persistent organic pollutants POPs such as pesticides can negatively impact insulin receptors
What are POPs and why are they implicated in T2M?
- Persistent Organic Pollutants (eg pesticides)
- Can negatively impact insulin receptors
What are the general nutritional aims to assist T2M?
- Avoid refined foods, alcohol, caffeine (they disrupt blood glucose)
- Replace with organic, complex carbohydrates and fibre rich foods e.g. whole grains, quinoa, buckwheat, broccoli and cauliflower (rich in nutrients; slow the release of glucose into the bloodstream)
- Avoid high glycaemic index and high glycaemic load foods (cause spikes in blood glucose)*
- Include ample low GI/GL fruit and vegetables (preferably organic) which are nutrient-rich, anti-inflammatory and antioxidant-rich. E.g. berries, dark leafy greens, pomegranates, carrots, garlic, green tea
- Keep saturated fats (especially animal fat) to a minimum, avoid trans-fats and optimize essential fatty acids such as flaxseeds, Chia seeds, hemp seeds and oily fish to maintain cell membrane fluidity and reduce inflammation. Reduced membrane fluidity can cause reduced insulin receptor binding.
- Include protein with each meal to help stabilize blood glucose
*Note: not all low GI/GL is healthy and not all high GI/GL is unhealthy!
How does Chromium help in T2D?
- Is a component of chromodulin – a protein that increases sensitivity of the enzyme tyrosine kinase.
- This enzyme facilitates insulin receptor activity allowing glucose entry into the cell
What are sources of Chromium?
Chromium: 200 – 1000 mcg/day as chromium picolinate
Food sources:
o Broccoli
o Green beans
o Barley
o Oats
o Whole wheat
o Turkey
o Beef
o Basil
How does Magnesium help in T2D?
- Deficiency is linked with poor glycaemic control and impaired insulin function
- Plays a role in pancreatic beta-cell function
- Intracellular magnesium helps regulate insulin action and glucose uptake
What are sources of Magnesium?
Magnesium: 500–1000 mg/day
o Almonds
o Seeds
o Dark leafy greens
o Whole grains
o Legumes
How do Omega-3 fatty acids help in T2D?
- Insulin resistance is strongly linked with inflammatory pathways that generate free radicals
- Omega-3 fatty acids reduce inflammation, protecting against insulin resistance
- Improve cardio-vascular health
What are sources of Omega-3 fatty acids?
Omega-3 fatty acids: 3-6g / day
Food sources:
o Coldwater fish
o Chia seeds
o Hemp and flaxseeds and oil
o Walnuts
How does Vitamin D help in T2D?
- Vitamin D plays a role in the synthesis and secretion of insulin (activates transcription of the insulin gene)
- Increases cellular sensitivity to insulin
What are sources of Vitamin D?
Vitamin D: 400 – 1000 iu/day
o Sunshine
o Mushrooms (with good sun exposure)
o Cod-liver oil
o Oily fish
o Egg yolks
What does stress do that impacts T2D?
- Cortisol increases blood sugars
- Persistent organic pollutants POPs such as pesticides can negatively impact insulin receptors
How can cinnamon help in T2D?
- Increases in the sensitivity of insulin receptors, facilitating transport of glucose into the cells.
- Add to soups, stews, curries, smoothies, drink as a tea
- ¼ tsp cinnamon in a glass of water twice-daily
How can green tea help in T2D?
- Has powerful antioxidant properties
- Protects against complications of diabetes including diabetic retinopathy
What is Polycystic ovarian Syndrome (PCOS)?
Polycystic ovarian syndrome (PCOS) is one of the most common hormonal disorders affecting women of reproductive age and is a major cause fertility issues
What are the main factors of PCOS?
- Insulin resistance and excess androgens (cyclical effects)
- Overweight* and obesity with central distribution of adipose tissue
*Not all PCOS sufferers though they will still have insuline resistance
How does insulin resistance and hyperinsulinaemia contribute to excess androgens?
- Insulin inhibits the liver’s production of SHBG*
- Decreased circulating SHBG increases levels of ‘free’ (active) testosterone
- Insulin stimulates ovarian and adrenal production of androgens
- Luteinising hormone (LH) activity is generally disrupted with impaired maturation of follicles and a lack of ovulation. Excess insulin further drives the imbalance
*Sex hormone binding globulin. Renders testosterone inactive
What are the general nutritional guidelines for PCOS?
Reflect those outlined for Type II diabetes, in an effort to address insulin resistance
How can Myo-inositol help with PCOS?
o Myo-inositol improves insulin sensitivity and supports a healthy body weight
o It decreases total serum testosterone and increases SHBG to reduce bioavailable testosterone
o Also improvements menstrual cycle regularity, oocyte (egg) quality and overall female fertility
What are the sources of Myo-inositol?
Myo-inositol (2-3 g/day)
Can be synthesised in the human body
o Whole grains
o Beans
o Nuts
o Fresh fruit and vegetables
o Grass fed meats
o Eggs
6C sugar alcohol, wrongly attributed as a B vit
How can Spearmint tea help with PCOS?
Spearmint tea: 1 - 2 cups per day
o Has been shown to decrease free testosterone levels
How can Alpha Lipoic Acid (ALA) help with PCOS?
ALA Is a short chain fatty acid that can be synthesised in the human body
o Useful for PCOS and Type 2 Diabetes
o ALA is a potent antioxidant*, reducing inflammation
o ALA supplementation improves insulin sensitivity and markers of diabetes severity
o Supports fertility by protecting oocytes (egg cells) from oxidative damage
o Has an immunomodulatory effect and can be helpful for implantation
*Water and fat soluble, recycles other antioxidants too
What are sources of Alpha Lipoic Acid (ALA) ?
Alpha Lipoic Acid (ALA): 600–1200 mg/day)
o Brassicas (e.g. broccoli, brussels sprouts)
o Spinach
o Potato
o Carrots
o Beets
o Tomatoes
o Peas
o Brewers yeast
o Lamb
o Beef
o Organ meats
How can the Maitake Mushroom help with PCOS?
Maitake Mushroom (Grifola frondosa): 3 – 7 g/day
o Maitake is crowned by the Japanese as the ‘king of mushrooms’.
o Maitake contains a proteoglycan* that improves insulin sensitivity
o Useful in cases of insulin resistance – type 2 diabetes and PCOS
o It can also help to induce ovulation in PCOS
o The fatty acids in Maitake inhibit the inflammatory COX-1 and COX-2 pathways, subsequently reducing inflammation
*Part protein, part carbohydrate
What are Asthma and Atopic dermatitis (Eczema)?
Atopic dermatitis (eczema) and asthma are hypersensitivity reactions* where the immune system overreacts to an antigen (dust, pollen, animal dander, certain foods)
*Type III, IgE-mediated
What are the Th1 and Th2?
- T-helper 1 (Th1) cells target viruses and certain bacteria that have entered body cells
- T-helper 2 (Th2) cells target allergens, toxins and parasites
