Exam 1 Flashcards
(95 cards)
1
Q
Adaptogen
A
Strengthens or tones the body
Ginseng
2
Q
Astringent
A
Shrinks tissue
Witch hazel and horse chestnut
3
Q
Bitter tonic
A
Stimulates digestive juice secretion
gentian root
4
Q
Carminative
A
Relieves intestinal gas
peppermint, chamomile
5
Q
Cholegogue
A
Stimulates secretion/release of bile
Dandelion
6
Q
Demulcent
A
soothes irritated tissue
slippery elm, aloe vera
7
Q
Types of extracts
A
Infusion Decoction Tincture Fluid extract Solid extract Standardized extract
8
Q
Decoction
A
Tea boiled for a long time
9
Q
Tincture
A
Extracted with solvent (e.g. alcohol)
1:5 concentration = 1 part herb in 5 parts solvent
10
Q
Fluid extract
A
Solvent partially distilled off
11
Q
Solid extract
A
All solvent removed
5:1 concentration = 1 part extract = 5 parts herb
12
Q
Standardized extract
A
Produced to deliver consistent amount of one or
more active or marker compounds
13
Q
What are the most modern clinical researshed styles?
A
solid extracts, often standardized
14
Q
What are the two views of standardization?
A
Guarantee levels of active or marker compounds
Guaranteed seed-toharvest-to-extract consistency of production (limited to one brand name)
15
Q
What are the Four Therapeutic Programs
A
Longevity
Therapeutic intervention
Allergy elimination
Prostaglandin modification
16
Q
Longevity
A
For prevention and treatment of age-related (and other)
diseases
17
Q
Functional Restoration
A
To restore optimal function of body systems
18
Q
Allergy Elimination
A
For removing symptom-producing sources in the diet or the environment
19
Q
Prostaglandin Modification
A
– For reducing the influences of “unfriendly” eicosanoids on health
20
Q
Staples of the longevity program
A
Diet Exercise Supplements Mental Health Environmental Health
21
Q
Supplements in the longevity program are recommended by
A
Harvard public health
Linus Pauling Institute
22
Q
Supplements in the longevity program: Possible additions
A
More vitamin D
More antioxidants
Fish oil
23
Q
Supplements help with
A
Birth defect risk Cancer risk (men, children) Infection risk in undernourished diabetics Macular degeneration risk Improved IQ in children Reduced effects of stress Malabsorption syndromes
24
Q
Areas of focus of Functional Restoration
A
Nutritional deficiencies Environmental factors Structural imbalances Physiological dysfunctions Mind-body issues
25
Two popular Functional restoration programs
Gastrointestinal Rehabilitation
| Detoxification Support
26
Gastrointestinal Rehabilitation
For improving digestion and assimilation, restoring
| normal flora and tissue integrity
27
Detoxification Support
For reducing body burden of xenobiotics (toxins)
28
Targets of GI rehabilitation
```
Poor digestion
Compromised integrity of gut lining (“leaky gut”)
Unbalanced microbiome (“dysbiosis”)
```
29
Tests to evaluate for GI rehabilitation first
Digestive analysis (gastric acidity, enzyme production)
Gut permeability test
Food allergy testing (see program discussed later)
Comprehensive stool analysis (digestive end-products,
tissue health indicators, microbial flora populations)
30
4 R's of building a better intestine
Improve digestion and elimination
Treat dysbiosis
Treat hyperpermeability
31
What can be used to improve digestion and elimination
Betaine hydrochloride, digestive enzymes, bile salts, fiber, and exercise
32
What can be used to treat dysbiosis
Introduce friendly bacteria with probiotics; encourage
their growth with prebiotics
Inhibit unfriendly bacteria
33
What can be used to treat hyperpermeability
Avoid substances that increase permeability
Control food allergies that produce local inflammation
Treat dysbiosis to lower endotoxin exposure
Supply key nutrients to intestinal cells
34
Evaluations to perform for Detoxification Program
History of possible toxin exposure
Tests for toxic metals
Tests for body detox function
Tests for nutrient adequacy for detox functions
35
Three things to do in detoxification support
Clean food, clean water, clean air
36
Hubbard Program
Only detox program with published research
Lipolytic exercise to mobilize fat-soluble toxins
Low-heat saunas
Nutritional supplementation
37
What organs are targeted in detoxification programs?
```
Intestine
Liver
Kidneys
Skin
Lungs
```
38
What general types may be prescribed to enhance liver function?
Antioxidants, lipotropics (to improve fat mobilization),
| cholegogues (to enhance bile production)
39
When eliminating allergies how long should this person be observed for?
1-3 weeks
Then re-challenge one at a time (one per 24-48 hrs)
40
Options for allergy elimination
```
Water fast
Hypoallergenic Formula
Hypoallergenic Diet (p. B31)
Combined Hypoallergenic Diet and Formula (better
compliance)
Remove suspect foods only
```
41
What substance may be implicated in asthma, hypertension, atherosclerosis menstrual cramps, and chronic inflammatory diseases
Arachidonic acid metabolites
42
Gammalinolenic acid can be a precursor to what?
beneficial eicosanoids, and may not be produced in adequate amounts under certain conditions
43
What can inhibit arachidonic acid production
Fish oil omega-3 fatty acids
44
Dietary sources of “unfriendly” arachidonic acid
Animal meats, dairy fats, shellfish
45
dietary inhibitors of normal prostaglandin metabolism
Hydrogenated (trans) fats
| alcohol
46
Cofactors for optimal prostaglandin metabolism
Vitamin B6, magnesium, zinc (or multi)
47
fatty acids that are precursors of “friendly” prostaglandins and/or inhibit production of “unfriendly” prostaglandins
Omega-3 fatty acids (oily fish and fish oil)
| Gamma-linolenic acid (available in supplements only)
48
low arachidonic acid “anti-inflammatory diet”
Dietary fat primarily or exclusively from plant sources only
Low to non-fat dairy only
Minimal to no consumption of animal flesh
No egg yolks
49
Omega-3 plant sources
Flaxseed, walnuts and their oils
| Canola oil
50
Omega-3 supplements in prostaglandin-modification program
1-10 grams per day of EPA+DHA, depending on treatment goals
| Fish oil is 30-50% EPA+DHA
51
Gamma-linolenic acid supplements in prostaglandin-modification program
500-2800 mg/day depending on health condition
Evening primrose oil
Black currant seed oil
Borage oil (most concentrated)
52
Antiinflammatory effects require at least What amount?
1200 mg/day GLA
53
Scientific name of St. John's Wort
Hypericum perforatum
54
3 active constituents of St. John's Wort
Hypericin (most important?)
Hyperforin
Flavonoids
55
Neurotransmitter function modification of St. John's Wort
Several are affected, including serotonin, norepinephrine, dopamine
Includes inhibition of synaptic reuptake, similar to common antidepressant drugs
56
What are two clinically tested extracts of St. john's Wort
Perika
| Kira
57
Effects for St John's Wort in mild-moderate depression
Helps mood, sleep, body symptoms
Equivalent to drugs with fewer side effects
65% respond significantly
58
What dosage for St John's Wort?
300 mg TID of dried alcoholic extract of flowering aerial parts containing either:
– 0.3% hypericin or
– 1%-3% hyperforin
59
Contraindications for SJW
Do not use in bipolar disorder
Do not mix with antidepressant drugs
crucial medications for transplant patients, heart failure, HIV, asthma, and oral contraception
60
Side effects of SJW
stomach upset, fatigue, itching, headache, sleep disturbance, skin rash, and skin photosensitivity at high doses
61
Side effects of SJW
stomach upset, fatigue, itching, headache, sleep disturbance, skin rash, and skin photosensitivity at high doses
62
Garlic for what cardiovascular condition?
Dyslipidemia
| Hypertension
63
Garlic scientific name
Allium sativa
64
Part of the plant used
Bulb, containing individual cloves
65
Two garlic products
Kwai - Stabilized garlic powder
| Kyolic - aged garlic extract
66
Garlic contains what two types of enzymes
alliin and enzyme alliinase
67
Aging of garlic creates complex sulfur
| compounds such as ____
S-allyl cysteine
68
Effects of garlic
```
Antioxidant
Hypolipidemic
Antihypertensive
Antithrombotic/antiplatelet
Hyperlipidemia
```
69
Hypertension effects of garlic
Systematic reviews report reduction of 8-16 mmHg systolic and 7-9 mmHg diastolic in hypertensives
AGE has weaker effect than allicin-rich garlic
70
Garlic's effect of artherosclerosis
Allicin-rich garlic has improved indicators of atherosclerosis progression
Intima-media thickness
Plaque volume
Aortic elasticity
71
Effective forms of garlic
Standardized garlic powder
Typically standardized for 1.3% alliin precursor, or 0.6% allicin “yield”
• 600-900 mg per day (3.6-5.4 mg/day allicin)
– Enteric-coating may be preferable
Aged garlic extract (AGE)
2.4-7.2 grams powder or 4-5 mL liquid
If standardized, 1.2-3.6 mg/day S-allyl cysteine, SAC)
72
Effective brands for garlic advertise what on labels?
Predictable allicin yield based on measured alliin content
| Enteric coating
73
Contraindications for garlic
Bleeding risks
Anticoagulants (anti-clotting effect)
Blood pressure drugs (hypotensive effect)
Diabetes drugs (hypoglycemic effect)
74
Old vs new guidelines for vascuar disease prevention
Old: initial use of non-pharmacological
New: Immediate use of statins for moderate to high risk
75
What associated symptoms for vasculaar disease should be treated?
Hypertension
Obesity
Metabolic syndrome
76
ASCVD High-Risk Indicators
Current ASCVD diagnosis
LDL cholesterol ≥190 mg/dl (5 mmol/L)
Diabetes, unless young with no other problems
Chronic kidney disease in older (50+ yrs) adults
History of abdominal aortic aneurysm
77
ASCVD low risk
US: below 7.5%
Canada: below 10%
78
ASCVD moderate to high risk
Above low risk percentage plus
US:
LDL over 70 mg/dl
```
Canada:
LDL over 135 mg/dl OR
LDL over 70 mg/dl with
additional risk factors OR
LDL over 70 mg/dl with
10-year risk of 20% or more
```
79
Mediterranean Diet Score
| At east six of these
```
Vegetables: 4+ per day
Legumes: 1+ per week
Fruit: 3+ per day
Nuts and seeds: 1+ per week
Whole grains: 1+ per day
Fish: 4+ per week
Fats: More unsaturated fats than saturated fats
Alcohol: Moderate
Red and processed meat:
– <2 oz per day women
– <3 oz per day men
```
80
Four proven heart healthy foods for lowering cholesterol
Plant sterols/stanols - 2g/day
Soy protein - 25-45g/day
Nuts - 1oz or 28 g
Viscous fibers - 10-20 grams/day
81
Results of heart healthy diet
Lowered LDL and lowered CRP
82
Supplement options to accompany phytosterols
Phytosterols - 2 grams per day with meals
Viscous fibers
– Beta-glucan - 3
– Glucomannan - 4
– Psyllium husk - 10
– Guar gum - 15
Standardized fresh garlic powder - 2 grams per day with meals
83
Higher-intensity interventions for ASCVD
```
Rule out secondary causes of hyperlipidemia
• Refer for intensive lifestyle coaching
• Chinese red yeast rice*
• Statin therapy* (refer)
• Niacin therapy*
```
84
Intensive LDL-Lowering Supplements
Red yeast rice: 1200-2400 mg/day
| Niacin: 1500mg.day
85
Dash diet rationale
```
Grain - 7-8 serbings
Vegetables - 4-5
Fruits - 4-5
Low fat or non-fat dairy foods - 2-3
Meats - 2
Nuts, seeds - 3-4 per weeks
```
86
Calcium in DASH diet
1000-1200 mg
87
Magnesium in DASH diet
350 mg
88
Potassium in DASH
Several thousand mg daily
89
Medical conditions possibly affecting potassium
| elimination by the kidney
Kidney disease
Diabetes
Advanced age
90
Hypertension treatment
Control weight
Control salt
Aerobic exercise
Control alcohol
Fiber and mineral-dense semi-vegetarian diet
Supplements/special foods (– Extra K, Ca, Mg, Coenzyme Q10, – Standardized fresh garlic, powder, – Fish and Fish oils; – Dark chocolate)
91
Best supplement for hypertension
Coenzyme Q, 100-200 mg/d
| ubiquinone
92
Fish oils, 1-3 g/d omega-3 fatty acids can be used for
Helps triglycerides
Helps platelet function
Helps endothelial function
93
Garlic, 4-5 mg/d allicin can be used for
Helps blood cholesterol
Helps blood pressure
Possible antiplatelet effects
Some improved vascular outcomes demonstrated
94
Multiple vitamin-mineral daily can be used for
– Manage deficiencies related to insulin resistance, inflammation
– B-vitamins to lower homocysteine
– Possible antioxidant benefits
95
Coenzyme Q, 100-200 mg/d can be used for
Helps blood pressure
Needed to offset statin risks
Some evidence of benefits to other ASCV D risk factors
