Nutritional Medicine Part 2
- Flynness HEALTHCARE
- Apr 14, 2022
- 11 min read
Updated: Apr 1, 2024
What is Nutritional Medicine?
Nutritional medicine is the practice of dietetics that deals with using food as the medicine source of healing and maintaining health.
It may involve direct changes of dietary components- addition eg. probiotic yoghurt or removal eg. gluten, lactose; it may involve balancing your protein, carbohydrate and lipid profile or for a period of time, using a nutriceutical supplement eg. multivitamin, B complex.
"let food be thy medicine, and medicine be thy food" Hippocrates ~500BC
Like any health based programme, results are not immediate so perseverance is important.
The Large Intestine - Anatomy
The role of Nutritional Medicine in the prevention and treatment of Diverticulosis and Diverticulitis
What are Diverticulosis and Diverticulitis?
Within the large are structures that develop both with age and with continued "food irritants" throughout life are pouches that occur in the large intestine wall called-
Diverticula
A condition develops called-
Diverticulosis
When the diverticula become Inflammed of the - infection/trapped food/trapped faecal matter, a condition develops called-
Diverticulitis
Comparison between a Healthy gut and one with Diverticulosis and Diverticulitis
Symptomatic Diagnosis
Diverticulosis can be
Asymptomatic OR Symptomatic
Uncomplicated OR Complicated
If Complicated, symptoms can include
Diverticular Bleeding AND/OR Diverticulitis
Acute eg. a sharp pain that is short lived
Chronic refers to ongoing symptoms
Causes & symptoms Diverticulosis & Diverticulitis
Causes
• Ageing - muscles become weaker
• Low fibre diet -cause of diverticulitis + infection
• Low fibre diet - pressure on colon - push the stool out, -lodging of stool matter in the diverticula,-
leads to infection
• Some cases -, excess of refined carbohydrates
• Food intolerances continuing for a long time or other medical conditions
• Medicines that cause constipation
• Gut dysbiosis
• Stress/lifestyle, Genetics, for some Obesity
Symptoms
Sudden pain in the lower left side of the abdomen is the most common symptom.
Can be confused with appendicitis if pain on the right side
Other symptoms include:
• Abdominal Pain
• Nausea
• Vomiting
• Fever
• Bloating or gas
• Constipation
For more information go to
Food & Diet Causes
Unfortunately, good foods can be a cause ie. grains, nuts and seeds, fruit and vegetables. However, with the help of a dietitian, naturopath or nutritional medicine practitioner, suggestions on cooking, amount etc can be provided so that you are not missing out on important nutrients.
Obviously, a poor diet has a major effect. Especially if it over a long period of time.
A lack of grains, fruits and vegetables and a diet high in animal products (even if they are good quality meats and dairy) will have an effect on the bowel walls, often reducing movement (peristalsis) causing constipation.
Food & Diet Prevention and Treatment
Prevention covers not developing Diverticulosis and bouts of Diverticulitis to start with and preventing it happening again if you do. However, over the age of 50, 50% of people will develop Diverticulosis due ageing of the smooth muscle.
Day to day - mixed fibre soluble and insoluble
• Sources grains, fruit & vegetables – individual choices including FODMAP aspects
• 21-25g women, 30-38g men
Total restriction does not appear to have any benefit
Water vital 1.5-2.5L depending on needs
If you are suffering diverticulitis
• Need to reduce inflammation and any infection
• Soft foods, pureed for at least a week
• gradually reintroduce more solid foods over a 6- 12 week period
Not food but found to be very important – movement/exercise NOT bed rest
Meat & Pulses
Meat
• Oily fish 3+ per week – anti-inflammatory
• Lamb – small pieces, soft texture Zinc good for healing
• Beef, pork – stir fry, soft texture, pork – no crackling
• Chicken – avoid dry, stir fry or grilled, soup
Pulses
• Beans, lentils and peas
• Good source of fibre but can get “stuck” in divertula
• Cook to soften
• Use in soups or blend as a smoothie
For information of dietary plans see "Food & Nutrition Basics" section
For more information go to
The role of Nutritional Medicine in the prevention and treatment of Irritable Bowel Syndrome (IBS)
What is IBS?
Irritable bowel syndrome also called: IBS, spastic colon
Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine causing pain in the stomach, wind, diarrhoea and constipation.
The cause of irritable bowel syndrome isn't well understood. A diagnosis is often made based on symptoms.
IBS is a chronic condition that you'll need to manage long term.
Only a small number of people with IBS have severe signs and symptoms. Some people can control their symptoms by managing diet, lifestyle and stress.
More-severe symptoms can be treated with medication and counseling.
IBS doesn't cause changes in bowel tissue or increase your risk of colorectal cancer.
Symptoms
The signs and symptoms of IBS vary but are usually present for a long time. The most common include:
Abdominal pain, cramping or bloating that is related to passing a bowel movement
Changes in appearance of bowel movement
Changes in how often you are having a bowel movement
Other symptoms that are often related include bloating, increased gas or mucus in the stool.
When to see a doctor
See your doctor if you have a persistent change in bowel habits or other signs or symptoms of IBS. They may indicate a more serious condition, such as colon cancer. More-serious signs and symptoms include:
Weight loss
Diarrhoea at night
Rectal bleeding
Iron deficiency anaemia
Unexplained vomiting
Difficulty swallowing
Persistent pain that isn't relieved by passing gas or a bowel movement
Symptoms of IBS can be triggered by:
Food. The role of food allergy or intolerance in IBS isn't fully understood. A true food allergy rarely causes IBS. But many people have worse IBS symptoms when they eat or drink certain foods or beverages, including wheat, dairy products, citrus fruits, beans, cabbage, milk and carbonated drinks.
Stress. Most people with IBS experience worse or more-frequent signs and symptoms during periods of increased stress. But while stress may aggravate symptoms, it doesn't cause them.
https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016
Dietary Causes of IBS
The most common causes of issues relating to diet and IBS are mainly due to a group of carbohydrates called Oligosaccharides. These are divided into
Fructo-oligosaccharides and Galacto-oigosaccharides.
Other foods include high intake of caffeine, carbonated drinks and artifical sweetners (either the foods they are in or the AS itself).
Collectively known as FODMAPs
This is caused by types of CARBOHYDRATE due to fermentation by microbiota
Main food related issue of IBS – Irritable Bowel Syndrome as well as general bloating with some foods
FODMAP diet designed for IBS (not weight loss)
FODMAP stands for-
Fermentable Oligosaccharide Disaccharide Monosaccharide And Polyols
Main food sources are
Grains, Fruit & Vegetables, Nuts & Seeds –
FOS - Fructoligosaccharides
Insoluble fibre portion &/orexcess soluble
Natural sugars - sucrose & fructose
Added “sugars” – processed sucrose & fructose
Artificial Sweeteners-”sugar”
(actually protein but gut biome cannot breakdown)
Dairy products-
GOS - Galactoligosaccharides
Lactose -Milk, Soft Cheeses
Lactose containing products
IBS DIET PLAN FODMAP
Designed for IBS by Dr Sue Shepherd Monash University, Australia
Phase 1 Low FODMAP diet for ~ 6 - 8wks
Strict restriction of high FODMAP foods to relief from symptoms
Usually start by removal of ALL FODMAP foods
Phase 2 High FODMAP dietary plan to suit individual
Re-introduce types/amounts determine trigger foods and quantity that maintains symptom relief
Very person and food specific covering both whole food groups or foods within a food group
You do need to reintroduce higher FODMAP foods to avoid constipation due to lack of fibre and also vitamins and minerals found in fruit, vegetables and grains
Food treatment for IBS includes both foods to help heal the bowel and foods to avoid or limit
As with any condition, a balanced diet from the 5 food groups + fibre and water are still applicable.
Prebiotics can be included but may increase symptoms.
Probiotics will help calm and heal the bowel enabling increase in good microbiota.
However, within the food groups, you may need to trial foods that do not increase your symptoms
This can be done by following a supervised Elimination diet
If you are aware of your triggers you can still include them in your diet plan by reducing amount, improving quality including organic, reducing frequency or consuming in another format, otherwise avoid.
Whilst there are books available as well as apps and oteher internet advice, I highy recommend that you -
Make an appointment with a GP to determine actual causeand to rule out gluten allergy (Coeliac) or intolerance or cancer then -
a referral to a Specialist Dietitian
other choices after diagnosis include -
Nutritional Medicine Practitioner or a
Naturopath with Herbal Medicine qualifications
Download Apps to assist shopping
The role of Nutritional Medicine in the prevention and treatment of Leaky Gut Syndrome (LGS)
What is Leaky Gut Syndrome?
Leaky gut syndrome (LGS) is a digestive condition that affects the lining of the intestines. In leaky gut syndrome, gaps in the intestinal walls allow bacteria and other toxins to pass into the bloodstream.
The gastrointestinal (GI) tract is a tube of connected organs that runs from the mouth to the anus. The organs of the GI tract include::
the oesophagus
the stomach
the small and large intestines
Digestive enzymes in the stomach and small intestine break down nutrients in food and drink into smaller molecules that the body uses for energy, growth, and repair.
The intestines also play an essential role in protecting the body from harmful bacteria and toxins.
Tight openings in the intestinal walls allow water and nutrients to pass through into the bloodstream while keeping harmful substances inside. In LGS, these openings become wider, allowing food particles, bacteria, and toxins to enter directly into the bloodstream. See the section “A Little Bit of Science” for on tight junctions.
Gut microbiota and leaky gut syndrome
The large intestine is also home to a wide range of bacteria called gut microbiota. These bacteria aid digestion, protect the intestinal wall and support normal immune function. LGS may involve imbalances in gut microbiota.
According to a 2016 article, imbalances in the gut microbiota can trigger the body’s immune response. This results in gut inflammation and increased intestinal permeability (IP). IP describes how easily substances can leak out of the intestines and into the bloodstream.
The link between LGS and other health conditions
Leaky gut may contribute to several health conditions. Examples include:
irritable bowel syndrome (IBS)
chronic liver disease
food allergies and sensitivities
It is still not clear whether LGS is a cause or a symptom of these conditions.
However, a 2015 review article suggests that increased IP may contribute to the development of inflammatory bowel disease (IBD). A separate 2019 review shows evidence of IP occurring before the onset of type 1 diabetes.
Scientists have also been investigating the gut-brain axis . This is the relationship between the GI tract and the brain. A 2017 review suggests that leaky gut may contribute to mental health conditions, such as anxiety and depression. However, scientists need to carry out further research to support this claim.
Symptoms
Leaky gut shares many of its symptoms with other health conditions. This can make the condition difficult for doctors to identify.
Leaky gut may cause or contribute to the following symptoms:
chronic diarrhoea, constipation, or bloating
nutritional deficiencies
confusion
difficulty concentrating
joint pain
widespread inflammation
Causes and risk factors
Experts do not yet know exactly what causes leaky gut syndrome. However, various risk factors can disrupt the gut microbiota and contribute to increased IP. Examples include:
Treatment and improving gut health
Dietary and lifestyle changes may help people to improve their gut health. This, in turn, may alleviate leaky gut symptoms.
The following dietary tips may help to improve gut health:
eating more probiotics to boost beneficial gut bacteria
eating foods rich in prebiotic fiber, such as vegetables and wholegrains
eating less meat, dairy, and eggs
avoiding added sugar and artificial sweeteners
The following lifestyle changes can improve digestion and support a healthy gut:
exercising regularly
getting enough sleep every night
reducing stress
avoiding unnecessary use of antibiotics
For the full article and references, go to
The role of Nutritional Medicine in the prevention and treatment of excess Cholesterol
What is cholesterol?
Cholesterol is an organic molecule.
It is a type of fat that is part of all animal cells.
Made in the liver from saturated fats
It is a sterol, a type of lipid.
Cholesterol is biosynthesized by all animal cells and is an essential structural component of animal cell membranes
It is essential for many of the body’s metabolic processes, including the production of hormones, bile and vitamin D.
Your levels are determined by genetics plus types of foods and specifically, types of fats.
However, only 20% of dietary fat (mainly saturated) has an effect on overall Cholesterol levels
How is Cholesterol produced?
Sources of Cholesterol
The Two main types of Cholesterol
High Density Lipoprotein HDL
Low Density Lipoprotein LDL
HDL is often referred to as "GOOD" as it takes cholesterol away from the heart
LDL (further reduced in size to VLDL, very lowdensity lipoprotein) often referred to as "BAD" as it takes cholesterol to the heart.
This is a simplified version as the body produces and required both types to some extent.
Some Facts and Figures
Levels are detected by a blood test
Total Cholesterol <5.5 mmol/L
HDL M 0.9 – 2.0 mmol
F 1.0 – 2.2 mmol/L
LDL 2.0 – 3.4 mmol/L
HDL:LDL <3.7 mmol/L
TCG <2.0 mmol/L
Genetic factor
Dominant Gene hypercholesterolaemia, hyperlipidaemia
Diseases atherosclerosis (build up)
atheroma (degeneration)
Causes/Risk factors
Symptoms high cholesterol
Hypercholesterolaemia does not cause any symptoms but may eventually lead to heart attack, peripheral artery disease, or stroke due to atherosclerosis.
Blood test results
Familial hypercholesterolaemia is associated with:
• Xanthelasma palpebrarum (yellowish patches underneath the skin around the eyelids)
• Arcus senilis (white or gray discolouration of the peripheral cornea)
• Xanthomata (deposition of yellowish cholesterol-rich material) of the tendons
Type III hyperlipidaemia may be associated with xanthomata of the palms, knees and elbows.
Foods High in Cholesterol
Food treatment for high cholesterol
Need to reduce LDL and increase HDL
Saturated fats 7-10% of daily intake Increase LDL
Unsaturated fats 10% +
• Omega 3 & 6 Increase HDL, Reduce LDL
• Omega 9 Increase HDL
Phytosterols
• whole grains, fruits, legumes e.g., lentils and soybeans
Fibre
• Soluble & Insoluble
Increase overall plant intake
Beta-glucans, oats
Reduce/Avoid high salt, high animal fats, caffeine & processed/refined foods, alcohol, fried foods, lower fat/lower amounts of dairy milk, cheeses
NOTE: Eggs – whilst they are high in cholesterol, they are low fat and contain a natural cholesterol lowering fat called Lecithin
Phytosterol designed margarines e.g. ProActiv (???)
Lowering cholesterol diet plans
5 Food Group basic plan
Mediterranean Diet especially oat grains, fruit & oily fish
Pisco-Ovo-Lacto Vegetarian
Flexitarian Diet emphasis on 3-5 days per week plant based
Specific cholesterol plan diets
Dr Sandra Cabot “ Cholesterol : the Real Truth”
Warning “High Protein/High Fat/Low Carb Keto-style” high in saturated fat can further increase total Chol. and LDL cholesterol.
Prevention of high cholesterol
The same heart-healthy lifestyle changes that can lower your cholesterol can help prevent you from having high cholesterol in the first place.
• Eat a low-salt diet that emphasizes fruits, vegetables and whole grains
• Limit the amount of animal fats and use good fats in moderation
• Lose extra kilos (if applicable) and maintain a healthy weight
• Exercise on most days of the week for at least 30 minutes
• Caffeine in high amounts (concentration, cups/day) can increase LDL (cafestol)
• If applicable
• Quit smoking
• Drink alcohol in moderation, if at all
• Manage stress/Sleep
Suggested supplements & nutraceuticals
Digestive enzymes proteases, lipases, amylases (bromelain, papain, ficin)
Beta glucans/oats
Linseed, Sunflower seeds (LSA mix) softened
Psyillum softened – reduce symptoms not recurrence
Apple cider vinegar and honey
If on Statin drugs – CoQ10
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