Nutrition - Week 1 PDF

NUTRITION – WK 1 NUTRITION FOR IMMUNE SUPPORT & H E A LT H Y F U N C T I O N Author: Dr. Michelle Richea, ND and Dr. Maryam Yavari, ND LEARNING OBJECTIVES Considerations for providing nutritional guidance as it relates to this week’s case presentation Sugar intake Protein intake H...

NUTRITION – WK 1 NUTRITION FOR IMMUNE SUPPORT & H E A LT H Y F U N C T I O N Author: Dr. Michelle Richea, ND and Dr. Maryam Yavari, ND LEARNING OBJECTIVES Considerations for providing nutritional guidance as it relates to this week’s case presentation Sugar intake Protein intake Honey Probiotics Vitamins D Vitamin C Zinc TREATMENT GOALS Reduce uncomfortable symptomatic experience Reduce severity and duration of illness Support full recovery Prevent sequela Prevent re-occurrence following resolution LOOK AT DIETARY SUGAR Too much sugar intake may have a deleterious effect on immune function, especially when fighting a bacterial infection Pro-Inflammatory proteins (TNF-alpha, CRP, IL-6) Changes to the microbiome Simple carbohydrates can decrease the phagocytic capacity of neutrophils (function not number was altered) - Effects can last up to 5 hours Citation, Click here: The American Journal of Clinical Nutrition WHAT TO EAT? Look to reducing obvious refined sugars, i.e. cookies, cakes, pastries, candies, sugary beverages, INSTEAD: Eat whole fruits or blended in smoothies for natural sweetness Fill up with whole fruits, vegetables, healthy protein, fibre, and complex carbs For a sore throat, instead of ice cream, try making a home iced made lolly made from herbal tea and lemon ENSURE ENOUGH DIETARY PROTEIN A deficiency in dietary protein/ amino acids impairs immune function and increases susceptibility to infection. Amino Acids are important to: Activate T-lymphcytes, B-lymphocytes, NK cells, & macrophages Lymphocyte proliferation Production of antibodies & cytokines Optimal Protein Guide: https://examine.com/guides/protein-intake/ Citation, Click here: British Journal of Nutrition WHAT TO EAT? Review typical diet to see if meeting dietary goals, consider increasing dietary protein with: Homemade bone broth & Homemade chicken noodle soup Congee made with bone broth, added chicken/ eggs Rice and lentils Homemade Jell-O/ Protein smoothie Chicken noodle soup for convalescence may be North American-centric, look to what traditional foods other cultures around the world might turn to during illness: https://www.insider.com/what-people-from-around-the- world-eat-when-they-are-sick-2016-6 HONEY FOR HEALING Natural antimicrobial properties Decreases inflammation Symptomatic management by easing discomfort Not for infants under 1 yoa, due to risk of Clostridium botulinum Try as: lemon and honey tea, iced lolly, lozenge Citation, Click here: Molecules PROBIOTICS Supports healthy microbiome, especially with/ following antibiotic use Safe and well-tolerated Streptococcus salivarius K12 (SsK12) may offer specific support with Strep throat infection, but more research needed Citation, click here: Clinical Microbiology and Infection VITAMIN D "Vitamin D supplementation has also been shown to enhance neutrophil killing of pathogenic streptococcal bacteria while concomitantly dampening excessive inflammatory responses and apoptosis, indicating vitamin D has chemotherapeutic potential against streptococcal infections." Citation, Click here: ACS Infectious Diseases VITAMIN D SUPPLEMENTATION Active Form, Vitamin D3 (cholecalciferol) Fat-soluble vitamin, liquid/ gel cap formula taken with food/ main meal Can dose appropriate to Vitamin D status if known Over 2,500 IU Vitamin D3 = Rx in Ontario (Over 1,000IU in BC) Given clear directions with dose and duration, too much can lead to toxicity **Get comfortable with electronic resource – Natural Medicines Database, available at CCNM Library website. Review Vit. D Monograph – look up dose considerations, interactions  VITAMIN C The total efficacy, the time for symptom amelioration, and the time for healing, were better with vitamin C supplementation than with antiviral therapy alone. Vitamin C could be used as a supplementary therapy along with antiviral regimens to relieve patients from the symptoms of common cold. Ran L, Zhao W, Wang H, Zhao Y, Bu H. Vitamin C as a supplementary therapy in relieving symptoms of the common cold: a meta- analysis of 10 randomized controlled trials. BioMed Research International. 2020 Oct 10;2020. VITAMIN C The Upper tolerable intake level (UL) for vitamin C is 2 g/d Most common adverse effects of high doses of oral vit C are gastrointestinal: Gastric irritation from the decreased pH of the stomach contents Intestinal gas, bloating, cramping, and pain cause by unabsorbed vitamin C metabolized by the colonic bacteria Diarrhea caused by unabsorbed vitamin C in the colon Dental erosion (chewable and powdered ascorbic acid only)  VITAMIN C Increasing vitamin C intake does cause an increase in the urinary excretion of uric acid. a large 20-year prospective study showed a decreased risk of gout with increased vitamin C intake from both food and supplemental sources. Choi HK, Gao X, Curhan G. Vitamin C intake and the risk of gout in men: a prospective study. Arch Intern Med. 2009 Mar 9;169(5):502-7. doi: 10.1001/archinternmed.2008.606. PMID: 19273781; PMCID: PMC2767211.  ZINC Zinc has been evaluated as a potential treatment for the common cold 17 trials involving 2121 participants were included in the meta-analysis Zinc was found to shorten the duration of cold symptoms compared to placebo (mean difference -1.65 days) Zinc was more effective in adults (mean difference -2.63 days) than in children (mean difference -0.26 days) Adverse events such as bad taste and nausea were more common in the zinc group than in the placebo group Johnstone J, Roth DE, Guyatt G, Loeb M. Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials. Cmaj. 2012 Jul 10;184(10):E551-61. WHAT WOULD YOUR DIETARY TREATMENT RECOMMENDATION LOOK LIKE? Depends on the individual: Chosen diet & preferences, i.e. vegetarian/ vegan Allergies Age Accessibility/ availability Past Medical history and presenting illness HEALTH CANADA & NHPS https://www.canada.ca/en/health-canada/services/drugs-health- products/natural-non-prescription.html Proper manufacturing – without contamination and incorrect ingredients Appropriate labelling Supported health claims 8 Digit NPN, or DIN-HM REFERENCES CDC: https://www.cdc.gov/ Online source Center for Disease Control and Prevention Updates 2022 Prousky J. Textbook of Integrative Clinical Nutrition. CCNM Press Inc.; 2012. Katz D. Nutrition in Clinical Practice. 2nd Edition. Lippincott Williams & Wilkins; 2008. Katsilambros N. Clinical Nutrition in Practice. WileyBlackwell; 2010. Pizzorno J and Katzinger J. Clinical Pathophysiology. Mind Publishing; 2012. Marz RB. Medical Nutrition from Marz. 2nd edition. Quiet Lion Press; 1999. Murray MT. Encyclopedia of Nutritional Supplements. Prima Health; 1996. Gropper S, Smith J. Advanced Nutrition and Human Metabolism. 7th Ed. Cengage Learning; 2018. Gaby A. Nutritional Medicine.; Perlberg Publishing 2011. Hoffer A, Prousky J. Naturopathic Nutrition: A Guide to Nutrient-Rich Food & Nutritional Supplements for Optimal Health. CCNM Press; 2006.