Nutrition Study Notes PDF

NMT 100: Nutrition – Study Notes Stephanie De Marchi Examine the Historical and Cultural Context of Naturopathic Therapeutics Topic Global Nutrition Crisis (-) Interest in Nutrition for Population – post WW2 (+) Description • Poor diets (deficiency or excess) • Double Burden: Food and diet “double...

NMT 100: Nutrition – Study Notes Stephanie De Marchi Examine the Historical and Cultural Context of Naturopathic Therapeutics Topic Global Nutrition Crisis (-) Interest in Nutrition for Population – post WW2 (+) Description • Poor diets (deficiency or excess) • Double Burden: Food and diet “doubleedged sword” disparities – undernutrition in developing countries, over nutrition in wealthy countries • • Health Care Cost (-) • • National Security (-) • Nutritional Science (+) • 60s/70s Dietary Advice (-) • • Improving Nutrition Practise • • • Discovery of Vitamin C (ascorbic acid) / its • • • • • benefits • Nutrition focus in the 1980s/90s • • • In times of crisis when food supply was in a shortage, government had to intervene w basic model of Canada’s first food guide much more nutrition research emerging re/ what/how much each gender/age group needs to eat to survive Increasing costs associated with treating sometimes preventable chronic illness (DM, HTN, cancer) Climate change = loss of crops = less accessible food = higher $$ of groceries Lack of nutrient access = Increase in chronic illness = decrease in country’s social stability More research in nutritional sciences = better foundation for policy change = increase health of general population Nutrition approaches = reductionist (only divided into input/output of calories) Dangerous calculation method bc it does not include nutrient density / quality of food, holistic factors that are all apart of dietary intake Increase research Increase reputable data and knowledge Implementing policy based on emerging credible research Discovered (1932) Research emerged that Vit C helps build collagen, connective tissue and bones Collagen – main structural protein found in skin, bones, joints, connective tissue Cofactor for many chemical rxtns in the body (I.e. AA metabolism) Anti-oxidant (donates electrons to transform molecules from oxidized to reduced, less harmful state) More of an understanding that food is medicine Link noticed between poor nutrition and chronic diseases (DM, hypertension) At this time, their solution was to reduce carbs, increase protein rich foods (-) Not much success re/ relation to chronic disease (bc did not include important cofactors i.e. nutrient density of food, incorporating exercise, quality, etc…) Modern Conclusions • • • Future Developments • • • • • • Canada’s Food Guide (2020) Principles • • • • • • • • Food as Medicine • • • Nutrition in Healthcare • • Compare and Contrast Different Dietary Guidelines Best to eat wide range of high quality, nutrient-dense foods Increase - fish, nuts, F & V, whole grains Limit – refined grains, sugars, processed meats Nutrient interactions (certain foods increase the bioavailability of one another, when eaten together) Diet and micro biome (we are born with “normal” bacteria in the gut. As we age, certain foods will either improve or inhibit its overall functioning) Effects of diet composition > just counting calories Accessibility – when prescribing nutrition support for patients, also need to consider cost, cultural, social preferences, etc… Regulations – i.e. sugar tax More discoveries that nurture > nature influences our nutrition (genetics does play a huge role in how we metabolize food, BUT the quality of foods that we ingest / how we eat is more important) Daily foods – vegetables, fruits, whole grains, proteins Proteins – legumes, soy, nuts, seeds, fish, lean red meat Low fat milk and yogurt, UFA should replace Fas Nutritious foods to eat regularly – fresh, frozen, canned, dried Water is beverage of choice – hydration / muscle recovery Socialization while eating is a key factor for health, when we eat with others, we calm our fight/flight instincts Daily physical activity recommended Limit ingestion of Trans Fats (increases risk of CVD and high cholesterol) – these are created by altering the hydrogen bonds of oils, making it harder to digest, more inflammatory Mindful eating Medication is not enough, we have to change the way we eat to actually influence long-lasting change CVD – almost 50% of CVD related mortalities related to dietary patterns Need to create public awareness on costs of chronic illness, the impact on society / economy, how proper nutrition / lifestyle can improve health As an ND – be an educator / role model for proper nutrition and lifestyle to others, organizing community health nutrition programs, advise good NUT practise to policy makers Food / Nutrient Description Research Discoveries Folic Acid Necessary for rapidly dividing cells, bacterial growth, nervous system development Deficiency – can cause spina bifida to babies developing in utero *Not good for cancer patients – bc folic acid promotes rapidly dividing cells ✓ Vitamin B12 ONLY found in animal products (vegetarians / vegans must supplement with it to meet DRIs) On average, humans need 2.4ug daily (small amt) Cobalt constituent gives it the “red” colour Niacin (B3) Tryptophan (protein) converts to B3 4 Ds of Niacin Deficiency (Pellagra) 1- Dermatitis 2- Diarrhea 3- Dementia 4- Death Selenium (Micronutrient) Chromium In pregnancy, need to supplement with BOTH folic acid + B12 (cofactors) First discovered in liver extracts (main storage area for this nutrient, can store here for 3 months) Enhancing bioavailability ✓ B12 + folate together = need to be taken together to meet body’s functional needs ✓ Discovered that alkalization of corn > releases Niacin (helped with global deficiencies of this nutrient) Essential for Activation of Vitamin E ✓ Dietary Source – Brazil nuts ✓ Essential for Glucose Metabolism, is a cofactor for insulin (helps to make insulin more effective when our body is processing glucose) ✓ Healthy thyroid functioning Healthy liver detox Can help patients / animals with DM Dietary source – grapes Zinc Plant-based foods rich in calcium or bone metals IMPAIR zinc absorption • (Calcium, copper, soy) all compete with zinc for absorption in the bloodstream NOT a common deficiency (since it is abundant in nearly all food types) ✓ ✓ Protein There is GREAT variation between diff proteins • AA structure, configuration Multiple AA’s are required to synthesize a protein structure for healthy body maintenance, which is Essential for fertility, sperm production Building a healthy skin barrier More discoveries that enhance the need to know WHERE our nutrition is coming from, how it is farmed ✓ Quality > Quantity ✓ Different requirements based why we need a variety of protein sources (and therefore AA’s) to fulfill our body needs Essential Fatty Acids Lipoproteins ✓ Essential nutrient – the body can’t produce them, therefore we MUST receive them from dietary sources ✓ Deficiency can cause: high bad cholesterol and IHD (Ischemic Heart Disease) *Note – fats themselves are NOT soluble in blood (if they were, they would clog our arteries) -Therefore, to make fats soluble, we MUST combine them with proteins ✓ ✓ ✓ Polyunsaturated Fatty Acids (PUFA) Fibre Big dietary source = fish! -fish has more Omega-3s>plants, making them more antiinflammatory -plants have higher ratio omega6:omega3, making them more inflammatory (compared to fishies) ✓ Dietary sources – whole grains, whole foods, vegetables ✓ Poor fibre intake = poor colon health -can result in lazy colon, therefore unable to excrete harmful bacteria from the gut efficiently, this bacteria just sits in the body, can cause harm overtime Mediterranean Diet CFG research determined the link between poor dietary fibre intake and high LDL, colon cancer, type 2 diabetes Lower end of the chart = our “baseline” – most important to maintain (therefore in this example, daily exercise is key) Goals = prevent CVD, certain cancers, cognitive decline, type II DM Food principles – seasonal grown, fresh F&V, beans, nuts, seafood ✓ ✓ Unsaturated fatty acids essential for skin health and growth Quality > quantity HDL has a higher concentration of protein, making them more water soluble, therefore easier to move through the bloodstream We need an appropriate ratio of BOTH HDL and LDL to be within a healthy / optimal range Helps to prevent heart disease and cholesterol concerns Important to advise patients about the QUALITY of different nutrient options when prescribing diet plans Fibre is necessary for colon heath (longterm deficiency may lead to colon cancer) Improves transit time of food, allowing bad bacteria’s to leave our body efficiently Research – people eating this diet in the Mediterranean have the least # incidences of heart disease / require the least # medical services Healthy diet = preventative healthcare, less costs associated with treatment ✓ Need to be conscious of where fish is coming from – risk of mercury poisoning (pregnant women / children at especially high risk) on age, gender, activity level Necessary for immunity – building antibodies Poultry and dairy should be grass>grain fed (less inflammation in animals' diet, which subsequently relates to the inflammation we receive when we eat them) ✓ Vegetarian Diet YES - V&F, milk and dairy, nuts, NO – meat, fish ✓ F&V - eat at least 5 servings/day Fats – should be unsaturated ✓ Increased risk of iron / B12 deficiency ✓ ✓ ✓ Vegan Diet ONLY plants and nuts NO – animal products ✓ Minimum 5 servings G&Veg / day Certain CVD can be reversed with vegan diet (alongside meds) ✓ ✓ ✓ Dietary Advice Micronutrients – Vitamins **necessary to PERSONALIZE diet towards each patient, depending on their treatment plan / specific needs **need to be mindful of religious beliefs, allergies, preferences, SES, health conditions Vitamins – organic molecule necessary in small quantities for healthy metabolism A)Water soluble -C, B5, B1,B2,B3,B5,B6,B7,B9,B12 – can be excreted by kidneys, harder to OD B)Fat soluble -ADEK – stored in fat,is metabolized by liver, CANT be excreted by kidneys -eat with fatty meals to increase absorption When prescribing, need to be conscious of patient affordability, budget and access (since food is a long-term solution you are recommending for people) Need to eat a variety of foods to enhance nutrient density, complimentary food absorption Lots of F&V are great sources of fibre = good digestion, colon health, blood sugar, normal lipid levels F&V = Rich in antioxidants Milk / dairy = support protein, calcium, vitamin A, B12 Eggs = animal protein, Vit B12 Vitamin D / Calcium achieved from dark green leafy veg, fortified soy products, pulses, sesame seeds, tahini, dried fruits Iron sources = whole bread, iron fortified cereals, nuts, dried fruits Fats – high quality veg oils Benefits – protection from CVD, certain types of cancer, managing DM II, weight loss B Vitamins Micronutrients – Minerals Essential FA -act as cofactors to help convert inactive proteins —> active form -therefore necessary to activate vital proteins (enzymes, hormones, etc) for healthy Fx Energy Releasing —Thiamin, Riboflavin, Niacin, Pantothenic Acid, B6, Biotin Hematopoetic (responsible for RBC/WBC formation) -Pantothenic Acid, B6, Folate, B12 Macrominerals – Ca, Mg, Ph, K, Na, Chorine -Maintains bone and connective tissue health, electrolyte balance, muscle and nerve action potential Microminerals- Iron, Copper, Zinc, Selenium, Chromium, Iodine, Manganese, Molybdenum, Fluoride, Boron, Silicon, Vanadium -needed in much smaller quantities, still essential for health ✓ Blood building, hemoglobin syntheses (Fe) ✓ Thyroid Fx (iodine, selenium) ✓ Glucose Met. (Chromium, vanadium) ✓ Bone, connective tissue (boron, silicon) Essential – body cannot produce itself, must obtain from diet 1)Linoleic Acid (Omega 6) 2)Alpha Linoleic Acid (Omega 3FA) -Precursor to EPA & DHA -Skin healthy Sources -Supplements (ethyl ester > triglycerides) more commonly used bc ethyl ester has a high boiling pt, therefore easier to produce -Good research on Krill Oil (contains EPA & DHA) -Higher ratio of high quality omegas in fish products > plants (-) Omega-3 FA Deficiency • Severe is rare – weakness, blurred vision, scaly dermatitis • Relative deficiency is common in North America (less access to high quality fish products) FAs compete with each other in biochemical pathways Conversation from EFA —> longer, more HUFAs (eicosanoids) Eicosanoids (3 types) -help make up cell membrane -byproduct of EFAs (via oxidation rxtns) 1) Prostaglandins ✓ Regulate inflammation ✓ Regulate vasoconstriction ✓ Regulate platelet aggregation ✓ Regulare hormones ✓ Regulate cell growth ✓ Regulate intra-ocular pressure (eye) ✓ Regulate fever ✓ Regulate GFR (Glomerular Filtration Rate I.e. renal, acid/base balance, fluid balance, Na/K balance,etc…) 2) Thromboxones ✓ Vasoconstrictive (alertness/focus) ✓ Hypertensive (within healthy range) ✓ Platelet aggregation (stop bleeding) 3) Leukotrienes ✓ Immunity – inflammation in asmtha, allergies, anaphylaxis ✓ Respiratory – bronchoconstriction