Nutrition Study Guide.pdf

2024 WELCOME TO THE NATUROPREP NUTRITION GUIDE NaturoPrep Information extracted from Core Knowledge for NPLEX 2 Textbook  QUICK GUIDE TO STUDYING NUTRITION Key Resources: Core Knowledge [Your Main resource for Nutrition content]...

2024 WELCOME TO THE NATUROPREP NUTRITION GUIDE NaturoPrep Information extracted from Core Knowledge for NPLEX 2 Textbook  QUICK GUIDE TO STUDYING NUTRITION Key Resources: Core Knowledge [Your Main resource for Nutrition content] RDA and dosing is NaturoPrep Nutrition guide (this document) important information to know for safety but should Your clinical knowledge from previous CCNM not be your key study courses and your internship year focus How to approach nutrition studying? Remember this is a clinical examination – focus on applying nutritional strategies to a patient case stem. Ensure you are focusing on safety nutritional interventions, including side effects, contraindications, interactions, and toxicity. Be knowledgeable of the food sources and therapeutic diets that provide these vitamins, minerals, amino acids etc and give the desired outcome! Vitamins WATER SOLUBLE Vitamin Key Information Deficiency/Toxicity Food sources Needed for energy production (Kreb’s cycle) & DNA Deficiency mainly in alcoholics & high blood synthesis sugar (diabetes) Thiamine (B1) Mg2+ needed to convert to active form Presents as: Brewer’s yeast RDA: 1.2mg/d Forms: Beriberi – “I can’t I can’t” Brown rice/ whole grains (Men), 1.1mg/d Thiamine hydrochloride – supplemental form Wernicke’s encephalopathy – ataxia and Egg yolk (Women) Bentotiamine – fat soluble Legumes psychiatric concerns Therapeutic: 300- Korsakoff’s – memory dysfunction 600mg/d Main indications: Toxicity: No UL Nerves – peripheral neuropathy, sciatica, dementia, Toxicity: None neuralgia Riboflavin (B2) **maintains Homocysteine levels** Deficiency presents as: Needed for energy production (Krebs) – Cheilosis – cracked corners of lips RDA: 1.3mg/d In 2 enzymes FAD and FMN Glossitis – swollen tongue Brewer’s yeast Conversion of tryptophan🡪 to niacin requires FAD Corneal vascularization – decreased visual Almonds (Men), 1.1mg/d Liver (Women) acuity Egg yolks Therapeutic: Main indications: Weakness, dermatitis Whole grains 400mg/d [25- Migraine prevention Legumes 30mg = max Cataracts Toxicity: None absorption] Sickle cell anemia Note: turns urine bright yellow Toxicity: No UL Derived from Tryptophan Needed for energy production – coenzyme in NAD+ /NADP Deficiency presents as: Fat, CL & CHO metabolism Niacin (B3) Pellagra (4 Ds) Sex hormone production Dermatitis RDA: 16mg/d Diarrhea Beef liver Forms: (Men), 14mg/d Dementia Brewer’s yeast Niacin (nicotinic acid) – Flushing, hepatotoxic Broccoli (Women) Death Niacinamide – non-flushing but hepatotoxic Carrots Therapeutic: 3- Inositol hexanicotinate – no flushing, no Lv toxicity Whole grains 6g/d At risk= Carcinoid syndrome & Hartnups Eggs Toxicity: 50mg disease Nuts Indications: can cause Fish Hyperlipidemia flushing, 3+g may Toxicity: Flushing skin Schizophrenia – niacin converted to seratonin cause LV toxicity Hepatotoxicity >3g/day CVD Hyperglycemia Alzheimer’s Acne Enhances insulin secretion & sensitivity Needed for energy and blood production Pantothenic Component of Co-enzyme A Creates adrenal hormones, RBCs, FAs acid (B5) Forms: Avocados Calcium pantothenate – adrenals Deficiency presents as: Brewer’s yeast AI: 5mg/day Pantethine – cholesterol & TG lowering Burning feet syndrome Beef Therapeutic: 300- Fatigue Legumes 1200mg/day Indications: Toxicity: None Fresh veggies Toxicity: none/ Mushrooms Adrenal insufficiency >100mg/day Hyperlipidemia increases niacin Dermatitis need Acne Vitamins WATER SOLUBLE Vitamin Key Information Deficiency/Toxicity Food sources Pyridoxine/Py **maintains Homocysteine levels** ridoxal 5’- Needed for energy and blood synthesis Deficiency presents as: Phosphate Neurotransmitter synthesis – serotonin, dopa, Cheilosis (B6) melatonin, epi, NE, GABA) Glossitis Tuna Needs B2 & Mg2+ to become active form Anemia Avocado Convulsions Chicken RDA: 1.3mg/day Indications: Peripheral neuropathy Turkey Therapeutic: 50- CVD – decreases homocysteine Carrot juice 400mg/day Banana N/V in pregnancy Toxicity: Toxicity: Asthma Ataxia >500mg/day or 2- PMS – decreases estrogen Severe neuropathy >2-6g/day 6g acute Psych – anxiety, depression, Alzheimer’s Needed for energy production Lipid & CHOP metabolism Deficiency presents as: Biotin (B7) Indications: Dermatitis Brittle hair & nails Alopecia Liver RDA: 30mcg/d Seborrheic dermatitis Brittle nails Yeast Therapeutic: Diabetes Depression Egg yolk 1000-10,000mg/d Cradle cap Cereal grains Toxicity: None Other: Absorbed in the jejunum Toxicity: None Is made by gut flora Avidin in egg whites inhibits absorption Not essential in the diet Functions in the cell membrane Inositol (B8) Necessary for nerves, brain and muscle function “unofficial B Vital for hair growth Brewer’s yeast Citrus fruits vitamin” Indications: Legumes None Meats Liver disorders Whole grains Therapeutic: 4- Depression Veggies 12g qd Diabetic neuropathy PCOS **maintains Homocysteine levels** Needed for energy and blood production Methylation, DNA synthesis Folate (B9) Indications: Deficiency presents as: CVD – atherosclerosis, stroke Megaloblastic anemia Birth defects RDA: 400mcg/day Increased homocysteine Green leafy veg Miscarriages Lentils Therapeutic: Neural tube defects Kidney beans 400mcg-1mg/day Cervical dysplasia Other: Avocado Toxicity: UL 1mg, Chickpeas Absorbed in the jejunum >15mg/day toxic Toxicity: >10mg Use MTHF if you suspect methylation issues range Can mask B12 deficiency Drugs that decrease folate: Phenytoin OCP TMP-SMX Abx Aspirin Methotrexate Vitamins WATER SOLUBLE Vitamin Key Information Deficiency/Toxicity Food sources **maintains Homocysteine levels** Needed for energy and blood production DNA, RNA, myelin synthesis Def can be caused by: Cofactor for methionine synthase Pernicious anemia Cobalamin Lack of HCL Forms: (B12) Methylcobalamin – best absorption Celiac disease Parasitic infections Hydroxycobalamin RDA: 2.4mcg/day Zollinger- Ellison syndrome Meat Cyanocobalamin –least absorption Clams Therapeutic: Elderly Eggs 300mcg or 1-5mg Fish Indications: start (pernicious Deficiency presents as: Cheese Anemia anemia) and 1- Macrocytic/megalo anemia Fatigue 2mg maintenance Parasethias Neuropathy Toxicity: no UL Depression Alzheimer’s/ Dementia Anxiety Toxicity: None Other: Absorbed in terminal ileum Needed for immune function, collagen synthesis, neurotransmitter synthesis and antioxidant function Indications: Vitamin C Cardiovascular – atherosclerosis, HTN, high CL Deficiency 20g can cause Egg yolks Therapeutic: Liver diseases – fatty changes Dead fish body odor Legumes 650mg-2g/d [3-4 High cholesterol N/V eggs/week in Alzheimer’s Increased sweating pregnancy] Bipolar Disease Increased salivation Toxicity: >20g/d Vitamins FAT SOLUBLE Vitamin Key Information Deficiency/Toxicity Food sources Needed for epithelial tissues, immune function, spermatogenesis, vision Forms: Preformed (retinol, retinyl esters) & Deficiency presents as: Provitamin A carotenoids (beta- Night blindness carotene) Follicular hyperkeratosis Impaired spermatogenesis Provitamin A carotenoids – B-carotene, Decreased immune function Vitamin A a-carotene, gamma- carotene, B- Stunted growth zeacarotene Liver RDA: 2300-3000IU Toxicity: Fish liver Therapeutic: 5000- Non-provitamin A carotenoids – 10,000IU/d, 50,000IU 1- Cheilitis Dairy products Lycopene, zeaxanthin, lutein, 2days [post viral Xerosis (dry skin) Dark leafy greens canthaxanthin, capsanthin infection] Headaches Bright colour fruits and Toxicity: >10,000 Joint &muscle pain veg teratogenic, 100,000- Indications: Fatigue 300,000 in acute single Skin concerns –acne, eczema dose Infections – URTI Teratogenic in pregnancy! Eyes – Retinitis pigmentosa, night vision Limit in – smokers, alcoholics & Liver Burns dysfunction Cancer Other: Interactions – Vit E, zinc and thyroid hormones needed for proper functioning Needed for bone health and immune Deficiency presents as: function Rickets – Children Acts as a hormone Osteomalacia – adults Stored in adipose tissue Vitamin D Essential if inadequate skin exposure to Note: darker skinned individuals are Cod liver oil light more likely to become deficient Fish – salmon, sardines, Deficiency: 40000IU Toxicity: 25,000- 40,000IU Osteoporosis, Osteomalacia, Hypercalcemia & hypercaluria Immune function Soft tissue calcification Kidney stones Forms: Ergocalciferol (D2) N/V/ anorexia Cholecalciferol (D3) Additional notes: Vitamins FAT SOLUBLE Vitamin Key Information Deficiency/Toxicity Food sources Needed for maintaining cell membranes, antioxidant, scavenging free radicals Indications: Deficiency presents as: Heart disease, stroke Hemolytic anemia Vitamin E Cancer Neuro symptoms Diabetes Polyunsaturated Muscle weakness RDA: 22.5IU/d Derm – herpes, scleroderma vegetable oils Therapeutic: 100- MSK – myopathy, Dupuytren’s contracture Nuts 800IU [usually Fibrocystic breast changes Seeds Toxicity: Whole grains around 400IU] Impaired blood coagulation Toxicity: 1500- Other: 3200IU Increased mortality Caution with warfarin Heart failure Increased vit E requirement in smokers and high PUFA consumption Vitamin C works synergistically as an antioxidant Needed for hemostasis (blood clotting) and healthy bones Forms: Vitamin K K1- phylloquinone (plants) K2- menaquinones (gut bacteria) RDA: 90-120mcg/d K3- menadione (synthetic) Deficiency rare in adults with gut flora Therapeutic: 100- Leafy green vegetables 1000mcg/d Would present as major bleeding Indications: Cheese [phylloquinone], Egg yolks Osteoporosis 45mcg/d [MK4 Toxicity: Atherosclerosis Made by gut bacteria!! (menaquinone)], Hemolytic anemia Hemorrhage in newborns 45-120mcg/d Jaundice [MK7] Toxicity: Other: Phylloquinone Babies given vit K shot at birth to prevent toxicity rare hemorrhage because they do not have gut flora yet Caution: Do not use with Warfarin Additional notes: Minerals Vitamin Key Information Deficiency/Toxicity Food sources Needed for metabolism of calcium, Boron phosphorus, magnesium, steroid hormones Deficiency not common but will add to and vitamin D vitamin D deficiency and increase bone Apples RDA: 1.5-3mg/d Enhances the effects of estrogen on bone loss Carrots Therapeutic: RDA density Grapes but can go up to 3- 9mg/d Indications: Toxicity: Dark green leafy veg Osteoporosis – prevention or tx Increased plasma estradiol Nuts Toxicity: 10mg/d 4 Vaginosis concentration Whole grains weeks, or 500mg/d Urolithiasis N/V/diarrhea Prostate cancer Needed for healthy teeth & bones, nerve conduction of muscle, contraction, coagulation, hemostasis, and cell membrane permeability Deficiency 2000mg, Tofu Indications: Toxicity: 500mg+/d Prevention of osteoporosis Increased risk of CVD events (MI, CAD, increases CVD risk Lower BP (systolic), stroke) Preeclampsia BP Depleted magnesium Protection against colon cancer Impaired zinc and iron absorption Notes: Contributes to BMD but not fracture risk prevention Vitamin D enhances Ca absorption Oxalates decreases absorption Needed for insulin cofactor, improving glucose tolerance, modifies brain serotonin function Form: Best absorbed: Chromium picolinate Deficiency presents as: Meats* Chromium Insulin resistance Whole grains* Indications: Peripheral neuropathy Liver RDA: 50- Eggs Insulin resistance Elevated blood sugar and insulin Brewers yeast 200mcg/d Therapeutic: 200- Diabetes Shrimp Weight management Toxicity: none mushrooms 1000mcg/d Notes: Absorption increased by vit C Decreased by phytates Interacts with hypoglycemic drugs Minerals Vitamin Key Information Deficiency/Toxicity Food sources Needed for wound healing, energy production, hair and skin coloring (melanin Deficiency presents as: formation), taste sensitivity Wilson’s disease Poor collagen integrity Copper Iron def Anemia – bc Cu needed for iron Indications: to be absorbed and used RDA: 900mcg/d Aneurysm Oysters Neutropenia Therapeutic: 1- Burns Shellfish Bone lesions 4mg/d Osteoporosis Legumes Toxicity: 10g/d [10- Osteoporosis Peptic ulcers 20g = lethal or 3.5g Decrease resistance against infections Rheumatoid arthritis for child] Toxicity: Notes: Nausea/vomiting High intakes of zinc, Vit C, iron interfere with Cu absorption Needed for healthy bones & teeth, formation of hydroxyapatite crystals Deficiency presents as: Fluoride Indications: Increased cavities Fluoridated water Bone formation/integrity Weak bones and teeth Seafood AI: 3-4mg/d Teeth integrity Toxicity: 10mg/d Toxicity: Rare Notes: Absorption inhibited by Ca and Mg Deficiency presents as: Goiter Neonatal hypothyroidism Needed to produce thyroid hormones T3 Iodine Cretinism and T4 Deficiency: Toxicity: Iodized salt Indications: 1.1mg/d Radiation emergencies Increased salivation Swelling of salivary glands Metallic taste Minerals Vitamin Key Information Deficiency/Toxicity Food sources Needed as a component in hemoglobin, oxygenation, synthesis of thyroid hormone, conversion of tyrosine to dopa and dopamine Forms: Fe2+ (bioavailable) Ferrous fumarate Ferrous bisglycinate Ferrous gluconate Deficiency presents as: Ferrous sulphate Iron deficiency anemia – Achlorhydria Eggs Iron Fish Fe3+ (food form) Gastritis Liver Ferric oxide RDA: 10-15mg/d Meat Ferric sulphate Toxicity: Therapeutic: 75- Poultry Ferric chloride Constipation Green leafy veg 120mg/d [50-60mg BID] Diarrhea Whole grains Indications: N/V Menorrhagia Abdominal discomfort Dysfunctional uterine bleeding Fatigue Infertility RLS Athletic performance Notes: Tannins decrease absorption Vit C increases absorption Needed for metabolism and enzymatic reactions Forms: Mg citrate- constipation Deficiency presents as: Mg glycinate – gentle, calming, no laxative Fatigue effect Mental confusion Mg threonate- crosses BBB, improved brain Cramping function Magnesium Irritability Mg Oxide- least optimal form Heart disturbances Mg Aspartate- fatigue and energy (more Insomnia Spinach RDA: 280- absorbable) Tofu 350mg/d Mg Malate- fibromyalgia Toxicity: Banana Therapeutic: 2x Mg Taurate- insulin sensitivity and calming White beans the RDA N/V/Diarrhea Almonds effect Toxicity: based on Hypotension Cashews kidney function; Sunflower seeds kids 65mg/d [1- Indications: 3yo] or 110mg/d [4- CVD – HTN, angina, arrythmias, 8yo] athrosclerosis CI in patients w/: end-stage renal Constipations, mm cramps disease, myasthenia gravis, cerebral Osteoporosis hemorrhage Pre-eclampsia/ eclampsia Mental health Asthma Notes: High Ca and vit D= decrease Mg absorption Minerals Vitamin Key Information Deficiency/Toxicity Food sources Needed for bone, cartilage, synovial fluid – chondroitin sulfate, Manganese Superoxide Deficiency presents as: Manganese dismutase (MnSOD) None reported in humans Nuts – pecans, Brazil, almonds, walnuts RDA: 1.8-2.3mg/d Indications: Toxicity: Whole grains Therapeutic: 2- Strains/ sprains & inflammation Parkinson’s like symptoms Green leafy beg 7mg/d Prevents osteoporosis Toxicity: >60mg/d Psychosis Epilepsy Diabetes – production of insulin Needed as a cofactor for sulfate oxidase and Deficiency presents as: Molybdenum other enzymes Nausea Headaches Legumes RDA: 45mcg/d Indications: Rapid heart and respiratory rates Grains Therapeutic: Sulfite sensitivities 2mg/d Toxicity: Esophageal cancer Toxicity: 10-15mg Gout like symptoms – elevated uric acid Asthma attack prevention 2nd most abundant mineral in the body Phosphorus Dairy foods Deficiencies: Rare Cereal products Needed for bone mineralization, energy RDA: 700mg/d Toxicities: None Meat production, cell signaling, acid-base fish Toxicity: UL 4000mg/d homeostasis Deficiency is usually caused by Needed for fluid & electrolyte balance, BP excessive fluid loss regulation, mm contraction, nerve transmission Presents as: Potassium Fatigue, Weakness Indications: Muscle cramps Fruits AI: 3400mg/d Hypertension mainly Palpitations Vegetables Therapeutic: 1- Arrythmia Nuts/seeds Dairy products 4g/d Notes: HTN Toxicity: >18g at K+ supplementation is contraindicated with once glycosides, K+ sparing diuretics, ACE Toxicity: inhibitors, and licorice Tingling of hands/feet CI in acute & chronic kidney failure Muscle weakness Cardiac arrest Minerals Vitamin Key Information Deficiency/Toxicity Food sources Needed as a cofactor for glutathione peroxidase, metabolism of vitamin E, Deficiency presents as: converting T4 to T3 and immune function Keshans disease Kashins-Beck disease Form: Selenium Selenomethionine Whole grains *Mainly where soil is deficient Organ meats RDA: 55mcg/d Indications: Tuna Therapeutic: Cancer prevention Turkey Toxicity: Mushrooms 200mcg/d Hashimoto’s thyroiditis Hair and nail brittleness and loss Wheat germ Toxicity: 400- CVD 900mcg/d Garlic breath odor Immune dysfunction Skin rashes Prostate cancer prevention Fatigue HIV/AIDS Irritability Absorption increased by Vvitamins A, C, E Needed for bone mineralization Deficiency presents as: Silicon Indications: Bone deformities Beer Bananas Brittle nails Wheat bran Therapeutic: 5- Toxicities: 20mg/d Osteoporosis Kidney stones Atherosclerosis Deficiency is uncommon but would present as: Needed for regulating fluid volume and Low BP Sodium osmotic pressure Fatigue/weakness Muscle cramps AI: 1.2-1.5g/d Basically, all foods contain Indications: sodium Toxicity: max daily Hypotension Toxicity: intake less than Heat Cramps Hypertension 2.3g (1tsp) Arrythmias Muscle weakness Needed for inhibiting bone resorption as Strontium Deficiency is unlikely well as stimulating bone formation Grains Cereals Therapeutic: 1g Toxicity: Root veggies Indications: Spinach (citrate) 2g Possibly nausea or diarrhea (ranelate)/d Osteoporosis Minerals Vitamin Key Information Deficiency/Toxicity Food sources Needed for healthy skin, hair & nails. Helps with collagen synthesis, production of methionine and cysteine, insulin production Sulfur and glutathione Deficiency: none Vegetables – asparagus, broccoli, cauliflower, Therapeutic: 2- brussel sprouts Indications: Toxicity: none 10% Garlic concentrations Dandruff Arthritis Itchy skin Deficiency: none Needed for cellular metabolism, mimics action of insulin & stimulates glucose Vanadium Toxicity: Dill uptake into cells. Oysters Green tongue* shellfish Therapeutic: 100- Diarrhea Olives Indications: 300mg/d Abdominal cramps Type 2 Diabetes mellitus Hypertension Kidney damage Needed for Vision, spermatogenesis, wound healing, immune function, intestinal Deficiency presents as: transport Impaired immune function Poor wound healing Forms: Dysgeusia Zinc Zinc citrate Night blindness Zinc sulphate Growth retardation Oysters RDA: 12-15mg/d Zinc picolinate Skeletal abnormalities Shellfish Therapeutic: 75- Diarrhea Beef 90mg/d Red meat Indications: Toxicity: 225- Whole grains Immune function 450mg/d [acute], 50-150mg Acne Toxicity: [chronic] Wilson’s disease Metallic taste Alzheimer’s disease Headaches, N/V Boosts CD4 in HIV Abdominal cramps Macular degenerations Loss of appetite Pregnancy Amino Acids ESSENTIAL MEMORY TRICK “PVT TIM HALL” Vitamin Key Information Deficiency/Toxicity Food sources Deficiency: None Needed for protein synthesis Precursor tyrosine, dopa, norepinephrine and melanin Toxicity: Almost all protein foods muscle cramps Poultry Phenylalanine Indications: H/A Beef Fish Vitiligo Nausea Therapeutic: 500- Pork 1000mg 2-3x/d Depression Vertigo Yogurt Parkinson’s disease Depression milk Chronic pain s/s of PKU – mental retardation (if untreated), seizures, odd behavior, light C/I in people with phenylketonuria (PKU)** skin (melanin def), hypothyroidism Valine Branched chain amino acid Dairy products Meat Needed for muscle metabolism, tissue Mushrooms Dosing for BCAAs: None Peanuts repair and nitrogen balance 2:1:1 of Leucine: Soy Isoleucine: valine Precursor to serine and glycine Lean beef Needed for formation of collagen, elastin Green tea and muscle Soy Threonine Helps liver digest fats None Pork Chicken Immunostimulant Liver Relaxing not sedating Precursor to serotonin, melanin & niacin Side effects: Tryptophan Tryptophan 🡪 5-HTP🡪 Serotonin Sleepiness Oats Therapeutic: Serotonin syndrome – caution with Bananas 1-2g hs [insomnia] Indications: SSRIs Dried prunes Milk and cheese 3-6g/d divided Insomnia Bread doses [depression] Anxiety Chicken/turkey 6g/day ovulation --> Depression Similar symptoms to hypoglycemia – Peanuts d3 [PMDD] Chocolate Pain dizzy, fatigue, headaches, etc. 50mg/kg [decrease Bipolar smoking] Almonds Isoleucine Branched chain amino acid Cashews Similar symptoms to hypoglycemia – Chicken Promotes glucose uptake into cells and Dosing for BCAAs: dizzy, fatigue, headaches, etc. Chickpeas converts to energy Eggs 2:1:1 of Leucine: Fish Isoleucine: valine Amino Acids ESSENTIAL MEMORY TRICK “PVT TIM HALL” Vitamin Key Information Deficiency/Toxicity Food sources Sulfur containing amino acid Precursor to cysteine Acts similar to SNRIs Deficiency: None Involved in synthesis of carnitine and S- Brazil nuts Methionine adenosylmethionine (SAM-E) Spinach Most toxic amino acid: Sesame seeds Therapeutic: 200- Indications: Salmon Anemia 1600mg/d [SAMe] Parkinson’s disease Decrease in growth UTIs Joint health Heart health – improper methylation increases homocysteine Poultry like chicken and RBC & WBC production turkey. Needed for Hb production Deficiency: Grass-fed beef and meats. Protein powders. Histidine Maintenance of myelin sheath Increases allergy symptoms Fish and seafood. Growth & repair of muscles Eggs. Soybean products Essential in infants ONLY – adults can synthesize it Deficiency: Precursor to Nitric oxide (NO) Arginine Delayed sexual maturity – decreased Helps vascular function, increases immune sperm in men Therapeutic: 3-6g system, increases wound healing Impaired insulin production [pre workout], 5g/d Mm weakness [Erectile Indications: Red meat Possible hair loss Poultry Dysfunction], 6- Angina Fish 20g/d [CVD] HTN Dairy products Toxicity: 30-60g/d Erectile dysfunction *L-citrulline Toxicity: Peripheral artery disease increases Overdose >30-60g/d may cause herpes absorption and because inhibits lysine **Interactions: Viagra, nitrates, concentration Severe hyperkalemia hypertensive meds Precursor to carnitine Needed for protein synthesis Fish Deficiency: None Immune system and anti-viral Eggs Lysine Lima beans Collagen formation & tissue repair Toxicity: Potatoes Meat Therapeutic: 1-3g/d Possibly abdo symptoms Indications: milk Herpes (cold sores) Leucine Branched chain amino acid Deficiency: None Beans Brown rice It is the most potent inducer of muscle Dosing for BCAAs: Metas protein synthesis on a molecular level and Toxicity: Nuts 2:1:1 of Leucine: is ketogenic Hypoglycemic sxs Whole grains Isoleucine: valine Amino Acids CONDITIONALLY ESSENTIAL Vitamin Key Information Deficiency/Toxicity Food sources Most abundant free amino acid in the body Role in SI structure & function In times of stress becomes essential Synthesized in skeletal muscle when Glutamine needed None Beef, pork, poultry, Supports production of glutathione Milk, yogurt, cheese, Therapeutic: 5- Caution use with liver disease Raw spinach, Raw parsley, Indications: Cabbage. 45g/d in divided Muscle building for athletes doses Digestive tract –Gastroenteritis, mucositis, colitis Nervous system function Cancer treatment – cachexia Excitatory & inhibitory NT Needed for protein & collagen synthesis Glycine Made in the liver from serine and threonine Works with taurine and GABA Therapeutic: 2g/d High protein foods – meat, fish, None dairy, legumes prn sublingual Indications: [onset panic attack], Anxiety 2-10g/d [chronic Panic attacks use] ADHD Insomnia Found in cartilage Helps maintain youthful skin, repair muscles & connective tissue Joints and tendon integrity Meat Collagen production Dairy Proline None eggs Indications: Burns Skin injuries Joint pain Nootropic Derived from glycine Nervous system and brain function Meat Muscle growth Dairy Serine None peanuts Indications: Cognitive decline – Alzheimer’s, dementia Precursor to dopamine, epi, Ne Needed to make thyroid hormones (thyroxine) – Iron is needed for conversion Cheese Tyrosine can be made from phenylalanine Soybeans Tyrosine Aids in melanin production Deficiency seen in low protein diets Beef, Lamb, Pork, Fish, Chicken Nuts/seeds Indications: Depression Thyroid concerns Amino Acids NON- ESSENTIAL Vitamin Key Information Deficiency/Toxicity Food sources Precursor to carnosine Benefits athletic performance Glucogenic To avoid deficiency in low protein diets Meat products Alanine & liver dz need alanine Wheat germ Indications: supplementation Cottage cheese T1DM Low blood pressure – preventing & tx Needed in Krebs cycle – energy production Not used to make protein Oysters Helps detox toxins Sausage meats Wild game Aspartate Immune function None Sprouting seeds Cognitive function Oat flakes avocado Indications: Chronic fatigue Contains sulfur Made from L-methionine N-acetylcysteine increases glutathione Meat Essential in Liver cirhossis Dairy products Toxicity: Eggs Cysteine Nuts Indications: Kidney stones Seeds Osteoporosis legumes Stroke prevention Anti-aging Reduce inflammation Excitatory neurotransmitter Detoxification of ammonia Can be converted to GABA Fish Meat Glutamate/ Indications: Eggs None Poultry Glutamic acid Depression Dairy products Bipolar Also in MSG ADHD Detoxification Stable angina Polyunsaturated Fatty Acids PUFAs Vitamin Key Information Deficiency/Toxicity Food sources Acts as an antioxidant and is anti- inflammatory Anti-viral and immune stimulating Red meats Organ meats like liver, Alpha Lipoic heart, kidney, etc Indications: Acid Broccoli Topically on skin Tox: Seizures, acidosis, vomiting, Spinach Diabetes unconsciousness Therapeutic: Tomatoes Cancer Brussels sprouts 600mg/d Cataracts Potatoes Dementia Green peas CAD/PAD CFS, Lyme Dz Mental health Essential omega-3 fatty acid Converted to EPA/DHA Anti-inflammatory, anti-hypertensive Flaxseeds Canola oil Alpha- Indications: Soybeans and soybean oil Linolenic Acid Pumpkin seeds and pumpkin Hypertension May increase triglycerides seed oil (ALA) High cholesterol Tofu. Prevention of coronary artery disease Walnuts Psoriasis, eczema Diabetes Lupus Precursor in the biosynthesis of Arachidonic prostaglandins, thromboxanes, and leukotrienes Meat, poultry, eggs, fish acid (AA) None Dairy foods Essential role in physiological homeostases, such as repair and growth of cells Short chain fatty acid (SCFA) produced by gut bacteria fermentation Produced int he colon Anti-inflammatory and maintains gut wall integrity Legumes (beans, peas, and Buteric acid, Energy metabolism soybeans) Butyrate Immune modulating None Fruits Nuts, cereals, and whole grains Indications: IBS/IBD Leaky gut Metabolic syndrome Fatty Acids PUFAs Vitamin Key Information Deficiency/Toxicity Food sources Omega-6 essential fatty acid Anti- inflammatory, immune modulating, Anti-thrombotic Dihomo- gamma- Indications: deficiency is a major cause of pain, Vegetable oils grains linolenic acid Inflammation cramps, nausea, vomiting, bloating and most meats (DGLA) Prevent stroke headaches dairy Dermatitis Asthma, eczema Side effects may include: Diabetes Loose stools, diarrhea, belching, ADHD bloating Interactions: Omega-6 essential fatty acid Blood thinners Gamma- Anti-inflammatory, immune modulator, Ceftazidime anti-estrogenic Vegetable oils linolenic acid Converted to DGLA Borage oil (GLA) Breast milk Indications: ^^ same as DGLA Omega-6 essential fatty acid Needed for collagen synthesis, anti- bacterial, anti-allergic, anti-cancerous Linoleic acid Vegetable oils GI symptoms Nuts, seeds (LA) Indications: Meats Prolonged bleeding time Heart health Eggs HTN Diabetes Metabolic syndrome Deficiency symptoms: Monounsaturated fatty acid Hair loss. Hypotensive Eczema-like symptoms/dry itchy Anti-inflammatory skin/cracking, peeling skin on Omega-9 Decreases LDL Sunflower, fingertips. Macadamia nut, hazelnut, (Oleic acid) Dry eyes. Olive oil, soybean oil, Indications: Almond butter Stiff/painful joints. Hypercholesterolemia Avocado oil, and canola oil HTN Cardiovascular function Lipid metabolism Pro-inflammatory Nuts Omega-6 Indications: Too much --> PRO-INFLAMMATORY Walnuts Limiting intake of omega 6 FAs decreases arthritis, inflammation, thrombotic events, cancer  Fatty Acids Vitamin Key Information Deficiency/Toxicity Food sources Anti-inflamamtory Lower blood pressure. Reduce triglycerides. Slow the development of plaque in the arteries. Reduce the chance of abnormal heart Omega-3 (EPA rhythm. Reduce the likelihood of heart attack and Fatty fish (salmon, mackerel, and DHA) Toxicity: herring) stroke. Fishy aftertaste, bad breath, indigestion, Walnuts Lessen the chance of sudden cardiac Flaxseeds Therapeutic: 1-3g/d nausea or loose stools. death in people with heart disease. Algae Indications: Atherosclerosis, HTN, reduce CVD, MI risk Reduce pain Menstrual cramps Depression, ADHD, other psychiatric illness Neurodegenerative disorders Lower LDL levels by competing for binding and decreasing biosynthesis Plant Sterols Indications: Hypercholesterolemia Interactions with Statins Fortified cereals and grains Therapeutic: 1-3g/d CHD Metabolic syndrome Saturated FA Immune modulating Used mainly for fungal infections May cause GI symptoms Anti-gluconeogenic Caprylic acid Interactions: Coconut oil Indications: MCT oil Therapeutic: 100- Antihypertensives Candida, yeast overgrowth 400mg bid-qid Warfarin Dysbiosis NSAIDs HTN Diabetes, metabolic syndrome Food poisoning  Therapeutic diets Diet Key Information The anti-inflammatory diet is a nutrition approach focused on reducing inflammation in the body, which is believed to contribute to various chronic diseases and conditions. While it may not be a cure, this diet aims to promote overall health and potentially alleviate symptoms associated with inflammation. Indications: rheumatoid arthritis, osteoarthritis, inflammatory bowel diseases (like Crohn's disease Anti-inflammatory and ulcerative colitis), preventive measure to support general well-being. Foods: whole foods like fruits, vegetables, and lean proteins, with an emphasis on omega-3 fatty acids, healthy fats, and anti-inflammatory herbs and spices. Processed foods, excess sugars, and alcohol are limited. The Candida diet aims to address overgrowth of the Candida yeast in the body. Key aspects include: Sugar and Carbohydrate Restriction: Limits intake of sugars and refined carbs. Limited Fruit Consumption: Initially restricts high-sugar fruits. Avoidance of Yeast-Containing Foods: Excludes bread, pastries, and fermented products. Anti-Fungal Foods: Includes coconut oil, garlic, ginger, and certain herbs. Candida Probiotics: Encourages probiotic-rich foods for a healthy gut balance. Lean Proteins: Emphasizes lean proteins like poultry, fish, and plant-based sources. Non-Starchy Vegetables: Allows non-starchy veggies in abundance. Nuts and Seeds: Permits some, but in moderation due to potential mold content. Elimination Diet, or Elimination Challenge Diet, is a short-term eating plan designed to identify and eliminate foods that may be causing adverse reactions or sensitivities. It is often used as a Elimination Challenge: diagnostic tool to pinpoint the culprits behind symptoms like digestive issues, skin problems, headaches, and fatigue. The process involves systematically removing certain foods from the diet for about 2-4 weeks, followed by a gradual reintroduction to observe any adverse reactions. The Low FODMAP diet is designed to alleviate symptoms of fructose intolerance and irritable bowel syndrome (IBS). FODMAPs are fermentable carbohydrates that can trigger digestive discomfort. Key points include: Limit High-FODMAP Foods: Reduce fermentable carbs, including fructose, lactose, fructans, Fructose intolerance galactans, and polyols. (FODMAP) Choose Low-Fructose Options: Opt for berries, citrus fruits, and low-fructose vegetables. Cut High-Lactose Dairy: Reduce or replace with lactose-free alternatives. Select Low-Fructan Grains: Choose rice and gluten-free grains. Moderate Legumes: Limit high-galactan legumes like beans and lentils. Minimize Polyols: Reduce intake of foods with polyols, including certain fruits and sweeteners. Watch Portion Sizes: Be mindful of quantities for better tolerance. The ketogenic diet is a low-carbohydrate, high-fat eating plan designed to induce a state of ketosis, where the body shifts from using glucose to burning stored fat for energy. It involves restricting carbohydrate intake, emphasizing healthy fats from sources like avocados and oils, and maintaining moderate protein levels to prevent excess protein conversion into glucose. Ketogenic The primary goal is to achieve and sustain ketosis, a metabolic state marked by the production of ketones. This shift in energy metabolism is believed to contribute to weight loss, improved blood sugar control, and potential benefits for certain neurological conditions. The diet focuses on minimizing sugar and processed food consumption, favoring nutrient-dense options such as meat, fish, eggs, non-starchy vegetables, and fats, while restricting grains, sugars, starchy vegetables, and most fruits.  Therapeutic diets Diet Key Information The low glycemic diet is a nutritional approach that focuses on consuming foods with a low glycemic index (GI), a measure of how quickly a food raises blood sugar levels. Key principles of this diet include selecting carbohydrates that cause a slower and steadier rise in blood sugar. Examples of low glycemic index (GI) foods include non-starchy vegetables like broccoli and Low Glycemic spinach, legumes such as lentils and chickpeas, whole grains like quinoa and barley, and fruits like cherries and apples. Additionally, dairy products like Greek yogurt, lean proteins such as chicken and fish, and healthy fats like avocado and olive oil are low-GI options. The Mediterranean diet is a well-known eating pattern associated with the traditional dietary habits of countries bordering the Mediterranean Sea. Key features of this diet include: Abundance of Fruits and Vegetables: Emphasizes a variety of colourful fruits and vegetables daily. Whole Grains: Includes whole grains like brown rice, quinoa, and whole wheat. Healthy Fats: Incorporates olive oil as a primary source of fat, along with nuts, seeds, and fatty fish rich in omega-3 fatty acids. Mediterranean Lean Proteins: Prioritizes lean protein sources such as fish, poultry, beans, and legumes. Dairy: Moderate consumption of dairy products, including yogurt and cheese. Herbs and Spices: Uses herbs and spices for flavouring instead of excessive salt. Red Wine in Moderation: Suggests moderate consumption of red wine with meals. Social and Active Lifestyle: Encourages socializing during meals and maintaining an active lifestyle. The Paleo diet, is a nutritional approach inspired by the presumed dietary patterns of our hunter- gatherer ancestors during the Paleolithic era. This diet aims to mimic the foods available to early humans before the advent of agriculture. Key principles of the Paleo diet include the consumption of whole, unprocessed foods, and the exclusion of modern processed items. Commonly consumed foods on the Paleo diet include: Palaeolithic Meat: Beef, pork, poultry, and game meats. Fish and Seafood: Salmon, mackerel, shrimp, and other seafood. Eggs: Preferably free-range or pasture-raised. Fruits: Berries, apples, citrus fruits, and other non-processed fruits. Vegetables: Leafy greens, broccoli, carrots, and other non-starchy vegetables. Nuts and Seeds: Almonds, walnuts, chia seeds, and flaxseeds. The vegan diet is a plant-based eating pattern that excludes all animal-derived products, focusing on a variety of plant foods for nourishment. The vegan diet is associated with various potential Vegan/Whole Food Plant- health benefits, including improved heart health, lower risk of certain chronic diseases, and positive Based environmental impacts. However, it requires careful planning to ensure adequate intake of essential nutrients like vitamin B12, iron, calcium, and omega-3 fatty acids, which are commonly found in animal products. The vegetarian diet is a plant-based eating pattern that excludes meat and seafood but includes a variety of plant foods and, in some cases, dairy and eggs. Vegetarian The vegetarian diet is associated with various health benefits, including improved heart health, weight management, and a reduced risk of certain chronic diseases. Like the vegan diet, careful planning is necessary to ensure adequate intake of essential nutrients.