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The Role of Nutrition in Integrative Medicine

The Role of Nutrition in Integrative Medicine. Rebecca Lee Campos, MD ABFM, ABIHM March 2015. Objectives. Recognize role of Nutrition in T raditional and C onventional M edicine Identify the areas within of Integrative Medicine that have a foundation in Nutrition

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The Role of Nutrition in Integrative Medicine

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  1. The Role of Nutrition in Integrative Medicine Rebecca Lee Campos, MD ABFM, ABIHM March 2015

  2. Objectives • Recognize role of Nutrition in Traditional andConventional Medicine • Identify the areas within of Integrative Medicine that have a foundation in Nutrition • Identify various dietary trends in IM • Current trends in consumer knowledge • Be able to engage with patients on nutritional therapy for various chronic conditions

  3. Role of Nutrition in Modern Medicine: Hypertension& Hyperlipidemia

  4. Dr. Mimi Guarneri, MD “Ill To the Pill”

  5. American Heart Assoc, 2013 • LDL(Grade A) • Emphasis of veg, fruit, whole grains • Lower fat diary, poultry, fish, legumes • Aim: 5-6% calories from saturated fat • Reduce trans fat • BP (A) • Emphasis on veg, fruit, whole grains • Lower fat diary, poultry, fish, legumes • Lower sodium intake (A) • Na(<2400mg/day) (B) • Combine DASH with lower sodium (A) • Physical activity (B) • 3-4 sessions/wk, avg 40min / session with moderate-to-vigorous – both BP and lipids. http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437740.48606.d1.long

  6. Role of Nutrition Modern Medicine:Diabetes

  7. ADA, 2014 Recommendations • Mediterranean • Plan foods, Fresh foods, olive oil(dietary lipids), Dairy products(low-mod), <4eggs/week • Vegetarian/Vegan • Ovo-, lacto- • Lower saturated fat and cholesterol • High fruits, veg, whole grains, nuts, soy, fiber, phytochemicals • Low fat • More veg, fruit, starches, lean protein, low fat diary • Low Carbohydrate • High protein intake, fats, veg that are low in carb. • DASH • Emphasizes fruits, veg, low fat dairy, whole grains, poultry fish, nuts; Reduced sodium http://professional.diabetes.org/admin/UserFiles/0%20-%20Sean/dc132042%20FINAL.pdf

  8. During 2007–2010, adults consumed, on average, 11.3% of their total daily calories from fast food. Non-Hispanic black adults consumed a higher percentage of calories from fast food compared with non-Hispanic white and Hispanic adults. The percentage of total daily calories from fast food increased as weight status increased. More than one-third of U.S. adults are obese The percentage of calories from protein, carbohydrate, and fat were within the ranges recommended for these macronutrients for this age group (3), but the percentage of calories from saturated fat was above the 10% recommended in the Dietary Guidelines for Americans, 2010 NCHS Data Brief http://www.cdc.gov/nchs/data/databriefs/db113.pdf http://www.cdc.gov/nchs/data/databriefs/db114.pdf

  9. During 2007–2010, adults consumed, on average, 11.3% of their total daily calories from fast food. Non-Hispanic black adults consumed a higher percentage of calories from fast food compared with non-Hispanic white and Hispanic adults. The percentage of total daily calories from fast food increased as weight status increased. More than one-third of U.S. adults are obese The percentage of calories from protein, carbohydrate, and fat were within the ranges recommended for these macronutrients for this age group (3), but the percentage of calories from saturated fat was above the 10% recommended in the Dietary Guidelines for Americans, 2010 NCHS Data Brief http://www.cdc.gov/nchs/data/databriefs/db113.pdf http://www.cdc.gov/nchs/data/databriefs/db114.pdf

  10. Dr. Mimi Guarneri, MD “Ill To the Pill”

  11. It is more important to know what sort of patient has a disease than what sort of disease a patient has Sir William Osler

  12. Role of Nutrition Within Integrative Medicine

  13. Food Is Medicine

  14. New Perspective on Old Ways • Practitioners are seeing a need • Patients are seeing a need • Patients are becoming consumers • Searching for holistic care • Alternative & integrative • Culture – herbal, ointment

  15. National Health Interview Survey, 201234,525 Adults; 10,218 children

  16. How many providers do nutritional referrals during preventive care visits?

  17. Principle: Food, Body, Environment & Epigenetics

  18. Nutritional Medicine • Individualized • Reactive hypoglycemia • Ex. Refined Sugars • Chinese Food Syndrome • MSG(monosodium glutamate) Identify lifestyle deficits vs excess

  19. Nutritional Medicine • “Nutritional Medicine is based on the principle that nutrients, including essential micronutrients, are required for the proper functioning of all the biochemical processes on which our bodies depend. Therefore, when treating symptoms or diseases, we look for the underlying causes which, although often partly genetic, are usually very much tied up with nutritional and environmental factors. This is in contrast to the tendency in the conventional medical approach to treat symptoms by means of drugs or surgery” • Meldrum JM1 What is nutritional medicine?NutrHealth. 1993;9(2):135-50.

  20. themicrogardener.com

  21. Functional Medicine • A methodology of approaching individualized patient centered medical care looking at risk factors (genetic, environmental, lifestyle), triggers, symptoms and presentation. • Goal to prevent illness and maintain a healthy life. https://www.functionalmedicine.org/getstarted/resources/IFMTools/

  22. “If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.” ― Hippocrates

  23. themicrogardener.com

  24. Herbal Medicine • Maximizing function of the body to improve status or recover health through the use of plant derivatives.

  25. Manzanilla German Chamomile • GI: colic, spasms, ulcers, nervous diarrhea, acute diarrhea • Rheumatic: fibromyalgia • Topical: pressure ulcer, mastitis, leg ulcers, atopic dermatitis, oral mucosal inflammation • Psychiatric: anixiety

  26. Local • Yerba buena – spearmint • Heartburn, colic, GI upset • Estafiate • Tea for GI symptoms, glucose • Topical for anti-inflammatory

  27. Ayuveda • Over 3,000 year old practice • Meaning: • Aur meanslife • Veda means science or knowledge • Both culture and belief system • Balance of the body and environment • BODY • Spirit – dosha • Physical body - prakriti https://nccih.nih.gov/health/ayurveda http://www.pbs.org/frontlineworld/stories/india701/interviews/ayurveda101.html

  28. Ayuveda • Composed of 3 Doshas: • Pitta • Vata • Kapha • Treatment: • Use of food, herbs, herbal teas, essential oil • Caution: metals in treatment and contamination

  29. Specific Dietary Protocols

  30. Guided Diets

  31. Elimination Diet • 2-3 weeks completely avoid common allergens • Complete Resolution symptoms before reintroduction • NO Food: • Diary, Corn, Wheat, Eggs, refined sugars • Additives • YES Food: • Cereals, grains, legumes, vegetables (no corn), olive oil, flaxseed oil. • Journal record • Withdrawal effect

  32. Guided Diets

  33. Anti-Inflammatory Diet • Less processed foods • Whole, fresh foods: fruits and vegetables • Certain cooking herbs and spices • Healthy fats as well: nuts and legumes • Focus on omega 3, fiber, phytonutrient • Patient panel: Rheumatic, Diabetic, autoimmune

  34. Guided Diets

  35. Mediterranean Diet • High in monounsaturated fats • Olive oil, avocado, olives, peanut oil • High in whole foods; less processed • Associated decrease in • Cardiovascular disease • Cognitive impairment http://oldwayspt.org/resources/heritage-pyramids/mediterranean-diet-pyramid

  36. Guided Diets

  37. Specific Carbohydrate Diet (SCD) • Entirely anecdotal • Focused for Celiac, IBD, IBS • Based on GI flora balance: • restriction of carbohydrates that promote proliferation of bacteria that may produce toxins inflaming intestinal lining.

  38. SIBO: Small Bowel Intestinal Overgrowth • Concept of gastrointestinal flora imbalances • Opportunistic bacteria flourish • Spectrum of disease process • Irritable Bowel Syndrome

  39. http://fnic.nal.usda.gov/dietary-guidance/myplate-and-historical-food-pyramid-resources/past-food-pyramid-materialshttp://fnic.nal.usda.gov/dietary-guidance/myplate-and-historical-food-pyramid-resources/past-food-pyramid-materials

  40. How do we treat our food? Consumer Trends

  41. We No Longer… “Eat to Live, but Live to Eat” • Processed foods • Increased shelf life.. • Apocalyptic Twinkie • Larger the Fish • Bigger the apples Enticing the eye of the stomach

  42. Chemicals &Food Genetics

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