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Food as Medicine

1. Food as Medicine. Using Foods to Treat Disease and to Maximise Optimal Wellness By Stephen Eddey M.H.Sc., B.Sc.(Comp.Med.), Dip.App.Sc.(Nat.), Ass.Dip.App.Sc.(Chem.), Cert.IV(Workplace & Training),N.D. . 1. Food as Medicine. Finding the right nutrition for: Obesity

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Food as Medicine

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  1. 1 Food as Medicine Using Foods to Treat Disease and to Maximise Optimal Wellness By Stephen Eddey M.H.Sc., B.Sc.(Comp.Med.), Dip.App.Sc.(Nat.), Ass.Dip.App.Sc.(Chem.), Cert.IV(Workplace & Training),N.D.

  2. 1 Food as Medicine Finding the right nutrition for: • Obesity • Anti-aging/Wellness • Diseases • Heart Disease • Detoxification • Cancer • Inflammation • Functional foods

  3. 1

  4. 2 Food as Medicine – Evolution of the Human Diettaken from work done by:Prof. Neil Mann, Australia

  5. 2 Basic Questions • Who were our ancestors ? • What did our ancestors eat ? • How do we know? • What dietary changes have occurred ? • What impact have dietary changes had ?

  6. 2 Evolution and Diet Evolution in a geological context Mammalian insectivores Or G Ch H. erectus “Lucy” (hominid) Primates Apes Ramapithecus H. habilis H. sapiens Oldest stone tools Oligocene Miocene Pliocene Pleistocene 25 mya 10 mya 2 mya 10,000 ya Major climatic change

  7. Australopithecus aferensis Approximately 4 million years ago

  8. 3 Evolution and Diet Dietary changes • Miocene apes: Specialised, leaf /fruit eaters >15 mya • Ramapithecus: First hominoid, ~ 10 mya • leaves /fruit /roots /meat scavenger (5-10% energy) • Lucy: First hominid, small, upright stance, ~ 4.5 mya, • fruits /roots /nuts /meat (>10% energy), probably hunted ! • Homo habilis: First tool maker, hunter, ~ 3 mya, • fruits /meat /roots /nuts (meat > 20% energy) • Homo erectus: Tall, large brain, big game hunter, ~ 1.5 mya • meat /fruits /roots /nuts (meat 20-50% energy) • Homo sapiens: Organised big game hunters, ~ 400,000 ya • energy intake from meat estimated > 60% • roots, fruits, vegetation, nuts, seeds

  9. 3 Optimal Foraging Theory • Pre-agriculture we were hunter-gatherers • Day-to-day survival depended on daily energy intake being adequate • Body energy use = Basal metabolism + activity • Best choices were foods with the greatest energy return(ie energy content - energy expenditure for collection and preparation) • High energy dense foods became critical (evident in brain gut trade off in our species)

  10. 4 Human Brain Size (Aiello & Wheeler 1995) 1800 Brain size (cc) Homo sapiens 1400  Homo erectus   1000 Homo habilis 600 Australopithecines 200 0 1 2 3 4 Age in millions of years

  11. 4 Gut morphology and diet Chimpanzee Insectivores Humans Horse Cat Gorilla Rabbit Dog Frugivores Martin, 1994. The life of primates. In: The Cambridge Encylopedia of Human Evolution Folivores (mid-gut) Faunivores Cow Folivores (fore-gut)

  12. 5 Hunter-Gatherers in Recent Time • Dietary data on 181 HG societies recorded in: “Ethnographic Atlas” (Murdoch 1967) • Animal:Plant subsistence ratio: 65:35 (Cordain, Brand-Miller, Mann, Eaton & Speth, Am J Clin Nutr, 2000) • Broad characteristic dietary macro-nutrient composition Hunter-gatherers USA Australia Protein 19 - 35% (15.5%) (17.0%) Carbohydrate 22 - 40% (49.0%) (45.1%) Fat 28 - 47% (34.0%) (32.4%)

  13. Atherosclerosis

  14. 32 PPHT induces Vascular Disease “Recent research shows close association of postprandial hyperlipidaemia (PPHL) with atherosclerosis. PPHL is closely correlated with carotid intima-media thickness in normolipidaemic and hyperlipidaemic individuals independent of other risk factors.” Misra A, Wasir JS, Vikram NK. Carbohydrate diets, postprandial hyperlipidaemia, abdominal obesity & Asian Indians: A recipe for atherogenic disaster. Indian J Med Res. 2005 Jan;121(1):5-8. 

  15. 32 Food as Medicine – PPHT induced Vascular Disease “Higher daytime triglyceridaemia with similar fasting triglyceride levels was observed in subjects with premature coronary artery disease (CAD) as compared to their first-degree relatives without CAD. Indeed some evidence suggests that postprandial plasma triglyceride levels (3-4 h postmeal) predict future myocardial infarction better than fasting triglyceride levels.” Misra A, Wasir JS, Vikram NK. Carbohydrate diets, postprandial hyperlipidaemia, abdominal obesity & Asian Indians: A recipe for atherogenic disaster. Indian J Med Res. 2005 Jan;121(1):5-8. 

  16. 32 PPHT induced Vascular Disease - Mechanisms “It is associated with alterations in several atherogenic factors; increase in intestinally-derived chylomicrons and their remnants, increase in VLDL and remnants secreted by liver, decrease in HDL, and increase in small dense LDL particles which are more susceptible to oxidation.” Misra A, Wasir JS, Vikram NK. Carbohydrate diets, postprandial hyperlipidaemia, abdominal obesity & Asian Indians: A recipe for atherogenic disaster. Indian J Med Res. 2005 Jan;121(1):5-8. 

  17. 44 Antiaging Nutrition Calorie Restriction

  18. 45 Anti Aging Nutrition – Calorie Restriction “Calorie Restriction (CR), the selective reduction of energy intake without compromising other essential nutrients, is the most powerful intervention known to retard biological aging in mammals, as assessed by extension of mean and maximum lifespan, reduced incidence or progression of age-associated diseases, and preserved physiological function and molecular fidelity with age.” Michael Rae. It's Never Too Late: Calorie Restriction is Effective in Older MammalsRejuvenation Research. Volume 7, Page 3-8, May 2004

  19. 45 Anti Aging Nutrition – Calorie Restriction

  20. 46 Anti Aging Nutrition – Calorie Restriction “Although attenuation of age-related deficits has been reported for different interventions, such as exercise and hormone replacement, calorie restriction (CR) is the only one reproducibly shown to slow aging and reduce age-related diseases in controlled studies.” Julie A. Mattison, George S. Roth, Donald K. Ingram, Mark A. LaneEndocrine Effects of Dietary Restriction and Aging: The National Institute on Aging Study Journal of Anti-aging Medicine. Volume 4, Page 215-223, September 2001

  21. 46 Anti Aging Nutrition – Calorie Restriction “It has become apparent that many of the beneficial effects of CR reported in rodents are also evident in monkeys. These include reductions in body weight, fat mass, plasma insulin and glucose, increased insulin sensitivity, delayed maturation, and lower blood lipids with increased HDL.” Julie A. Mattison, George S. Roth, Donald K. Ingram, Mark A. LaneEndocrine Effects of Dietary Restriction and Aging: The National Institute on Aging Study Journal of Anti-aging Medicine. Volume 4, Page 215-223, September 2001

  22. 46 Calorie Restriction: Mechanism of Action

  23. 47 The Thyroid and Calorie Restriction “Calorie restriction has been shown to have immediate effects on thyroid hormones in Sprague-Dawley rats. T3 decreased by 60% within 3–4 days of restricted feeding and T4 levels were significantly lower within 7 days of diet change. These changes persisted for over a year but returned to normal with 7 days of re-feeding.” Julie A. Mattison, George S. Roth, Donald K. Ingram, Mark A. LaneEndocrine Effects of Dietary Restriction and Aging: The National Institute on Aging Study Journal of Anti-aging Medicine. Volume 4, Page 215-223, September 2001

  24. 47 Resveratrol; a calorie restriction mimetic “Resveratrol, a small molecule found in red wine, is reported to slow aging in simple eukaryotes and has been suggested as a potential calorie restriction mimetic.” Matt Kaeberlein et al. Substrate specific activation of sirtuins by resveratrol. J Biol Chem. 2005

  25. 47 Resveratrol; a calorie restriction mimetic “Resveratrol has also been reported to act as a Sirtuin activator, and this property has been proposed to account for its anti-aging effects. We show here that resveratrol is a substrate-specific activator of yeast Sir2 and human SirT1.” Matt Kaeberlein et al. Substrate specific activation of sirtuins by resveratrol. J Biol Chem. 2005

  26. 48 What are Sirtuins? “Sirtuins have been implicated in several important cellular processes, including genomic stability, DNA repair, transcriptional silencing, p53-mediated apoptosis, and adipogenesis.” Matt Kaeberlein et al. Substrate specific activation of sirtuins by resveratrol. J Biol Chem. 2005

  27. 48 What are Sirtuins? “In addition, Sir2- orthologs have been shown to promote longevity in yeast, worms, and flies, supporting the hypothesis that Sirtuins may act as evolutionarily conserved regulators of aging. Deletion of Sir2 increases rDNA recombination and shortens life span, while over-expression has the opposite effect.” Matt Kaeberlein et al. Substrate specific activation of sirtuins by resveratrol. J Biol Chem. 2005

  28. 48 Resveratrol: Mechanism of Action “Calorie restriction is the only intervention known to increase life span in yeast, worms, flies, and mammals, and resveratrol has been proposed to be a potential CR mimetic. The mechanism by which CR increases replicative life span in yeast had been thought to require activation of Sir2.” Matt Kaeberlein et al. Substrate specific activation of sirtuins by resveratrol. J Biol Chem. 2005

  29. 49 Insulin and Aging

  30. 49 Anti Aging Nutrition – Carbohydrate Restriction “It is generally accepted that caloric restriction retards ageing in laboratory rodents. Interestingly, Research has shown that total calories must be restricted to increase lifespan. Restriction of dietary protein or fat calories did not extend lifespan.” Richardson A, Liu F, Adamo ML, Van Remmen H, Nelson JF. The role of insulin and insulin-like growth factor-I in mammalian ageing. Best Pract Res Clin Endocrinol Metab. 2004 Sep;18(3):393-406.

  31. 49 Anti Aging Nutrition – Insulin Restriction “It is noteworthy that low plasma insulin concentrations in humans have been shown to be correlated with reduced mortality risk and that low insulin resistance, usually associated with reduced plasma insulin, has been found in one centenarian population.” Richardson A, Liu F, Adamo ML, Van Remmen H, Nelson JF. The role of insulin and insulin-like growth factor-I in mammalian ageing. Best Pract Res Clin Endocrinol Metab. 2004 Sep;18(3):393-406.

  32. 52 Low Fat Diets Their effects on the biomarkers of aging

  33. 52 Low Fat Diets “To validate our hypothesis that reduction in dietary fat may result in changes in androgen metabolism, 39 middle-aged white, healthy men (50 to 60 years) were studied while they were consuming their usual high fat, low fiber diet and after 8 weeks modulation to an isocaloric low fat, high fiber diet.” Wang C, Catlin DH, Starcevic B, Heber D, Ambler C, Berman N, Lucas G, Leung A, Schramm K, Lee PW, Hull L, Swerdloff RS. Low Fat High Fiber Diet Decreased Serum and Urine Androgens in Men J Clin Endocrinol Metab. 2005 Mar 1 

  34. 52 Low Fat Diets Reduce Androgens in Men “After diet modulation, mean serum testosterone (T) concentration fell (p<0.0001) accompanied by small but significant decreases in serum free testosterone (p=0.0045), 5 alpha dihydrotestosterone (DHT, p=0.0053), and adrenal androgens (Androstendione, p=0.0135; DHEA-S, p=0.0011).” Wang C, Catlin DH, Starcevic B, Heber D, Ambler C, Berman N, Lucas G, Leung A, Schramm K, Lee PW, Hull L, Swerdloff RS. Low Fat High Fiber Diet Decreased Serum and Urine Androgens in Men J Clin Endocrinol Metab. 2005 Mar 1 

  35. 53 Low Fat Diets Reduce Androgens in Men “Metabolic clearance rates of T were not changed and production rates of T showed a downward trend while on low fat diet modulation. We conclude that reduction in dietary fat intake (and increase in fiber) results in 12% consistent lowering of circulating androgens levels without changing the clearance.” Wang C, Catlin DH, Starcevic B, Heber D, Ambler C, Berman N, Lucas G, Leung A, Schramm K, Lee PW, Hull L, Swerdloff RS. Low Fat High Fiber Diet Decreased Serum and Urine Androgens in Men J Clin Endocrinol Metab. 2005 Mar 1 

  36. 53

  37. 53 Inflammation and Heart Disease

  38. 54 hs-C Reactive Protein (hs-CRP) Hs-CRP is the single biggest risk factor for atherosclerosis. It is the new ‘LDL’ for heart disease and predicts vascular events better than any other single parameter. The more carbohydrate consumed in the diet, the higher the levels of hs-CRP are.

  39. 54 Osiecki, H. (2004) Alternative Medicine Review,9, 32-53.

  40. 54 CRP Promotes Cardiovascular Disease “CRP was shown to possess proatherogenic properties. For example, CRP activates endothelial cells to express adhesion molecules, ICAM-1, vascular cell adhesion molecule 1, selectins, and the chemokines, monocyte chemotactic protein 1.” V. Pasceri, J.T. Willerson and E.T. Yeh, Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation 102 (2000), pp. 2165–2168.

  41. 55 CRP Promotes Cardiovascular Disease “CRP also induces the secretion of interleukin 6 and endothelin 1 and decreases the expression and bioavailability of endothelial nitric oxide synthase in human endothelial cells.” S. Verma, C.H. Wang, S.H. Li et al., A self-fulfilling prophecy: C reactive protein attenuates nitric oxide production and inhibits angiogenesis. Circulation 106 (2002), pp. 913–919.

  42. 55 High Carb Eating Promotes hs-CRP “Dietary glycemic load is significantly and positively associated with plasma hs-CRP in healthy middle-aged women, independent of conventional risk factors for ischemic heart disease.” Simin Liu, JoAnn E Manson, Julie E Buring, Meir J Stampfer, Walter C Willett and Paul M Ridker. Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women. American Journal of Clinical Nutrition, Vol. 75, No. 3, 492-498, March 2002

  43. 55 High Carb Eating Promotes hs-CRP “Exacerbation of the proinflammatory process may be a mechanism whereby a high intake of rapidly digested and absorbed carbohydrates increases the risk of ischemic heart disease, especially in overweight women prone to insulin resistance.” Simin Liu, JoAnn E Manson, Julie E Buring, Meir J Stampfer, Walter C Willett and Paul M Ridker. Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women. American Journal of Clinical Nutrition, Vol. 75, No. 3, 492-498, March 2002

  44. 56 Simin Liu, JoAnn E Manson, Julie E Buring, Meir J Stampfer, Walter C Willett and Paul M Ridker. Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women. American Journal of Clinical Nutrition, Vol. 75, No. 3, 492-498, March 2002

  45. 56 DHEA Declines with Metabolic Syndrome

  46. Testosterone Declines with Metabolic Syndrome

  47. 57 “Super Diets” Which Diet for Which Person?

  48. 57 Super Diets – Zone Diet The Zone Diet is based on work done by Barry Sears. It states that a macronutrient ratio of 30 protein: 40 carbs and 30 fats (30:40:30) is the best ratio for health. This ratio should be maintained at each meal. The Zone Diet also restricts calories and has some scientific backing.

  49. 57 Super Diets – Zone Diet Pros: • Some scientific backing • Restricts calories (mainly refined carbs) • Balances sugars Cons: • Difficult to administer • Have to ratio each meal • Restricts calories

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