functional medicine and nutritional genomics - American Association ...

More documents

Recommendations

Info

AAPI’S NUTRITION GUIDE TO OPTIMAL HEALTH: USING PRINCIPLES OF FUNCTIONAL MEDICINE AND NUTRITIONAL GENOMICS Etiology and Pathophysiology Social Etiologies Structural violence xxv has driven the obesity epidemic through an obesogenic environment. Policies and practices in agriculture, transportation, education, advertising, technology, health care, environment and the food industry promote obesity. These polices and practices have created limited access to whole fresh foods, but unlimited access to calorie dense, nutrient poor foods consumed mostly outside the home, or made in a plant, rather than grown on a plant. The built environment and adoption of technology limits physical activity. Hours of television watched are second only to consumption of liquid sugar calories as a risk factor for obesity. xxvi Environmental toxins also promote obesity. xxvii Obesogens are implicated in the 73% increase in obesity in six-month-old infants since 1980. xxviii Growing awareness of the obesogenic environment is driving changes in social, media, business and government polices including limiting sweetened beverages in schools, science rather than industry based nutrition guidelines from the USDA xxix and Michelle Obama’s Let’s Move campaign. xxx Biological Etiologies Emerging evidence points to obesity as more than simply genetics or a thermodynamic problem of calories in/calories out or eating less and exercising more. Contributing etiologies include poor quality food, nutritional deficiencies, hormonal dysfunction, inflammation, food allergens, chronic infections, gut-derived endotoxins, environmental toxins, oxidative stress, defects in energy metabolism and mitochondrial function, and chronic stress. These factors all interact in a dynamic network of dysfunction that leads to insulin resistance and obesity better described as diabesity. Systematic focus on diagnosing and treatment of each and all of the underlying causative factors in the network of metabolic dysfunction will result in more successful clinical outcomes and improved gene expression. 46 Nutritional Factors: Sugar, Fiber, Micronutrients, Macronutrients Nutrigenomics, the effect of macronutrients, micronutrient, phytonutrients, and glycemic load on gene expression provides an important lens in understanding the impact of nutrition on obesity and insulin resistance. xxxi,xxxii The single biggest contributor to obesity is the increased consumption of refined sugar and carbohydrates. Our Paleolithic ancestors ate 22 teaspoons of sugar per year xxxiii . Sugar consumption increased from 10 pounds in 1800 to 150-180 pounds per person per year. In the last 30 years, the sugar calories we consume from high-fructose corn syrup have increased from 0 percent to 66 percent, mostly in the form of liquid calories from soft drinks and other sweetened beverages. Liquid calories increase obesity more than calories from solid food. xxxiv Glycemic load and nutrient density is also controlled by fiber content of food. Our Paleolithic fiber consumption decreased from 100 grams a day to less than 8 grams per day. xxxv Lack of fiber promotes heart disease, diabetes, obesity, cancer and many other chronic diseases. xxxvi Consumption of 50 grams of fiber per day lowers hemagloblin A1c as effectively as diabetic medication. xxxvii Obesity is often associated with malnutrition. Obese children are increasingly diagnosed with scurvy, B vitamin deficiencies and rickets. Nutrient poor, calorie dense diets promote a society of overfed and undernourished citizens. A number of nutrients are particularly important in the prevention and treatment of diabesity, including vitamin D, xxxviii chromium, xxxix,xl magnesium, xli zinc, xlii biotin, xliii omega 3 fats, xliv and antioxidants such alpha lipoic acid. xlv,xlvi These nutrients regulate glucose metabolism and insulin sensitivity. xlvii,xlviii Supplementing with nutrients is necessary because modern foodgrowing and processing practices have greatly diminished the quality of our diet. xlix Shifting from a nutrient-poor diet to a nutrientdense diet that is abundant in plant foods such as fresh, whole fruits, vegetables, nuts, seeds, beans, and whole grains improves the function of 2012
AAPI’S NUTRITION GUIDE TO OPTIMAL HEALTH: USING PRINCIPLES OF FUNCTIONAL MEDICINE AND NUTRITIONAL GENOMICS hundreds of genes that control insulin function and obesity. An optimal diet to prevent and treat diabesity includes healthy fats such as olive oil, nuts, avocados, and omega-3 fats, along with modest amounts of lean animal protein. This is commonly known as a Mediterranean diet. l,li Hormonal Dysregulation: Insulin, Thyroid, Adrenal and Sex Hormones Obesity results from and drives neurohormonal immune dysregulation. lii Impairment in insulin sensitivity, thyroid metabolism, adrenal function and sex hormones, neuroendocrine appetite regulation are common features in diabesity. Undiagnosed thyroid disease worsens insulin resistance, liii and insulin resistance worsens thyroid function. liv Chronic stress drives chronically elevated cortisol which promotes insulin resistance, central adiposity, dyslipidemia, depression even dementia. lv Elevated cortisol also promotes muscle loss, interferes with thyroid and growth hormones, and negatively impacts sleep, all of which leads to problems with weight gain. Sleep deprivation or impaired sleep, in turn, increases appetite and increases sugar and refined carbohydrate cravings. In a study of healthy young men deprived of just 2 hours of sleep, their blood levels of ghrelin (the hunger hormone) increased and PYY (the brake on appetite) decreased. lvi Diabesity also drives sex hormone dysregulation. Insulin resistance underlies infertility lvii and polycystic ovarian syndrome. lviii In men, insulin resistance results in androgen deficiency and impaired sexual function. lix Inflammation: Refined Sugars and Food Sensitivities Silent inflammation is a final common pathway in most chronic diseases, including heart disease, cancer, Alzheimer’s, and diabesity. lx Elevated Creactive protein confers a 1700% increased risk of developing diabetes. lxi Inflammation from any source (allergen, infection, toxin, diet, stress) promotes obesity and obesity drives further inflammation. Anti-inflammatory medications do not address the most important question, ‚What is 47 causing the inflammation, and how do we treat it most effectively?‛ Sugar, refined carbohydrates, artificial sweeteners, food allergies and sensitivities, chronic infections, environmental and metabolic toxins, stress, and a sedentary lifestyle all promote inflammation. Each of these underlying causes of inflammation has to be addressed if diabesity is to be treated effectively. Dietary Sugars, Refined Flours, and Artificial Sweeteners Dietary sugars and refined flours are the single biggest triggers of inflammation driving hyperinsulinemia leading to a biochemical cascade that alters gene expression promoting inflammation, lxii and downward spiral into further inflammation and insulin resistance. Lack of fiber and too many inflammatory omega-6 fats (soybean and corn oil) and not enough anti-inflammatory omega-3 fats (fish oil, flax seeds) also contribute to the development of systemic inflammation. Special Note: Artificial Sweeteners Artificial sweeteners promote obesity through increasing hunger, food consumption, and reductions in body temperature and thermogenesis. In a recent study, rats were fed yogurt sweetened either with sugar or artificial sweetener for 14 days. The rats that consumed the artificially sweetened yogurt increased their total food consumption, but not total calories, and yet body fat and weight increased, while body temperature and thermogenesis decreased. lxiii Food Sensitivities and Allergies Delayed or Type 3 IgG food sensitivities or allergens also may play a role in the development of insulin resistance and diabesity through promotion of systemic low-grade inflammation. In a study that compared obese children to-normal weight children, the obese children had three-fold higher levels of C-reactive protein and a twoand-a-half-fold higher level of IgG antibodies for the 277 different foods tested. lxiv In addition, these 2012
Page 1 and 2: 2012 AAPI’S NUTRITION GUIDE TO OP
Page 3 and 4: AAPI’S NUTRITION GUIDE TO OPTIMAL
Page 51: AAPI’S NUTRITION GUIDE TO OPTIMAL
Page 103 and 104:
AAPI’S NUTRITION GUIDE TO OPTIMAL
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
show all

functional medicine and nutritional genomics - American Association ...

Create successful ePaper yourself

Delete template?

Save as template?