functional medicine

The short answer would be ‘it depends’.

If you have had even the tiniest of experiences in weight loss or ‘toning’ your body (i.e. building muscle) you would have been told to stick to your daily calorie target. You would also have been told about the concept of ‘calories in’ vs. ‘calories out’. In order to lose weight the calories consumed should be less than the calories used up.

Although this concept is very true and correct, simply looking at calories is not automatically going to give you good health (even if you’re achieving your fitness/weight loss targets!).

Calories post

Why is that? Because each calorie has its own nutritional value. That means that, depending on its source, a calorie will have a different composition of nutrients (protein, carbohydrates, fats, vitamins, minerals and water). And so calories from fat will function differently in the body compared to calories from sugar.

Sugar, the simplest form of carbohydrates, requires very little digestion and goes straight into the bloodstream. Now, the body can only process the sugar at a certain rate and it also has a limit as to how much sugar should be circulating in the blood. Too much sugar in the blood can cause a range of serious metabolic derangements in the body and so our bodies try really hard to remove excess sugar from the bloodstream (in fact, our bodies work best when we have less than 1 teaspoon of sugar circulating in the bloodstream). And so the body will first use as much sugar as it can for energy and then the rest will be stored as fat.

Blood sugar

On the other hand, calories from fats are released more slowly because fats take longer to digest and absorb (some say up to 8 hours!). This allows the body to use up the energy released from the fats in small batches, avoiding the flood of energy which then has to be stored as fat.

To make things more complicated, it is not just about the macronutrients (those required in large quantities) – proteins, fats and carbohydrates. We can think of these macronutrients as the fuel and building blocks of the body. However, it is the micronutrients (vitamins and minerals) which act as the gears that enable the body to use the fuel and function properly. Thus, a calorie which contains mostly macronutrients but little or no micronutrients is also of little use to the body.

And so we go back to the beginning – not all calories are made equal. If you’re just interested in weight loss, eating anything within your calorie target could still help you lose weight. However, in addition to losing weight you may also deplete the body of the vital minerals and vitamins, the gears of the body, which affect how your body functions and ultimately your health!

Oh, by the way, did you also know that calories from different food sources are burnt differently? We’ll talk about this and the various factors which affect how we burn calories in part 2 of this post. Stay tuned!

Nutrition

What is Functional Nutrition and Why Should You Care?

June 16, 2018June 16, 2018 Miranda

Nutrition – the word itself conjures images of strict diets and weight scales, doesn’t it? And yet nutrition is about a lot more than just that.

Over the years nutrition has started taking a more prominent spot in the worlds of health and medicine. Not just in the treatment of digestive diseases, but for a wide variety of ailments and health situations.

Functional Nutrition post

At the forefront of change is a new discipline called ‘Functional medicine’ – I spoke about it in an earlier post. In a nutshell, functional medicine relies heavily on nutrition and lifestyle interventions before turning to pharmaceuticals.

Why are these changes happening now? Because people from both sides of the field (i.e. patients and healthcare providers) are starting to realize that the current system doesn’t work.

To put it in the words of the great biochemist and author Dr. T. Colin Campbell, most countries today have a “disease-care system” rather than a healthcare one.

Current Western medical models are too focused on the individual parts of the human body (reductionism). Although this approach can tell us a lot about how specific organs work on their own, it doesn’t reveal much about how they all function together in the complex human body. For example, knowing how the neurons in the brain work doesn’t really help us understand why we react emotionally to our favorite song.

We need to see the full picture to truly understand what is going on. And we can do this through functional medicine and functional nutrition.

How? Functional nutrition goes much deeper than food labels and diet plans – its main focus is finding the root cause of your symptoms and resolving them. A nutritionist trained in functional medicine will use advanced laboratory testing and other assessment techniques to create powerful and highly personalized therapeutic interventions.

The first step in the functional approach is to take a detailed look at the patient’s history – not just the physical symptoms but also other predisposing factors, such as past stressful life events. Stress is a huge factor in many (if not all!) diseases.

The next step would be lab testing to confirm (or exclude) possible underlying causes of the symptoms. As the saying goes – “test, don’t guess”.

Based on all of the information collected, a functional nutritionist will then start investigating what is the root cause. Where are all of your symptoms and ailments intersecting? Is there a common factor, pathway or axis? Are there any imbalances in body functions and systems?

You may be surprised how intricately all systems of our body are connected. For example, food intolerances (e.g. lactose and gluten) can cause headaches and migraines with mild or minimal symptoms in the digestive tract (which may be missed easily). A traditional doctor may just prescribe you a medicine for the migraines, without really looking into the root cause.

In other cases, a person may be experiencing a range of symptoms, however standard medical tests would come back “in the clear” and the person would be told that there is nothing wrong with them. This is usually because most lab reference ranges are for end-stage disease and not for optimal health – just because something isn’t marked red on the test result doesn’t mean that all is ok!

Another example is the link between inflammation and many “incurable” chronic diseases:

what-is-chronic-inflammation-jan-overbay

As you can see, a functional nutritionist is committed to finding the root cause of your symptoms and resolving them, no matter how long it takes. They are also committed to working together with you, listening to your story and how your body feels. And that is why functional nutrition and functional medicine is the answer to some of the problems in health and healthcare today.

Nutrition, psychology

Is Your Food Making You Depressed?

May 13, 2018May 19, 2018 Miranda

No, I don’t mean that “boring, bland, diet food” (although healthy food is not boring, but more on that later). What I’m talking about is your standard food intake. You know, the “wholegrain” sandwich and pasta, the takeaway pizza, the “healthy” rice bowl or potato mash – those kind of things.

How can they make you depressed – they taste like happiness right?! Well, despite the short-term boost in mood, a high-carbohydrate, high-sugar diet can lead to something called insulin resistance.

Insulin resistance (IR)

What is it? IR happens when the cells in your body are not responding to the hormone insulin. Insulin, a hormone produced by the pancreas, takes excess glucose from our blood stream into many cells throughout the body.

When your cells refuse to open their ‘doors’ to insulin, the excess glucose remains in the blood wreaking all sort of trouble. Here’s just a few of the issues caused by IR:

The cells run out of fuel. Yes, our cells need glucose to produce energy and function properly.
The cells become malnourished. When our cells open their ‘doors’ to glucose, they also let in vital nutrients such as amino acids and vitamins. These nutrients are also needed for proper cellular function.
Burnout of pancreatic cells. The beta-cells of the pancreas are responsible for producing insulin. These cells are stimulated by excess glucose in the blood. Constantly high blood glucose levels will force these cells to work overtime, pumping out as much insulin as they can until they start to burn out and die. The result: reduced capacity of the body to produce insulin. This is the beginning of diabetes.

IR and brain chemistry

OK, we now know that both insulin and glucose are needed to take nutrients into our cells. But how does that relate to our mood, brain chemistry and depression specifically?

You may have heard that our moods are regulated by our brain chemistry. What that means is that certain chemical molecules can affect how our brain cells function. Such molecules are called neurotransmitters – they transmit ‘information’ from a nerve cell to another nerve cell or a muscle cell or any other cell in our body.

Neurotransmitters are made inside the brain from amino acids (the building blocks of protein) and other compounds. To get inside the brain, the amino acids have to pass a protective barrier called the blood-brain barrier (BBB). This process requires sufficient amounts of insulin and the cells to be sensitive to insulin’s actions.

The important neurotransmitters for regulating our moods are serotonin, dopamine, adrenalin, acetylcholine and GABA. Here’s how two of them are made:

Serotonin Synthesis — Serotonin synthesis

Audio from Dr. Oscar Coetzee, Masters in Human Nutrition lecturer and clinical nutritionist.

So when the cells in our body, including the brain, are not responding properly to insulin fewer amino acids can cross the BBB leading to a drop in the amount of neurotransmitters in the brain. This alters our brain chemistry and can lead to many emotional and psychological symptoms including the below:

So here you are – what you eat can make you depressed by altering your brain chemistry! Of course there are more factors including stress, addictive and toxic foods as well as vitamin and mineral deficiencies. These will be covered in future posts, so keep an eye out if you’re interested!

Nutrition

What is Alternative Medicine and Where does Nutrition Fit?

March 13, 2018March 13, 2018 Miranda

Alternative medicine has been on the rise for several decades now and it seems that it will keep growing in the foreseeable future. The most recent addition to the alternative medicine family is Functional medicine. Why is it different? Because it offers something traditional medicine doesn’t – that is working on the body as a whole to eliminate the root cause, rather an as isolated systems of organs and suppressing symptoms.

So what’s the big fuss? Let’s take a look at the current healthcare landscape.

Conventional Medicine

Western medicine or allopathic medicine is the dominant approach to health are not only in the West but in any developed country (thanks to globalization). These paradigm treat the symptoms of disease rather than the root cause. The National Cancer Institute’s describes allopathic and Western medicine as using “drugs, radiation or surgery to treat symptoms and disease. These can also be called conventional medicine or mainstream medicine.

Alternative Medicine

There are many paradigms which fall under “alternative medicine”. According to the American Association of Colleges of Osteopathic Medicine (AACOM), this approach goes beyond just treating symptoms and aims to achieve optimal health.Osteopathic healthcare consists of conventional drugs, surgery and special osteopathic manipulative techniques.These techniques are hands-on – an osteopathic doctor would use their hands to stretch or apply gentle pressure on muscles and joints.

Holistic medicine encompasses body, mind and soul into its practice. It treats the person as one whole, rather than the sum of its parts/organs/systems, and thus the name holistic.Like osteopathic medicine, holistic medicine looks for the root cause of problems, rather than just treating symptoms. It includes physical, social, psychological and spiritual elements of health and disease.

Naturopathic medicine has self-healing at the core of its paradigm.It uses therapeutic methods (including nutritional, manipulative, homeopathic and botanical therapies) and substances to assist the body in healing itself.It also focuses on identifying and eliminating the root causes of disease and ill health.

And finally, integrative medicine is the marriage of mainstream and alternative medicine. I believe integrative medicine incorporates all of the above. Some of the top interventions used in integrative medicine are nutrition, yoga, supplementation, massage, meditation and acupuncture.

Functional medicine is a systems-based method, linking physiology and function.It takes into account the patient’s lifestyle, genes and environment when looking for the root cause and developing a treatment plan. It is often confused with integrative medicine, because of their many similarities, including a patient-centered approach.

I really like the definition below from this article on Deepak Chopra’s website:

“The Textbook of Functional Medicine defines FM as the ‘prevention, early assessment, and improved management of complex, chronic disease by intervening at multiple levels to correct core clinical imbalances and thereby restore each patient’s functionality and health to the greatest extent possible’.”

Functional Medicine’s 6 Core Principles:

Recognizing the individuality and genetic uniqueness of each human being
Supporting a holistic, patient-cantered — rather than disease-cantered — approach to treatment
Searching for a dynamic balance between body, mind, and spirit
Acknowledging the interconnectedness of all internal body functions
Seeing health as a positive vitality — not just the absence of disease
Striving to enhance the health span, not just the life span, of each patient

There’s a good analogy of functional medicine as a tree: the leaves are the symptoms, the trunk is the clinical imbalances, and the roots are the environmental and genetic dispositions.

Functional medicine was found on the premise that dysfunctions on multiple levels (psychological, physiological, etc.) precede disease. Part of its approach is to define disease in terms of how the individual’s genome interacts with the environment and lifestyle and how that is expressed in physiological function.

A typical course of action would be to correct physiological imbalances and change the environmental factors (including nutrition) which undermine optimal function.

Back to Alternative Medicine

All of the outlined medicine paradigms have one goal in common – to restore and maintain optimal health. Alternative and especially functional medicine aims to go beyond the absence of disease and towards 100% function of the body.

Where does nutrition fit into this? Nutrition fits in each and every model. It is a core component of osteopathic, naturopathic, holistic and functional medicine. It can also help many hospital in-patients and out-patients in their recovery from invasive treatments or to counter-balance the effects of medications. Nutrients affect us not just on a system level but also on a cellular level. We need good nutrition in order function optimally and support our bodies to maintain homeostasis (balance).

I believe all of these approaches can work together under a funnel approach. At the top of the funnel we have the less invasive/aggressive approaches: osteopathic medicine, holistic medicine, naturopathic medicine and functional medicine. In this way most of the chronic diseases can be prevented and reversed, the burden on public health systems and hospitals can be lowered and patients can actively participate (and choose) their treatment plans.

At the bottom of the funnel would be the remaining approaches: western medicine, allopathic medicine and regenerative medicine. Let’s not forget that A&E doctors save lives every day! That is why we cannot completely eliminate traditional medicine – we still need it for emergency and severe cases. However, I would rather see them as a last resort.

The “funnel” approach as I would like to call it will limit the number of people requiring medications and surgeries, free up more time for the allopathic doctor so that he/she can focus more on their patient’s care and thus improve their service. And this is why non-mainstream medicine will continue to grow.

Tag: functional medicine

Calorie Counting – Is It Really That Important?