Блог Анкара

In This Chapter

^ Finding out what nutritional therapy is all about ^ Understanding how it works

^ Discovering what nutritional therapy can be good for ^ Knowing what to expect in a typical consultation ^ Finding a safe and effective nutritional therapist

Utritional therapy is all about what you consume and the effect that has on your health, both now and in the future. You may hanker for cream cakes and burgers but are they doing you any good? Are they setting you up for a range of health problems in your old age such as diabetes and heart disease? A nutrition practitioner can help steer you towards making healthy dietary choices to promote health and prevent disease.

No matter which complementary therapies you’re interested in, diet and nutrition always play a part to a greater or lesser degree. You have to eat to live and what you eat affects your health. Many of the therapies incorporate general dietary advice while some have quite specific dietary approaches, which this chapter explores.

I take a look at the origins and key principles of nutritional therapy and how it’s practised today, including the latest in nutritional diagnostic testing. I also chew over a few of the different types of diet that are currently used in therapy.

At the end of the chapter you’ll find a few nutritional therapy tips for improving your diet and your health.

Finding Out about Nutritional Therapy

Nutritional therapists work by assessing your diet and nutritional status and investigating how any dietary imbalance or nutritional deficiencies or excesses may be affecting your health. To assess digestive health and pinpoint problem areas, they may use food diaries; dietary analyses; nutritional

D^SEYOS

Testing by means of blood, urine, saliva, or hair analysis; and allergy or food intolerance testing.

Treatment involves dietary change, sometimes food exclusion (as in the case of food allergies or intolerances), and sometimes the use of nutritional supplements. You may also be put on some sort of detox regime to cleanse your gut and strengthen the digestive system. Sometimes other therapies may also be used such as colonics, which uses water to flush the bowel clean.

Traditional medical systems such as Chinese, Ayurvedic and Tibetan medicine all have their own specific approaches to diet. Nutritional regimes have also always been central to Nature Cure and naturopathy (see Chapters 8 and 13).

Modern nutritional medicine has taken things a step further, by incorporating scientific advances concerning individual nutrients and their role in the body, and identifying specific food and nutrient programmes for individual diseases. A large body of research now exists to support this approach.

Scientific work has also led to a specific nutritional approach called Orthomol-ecular therapy, Which recommends the use of mega doses of certain vitamins and minerals to treat particular physical or psychological disorders.

The aim of all nutritional therapy is to use nutritional means to strengthen the digestive process, rid the body of any excess toxins, and rebalance nutrient status in order to promote healing and well-being.

Lifestyle, exercise, stress levels, emotional well-being, and medical history are also considered as part of the diagnosis and treatment.

Nutritional therapy is used for all types of people, of all ages, with a wide range of different conditions or diseases.

A (Very) brief history of nutritional therapy

In this section I look first at the nutritional approaches in traditional medicine, then consider the Nature Cure and naturopathic approaches, and lastly introduce you to modern developments in the field of nutrition.

Exploring traditional medicine ideas about nutrition

The dietary approach in traditional medicine focuses on the ‘energetics’ of foods and their general effects on the body.

In Traditional Chinese Medicine (TCM), Foods are divided according to their Yin, yang, Or neutral properties, and food advice is based on identification of the balance of the Five Elements – water, wood, fire, earth, and metal – in a person. For example, if a person is diagnosed as having an imbalance of the wood element, associated with the liver and gall bladder, then raw foods, especially leafy greens and salads, would be recommended while a person with an imbalance of the earth element, associated with the spleen and stomach, would be advised to limit sweets and sugary foods and to eat easily digestible and warming foods such as casseroles and soups. (For more about this TCM dietary approach, check out Chapter 4.)

In the ancient Indian medical tradition of Ayurveda, You’re assessed according to the strength of your digestive ‘fire’ and the balance of the Doshas That determine your constitutional type. Each type is associated with specific dietary recommendations. Vata (wind) types are advised to chew their food slowly and to eat mainly light, easily digestible foods while avoiding stimulants like coffee and sugar and also any cold or raw foods. On the other hand, Pitta (choler or bile) types are advised to drink lots of water and to have cooling food and drinks such as raw food, salads, and mint tea while avoiding an excess of curries and spices. The Kapha’ (phlegm) types are advised to avoid mucus-producing ‘phlegmy’ foods such as ice cream, dairy products, and wheat, and to control their cravings for fatty and sugary foods. Instead they’re encouraged to eat and drink natural diuretics, such as watermelon and parsley tea, to get rid of excess fluid in the body. (For more about the Ayurvedic approach to diet, nip over to Chapter 5.)

I In Japanese medicine, The emphasis is on eating seasonal, fresh food in the correct combinations. Foods are classified according to their Yin (cooling) and Yang (warming) properties as in TCM, and alkaline foods, such as green, leafy vegetables and seaweeds, are seen as particularly beneficial to health. (For more about the Japanese approach to diet, take a look at Chapter 7.)

I In Tibetan medicine, Dietary change is regarded as the most important form of therapy in tackling disease. Dietary advice is based on your classification according to the balance of three Humours In the body. The approach is similar to the Dosha System in Ayurveda but some of the dietary recommendations are specifically Tibetan.

Windy (loong) Types are advised to eat nourishing foods such as Ma-sha (soya beans), milk and butter from the female yak (known as a Dri), And lamb dumplings (a type of Momo) - if not vegetarian – to eat in a calm and quiet environment, and to take their time with a meal to aid digestion. They also need to avoid stimulants such as tea, coffee, and sugar. Bile (tripa) Types need to eat lots of fresh and cooling foods and avoid mustard and other hot foods and spices and also an excess of Tibetan beer, known as Chang. Phlegm (peken) Types should avoid mucus-producing, cold foods like cold milk or ices and eat lots of warming foods such as clear broths that incorporate onions, garlic, and radish. (For more on the dietary treatments in Tibetan medicine, go to Chapter 6.)

Exploring Nature Cure and naturopathic ideas about nutrition

Nature Cure practitioners in the 19th and 20th centuries started looking at the constituents of individual foods and evolving the concept of ‘food as medicine’ for improving health and longevity and relieving disease.

I The Nature Cure Approach to diet, advocated in Europe and the US, emphasised the benefits of a vegetarian diet combined with careful fasting to keep the colon cleansed. Raw and living foods, packed with live enzymes, were seen as particularly beneficial, as was milk, which at that time was unpasteurised and untreated and considered wholesome since it came from mountain grass-fed, free-range cattle that led natural lives. Whole grain, unrefined, and simple foods were considered the most nutritious and health-giving. (For more about this approach, take a look at Chapter 8.)

I The Nature Cure approach was incorporated into modern Naturopathic nutrition, Which uses dietary advice, healing foods, and sometimes nutritional supplementation to stimulate your body’s natural healing ability and to address specific ailments by nutritional means. (For more about naturopathy, go to Chapter 13.)

Exploring modern ideas about nutrition

In the 20th and 21st centuries, the focus in nutritional medicine has been on identifying and investigating the role of individual nutrients. This work grew out of earlier discoveries that certain foods can help prevent and relieve particular diseases. For example, James Lind discovered that citrus fruit can ward off the disease of scurvy, characterised by bleeding gums, bruising, and eventually death, and suffered by sailors on long voyages without any fresh fruit or vegetables. However, he didn’t know that scurvy was actually a nutritional deficiency disease.

That leap came later from the work of Polish biochemist Casimir Funk, living in London in the 1920s, who first suggested that tiny components of food may be vital for the maintenance of health. He called these Vital amines (vita Meaning life and Amines Meaning organic derivatives of ammonia), also known as Vitamines And then later renamed as Vitamins, When it was realised that he’d got the ammonia bit wrong!

Funk and British biochemist, Frederick Hopkins, went on to propose that diseases such as scurvy, rickets, beri-beri, and pellagra (take a look at Table 12-1 for the gory details) were actually nutrient deficiency diseases. This simple, yet earth-shattering, proposal was the beginning of the end for such diseases and the beginning of nutritional therapy as an important field of medicine.

Table 12-1

Dietary Deficiency Diseases

Stay fully covered whenever outside

(continued)

Table 12-1 (continued)

Vitamin Vitamin A Vitamin B1 Vitamin B2 Vitamin B3 Folic Acid Vitamin C Vitamin D

Deficiency (Retinol) (Thiamin) (Riboflavin) (Niacin)

Vitamins and minerals are not the only nutrients to have made headline news. Other hot topics in the field of nutrition have been the following:

Fibre: Found in plant foods, fibre passes undigested through the body and is needed to promote regular bowel movements and maintain healthy cholesterol levels. Soluble fibre, Found in oats, pulses, fruits, and vegetables, can help reduce low-density lipoprotein (LDL) (sometimes known as bad cholesterol) in the blood and balance blood sugar levels by slowing sugar absorption. Insoluble fibre, Found mainly in cereals and whole grains, aids bowel movements and helps ward off hunger by making you feel full. Adults need a minimum of 25g of fibre in their diet every day.

Water: Dehydration is a really common problem due to people not drinking enough water and drinking too many diuretic drinks such as coffee, tea, and colas, which cause your body to lose water. Around 70 per cent of your body is made up of water and it is essential for normal cellular function, for healthy digestion, circulation, excretion, brain function, and temperature regulation. Dehydration can cause impaired mental function; headaches; heart, kidney, liver, and gall bladder problems; and eventually death. You can get water from both foods (fruit, vegetables, grains, fish, meat, and so on) and drinks, but adults need 35ml fluid per kilogram of body weight from all these sources daily to stay healthy. For most people, this means around six to eight glasses of water daily sipped between meals or before meals (to prevent dilution of digestive juices). Tap water may be contaminated with heavy metals, pesticides, and other pollutants, so drinking filtered or glass-bottled water may be more beneficial for health.

Drinking an excess of water can be as dangerous as not drinking enough as it can seriously affect the sodium/potassium mineral balance in the body and cause kidney problems.

Antioxidants: A lot of attention has been paid recently to the role of certain antioxidants, which are food substances that may help prevent damage and ageing in the body. Antioxidants include vitamins A, C, and E, carotenoids (substances such as beta-carotenes that give carrots and other vegetables their orange, red, yellow, and green colours and which the body can convert into Vitamin A), and the mineral selenium. Some studies suggest that these substances may help prevent diseases such as cancer, heart disease, and stroke and that they should be included in the diet daily in the form of fresh fruit and vegetables, nuts, and seeds.

Phyto-nutrients: From the Greek word Phyto, Meaning ‘plant’, phyto-nutrients are biologically active plant compounds that give plants their colour, flavour, and smell, and which also have special health benefits. They are thought to protect the body against damage from free radicals (rogue particles that damage and destroy tissue) and a range of diseases including cancer and heart disease. Hundreds of phyto-nutrients have been identified in recent years and they include phyto-oestrogens, found in soya, red clover, cereals, pulses, nuts, and seeds, which are similar to human oestrogen and may help prevent menopausal symptoms and certain types of cancer; and glucosino-lates, found in brassica vegetables such as broccoli and cabbage, which may protect against heart disease and cancer.

U ‘Good’ and ‘bad’ fats: Saturated fatty acids – found mainly in animal fats – plus trans fats and hydrogenated fats created unnaturally during food processing have been linked to heart disease and cancer. However, polyunsaturated Essential fatty acids Found in vegetable oils, polyunsaturated margarine, nuts, and seeds (the omega 6s) and in oily fish, such as mackerel, salmon, trout, herring, sardines, and pilchards; fish oils; and some nuts and seeds (the omega 3s) have been found to be beneficial for health and to help maintain healthy heart, liver, and brain function.

W Cholesterol: Made in the body and obtained from the diet (liver, eggs, and meat) and

Needed for building and repair of cells. It is now known that both good and bad types of cholesterol exist. Low-density lipoproteins (LDL cholesterol), and very-low-density lipoproteins (VLDL cholesterol), known as bad cholesterols, increase in the body with diets high in saturated fats and lead to increased risk of blocked arteries and heart disease. On the other hand, high-density lipoproteins (HDL cholesterol), also known as good cholesterol, help remove excess cholesterol from the tissues and reduce the risk of cardiovascular problems.

Grasping the idea behind nutritional therapy

According to nutritional therapy, the underlying root cause of nutritional and digestive imbalances leading to diseases may be any, or a combination of, the following:

U Regular consumption of refined and processed foods, such as white bread, flour, pasta and rice, ready-meals, and so on, leading to a low intake of essential nutrients.

U Frequent intake of junk foods loaded with unhealthy fats, salt, sugar, and so on that may damage the internal organs.

U Modern vegetables having lower levels of nutrients due to impoverisa-tion of the soil because of intensive farming practices.

U Inadequate fibre in the diet due to eating refined bread, pasta, cereals, and so on, leading to constipation.

U Dehydration due to low water intake and high intake of diuretics such as coffee and tea, which contribute to a loss of body fluids and slow down gut function.

U Lack of sufficient essential fatty acids, found in plant, nut, and seed oils and in oily fish, to soothe the lining of the intestines and prevent or reduce inflammation.

U Intake of anti-nutrient foods that may strip the body of important nutrients, for example over consumption of caffeine and tannins in tea and coffee can interfere with absorption of minerals such as magnesium and calcium.

U Toxins and chemicals ingested with foods such as pesticides on grains; heavy metals contained in fish oils; growth hormones, antibiotics, and other drugs given to commercially reared animals and fish.

U Weakened digestive systems due to intake of antibiotics and other medications that affect the balance of healthy bacteria in the gut.

U Improper digestive enzyme and stomach acid production due to irregular eating habits, not chewing food properly, eating too fast, chewing gum, and stress, leading to inadequate breakdown of foods in the stomach and malabsorption of nutrients.

U ‘Leaky gut’ syndrome whereby the gut becomes increasingly permeable due to inflammation and damage, and toxins and food waste products are passed back into the bloodstream.

U Food allergies and food intolerances (delayed onset food sensitivities), which mean that the body identifies ‘safe’ foods as ‘invaders’ and produces antibodies against them.

U Poor eating habits such as skipped meals (especially breakfast), bolting down food at a desk instead of taking lunch breaks, doing other activities (such as watching TV) while eating, eating late at night, and eating in-between meals.

U Bad cooking habits such as over-boiling food, cooking in lots of water, keeping food hot for long periods, and reheating food, which can lead to destruction and loss of nutrients in food.

U Lifestyle habits, such as stress, late nights, and overwork, that impair the body’s physical functions including digestion.

U Exposure to environmental chemicals via pollution, paints, solvents, cleaning fluids, dental amalgam, and so on, which increase the toxic load in the body.

U Sedentary lifestyles and lack of regular exercise leading to loss of muscle tone and constipation, which contribute to a build up of waste products in the body.

U Less, and shorter duration of, breastfeeding of babies and too early, or inappropriate, weaning of infants onto solid foods, predisposing them to digestive problems as adults.

The aim of nutritional therapy is to identify and correct these sources of imbalance using dietary adjustment, nutritional supplements (if necessary), and lifestyle change.

Since nutrition is not yet fully regulated as a profession, the differences between various professionals offering nutritional advice can be confusing and so it is a good idea to ask your practitioner about training, experience and membership of a professional body. At this point, anyone can call themselves a nutritional therapist or nutritionist, but the title dietician is protected.

Nutritional therapists Are usually people who have taken some sort of nutritional therapy training that includes nutrition theory and clinical practice. In general, these courses are becoming increasingly comprehensive and many now have degree status. The new Nutritional Therapy Council (NTC) (Www. nutritional Therapycouncil. org. uk), which is spearheading self-regulation for nutritional therapists, recommends that anyone using this title should meet the National Occupational Standards for Nutritional Therapy and should complete a recognised training course with minimum requirements for training and practice. Nutritional therapists may be members of various bodies but are now being encouraged to register with the new NTC.

Some nutritional therapists prefer to call themselves Nutritional practitioners Or Consultants. There is also a move to classify those who have done just short courses in nutrition as Nutritional advisors Rather than fully trained therapists/practitioners.

People using the title Nutritionistare Often those who have done a degree-level training in nutrition but who may have had no clinical experience in treating people with nutritional therapy and are unable to advise on the use of nutrition in the treatment of disease. Often such people work in public health, commercial, or educational settings, and give dietary advice based on the latest research and nutritional knowledge. Many of these degree-level nutritionists are members of the Nutrition Society (www. Nutritionsociety. org), which operates a voluntary register for trained nutritionists and is seeking protection for this title. However, just to make this situation more confusing, some practitioners, using nutrition in clinical settings, like to call themselves nutritionists too, whether they have a degree-level training or not and even if they’re not members of the Nutrition Society.

Dieticians Are those who have taken a regulated degree-level training in dietetics and have had clinical training in the NHS. They can call themselves dieticians only if they have completed this training, and they must be registered with the Health Professions Council (HPC) in the UK to be allowed to work. Dieticians are trained to advise on special diets for people with different diseases, usually in hospital settings, and the professional body that represents them is the British Dietetic Association (BDA) (www. Bda. uk. com).

Nutritional therapy today

With nutrition constantly in the media, from chef Jamie Oliver’s focus on the poor state of school dinners; to the National Health Service’s (NHS) focus on child obesity; to food scare stories and well-publicised government dietary

Guidelines, nutrition education, research and therapy are all becoming increasingly important.

As consumers become more aware of what they eat, highlighted by various popular television programmes on nutrition, increasing numbers of people are seeking out nutritional experts for help and advice.

Many different health professionals provide nutrition advice. These include nutritional therapists, practitioners or consultants, nutritionists, dieticians, doctors, nurses, and other complementary medicine practitioners such as naturopaths.

Exploring other types of nutritional therapy

Orthomolecular therapy, Created by the double Nobel-prize-winning scientist, Dr Linus Pauling, in the 1990s, advocates the use of large doses of individual vitamins, minerals, or amino acids to treat different types of illnesses. Some support for this comes from research, which shows that high doses of Vitamin C may reduce the duration and severity of the common cold and may help clear blocked arteries, while high doses of magnesium may aid recovery after heart attacks and may help ease chronic fatigue syndrome. However, this approach remains controversial and research into it is ongoing.

Understanding How It Works

Nutritional therapy aims to strengthen your digestive system and rebalance nutrient status by means of the following:

U Providing you with a revised diet to improve your health. Often junk food items, refined foods, processed foods, and ready-meals are replaced with whole grains, and increased fresh fruit and vegetables, to give a more balanced intake of food components and nutrients.

U Dietary variety may be increased by introducing you to new foods, thus widening the range of foods eaten.

U Foods that trigger allergies or intolerances may be identified and

Removed from your diet or put on a rotation basis whereby you eat them only every other or every fourth day.

U Individual nutrient deficiencies may be identified and then corrected with either foods or nutritional supplements; for example, people low in iron may be encouraged to eat more iron-rich foods, such as prunes, or to take iron supplements.

Excess nutrients, usually due to taking too much of a particular supplement, will also be corrected (usually by stopping or replacing the supplement). For example, some people take high levels of pure ascorbic acid (Vitamin C) and this can cause stomach irritation and diarrhoea. A ‘buffered’ type of non-acidic Vitamin C may be recommended in its place and the dose adjusted according to need.

Individual foods or nutrients may be used to rebalance particular parts of the digestive system. For example, digestive enzymes from papaya, pineapple, or sprouted seeds, such as alfalfa, may be used to increase enzyme levels in the stomach to aid in the breakdown of foods. Or Probiotics -beneficial bacteria – found in live and fermented foods such as live yoghurt or buttermilk, may be introduced to increase the levels of healthy bacteria in the intestines.

Cleansing and detox diets may be used to cleanse the gut. For example, powdered psyllium husk and slippery elm compounds are sometimes used to facilitate the removal of waste products from the large intestine and to promote effective bowel movements.

The idea is that when the digestive system is working more efficiently, the diet is balanced, and correct nutritional status is established, better health ensues.

Discovering Whom and What Nutritional Therapy Is Good For

Nutritional therapy may be requested by those who just want general dietary advice, for example a young mother wanting advice on feeding her child, a teenager who wants to become vegetarian, or an athlete aiming for optimum sports nutrition. Increasingly, however, nutritional advice is being sought for specific conditions.

Conditions that nutritional therapists treat

Today’s nutritional therapists commonly treat a wide range of disorders, including the following:

U Digestive problems including constipation, diarrhoea, indigestion, irritable bowel syndrome, Crohn’s disease, and colitis

U Attention deficit and hyperactivity disorders

U Headaches and migraine

U Arthritis

U Circulation problems U Respiratory problems such as asthma U Menstrual and menopausal problems U Eye, ear, nose, and throat problems U Food intolerances and food allergies

Research evidence supports the use of nutritional therapy for a range of conditions but more good research is also needed.

Evidence that it works

A substantial body of research now exists linking certain foods and diets to particular health conditions such as high levels of fat intake with heart disease, high-sugar and refined carbohydrate diets with late onset diabetes, and diets low in fresh vegetables and fruits with certain cancers. The work of Professor Jane Plant has also suggested that intake of dairy products may be linked to breast and prostate cancers, and research by Dr Alan and Maryon Stewart has linked different types of diets with menstrual and menopausal imbalance.

Other research has shown that certain types of diet may lower risk and reduce symptoms. Examples of this type of research include evidence that high fibre diets can decrease the risk of colon cancer and that vegetarian diets can decrease the risk of conditions including gall bladder disease and the symptoms of some types of arthritis.

Increasing numbers of studies have also looked at the role of individual nutrients or foods in different diseases. Research at Bastyr University in the US has investigated the role of Vitamin C intake during pregnancy, the role of garlic in treating helicobacter pylori infection, and the role of chromium in balancing blood sugar levels, to name but a few examples. Other research has shown the role of B vitamins such as folic acid in reducing the risk of heart disease and preventing spina bifida in newborns (a condition where the spine and nerves don’t form properly), the role of magnesium in treating chronic fatigue conditions, and the role of Vitamin B6 in treating premenstrual syndrome.

Sometimes nutrition research has been controversial, as in a large study using Vitamin E with patients with lung cancer, which had to be stopped because those taking the supplement were faring worse than those who were not. However, close investigation showed that Synthetic Vitamin E, rather than natural form Vitamin E, was being used in the trial, which may have confounded results since synthetic Vitamin E is far less beneficial to the body and may even be harmful. This example illustrates how important it is to examine studies and their results carefully when drawing conclusions.

_jS>°TF

I recently had a businessman as a patient who’d experienced digestive problems for 20 years. He suffered from abdominal pain, wind, bloating, indigestion, and vomiting, and was frequently unable to keep his food down. He had had every type of medical investigation possible and had seen a whole host of specialists, who could find nothing abnormal. On looking at his diet, I saw that certain foods were repeated over and over and decided to run a food intolerance test. His results came back showing a strong intolerance to some of these foods. I helped him to plan a new diet avoiding these foods and adding in lots of healthy alternatives. He kept to the new diet religiously, with the help of his family, although he was pretty sceptical about its likely effects. At the same time I recommended some digestive enzymes, essential fatty acids, and beneficial bacteria (probiotics) to rebalance his digestive system.

Within three weeks he was amazed to find his symptoms markedly improved, and within five weeks they had completely cleared. As a side effect, he was also feeling more energetic and clearer headed. He couldn’t believe that 20 years of discomfort and pain could be resolved so simply, and he enthusiastically informed his doctor about his progress. The doctor completely rejected the idea of food intolerance, saying it was unproven, and suggested that his cure had been ‘all in the mind’ and resolved itself. So my patient did an experiment for himself. He reintroduced a few of the offending foods and within hours all his symptoms were back! He has therefore stuck to his new diet, gradually reintroducing some of the foods to which he was only mildly sensitive, and three years later he is still symptom-free.

For more on nutritional research, check out the Cochrane Library (www. Cochrane. org/reviews/clibintro. htm), the NHS Complementary and Alternative Medicine Specialist Library (Www. library. nhs. uk/cam), the Bastyr University site (Www. bastyr. edu/research), and the PubMed database (Www. nlm. nih. gov/nccam/camonpubmed. html).

When not to use nutritional therapy

Nutrition and diet play a useful role in most conditions but you must always consider medical treatment in the case of serious diseases such as cancer and diabetes. In such cases, keep your doctor informed about any dietary changes or nutritional supplementation.

Care also needs to be taken if you’re on medication since some nutrients and drugs can interact. Always seek careful advice from an experienced and qualified nutritional therapist and your doctor in such cases.

Never take mega doses of nutrients unless a specific clinical reason exists and a trained professional is carefully monitoring their use. Nutritional supplements also need to be used with great care in the case of pregnant women, the elderly, and children.

Never use nutritional supplements as a substitute for proper, healthy eating.

What to Expect in a Typical Consultation

A consultation with a nutritional therapist generally starts with a discussion about your diet and health.

Questioning

The nutritional therapist will ask about your medical history and general health as well as your current symptoms. You’ll be asked detailed questions about your diet and may be asked to complete a food diary for a week before attending. Also be prepared to be asked questions about your bowel movements, which give the practitioner valuable information about the functioning of your digestive system.

Diagnostic methods

The practitioner may examine your tongue, eyes, and skin and may palpate your abdomen to obtain information about digestive function. Tests may also be used to investigate your nutritional status. These tests can be any of the following:

U Hair mineral analysis To test for mineral levels and the presence of toxic heavy metals such as lead and mercury. This test is regarded as useful by many nutritional practitioners but considered unreliable by most medical practitioners.

U Blood tests To investigate your levels of different vitamins and/or minerals, essential fatty acids, and so on. These tests are generally considered to be reliable by both nutritional practitioners and medics.

U Toxicity tests That use urine analysis to investigate the levels of heavy metals and toxins stored in your tissues. These tests are used by doctors and naturopaths in the US and by nutritional therapists in the UK.

U Bio-electrical tests That use various types of electrical measuring devices to test for food sensitivities and allergies and ‘energetic’ imbalances. These devices are generally considered to be unreliable by doctors. Go to Chapter 22 on Energy Medicine for more details about these devices.

U Kinesiology, Which is a form of muscle testing, is sometimes used to test for problem foods or nutritional deficiencies. Many regard this technique as unreliable. Read more about it in Chapter 16 on bodywork therapies.

U Food allergy and food intolerance testing Using blood tests to determine immediate or delayed onset food allergies. See the nearby sidebar for more details.

Food allergies and food intolerances are both sensitivity reactions to foods (or drinks, food additives, colourings, and so on) and can lead to a range of symptoms. Food allergies involve an immune system response and the production of specific antibodies called IgE antibodies. Common allergens are peanuts, shellfish, tree nuts, and eggs, and reactions can be swift and even life-threatening as the tissues swell and the airways become restricted.

In the case of food intolerances, also known as delayed onset food sensitivity, the reaction is less severe and may occur some time after the food has been eaten. In this case, the body is thought to produce different types of antibodies known as IgG antibodies, although this has not yet been conclusively demonstrated. Such sensitivities may also be linked to a lack of digestive enzymes for breaking down food effectively. Typical symptoms are bloating, wind, and an irritable bowel and may also include other conditions such as migraine, asthma, and eczema.

In the case of food allergies, any contact with the offending foods must be avoided completely, so sufferers need to read food labels

Carefully and take care in public places such as restaurants. Many food allergy sufferers carry emergency auto-injectors for the administration of a drug in case they inadvertently come into contact with an allergen and suffer a sudden extreme reaction, known as Anaphylactic shock. In the case of delayed onset food intolerances, it may only be necessary to avoid the food for a period of time, after which it may be reintroduced on a rotation basis. Introducing a wider range of alternative foods, strengthening the digestive system and increasing digestive enzyme production may also help. In some cases where the food intolerance remains the food may need to be avoided on a more long-term basis. Common food intolerances are wheat, dairy, citrus fruit, tomatoes and potatoes.

The whole topic of food intolerance and food intolerance testing remains controversial in the eyes of many medics, and many people choose to do food intolerance testing privately. A recent study showed that more than 70 per cent of people using a home food intolerance test kit reported symptom relief after excluding the identified foods.

Types of treatment

Treatment involves recommendations on dietary adjustments, sometimes with food exclusion or food rotation, and often the introduction of new foods. Nutritional supplements may also be recommended.

Nutritional therapists may also recommend certain therapies alongside their nutritional advice. These may include the following:

U Colonics: A technique using water to flush the intestines and remove compacted waste matter. This is more thorough than an enema and involves special equipment and training. There is little research evidence to support its use however, and some critics believe that it can lead to weakening of the colon if done incorrectly or too often.

U Chelation therapy: This involves introducing certain nutritional compounds into the body intravenously to draw out heavy metals from the tissues. This treatment has been used for several decades but remains controversial as insufficient research evidence exists to support it.

Some nutritional therapists are also trained in other disciplines such as naturopathy, homeopathy, and herbal medicine and may incorporate approaches from these disciplines into your consultation.

Duration and frequency

The first nutritional therapy session is generally around 60 minutes, while follow-up visits may be 30 minutes. Follow-up sessions are usually after a few weeks, once you’ve had a chance to put the dietary advice into practice or to get started on taking nutritional supplements.

At the end of the first consultation, you may be asked

U To follow some sort of diet sheet outlining the dietary recommendations given to you. You’ll need to rethink your food shopping, meal preparation, and eating habits to put these recommendations into practice.

U To take certain nutritional supplements. To make this easier you should be given details of when and how, and for how long, to take each one.

Follow the advice that you are given carefully and do not exceed the recommended doses for any supplements prescribed. More is not necessarily better and can be dangerous.

Your practitioner may recommend a specific type of diet for you. Here are some diets that are currently popular:

U Atkins Diet: A low-carbohydrate, high-protein diet devised in the 1970s, by American Dr Robert Atkins, this diet involves cutting out high-carbohydrate foods such as bread, pasta, and sugar while eating lots of high-protein food such as meat, cheese, and eggs. Critics have said that it can lead to heart and kidney problems and it is falling out of favour.

U Blood Group Diet: Formulated by American naturopath Peter D’Adamo, this plan involves basing your diet on your blood type. This diet has a celebrity following but many doctors and nutritionists don’t believe that it has any scientific basis.

U Detox Diet: Many variations of this diet exist within the naturopathic tradition. It generally involves cutting out all refined and processed foods and following a vegetarian (no meat or fish) or vegan (no meat, fish, dairy, eggs, or any animal products) diet and drinking plenty of water.

U Gerson Diet: This controversial anti-cancer diet developed in the 1920s, by Dr Max Gerson is based on an hourly intake of juiced organic vegetables, an organic, low-salt vegan diet, and coffee enemas.

U Hay Diet: A system devised by Dr William Hay based on optimal food-combining. It involves avoiding combinations of proteins and carbohydrates at the same meal, and

Many people find it helpful. However, doctors generally reject it arguing that most plant foods contain both proteins and carbohydrates and that the digestive system is designed to deal with both mixed together.

U Living Foods Diet: Formulated by Dr Ann Wigmore from the 1950s onwards and based on raw, enzyme-rich live foods such as sprouted seeds, grains, and wheatgrass. Her work has also led to the popularity of many raw food diets today where no cooked food is consumed.

U Life Choice Diet: Formulated by American Dr Dean Ornish in the 1990s, this low-fat vegetarian diet emphasises vegetables, fruit, and beans and an intake of less than 10 per cent fat. Sugar and alcohol are also avoided.

U Macrobiotic Diet: Devised by George Osawa in Japan in the 1950s, this diet classifies foods according to their YinAnd Yang Properties (see Chapter 7) and excludes sugar and refined and processed foods.

U Zone Diet: Formulated by American biochemist Dr Barry Sears in 1990, this diet is based on keeping insulin levels on an even keel by having a balanced intake of proteins and carbohydrates and avoiding sudden high-carbohydrate/refined-sugar intake.

Users of these diets have claimed many health benefits from them; however, few are backed by conclusive research and many regard them as fad diets.

Inform your nutritional therapist of any medication that you’re on and to inform your doctor of any supplements that you decide to take. Also inform your practitioner if you’re pregnant or likely to become pregnant, because you’ll need to avoid certain foods and supplements. A folic acid supplement is usually recommended to reduce the risk of the baby developing spina bifida (a condition where the spine and nerves don’t form properly).

Knowing whether your nutritional therapy treatment is working

Sometimes people feel almost immediate benefits after making simple dietary changes, but others may find that reduction of symptoms can take time, as the body needs to readjust and heal. Nutritional supplements can also take time to become fully effective in the body.

Keeping a food diary and a symptom record to monitor changes can be helpful so that you can discuss your progress with your practitioner.

Finding a Good Nutritional Therapist or Nutritionist

The Nutritional Therapy Council (NTC; Www. nutritionaltherapycouncil. Org. uk) is leading the way with professional voluntary self-regulation of nutritional therapists and is establishing a register of practitioners and a process for accrediting nutrition training courses.

Other nutrition associations that currently maintain directories of nutritional therapists include:

U British Association for Nutritional Therapy (BANT; Tel/Fax: 0870 606 1284; Www. bant. org. uk)

U The Register of Nutritional Therapists (RNT; Www. nutritionalmed.

Co. uk)

U Wholistic Nutritional Medicine Society (WNMS; Tel: 0207 935 3533)

The Nutrition Society (Www. nutritionsociety. org) also maintains a voluntary register for nutritionists.

In the US, many nutritional therapists are members of The American Association of Nutritional Consultants (AANC; Tel: 00 1 888 828 2262 or see Www. aanc. net for an online directory). However, the credentials of some of its members have been questioned as some only have correspondence course training in nutrition.

The American Society for Nutrition (Www. nutrition. org) is a learned society dedicated to nutrition research and education. Lots of nutrition information can be found in its journals; The Journal of Nutrition And The American Journal of Clinical Nutrition.

Because no formal registration currently exists for nutritional therapists, enquiring about the practitioner’s level of experience and training is essential.

The following are some other suggestions for finding a nutritional therapist:

U Ask friends, family, and colleagues for personal recommendations of practitioners.

U Some sports and leisure clubs offer nutritional consultations.

U Consider visiting the teaching clinics at colleges with courses in

Nutrition. Students practise under close supervision from experienced practitioners and fees are low compared to private practice.

Counting the cost of nutritional therapy

Initial nutritional therapy consultations may cost between Ј35 and Ј100, while follow-up sessions are between Ј25 and Ј65. The cost of tests and supplements is usually extra.

Ensuring satisfaction

If you’re dissatisfied with your treatment, first talk things over with your practitioner.

If you think that the practitioner has been negligent, unethical, or incompetent, contact their professional body and use the formal complaints procedure.

Helping Yourself with Nutritional Therapy

^___>,

Here are ten dietary tips to help you achieve better health:

Eat more vegetables and fruit. These foods are rich in nutrients, fibre, and health-giving antioxidants and including at least five a day in your diet is recommended.

Eat more healthy fats. Decrease your intake of unhealthy, saturated or hydrogenated fats and increase intake of essential fats contained in seeds, nuts and plant oils and in oily fish (no more than three times a week for the latter, in case of contamination with heavy metals).

U Eat more fibre. Replace white bread, rice, and pasta with brown, whole grain versions.

U Eat less sugar. Cut out the sweets and sugary treats and satisfy your sweet tooth with fresh fruits and berries.

U Go raw! Try having a little raw food at the start of each meal, such as a side salad or a piece of fruit, to encourage digestive enzyme production.

U Drink more water and less caffeine and alcohol. Try swapping your latte for a healthy herbal tea or fresh juice and drink water throughout the day to stay hydrated.

U Eat fresh organic and free-range produce. Buy it whenever you can and support local producers to reduce your ‘food miles’.

U Cut down on table salt. Flavour your food with a little seaweed or vegetable salt instead.

U Maintain a healthy body weight. And don’t over – or under-eat.

U Adopt healthy eating habits. Always eat breakfast. Eat a wide variety of foods to meet all your nutrient needs. Eat little and often, if necessary, to maintain even blood sugar levels. Eat slowly in a calm environment to aid digestion. Chew your food well.

The 5th Wave_By Rich Tennant

"THE SHORT ANSWER TO YOUR REQUEST FOR A RAISE 15 *N0′ THE LONQ ANSWER IS ‘NO, WD (SETOUT OF MV OFFICE.’"

In this part…

I\lot Too long ago, work used to be a very physical # W activity for almost everybody on the planet. Sure, there were always a few pharaohs, high priests, and ladies-in-waiting whose main activity was flicking fingers and shouting commands, but for 99.99 percent of humanity throughout our entire history, "work" meant physical work, and we used our bodies a lot.

As you may have noticed, this is not the case anymore. In a sense, we’ve all become pharaohs, masters of a digital domain in which we push around bits of data as if they were slaves. Click a button, and your wish is executed. Most of us check our bodies at the door when we walk into work each morning.

However, even though many of us don’t use them as much anymore, our bodies are still subject to high levels of stress and strain. Recently in the U. S. alone, absenteeism went up 25 percent in one year, and stress was the top reason sited for missing work.

Luckily, massage is here for us, ready to breathe some life back into our corporate bodies. It is now possible for massage to become a part of your life at work, where you may need it the most. I’m talking about corporate massage here, which is the subject of Chapter 12, in which you find out how to take advantage of the growing number of massage pros who specialize in on-the-job stress reduction.

Of course, a massage pro might not always be available, and you need to know how to de-stress yourself on the job too. Chapter 13 is all about self-massage and stretching that you can do right at the desk or workstation. In addition to relaxation techniques, you’ll discover some basics about how to combat a very serious problem many office workers, and others, face: carpal tunnel syndrome (CTS).

The work environment also forces many of us, especially females, to wear strange, sadistic contraptions on our feet, what Steve Martin called "cruel shoes." We then walk around on hard, unnatural surfaces all day, until our feet end up needing some serious massage attention of their own. Chapter 14 explains reflexology, a type of massage that concentrates on the feet, with the added benefit of affecting the entire body through its actions as well.

Chapter 12