Therapeutic Diet

Overview

Developed and compiled by

Joseph B. Gentzel, B.S., P.T., T.N.

seniorphysicaltherapist@windstream.net

Fact

       Indigenous/biblical man ate a diet that was roughly 1 to 1 ratio of Omega-6 essential fatty acids to Omega-3 essential fatty acids.[1]

Fact

       The average ratio of Omega-6 essential fatty acids to Omega-3 essential fatty acids in our contemporary lifestyle is between 15-20 to 1 Omega 6 to Omega 3.

Fact

       All foods have properties that upon ingestion are inflammatory, anti inflammatory with a few being neutral to the body.

Fact

       The average contemporary diet causes a generalized chronic inflammatory state in the body. This can be measured by C Reactive Protein tests and other tests of inflammation.

Fact

       This chronic inflammatory state results in many symptoms over the years. The most by incidence is overweight/obesity. Sixty six (66%) percent of the American population is overweight. This number is presently exploding.

Fact

       Fat is inflammatory. Fat cells produce cytokines or pro inflammatory proteins. Some scientists consider fat a separate body organ.[2]

Fact

       The dietary inflammatory sequence begins in utero [3] and progresses throughout life with each generation to date seemingly exhibiting overweight earlier in the life cycle and to a greater degree than the prior generation.

Fact

       Many other medical conditions are caused from overweight/obesity. One of these includes various cancers. From the 15th congress of the European Cancer Organization, and the 34th congress of the European Society for Medical Oncology (ECCO 15 B ESMO 34) held in Berlin on September 24, 2009 the following headlines made the national news around the world.[4],[5]

       Obesity Triggers Cancer Epidemic; Some 124,000 weight-related cases appear yearly

Fact

       The evidence of a massive amount of health problems associated with obesity/inflammation (some inflammatory symptoms are developed in the absence of obesity, but obesity exacerbates the problem as it becomes an inflammatory generating system in the body) is overwhelming. A partial list follows with incidence.

• Over 200 million overweight; 40 million obese; 3 million morbidly obese in US  The numbers are all over the place, but all statistically extremely high.
• In 2007 26.4% of men and 24.8% of women were obese
• Eight out of ten people over age of 25 were overweight (potentially on the road to obesity)
• 80% of type II diabetes related to obesity
• 70% of Cardiovascular disease related to obesity
• 42% breast and colon cancer diagnosed among obese individuals
• 30% of gall bladder surgery related to obesity
• 26% of obese people having high blood pressure
• 4% overweight children 1982 | 16% overweight 1994
• 25% of all white children overweight 2001
• 33% African American and Hispanic children overweight 2001
• More than two thirds of patients with obstructive sleep apnea are obese.
• Obese men may be more than twice as likely as lean men to die of prostate cancer.
• With the increase in obesity and resultant weight-related disease for both adults and children, more successful long term solutions to obesity are urgently needed. Individuals with Morbid Obesity who do not receive treatment have only a 1 in 7 chance of reaching their normal life expectancy
• Mayo Clinic estimates that 21 Million people in US have osteoarthritis and the CDC says that 42.7 million noninstitutionalized adults had arthritic symptoms in the US 2002.
• Rheumatoid Arthritis (RA)-2.1 million cases of RA in the US (NIH, The National Women’s Health Centre, 2004)
• The American College of Rheumatology estimates that 3 to 6 million Americans have fibromyalgia. Since this disease is misdiagnosed and missed much of the time, these numbers could be very low.
• Approximately 1 in 544 (0.18%) or 500,000 people in USA have Crohn’s Disease (sometimes seen as Krohn’s Disease)
• 17.4 Million of the people in US have Asthma according to National Institute of Allergy and Infectious Diseases (NIAID). That includes 8.1 million children.
• Heart Disease affects 22 million people according to CDC.
• CDC says 4 million people have Alzheimer’s Disease in US.
• 4.6 Million people have atherosclerosis according to National Health Interview Survey, 1995 (NHIS95).
• Cleveland Clinic estimates that 1.5 million people in US have Parkinson’s Disease.

• According to NHIS95 report 3.3 million people in US have colitis.
• 8 million people in US have dermatitis according to NHIS95 report.
• 2 million people in US have diverticulitis according to NIH report.
• Women on hormone replacement therapy have higher levels of inflammation in the body.
• NIH report states that 5 million people in US have irritable bowel syndrome (IBS).
• One third of the women in US and UK take Hormone Replacement Therapy (HRT).

• 1.4 million people have lupus erythematous in US according to the National Women's Health Information Center (NWHIC).
• About half the people with IBS have ulcerative colitis. This estimate places the number of people in the US at approximately 2.5 million.
• One has to wonder about the catch all category of auto immune disorders. Are they just the constant bombardment of the body by an inflammatory diet gone haywire?

The list continues with many other problems that can be traced to diet as a cause or contributor to the incidence and severity of the problem.

Fact

       Other than anecdotal evidence no intervention, medical or otherwise, is successful with any overweight/obese groups past the 10 year period. That includes all forms of Bariatric surgery, all diets including restricted calorie, with or without exercise. They all fail. The only success seen is a few isolated individuals and/or for short periods of time. For most this short term loss actually compounds the problem with “yo-yo” effect that catabolizes muscle in the weight loss cycle. This results in the body having less muscle mass to function and burn calories going forward. They always regain the weight loss and more.

Fact

You can substitute obesity for inflammation in terminology and extrapolate the other inflammatory effects (diseases) by incidence and severity.

The diet inflammatory cycle is represented by the following schematic.

Obesity, inflammation and ovarian cancer

Evidence is emerging showing positive correlation between obesity and associated inflammation on an increased risk of ovarian cancer in pre menopausal women. Study is continuing on post menopausal women. [6]  Obesity and associated inflammation is linked to poorer outcomes in women with ovarian cancer.[7] Many theorize that inflammation follows obesity, but evidence is significant that inflammation precedes or at least accompanies the incidence of overweight and obesity over time. Type 2 diabetes has been shown to be caused by the inflammation as opposed to the obesity as was always theorized in most studies.  [8], [9]

Obesity, inflammation and cardiovascular disease

       There are many studies that link the inflammation from obesity to cardiovascular disease and other vascular diseases. [10], [11] All the models theorize that obesity causes the inflammation, but the prospect that the diet that is inflammatory and overly high in Omega 6 fatty acids needs to be studied much more as the genesis of the whole process. There are studies that eliminate obesity from the equation and indicate that type 2 diabetes is caused by the inflammation and not the obesity. [12]There is no doubt that once the obesity is in place, the fat cells themselves become an inflammation producing center, but what started the obesity in the first place? In order to treat the initial cause that will render results that will stand the test of time, this is an important question. If for no other reason, it is important as a critical link between heart disease and many other conditions that are killing us all in epidemic numbers. It’s a moot question though as there is plenty of data that supports the lowering of weight and a decrease in all markers for inflammation including Bariatric surgery. The major problem with this is they all fail by the ten year mark primarily because the inflammatory diet mostly remains in some form; a diet that is high grain and dairy component at least. Most swear they are eating better, but by what standards? All the highly worshiped theoretical models have all failed over and over again? “Eating better” has to include the net ingestion of a diet that is anti inflammatory and is as close to a ration of 1 to 1 Omega 6 fatty acids to Omega 3 fatty acids as is reasonably possible. The inflammatory high omega 6 diet will result in much the same problems occurring later that was being prevented through weight reduction. It is the core problem why all the diets and surgery fail in the long run for all the groups studied. The few anecdotal individual success stories do not support any of the present theories in any meaningful fashion.

One would have to ask; how many are developing heart disease in the absence of obesity? There is likelihood that chronic inflammation resulting from the diet, over time would result in the same damage to the body i.e. cardiac disease, osteoarthritis, cancer, diabetes, etc. as does obesity. Obesity is much more evident. Looking at the marathon runners with their high carb diets would be an interesting study. They will never be fat with their severe energy requirements. Could the physiological byproducts associated with running handle the highly inflammatory diet they celebrate ingesting? When the marathoners drop over dead to everyone’s great surprise, invariably the cause comes back as underlying heart disease. How much of has its beginning in their diet? If not diet, what? These people appear to lead a very healthy lifestyle except for maybe the amount of extreme exercise they subject their bodies too and of course their diet.

Strategy

       Diet, dietary supplements and activities/practices designed to decrease the generalized inflammation in the body, even in the presence of high levels of obesity. One of the goals is to get the Omega-6 to Omega-3 essential fatty acid ratio to 4 to 1. One to one (1 to 1) might be theoretically ideal, but first steps first. Evidence shows that a ratio of even 7 to 1, Omega 6 to Omega 3 fatty acids is beneficial.

Therapeutic Lifestyle measures to combat generalized chronic inflammation in the body

·         Design a diet that is net anti inflammatory and also has an increase in Omega-3 fatty acids (they usually go hand in hand but there are many exceptions).You do this through decreasing omega-6 ingestion and/or increasing omega-3 ingestion.

·         Supplementation; many times with high Omega 3 fatty acids with high EPA component will assist with decreased inflammation. Over the long run this will help with the next item.

·         Make sure there is enough Vitamin D and Vitamin K available. Supplement if necessary.

·         If diet is poor due to appetite or other, take complete vitamin supplement as needed.

·         Look for food and environmental allergies. Try to eliminate them.

·         Proper Sleep

·         Relaxation

·         Proper breathing (one of the most important and one of the simplest to address)

·         Diminished stress

·         Diminished anger

·         Promote love of self and self worth. Help someone else.

·         Other people and/or animals in your life

·         Mild (very low impact) kinetic exercise to stimulate the mechanoreceptors

·         Weight reduction if that is a problem

·         Belief in a higher being, Intercessory Prayer where appropriate

·         Promote activities that produce Endorphins such as visualization, imagery, meditation, Yoga, and related, etc.

Use of acupuncture, acupressure and potentially TENS to improve indigenous opiate production in the body and promote relaxation and pain modulation in a natural way that diminishes or eliminates drugs for same. The kinetic exercise will aid this area greatly and can be as simple as using a rocking chair for 30 minutes daily and/or other times (very powerful