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What type of insomnia is it when you struggle to fall asleep?
Sleep ONSET insomnia
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What is HyperTROPHIC obesity?
- Increase SIZE of fat cells
- *Think LARGE TROPHY
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What is HyperPLASTIC obesity?
- Increase in the NUMBER of fat cells
- Think of millions of plastic bottles*
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What type of insomnia is it when you fail to stay awake or keep waking up?
Sleep MAINTENANCE insomnia
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What therapeutic recommendations would you make for constipation?
1) Increase fluids, minimum 2L per day
2) No dieuretics
3) Increase fibre intake
4) Natural laxatives - prunes, figs, apricots
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What are the complications of constipation?
Haemorrhoids
Anal fissures
Rectal prolapse
Loss of bladder control (because of weakening pelvic floor muscles due to straining)
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What medications may cause constipation as a side effect?
Iron supplements
Antacids
Antidepressants
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Give 4 risk factors for constipation
1) Low fibre intake
2) Low fluid intake
3) Lack of exercise
4) IBS
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What medications may cause constipation as a side effect?
Iron supplements
Antacids
Antidepressants
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Why might constipation become severe?
Severe cases may result from fecal impaction which can cause diarrhoea, ulceration of the colon and intestinal obstruction.
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What is the definition of constipation?
A condition in which there is difficulty in emptying the bowels, usually associated with hardened faeces.There are issues of quantity and quality - hard painful stools, difficulty evacuating, straining during defecation.Frequency may range from several a day to once a week.
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List 5 functions of iron
1) Energy carrier
2) It is part of several mitochondrial electron transport proteins required for ATP production
3) It is a cofactor for an enzyme in the citric acid cycle
4) Powers a step in gluconeogenesis
5) Plays a role in the function of certain neurotransmitter amines
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List the nutrients that are essential for mitochondrial function
- Acetyl-L-Carnitine (or N-ACetyl-Carnitine)
- Alpha Lipoic Acid
- CoQ10
- Magnesium
- B Vitamins
- Essential Fatty Acids
- Antioxidants
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Name four types of herbal preparations
1) Infusion
2) Decoction
3) Glycerite
4) Tincture
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This type of obesity is related to diabetes, high BP and other serious metabolic disorders.
Usually the fat distribution is around the WAIST.
It is usually referred to as male-patterned obesity because it is typical in obese men.
hyperTROPHIC obesity
*Think large trophy around the waist
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This type of obesity is related to the diet of the mother while the person was still in the womb and an excess of calories in early infant nutrition.
hyperPLASTIC obesity
*Think of a baby playing with lots of plastic bottles
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What are Metallothioneins (MTs)?
Intracellular, low molecular weight, cysteine-rich proteins.
They have metal-binding and redox capabilities.
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What are the most widely expressed isoforms of metallothioneins (MTs) in mammals?
Where are they commonly found?
MT-1 and MT-2.
They are rapidly induced in the liver by metals, drugs and inflammatory mediators.
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Which brain isoform of metallothionein (MT) has a specific neuronal growth inhibitory activity and is an appetite suppressant?
MT-3
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True or false: Metallothioneins hold a role in Zinc homeostasis
TRUE
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Which heavy metal in particular can MTs protect against?
Cadmium (Cd)
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What is the Portfolio diet? (Cardiovascular)
- The Portfolio diet is a recognised dietary
- approach to lowering cholesterol. It involves a
- combination of plant sterols/stanols, almonds, plant fibres and soya protein alongside regular physical activity.
It is largely a vegetarian diet.
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What would a portfolio diet typically involve? (broadly speaking)
Low Salt
Low Sat Fat
High Fibre
High Fruit & Vegetables
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What is a plant sterol and a plant stanol?
Substances that occur naturally in small amounts in many grains, vegetables, fruits, legumes, nuts, and seeds.
They have powerful cholesterol-lowering properties.
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What would a portfolio diet typically involve (specifically speaking)?
Plant Sterols & Stanols - 2g day
Almonds - 30g day (about 23 almonds)
Soluble fibre - 20g day
Soya Protein - 50g day
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What is the Methylation diet? (nutrigenomics)
1) Methionine-rich foods:
broccoli, mushrooms, cauliflower, bean sprouts
2) Folate-rich foods:
spinach, turnip greens, sunflower seeds
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What is methylation?
Methylation uses the process of donating a methyl group to a substrate.
A methyl group = 1 carbon bound to 3 hydrogen
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What are some functions of methylation?
1) Gene regulation (turn genes on and off)
2) Biotransformation (process chemicals and toxins
3) Important for metabolism of neurotransmitters, hormones, drugs and xenobiotics
4) Build neurotransmitters (dopamine, serotonin, adrenalin)
5) Process hormones (oestrogen)
6) Build immune cells (T cells and NK cells)
7) Produce energy (CoQ10, carnitine and ATP)
8) Myelination (produce protective coating on nerves)
9) DNA and RNA synthesis
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What is the cross-reactive antigen theory?
Antigens (i.e. toxin or foreign substance) on certain pathogens may have determinants which cross-react with self antigens (i.e. antigens that are part of the human body) and an immune response against these determinants may lead to antibodies against tissue antigens.
An example of cross-reativity is an association between klebsiella + ankylosing sponylitis.
In summary, Cross-reactivity applies to the reaction between two different species.
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What is the highest food source of N-Acetyl-Carnitine?
Red meat
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What is a food source of Alpha Lipoic Acid?
Red meat
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What does the methylation process require?
Uncooked leafy greens
Functional enzymes
Available receptors
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Why is folate important for methylation?
It is an essential micronutrient that is a critical cofactor in one-carbon metabolism.
We cannot synthesise folate and must rely on supplementation.
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What is the aetiology (cause) of SLEEP ONSET INSOMNIA?
- Climate
- Anxiety / Fears
- Stimulants
- Pain
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What is the aetiology (cause) of SLEEP MAINTENANCE INSOMNIA?
- Hypoglycaemia
- Sleep apnoea
- Medications
- Alcoholism
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What therapeutic recommendations would you make for insomnia?
Darken Room - draw curtains and reduce light
Avoid Midday Naps
Ensure bedding and mattress is comfy
Maintain neurotransmitter levels - nutritional precursors and co-factors
Remove EMF sources in bedroom
Herbs e.g. ashwagandha, valerian to promote healthy sleep cycle
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Give 5 major functions of the liver
1. Detoxification
2. Normalisation of blood fats
3. Synthesis and normalisation of blood proteins
4. Manufacture of bile
5. Synthesis and storage of glycogen.
-
Define liver detoxification
The biotransformation of a fat-soluble (lipophilic) compound, not able to be excreted in urine or bile, into a water soluble compound.
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Which group of enzymes are needed in Phase 1 detoxication ?
Cytochrome P450 enzymes (CYP450)
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Give 4 Phase I Liver Detox Inhibitors
Curcumin
Watercress
Garlic
Echinacea
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Give 4 Phase I liver detox Inducers
Alcohol
Nicotine
Caffeine
Stress
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List some nutrients to support phase I detoxication
Turmeric - provides antioxidant support to neutralise free radicals produced in Phase I detoxication
Cysteine, glycine, glutamine, vit C = all precursors for glutathione production, which counteracts free radicals produced in phase I detoxication.
Vitamin A, E, Zinc, Selenium, Magnesium - Antioxidant nutrients to counteract and neutralise free radicals produced in phase I detoxification.
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List some nutrients to support Phase II detoxication
Cysteine, Glycine, Glutamine, Vit C - supports glutathionation pathway and glutathione production
Magnesium - supports glucoronidation pathway
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What is required for phase III detoxification?
GLUTATHIONE
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Antioxidants can divided into the 3 following groups. Please list:
1) Antioxidant Enzymes
2) Chain Breaking Antioxidants
3) Transition Metal Binding Proteins
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What is the 4 R Programme?
A comprehensive approach for the normalisation of gastrointestinal function:
1) Remove
2) Replace
3) Reinoculate
4) Repair
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Give a food source of Arachidonic Acid
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