Why Nutrition Matters in Health and Disease

by John W. Cartmell, MS

Food And Nutrition
The body needs a constant supply of nutrients for normal structure and function. Protein, carbohydrates, fats, fluid and fiber are known as macronutrients and all are essential in a well balanced diet. Protein is needed for proper tissue structure and also as an energy source. Carbohydrates are used primarily for energy. Fats are used for padding, insulation, energy, hormones and proper cell membranes. Adequate fluid is needed to maintain hydration of all tissues; providing a liquid medium for the blood to carry nutrients to tissues and the kidneys to filter and excrete metabolic wastes or excess minerals. Fiber is needed for proper bowel function. (http://www.nal.usda.gov/fnic/). Micronutrients like Calcium, Magnesium, Manganese, Potassium, Phosphorous, and Vitamins A, D, C, E, and B-complex are needed in smaller amounts for skeletal integrity and proper metabolic and enzymatic processes. (http://www4.dr-rath-foundation.org/).

The food we eat is digested and absorbed into the blood where the nutrients are carried to all tissues to be metabolized and used for tissue structure or chemical energy. There must be a proper balance of protein, carbohydrates, fats, fluid and fiber for the body to operate normally. Adults should get 45 percent to 65 percent of their calories from carbohydrates, 20 percent to 35 percent from fat, and 10 to 35 percent from protein. Water recommendations for women are approximately 2.7 liters (91 ounces) of total water (from all beverages and foods) each day, and for men, approximately 3.7 liters (125 ounces daily) of total water. The recommended intake for total fiber for adults 50 years and younger is set at 38 grams for men and 25 grams for women; for men and women over 50 it’s 30 and 21 grams per day, respectively. (Institute of Medicine) 

Proteins come in two forms; complete and incomplete. Complete forms of protein are obtained from any kind of animal protein like, meat, fish, eggs or milk products. Incomplete forms of protein are obtained from plant sources and comprise three primary groups; nuts (usually encased in a hard shell), seeds (generally found in clusters), and legumes (generally encased in a pod like peas, beans and peanuts). Soy beans are a legume, but protein extracted from soy has enough of all the essential nutrients to be considered a complete protein (Concepts and Controversy). However potent enzyme inhibitors which block the action of trypsin and other enzymes needed for normal protein digestion raise legitimate concerns about consuming high amounts of soy protein on a regular basis. 

Complete proteins contain all the amino acids necessary to build human tissue and sustain life.  Incomplete plant based proteins lack one or more essential amino acids and must be combined with a different plant-derived protein group or with an animal-derived complete protein to ensure all essential amino acids are included in a meal or daily dietary intake. (Concepts and Controversy). Take for example a peanut butter sandwich made with whole grain bread. The essential amino acids lacking in the peanut butter are provided by the whole grain seeds in the bread, and the essential amino acids lacking in the bread are provided by the peanut butter. Eaten together they provide a complete protein. A glass of milk with the peanut butter sandwich would ensure the completeness of the protein.

Carbohydrates are found in two forms; simple and complex. Simple carbohydrates are typically sugars and are sweet to the taste. They are easily absorbed with minimal digestion and increase blood sugar rapidly. Complex carbohydrates are typically starches like bread, pasta or potatoes. They generally take longer to digest and tend to satisfy hunger longer than simple carbohydrates (Concepts and Controversy). 

Fats can be saturated (like butter; solid at room temperature), polyunsaturated (like corn oil; liquid at room temperature or refrigerated), or monounsaturated (like olive oil; liquid when at room temperature, but often solid when refrigerated). Fats are categorized further as to whether they are omega-6 (generally from warm climate plants like corn or safflower), or omega-3 (from cold climate plants like flax or cold water fish like salmon). Both are essential for health, but omega-6 fats are commonly found in the American diet in much higher amounts than omega-3 fats (Concepts and Controversy).

Fiber can be insoluble (as in bran) or water soluble and gelatinous (as in psyllium seed husks). Insoluble fiber provides bulk in the intestines and helps move food through the gut. Soluble fiber is important as a stool moisturizer and softener, helps lower blood cholesterol and decreases the rate of glucose absorption into the blood (Concepts and Controversy).

Fluid content in food varies with the type of food. Plain water is unique in that it contains no calories, natural or synthetic flavors, colors, preservatives or other chemicals found in juices, teas, coffee, milk or soft drinks. 

To ensure nutritional completeness with each meal one should ask the following: What is my source of protein; is it complete or incomplete?  What is my source of carbohydrate; is it simple or complex?  What is my source of fat; is it saturated or polyunsaturated, is it omega 6 or omega-3?  What is my source of fluid; is it water or other liquid?  What is my source of fiber; is it soluble or insoluble?     

Nutrition provides the raw materials needed for energy, structure and function of the organism. A proper diet should have adequate nutrients from a variety of foods, moderate in calories and balanced to include all nutrient groups without excess or deficiency (Concepts and Controversy). If the nutritional balance is insufficient to maintain or support health, it only makes sense that there will be a greater risk of developing disease. 

Nutrition and Health
The nutritional state of health is influenced by three factors; dietary intake, digestion and absorption, and metabolism of absorbed nutrients. Insufficiencies in any of these three areas can cause symptoms of malnutrition and diminished health. Thus, one can be “well fed” and eating a “good diet” and still be malnourished if the food in the diet is not being properly digested, absorbed or metabolized. 

If “Health” is defined as a state where all systems and organs are operating normally and in a proper balance with other organs and systems, then it can be said that proper nutrition is essential for optimal health and wellness along with adequate exercise, rest, stress management and minimal exposure to substances that are reactive or toxic. The loss of health is the single common symptom in every disease. Health should not be taken for granted but rather supported and actively promoted particularly in the face of disease.

Health Care vs. Disease Care
When you understand that all disease is associated with a loss of health, you realize that our “health care” system is actually more a system of “disease care” focused primarily on treating the symptoms of disease rather than actively promoting the restoration of health. Proper nutrition is important for the health of every form of life. If plants in your garden or home are looking weak or sickly, you first think of water and fertilizer; both essential nutrients. If you take your dog or cat to the veterinarian for any disease condition, the vet will invariably ask you about the animal’s diet. He understands the importance of proper nutrition in the health and health care of any animal. Yet if you go to your doctor with the exact same condition, he’ll likely suggest a drug. This is the difference between assessing the cause of disease and treating the symptoms; the difference between health care and disease care. 

Because adequate nutrition is essential for optimum health, an assessment of the diet and nutritional status should be routine in the work-up of any patient for any disease. But nutritional concerns are largely ignored in conventional health care, and whether a disease is caused in part or in whole by malnutrition is rarely considered.

Two examples from personal experience serve to illustrate the problem. My mother had diabetes and congestive heart in the mid 1980s. One night she called me in tears saying she had shortness of breath and pain in her heart, left arm and left side of her neck, classic symptoms of myocardial infarction (heart attack). I rushed her to the hospital emergency room where they did an electrocardiogram exam which indicated no heart irregularities. They recommended she be admitted her for observation. After three weeks of observation she was examined by a doctor specializing in internal medicine who diagnosed her with a hiatus hernia (where the top part of the stomach becomes displaced above the diaphragm), prescribed Tums as an antacid, and arranged for her discharge an hour later. The hospital bill was $20,000.00. 

I explained to her cardiologist that acid reflux from a hiatus hernia could be corrected in five seconds by simply having the patient lie on their back and exhale as far as possible to bring the diaphragm up as high as possible, and then gently pushing your fingers in below the sternum and pulling the stomach down into its normal position eliminating the pain and discomfort immediately. His eyes suddenly grew wide as he told me in a very serious tone that such a procedure was not approved by the American Medical Association (AMA) and he could get in a lot of trouble for doing such a manipulation (despite the fact that as a doctor he was qualified to do such a massage technique). Being a licensed massage practitioner, I would perform this technique whenever mother had chest pain and within a couple of minutes she would be symptom free, laughing and enjoying her favorite TV program.

A few years after my bone marrow transplant, I scheduled an appointment with a doctor for a routine physical.  The doctor reported that everything was normal except my triglycerides and cholesterol levels were elevated. She offered to prescribe a cholesterol lowering drug but I declined saying that I would make revisions to my diet. When I returned for a follow up exam two weeks later, my triglycerides and cholesterol were normal. She said she could still give me the drug if I wanted but since the problem had been resolved with diet I again declined. A week later I called and asked her nurse to pull my record and tell me which cholesterol had been high in the initial test; the good cholesterol or the bad. She said it was my HDL (good cholesterol) that had been high and that my LDL (bad cholesterol) had been normal. Prescribing a drug unnecessarily is no way to treat the healthy; I shudder to think how she treats the sick. I still take no medications and my health is better now than it was ten years ago when I had symptoms of fibromyalgia and chronic fatigue.

WASHINGTON (Reuters)  - About half of all U.S. women and 40 percent of U.S. men are currently using or have recently used a prescription drug, according to government statistics published Jan 12, 2006.

This "snapshot" of information was based on a survey that found that 54 percent of white non-Hispanic women and 43 percent of white non-Hispanic men had used a prescription drug in the past month, the National Center for Health Statistics said in a statement.

Fewer blacks and Hispanics used prescription drugs, according to the survey, done between 1999 and 2002.

Nearly 44 percent of black women and 35 percent of black men reported using prescription drugs and nearly 38 percent of Mexican-American women and nearly 26 percent of Mexican-American men, the survey found.

Despite the occasional use of complementary medical treatments intended to support health during the treatment of cancer, the standard treatments are still radiation, surgery and chemotherapy, all of which make the patient sicker while doing nothing to support the restoration of health or recovery from the stress of treatment. The fact that some cancer patients recover in spite of these conventional treatments is more likely a testament of the patient’s natural resilience than a validation of the treatment’s effectiveness in restoring health. It’s only logical that the treatment of cancer or any other disease should routinely include a conscious effort to support the restoration of health. But in a disease care system, bad medicine is good for business and good medicine is bad for business. If the patient is cured, it’s just the same as if they’ve died; they won’t be back for further treatment. This is not to question the ethics of the individual provider; but rather to acknowledge the business aspect of health care and the natural disincentive to promote health in the face of disease.

The 6-26-05 issue of the Seattle Times published a series of articles on the business of health care and how business concerns of medical venders are taking precedence over knowledge based scientific research, observations, and experience. (http://seattletimes.nwsource.com/html/health/sick1.html) By revising the definition of "disease" to include previously normal conditions, the number of patients needing treatment is being increased and the periods of treatment extended. According to the Seattle Times, hypertension was defined in 1999 as any blood pressure over 140/90, and “normal” was defined as 120/80. In 2003, a new classification defined any blood pressure with a systolic value of 120-139, and a diastolic value of 80-89 as “prehypertension”. Thus, the previously normal blood pressure of 120/80 has now been defined as prehypertension, a condition needing drug treatment intervention in hopes of preventing the progression of the “disease” to full blown hypertension. Yet no one knows for sure whether treating a “prehypertensive” blood pressure with medications will prevent a progression to hypertension; it’s only theoretical. Promoting health and wellness through good nutrition and a healthy lifestyle is likely to prevent disease more effectively simply because you can’t be sick if you maintain health

Codex Restrictions on Access To Nutritional Supplements:
The Codex Alimentarius Commission was created in 1963 as a subsidiary body of the Food and Agriculture Organization (FAO) and World Health Organization (WHO) of the United Nations. One of the objectives of the commission is to “harmonise” worldwide health standards, creating a global health policy. The Codex Alimentarius Guidelines for Vitamin and Mineral Supplements were proposed to set food safety requirements as a reference for the international trade of food, including dietary supplements (
http://www4.dr-rath-foundation.org/ accessed 6-25-05).

 The Codex Alimentarius agreement with the World Trade Association (WTO) creates trade standards that the WTO uses to resolve international trade disputes. The WTO currently has a total membership of 146 countries and the Codex standards are generally understood to be mandatory for all WTO Members. Because Codex standards are used by the WTO to resolve international trade disputes, countries who are WTO members can literally have Codex Guidelines and Standards forced upon them. Codex texts, guidelines and standards are effectively mandatory for all WTO Members. Because the WTO does not distinguish between guidelines and standards, and because the WTO uses Codex texts to resolve international trade disputes, a finalised Codex text would have the ability to override the dietary supplement laws of all countries - including the United States, despite its passing the Dietary Supplement and Health Education Act (DSHEA) in 1994 to protect the health food industry and sale of dietary nutritional supplements (http://www4.dr-rath-foundation.org/ accessed 6-25-05)..

 The European Union (EU), an intergovernmental trade organization of 15 European nations, passed The Food Supplements Directive (FSD) on 13th March 2002. Similar to the Codex Draft Guidelines for Vitamin and Mineral Supplements, its effect, when it becomes fully implemented on 1st August 2005, will be to remove large numbers of nutrient supplements from the EU market; set restrictive upper limits on the dosages of all nutrients permitted in the EU; and prevent the sale of all supplements for curative, preventative or therapeutic purposes within the EU without a doctor’s prescription. Because of the strength of the EU block-vote at Codex, the passage of the FSD has ominous implications for legitimizing the Codex Draft Guidelines for Vitamin and Mineral Supplements (http://www4.dr-rath-foundation.org/ accessed 6-25-05). 

Legal challenges to the Food Supplements Directive were struck down in July, 2005. The EU Food Supplements Directive is now essentially the blueprint for the Codex Guidelines for Vitamin and Mineral Supplements and the dismantling of the health food industry in Europe was expected to begin in August, 2005. As a result, thousands of vitamin and mineral supplements in Europe are expected to be outlawed or potencies severely restricted. Similar restrictions under the Codex Draft Guidelines for Vitamin and Mineral Supplements are expected to apply worldwide, including the United States if the Central American Free Trade Agreement (CAFTA) is passed by Congress (http://www4.dr-rath-foundation.org/, http://www.thenhf.com/newsflash_49.htm accessed 7-25-05).

 If such a dramatic restriction of dietary supplements actually occurs as feared, consumers will be less able to ensure the nutritional adequacy of their diets through the convenient use of vitamin or mineral dietary supplements and a proper balance of diet and nutrition will become even more important in promoting health in the face of fibromyalgia and other diseases.

© 2005 by John W. Cartmell

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