Nutrition & Chronic Illness

The importance of nutrition should never be understated.

Throughout evolution, human beings adapted to a wide range of naturally occurring foods. But the types of food and the mix of nutrients (in terms of carbohydrates, fats, and proteins) remained constant. Food supplies were often precarious, and the threat of death from starvation was a constant preoccupation for most early humans.

However, about 10,000 years ago the agricultural revolution began making profound dietary changes in many human populations. The ability to produce and store large quantities of dried foods led to preferential cultivation of some foods, such as grains, which constituted new challenges to the human digestive system. Then, about 200 years ago, the Industrial Revolution introduced advances in food production, processing, storage, and distribution.

Recent technological innovations, along with increased material well-being and lifestyles that have allowed people more freedom in deciding what and when they wish to eat, have led to even further major dietary changes in developed countries.

Because changes in the dietary patterns of the more technologically developed countries, such as the United States, have been so dramatic and rapid, the people consuming these affluent diets have had little time to adapt biologically to the types and quantities of food that are available to them today.

The longer term adverse health effects of the diet prevailing in these countries — characterized by an excess of energy-dense foods rich in animal fat, partially hydrogenated vegetable oils, and refined carbohydrates but lacking in whole grains, fruits, and vegetables — have become apparent only in recent decades.

Because of the recent, rapid rise in chronic illness related directly or indirectly to diet, the focus of nutrition research has shifted away from eliminating nutritional deficiency to dealing with chronic diseases caused by nutritional excess. Another concern among nutrition researchers is the accumulation of evidence indicating that a less-than-adequate intake of some micronutrients, over a long period, may increase the risks of developing coronary heart disease, cancers, cataracts, and birth defects.

In recent decades, the data on the relationship between certain dietary habits and nutritional intake have been growing exponentially. Designing interventions based on this wealth of research has become increasingly more difficult and complex.

Dietary Supplements

The U.S. federal government’s approach to dietary intervention, formulated by boards composed of nutrition scientist, generally does not recommend supplementing the typical American diet with vitamins or nutrients beyond the recommended daily allowances (RDAs), nor does it suggest that some foods never be eaten.

In contrast, many alternative dietary approaches contend that no amount of manipulation of the typical American diet is enough to promote optimum health or prevent eventual chronic illness. These alternative approaches represent a continuum of philosophies ranging from the concept that supplementing the typical American diet somewhat beyond the RDAs is necessary to promote optimum health, to the idea that supplementation well beyond the RDAs is often required to reverse the effects of long-term deficiencies.

Other approaches advocate drastic dietary modification, either eliminating or adding certain types of foods or macronutrients, to treat specific types of conditions such as cancer and cardiovascular disease. Finally, there is the view that certain major staples of typical American diet, such as meat and dairy products, are basically unhealthy and should be generally avoided.

There is a growing body of data supporting the notion that the RDAs for mineral, such as calcium and magnesium, may be too low and that supplementation may be necessary to prevent the onset of chronic diseases. In addition, the RDAs for a number of vitamins and micronutrients, such as vitamin C, vitamin D, vitamin E, folate, and beta-carotene, may not be adequate to prevent chronic illness. For example, recent studies have found that the RDA for folate may need to be doubled for women as well as men.

Orthomolecular Medicine

Orthomolecular medicine-the therapeutic use of high-dose vitamins to treat chronic disease-promotes improving health and treating disease by using the optimum concentration of substances normally present in the body. Increasing the intake of such nutrients to levels well above those usually associated with preventing overt deficiency disease may have health benefits for some people. There is at least preliminary evidence that orthomolecular remedies may be effective in treating AIDS; brochial asthma; cancer; cardiovascular disease, heart attacks, and stroke; lymphedema; and mental and neurological disorders.

Alternative Diets

A variety of alternative diets are offered for treating cancer, cardiovascular disease, and food allergies. Virtually all of these interventions focus on eating more fresh and freshly prepared vegetables, fruits, whole grains, and legumes. Allergy to food has become a major area of research. Food intolerance is being studied as a causal or contributing factor in rheumatoid arthritis.

Some alternate dietary lifestyles are believed to offer a greater resistance to illness. These include several variations of the vegetarian diet, such as those consumed by Seventh-Day Adventists and proponents of the macrobiotic diet. Studies have found a significant lowering of risk factors for heart disease and certain forms of cancer in these two groups.

Recent studies have also reported that certain cultural eating styles, such as the Asian and Mediterranean diets, appear to lower risk factors for heart disease and certain forms of cancer as well. Although there have been few controlled studies of the benefits of many traditional diets, such as those originally consumed by Native American Indians, diseases such as diabetes and cancer were not a problem for these populations until their diets became more Western, or affluent.

Because dietary and nutritional therapy interventions affect an array of biochemical and physiological processes in the body, evaluating their effectiveness may require equally complex methods.

It is for this reason that the internet, which has swept the world, is taking on a greater role in educating the public. It is the intention of FOG magazine to have a regular column on Nutrition from reputable sources to help you cope with your chronic illnesses. It is expected that with proper knowledge, action, and your physician’s input, you will live a healthier and happier life.

Furthermore, developing a comprehensive health care policy that incorporates diet and nutritional interventions may require taking into account federal feeding programs and dissemination strategies that might present barriers to the effective propagation of adequate nutritional knowledge.