My approach to nutrition

 

The science on nutrition and health is advancing with enormous speed. Keeping up with it all takes a considerable amount of time and energy. I read hundreds of scientific papers each year as well as attending dozens of live and online seminars. One of the reasons I write a nutrition blog is to help me assimilate and link up some of the new information.

There are many popular diets that appear in the newspapers and get celebrity endorsements such as the Paleo, Zone, South Beach or DASH diets. These are often promoted in the media as weight-loss or ‘healthy’ diets and are often over-hyped one month only to be knocked down the next, leaving the public bewildered and sceptical. In my work as a clinician such a superficial understanding has no place and I certainly do not promote any one diet as a the Ideal. People are far too individual for that.

However, what few people realise it that behind the headlines some of these diets or aspects of them, have profound disease altering properties. Here are a few examples:

Diet NameProtocolTherapeutic function
MediterraneanBased around real foods inc. fruit, vegetables, nuts, fish, olive oilImproved metabolic and cardiovascular functioning. Associated with extended life. A basic healthy diet for everyone and the starting point for all the other diets below
KetogenicVery low carbohydrate, very high fatNeuroprotective. Used to treat intractable epilepsy, brain trauma, neurodegeneration and as an adjunct to cancer therapy. Role in mitochondrial conditions, endurance sports and diabetes.
AtkinsLow carbohydrateCan provide some of the benefits of the ketogenic diet but is less restrictive. May be used as a follow-on diet for recovering epileptics and diabetics.
Gluten-free,
Grain free,
Pulse free
Zero gluten / zero grains of all kinds / zero beans and legumesCan help in immune and autoimmune conditions which may involve digestive, skin, joints and/or neurological problems
Casein-free, Dairy-freeZero milk productsAs for gluten-free. In mild cases switching from cow to goat and sheep products can be enough.
Omega 6/3 balancingReduced use of vegetable oils, increased fish, grass-fed meat, flaxseedHelps in inflammation, reproductive disorders, brain development.
OrganicLow pesticide and chemical residue dietRecommended in all the above diets. Specific in cases where environmental toxins have been identified as problematic
PaleoNo grains, pulses, dairy. Eat pasture raised meat, fish, eggs, berries, vegetablesIncorporates many of the above, but carbohydrate levels are more flexible
GAPSElimination diet often starting with bone brothAn approach suitable for autism spectrum and other conditions that involve the gut-brain axis. Also effective in difficult cases of Crohn’s and ulcerative colitis.
Anti-candidaNo sugar, low carbohydrate. Probiotics and anti-candida herbsIncorporates many of the above, but carbohydrate levels are more flexible

Despite having their own names these diets are not used in isolation and often a combination of several diets will be necessary. For example a gluten-free diet consisting of gluten-free bread, cakes and biscuits, will have a very different effect to a gluten-free Mediterranean diet based around fresh ingredients.

As well as the named diets above I use foods with specific actions in the following:

  • Increasing or decreasing intestinal fermentation (e.g. FODMAP, probiotic, prebiotic)
  • Altering gut permeability
  • Reducing histamine levels
  • Increasing antioxidant status
  • Increasing liver or gall bladder function
  • Altering methylation pathways and gene expression (epigenetics)
  • Addressing specific mineral or vitamin imbalances

My dietary recommendations will depend on the individual condition, symptoms and background, and can be informed by lab tests (e.g. genetic testing, organic acid test and food reactivity tests). In some cases lab testing is crucial if dietary changes are to be effective. In some situations nutritional supplements and herbal medicines have a clear role alongside diet.

The term ‘doctor’ originally meant ‘teacher’, and in making dietary recommendations for my patients I spend considerable time explaining the reasons behind the changes. Knowledge, as they say, is power. Empowering patients is what it is all about and is why I run workshops and talks.