THE SCIENCE OF NUTRITION SERIES

Lecture 8 – Dietary Approaches Part 2 1

THE SCIENCE OF NUTRITION SERIES

LECTURE 8 – SON

DIETARY APPROACHES – PART 2


CONTENTS

INTRODUCTION - THERAPEUTIC DIETS

DETOXIFICATION DIETS

FASTING

ALLERGY EXCLUSION DIETS

LOW-CARBOHYDRATE DIETS

PRITIKIN DIET

HIGH-FIBRE DIET

THE GERSON DIET

LOW-SODIUM DIET

LOW-POTASSIUM DIET

REFERENCES


INTRODUCTION - THERAPEUTIC DIETS For the most part, the dietary approaches discussed in booklet 1 of this module are

used as every-day, long-term diets to maintain good health. The diets we will discuss

next are termed ‘therapeutic’ because they are typically done for a short period to bring the body back to balance, or to reverse adverse physical symptoms.

The therapeutic diets we will be discussing include: Detoxificaion Diets

Fasting

Allergy Exclusion Diets

Low-Carbohydrate weight loss diet

Pritikin Diet

High fibre diets

The Gerson Diet

Low-sodium and Low-potassium diets

DETOXIFICATION DIETS In your Nutrition Physiology I module, we discussed the process of detoxification. By

now, you should have a general understanding of the relationship between toxic

burden and disease in our bodies (I f you would like a review of this, refer to: Nutr.

Phys. Part 1, booklet 2). We remember that the liver is the key organ of

detoxification, and that other organs contribute as well. The liver’s role is to chemically alter toxins to make them more water-soluble. These toxins are then

excreted through the urine or faeces. Other avenues of elimination include the lungs

and skin

The detoxification system works by eliminating toxins through:

1. Neutralizing them (by chemical modification)

2. Excreting them v ia urine, faeces, lungs and skin.

The primary organs involved are the liver, intestine and kidneys. Other

tissues include the skin, lungs, lymphatic system and gall bladder.

Good health is maintained by consuming a diet that balances building foods (like

protein foods) and cleansing foods (like high-fibre vegetables). Each day we can

consume a balanced variety of these food types. There are also larger cycles

where we might do more building (say in the winter time) or more cleansing (in

the summertime). By honouring these natural cycles, the body can stay both

well-nourished and free of excess toxins.

At certain times, it is helpful to focus on the detoxification process. This is most

commonly done at the change of each season, particular the spring and autumn

equinox. There are a variety of books and methods of detoxification. Generally,

a detox diet can be as simple as cutting out the junk and increasing fluids,

nutrient-dense and high-fibre foods. It is safe for all people to follow, if one

modifies it to their needs.


Why do a detox? One may choose to do a detox diet after a

period of poor eating habits, excessive

drinking or during a transition point in their

lives. There are times when all of us feel the

effects of not-so-healthy liv ing and feel we

need a good clean out.

When a detox diet may not be a good idea

As an individual or a health professional, it is important to know when NOT to advise

a detox diet.

Eating disorders: Some individuals have eating disorders where they are very

restrictive with their foods (such as anorexia nervosa). Imposing a detox diet

may simply re-enforce their restrictive behaviour and may not be appropriate

at the time. Others who suffer from compulsive/binge eating may find a

detox very calming and focusing.

Pregnant and lactating women need to be cautious about taking on a detox

diet. Not only do they have increased nutritional needs, but when toxins are

released, they can harm their child. It is highly advised for a woman to follow

a detoxification programme some months BEFORE conception. However, she

will still benefit from a moderate detox programme which simply excludes

harmful chemicals, sugar and junk foods and includes more water, fibre, fruits and vegetables in her diet.

Examples of how detox diets can vary

For a robust person: Follow the detox guidelines and rely solely on plant

protein sources to minimise build-up from excess protein. Also avoid saturated

fat and include lighter fats such as olive oil, avocados, nuts and seeds.

Consider a fast.

For a more deficient person: Follow the guidelines, but don’t restrict your intake. Include a moderate amount of building foods such as fish or organic

chicken each day. Also, include more cooked foods than raw foods.

There are common threads of a good ‘detox’ based on what we know about how our body eliminates wastes.

Indications that it might be time to

detox Skin eruptions

Constipation

Poor digestion

Excess gas

Bad breath

Achy joints

Low energy

Headaches

Insomnia

Fuzzy head

Lack of concentration


A good detoxification regime

Restricts toxic chemicals such as alcohol, caffeine, drugs, additives and

preservatives.

Minimises or restricts heavy building foods such as red meat, other animal

proteins, dairy foods and eggs.

Minimises or restricts hard-to-digest foods such as wheat and refined grains

Restricts sodium, sugar and other sweeteners.

Includes adequate fluids to help flush toxins from the body

Includes adequate fibre to promote bile excretion and support colon

microflora

Emphasises moderate exercise to promote lymph circulation, oxygenation of

the lungs and sweating.

Emphasises other detoxification support methods such as colonics, fasting,

massage, nutritional and herbal support.

In order for the to rid itself of toxins, one must

Get the toxins from cells to the liver/kidney which requires physical movement

to move lymph (exercise, massage)

Provide the liver with adequate nutrients in order to process all the toxins (see

Detoxification section in Nut Phys I )

Have good bile secretion and bowel function (fibre, fluids, exercise, moderate

fat intake, herbal support)

Drink enough water to provide the medium through which the kidney can

release toxins.

Common side effects of ‘detoxing’

Headaches

Insomnia

Sensitivity to cold

Diarrhoea

Skin rashes

Feeling ‘flu-ish’ or tired

These can all be the side effects of your body eliminating toxins. Rest, warm baths, and extra attention to the process can help support you until they subside. They

shouldn’t last more than 3 days.

A detox is best done for 5-30 days. Often it is desirable to fast at some point during

your detox. While the detoxification process is slow and steady, providing

nourishment for your liver while supporting the elimination process, a fast will speed

things up a bit. After at least 3 days on a ‘detox diet’, a 1-3 day fast will expedite the

mobilization of toxins from your cells and their elimination.


FASTING

Fasting is often associated with restriction and weight-loss. In a fast we deprive

ourselves, giv ing it a negative feeling. People often comment that when

undergoing a fast with a positive attitude, say when on a meditation retreat, they

feel nourished in deep way, rather than deprived. Religions such as Christianity,

Judaism and Eastern religions have encouraged fasting for a variety of reasons,

such as penitence, preparation for ceremony, purification, mourning, sacrifice and

union with god and the enhancement of knowledge and powers. The Essenes

believe that our body – our temple – must be purified for God to reside there.

But from a physiological perspective, Elson Haas, in his book Staying Healthy

with Nutrition, writes that ‘Fasting is the single greatest natural healing therapy.’ Indeed, fasting is used by all the ancient

healing traditions. Today, fasting can be

a marvellous tool with diseases of excess,

characteristic of our overconsuming

society. Physically it can reduce the toxic

load in our bodies. Equally as important,

it helps make us aware of our relationship

with hunger and food. Drs Murray and

Pizzorno state that fasting is one of the

quickest ways to increase elimination of

wastes and enhance the healing

processes of the body. Although

therapeutic fasting is one of the oldest

known therapies, it has largely been ignored by the medical community.

Paul Pitchford discusses fasting and purification methods at length in ‘Healing with

Whole Foods’. He reminds us that the word ‘fast’ itself indicates an important feature of a fast. It signifies a speeding up of the cleansing and renewal process

by slowing down the normal digestive routine.’ In this section, he rates some more gradual fasts which include some solid foods. Take a look at this section, in

particular note indications for recommending one type of fast over another.

Supportive reading: Review Fasting in Healing with Whole Foods

Fasting is a tool in detoxification. A true fast

restricts solid foods and takes water only. But

many feel that juice fasts are safer, and

possibly more conducive to detoxification, as

they can provide nutrients essential for the liver.

Animals instinctively fast when they are sick.

Often young children will refuse food (much to

the confusion of their parents) as they sense the

onset of illness.

Fasting as a Spiritual Tool Fasting is commonly used in spiritual

traditions. In yogic traditions, fasting is

used as a method of ‘tapas’. Tapas (a

sanskrit word) is thought of as creating

heat, burning up impurities, purification,

single-minded focus. In the Yoga-Sutras

of Patanjali, fasting is thought to teach us

why we eat. It teaches us that it is not

food we crave, but comfort. By fasting,

they say we are encouraged to look not

outwards towards food for this comfort,

but inwards to our deeper Self, or towards

‘God’. Buddhist traditions such as Vipassina use it to enhance our

awareness/mindfulness during some of

our most commonplace activities.

PCB Detoxification American Journal of Industrial

Medicine in 1984 reported a study in

which patients who had ingested rice

oil contaminated with

polychlorinated-biphenyls (PCBs)

found ‘dramatic’ relief after undergoing seven-to-10 day fasts.

Thus indicating its power in promoting

detoxification.


Benefits of fasting

Acts as a catalyst for change

Supports a greater awareness and mindfulness (spiritual and otherwise)

Blood and lymph can clear toxins from tissues

Liver can spend more time detoxifying stored toxins when it’s not dealing with the process of digestion and absorption of food.

Increases release of toxins from the colon, kidneys, lungs and skin.

Fasting can be done unsupervised for up to 3-5 days. Many do longer fasts, but

these must be monitored for safety. Many people experience a ‘healing crisis’ during which old symptoms may reoccur, or new detoxification symptoms may

appear. They usually last 2-4 days and as long as they do not worsen, are not

problems other than the discomfort they cause. Watch for severe symptoms such as

fainting, heart arrhythmias or bleeding.

Fasting may be beneficial for the following conditions Colds

Flu

Bronchitis

Headaches

Constipation

Indigestion

Diarrhea

Food allergies

Environmental allergies

Asthma

Insomnia

Skin conditions

Arteriosclerosis

Coronary artery disease

Hypertension

Diabetes

Fever

Fatigue

Back pains

Mental illness

Obesity

Cancer Source: Staying Healthy with Nutrition by E. Haas

When to fast The natural times of fasting are spring and autumn. In Traditional Chinese

Medicine, fasting is recommended the ten days before and after the equinox.

Fasting can be difficult for the body in cold weather, so in colder climates, one

may want to shift the times slightly towards the warmer season. Alternately, some

do short (one day) fasts on a regular basis (fortnightly or monthly) or when on

retreat to support a meditation practice.


How to fast

1. Phase one: Preparation and simplification. To keep the actual fast from being

so intense, and to minimize the healing crisis, one would do well to eat a pure,

healthy diet for a few days (like a ‘detox diet’). Avoid chemicals such as alcohol, caffeine, preservatives and heavier foods such as red meats, milk

products and eggs and increasing the amount of fluids, fruits and vegetables.

This begins a slow, nourishing detoxification process. Do this for at least 3 days

prior to fasting (longer if regular diet is particularly unhealthy).

2. Phase two: Fasting. This can be just water or a juice/broth of some type. Most

people do well to start with a one-day fast. Then subsequently (the next

season) do 2-3 days, working up to 5 days if they wish. This period is best done

when not involved in normal activ ities like working. I t is an ideal time for

reflection, meditation, exercise, massages and house cleaning projects.

3. Phase three: Breaking a fast. I t is important to make a gradual transition to a

regular diet, rather than planning a great feast on pizza and ice cream on

your first day off your fast. One can become very sick by overeating after a

week-long fast. Take a day or two to eat simply and minimally, going slowly

to allow your digestive system to readjust to food again. After a water fast,

start with juices and broths. With juice fasts, start with simple vegetable dishes

or fruits. The next day, move to well-cooked grains such as brown rice or

millet with vegetables.

Support during a fast

It is important to support the body and soul

during a fast. The liver detoxification process

needs support, which may require a

supplement. Some feel it helps to promote

bowel function, and recommend a fibre

supplement. To encourage the movement of

toxins around the body and out, one can

engage in activ ities like light exercise, massage,

dry skin brushing, colon irrigation. For the soul,

keep focused. I t’s best not to plan a hectic schedule during a fast, but stick to single

minded projects, and mindfulness/meditative

practices.

Fasting in Ayurvedic Medicine Vasant Lad, a well regarded

Ayurvedic physician and author of

books like Ayurveda, the Science

of Self-Healing, notes that people

should take their individual

constitutions into account when

planning a fast. In Ayurveda,

people will exhibit one or more

predominant ‘doshas’ which determine their constitution. Some

will flourish on long fasts, and

others must stick with shorter fasts.

Ayurveda also recommends herbs

and spices which have hot and

spicy attributes (like ginger, black

pepper and cayenne pepper)

help to kindle the agni, or

digestive fire and burn impurities.


Ideas for support during a fast

Hazards of fasting

If overused, can create depletion and weakness, lower resistance.

Can temporarily lower thyroid levels

Female sex hormones may drop (with prolonged fasting), resulting in

delayed menses or amenorrhoea.

Cardiac arrhythmias can occur with prolonged fasting

When not to fast

Malnourished people should not fast. This includes overweight people who

are undernourished.

Those with fatigue resulting from nutrient deficiency (iron, B12, folic acid

related anaemia)

Those who are underweight

Pregnant or lactating women

Weak hearts (those with CHF)

Weakened immunity

Before or after surgery

Cancer patients who are experiencing wasting

Low blood pressure (may cause dizziness)

Cold weather (may not be a good time to fast)

Take multi v itamin/mineral

Vitamin C 1g 3x/day

1-2 Tbls fibre supplement at night before bed

Silymarin (milk thistle) at 70-210 mg 3x/day

Light exercise like walks or stretching

Massage, colon irrigation, dry skin brushing

Fresh juices

Extra rest

Lots of fluids

Meditation/mindfulness practice


ALLERGY EXCLUSION DIETS

If you remember back a few modules to our study of food intolerances, we discussed

the use of an elimination diet as a method for determining which food(s) an

indiv idual was intolerant to. If you want a bit of background information, please

review that section, as well as the section on the General Adaptation Syndrome.

Background reading:

Nutritional Physiology Part 1 (book 2): Food Intolerances and elimination diets (p. 20)

Nutrition Physiology Part 2 (book 1): General Adaptation Syndrome (p. 14)

It can be very tricky to discern which foods (if any) are causing us to have

migraine headaches or other complaints. Often, people will attempt to figure it

out by avoiding the food for a few days or weeks to see if they have any

symptoms. However, we are usually not so strict, or do not know what categories

of foods to suspect in these cases. So our experiments, lacking in rigor, fail to give

us satisfactory answers. Often we just go back to the same old foods, or worse,

avoid all foods we suspect and live our lives in fear of wheat, dairy, citrus, peanuts

and other perfectly healthy foods.

Like it says in the tin, an exclusion diet is a diet which excludes one or more types

of food. These are done for one of two reasons, generally. Either to identify a

food which is causing an individual some problems, or to avoid a food which

someone has already identified as harmful. A ‘hypoallergenic’ diet refers to a diet which excludes the major food ‘allergens’. That is, the foods which most commonly cause people health problems.

The top 7 ‘food intolerance’ culprits include: Wheat

Other gluten grains

Dairy (cow’s milk products) Soya

Citrus

Corn

Eggs

The most common exclusion diet used by nutritionists is an elimination diet. I t is

done when a person is exhibiting symptoms related to food intolerance and wants

to identify the precise foods causing them trouble. Quite often, the symptoms

associated with food intolerance do not appear immediately after consumption,

but appear hours or even days later. Sometimes symptoms only appear after

enough of the offending food is eaten, so one egg may be fine, but 2 would bring

on symptoms. This makes it hard for the individual to assess the situation on their

own.


Symptoms and Diseases Commonly Associated with Food Intolerance

Mouth Ulcers

Celiac disease

Chronic diarrhea

Gastro-oesophageal reflux

Duodenal ulcer

Irritable bowel syndrome (IBS)

Ulcerative colitis

Bed wetting

Chronic cystitis

Chronic infections

Frequent ear infections

Hyperactivity

Depression

Poor concentration

Joint pain

Migraines/other headaches

Eczema

Hives

Acne

Skin rashes

Oedema

Fatigue

Chronic stuffy nose

Sinusitis Source: Modified from Encyclo. of Nat Med, by Murray and Pizzorno.

The elimination diet works on the premise of the General Adaptation Syndrome

(GAS). I t assumes that our bodies have adapted to the stress of the offending

food and if we want to examine the effects of said food, say cow’s milk, we need to completely abstain from it for a period of time in order to re-sensitise our

systems. Once symptoms have abated, and sensitivity is restored, one can

challenge with suspect foods. The process looks like this.

Stage 1: Elimination. Eliminate all suspect foods. This should also include refined sugar, alcohol, caffeine, nicotine (if possible), recreational drugs and additives, as

they stress the body. This stage is done for 2-4 weeks. Ideally, symptoms should be

gone (or significantly reduced) for 5 days prior to the challenge phase.

Note: The elimination diet tends to trigger detoxification in many people. After a

few days of such a pure diet, the client may experience ‘detox’ symptoms which can resemble withdrawal symptoms, PMT or the flu. This is extremely common,

and can cause phase one to last up to 4 weeks! One way to deal with this is to

start with a pre-elimination phase where one does a bit of a ‘detox’ diet, or just eat more healthfully, restricting alcohol, caffeine, additives and sugar and eating

more fibre and vegetables. After 1-4 weeks of this, they may do a more strict

elimination phase, which will be shorter than if they hadn’t had the ‘detox’ beforehand.


Stage 2: Challenge. In this stage, the person challenges with one pure

food substance for 3 days, or until

there is a reaction. Pure food means

only one ingredient. For example, to

challenge wheat, you would use

bulgur wheat or 100% whole-wheat

noodles, rather than bread, as bread

may contain a variety of other

ingredients. Individual foods are

challenged one-at-a-time, and a

thorough diary is kept of what is

eaten, challenged and all possible

symptoms (including energy, moods,

bowel activity, digestion, skin

reactions, headaches, muscle pain).

The reaction is often not the original

complaint (i.e. a person who gets

migraine, may react with an unusual

skin rash instead).

Stage 3: Revise diet to avoid offending foods. This is a critical step. Often, when a person simply goes

in for blood tests or ‘food allergy testing’ they are told what to avoid, but not how to rebalance their diet. Here, the professional educates them on how to best

avoid the offending food and how they might plan their meals in order to achieve

balanced nutrition without. This is because the offending food is often frequently

consumed and a major macronutrient source.

Stage 4: Try the food again. Quite often, the food which once caused us so much trouble can be

reintroduced back into the diet. Usually, it has to be in small amounts. But once

the gut has healed and the body has found a better place of balance, the

offending food can come back in, allowing the individual to be more flexible in

situations such as holidays, eating our or travelling. Some recommend a ‘rotation diet’ to desensitise the individual to the food. This is beneficial to many. (Examples

of 4-day rotation diets can be found in Encyclopedia of Natural Medicine, by

Murray and PIzzorno)

All four stages are very important, so it is advisable to make a series of appointments

at each transition for the client to receive feedback and guidance.

The importance of keeping a DIARY This is critical for the whole process. Best

begun in stage 1 to assess the level of

original complaint. We tend to have a very

poor memory. It is fictional on a good day,

ESPECIALLY when it comes to what we ate or

how we felt a few days ago. By keeping a

diary, the individual (and nutrition

professional) can more objectively look

back and make connections between food

and symptom. Without it, the nutrition

professional only has the memory of the

client to base their recommendations on. In

stage 1, a general diet diary is kept with

more emphasis on undesirable symptoms,

bowel activity and activities. In stage 2,

challenge food is included, and a general

list of other foods eaten. Sometimes

symptoms could be complicated by skipped

meals, excessively heavy meals or stressful

life situations.


Benefits When done under supervision and followed to the end, this can provide people

with a clear method to evaluate the effect of foods on their health. It can avoid

the common problem of people self-diagnosing food sensitivities and coming to

fear all foods unnecessarily.

Drawbacks Even when done to the letter, the results are sometimes not crystal-clear. Often, a

food must be challenged twice to be sure the reaction wasn’t due to someth ing

else. This is why the diary is so important. It allows the individual AND the

practitioner to look back with better objectivity to see how the body responded to

foods. Also, this process can take from 4-8 weeks. This is a significant amount of

time to have a restricted diet, particularly if one is avoiding and challenging a

number of different foods. A sincere commitment must be made and support

given by the practitioner and family members or the efforts will be in vain.

Different types of exclusion diets may avoid the following food groups:

Resources for these diets include books by Elson Haas, ‘The False Fat Diet’ Dr. Alan Gaby

Suzanne Meyer

Brostoff and Gamlin, Food Allergy and Intolerance

Murray and Pizzorno, Encyclopedia of Natural Medicine.

Main food allergens: wheat, other gluten grains, dairy, eggs, soya, corn, and

citrus.

Additional foods:

Vasoactive amines/tyramines: These compounds are culprits in triggering

migraine headaches and rosacea. Food sources include: Red wine, aged

cheeses, aged meats, chocolate, dried sausages, and smoked fish.

Salicylates: Salicylates are a very common component of many plant foods.

Salicylic acid is the active component in aspirin, and is considered generally

beneficial in foods, connected with lower cancer rates and anti-inflammatory

actions. However, some feel excessive amounts of this compound can lead

to headaches and joint pains. Foods high in salicylates include: Peppermint,

black tea, most spices, licorice, honey, port, rum and wine. Most people find

that if they ARE sensitive to salicylates, they can still eat foods which contain

them, they just have to find their threshold and avoid over consumption. The

challenge for this substance is usually pure aspirin.

Yeast-containing foods: Breads and bread products, mushrooms, cheeses,

vinegars (most pickles and condiments), beer, wine, Quorn and tempeh.

Peanuts, or other nuts eating regularly.

Beef, chicken, shellfish. Any food you eat every day or have cravings for.

Caffeine, alcohol, sugar, food colourings and artificial preservatives.


LOW-CARBOHYDRATE DIETS

The low-carb diets have seen massive popularity between 2000-2004. The man who

made this method so popular was Dr. Robert Atkins, who first published these ideas to

the mainstream in 1992. His method, called ‘The Atkins Diet’, is based on the basics of carbohydrate metabolism and the actions of insulin.

Principles of the Atkins diet

When we eat a carbohydrate containing food, our bodies produce insulin in

response.

Insulin is an anabolic hormone which facilitates the storage of fat/energy.

Only in the absence of insulin, can we release stored fat and oxidize it.

Therefore, if we avoid (or minimise) carbohydrate foods, we reduce our

insulin secretion and promote ‘fat burning’.

The Atkins diet Stage one is characterised by strict avoidance of carbohydrates, and the

induction of ketosis. This creates an acidic environment for the body, but forces

the body to utilize stored fat for energy. Stage two allows for small increases in

carbohydrates which control how much insulin is produced. Generally, the Atkins

Diet does not place much emphasis on food quality. I t is mainly concerned with

how many grams of carbohydrate are in a food.

Other low-carb diets

Other popular low-carb diets have been ‘The Zone’ by Barry Sears, ‘The

Schwarzbein Principle’ by Diana Schwarzbein, and ‘The South Beach Diet’. They all use similar principles, with variations in their approaches. Diana Schwarzbein is

a practicing endocrinologist who promotes the use of whole, natural foods and tailors the diet to suit a few different types

of people.

The basic ‘low-carb’ approach is not as

extreme as one might think. Aside from the

phase 1 (induction phase) of the Atkins

diet, ‘low-carb’ is just a sexy way of advising we eat carbohydrates in

moderation, balanced with lots of non-

starchy vegetables, healthy fats and

protein sources. When you look at the

average diet these days, one sees a heavy

reliance of carbohydrates, particularly

simple carbohydrates. See box to the right.

The following 2 pages demonstrate the quantity of carbohydrates in certain foods

and how one might plan their diet while staying within fairly strict carbohydrate

restrictions.

A typical day demonstrates our

reliance on carbohydrates Breakfast: Cereal, milk, fruit/juice,

tea

Snack: Biscuits and tea

Lunch: Sandwich and fruit

Snack: Crisps or crackers

Dinner: pasta, rice or potatoes with

vegetables

Snack: Sweets

Carbohydrate foods are cheapest

and most convenient foods to

obtain or prepare. We tend to rely

on them to the exclusion of other

nutritious foods.


CARBOHYDRATE COUNTING ON A LOW-CARB DIET

STARCHY VEGETABLES (Cooked unless noted otherwise. Each selection

contains 15 grams of carbohydrate)

Food Item Serving Food Item Serving Winter squash ½ cup Artichokes 1

Beetroot 1 cup Burdock Root (raw) ½ root

Carrots 1 cup Corn ½ cup

Green peas ½ cup Jerusalem artichokes ½ cup

Sweet potato/yam ½ medium Butter Beans ½ cup

Parsnip 2/3 cup Baked Potato ½ medium

Pumpkin 1 cup Swede ¼ large

LEGMES (amounts are cooked unless noted otherwise. Each serving

contains 15 grams of carbohydrate)

Food Item Serving Food Item Serving Adzuki beans ¼ cup Split peas 1/3 cup

Broad (fava) beans ½ cup Chickpeas 1/3 cup

Black-eyed beans ½ cup French beans 1/3 cup

Kidney beans 1/3 cup Lentils 1/3 cup

Grains (cooked unless noted) each serving contains 15 grams carb

Food Item Serving Food Item Serving Barley 1/3 cup Brown rice 1/3 cup

Buckwheat (kasha) 1/3 cup Bulgar wheat 1/3 cup

Corn grits ½ cup Millet 1/3 cup

Oats 2/3 cup Polenta 1/3 cup

Popcorn (popped) 2 ½ cups Quinoa 1/3 cup

Dairy Each serving contains 15 grams carbohydrate

Food Item Serving Food Item Serving Plain full-fat yogurt 1 cup Soy yogurt 1 cup

Fruit (all fruits are raw, unless noted) Selections equal 15 grams carbohydrate

Food Item Serving Food Item Serving Apple 1 small Banana ½ medium

Dates 2 medium Grapes 15 grapes

Mangos ½ medium Dried apricots 7 halves

Oranges 1 medium Figs, dried 1 medium

Peaches 1 medium Pears ½ large

Cherries 1 cup Raisins 2Tbls

Bread and crackers each contains 15 grams carbohydrate

Food Item Serving Food Item Serving Tortilla 1 tortilla Rye crispbread 2 crackers

Most breads 1 slice Dinner rolls 1 roll

Rice crackers 4 crackers Rice cakes 2 cakes

Source: The Schwarzbein Principle, by D. Schwarzbein


Low-carbohydrate sample menus (vegetarian + fish)

Benefits of low-carb This approach is highly beneficial to certain individuals. I t is a natural balance to

the popular diets of the 80’s and 90’s which had us eating vast quantities of bread, cereals and pastas and very little protein. Those with a metabolism that

tends towards dysglycaemia and requires more animal protein, benefit from a

diet with low-moderate carbohydrates and more emphasis on protein foods,

healthy fats and lots of vegetables. I t might be considered a therapeutic diet for

Individuals who have insulin resistance-related obesity, polycystic ovary syndrome

(PCOS) and many diabetics (type 2 especially) do quite well on this type of diet,

provided they do not completely abstain from carbohydrates. I t helps to regulate

their blood sugar levels, maintain a healthy weight and keep blood lipids down.

Drawbacks of low-carb The drawbacks of this diet are mainly for those who are not suited to this type of

diet, and those who practice it without regard for food quality. If one consumes

excessive quantities of animal protein, saturated animal fats and other damaged

fats, one can overwork the kidneys, overly acidify their bodies, become

constipated, lose calcium and increase oxidative stress. This can be avoided by

regulating portion sizes for animal proteins and making wise food choices. Some

indiv iduals are not suited for this type of diet, and do better on a whole-foods diet

which is predominantly plant-based. These individuals may lack the stomach acid

required to digest animal proteins and may not tolerate high-fat meals well.

The following sample menus consist of 3 meals each containing 15 grams of

carbohydrate and 2 snacks containing 7.5 grams of carbohydrate.

Day 1

B: Two scrambled eggs with soy sausages. 2/3 cup oatmeal with butter and cream.

Sliced tomatoes.

S: Cheese and ¼ cup sunflower seeds.

L: Egg salad with mayo, tomato on greens with carrot sticks.

S:1/4 cup almonds. Mozzarella cheese

D: Vegetable stir-fry with snow peas, mushrooms, scallions and peanuts. Serve with 1/3

cup brown rice, grilled salmon and a spinach salad with olive oil/vinegar dressing.

Day 2

B: 2 fried eggs. 1 slice buttered whole-grain toast. 3 ounces vegetable juice.

S: 2 Tbls. peanut butter on celery sticks.

L: Grilled tofu marinated in shoyu, balsamic vinegar, thyme and black pepper. Serve

with coleslaw (made from shredded cabbage, carrots, onions and real-egg

mayonnaise/vinegar dressing).

S: 1/3 cup hummus w/ carrot and celery sticks.

D: Aubergine Parmigiana (fry sliced aubergines in olive oil. Then layer tomato sauce

(spiced up with oregano, etc), aubergines, and ricotta cheese like lasagna. On top,

finish with ricotta, mozzarella and parmesan and bake 20-25 mins in medium oven).

Serve with mixed green salad.

Day 3: B: 2-egg omelettes with spinach and feta. 1 cup cubed melon.

S: Cheese and 1 Tbls. raisins.

L: Tuna salad (made with mayo-vinegar) over greens with parmesan and tomato.

One orange.

S: 1 cup cottage cheese with carrot sticks.

D: Tempeh and cheese quesadillas. Marinate sliced tempeh in shoyu, lime juice,

cumin and oregano. Fry up and fill 1 corn tortilla. Top with salsa and sour cream or

guacamole. Green salad with olive oil, lime juice and cumin dressing.

Modified from: The Schwarzbein Principle, by D. Schwarzbein


PRITIKIN DIET On the other end of the weight-loss spectrum, we have the Pritikin Diet. Nathan

Pritikin, the late scientist, inventor and founder of the Pritikin Center in Santa Monica,

California, developed the ‘Pritikin Diet’ after he discovered a way to cure his own cardiovascular ailments through diet.

This diet is designed to counterbalance the standard American diet (SAD), which

leads to obesity, diabetes and heart disease. The SAD is high in fat, high in protein,

high in salt, high in sugar and low in fibre. The Pritikin Diet balances it by eliminating

all of the excesses of the former diet, forcing the body to use up its own stores and

come back to balance. Those adhering to it following a heart attack have reported

excellent results in the months after, reducing lipid levels and insulin requirements and

blood pressure.

The Pritikin Diet consists of (daily recommendations)

Whole grains, beans (except soya beans), vegetables (except avocados and

olives), fruits (except coconut), limited dried fruit

3 oz lean meat, skinless chicken or fish

One glass skim milk and 2 oz cottage cheese daily

Linden tea

Egg whites

Exercise

It Forbids

All fats, oils, avocados, olives, salty meats, full-fat dairy, soybeans, table salt and

prepared foods containing it, refined carbohydrates, caffeinated drinks, whole

eggs, egg yolks, alcohol and soft drinks.

Nutritional Breakdown

10% of calories from fats

10-12% of calories from proteins

80% of calories from complex carbohydrates

Benefits

Many people who have followed this diet have found their health improve

drastically. In people who formerly followed SAD, it increased their intake of fibre,

increased potassium/sodium ratio, increase vegetable intake and balanced their

tendency for a diet excessively high in fat and protein.

Drawbacks

Complete lack of added fats can lead to deficiencies in fat-soluble vitamins,

digestive disorders, lack of satiety and overeating carbohydrates and essential

fatty acid deficiencies. While in the short-term, it may quickly bring a person back

into health, in the long-term it may cause the opposite imbalances. Deficiencies,

coldness, lack of grounding and cravings for salt and fat may result in the long

term.


HIGH FIBRE DIET

Dietary fibre was discussed at length in the macronutrient section as a

heterogeneous group of non-nutritive components of plants. That is, we can’t absorb them.

Some general properties of dietary fibre include: Some are soluble in water and some insoluble

Some are fermentable by colon microflora

Some speed up GI transit time and some slow it down

Some dietary fibre can bind bile acids, promoting their excretion

Fibre generally increases faecal bulk

Can bind up nutrients preventing their absorption (this can be beneficial or not)

Health issues A low-fibre diet is generally associated with a variety of adverse health situations (see table below). Numerous studies have demonstrated links between higher

fibre diets and better health. Of course, a high-fibre diet will naturally include lots

of whole grains, legumes, fruits and vegetables. These also contain multiple

vitamins, minerals and other phytonutrients prev iously discussed. It is difficult to

separate the effects of individual nutrients. However, some studies simply add

dietary fibre of various types and have demonstrated that it improves blood sugar

regulation in diabetics and non-diabetics.

Diseases highly associated with a low-fibre diet Metabolic Obesity, gout, diabetes, kidney stones, gallstones

Cardiovascular Hypertension, cerebrovascular disease, ischemic heart

disease, varicose veins, deep vein thrombosis, pulmonary

embolism

Colonic Constipation, appendicitis, diverticulosis, diverticulosis,

haemorrhoids, colon cancer, irritable bowel syndrome,

ulcerative colitis, Crohn’s disease

Other Dental caries, autoimmune disorders, pernicious anaemia,

multiple sclerosis, thyrotoxicosis, dermatological conditions. Source: Encyclo. of Nat. Med. by Murray and Pizzorno

Recommendations for fibre in the diet

Most people consume only 10-15grams of fibre each day. Most health professions

now recommend a diet which includes 25-35 grams of dietary fibre each day. This is easy to achieve when consuming a whole-foods diet rich in unprocessed

plant foods. In studies with constipation, greater than 50g of fibre per day did not

appear to improve bowel function any further, and may actually create problems

with abdominal distention and excessive flatulence.

Extra water is required with a high-fibre diet. Again, this is easily achieved by eating whole foods including cooked whole grains. The fruits and vegetable

contain a lot of water and cooking grains and legumes causes them to absorb

quite a bit of water proportional to their fibre content. The trouble comes when

people get their fibre from whole-grain breads, dry muslei, dry cereals or fibre

supplements which are lacking in water. This excess fibre without water can

cause gastric obstruction and faecal impaction. Therefore, if an individual with a

low-fibre diet and constipation wants to improve their lot, it is best to increase fibre

intake slowly and do so with attention to their hydration status.


Guidelines for a high-fibre diet

Increase consumption of whole-grains and whole-grain products

Increase consumption of vegetables, especially legumes, fruits

and those with edible skins, seeds and hulls.

Consume a minimum of 25g of fibre daily

Increase water consumption to at least 2 litres daily

Source: Modified from Krause’s Food, Nutrition and Diet Therapy, by Mahan and Escott- Stump.

Compare the fibre content between whole foods

and processed foods!

Food g fibre per 100g food

White bread 2.3

Whole grain 5.0

White rice 0.5

Brown rice 1.7

Apple juice 0.1

Apple w/ skin 2.2

Cornflakes 2.2

Porridge 5.0

Crisps 4.8

Rye crisp bread 16.2

Spaghetti, white (dry) 2.4

Spaghetti, whole-wheat (dry) 11.8

When to advise a high-fibre diet

Constipation: along with increased

exercise and fluid intake, fibre will

increase faecal bulk and promote

increased transit time.

When improved detoxification is

desired: As fibre will bind bile and

promote good elimination.

Conditions of hormone imbalance

such as polycystic ovary syndrome

(PCOS), premenstrual tension (PMT),

benign prostate hyperplasia (BPH),

hormone sensitive cancers (Fibre will

facilitate the excretion of sex

hormones in faeces).

Diabetes: Dietary fibre helps to

regulate blood sugars

Cardiovascular diseases

Kiddie Constipation: Lack of fibre? In the television programme ‘Jamie’s School Dinners’, they visited a town that was considered to have the worst diet in

Britain. In this town, the local surgery ran

regular ‘constipation clinics’ for the children. Indeed, if one looked at the

diets of the residents, it was a very low in

fibre. The diet included large quantities

of processed foods including processed

meats, cheeses, sweets, ready meals,

crisps, frozen chips, juice and fizzy drinks.

Constipation continues to be one of the

main health complaints of individuals in

living in care such as adults with learning

and developmental difficulties and the

elderly. We know that regular bowel

function is critical in the body’s overall detoxification process. When this key

route of elimination is impaired, it affects

the whole body, in addition to being very

uncomfortable.


When high-fibre is not appropriate

While the vast majority of us greatly benefit from a high-fibre diet, sometimes a

low-residue diet is called for. Residue refers to the amount of net faecal mass

remaining after the processes of food ingestion, absorption and fermentation. The

primary components of faecal residue are bacteria and water. The remaining

content includes dietary fibre, sloughed mucosal cells, mucous and varying

amounts of unabsorbed starches, sugars, protein and minerals.

Reduced faecal output is desired when the GI tract is restricted or obstructed. This

can include inflammatory bowel disease (sometimes), severe peptic ulcers or GI

surgeries. Small amounts of fibre with small particle sizes may be beneficial (i.e.

pureed vegetable soups). Individuals who have had a portion of their large

intestine removed and diverted to an external bag (ileostomy or colostomy) may

need to monitor their fibre intake. Increase fibre can lead to excess gas, and

poorly chewed fibrous foods can cause blockages in the stoma (the hole).

Historically, people advised those with colitis and other inflammatory bowel

diseases to follow a low-residue and low-fibre diet. While this may suit some, it is

recognized that optimal GI health can be achieved by including high fibre foods

which are more easily digestible (minimize gluten, soak/ferment grains, well-

cooked grains only) and identifying the specific foods which aggravate their

condition (through an elimination diet).


THE GERSON DIET

The Gerson Institute is a non-profit organization founded in 1977 by Charlotte Gerson.

The aim is to heal and prevent chronic and degenerative diseases based on the

philosophy of Max Gerson, MD. He believed that degenerative diseases were

brought on by toxic and degraded food, water and air.

Proponents of the diet say it is designed to ‘boost your body’s own immune system to heal cancer, arthritis, heart disease, allergies and many other degenerative

diseases.’ I t works to cleanse and reactivate the body.

Emphasis of the Gerson Diet Most of the work focuses on cancer.

The diet works to restore cellular health in the entire body.

Its focus is to eliminate built-up waste and increase ‘oxygenation’ and strengthening the immune system so the body can better heal itself.

They believe too much sodium and too little potassium connects with disease

and water retention and restoring the Na/K balance is crucial to healing.

Extensive detoxification is employed to eliminate wastes. Enemas aid in

elimination of toxins.

What does the Gerson Diet look like? The Gerson Diet Advises a Daily intake of:

13 juices, raw carrot/apple and green-leaf juices each hour (using nearly 20

pounds of organic produce)

Three full vegetarian meals, using organic fruit, veg and whole grains. (Examples:

salad, cooked vegetables, baked potato, vegetable soup and juice)

Fresh fruit and fresh fruit desserts for snacking.

Medications used on the Gerson Diet Potassium compound

Lugol’s solution

Vitamin B12

Thyroid hormone

Injectable crude liver extract

Pancreatic enzymes

Enemas of coffee and/or chamomile

Caster oil

The Gerson Diet avoids heavy animal fats, excess protein, sodium and other toxins

Dr. Max Gerson has published extensively on diet therapy and cancer, and there are

many other published works evaluating the effectiveness of Gerson Therapy in other

degenerative diseases.

See http://gerson-research.org/overview.html for more details

http://gerson-research.org/overview.html


LOW-SODIUM DIET

One can look at low-sodium diets much the way we have looked at low-carb diets.

Our modern diets are so high in sodium, that for some, coming back to a sensible

diet has to be termed ‘low-sodium’. In fact, the 2 grams of sodium (per day) recommended by a moderately low-sodium diet is easily achieved on a whole-foods

diet which avoids processed foods and most commercial condiments. There are a

few disease states where low-sodium diets are advised that you may want to know

about.

Congestive heart failure (CHF)

CHF is a disease characterized by a mix of symptoms such as fatigue, shortness of

breath and congestion that occurs because the heart cannot pump blood

through the body adequately. This tends to occur as a result of cardiovascular

diseases which weaken the left ventricle of the heart. 5-year survival rates from

CHF are quite low, and involve significant nutritional management. For example,

because of inadequate blood flow, fluid balance is severely compromised.

Oedema develops, where the patient retains excessive amounts of sodium and

fluid in their tissues. Sodium restriction is advised in this case, maintaining a diet of

less than 2 grams sodium per day. Less sodium may be needed, but the

recommendation is to follow the least restrictive diet necessary to achieve the

desired results.

In CHF, people are often given diuretics to minimise oedema. It is important to

evaluate the type of diuretic to know if it is potassium sparing or not. Diuretics (like

hydrochlorothiazide) increase potassium excretion, which can lead to digitalis

toxicity, and may require an increase of high-potassium foods or supplements

Hypertension is another case when a low-sodium diet is often recommended.

However, we know that there is only a fraction of people with hypertension who

are ‘salt-sensitive’. (See micronutrient section for a discussion of other nutrient factors in hypertension.)

In order to determine if someone IS salt-sensitive, follow this protocol:

Step 1: Eat normally for a week, keep a diet diary and calculate sodium

intake. Take blood pressure, and if possible, determine urinary sodium

excretion.

Step 2: Consume a diet under 2g sodium per day for 2 weeks. Then measure

blood pressure.

If diastolic blood pressure is <90mg/Hg, the patient is salt-sensitive

If after one month on this diet, the diastolic blood pressure is >90 mmHg, with

a urinary NaCl of <34 mmol/24 hours, then patient is salt-resistant

Step 3: If salt-sensitive, stay on 2g/day diet, but add 300mg sodium per day,

taking blood pressure each day to determine when pressure goes up. This will

help determine sodium threshold.


Acute or chronic renal failure

Is another incidence where sodium restriction is prudent. When in renal failure,

whether acute or chronic, most patients are monitored by their doctors for their

blood electrolytes (and cared for by a registered dietician in hospital). Both

sodium and potassium levels must be watched and these will vary depending on

dialysis and use of diuretics. It is recommended that those in renal failure observe

a diet that contains 2 grams sodium per day, balanced with fluid intake.

Congestive heart failure (CHF) is a disease characterized by a mix of symptoms

such as fatigue, shortness of breath and congestion that occurs because the

heart cannot pump blood through the body adequately. This tends to occur as a

result of cardiovascular diseases which weaken the left ventricle of the heart. 5-

year survival rates from CHF are quite low, and involve significant nutritional

management. For example, because of inadequate blood flow, fluid balance is

severely compromised. Oedema develops, where the patient retains excessive

amounts of sodium and fluid in their tissues. Sodium restriction is advised in this

case, maintaining a diet of less than 2 grams sodium per day. Less sodium may be

needed, but the recommendation is to follow the least restrictive diet necessary to

achieve the desired results.

In CHF, people are often given diuretics to minimise oedema. It is important to

evaluate the type of diuretic to know if it is potassium sparing or not. Diuretics (like

hydrochlorothiazide) increase potassium excretion, which can lead to digitalis

toxicity, and may require an increase of high-potassium foods or supplements


Guidelines on a low-sodium diet

If one prepares their own foods from whole, or minimally processed foods and

uses sea salt and shoyu modestly in their food preparation, one can quite easily

stay under 2 grams of sodium per day. One only need eliminate processed foods,

tinned soups, crisps, take-away’s, restaurant foods, and heavy use of condiments and cheese to stay in the clear. Whole foods are naturally high in potassium and

low in sodium. The following table it a common guideline for those who need to

reduce sodium in their diet.

Low sodium diet guideline

Food category Food allowed Food restricted

Beverages Milk, salt-free fruit and

vegetable juices, low-

sodium carbonated

beverages

Milkshakes, chocolate milk,

salted vegetable juices

(likeV8), softened water

Breads and cereals Whole grain breads,

cooked whole grains pastas

and cereals without added

salt

Breads, rolls and crackers

with salt on top, quick

breads, instant hot cereals,

commercial stuffings and

commercial biscuit mixes.

Desserts Most desserts are fine Instant pudding and cake

mixes

Fats Most fats are fine Bottled salad dressings,

bacon bits and snack dips,

processed cheese dips

Meats All fresh meats, poultry and

fish are fine

Processed, smoked, cured

meats, pickled fish.

Dairy Milk, yogurt, low-sodium

cheeses, eggs

Regular hard and

processed cheese

Soups Homemade soups and

stocks made with minimal

salt

Tinned soups and bouillon

Condiments Herbs, spices, vinegars, chilli

sauce

Seasonings made with salt

(celery salt, garlic salt, etc),

regular soya sauce,

barbecue sauce, teriyaki

sauce, and Worcestershire

sauce.


LOW-POTASSIUM DIET

Given all the (positive) attention we’ve given potassium in our nutrition education,

you might be wondering why we would ever advise a low-potassium diet! The

situations you would advise this are rare and include when a person takes potassium

sparing diuretics and renal failure.

Renal failure This is one situation in particular where a low-potassium diet is advised. Normally,

our kidneys are quite efficient at getting rid of potassium, which is why it’s so important to eat lots of it every day. However, if the kidneys are not able to

excrete it, and/or the individual is taking potassium-sparing diuretics (as in the

case of CHF), there may be elevated potassium levels in the blood. In cases such

as these, diets containing a maximum of 2-3g of potassium per day are advised,

along with regular monitoring.

The low-potassium diet

This type of diet is VERY difficult to achieve, especially with whole foods. One

example of a tactic used by dieticians is to soak potatoes (cut up) in cold water

first, so they leach their potassium out into the soaking water before they are

cooked. By the same token, boiling vegetables and throwing away the cooking

water helps to minimise potassium. Patients are advised to avoid foods with over

250mg potassium per serv ing.

Generally, serum potassium levels can fluctuate markedly in patients with renal

disease and this needs to be monitored regularly. In this case, serum potassium is

regulated with dialysis, and between dialysis, intake must be based on serum

levels. These individuals should be under regular supervision by their doctor and

hospital dietician who is trained in critical care nutrition.


REFERENCES

Billings TE. Notes for a talk held at the SF-LiFE Expo on June 1, 1997. Taken from the

website: www.living-foods.com.

Colbin A. Food and Healing. Ballentine Books, New York 1986.

D’Adamo PJ. Eat Right for your type. Century, London 2001.

Dries J and Dries I . The complete book of food combining. Element Books Limited,

Shaftesbury, Dorset 1998.

Fallon S. Nourishing Traditions. ProMotion Publishing, SanDiego, California. 1995.

Farquharson M. Natural Detox. Element Books Ltd, Shaftesbury, Dorset 1999.

Gates D. The Body Ecology Diet. B.E.D. Publications, Decatur, Georgia. 1996

Haas EM. Staying Healthy with Nutrition. Celestial Arts. Berkeley, California.1992.

Howell, Edward MD. Enzyme Nutrition 1985. Avery Publishing Group Inc. Wayne, New

Jersey.

Lad V. Ayurveda, the science of self-healing. Lotus Press. Wilmot, Wisconsin 1984.

Price, WA DDS. Nutritional Degeneration, 1945 Price Pottenger Nutrition Foundataion,

Inc., La Mesa, California.

Ray Peat, Health Freedom News, September 1993, 33-34. In Fallon

Schwarzbein, D. The Schwarzbein Principle, Health Communications Inc., 1999.

Turner K. The Self-Healing Cookbook, A macrobiotic Primer. Earthtones Press, 1987

Grass Valley, California.

http://www.living-foods.com/

THE SCIENCE OF NUTRITION SERIES

Documents

Transcript of THE SCIENCE OF NUTRITION SERIES