An Evidence Based Approach

Nutrition & Health

The World Health Organization identifies eating too many foods rich in calories and poor in nutrients as the main cause of chronic ill-health and obesity. With poor nutrition our metabolism slows down and we lose the energy to maintain the structures and functions of the body.

Inadequate vitamin and mineral intake is widespread in the UK, affecting around 1 in 2 of us, and often involves weight gain. Malnutrition is a more severe form of inadequacy, involving weight loss, affecting 1 in 20 of us.

Nutritional shortfalls increase with age, as appetite and activity decline. In recent years, the general level of physical activity in the UK has dropped by a quarter, reducing the amount of food we can eat without gaining weight.

The concentration of key minerals in vegetables has decreased by around a third over the years, due to soil depletion, whilst our metabolic requirement for such nutrients increases with exposure to environmental chemicals such as pesticides, plastics and drugs.

Two thirds of people in the UK describe themselves as not in good health and a similar proportion are overweight. To stay well and not change weight we need to eat especially nutritious and healthy foods.

Nutrition & Dysfunction

Many people in the UK also experience chronic physical and mental health problems with significant dysfunction but often lack a meaningful diagnosis or explanation. They face the prospect of long-term drug use or dieting due to apparent food intolerance. As a result, they may resort to trial and error experiments with expensive supplements and novel health foods without professional guidance and at potential risk to their health.

A combination of health and nutritional sciences provides the foundation for a professional dietary approach to alleviating nutritional symptoms of ill-health and dysfunction, as advocated by the Institute for Functional Medicine. Among these sciences, there is debate about the appropriateness of focusing entirely on individual nutrients and super foods (1, 2).

A case has been made for more emphasis on holistic dietary patterns or systems as well as individual variation in requirements. Similarly, there is concern about relying entirely on clinical trial methods designed for the evaluation of single drugs rather than comparative methods more suitable for complex dietary exposures that are multiple, subtle, inter-related and prolonged.

Theoretical Framework

The Help 4health approach is based on an evolutionary theory of health and dysfunction, involving adaptation to a long-established staple dietary system.

Cumulative changes, occurring in farming, food processing and occupation, have altered the nature and amount of key nutrients, plant chemicals and other factors contributing to the Western European diet.

Such change is particularly challenging to people highly adapted to a narrow range of traditional regional foods, and thereby reliant on specific nutrient-rich produce from sea, forest and garden.

The underlying morbid mechanism involves shortfalls and imbalances in nutrient, fibre and anti-nutrient intakes acting synergistically with lifestyle and constitutional traits related to the metabolic syndrome.

Associated chronic ill-health and systemic dysfunction may take diverse forms, due to individual variations that once were advantageous familial adaptations to regional conditions.

Causal Model

A wide range of evidence from nutritional, medical, bio-chemical, epidemiological, environmental, historical and archaeological sources, was integrated into a coherent holistic framework for physical and mental ill-health with chronic inflammatory and metabolic dysfunction. A related causal model was formulated, featuring key recognised deficits in food and nutrient intakes plus lifestyle risk factors in the UK.

This model was tested using special graphical and standard data modelling of diet and lifestyle factors in relation to changes in health and dysfunction, within a large representative cohort drawn from our Leicestershire MRC study (3). The results confirm that key recognised food, nutrient and lifestyle risk factors predict deterioration in reported general health and the onset of dysfunction.

References

1. Nutritional epidemiology issues in chronic disease at the turn of the century. Willet WC. Epidemiological Reviews. 2000; 22(1):82-86.
2. The ancestral human diet: what was it, and should it be a paradigm for contemporary nutrition? Eaton SB. Proceedings Nutrition Society 2006; 65(1):1-6.
3. Etiology of Overactive Bladder: A Diet and Lifestyle Model for Diabetes and Obesity in Older Women. McGrother  CW, Donaldson MMK, Thompson J Wagg A, Tincello DG, Manktelow BN. Neurourology and Urodynamics 2012;31:487–495