specialist clinical nutrition: an essential adjunct to successful manual therapy
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Specialist clinical nutrition: an essential adjunct to successful manual therapy. Dr Nina BaileyTRANSCRIPT
Specialist clinical nutrition: an essential adjunct to successful manual therapy
Dr Nina BaileyBSc (Hons) MSc PhD
• Igennus Healthcare Nutrition are a clinical nutrition specialist providing bespoke support for inflammatory conditions
• You don’t need to be a nutrition specialist to make a difference to your client’s health!
• Igennus has established relationships with over 50 chiropractors, osteopaths, acupuncturists, reflexologists, massage therapists, personal trainers and fitness instructors…….
CFS/ME/FMS
• Dr Raymond Perrin (PhD) osteopath, neuroscientist and pioneer of The ‘Perrin Technique’
• The Perrin Technique is a unique lymphatic drainage technique that treats CFS – all Perrin CFS patients are recommended to take 1-2g of Igennus EPA
• Igennus collaborates with 96 ‘Perrin Practitioners’ who use this protocol successfully
Neurodevelopmental disorders
• Robin Pauc – neurologist and chiropractor, founder of the UK renowned Tinsley House Clinic for childhood developmental disorders
• Robin Pauc regularly recommends Igennus’ products as an addition to his treatment programmes:• ADHD• Autism• Asperger's • Dyslexia• Dyspraxia
• Igennus EPA used by Dave Scott U.S. triathlete and six-time Ironman Triathlon World Champion
• Numerous personal trainers use Igennus’ products over generic oils as part of their sports nutrition package - clients get better results: Modulates inflammation Immunity support Cardiovascular support Joint and bone support Reduced oxidative stress Supports energy requirements Supports lean muscle mass/fat burn Supports recovery time and performance
Our biggest practitioner accounts are manual/physical therapists NOT nutrition specialists….
Why do they choose us?
Premium quality ingredients Scientifically proven formulations Niche therapeutic target Highly specialised Expert support team Highest purity and lowest contaminants They really work!
• Accident• Injury• Illness• Stress
• Tension• Posture issues• Muscle spasm• Over-exertion
All result in nerve and muscle damage = short/long term reduced mobility, pain and subsequent secondary issues
But most importantly the science……..
Top reason to see a manual therapist:PAIN! Pain due to:
• Pain = inflammation = pain – signal that damage is present and protects against worsening
• Process of inflammation must be tightly regulated in the body. If not, can lead to unnecessary inflammation and exacerbate pre-existing issues or initiate new ones otherwise non-problematic
• Unnecessary inflammation / inability to switch off inflammation = chronic pain and reduced mobility
• PLUS very high risk of inflammation ‘spreading’ systemically = increased risk of inflammatory disease
Managing pain
• Medication – but like fighting an Australian bush fire with oil - if you use enough may put out the flame in the short term but long term MUCH worse
• Many pharmaceuticals also have potentially detrimental side effects (i.e. COX-2 inhibitors)
• Manual therapy addresses the muscle and nerve issues and restores function to the body to reduce pain and promote mobility
• But without addressing the route cause of unnecessary inflammation leads to long term issues and numerous secondary problems
What is inflammation?
– the normal response of a tissue to injury – triggered by a number of causes including infection, invading
pathogens (such as bacteria or viruses), trauma or compromised blood flow
– desirable defence mechanism with undesirable side effects– normal inflammatory response has an on/off switch– in chronic inflammation there are issues with down-regulating signals
The key to regulating inflammation is through the modulation of eicosanoids:
• Pro-inflammatory eicosanoids drive the immune and inflammatory processes
• Anti-inflammatory eicosanoids act to end the process
• Overproduction of pro-inflammatory products or reduced production of anti-inflammatory products can result in continued production of inflammatory products – the hallmark of silent inflammation
Regulating eicosanoids through diet
• Eicosanoids are derived from a group of polyunsaturated fats known as omega-6 and omega-3
• The ratio of omega-6 to omega-3 in the diet influences the type of eicosanoid produced
• The ratio of omega-6 to omega-3 is commonly associated with health status
• The ratio of KEY omega-6 and omega-3 fats AA and EPA gives us a direct indication of inflammatory health
• The AA to EPA ratio is an indication of the balance between pro-inflammatory and anti-inflammatory eicosanoids
• High AA and low EPA levels will drive the inflammatory response and the subsequent failure to resolve inflammation may increase susceptibility to the development of chronic, low-grade, inflammation-based diseases
AA to EPA ratio - biomarker of inflammatory status
0 % 4% 8% 12%
Omega-3 index* - biomarker of cardiovascular health
Desirable OptimalUndesirable
*Harris & Von Schacky, 2004
The role of diet and lifestyle in modulating inflammation
• Triggers from chronic altered diet and psycho-emotional stress negatively influence the resolution step of the inflammatory response
• Failure to resolve inflammation increases susceptibility to the development of chronic, low-grade, inflammation-based diseases due to the constant activation of both the HPA-axis and innate immune system (Bosma-den Boer et al., 2012)
Resoleomics - the process of inflammation resolution In
flam
mat
ory
resp
onse
Initiation Resolution Termination
PGE2
LTB4
Eicosanoid switch Stop signal
Time
Pro-inflammatory reduced
Anti-inflammatory increased
Bosma-den Boer MM, van Wetten ML, Pruimboom L: Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering. Nutrition & metabolism 2012, 9:32
• Oily fish via diet in decline• A major 1st world dietary deficiency• Supplementation of food necessary – milk, spreads
Omegas in food
Omega-3 transition to medicine
Increasing health problems relating to weight issues
Flock MR, Rogers CJ, Prabhu KS, Kris-Etherton PM: Immunometabolic role of long-chain omega-3 fatty acids in obesity-induced inflammation. Diabetes/metabolism research and reviews 2013, 29:431-445.
Makki K, Froguel P, Wolowczuk I: Adipose Tissue in Obesity-Related Inflammation and Insulin Resistance: Cells, Cytokines, and Chemokines. ISRN inflammation 2013, 2013:139239.
Titos E, Claria J: Omega-3-derived mediators counteract obesity-induced adipose tissue inflammation. Prostaglandins & other lipid mediators 2013, 107:77-84.
White PJ, Marette A: Is omega-3 key to unlocking inflammation in obesity? Diabetologia 2006, 49:1999-2001.
White PJ, Marette A: Potential role of omega-3-derived resolution mediators in metabolic inflammation. Immunology and cell biology 2014, 92:324-330.
Omega-3 and bone health
Mangano KM, Sahni S, Kerstetter JE, Kenny AM, Hannan MT: Polyunsaturated fatty acids and their relation with bone and muscle health in adults. Current osteoporosis reports 2013, 11:203-212.
McMahon MS: Beneficial effect of omega-3 fatty acids on bone metabolism. Orthopedics 2012, 35:735-736.
Rousseau JH, Kleppinger A, Kenny AM: Self-reported dietary intake of omega-3 fatty acids and association with bone and lower extremity function. Journal of the American Geriatrics Society 2009, 57:1781-1788.
Saidenberg Kermanac'h N, Bessis N, Cohen-Solal M, De Vernejoul MC, Boissier MC: Osteoprotegerin and inflammation. European cytokine network 2002, 13:144-153.
Inflammation, omega-3 and rheumatoid arthritis
Curtis CL, Rees SG, Little CB, Flannery CR, Hughes CE, Wilson C, Dent CM, Otterness IG, Harwood JL, Caterson B: Pathologic indicators of degradation and inflammation in human osteoarthritic cartilage are abrogated by exposure to n-3 fatty acids. Arthritis and rheumatism 2002, 46:1544-1553.
Sperling RI: Dietary omega-3 fatty acids: effects on lipid mediators of inflammation and rheumatoid arthritis. Rheumatic diseases clinics of North America 1991, 17:373-389.
Lee YH, Bae SC, Song GG: Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: a meta-analysis. Archives of medical research 2012, 43:356-362.
Omega-3 and pain
Maroon JC, Bost JW: Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surgical neurology 2006, 65:326-331.
• AA and EPA contents of cell membranes can be altered through oral administration of omega-3 EPA
• Increasing EPA levels results in a changed pattern of production of eicosanoids
• Changing the fatty acid composition of cell membranes also affects immune function and pathways
– changes in membrane structure– cell signalling– gene expression of cells and products involved in the inflammatory
cascade and pain signalling
• As health practitioners, you are perfectly placed to guide patients toward natural co-therapies
• Route of inflammation may not just be due to pain/injury issue, as consultation/client history may reveal:
• High stress• Fatigue• Neurological disorder• Poor diet and lifestyle• CVD• Low mood
• Inflammation is a key driver of a myriad of diseases/conditions
Thus, addressing high levels of inflammation by restoring AA to EPA ratio and increasing the omega-3 index willreduce:
Pain Fatigue Stress Risk of modern illness
Measuring inflammation and tracking progress
• Blood spot fatty acid profilingOmega-6 to omega-3 ratioAA to EPA ratioOmega-3 index
• Knowing a client’s baseline omega-3 index allows effective dosing to increase omega-3 index and reduce the AA to EPA ratio
Omega-3 index Dose required Body weight Minimum dose
Base line Target (mg/kg) (kg) (g)
3 8 0.0222 89 1.98
4 8 0.0172 89 1.53
6 8 0.0072 89 0.64
So remember!
You don’t need to be a nutrition specialist to make a difference to your clients’ health
Our biggest practitioner accounts are manual therapists NOT nutrition specialists….
Expertly formulated EPA supplements to suit all ages and needs
Scientifically proven co-therapies to support long term health
Technical support from MSc Nutrition Specialists
Literature and personalised support for your clients
Fatty acid blood profiling service allows a bespoke and effective supplementation regime
Practitioner Scheme benefits:
A personalised referral code (i.e. SMITH25) Highest commission on direct orders Best discount for your clients Free 1-2-1 training with our highly qualified nutrition team Free promotional materials for your clients Free profile feature on our website Over 45% profit on trade orders Instant 30 days free credit PLUS additional 20% off your first trade order (effective profit
up to 57%)
References
Bosma-den Boer MM, van Wetten ML, Pruimboom L: Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering. Nutrition & metabolism 2012, 9:32. Flock MR, Skulas-Ray AC, Harris WS, Etherton TD, Fleming JA, Kris-Etherton PM: Determinants of erythrocyte omega-3 fatty acid content in response to fish oil supplementation: a dose-response randomized controlled trial. Journal of the American Heart Association 2013, 2:e000513. Harris WS, Von Schacky C: The Omega-3 Index: a new risk factor for death from coronary heart disease? Preventive medicine 2004, 39:212-220. .