A participant's assessment of our medical nutrition courses
In January 2002 "Nutrition Matters" presented at Milton Hill Conference Centre ( Abingdon, Oxford ) a new modular course on Nutritional Medicine for Doctors. A retired GP, Dr David Williams reports on his experience as a participant.
Why are the diseases of old age such as Type 2 Diabetes, age-related macular degeneration and osteoporosis, appearing in ever younger patients? "We are what we eat"; and it would appear that we’ve never been so well fed but at the same time so badly nourished.
For the last three years I had been interested in the nutritional aspects of medicine and Nutrition Matters came just at the right time. A new course for doctors, dental and veterinary surgeons is aimed at raising the awareness in their professions of the role of nutrition in health and disease; and to enable them to bring nutritional approaches into mainstream practice.
I attended the first module in January of this year. The opening lecture by Professor Martin Wiseman (Visiting Professor of Human Nutrition Southampton University) set the epidemiological scene. The United Kingdom has a disastrous record in coronary artery disease, cancer and a number of other diseases. A large proportion of the population can expect to live at least 35-45 years beyond reproductive life. For most of us the latter part of those four decades is ruined by degenerative disease. We need to add LIFE to those latter years. They used to call them "quality adjusted life years" – QALYS if I remember correctly……..
Epidemiological studies show that people who consume larger amounts of fruit and vegetable in their diet have a lowered incidence of nearly all these diseases- hence the current governmental guidelines or should I say wishlist! But now it seems we can begin to move this onto a more scientific footing because the links between the pharmacological actions of these various micronutrients, and the patho-aetiology of many diseases is becoming clearer.
Surveys show that most of us can no longer obtain the micronutrients we need from a well-balanced diet, whatever that might be. This pattern of multiple micronutrient depletion-not deficiency- is termed Type B malnutrition, and it appears to be an increasingly likely cause of much degenerative illness. There is good evidence that depletion of many vitamins and minerals impedes anabolic processes within the body; and conversely, depletion of some of the newer micronutrients ( omega 3 oils, carotenes, flavonoids etc) may accelerate various catabolic processes.
Viewed from this biologically dynamic perspective, its obvious that even a minor discrepancy between rates of bone formation and resorption or between atheroma deposition and clearance- will eventually lead to an osteoporotic fracture or heart attack. And whereas these clinical end-points can be crisis-managed with surgery and/or drugs, they cannot be cured with drugs, if as the evidence indicates, their aetiology rests in Type B malnutrition.
Free radicals, antioxidants and even glycosolation/cross link reactions are increasingly familiar to nutritionists and newspaper columnists. By and large, however, the medical profession has shut its collective eyes and ears to this topic. It can afford to do so no longer.
Dr Paul Clayton (consultant in nutraceuticals and functional foods) believes that the onset of many disorders of old-age eg. NIDDM, osteoporosis can be delayed and potentially reversed by appropriate supplementation of the diet. Early diagnosis is vital for early treatment with nutritional supplementation but it's is a pretty safe assumption that everyone over the age of 40 has degenerative disease established in all systems.
Dr Clayton (favourite saying "you remember your biochemistry....? " ) taught us that free radicals and cross-link reactions, exacerbated by Type B malnutrition , play a role in many disease states and perhaps the aging process itself.
Drs Mark Draper and Charles Forsyth taught us that studies have shown that the tissues of most people on Western diet are significantly depleted of zinc, selenium, chromium and many other trace elements. Although most of these are required only in micrograms amounts, these metals have many important roles as coenzymes but also as antioxidant scavengers and sinks for the damaging free radicles.
Dr Clayton explained the importance of the antioxidants and anti-inflammatory flavonoids in fruit and vegetables for vascular integrity; and of the methyl groups in betaine, choline and the B vitamins for good quality DNA replication, cell membrane integrity and homocysteine regulation. He also explained that the "five fruit and veg" government recommended diet is no longer sufficient to provide the necessary levels of vital nutrients to permit a healthy old-age.
In conversations over lunch and an excellent dinner I found that the other participants were very enthusiastic. I found it very significant that one is a veterinary surgeon. By the end of the two days all those who had come just for a one-module taster had signed up for the full course.
The Nutrition Matters course is twelve days in six modules. It is aimed at educating doctors who wish to invest in their own future wellbeing as well as that of their patients. The organisers have recognised that committing to a whole year of modules can be a bit daunting for the average GP with a practice and the family. This course has the added advantage that there is built in provision to catch in the subsequent year up on missed modules.
Although there is a printed scientific bibliography, the course is built around a book by Dr Clayton, " Health Defence". Written for non-medical readership it serves the medical doctor extremely well. Let's face it, few of us know much about nutrition which is why there are so many nutritionists out there making a living. Even if you don't sign up for the course this is a book worth having for home and surgery. I have already given five copies away to my family.
GPs need practical information and advice to pass on to patients. This course abounds with both. Mind you, the real reason I signed-up is because I'm looking first to my own future!
Dr David T H Williams
Independent medical practitioner (retired GP)
Course details can be obtained fromwww.nutrition-matters.co.uk or the Course Administrator firstname.lastname@example.org .
Mrs Bev Britten,70, Court Road, Malvern, Worcs.WR14 3EG.