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Nutrition

Diet and Nutrition significantly influence health and well-being

Lifestyle Medicine (LM) requires a comprehensive understanding of nutrition, from biochemistry to the grocery store and kitchen, and through to evidence-based recommendations. Nutritional medicine is a fundamental part of lifestyle medicine.

An unhealthy diet is one of the major risk factors for a range of chronic diseases and disorders, including cardiovascular diseases, cancer, and other conditions linked to obesity. Hyperglycaemia (high blood glucose), hyperinsulinaemia (high blood insulin) from the over-consumption of processed carbohydrates and simple sugars are implicated in metabolic syndrome and type 2 diabetes, and the accumulation of the advanced glycation end-products.

Human nutritional recommendations for a healthy diet include: eating more fruit, vegetables, legumes and nuts; cutting down on salt, sugar, processed meat and the wrong type of fats. WHO have recently initiated a campaign for the global elimination of trans fats by 2023.

Improving dietary habits is a societal, not just an individual problem. Therefore it demands a population-based, multi-sectoral, multi-disciplinary, and culturally relevant approach. Improving dietary habits is a Lifestyle Medicine priority.

Biochemistry of nutrition

Noncommunicable diseases are often associated with chronic systemic inflammation – a high ratio of omega-3 to omega-6 fatty acids has been shown to be pro-inflammatory. Certain substances and phyochemicals (such as polyphenols) from vegetables, fruits, nuts and other foodstuffs have been shown to have an anti-inflammatory effect.

Different flavonoid subclasses from fruits and vegetables have been associated with a reduction in risk of type 2 diabetes, as have foods and drinks rich in flavonoids, including apples, pears, tea, red wine, and berries. The flavonol and anthocyanin subclasses have also been inversely associated with biomarkers of adiposity-associated inflammation, including increased TNF-a, IL-6, and high-sensitivity C-reactive protein (hs-CRP).
Novel data provide mechanistic support for the previously observed association between anthocyanin intake and type 2 diabetes mellitus risk and other chronic diseases and suggest a beneficial role for increased intake of anthocyanins and flavones on HOMA-IR and hs-CRP concentrations. These results are of public health importance because the intakes associated with these findings are easily achievable through a habitual, healthy diet.

Overview of current recommendations

  • achieve energy balance and a healthy weight
  • limit energy intake from total fats and shift fat consumption away from omega-6 fats to omega-3 fats, and towards the elimination of trans-fatty acids
  • increase consumption of fruits and vegetables, legumes and nuts
  • limit the intake of free sugars
  • limit salt (sodium) consumption from all sources and ensure that salt is iodised