Inflammation and Lifestyle Factors

Vitamin A, vitamin D, vitamin E, zinc, omega-3 fatty acids, and omega-6 fatty acids are among the most-studied nutrients active in the immune response, though many other nutrients play integral parts in the optimal function of the immune system. Prolonged inflammation contributes to the progression of many chronic diseases, such as types 1 and 2 diabetes mellitus, cardiovascular disease, Alzheimer’s, psoriasis, lupus, and more. Modifiable lifestyle factors including diet, smoking, and exercise have profound impacts on these levels of inflammation. While acute inflammation is necessary for healing, chronic, low levels of inflammation appear to be major players in chronic disease etiology. Immune dysregulation and oxidative stress are closely related to inflammation in the body, with common etiology and positive feedback loops, compounding the detrimental impacts. For many, this inflammation may go undetected for years, leading it to be termed the “silent killer” by scientific and media reports. Regardless of a symptom manifestation, chronic inflammation poses a damaging impact, increasing risk of chronic disease and mortality. Western lifestyle behaviors such as poor diet, inactivity, and smoking are often underlying root causes of this inflammation. Relationships are a major part of an individual’s health and well-being. Often, a community or intimate relationships can have a direct influence on diet choices. Positive relationships can allow for easier implementation of nutritional interventions, particularly in the case of caregiver support. Spouses committed to health changes can promote reciprocal behavior in their partners; stressed relationships can also prevent adequate nourishment and be a burden to one’s health. Even beyond diet choices, induced stress, potentially from a relational cause, can alter digestive, lipid, glycemic, and inflammatory responses to meals. Physical activity is an integral part of an individual’s nutritional status. Physical activity has a long-established role in body composition and nutrient metabolism. One of the most-studied nutrients involved in mitochondrial function is coenzyme Q10 (CoQ10). CoQ10 is required for ATP production via the electron transport chain and also has a powerful antioxidant function. Deficiencies in CoQ10 caused by metabolic disorders or statin medications can result in mitochondrial dysfunction and reactive oxygen species.

Integrative and Functional Medical Nutrition Therapy by: Diane Noland, Jeanne A. Drisko, Leigh Wagner

The Standard American Diet

The NIBLETS assessment was developed as a way to assess factors that are affecting nutrient metabolism. The NIBLETS model is named for its seven components: Nutrient deficiencies/insufficiencies, Inflammation/immunity, Biochemical individuality (genetic/epigenetic influences on chronic disease), Lifestyle factors, Energy, Toxic load, and Stress and sleep. To treat a person rather than a condition requires a thorough assessment of external factors negatively impacting that person’s health. Regardless of the advances in pharmaceutical and nutraceutical support the medical community is able to make, patients will find themselves in a similar position once again if interventions are not made to change the patterns that helped cause the problem in the first place. The Standard American Diet, consisting of mostly nutrient-poor processed and fast foods, has left the majority of the public overfed and undernourished. Three-quarters of Americans consume less than the recommended intake of vegetables and fruits, and that is when fried potatoes and refined juices are included in these counts. The majority of Americans are not even reaching the estimated average requirement or adequate intake of potassium, fiber, choline, magnesium, calcium, and vitamins A, D, E, and C. Meanwhile, these standards for nutrient consumption are currently based on average needs for our population to remain in a disease-free state. For many individuals, nutrient needs may actually be much higher for optimal function, driving the chasm between need and intake even wider. Americans’ consumption of food prepared outside the home, as a percentage of total calories consumed, nearly doubled. This has a direct correlation with decline in diet quality. However, even within the home, the standard American way of eating is heavy in refined grains and added sugars and increasingly lacking in whole, nutrient-dense foods. Considering our currently overworked, under-rested, hurried lifestyles, it is no wonder why these convenience foods are highly sought after. For this reason, intervening to improve diet quality will undoubtedly require directives on addressing these time and budget constraints. Those who follow restrictive diets such as vegetarianism and veganism are at risk for further nutrient deficiencies. While many factors may lead a person to this dietary pattern including moral, religious, or even health-based motivations, it is still worth noting the increased risk. In addition to the aforementioned nutritional deficiencies for those with a Western-style diet, those who avoid animal products are at further risk of inadequate intakes of protein, omega-3 fatty acids, vitamin B12, iron, zinc, vitamin K2, and iodine. While a nutritionally adequate diet can still be achieved, special attention should be given to those adopting this dietary pattern to address the higher risk. 

Integrative and Functional Medical Nutrition Therapy by: Diane Noland, Jeanne A. Drisko, Leigh Wagner