"The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and the cause and prevention of disease", Thomas Edison !
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Always discuss any dietary interventions you make with your regular physician, as changes in diets can affect medications that you are taking. Although, diets benefit many chronic conditions, they are not a replacement for appropriate diagnosis and treatment.

Nutritional Approaches to Chronic Disease
Katarzyna Ferraro MD

It has been known for quite some time that nutrition can dramatically improve general health and wellness. We are all aware of the benefits diets for weight loss, management of diabetes and prevention/management of diseases. As with medications, diets are not a one size fits all and each individual has different nutritional needs and resources available to them. These are a few diets that may be recommended after an evaluation at The Center for Holistic Medicine.

Gluten free diets

Gluten is a dietary protein found in wheat, barley and rye. It is a ubiquitous protein and is found in the majority of processed foods. Gluten is an inflammatory peptide(small protein) that induces inflammation in the gastrointestinal tract and also binds to a receptor on the wall of the gut (1) This opens up the GI tract for the absorption of larger molecules than can be used by the body for making its protein. The body's immune system is very closely associated with the gastrointestinal tract. When it sees large proteins rather than individual amino acids it creates inflammation. If those particles look like other parts of your body it can create autoimmunity(Your immune system thinking that your joints, or your thyroid or your skin are not your own and hence Rheumatoid arthritis, thyroiditis etc.). Gluten free diets are a staple for anyone with autoimmune diseases especially celiac disease. Gluten free and Dairy free diets are also associated with improved symptoms of autism spectrum disorder in many cases. (2)

Milk free and Casein free diets

It is estimated that 75% of the world's population is lactose intolerant. This is a deficiency of an enzyme in the gastrointestinal tract that breaks down the disacharride lactose. When the enzyme is not working or is not present it can lead to gas, bloating diarrhea and other digestive discomforts. Beyond lactose problems, there are also conditions in which individuals can be sensitive to the milk protein "casein". This is seen quite commonly in autism spectrum disorder, leading to colicky symptoms as a baby(4), frequent ear infections(3) and also developmental delays(2).

One of the new theories is that many of these children form a molecule called casomorphin which acts like it sounds, like a narcotic in the body and makes these children have a high pain tolerance and promotes lack of social engagement. Dr. Reichelt in Norway, Dr. Cade at the University of Florida and others have found elevated casomorphin petide in urine samples from people with autism, PDD, celiac disease and schizophrenia.

A second theory for milk intolerance in autism is a recent discovery of folate receptor blocking antibodies. (5) When someone ingests milk, who has a susceptibility to this autoimmune condition they create antibodies to the folate receptor. By removing milk from the diet, many of the of these individuals may reverse some the neurologic symptoms of autism(especially if caught at an early age before the age of 3. For completeness, the folate receptor is necessary for the B vitamin folic acid to enter the brain, if your brain is deprived of folic acid neurologic conditions like symptoms of autism can develop.

Specific Carbohydrate diet/GAPS diet

These diets are very good for individuals with inflammatory bowel disease such as ulcerative colitis and crohn's disease or autistic colitis. They are very challenging and restricting diets because of the limited amount of carbohydrates that are premitted. The diets, however, are excellent for controlling yeast symptoms and also dysbiosis(abnormal germ overgrowth in the bowels) It is recommended that you read the books "Breaking the Viscious Cycle" by Elaine Gotshall or "The Gut and Psychology syndrome" by Natasha Campbell McBride if you are considering this nutritional intervention. These books provide the basic foundation for this diet.

Elimination diets

There are many forms of elimination diets. The simplest ones are those that remove 1-2 food substances such as gluten and or casein removal. Elimination diets can be standardized with the elimination of the top 10 food allergens:

Dairy, Gluten-wheat, sugar, soy, shellfish, eggs, peanuts, oranges etc.

Or they can be individualized based on lab assessments of IgG levels. IgG levels are antibodies that your body produces in response to foods/allergens/pollens etc. A specialty lab panel can be run to determine the foods that your body is reacting to.

Unlike typical allergies that present with immediate symptoms, these are delayed reactions that can occur 3-6 days after ingesting a food(ie. Fatigue, muscle aches, headaches, nausea, malaise etc) making it difficult to track what caused your symptoms.

(1)Fasano, Physiol Rev January 1, 2011 vol. 91 no. 1 151-175

(2)Nutr Clin Pract. 2008 Dec-2009 Jan;23(6):583-8.

(3)Acta Otolaryngol. 1999;119(8):867-73.

(4) Paediatr Child Health. 2011 January; 16(1): 47?49.

(5) Molecular Psychiatry advance online publication 10 January 2012; doi: 10.1038/ mp.2011.175 .

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