Nutritionists apply knowledge of the therapeutic & preventive potential of food, diet & supplements including vitamins, minerals & trace elements to maintain and promote our patient's health.
The nutritionist may plan appropriate patient-based diets and prescribe nutritional supplements for general well being, or to treat clients with specific health conditions. Studies in nutrition are supported by a strong underpinning of biological and social sciences subjects.
A nutritionist assesses a patient’s diet for nutritional deficiencies and also determines particular nutritional deficiencies by the symptoms a patient has. For example, spasms and twitches of the eye are a symptom of magnesium deficiency. White spots on the nails are either zinc or calcium deficiency etc. My priority is to replace with supplements and maintain with food. In an ideal world, we can get all our nutrients from our food, however, the 21st century poses many challenges, with non-organic farming methods, environmental pollution including the current plastic apocalypse and the overuse or abuse of pharmaceuticals indicate the need for supplementation.
My focus is always on foods that are the known richest sources of a nutrient to prevent a condition. For example, sulforaphane and indoles rich broccoli to prevent prostate cancer, isoflavone-rich Kudzu root powder to prevent hormone dependant female cancers and beta-glucan-rich oats to lower your cholesterol etc. Most importantly I tell you what you can eat, not what you cant. I will prescribe a diet that is suited to your lifestyle and environment and your social life. My philosophy is to take stress off the menu, enjoy your food life!
In an ideal world, a balanced and varied diet is the best source of essential vitamins and minerals. In reality, however, nutrient deficiencies can and do occur, including in populations with bountiful food supplies and the means to procure nutrient-rich foods. For example, the Standardised American Diet (SAD) bears little resemblance to what experts recommend for fruit, vegetables, and whole grains, which serve as important sources of an array of vitamins and minerals. With time, deficiencies in one or more micronutrients may lead to serious health issues. So dietary advice and nutritional supplementation prescriptions are absolutely warranted.
Higher intakes of omega-3 PUFAs, either from fatty fish or from supplements, continued over a lifetime contribute towards lower risk for CVD. Kate J. Bowen et al., Omega-3 Fatty Acids and Cardiovascular Disease: Are There Benefits? Curr Treat Options Cardiovasc Med. 2016; 18(11): 69.
Studies show high circulating levels of the caretenoids lycopene, lutein/zeaxanthin and beta-cryptoxanthin are associated with a low risk of prostate cancer. Zhang J et al., Plasma carotenoids and prostate cancer: a population-based case-control study in Arkansas. Nutr Cancer. 2007;59(1):46-53.
Supplements containing 200-1,000 mcg chromium as chromium picolinate the most efficacious form of chromium supplementation. a day have been found to improve blood glucose control. Diabetes Educ. 2004;Suppl:2-14.
Not all nutritionists courses are equal
In Australia a naturopathic degree is a degree in herbal medicine and nutrition. Naturopathy is not pseudo science. The problem with the industry, is not the lack of evidence for herbal medicine and supplements, but the lack of regulation in both the education sector and the industry, resulting in the difference in qualifications of your homeopath, acupuncturist, naturopath or nutritionist. In order to successfully integrate Complementary and Alternative Medicine (CAM) into main-stream healthcare the basis of training of CAM practitioners needs to be equivalent to university degree programmes offered currently to mainstream health professionals. In Australia it is moving that way. My degree in Naturopathy is recognised as level 8 on Australia's AQF by the Australian government and also as level 8 on the Irish NFQ through the UK NARIC. The NARIC is the designated United Kingdom national agency for the recognition and comparison of international qualifications and skills, on behalf of the UK Government. I am presently studying a Master in Public Health on the back of my degree.
Australia is at the forefront of natural medicine training, having offered degree programmes for 20 years. MY course provider is still going strong. The industry is well-regulated and moving towards registration with the Australian Health Practitioner Regulation Agency (AHPRA) the national registration body that develops a nationally consistent approach to auditing health practitioners including doctors, nurses, acupuncturists and allied health professionals. I was, while living in Australia, a registered acupuncturist. Common registration standards include criminal history checks, ensure English language skills are met and ensures all it's members meet continuing professional development requirements. Registration standards are regularly reviewed. This National registration body will, soon cover Naturopathy as a discipline.
Nutritional supplementation and safety
The use of dietary supplements is primarily self-initiated rather than practitioner-based and presents unique regulatory, safety, and efficacy challenges to consumers, researchers, and practitioners. Many supplements are contraindicated with certain medications. Many supplements should not be taken together. Some need to be taken before or after meals. Many people are taking too much or alternately not enough of the supplement. Excess dosing, particularly of fat-soluble nutrients, can be dangerous as they accumulate in the liver. Taking too little equates to taking none at all. Like herbal medicine, supplements need to be taken in their correct therapeutic doses in order for them to work. This can only be achieved by seeing a qualified practitioner. I would never recommend someone self-prescribe supplements. It is strongly advisable if you are taking a supplement or are considering taking supplements that you have a consultation with a degree qualified practitioner who is adequately trained in drug/nutrient interactions to ensure safety and is able to ensure you are taking the right supplement is in the right form and taken at the right times.
Not all nutritional supplements are considered equal
On top of the safety issues, not all nutritional supplements are considered equal. Some supplements are bioavailable meaning they can be and able to be digested and absorbed and used by the body. Some are not bioavailable and as much use as a chocolate teapot or even worse can cause disease. For example, the most common and least expensive type of supplemental calcium available is calcium carbonate. This supplement is poorly assimilable therefore unable to be absorbed. Thus making it not only doesn't strengthen your bones, on the contrary, but it is also excreted by the kidneys and can contribute to kidney stones. Calcium carbonate is also an antacid so neutralises stomach acid and inhibits absorption of both calcium and iron so taking calcium in this form can actually lead to osteoporosis and iron deficiency anaemia. Supplements need to be prescribed in their correct form to ensure they are bioavailable. Supplements that are in the wrong form and not bioavailable are as much use as a chocolate teapot. I can prescribe practitioner only nutritional supplements that are readily absorbed and utilised.
Determining food allergy or food intolerance
A nutritionist can determine food allergy or intolerance. In fact, these words often get misused by many under trained practitioners. Food allergy is described as an immunological reaction involving the production of an anti-body whereas food intolerance is described as a pharmacological reaction to the compounds in foods, similar to the side effects when taking medication. The word allergy should be reserved for reactions that involve the immune system only. A true food allergy requires the presence of IgE antibodies against the food.
A common example of misuse is when people say they are allergic to cheese because it gives them headaches. This reaction is not an allergy, but actually food intolerance to the vasoactive amines in the cheese. In reality, food allergy affects relatively few people but can be quite severe when it does.
A good nutritionist will use a low reactive diet and an oral food challenge to test for food allergy. This is the gold standard test. Machines will give false positives due to different circumstances. A nutritionist will prescribe foods known as “living foods” or “super foods”. These are enzyme rich and nutrient dense foods.
Fasting is not junk science
Fasting is a useful therapeutic tool prescribed by naturopaths and nutritionists for certain health conditions. Fasting is Calorie Restriction (CR). The benefits of CR are scientific fact. A therapeutic fast simulates the Calorie Restrictive Diet that scientists have touted for the main reason behind Okinawan longevity. Like CR, fasting also activates telomerase the anti-ageing enzyme. Fasting, like CR, improves how cells respond to stress, how they break down (autophagy), induces apoptosis (programmed cell death ie in cancer cells), and alters hormonal balance. Autophagy in particular, is quality control inside cells. It is essential to maintain cellular homeostasis and to improve how the cell responds to stress. Autophagic activity declines with age, therefore fasting is anti-ageing. In relation to heavy metal accumulation, CR/fasting enhances Phase II Detoxification thus will assist in the elimination of heavy metals.
My preferred take on fasting
Fasting is a difficult and anti-social experience and difficult to achieve in the modern working day, however, so my approach is to mimic fasting to achieve all the benefits of fasting without the pitfalls. This is why I prescribe a ketosis diet as opposed to a fasting diet. This diet is a carbohydrate restrictive, high good fat, high healthy protein (including veg/vegan based protein) diet. Ketosis is a perfectly normal metabolic process. When we are unable to use carbohydrates as fuel for cells to burn for energy, fats are used instead. Ketones are produced as part of this process. In fact, ketones are the preferred source of fuel for our bodies. This diet can be adjusted and made suitable for vegetarians/vegans.
Benefits of a Keto Diet
Lowers cholesterol: Lowers LDL & triglyceride levels and raises HDL (good cholesterol). (1)
Induce Rapid Weight Loss: Reduces body weight and body mass index. (1)
Lowers Blood Sugar: Studies show a ketosis diet can eliminate type 2 diabetes. (2, 3)
Enhances physical and cognitive performance: Ketone bodies are the most energy-efficient fuel and yield more ATP. (4)
Suppresses Appetite: High fats diets increase satiety. (5)
Starve Cancer Cells: Cancer cells need glucose for fuel. Only healthy cells can live on ketones. Studies indicate a ketosis diet is an adjunct therapeutic aid in cancer. (6, 7)
Treats neurodegenerative disease: Ketosis is neuroprotective and neuroregenerative (8) & therapeutic treatment in traumatic head injury, neurological disease (9) including Parkinson’s, Alzheimer's (10) & epilepsy, (11)
Extends Life: The benefits of Calorie restriction/Keto diet are scientific fact. A Ketosis diet simulates the Calorie Restrictive Diet (12) that scientists have touted for the main reason behind Okinawan longevity. Like CR, Ketosis also activates telomerase the anti-ageing enzyme. Calorie restriction increases telomerase activity and enhances autophagy (breakdown of dead cells). (13) CR improves how cells respond to stress, how they break down (autophagy), induces apoptosis (programmed cell death ie in cancer cells), and alters hormonal balance. Autophagy in particular, is quality control inside cells. It is essential for the maintenance of cellular homeostasis and for the orchestration of an efficient cellular response to stress. Autophagic activity declines with age, and this contributes to the ageing process. (14)
The Keto Diet also aims to;
Stabilises blood sugar to reduce cravings for carbohydrates.
Improves insulin sensitivity to treat Metabolic Syndrome & address central obesity.
Promotes bile flow from the liver to assist fat metabolism & address a “Sluggish Liver”.
Tonifies the thyroid gland to boost the Basal Metabolic Rate (BMR).
Addresses the mental emotional disorders that lead to comfort eating & food addiction.
Carina Harkin BHSc.Acu.BHSc.Nat.BHSc.Hom. Cert IV TAE.
1. Dashti HM, Mathew TC, Hussein T, Asfar SK, Behbahani A, Khoursheed MA, et al. Long-term effects of a ketogenic diet in obese patients. Experimental and clinical cardiology. 2004;9(3):200-5.
2. Westman EC, Tondt J, Maguire E, Yancy WS, Jr. Implementing a low-carbohydrate, ketogenic diet to manage type 2 diabetes mellitus. Expert review of endocrinology & metabolism. 2018;13(5):263-72.
3. Yancy WS, Jr., Foy M, Chalecki AM, Vernon MC, Westman EC. A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutrition & metabolism. 2005;2:34-.
4. Murray AJ, Knight NS, Cole MA, Cochlin LE, Carter E, Tchabanenko K, et al. Novel ketone diet enhances physical and cognitive performance. FASEB journal : official publication of the Federation of American Societies for Experimental Biology. 2016;30(12):4021-32.
5. Gibson AA, Seimon RV, Lee CMY, Ayre J, Franklin J, Markovic TP, et al. Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. 2015;16(1):64-76.
6. Klement RJ. Beneficial effects of ketogenic diets for cancer patients: a realist review with focus on evidence and confirmation. Medical oncology (Northwood, London, England). 2017;34(8):132.
7. Morscher RJ, Aminzadeh-Gohari S, Feichtinger RG, Mayr JA, Lang R, Neureiter D, et al. Inhibition of Neuroblastoma Tumor Growth by Ketogenic Diet and/or Calorie Restriction in a CD1-Nu Mouse Model. PLOS ONE. 2015;10(6):e0129802.
8. Shaafi S, Mahmoudi J, Pashapour A, Farhoudi M, Sadigh-Eteghad S, Akbari H. Ketogenic Diet Provides Neuroprotective Effects against Ischemic Stroke Neuronal Damages. Advanced pharmaceutical bulletin. 2014;4(Suppl 2):479-81.
9. Gano LB, Patel M, Rho JM. Ketogenic diets, mitochondria, and neurological diseases. Journal of lipid research. 2014;55(11):2211-28.
10. Włodarek D. Role of Ketogenic Diets in Neurodegenerative Diseases (Alzheimer’s Disease and Parkinson’s Disease). . Nutrients. 2019;11(169).
11. Agarwal N, Arkilo D, Farooq O, Gillogly C, Kavak KS, Weinstock A. Ketogenic diet: Predictors of seizure control. SAGE open medicine. 2017;5:2050312117712887-.
12. Maalouf M, Rho JM, Mattson MP. The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies. Brain research reviews. 2009;59(2):293-315.
13. Wang B-H, Hou Q, Lu Y-Q, Jia M-M, Qiu T, Wang X-H, et al. Ketogenic diet attenuates neuronal injury via autophagy and mitochondrial pathways in pentylenetetrazol-kindled seizures. Brain Research. 2018;1678:106-15.
14. Veech RL, Bradshaw PC, Clarke K, Curtis W, Pawlosky R, King MT. Ketone bodies mimic the life span extending properties of caloric restriction. 2017;69(5):305-14.