Specialist clinical nutrition: an essential adjunct to successful manual therapy


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  • 100,000 years ago
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  • Inflammation is a key player in bone resorption Role for omega-3 in reducing bone and muscle loss with ageing and reduce fracture risk, higher BMD in omega-3 users
  • Lee = high doses (2.7g) reduces NSAID intake
  • Our results mirror other controlled studies that compared ibuprofen and omega-3 EFAs demonstrating equivalent effect in reducing arthritic pain. Omega-3 EFA fish oil supplements appear to be a safer alternative to NSAIDs for treatment of nonsurgical neck or back pain in this selective group.
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  • Specialist clinical nutrition: an essential adjunct to successful manual therapy

    1. 1. Specialist clinical nutrition: an essential adjunct to successful manual therapy Dr Nina Bailey BSc (Hons) MSc PhD
    2. 2. • Igennus Healthcare Nutrition are a clinical nutrition specialist providing bespoke support for inflammatory conditions • You don’t need to be a nutrition specialist to make a difference to your client’s health! • Igennus has established relationships with over 50 chiropractors, osteopaths, acupuncturists, reflexologists, massage therapists, personal trainers and fitness instructors…….
    3. 3. CFS/ME/FMS • Dr Raymond Perrin (PhD) osteopath, neuroscientist and pioneer of The ‘Perrin Technique’ • The Perrin Technique is a unique lymphatic drainage technique that treats CFS – all Perrin CFS patients are recommended to take 1-2g of Igennus EPA • Igennus collaborates with 96 ‘Perrin Practitioners’ who use this protocol successfully
    4. 4. Neurodevelopmental disorders • Robin Pauc – neurologist and chiropractor, founder of the UK renowned Tinsley House Clinic for childhood developmental disorders • Robin Pauc regularly recommends Igennus’ products as an addition to his treatment programmes: • ADHD • Autism • Asperger's • Dyslexia • Dyspraxia
    5. 5. • Igennus EPA used by Dave Scott U.S. triathlete and six-time Ironman Triathlon World Champion • Numerous personal trainers use Igennus’ products over generic oils as part of their sports nutrition package - clients get better results:  Modulates inflammation  Immunity support  Cardiovascular support  Joint and bone support  Reduced oxidative stress  Supports energy requirements  Supports lean muscle mass/fat burn  Supports recovery time and performance Our biggest practitioner accounts are manual/physical therapists NOT nutrition specialists….
    6. 6. Why do they choose us?  Premium quality ingredients  Scientifically proven formulations  Niche therapeutic target  Highly specialised  Expert support team  Highest purity and lowest contaminants  They really work!
    7. 7. • Accident • Injury • Illness • Stress • Tension • Posture issues • Muscle spasm • Over-exertion All result in nerve and muscle damage = short/long term reduced mobility, pain and subsequent secondary issues But most importantly the science…….. Top reason to see a manual therapist: PAIN! Pain due to:
    8. 8. • Pain = inflammation = pain – signal that damage is present and protects against worsening • Process of inflammation must be tightly regulated in the body. If not, can lead to unnecessary inflammation and exacerbate pre-existing issues or initiate new ones otherwise non-problematic • Unnecessary inflammation / inability to switch off inflammation = chronic pain and reduced mobility • PLUS very high risk of inflammation ‘spreading’ systemically = increased risk of inflammatory disease
    9. 9. Managing pain • Medication – but like fighting an Australian bush fire with oil - if you use enough may put out the flame in the short term but long term MUCH worse • Many pharmaceuticals also have potentially detrimental side effects (i.e. COX-2 inhibitors) • Manual therapy addresses the muscle and nerve issues and restores function to the body to reduce pain and promote mobility • But without addressing the route cause of unnecessary inflammation leads to long term issues and numerous secondary problems
    10. 10. What is inflammation? – the normal response of a tissue to injury – triggered by a number of causes including infection, invading pathogens (such as bacteria or viruses), trauma or compromised blood flow – desirable defence mechanism with undesirable side effects – normal inflammatory response has an on/off switch – in chronic inflammation there are issues with down-regulating signals
    11. 11. The key to regulating inflammation is through the modulation of eicosanoids: • Pro-inflammatory eicosanoids drive the immune and inflammatory processes • Anti-inflammatory eicosanoids act to end the process • Overproduction of pro-inflammatory products or reduced production of anti-inflammatory products can result in continued production of inflammatory products – the hallmark of silent inflammation
    12. 12. Regulating eicosanoids through diet • Eicosanoids are derived from a group of polyunsaturated fats known as omega-6 and omega-3 • The ratio of omega-6 to omega-3 in the diet influences the type of eicosanoid produced • The ratio of omega-6 to omega-3 is commonly associated with health status • The ratio of KEY omega-6 and omega-3 fats AA and EPA gives us a direct indication of inflammatory health
    13. 13. • The AA to EPA ratio is an indication of the balance between pro- inflammatory and anti-inflammatory eicosanoids • High AA and low EPA levels will drive the inflammatory response and the subsequent failure to resolve inflammation may increase susceptibility to the development of chronic, low-grade, inflammation-based diseases AA to EPA ratio - biomarker of inflammatory status
    14. 14. 0 % 4% 8% 12% Omega-3 index* - biomarker of cardiovascular health Desirable OptimalUndesirable *Harris & Von Schacky, 2004
    15. 15. The role of diet and lifestyle in modulating inflammation • Triggers from chronic altered diet and psycho-emotional stress negatively influence the resolution step of the inflammatory response • Failure to resolve inflammation increases susceptibility to the development of chronic, low-grade, inflammation-based diseases due to the constant activation of both the HPA-axis and innate immune system (Bosma-den Boer et al., 2012)
    16. 16. Resoleomics - the process of inflammation resolutionInflammatoryresponse Initiation Resolution Termination PGE2 LTB4 Eicosanoid switch Stop signal Time Pro-inflammatory reduced Anti-inflammatory increased Bosma-den Boer MM, van Wetten ML, Pruimboom L: Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering. Nutrition & metabolism 2012, 9:32
    17. 17. •Oily fish via diet in decline •A major 1st world dietary deficiency •Supplementation of food necessary – milk, spreads Omegas in food Omegas in dietary Supplements Omegas in medicines Omega-3 transition to medicine
    18. 18. Increasing health problems relating to weight issues Flock MR, Rogers CJ, Prabhu KS, Kris-Etherton PM: Immunometabolic role of long- chain omega-3 fatty acids in obesity-induced inflammation. Diabetes/metabolism research and reviews 2013, 29:431-445. Makki K, Froguel P, Wolowczuk I: Adipose Tissue in Obesity-Related Inflammation and Insulin Resistance: Cells, Cytokines, and Chemokines. ISRN inflammation 2013, 2013:139239. Titos E, Claria J: Omega-3-derived mediators counteract obesity-induced adipose tissue inflammation. Prostaglandins & other lipid mediators 2013, 107:77-84. White PJ, Marette A: Is omega-3 key to unlocking inflammation in obesity? Diabetologia 2006, 49:1999-2001. White PJ, Marette A: Potential role of omega-3-derived resolution mediators in metabolic inflammation. Immunology and cell biology 2014, 92:324-330.
    19. 19. Omega-3 and bone health Mangano KM, Sahni S, Kerstetter JE, Kenny AM, Hannan MT: Polyunsaturated fatty acids and their relation with bone and muscle health in adults. Current osteoporosis reports 2013, 11:203-212. McMahon MS: Beneficial effect of omega-3 fatty acids on bone metabolism. Orthopedics 2012, 35:735-736. Rousseau JH, Kleppinger A, Kenny AM: Self-reported dietary intake of omega-3 fatty acids and association with bone and lower extremity function. Journal of the American Geriatrics Society 2009, 57:1781-1788. Saidenberg Kermanac'h N, Bessis N, Cohen-Solal M, De Vernejoul MC, Boissier MC: Osteoprotegerin and inflammation. European cytokine network 2002, 13:144-153.
    20. 20. Inflammation, omega-3 and rheumatoid arthritis Curtis CL, Rees SG, Little CB, Flannery CR, Hughes CE, Wilson C, Dent CM, Otterness IG, Harwood JL, Caterson B: Pathologic indicators of degradation and inflammation in human osteoarthritic cartilage are abrogated by exposure to n-3 fatty acids. Arthritis and rheumatism 2002, 46:1544-1553. Sperling RI: Dietary omega-3 fatty acids: effects on lipid mediators of inflammation and rheumatoid arthritis. Rheumatic diseases clinics of North America 1991, 17:373-389. Lee YH, Bae SC, Song GG: Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: a meta-analysis. Archives of medical research 2012, 43:356-362.
    21. 21. Omega-3 and pain Maroon JC, Bost JW: Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surgical neurology 2006, 65:326-331.
    22. 22. • AA and EPA contents of cell membranes can be altered through oral administration of omega-3 EPA • Increasing EPA levels results in a changed pattern of production of eicosanoids • Changing the fatty acid composition of cell membranes also affects immune function and pathways – changes in membrane structure – cell signalling – gene expression of cells and products involved in the inflammatory cascade and pain signalling
    23. 23. • As health practitioners, you are perfectly placed to guide patients toward natural co-therapies • Route of inflammation may not just be due to pain/injury issue, as consultation/client history may reveal: • High stress • Fatigue • Neurological disorder • Poor diet and lifestyle • CVD • Low mood • Inflammation is a key driver of a myriad of diseases/conditions
    24. 24. Thus, addressing high levels of inflammation by restoring AA to EPA ratio and increasing the omega-3 index will reduce:  Pain  Fatigue  Stress  Risk of modern illness
    25. 25. Measuring inflammation and tracking progress • Blood spot fatty acid profiling Omega-6 to omega-3 ratio AA to EPA ratio Omega-3 index • Knowing a client’s baseline omega-3 index allows effective dosing to increase omega-3 index and reduce the AA to EPA ratio Omega-3 index Dose required Body weight Minimum dose Base line Target (mg/kg) (kg) (g) 3 8 0.0222 89 1.98 4 8 0.0172 89 1.53 6 8 0.0072 89 0.64
    26. 26. So remember! You don’t need to be a nutrition specialist to make a difference to your clients’ health Our biggest practitioner accounts are manual therapists NOT nutrition specialists….
    27. 27.  Expertly formulated EPA supplements to suit all ages and needs  Scientifically proven co-therapies to support long term health  Technical support from MSc Nutrition Specialists  Literature and personalised support for your clients  Fatty acid blood profiling service allows a bespoke and effective supplementation regime
    28. 28. Practitioner Scheme benefits:  A personalised referral code (i.e. SMITH25)  Highest commission on direct orders  Best discount for your clients  Free 1-2-1 training with our highly qualified nutrition team  Free promotional materials for your clients  Free profile feature on our website  Over 45% profit on trade orders  Instant 30 days free credit  PLUS additional 20% off your first trade order (effective profit up to 57%)
    29. 29. info@igennus.com www.igennus.com 01223 421434 31
    30. 30. References Bosma-den Boer MM, van Wetten ML, Pruimboom L: Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering. Nutrition & metabolism 2012, 9:32. Flock MR, Skulas-Ray AC, Harris WS, Etherton TD, Fleming JA, Kris-Etherton PM: Determinants of erythrocyte omega-3 fatty acid content in response to fish oil supplementation: a dose-response randomized controlled trial. Journal of the American Heart Association 2013, 2:e000513. Harris WS, Von Schacky C: The Omega-3 Index: a new risk factor for death from coronary heart disease? Preventive medicine 2004, 39:212-220. .