4.1 Overview of Basic Functional Nutrition Programmes

Topic Progress:

Looking at food and nutrients in terms of function means adopting a broader perspective than the classical health viewpoint of the diet, i.e. that diet is derived solely from calories, macronutrients and defined essential vitamins and minerals. Functional nutrition acknowledges nutrients as multipurpose molecules then adapts the applications of those molecules to meet the unique genetic and environmental needs of each particular individual.

We’ve already begun to discuss how different foods and nutrients can influence key systems including detoxification pathways and digestion; mitochondrial health and function; DNA translation; hormone and neurotransmitters levels, as well as interacting with the immune system and gut bacteria, which in turn influence many functions in peripheral tissues with associated changes in performance, including mental health.

Simply put, nutrition drives our physical, psychological and energetic health! Importantly, this means we can apply functional nutrition to key points of the fundamental clinical imbalances rather than only viewing health from a symptom perspective.

Nutrition & Homeodynamics

Modern medicine describes balance in the body as the concept of homeostasis, although we have discussed we prefer the notionally more accurate nomenclature of homeodynamics.

So what does homeodynamics really mean? Basically, this term describes the relatively stable physical and chemical composition of the internal environment of the body that results from the actions of the compensating regulatory systems. Body temperature, blood pressure and pH are good examples of homeodynamic mechanisms designed to keep balance and the body and mind functioning optimally. However, these biological parameters are not fixed numbers, as suggested in many textbooks. As you know, metabolic and biological systems respond to, and are influenced by our lifestyles and environment, so their patterns are unique to each and every one of us – something medical science does not allow for in clinical tests.

For example:

  • Body temperature fluctuates throughout the day and night by about 3-40F.
  • Hormone levels fluctuate depending on time of day (as well as gender and age) and also operate on a fixed cyclical basis, e.g. circadian rhythms involved in the sleep-wake cycle where healthy cortisol levels are highest around 6-7am to facilitate waking up, then decreasing through the day to their lowest level in the evening to promote sleep, alongside rising melatonin levels.
  • Metabolic activity in the body fluctuates according to activity, food choices and the environment, as well as gender and age.

So what’s the problem when body system homoedynamics is out of kilter? We don’t necessarily have a defined disease state but if people are experiencing stress, lack of sleep and slightly lower core body temperature they are not going to be feeling at their most healthiest, and certainly not if these symptoms are more long term. And what if these early warning signs are ignored or maybe not even recognised? This is so often is the case when individuals do not necessarily deem “feeling chronically colder than normal” or “not sleeping well” drastic enough to seek professional advice but nonetheless they continue suffer from increasing poor health and lack of energy.

One of the main issues is that these factors (individually or synergistically), along with other modern living, can alter the body pH to ever so slightly higher acid levels. It’s at this point, as with detoxification, we have hit another sometimes contentious issue between practitioners. Medical research agrees that there are a number of defined disease states that induce severe metabolic acidosis (e.g. renal disease) but some functional practitioners recognise a subtler sub-clinical rise in acidity within the body referred to as low-grade chronic metabolic acidosis. Of course, the body has several homeodynamic mechanisms in place to keep blood pH within a tight range but as a result of modern dietary and lifestyle choices (e.g. smoking, alcohol, city pollution, poor nutrition contributing to low ATP production) impact on the home dynamics of systems means low-grade chronic metabolic acidosis (i.e. change in cell and tissue pH) is now thought to be a common problem in many industrialised societies.

In a little more detail, this sub-clinical but chronic state is believed to emerge as a result of chronic cellular electrolyte imbalances where the four main electrolytes in the body (calcium and magnesium; sodium and potassium) are in part responsible for the pH gradient across the cell membrane and therefore the surrounding fluids. As we’ve discussed, many commonplace diet and lifestyle factors lead to low ATP production, as well as enzyme dysfunction including the sodium potassium ATPase enzyme, which balances the electrolytes sodium and potassium between the internal and external cell environment (as discussed in module 2, section 2.2); couple this with persistent sodium and potassium imbalance (e.g. through high sodium diet and low vegetable diet choices), as well as over-supply of calcium and shortage of magnesium (through poor dietary choices/ lack of plant food) eventually results in reduced ability of the body to control intracellular sodium and calcium levels and in turn cellular pH.

Excessive sodium can mainly be attributed to dietary excess. Table 4.1 outlines potassium and magnesium depleting factors that can chronically affect cellular pH:

Factors that deplete potassium Factors that deplete magnesium
Medications including diuretic drugs, laxatives, aspirin Alcohol and coffee consumption
Alcohol and coffee consumption Medications including diuretics
Low dietary potassium intake, e.g. too few vegetables Excess dietary calcium leads to kidney excretion of magnesium
Excessive sugar intake Excessive sugar intake may block magnesium absorption in the GI tract
Low levels of glucose in the blood (hypoglycaemia) Low dietary intake, e.g. too few vegetables
Magnesium deficiency  
Dietary sodium excess  

This problem with altered cellular pH remains unrecognised and hence undiagnosed by many in the medical profession but traditionally trained practitioners believe that these changes to tissue and cellular pH may induce or aggravate multiple inter-related biochemical and physiological changes from chronic tissue stress contributing to the viscous circle of mitochondrial dysfunction, ATP depletion and chronic inflammation. We are outlining this process here as one of the final pieces of the jigsaw puzzle in understanding chronic clinical imbalances in the body and how we can influence them through using the functional nutrition framework.

As we said, low-grade chronic metabolic acidosis, like detoxification, can be a contentious health topic in the scientific arena and there is often misunderstanding about how food and the diet affect cellular pH. However, we feel this is a fundamentally physiological process of great importance to health so we will cover this subject in more detail throughout the rest of this module and in Part 2. To get up to speed with some basic pH biochemistry and to help you understand the importance of cellular pH please read the first couple of pages of the nutrihub education article “The Importance of Balancing Body pH”.

So to recap: What we’re focussing on here is dynamic balance; constant fluctuations within the body that are unique to that person and their environment. So where does this place laboratory test results of say, blood homocysteine levels or thyroid hormones that are fixed in average ranges? Does that single number tell the whole story? We would suggest not. We suggest that the number is just one point that needs to be put into context for the whole individual. Recognising clinical imbalances and applying functional nutrition is about addressing that dynamic fluctuating process within the context of the individual and their internal and external environment and not solely relying on fixed health points.

So, you might be wondering, where does this leave us when trying to understand the application and combination of potentially hundreds of different foodstuffs to clinical imbalances? This might seem like an impossible task! But we are asking you to take a fresh approach to nutrition. By realising that nothing in the body is entirely “fixed” and beginning to “join the dots” between systems moves you into a more web-like interconnected way of thinking about health rather than the “single agent-single outcome” approach. This means that applying several (often small) dietary changes, frequently coupled with other simple but meaningful lifestyle interventions, can have a profound impact on shifting clinical imbalance(s) back towards the optimal state of function for that individual.

For example, somebody presents with anxiety and Irritable Bowel Syndrome (IBS) – you now know about the gut-brain axis connection so you have already identified one major system and clinical imbalance; working on dietary modifications to reduce the gastrointestinal (GI) system imbalances, coupled with relaxation practice which helps multiple systems including GI muscle relaxation and reduction of sympathetic nervous system activation, is a powerful long-term approach to therapeutic intervention for IBS. This is empowering the individual to understand and become involved in their self-care rather than fixing them in a situation where they solely rely on exogenous medication as a crutch.

This of course means that there may not be an established nutrient deficiency within a case, such as a blood test that demonstrates low mineral status or a specific clinically defined vitamin deficiency. Rather we’re seeking to restore balance to many different pathways and systems that require many different nutrients. Remember that sub-clinical changes will have been in existence for months and even years before symptoms may present or become severe enough for someone to seek treatment/support, as with the case of low grade chronic metabolic acidosis. Please read p3 of the nutrihub education article that outlines some of the symptoms and named diseases, which may be linked, in part, to developing low-grade metabolic acidosis. “The Importance of Balancing Body pH”.

We also need to remember that restoring the balance to underlying metabolic patterns is a process that makes demands on the body. So not only is a “one size fits all” dietary approach not suitable for named diseases/system imbalances but also recognition is required that dietary programmes change as the individual’s needs change. We will discuss this aspect of functional nutrition as we move through this module and in Part 2 of this nutrihub advanced course.

We will also explore in Part 2 how functional nutrients work synergistically to support absorption, e.g. flavonoids enhancing absorption of Vitamin C in the digestive tract; as well as the impact that anti-nutrients (e.g. oxalates and phytates) found in certain foods can have on inhibiting the absorption of certain nutrients. This means we must think about food not just for its nutritional properties, but for its effects on absorption and utilisation of other nutrients within the body, as well its therapeutic effects. It’s no simple task when considering a functional nutrition programme!

But before we start looking at individual foods, food groups, dietary interventions and nutritional programmes in the remainder of this module, let’s remind ourselves once again that we’re not solely considering what to exclude from the diet; problem food avoidance is the classical exclusive intervention. Whilst sometimes necessary in symptomatic management, e.g. avoidance of refined sugars to manage dysglycaemia or excluding specific food derived antigens in cases of digestive-based immune disorders etc., this type of approach to nutrition does not address functionality of that person’s system. We are therefore also considering not only what to potentially remove for a period of time, but also what to add in to re-establish positive balance in the underlying metabolic patterns and so restore resilience within the body and mind. Restoring reserves (i.e. building resilience) is crucial as we face many challenges in everyday life from stress, communicable disease (e.g. cold and flu viruses) and toxic environments, to name a few.

So, let’s move through the sections of this final module of Part 1 investigating different food groups, nutrients, dietary interventions and the impact these have on the balance within the body and how we may maintain and restore the homeodynamic state unique to that individual. We’ll look beyond defined nutrient deficiencies so you can be confident in understanding the multiple roles of various nutrients and other necessary food factors.