WHAT FOLLOWS IS AN ARTICLE I wrote a few years ago that reviews the intellectual history of the pioneers in nutrition and the fathers of functional medicine. These revolutionary thinkers and scientists are responsible for re-framing our entire notion of nutrition and vitamin and mineral therapy away from its once limited use in the treatment of vitamin deficiency diseases, to the breakthroughs of nutrigenomics and the use of these therapies as a novel way to treat long-latency deficiency diseases.  In addition, I have included a few quotes used in my article that come from papers that have informed and inspired me.

I hope you enjoy this journey through history and the thinking of visionaries including Linus Pauling, Roger Williams, Bruce Ames and Robert Heaney (and that your thinking is changed as a beneficial side-effect).

Paradigm Shift: The End of “Normal Science” in Medicine–Understanding Function in Nutrition, Health, and Disease

The following article first appeared in the September/October 2004 issue of Alternative Therapies in Health and Medicine, 10(5):10-94, published by InnoVision Health Media. All rights reserved. To request permission to photocopy, post, or distribute this article, visit copyright.com

Those who believe that there are two categories of patients, those who are malnourished or vitamin deficient, and the rest of us, are fundamentally misguided and misinformed given the current depth of understanding about the role of nutrition in health and disease. Nutrigenomics, the study of the influence of nutrients on gene expression in acute and chronic illness, is the fulcrum for a changing medical paradigm. Kaput outlines the potential for this paradigm, which he describes as “the next frontier in the post genomic era,” to radically change our approach to health and disease. In fact, for the first time in medicine, we have the opportunity to not only treat disease but to create health.

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Bruce Ames says that….

“Nutritional interventions to improve health are likely to be a major benefit of the genomics era… . It will soon be possible to identify the complete set of genes having cofactor binding sites and the polymorphisms that fall into these regions, with an end goal of using vitamins, and possibly amino acids, hormones and minerals to effect a metabolic “tune-up.”

Ames, B. 2003. The Metabolic Tune-Up: Metabolic Harmony and Disease Prevention. J Nutr. 133: 1544S–1548S.

“Our analysis of metabolic disease that affects cofactor binding, particularly as a result of polymorphic mutations, may present a novel rationale for high-dose vitamin therapy, perhaps hundreds of times the normal dietary reference intakes (DRI) in some cases.”

Ames, B. 2002. High dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased Km): Relevance to genetic disease and polymorphisms. Am J Clin Nutr. 75: 616-58.

Dr. Robert Heaney shares some revolutionary ideas about nutrient deficiency…

“…inadequate intake of specific nutrients may produce more than one disease, may produce them by more than one mechanism, and may require several years for the consequent morbidity and mortality to be sufficiently evident to be clinically recognizable as ‘disease’.”

“…because the current recommendations [for vitamin and mineral intakes] are based on the prevention of the index disease only, they can no longer be said to be biologically defensible. The pre-agricultural human diet, insofar as it can be reconstructed, may well be a better starting point for policy… . Such a diet would have had at least some of the following features: high protein intake, low glycemic index, high calcium intake, high folic acid intake, an alkaline ash residue and high vitamin D input. It is in this nutritional context that human physiology is adapted. The burden of proof should fall on those who say that these more natural conditions are not needed and that lower intakes are safe.”

Heaney, R. 2003. Long-latency deficiency disease: insights from calcium and vitamin D. Am J Clin Nutr. 78: 912-9.

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