Foundations For Health – Part 2

Dr. Kate Kuntze, ND Foundations For Health

Welcome back!

If you haven’t read it yet, take a look at the first blog in this series HERE, where I begin to highlight something I feel is arguably of the utmost importance.

Recap: Macronutrients are what the body needs in larger amounts. This includes proteins, fats and carbohydrates. This also includes water, though it is not always seen as a macronutrient, but it is essential in larger amounts.

Next up: Micronutrients – what the body needs in smaller amounts. These include vitamins and minerals. In general, a healthy person with a diet with a wide variety of nutrient dense foods should be getting enough micronutrients. However, that doesn’t take into consideration predisposition and conditions which require more of certain micronutrients, as well as the standard North American diet (increased refined and processed foods) and environmental aspects (farming practices, pollution, heavy metals, etc) which can lead to nutrient depletions and imbalances.

Without an adequate supply of micronutrients, not only are we less likely to sleep deeply, recover briskly from exercise, ward of sickness, and fully exploit our brainpower, we get hungry. And we stay hungry” – Brendan Brazier

Common nutrient depletions seen in clinical practice:Magnesium, B vitamins, Vitamin C, and Vitamin D.

Occasional nutrient depletions seen in clinical practice: Zinc, Iron, Iodine.

Because of the various nutrient depletions, it may be worth considering a multivitamin/mineral to support your base micronutrient status. This is best decided with your naturopathic doctor as there are MANY out there on the market and there is no one-size fits all approach here. I could write a short book going over all the micronutrients for human health, but I will highlight the most common nutrient depletions seen in clinical practice.

Magnesium is required in many functions in the human body, being a cofactor in more than 300 enzyme reactions that include energy production, muscle and nerve function, blood sugar control, blood pressure regulation, hormone regulation, electrolyte balance, protein and glutathione synthesis. Because of its widespread role in the body, there is more demand for this mineral than most others. Magnesium depletion can result because of reduced absorption due to prescription medications (acid suppressants, antihypertensive, oral contraceptives, hypoglycemics, and corticosteroids) or digestive conditions, or increased loss due to stress (expended to produce cortisol), excess alcohol consumption, and insulin resistance. Not to mention traditionally magnesium-rich foods like leafy green vegetables and whole grains may not be good sources of magnesium if they are grown in nutrient-depleted soil from modern agricultural practices. Processed foods have even less and your water likely contains little to none as municipal water treatment usually removes much of the mineral content. For more information on magnesium, read this past blog post.

B vitamins are a group of vitamins that play an essential role in many cellular processes. B vitamins are needed for healthy maintenance of brain cells, metabolism of carbohydrates, production of neurotransmitters which regulate mood and conduct messages. Often called “the energy vitamins”, but they function more like cogs in a clock that all need to be available for the clock to work (producing energy). A deficiency in any one of them can lead to a host of health problems, as you can imagine a clock won’t work very well if one cog is missing or functioning slowly. Trying to pick the most important B vitamin is like picking the most important cog in the clock – they all work in synergy. If you choose to supplement, there is no known reason not to take the all the B vitamins, but there are also instances where taking additional individual B vitamins may be appropriate. You do not want to take a single B vitamin in the absence of a complex for long term because the functioning of the body (the clock) is reliant on all B vitamins (the cogs of a clock). Eating a healthy diet with a variety of foods will give the body a variety of B vitamins. However, the body doesn’t store B vitamins well. Just like with magnesium, depletion of B vitamins can result because of reduced absorption due to prescription medications (acid suppressants, anti-hypertensives, oral contraceptives, hypoglycemics, and NSAIDs) or digestive conditions, or increased need due to stress, smoking, use of alcohol and drugs, and illnesses.

Vitamin C also called ascorbic acid is an essential dietary component because humans are unable to make it. Its most well known functions in the body are acting as an antioxidant, scavenging up free-radical damage, and immune function. It is also required for making and metabolizing certain proteins such as collagen (think tendons, ligaments, skin and muscles), and carnitine (energy production), and improves the absorption of nonheme iron (plant based). Because of its widespread effects it may be considered for cardiovascular, dermatological, gastrointestinal, musculoskeletal and immune system benefits. Deficiency of vitamin C leads to scurvy with a variable timeline and initial presenting symptoms of fatigue, malaise, inflammation of the gums. As the deficiency progresses, collagen synthesis becomes impaired and connective tissue weakened leading to bruises, poor wound healing, corkscrew hairs. Left untreated, scurvy is fatal, but this is rare in developed countries where fruits and vegetables are plenty. Problem is that the standard North American diet is often lacking in the recommended 5-9 servings of fruit and vegetables daily (with greater emphasis on vegetables), and certain conditions (stress again!) and medications (acid suppressants, NSAIDs, and oral contraceptives) can result in depletions.

Check out information on serving sizes of fruits and vegetables here and tips for increasing consumption of fruit and vegetables here.

Vitamin D, the divine sunshine vitamin! It is often referred to as the sunshine vitamin because our bodies can produce it when the skin is exposed to adequate sunlight. Due to Canada’s geographical location, except during the summer months, the skin makes little if any vitamin D from the sun. A 2010 review from the University of Alberta found an astounding 75-97% of Canadians demonstrated vitamin D insufficiency, and a considerable proportion of the population sustaining a severe deficiency. Other factors that can contribute to a vitamin D deficiency include sunscreen use, air pollution, colour and temperature of your skin, as well as the health of your gut, liver and kidneys. We also know certain medications are associated with vitamin D depletions such as statins, hypoglycemics, corticosteroids, bronchodilators, and antidepressants. In addition it is naturally present in very few foods, which is why it is commonly added to others, or supplemented. Caution should be done if supplementing with vitamin D as it is a fat soluble vitamin which can be retained in high amounts in the body and does have toxicity concerns.  The research behind vitamin D is growing for bone, muscle, immune, cardiovascular, pregnancy, brain and mood health.

As you can see micronutrient status is not something to scoff at. There are many benefits of working with someone who has advanced nutritional medicine knowledge such as a Naturopathic Doctor.

References:

Bede O, et al. Effects of magnesium supplementation on the glutathione redox system in atopic asthmatic children. Inflamm Res, 2008;57(6):279-86. doi: 10.1007/s00011-007-7077-3 

Dietary Supplement Fact Sheet: Magnesium. National Institute of Health. Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/#en3 Accessed 04/14/20

Dietary Supplement Fact Sheet: Vitamin C. National Institute of Health. Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/ Accessed 04/16/20

Dietary Supplement Fact Sheet: Vitamin D. National Institute of Health. Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/ Accessed 04/16/20

Gaby AR. Nutritional Medicine. Fritz Perlberg Publishing, 2011.

Mohn ES, Kern HJ, Saltzman E, Mitmesser SH, McKay DL. Evidence of Drug-Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update. Pharmaceutics. 2018;10(1):36. Published 2018 Mar 20. doi: 10.3390/pharmaceutics10010036

Nair R, Maseeh A. Vitamin D: The “sunshine” vitamin. J Pharmacol Pharmacother. 2012;3(2):118–126. doi:10.4103/0976-500X.95506

Schwalfenberg GK, Genius SJ, Hiltz MN. Addressing vitamin D deficiency in Canada: A public health innovation whose time has come. Public Health. 2010;124(6):350-9. doi: 10.1016/j.puhe.2010.03.003

Whitney EN, Cataldo CB, Rolfes SR. Understanding Normal and Clinical Nutrition. 8th Ed. Wadsworth, 2002.