Nutrition In Complementary Care NCC Winter 2005 Volum… · NCC DPG Annual Report . . .59 Chair’s Corner. . . . . .42 Editor’s Notes. . . . . . .42 NEXT ISSUE • Spring 2005

Winter 2005 Volume 7, Issue 3

NCCContentsSupplements:The Effect of Epigallocatechin

Gallate (EGCG) On Thermogenesis

& Weight Control . . . . . . . . . .41

Putting It Into Practice:Combining Prayer & Optimal

Nutrition: An Effective Adjunct

to Conventional Medicine in

Hepatitis B Therapies . . . . . .43

Therapies:Ayurveda, the traditional system

of Indian Medicine . . . . . . . .53

Resource Reviews .50

Of Interest to Members:Thanks To Our Sponsors . . . .58

Editorial Staff . . . . . . . . . . . . .59

Key Contacts . . . . . . . . . . . . .60

FNCE NCC Review . . . . . . . . .57

NCC DPG Annual Report . . .59

Chair’s Corner . . . . . .42

Editor’s Notes . . . . . . .42

NEXT ISSUE• Spring 2005Editor’s Deadline, Feb. 1• Summer 2005Editor’s Deadline, April 1• Fall 2005Editor’s Deadline, July 1

A Diete t ic Pract ice Group of the Amer ican Diete t ic Associa t ion

cont. on page 47

Winter 2005 Volume 7, Issue 3 Page

41

Nutrition InComplementary Care

SUPPLEMENTS:The Effect Of EpigallocatechinGallate (EGCG) OnThermogenesis & Weight ControlIlene Smith RD

Although manysolutions have beenproposed to help theUnited States grapplewith its weight prob-lem, the formula forweight loss is rela-

tively simple: decrease energy intakeand/or increase energy expenditure.The former has spurred the foodindustry to produce a broad array offood products with reduced fat, carbo-hydrates, and calories. The latter hasstimulated investigation of ways toincrease energy expenditure.

About 60% of the energy we burnis used to maintain basic metabolicactivities of cells and tissues, as well asblood circulation, respiration, and gas-trointestinal and renal processing (i.e.the basal cost of living). This amountof energy known as the basal metabol-ic rate (BMR)—or resting metabolicrate (RMR) when extrapolated tobasic energy expenditure over 24hours—is related to age, gender, andthe fat-free mass of the body. About30% of energy is expended for physi-cal activity, and about 10% is expend-ed in thermogenesis, the productionof body heat.1

While BMR and RMR may onlyvary 5% to 8% among individuals,total daily energy expenditures mayvary several-fold from one individualto another, independent of physicalactivity. One factor may be the differ-ences in non-exercise activity thermo-genesis (NEAT). This can includeanything from walking to work totyping to yard work, even fidgeting.Variation in total energy expendituremay also come from diet-inducedthermogenesis (DIT). Although rela-tively small, this production of bodyheat in response to eating may have acumulative impact on body weightand composition over time.1

What is thermogenesis?

Thermogenesis is centrally con-trolled by the hypothalamus and gov-erned by the catecholamines norepi-nephrine and noradrenaline that arereleased by the sympathetic nervoussystem.6 From an evolutionary stand-point its function is to maintainhomeostasis by generating heat asneeded by the organism.

Don’t Forget to

Cast YOUR Vote for2005-2006

NCC & ADA Leaders!See page 54 for more information.

The views expressed in this newsletter are those of the authors and do notnecessarily reflect the policies and/or official positions of the AmericanDietetic Association.

We invite you to submit articles, news and comments. Contact us for authorguidelines.

Send change-of-address notification to the American Dietetic Association,120 South Riverside Plaza, Ste. 2000, Chicago, IL 60606-6995.

Copyright © 2003 Nutrition in Complementary Care, a Dietetic PracticeGroup of the American Dietetic Association. All material appearing in thisnewsletter is covered by copyright law and may be photocopied or otherwisereproduced for noncommercial scientific or educational purposes only, provid-ed the source is acknowledged. For all other purposes, the written consent ofthe editor is required.Annual Subscription Rates (in U.S. dollars, payable in U.S. funds)Individuals who are ineligible for ADA membership . . . . . . . . . . . . . . . . . . . . . . . . . . . .$35/yearBack issues . . . . . . . . . . . . . . . . . . . . . . . . . $10 each, 4 for $35For international orders, add $5 shipping and handling per annual subscription and for eachback issue order of 1–4 issues. For orders of 5 or more back issues, shipping is $6.50 and $1.50for each additional issue. Make checks payable to NCC DPG#18 and mail to the Treasurer. Seeback cover for address. ISSN 1524-5209

Winter 2005 Volume 7, Issue 3Page

42

Chair’s Corner:RRiicckk HHaallll,, MMSS RRDD CChhaaiirr 22000044--22000055

Editor’s Notes:SSaarraahh HHaarrddiinngg LLaaiiddllaaww,, MMSS RRDD MMPPAA

It is hard to believe that we are now into 2005! Thepast year has been full of personal and professionalchallenges for me. The most recent challenge beingmy husband’s diagnosis of melanoma that occurredjust as the holidays were upon us. For this reason, thewinter issue of the newsletter is unusually late ingetting to you. For that I must apologize. I am happyto report that his surgery was successful removing theentire tumor and there were no metastases to thelymph nodes. It was quite a shock for someone sohealthy to be diagnosed with this disease, but hisyears of mountain climbing, without a hat in goodweather, took its toll. My words of advice toeveryone…. Always wear a hat, even if the sun is notshining!

Aside from this, it was wonderful seeing so manymembers at FNCE in October. It is always hearteningto hear the positive comments (and criticisms) aboutthe newsletter. I appreciate getting new ideas for arti-cles and gathering the names of potential authors andvolunteers to help with the publication.

I would like to thank the Executive Committee forthe award that was given to me: Excellence In ServiceAward. I was quite honored to receive this recogni-tion from my peers in the field of ComplementaryNutrition. The newsletter and the work I do for thepractice group is not work, but an opportunity toexpand the knowledge that I can use to help othersand the chance to meet and work with many wonder-ful individuals.

As always, I encourage all of you to becomeinvolved with NCC. There are so many opportunitiesavailable for members to contribute—from thenewsletter, to the web site to the nominating commit-tee. I am looking for authors for up coming issues,Spring cardiovascular disease and Summer, generaltopics. I would be interested in knowing what topicsYOU would like covered as well, so please let meknow. You may contact me if you are interested inany opportunities with the newsletter at [email protected]. For other opportunities, please con-tact our Member Services Chair, Susan Drake [email protected].

It’s always exciting to get an issue of the NCCnewsletter in my mailbox! Personally, I prefer not toread it all at once because they only come four timesa year. The great news, however, is that NCC keepsme informed about cutting edge issues daily. If youaren’t reading the NCC webpage often(http://ComplementaryNutrition.org), you are trulymissing out. Our web editor, Dr. Susan Moyers,keeps the content fresh and exciting. Another way tostay informed is through our email mailing list(EML), which is utilized by hundreds of NCC mem-bers sharing information daily. To find out how toget plugged in to the EML, visit our webpage.

Did you miss the Food and Nutrition Conference(FNCE) in October? If you missed it, you’ll notwant to repeat that mistake when we head back to StLouis in 2005. The Nutrition in ComplementaryCare (NCC) sponsored events just seem to get betterevery year. In this issue of our newsletter, our dietet-ic practice group’s administrative assistant, KathyBernard MS RD, shares a detailed account of herexperiences at her first FNCE this past year inAnaheim.

As we begin the New Year, the NCC executive co-mmittee is planning to convene in New Jersey to mapout our short-term and long-term goals. The faces ofmany of our leaders will likely change in the nearfuture, with elections underway and new appointedleaders taking positions in the next several months.Speaking of elections, if you have not done so already,please go to www.ComplementaryNutrition.org andcast your vote today. If you have an interest in serv-ing as a volunteer on a project or on the executivecommittee, I urge you to contact NCC’s memberservices Chair, Susan Drake at [email protected].

On behalf of the entire Nutrition inComplementary Care Executive Committee, I wishyou a prosperous and healthy 2005!


43 cont. on page 44

Putting It Into Practice:Combining Prayer & Optimal Nutrition:

An Effective Adjunct to Conventional

Medicine in Hepatitis B TherapiesNancy Patin Falini, MA RD LDN

Hepatitis B (HBV) is a bloodborn virus that affects 400 millionpeople throughout the world andresults in 1 million deaths annually.1

These statistics became a reality formy husband and I two weeks afteradopting our Vietnamese son who

was diagnosed with active and aggressive HBV.

In the United States, approximately 1.25 millionpeople are infected with the virus.2 A large percentageof those affected are of Asian descent. Infants usuallycontract the disease through vertical transmissionfrom their mothers during childbirth. Young childrenoften become infected by very close contact with aninfected peer.

HBV is one of the toughest viruses to eradicate andit is difficult to know when to treat. Ten percent ofinfected adults are unable to get rid of the virus andbecome chronic carriers of the disease.4 A similar phe-nomenon occurs in 90% to 95% of infected infantsand 60% of infected children.4 Immune tolerancemay be the reason why HBV is not recognized duringinfancy and early childhood. 3

The morbidity and mortality occurring from HBVis due to the complications of chronic hepatitis, livercirrhosis, and hepatocellular carcinoma (HCC).5

Evidence indicates Asian men are quite susceptible todying from HCC.2,3 Those with the worst prognosishave actively replicating HBV as indicated by positiveHBV DNA (deoxyribonucleic acid) or hepatitis Beantigen (HBeAg). These individuals have biochemi-cally and histologically more aggressive disease activi-ty.5 In a study of 363 patients, 39% were HBeAg-positive while 61% were HBeAg-negative. 6

Consequently, 72% of HBeAg- positive patients hadcirrhosis, versus 46% of those who were HBeAg-neg-ative.6

The limited drugs available to treat HBV do notcure the disease. However, a successful treatment out-come does result by suppressing viral replication. Thefollowing indicate successful disease suppression: 1)seroconversion - the development of detectable anti-bodies in the blood directed against HbeAg 2) theresolution of HbeAg 3) a minimal HBV DNA level4) normal alanine aminotransferase (ALT). Only 30%to 40% of children respond positively to treatment.The risk for developing cirrhosis and HCC are less-ened when the above biochemical indices prevail.1

Prayer: Spiritual Food

A broad and all-inclusive description to defineprayer is “communication with the absolute.” 7 Formost of the twentieth century, the medical communi-ty disregarded the use of prayer in therapy. However,according to national surveys, many Americansbelieve in the power prayer has on healing.8 Researchsuggests that children perceive themselves as beingspiritual beings.9 Consequently, prayer may have amore profound impact on the pediatric population.

Intercessory prayer (also known as distant prayer) isa commonly used form of prayer that essentiallymeans, “to go between.”7 This form of prayer entailsmeditation on behalf of the needs of someone orsomething else. Frequently, the individuals prayingare physically removed from the recipient. Moreover,the recipient need not be human. Nonhuman sys-tems, such as bacteria, yeast, cancer cells, and rodentshave been positively influenced by prayer.7 The effica-cy that intercessory prayer has on healing is difficultto measure partially due to disagreement concerningsemantics. Often the terms “concentrated” or “mentaleffort” replace the word “prayer.” Parapsychology (psihealing) is a term used in some research that actuallyinvolves prayer.7

A renowned study involving intercessory prayer wasconducted by cardiologist Randolph Byrd, MD at theUniversity of California School of Medicine, SanFrancisco. Byrd randomized 393 patients in a double-blind study. One group received intercessory prayer,while the other did not. The intercessory prayer wasprovided by people outside of the institution and wasconducted as desired. The recipients of the prayerreportedly needed less powerful medications, endotra-cheal intubation, ventilation, and cardiopulmonaryresuscitation. They also had less pulmonary edemaand fewer deaths.7


44

cont. from page 43

cont. on page 45

Putting It Into Practice: Combining Prayer & Optimal Nutrition: AnEffective Adjunct to Conventional Medicine in Hepatitis B Therapies

McCaffrey et al. investigated the relationshipbetween prayer and health in a telephone survey. Of2055 respondents, 35% prayed for either wellness orspecific medical conditions, including gastrointestinalproblems and allergies. Sixty-nine percent of thosepraying for specific medical conditions claimed prayerto be helpful. In individuals using conventional medi-cine as a primary treatment, 72% enlisted prayer aspart of their therapy, and only 11% of this groupinformed their physicians of using prayer.8

Nutrition: Physical Food

Optimal nutrition helps sustain the body andenables it to function at its potential. Functionalfoods are becoming popular and economical optionsfor promoting optimal nutrition, wellness, andimproving health.10 Nutritional components in foods,or the foods themselves, may be considered in therealm of functional foods. A diet rich in plant foodsprovides nutrients in addition to thousands of cancerfighting phytochemicals. These substances are vital inhelping to prevent HCC in those with HBV, especial-ly Asian males who are more susceptible. Vitamins A,C, E, iron, and zinc are nutrients that play an impor-tant role in immune function11 as does selenium, allof which may be components of functional foods.Vitamin E and selenium may specifically contributeto the prevention of liver damage.12

Essential fatty acids, especially alpha-linolenic acidfound in flax, canola oil, nuts, seeds, and their non-hydrogentated butters, contribute to the developmentof healthy cell membranes and controlling infections.A diet rich in essential fatty acids may also lower therisk of cancer.13 This is important in active hepatitis,where liver cells are destroyed and the risk of HCC isincreased. .Excess trans-fatty acid intake may hinderthe conversion of essential fatty acids to their activeforms.14 Additionally, trans-fatty acids may increasethe risk for chronic disease, such as cancer.Consequently, fast foods, snack foods, such as chipsand cookies, should be consumed in moderation.

Probiotics present in foods like yogurt and kefirprovide numerous health advantages. These benefitsinclude normalizing intestinal flora, increasingbioavailability of nutrients, and improving immunefunction.15 Prebiotics are nutrients used by intestinal

bacteria as food and promote the synthesis of probi-otics. Subsequently prebiotics such as fructoogliosac-charides are added to the diet to aid probiotic prolif-eration in the intestine. Under normal circumstancestoxins and microorganisms transfer across the intes-tinal barrier and affect neighboring parts of thebody.16 A healthy intestinal flora can influence thebarrier integrity and work as a mode of protectionagainst the translocation of pathogens. When naturalflora colonizes the intestine it facilitates nutrientabsorption that would otherwise be absorbed bypathogenic organisms. It also prevents the adherenceof pathogens to the intestinal mucosa. Maintaining ahealthy mucosa is important since the majority of thebody’s immune cells reside in the intestinal lymphatictissue.17

Case Study: A Formula for healing

When our son was diagnosed with HBV, he hadcoexisting positive HBeAg. This correlates with aworse prognosis than being HBeAg-negative. In addi-tion, a baseline HBV DNA of 42 pg/mL indicatedthe virus was actively replicating. Aspartate amino-transferase (AST) and alanine aminotransferase (ALT)values were 234 U/L and 382 U/L, respectively. Aliver biopsy at the age of 19 months revealed fibrosis.Simultaneously, a tuberculin purified protein deriva-tive (PPD) test showed a positive result. Isoniazid wasadministered to cure the potential for a future tuber-culin manifestation. Since isoniazid can be hepatotox-ic (but rarely in children), we postponed the optionto treat the HBV concurrently. The isoniazid was welltolerated. Once completed, it was again time to con-sider treatment for HBV. However, our son’s HBVDNA level had rapidly progressed ranging from 1200to 1400 pg/mL. The rise in HBV DNA meant hisprognosis had worsened due to aggressive viral repli-cation. Given this particular clinical scenario, therewere no ideal treatment options for pediatric patientsat that time.

Realizing there was no available treatment to con-trol the virus, we decided to coordinate a large inter-cessory prayer campaign. The participants were ini-tially contacted via electronic mail, telephone calls,


45

cont. from page 44

cont. on page 46

and the postal service. They were asked to recite aspecific prayer daily for a nine-day period. The partic-ipants spanned from the United States, Italy, andIndia; consisting of clergy, seminarians, religious sis-ters, and the laity. After nine days, many continued topray indefinitely, anticipating a positive outcome.Very shortly following the initial prayer devotion, ourhepatologist informed us of a potential for treatmentthrough clinical trials. This information provided ushope to continue to cope with the disease. In August2001, less than two months later, lamivudine wasapproved for pediatric patients ages 2 to 17 years.18

Fortunately, lamivudine is better tolerated than inter-feron alpha by children infected at birth.19

Prior to starting treatment, our son’s HBV DNAhad escalated to 2359 pg/mL, which again revealedcontinuous and aggressive viral replication. However,within one month of initiating lamivudine, the HBVDNA plummeted to a mere 2 pg/mL. The healthcare team was surprised and elated at such an imme-diate and abrupt drop in HBV DNA. Our hepatolo-gist expressed delight and optimism, which in con-junction with prayer, instilled greater hope. In justunder nine months, the HBV DNA was undetectableand the hypertransaminasemia was progressingtoward normal.

Lamivudine was administered for a total of 13months and discontinued after a subsequent unde-tectable HBV DNA was confirmed. Nine monthslater the prayers of hundreds of supporters wereanswered - the HBV DNA remained undetectableand the hypertransaminasemia resolved. Seroconver-sion occurred as indicated by a non-reactive HBeAgand a reactive corresponding antibody. Additionally,the hepatitis B surface antigen was non-reactive indi-cating viral recovery.20 The liver has an ability toregenerate, and according to our hepatologist, theprevious liver damage was likely healed.

Currently, our son is healthy. The long-term plan isto have yearly follow-up exams to monitor alpha-feto-protein. This marker can indicate the presence ofHCC. In spite of our son’s treatment, previous DNAdamage causes the risk for HCC development toremain. During his next exam, the hepatitis B anti-body will be checked. According to our hepatologist,

this particular antibody can take some time to develop.

Even though lamivudine is an antiviral agent thathinders viral replication, it appears that complementa-ry care contributed significantly to the successful heal-ing described here. Our son was nourished by asteady dose of intercessory prayer and a well balanceddiet containing functional foods. In addition, extraattention and vigilance was given to implementingsound food safety practices; therefore, sparing theimmune system and liver of any unnecessary stress.

Foods that formed the base of the diet were selectedfor their health benefits. In particular, such foods assteamed cruciferous vegetables, raw fruits, driedbeans, brown rice, nut and seed butters, and yogurt.When poultry and red meat were served, they werenot fried. We used canola and flax oils in place ofhydrogenated fats for such items as cooked cereal,vegetables, and starches, as well as in homemadebaked goods like cookies. At home we used purifiedwater for drinking and cooking. Careful attention wasgiven to removing blemished parts of produce. Onthe occasion when lunchmeats were eaten, we cookedthem. We did not implement supplementation due tothe potential ill effects some supplemented nutrients,such as excess vitamin A and iron, can impose on theliver.

Take Home Message

As nutrition professionals, we should promote goodhealth by being sensitive to the entire needs of apatient’s medical condition. Prayer is commonly prac-ticed to obtain positive health outcomes. Prayer isuplifting and can offer coping mechanisms and hope.Exploring a patient’s spirituality enables us to be sup-portive, compassionate, empathetic, and humanisticin a high tech world, where personal interaction andintimacy is diminishing. Spirituality can be addressedby simply stating the intent to pray for a patient’sneeds; in particular, for their ability to implement therecommended nutrition management techniques. Bydoing this, we are supplying both spiritual and physi-cal nutrition interventions.

The synergy of spirit and body was constantlynourished in our son by prayer and optimal nutrition.His spiritual and physical nourishment consisted of


cont. from page 45


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intercessory prayer and a well balanced diet rich infruits, vegetables, legumes, nuts/seeds, probiotics, andessential fatty acids. Protein, saturated fat, and trans-fatty acid intake were kept moderate. These forms ofcomplementary care when used with medicationbrought healing. Sharing with patients such a positiveexperience resulting from the power of prayer and anutritious diet can be inspirational. Patients may feelmore open to express their own spirituality andbecome more motivated to implement nutrition rec-ommendations.

For More Information:

Hepatitis B Foundation700 East Butler AvenueDoylestown, PA 18901http://www.hepb.org215-489-4900

Science & Theology Newshttp://www.stnews.org516-432-5550

Nancy Patin Falini, MA,RD owner of NutritionalGraces, LLC and author of Gluten-Free Friends: AnActivity Book for Kids is a consultant, author, lecturerspecializing in celiac disease. Contact Nancy at (610)-696-8655 or [email protected].

References:1. Block J. B Informed. Doylestown, PA: Hepatitis B

Foundation; Summer 2004. 2. Hepatitis B Foundation. Trinh HN. Hepatitis B

and the Vietnamese Community. Available at: http://www.hepb.org/07-0297.hepb. Accessed 6/10/04.

3. Lai CL, Chien RN, Leung NWY, et al. A one-year trial of lamivudine for chronic hepatitis B. N Engl J Med. 1998;339:61-68.

4. Hepatitis B Foundation. About Hepatitis B Infections. Available at: http://www.hepb.org/12-0651.hepb. Accessed 6/10/04.

5. Douglas DD, Post DJ. Hepatitis B: an assessment of current and future treatment options. Formulary. 2001;36:708-724.

6. Amarapurkar DN, Baijal R, Kulshrestha PP, et al.Profile of hepatitis Be antigen-negative chronic hepatitis B. Indian J Gastroenterol. 2002;21:93-95.

7. Dossey L. Healing Beyond the Body. Boston, MA:

Shambhala; 2001.8. McCaffrey NM, Eisenberg DM, Legedza ATR, et

al. Prayer for health concerns. Arch Intern Med. 2004;164:858-862.

9. Houskamp BM, Fisher LA, Stuber ML. Spiritualityin children and adolescents: research findings and implications for clinicians and researchers. Child Adolesc Psychiatr Clin N Am. 2004;13:221-230.

10. Hasler CM, Bloch S, Thompson CA. Position of the American Dietetic Association: functional foods. J Am Diet Assoc. 2004;104:814-826.

11. Kruzich LA, Marquis GS, Carriquiry AL, et al.U.S. youths in the early stages of HIV disease have low intakes of some micronutrients important for optimal immune function. J Am Diet Assoc. 2004;104:1095-1101.

12. Palmer M. B Informed. Doylestown, PA:Hepatitis B Foundation; Fall 2000.

13. Morris D. Flax: A Health and Nutrition Primer. Winnipeg, Canada: Flax Council of Canada, 2003.

14. Elias SL, Innis SM. Bakery foods are the major dietary source of trans-fatty acids among pregnant women with diets providing 30% energy from fat. J Am Diet Assoc. 2002;102:46-51.

15. Kopp-Hoolihan L. Prophylactic and therapeutic uses of probiotics: a review. J Am Diet Assoc. 2001; 101:229-238.

16. Markowitz JE, Bengmark S. Probiotics in health and disease in the pediatric patient. Ped Clin N Am. 2002;49:127-141.

17. Chiavacci A, Kennedy S, Vangsness S. Safety and efficacy of herbs and dietary supplements popular among persons with cancer. Nutr In Complementary Care. 2003;5:45-49,51.

18. Food and Drug Administration. Drug Approval Letter. Available at http://www.fda.gov./cder/foi/ appletter/2001/21004s2ltr.pdf. Accessed 7/20/04.

19. Farrell G. Hepatitis Be antigen seroconversion: effects of lamivudine alone or in combination withinterferon alpha. J Med Virol. 2000;61:374-379.

20. Yashina T, Peter JB. Hepatitis B Virus. In: Peter JBed. Gastroenterology. 6th ed. Santa Monica, CA: Specialty Laboratories; 2004:1-5. Available at: http://www.specialtylabs.com/books/display.asp?id=362.Accessed 7/27/04.



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Nonshivering thermogenesis requires the presence ofbrown adipose tissue (BAT), which is rich in sympa-thetic nerves and is the site of conversion of energy toheat. It is initially activated at birth and continues tobe stimulated whenever the body needs heat, such asat arousal from sleep, by cold, and by diet.6

The rate of thermogenesis that occurs in responseto diet varies among individuals, with some being fastburners and others being slow burners.5,7,8 For exam-ple, a recent comparison of the thermogenic responseto food intake between obese and non-obese youngwomen found that the thermogenic increase in ener-gy expenditure after eating a mixed meal was signifi-cantly lower in the obese women than in the controls.The authors suggested that despite identical sympa-thovagal activities in a resting condition, the obesewomen may have a reduced sympathetic response tomixed food intake, which might be related to lowercapacity for thermogenesis. This phenomenon incombination with the concept of NEAT, may helpexplain why at similar food intakes, some individualsgain weight and others do not.

In response to negative energy balance, thermogen-esis appears to be suppressed beyond what might beexpected from the loss of body weight and changes inbody composition. In fact, during energy repletionthe suppression persists such that energy is directedspecifically at rapid restoration of the depleted fatstores.10 It has been hypothesized that this phenome-non demonstrates an adipose-specific control of ther-mogenesis via an autoregulatory feedback system.This may explain in part the recidivism that often fol-lows weight loss.12

The sympathetic nervous system and brownadipose tissue

When activated, BAT burns high amounts of lipidsand glucose within the tissue. In response to releaseof noradrenaline from the sympathetic nervous sys-tem, specialized receptors (beta-3-adrenoreceptors) onbrown adipocytes produce a unique protein calleduncoupling protein-1 (UCP1). UCP1 enables theoxidation of substrate without synthesis of ATP. The

net result is an increase in heat production.5

Certain natural plant substances are able to stimu-late thermogenesis, including caffeine from coffee andtea, capsaicin from hot spices, and catechins fromtea.13 It is thought that the mechanism is via inhibi-tion of enzymes that degrade noradrenaline. Theactions of sympathetically released noradrenaline arepartially modulated by negative feedback mechanismsat several points. Both in the synaptic cleft and thesynaptic junction, noradrenaline may be degraded byenzymes. However, this degradation may be inhibitedby plant polyphenols, including epigallocatechin gal-late (EGCG). By virtue of its EGCG content, tea isbelieved to stimulate thermogenesis by inhibitingenzymes that diminish the action and duration ofnoradrenaline in BAT.14 This characteristic has stimu-lated interest in tea’s potential utility in weight con-trol.

Tea and tea catechins

Catechins are a group of highly active flavonoidspresent in large amounts in the tea plant Camelliasinensis. The dominant catechin in tea is EGCG.Green or unfermented tea contains the highest con-centrations of EGCG. When tea leaves are fermentedby exposure to air, changes in taste and compositionoccur, resulting in the black and red teas that are con-sumed most frequently in Western societies. Oolongtea, sometimes called Chinese tea, is partially fer-mented and therefore has a catechin content some-where between green tea and black or red teas.15

Although many observations have been made aboutthe potential health effects of green tea and/or greentea extract, the most recent investigations havefocused on the active ingredient EGCG.

Human studies of weight and fat loss

Several human studies have looked at weight andfat reduction in humans consuming EGCG and/ortea catechins for 12 weeks. Chantre and Lairon testedthe effect of a daily supplement in 66 moderatelyobese subjects with a mean BMI of 28.9. The sup-plement provided 375 mg catechins, of which 270mg were EGCG. After three months body weight was

cont. from page 41 Supplements: The Effect of Epigallocatechin Gallate(EGCG) On Thermogenesis and Weight Control

cont. on page 48


48

NNUUTTRRIITTIIOONN IINN CCOOMMPPLLEEMMEENNTTAARRYY CCAARREE

Web site: www.ComplementaryNutrition.org

Member ElectronicMail List:Contact Gretchen Forsellto get connected([email protected])

cont. on page 49

decreased by 4.6% and waist circumference by4.48%. The authors suggested that the green teaextract used may be a natural product for the treat-ment of obesity.16

In another trial, 12 male volunteers with a BMI>25 were administered green tea extract that waseither high in EGCG (483 mg/day) or low in EGCG(118.5 mg/day) for 12 weeks. The high-dose EGCGgroup had significantly decreased BMI and weight,with significant reductions in visceral fat area andbody fat ratio.17

A third, randomized, double-blind trial in 80 adultsfound a decrease in body weight, BMI, and body fatafter 12 weeks supplementation with 115 mg EGCGper day. In addition, the effect persisted over a 12-week washout period.18

The results of these trials are consistent with thosefound by Rumpler et. al. where energy expenditureand fat oxidation were significantly higher in subjectswho drank oolong tea over three-day periods com-pared with water. Energy expenditure increased by281 calories/day in the full-strength tea group and by331 calories/day in the caffeinated water group.However, fat oxidation was 12 percent higher whensubjects consumed the full-strength tea rather thanwater.19

Synergy with caffeine

Since green tea also contains caffeine and caffeine isknown to be thermogenic, research was conducted todetermine the relative effects of these two substances.Dulloo et. al. measured 24-hour energy expenditureand respiratory quotient in 10 healthy men randomlyassigned to green tea extract (EGCG) plus caffeine,

caffeine alone, or placebo. Relative to placebo EGCGproduced a significant increase in 24-hour energyexpenditure and a significant decrease in 24-hour res-piratory quotient, indicative of a shift in substrateutilization in favor of fat oxidation. Fat oxidation wassignificantly higher after the green tea extract, and thecontribution of fat oxidation to 24-hour energyexpenditure was significantly higher during treatmentwith green tea extract than during placebo treatment.In contrast, there were no significant differences insubstrate oxidation between the caffeine and placebogroups. The increases in both energy expenditure andfat oxidation were greater than could be explained bythe caffeine content of green tea extract alone.13

Experimental data

Animal and in vitro studies have predicted the find-ings of EGCG affects in humans. For example: Supplementation with tea catechins reduced bodyweight gain and visceral and liver fat accumulation inmice fed a high-fat diet.20

Supplementation with both catechins and caffeinedecreased intraperitoneal adipose tissue weight ofmice by 76.8 percent after 16 weeks.21

Intraperitoneal injection of EGCG caused acuteloss of body weight (20% to 30%) in rats within twoto seven days of treatment.22

Mice fed a diet high in fat and carbohydrates con-taining 1% EGCG gained significantly less weightand accumulated less body fat over five months thantheir counterparts receiving the same diet withoutEGCG.23

EGCG as a dietary supplement

EGCG in tea is shown to be the catechin responsi-ble for the positive effects of green tea on weight con-trol and other health parameters. EGCG has a longerhalf-life in the body than other catechins; epicatechinand epigallocatechin are partly recovered in urine, butEGCG is not.24 In animal experiments other tea cate-chins did not reduce body weight when given at thesame dose as EGCG.25

cont. from page 47Supplements: The Effect of Epigallocatechin Gallate(EGCG) On Thermogenesis and Weight Control


49

Purified EGCG is now available as a dietary supple-ment ingredient. This makes it possible to addEGCG to the diet in a more precise and convenientway. Green tea and other tea beverages likely containhighly variable amounts of catechins due to differ-ences in plant strains, growing conditions, processing,and preparation methods. In addition, green tea has apungent taste not yet widely accepted in Westernpopulations.

No adverse effects are seen in studies where humansingested EGCG in concentrated form. For example,one study showed the daily consumption of 800 mgof EGCG to be safe when taken for four weeks;either as a single dose or in divided doses.26 Thisamount of EGCG is equivalent to the amount con-tained in eight to 16 cups of green tea. A single-dosesafety study showed that supplements of EGCG rang-ing from 50 mg to 1600 mg were safe and very welltolerated.27

Take-Home Message

The prevention of obesity has emerged as a majorpublic health concern over the past decade. Since cur-rent weight control strategies have not been adequate-ly effective, safe alternatives are desirable. Researchsuggests that some natural plant compounds such asEGCG can increase energy expenditure and fat oxida-tion in both laboratory animals and humans. Byincreasing thermogenesis - in essence helping “slowburners” become more like “fast burners” - EGCGsupplements may enhance diet and physical activityprograms, thus helping individuals achieve and main-tain appropriate weight. Since even small losses in anoverweight person can have beneficial effects, EGCGmay prove to be a useful weapon in the public healtheffort for weight control. References1. National Research Council, Food and Nutrition

Board. Energy. In: Recommended Dietary Allowances,10th edition. National Academy Press,1989: 24-38.

2. Institute of Medicine of the National Academies, Standing Committee on Evaluation of Dietary Reference Intakes, Panel on Macronutrients. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and

Amino Acids (Macronutrients). National Academies Press 2002, Washington, DC.

3. Donahoo WT, Levine JA, Melanson EL.Variabilityin energy expenditure and its components. Curr Opin Clin Nutr Metab Care. 2004;7:599-605.

4. Levine JA. Non-exercise activity thermogenesis. Proc Nutr Soc 2003 62:667-679.

5. Dulloo AG, Samec S. Uncoupling proteins: theirroles in adaptive thermogenesis and substrate metabolism reconsidered. British J Nutr.2001; 86:123-139.

6. Cannon B, Nedergaard J. Brown adipose tissue: function and physiological significance. Physiol Rev.2004; 84:277-359.

7. Levine JA, Eberhardt NL, Jensen MD. Role of non-exercise activity thermogenesis in resistance tofat gain in humans. Science 283:212-214.

8. Stock MJ. Gluttony and thermogenesis revisited. Int J Obesity. 1999; 23:1105-1117.

9. Matsumoto T, Miyawaki C, Ue H, et al.Comparison of thermogenic sympathetic response to food intake between obese and non-obese young womenObes Res. 2001;9:78-85.

10.Dulloo AG, Jacquet J. Adaptive reduction in basalmetabolic rate in response to food deprivation in humans: a role for feedback signals from fat stores. Am J Clin Nutr. 1998;68:599-606.

11.Dulloo AG, Jacquet J, Girardier L. Autoregulationof body composition during weight recovery in humans: the Minnesota Experiment revisited. Int JObesity. 1996;20:393-405.

12.Dulloo AG, Jaqcuet J. An adipose-specific controlof thermogenesis in body weight regulation. Int J Obesity. 2001;23:1118-1121.

13.Dulloo AG, Duret C, Rohrer D, et al. Efficacy of a green tea extract rich in catechin polyphenols and caffeine in increasing 24-h energy expenditureand fat oxidation in humans. Am J Clin Nutr.1999; 70:1040-1045.

14.Dulloo AG, Seydoux J, Girardier L, et al. Green tea and thermogenesis: interactions between catechin-polyphenols, caffeine and sympathetic activity. Int J Obesity. 2000;24:252-258.

15.Liao S, Kao Y-H, Hiipakka RA. Green Tea: Biochemical and Biological Basis for Health Benefits.Academic Press, 2001.

16.Chantre P, Lairon D. Recent findings of green teaextract AR25 (Exolis) and its activity for the treatment of obesity. Phytomedicine. 2002;9:3-8.

17.Hase T, Komine Y, Meguro S, et al. Anti-obesity effects of tea catechins in humans. J Oleo Sci50:599-605, 2001.

18.Tsuchida T, Nakamura H. Reduction of body fat in humans by long-term ingestion of catechins. Prog Med. 2002;22:9.

19.Rumpler W, Seale J, Clevidence B, et al. Oolong

cont. from page 48 Supplements: The Effect of Epigallocatechin Gallate(EGCG) On Thermogenesis and Weight Control

cont. on page 50


50

Resource Reviews:The Cancer Lifeline CookbookMathai K, Smith G.

Seattle, WA:Sasquatch Books, 2004. 234 pp.,

Softcover; $19.95. ISBN: 1.57061-411-3.

The first edition of The Cancer Lifeline Cookbook,was published in 1996 with its mission to “empowercancer patients, caregivers, and others to actively par-ticipate in creating a healthful nutrition plan.” Thisupdated and revised edition provides 90 deliciousrecipes from Seattle, WA chefs as well as cancerpatients and survivors, and people working in thefield, and a wealth of up-to-date nutrition informa-tion and practical tips for making healthy eating easy.

This book deserves review here because of itsemphasis on the foods that provide complementarynutrients—phytonutrients—with strong evidencetowards protection against cancer and other chronicdiseases. The top ten foods identified as the bestchoices for phytochemical rich foods include: vegeta-bles of the cruciferous family, beans including soy-beans, berries and cherries, vegetables in the Alliumfamily, carotenoid rich vegetables, fish, tomatoes,mushrooms, nuts, seeds and flaxseeds, and green tea.Each of these foods and their benefits are spotlightedin the chapter on The Top 10 “Super Foods.”.

Although the emphasis is on nutrition for the can-cer survivor, this book has something for everyone. Itis more than a cookbook providing a wealth of easyto understand information accompanied by beautifulfull color photographs. The chapter entitled“Nutrients That Promote Good Health” includesinformation on all nutrients and their importance tohealth. “Creating A Healthy Diet” is a chapter thatillustrates how the reader can move into healthierfood choices and maintain those choices on a dailybasis. More suggestions for making favorite foodshealthier are offered in later chapters. The emphasis

tea increases metabolic rate and fat oxidation in men. J Nutr. 2001;131:2848-2852.

20.Murase T, Nagasawa A, Suzuki J, et al. Beneficial effects of tea catechins on diet-induced obesity: stimulation of lipid catabolism in the liver. Int J Obes Relat Metab Disord. 2002;26:1459-1464.

21.Zheng G, Sayama K, Okubo T, et al. Anti-obesity effects of three major components of green tea, catechins, caffeine and theanine, in mice. InVivo. 2004;18:55-62.

22.Kao YH, Hiipakka RA, Liao S. Modulation of obesity by a green tea catechin. Am J Clin Nutr.2000; 72;1232-1233.

23.Wolfram S, Raederstorff D, Elste V, Weber P. The green tea catechin EGCG prevents obesity in mice. Annals of Nutrition and Metabolism. 2003;47:PS.K24 (abs).

24.Dufresne CJ,Farnworth ER. A review of latest research findings on the health promotion properties of tea. J Nutr Biochem.2001;12:404-421.

25.Kao YH, Hiipakka RA, Liao S. Modulation of endocrine systems and food intake by green tea epigallocatechin gallate. Endocrinology.2001;141:980-987.

26.Chow HH, Hakim IA, Crowell JA, et al. Pharmacokinetics and safety of green tea polyphenols after multiple-dose administration of epigallocatechin gallate and polyphenon E in healthy individuals. Clin Cancer Res. 2003;9:3312-19.

27.Ullmann U, Haller J, Decourt JP, et al. A single ascending dose study of epigallocatechin gallate in healthy volunteers. J Int Med Res.2003;31:88-101.

cont. from page 49Supplements: The Effect of Epigallocatechin Gallate(EGCG) On Thermogenesis and Weight Control

Functional Nutrition Trainingand Education Opportunity

This year, the Clinical Nutrition Certification Board(CNCB) will once again offer its Post Graduate Studies inClinical Nutrition program (PGSCN) to candidates for theCertified Clinical Nutritionist (CCN) designation. Althoughspecially scheduled programming is no longer offered toRDs, the CNCB board will still extend a substantial $1000discount (a 22% savings) exclusive to RDs who are mem-bers of NCC DPG. This advanced training is offered in Feb,April and June of 2005 in either Phoenix, AZ, Orlando, FLor Tampa, FL (more dates and locations may be added). Theprogram offers 27 CEUs for each weekend of training (56in all). PGSCN’s specific listing of content in functionalnutrition training is listed on page 13 of the CCN examcandidate handbook which can be accessed atwww.CNCB.org. Please call (972) 250-2829 or visit theirwebsite for more information.

cont. on page 51


51

in these chapters is on the “New American Plate”which focuses on plant foods rather than animal-based foods as the center of the diet. In addition, thebook provides practical ways people can movetowards a more plant-based meal plan.

For persons coping with the side effects of cancertreatment there is a chapter on how to effectively dealwith these side effects. The chapter also providesthose with cancer and persons with appetite loss, sug-gestions for improving calorie and nutrient intake.Important tips on food safety are included to helpprevent foodborne illness in persons who are alreadycompromised. Organization and grocery shoppingtips are helpful for those who have limited energy.

Any nutrition professional who works with personsstruggling to adopt a more healthful way of eatingshould find this book helpful. It could be useful inany practice setting, but especially so for those whowork directly with persons suffering from the sideeffects of cancer and its treatment.

Reviewed by Sarah Harding Laidlaw, MS, RD, MPAEditor, Nutrition In Complementary Care Newsletter.Contact Sarah at [email protected] or 702-346-7968.

The Amazing Flax CookbookReinhardt-Martin J.

Moline, IL: YSA Press, 2004. 249 pp.,

Spiral Bound; $17.05. ISBN:0-9712304-1-2.

As a response to readers request for more ways toincorporate flax into their diet, author JaneReinhardt-Martin introduced a sequel to her bookpublished in 2001 titled: Flax Your Way to BetterHealth. The Amazing Flax Cookbook was introducedin the spring of 2004. It is the culmination of workwith Chef Ron Garrett, CEC, as well as numerousrecipe testers and reviewers with the goal of helpingcooks discover the versatility of flax. The Flax RD, asshe is known, appears to have done what she set outto do.

The cookbook is arranged in chapters, with the firstthree providing some basic and understandablereviews of what flax is and the benefits it bestows onthe consumer. The following twelve chapters containtasty ways to incorporate flax into everyday foods andmeals. Lengthy discussions about the nutritionalproperties and health benefits of flax have been left toher first book.

Chapter one provides basic information on flaxincluding its properties and health benefits, as well as,the different options for flax, such as seed, meal oroil, and the best uses and storage of each. Chaptertwo provides two weeks of meal plans at differentcalorie levels and for different goals. “The women’sslim down flax plan,” a 1500-calorie meal plan; “themen’s slim down flax plan,” an 1800-calorie mealplan; and for athletes, a 2200-calorie meal plan. Eachplan could easily be adapted to other health condi-tions. In chapter three, there are suggestions for usingflax in many kitchen staple recipes—a variety of fla-vorful breadings for meat, poultry, and fish, salt freeseasoning blends, and vinaigrettes and salad dressings.

Each of the following chapters with recipes providesan enticing introduction of what is to come. Most ofthe chapters are devoted to main dish recipes that areeasy to fix and flavorful. Soups and stews, chapterfour, demonstrates an easy way to add flax to a mealwithout it being noticed. Every menu option you canthink of has a recipe that incorporates flax—casseroles, sandwiches, comfort foods, main dishesand salads. There is even an ethnic flair withMexican, Italian, and pizza recipes offered. Flax aspart of desserts can make a person feel a bit less guiltyin indulging in their favorite cookie, crisp, and yes,even cheesecake.

For anyone interested in learning more about flaxand its versatility as a recipe ingredient, this is thebook to have. It is both useful and practical in itspresentation of ways flax can be used for not only therecipes in the cookbook, but also in how ever far one’sculinary imagination can take them.

Reviewed by Sarah Harding Laidlaw, MS,RD, MPA,Editor, Nutrition In Complementary Care. ContactSarah at [email protected] or 702-346-7968.

cont. from page 50Resource Reviews: The Cancer Lifeline Cookbook


52

Pocket Guide to Herbal MedicineKraft K, Hobbs C

Thieme Medical Publishers, May 2004.

350 pp., Soft bound; $34.95. ISBN: 1-58890-063-0

This concise yet well-detailed book has nearly 500informative pages on herbal medicines and phy-totherapy. First published in German, this is anauthorized and revised translation of the original2000 edition.

The guide is divided into five color-coded sectionsfor easy use.

The first section covers fundamentals of phytother-apy and gives herbal medicine guidelines. Topicsrange from determination of dose to a diagram illus-trating the transformation of plants to extracts.

The second section alphabetically summarizes over100 medicinal plants. Detailed summaries providesynonym names, pharmacology, indications, con-traindications, dosage and duration of use, adverseeffects, herb-drug interactions, a summary assess-ment, literature references, and general comments.

Next you will find a very useful section listingherbal treatments for specific conditions. Clinicalconsiderations for each disease are addressed, alongwith an overview of recommended herbal therapies.Quite often a detailed discussion on dosage and treat-ment application is also given. The general categoriesof conditions are: cardiovascular, respiratory, diges-tive, urogenital, nervous, adaptive and functional,immune, rheumatic, gynecological, pediatric, derma-tological, wounds, and trauma.

The fourth section covers practical applications ofherbs, such as wraps, compresses, and hydrotherapy.For each disorder, clinical considerations and herbalremedies with their range of uses are addressed.When appropriate the authors also provide specifictreatment procedures.

The final section is a potpourri of informationgiven in the form of lists and tables. Here you willfind a plant glossary; a table of conditions anddosages; names and contact information for herbal

medicine associations, companies and suppliers; liter-ature references; and websites.

Whether you are looking for a reference book onherbs or a practical guide to phytotherapy, this wellwritten, easy to use resource is not to be overlooked.

At the time of publication, author Karin Kraft,M.D. resided as Chair for Natural Medicine at theUniversity of Rostock, Germany; was a member ofCommission E (the expert German committee thatconsiders safety and efficacy of herbal medicines); andsupervising editor of the European ScientificCooperative on Phytotherapy. Christopher Hobbs,L.Ac. was recruited by the publisher to put this trans-lated version into the U.S. context. Hobbs is a fourthgeneration botanists, practicing herbalist and licensedacupuncturist; co-founder of the American HerbalistsGuild; former vice president of the American HerbalProducts Association; and board member and vicepresident for the United Plant Savers.

Rebecca Schauer, RD is a Nutrient Database Scientistfor the Nutrition Coordinating Center, Department ofEpidemiology, University of Minnesota, Minneapolisand the copy editor for the NCC-DPG newsletter.Contact Rebecca at [email protected].

The University of Arizona is offering NCC membersa great opportunity for learning! “Nutrition & Cardiovascular

Health” - a 16.5 CPEU online course offered by the Program inIntegrative Medicine. Sign up online at:

www.integrativemedicine.arizona.edu and receive a 10% discount.To obtain the discount use the code: NCC1

MEMBER BENEFIT


53

Therapies:Ayurveda: The TraditionalSystem of Indian MedicineGuari A. Junnarkar, B.A.M.S, Registered Ayurvedic

Practitioner (India)

Complementary and alternative

medicine (CAM) is gaining populari-

ty in the world today. A good exam-

ple is the National Institutes of

Health (NIH) recognizing Ayurveda

as a CAM therapy.1 Ayurveda is one

of the oldest systems of medicine practiced today,

originating in India over five thousand years ago. The

word Ayurveda comes from a Sanskrit word that

means “science of life.” It is a holistic system of medi-

cine that focuses equally on body and mind.

Ayurveda comprises of eight specialty branches name-

ly internal medicine, pediatrics, psychological medi-

cine, ear, nose, and throat (ENT) diseases, general

and specialized surgery, toxicology, geriatrics, and

study of aphrodisiacs.2-6

Principles of Ayurveda

The goal of Ayurveda is maintaining the health of a

healthy individual and treating the disease of a sick

person. Ayurveda’s foundation lies in its set of princi-

ples to determine the line of therapy for a disease.

These principles are: tridoshas (three humors), pan-

chamahabutas (five elements), dhatus (tissues), malas

(bodily wastes), gunas (attributes of mind), ama (tox-

ins), prana (life force), and prakruti (physiological

constitution of the body). 2-6

Tridoshas (Three Humors): Ayurveda believes that

three basic doshas - vata (wind element), pitta (meta-

bolic enzymes), and kapha (phlegm) - govern the

physiology in a human body. Vata is responsible for

all bodily functions involving movement like breath-

ing and muscular contractions. Pitta is a set of

enzymes responsible for the various metabolic func-

tions in the body like digestion, absorption, and

assimilation. Kapha represents phlegm, the funda-

mental quality of structure; it aids in lubrication,

healing, and provides biological strength. All the

doshas are present in an individual in varying degrees

depending upon the person’s physiological constitu-

tion.

Panchamahabutas (Five Elements): Ayurveda

believes that everything in the world is made up of

five basic elements: akasha(space or ether), vayu (air),

agni (fire), apa (water), and prithvi (earth). Hence,

disease can be treated on the basis of increase or defi-

ciency in one or a combination of the elements. In

loss of appetite from indigestion, patients are given

warm herbal teas to increase agni and improve diges-

tion.

Dhatus (Tissues), Malas (Bodily Wastes), andGunas (Attributes of Mind): According to Ayurveda,

the body is made up of seven dhatus: plasma, blood,

muscle, adipose, bone, nerve, and reproductive; three

types of malas produced are urine, feces, and sweat.

Ayurveda also believes that mind is governed by these

three gunas: satva (balance), rajas (hyperactivity), and

tamas (hypoactivity).

Ama (Toxins) and Prana (Life Force): Ayurveda

maintains that body is preserved by prana, which rep-

resents the life force. Examples of prana can be oxy-

gen, and macro and micronutrients. Ama is the toxins

the body produces that are responsible for develop-

ment of disease. These toxins are produced as a result

of improper digestion, absorption, and assimilation of

foods. Ama affects the normal functioning of the

body by causing improper absorption of nutrients,

which further leads to development of diseases.

Prakruti (Physiological Constitution of the Body):

According to Ayurveda, the prakruti of a humancont. on page 54

Winter 2005 Volume 7, Issue 3

Cast Your Vote!This year Nutrition in

Complementary Care DPG will beconducting its election of

officers online.

Please exercise your right to vote toselect your future NCC leaders.

The online polls will open January15, 2005 and will close Feb. 25, 2005.

Visitwww.ComplementaryNutrition.org

to view candidate bios andto cast your vote online.

Paper ballots are available uponrequest by contacting the Practice

Team at: [email protected] 800/877-1600 ext. 4815.

Paper ballots must be faxed to312/899-4812 by Feb. 20, 2005.

Your vote is appreciated!

cont. from page 53Therapies: Ayurveda: The TraditionalSystem of Indian Medicine

cont. on page 55

have dry and fragile hair. A person having pitta con-

stitution will have curly hair, while a person with

kapha constitution will have thick and soft hair. A

person’s prakruti can be a combination of two or all

of the doshas. Determining prakruti is an important

criterion for deciding a therapeutic regimen.2-6

Ayurvedic Physiology of Disease

According to Ayurveda, the physiology of a disease

depends on factors called “causes and diagnosis.”

Causes: Ayurveda considers diseases to be

caused by the basic imbalance among the tri-

doshas. One cause of imbalance in the tri-

doshas is attributed to diet and lifestyle.

Disharmony between mind, speech, and

action is also listed as the primary cause of

disease.

Diagnosis: Diagnosis of a disease in Ayurveda

is done by feeling a person’s pulse; assessing

the pallor of the face; color of the eyes, nails,

tongue, and urine; the number of disease

symptoms developed; location of the disease

in the body; and finally digestion, tactile

response, age, sex, eating habits, seasonal

change, and general metabolism.2-6

Treatment of disease:

Once a disease is diagnosed and the doshas affected

are determined, a treatment for the person can be

established. In Ayurveda, basic treatment is divided

into two main categories: Shamana (pacifying disease

symptoms) and Shodhana (detoxification). Either or

both types of treatment are done depending upon the

the severity of disease condition. Both the treatments

Page

54

being is determined at the time of conception.

Prakruti in Sanskrit means “nature,” “creativity,” or

“the first creation.” Ayurveda believes that one’s basic

physical constitution remains fixed throughout life-

time. Prakruti of an individual is determined based

on predominance of the three doshas vata, pitta, or

kapha. The levels of these doshas ocurring in an indi-

vidual are determined based on the physical charac-

teristic of the primary dosha present in the person.

For example, a person having vata constitution will


55 cont. on page 56

cont. from page 54

bring balance to the doshas by pacifying symptoms or

eliminating toxins.

Shamana (Pacifying Diseases Symptoms):This treatment method is based on diet and

herbs. Diet forms an integral part of therapy

in Ayurveda and is mainly classified under

three types: daily diet, seasonal diet, and dis-

ease diet. The daily diet principle states that a

person’s meal should contain all the rasas

(tastes), i.e. sweet, salty, bitter, pungent, and

astringent. A person should eat a balanced

meal. In the seasonal diet concept a person

should make changes to the diet according to

the present season. For example, in summer a

person should consume more soothing and

cooling foods like cucumber and buttermilk.

In a disease diet, a person is assigned a diet

depending upon the disease and the digestive

power. For example, in patients suffering

from fever easily digestible rice and lentil

broth is advised. The symptoms of the dis-

ease, stage of the disease, prakruti of the per-

son, and seasonal changes can also influence the

disease diet.

Herbs form the main line of therapy in all

diseases. Herbal remedies are rendered orally

in the form of oral powders, pills, infusions,

and medicated oils. Prescriptions depend on

the pharmacological action of the herb and

severity of symptoms. Dosage of herbs is

defined according to disease condition and

prakruti of the person.

Shodhana (Detoxification): Detoxification of

body is done with the help of specialized ther-

apy called panchakarma meaning “five thera-

pies.” Before any panchakarma procedure is

carried out, the patient has to undergo a

preparatory procedure called snehana

(oleation) to help the easy removal of toxins.

In shodhana, a person is given clarified butter

infused with herbal extracts. This is eaten in

the morning on an empty stomach for about

four to five days. The person is asked to take

the next meal after the clarified butter is

digested and the person feels hungry again.

This medicated clarified butter is given to liq-

uefy toxins and help in their easy elimination

via oral or fecal routes. Next, the panchakar-

ma procedure is carried out using five basic

therapy methods.

1. Vamana (Induced Emesis): In this proce-

dure, emesis is induced by consumption of

herbal teas to take excess kapha out of the

body. Vamana is used in conditions of aggra-

vated kapha like asthma, bronchitis, and

coryza.

2. Virechana (Induced Purgation): In this

procedure, purgation is induced with the con-

sumption of herbal teas to eliminate excess

pitta.Virechana is used in conditions of aggra-

vated pitta, like chronic hyperacidity.

3. Basti (Medicated Enema): In this proce-

dure an enema is given with herbal infusions

or medicated oils, or a combination of both.

This procedure reduces excess vata in the

body. Basti is used in conditions of aggravated

vata like chronic arthritis, constipation, and

spondiliosis.

4. Nasya (Nasal Insufflation): In this proce-

dure herbal powder or herbal medicine drops

are put in the nose. Nasya is used in diseases

where one or more doshas are aggravated,

such as chronic sinusitis and insomnia.

Therapies: Ayurveda: The TraditionalSystem of Indian Medicine


56

5. Rakta Mokshana (Blood letting): Rakta in

Sanskrit means blood and mokshan means “to

remove.” Hence the phrase rakta mokshan

means “removing blood from the body to

remove toxins.” Rakta mokshan is done today

as a localized procedure. Blood is taken out

from the superficial veins of the upper and

lower limbs and the part of the body affected

with a skin disease. The procedure is done

either with the help of venesection, or using

leeches under the strict guidance of an

Ayurvedic physician. It is mainly used to cure

skin disorders like psoriasis, eczema, photo-

dermatitis ECT. The duration of the treat-

ment depends on the symptoms of the dis-

ease, chronicicity of the disease, and the area

of the body affected.

After any panchakarma therapy is done, the patient

is given smsarjan karma (post panchkarma procedure)

and rasayana (rejuvenation therapy). During samsar-

jan karma a person is asked to take rest and drink rice

soup. This gives the body time to recover from the

stress of the panchakarma procedure. In rasayana

therapy a person is given jams prepared with different

herbs and the fruit Amala (Embellica Officinalis) toeat. This herbal fruit jam rejuvenates the body after

the stress of detoxification. It replenishes and relaxes

the body helping it to heal, bringing balance in the

doshas. Thus according to Ayurveda the secret of

good health is in the balance of doshas, proper func-

tioning of dhatus, proper elimination of malas, and

proper function of agni.2-6

Take Home Message: The Importance of knowing

Ayurveda

Ayurveda can help establish perfect harmony

between mind and body and can be adopted by any-

one. Many studies are being conducted on Ayurvedic

herbs and therapies around the world to establish

their efficacy. More people are turning towards

Ayurveda because of its holistic lifestyle approach.

There is also increased interest among the medical

establishment to integrate traditional systems of med-

icine with modern medicine. It is important for

nutrition professionals to have basic knowledge of

Ayurveda to satisfy the queries of patients seeking

CAM therapies. Especially since key components of

Ayurveda are the use of diet and herbs in treating dis-

ease.

Gauri A. Junnarkar, BAMS (Bachelor of AyurvedicMedicine and Surgery), is a Registered AyuvedicPhysician (India) who has worked as AyurvedaPhysician and Research Scholar at CharakPharmaceuticals and Medical Officer in Department ofClinical Pharmacology, Nair Hospital Research Center,Mumbai, India. She is presently studing for her Master’sdegree in nutrition at Texas Woman’s University. ContactGauri at [email protected] or 940-382-5122.

References1. National Center for Complementary and

Alternative Medicine. Available at:http://nccam.nih.gov/health/whatiscam/index.htmlAccessed 11/02/04.

2. Sastri K, Chaturvedi G. Charak Samhita. 22nd ed. Varanasi, India: Chaukahmba Bharati Academy, 1996.

3. Shastri KA. Susruta Samhita. 11th ed. Varanasi, India: Chaukhamba Sanskrit Sansthana, 1997.

4. Gupta KA, Upadhyaya Y. Ashtangahridayam. 12th

ed. Varanasi, India: Chaukhamba Sanskrit Sansthan, 1997.

5. Department of Ayurveda, Yoga, and Naturopathy, Unani Siddha and Homeopathy. Ministry of Health & Family Welfare. Govt Of India. Availableat:http://indianmedicine.nic.in/html/ayurveda/ay urveda.htm. Accessed 11/02/04.

6. The Ayurvedic Institute. Available at: www.ayurv eda.com/online%20recource/index.html. Accessed 11/02/04.

cont. from page 55Therapies: Ayurveda: The TraditionalSystem of Indian Medicine


57

From My Perspective:FNCE NCC 2004 ReviewKatherine Bernard, MS RD

NCC Administrative Assistant

This was my first year attending ADA’s annualFood and Nutrition Conference and Exhibition(FNCE) and it was a wonderful experience. Eventsbegan with the NCC Executive Committee meetingon October 2nd. NCC has a wonderful leadershipteam; a very diverse group of professionals who wantto make a difference in complementary care. Theyare very dedicated in continuing to make NCC a rep-utable and respected practice group. A thank yougoes to Wyeth-Centrum for making it possible for theleadership team to conduct business face to face.

The evening of October 2nd was ADA’s openingreception. “WOW” is the simplest way to describe it.The crowd was large and the reception to the pro-gram was wonderful. It was so enlightening andmotivating to see so many awards given to memberswho have excelled in the nutrition profession. Afterthe opening ceremonies I was even more excited thatI was able to attend FNCE.

NCC had an early morning the next day, onOctober 3rd as we held our annual breakfast meetingat 7:00am. We had the honor of Dr. Jeffrey Blumbergspeaking to us on A Review of the Potential HealthBenefits of Herbal Teas and Their PhotochemicalIngredients. Thank you to Celestial Seasonings formaking this breakfast possible. In addition to theirsponsorship, they graciously put baskets filled withtheir specialty teas and products on each table as cen-terpieces and one lucky winner from each table waschosen to take it home. Each attendee was also givena nice tote bag filled with a mug and several deliciousCelestial Seasonings teas and related materials.

That morning NCC was exhibiting at ProductMarket Place. This was a great opportunity to meet

cont. on page 58


58

cont. on page 59

very enjoyable and the food was outstanding, espe-cially the desserts! Once again, a thank you goes toWyeth-Centrum for help making this event possible.

The dietetic practice group (DPG) showcase washeld on October 4th, allowing us once again to seemany members and recruit new ones. IntegrativeTherapeutics and American Specialty HealthNetworks made the overflowing baskets that wereoffered as incentives to those who joined NCC at thebooth possible. These baskets were raffled off to threeof our new members that joined at FNCE.Congratulations to you!!!!

I had the opportunity to explore many exhibits atthe FNCE where I determined that I needed at least afull day to see them all. The amount of exhibitorsseemed endless.

Again this year as in the past three, NCC partneredwith the American Dietetic Association Foundation(ADAF) to offer Yoga sessions during the conference.This was a great way to unwind and revive.

I would especially like to include what made mytrip to FNCE even more exciting and invigorating.One of our NCC members, and a fellow New Yorker,Constance Brown Riggs, was part of a panel sessionstitled Job Security or Job Change? What’s in YourFuture?

Unfortunately because of flight schedules, I wasunable to attend the NCC sponsored session given byDiane Noland entitled: Chronic Disease: where’s theevidence and what’s a Dietetics Professional to do? Iheard that it was a very informative session. Thankyou Diane.

There is a lot of planning that goes into FNCEbeginning at the top with ADA, the DPG’s, the spon-sors, the convention center, hotels, and more. Iwould like to thank our leadership team and volun-teers for all their hard work. With their assistance, theconference went very well. I would especially like tothank the leadership team for assisting and showingme how things operate at FNCE and to Gretchen

many members as well as sign up new members.Those who stopped by the booth learned of our fan-tastic member benefit: Internet access to the profes-sional version of the Natural MedicineComprehensive Database.

In the evening the annual networking receptionwas held. This event was a cooperative effort betweenthe Dietitians in Business Communications (DBC)and Nutrition Entrepreneurs (NE) practice groupsand NCC. Everyone was able to network and enjoysome Caribbean style music. The entertainment was

Thank You to Our Sponsors!Without you, much of what we are able to do

would not be possible.

DIAMONDPharmavite/ Nature Made

PLATINUMCentrum

Celestial SeasoningsNutrition 21

GOLD

Nutrilite Division of Access Business Group

Metagenics

Vitamin Nutrition Information Service (VNIS)

SILVER

Almond Board of California

National Starch & Chemical Co.

BRONZE

OatVantage

Pioneer Nutritionals

Solgar

FRIENDS OF NCC

American Botanical Council

Canyon Ranch

Wild Oats Natural Marketplace

cont. from page 57From My Perspective: FNCE NCC 2004Review


59

NCC EDITORIAL STAFFEditor

Sarah Harding Laidlaw, MS RDCopy Editor

Rebecca Schauer, RDPublications Chair

Tamara Schryver, MS RDEditors

Christian Calaguas, MPH RDKaren Lyon, RD

Sheryl Murphy, RDDanielle Torisky, PhD RD

CPE EditorKatherine Stephens-Bogard, RD

Web SiteSusan Moyers, PhD MPH LD/N, Web Editor

Cory Gransee, WebmasterKaren Higgins, MS RD, Heads Up!

Kathie Swift, MS RD, ResourcesEML Coordinator

Gretchen Forsell, MPH RD

NCC DPGAnnual Report

2003-04

The Nutrition in ComplementaryCare (NCC) DPG has had anothergreat year. We continue to providemembers with important professionalopportunities to excel and growthrough networking, leadershipdevelopment and specialization.

Program of Work Outcomes:

* Publications and Communications -our stellar newsletter continues to bea much-anticipated member benefit.

* NCC’s website has been re-designedand is updated continuously withrecent information and links to newsinvolving complementary nutrition.

* NCC recognized two members withawards ($300 each) for professionalwork and contribution to theprofession.

* NCC has negotiated additional

benefits with outside organizations,including another year of free accessto the online Natural Medicine’sDatabase for our members and soon-to-come free subscriptions tocomplementary medicine publicationsfrom Innovision.

Financial Outcomes:

Revenues totaled: $ 90,848

Expenses totaled: $ 77,086

The DPG ended the year with asurplus of $13,762.

Thanks to the efforts and support ofour leaders, industry partners and

you - our members, NCC DPGcontinues to be a strong and

effective DPG.

Forsell (NCC treasurer), my FNCE roommate, whohelped me tremendously during the conference. Herkindness and support contributed to an extremelyenjoyable first experience at FNCE.

If you have not had the opportunity to attendFNCE, I highly recommend going. It is somethingyou will never forget. The learning and networkingopportunities are endless. I only highlighted a fewthings that occurred during the conference. EveryADA member should experience FNCE at least once.I hope to see you in St Louis for FNCE 2005 andHonolulu, Hawaii for FNCE 2006. Be sure and markyour calendars now!

cont. from page 58 From My Perspective: FNCE NCC 2004Review

NCC 2004-2005LEADERSHIP CONTACT

INFORMATIONEXECUTIVE COMMITTEERick Hall, MS RD Chair 3211 West Fuller DriveAnthem, AZ 85086voice: [email protected]

Susan Pitman, MA RD Immediate Past Chair 4618 Yuma St, NWWashington, DC 20016voice: [email protected]

Susan Allen, MS RDChair-Elect 7771 Lake St 3WRiver Forest, IL 60305office: 800-917-3688home: 708-366-8947cell: 630-853-8891 [email protected]

Susan Drake, MS RDMember Services Chair 10211 W. Exposition Dr.Lakewood, CO 80226daytime: 303-200-0808fax: [email protected]

Gretchen Forsell, MPH RD LD Treasurer 2004-20062002 Highland DrNorfolk, NE 68701daytime: 402-644-7256fax: [email protected] email: [email protected]

Mary Harris, PhD RD Nominating Chair 7721 Promontory Dr.Fort Collins, CO 80528-9306voice: 970-491-7462fax: 970-491-7252 [email protected]

Tamara Schryver, MS RDPublications Chair 1508 Earle WayBurnsville, MN 55306daytime: [email protected]

Kathie Swift, MS RD LDNExternal Fundraising Chair235 Champlain DrPlattsburgh, NY 12901phone/fax: [email protected]

Elizabeth Thompson, MPH RDSecretary 2003-20054896 Valdina WaySan Diego, CA 92124-2432daytime: [email protected]

ADMINISTRATIVE ASSISTANT

Katherine L. Bernard, MS RD CDN90 Panamoka TrailRidge, NY 11961voice: 631-929-3834fax: [email protected]

ADA STAFF LIAISON

Diane Barrera, MPH RD American Dietetic Association120 Riverside Plaza, Suite 2000Chicago, IL 60606voice: 800-877-1600 ext. 4813fax: [email protected]

PROFESSIONAL ISSUES DELEGATE

Kathleen Rourke, PhD RD RN CHES6977 Driftwood LnCincinnati, OH 45241home: [email protected]

OTHER LEADERS

Rita Kashi Batheja, MS RD CDNReimbursement/Legislative ChairMembership Chair825 Van Buren StBaldwin Harbor, NY 11510daytime/eve: [email protected]

Ruth DeBusk, PhD RDTechnical Resource Advisor3583 Doris DriveTallahassee, FL 32303-2304daytime: 850-877-5865fax: [email protected]

Gretchen Forsell, MPH RD LD Electronic Mail List Coordinator 2002 Highland DrNorfolk, NE 68701daytime: 402-644-7256fax: [email protected] email: [email protected]

Cheryl Galligos, MA RD LDNAdministrative Advisor1773 Lynnville Woodson RdMurrayville, IL 62668daytime: 217-782-8826fax: [email protected]

Cory GranseeWebmaster 7653 E. Camino StMesa, AZ 85207phone: [email protected]

Roz Franta Kulik, MS RD FADAMarketing/Strategic Planning Advisor16503 Cerrillo De AvilaTampa, Fl 33613-1080voice: 813-960-1557fax: [email protected]

Sarah Harding Laidlaw, MS RD MPANewsletter Editor 1045 Raptor CircleMesquite, NV 89027voice: 702-346-7968fax: [email protected]

Natalie Legomarcino-Ledesma, MS RDNominating Committee Chair-ElectCancer Resource CenterUSSF Comprehensive Cancer Center1600 Divisadero St, 1st Fl

Sarah Harding Laidlaw, MS, RD, MPA1045 Raptor CircleMesquite, NV 89027

PRSRT STDUS POSTAGE PAIDGrand Junction, CO

PERMIT 229

San Francisco, CA 94143-1725voice: 415-885-7608fax: [email protected]

Susan Moyers, PhD MPH LD/NWeb Editor 2004-20061605 Send WayLutz, Fl 33549voice: 813-948-9040fax: [email protected]

Carmen Nochera, PhD RDNominating Committee Member Apt 124315 Wimbledon Dr SWGrandville, MI 49418-2836voice: 616-538-4226Fax: [email protected]

Rebecca Schauer, RDCopy Editor2916 42nd Ave SouthMinneapolis, MN 55406ph/fax: 612-722-6080work: [email protected]

Gretchen K. Vannice, MS RDMentoring ChairPO Box 3812Tualatin, OR 97062phone: 503-885-7585fax: [email protected]

Annie Griffin,, RD LDCPE Liaison13611 Ferlace Ct NWPickerington, OH 43147phone: [email protected]

Nutrition In Complementary Care NCC Winter 2005 Volum… · NCC DPG Annual Report . . .59 Chair’s Corner. . . . . .42 Editor’s Notes. . . . . . .42 NEXT ISSUE • Spring 2005

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