The Power of Nutrition: Children’s Health and Digestive Problems Alison Peacham Course Leader NTDC, ION Nutritional Therapist B Ed (Hons) Dip ION.

The Power of Nutrition: Children’s Health and Digestive Problems

Alison Peacham

Course Leader NTDC, ION

Nutritional Therapist

B Ed (Hons) Dip ION

What will we cover?

Introduction to the ION Children’s Clinic

Overfed and undernourished

Review common digestive problems and the Nutritional Therapy approach

Links between the gut and a number of conditions

Nutritional management

Clinical case

The ION Children’s Clinic

Clinic for the nutritional treatment of children from birth to 18

Diet, lifestyle and supplement advice

Biochemical tests

The approach is based on ‘biochemical individuality’ tailored to age and development to address health imbalances

Assessing the condition

Testing plays a central role in identifying the underlying aetiology of a health condition. Tests commonly used in the Children’s Clinic:

Stool tests for digestive imbalances and parasites

Finger prick blood sample for food intolerances

Urine tests for metabolic imbalances

The National Diet & Nutrition Survey: young people aged 4-18 years

Most common foods (more than 80%) during a 7 day dietary record were white bread, savoury snacks, potato chips, biscuits, boiled, mashed or jacket potatoes & chocolate confectionery

Three quarters of young people drank standard carbonated soft drinks & 45% low calorie versions Food standards Agency 2000

The National Diet & Nutrition Survey: young people aged 4-18 years

Average intake of most minerals in the youngest were above RNI – except zinc

Older groups average intakes of minerals below RNI: zinc in all groups, potassium, magnesium, calcium and iron in older girls

13% of 11-18 year olds had poor vit D status

Those in lower socio-economic groups tended to have lower biochemical status of vitamins such as folate, riboflavin, vit D and iron

Why is this important?

Vital for growth, development, mind and mood

Common gastrointestinal

problems in children

Functional abdominal pain

Functional abdominal pain (FAP) where histopathology is normal

In a prospective cohort study of 237 children, higher rates of anxiety and depression were reported. Gastrointestinal symptoms were assessed weekly. During the course of the research 23% of children were absent from school. (Saps et al., 2009)

GP testing important

A comprehensive digestive stool analysis is recommended

Sensitivities and allergies

“Food allergy is becoming an increasing problem worldwide with an estimated 6 – 8% of children affected at some point in their childhood...Estimated 20% of children adhering to some form of elimination diet” (Noimark & Cox, 2008)

Six Day Diet Diary

What is the child eating regularly?

Some food may be eaten extensively

Simple exclusion diets can be appropriate for young children

Many underlying factors cause reactions to foods e.g. Lack of digestive enzymes, dysbiosis, nutritional insufficiency

Dietary Assessment – provides clues to problem foods

Reactions that are immunologically mediated (allergic IgE reactions)

Non-IgE mediated reactions e.g. food intolerances

Consider Functional Laboratory Testing

Healing options: elimination or rotation diet, glutamine, probiotics, digestive enzymes, liver support

Increased intestinal permeabilityFoods can damage the gut mucosa

Chronic stress, infection with bacteria, yeast or parasites, repeated use of antibiotics can cause ‘leaky gut’

Enzyme production may be negatively affected and food may not be fully digested; puts an extra burden on the liver

Healing options

Functional testing – Intestinal permeability test, may be done in conjunction with CDSA & parasitology

Avoidance of sensitive foods

Digestive enzymes to assist digestion and absorption of food

Zinc for gut repair

Glutamine to repair mucosal lining

Probiotics and prebiotics to increase beneficial bacteria

Management of food allergy: vitamins, fatty acids or probiotics?

Probiotics have been shown to reverse the increased intestinal permeability characteristic of children with food allergy and to enhance specific IgA responses frequently defective in children with food allergy (Laitinenk & Isolauri, 2005)

Constipation

Constipation: The prevalence in children (0-18) is estimated to be between 0.7 and 29.6 per cent (Van den Berg et al.,2006)

Underlying causes include poor diet, lack of physical activity and psychological factors & a family history of constipation (Inan et al.,2007)

Healing options

Consider lactose intolerance, food sensitivity, leaky gut, dysbiosis, parasitic infection

See Nutritional Management

Prune juice is tasty and has a laxative effect. (1/3 cup diluted with 2/3 water)

Magnesium relaxes muscles and promotes peristalsis

Other common GI problems in children

Colic in infants

Nausea and vomiting

Celiac disease / gluten intolerance

Diarrhoea

Ulcerative colitis

Crohn’s disease

IBS

Aim to look at how GI problems are linked to other conditions

Autism

Evidence of impaired gut immunity and gut inflammation

The possibility and probability of a gut-to-brain connection in autism (Reichelt & Knivsberg, 2009)

Support with probiotics

Support SigA production – whey protein powder

Reduce inflammation – Essential fatty acids, antioxidants

Gut link with inflammation

Commensal microbes of the intestine actively induce tolerant responses from the host that coordinate healthy immune responses

Disruption of this dialogue between the host and microbe can lead to the development of autoimmune diseases such as inflammatory bowel disease (IBD), rheumatoid arthritis (RA), or Type I diabetes (TID). (Round et al., 2010)

4R model

Remove (e.g. Yeast, bacteria, parasites, foods that result in allergic or intolerant responses)

Replace (e.g. digestive enzymes, hydrochloric acid)

Re-inoculate ( e.g. pre and probiotics. Lactobacillus and bifidobacteria. Saccharomyces boulardii increases Sig A)

Repair (e.g. Glutamine for gut lining, EFAs, zinc)

Strategy for GI problemsNo two children are treated identically but there is

advice common to most children

Keeping processed foods low e.g. Cakes, biscuits, crisps – make every meal count towards nourishing your child

Eating healthy whole foods rich in fibre such as oats and legumes including at least 5 fruit & veg per day

Careful use of fibre

e.g. 1 teaspoon soaked linseeds

Strategy for GI problems

Drinking fluids as dehydration may be a factor in constipation (Arnaud, 2003)

Removal of food allergens

Restore nutrient adequacy – achieving balance of macro and micronutrients

Ideas to help change habits

Lead by example

Reward charts

Gradual introduction of healthy ingredients

Make your own versions e.g. fish fingers

Special cups and plates.

Involve children – selecting foods, cooking foods, growing foods.

Don’t let meals become a battleground

Older children need to understand the benefits.

Case Study

Natalie aged 8 years

Persistent abdominal pain

Medical investigations could find no cause. Blood tests for inflammatory markers and coeliac disease are negative

Case study

RecommendationsComprehensive Digestive Stool Analysis and Parasitology test

Foodscan 113 Food Intolerance Test from York Laboratories

Comprehensive Digestive Stool Analysis

Indicates good digestion and absorption i.e. adequate digestive enzymes

No indication of inflammation or tissue damage

Low levels of beneficial bacteria.Bifidobacterium should be recovered at levels of 4+ so beneficial to supplement probiotics.

Candida albicans 1+ levels (signifies dysbiosis)

Parasite Dientamoeba fragilis at low levelssignificant and requires treatment

York Foodscan IgG food intolerance:

Cows milk (3)

Some reaction to egg white and yeast

Strategy

Improve diet and support digestive system:

Aim to balance diet and macronutrients

Aim for 5 fruit and veg daily.

Natalie is a fussy eater but she thought peas, raw carrot sticks, sweet corn and broccoli may be ok. Introduce a tiny amount initially. The reward chart may help with trying new foods

Strategy

Introduce oily fish such as salmon, mackerel, & sardines (2 – 3 times a week). Essential fats support the gut lining. Fish pies, fish cake and homemade fish fingers can be a good way of disguising fish

1 tsp soaked linseeds ground provide EFAs and are cleansing for the gut. Sprinkle on cereal

Ensure eating when relaxed and food chewed well

Strategy

Avoid dairy products for about 8 weeks– re IgG antibody reaction. Replace with fortified rice, oat, almond or coconut milks. Soya yoghurt. Inclusion of calcium rich foods such as sardines, broccoli, nuts and seeds

Protocol – remove parasite (anti-fungals), remove intolerant foods, add probiotics, support liver function, heal the gut

The power of nutritionMany adults who consult a nutritional therapist have years of health problems to improve

Children tend to respond quickly to improvements in diet and lifestyle

NT gives children the possibility of achieving their potential. It looks at the combined effects of the child’s biochemistry, physiology, psychology and a host of environmental factors

The Institute for Optimum Nutrition

Children’s clinic

Come and visit us at stand 2116

www.ion.ac.uk/clinics.htm

To book an appointment call

020 8614 7822

A specialist clinic and centre of excellence