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Seven Principles of Nutritional Medicine

Majid Ali, M.D.

Mutritional medicine is a philosophy of health based on sound scientific knowledge of what nourishes the body in health, and on what are the special needs for nurturing injured tissues under duress. To paraphrase Bertrand Russel, the British philosopher, to know nutritional medicine is to do nutritional medicine. It is preserve health and reverse chronic disease with nutritional remedies in the broader context of holism, integration, bioenergetics, and personal ethics. 

The human frame cannot remain healthy without light and love. The requirements of the unwell for that light and love during the process of healing are substantially larger than those in good health. Thus, my definition of nutritional medicine extends far beyond the low-carb, low-fat, or any other diet-of-the month . Nutritional medicine is not mere prescription of coenzyme Q 10, magnesium, and arginine for heart disease. Nor is it the use of vitamins by intravenous infusions for anyone to 'anti-age' or cure cancer. My definition of nutritional medicine requires that the practitioner must have a gardener's deep sense of nurturing his plants integrated with a scientist's devotion to the purity of his observation. That—for me—constitutes the first fundamental issue in nutritional medicine.

The First Principle of Integrative Thinking

The first principle of nutritional medicine calls for integrative thinking about nurturing the whole person, and not about correcting one or more nutritional deficits. It requires a gardener's sense of soil, roots, and the sunshine that brings forth the celebration of colors in his garden. For a gardener, the roots, the soil, and sunshine make up a continuum that sustains the growth of the whole plant. Also for him, a plant is the best judges of what it needs and how much. The energy and the color of the branches, leaves, and flowers announce for him whether or not the needs of the plant have been met. That precisely is what is required of a clinical nutritionist — to flush the body with nutrients without incurring any risk of overload or toxicity. And that is the intellectual barrier we physicians need to break for practicing sound nutritional medicine. We must let the energy and the color of our patients — and other characteristics of health presented in the preceding chapter — tell us whether or not their nutritional needs are optimally met. In the clinical outcome sheet included in the chapter entitled "Clinical Charts for Nutritional Medicine," I furnish the clinical outcome criteria my colleagues at the Institute and I use for assessing what I mean by the energy and color of the patient as the true indicators of the nutritional status of the patient.

We physicians, of course, are not trained to develop a gardener's sense of his plants. But I ask: How often does a gardener count the wilting leaves of a plant and pronounce that the plant suffers from eight-leaves-that-are-wilting syndrome? How often does he count the buds that are not blooming and diagnose the nine-buds-that-are-blooming syndrome in his plants? Those questions may be irksome for some readers, but sometimes we need sharp words to shake off old and obsolete beliefs. Again, The problems caused by chronic suboptimal nutritional status can be understood nor effectively managed with the prevailing one-disease/one-drug model of medical thinking.

The Second Principle of Energetic-molecular Thinking

The second principle of nutritional medicine calls for energetic-molecular thinking for the health/dis-ease/disease continuum. Such thinking must be based on sound scientific knowledge of health before molecular/cellular injury occurs rather than on morphologic studies of tissues after the injury has occurred. In mid-1980s, I used the term molecular medicine — a term introduced by Linus Pauling much earlier — to refer to a practice of medicine based on molecular events which occur before the cells and tissues are injured by the disease. The clinical practice of integratve nutritional medicine cannot be based upon what we observe in cells with microscopes after the cells have been damaged.

The simple terminology of aging-oxidant molecules (AOMs) that cause premature aging and life span molecules (LSMs) that provide a counterbalance and prevent accelerated and premature aging, originally presented in The Cortical Monkey, is very valuable for keeping a sharp focus on the crucial distinction between the health and the state of absence of health. I have also found those terms to be very valuable for patient education. Not unexpectedly, under certain conditions, LSMs can turn into AOMs, as is the case with food allergies and other forms of adverse responses to ingested food items and nutrient supplements.

The Third Principle of Achieving Oxygen Homeostasis

The third principle of nutritional medicine calls for an understanding of redox equilibrium and oxygen homeostasis as the fundamental homeostatic mechanisms of health, and oxidosis and dysoxygenosis as the molecular basis of all states of absence of health. This principle dramatically shifts the focus from blind subservience to names of diseases to disciplined efforts to search for the true underlying energetic-molecular causes of illness. The principe is further elaborated in the chapter entitled "Nutrition Through the Prism of Oxygen Homeostasis."

The Fourth Principle of Optimal Need, Not for Minimum Requirements

The fourth principle calls for a clear commitment to the concept of optimal therapeutic dosage determined by long-term true-to-life clinical experience, rather by limited studies of animal and/or human subjects. It was the failure to understand this crucial issue that led to the travesty of RDAa which robbed hundreds of millions of people all over the world of wonderful opportunities of preserving health and reversing chronic disorders. I refer the readers in this subject to RDA: Rats, Drugs and Assumptions for an in-depth discussion of this issue.

The Fifth Principle of Molecular Nurturing, Not of Molecular Blockade

The fifth principle of nutritional medicine calls for recognition of the need for supportive and enabling roles of redox-active and oxystatic molecules for preserving health and reversing chronic illness. Of course, agents of molecular blockade — of membrane channels, receptors, and pump blockers, as well as inhibitors of mediators of inflammation and healing — are necessary for managing acute illnesses.

The Sixth Principle of Primacy of the Patient's Own Sense of His Being

The sixth principle of integrative nutritional medicine calls for a practitioner to subordinate his clinical sense to patient's own sense of her/his well being, and how it is affected in the long run by nutritional interventions undertaken by her/him. This principle essentially concerns the period of clinical management. In acute illness, clearly the clinician is in much stronger position to determine the efficacy of treatment. However, that is not the case in chronic nutritional, ecologic, autoimmune, and and degerative disorders. This is, of course, the most troublesome area for the traditionally trained physicians who have ingrained distrust of what they dismiss as 'unreliable soft data.' Again, at the risk of irksome repetition, I assert that none of then true markersof good health enumerated in the earlier section entitled "What Is Health?" can be evaluated with any laboratory procedures.

The Seventh Principle of Assessment of Long-term Results by the Patient

The seventh principle of integrative nutritional medicine requires that a patient's own assessment of the long-term benefits of the integrative nutritional protocols be deemed as the single most important element in measuring the clinical outcome. By contrast to the sixth principle, this principle concerns the lomng-tem clinical outcome. The need for assessment by the clinician employing appropriate laboratory parameters is self-evident. However, that does not take away anything from the primacy of patient's own assessment of the long-term benefits-or absence of those-of the nutritional programs.

The literature is replete with short-term studies of nutrient therapies that are useful in the sense that they provide a general direction for sound clinical approaches. However, none of those studies are acceptable substitutes for diligently gathered long-term clinical follow-up data, for the efficacy of intergrative protocols, as well as ptential long-term adverse effects. Again, I the readers interested in this subject are referred to RDA: Rats, Drugs and Assumptions for an in-depth discussion of this subject.

 

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