The female-centric 411 on this essential nutrient
by Ashley Jordan Ferira, PhD, RDN
Vitamin D research and daily news headlines are ubiquitous. PubMed’s search engine contains over 81,400 articles pertaining to vitamin D.1 Information abounds on vitamin D, but the vetting and translation of that information into pragmatic recommendations is harder to find. Evidence-based takeaways and female-centric recommendations are crucial for healthcare practitioners (HCPs), their female patients and consumers alike. Women are busy, multi-tasking pros, so practical, personalized takeaways are always appreciated. In other words, women need the “411” on vitamin D. Merriam-Webster defines “411” as “relevant information” or the “skinny”.2 So for all of you busy women, here’s the skinny on vitamin D. Let’s explore common questions about this popular micronutrient.
Q: Is vitamin D more important for younger or older women?
A: All of the above. Vitamin D plays a critical role in women’s health across all life stages, from fertility/conception, to in utero, childhood, adolescence, adulthood, older adulthood, and even in palliative care. Vitamin D is converted by the liver and kidneys into its active hormone form: 1,25-dihydroxyvitamin D. This dynamic hormone binds nuclear receptors in many different organs in order to modulate gene expression related to many crucial health areas across the lifecycle, including bone, muscle, immune, cardiometabolic, brain, and pregnancy to name a few.3
Q: I am a grandmother. Are my vitamin D needs different than my daughter and granddaughter?
A: Yes, age-specific vitamin D recommendations exist. As an essential fat-soluble vitamin, women need to achieve adequate levels of vitamin D daily. Age-specific Recommended Dietary Allowances (RDA) from The Institute of Medicine (IOM),4 as well as newer clinical guidelines from The Endocrine Society,5 provide helpful clinical direction for daily vitamin D intake and/or supplementation goals.
The IOM RDAs4 are considered by many vitamin D researchers to be a conservative, minimum daily vitamin D intake estimate to support the bone health of a healthy population (i.e. prevent the manifestation of frank vitamin D deficiency as bone softening: rickets and osteomalacia):
Infants (0-1 year): 400 IU/day
Children & Adolescents (1-18 years): 600 IU/day
Adults (19-70 years): 600 IU/day
Older Adults (>70 years): 800 IU/day
The Endocrine Society’s clinical practice guidelines5 recommend higher daily vitamin D levels than the IOM, with a different end-goal: raising the serum biomarker for vitamin D status [serum 25-hydroxvitamin D: 25(OH)D] into the sufficient range (≥ 30 ng/ml) in the individual patient:
Infants (0-1 year): At least 1,000 IU/day
Children & Adolescents (1-18 years): At least 1,000 IU/day
Adults (19+ years): At least 1,500 – 2,000 IU/day
Q: I am a health-conscious woman who eats a nutritious, well-rounded diet. I should not need a vitamin D supplement, right?
A: Not so fast. Daily micronutrient needs can be met via diet alone for many vitamins and minerals. Vitamin D is one of the exceptions, which is why an alarming number of Americans (93%) are failing to consume the recommended levels from their diet alone.6-7 Very few foods are endogenous sources of animal-derived vitamin D3 (cholecalciferol) or plant-derived vitamin D2 (ergocalciferol). Some natural vitamin D sources include certain fatty fish (e.g. salmon, mackerel, sardines, cod, halibut, and tuna), fish liver oils, eggs (yolk) and certain species of UV-irradiated mushrooms.8 In the early 20th century, the US began fortifying dairy and cereals with vitamin D to help combat rickets, which was widespread. For example, one cup (8 fluid ounces) of fortified milk will contain approximately 100 IU of vitamin D.
Even though some food sources do exist, the amounts of these foods or beverages that an adult would need to consume daily in order to achieve healthy 25(OH)D levels (> 30 ng/ml) is quite unrealistic and even comical to consider. For example, you would need to toss back 20 glasses of milk daily or 50 eggs/day to achieve 2,000 IU of vitamin D! In contrast, daily vitamin D supplementation provides an easy and economical solution to consistently achieve 2,000 IU and any other specifically targeted levels.
Q: I enjoy the outdoors and get out in the sun daily, so I should be getting all of the vitamin D that I need, correct?
A: Vitamin D is a highly unique micronutrient due to its ability to be synthesized by our skin following sufficient ultraviolet (UV) B irradiation from the sun. Many factors can result in variable UV radiation exposure, including season, latitude, time of day, length of day, cloud cover, smog, skin’s melanin content, and sunscreen use. Furthermore, medical consensus advises limiting sun exposure due to its established carcinogenic effects. Interestingly, even when dietary and sun exposure are both considered, conservative estimates approximate that 1/3 of the US population still remains vitamin D insufficient or deficient.9
Q: What factors can increase my risk for being vitamin D deficient? Are there female-specific risk factors?
A: Although the cutoff levels for vitamin D sufficiency vs. deficiency are still debated amongst vitamin D researchers and clinicians, insufficiency is considered a 25(OH)D of 21-29 ng/ml, while deficiency is < 20 ng/ml.5 Therefore, hypovitaminosis D (insufficiency and deficiency, collectively) occurs when a patient’s serum 25(OH)D falls below 30 ng/ml. The goal is 30 ng/ml or higher.
Ideally, vitamin D intake recommendations4-5 and therapy are personalized by the HCP based on patient-specific information, such as baseline vitamin D status, vitamin D receptor single nucleotide polymorphisms and other pertinent risk factors.
Common risk factors for vitamin D deficiency to look out for include:
-> Older age
-> Regular sunscreen use
-> Winter season
-> Frequent TV viewing
-> Dairy product exclusion
-> Darker skin (more melanin)
-> Not using vitamin D supplements
-> Malabsorption disorders (e.g. bariatric surgery, IBD, cystic fibrosis)
-> Liver disease
-> Renal insufficiency
-> Certain drug classes: weight loss, fat substitutes, bile sequestrants, anti-convulsants, anti-retrovirals, anti-tuberculosis, anti-fungals, glucocorticoids
-> Lastly, additional female-specific risk factors to look out for include exclusive breastfeeding while mother is vitamin D insufficient (can result in infant being vitamin D deficient) and certain cultural clothing that covers significant amounts of skin surface area (e.g. hijab, niqab).
Ashley Jordan Ferira, PhD, RDN is Manager of Medical Affairs and the Metagenics Institute, where she specializes in nutrition and medical communications and education. Dr. Ferira’s previous industry and consulting experiences span nutrition product development, education, communications, and corporate wellness. Ashley completed her bachelor’s degree at the University of Pennsylvania and PhD in Foods & Nutrition at The University of Georgia, where she researched the role of vitamin D in pediatric cardiometabolic disease risk. Dr. Ferira is a Registered Dietitian Nutritionist (RDN) and has served in leadership roles across local and statewide dietetics, academic, industry, and nonprofit sectors.
by Ashley Jordan Ferira, PhD, RDN
Vitamin D is essential- it helps absorb calcium, supports nervous and muscle tissue, and the immune system. Compared to normal-weight counterparts, vitamin D deficiency is more prevalent in those with obesity. In the US over one-third of adults meet obesity criteria.1
A study in The Journal of Clinical Endocrinology and Metabolism2 examined cellular mechanisms of vitamin D trafficking in metabolically dysfunctional adipose tissue as compared to normal adipocytes in conjunction with a vitamin D supplementation intervention in a randomized, controlled trial.
Ninety-seven male subjects completed the vitamin D intervention study. Fifty-four normal-weight and 67 obese males were initially randomized to receive either 50 mcg/week of 25-hydroxyvitamin-D3 [25(OH)D3] (2,000 IU/week equivalent) or 150 mcg/week of vitamin D3 (6,000 IU/week equivalent) for one year. Vitamin D sufficiency was defined as a 25(OH)D blood level > 20 ng/ml. This serum concentration is aligned with the National Academy of Medicine’s cutoff for vitamin D sufficiency.3
Vitamin D uptake, conversion and release were investigated in control (non-insulin-resistant) and insulin-resistant 3T3-L1 adipocytes, as well as in subcutaneous adipose tissue (SAT) samples from lean and obese participants. The release of vitamin D and its metabolites were induced with the addition of adrenaline. Expression of the vitamin D receptor and vitamin D conversion enzymes, 25-hyroxylase and 1α-hydroxylase, was also examined.
The research team elucidated key differences in cellular vitamin D trafficking effects and supplementation effects:
Why is this Clinically Relevant?
Link to Abstract
Have you ever stood before the wall of vitamins at the drugstore or your healthcare practitioner’s office, wondering what you should take? Choosing supplements can be a daunting experience: Some boxes are orange. Some bottles are silver. Some contain iron, while others do not. Which one is right for you?
Start the selection process by getting specific about your particular stage of life. From young adulthood to the childbearing years and into menopause, each life stage may require greater emphasis on different nutrients to help your body get what it needs for optimal wellness.
Young, ambitious, and carefree! Does this ring true for you? Women in their late teens or early 20s are going off to college, choosing a career path, and just beginning to explore adulthood. This is a time to be mindful of getting the appropriate nutrients you need to create a healthy foundation for the years ahead.
Calcium. This mineral is important for women of all ages, but especially so in your 20s when bone mass reaches its peak. After this time, the risk of losing bone mass increases as a woman moves into her 30s and beyond.1 Taking a calcium supplement can help the body build bone, especially when paired with vitamin D3, which is known to enhance absorption of this vital mineral.2
Iron. Iron is important for young ladies, as menstruation is one of the ways this mineral is depleted from the body. In fact, menstruation increases the average daily iron loss to about 2 mg per day in premenopausal female adults,3 with excessive menstrual blood loss as the most common cause of iron deficiency in women.3
Baby, it’s you!The time of a woman’s life when she can become pregnant and have a baby is very special. It is also especially important to consider which nutrients are needed before conceiving and to ensure a smooth pregnancy and delivery.
Folic acid. This vitamin (known as folate in its natural form) is needed before and during pregnancy. If you are considering getting pregnant, it is smart to increase folic acid intake before conceiving—there is strong evidence that taking folic acid prior to conception and during the first trimester of pregnancy can reduce the risk of neural tube defects of the brain, spine, or spinal cord by up to 70%.4Additionally, folic acid requirements are 5- to 10-fold higher in pregnant women than nonpregnant women,5 so get your folic acid going!
Iron. Iron supplementation in pregnancy is often recommended. During pregnancy, the body’s iron requirements progressively increase until the third month.6 This is because more iron is needed for the growing fetus and placenta, as well as to increase your red blood cells.7
Calcium. Calcium is essential for fetal development, and this requirement increases during pregnancy (from 50 mg/day at the halfway point up to 330 mg/day at the end) and lactation.6
Iodine. During pregnancy, iodine is needed in the production of fetal thyroid hormones (the fetus’ thyroid begins functioning as early as 12 weeks in the womb!) and should be increased by about 50%.6
Vitamin D. Vitamin D (mostly vitamin D3, as it’s the predominant form in mom’s blood) is needed in the first stage of pregnancy, as it contributes to embryo implantation and the regulation of several hormones.6
Choline. Choline is an important nutrient for the health of women throughout their lifetime, and in particular during pregnancy. Choline is also vital for early brain development.8
The change of lifeAs your body progresses toward menopause, it produces less estrogen, opening up a world of change. It is during this time that certain nutrients can help support you in the management of symptoms like hot flashes and mood fluctuations, as well as help stave off concerns about bone mass loss.
Calcium and vitamin D. In menopause, calcium remains a top nutrient to support the maintenance of bone mass. Bone turnover increases at this time, while the creation of new bone does not, which can lead to bone mass loss. Along with calcium, vitamin D is an important factor in helping to support bone health, which has been shown to help prevent bone mass loss in perimenopausal and menopausal women.9
Vitamin K and vitamin D. It has been shown that Vitamin D and K are both important nutritional factors in supporting mineralization and healthy structure of bones.10
Vitamin B12. When it comes to menopause, the B’s have it! Vitamin B12 plays a key role in energy metabolism, something we all need more of during menopause.11
Where to begin?Your healthcare practitioner is the best person to ask about which nutrients you may need. So get out of the vitamin aisle and in to see your doctor!
This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues.
By Nilima Desai, RD
If you have ever experienced hot flashes, night sweats, etc., due to menopause, you are not alone. About 80% of menopausal women suffer from hot flashes, night sweats, sleep disturbances, depression, anxiety, and vaginal dryness,¹ which can significantly affect their quality of life. Menopause is characterized by a decrease in estrogen levels, which triggers these uncomfortable symptoms. Most women report hot flashes to be the most bothersome symptom and the reason for starting hormone therapy.²
Symptom Relief OptionsIn addition to lifestyle recommendations, such as following a plant-based diet, increasing physical activity, and minimizing smoking and alcohol intake, the addition of hormone replacement therapy (HRT) has been most effective in reducing vasomotor symptoms (hot flashes, night sweats) commonly associated with decreased estrogen levels.²,³*
However, current recommendations from the American Congress of Obstetricians and Gynecologists suggest limiting HRT to the lowest effective dose for the shortest amount of time possible.⁴ As a result, 40-50% of women choose to use practical alternative options, such as plant-derived solutions to address menopause-related symptoms.³ Various plant-derived solutions including phytoestrogens such as isoflavones, lignans, and other Chinese and herbal remedies such as ginseng, black cohosh, etc., have been studied for the relief of menopausal symptoms.*
Plant-Derived Solutions: Phytoestrogens are a group of nonsteroidal plant-derived compounds with estrogen-like properties. The chemical structure contains a phenolic ring that enables them to bind to estrogen receptors in the body.⁵ They bind to both types of estrogen receptors, Erα and Erβ.⁵ However, research suggests that majority of the phytoestrogens have a higher affinity to bind to Erβ as compared to steroidal estrogens.⁵ Therefore, they may exert their actions through different pathways and may potentially induce different beneficial responses.*
There are four classes of phytoestrogens: isoflavones, lignans, coumestans, and stilbenes.⁶
Results from 21 randomized controlled trials (RCTs) examining the association between different phytoestrogens and menopausal symptoms (frequency and duration of hot flashes, vaginal dryness, etc.) included in a meta-analysis concluded that there was an association of overall phytoestrogen use with a decrease in the number of daily hot flashes and in vaginal dryness scores.³ However, the use of phytoestrogens was not associated with significant changes in 24-hour night sweat episodes.³*
ERr 731® is a standardized extract of Siberian rhubarb root, a plant-derived, nonhormonal therapy designed to alleviate menopausal symptoms, including hot flashes.*
In a confirmatory RCT involving 119 perimenopausal women, compared with perimenopausal women receiving placebo, those receiving ERr 731® experienced a median 83% decrease in daily hot flashes over the course of 12 weeks.⁷ Compared to placebo, perimenopausal women who received ERr 731® (the extract found in Estrovera) experienced a decrease in symptoms (as indicated by an average [mean] reduction) of up to 83% in individual Menopause Rating Scale scores.⁸ Clinical benefits of ERr 731® appear to be related to selective binding of Erβ and lack of affinity for Erα.9,10*
Black cohosh is an herb that has a long history of use for the relief of menopausal symptoms, including hot flashes and night sweats. Results from four RCTs examining the association between black cohosh with menopausal symptoms included in a meta-analysis concluded that black cohosh was not associated with changes in the number of hot flashes and night sweats within a 24-hour period.³ Therefore, although black cohosh is a popular herbal remedy to address menopausal symptoms, research has shown no significant association between black cohosh supplementation and relief in menopausal symptoms.³*
Other herbs: There aren’t many studies conducted on the associations of Chinese and non-Chinese medicinal herbs with menopausal symptoms. The few RCTs conducted on the various herbs were not consistent and in general didn’t show any association with symptom relief.³*
Although many RCTs have been conducted on phytoestrogens and herbal remedies in relation to menopausal symptom relief, further studies are needed to determine potential long-term adverse health effects.*
Next StepsUse of HRT needs to be evaluated carefully, and the clinician should assess the risks and benefits associated with prescribing HRT for each individual woman based on her symptoms and personal and family medical history. For women who choose to avoid or have contraindications to HRT, plant-derived therapies in conjunction with a patient-centered approach may potentially provide an alternative in relieving certain symptoms associated with menopause. To determine the best options, patients should always consult with their healthcare provider.
*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.References:
Fish and shellfish are full of healthy fats, vitamins, and minerals. Great for our physical and cognitive wellbeing, they’re a solid addition to a nutritious diet.1
That said, not all seafood is created equal. This post will outline the differences between farm-raised and wild-caught fish, including their impact on our health and the environment.
What are the differences between farm-raised and wild-caught fish? Fishermen catch wild fish and shellfish in lakes, rivers, oceans, and other bodies of water. These fish eat a natural diet.
Farmed fish are bred for human consumption through a process called aquaculture. This means they live outside their natural environment and are generally given processed feed.2
Specifically, farmed fish are placed in pens submerged in ponds, lakes, or even saltwater.1 Some pens are filled with water and kept on land.
While this might not sound ideal, fish farming isn’t inherently bad. Sustainable farming practices have become more common than ever, as the World Bank estimates that almost two-thirds of seafood will be farm-raised by 2030. In Norway and Canada, for instance, most farmed salmon are cultivated through an eco-friendly recirculating aquaculture system.3
Here are some other items to consider:
Nutrition: Which fish variety is better for your health?Fish have been shown in clinical studies to display anti-inflammatory properties, not to mention being rich in heart-healthy omega-3 fatty acids.3 The overall quality of seafood, however, depends largely on what fish eat. Wild fish consume a natural diet lower in saturated fats.5
What does this mean? Let’s focus on salmon for a moment. In addition to being higher in saturated fat than wild salmon, farmed salmon contains more omega-3s and 46% more calories. The wild-caught stuff, however, is richer in minerals like potassium, zinc, and iron.4
Consider the following when evaluating both fish varieties for your health:
Most people consume too much omega-6, which may cause inflammation and other symptoms. And farm-raised salmon specifically—despite containing higher quantities of omega-3—has a significantly higher omega-3-to-omega-6 ratio.4 The ratio is still good enough, but it isn’t quite at the level you would find in wild seafood.
Of course, the trace metals found in fish aren’t limited to mercury. Farmed salmon contains higher arsenic levels, while wild salmon contains more cobalt, copper, and cadmium.7 Fortunately, levels of trace metals in both wild and farmed fish are usually so low they’re unlikely to harm the average person.4
Some studies indicate that farm-raised fish have higher levels of contaminants.4 Furthermore, seafood raised via aquaculture may have a higher rate of disease because of some of the farming practices and conditions.5
For example, approximately 530 grams of antibiotics were used per ton of harvested Chilean salmon in 2016. (In contrast, Norway used just 1 gram of antibiotics per ton of harvested salmon in 2008.)4As such, it’s essential that you understand where your fish is from before consumption.
Sustainability: Which fish variety is better for the environment?Fish accounts for 17% of our global protein intake.8 For this reason, we can’t rely on wild-caught fish alone. There just isn’t enough wild seafood to keep up with the growing demand.
Based on our current trajectory, there’s a global need for another 80 million tons of farmed fish per year by 2050.8 Yet aquaculture may be detrimental to the environment too. Use of antibiotics can cause damage to the environment and adversely affect human health as well.4
Moreover, when lots of fish are crammed together in a small space like a pen, they create a ton of waste that can pollute rivers, lakes, and oceans.8
And the environmental consequences of fish farming doesn’t end there, either. Some fish farms are disease-ridden, which can be toxic to the environment; in Indonesia, shrimp farming specifically has contributed to the decline of the nation’s mangrove forests.8
Since we don’t want to deplete what’s left of our wild fish resources, where does that leave us?
Fortunately, some experts say that feeding farmed fish a higher-quality diet free from antibiotics can help address some of the problems described above. Similarly, as fish farmers gain efficiency, governments will be more likely to offer incentives for the adoption of sustainable practices.8 Ideally, the environment will become an even greater focus for everyone in the near future.
The verdict on wild-caught vs. farm-raised fishWhile wild seafood is generally healthier than farmed fish and shellfish, sustainable methods make many farm-raised options completely viable. Both wild-caught and farm-raised fish varieties offer plenty of protein, the omega-3 Docosahexaenoic acid (DHA), and other essential nutrients.4
To make sure you’re eating top-quality seafood, be sure to look into where your seafood is from, and opt to eat local, low-mercury varieties when possible.
For more information on nutrition and general wellness topics, please visit the Metagenics blog.
You probably know about probiotics. They’re the tiny, “friendly” bugs that support a balanced and healthy gut. What you may not know is that their benefits go well beyond gut health!*
Your body is full of both good and bad bacteria, and when this delicate bacterial balance is out of whack, probiotics may be your most powerful ally to help restore your intestinal ecosystem.*
Before adding a probiotic to your daily routine, it’s important to consider the following factors:
With all the benefits probiotics have to offer, there are many reasons to consider probiotic supplementation. Talk to your healthcare practitioner today about which probiotic formula may be best for you.
*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.
For the one out of six Americans sleeping less than seven hours per night, a sleep debt may feel “normal.”1 But, similar to a financial debt, the real cost may not be immediately apparent and can be damaging with time.
Sleep debt is costly for your body, even a few nights of insufficient sleep can leave you sleepy, with slower reaction times, foggy thinking, overall decreased performance, and, perhaps, a less than sunny disposition. Less noticeable is the disruption that may happen silently inside of our body: The effects of long-term sleep deprivation can possibly lead to negative health consequences.
Weekend catch-up sleep: does it work?Extra weekend shut-eye is a coveted treasure for the sleep-deprived. While we know it makes us feel better, can those extra hours of sleep reverse the health risks of a sleep-poor Monday-Friday?
Catch-up sleep and weight gain Studies have found a consistent link between sleep deficiency and weight gain—even over a very short time frame.2 In fact, when it comes to weight, every hour of sleep counts—not only for weight gain but also preventing it. In a study of over 2,000 participants, those who slept longer on the weekends, nearly two hours longer on average, had a significantly lower body mass index (BMI) than those who didn’t. Further, every extra hour of weekend catch-up sleep was associated with a significantly lower body mass.3
Strategies to help you get—and stay—out of sleep debt, so short-term, catch-up sleep can be helpful for paying back your sleep debt. But it shouldn’t be your only strategy. In addition to eliminating lifestyle-related sleep issues (over scheduling, limiting caffeine and electronics before bed, room temperature and darkness, etc.), you may want to consider dietary supplements that help support relaxation and healthy sleep.*
Some ingredients that can help support rest and relaxation include:
There are a number of specialised formulas that contain the above ingredients which can help you relax and relieve occasional sleeplessness.* Talk to your healthcare practitioner to determine which options are best for your individual needs.
*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.
Dining out should be relaxing. But if you have a gluten sensitivity, a bit of skepticism should be on the menu. Typical recommendations, such as seeking a gluten-free menu and letting the server know about one’s dietary restrictions, may give the diner a false sense of assurance.
Here’s why—and how—gluten digestive enzymes can improve your dining experience.
Is the Gluten-Free Menu Really Enough?
First, consider economics. While awareness for the concerns of gluten-free customer is growing, the restaurant industry is challenged by slim margins and regular employee turnover. Further, appropriately accommodating these customers requires much more than simply stocking gluten-free breads and pastas. So, if a restaurant invests in the training and infrastructure to adequately support the needs of these customers, it will likely promote its efforts and will welcome questions.
Second, not all restaurants have a gluten-free menu, leaving the diner to navigate the standard menu. Unfortunately, it’s not a good idea to assume anything about the ingredients on any menu, especially those of chain restaurants, often the only option for a traveler.
Discerning gluten-free diners need to ask some very specific questions to determine the risk for gluten exposure from raw ingredients or cross-contamination. But will a well-meaning airport restaurant manager have the answers?
Some Questions to Determine Possible Gluten Exposure
How Can the Right Enzymes Help?
Gluten-sensitive patients will always need to wear their detective hat when dining out. However, medical professionals can support them by recommending targeted support to break down hidden gluten enzymatically. But which gluten enzymes might help the most?
SpectraZyme Gluten Digest is a bacterially derived, clinically researched prolyl endoprotease (AN-PEP). It has many advantages over popular market offerings that feature exoprotease proteolytic enzymes, also known as didpeptidyl peptidase IV (DPP-IV). In short, the AN-PEP is more effective in the low pH environment of the stomach with or without the other enzymes naturally present in the digestive tract.
SpectraZyme Gluten Digest is also a proline-specific endoprotease. This means it can specifically cleave the gluten and gluten peptides after any of the many proline residues, breaking down protein over the entire length of protein and peptide chains, not just at the ends. As a result, the enzyme breaks up the gluten more completely. So less hidden gluten will reach the duodenum
Gluten-sensitive individuals can’t avoid all gluten exposure. But, with SpectraZyme Gluten Digest, they can minimize their risk when dining away from home.
About Maribeth Evezich
Maribeth Evezich, MS, RD is a functional nutrition and therapeutic lifestyle consultant. Maribeth is also a graduate of Bastyr University and the Natural Gourmet Institute. Whether she is in her kitchen experimenting, at her computer researching, or behind the lens of her camera, she is on a mission to inspire others to love whole foods. as much as she does. She lives in Seattle and is the founder of Lifestyle Medicine Consulting, LLC and the culinary nutrition blog, Whole Foods Explorer. Maribeth Evezich is a paid consultant and guest writer for Metagenics.
A Guide to the Scientifically Based, Functional Medicine Approach
People either swoon or cringe when they hear the word “detox.” Those who stand behind it claim it gets rid of their symptoms—everything from brain fog to joint pain and fatigue—while others strongly assert there is no need to detox, and it is just marketing hype. Why such polarized views?
“Detox” used to mean many things, which may be part of the reason for the discrepancy. To some, it might simply be drinking lemon juice in water, sitting in a sauna, or maybe doing a juice fast. However, within Functional Medicine, detox has a specific definition: it is the process of reducing the body’s toxic load by lessening exposure to harmful chemicals we are taking in, while simultaneously implementing nutrition and lifestyle strategies to promote efficient elimination of toxins from the body1.
The first step of detoxification can be done, in part, by lessening the immune system load by removing reactive foods from the diet. The gold standard for this removal is the aptly named “elimination diet”, which is a simplified list of foods to eat and foods to exclude as part of a detox program.
Typically, common allergenic foods and beverages containing corn, soy, wheat/gluten, eggs, dairy, shellfish, and peanuts are omitted from the daily diet in conjunction with caffeine, sugar, alcohol, and red meat for 10 to 28 days, depending on the duration of the program. In scientific literature, using an elimination diet in various formats has historically been used to address various conditions2,3,4,5,6 with differing levels of success.
In Functional Medicine, the elimination diet is often used as the first line of therapy for immune and gastrointestinal issues since it can help with reducing toxic load and cooling down any immune reactivity to foods.
In conjunction with removal of foods, it’s best to take a complementary approach to bolstering the body with specific nutrients to help fortify its pathways of detoxification in the liver, so toxins can be easily removed. For example, it is well known that certain vitamins and minerals—like B vitamins and iron—are required to assist in the activity of these enzymes7. Coupling nutrients together with an elimination diet (through their inclusion as whole, plant-based foods and as scientifically formulated dietary supplements) is perhaps the most robust protocol for a medical detoxification regimen.
In support of this approach, Lamb et al8. showed that a 4-week elimination diet? together with nutrient supplementation ? was helpful in reducing symptoms in women with fibromyalgia.
In conclusion, detox has a very specific and science-based definition within Functional Medicine. In practice, Functional Medicine programs that modify dietary intake and supplement nutritional co-factors that support the body’s endogenous detoxification pathways can mitigate toxic burden to reduce incoming toxic exposures, and, at the same time, equip the body with nutrients known to support the body’s natural capacity to shuttle toxins out.
1 Institute for Functional Medicine. https://www.functionalmedicine.org/
2 Warners MJ, Vlieg-Boerstra BJ, Bredenoord AJ. Elimination and elemental diet therapy in eosinophilic oesophagitis. Best Pract Res Clin Gastroenterol. 2015 Oct;29(5):793-803.
3 Kim J, Kwon J, Noh G, Lee SS. The effects of elimination diet on nutritional status in subjects with atopic dermatitis. Nutr Res Pract. 2013 Dec;7(6):488-94.
4 Alpay K, Ertas M, Orhan EK, Ustay DK, Lieners C, Baykan B. Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomised, cross-over trial. Cephalalgia. 2010 Jul;30(7):829-37. doi: 10.1177/0333102410361404. Epub 2010 Mar 10.
5 Bunner AE, Agarwal U, Gonzales JF, Valente F, Barnard ND. Nutrition intervention for migraine: a randomized crossover trial. J Headache Pain. 2014 Oct 23;15:69. doi: 10.1186/1129-2377-15-69.
6 Pastorello EA, Stocchi L, Pravettoni V, Bigi A, Schilke ML, Incorvaia C, Zanussi C. Role of the elimination diet in adults with food allergy. J Allergy Clin Immunol. 1989 Oct;84(4 Pt 1):475-83.
7 Textbook of Functional Medicine. Institute for Functional Medicine. Gig Harbor, WA. 2006.
8 Lamb JJ, Konda VR, Quig DW, Desai A, Minich DM, Bouillon L, Chang JL, Hsi A, Lerman RH, Kornberg J, Bland JS, Tripp ML. . Altern Ther Health Med. 2011 Mar-Apr;17(2):36-44.
About Deanna Minich
Guest blogger Dr. Deanna Minich is an internationally recognized health expert and author with more than 20 years of experience in nutrition, mind-body health, and functional medicine. Dr. Minich holds Master’s and Doctorate degrees in nutrition and has lectured extensively throughout the world on health topics, teaching patients and health professionals about nutrition. She is a Fellow of the American College of Nutrition, a Certified Nutrition Specialist, and a Certified Functional Medicine Practitioner. Currently, Dr. Minich teaches for the Institute for Functional Medicine and for the graduate program in functional medicine at the University of Western States. Her passion is bringing forth a colorful, whole-self approach to nourishment called Whole Detox and bridging the gaps between science, soul, and art in medicine.