Nutrition Lecture: Week 5 Liver Nutrition

[liveonearth]

if you don't know what to do with a patient: start with the gut
SAD: cheese, fruit, grains, fat, sugar (what about meat?)
careful using fiber: can cause gas/bloat/constip opposite from intention
liver support: phase II first so that when phase I ramps there's no toxic intermediate burden
central to her BTGs: fish oil

US MILITARY MAY GET FISH OIL SUPPS
http://www.nutraingredients.com/On-your-radar/Omega-3/US-military-may-enlist-Omega-3s-to-boost-performance-but-why-wait
http://www.nutraingredients-usa.com/On-your-radar/Omega-3/US-military-may-shock-and-awe-omega-3-market


TERPENES
yellow, orange, red plant pigments
carotenoids
lycopene in tomatoes-->decr prost, lung, gast CA
limonids in citrus-->activete phase I, II liver enzyme detox system

PHENOLS
blue, blue-red, violet
scavenge free radicals
flavonoids
anthocyanins (blueberries) richest antioxidant
quercetin (apples, onions) mast cell stabilizer
isoflavones (mostly from fabaceae family)
phytoest (flax)
genestein (soy)

LIGNANS
flax, wheat bran, rye meal, oat, buckwheat
bifidobacteria in gut convert to useful form
anti-mitotic
anti-oxidant
may prevent hormone-sensitive cancers
interferes with endogenous sex hormone production ???

THIOLS
sulfur containing
onion, garlic, crucifers: brocc, cauliflower, kale, cabbage
incl dithiothiones, indoles, isothiocyanates
upreg enz involved in detox
allyl sulfides from galic incr phase II,
inhib mutagenesis and incr activity of macrophages and T cells
reduce chol

LIQUID & POWDER SUPPS

GI NUTRITION
fiber is nutrition for GI cells
SCFA (short chain fatty acids??) from soluble fiber
bifidobact break down SCFA from indigestible fiber/carbs
butyric acid preferred fuel of colonocytes, from fermented fiber
liver uses proprionate & acetate for energy
liver byproducts are preferred fuel of SI: glutamine, glutamate, acetoacetate

GI NUTRIT
polysacc-->microbes hydrolyze-->gluc and other monosacc-->pyruvate-->acetyl CoA-->acetate
this is rementation
pyruvate can go to propionate in liver
acetyl CoA can go to butyrate in colon

MICROFLORA
gut has approx 1 trillion critters, many species (in the hundreds)
LI has 400 sp
35-50% of colon content = bacterial
"classically" considered--
pathogentic: E coli (hemolytic), Clostridium, Campylobacter, Listeria
beneficial: bifido, lacto, E. coli (non hemolytic)

BALANCED BACT
pH good-->defense
stim local immune defense (IgA)
digest food
produce vitamins
imbalance-->inflam gut dz, arthritis

SARCOMYCES BOULARDII
RCT of Loperamide/Simeticone (Imodium) and Probiotic (S. Boulardii) in tx of D in 375 adults
measured # unformed stools/24 hours
sponsored by J&J
another study: improved "fecal biostructure" in pts with D but no influence on healthy pts
IBD study

GALT
gut associated lymphatic tissue
"largest organ of defense"
majority of body's lymphoid tissue and antibody production
sIgA ncr by bifidobacteria, inactivates toxins from gut bact

LIVER
lipid soluble-->water soluble-->into bile or excreted by kidneys
two phases: I and II, products of phase I mb more toxic than precursor
AA to supp: methionine, choline, cysteine
if pt is very toxic DON'T do liver detox, support phase 2 gently
handout in clinic: foods and herbs the "liver loves"

PHASE 1
nutrients needed: B's, folic, glutathione, anti-ox, milk thistle, carotenoids, vits E and C
50-100 enzymes, cyp450
glutathione conjugation
supported by indoles (crucifers)
blocked by grapefruit juice (statins 12x more in blood when taken w/ grapefruit)

PHASE 2
nutrition needed: aa's: glutamine, glycine, taurine, CANT READ SLIDE FINISH LATER
conjugation by glutathione
methylation (give activated folate if def, 75mg, Deplin scrip http://www.deplin.com/)
sulfation
amino acid conjugation
acetylation
glucuronidation
USE
glucuronic acid, glutathione, glycine
dithiolthiones
isothiocyanates from crucifers
liminoids from citrus
organosulfurs from allium to incr enz

**every time she seems me typing from what she has on the screen she changes the slide
I am her signal