16. DIETARY MODELS

Question 1

Which minerals are bound most tightly with lectins?

Answer 1

Iron, calcium, zinc and phosphorus

Question 2

In the introduction phase of the SCD/GAPS diet, how many grams of carbohydrates are allowed per day?
a) 20g
b) 10g
c) none

Answer 2

c) none

Question 3

What percentage of the macronutrient ration does fat account for in a ketogenic diet:
a) 5%
b) 45%
c) 75%
d) 90%

Answer 3

c) 75%

Question 4

What are the main characteristics of the Mediterranean diet?

Answer 4

Abundance of plant food (fruits, vegetables, whole-grain cereals, nuts, and legumes).
* Olive oil as the principal source of fat.
* Low consumption of red meat.
* Fish and poultry consumed in low to moderate amounts.
* Moderate consumption of wine, normally with meals.

Question 5

What are the costs associated with the industrialisation of food?

Answer 5

• Pesticide toxicity: Herbicides and insecticides.
• Water pollution: From fertilisers and pesticides.
• Soil depletion: Monoculture depletes soil of nutrients, impacting biodiversity and ecosystems.
• Antibiotic resistance: Overuse of antibiotics in animal stocks.
• Junk food: With costly and serious health impacts.
• Chemical-laden ‘foods’ contribute to diseases that affect quality and length of life.
• Chronic health issues e.g. obesity, cancer, heart disease, diabetes, Alzheimer’s, Parkinson’s disease are at an all-time high

Question 6

What is a Blood Type Diet?

Answer 6

Your blood type determines your
diet, supplements and personality because it is ‘the key to your body’s entire immune system’.
* Eat Right for Your Type by Dr. Peter
J. D’Adamo was first published in 1996.
* According to the author, the blood type reflects which foods are best for health.
* Foods are divided into three categories:
- Highly beneficial (act as medicines).
- Neutral.
- Ones to avoid (act like poison).

Question 7

Eat Right for Your Type by Dr. Peter
J. D’Adamo was first published in 1996.

According to the author, what does your blood type reflect? And what are the categories food is divided into?

Answer 7

It reflects which foods are best for health

• Foods are divided into three categories:
• Highly beneficial (act as medicines).
• Neutral.
• Ones to avoid (act like poison).

Question 8

For blood type O, which foods would you:

• Recommend?
• Avoid?
• Incorrect eating?

Answer 8

• Recommended foods: Meat, poultry, seafood, certain fruits and vegetables. High protein, low carbohydrate.
• Avoid: Wheat and most other grains.
• Incorrect eating: Said to ↑ risk of ulcers and inflammatory diseases such as arthritis.

Question 9

For blood type A what are the food you would:

Recommend?

Avoid?

Incorrect eating?

Answer 9

• Recommended foods: Fruits, vegetables, beans, most seafood. High carbohydrate, low fat.
• Avoid: Meat, dairy, wheat.
• Incorrect eating: Said to ↑ risk of cancer and heart disease.

Question 10

For blood type B what are the food you would:

Recommend?

Avoid?

Incorrect eating?

Answer 10

People with blood Type B are dairy-eating omnivores.

• Recommended foods: Meat, beans, fruits, vegetables, some dairy.
• Avoid: Chicken, pork, wheat.
• Incorrect eating for this blood type is said to increase the risk of slow-growing viruses that attack the nervous system.

Question 11

For blood type AB what are the food you would:

Recommend?

Avoid?

Which system this blood type is regarded as ‘friendliest’?

Answer 11

Recommended: Seafood, dairy, fruits, vegetables.

• Eat less: Red meat.
• Regarded as the ‘friendliest’ immune system of all the blood types.

Question 12

What is the main concerns of the action of lectins (proteins) found on the surface of certain foods? Give an example.

Answer 12

Most pass through the GIT without being digested or absorbed.

Those that are harmful can bind to GI cells inciting inflammation.

Lectins can also bind with minerals, especially iron, calcium, zinc and phosphorus, impeding their absorption.
lectins specifically target different blood groups.

Lectins can cause serious disruptions in the body including agglutination of blood, liver cirrhosis and kidney failure.

D’ Adamo states that if a Type A person drinks milk, the body will immediately start the agglutination process in order to reject it.

This assumes that around 30% of the population experience significant ill effects from consuming milk.

Question 13

What are lectins and where are they found?

Answer 13

Lectins are carbohydrate-binding
proteins naturally occurring in plants.

Highest amounts are found in raw legumes and grains.

There is a range of different lectins, some of which are harmless while others can be detrimental to health

Question 14

How can you reduce the lectin content in food?

Answer 14

• Lectins are water-soluble and often found on the outer surface of foods — soaking in water for many hours before cooking greatly reduces the content.
• Similarly, cooking with wet, high-heat methods such as boiling inactivates most lectins.
• Sprouting legumes and grains is another way to decrease lectins.

Question 15

What is the concept of Ketogenic Diet and why was it introduced?

Answer 15

Keto has a significant reduction in carbs changes the body’s primary fuel source from glucose to fat, putting the body into ketosis.

The macronutrient ratio is:
75% fat, 20% protein, only 5% carbs

When glycogen stores are depleted, glucose levels become insufficient to support normal fat oxidation.

First introduced as a treatment for epilepsy in the 1920s

Question 16

What are 10 foods you would advise a client to eat on a Keto diet?

Answer 16

Foods to eat:
* Meat: Red meat, steak, ham, sausage, bacon, chicken, turkey.
* Oily fish: Salmon, trout, tuna, mackerel.
* Eggs, butter, cheese, creams.
* Nuts and seeds: Almonds, walnuts, flax seeds etc.
* Oils, avocados
* Low-carb veggies: Most green
veggies, tomatoes, peppers, etc.

Question 17

What are 10 foods you would advise a client to avoid on a Keto diet?

Answer 17

Foods to avoid:
* Foods made with flour: Such as bread and pasta.
* Grains: Rice, oats, and quinoa.
* Foods with lots of sugar: Honey, syrup, fruits.
* Starchy vegetables: Potatoes, corn and peas
* Lactose-rich dairy products: Milk, ice cream, yoghurts

Question 18

Give 2 conditions that Keto Diet can help and explain how.

Answer 18

• Epilepsy: Significant reductions in seizures (30–40%) observed in clinical trials.
  – It is thought that ketone bodies exert anticonvulsant effects and decrease neuronal excitability.
• Neurological disease: e.g. Alzheimer’s and Parkinson’s disease. A neuroprotective effect by ketone bodies is proposed relating to:
  – Increased ATP production and reduced ROS in nervous tissue.
  – Increased synthesis of PUFAs — helps stabilise cell membranes.
  – An influence on neurotransmitter activity in neurons.

Other answers:

• Cancer:
  – Thought to change the preferred energy source of some cancer cells, e.g. those expressing insulin and IGF-1 receptors.
  – Research has mostly focused on brain tumours.
• Cardiovascular disease:
  – Marked improvements in triglyceride levels.
  – Increase HDL cholesterol and increase LDL cholesterol size, which have lower atherogenic potential.
• Type II diabetes.
  – Shown to improve glycaemic control and insulin sensitivity

Question 19

How can the Keto diet help with weight loss?

Answer 19

The ketogenic diet is associated with long-term weight management. Proposed mechanisms include:
* Lack of glucose in the diet leads to a decrease in insulin, in turn reducing
lipogenesis and increasing lipolysis.

• Appetite-suppressant effect of ketosis
  related to modification of levels of hormones that influence appetite — ghrelin and leptin.
• Increased metabolic cost of gluconeogenesis and the thermic effect of protein.

Question 20

Explain the following:
lipogenesis
lipolysis
gluconeogenesis

Answer 20

Lipogenesis: Synthesis of fatty acids

Lipolysis: Breakdown of fats

Gluconeogenesis: Generation of glucose
from a variety of sources

Question 21

When would you not advise a Keto diet?

Answer 21

• Tachycardia, dehydration, acidosis, hypoglycaemia and constipation (lack of fibre), kidney stones, overacidity, arthritis.
• Key vitamin and mineral deficiencies: Lack of plant-based polyphenols and phytonutrients may require supplementation.
• Dyslipidaemia and elevated cholesterol levels: High fat intake.
• The quality of dietary fats needs to be considered.

Note: Long-term viability and limitations of following a restrictive diet such as keto needs to be assessed by the practitioner.
Long-term compliance can be difficult

Question 22

Explain the Atkins diet, what condition it is mostly recommended for and its disadvantages

Answer 22

Atkins diet: Low carbohydrate, high protein diet devised by Robert Atkins. Unlimited amounts of protein and fat.

• Mostly recommended for weight loss.
• Atkins can support weight loss, but is limited in fibre-rich foods and
  encourages excess consumption of animal protein and fats which are linked with health risks such as heart disease and cancer

Question 23

How is the Atkins diet related to the Keto diet?

Answer 23

Works on the principles of the ketogenic diet.

• After the initial phase of weight loss, Atkins differs from the KD as more carbs are gradually introduced to determine carb tolerance level that allows maintenance of the individual’s ideal weight.

Question 24

Outline the Paleo diet, with mention of the foods excluded and its benefits and disadvantages.

Answer 24

Represents the hunter / gatherer diet from the Paleolithic era (around 2.5 million years ago to 10,000 B.C.):

• Excluded foods: Legumes, grains, dairy products, refined sugar, processed foods.
• Included foods: Fruits, vegetables,
  nuts, seeds, meat, fish and plant oils.
• Benefits: Excludes pro-inflammatory
  dairy products, refined sugar and processed foods which lack nutrients and create health issues.
• Disadvantages: Protein intake, especially high animal protein.

Lack of legumes and grains limits intake of fibre and nutrients.

Question 25

What is the goal of SCD (Specific Carbohydrate Diet) and GAPS (Gut and Psychology Syndrome Diet) diets?

Answer 25

SCD and GAPS are designed to support optimal health by:
– Improving the health and integrity of the digestive tract.
– Promoting a symbiotic relationship with the internal bacteria.

Question 26

What is proposed by SCD and GAPS diets?

Answer 26

A causal link between GIT disturbance
and various neurological, auto-immune and allergic responses.

People with neurological diseases frequently have concurrent gastrointestinal issues.
* Maldigestion of carbohydrates may promote the growth of pathogenic bacteria and yeasts.
* This can cause or exacerbate raised intestinal permeability and lead to malabsorption, allergies and food intolerances.
* Vaccination, Caesarean birth, antibiotic use and chemical exposure disrupt the healthy functioning of the GIT

Question 27

SCD and GAPS are strict elimination diets with three key stages. Explain those stages

Answer 27

• Stage one — introduction phase.
  Lasts up to a year depending on severity of symptoms and is the most restrictive phase. All starchy carbs are removed, with the diet based mainly on bone broths, stews and probiotic foods.
• Stage two — maintenance phase.
  Lasts 1.5–2 years. Diet includes vegetables and fermented foods, meat, fish, eggs, animal fats.
• Stage three — reintroduction phase. Reintroduces other foods one at a time and in small amounts. If no digestive symptoms occur the amount can be increased. Refined carbs should still be avoided

Question 28

What are the benefits and disadvantage of SCD and GAPS?

Answer 28

Benefits:
- Encourages home-cooked meals made from fresh vegetables, fruits, meat, poultry, fish (promotes organic foods, grass-fed meat).
- Does not allow convenience food, processed foods.

Disadvantages:
- Clinical reports show benefits in some cases, but more research is needed.
- Extremely restrictive, difficult to follow long term.
- Cuts out many nutrient-dense foods especially whole grains and legumes for lengthy periods.
- The diets are based heavily on animal foods.

Question 29

Give an outline of the Low FODMAP diet

Answer 29

FODMAPs — An acronym for fermentable oligosaccharides, disaccharides, monosaccharides and polyols.

• FODMAPs are short-chain carbohydrates found in certain foods.
• They are poorly absorbed in the small intestine and ferment in the colon aggravating GI symptoms.
• The low FODMAP diet was developed at Monash University in Melbourne, Australia.
• It was designed to help combat IBS and is also used as a therapy for other bowel disorders.

Question 30

FODMAPs are found in many foods. For which types of conditions would you advise avoidance of FODMAPs and why?

Answer 30

• In people with GI issues where gut motility is altered and / or the gut wall is highly sensitive, the increased water and gas generated as bacteria ferment FODMAPs which can cause GI symptoms including pain, bloating, diarrhoea or constipation.
• FODMAPs are also problematic in those with SIBO because they provide fuel for bacteria that are already causing issues by residing in the small intestine where they don’t belong.

Question 31

List 5 vegetables and fruits which are high FODMAPs with suitable alternatives.

Answer 31

Vegetable:
High: Artichoke, asparagus, cauliflower,
garlic, green peas, mushrooms,
onion, sugar snap peas.

Alternatives: Aubergine / eggplant, beans
(green), bok choy, bell pepper,
carrot, cucumber, lettuce,
potato, tomato, zucchini.

Fruits:
High: Apples, apple juice, cherries, dried
fruit, mango, nectarines, pears,
plums, watermelon.

Alternatives: Cantaloupe, grapes, kiwi fruit
(green), mandarin, orange,
pineapple, strawberries.

Question 32

List 5 protein sources, nuts and seeds which are high FODMAPs with suitable alternatives?

Answer 32

Protein sources
High: Most legumes / pulses, some
marinated meats / poultry / seafood,
some processed meats.

Alternatives: Eggs, firm tofu, plain cooked
meats / poultry / seafood,
tempeh.

Nuts and seeds
High: Cashews, pistachios.

Alternatives: Macadamias, peanuts, pumpkin seeds / pepitas, walnuts.

Question 33

What are the 3 stages of The FODMAP diet?

Answer 33

The FODMAP diet involves three stages:
1. Restriction — strict avoidance of all high
FODMAP foods, 2–6 weeks.

2. Reintroduction — high FODMAP foods
   are progressively reintroduced to identify which types of FODMAPS and how much are tolerated, 8–12 weeks.
3. Personalisation — amount and type of FODMAPS are tailored to the individual. Possibly longer term.

Question 34

Why is a strict FODMAP diet not intended for long-term use?

Answer 34

FODMAPs are important because of their role as prebiotics to support healthy gut flora. Long term dietary restriction could also lead to nutrient deficiencies.

Question 35

Why should garlic be avoided on a Low FODMAP diet and what is a good alternative?

Answer 35

Garlic contains high amounts of fructans which are water-soluble
and may leach into food.

Alternative: Garlic infused oil.

Question 36

Why are the bulbs of spring onions or leeks to be avoided on a Low FODMAP diet and what is a good alternative?

Answer 36

• The bulbs of spring onions and leeks are high in fructans.

Alternative: The green tops are not and still provide flavour.

Question 37

What is the Blue Zone diet and where does it come from?

Answer 37

Researcher Dan Buettner identified ‘longevity’ as a key in the Bluezones in
Areas with long living populations (many 100 years+) were termed Blue Zones.

• Blue Zones: Sardinia, Italy.
  Okinawa, Japan, Loma Linda, California. Ikaria, Greece. Nicoya Peninsula, Costa Rica.

The Blue Zone diet:
* 65% complex carbohydrates
* 15% proteins
* 20% fats

95 / 5 RULE:
* 95% of food is vegetables, fruits,
herbs, grains, nuts, seeds, greens
and beans. Extra virgin olive oil to
sauté and spices to season vegetables.
* 5% animal protein

Question 38

What are the important dietary aspects that contribute to longevity according to a Blue Zone Diet?

Answer 38

• Low in saturated fat (almost no meat and dairy). Protects against heart disease, diabetes, certain cancers, dementia.
• High in nutrient-dense foods — vitamins, minerals, phytochemicals (vegetables, fruit, beans).
• High in fibre (mostly unrefined plant foods).

Protects against diabetes, obesity, certain cancers.

• High in plant protein. Protects against numerous cancers, high cholesterol, slows down the ageing process.
• With adequate intake of omega-3 essential fats (seeds, fish).

Question 39

Apart from common dietary
features, what other factors contribute to the health and longevity of Blue Zone populations?

Answer 39

• Have active, outdoor lifestyles.
• Low alcohol intake, no smoking.
• Less drugs — medications or vaccinations.
• Embrace being part of a community.
• Engage in spiritual beliefs.

Question 40

What are the principles behind the Macrobiotic Diet?

Answer 40

Founded by George Oshawa who drew from Asian and Japanese folk medicine to create his version of this philosophy of health.
* The principle behind the macrobiotic diet combines tenets of Zen Buddhism with a Western-style vegetarian diet.
* Foods are combined into meals according to the principle of balance; known as Yin and Yang.
* Yin foods are cold, sweet, and passive.
* Yang foods are hot, salty, and aggressive.

Question 41

Explain the Macrobiotic Diet, what it involves and what is excluded.

Answer 41

The macrobiotic diet is similar to a vegan diet and is a regimen that involves:
* Well chewed, whole cereal grains, especially brown rice: 25‒30%.
* Vegetables: 30‒40%
* Beans and legumes: 5‒10%
* Miso soup: 5%
* Traditionally or naturally processed foods: 5‒10%.
* The remainder: Fish, seeds, nuts and nut butters, seasonings, sweeteners, fruits, and beverages.
* Excluded foods: Dairy, meat, processed foods, nightshade vegetables.
* Practise mindful eating, chew foods well, avoid overeating

Question 42

Outline two therapeutic effects of a Macrobiotic Diet

Answer 42

• Shown to improve glycaemic control in individuals with Type II diabetes — Increase fibre and complex carbs, decrease refined carbs.

– Slows glucose absorption, decreases insulin requirements.

– Supports intestinal flora, increases SCFAs which can support blood glucose balance.

• Reduces the risk of hormone-dependent cancers in women by lowering oestradiol levels.

Question 43

What is the difference between a vegetarian and vegan diet?

Answer 43

• Vegetarian diet: Plant based but includes small amounts of eggs
  and dairy products while excluding meat, fish and poultry.
• Vegan diet: Vegetarian diet that excludes all animal-derived ingredients including eggs, dairy products and honey / bee products.
• This may extend to non-dietary aspects
  as well including avoidance of leather, fur, silk, wool and cosmetics derived from or tested on animals.

Question 44

What would be a concern in regards to a badly formulated vegan or vegetarian diet?

Answer 44

Vegetarian / vegan diets that are based on pre-packed, refined foods that are high in sugars and highly-processed oils are no more healthy than their meat-eating equivalents.

• The quality of the food must always be considered which is whole, organic, seasonal and locally sourced.

Healthy vegetarian / vegan diets are fresh and free of processed, refined foods

• A varied vegetarian and vegan diet
  provides an abundance of nutrients.

Question 45

Give 4 health conditions explaining how they can benefit from a vegetarian and vegan diet?

Answer 45

• Less obesity: Translates into better metabolic health.
  Obesity is linked with an increased risk of heart disease,
  hypertension, diabetes, musculoskeletal disorders and cancers.
• Improves glycaemic control:
  – Plant foods are high in fibre, which slows glucose absorption.
  – Linked to increased insulin sensitivity — an effect attributed, at
  least in part, to increased production of SCFAs that interact
  with tissue receptors to reduce inflammation that causes
  insulin resistance and encourages production of GLP-1

Reduced risk of heart diseases:
– Total cholesterol levels are up to 14% lower in vegetarians and 35% lower in vegans.
– Vegetarians have lower blood pressure
(5‒10 mm Hg less) than non-vegetarians.
– Hypertension rates in vegetarians are
one-third to one-half that of non-vegetarians.
– Healthy vegetarians have higher levels of
antioxidants and lower levels of oxidised
LDL cholesterol than non-vegetarians.

Reduced risk of cancer: Healthy vegan
and vegetarian diets are associated with
decreased risk of many types of cancer.
* Based on higher consumption of plant
foods that are rich in immune-enhancing and antioxidant vitamins, minerals and phytonutrients e.g. vitamins C and E,
carotenoids, flavonoids including anthocyanins and quercetin.

• Reduced incidence of other risk factors for cancer such as overweight / obesity and less exposure to carcinogens that are in cooked meats such as heterocyclic amines.

Question 46

What are the environmental and pathogenic benefits of eating a vegan and vegetarian diet?

Answer 46

Lower intake of environmental contaminants:
Exposure to heavy metals, DDT, PCBs, etc., is reduced, as these substances accumulate as we move up the food chain (more in animal products).

• Reduced risk of foodborne diseases:
  The risk of contracting E. coli, salmonella, listeria, campylobacter and other foodborne pathogens is significantly lower.

Question 47

What are 4 key nutrients you will to keep an eye on for a vegan/vegetarian client? Give at least one food source of each. Also give consideration to co-factors where appropriate.

Answer 47

Vitamin B12
* Vegan / vegetarian: Chlorella pyrenoidosa, nutritional yeast, sea vegetables (nori, kombu, kelp and dulse), shiitake and Lion’s mane mushrooms.
* Vegetarian: Cottage and feta cheese, eggs.
* Ensure good HCl production to improve available intrinsic factor needed for B12 absorption

Vitamin D
* Sunlight is the best source of vitamin D. Plant source: vitamin D2 — in mushrooms (if good sun exposure). Egg yolks.
* Supplemental vitamin D may be necessary for some during the winter months — general recommendations: 5‒15 mcg or 200‒400 IU / day.

Iron
* Plant sources (non-haem): Dark green veg, lentils, pumpkin seeds, quinoa, oats, chickpeas.
* Combine with vitamin C-rich foods to enhance absorption, e.g. peppers, cruciferous veg, kiwis, oranges, lemon.

Omega-3 essential fatty acids
* Vegetarians must rely largely on the conversion of alpha-linolenic acid (ALA) to eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA) — the biologically-active forms.
* To support this conversion, avoid over-consumption of omega-6 fatty
acids (abundant in plant oils) as OM-3 and OM-6 compete for the same enzyme — delta-6-desaturase. Ensure adequate intake of zinc, magnesium and vitamin B6 to support delta-6-desaturase activity.
* The richest plant sources of ALA are chia seeds, flaxseeds, flaxseed oil, hempseeds, hempseed oil and walnuts.

Question 48

At what temperature is food considered raw? And why would you advocate to have some raw food in the diet?

Answer 48

• Food is considered raw if it has never been heated above 40‒48°C (temp. range depending on source).
• Food as cooking destroys enzymes and a range of nutrients, especially vitamin C, B vitamins and chlorophyll

Question 49

What are the Benefits and Disadvantages of eating raw?

Answer 49

Benefits:
* High in fibre, vitamins, minerals and phytonutrients.
* Based on fruits and vegetables which are alkalising.
* Avoids issues with high-heat cooking that can generate carcinogenic compounds such as heterocyclic amines and polycyclic aromatic hydrocarbons.
* Suits those with hot constitutions (cooling and calming).

Disadvantages:
* Raw foods are cold / cooling, and are not suitable for cold constitutions.
* Not suitable for those with impaired digestion or lowered vitality.

Question 50

As a Naturopathic Nutritionist, what would you consider in planning a individual diet?

Answer 50

A naturopathic nutritionist’s aim
is to provide individual dietary plans
according to the condition and
constitution of a client following
naturopathic principles.

Question 51

Outline 5 key principles of the CNM Naturopathic Diet?

Answer 51

1) Free of harmful substances.
* Free of junk food, highly-processed foods, microwaved foods.
* Free of stimulants — coffee, chocolate, alcohol.
* Free of sugar and artificial sweeteners.
* Free of table salt: Use sea salt, rock salt or Himalayan salt in small amounts.
* Free of cow’s dairy (small amounts of raw dairy may be included).
* Free of soya, which is hard to digest. If from the US, it is GMO.

2) Focus on local, seasonal, whole, fresh and organic foods.

3) Small amounts of oily fish and meat (organic, grass-fed)

4) Food is prepared to maintain the optimum amounts of nutrients and prevent formation of damaging compounds associated with high-heat cooking and heating of oils.

5) Food-combining principles are followed.

6) Foods are prescribed according to the constitution of the patient. Different foods work for different constitutions / physical conditions (hot, cold, dry, moist).

7) Focus is on quality of the food, not calories.

8) Remember the value of detoxification, cleansing and fasting.

9) Encourage effective digestion — chew food well, keep fluids away from meals, avoid snacking (stick to three meals / day)

Question 52

What is the purpose of fasting and list 4 types of fasting?

Answer 52

Fasting: Abstinence from food for a specific time period.
* Purpose: The body uses a considerable amount of its energy digesting food. By fasting, energy can be redirected to self-healing.

• Types of fasting:
• Vegetable broth fasting.
• Juice fasting.
• Lemon water fasting.
• Intermittent fasting.
• Water fasting

Question 53

What are the benefits of fasting?

Answer 53

• Improves overall emotional and physical well-being.
• Enhances cognition and mood.
• Helps weight loss including visceral adipose tissue.
• Normalises blood pressure.
• Improves blood lipid profiles.
• Improves glycaemic control.
• Reduces inflammation and oxidative stress.
• Promotes healthy ageing.

Question 54

To which clients would you not recommend fasting?

Answer 54

• Pregnancy and breastfeeding.
• Infants.
• Severe liver, heart or kidney disease.
• Emaciation and debility.
• Eating disorders (e.g. anorexia nervosa).
• Prescription / recreational drugs.
• Adrenal exhaustion.
• Diabetes only under supervision.

Question 55

What length of fast needs supervision by a naturopath?

Answer 55

All fasts over 48 hours should be
supervised by a naturopath.

Question 56

What guidance can you give to someone starting a fast?

Answer 56

• Reduced calorie intake can lead to cold intolerance. Keep warm, take warm baths.
• Fasting days should be relaxing days:
  enjoy baths, stretching, deep breathing.
  Avoid high-intensity physical exertion.
• Periodic fasting should be incorporated as part of a healthy lifestyle routine.
• For best results carry out a six week lead-in programme, particularly if it is the first time fasting.

Question 57

What advice can you provide to someone preparing for a fast?

Answer 57

Preparing for a fast: It is important to transition from a normal diet to a fast, and from a fast to a normal diet.

• The longer the fast, the more important the transition phase.
• For shorter fasts, for those who fast regularly and for those already on a healthy diet, preparation time can be shorter.

Three days before the fast:
* Consume mainly vegetables (steamed) and salads, stay hydrated.
* Avoid meat, dairy, sugar, caffeine, alcohol.
* For those new to fasting and for longer fasts, a longer lead-in phase is recommended.

Question 58

How would you maximise benefits from fasting and minimise the risk of a healing crisis?

Answer 58

The system should be progressively
cleansed and alkalised over six weeks.
* Week 1 – No alcohol.
* Week 2 – No caffeine, alcohol.
* Week 3 – No meat, alcohol and caffeine.
* Week 4 – No dairy, meat, alcohol, caffeine.
* Week 5 – No wheat, dairy, meat, alcohol, caffeine.
* Week 6 – No sugar, wheat, dairy, meat, alcohol, caffeine.
* During this time increase intake of alkalising fruits and vegetables.
* Ensure adequate water intake

Question 59

How should food be reintroduced after fasting?

Answer 59

• For three days after fasting start with easy-to-digest foods in small quantities (avoid overloading the system and congesting the liver).
• Begin with vegetable broths, vegetable juice, steamed vegetables and salads; then add whole rice.
• Eat slowly, chew thoroughly.
• Porridge is a good introduction for breakfast.
• Daily exercise incl. walking, yoga, Pilates.
• Return to normal eating after three days focusing on seasonal, organic, whole foods.
• Reduce food quantity, increase nutrient density instead

Question 60

What is a healing crisis during fasting and what are the signs?

Answer 60

As the body stores significant levels of toxins, fasting may provoke a ‘healing crisis’ as toxins mobilise out of adipose tissues and enter the bloodstream.

Signs: Nausea, muscle and joint pain, mucus
(colds), furred tongue, slow bowel movement, spots, rashes, headaches, dizziness, strong emotions, fatigue, body odour, darker urine.

• Effects soon pass as toxins are metabolised and eliminated.
• The more toxic (acidic) the system the greater the crisis, therefore alkalise the system beforehand (fasting preparation).

Question 61

How would you help the channels of elimination to function optimally with increased mobilisation of toxins during a fast?

Answer 61

• Adequate fluid intake must be maintained to support the removal of wastes via kidneys, support the production of bile and bowel function. Whenever dizzy — drink and / or take an enema.
• Good bile flow is vital to carry away
  the products of detoxification.
• Herbal teas e.g. dandelion root, globe artichoke and barberry support this process (ideally include as part of the fasting preparation — the herbs have bitter properties so tend to stimulate appetite).

Question 62

How would you support the channels of elimination during fasting?

Answer 62

• Enemas can be particularly effective in immediately evacuating the bowels and aiding removal of detoxified products.
• Prevents re-absorption of toxins during a fast.
• Accelerates a fast for better results.
• Reduces cleansing reactions
  (e.g. headache, nausea, dizziness).
• Enemas are easier to administer while submerged in a warm bath, as the abdominal muscles are able to relax.

Question 63

Why would you advise vegetable broth fasting?

Answer 63

Vegetable broth fasting:
* ‘The gentlest of fasts’.
* Ideal for those who are new to fasting or have lowered vitality.
* Provides the body with minerals which balance and neutralise toxins in the body.
* Vegetable broth is very alkalising.
* Supports cleansing via the kidneys, is gentle and nourishing on the digestive system.
* Vegetable broth fasting can be combined with saunas, dry skin brushing, colon hydrotherapy or enemas to enhance cleansing

Question 64

What is the advantage of Juice fasting and what would you add and avoid?

Who would benefit from a juice fast?

Answer 64

Juice fasting:
- Alkalises the body.
- High nutrient density and easily absorbed.
- Rich in antioxidant and anti inflammatory nutrients.
- Supports healing and regeneration.

• Do not add sugar or honey.
• Pure vegetable juices are preferable if there are signs of dysbiosis (digestive disturbance, candida, history of antibiotic use).
• Adding fresh ginger maintains warmth and digestive strength
  *Preferable for lowered vitality, the weak or elderly.

Question 65

What would a nutritious vegetable juice fast include?

Answer 65

• Carrots — antioxidants, vit. A, C, K, beta-carotene calcium magnesium, potassium.
• Kale — Vit. K, A, C; calcium, magnesium,
  high fibre, antioxidant.
• Celery — Vit. K, C, A, folate, potassium,
  antioxidants, benefit for high blood pressure.
• Parsley — Vit. K, C, calcium, iron, zinc.
• Beetroot (beets) — Vit. A, C, folate, calcium, iron,
  magnesium, potassium, betaine (supports liver detoxification).
• Cucumber — Vit. A, C, K, folate, calcium, magnesium, potassium.

Question 66

What would you advise on a one day fast?

Answer 66

Focus on organic vegetables and fruits
for one day each week or weekend.
* Baked, steamed or stewed (no sugar).
* Easily digestible, cleansing for the system.
* If gastric HCI is adequate use raw fruit
and vegetables.
* In the summer, salads are most suitable,
during the winter warm vegetable
broths and soups are more appropriate.

Question 67

What is a Mono fast?

Answer 67

Mono fasts focus on one type of food.
* The body is provided with energy but the
digestive system and liver are rested.
* Eat only one type of fruit,
vegetable or grain on fast days.
* E.g. brown rice, grapes, apples.

Question 68

What is intermittent fasting?

Answer 68

Intermittent fasting (IF) describes a cycle
between a period of fasting and non-fasting.
* It splits the day or week into eating periods and fasting periods.
* There are various methods of IF including:
- The 16 / 8 method: Fast for 16 hours each
day, eating only between noon and 8pm.
Breakfast literally means ‘break’ the ‘fast’.
- Eat-Stop-Eat: Once or twice a week, don’t
eat anything from dinner until dinner the
next day (24-hour fast).

Question 69

What are the benefits of intermittent fasting?

Answer 69

Activation of cellular stress response pathways that in turn protect and promote cellular function
e.g. increased production of endogenous
antioxidants; DNA repair mechanisms.
- Decreased oxidative stress in cells
throughout the body.
- IF is also linked with enhanced immune function.

Question 70

Name two health conditions that can benefit from intermittent fasting.

Answer 70

• Weight loss:
  – Metabolic shift to using fat stores to fuel energy production when supply of glucose is diminished.
  – Reduced insulin production which supports lipolysis and decreases lipogenesis.
  – Increased sensitivity to leptin, the hormone that controls appetite regulation by signalling the hypothalamus that fat stores are adequate.
• Reduced risk of Type II diabetes:
  – Increases insulin sensitivity leading to decreased plasma glucose and insulin concentrations and improved glucose tolerance.
• Protects against cardiovascular disease:
  – Decreases oxidative stress and inflammatory processes associated with atherogenesis.
  – Increases resistance of cardiac cells to ischaemia.
  – Decreases resting heart rate and blood pressure.
• Neurological benefits:
  – Increases alertness and mental acuity — linked with a metabolic shift to ketone utilisation and neuroprotective effects.
  – Increases stress-resistant proteins and BDNF to protect against oxidative, metabolic and excitotoxic insults and ischaemic injury.

Question 71

Explain Ketosis

Answer 71

Ketosis is a metabolic state characterised by raised levels of ketone bodies in the body tissues.

Fat is converted to ketones in the liver and ketones are transported to body tissues, to enter the mitochondria for generation of ATP.

Ketone bodies (ketones) are able to cross the blood-brain barrier to provide an alternate source of energy for the brain.

Question 72

What’s the difference between ketosis and keto-acidosis?

Answer 72

Ketosis is a normal physiologic
response is distinct from keto-acidosis where ketone bodies exceed levels the body can deal with leading to a decrease in pH —
seen with poorly-controlled diabetes.