Exam 1 Flashcards

1
Q

Adaptogen

A

Strengthens or tones the body

Ginseng

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2
Q

Astringent

A

Shrinks tissue

Witch hazel and horse chestnut

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3
Q

Bitter tonic

A

Stimulates digestive juice secretion

gentian root

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4
Q

Carminative

A

Relieves intestinal gas

peppermint, chamomile

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5
Q

Cholegogue

A

Stimulates secretion/release of bile

Dandelion

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6
Q

Demulcent

A

soothes irritated tissue

slippery elm, aloe vera

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7
Q

Types of extracts

A
Infusion
Decoction
Tincture
Fluid extract
Solid extract
Standardized extract
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8
Q

Decoction

A

Tea boiled for a long time

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9
Q

Tincture

A

Extracted with solvent (e.g. alcohol)

1:5 concentration = 1 part herb in 5 parts solvent

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10
Q

Fluid extract

A

Solvent partially distilled off

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11
Q

Solid extract

A

All solvent removed

5:1 concentration = 1 part extract = 5 parts herb

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12
Q

Standardized extract

A

Produced to deliver consistent amount of one or

more active or marker compounds

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13
Q

What are the most modern clinical researshed styles?

A

solid extracts, often standardized

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14
Q

What are the two views of standardization?

A

Guarantee levels of active or marker compounds

Guaranteed seed-toharvest-to-extract consistency of production (limited to one brand name)

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15
Q

What are the Four Therapeutic Programs

A

Longevity
Therapeutic intervention
Allergy elimination
Prostaglandin modification

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16
Q

Longevity

A

For prevention and treatment of age-related (and other)

diseases

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17
Q

Functional Restoration

A

To restore optimal function of body systems

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18
Q

Allergy Elimination

A

For removing symptom-producing sources in the diet or the environment

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19
Q

Prostaglandin Modification

A

– For reducing the influences of “unfriendly” eicosanoids on health

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20
Q

Staples of the longevity program

A
Diet
Exercise
Supplements
Mental Health
Environmental Health
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21
Q

Supplements in the longevity program are recommended by

A

Harvard public health

Linus Pauling Institute

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22
Q

Supplements in the longevity program: Possible additions

A

More vitamin D
More antioxidants
Fish oil

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23
Q

Supplements help with

A
Birth defect risk
Cancer risk (men, children)
Infection risk in undernourished diabetics
Macular degeneration risk
Improved IQ in children
Reduced effects of stress
Malabsorption syndromes
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24
Q

Areas of focus of Functional Restoration

A
Nutritional deficiencies
Environmental factors
Structural imbalances
Physiological dysfunctions
Mind-body issues
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25
Q

Two popular Functional restoration programs

A

Gastrointestinal Rehabilitation

Detoxification Support

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26
Q

Gastrointestinal Rehabilitation

A

For improving digestion and assimilation, restoring

normal flora and tissue integrity

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27
Q

Detoxification Support

A

For reducing body burden of xenobiotics (toxins)

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28
Q

Targets of GI rehabilitation

A
Poor digestion
Compromised integrity of gut lining (“leaky gut”)
Unbalanced microbiome (“dysbiosis”)
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29
Q

Tests to evaluate for GI rehabilitation first

A

Digestive analysis (gastric acidity, enzyme production)
Gut permeability test
Food allergy testing (see program discussed later)
Comprehensive stool analysis (digestive end-products,
tissue health indicators, microbial flora populations)

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30
Q

4 R’s of building a better intestine

A

Improve digestion and elimination
Treat dysbiosis
Treat hyperpermeability

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31
Q

What can be used to improve digestion and elimination

A

Betaine hydrochloride, digestive enzymes, bile salts, fiber, and exercise

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32
Q

What can be used to treat dysbiosis

A

Introduce friendly bacteria with probiotics; encourage
their growth with prebiotics
Inhibit unfriendly bacteria

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33
Q

What can be used to treat hyperpermeability

A

Avoid substances that increase permeability
Control food allergies that produce local inflammation
Treat dysbiosis to lower endotoxin exposure
Supply key nutrients to intestinal cells

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34
Q

Evaluations to perform for Detoxification Program

A

History of possible toxin exposure
Tests for toxic metals
Tests for body detox function
Tests for nutrient adequacy for detox functions

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35
Q

Three things to do in detoxification support

A

Clean food, clean water, clean air

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36
Q

Hubbard Program

A

Only detox program with published research
Lipolytic exercise to mobilize fat-soluble toxins
Low-heat saunas
Nutritional supplementation

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37
Q

What organs are targeted in detoxification programs?

A
Intestine
Liver
Kidneys
Skin
Lungs
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38
Q

What general types may be prescribed to enhance liver function?

A

Antioxidants, lipotropics (to improve fat mobilization),

cholegogues (to enhance bile production)

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39
Q

When eliminating allergies how long should this person be observed for?

A

1-3 weeks

Then re-challenge one at a time (one per 24-48 hrs)

40
Q

Options for allergy elimination

A
Water fast
Hypoallergenic Formula
Hypoallergenic Diet (p. B31)
Combined Hypoallergenic Diet and Formula (better
compliance)
Remove suspect foods only
41
Q

What substance may be implicated in asthma, hypertension, atherosclerosis menstrual cramps, and chronic inflammatory diseases

A

Arachidonic acid metabolites

42
Q

Gammalinolenic acid can be a precursor to what?

A

beneficial eicosanoids, and may not be produced in adequate amounts under certain conditions

43
Q

What can inhibit arachidonic acid production

A

Fish oil omega-3 fatty acids

44
Q

Dietary sources of “unfriendly” arachidonic acid

A

Animal meats, dairy fats, shellfish

45
Q

dietary inhibitors of normal prostaglandin metabolism

A

Hydrogenated (trans) fats

alcohol

46
Q

Cofactors for optimal prostaglandin metabolism

A

Vitamin B6, magnesium, zinc (or multi)

47
Q

fatty acids that are precursors of “friendly” prostaglandins and/or inhibit production of “unfriendly” prostaglandins

A

Omega-3 fatty acids (oily fish and fish oil)

Gamma-linolenic acid (available in supplements only)

48
Q

low arachidonic acid “anti-inflammatory diet”

A

Dietary fat primarily or exclusively from plant sources only
Low to non-fat dairy only
Minimal to no consumption of animal flesh
No egg yolks

49
Q

Omega-3 plant sources

A

Flaxseed, walnuts and their oils

Canola oil

50
Q

Omega-3 supplements in prostaglandin-modification program

A

1-10 grams per day of EPA+DHA, depending on treatment goals

Fish oil is 30-50% EPA+DHA

51
Q

Gamma-linolenic acid supplements in prostaglandin-modification program

A

500-2800 mg/day depending on health condition
Evening primrose oil
Black currant seed oil
Borage oil (most concentrated)

52
Q

Antiinflammatory effects require at least What amount?

A

1200 mg/day GLA

53
Q

Scientific name of St. John’s Wort

A

Hypericum perforatum

54
Q

3 active constituents of St. John’s Wort

A

Hypericin (most important?)
Hyperforin
Flavonoids

55
Q

Neurotransmitter function modification of St. John’s Wort

A

Several are affected, including serotonin, norepinephrine, dopamine
Includes inhibition of synaptic reuptake, similar to common antidepressant drugs

56
Q

What are two clinically tested extracts of St. john’s Wort

A

Perika

Kira

57
Q

Effects for St John’s Wort in mild-moderate depression

A

Helps mood, sleep, body symptoms
Equivalent to drugs with fewer side effects
65% respond significantly

58
Q

What dosage for St John’s Wort?

A

300 mg TID of dried alcoholic extract of flowering aerial parts containing either:
– 0.3% hypericin or
– 1%-3% hyperforin

59
Q

Contraindications for SJW

A

Do not use in bipolar disorder
Do not mix with antidepressant drugs
crucial medications for transplant patients, heart failure, HIV, asthma, and oral contraception

60
Q

Side effects of SJW

A

stomach upset, fatigue, itching, headache, sleep disturbance, skin rash, and skin photosensitivity at high doses

61
Q

Side effects of SJW

A

stomach upset, fatigue, itching, headache, sleep disturbance, skin rash, and skin photosensitivity at high doses

62
Q

Garlic for what cardiovascular condition?

A

Dyslipidemia

Hypertension

63
Q

Garlic scientific name

A

Allium sativa

64
Q

Part of the plant used

A

Bulb, containing individual cloves

65
Q

Two garlic products

A

Kwai - Stabilized garlic powder

Kyolic - aged garlic extract

66
Q

Garlic contains what two types of enzymes

A

alliin and enzyme alliinase

67
Q

Aging of garlic creates complex sulfur

compounds such as ____

A

S-allyl cysteine

68
Q

Effects of garlic

A
Antioxidant
Hypolipidemic
Antihypertensive
Antithrombotic/antiplatelet
Hyperlipidemia
69
Q

Hypertension effects of garlic

A

Systematic reviews report reduction of 8-16 mmHg systolic and 7-9 mmHg diastolic in hypertensives
AGE has weaker effect than allicin-rich garlic

70
Q

Garlic’s effect of artherosclerosis

A

Allicin-rich garlic has improved indicators of atherosclerosis progression

Intima-media thickness
Plaque volume
Aortic elasticity

71
Q

Effective forms of garlic

A

Standardized garlic powder
Typically standardized for 1.3% alliin precursor, or 0.6% allicin “yield”
• 600-900 mg per day (3.6-5.4 mg/day allicin)
– Enteric-coating may be preferable

Aged garlic extract (AGE)
2.4-7.2 grams powder or 4-5 mL liquid
If standardized, 1.2-3.6 mg/day S-allyl cysteine, SAC)

72
Q

Effective brands for garlic advertise what on labels?

A

Predictable allicin yield based on measured alliin content

Enteric coating

73
Q

Contraindications for garlic

A

Bleeding risks
Anticoagulants (anti-clotting effect)
Blood pressure drugs (hypotensive effect)
Diabetes drugs (hypoglycemic effect)

74
Q

Old vs new guidelines for vascuar disease prevention

A

Old: initial use of non-pharmacological
New: Immediate use of statins for moderate to high risk

75
Q

What associated symptoms for vasculaar disease should be treated?

A

Hypertension
Obesity
Metabolic syndrome

76
Q

ASCVD High-Risk Indicators

A

Current ASCVD diagnosis
LDL cholesterol ≥190 mg/dl (5 mmol/L)
Diabetes, unless young with no other problems
Chronic kidney disease in older (50+ yrs) adults
History of abdominal aortic aneurysm

77
Q

ASCVD low risk

A

US: below 7.5%
Canada: below 10%

78
Q

ASCVD moderate to high risk

A

Above low risk percentage plus
US:
LDL over 70 mg/dl

Canada:
LDL over 135 mg/dl OR
LDL over 70 mg/dl with
additional risk factors OR
LDL over 70 mg/dl with
10-year risk of 20% or more
79
Q

Mediterranean Diet Score

At east six of these

A
Vegetables: 4+ per day
Legumes: 1+ per week
Fruit: 3+ per day
Nuts and seeds: 1+ per week
Whole grains: 1+ per day
Fish: 4+ per week
Fats: More unsaturated fats than saturated fats
Alcohol: Moderate
Red and processed meat:
– <2 oz per day women
– <3 oz per day men
80
Q

Four proven heart healthy foods for lowering cholesterol

A

Plant sterols/stanols - 2g/day
Soy protein - 25-45g/day
Nuts - 1oz or 28 g
Viscous fibers - 10-20 grams/day

81
Q

Results of heart healthy diet

A

Lowered LDL and lowered CRP

82
Q

Supplement options to accompany phytosterols

A

Phytosterols - 2 grams per day with meals
Viscous fibers
– Beta-glucan - 3
– Glucomannan - 4
– Psyllium husk - 10
– Guar gum - 15
Standardized fresh garlic powder - 2 grams per day with meals

83
Q

Higher-intensity interventions for ASCVD

A
Rule out secondary causes of hyperlipidemia
• Refer for intensive lifestyle coaching
• Chinese red yeast rice*
• Statin therapy* (refer)
• Niacin therapy*
84
Q

Intensive LDL-Lowering Supplements

A

Red yeast rice: 1200-2400 mg/day

Niacin: 1500mg.day

85
Q

Dash diet rationale

A
Grain - 7-8 serbings
Vegetables - 4-5
Fruits - 4-5
Low fat or non-fat dairy foods - 2-3
Meats - 2
Nuts, seeds - 3-4 per weeks
86
Q

Calcium in DASH diet

A

1000-1200 mg

87
Q

Magnesium in DASH diet

A

350 mg

88
Q

Potassium in DASH

A

Several thousand mg daily

89
Q

Medical conditions possibly affecting potassium

elimination by the kidney

A

Kidney disease
Diabetes
Advanced age

90
Q

Hypertension treatment

A

Control weight
Control salt
Aerobic exercise
Control alcohol
Fiber and mineral-dense semi-vegetarian diet
Supplements/special foods (– Extra K, Ca, Mg, Coenzyme Q10, – Standardized fresh garlic, powder, – Fish and Fish oils; – Dark chocolate)

91
Q

Best supplement for hypertension

A

Coenzyme Q, 100-200 mg/d

ubiquinone

92
Q

Fish oils, 1-3 g/d omega-3 fatty acids can be used for

A

Helps triglycerides
Helps platelet function
Helps endothelial function

93
Q

Garlic, 4-5 mg/d allicin can be used for

A

Helps blood cholesterol
Helps blood pressure
Possible antiplatelet effects
Some improved vascular outcomes demonstrated

94
Q

Multiple vitamin-mineral daily can be used for

A

– Manage deficiencies related to insulin resistance, inflammation
– B-vitamins to lower homocysteine
– Possible antioxidant benefits

95
Q

Coenzyme Q, 100-200 mg/d can be used for

A

Helps blood pressure
Needed to offset statin risks
Some evidence of benefits to other ASCV D risk factors