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AFTER COMPLETING THIS CONTINUING EDUCATION COURSE, NUTRITION PROFESSIONALS SHOULD BE ABLE TO: Learning Objectives Discuss the concept of digestive fire (agni) from an eastern perspective of ayurvedic medicine. Understand the state of evidence-based research supporting the healing aspects of spices and how to effectively use them to diversify the gut microbiome of adults and children. Provide practical suggestions on how to create mindful awareness and savor meals according to the season. Apply an integrated approach with eastern wisdom and modern science in helping adult and pediatric clients establish diverse gut microbiota to strengthen the overall immune health
HEALTH & GUT MICROBIO ME 3
GUT MICROBIO ME Gut microbiota refers to microbe population in our intestine. Average human contain trillions of gut bacteria. Composition and diversity is unique to each individual. Begins to evolve at birth and influenced by multiple factors Mode of infant delivery and feeding Lifestyle Stages Diet composition Geography Medications Antibiotics and Gastric Acid Suppression Stress Exercise, Metabolic, Psychological 4
FU NCTIONS OF GUT MICROBIO ME Metabolism energy homeostasis, host digestion & nutrition Host Protection and Immune system development Gut Brain Axis Possible link to Chronic gastrointestinal disease IBS & IBD Systemic metabolic disease obesity & type 2 dm Atopic eczema and other allergic disease 5
USE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE IN USA OVER THE YEARS A 2008 report from the National Center for Complementary and Alternative Medicine (NCCAM) indicates that 38 percent of Americans are using some form of complementary or alternative medicine, including herbal supplements, meditation, Ayurveda, acupuncture, chiropractic, and yoga 6 Source: CDC National Health Statistics Report #12
Practiced more than 5000 years AYURVEDA AYU = Life or daily living VEDA = Knowing SCIENCE OF LIFE To preserve health To promote health of the healthy To prevent and cure the disease of the ill person The practical knowledge of selfhealing may be acquired by anyone. Each individual is capable of selfhealing Observing cycles of nature and align practices and routines is of fundamental importance World Health Organization (WHO) Ayurveda as Traditional Medicine (TRM) National Institute of Medicine (NIH) Ayurveda as Complementary and Alternative Medicine (CAM) 7
AYURVEDA MODERN MEDICINE Mind, Body, Spirit Prevents Disease Treats the whole individual Importance to Qualitative and doesn t ignore subjectivity Multiple Approach Diet, Lifestyle, meditation, pranayama, detox Physical Body, Recent Openness to Mind-Body Connection Treats the Disease Quick fix the problem Focus on Objectivity and Quantitative in Nature Single Approach Medicine, Surgery, (Diet and Exercise recent focus) Live in harmony with Nature No connection to Nature 8
INTEGRATIVE MEDICINE Integrative medicine promising model of care Gaining acceptance in medical centers, hospitals and healthcare systems Integrative medicine shows great promise for chronic GI and digestive issues Ayurveda, Chinese Medicine, Use of Herbs, Spices, Food as Medicine 9
Rasayana Herbs/ Spices Aromatherapy Dinacharya Daily Self Care Yoga / Pranayama How to Incorporate Ayurveda into Modern Living Pancha Karma- Seasonal Cleanse Sound Therapy/ Mantras Cooking - Dosha Balancing Diet Meditation Vedic Astrology 10
STUDY OF ELEMENTS Space Air Fire Water Earth Energy of Movement Energy of Metabolism Energy of Structure Catabolic Balancing Anabolic SEASONS: Fall through Early Winter SEASONS: Summer through Early Fall SEASONS: Late Winter through Spring 11
AYURVEDIC DAILY CLOCK 10am Strong Agni Big Lunch Important Meetings Challenging Tasks 2 pm Light Breakfast Exercise Follow -To Do List PITTA Creative Work Art Plan Task List 6 am 2 am Dream Wake Eliminate Meditate Exercise KAPHA VATA PITTA Sleep Digestion of Food and Thoughts VATA KAPHA Light Dinner Unwind Relax 10 pm 6 pm 12
GUT MICROBIO ME AND AYURVEDA 13
TRADITIONAL AYURVEDIC DIETS FOCUSES ON - - Importance to how food is prepared, timing of meals, seasonal eating, food combinations, quantity and quality of meals. - Plant Protein high short chain fatty acids increase gut barrier and reduces inflammation - Diet high in plant based polysaccharides, resistant starch, dietary fiber adding diversity to gut microbiota - Spices and Herbs contains phytonutrients, antimicrobial properties, polyphenols, prebiotics - Fermented Foods Yogurt, Buttermilk, Grains and Legumes contains probiotics. 14
CIRCADIU M RHYTH M AND GUT MICROBIO ME Intestinal Microbiota Regulated by Time of Eating Diet Host Circadian Rhythms Disrupted by Irregular eating patterns High-fat diet* /high-sugar diet * saturated fats, trans fats, safflower polyunsaturated fatty acids Disruption = metabolic syndrome Several studies demonstrate a clear link between disruption of microbiota rhythms with host metabolic syndrome and obesity 15
MEALTIMES & SEASONAL M IND FULNESS MEALTIMES BREAKFAST Light meal in summer or when agni is low, more substantial in winter time LUNCH Main Meal. Eaten between 11 am and 1 pm. Do not snack between meals unless hungry and clear burp. DINNER Light meal around sunset or earlier. 2 hours between dinner and bedtime. SEASONS VATA (FALL/ EARLY WINTER) Favor warming soups, herbal teas, easy to digest food PITTA (SUMMER/EARLY FALL) Favor foods that internally cool and hydrate, cooling spices, rice, easy to digest millets KAPHA (LATE WINTER/SPRING) Favor pungent, bitter, warm foods, spiced foods, raw foods 16 Reference: textbook of Ayurveda Vol 3 by Dr. Lad
AGNI DIGESTIVE FIRE Agni is responsible for life span, complexion, strength, health, enthusiasm, lustre, immunity, energy, heat processes and prana. Agni is the root cause of both health and disease - Charaka Samihita. Chikitsa Sthana. Ch.15 v1-2 17
AGNI, IM MU NITY AND MICROBIO ME Agni is metaphor for digestive system, sense perception and even cellular metabolism It corelates with digestive fire and associated with activities of hormones, enzyme and co-enzymes. It represents the metabolic function by which the food we eat is digested, ingested and the nutrition derived from it. Agni is the ignition switch for digestive enzymes to start work. Low Agni is the root cause of all disease Blocks nutrition Poor microbiome Lowers immune response Creates mental fatigue 18
SIMPLE WAYS TO KINDLE AGNI Eat a slice of ginger root, sprinkled with lime juice and rock salt Avoid drinking excess water, especially after meals Avoid ice cold or refrigerated drinks Avoid excessive consumption of caffeine. Do not eat unless hungry Eat and drink with awareness and mindfulness, so that overeating does not occur Drink digestive spiced teas before, with or after a meal. Walking improves circulation and enhances agni. Brief walk before and after eating. 19
DIVERSIFY GUT MICROBIO ME THE AYURVEDIC WAY 20
IMPROVE AND DIVERSIFY GUT MICROBIO ME Include all six tastes in your diet each day. Sweet, Sour, Salty, Bitter, Pungent, Astringent Regular intake of vegetables, legumes, beans and fruits - best sources of prebiotics promotes healthy microbiota Include fermented foods: Yogurt, Kimchi, Pickled veggies, Lassi probiotic rich spiced yogurt drink, Dosas Fermented savory crepes Cut down on sugar and processed foods. Chew food thoroughly. Eat with no distractions. Fiber supports gut and microbiome. The more the better! Eight hours of sleep per night. Meditation and Deep Breathing reduces stress which in turn influences gut health 21
DIGESTIVE SPICES AND HERBS Pungent taste of spices clarifies the senses, liquefies secretions and stimulates digestion Spices contain many antimicrobial, anti-inflammatory properties. They are also a source of polyphenols which are beneficial for gut bacteria. Cumin, Coriander, Fennel, Ginger, Black Pepper, Turmeric, Clove, Cinnamon are ideal spices for digestive health 22
YOUTUBE VIDEO BESP ICED CHANNEL Hot water infusion of cumin, coriander and fennel seeds is a classic recipe in Ayurveda due to its dipana and pachana properties Dr. Vasant Lad: Textbook of Ayurveda VOL 3: General Principles of Management and Treatment 23
YOUTUBE VIDEO BESP ICED CHANNEL Dosas are fermented rice and lentil savory crepe that is traditionally enjoyed as a staple in the Southern part of India. Contains lactobacillus plantarum strain of probiotics shown to inhibit growth of a range of food-borne pathogens. 24
REFERENCES Gail Cresci. The Gut Microbiome - What we do and don t know. Nutr Clin Prac: 2015;30(6):734-746 Shreiner A, Kao J, Young V. The gut microbiome in health and disease. Curr Opin Gastroenterol. 2015;31(1): 69-75 Murphy A, Velazquez K, Herbert K. Influence of high-fat diet on gut microbiota. A driving force for chronic disease risk. Curr Opin Clin Nutr Metab Care. 2015; 18(5): 515-520 Voigt RM, et al. Circadian rhythm and the gut microbiome. Int Rev Neurobiol. 2016;131:193-205 Zarrinpar A, Chaix A, Panda S. Daily Eating Patterns and their Impact on Health and Disease. Trends Endocrinol Metab. 2016; 27(2): 69-83 Barnes PM, Bloom B, Nahin R. Complementary and Alternative Medicine Use Among Adults and Children: CDC National Health Statistics Report #12. United States, 2007. December 2008 Rastogi S. Building Bridges between Ayurveda and Modern Science. Int J Ayurveda Res. 2010; 1(1):41-46 Horrigan B, et al. Integrative Medicine in America How Integrative Medicine is Being Practiced in Clinical Centers Across the United States. Glob Adv Health Med. 2012;1(3):18-94 Dr. Vasant Lad. Textbook of Ayurveda: General Principles of Management and Treatment: Volume 3. 1 st ed. Albuquerque: The Ayurvedic Press; 2012. Naharia Ranjita, Verma Anand. Ayurveda perspective of Agni and its correlation with disease pathogenesis. World Journal of Pharmaceutical and Medical Research. 2018;4(3): 210-212. 25
REFERENCES Kaitlyn Shondelmyer, et al. Ancient Thali Diet - Gut Microbiota, Immunity and Health: Yale J Biol Med. 2018 Jun; 91(2): 177 184. Opara E, Chohan M. Culinary Herbs and Spices: Their bioactive properties, the contribution of polypheonols and the challenges in deducing their true health benefits. Int J Mol Sci. 2014; 15(10): 191983-19202. Krishnaswamy K. Traditional Indian Spices and their health significance. Asia Pac J Clin Nutr. 2008;17(S1):265-268 Kumar S, Dobos G, Rampp T. The Significance of Ayurvedic Medicinal Plants. J Evid Based Complementart Altern Med. 2017;22(3): 494-501 Quing-Yi Lu et al. Prebiotic Potential and Chemical Composition of Seven Culinary Spice Extracts. J Food Sci. 2017; 82(8): 1807-1813. Peterson C et al. Effects of Turmeric and Curcumin Dietary Supplementation on Human Gut Microbiota: A Double-Blind, Randomized, Placebo-Controlled Pilot Study. J Evid Based Integr Med. 2018; 23: 1-8 Gupta A, Tiwar SK. Probiotic Potential of Lactobacillus plantarum LD1 isolated from batter of Dosa, a South Indian Fermented Food. Probiotics Antimicrob Proteins. 2014; 6(2): 73-81 Chilton S, Burton J, Reid G. Inclusion of Fermented Foods in Food Guides around the world. Nutrients. 2015;7: 390-404 26
QUESTIONS 27
Credit Claiming You must complete a brief evaluation of the program in order to obtain your certificate. The evaluation will be available for one year; you do not need to complete it on August 15, 2018. Credit Claiming Instructions: 1. Go to CE.TodaysDietitian.com/GutMicrobiome OR log on to CE.TodaysDietitian.com, go to My Courses and click on the webinar title. 2. Click Take Course on the webinar description page. 3. Select Start/Resume Course to complete and submit the evaluation. 4. Download and print your certificate. 28