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The Importance of Discussing Micronutrients with Your Patients


The fact that most American adults cannot define what real food is, and that food-like substances such as hot dogs suffice for their needs, boggles my mind to no end.

Human beings, like any primates, require micronutrients for optimal cellular health. Cellular health, in turn, is necessary for organ system health and overall organismal health. There is considerable epidemiologic and retrospective evidence to indicate that insufficient micronutrient intake is an essential etiologic factor in the pathogenesis of the chronic disease and obesity epidemics that are threatening to overwhelm our species.

By micronutrients, I refer to essential cofactors, enzymes, vitamins, minerals, substrates, amino acids, nucleic acids, and fats that are the basic fuels that power each individual cell. I refer to cobalt, phosphatidylcholine, chromium, manganese, acetyl cysteine, cholecalciferol, ascorbic acid, zinc, glutamine, etc. When the human being doesn't eat enough of such basic fuels, maladaptive physiologic processes occur due to cellular stress and disease. Such stress goes on to affect multiple organ systems and physiologic processes. For example, relative cobalt deficiency leads to gastrointestinal estrogen loss. This is significant to the millions of post-menopausal women dealing with estrogen insufficiency. Another example is inadequate anti-oxidant intake which leads to oxidative stress that overwhelms mitochondria. The net effect of such cellular disease is the release of inflammatory cytokines, another maladaptive mechanism which leads to more disease. It is now understood that chronic inflammation due to cellular stress and influenced by epigenetic mechanisms is the basic cause of all diseases of our modern world, from atherosclerosis to cancer.

Unfortunately it is not known how much micronutrient intake is optimal for a human being. Plentiful evidence indicates that the USDA underestimates RDAs (recommended daily allowances). This doesn’t surprise me since it is no secret that the USDA is deeply connected to the food industry powers that be. Political corruption and market realities aside, it is imperative that physicians, especially internists, educate themselves and their patients on micronutrient science.

From a 2003 article in Comparative Biochemistry and Physiology:

Among primates, the great apes are most closely related to humans, and considerable data indicates that we shared a common ancestor 7 million years ago. The natural diets of wild orangutans, chimpanzees, and gorillas are composed almost exclusively of plant-based foods (>97%)... fruits available in the jungles of Panama, Samoa, and Cameroon contain more potassium, calcium, and phosphorus than do cultivated fruits available in the USA …Howler monkeys take in significantly higher quantities of minerals compared to human RDAs (recommended daily allowances). A 7kg howler monkey, for example, will consume 600g of fruit and 400g of plant material, which together yields 614mg of Vitamin C. The human RDA for Vitamin C is 70mg for a 70kg human...

I have two take-away points from this article: First, that processed/cultivated foods are nutritionally depleted compared to fresh/wild counterparts, and second, that humans do not eat enough micronutrients. Regardless of what the USDA tells people to do, the above evidence should speak for itself. Let me be clear: the USDA’s recommendations are nothing more than either corrupt untruths or quackery pseudoscience.

Even if we don't know the micronutrient constitution of every edible thing in our lives, physicians must be able to provide basic common sense advice about micronutrient intake. The analogy I use when I speak with my patients is that of “putting fuel in one’s system.” Any of my patients acknowledge that pouring water or soda into a car gas tank is inappropriate, and that the outcome of such an action is obvious. The same applies to the human body. The human body requires the proper fuel - that fuel is rich in micronutrients found in vegetables, whole grains, fruits, fresh water, herbs, roots, and lean meats including fish. I especially adore the micronutrient treasure-troves found in yams, squash, beets, lentils, and shitake mushrooms.

Micronutrients are noticeably absent in processed foods, junk food, processed red meats, packaged foods, and in foodstuffs containing carcinogenic substances such as high fructose corn syrup, phosphoric acid, indigestible starches, and meal replacements: all human-made food-like substances that cannot be called “food.” The fact that most American adults cannot define what real food is, and that food-like substances such as hot dogs suffice for their needs, boggles my mind to no end. This is what I call a dangerous cognitive discrepancy.

This cognitive discrepancy is something that requires medical intervention. It is by addressing this cognitive discrepancy that the physician can be of most service to his patients. Unfortunately many industries- the fast food, processed meat, GMO (genetically modified organisms), soy, and corn industries - profit by the perpetuation of this cognitive discrepancy: by American consumption of micronutrient-depleted food-like substances. This socioepidemiologic fact is heartbreaking, and I fight it every day.

But every day there are more obese children, more debilitated elders, more chronically ill people living pain-filled, miserable lives via atherosclerotic blood vessels hanging off of osteoporotic bones. In the hospital we can temporarily stabilize the life-threatening problems engendered by disease-promoting lifestyles, but in the big picture, we just do not get the point, and we just perpetuate the discrepancy. Please, talk to your patients about what they eat and how they live. Or if you scoff at all this, send your patients to me. I’d be happy to do it. They can join my patients on a trajectory of healing.

For more from Dushyant Viswanathan and our other Practice Notes bloggers, click here.

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