Nutritional Medicine
Introduction
Nutritional medicine involves the use of vitamin and mineral supplements, usually given orally, in the form of tablets or liquids. In order for any living organism to function adequately, there are a whole series of trace elements such as zinc, magnesium and chromium and a number of vitamins usually described by letters of the alphabet (A to E) that are essential. Their absence leads to disease, an observation first noted by James Lind in 1753. He was a naval physician who observed that sailors on long voyages, and therefore without fresh fruit and vegetables, developed scurvy. This deficiency illness could kill a significant proportion of the crew on a long voyage, consequently significantly debilitating the navy’s ability to fight or even man their ships of discovery. Lind observed that the addition of lime juice to the sailor’s diet could prevent scurvy. Vitamin C itself, however, was not chemically isolated until the 20th Century. A whole series of specific nutritional deficiency diseases such as pellagra and beriberi (both deficiency diseases of the Vitamin B group) were carefully documented, and their cause isolated, in the 1920s and 30s.
As a consequence, the dietary recommendations made by most Western governments tend to be more focused on the specific intakes that avoid deficiency rather than those which promote optimal health. While we are almost invariably certain about the nutritional requirements that are needed to avoid illness, there is often little information, and indeed much argument in the nutritional world, about the doses of nutritional supplements required to sustain optimal health, particularly in a high state of nutritional demand, for instance during a disease process or when an individual is undergoing unusual physical or mental demands such as competitive sport. This is perhaps illustrated by the differences that exist in Reference Nutrient Intakes (RNI) between the United States and the United Kingdom, almost uniformly the RNIs in the US are higher than those in the UK in spite of the fact that the Ministry for Agriculture, Fisheries and Food (MAFF) has recently increased its recommended RNI for the UK population. This shows how much of the average UK population falls below the recommended intakes. This suggests a somewhat worrying picture. While we certainly eat enough to suffer from increasing rates of obesity, a significant minority are probably simultaneously suffering from nutritional deficiencies. This is probably associated with the rise of high fat, high carbohydrate and low nutrient value junk food in association with the increased industrialisation of farming tending to produce products with relatively lower levels of trace elements and vitamins.
Is nutritional medicine conventional or complementary?
The original discoveries of the physiological functions of various trace
elements and vitamins represent a very important part of the development
of conventional medicine. However, it is interesting to note that many
conventional physicians just assume that the average British diet is
nutritionally adequate and other than in quite specific illnesses such
as eating disorders or anaemia, will rarely investigate nutritional status.
There are some types of nutritional medicine, generally described as
orthomolecular medicine, in which very large doses of vitamins and minerals
are used in order to treat illnesses varying from the common cold to
cancer.
A point made frequently within the context of complementary medicine is that
of individuality. One of the underlying principles of nutritional medicine is
that each person is unique and has unique nutritional requirements so that what
might be an adequate nutritional intake for one person may be inappropriate for
another.
