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Aging - Defined

• It is widely accepted that aging is a multifactorial cellular, biochemical and physiological process that ultimately leads to cellular deterioration. 
• In other words there are multiple factors affecting your body's biochemistry and multiple changes that occur with regard to cell function, organs and tissues as you age.
• At this stage of knowledge the term anti-aging medicine cannot be truly applied as we do not have the means to halt or reverse the slow and inexorable decline that is known as aging.
• I prefer to use the term 'Age-Well' or perhaps even 'Longevity Medicine' as there are many science-based strategies that can be applied to slow down the aging process.

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NutriDesk has been the culmination of 26 years of medical experience and post-graduate study and has taken 5 years to design with an additional 2 years of website development to work out how to incorporate all of these complex nutritional concepts and benefits
into one easy to follow diet!

About NutriDesk

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Targeting the major processes involved in aging

1.  Inflammation:
   An article titled 'How genes make our skin look older.' and published in New Scientist 27th June, 2009 [No 2714], described research by Proctor & Gamble who used DNA microarrays to study gene expression of skin cells. They looked at skin from the buttocks and forearms of younger and older individuals . What was found was that:
   "In older skin there was an increase in expression of genes associated with inflammation."
   There seems to be a slow but progressive increase in systemic inflammation as we age.
2. The free radical theory of aging
   Free radicals are atoms, molecules or ions that have an unpaired electron. These occur in the process of producing energy from food. Are all free radicals bad? Well the simple answer is no! Free radicals are a double-edged sword though. On the one hand they are key players that determine whether a cell survives or dies [cell death is known as apoptosis].
   
   A damaged and potentially cancerous cell disintegrates under the pressure of free radicals. So we don't want to wipe these free radicals out completely. However, if your diet is not optimal, if you are under stress, if you have a chronic illness, or suffer from insulin resistance, then you may be producing far more free radicals than you would like.
   
   An excess of free radicals will only speed up aging and organ failure. The NutriDesk diet is an antioxidant rich diet.
   
   Testing for Oxidative Stress
   
   To see how much you may need to concentrate on additional antioxidant supplementation, you can do some simple tests to see if you are indeed suffering from oxidative stress [an overabundance of free radicals]
   
   a] CRP [C-reactive protein] --- this is a simple blood test your doctor can order. CRP or better still highly-sensitive CRP [hs-CRP] is a sensitive marker of inflammation. It correlates with F2-isoprostanes [prostaglandin-like compounds] that are thought to be the best markers for oxidative stress in the body.
   
   b] Malondialdehyde [MDA] ---this is a simple urine test that you can do at home to assess for oxidative stress. MDA is a reliable and inexpensive marker of current oxidative stress in your body. Click on the following link: CheckUp
3. Glycation or the Cross-Linkage Theory of Aging
   Every mouthful of food you consume can lead to increased glycation of proteins to produce Advanced Glycation Endproducts or AGEs.
   
   For a detailed discussion of this important process in aging click on the following link: QuickGuide: Advanced Glycation Endproducts [AGEs].
   
   The NutriDesk diet limits your calories and in particular guides you towards the right type of carbohydrate in the right amount to keep your glucose spikes to a minimum helping you decrease the risk of glycation of your body's important proteins. Glycation of your skin collagen for example leads to the wrinkling of your skin.
4. Mitochondrial Decline, Methylation Problems, DNA Repair and Cell Membrane Protection
   Aging as indicated above is a complex mix of abnormal cellular processes that occur in the body as we age. Genetic factors also conspire against us as well as a multitude of environmental noxious compounds we all have to deal with in daily life from the air we breathe to the contaminated food we eat.
   
   The challenge of the NutriDesk diet is to look at all these complicated factors and to encapsulate these into an easy to follow system. Within each diet you will see the NutriDesk Diet Button Panel [see below] and clicking on each tab will provide you with a wealth of information to see how each of these problems are being dealt with in this diet.
5. Hormones
   Hormones are powerful and critical chemicals that have powerful efffects on various cells in the body. Mother nature seems to lavish the younger human with amazing vitality and strength by flooding the body in the reproductive prime with an abundance of hormones.
   
   When a woman reaches peri-menopause or menopause [ovarian failure and low estrogen] which follows soon after or when males reach andropause [testicular failure and low testosterone], the situation changes drastically. 
   
   Conventional thinking in medicine is to treat flushes or sweats caused by hormone deficiency, but to absolutely ignore the devastating effects on the body caused by hormone deficiency.
   
   The Rotterdam Study showed conclusively how lower testosterone levels in men can lead to early death from cardiovascular disease [Morgentaler 2009].
   
   Low testosterone levels can also significantly increase men's risk of developing aggressive prostate cancer [Morgentaler 2009].
   
   Hormone deficiency can also increase the risk of developing central fat accumulation and this can increase the risk for developing insulin resistance and diabetes with premature cardiovascular disease. The Women's Health Initiative [WHI] study that caused huge numbers of women to abandon hormone replacement treatment had to go back to the drawing board due to the huge amount of criticism directed at flaws in the study design. When they reassessed the data, what was found was that timing was the critical factor in determining benefit from hormones. Thus treating hormone deficiency as early as possible offered the greatest benefit in terms of health outcomes.
   
   Artificial hormones are not the answer and you should start to look into bioidentical hormones. Pharmaceutical companies themselves produce bioidentical hormone replacement formulations such as Testogel^® used for treating testosterone deficiency in males. Discuss bioidenticals with a compounding pharmacy and your general practitioner. There are many GPs that prescribe bioidentical hormones and your local compounding pharmacy will be of help here to provide you with names of knowledgeable GPs.
   
   Remember, the whole ideat is to use hormones if you are suffering from a deficiency and to replace these so that your levels are within recognized reference ranges. You will need to discuss testing for hormone deficiency with your general practitioner. Underlying hormone-sensitive cancers such as existing breast or prostate cancers will also need to be excluded by your GP before you begin any hormone replacement program. There should also be regular blood testing after commencing hormone replacement to see if the hormone levels are within an optimal range See below for more information.

The diets are very easy to follow ---too easy!

• If you can follow a recipe, then you will be able to follow a NutriDesk diet.
• Don't be concerned about the depth of knowledge provided here for you. The information is there for you to see the science behind the diet.
• You can rest assured that the concepts that have been described are embedded in the diets themselves. So you don't need to understand what is being presented, you can simply follow the diets like one would follow a recipe.

A big thumbs-up for ease of use.

• The aim of these diets is to provide an in-depth analysis of the nutritional factors thought to prevent or alter the course of a disease. NutriDesk confronts the complexities involved and takes great effort to provide a clear and concise picture of knowledge as it currently stands.
• This knowledge is expanded upon by rich graphical representations and by multimedia tutorials that are aesthetically pleasing but also carry scientific depth. These features are used to help a lay individual navigate through the knowledge base in a highly visual and easy-to-understand way making the learning experience that much more pleasant.
• Remember, you can save the diet you have chosen and you also have 24 hours to change your body composition data in BodyCalculator if you feel you have made a mistake.
• You can then take your time to go back and again to this saved diet within the MyNutriDesk panel. Simply go to My Diets within this personal panel and here you can view the details of your diet at your leisure.

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The Info button on the NutriDesk Diet Button Panel

• Further information can be found within the purchased diet by clicking the buttons of the NutriDesk Diet Button Panel above.
• You can find all the information presented on this page by clicking the 'Info' tab within the diet. This information may or may not be expanded upon.
• Each diet you choose is rich with specific information about your particular dietary or medical concern.
• To make it easy for you, a wealth of highly specific information has been placed into special compartments and accessed by clicking the buttons on the NutriDesk Diet Button Panel found on the top of each purchased diet.

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How is diet related to cardiovascular disease?

• Avoiding premature heart disease and robbing you of a chance to reach a ripe-old age.
• There is a direct link between diet and blood lipid [cholesterol, triglycerides, LDL and HDL] levels, body weight, blood pressure, hyperinsulinaemia [high insulin levels], hyperhomocysteinaemia [high homocysteine levels], and blood glucose levels.
  
  
• Every meal you eat can make a difference whether you are diabetic or not and can cause damage to the blood vessel lining [the endothelium]. If you want to age gracefully, you will need to look at what you put in your mouth with each and every meal. The NutriDesk diet makes this very easy for you indeed as all the complicated calculations on quantities have been done for you - you simply use the guidelines, add your own recipes and you have a truly great age-well diet at hand.
• Professor Jennie Brand-Miller from Sydney University's Faculty of Nutrition, has stated that "around one in four adults has impairments in postprandial glucose regulation" in other words, the food that you eat can determine how high blood glucose rises and how long blood glucose levels stay elevated. This is a risk for any individual but is particularly dangerous for the 25% of individuals in the country that may have abnormal responses to high glycemic index [GI] or glycemic load [GL] meals (Dickinson and Brand-Miller 2005). If you are concerned about cardiovascular risk then this is a factor well within your control and NutriDesk will show you how to avoid this particular risk.
• The higher your blood glucose levels rise after a meal will determine the amount of glycation that damages your proteins causing Advanced Glycation Endproducts [AGEs]
• Insulin Resistance can make things many times worse for an individual. It leads to abnormal blood lipids [fats] and increasing accumulation of fat in the waist area of the body --- a very dangerous area to accumulate fat. Accumulating abdominal fat causes numerous chemicals [cytokines] to be released resulting in inflammation and insulin resistance. Please view the following free NutriDesk tutorial 'Atherosclerosis & Inflammation'

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Cardiovascular risk factors include: 

The type of food consumed

• Glycemic Index
• Glycemic Load
• Saturated & Trans Fat Intake
• Omega 6 to Omega-3 ratio.

Genetic Factors

• Numerous mutations are being discovered linked to obesity, hypertension, abnormal blood lipids [fats], insulin resistance etc.
• Delve into your family history. Who has had premature heart disease in your family? Can you influence your genetic destiny? Well billions of dollars are being spent to look at this question in terms of pharmacogenetics [drugs affecting or being affected by genetic makeup] and nutrigenomics - how diet and nutrients influence or are influenced by genetic expression.
• That diet and nutrients can affect genetic expression is beyond doubt. A good introduction into this topic can be obtained from the following free tutorials: Epigenetics & Nutrigenomics 
• Methylation is a process that is involved in epigenetic expression and is the process involved in creating neurotransmitters [serotonin, dopamine, noradrenaline], it is the process involved in DNA/RNA repair and enables your liver to get rid of dangerous chemicals that are produced everyday in your body and that enter your body from the environment. Maximizing methylation [the cell energizing process] is critical if you want to age-well. Click on the following link: Homocysteine

Hormonal imbalances

• Age related, hormonal changes can lead to expanding waistlines.
• Menopause [low estrogen, progesterone and testosterone in females].
• Andropause [low testosterone in males], hypothyroidism [low thyroid hormone] & adrenal gland dysfunctions. In the Rotterdam Study, researchers examined testosterone levels and cardiac health among 504 individuals from the ages of 67 to 75. It was conclusively shown that men with higher levels of testosterone had lower levels of coronary artery disease and that men with the lowest testosterone levels had the highest level of atherosclerosis. In fact Professor Abraham Morgentaler from the Harvard School of Medicine stated in a breakthrough book on testosterone treatment 'Testosterone for Life' that low testosterone was a risk for atherosclerosis and that higher testosterone levels appeared to be protective of the cardiovascular system.
• If you are male or female ask your doctor to check your hormone levels. If your free testosterone level is low and you have symptoms of low testosterone [lethargy, decreased libido, lack of motivation, erectile dysfunction, anaemia or low bone density, then these are valid clinical reasons to seek testosterone treatment. If your doctor seems concerned about testosterone treatment, please refer them to the book 'Testosterone for Life' [link above] as this book dispels the myths and fears about testosterone treatment. It took the courage, intelligence and insight by a Harvard University urology professor who dared to question the dogma of his day to dispel unnecessary and counterproductive myths about testosterone in medicine.
• Please click on the following link and please ask your doctor to refer to this link to learn about the importance of testosterone in the health of middle aged men: Testosterone
• Women also suffer from testosterone deficiency that affects libido, weight gain, muscle mass and mood. Replacing estrogen and progesterone is also important if you are suffering from symptoms.
• At the bottom of this page is information for your general practitioner so please refer them to this website to review this information.

Weight gain: Especially Abdominal Fat [expanding waist]

• If you want to age well, you will need to keep fat levels in your abdominal area down to an absolute minimum otherwise inflammatory processes will predominate.
• Due to your energy intake [how much food you consume] being far greater than your energy expenditure [how much of this energy you burn off] - Yes, this is an important factor for weight gain but not the only cause of weight gain.
• There are many dietary factors for putting on weight and NutriDesk has a multi-targeted approach to this problem providing you with the concepts and strategies to beat this aging problem.
• A great strength of the NutriDesk diet is to be able to calculate food quantities [portions] automatically for you and to guide you to food choices and strategies that keep the glycemic index [GI] and glycemic load [GL] of each meal low and scientifically proven thermogenic [fat burning] foods that will help you with weight management.
• Weight gain in the abdominal area is the typical result of low testosterone in both men and women and on commencing testosterone body composition will change towards less fat in the body and more lean muscle mass. It is not the aim to just use a hormone in this circumstance as without an optimal nutritional foundation, nothing will help or decrease your risk factors for cardiovascular events such as a heart attack or a stroke. Dietary change is vital to success.

Decreased Resting Energy Expenditure [REE] with Age:

• A major reason why humans accumulate white adipose [fat] tissue [WAT] as they mature is that there is a dramatic drop in metabolic energy expenditure i.e. your ability to burn off excess energy decreases as you get older. 
• Boosting resting energy expenditure [REE] is explained within the diet. More information can be obtained on clicking the buttons of the NutriDesk Diet Button Panel found within your chosen diet.

Multiple physiological mechanisms:

• Can bowel bacteria influence fat accumulation in your body? There are multiple research papers now that show why abnormal bowel bacteria can affect fat accumulation in your body.
• Muscle mass diminishes from your mid 20's [sarcopenia] and muscle mass is an important contributor to your metabolic rate [BMR] as it is metabolically very active tissue.
• Hormonal problems such as low testosterone or hypothyroidism or simply getting older, can lead to low testosterone levels. Low testosterone levels will lead to diminishing lean muscle mass.
• Lean muscle mass loss could also be worsened by protein deficiency  --- can people in first world countries suffer protein deficiency? you bet!.
• Helping you to increase your muscle mass by an optimal diet and by exercise and lifestyle change is a focus of NutriDesk.

Multiple molecular mechanisms:

• Insulin resistance, leptin resistance, cell membrane fluidity affecting receptor sensitivity and cell metabolism, abnormal adipocyte command signals and numerous others that can not only lead to weight gain but also lead to abnormal blood lipids [fats] and increasing inflammation in the body.
• NutriDesk helps you cover all these issues related to dietary intake and optimal nutrition to help you decrease your risk for an adverse cardiovascular event like a heart attack or stroke or poor circulation in your legs.

Low Vitamin D Levels:

• Vitamin D3 [Pictured] is technically, not a true vitamin. The term vitamin means it must come from a dietary source but sun exposure can also stimulate the synthesis of Vit D in the body, and as such is not necessarily required in the diet.
• It is essentially a fat-soluble prohormone which is converted to a hormone in the body [1, 25-dihydroxyvitamin D3]. In a review published in the Journal of the American College of Cardiology it stated "Vitamin D deficiency is an unrecognized, emerging cardiovascular risk factor, which should be screened for and treated."
• Vitamin has a critical role in immune system function.

• This review article goes on to say "Vitamin D deficiency activates the renin-angiotensin-aldosterone system and can predispose to hypertension and left ventricular hypertrophy. Additionally, vitamin D deficiency causes an increase in parathyroid hormone, which increases insulin resistance and is associated with diabetes, hypertension, inflammation, and increased cardiovascular risk. Epidemiologic studies have associated low 25-hydroxyvitamin D levels with coronary risk factors and adverse cardiovascular outcomes. Vitamin D supplementation is simple, safe, and inexpensive." (Lee, O'Keefe et al. 2008)
• The Medical Journal of Australia [MJA] has stated that almost 1 in 3 Australians suffer from mild to moderate Vit D deficiency. A paradox in a 'sun-burnt country'. (McGrath, Kimlin et al. 2001)
• NutriDesk will show you what to look for in terms of supplementation especially if you don't go out in the sun on a regular basis, if you are an office worker working long hours stuck between four walls and artificial lighting, if you are physically incapacitated and if your fish intake is poor. Click on the Nutraceutical tab within the diet.

Poor micronutrient intake:

• Poor food choices and in particular carbohydrate rich food choices may lead to micronutrient deficiencies. This will have an impact on numerous enzymes in the body that are important to neutralize free radicals and reactive oxygen species [ROS] that damage your blood vessels and body organs including your heart.

Homocysteine & Methylation:

• An elevated homocysteine levels is an indicator of suboptimal methylation in your body.
• Homocysteine is an amino acid that is produced in the body and not acquired from your diet. High homocysteine levels are associated with cardiovascular disease and dementia.
• Elevated homocysteine can promote inflammation in blood vessel walls through various mechanisms.
• However, elevations in homocysteine commonly occur due to vitamin deficiencies and in particular folic acid, Vitamin B12 and Vitamin B6 deficiencies.
• New studies are showing how important it is to ensure this amino acid is kept as low as possible to prevent heart and vascular complications. It is emerging that this should be done as early as possible in life and not after the damage has been done. It is however never too late to lower this toxic molecule.
• A study published in the New England Journal of Medicine [NEJM] concluded that
  "An increased plasma homocysteine level is a strong, independent risk factor for the development of dementia and Alzheimer's disease." (Seshadri, Beiser et al. 2002)
• This shows once again how one risk factor can be a common determinant for many disease states.
• The NutriDesk diet aims is to help you lower homocysteine levels where possible through dietary means.
• You can get more information on this important risk factor for cardiovascular disease by clicking on this link: Homocysteine QuickGuide

Inflammation

• Fat in the central abdominal area is not benign! 
• This fat is regarded as a ‘hormone factory’ producing many inflammatory chemicals. One cytokine [IL-6] produces a very specific marker for inflammation called CRP which is now known to be a powerful inhibitor of leptin causing leptin resistance leading to worsening overweight/obesity. An important ‘vicious cycle’.
• Targeting inflammation and CRP is an important focus of the NutriDesk diet. Cardiovascular complications are directly related to an inflammatory process involving LDL [the 'bad' cholesterol] in the blood vessel wall.

The Endothelium & Oxidative Stress

• The endothelium Is the lining of blood vessels.
• It is important to protect the endothelium from damage by the effects of insulin resistance [IR] and from the damaging effect of high blood sugar levels and high fat levels after meals.
• It is also important to ensure you consume quality protein to provide the amino acid arginine so that Nitric Oxide [NO] can be produced which is important in blood vessel dilation and to provide copious amounts of antioxidants to protect the heart and blood vessels from dangerous free radicals and reactive oxygen species [ROS] 

The aim of this diet is to provide you with copious amounts of antioxidants and phytochemicals along with nutraceuticals that have a research base that promote the quenching of free radicals and reactive oxygen species [ROS] by inducing innate cellular defence mechanisms and increasing superoxide dismutase [SOD] to protect this delicate lining and the heart and blood vessel walls from chemical damage.

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What you should know:

• Always discuss your dietary choice with your doctor before paying for and proceeding with any diet.
• At the bottom of this text box you will see 'Information for General Practitioners'. Your GP can view this information to see if there are any problems for you as an individual especially if you have a medical condition, are taking certain medications or if you have a genetic predisposition to a particular problem.
• The 'info' tab within the diet of your choice will have expanded explanations to the points and  questions raised below.
• The main reference database is also located in the NutriDesk Diet Button Panel under 'References' which can be viewed once you purchase the diet of your choice.
• NutriDesk uses highly reputable sources of information for this website. However, the onus is on you to research and seek medical counsel to see if any information or recommendation found within this diet or on this website is appropriate to your unique personal needs.
• Please view 'Our Philosophy' and the 'Terms of Use' of this website before proceeding.
• The 'My Research' portal is your gateway to wonderful resources to begin your personal research. It is your right to question anything being presented to you and this is encouraged. My Research is a great tool to begin this journey of nutritional discovery.
• The GP Resources area will provide your general practitioner with not only the resources you have access to, but also resources aimed more at a professional level. This will enable your GP to do some research on your behalf if presented with personal queries triggered by this website.

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Hungry for more information?

Read on only if you want more detailed information.

You can go straight to the diet by clicking
Add to Cart at the top right hand side of this diet topic.

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The Endothelium: The chemically active yet fragile blood vessel lining.

• The endothelium performs the following functions in blood vessels:

1. It forms a barrier to prevent harmful substances in the blood from entering the elastic smooth muscle within middle vessel wall. This is a vital function of the endothelium.
2. It reacts to mechanical forces such as blood pressure and to the blood flow generated by the beating of your heart.
3. It is an endocrine organ as indicated above and releases chemicals that penetrates and signals the middle layer smooth muscle to change the blood vessel tone or stiffness.

• One clinical review stated "The vascular endothelium, building the inner layer of capillaries and blood vessels of all sorts, represents a highly active metabolic and endocrine organ producing a multitude of different molecules, including vasoactive peptide hormones, growth factors, coagulation factors and adhesion molecules. In addition, it expresses many of the respective endocrine, paracrine and cytokine/growth factor receptors. It thereby regulates the delicate balance between vasoconstriction and vasodilation, between coagulation and fibrinolysis, proliferation and apoptosis, as well as between transient adhesion and diapedesis [migration] of blood borne leukocytes." (Baumgartner-Parzer and Waldhausl 2001)
• What damages the endothelium ---Getting older, smoking having high blood pressure, having high blood fat levels [high LDL and triglycerides, low HDL], if you smoke, if you are overweight or obese [check this using BodyCalculator], if you lead a sedentary life with low exercise levels --- all of these factors can lead to  endothelial dysfunction and atherosclerosis.
• You may also have one or more of the following factors that can be detrimental to the endothelium --- elevated glucose [insulin resistance, eating the wrong carbohydrates in the wrong quantities, the metabolic syndrome], high iron in your system, elevated homocysteine levels [a toxic amino acid created in the body], high fibrinogen levels that increase your risk of clotting, and high C-reactive protein [CRP - this protein reflects inflammation in the body and can bind to leptin increasing your risk of getting fatter], and low free testosterone (in men) - low testosterone levels is now more and more being recognized as a significant risk for cardiovascular disease. All of these can lead to endothelial dysfunction.
• Apart from lifestyle choices such as smoking or drinking too much alcohol or not having enough exercise which is beyond the scope of this diet, NutriDesk targets a multitude of dietary risk factors to help decrease your chance of having a premature cardiovascular event by helping to protect the endothelium by the right choice of carbohydrates, fats and protein in the right quantities and to provide you with a high intake of micronutrients,  antioxidants, phytonutrients, omega-3's, and fibre intake. It encourages lifestyle changes as well which can only improve your risk if you deal with these issues effectively. 

 Improving Insulin Sensitivity

Insulin resistance causes not only fat storage and weight gain especially around the central abdominal area but will also increase the risk of inflammation in the body and of many cancers now known to be associated with high insulin levels.

There are numerous reasons why insulin resistance occurs:

• The aging process where receptors become less sensitive
• Insulin itself - with increased levels in the blood stream the GLUT4 insulin receptor is downregulated i.e. less of this receptor is produced causing insulin resistance.
• We know that high glycemic index [high-GI] and high glycemic load [high-GL] carbohydrate diets can cause short-term or long-term elevations in insulin which can result in insulin resistance through the GLUT4 downregulation mechanism or through other molecular mechanisms.

 How can NutriDesk's Diet Help? 

• The diet revolves around an Optimal Nutrition Core that guides the user towards low-GI and low-GL choices by automatically calculating the amount of carbohydrate required and providing excellent carbohydrate choices
• The 'info' button of the purchased diet will discuss numerous nutritional approaches to significantly improve insulin resistance.
  

 

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 Overcoming Fat Induced Inflammation

• Many factors work together to produce ever increasing fat gain and inflammation in the body. Picture each factor for fat gain and inflammation like dominoes all in a straight row  --- push one over and they  topple  into each other.  There are many factors [dominoes] and biological closed-loops caused by aging or hormonal imbalances or chronic ill health. The trick is to interrupt these factors and closed-loops as best we can once the reaction has set-in and move the body back to homeostasis [physiological and chemical balance].
• The hyperinsulinaemia [high blood insulin level] mentioned above  is associated with systemic [body] inflammation. A high insulin level is associated with many inflammatory markers such as nuclear factor-kappa B, interleukin-6 [IL6] and C-reactive protein [CRP]. The CRP test has now emerged as a sensitive marker for hidden inflammation in the body. It is a very sensitive marker for inflammation and elevated levels should never be ignored. One test readily available in the general practice setting is the highly sensitive CRP or hs-CRP test which can be ordered by your doctor if you are overweight or obese.  Higher CRP's indicate higher inflammation levels and the greater your risk for cardiovascular disease, heart attacks and diabetes.

Inflammation a great risk for Heart Disease, Cancers and Alzheimer's Disease

• It is critical to control inflammation as it places you at high risk for many chronic diseases. Inflammation is also self-perpetuating by producing numerous suppressors of cytokine signaling [SOCS]. An important SOCS molecule has been discussed above and will be discussed further in the third pillar. Cytokines are molecules produced in significant amounts by the fat cells that accumulate in the mid-abdominal area and are involved in cell-signaling throughout the body. Some cytokines such as tumour necrosis factor alpha [TNF-a] are potent signaling molecules for inflammation.
• It is important to note that cardiovascular disease is an important risk factor in the development of dementia. So you have to look at this problem in a big-picture sense and not place an organ such as the heart in one little compartment as if you can isolate this organ from the rest of the body or that the body can be seen separate to the organ. Factors that determine disease affect every cell and every organ of the body!

How can the NutriDesk 'Weight Management Diet' help?

1. Fat accumulation in the midsection is a major risk factor for not only insulin resistance and diabetes but for chronic inflammation in the body and many cancers. It is for this reason that many governments, including the Australian government are running expensive advertising campaigns to educate individuals about this dangerous abdominal fat. One published paper published in the prestigious in the British Journal of Nutrition stated the following about the large number of dangerous protein chemicals called cytokines secreted by this abdominal fat mass : "Production of these proteins by adipose tissue is increased in obesity, and raised circulating levels of several acute-phase proteins and inflammatory cytokines has led to the view that the obese are characterised by a state of chronic low-grade inflammation, and that this links causally to insulin resistance and the metabolic syndrome." [Trayhurn et al 2004]
   
2. A tremendous amount can be achieved through diet but often a pharmacological approach is used to control inflammation. Inflammation is either the cause or effect of many chronic illnesses and many dietary practices only help to 'feed' this inflammatory process. Powerful anti-inflammatory nutritional approaches can be used and the strength of the NutriDesk approach is to show diets in all its complexity but to simplify the process for you so that you know exactly what can be used and why. The 'info' tab will highlight how the NutriDesk diet will help you overcome this inflammatory response of increasing body adiposity [fat accumulation] and other tabs within the diet such as the 'Special Foods' tab, 'Nutraceuticals' and 'Functional Foods' tabs will highlight specific and powerful dietary approaches to inflammation. Too often the clinical application of diet and nutrition is underestimated in the prevention or co-treatment of disease.

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Overcoming Leptin Resistance

Suppressors of cytokine signaling [SOCS]  as mentioned above are produced by the accumulating abdominal fat levels.

One of these suppressors has been recently identified as being due to CRP the inflammatory marker mentioned above.

CRP is a potent inhibitor of leptin (Chen, Li et al. 2006). Leptin has two main functions:

1] To suppress appetite
2] To promote the burning of triglycerides [trigs] in bloated fat cells

 

 

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Leptin Resistance [Graphic Above]: Increasing fat accumulation in your abdomen [midsection] leads to a vicious-cycle where the fat cells of the central abdomen produce inflammatory cytokines such as interleukin-6 [IL6]. IL6 stimulates the production of CRP a protein marker of background inflammation in the body. CRP is a potent inhibitor of leptin. CRP-Bound Leptin cannot cross the Blood Brain Barrier [BBB] and as a result cannot suppress appetite. As a result hunger is increased leading to increased caloric intake, increased adiposity and thus increased IL6 and CRP production – the cycle continues.

How can the NutriDesk diet help to decrease leptin resistance?

Well, quite a lot. The strategies embedded  in the Weight Management Diet in NutriDesk are designed to be anti-inflammatory. It is a diet rich in antioxidants and essential fatty acids that will help to suppress CRP. Nutraceuticals found by clicking the 'Nutraceuticals' tab of the  purchased diet will feature products designed to have an anti-inflammatory, CRP suppressing effect helping to support this pillar of successful weight loss.

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  Providing nutrient-dense calorie sparing foods.

 The NutriDesk 'Weight Management Diet' ensures that you have all the vitamins, minerals, trace elements, amino acids, essential fatty acids that your body needs to function at optimal levels.

Without this vital nutritional support, your cells cannot burn off excess fat.

 With all these nutrients available to the cells of your body, there won't be that constant hunger signal forcing you to eat simply to acquire adequate quantities of a particular micro or macro nutrient.

 How can the NutriDesk diet help you?

The Optimal Nutrition Core in NutriDesk ensures food choices that are absolutely nutrient dense and choices that have multiple nutritional benefits. You have many choices within the diet and clicking on each choice will provide you with a wealth of information on each item chosen with information gathered from the most respected sources of information and this information is referenced - just click on the 'References' tab within the purchased diet.

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 Boosting resting energy expenditure [REE]

This may sound a difficult task but there are numerous nutritional and exercise approaches that can do exactly this - boost resting metabolic rate so that your body is in a fat burning state. 

As mentioned above, many studies have shown a distinct drop in the ability to burn off energy as you get older. One study in the European Journal of Clinical Nutrition noted:

"Aging is accompanied by a decrease in REE that is significantly greater than what is predicted by variations in body composition. This decrease may reach a mean level of about 500–800 kJ/day." [Alfonzo-González et al 2006]. References within the purchased diet in the NuriDesk Diet Button Panel.

In terms of calories that is 120 to 191 calories per day that will not be converted to energy. So if your energy intake [caloric intake] has stayed the same throughout your life then increasing adiposity is an almost certain outcome.

How can the NutriDesk diet help you?

There are numerous strategies that can be used to boost resting energy expenditure [REE]. The thermic energy of food [TEF] can be used to advantage and there are numerous food components and supplements that can help to 'uncouple' energy production by diverting energy conversion to heat production rather than producing the energy storage molecule called ATP by activating mitochondrial uncoupling protein 1 [UCP1]. Simply click on the NutriDesk Diet Button Panel to view the possibilities.

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Restoring hormonal balance or using medications where appropriate.

There are many disease states that can affect your ability to burn off fat. Many of these disease states where this is a hormonal problem can increase your risk for heart and cardiovascular disease in many ways.

Here is where your general practitioner [GP] becomes a great ally and can either manage your condition or refer you to a specialist that can.

• Polycystic Ovarian Syndrome PCOS]: This is a disease affecting many young women who find it difficult to lose weight. Women suffering from PCOS often have insulin resistance in the background placing them at high risk for developing diabetes before they reach menopause. They are at high risk for cardiovascular disease early in life as a result.
• If you have been suffering from irregular ovulation or menstruation, acne, increased hair growth in unusual locations for women, weight gain then PCOS is something high on the list for consideration. You should be assessed for diabetes or insulin resistance. 50% of women with PCOS will become frankly diabetic sometime prior to menopause.

Find out which medication can significantly improve insulin resistance in this setting. Simply click on the 'info' tab of the purchased 'Weight Management Program' to find out which medication to investigate and discuss with your doctor.

• Hypothyroidism: An underactive thyroid may be the reason why many individuals [especially women] are unable to lose their weight. Find out what to look out for in this regard under the 'info' tab of the purchased diet.
• Menopause and testosterone levels in women: The pendulum swings in favour of hormone replacement therapy [HRT] one way or the other over the decades. The Women's Health Initiative seemed to throw a spanner in the works but on closer appraisal of this study, many findings were found to be absolutely false ones. Timing of HRT was found to be absolutely critical as to whether HRT showed benefit or not and the earlier you start HRT the better off you are. Testosterone in this setting is extremely important as testosterone determines muscle mass and hence resting metabolic rate. Low testosterone in middle aged women will lead to increased weight gain especially in the abdominal region which increases cardiovascular risk and risk for developing insulin resistance and diabetes.
• Andropause and low testosterone levels in men: Men have often suffered from the devastating effects of low testosterone levels as they age. There has been an absolute misconception in the medical profession that testosterone treatment causes prostate cancer. The myth about testosterone replacement was destroyed by experts at Harvard University. In fact these experts from a highly respected university have shown that low testosterone levels can actually increase the risk of prostate cancer in aging men. Find out about this important topic by clicking on the following link:
  'Testosterone'

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Exercise and Energy Expenditure

Exercise is vital for a strong cardiovascular system and to create what is known as an 'Energy Deficit'. If you can keep your caloric intake to that calculated for you in NutriDesk, this energy deficit will mean that you will tap into your fat stores to 'fill' this deficit needed by the body.

Muscle fibre dysfunction is associated with many diseases of Western societies such as obesity, metabolic syndrome and diabetes.

Aerobic exercise helps to change muscle fibres from type-IIb to fat burning type-1 muscle fibres which have a high ability to oxidize ['burn'], fat as fuel.

Another form of exercise is also important and this will be discussed further --- please check the 'Special Access' part of 'My NutriDesk'

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 Optimizing Bowel Health

So what does bowel health have to do with overweight/obesity?

Well, quite a lot. A recent article in Research Matters on the National Institutes of Health [NIH] website was titled 'Gut Microbiomes Differ Between Obese and Lean People' . This article stated that: 

"A new study has found that obese and lean twins have clear differences in their gut microbial communities. The finding points the way for future research into the roles that gut microbes may play in obesity and other health conditions.- The researchers found differences between obese and lean people in over 300 bacterial genes, many of which are involved in carbohydrate and lipid metabolism. This initial set of markers for the obese gut microbiome is a major step toward understanding the role that gut microbes may play in obesity and its related diseases." by Harrison Wein, Ph.D.

 

Many studies have shown the benefit of prebiotics, probiotics and of many forms of carbohydrate [grain choices] that can have a marked effect on bowel flora.

NutriDesk will guide you towards bowel friendly nutritional choices and indicate if supplements are available that may be of benefit.

The significance of this colony of bowel organisms can be seen in the free NutriDesk tutorial 'Bowel Flora and Health'

 

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 Optimum nutrition with any diet chosen: The Optimal Nutrition Core

You can rest assured that the core of any diet you choose is based on cutting-edge nutritional principles for optimum health. So how do the diets differ? Recommendations of the various nutritional components are based on clinical trials, laboratory research or epidemiological studies that show an advantage for a particular diet, food, functional food or nutraceutical that can be used for the purpose of disease modification or to provide a preventative advantage in a particular disease state or risk-of-disease setting. 

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Information for General Practitioners

• This diet is rich in plant foods and thus high in vitamin K. Vitamin K is found mainly in dark green leafy vegetables and parsley is a rich source of vitamin K. Thus Warfarin [Coumadin] is not contraindicated however, if a patient commences this diet, the INR will need to be monitored regularly until it has stabilized. Plant foods are highly beneficial and often these foods are restricted in those taking warfarin to the detriment of the individual’s health. The INR’s simply need to be adjusted to the patient’s daily intake. The patient needs to understand if they are on warfarin that plant food consumption should be consistent day-by-day and that they should not vary this intake dramatically while on Warfarin. Any significant variation in intake of plant foods will require close INR monitoring once again.
• This diet is a rich and healthy source of beneficial potassium and if the individual is on an ACE inhibitor or potassium sparing diuretic or other potassium sparing medication, the blood potassium should be monitored closely as well.
• A high dietary intake of potassium is desirable from a health perspective for a variety of reasons and blood pressure may respond favourably to a high potassium diet. Please monitor the individual’s blood pressure regularly while on the diet. Adjustments in the dose of medication/s may be necessary or perhaps even ceased for reasons of weight loss or the beneficial effects of an optimal diet.
• If the individual has gout, then specific high-purine foods advised within the diet will need to be avoided. Some foods may contain high sodium levels such as the fermented soy drink called Miso soup. Individuals with hypertension will need to limit consumption of this food.
• Many grains have moderate to high oxalate levels and those individuals with calcium-oxalate stones may need to restrict consumption of such foods. White rice does not have significant oxalate levels whereas brown rice does.
• Advise the patient to avoid any known dietary triggers
• Encourage the patient to exercise regularly.

Hormone Replacement Therapy

• HRT should be considered where hormone levels have been shown to be diminished by blood testing and where the patient shows signs or symptoms of hormone deficiency such as vasomotor flushing [US Flashing] or abnormal sweating, loss of muscle mass and weakness, increasing abdominal adiposity. For testosterone deficiency view the QuickGuide on testosterone [link below]
• According to the Bayer-Schering Consumer Product Information [CPI]
  "The testosterone in Testogel^TM is identical to the naturally occurring testosterone present in the body." Thus this hormone is a bioidentical hormone, meaning that it looks and acts exactly like the hormone your body has been producing all its life. Dr Abraham Morgentaler in the book Testosterone for Life, indicates that about 60% of the US market for testosterone replacement is through the use of bioidentical testosterone gels like Testogel^TM.
• If HRT or testosterone replacement is being considered, then due diligence needs to be shown to assess for existing hormone sensitive malignancies in the breast or prostate by a combination of blood tests, imaging and physical examination. Counsel the patient on possible side-effects of testosterone such as hirsuitism or deepening voice [unlikely if testosterone levels are kept at an optimal range for the gender.]
• Follow-up check-ups and blood testing are mandatory steps to keep side-effects to a minimum and ensuring an optimal level of hormone.
• Remember to check SHBG when testing hormones - SHBG binds free hormones [estrogen or testosterone]. The higher the SHBG, the lower the free hormone level. Look for factors that increase SHBG levels.
• Accepted dogma should always be challenged!  In the case of not using testosterone in middle-aged men due to the fear of promoting a prostate cancer, the dogma has indeed been challenged. The extremely tenuous roots of this myth have been delved into by reviewing the original articles in the inner sanctum of Harvard's professional library, one that has an incredible archive of important medical research - the  Countway Medical Library. These oft cited references were used in absolute defence of the dogma. The slender threads of this misunderstanding have been severed one-by-one in this important book 'Testosterone for Life'.
• Dense Breasts on Mammograms

  - GPs often see comments on mammograms such as 'dense breasts' or 'dense glandular architecture' or similar wording.

  - What the radiologist is referring to is a mammogram that is diffusely white reflecting dense glandular tissue within the breasts. If 50% or more of of the mammogram is dense [white] then the woman is at risk of breast cancer. In this setting the NutriDesk Breast Health Diet would be an appropriate choice.

  The mammographi