The New Age of Sickness and Scarcity:Critical Illness in Slow Motion - Introducing Entry Level Clinical Nutrition™ - Part IV
The New Age Of Sickness And Scarcity: Critical Illness in Slow Motion?
My last post in this series made the case that the principles of critical care nutrition can be extrapolated to the complex, chronically ill patients we see every day. I described the simple, effective and comparatively inexpensive solutions used by critical care nutritionists to stabilize critical care patients; and offered evidence that these solutions can be valuable when treating the chronically ill. I also explained that these solutions are at the heart of the nutritional program called Entry Level Clinical Nutrition.
Perhaps you read that post and reviewed the accompanying references, but still wondered how much similarity there could really be between burn patients or surgical patients and the chronically ill. To help answer such questions, I'd like to share a few quotes from an internationally recognized expert on critical care nutrition, Stig Bengmark, MD, PhD.
"A series of complex reactions occur in the body when an individual is threatened by stress, mental or physical [whether it's] infection trauma, surgical operation, advanced medical treatment or child delivery-all [of these reactions are] aimed to provide optimal protection against progress of disease. These changes are usually summarized under the name of acute phase reaction . . . [and] involve the whole body . . ." 1
Having described the body's acute phase reaction (APR) to critical care situations, Bengmark then highlights the direct connection to chronic illness:
"Similar . . . mechanisms are activated when an individual is affected by a long-lasting, continuous . . . mental and/or physical stress. The observed mechanisms have similarities with APR . . . [we can define] the latter as chronic phase response (CPR). Characteristic to APR is increase in temperature, chills, somnolence, anorexia and profound changes in blood levels of plasma proteins, lipids, minerals, hormones, cytokines as well as cellular elements. CPR manifests itself mainly as chronic fatigue, asthenia, reduced appetite, reduced physical activity, reduced mood, sometimes mental depression and reduced muscle mass. The changes in chemical and cellular parameters in CPR, although obvious, are more discrete."
This is an extraordinary, possibly revolutionary statement. It is here that Bengmark draws the unmistakable linkage between APR - a response to a short, intense, traumatic stress - and the chronic phase response. He says that the CPR is the body's response to "long-lasting, continuous . . . mental and/or physical stress". So, according to Dr. Bengmark, it is really just a matter of degree of stress and duration of the responses (APR vs. CPR) that differentiate chronic disease and critical illness.
He then says that the CPR is manifested as illnesses, such as chronic fatigue, depression and reduced muscle mass, which are the chief complaints of many of the chronically ill patients we see every day. Bengmark says - and I agree - that these so-called "diseases" are not diseases at all, but actually responses to long-term mental and physical stressors.
It is this remarkable idea that forms the biochemical and physiological basis for Entry Level Clinical NutritionTM. In fact, the methodology used by critical care nutritionists to stabilize the APR in their critically ill patients is the foundation on which the Entry Level Clinical NutritionTM program is built.
If you find this concept as striking as I do, I invite you to talk with us about it. At Moss Nutrition, an experienced health care professional is just a phone call away.
All of us at Moss Nutrition want to share our knowledge of Entry Level Clinical NutritionTM and how it works in practice. We talk regularly with the many practitioners already achieving great results with this program. We'd like you to see for yourself how this simple, cost-efficient approach can resolve the chief complaints of your chronically ill patients.
So, lastly, I'd like to touch on the important patient care considerations of Entry Level Clinical NutritionTM, which are:
- Optimization of muscle mass and amino acid levels
- Reduction of inflammation
- Improvement of insulin sensitivity
- Optimization of pH
- Optimization of dietary carbohydrate / protein ratio
- Optimization of gastrointestinal function
- Optimization of deficiencies of key micronutrients such as vitamin D, iodine, and zinc
In my next post, I'll present the specific modalities we use to address each of these considerations.
Meanwhile, to learn more about Entry Level Clinical NutritionTM please call us at 800-851-5444. You will be greeted by one of our clinical specialists who will be happy to talk with you.
Click Here to view the Entry Level Clinical Nutrition Training Series at FMTown!
1Bengmark S. Acute and "chronic" phase reaction - a mother of disease. Clin Nutr. 2004;23:1256-1266.