Nutritional Therapy - Ann Pinkney
Notes taken during a meeting of the Cambridge Sjögren’s Syndrome Group held at the Tesco Community Room, Bar Hill at 11:00 am on 14 Nov 2016
Welcome and Introduction
Carol introduced Ann Pinkney a clinical nutritionist who would be talking about Nutritional Therapy for the remainder of the meeting.
Ann Pinkney, Nutritional Therapy
Ann explained that she is a clinical nutritionalist with a practice in Boxworth. Her professional body is the British Association for Applied Nutrition and Nutritional Therapy (BANT) whose web site contains details of local practitioners. She defined nutritional therapy as the application of nutritional performance, in particular, the influence of food intake on bodily chemistry. For people with an autoimmune disease such as Sjögrens the emphasis should be on reducing the body’s toxic load. However, she warned against the use of detox diets without specialist guidance. Toxic load, she said, can be measured using instruments to analyse both saliva and urine. Unbalances can give an idea of toxic load but although GPs may be willing to provide limited screening they would not normally fund the testing described; she considered it better to contact a specialist.
The first action of a specialist would be to look at diet and lifestyle before embarking on expensive testing. Stress and lifeloads can be as damaging as a poor diet. Genetic factors and lifestyle would be assessed by the use of a health questionnaire whose timeline would go back to birth and childhood as every significant situation can be important.
Ann then went on to talk about gut restoration and the 5R framework. She said that Sjögrens Syndrome can be triggered by various combinations of factors but now with increased genetic knowledge more can be done towards the goal of removing these autoimmune triggers. She spoke of “Leaky Gut Syndrome” where the colon can act like a sieve causing over-reaction of the immune system. She said that three months is the minimum period needed to assess dietry level changes, hence a three month programme would be proposed together with the necessary stool sampling. The object would be to calm inflammation in the gut.
The 5R framework starts with Remove allergic food parasites, bacterias (which can stay in the gut for 15 years) and viruses. Next is to Replace disgestive enzymes which can have been removed during times of stress. First by the natural action of the liver and secondly by the intake of correct food. Then Re-inocculation by the use of probiotics which add bacteria and prebiotics which stimulate existing bacteria. This is followed by Repair of the digestive tract with use of supplements and rebalancing of life load and stress. Change of diet alone is not enough.(1)
The next topic was diet. Ann’s handouts included an extensive listing of the Paleo Diet specifically composed for those with autoimmune diseases. Her advice was to try it and stick with it for at least one month before making a judgement. She said be careful with sourcing protein, for example, eat only grass fed meat, have turkey rather than chicken and although fish is a really good source of protein buy line caught rather than farmed fish to avoid toxins. When asked about a vegetarian diet she said that soya is not good and quorn can promote fungals. Her advice was to stick to beans and pulses. She emphasised that the diet sheet is very generalised, everyone has specific needs so that a diet should be matched to individual requrements. It was observed that dairy food was not in the protocol and her response was that however hard this may seem, because a high proportion of autoimmune disease sufferers react badly to dairy products including eggs, try going without and see what happens. Allthough potatoes can be bad, being part of the nightshade group, try observing the 80/20 rule. That is, restrict the intake of foods known to be triggers to 20%(2).
Ann’s advice on experimenting with diet change was to try any change for two weeks to see if the condition improves or deteriorates. Some people have a high toxic load but their body adjusts itself to cope with it. She mentioned histamine intolerance resulting from eating food with a high level of histamine which mimics an allergy. For example ripened fruit can have a high histamine level. Various alternative diets were considered such as a low histamine diet or a gluten free diet, these could be a starting point to see what happens. Because many people with autoimmune diseases are intolerant to nightshades, try cutting these out to see the effect. When re-introducing food give a three day period before trying something new and balance the undesirable symptoms against the problems of changing diet before making an assessment. Changes do not necessarily need to be complex, some can be simple like changing fluid intake. Ann suggested that people can take back control by changing their diet. She advised care when taking supplements if on pharmeceuticals and recommended taking clinical advice especially where the supplement level needs to be higher than normally supplied by healthy food shops.
Discussion and Thanks
There followed a brief discussion centred mainly on the relationship between GPs/Hospital Specialists and practitioners outside mainstream medicine.
Finally Carol thanked Ann for her presentation and the comprehensive information she was able to provide.