Briefing Note - Detoxification

Briefing Note - Detoxification

BRIEFING NOTE 08/09

DETOXIFICATION: UNDERSTANDING THE DIFFERENCES BETWEEN DIETITIANS AND NUTRITIONAL THERAPISTS

This is the second in a series of briefing notes setting out the key differences between dietitians and nutritional therapists.

For dietitians the idea of aiding detoxification through nutrition is “a load of nonsense”. In January 2009 the British Dietetic Association issued a press release stating that the body has a well-developed system of the skin, gut, liver and kidneys all responding to chemical signals to constantly eliminate toxins. Proper hydration, a sensible diet and regular physical activity “really are the only ways to properly protect your health for the year ahead”.

For nutritional therapists, detoxification, which is the biotransformation of harmful molecules, is a core determinant of physical and mental health and is dependent on nutritional status. Poor conjugation and poor excretion of exo- and endo-toxins, combined with elevated toxic load, results in insidious and cumulative damage to metabolic processes and increasing susceptibility to disorders such as inflammatory joint disease, neurological impairment, atherosclerosis, allergies, chronic fatigue, and cancer.

The primary mechanism of biotransformation involves activation of cytochrome P450 enzymes for Phase I oxidative metabolism followed by Phase II conjugation to facilitate excretion. Phase I metabolism can either directly neutralise some compounds or transform them to highly reactive metabolites ready for phase II conjugation. Balanced Phase I and Phase II activity is important to avoid increased production of intermediary metabolites which, without sufficient antioxidant protection, are damaging to DNA. Common variants (including deletions) in genes encoding for Phase I and II enzymes increase genome events which mediate aging (mitochondrial decay) and the disease process. Poor nutritional status leading to inefficient biotransformation contributes to long-term adverse health outcomes.

A healthy gut ecology is also important for optimal biotransformation and therefore hormonal balance and immunity. Biotransformed compounds can be deconjugated by enzymatic products of unfriendly gut flora and reabsorbed into hepatic circulation.

Functional testing is used by nutritional therapists to target individual advice.

References

1. http://www.bda.uk.com/news/090101Detox.pdf
2. Ames, BN, I Elson-Schwab,EA Silver: High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased K(m)): relevance to genetic disease and polymorphisms. Am J Clin Nutr 75, 616-58 (2002).
3. Choi, W, SY Eum, YW Lee, B Hennig, LW Robertson,M Toborek: PCB 104-induced proinflammatory reactions in human vascular endothelial cells: relationship to cancer metastasis and atherogenesis. Toxicol Sci 75, 47-56 (2003).
4. Guengerich, FP: Influence of nutrients and other dietary materials on cytochrome P450 enzymes. Am J Clin Nutr 61, 651S-658S (1995)
5. Hennig, B, BD Hammock, R Slim, M Toborek, V Saraswathi,LW Robertson: PCB-induced oxidative stress in endothelial cells: modulation by nutrients. Int J Hyg Environ Health 205, 95-102 (2002)
6. Hennig, B, AS Ettinger, RJ Jandacek et al.: Using nutrition for intervention and prevention against environmental chemical toxicity and associated diseases. Environ
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7. Ito, S, C Chen, J Satoh, S Yim,FJ Gonzalez: Dietary phytochemicals regulate whole-body CYP1A1 expression through an arylhydrocarbon receptor nuclear translocator-dependent system in gut. J Clin Invest 117, 1940-50 (2007)
8. Loktionov, A: Common gene polymorphisms, cancer progression and prognosis. Cancer Lett 208, 1-33 (2004)
9. Ramadass, P, P Meerarani, M Toborek, LW Robertson,B Hennig: Dietary flavonoids modulate PCB-induced oxidative stress, CYP1A1 induction, and AhR-DNA binding activity in vascular endothelial cells. Toxicol Sci 76, 212-9 (2003)
10. Hattori M & Taylor TD: The Human Intestinal Microbiome: A New Frontier in Human Biology. DNA Res 16(1):1-12 (2009)
11. Round JL & Mazmanian SK: The gut microbiota shapes intestinal immune responses during health and disease. Nat Rev Immunol 9, 313-323 (2009)

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