![Page 1: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/1.jpg)
Specialist clinical nutrition: an essential adjunct to successful manual therapy
Dr Nina BaileyBSc (Hons) MSc PhD
![Page 2: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/2.jpg)
• Igennus Healthcare Nutrition are a clinical nutrition specialist providing bespoke support for inflammatory conditions
• You don’t need to be a nutrition specialist to make a difference to your client’s health!
• Igennus has established relationships with over 50 chiropractors, osteopaths, acupuncturists, reflexologists, massage therapists, personal trainers and fitness instructors…….
![Page 3: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/3.jpg)
CFS/ME/FMS
• Dr Raymond Perrin (PhD) osteopath, neuroscientist and pioneer of The ‘Perrin Technique’
• The Perrin Technique is a unique lymphatic drainage technique that treats CFS – all Perrin CFS patients are recommended to take 1-2g of Igennus EPA
• Igennus collaborates with 96 ‘Perrin Practitioners’ who use this protocol successfully
![Page 4: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/4.jpg)
Neurodevelopmental disorders
• Robin Pauc – neurologist and chiropractor, founder of the UK renowned Tinsley House Clinic for childhood developmental disorders
• Robin Pauc regularly recommends Igennus’ products as an addition to his treatment programmes:• ADHD• Autism• Asperger's • Dyslexia• Dyspraxia
![Page 5: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/5.jpg)
• Igennus EPA used by Dave Scott U.S. triathlete and six-time Ironman Triathlon World Champion
• Numerous personal trainers use Igennus’ products over generic oils as part of their sports nutrition package - clients get better results: Modulates inflammation Immunity support Cardiovascular support Joint and bone support Reduced oxidative stress Supports energy requirements Supports lean muscle mass/fat burn Supports recovery time and performance
Our biggest practitioner accounts are manual/physical therapists NOT nutrition specialists….
![Page 6: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/6.jpg)
Why do they choose us?
Premium quality ingredients Scientifically proven formulations Niche therapeutic target Highly specialised Expert support team Highest purity and lowest contaminants They really work!
![Page 7: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/7.jpg)
• Accident• Injury• Illness• Stress
• Tension• Posture issues• Muscle spasm• Over-exertion
All result in nerve and muscle damage = short/long term reduced mobility, pain and subsequent secondary issues
But most importantly the science……..
Top reason to see a manual therapist:PAIN! Pain due to:
![Page 8: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/8.jpg)
• Pain = inflammation = pain – signal that damage is present and protects against worsening
• Process of inflammation must be tightly regulated in the body. If not, can lead to unnecessary inflammation and exacerbate pre-existing issues or initiate new ones otherwise non-problematic
• Unnecessary inflammation / inability to switch off inflammation = chronic pain and reduced mobility
• PLUS very high risk of inflammation ‘spreading’ systemically = increased risk of inflammatory disease
![Page 9: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/9.jpg)
Managing pain
• Medication – but like fighting an Australian bush fire with oil - if you use enough may put out the flame in the short term but long term MUCH worse
• Many pharmaceuticals also have potentially detrimental side effects (i.e. COX-2 inhibitors)
• Manual therapy addresses the muscle and nerve issues and restores function to the body to reduce pain and promote mobility
• But without addressing the route cause of unnecessary inflammation leads to long term issues and numerous secondary problems
![Page 10: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/10.jpg)
What is inflammation?
– the normal response of a tissue to injury – triggered by a number of causes including infection, invading
pathogens (such as bacteria or viruses), trauma or compromised blood flow
– desirable defence mechanism with undesirable side effects– normal inflammatory response has an on/off switch– in chronic inflammation there are issues with down-regulating signals
![Page 11: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/11.jpg)
The key to regulating inflammation is through the modulation of eicosanoids:
• Pro-inflammatory eicosanoids drive the immune and inflammatory processes
• Anti-inflammatory eicosanoids act to end the process
• Overproduction of pro-inflammatory products or reduced production of anti-inflammatory products can result in continued production of inflammatory products – the hallmark of silent inflammation
![Page 12: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/12.jpg)
Regulating eicosanoids through diet
• Eicosanoids are derived from a group of polyunsaturated fats known as omega-6 and omega-3
• The ratio of omega-6 to omega-3 in the diet influences the type of eicosanoid produced
• The ratio of omega-6 to omega-3 is commonly associated with health status
• The ratio of KEY omega-6 and omega-3 fats AA and EPA gives us a direct indication of inflammatory health
![Page 13: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/13.jpg)
• The AA to EPA ratio is an indication of the balance between pro-inflammatory and anti-inflammatory eicosanoids
• High AA and low EPA levels will drive the inflammatory response and the subsequent failure to resolve inflammation may increase susceptibility to the development of chronic, low-grade, inflammation-based diseases
AA to EPA ratio - biomarker of inflammatory status
![Page 14: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/14.jpg)
0 % 4% 8% 12%
Omega-3 index* - biomarker of cardiovascular health
Desirable OptimalUndesirable
*Harris & Von Schacky, 2004
![Page 15: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/15.jpg)
The role of diet and lifestyle in modulating inflammation
• Triggers from chronic altered diet and psycho-emotional stress negatively influence the resolution step of the inflammatory response
• Failure to resolve inflammation increases susceptibility to the development of chronic, low-grade, inflammation-based diseases due to the constant activation of both the HPA-axis and innate immune system (Bosma-den Boer et al., 2012)
![Page 16: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/16.jpg)
Resoleomics - the process of inflammation resolution In
flam
mat
ory
resp
onse
Initiation Resolution Termination
PGE2
LTB4
Eicosanoid switch Stop signal
Time
Pro-inflammatory reduced
Anti-inflammatory increased
Bosma-den Boer MM, van Wetten ML, Pruimboom L: Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering. Nutrition & metabolism 2012, 9:32
![Page 17: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/17.jpg)
• Oily fish via diet in decline• A major 1st world dietary deficiency• Supplementation of food necessary – milk, spreads
Omegas in food
Omega-3 transition to medicine
![Page 18: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/18.jpg)
Increasing health problems relating to weight issues
Flock MR, Rogers CJ, Prabhu KS, Kris-Etherton PM: Immunometabolic role of long-chain omega-3 fatty acids in obesity-induced inflammation. Diabetes/metabolism research and reviews 2013, 29:431-445.
Makki K, Froguel P, Wolowczuk I: Adipose Tissue in Obesity-Related Inflammation and Insulin Resistance: Cells, Cytokines, and Chemokines. ISRN inflammation 2013, 2013:139239.
Titos E, Claria J: Omega-3-derived mediators counteract obesity-induced adipose tissue inflammation. Prostaglandins & other lipid mediators 2013, 107:77-84.
White PJ, Marette A: Is omega-3 key to unlocking inflammation in obesity? Diabetologia 2006, 49:1999-2001.
White PJ, Marette A: Potential role of omega-3-derived resolution mediators in metabolic inflammation. Immunology and cell biology 2014, 92:324-330.
![Page 19: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/19.jpg)
Omega-3 and bone health
Mangano KM, Sahni S, Kerstetter JE, Kenny AM, Hannan MT: Polyunsaturated fatty acids and their relation with bone and muscle health in adults. Current osteoporosis reports 2013, 11:203-212.
McMahon MS: Beneficial effect of omega-3 fatty acids on bone metabolism. Orthopedics 2012, 35:735-736.
Rousseau JH, Kleppinger A, Kenny AM: Self-reported dietary intake of omega-3 fatty acids and association with bone and lower extremity function. Journal of the American Geriatrics Society 2009, 57:1781-1788.
Saidenberg Kermanac'h N, Bessis N, Cohen-Solal M, De Vernejoul MC, Boissier MC: Osteoprotegerin and inflammation. European cytokine network 2002, 13:144-153.
![Page 20: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/20.jpg)
Inflammation, omega-3 and rheumatoid arthritis
Curtis CL, Rees SG, Little CB, Flannery CR, Hughes CE, Wilson C, Dent CM, Otterness IG, Harwood JL, Caterson B: Pathologic indicators of degradation and inflammation in human osteoarthritic cartilage are abrogated by exposure to n-3 fatty acids. Arthritis and rheumatism 2002, 46:1544-1553.
Sperling RI: Dietary omega-3 fatty acids: effects on lipid mediators of inflammation and rheumatoid arthritis. Rheumatic diseases clinics of North America 1991, 17:373-389.
Lee YH, Bae SC, Song GG: Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: a meta-analysis. Archives of medical research 2012, 43:356-362.
![Page 21: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/21.jpg)
Omega-3 and pain
Maroon JC, Bost JW: Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surgical neurology 2006, 65:326-331.
![Page 22: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/22.jpg)
• AA and EPA contents of cell membranes can be altered through oral administration of omega-3 EPA
• Increasing EPA levels results in a changed pattern of production of eicosanoids
• Changing the fatty acid composition of cell membranes also affects immune function and pathways
– changes in membrane structure– cell signalling– gene expression of cells and products involved in the inflammatory
cascade and pain signalling
![Page 23: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/23.jpg)
• As health practitioners, you are perfectly placed to guide patients toward natural co-therapies
• Route of inflammation may not just be due to pain/injury issue, as consultation/client history may reveal:
• High stress• Fatigue• Neurological disorder• Poor diet and lifestyle• CVD• Low mood
• Inflammation is a key driver of a myriad of diseases/conditions
![Page 24: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/24.jpg)
![Page 25: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/25.jpg)
![Page 26: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/26.jpg)
Thus, addressing high levels of inflammation by restoring AA to EPA ratio and increasing the omega-3 index willreduce:
Pain Fatigue Stress Risk of modern illness
![Page 27: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/27.jpg)
Measuring inflammation and tracking progress
• Blood spot fatty acid profilingOmega-6 to omega-3 ratioAA to EPA ratioOmega-3 index
• Knowing a client’s baseline omega-3 index allows effective dosing to increase omega-3 index and reduce the AA to EPA ratio
Omega-3 index Dose required Body weight Minimum dose
Base line Target (mg/kg) (kg) (g)
3 8 0.0222 89 1.98
4 8 0.0172 89 1.53
6 8 0.0072 89 0.64
![Page 28: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/28.jpg)
So remember!
You don’t need to be a nutrition specialist to make a difference to your clients’ health
Our biggest practitioner accounts are manual therapists NOT nutrition specialists….
![Page 29: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/29.jpg)
Expertly formulated EPA supplements to suit all ages and needs
Scientifically proven co-therapies to support long term health
Technical support from MSc Nutrition Specialists
Literature and personalised support for your clients
Fatty acid blood profiling service allows a bespoke and effective supplementation regime
![Page 30: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/30.jpg)
Practitioner Scheme benefits:
A personalised referral code (i.e. SMITH25) Highest commission on direct orders Best discount for your clients Free 1-2-1 training with our highly qualified nutrition team Free promotional materials for your clients Free profile feature on our website Over 45% profit on trade orders Instant 30 days free credit PLUS additional 20% off your first trade order (effective profit
up to 57%)
![Page 32: Specialist clinical nutrition: an essential adjunct to successful manual therapy](https://reader036.vdocument.in/reader036/viewer/2022070318/5576d163d8b42a87588b456e/html5/thumbnails/32.jpg)
References
Bosma-den Boer MM, van Wetten ML, Pruimboom L: Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering. Nutrition & metabolism 2012, 9:32. Flock MR, Skulas-Ray AC, Harris WS, Etherton TD, Fleming JA, Kris-Etherton PM: Determinants of erythrocyte omega-3 fatty acid content in response to fish oil supplementation: a dose-response randomized controlled trial. Journal of the American Heart Association 2013, 2:e000513. Harris WS, Von Schacky C: The Omega-3 Index: a new risk factor for death from coronary heart disease? Preventive medicine 2004, 39:212-220. .