Summary of a talk given to final-year GP trainees
John Radcliffe Hospital, 8th April 2014 – by Maureen Houston
My talk was to cover my background, an explanation about nutritional therapy, and reasons why GPs may want to refer patients to a nutritional therapist. I then covered three case histories, showing examples of how nutritional therapy had helped to resolve a clinical condition.
At the beginning, I threw the ball in their court – asking how much they knew about nutrition – how much nutrition training they’d had during their course. I was quite astounded to discover they’d had virtually none. I then asked if anyone thought that food could make a difference to the outcome of a patient’s condition, or recovery. It was gratifying to see all hands raised.
After covering my background, I spoke of nutritional therapy being an evidence-based complementary therapy – not alternate – and how this discipline is particularly relevant for many chronic conditions, such as digestive problems, tiredness and lack of energy, female hormonal imbalances, and people struggling with weight control.I talked about how the first consultation lasts 90 minutes, with a thorough review of the patient’s background, lifestyle, family medical history, and dietary analysis; that practitioner and patient work together to devise a treatment plan, with the patient agreeing which foods to focus on and which to avoid.
The first case study covered infertility. I described the background of the couple, both in their early 40s, their lifestyle and dietary habits. The wife had gone through early menopause, and the husband’s sperm count was very low. I listed all the necessary changes to their diet, and the recommended nutritional supplements. One GP commented that she thought all those dietary changes were totally unrealistic, and she questioned how any ‘ordinary person’ could possibly take so much on board – and how could they even source some of the ingredients. I pointed out that (a) this couple were highly motivated, and (b) my service includes providing patients with information and resource sheets, giving them help and support to get through the early stages, until it becomes familiar and sustainable. Monitoring progress with monthly visits, I could observe significant improvements to their health; this was verified by test results on both showing a turn-around after three months. After six months the wife was pregnant, and subsequently gave birth to a healthy baby boy.
The second case involved irritable bowel syndrome (IBS), probably the most common complaint – more than 50% of my patients have presented with IBS symptoms, and for many it’s been long-term suffering, sometimes over 20 years. This patient was female, aged 56, with multiple digestive problems and increasing food intolerances. She also had low energy and intermittent palpitations. Her symptoms began 19 years earlier, when she was prescribed a daily aspirin for a heart murmur. She’d discontinued the aspirin after nine years, but her symptoms persisted, altered, and worsened, despite numerous visits to her GP, referrals to consultants, and several endoscopies. She was told all was clear. She agreed to alter her diet radically – it was replete with high levels of sugar, refined white flour products, processed foods, and very few fresh vegetables. She cut out sugar and wheat products, and started cooking simple meals from scratch, including many fresh vegetables. A stool test revealed a candida infection and low levels of healthy gut flora. These were addressed with a specific diet and therapeutic supplement programme for 2-3 months, after which there was a gradual improvement in her health and energy levels. After a year she was back to normal – healthier than she’d been for many years.
The third case study entailed obesity – a condition they would probably see in increasing numbers over the course of their careers as GPs, even if patients had come to them for some other complaint. I cautioned against taking a ‘one-size-fits-all’ approach, instead treating each obese patient as an individual. I discussed a 54-year-old female with a BMI of 35, who had struggled with her weight all her life. She had a heavy alcohol habit, and came from a family of alcoholics. She had painful joints, which deterred exercise, and several digestive problems. She was also concerned about uncontrolled anger. Although an avid cook, she needed to curb her love of starchy carbs, dramatically reduce her portion sizes, and address her drinking problem. She voluntarily agreed to cut out alcohol and bread right from the start, and this produced such positive results that she was motivated gradually to introduce my other recommendations. After the first year, with monthly visits, she had lost four stones, and after another few months she had lost another stone, reduced her body fat by nearly 20%, and her BMI was down to 23.2. She was pain-free and exercising regularly, was calm and even-tempered, and all digestive complaints had cleared. This strategy worked so well because, unlike specific ‘weight loss diets’, the patient learns how to eat to promote optimum health, deciding which changes to incorporate and when, and consequently she is in control.
I ended the talk with a mention about prevention – that making just a few small changes to what you eat, and doing some exercise every day – can go a long way towards improving health and preventing the onset of disease.
I felt the talk was well received on the whole; the audience was engaged, and they asked interesting and thought-provoking questions. They frequently enquired about evidence for various aspects of the case studies; and they were curious about where to find information about which foods contained specific nutrients. They revealed a significant gap in their understanding of the functioning of the gut (the very basis of nutritional therapy). For example, they asked questions about probiotics, but were unfamiliar with the names of different species of gut flora. They were bemused at the concept of wheat as a trigger for so many digestive problems. Their feedback is eagerly awaited!
If you would like to ask any questions or book an appointment with Maureen Houston please ring our friendly receptionists on 01865 558561 who would be happy to help.
