Everyone knows that food is essential to continue living, but only a few people are aware of the role food plays in our health and quality of life. Not only does food provide us energy and nutrients, it also promotes general health and disease prevention. Foods are related to our physical, mental and social health because each food or liquid contains particular nutrition such as carbohydrates, protein, vitamins, minerals, fats, etc. which are very necessary for our physical and mental growth. However, many people neglect this fact and pay little to no attention to what they eat just so they can satisfy their hunger, not realising this can lead to health problems like diabetes, heart disease, hypertension and many others. We must know that the terms ‘food’ and ‘nutrition’ are sometimes used synonymously, which unfortunately is not completely correct.

Basically, many people try many ways to stay healthy. Some may diet, others will exercise; the combination of these two is what is needed to stay healthy and energetic. There are many approaches to staying healthy, however we must be smart to apply the correct methods for our individual bodies and often times approaching a specialist is a key part of that. Rather than extreme diets (such as skipping meals or entire food groups) we should focus on a correct and healthy diet with the exercises. A healthy diet consists of providing the body with all essential nutrition including fluid, macronutrients (carbohydrates, protein, fat), micronutrients (Vitamins, minerals) and adequate calories (WHO2004). Our body needs a healthy diet to produce energy and at the same time keep nutrition for a body.

A healthy diet with regular exercises can help prevent non-communicable diseases (NCD) such as heart disease, high cholesterol, high blood pressure, diabetes, and stroke. These two combined together also can help to boost the immune system of our body. In addition, a healthy diet with regular exercises also affects our mood through the release of chemicals in the brain called “endorphins” causing us to feel happy, positive, and help to curb depression. Not only that, correct nutrition and exercise can potentially aid against sleep issues. In the end, we must remember that a healthy diet and exercises always work hand to hand to achieve the goal of healthiness.

 NUTRITION

“Nutrition is defined as the “science of food”, the nutrients and other substances therein, their action, interaction and balance in relation to health and disease, and the processes by which the organism ingests, absorbs, transports, utilizes and excretes food substances.”. There are five basic sources of nutrition for our body:

CARBOHYDRATES

Carbohydrates comprise the sugars, starches, and fibers found in fruits, grains, vegetables and milk products, and are the body’s main source of energy. They are called carbohydrates because at the chemical level they contain carbon, hydrogen, and oxygen. Carbohydrates are classified as simple or complex, and are a core part of your nutrition.

Simple and Complex

The difference between simple and complex carbohydrates is the form of chemical structure and how quickly the sugar is absorbed and digested. Simple carbohydrates are sugars and include monosaccharides (which consist of one sugar unit per molecule) and disaccharides (containing two sugar units per molecule). The monosaccharides glucose and fructose and disaccharides sucrose, maltose and lactose occur naturally. Glucose and fructose are found in honey and fruits, whereas sucrose is common table sugar and found in molasses, maple syrup and small amounts in fruits. Simple carbohydrates can also be found in candy, soda, and syrups, however these are made with processed, refined sugars and do not have vitamins, minerals or fiber. Therefore, they are called “Empty Calories” and can lead to unhealthy weight gain.

Complex carbohydrates contain more nutrients than simple carbohydrate and have a higher fiber content making them more filling. This effectively means that complex carbohydrates are agood option for weight control. Fiber is especially important because it promotes bowel regularity and helps to control cholesterol. Other than that, complex carbohydrates can help guard against type 2 diabetes and cardiovascular problems in the future.

Function of Carbohydrates

Carbohydrates are known as functional, quick energy sources and simple carbohydrates cause a burst of energy much more quickly than complex carbs due to the quicker rate at which they are digested and absorbed. Overall, simple carbohydrates can lead to spikes in blood sugar levels while complex carbohydrates provide more sustained energy.

Carbohydrates provide fuel for the central nervous system and energy for working muscles. In addition, carbohydrates prevent protein from being used as an energy source and enable fat metabolism. Carbohydrates are also extremely important for brain function in which they influence mood, memory, and other core nervous processes.

PROTEIN

Protein is a macronutrient that is essential to help in building muscle mass and is commonly found in animal products, though is also present in other sources such as nuts and legumes. Chemically, protein is composed of amino acids, which are organic compounds made of carbon, hydrogen, nitrogen, oxygen or sulphur.

The nutritional value of a protein is measured by the quantity of essential amino acids it contains. Different foods contain different amounts of essential amino acids. Generally:

• Animal products (such as chicken, beef or fish and dairy products) have all the essential amino acids and are known as ‘complete’ proteins (or ideal or high-quality protein).
• Soy products, quinoa and the seed of a leafy green called amaranth (consumed in Asia and the Mediterranean) also have all the essential amino acids.
• Plant proteins (beans, lentils, nuts and whole grains) usually lack at least one of the essential amino acids and are considered ‘incomplete’ proteins.

Majority of the foods we eat contribute some amounts of protein to our diet. Animal products have a higher protein content than fruits, vegetables and breads. Muscle meat is a good source of protein. Meat is rich in essential amino acids, particularly sulphur amino acids. Protein from meats, fish and poultry are more easily digested than protein from beans and wholewheat. Animal product from poultry, fish and low fat dairy were associated with a lower risk of heart disease reported by Nurses’ Health studies. Eating animal protein can help increase lean muscle mass and provide a reduction in the muscle loss that occurs with age.

People following a strict vegetarian or vegan diet need to choose a variety of protein sources from a combination of plant foods every day to make sure they get an adequate mix of essential amino acids. If you follow a vegetarian or vegan diet, as long as you eat a wide variety of foods, you can usually get the protein that is needed. For example, a meal containing cereals and legumes, such as baked beans on toast, provides all the essential amino acids found in a typical meat dish.

Function of Protein

Protein is needed by the body for growth and maintenance of tissues as well as the repair of tissues. For example, people recovering from an injury or surgery, older adults and athletes require more protein to assist the reparation of damaged tissues. Proteins are also needed to aid the thousands of biochemical reactions that take place within and outside of cells, such as digestive enzymes. Other than that, protein acts as a messenger as a hormone, which are effectively chemical messengers that communicate between cells, tissues, and organs. They are made and secreted by endocrine tissues or glands and then transported in a blood to their target tissues/organs, where they bind to protein receptors on the cell surface.

Protein also plays a vital role in regulating the concentrations of acids and bases in our blood and other bodily fluids. Proteins such as albumin and globulin regulate body processes to maintain fluid balance by attracting and retaining water. Proteins bolster immune health in the form of antibodies that help protect our body from harmful invaders like bacteria and viruses.

Finally, proteins also provide energy contributing to overall nutrition. However, the last thing a body wants to use for energy is protein because carbohydrates and fats are much better suited for providing energy and proteins have other major functions to perform.

FATS

Fats are the body’s primary mechanism for storing energy which is their main function. In addition, they do also help the body use some vitamins and keep the skin healthy.. There are four major dietary fats in the food;

1. Saturated fats
2. Transfats
3. Monounsaturated fats
4. Polyunsaturated fats

These four types have a different chemical structures and physical properties. The ‘body fats’, saturated and trans-fats, tend to be more solid at room temperature like a stick of butter, while the ‘good fats’ monounsaturated and polyunsaturated fats tend to be more liquid.  The saturated and trans-fats can raise bad cholesterol (low-density lipoprotein, LDL) levels in the blood. Bad cholesterol contributes to build up the fatty in arteries and narrows the arteries also increase the risk for heart attack and stroke. On the other hand, monounsaturated and polyunsaturated fats can lower bad cholesterol levels with the good cholesterol (High-density lipoprotein, HDL) which is help to carry away bad cholesterol from the arteries and back to the liver but good cholesterol does not completely eliminate the bad cholesterol only one-third to one – fourth of blood cholesterol will be carried.

Eating food with fat is definitely part of a healthy diet, however it is important to select foods that provide good fats in the monounsaturated and polyunsaturated groups and balance the amount of calories we eat from all other food against the calories we burn. Emphasize intake of vegetables, fruits and whole grains while including low-fat dairy products, poultry, fish, legumes, non-tropical vegetable oils and nuts. Limit the intake of sodium, sweet, sugar sweetened beverages and red meats.

Foods consisting of good fat in monounsaturated form are nuts (almonds, cashews, peanuts, pecans), vegetable oil (olive oil, peanut oil), butter (peanut, almond) and avocado. Meanwhile, polyunsaturated fats are contained the foods such as salmon, herring, sardines, trout, walnuts, chia seed and canola oil. Hence, food consisting of bad fat in saturated form are the fatty cuts of beef, pork and lamb, dark chicken meat and poultry skin, high fat dairy foods (whole milk, butter, cheese, sour cream, ice cream), tropical oils (coconut oil, palm oil, cocoa butter) and lard. The transfats are primarily contained in fried foods, margarine, baked goods (cookies, cakes, pastries) and processed snack foods (crackers, microwave popcorn).

Function of Fats

Fat tissue, also known as an adipose tissue, can provide insulation in which fat tissue helps to insulate body and keeps it warm when exposed to cold temperatures. Fat tissue also helps in protection of the organs, bones and other tissues by acting as a cushion. Other than that, fats help in energy storage because any unused energy (calories) will be stored in adipose tissue. Whenever the body goes through fasting, dieting or is unable to eat, our body releases the stored energy to maintain all of its important functions. Adipose tissue also helps in hormone production, for example adipose tissue releases leptin hormone which sends signals to stop eating.

VITAMINS AND MINERALS

Vitamins and minerals are considered essential nutrients because they perform hundreds of roles in the body. They help shore up bones, heal wounds and bolster your immune system. They also convert food into energy and repair cellular damage.

Vitamins and minerals are often called micronutrients because a body needs only tiny amounts of them. Yet, failing to get even those small quantities virtually guarantees disease. Here are a few examples of diseases that can result from vitamin deficiencies:

• Scurvy – Old-time sailors learned that living for months without fresh fruits or vegetables—the main sources of vitamin C—causes the bleeding gums and listlessness of scurvy.
• Blindness – In some developing countries, people still become blind from vitamin A deficiency.
• Rickets – A deficiency in vitamin D can cause rickets, a condition marked by soft, weak bones that can lead to skeletal deformities such as bowed legs. Partly to combat rickets, the U.S has fortified milk with Vitamin D since the 1930s.

Just as a lack of key micronutrients can cause substantial harm to your body, getting sufficient quantities can provide a substantial benefit. Some examples of these benefits:

• Strong bones – A combination of calcium, vitamin D, vitamin K, magnesium, and phosphorus protects your bones against fractures.
• Prevents birth defects – Taking folic acid supplements early in pregnancy helps prevent brain and spinal birth defects in offspring.
• Healthy teeth – The mineral fluoride not only helps bone formation but also keeps dental cavities from starting or worsening.

Difference between vitamins and minerals

Although they are all considered micronutrients, vitamins and minerals differ in basic ways and perform different roles in nutrition. Vitamins are organic and can be broken down by heat, air, or acid. Minerals are inorganic and retain their chemical structure.

The minerals in soil and water easily find their way into a body through the plants, fish, animals, and fluids we consume. However, it’s tougher to shuttle vitamins from food and other sources into a body. Mainly because cooking, storage, and even simple exposure to air can de-activate these more fragile compounds.

In addition, there is plenty of interaction between vitamins and minerals in the body; Vitamin D enables a body to pluck calcium from food sources passing through the digestive tract rather than harvesting it from a bone. Vitamin C helps a body to absorb iron. However, the interplay of micronutrients isn’t always cooperative, For example, vitamin C blocks your body’s ability to assimilate the essential mineral copper. And even a minor overload of the mineral manganese can worsen iron deficiency. Nonetheless, it is clear that the intake of both vitamins and minerals is key to our overall diet and nutrition.

Fat-soluble vitamins

Fat soluble vitamins are similar to oil and do not dissolve in water and are most abundant in high-fat foods. Thus, they are much better absorbed into the bloodstream when we eat them with fat. Fat soluble vitamins are:

• Vitamin A – is essential for maintaining the light sensing cells in the eyes and for the formation of tear fluid, immune function with increasing susceptibility to infections. It promotes body growth with help for cell growth and if deficient may slow or prevent growth in children. It is vital for hair growth and reproductive function with maintains fertility and vital for fetal development
• Vitamin D – also known as calciferol, and comes in two main dietary forms: Vitamin D2 (ergocalciferol): found in mushrooms, vitamin D3 (cholecalciferol): found in animal sourced foods such as eggs, fish oil and produced by skin when exposed to sunlight. Vitamin D helps to regulate the circulating levels of calcium and phosphorus which are the most important minerals for bone growth and maintenance. It also regulates and strengthens immune system function
• Vitamin E – Act as an antioxidant, preventing oxidative stress and protecting fatty acids in a cell membranes from free radicals, enhanced by other nutrients such as vitamin C, vitamin B3 and selenium. It also acts as a blood thinner, reducing blood’s ability to clot
• Vitamin K – Essential role in a blood clotting, supporting bone health and helping prevent the calcification of blood vessels and potentially reducing the risk of heart disease.

Water-soluble vitamins

Water-soluble vitamins (B and C) are of special importance to the body, and are packed into the watery portions of the foods you eat. They are absorbed directly into the bloodstream as food is broken down during digestion. Water-soluble vitamin (B vitamins) are:

• Biotin (Vitamin 7)
• Folic acid (folate, Vitamin 9)
• Niacin (vitamin B3)
• Pantothenic acid (vitamin B5
• Riboflavin (vitamin B2)
• Thiamin (vitamin B1)
• Vitamin B6
• Vitamin B12

Although water-soluble vitamins have many tasks in the body, one of the most important is helping to free the energy found in the food you eat. Others help keep tissues healthy. Here are some examples of how different vitamins help you maintain health:

• Release energy – Several B vitamins are key components of certain coenzymes (molecules that aid enzymes) that help release energy from food.
• Produce energy – Thiamin, riboflavin, niacin, pantothenic acid, and biotin engage in energy production.
• Build proteins and cells – Vitamins B6, B12, and folic acid metabolize amino acids (the building blocks of proteins) and help cells multiply.
• Make collagen – One of many roles played by vitamin C is to help make collagen, which knits together wounds, supports blood vessel walls, and forms a base for teeth and bones.

NUTRITION APPROACHES FOR INJURY MANAGEMENT AND HEALING

As part of our core services, Rehamed Therapy focuses on injury rehabilitation and management. In injury management, a goal of any treatment plan for acute injuries should be to manage properly the inflammatory process. During the early rehabilitation phase, we control or manage the swelling, reduce the pain and restore the range of motion to help in healing process and prevent the further injury. Physiotherapy plays a role to control and manage the inflammatory process, either by electrotherapy agent (ultrasound, TENS, MENS) or cold agent (Ice pack, cryo cuff) and restore the limitation range of motion by manual therapy and exercises. Not only that, nutrition also can help to control or manage the inflammatory process.

In the inflammatory phase, intake of dietary fats high in monounsaturated and omega-3-fats can act as an anti-inflammatory, while fats high in trans- or omega-6-fats are pro-inflammatory and would hamper the progress. Effectively, the ratio of omega-3 to omega-6 in the diet is important to keep inflammation under control.  Typically, a ratio of 3:1 to as low as 1:1 should be maintained to achieve a balanced inflammatory profile. Other than that, we can take herbs and spices likes curcumin from turmeric, garlic and bromelain from pineapple, also can eat cocoa, tea and berries extract and bioflavonoid supplements.

After the inflammatory phase we move to the proliferation and remodeling phase, combining physio- and sport-therapy more focused on a rehabilitation exercise program. During this phase, adequate calorie and micronutrient intake should be ensured. It is recommended to eat adequate protein which is minimally processed meats, legumes, eggs, plant-based protein and protein supplements. In addition, we should balance the dietary fat to only a third saturated fats. Other than that, during this phase a diverse mix of fruits and veggetables should be consumed while also a healthy level of carbohydrates is required to support the recovery process.

Vitamins and mineral are nutrients required in small amounts for metabolic reactions in the body during injury recovery. They can act as catalyst or can act as substrates in which they are directly metabolized themselves. Vitamin A, B and D as well as calcium, copper, iron magnesium, manganese and zinc can all play important roles and vitamin E should be avoided because may slow the healing process.

Athlete’s Approach to Nutrition

In an athlete, they should focus on improving their omega 3 to omega 6 ratio while adding in healthy monounsaturated fats and balancing out their saturated and polyunsaturated fats both during healthy competitive periods as well as during times of injury repair. They need to balance fat intake with increased intake of olive oil, mixed nuts, avocados, flax oil, ground flax and other seeds. Other than that, they also need balanced omega 6 – omega 3 rations, for example by adding 3-9g of fish oil each day to their diet while reducing omega 6 fats like vegetable oil (corn oil, sunflower oil, safflower oil, cottonseed oil and soybean oil).

To help athletes ensure adequate calories and macronutrient intake for both sport and injury recovery, it is recommended they eat every 2-4 hours, within which the protein of each meal should contain complete proteins including lean meats, lean dairy, eggs, or protein supplements. For vitamins and minerals, each meal should contain 1-2 servings of vegetables and fruit. Additional carbohydrates should come from whole grain, minimally processed sources like whole oats, yams, beans, whole grain rice but the athlete should eat fewer starches when not actively training (during injury recovery).

COMMON MISCONCEPTIONS ON NUTRITION

A typical assertion is that high protein or low carbohydrate diets and nutrition are a healthy way to lose weight. High-protein/low-carbohydrate diets are often low in calories because food choices are strictly limited, so they may cause short-term weight loss. But a reduced calorie eating plan that includes recommended amounts of carbohydrate, protein, and fat will also allow you to lose weight. By following a balanced eating plan, we will not have to stop eating whole classes of foods, such as whole grains, fruits, and vegetables and miss the key nutrients they contain. You may also find it easier to stick with a diet or eating plan that includes a greater variety of foods.

There is no need to avoid all fats when trying to be healthy or lose weight, as the good fats provide nutrition for the body. Other than that, some people say dairy products are fattening and unhealthy.  However, dairy products are an important food group because they have protein needed for a body to build muscles and help organs work well, and also contain calcium to strengthen bones. Choose fat free or low fat milk to reduce caloric intake. If you are lactose intolerant, choose other foods and beverages with calcium and vitamin D.

As a final tip, many people try to give up their favourite food because they want to lose weight. In fact, there is no need to give up the favourite group, the best way to lose weight is to keep track of the total caloric intake, eat the right types of nutrients (as explained above) and to burn more calories through exercise.

If you want to know more about what nutrition to put in your stomach, feel free to give us a call at 03-50315946 or send us a Whatsapp or Make an Appointment. We at Rehamed Therapy are always here to help!