PHYTONUTRIENTS

Module 1: Aspects of Nutrition

Course 4
Presented by: Derek Strong, DC

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 Objectives

• Review the Phytochemical Classifications

• Highlight the most evidence-based phytonutrients
used for functional nutrition
• Review various food sources for selected
phytonutrients
• Outline the Functional Nutrition Operating Systems
• Discuss objective biomarkers for nutrition
evaluation
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 Aspects of Nutrition

Proteins
Fats/Oils
Carbohydrates
Minerals
Vitamins
Phytonutrients
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 Phytochemicals
Phytochemicals also known as Phytonutrients (phyto = plant) refers to the several thousands of
different, healthful, non-nutritive compounds in plants.
Natural compounds called phytonutrients or phytochemicals are components of plants that are
powerful defenders of health.
More than 25,000 phytonutrients are found in plant foods they have other benefits like changing
the structure and function of cells. In the human body, phytonutrients:

• Stimulate enzymes that help the body get rid of toxins

• Boost the immune system
• Improve cardiovascular health
• Promote healthy estrogen metabolism
• Stimulate the death of cancer cells

Heneman, Karrie; Zidenberg-Cherr, Sheri (2008). "Publication 8313: Phytochemicals" (PDF). University of California Cooperative Extension.

Halliwell B, Gutteridge JMC. Free Radicals in Biology and Medicine. 3rd ed. New York, NY: Oxford University Press; 1999.

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Phytochemical Classification

DNA Damage Protection and Induction of Repair by Dietary Phytochemicals and Cancer Prevention: What Do We Know? - Scientific Figure on ResearchGate.

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 Carotenoids
• Carotenoids are yellow, orange, and red pigments synthesized by plants. The most common
carotenoids are α-carotene, β-carotene, β-cryptoxanthin, lutein, zeaxanthin, and lycopene.
• Provitamin A carotenoids, α-carotene, β-carotene, and β-cryptoxanthin, can be converted by
the body to retinol (vitamin A).
• No vitamin A activity can be derived from lutein, zeaxanthin, and lycopene. Dietary lutein and
zeaxanthin are selectively taken up into the macula of the eye, where they absorb up to 90%
of blue light and help maintain optimal visual function.
• Nrf2-dependent antioxidant pathway - Some evidence suggests that carotenoids and/or their
metabolites may upregulate the expression of antioxidant and detoxifying enzymes via the
activation of (Nrf2) dependent pathway.

Kaulmann A, Bohn T. Carotenoids, inflammation, and oxidative stress--implications of cellular signaling pathways and relation to chronic disease prevention. Nutr
Res. 2014;34(11):907-929. (PubMed)

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 Food Sources of β-Carotene
Food Serving β-Carotene (mg)
Carrot juice,
1 cup (8 fl oz) 22.0
canned
Pumpkin, canned 1 cup 17.0
Spinach, frozen,
1 cup 13.8
cooked
Sweet potato,
1 medium 13.1
baked
Carrots, cooked 1 cup 13.0
Collards, frozen,
1 cup 11.6
cooked
Kale, frozen,
1 cup 11.5
cooked

US Department of Agriculture, Agricultural Research Service. USDA Nutrient Database for Standard Reference; Release 28. 2015.

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 Food Sources of Lycopene
Food Serving Lycopene (mg)
Tomato paste, canned 1 cup 75.4
Tomato purée, canned 1 cup 54.4
Tomato soup, canned,
1 cup 26.4
condensed
Vegetable juice cocktail, canned 1 cup 23.3
Tomato juice, canned 1 cup 22.0
Watermelon, raw 1 wedge 13.0
Tomatoes, raw 1 cup 4.6

US Department of Agriculture, Agricultural Research Service. USDA Nutrient Database for Standard Reference; Release 28. 2015.

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 Food Sources of Lutein + Zeaxanthin
Lutein + Zeaxanthin
Food Serving
(mg)
Spinach, frozen, cooked 1 cup 29.8
Kale, frozen, cooked 1 cup 25.6
Turnip greens, frozen, cooked 1 cup 19.5
Collards, frozen, cooked 1 cup 18.5
Dandelion greens, cooked 1 cup 9.6
Mustard greens, cooked 1 cup 8.3
Summer squash, cooked 1 cup 4.0

US Department of Agriculture, Agricultural Research Service. USDA Nutrient Database for Standard Reference; Release 28. 2015.

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 Organosulfur compounds (OSC)
OSC are widely present in our bodies and the natural environment. Theories have emerged that explain these
properties of OSC by their correction of redox-sensing and redox-signaling properties. OSC as nutraceutical agents not
only can serve as direct antioxidants trapping electrons but also can have non-antioxidant effects, such as:

• Antiplatelet

• Fibrinolytic

• Anti-inflammatory

• Immunomodulatory

• Antibacterial/antiviral

These properties of OSC are useful in the prophylaxis and treatment of various pathological states, such as:

• Cardiovascular diseases

• Cancer

• Neurodegenerative disorders

• Diabetes

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 OSC Food Sources

Allium genus - Garlic, onion, shallot, leek, and chives

Brassica genus - Cabbage, cauliflower, Brussels sprouts, and kale

Glucosinolates - Isothiocyanates (indole-3-carbinol, sulforaphane) - Horseradish,

mustard, radish, rutabaga, turnip, and watercress

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Diet components can suppress inflammation and reduce cancer risk - Scientific Figure on ResearchGate. Available from:
https://www.researchgate.net

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 Polyphenol - Curcumin

Extensive in vitro and in vivo studies suggest curcumin has anticancer, antiviral, anti-arthritic, anti-amyloid,
antioxidant, and anti-inflammatory properties.
The underlying mechanisms of these effects are diverse and appear to involve the regulation of various
molecular targets, including:
• Transcription factors (NF-κB)
• Growth factors (VEGF)
• Inflammatory cytokines (TNF, IL-1, IL-6)
• Protein kinases (mTOR, MAPK, Akt)

Kiuchi F, Goto Y, Sugimoto N, et al. Nematocidal activity of turmeric: synergistic action of curcuminoids. Chem Pharm Bull (Tokyo) 1993;41:1640–3. [PubMed:
8221978] Aggarwal BB, Harikumar KB.

Potential therapeutic effects of curcumin, the anti-inflammatory agent, against neurodegenerative, cardiovascular, pulmonary, metabolic, autoimmune and
neoplastic diseases. Int J Biochem Cell Biol 2009;41:40–59. [PubMed: 18662800]

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 Polyphenol - Lignans

Lignans are fiber-related phytonutrients that act as antioxidants and phytoestrogens,

or plant compounds with weak estrogen activity.
The benefits of lignans are that they are:
Anti-inflammatory
Promote healthy blood vessels
Anti-cancer agents

Critical Reviews in Clinical Laboratory Sciences, Lignans and Human Health, Adlercreutz 2007;44(5-6):483-525.

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 Polyphenol – Pterostilbene/Resveratrol

Resveratrol is a polyphenolic compound naturally found in peanuts, grapes,

red wine, and some berries.
In preclinical studies, resveratrol has been shown to possess numerous
biological activities, which could possibly be applied to the prevention and/or
treatment of cancer, cardiovascular disease, and neurodegenerative diseases.

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Prevention of Cardiovascular Disease: A Systematic Review - Scientific Figure on ResearchGate. Available from: https://www.researchgate.net/Structural-
skeleton-of-flavonoids-and-classification-hierarchy-of-common-flavonoids_fig1_7379974

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Panche, A., Diwan, A., & Chandra, S. (2016). Flavonoids: An overview. Journal of Nutritional Science, 5, E47. doi:10.1017/jns.2016.41
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Epigenetic Considerations

Shankar S, Kumar D, Srivastava RK. Epigenetic modifications by dietary phytochemicals: implications for personalized
nutrition. Pharmacol Ther. 2013;138(1):1-17. doi:10.1016/j.pharmthera.2012.11.002
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 Functional Nutrition

Functional Nutrition Operating

System

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 Functional Nutrition Operating System

In order to prescribe and personalize functional nutrition, the practitioner must have
information about each patient.
• Gather relevant information
• Organize patient data
• Begin patient treatment
• Track patient progress

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 Gather Subjective Information

Patient Medical and Nutrition History

• Chief Complaints & Symptoms
• Current & Past Conditions
• Diet Diary
• Medication Review
• Supplement Review

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 Gather Objective Information

Comprehensive Anthropometric Examination

Body Composition Assessment
• Height and Weight (BMI)
• Truncal Obesity Evaluation (WHR)
• Bioelectrical Impedance Analysis (BMR)

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 Gather Objective Information

Physical Exam
Vital Signs
• Temperature
• Pulse
• Respirations
• Blood Pressure
Nutrition Exam
Mouth, Mucosa and Skin
• Nails, tongue, and Hair
• Senses and Nerve Function
• Muscle Testing, AK

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 Standard Blood Chemistry

• HgA1c/Fasting Glucose/Fasting Insulin – to assess blood sugar status

• High-sensitivity C-reactive protein (abnormal > 1.0 mg/liter) — to assess
inflammation
• Fibrinogen (abnormal > 350 mg/deciliter) — to assess clotting risk and thick blood
• Lipoprotein (a) (abnormal > 30 nmol/L) — to assess treatable genetic cholesterol
marke
• Uric acid (abnormal > 7.0 mg/dl) — to assess gout risk caused by diet
• Liver function tests (elevated AST, ALT, GGT are abnormal) — to assess fatty liver
• Kidney function tests (BUN ( abnormal > 20 mg/dl), creatinine (abnormal< 1.2
mg/dl))

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 Lipoprotein (a)

This study included a total of 82 patients with type II diabetes, 18 to 65 years of age. Each patient
took either 1000 mg of standardized curcumin or a placebo for 12 weeks. Baseline lab testing
included serum triglycerides, total cholesterol, HDL-C, non-HDL-C, and lipoprotein(a). At the end
of the 12 weeks there was a significant reduction of serum lipoprotein(a) and an increase in HDL-
C concentrations only seen in the curcuminoid group. There were no significant changes in total
cholesterol, LDL-C, and triglycerides in either group.
This is an interesting study since the ability to influence lipoprotein(a) is very limited. Niacin is
one of the only natural agents that can significantly reduce lipoprotein(a); however, it is not
effective for everyone

Jurgelewicz, M. Study demonstrates an increase in HDL and lower lipoprotein(a) in type 2 diabetes patients with
this nutritional intervention. https://www.functionalmedicineuniversity.com/public/1265.cfm
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 Standard Blood Chemistry

• Microalbumin (abnormal > 20 mg/dl) — to assess protein in urine

• 25-OH vitamin D (abnormal < 45–60 ng/dl) — for vitamin D status
• Anti-Nuclear Antibodies ANA to assess autoimmunity
• Homocysteine (abnormal > 8.0 micromoles/liter) — a sensitive marker for folic acid
deficiency
• Ferritin (abnormal > 150 ng/ml) — to assess inflammation and iron status
• Thyroid hormones (TSH, free T3, free T4, TPO antibodies)
• Sex hormones (male and female) DHEAS, estradiol, progesterone, free
testosterone, and sex hormone binding globulin) — to assess sex hormones

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 Functional Lab Testing & Biomarkers

Vitamins/Minerals
Food sensitivities
Amino Acids
Urinary pH
Antioxidants
Adrenal Salivary Index
Carbohydrate/ Fatty Acids Metabolism
Metabolites
Microbiome Panels
SNP Panels
Toxicity and Pathogens

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 Organize Information

Make the proper diagnosis

Document Appropriately (SOAP)
Use appropriate tracking tools
Construct dietary gameplan

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 Provide Functional Nutrition Rx

Implement Foundational Food Plan

Phytonutrient Diversity
Focus on Whole Foods
Eat Clean & Organic
Adequate Quality Protein
Balanced Quality Fats
Low is Simple Sugars
High in Fiber?
Clean water

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 Provide Personalize Foodplan

Elimination Diet
Keto Diet
Cardiometabolic Diet
Detox Diet
Mediterranean Diet
Low FODMAP Diet

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 Provide Personal Dietary Recommendations

Target Calorie Range

Macronutrient Distribution
Meal Timing/Intermittent Fasting
Pace of Implementation

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 Prescribe Nutraceutical & Supplement Rx

Address clinical imbalances identified

Complements appropriate personalized food plan
Recommend a personalized strategy designed for success based
on each patients unique needs

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