Nutrition for Docs: Workshop learning objectives

The Canada Food Guide: Friend or Foe? In this session, the issues of dietary balance with proteins, fats and carbohydrates will be addressed in terms of the current epidemic of insulin resistance and diabesity, especially in terms of childhood obesity. High protein, moderate fat and balanced carbohydrate dietary approaches will be reviewed and recommendations made.
Learning Objective: At the end of this session, participants will have tools in hand to knowledgeably discuss the current dietary trends, pros and cons and tailor dietary approaches along with recommended resources for patients.

The Impact of Magnesium Deficiency on Pain Syndromes: Fibromyalgia, Myofascial Pain, and Migraine Magnesium deficiency is one of the most frequent electrolyte abnormalities in clinical practice and probably the most under-diagnosed. A considerable amount of research exists linking magnesium deficiency to pain syndromes such as fibromyalgia, myofacial pain and migraine. Since magnesium intake is thought to be marginal in North America, supplementation with magnesium to more optimal levels in such conditions would make sense. However, the accurate assessment of magnesium needs is difficult. Blood tests are unreliable. Only one per cent of whole body magnesium is in the blood and that is under tight homeostatic control - patients with normal plasma or red cell magnesium may actually be hypomagnesemic. This talk will focus on the assessment of magnesium needs using functional markers of magnesium deficiency.
Learning Objective: At the end of the talk participants will have a better understanding of the mechanisms whereby magnesium deficiency might contribute to pain syndromes and will be able to assess patient needs and monitor response to supplementation using a questionnaire-based approach.

Case Presentation To illustrate the practical application of assessing magnesium deficiency from history and titrating oral magnesium supplementation, a case where chronic pain and other symptoms related to Repetitive Strain Injury and Fibromyalgia improved with magnesium supplementation will be presented.

The Multi-Symptom Patient: Can Nutritional Strategies Help in Their Management? Patients who come with long lists of symptoms in different organ systems can strike a sense of dread into the busy family practitioner's day. Many of these polysystemic non-specific symptoms can often be classified under the rubric of "oxidation/inflammation". The good news is that treatment of these symptoms can often be ameliorated with a good lifestyle and nutritional assessment, together with therapeutic nutritional régimes that target the whole person as opposed to specific organs.
Learning Objective: In addition to some theoretical and biochemical models of oxidation/inflammation, participants will learn how to identify, classify, and treat these inflammatory states. The outcome is usually gratifying for both practitioner and patient.

Vitamins, Minerals and Other Nutritional Supplements - Canada Embarks on New Legislation Health Canada has established a new system to deal with vitamins, minerals, herbal products and other nutritional supplements. As of January 1, 2004, the Natural Health Products Regulations come into force and apply to all natural health products. The role of the Natural Health Products Directorate is to ensure that Canadians have ready access to natural health products that are safe, effective, and of high quality while respecting freedom of choice and philosophical and cultural diversity.
Learning Objective: Participants will be able to advise their patients regarding safety and health claims with respect to natural health products.

Irritable Bowel Syndrome, Bloating and Other Common GI Disorders - The Nutritional Approach A large percentage of patients visiting both gastrointestinal specialist's and family physician's offices have symptoms related to so-called "functional GI disorders". Often promoted as a psychosomatic illness Irritable Bowel Syndrome requires nutritional treatment. Intolerances to certain foods, excessive gas production, or bacterial overgrowth may contribute to this disorder in addition to stress and other triggering factors.
Learning Objective: An organized approach to the diagnosis and treatment of this condition will be presented together with suggestions for nutritional régimes aimed at normalizing gastrointestinal colonic bacterial balance.

The Low Fat Diet - Where Have We Gone Wrong? During this session, the latest research regarding fat content and types of fat in the diet will be reviewed, including information on the newly available essential fatty acid profiling offered by MDS labs.
Learning Objective: At the end of this session, participants will have a good understanding of fatty acid metabolism, it's importance in human physiology, and the practical applications of fatty acid balancing in the treatment of inflammatory conditions, including heart disease.

Evidence-based Opportunities for Use of Omega-3 Fatty Acids in Complementary Medicine Numerous intervention trials have indicated that fish oil supplements/concentrates enriched in EPA/DHA can favorably influence several risk factors for cardiovascular disease including reductions in fasting triglyceride levels, lowering of the triglyceride:HDL-cholesterol ratio, reduce blood viscosity, reduction in blood platelet reactivity and other thrombogenic risk factors, plus effects on other nonconventional risk factors which are not routinely measured in the public health care system. The latter include a favorable influence of omega-3 fatty acid intakes (as EPA/DHA) on postprandial lipemia, heart rate variability, arterial compliance as well as anti-arrhythmic affects. The GISSI-Prevenzione Study has reported that, over and above the clinical use of appropriate pharmaceutical therapeutics plus a Mediterranean-type diet including some fish, supplementation with 900 mg/day of EPA/DHA (omega-3) could reduce sudden cardiac death by approximately 45% in patients having experienced a prior myocardial infarction.
Learning Objective: Following this lecture, the informed practitioner can expect to offer both alternative as well as complementary options for preventive and management strategies for patients.

Controversy: Vitamin E and Heart Disease - Two Major Studies; One Common Flaw Despite the widespread use of vitamin E by heart patients, two recent trials - the British Heart Protection Study and the Women's Angiographic Vitamin and Estrogen Study (WAVE) failed to show a benefit, and one apparently showed an adverse effect. In this talk both studies are reviewed, and possible flaws in their design are considered. The studies are then used as a jumping off point for a general discussion of confounding factors in clinical trials of vitamins.
Learning Objective: At the end of this session, participants will be better able to advise patients on the different types of vitamin E, and to evaluate critically these and future studies of vitamin E safety and efficacy.

Vitamin D Deficiency - Public Health Emergency In this session, Dr. Vieth will explain the biology of vitamin D from the perspective of human evolution, and why an endemic lack of vitamin D may be the mechanism by which many diseases correlate with latitude (breast and prostate cancer, hypertension, Type I diabetes, multiple sclerosis); review the toxicology of vitamin D and present evidence for the safety of physiologically meaningful doses; discuss the clinical and epidemiologic evidence for health effects of vitamin D nutrition beyond osteoporosis.
Learning Objective: At the end of the session participants will understand the new safe levels for Vitamin D and the evidence for prescribing higher levels for all Canadians.