Nutritional medicine is an interdisciplinary subject of modern medicine. Especially in today’s politics, in the sense of prevention to relieve the health care system in Germany, nutritional medicine is one of the top disciplines discussed. Hippocrates already expressed his thoughts and opinion about the connection between disease and nutrition or health and diet: “The causes of disease are directly due to internal difficulties or indirectly to external influences such as climate, hygiene, diet, physical activity and environment.” The term nutritional medicine is defined as follows: “Nutritional medicine is the science of the influence of nutrition on the functional state of the healthy and diseased human organism, as well as the influence of diseases on food requirements, intake and utilization.”
Nutritional medicine deals with all forms of nutrition, which means that it deals with both natural, physiological nutrition and the artificial supply of nutrients (oral – via the mouth; enteral – via the gastrointestinal tract; parenteral – bypassing the gastrointestinal tract, e.g. venous). For this reason, it must be distinguished from dietetics, which does not deal with artificial nutrition.
The procedure
The field of nutritional medicine includes the cure, the alleviation as well as the prevention of nutrition-dependent diseases, disease-associated malnutrition or overnutrition and metabolic diseases. This is very important especially in an affluent society as it is mainly found in the western world. The increasing proportion of people who have a BMI of over 30 (BMI – so-called body mass index; this is calculated from the body weight [kg] divided by the square of the body size [m2]. The formula is: BMI = body weight: (height in m)2. The unit of BMI is therefore kg/m2; BMI is used to assess overweight or underweight) inevitably leads to the necessary discussion of this aspect of medicine. Here, nutritional prophylaxis is of particular importance. In order to cope with these and other nutritional medical tasks, it is necessary to act in an interdisciplinary manner. The following disciplines are part of nutritional medicine:
- Nutritional science
- Epidemiology
- Biochemistry
- Molecular Biology
- Ecology
- Economy
- Sociology/Psychology
Nutritional factors such as lack of exercise and high-fat or high-calorie diets are causing an increase in noncommunicable chronic diseases. The treatment of these clinical pictures is the task of nutritional medicine. These include, but are not limited to, the following diseases:
- Cause: nutrient oversupply (excess macronutrients):
- Obesity (overweight; obesity).
- Arterial hypertension (high blood pressure)
- Cholelithiasis (gallstones)
- Degenerative skeletal diseases
- Diabetes mellitus type 2 (diabetes)
- Dyslipoproteinemia – disproportion of lipoproteins (transport proteins for fatty acids and cholesterol such as HDL and LDL) in the serum or hyperlipoproteinemia (lipid metabolism disorders).
- Cardiovascular disease – e.g. coronary heart disease (CHD) or myocardial infarction (heart attack).
- Hyperuricemia (gout) – metabolic disorder characterized by a rise in uric acid in the blood, which can lead to painful crystallization in the joints.
- Dental caries
- Cause: nutrient deficiency (macro or micronutrient deficiency / nutrient or vital substance deficiency):
- Iron deficiency anemia – due to a lack of iron, which is needed for the synthesis of hemoglobin (red blood pigment), anemia (anemia) occurs.
- Beriberi – disease caused by vitamin B1 deficiency.
- Marasmus, Kwashiorkor – protein-energy deficiency syndromes.
- Osteoporosis (bone loss)
- Scurvy – this disease is caused by vitamin C deficiency and disrupts collagen synthesis.
- Goiter – swelling or enlargement of the entire thyroid gland.
- Other causes:
- Alcoholism
- Intoxications (poisonings)
- Food infections
- Food allergy
In Germany, licensed physicians can obtain a certificate with the designation “Ernährungsmediziner/DAEM/DGEM” (DAEM – German Academy of Nutritional Medicine; DGEM – German Society of Nutritional Medicine) through continuing education. Nutritional Medicine Objectives:
- Primary prevention – nutritional prophylaxis or prevention, ie maintenance of health.
- Secondary prevention – nutrition therapy, ie restoration of health.
- Tertiary prevention – alleviation of disease.
Nutritional medicine is a comprehensive, multifaceted field and deserves the utmost attention, since the prevention of many diseases, in particular, should be sought in the field of this discipline.
