Dr Christine Houghton
PhD, B.Sc.(Biochem.), Grad.Dip.Hum.Nutr., R.Nutr.
Opening Address – Revelations of 21st Century Nutrition Science
Saturday 04 | 8:40am
Having traversed several decades as a clinician, nutritional biochemist, researcher and educator, I have observed extraordinary changes in the knowledge base and practice of nutrition-based medicine. The completion of the Human Genome Project in the early 2000s catalysed a veritable explosion of information that linked food science to changes in the expression of our genes; the notion that food could ‘talk to our genes’ was captured within the nutrition sub-specialty, nutrigenomics.
The rapid evolution of nutrition science in the ensuing 20 years has revealed much new information about the function of human cells and how clinicians can appropriately target the upstream cellular mechanisms that drive much of our downstream biochemistry. Our growing ability to identify the gene polymorphisms that govern upstream cellular processes has unveiled strategies capable of streamlining and fast-tracking patient recovery. What becomes increasingly evident in 21st century nutrition science is that food is so much more than its macro- and micro-nutrients. Its array of potent non-nutrient signalling molecules has become an effective tool in activating the expression of cell-protective genes.
Over the following two days, our faculty of international and local speakers will present evidence that integrates with our existing knowledge base, highlighting novel, clinically-relevant aspects of food. Drawing from the diverse disciplines of our experts, the symposium programme encompasses multiple aspects of food - from its soil origins to its inter-connectedness with the gut ecosystem, its influence on the underlying immune network and subsequently its impact on the entire human physiology.
A key focus of this symposium lies in highlighting the remarkable properties of wholesome, nutritious food in restoring and maintaining human health.
Modulating the Biochemical ‘Orchestra’ We Call Inflammation
Sunday 05 | 9:10am
The process of inflammation is a key defensive mechanism for protecting human cells against injury and pathogens. It is well-established that uncontrolled inflammation is a major factor underpinning chronic disease. An intricate and complex array of inbuilt self-regulating immune mechanisms operates to ensure that healthy cells remain in homeostasis.
Whilst several of these mechanisms and their relevant therapies are familiar to clinicians, others are less well-known. Even so, these newer mechanisms are well-enough understood that nutrition-focused therapies can be used to favourably modulate these processes.
Aberrant cellular functions that generate uncontrolled inflammatory cytokines and related molecules are closely associated with other core upstream processes that include redox imbalance, compromised mitochondrial ATP synthesis, defective Phase 2 detoxification and impaired methylation.
This presentation aims to outline the many other specific contributors to the process of inflammation, highlighting those mechanisms that can be readily influenced by the clinician. In so doing, we reveal the roles not only of enzymes like COX-2 and the familiar transcription factor Nf-kB but also of other elements such as the inflammasomes, resolvins, autophagy, T cells, endotoxins, short-chain fatty acids, itaconate, a dysfunctional gut barrier and elevated sodium; for each of these, there is a nutritional solution. Combining them into one over-arching approach to managing uncontrolled inflammation provides an effective multi-armed strategy.
In doing so, we reference clinical trial data where measured quantities of plant foods can significantly downregulate biomarkers of inflammation such as CRP, TNF-α and IL-6 in specific chronic diseases. In other cases, supplements of concentrated food bioactives have demonstrated significant clinical benefit across a broad range of inflammation-based disorders including cardiometabolic, digestive, neuropsychiatric and neurodegenerative diseases. We also identify examples where manipulation of macronutrient proportions and meal timing is sufficient to modulate the process.
Dr Yael Joffe
RD, PhD, FACN
The Chicken and the Egg: Bringing together the Worlds of Genetics and Epigenetics
Saturday 04 | 1:50pm
It is a mere two decades since clinicians were made aware that a snapshot of an individual’s biochemical individuality could be readily accessed through genetic testing. Such a technique records some of the many single nucleotide polymorphisms (SNPs) each of us carries. When these SNPs are grouped by functional category, a clinician can discern a good deal about the patient’s ability or inability to prevent, repair or recover – or even the patient’s predisposition to certain types of cellular dysfunction and related disease.
Fast forward 20 years in this field and it becomes apparent that there is a great deal of discussion within the profession about the value of genetics versus epigenetics and the comparative value of one against the other. Which is the proverbial chicken and which is the egg?
This presentation will define the differences, highlighting how we can gain insight into why an understanding of both is necessary for us to meaningfully bring personalised nutrition into clinical practice. Clinicians can now access both types of test, thereby raising a number of concerns surrounding relevance and reliability of the resulting data; we do present some solutions. A case study case that includes interpretation of both genetic and epigenetic findings helps to put this into a clinical context. Because there are many bringing polarity to these two subcategories of genetics, this presentation aims to show the value of considering them together in a manner that can further contribute to personalised recommendations.
‘Genes First’: Genetics as a Screening Tool
Sunday 05 | 2:00pm
By acknowledging that a genetic test provides a snapshot of each patient or client’s biochemical individuality, a clinician has a valuable starting point for every new consultation. For clinicians utilising genetic testing for the first time and with access to so much information, the task can be daunting. Addressing the task systematically can remove the feeling of overwhelm often experienced by both clinician and patient. This presentation outlines an approach that can streamline the process; it also provides a foundation for analysis of the case and subsequent development of the appropriate treatment plan.
In offering genetic testing to our patients, it is imperative that we have a clear understanding of WHY and HOW genetics adds value to clinical practice. By adopting a ‘genes first’ philosophy, genetics can be considered a useful screening tool.
One of the most useful roles for such a screening test is to arm the clinician with a means of anticipating an expected timeline for recovery of the patient’s presenting complaints. From the patient’s perspective, the clinician’s ability to offer a realistic expectation of the time needed for recovery is very valuable information.
In this presentation, we review the five pillars that constitute a ‘genes first’ approach. These pillars can be practically represented as: a.) Know where to start b.) You don’t know what you don’t know, c.) Personalised Diet and Lifestyle Recommendations d.) Precision Functional Testing, e.) Targeted recommendations using specific foods and supplementation. In the second half of the presentation, we will use case studies to work through each of the five pillars, resulting in a personalised treatment plan.
Ms. Amanda Archibald
BA (Hons), BSc.,RD
The Mediterranean and Its Diet Through the Lens of Nutrigenomics
Saturday 04 | 9:30am
Few areas of the world have been subjected to such nutrition science scrutiny as The Mediterranean. Idyllic beaches, ancient piazzas, chateaus and perfect food platters adorn our minds while infinite studies fill our paper and digital science libraries. The intensity of research often mirrors similar conclusions: lower incidence of cardiovascular disease; lower incidence of cognitive decline and dementia. But what if we remove the traditional (epidemiological) approach to studying the “Mediterranean effect,” and replace with an investigation through the scientific lens of nutrigenomics and the nutritional biochemistry it influences? Would this approach yield a more concrete understanding of the molecular business of cells which substantiate the observations associated with the Mediterranean.
This presentation examines this culturally diverse world region through the lens of nutrigenomics and culinary genomics with a small side of human social genomics. We’ll peer deeply into not only how ingredients that are indigenous to the Mediterranean are transformed into some of the most recognized and loved food from this world area but why their unique combinations dish up some of the best food-gene crosstalk in the world. From here we will connect the dots from the food to the health outcomes for which the Mediterranean is so renowned.
From the Cicoria of Italy to the Horta of Greece to the Za’atar of the Eastern Mediterranean and Middle East, take a seat at a table where Mediterranean ingredients provide some of the best Return On Ingestion for our genes. From this table, take home simple ingredient and recipe insights to help your patients understand how to take nourishment to the nutrigenomic level.
Culinary Genomics: Translating Nutrigenomic “Therapy” to the Plate
Sunday 05 | 3:25pm
Food contains information in a matrix, designed by nature, to efficiently fuel the biochemical machinery that supports human life. There are no nutrient extremes in nature which should be reflected in what transitions from the plate and into our stomachs. As clinicians, our job is to rebalance and refuel the disrupted biochemistry of each of our patients. While it is easy to plug and play with supplements for an interim fix, food is the medium to achieve sustainable homeostasis. But have we forgotten how to use food to restore biochemical balance? Afterall, we are one interlinked biochemical circuit which is easily disrupted if when we pour nutrients into one pathway without considering the next.
In this short session, we’ll visited a disrupted biochemical pathway and discuss how to strategically think through the nutrient decision steps to arrive at a nutrient intervention plan. From here we’ll connect the dots from nutrients to ingredients to culinary translation. We’ll consider nutrigenomic principles and combine them with culinary thinking to understand culinary genomics in action.
This session will provide you with a simple Culinary Planning Framework which you can customize to your practice using your recipes and meal ideas for your patients.
Dr Leland Stillman
Ironic Realities of Iron and Iron-Overload
Saturday 04 | 2:40pm
Iron is an essential nutrient. Iron is essential for mitochondrial function and transport of both oxygen and carbon dioxide around the body. Yet iron is also the chief source of oxidative stress within the body. Iron overload is a condition that occurs when the body absorbs too much iron, leading to a build-up of iron in the organs and tissues. While iron is an essential nutrient for the body, excessive amounts can cause significant harm to the body's organs and tissues, including the liver, heart, and pancreas.
Iron-overload is known as hereditary hemochromatosis and is caused by mutations to the HFE gene. While homozygosity for these mutations is uncommon (1 in 300 to 500, depending on the population), iron-overload syndromes due to heterozygosity or due to hemoglobinopathies, such as thalassemias, are common. Heterozygosity for the two most common genetic mutations predisposing to hemochromatosis are between 5 and 13% in the United States. Emerging literature has demonstrated that iron depletion through therapeutic phlebotomy may reduce the risk of stroke, heart attack, and all-cause mortality. There is mechanistic data suggesting that iron-overload is contributing to rising rates of autoimmunity, cancer, and neurodegenerative diseases.
In this presentation, we will explore the dangers of iron overload and the impact it has on overall health. We will discuss the causes of iron overload, including genetic disorders such as hemochromatosis, as well as dietary factors and environmental exposures. We will discuss what optimal iron intake is and when supplementation is appropriate.
We will also examine the symptoms and potential complications of iron overload, including liver disease, diabetes, and heart failure. Additionally, we will discuss the importance of early detection and treatment of iron overload to prevent irreversible damage. We will specifically discuss the applications of therapeutic phlebotomy, including risks, benefits, and relative and absolute contraindications.
Dr Brad Leech
PhD (UTS), BHSc Nut Med (Hons. Class I) (Endeavour), Adv Dip Ayur.
Functional Dysbiosis: The Food as Medicine Approach
Saturday 04 | 11:50am
Functional dysbiosis is characterised by an imbalance or dysfunction of the microbial ecosystem in the gut, resulting in metabolites that fall outside the healthy range. While dysbiosis is a commonly used term, it does not provide context to the specific health and function of each person's microbiome, as the combination of species present in the gut is unique to each individual. Therefore, to effectively treat functional dysbiosis, a comprehensive assessment of microbial metabolites is necessary.
In the past, antimicrobial herbs have been used to treat dysbiosis. However, with the advancement of microbiome sequencing technology, this approach has shown these interventions to be inferior to other food-based compounds. Supporting the microbial ecosystem with whole foods, targeted prebiotics and foods rich in polyphenols can effectively treat functional dysbiosis by restoring a healthy balance of functions in the gut microbiome. Each type of functional dysbiosis is unique and requires a personalised treatment strategy.
Clinicians should follow the A.I.M approach, which involves assessing the microbiome, implementing personalised treatments, and monitoring progress. By taking a personalised, targeted approach to treating functional dysbiosis, patients can experience significant improvements in their gut health and overall wellbeing. Targeted food-as-medicine interventions for the microbiome require a deep understanding of microbial metabolites and their impact on health. By identifying which microbial metabolites are outside the healthy range, clinicians can develop personalised treatment plans that address the specific imbalances present in the gut microbiome. Prebiotics and polyphenols have been shown to be effective in restoring a healthy balance of functions in the gut microbiome by selectively promoting the growth of beneficial bacteria and suppressing harmful bacteria.
Dr Tim Ewer
MB ChB, MMedSc, MRCP(UK), FRACP, FRNZCGP, FACNEM, Dip Occ Med, DCH, DRCOG
An Integrative Approach to the Prevention and Treatment of Cancer and Neurodegenerative Disorders
Sunday 05 | 11:40am
There is a growing evidence base for using nutritional, lifestyle and environmental components in both the prevention and management of cancer and certain neurodegenerative conditions.
In this presentation, I will begin with a general overview of our current understanding about the factors that can increase the likelihood of these diseases and then go on to look at some specific diet and nutritional options for the supportive care of cancer and two specific neurodegenerative processes, Dementia and Parkinson’s Disease.
It has been estimated that 30–40 percent of all cancers can be prevented by lifestyle and dietary measures alone. Obesity, nutrient-sparse foods such as concentrated sugars and refined flour products, low fibre intake, consumption of red meat, alcohol, and an imbalance of omega-3 and omega-6 fats all contribute to excess cancer risk. Reductions of 60 percent in breast cancer rates have already been seen in human diet studies, and a 71 percent reduction in colon cancer for men.
There is strong evidence that some foods increase the risk of Alzheimer's disease (AD) and other types of dementia, while specific diets, exercise and smoking avoidance play a role in reducing the risk. In addition, there is growing evidence of the beneficial effect of certain nutrients on the course of AD.
Parkinson's disease (PD) is the second most prevalent neurodegenerative disease in ageing individuals and, while there are environmental factors involved with many of the cases of PD, it is important to understand the role that nutrition plays in both neuroprotection and neurodegeneration.
Dr David Montgomery
Ms. Anne Biklé
BA.(Biol.), MLA. (Environ. Plan.)
What Your Food Ate - Restoring Health to the Land and People
Saturday 04 | 10:55am (Pre-recorded)
Soil health is a relatively new concept in agriculture that sheds light on the pathways and mechanisms by which agricultural practices affect the diversity, abundance, and balance of nutrients in the human diet linked to the onset of diet-related chronic diseases. Although agriculture and medicine are two of humanity's oldest and greatest endeavors, neither has seized on the potential of soil health to deliver their common goal — a stable, nutritious food supply to support lifelong health for all people.
In general, higher levels of organic matter levels and well-functioning soil microbiomes confer better soil health, which in turn leads to provisioning of health-imbuing compounds (i.e., phytochemicals, trace minerals, and beneficial microbial metabolites) to crops and thus people. The most health-favorable meat and dairy foods are linked to fat and phytochemical profiles from ruminant livestock that consume leafy, living plants growing in healthy soils.
Every farming system (e.g., conventional, organic, or biodynamic) has the potential to adopt practices that build, maintain, and safeguard soil health. Although implementing such practices varies from farm to farm, the principles of soil health apply everywhere and include minimal soil disturbance, year-round plant cover, diverse crop rotations, and integrating animals back onto farms.
Given the global extent of poor soil health and the decades-long rising incidence of diet-related chronic diseases, the time is ripe to invoke strategies and approaches that simultaneously restore the ecological processes that underpin the health of the land and the biology of the human body.
Dr J. Helen Fitton
Seaweed Science, Dietary Studies and Clinical Potential
Sunday 05 | 12:30pm
As the world comes to terms with climate change there is a new focus on seaweed and ‘bioactive’ extracts to create resilience in food systems. Rather than referring to a collective ‘seaweed’, it is better to consider each harvest as a separate source. Macroalgae are classified into three groups; brown, red and green seaweeds. This presentation will clarify which are included in diets, traditional medicines and supplements, what to look for and what to avoid. This will include an overview of proteins, polysaccharides, bioactives and micronutrients and their clinical relevance.
Green seaweeds have been underappreciated as a source of nutrients and bioactives. Cultivation of a unique strain of an Australian green seaweed, captures CO2 and nutrients from an ethanol fermentation. This fast-growing crop is made into a nutrient rich food and supplements. The polysaccharide or ‘glycan’ part of the seaweed (known as SXRG84) has been clinically tested for its effects on inflammation, serum lipids, gut microbiome and inflammatory skin conditions in over-weight middle aged subjects. This demographic may particularly benefit from a reduction in the low-level chronic inflammation that drives other pathologies.
Ingestion of SXRG84 significantly reduced inflammatory cytokines, improved serum lipids and modulated the gut ecosystem. Some participants saw improvements in skin conditions. The outcomes of these recent clinical trials and striking case studies will be discussed, with a view to clinical utility.
Dr Joanna McMillan
PhD, BSc. (Hons1) Nutrition Science
The Science & Benefits of Extra Virgin Olive Oil
Sunday 05 | 9:55am
There has long been interest in the Mediterranean Diet, with evidence continuing to build to show it to be one of the healthiest eating patterns in the world. There are several aspects of the diet that likely contribute to this, with recent evidence pointing towards the ubiquitous use of extra virgin olive oil (EVOO) as being a key driver of the health benefits.
EVOO stands out for several reasons. It has a healthy fatty acid profile, with the monounsaturated fat oleic acid dominating. This is a very stable fat, not prone to oxidation, both in the oil and once in the body. The major difference however with other fats and oils is that EVOO contains a rich array of polyphenols, including phenolic acids, flavonoids, lignans, secoiridoids and phenolic alcohols, along with compounds including vitamin E, squalene and phytosterols.
Collectively this rich mix of phytochemicals and healthy fats have been shown to benefit heart, brain, liver, vascular and gut health, while improving blood glucose control, insulin sensitivity, blood cholesterol profiles, blood pressure, appetite and weight control. Optimal benefits are seen at an intake of three tablespoons a day.
Ms. Jenny Blondel
N.D, Dip BM, Dip Nut, Dip Hom, Dip BRT
How to Build a Successful Practice with a Food-First Approach
Sunday 05 | 2:00pm
It is not uncommon for clinicians in nutritional medicine to be greeted by a patient who has brought a shopping bag full of supplements, having received little or no guidance around making the food choices needed to sustain health over time.
One objective of this presentation is to provide patient-tailored practical advice designed to help them understand why implementing a food-first approach should ideally underpin both preventive and therapeutic treatment programmes.
Even though clinicians are becoming much better informed about the role of nutrigenomics (the role of nutrition in influencing the expression of our genes), introducing the concept to patients is considerably more difficult. A key focus of an experienced clinician is the ability to translate and simplify complex science so that the patient confidently understands the goal of an approach that selects foods for their ability to influence gene expression. Such advice must be quite specific, gradually guiding the patient through a series of consultations, not only in the selection of foods but also in their appropriate preparation.
A second objective of this presentation is to outline management strategies that enable a clinician to leverage his or her time so that the practice can grow and expand whilst still providing patients with the required level of care.
As an over-arching principle, the clinician should be mindful of the ‘nocebo’ effect, that is, the power of our words to keep patients positive, motivated, and ultimately compliant with adopting what may be a very different approach to their healing.
Dr Natessa Henville
BSc., M.Chiro, DACNB, DACCP
When the Plumbing’s the Problem - Manual Therapy Approaches to Gastrointestinal Dysfunction
Saturday 04 | 4:05pm
Many patients suffering with disorders of the gastro-intestinal tract present with symptoms of pain or problems with motility. Typically, within the allopathic model these patients will be prescribed drug X or Y. Alternative food-based interventions are growing in popularity and gaining increased scientific validation. Unfortunately, when food-based interventions are ineffective, it is usually assumed to be because they are less potent than pharmaceuticals and the patient is redirected to drug X or Y. That may not always be the correct approach.
The gastro-intestinal tract is the only organ system to have evolved with its own discrete nervous system. In humans, the enteric nervous system has approximately five hundred million neurons. The sensory receptors of which can be very broadly divided into mechanoreceptors and chemoreceptors. Mechanoreceptors far outnumber chemoreceptors. Some authors claiming up to 92% of all enteric receptors are mechanoreceptors. This underlines the fact that whilst the purpose of the gastrointestinal tract is, in simple terms, the ingestion and digestion of food in order to obtain the energy and nutrients essential for life and the excretion of waste, it is in essence a mechanical or motor system. Being a motor system, the gastro-intestinal tract can be subject to motor dysfunction.
This session will address three common mechanical presentations of gastrointestinal dysfunction and distress, will describe when to include them in a differential diagnosis and most importantly, will demonstrate safe and effective manual therapy techniques to treat them.