Disorders That Can Compromise Health

When nutrients and energy are in short supply, cells, tissues, organs, and organ systems do not function properly. Unbalanced diets can cause diseases and, conversely, certain illnesses and diseases can cause an inadequate intake and absorption of nutrients, simulating the health consequences of an unbalanced diet. For examples, overeating highly caloric, nutrient-poor foods can lead to an increase in weight and exacerbate symptoms of gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS). There are some conditions such as celiac disease that interfere with the body’s ability to obtain its nutritional requirements. A host of other conditions such as food allergies, cancer, stomach ulcers, Crohn’s disease, and kidney and liver disease can also impair the process of digestion and/or negatively affect nutrient balance and decrease overall health. Some illnesses that can compromise health are chronic and persist for a long time, some are communicable and can be transmitted between people, and some are non-communicable and are not infectious.

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is a persistent form of acid reflux that occurs more than two times per week. Acid reflux occurs when the acidic contents of the stomach leak backward into the esophagus and cause irritation. The most common GERD symptom is heartburn, but people with GERD may also experience regurgitation (flow of the stomach’s acidic contents into the mouth), frequent coughing, chest discomfort, and trouble swallowing. It is estimated that GERD affects around 20% of adults and most commonly people that are overweight or obesity, pregnant, or those that smoke or have smoked.^[1]

GERD often develops when the lower esophageal sphincter that separates the stomach’s internal contents from the esophagus often may not function properly and allows acidic gastric contents to push upward. Certain foods and drinks may trigger symptoms in some people, including high-fat meals, alcohol, caffeine, chocolate, spicy foods, or acidic foods such as tomato-based products. Triggers vary widely from person to person, so not everyone with GERD needs to avoid the same foods.^[2]

The first approach to GERD treatment is dietary and lifestyle modifications. This includes reducing weight if you are overweight or obese, avoid foods that worsen GERD symptoms, eat smaller meals, stop smoking, and remain upright for at least three hours after a meal. People with GERD may not take in the nutrients they need because of the pain and discomfort associated with eating. As a result, GERD can be caused by an unbalanced diet and its symptoms can lead to a worsening of nutrient inadequacy, a vicious cycle that further compromises health. When nutritional and pharmaceutical treatment approaches do not work, surgery is an option.^[3]

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is characterized by muscle spasms in the colon that result in abdominal pain, bloating, constipation, and/or diarrhea. Interestingly, IBS produces no permanent structural damage to the large intestine as often happens to patients who have Crohn’s disease or inflammatory bowel disease. It is estimated that 10-15% of Americans display symptoms of IBS. The disorder is more prevalent in women than men. Factors contributing to IBS include genetics, antibiotic use, stress, inflammation, and changes in gut bacteria.

Symptoms of IBS can decrease a person’s quality of life, as it causes abdominal pain, diarrhea and/or constipation, and bloating. Large meals and foods high in fat and added sugars, or those that contain wheat, rye, barley, peppermint, and chocolate may intensify symptoms of IBS. Caffeine and alcohol may also worsen IBS. As with GERD, the first treatment approaches for IBS are diet and lifestyle modifications. Recommendations include adding soluble fiber to the diet, limiting dairy or gluten, avoiding sugar substitutes, and trying a low-FODMAP diet with the oversight of a dietitian. In addition to diet changes, regular exercise, stress management, adequate sleep, and good hydration can also help. ^[4]

Oral Disease

Oral health refers not only to healthy teeth and gums but also to the health of all the supporting tissues in the mouth, such as ligaments, nerves, jawbone, chewing muscles, and salivary glands. Per the Surgeon General, oral health is “inextricably linked to overall health and well-being.”^[5]

Diet plays a major role in oral health. Bacteria in the mouth feed on fermentable sugars from sources like soft drinks, sports drinks, energy drinks, fruit juices, candies, and desserts, and produce acids that can wear away enamel and lead to cavities. The acid can also damage the gums and may lead to gingivitis (characterized by inflamed and bleeding gums). Saliva is a natural “mouthwash” that neutralizes the acids and helps to prevent cavities.^[6]

Cavities are an epidemic health problem in the United States and are associated with poor diet, poor dental hygiene, and the inaccessibility to regular oral health care. According to the CDC, 46 percent of children ages 2 to 19 had untreated or restored cavities in one or more teeth between 2017 and 2020. This is not only an issue for children – in the aging population, missing teeth and poor oral health can affect the ability to properly chew and swallow foods and can be a driver of malnutrition. Consuming primarily water and unsweetened beverages, reducing processed added sugar consumption, and practicing regular oral hygiene throughout life will positively affect overall health long term.^[7]

Colon Health

A substantial health benefit of whole grains, fruits, vegetables, beans, and other high-fiber foods is that they actively support digestion and optimize colon health. Whole grains are especially rich in insoluble fiber that adds bulk to stool and helps foods move through the digestive tract more easily. Diets high in fiber are associated with a lower risk of constipationand may even reduce the risk of diverticulosisand diverticulitis.

Diverticulosis is a condition characterized by small pouches called diverticula that form in weak spots in the wall of the colon. Diverticulitis occurs when those small pouches become inflamed, causing lower abdominal pain, nausea, constipation or diarrhea, and sometimes fever or chills. According to the National Institute of Diabetes and Digestive and Kidney diseases, more than 30% of adults ages 50 to 59 and more than 70% of adults over age 80 have diverticulosis ^[8]. Less than 5 percent of those with diverticulosis will go on to develop diverticulitis ^[9].

The chances of developing diverticulosis can be reduced with fiber intake because of what the breakdown products of the fiber do for the colon. The bacterial breakdown of fiber in the large intestine releases short-chain fatty acids. These molecules have been found to nourish colonic cells, inhibit colonic inflammation, and stimulate the immune system, providing protection of the colon from harmful substances. Additionally, the bacterial indigestible fiber, mostly insoluble, increases stool bulk and softness increasing transit time in the large intestine and facilitating feces elimination. One phenomenon of consuming foods high in fiber is increased gas, since the byproducts of bacterial digestion of fiber are gases. For this reason, increasing fiber gradually and drinking enough fluids can help with this often-unpleasant side effect.

Many studies have found a link between high dietary-fiber intake and a decreased risk for colon cancer. ^[10] Researchers are still working out which types of fiber may be the most protective and how much is needed, but the overall message is clear that eating more fiber-rich plant foods supports colon health.

attributions

This section is an adaptation of “Nutrition, Health, and Disease” in Human Nutrition: 2020 Edition by University of Hawai‘i at Mānoa Food Science and Human Nutrition Program licensed under a Creative Commons Attribution 4.0 International License.