In a world where there are so many influences upon our health, and so many diets to perfect our health, and so many supplements to promise us health, many of our patients and clients really just want to know, “Where should I invest the most time, money or effort?” I understand. The amount of information and options is overwhelming. The contradictions in information are mind boggling. And the resources we each have are usually limited. Because I have a background of working one on one with nutrition counseling, and because I also educate in health food stores where a health advisor may only have a few minutes to get their point across, I’ve learned to refine my answer down to three basic components.
First off, let’s clarify that we are not talking about a person who has a broken arm, a sprained ankle, or a fresh concussion (or any other acute injury or infection). The most common health concerns we see as practitioners are chronic, and sometimes complex, issues that often originate in a way of which the patient may not even have been aware. These chronic health issues, and the prevention of them, are really the focus for this Trifecta for Health. And we will address both the aspects of health on which to focus with diet and lifestyle changes, as well as supplementation that can support the angles of this equilateral triangle.
Each of the angles of this equilateral triangle represent an aspect of natural living that most of us no longer access. In each of us our microbiome is informed by the world in which we live, and our environment in the modern Western world today is far more sterile and lacking in microbial diversity than that of our ancestors. I always say that if you do not grow your own garden, have dirt under your fingernails, eat from your garden without scrubbing your produce in chlorinated and fluoridated water, and/or raise livestock, then you need a supplement of soil-based organisms like Bacillus subtilis, coagulans, lichenformis and Lactobacillus plantarum. If you don’t ferment your own kefir, yogurt, buttermilk, sauerkraut, kimchee or other cultured foods on your counter at home, then you need a supplement that includes organisms that come from these foods and fuels your innate microbiome. If you don’t eat a diet rich in vegetable fibers and resistant starches, then you need a supplement that will provide the fermentation medium (like a compost) for your internal garden—your microbiome. Not only is this so important for overall digestive health and being able to absorb nutrients, it also is critical for a powerful and balanced immune response. We now know that those raised on farms or with family pets tend to have less allergies or autoimmune symptoms. Their immune systems seem to be better educated about what is self, and what is non-self.
Now on to the endocannabinoid system (ECS). We all have one, and it may or may not be relevant to the cannabis species of herbs. Cannabis just happens to be the source of the plant compounds used to map and study receptors in this system that already exists in all humans, and in many other organisms. Thus the system and its receptors and enzymes owe their identity to the cannabis plants. Technically, they could have discovered it using echinacea, kava kava, cacao and many other herbals. But the cannabis herbs are the most potent source of phytocannabinoids, similar to the way opium poppy derivatives were used to probe the opiate receptors, and tobacco derivatives were used to probe the nicotinic receptors.
While both high CBD (cannabidiol) and high THC (tetrahydrocannabinol) cannabis, with their host of complimentary phytocannabinoids, can support our ECS’s functioning, many lifestyle habits also create a positive feedback within the system. Examples are adequate time and depth when sleeping, exercise, a whole-food diet rich in EFAs (essential fatty acids) and low in sugar and refined foods, relaxation techniques, community belonging, a sense of purpose and adequate sunshine. Sounds like a regular prescription for good health, right? This makes sense, though, knowing that the ECS is a master regulator for the nervous, endocrine and immune systems, and plays an important role in other physiological systems as well.
When a person is in too much pain to exercise, too anxious or stressed to leave the house and be social, too exhausted and inflamed to shop or cook healthy foods, and too depressed to even sit out in the sunshine, medical cannabis rich in CBD or THC and other cannabinoids can be very important supplements. I put D3 into this category as well for supplementation, because in our modern Western world most everyone is deficient in D3 either because they do not get adequate sun exposure (without sunscreen or protective clothing) or they are not properly metabolizing D3 due to other deficiencies and illnesses. D3 is implicated in or associated with practically every chronic inflammatory disease state we know of, as well as things like sleep disorders and depression. While D3 cannot replace everything that the sunshine does for our ECS, it certainly helps in both the endocrine and the immune system functioning. We can also support a person’s ECS with supplements for better sleep, stress management, weight management, cognitive functioning through BDNF (brain derived neurotrophic factor) enhancement, and even mild detoxification.
At the apex of this equilateral triangle I include omega-3 fats, from oily fish and even algae. There is not just one system they support, but nearly every one of us does not get enough through diet alone. They are foundational to balanced health. And, it turns out, they are precursors to many crucial compounds, including endocannabinoids and specialized pro-resolving mediators of inflammation (SPMs or PRMs). Everything that the ECS master regulates relies upon all EFAs (omega-6 and omega-3) as precursors to signaling compounds. Most people get plenty of omega-6 fatty acids from their diet and are imbalanced in their ratio of omega-6:omega-3. I explain it with a wildfire scenario. Your Omega-6 Fire Department is responsible for starting controlled burns to manage the health of the forest (it initiates the inflammatory response in your body in response to a stressor, injury or pathogen). On a nice day your Omega-6 Fire Department starts a series of controlled burns for forestry management. Suddenly a stressor arises. The wind picks up. Now the fires are blazing out of control. The head of the Omega-6 department calls the Omega-3 department and says, “Hey, we have a problem in our sector, our fires are raging out of control, we have inflammation everywhere! Can you send some people and trucks and helicopters to help us?”
The Omega-3 department head responds, “So sorry, but the governor did not fund us this year and we have no resources to help you.”
The Omega-6 department head pleads, “Don’t you at least have some of those smoke jumpers (SPMs or PRMs) you can drop right into the fire zone to fight it from within? We are desperate here!”
The Omega-3 department head responds again, “So sorry, but we have no resources to pay the smoke jumpers so no one is available. We cannot help you.”
So the omega-6 initiated fires of inflammation burn out of control in a situation of excessive stressors and an imbalance in funding the two departments. This person is experiencing unresolved inflammation in their body that may be affecting multiple systems.
Even the microbiome benefits from omega-3 fats like DPA (docosapentaenoic acid), and from endocannabinoids made from EPA (eicosapentaenoic acid), DHA (docosahexaenoic acid), and DPA. Most people will not make enough precursor omega-3 fats from plant sources like flax, chia and hemp. They may convert ALA (alpha-linolenic acid) to adequate amounts of EPA, but DPA and DHA will get the short end of the stick and they are crucial. Fortunately there are now many EPA, DHA and even DPA supplements coming from algae that are suitable in a strict plant-based diet.
So now we’ve connected the three angles of this equilateral triangle to form what I believe is the Trifecta for Health. At a minimum, nearly every client or patient or customer we work with will need to know about these three areas. They will need to either make diet and lifestyle changes to support these three important aspects, or they will need to supplement. Many will choose to do both for a time. It seems at this point I always come around to discussing the Blue Zones. If we look at Sardinia, Icaria, Nicoya and Okinawa we see cultures that are still centered around diet and lifestyle that support every aspect of this Trifecta for Health. These are people with the documented longest lifespans and health spans. To me, it has always made sense to look at what has worked for a long time and is well documented and proven. The experiment has already been conducted, and we would be wise to look back on our human history to the best examples and take some lessons from our ancestors. Enjoy natural sunlight in moderation, move your physical body in moderation, eat fiber rich foods and plenty of brightly colored vegetables and fruits, take it easy on land animals, eat more seafood rich in omega-3 fats, eat more nuts and seeds, drink fermented polyphenols in moderation, be a part of a supportive community, dance, sing, pray, meditate, find your purpose and live a long healthy lifespan so you can see it through.
Amber Lynn Vitale has practiced as a certified nutritionist, ayurvedic specialist, advanced bodyworker and yoga therapist since 1996. Much of her nutrition practice was in collaboration with functional medicine doctors and other integrative practitioners. Since 2008, she has also produced written and video educational content for many publications, as well as for her own clients and an interested public audience. By 2012, she had realized that raw materials sourcing, labeling transparency, legitimate certifications and educational support were the criteria that would set quality natural products companies apart from others—and she made it her mission to educate the public on the importance of education before supplementation. In 2014, she became the Northeast regional educator for Garden of Life and continues to write, lecture and produce online content on health and wellness topics important to the practitioner and the patient alike.