The Role of Nutrition and Integrative Medicine
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Integrative Health and Wellness

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Jul 21, 2022

Integrative Health and Wellness

The Role of Nutrition and Integrative Medicine

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Oct 02, 2022

Integrative medicine doctors and those practicing functional medicine often say that “food is medicine.” And it’s true! But what does that really mean? In a nutshell, the nutrients in the food you eat provides data to your cells, and this information can affect your health and how you age. (12)

While a nutrient-dense diet can help prevent disease and foster good health, the typical Western diet filled with ultra-processed food high in salt, sugar, and trans fats can increase the risk of a number of diseases. These include cardiovascular disease, elevated cholesterol, high blood pressure, obesity, osteoporosis, and type 2 diabetes. (10

Because diet can be such a powerful tool for influencing health and disease, integrative and functional medicine doctors often turn to nutrition to help prevent or manage various health problems. (5)(8)(15)(17) This sets them apart from allopathic doctors who typically rely solely on drugs and other conventional tools to treat a patient’s symptoms. (3) Continue reading to learn more about nutrition and integrative medicine. 

Did you know? Doctors historically receive little or no education about diet or nutrition in medical school. (4)(6)

nutrition and integrative medicine
The modern Western diet, which is high in ultra-processed foods, has been linked to the development of a number of chronic diseases.

What is integrative nutrition?

Most popular diets, like the ketogenicMediterraneanpaleo, or vegetarian diets, are geared for the masses. Nutrition as it applies to integrative medicine, however, takes a much more personalized approach and focuses on how foods impact the whole person. This means that integrative nutrition looks beyond federal dietary guidelines and one-size-fits-all eating plans to tailor a patient’s diet to meet their specific nutritional needs in relation to their health. (13)

When developing an integrative nutrition program, medical professionals consider a patient’s current health conditions and their personal food preferences. Other factors that are frequently taken into account are the state of a patient’s lab work, microbiome, their genetic predisposition, and their home/work environment. These factors can help the integrative or functional medicine practitioner create a personalized diet that addresses the current health needs of the individual. (9)(11)

According to the American College of Preventive Medicine, nutrition is one of the key evidence-based behavioral interventions used to treat and manage chronic diseases related to a patient’s lifestyle. Other interventions include physical activity, stress managementsleep, social support, and environmental exposures. (7

The American Board of Physician Specialties notes that integrative practitioners consider the following when incorporating an integrative nutrition plan into patient care:

  • A patient’s lifestyle (sedentary vs. active)
  • The influence of nutritional balance on the patient’s overall health
  • How a mindful approach to eating patterns can contribute to better health
  • The ability of food (as opposed to dietary supplements) to meet nutritional requirements (9

Conditions that may benefit from integrative nutrition

Since 60% of Americans suffer from one or more chronic diet-related diseases, nutrition is typically one of the main factors addressed by integrative and functional medicine doctors. (7) Conditions that may be helped by personalized integrative nutrition include:

  • Cardiovascular disease 
  • Chronic kidney disease (5)
  • Headache (15)
  • Metabolic syndrome 
  • Neurodegenerative diseases 
  • Obesity 
  • Osteoporosis (5)
  • Pain (17)
  • Type 2 diabetes (5)

Did you know? Integrative nutrition can also be used to help disease-free patients achieve optimal health. (18)

nutrition and integrative medicine practitioner looking at a food chart
Integrative dietitians work with doctors and patients to provide personalized nutritional therapies.

The role of integrative dietitians

Integrative nutrition isn’t just a tool used by integrative medicine physicians or functional medicine doctors. Increasingly, integrative dietitians are working with both doctors and patients directly to provide holistic, personalized nutritional therapies based on whole foods. Registered dietitians have a long history of counseling patients on the fundamentals of nutrition, including understanding calories, macronutrients, micronutrients, and how to decipher food labels. Integrative dietitians go a step further to educate patients in the many ways personalized nutrition can help heal the body, both physically and mentally. (13)

When creating a personalized plan, integrative dietitians take into account the patient’s current and past food habits, lifestyle, support system, family dynamics, medication and supplement use, allergies, and general attitude toward food. In addition, they often discuss a number of nutritional concepts with their patients. These can include the connection between certain foods and mood, previous experiences from fad diets, food cravings and addictions, and the role antioxidants and phytonutrients play in cellular health. (13

What is medical nutrition therapyAnother nutrition-based specialty called medical nutrition therapy (MNT) includes a nutritional diagnosis as well as therapeutic and counseling services by a registered dietitian. However, unlike integrative nutrition, MNT does not consider the other aspects of the patient’s life. (14)(16

nutrition and integrative medicine medical students
A number of medical schools are starting to offer more classes focusing on nutrition and the role it plays in health and disease.

Integrative nutrition certification

Because of nutrition’s importance to disease prevention and treatment, a growing number of integrative medical associations and traditional medical schools are beginning to offer integrative nutrition certifications. (2)(7) However, since integrative nutrition is still a fairly new field, a standardized definition of integrative nutrition and the current scope of programs granting certification can vary widely. (1) For instance, the Academy of Nutrition and Dietetics offers an online certification program comprised of several modules geared for registered dietitians. (2) Physicians, on the other hand, can demonstrate their proficiency in the core competencies of integrative nutrition during the process of becoming board certified through the American Board of Integrative Medicine. (9)

Some medical schools are also getting on the bandwagon, developing and offering expanded nutritional training and certification to both practicing clinicians and future clinicians. But it’s a work in progress and consensus on how much education is needed varies. For instance, the National Academy of Sciences recommends that medical schools provide at least 25 hours of nutrition education, while the American Society for Nutrition proposes a minimum of 44 hours. The current average is less than 20 hours. (7)

If you’re seeking a practitioner well-versed in nutrition, it’s wise to look for an integrative or functional medicine provider. Although providing this type of personalized nutrition is often an established part of a practitioner’s practice, it’s a good idea to ask them about their experience.  

The bottom line

Because many chronic diseases are rooted in poor nutritional status, integrative nutrition focuses on diet as an important part of treatment. Integrative medicine doctors, functional medicine practitioners, and integrative dietitians are often experienced in preventing and managing chronic disease through a personalized diet as part of an overall treatment plan. Instead of a cookie-cutter diet, integrative nutrition takes all aspects of the patient into consideration, including lifestyle, food preferences, and personal environment.

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REFERENCES
  1. Bush, C.L., Blumberg, J.B., El-Sohemy, A., Minich, D.M., Ordovás, J.M., Reed, D.G., & Behm, V.A.Y. (2020). Toward the definition of personalized nutrition: A proposal by The American Nutrition Association. Journal of the American College of Nutrition, 39(1):5-15. 
  2. Certificate of training program. (2022). Dietitians in Integrative and Functional Medicine.https://www.integrativerd.org/resources/cotp
  3. Conventional medicine. National Cancer Institute. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/conventional-medicine
  4. Crowley, J., Ball, L., & Hiddink, G.J. (2019). Nutrition in medical education: A systematic review. Lancet Planet Health3(9),e379-e389. 
  5. Di Renzo, L., Gualtieri, P., Romano, L., Marrone, G., Noce, A., Pujia, A., Perrone, M.A., … De Lorenzo, A. (2019). Role of personalized nutrition in chronic-degenerative diseases. Nutrients11(8), 1707. 
  6. Downer, S., Berkowitz, S.A., Harlan, T.S., Olstad, D.L., & Mozaffaroam, D. (2020). Food is medicine: actions to integrate food and nutrition into healthcare. BMJ, 369, m2482.
  7. Frame L.A. (2021). Nutrition, a tenet of lifestyle medicine but not medicine? International Journal of Environmental Research and Public Health18(11), 5974. 
  8. Heianza, Y. & Qi, L. (2017). Gene-diet interaction and precision nutrition in obesity. International Journal of Molecular Sciences18(4), 787. 
  9. Integrative medicine: Better health through individualized nutrition. (2022). American Board of Physician Specialties. https://www.abpsus.org/integrative-medicine-nutrition/
  10. Institute of Medicine (US) Committee on Examination of Front-of-Package Nutrition Rating Systems and Symbols; Wartella EA, Lichtenstein AH, Boon CS, editors. Front-of-Package Nutrition Rating Systems and Symbols: Phase I Report. Washington (DC): National Academies Press (US); 2010. 4, Overview of Health and Diet in America. Available from: https://www.ncbi.nlm.nih.gov/books/NBK209844/
  11. Integrative nutrition. University of California San Francisco Osher Center for Integrative Health. https://osher.ucsf.edu/patient-care/clinical-specialties/integrative-nutrition
  12. Leung, C.W., Fung, T.T., McEvoy, C.T., Lin, J., & Epel, E.S. (2018). Diet quality indices and leukocyte telomere length among healthy US adults: Data from the National Health and Nutrition Examination Survey, 1999–2002, American Journal of Epidemiology187(10) 2192–2201.
  13. Lund, M. Integrative medicine embraces nutrition. (2013). Today’s Dietitian, 15(2), 26.
  14. Medical nutrition therapy. (2021). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/dsmes-toolkit/reimbursement/medical-nutrition-therapy.html
  15. Millstine, D., Chen, C.Y., & Bauer, B. (2017). Complementary and integrative medicine in the management of headache. BMJ16;357:j1805. 
  16. MNT versus nutrition education. (2021). Academy of Nutrition and Dietetics. https://www.eatrightpro.org/payment/coding-and-billing/mnt-vs-nutrition-education
  17. Tick H. (2015). Nutrition and pain. Physical Medicine and Rehabilitation Clinics in North America,26(2):309-20. 
  18. Wongvibulsin, S., Lee, S.S. & Hui, K.K. (2012). Achieving balance through the art of eating: Demystifying Eastern nutrition and blending it with Western nutrition. Journal of Traditional and Complementary Medicine2(1), 1–5.

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