We had been searching for answers for months. Four different doctors had given 4 different diagnoses. Finally, a specialist gave us the diagnosis of psoriasis.
My husband had an autoimmune disease that meant his own body was essentially attacking his skin.
We were written the standard prescription for steroid creams and instructed to return for heavier medications when they ceased working.
We were not warned to beware of telltale signs of joint pain, since 20% of psoriasis sufferers develop an even worse autoimmune condition that could attack his joints. That would be a rheumatologist’s area of concern, I guess.
Nobody else seemed to be asking the same question I was: Why?
Why was his body attacking itself? Why had the immune system that normally protected him gone awry? Why would he have this forever? And why could we only expect it to get worse?
Learning Functional Nutrition
I had already been a dietitian for several years when my husband received his first autoimmune diagnosis. But my training thus far had given me no tools to help with autoimmunity. Indeed, I thought that was out of my practice scope.
But when topical steroids stopped working after a couple years, and my husband asked if I could somehow help, I stumbled into functional nutrition not knowing (at first) that it had a name or whether any other dietitians were using it.
I focused my studies on “why”. At first I could find no answers. My go-to sources for good information gave mostly lists of medications as treatments, and possibly some vague lifestyle recommendations (can you relate?)
Frustrated, but determined, I expanded my search to research articles, books, and podcasts. I consumed everything I could get my hands on and curated nuggets of information into a plan that might help my husband.
Our hope that he could do more than suffer through this was rekindled. I was thrilled with the information I was discovering.
When I began to “experiment” on my husband and family members (how grateful I am for them believing in me!), and to see results, I realized nutrition is SO much more powerful than I realized.
What Does Functional Nutrition Mean?
Functional nutrition is a shift in how we typically look at disease. In a nutshell, it asks “Why?”
- “considers the whole person, not just an isolated set of symptoms”
- “addresses the underlying causes of disease”
- “engages both patients and practitioners in a therapeutic partnership” (3)
- “proposes that even a minor imbalance within the body can produce a cascade of biological triggers commonly termed a ‘snowball effect’”
- relies on “knowledge of the dynamic interplay of genetics, biochemical processes, and biological systems and networks for establishing an innovative, holistic nutrition care process”
- “incorporates varied modalities such as… food elimination diets; … supplements… and detoxification programs” (4).
Doesn’t this sound like what healthcare should be?
Though they are not exactly the same, you might also hear functional nutrition referred to as (3):
- Complementary medicine
- Alternative medicine
- Integrative nutrition
- Holistic health care
I can’t talk about functional nutrition without talking about functional medicine. The two are inseparable because nutrition is at the heart of every functional medicine treatment plan. (That’s why a good functional nutritionist is essential to include in your healthcare team.)
I will explain more of why functional medicine is so powerful in a minute, but first I want to touch on why chronic disease needs functional medicine in the first place.
Why Chronic Disease Needs a Different Approach
What is Chronic Disease?
Chronic diseases are conditions not caused by infections, injuries, or short-term nutrient deficiencies, but rather a dysfunction in your own body.
My husband has two autoimmune diseases, which are both types of chronic diseases.
It turns out he is in good company.
Chronic Disease is Out of Control
- 60% of Americans have a chronic disease
- 40% have 2 or more chronic diseases
- Chronic disease accounts for 90% of healthcare costs in the U.S.
- Health expenses per person were over $9,000 in 2014
- We spend 1.5 to 2 times more per person on healthcare than other industrialized countries but rank last in most health outcomes, including percentage with multiple chronic diseases, and life expectancy.
Chronic Disease is Disabling and Deadly
- Autoimmune diseases
- Heart disease
- Chronic lung disease
- Chronic kidney disease
Chronic Disease Is Only Getting Worse
Despite an increased number of diets, surgeries, and medications, the number of Americans diagnosed with chronic diseases continues to grow.
Our children are now being affected at younger ages and in greater numbers than ever before. For the first time in a long time, life expectancy of the rising generations is decreasing!
Our modern medical system is incredible at saving lives related to infections, trauma, and so much more. We’ve made incredible advances in the past century.
But the medical model that works so well for these acute conditions is still being applied to chronic disease. And it clearly isn’t working.
Health Professionals Lack Training
- most feel unprepared to deliver lifestyle recommendations even though nutrition and lifestyle are a foundation for most guidelines.
- they lack nutrition education,
- they lack confidence in the available nutrition evidence
- their time with the patient is so limited.
A 2005 survey found that even dietitians lack education in complementary and alternative medicine. ACEND (Accreditation Council for Education in Nutrition and Dietetics) has recommended more functional medicine education in schools so dietitians can be leaders in this practice area. (3)
This may be the reason that some of my dietitian colleagues discredit functional nutrition approaches as well. Unless we have sought out the education on our own, many dietetics training programs lack, and even discourage, functional nutrition.
Nutrition Guidelines are Not Being Used
In 2012, the American Medical Association issued a call to action for physicians to “offer evidence-based lifestyle medicine interventions as the first and primary mode of preventing and, when appropriate, treating chronic disease within clinical medicine” (15).
In addition, many major agencies recommend diet and exercise for prevention or treatment of various chronic diseases, including:
- The American Heart Association
- US Department of Health and Human Services
- US Department of Agriculture
- American Cancer Society
Americans Want a Food as Medicine Approach
Meanwhile, Americans WANT a food as medicine approach. Over half of Americans are buying supplements (3). Many are trying various diets to help their diseases without guidance from true health professionals.
It Takes a Team
It would be crazy to expect doctors, nurse practitioners, physician assistants, and nurses to be experts in nutrition therapies and behavior change, in addition to all their other areas of expertise.
I believe a TEAM approach that also involves, at a bare minimum, a physician and a functional nutritionist is most effective. Health coaches, mental health experts, physical therapists and others would also be very helpful.
Indeed, functional medicine clinics that use an interdisciplinary team are getting their patients better results for far less money than conventional medicine clinics (11).
Why Functional Nutrition is a Different Approach
Here are several ways that functional nutrition/medicine is a different approach to chronic disease:
Functional Nutrition Asks Why
In a nutshell, functional nutrition asks why.
So together with my clients, we explore subtle clues in their history that might help us understand WHY and WHERE things began to go wrong.
Functional Nutrition Recognizes It’s All Connected
Modern medicine classifies diseases according to the body system where symptoms are most prevalent (5).
My husband was referred to a dermatologist for his eczema, and a rheumatologist for his arthritis. A gastroenterologist would be the one to see for the chronic acid reflux he once had.
But all of your body systems are actually connected. Dysfunction in one organ has a ripple effect on all the other organs. Especially when it comes to chronic conditions like diabetes or Hashimotos, or Crohn’s Disease.
If my husband’s dermatologist had considered ALL my husband’s symptoms, not just the skin ones, we may have realized he also had psoriatic arthritis (not just a “bad back” and “weird toenails”) years earlier, and prevented years of joint damage at the same time.
Functional Nutrition Addresses Root Causes
Functional medicine proposes that if we can remove the root causes, the body can heal itself. Rather than suppressing symptoms, we try to address the deeper imbalances causing the symptoms (5, 6, 13).
As we explore your history, lifestyle, genetics, and ALL your symptoms, we can clue into the imbalances behind your symptoms. Root causes that might be considered include:
- Chronic vitamin or mineral deficiencies
- Food sensitivities and intolerances
- Bacterial, fungal or viral infections or overgrowths
- Stress or trauma
- Microbiome health
- Genetic variations
- Diet quality
- So much more….
Functional Medicine Seeks to Reverse Disease
Conventional medicine believes my husband’s autoimmune diseases (and most chronic conditions) are incurable and require lifelong treatment and an increasing cocktail of medications to manage them.
Functional Nutrition Embraces Many Healing Modalities
The treatment for every imbalance almost always involves nutrition and sometimes supplement support.
But it often involves other therapies that address sleep, stress, mind-body practices like yoga or meditation, exercise, nature and sunshine, and conventional drugs or surgeries when needed (4).
This is again where that interdisciplinary team is so important (11).
Functional Nutrition Involves the Patient
You can expect your visits with your functional doctor or dietitian to be longer, especially the initial visit. You may be surprised that they want to hear your story. The health history they collect will likely be much more extensive (4).
Functional nutrition requires action on your part beyond popping a pill or prescribing a standard diet. A good functional nutritionist will work with you to create a step by step plan that works with your circumstances. Your nutritionist will ask you to work hard, without overwhelming you.
Your healthcare team will guide you to what will work, follow up with you, trouble shoot with you, and give you every resource to succeed… but ultimately, YOU are the change-maker that makes the magic happen (10, 11).
You might require more follow-up visits at first than conventional treatments typically require. Plus more tweaking of “treatments” to find your optimal health long term.
Functional Nutrition is Evidence Based
Functional nutrition is informed by available evidence and based in science. We combine knowledge from published research with our in-depth understanding of the body, food, and nutrient interactions, and expert experience and opinion to help you achieve optimal health (4, 10).
Elizabeth Boham, MD, MS, RD states: “The evidence is now incontrovertible that the root causes of chronic disease are to be found primarily in diet and lifestyle choices. It is only logical… to confer that a treatment plan that focuses on diet and lifestyle is far more likely to reverse and prevent the vast majority of chronic diseases–an inference that is increasingly supported by a growing evidence base.” (9)
Functional Nutrition is Getting Better Results
One study compared patients treated at a family medicine clinic and an Integrative and Functional Medicine Clinic. The functional medicine patients reported bigger improvements in physical and mental health scores at 6 months and one year (11).
Note that this functional medicine clinic involves a TEAM. Every patient visits with a doctor, dietitian, AND health coach, and mental health professionals are also available.
One study looked at pre-diabetics using “lifestyle interventions” versus the popular drug Metformin. “Lifestyle interventions” reduced diabetes by 58% and delayed onset for those who did get it for 11 years! Those given the standard drug therapy of metformin delayed diabetes for 3 years and reduced cases by 31% (16). Food and lifestyle ARE medicine!
Functional Nutrition is Cost Effective
Boham urges, “Nutrition is one of the most powerful interventions available to clinicians. In many cases, it is less expensive, safer, and more effective than reaching for a medication to relieve every symptom….
“[O]ptimal nutrition interventions to both prevent and treat disease… can help patients reach the highest expression of their health.” (9)
Functional medicine treatments often involve food, sleep, exercise, and other free or inexpensive therapies.
Even with increased appointments or prescribed supplements, they are usually cheaper than medications, and often temporary while you correct imbalances, rather than lifelong.
Is Functional Medicine the Future?
The American Medical Association has called for more education in nutrition and lifestyle medicine for physicians (14).
In fact there is a whole “Personalized Lifestyle Medicine” movement that is based upon functional medicine and is gaining acceptance among healthcare practitioners (14).
Many major agencies already have extensive nutrition and lifestyle guidelines in place.
The American people are craving nutrition treatments (no pun intended) and the chance to be partners in their healthcare.
And a growing body of evidence supports functional medicine as more effective, safe, and affordable than conventional methods.
I think it is safe to say, functional medicine (and nutrition) are here to stay and will only become more mainstream.
A functional medicine proponet, Dr. Boham, urges fellow practitioners to use food as an intervention with EVERY patient. “Diet is often addressed when patients are obese,” but she encourages us to consider diet with other diagnoses like:
- mood changes,
- irritable bowel syndrome,
- acid reflux,
- insulin resistance,
- metabolic syndrome,
- chronic obstructive pulmonary disease,
- inflammatory bowel disease,
- cancer, or
- autoimmune diseases such as multiple sclerosis.
In short, “We should think about the nutritional status of every patient we see,” says Boham (9).
How Do I Find a Functional Nutritionist Near Me?
Another pretty sure resource to get a nutritionist thoroughly trained in functional medicine is to find a graduate of the Integrative and Functional Nutrition Academy. You can search graduates here. I will soon be a graduate of this thorough program as well!
You can also search for dietitians that are members of the Dietitians in Integrative and Functional Medicine (DIFM) Practice Group. DIFM is not a training program, simply a group for interested dietitians. Recognize that these dietitians have widely varying levels of experience and continuing education.
NOTE: Many functional dietitians and nutritionists practice virtually now! If you can’t find an integrative and functional dietitian or nutritionist near you, many will work with you by phone or video JUST as effectively.
How Do I Become a Functional Dietitian or Nutritionist?
Of course, there are many ways to learn functional nutrition.
Stay tuned for an article I’ll be releasing: How to Become a Functional Nutritionist with free, paid, and CPEU resources.
In short, functional nutrition takes a different approach to chronic disease than our conventional medicine system.
Natural treatments like food, movement, sleep, and mind-body exercises are at the heart of every treatment.
Studies are finding functional medicine is safer, cheaper, and more effective in many cases.
It involves you as the patient more, views the body as an interconnected whole, and seeks to reverse root causes behind disease, rather than treating symptoms alone.
Of all the solutions we have tried to help my husband’s autoimmune arthritis and psoriasis, both conventional and functional, functional nutrition has brought the best results with the least ill side effects and risks.
As a dietitian, using functional nutrition with my clients has allowed me to help people find healing for chronic disease I never thought possible!
I believe functional medicine is the future of healthcare! I hope if you’ve failed to find answers to your health struggles, you’ll look to functional medicine for hope and healing!