Functional Nutrition Is a Modern Approach to Wellness
“Let food be thy medicine”. – Hippocrates
What is Functional Nutrition?
You may have heard the terms Functional Nutrition or Integrative Nutrition floating around. This modern approach to healthcare has likely piqued your interest but also left you with some questions.
Functional Nutrition or Integrative Nutrition is an application of medical nutrition therapy that aims to join both integrative and functional medicine principles and conventional nutrition practices1. Functional medicine is designed to be a collaborative experience that allows practitioners and patients to work on the underlying cause of disease and achieve optimal wellness together. It focuses on why and how illness occurs- essentially addressing the root cause2. Actual health is viewed as an “integrated function of biology, environment, and behavior, and something other than the absence of disease”1.
This paradigm upholds that the biochemical individuality of each person is best served by a personalized, evidenced based approach to nutrition. Integrative and functional medicine views the body as a whole, with each system interconnected and influencing the other as a result of various inputs. It takes into account lifestyle, genetics, beliefs, physical and social parameters, and environmental factors that could influence an individual’s mind, body, and spirit1. The goal of this approach is to give the body the opportunity to achieve the extent of healing it is most capable of.
Within conventional nutrition, interventions are often based on addressing symptoms rather than the underlying cause. These practices tend to follow government guidelines and provide recommendations for disease states and the population as a whole as opposed to treating the individual separately. Managing chronic conditions through nutrition is vital, but interventions can fall short when they don’t offer the client the best, evidenced-based option for actually improving their physiology. Conventional nutrition counseling would typically include discussing macronutrients, micronutrients, energy (calories), and food labels3. While those areas are important and necessary, it’s not the full picture. Integrative nutrition acknowledges that, in addition to diet optimization, addressing root causes is critical for lasting health improvement.
Consider the Following Examples that Highlight Conventional vs. Functional Approaches to Nutrition:
An overweight client seeking weight loss is put only on a calorie deficit diet and told to exercise more rather than considering their relationship with food and how bingeing and emotional eating influenced their weight gain as well.
A client struggling to control blood sugar is recommended carbohydrate limits for meals and snacks. However, their microbiome, micronutrient intake, muscle mass, and stress are all factors that could influence insulin sensitivity and glucose control. Assessing and addressing these factors is more optimal than just focusing on reducing carbs.
An individual who has been dealing with chronic constipation is told to increase fiber and water intake and go on walks after meals. A functional approach would additionally address how gut bacteria, intestinal motility, hormones and the nervous system could be causing the chronic constipation.
Scope Of Practice: Registered Dietitians Vs. Certified Nutrition Specialists
Both Registered Dietitians (RD’s) and Certified Nutrition Specialists (CNS’s) are nutrition professionals qualified to practice medical nutrition therapy – the act of providing nutrition care services for managing or treating a medical condition – in an integrative and functional manner. Many RD’s undergo a conventional education but choose to receive further comprehensive training in functional nutrition. The education required for the CNS track is usually taught from a functional nutrition perspective and most graduates continue broadening their baseline of knowledge in this area. Both the RD and CNS are federally recognized board certifications, but the license, and therefore scope of practice, varies by state. In North Carolina, RD’s and CNS’s are eligible for licensure and their scope of practice is generally the same. Per the North Carolina Board of Dietetics and Nutrition it includes:
- Assessing and evaluating the nutritional needs of individuals and groups, and determining resources and constraints in the practice setting, including ordering laboratory tests related to the practice of nutrition and dietetics
- Establishing priorities, goals, and objectives that meet nutritional needs and are consistent with available resources and constraints
- Providing nutrition counseling in health and disease
- Developing, implementing, and managing nutrition care systems (i.e. systems established for hospitals, long term care facilities, schools systems, government programs, etc.)
- Evaluating, making changes in, and maintaining appropriate standards of quality in food and nutrition services
- Ordering therapeutic diets
The only difference in scope between the two nutrition professionals is regarding enteral and parenteral nutrition therapy. A CNS does not receive educational training in this therapy and so an RD is the only one licensed to order specialized intravenous solutions or tube feeds.4
Essentially, only a licensed nutrition professional is able to give specific recommendations for a medical condition in the state of North Carolina. To provide further context for what this would look like, see the following examples:
- It is not legal to recommend a diet for someone diagnosed with hypertension, but anyone could advise including foods that are known to be healthy for the general population, such as vegetables.
- Prescribing supplements for clinical conditions like IBS or depression is limited to RD’s and CNS’s, but discussing foods that are good sources of particular nutrients is accepted.
- Calculating macronutrient ratios for aesthetics or performance is suitable for non licensed individuals, but determining macronutrients for the management of a disease is relegated to nutrition professionals.
When it comes to ordering and interpreting labs, any nutritionist that is licensed in North Carolina can legally do so if the test relates to the practice of nutrition and dietetics4. That being said, the Academy of Nutrition and Dietetics advises that RD’s who have been licensed for under 3 years not assess conventional or functional lab tests nor recommend specific dietary supplements to clients1. There are no additional regulations for CNS’s surrounding the use of labs and supplements, but discretion should be employed by the practitioner based on their experience level when choosing to utilize these forms of assessment and intervention5.
A Visit With A Licensed Functional Nutritionist
By now, you’re probably wondering, “Okay, so what actually happens in an appointment if I were to schedule for a functional nutrition consultation?”
The initial functional nutrition consultation will start with an assessment. Usually, you will fill out an in-depth nutrition intake form before the first appointment that could cover areas such as: medical and health history, current symptoms, lifestyle factors (sleep, stress, physical activity), supplements and medications, labs, diet habits, and a food log.
During the consultation, they will review the forms and ask more detailed questions that might encompass events from childhood to present. Share your story! They’re trying to garner insight and paint a comprehensive picture about what has influenced and contributed to your health up until this point. A nutrition focused physical exam, where the licensed nutritionist looks for physical signs of nutrient deficiencies and malnutrition, may also be conducted.
Depending on your goals, symptoms, and what they’ve identified as core imbalances, the licensed nutritionist may focus on one area over others. Many clients come in having multiple conditions or desires for their health. So, understanding where your priorities are is key in creating a viable partnership. The practitioner will assess your readiness for integrating change and will cater their recommendations to best suit your needs.
After they’ve reviewed all findings, the licensed nutritionist will present possible dietary, supplement, and lifestyle interventions for you to consider as well as provide any desired education. Depending on the situation, they may also recommend further conventional and/or functional lab testing.
The functional nutrition practitioner’s goal is to encourage your engagement, empowering you to take a central role in your health journey. The practitioner sees you as part of the decision making process!
Because there is a lot of content discussed in functional nutrition appointments, they tend to be much lengthier than a typical doctor’s visit. Also, functional nutrition therapy will always include follow up visits, with the frequency and amount depending on your specific needs. You also have access to your functional nutrition practitioner for questions between visits.
The following list will give you an idea of some areas or conditions best served by functional nutrition:
- Hormone Imbalances
- Women’s Health (infertility, menopause, prenatal nutrition)
- Infant and Child Feeding
- Disordered Eating & Eating Disorders
- Autoimmune Disease
- Hypertension
- Type 1 and 2 Diabetes
- Metabolic Syndrome
- Food Sensitivities/Intolerances
- Weight Concerns
- Sports Nutrition
- Digestive and gut health (IBS/IBD, Chron’s, SIBO, GERD, histamine intolerance, post-cholecystectomy)
- Specialty Diets
- Mindful/Intuitive Eating
Common Myths About Functional Nutrition
Too Expensive
Many functional dietitians now take insurance which helps make this type of care more widely available. Even if insurance is not an option, clients tend to have great success and start seeing changes in just a few appointments. A short term investment will lead to long term benefits, and we do not want to make you dependent on our care. The goal is to educate and empower you with the best tools for sustainable health. Some practitioners may also offer a sliding scale for fees that may be worth inquiring about.
Tons of supplements
Supplements are just one tool we use, not the only! They can be a powerful adjunct to any nutrition plan but they are not intended to be the main focus. Supplements are typically needed for therapeutic interventions and can help accelerate healing. We are also aware of better quality options and use them in a strategic manner so we won’t make you waste time and money on ones that won’t provide benefits. We will always prioritize diet and lifestyle changes over a long list of supplements!
You will take me off medication
Absolutely not! As licensed nutritionists, medication management is out of our scope of practice. Whether you desire to stay on medication or change your dose that is between you and your health care provider. We will work with your medical team to make sure that our recommendations do not interfere with your current prescriptions. We will provide you with information on any interactions that your medications may have with nutrients, supplements, and body systems so that you can make the most informed decision for yourself.
I will have to eat a diet/food I don’t like
Our goal in functional nutrition is to work with you to create habits that you want to continue. We don’t think our clients should feel miserable or uninterested in the food they’re eating. With that said, we may encourage you to broaden your horizons and possibly incorporate foods you’re unfamiliar with or have never tried. We’ve noticed that when a client understands the why or the importance behind foods we recommend, they are much more motivated and excited to eat them. We acknowledge that change takes time, but our palates can adapt to new flavors and tastes if we allow them! We may also recommend a therapeutic diet for particular conditions but our aim is to not have that be the long term solution.
How To Get Started With Functional Nutrition
We know how vital personal health is for quality of life, and we’re here to offer robust support to assist you in achieving your goals. If you’re ready to optimize your nutrition and start on a journey to healing, we would love to connect with you!
If you feel that you could benefit from functional nutrition, please schedule a chemistry call with us HERE, message us on our CONTACT PAGE, or reach out by phone at 916-431-0236. We can discuss your situation in more detail, and also discuss how to get insurance coverage for functional nutrition.
References
- Noland D, Raj S. Academy of Nutrition and Dietetics: Revised 2019 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Nutrition in Integrative and Functional Medicine. J Acad Nutr Diet. 2019;119(6):1019-1036.e47. doi:10.1016/j.jand.2019.02.010
- The Institute for Functional Medicine. Functional Medicine. Accessed October 19, 2020. https://www.ifm.org/functional-medicine/
- Lund M. Integrative Medicine Embraces Nutrition. Today’s Dietitian. February 2013. Accessed October 19, 2022. https://www.todaysdietitian.com/newarchives/021313p26.shtml
- North Carolina Board of Dietetics and Nutrition. Scope of Practice. Accessed October 19, 2022. https://www.ncbdn.org/scope-of-practice
- North Carolina Administrative Code, Title 21, Chapter 17- Dietetics/Nutrition. Accessed November 17, 2022. https://www.ncbdn.org/media.ashx/north-carolina-administrative-codeupdateddecember2019.pdf
