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“When diet is wrong, medicine is of no use; when diet is correct, medicine is of no need.” – Ayurvedic Proverb
Considering that what we eat has been proven countless times over to profoundly impact our health, wellbeing, and overall quality of life (physically, mentally, and emotionally), it comes as no surprise that functional nutrition and functional medicine are now peaking the interest and getting the attention of healthcare providers and patients worldwide!
To boot, research is confirming that functional nutrition and functional medicine are likely the “secret sauce” to addressing and resolving many types of long-standing chronic health conditions at the cellular, root-cause level (1).
What is functional nutrition?
Functional nutrition is a branch of functional medicine which leans heavily on the concept of “food as medicine”.
The term “functional” is referring to chronic illnesses and subclinical imbalances that often don’t get completely addressed or supported by the conentional healthcare system. This is because a person with functional or subclinical imbalances is considered to be clinically stable and thus is able to still live and “function” with these issues and imbalances in day-to-day life.
The mainstream approach for these types of chronic “functional” conditions is to give someone a long-term medication that will keep them clinical stable.
A few examples of conditions that are often labeled functional include, but are certainly not limited to:
- Irritable bowel syndrome (IBS)
- Dysbiosis
- Leaky gut
- Hashimoto’s disease (autoimmune hypothyroidism)
- Grave’s disease (autoimmune hyperthyroidism)
- Chronic fatigue / adrenal fatigue
- Lupus
- Arthritis
- Fibromyalgia
- Psoriasis
- Polycystic ovarian syndrome (PCOS)
Functional nutrition is essentially a cross between clinical and holistic nutrition. For this reason, functional nutrition is also often referred to as “integrative nutrition” because it integrates the best of both worlds!
What is clinical nutrition?
Registered dietitians are formally trained, supervised, and board-certified to provide dietary recommendations and interventions for patients with acute and chronic medical conditions in various types of clinical settings. This type of consultation is often referred to as “medical nutrition therapy”, and the field is called “clinical nutrition”.
The main purpose of clinical nutrition and medical nutrition therapy is to help patients reach a certain level of clinical stability, so they can get discharged, stay out of the hospital, and better manage symptoms of their acute or chronic illness based on how their body responds to food and nutrients.
In a clinical nutrition assessment, dietitians will gather information on a person’s goals, food preferences, anthropometrics (height and weight history), appetite, patterns of eating, family dynamics, grocery budget, as well as their digestive patterns, nutritionally pertinent lab test results/patterns, medications, supplements, potential food-drug interactions, and more.
- All of the above information is taken into account so that the dietary recommendations provided are synergistic and compatible with a patient’s medical treatment plan as well as his or her lifestyle.
A clinical dietitian is an integral part of an interdisciplinary team of doctors, nurses, social workers, physical therapists, occupational therapists, speech-language pathologists, and other types of healthcare providers in various clinical settings (whether inpatient or outpatient).
Clinical nutrition is a crucial foundation on which other branches of nutrition (including holistic and functional nutrition) must stand!
Clinical nutrition limitations
While clinical nutrition is an amazing and vital component of a person’s plan of care, and it can’t be left out, clinical nutrition alone doesn’t leverage and make the most of all the wonderful potential healing benefits that food, nutrition, and herbal medicine have to offer us.
For those who are striving to live more optimally, experience more medical freedom, and live more in alignment with nature, that’s where holistic and functional nutrition come into play!
What is holistic nutrition?
“Holistic” has become a bit of a buzzword nowadays, and it can mean a lot of things!
In this context, holistic nutrition is a branch of nutrition that looks at the full picture of a person’s health and well-being from all angles. Holistic nutrition practitioners acknowledge and understand the whole is greater than the sum of its parts, and everything is interconnected.
The field of holistic nutrition is more wellness-oriented than clinical nutrition. The focus is on nourishing and supporting the person as a whole. Holistic nutrition practitioners firmly believe we can’t just treat a person’s symptoms, or even just the physical body – we must also consider the mind, emotions, and spirit, which collectively impact a person’s wellbeing and quality of life.
The goal of a holistic nutrition intervention is for the client to live more optimally, achieving outcomes such as more energy, improved mood, and healthier digestion through a “food as medicine” approach.
Holistic nutritionists teach clients to prepare and incorporate a variety of wholesome, nutrient-dense, minimally processed foods into their diet. There’s also a focus on encouraging people to increase their intake of anti-inflammatory foods naturally high in vitamins, minerals, antioxidants and omega-3 fatty acids.
Holistic nutrition practitioners will take into account just to the quantity of nutrients in food (“macros” – carbs, fats, protein and calories), but also the quality of the food (ingredients, additives, nutrient density, degree of processing, etc.).
Downsides and limitations of holistic nutrition
Holistic nutrition is a wonderful way to help people improve and enhance their quality of life through the power of food; however, when taken too far, holistic nutrition can spiral into “diet culture” and excessive dietary restriction, which could create extra stress and anxiety around food.
- Well-meaning holistic nutrition principles have the potential to trigger a type of eating disorder known as “orthorexia”, which is an unhealthy obsession around the purity and quality of food.
- People with orthorexia become crippled with fear and anxiety around eating a food that is considered “bad”.
- Orthorexia left unchecked can lead to unnecessary dietary restrictions, unintentional weight loss, and subsequent nutritional deficiencies.
It’s important to remember the purpose of a holistic nutrition intervention is to nourish, support, and enhance a person’s quality of life – not to create extra stress or make someone feel they need to eat as strict or “perfectly” as possible.
A truly holistic approach must take into account a person’s favorite foods and their overall relationship with food as part of their quality of life. We must know where to draw the line!
Bridging the gaps with functional nutrition
While the terms “functional nutrition” and “holistic nutrition” are often used interchangeably; the difference is that the field of functional nutrition also integrates more clinical approaches.
- A functional nutrition practitioner receives some kind of clinical training and licensure, as a registered dietitian, acupuncturist, chiropractor, naturopathic doctor (ND), osteopathic doctor (DO), or medical doctor (MD).
- Registered dietitians are the only type of functional nutrition practitioner who are formally trained in clinical nutrition and licensed to provide medical nutrition therapy; however, not all dietitians are functional nutritionists.
- Working directly with a functional dietitian-nutritionist specifically for your dietary interventions will allow you to get the most out of a holistic nutrition healing journey (if that’s what you’re going for)!
Branches of functional nutrition
Within the field of functional nutrition, there are some key branches or sub-categories which make it extra cutting-edge!
Four primary branches or sub-categories of functional nutrition are:
- Functional nutrition lab testing
- Optimal nutrition lab reference ranges
- Functional foods
- Complementary alternative medicine
Functional nutrition lab testing
In functional nutrition, in addition to looking at the full picture of health and leveraging the power of “food as medicine”, we have access to advanced, state-of-the-art lab tests that aren’t routine or even offered at all in mainstream healthcare.
- Please note that functional nutrition tests are not meant to replace clinical diagnostic testing, which is fundamental; they serve to complement and enhance it!
Obtaining the right information about your body through functional nutrition lab testing is a great first step in gaining clarity and awareness of your full picture. (Knowledge is power! We can’t address problems if we don’t know what they are, or where/how they started.)
The bottom line is that whatever’s going on with your health – whether it be frequent/chronic brain fog, fatigue, adverse food reactions, depression, anxiety, skin breakouts/rashes, irritable bowel syndrome, chronic bloating, pain, migraines, Hashimoto’s/Grave’s autoimmune thyroid, or something else – it’s NEVER for no reason!
I’m a firm believer that there’s an underlying reason for everything… which brings me back to functional nutrition testing!
(Testing is SO much better than guessing. Leave no stone unturned until you feel realigned.)
Functional nutrition testing will allow you and your treatment team to identify and address sub-clinical imbalances and underlying issues, so you can then take strategic action to prevent these issues from snowballing into bigger problems (if left unchecked).
There are dozens of types of functional nutrition lab tests out there! Some examples of popular functional nutrition labs include, but aren’t limited to:
- Micronutrient testing
- Mediator Release Testing (MRT)
- DUTCH hormone testing
- GI Mapping / Comprehensive Stool Analysis
- Organic acid testing (“OAT”)
- Genetic testing (“Nutrigenomics”)
- Omega testing
- Mold “Mycotox” testing
- Heavy metal testing
- Glyphosate testing
- And lots more!
Keep in mind: most of the time, these tests are not available at your primary care doctor’s office or GI clinic. Not everyone will benefit from all of these tests, not everyone needs the SAME tests, and not all versions of these tests are created equal!
- To get the best return on investment, it’s recommended to work alongside a functional dietitian and/or functional medicine practitioner who can help you to craft and customize your unique roadmap to better health.
While functional nutrition testing is more expensive and not usually covered by insurance, it can go a long way to help you fill in the gaps, crack your code, connect the dots and tie everything together a whole lot faster than trying to figure it all out on your own.
Trust me – I’ve seen way too many people waste years of their life throwing a bunch of cookie-cutter diets and supplements at the wall like spaghetti until something sticks! (Not to mention – it’s incredibly validating to realize all those wonky symptoms you’ve been experiencing for months/years are not “all in your head”…)
Once you opt to go down the path of functional nutrition testing, you’ll be able to then receive highly customized nutrition and supplement recommendations and guidelines (ideally including medical nutrition therapy) – all designed just for you, based on what’s going on in YOUR body – so that you can make quantum leaps on your healing journey.
From there, the next step is to implement what you’ve learned, consistently enough so that your body is set up to start healing itself!
Functional nutrition lab reference ranges
How can you tell if your labs are “normal”? Why are the reference ranges different at every lab?
In clinical nutrition, and in most labs/hospital settings, with the exception of cholesterol, the established reference ranges deemed safe or “clinically acceptable” at each lab will actually vary.
This is because the standard lab reference ranges are determined based on averages of 95% of patients that go to the lab and get the tests done in a given timeframe (2, 3).
The challenge with this is 95% of the patients receiving these lab tests are not necessarily “healthy”, and as a certain percentage of people seem to be getting sicker, this can skew the standards and set the stage for more subclinical nutrition deficiencies to go unchecked.
In the field of functional nutrition, we have access to more optimal lab reference ranges with tighter standards.
- These optimal or “functional” lab reference ranges are determined based on samples collected from groups of people who do not experience any symptoms of chronic illness or have any known underlying medical conditions.
What are functional foods?
“Functional foods” are foods that are eaten or incorporated into a regular dietary regimen to serve a specific health purpose. In holistic and functional nutrition, we’ll often incorporate functional foods in a client’s nutrition protocol as a component of their “food as medicine” approach.
There are many dozens of types of functional foods out there! For example, some popular functional foods for digestive health include but are not limited to:
- Probiotic foods for supporting a healthy microbiome
- (Yogurt, kefir, raw sauerkraut, kombucha, and raw homemade pickles are a few examples)
- Prebiotic foods for supporting a healthy microbiome
- Bone broth for supporting the gut
- Flax seeds, psyllium husks, or chia seeds for extra fiber
Complementary alternative medicine
Dietitians are able to prescribe evidence-based herbal medicine recommendations for clients on an as-needed basis, as it falls under the category of “complementary alternative medicine” which is within our scope of practice.
- This is different from “alternative medicine” in that “alternative medicine” is used in REPLACE of conventional medicine, while “complementary alternative medicine” is incorporated in ADDITION to traditional allopathic medicine.
Herbal medicine is a primary focus within the complementary alternative medicine branch of functional nutrition. Again, everyone is going to receive their own level and form of training.
Herbs are a wonderful natural and empowering way to help people reduce symptoms or even restore balance in the body, usually with less if any side effects (“collateral damage”) along the way, compared to their pharmaceutical counterparts.
- Starting in 2018, I decided to take my complementary alternative herbal medicine training to the next level and become a clinical herbalist alongside being a functional dietitian and holistic nutritionist. This experience has been life-altering (for the better) for me as well as for many of my clients!
What is functional medicine?
Functional medicine, also often referred to as “integrative medicine”, is the base of the pyramid on which functional nutrition lives. Functional medicine is the broader spectrum of integrative healthcare that goes beyond the scope of just nutrition.
According to Dr. Mark Hyman, functional medicine is “the future of conventional medicine – available now.”
Conclusions
While functional nutrition and functional medicine aren’t everyone’s cup of tea (and that’s okay!), it’s important to make more people aware these options exist, so they may make more informed choices about their health from a place of empowerment.
(After all – knowledge is power!)
It’s my mission to play a role in changing the trajectory of healthcare for the better. I know it’s possible! But it starts with creating more awareness – people don’t know what they don’t know, so they aren’t aware of the potential opportunities they’re missing out on in the world of functional nutrition and functional medicine.
That said, if you’re still reading this, and you’re on board with my mission… please help spread the “good word” by sharing this article with someone you love who might need to see it! 😉
References:
- DeBusk, Ruth et al. “Applying functional nutrition for chronic disease prevention and management: bridging nutrition and functional medicine in 21st century healthcare.” Explore (New York, N.Y.) vol. 7,1 (2011): 55-7. doi:10.1016/j.explore.2010.10.007
- Ceriotti, Ferruccio, and Joseph Henny. “”Are my Laboratory Results Normal?” Considerations to be Made Concerning Reference Intervals and Decision Limits.” EJIFCC vol. 19,2 106-14. 16 Oct. 2008
- Petersen, Per Hyltoft et al. “Analytical performance, reference values and decision limits. A need to differentiate between reference intervals and decision limits and to define analytical quality specifications.” Clinical chemistry and laboratory medicine vol. 50,5 819-31. 23 Dec. 2011, doi:10.1515/cclm-2011-0844
