Food First: Dietary Change Improves Outcomes

Family eating together

Most cultures recognize that food has the capability to both heal and harm. To date, much of the medical research into nutrition has focused on the ways in which foods harm health and contribute to the risk of chronic disease.1 More recently, some of this research has begun to examine the potential for food to help those with chronic diseases, perhaps even as a frontline treatment. In short, treating patients with food first can improve outcomes for a wide variety of chronic diseases.2

The idea behind a “food first” approach is that patients with chronic complaints who change their diet first, before trying pharmaceuticals, or perhaps even nutraceuticals, often see dramatic improvements in their health. This approach does not suggest that food can help every patient, nor that dietary changes alone are all that is needed to get patients to wellness. Instead, it encapsulates the idea that changing eating habits can be an effective first step for many patients, and the improvements that they experience can serve as empowering feedback, motivating them to make other sustainable lifestyle changes.

The research into the effectiveness of a food first approach includes many population and epidemiological studies, as IFM educator P. Michael Stone, discusses in the following video.

IFM Educator P. Michael Stone discusses how a food first approach can help patients with chronic diseases.

While the types of personalized dietary interventions that may be most beneficial for patients do not lend themselves well to randomized controlled trials, broader evidence that dietary change is effective in combatting chronic diseases abounds, including in the mainstream media3—the DASH diet for hypertension,4 the Mediterranean diet for cardiovascular disease,5 healthy eating in midlife for dementia prevention,6 and others. While this research is proof-of-concept that dietary interventions can improve outcomes, the Functional Medicine approach to dietary change goes beyond recommending a specific dietary plan as treatment for everyone with a certain disease. Instead, Functional Medicine advocates examining each patient’s specific genetics, history, and lifestyle and tailoring a dietary treatment that fits that patient’s specific needs. Indeed, recent research suggests that precision nutrition, in which nutritional treatments are based on an individual’s unique genetic makeup, is an idea whose time has come.7

To this end, IFM has developed several therapeutic food plans designed to address nutritional inadequacies and impact health through a food first approach. Each food plan has clear directives for modifying the food lists and identifying an appropriate macro- and micronutrient distribution based on the health needs and lifestyle preferences of each patient. These dietary interventions are not short-term fixes, but rather designed to be a sustainable lifestyle change to optimize health and well-being.

In collaboration with the American Nutrition Association, IFM has developed an online learning course designed to educate clinicians on the clinical application and personalization of each food plan. Therapeutic Food Plans: A Component of Personalized Nutrition provides case-based scenarios for customizing dietary interventions to meet the unique health needs of diverse patients.

Other factors can influence a patient’s dietary patterns, including stress, exercise, and sleep habits. Fundamental takeaways from the course materials focus on strategies for addressing these factors with tips for keeping patients engaged and aligned with their prescribed food plan. Through small, achievable changes in their diet and beyond, patients should begin to see meaningful improvement in their symptoms. This course will benefit all clinicians and healthcare workers who work closely with patients on their nutrition.



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  1. Blackburn GL. Treatment approaches: food first for weight management and health. Obes Res. 2001;9(Suppl 4):223S-227S. doi:1038/oby.2001.122
  2. Sandquist L. Food first: nutrition as the foundation for health. Creat Nurs. 2015;21(4):213-221.
  3. Park A. Why food could be the best medicine of all. Published February 21, 2019. Accessed September 13, 2019.
  4. Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001;344(1):3-10. doi:1056/NEJM200101043440101
  5. Kris-Etherton P, Eckel RH, Howard BV, et al. AHA Science Advisory: Lyon Diet Heart Study. Benefits of a Mediterranean-style, National Cholesterol Education Program/American Heart Association step I dietary pattern on cardiovascular disease. Circulation. 2001;103(13):1823-1825. doi:1161/01.cir.103.13.1823
  6. Sindi S, Kåreholt I, Eskelinen M, et al. Healthy dietary changes in midlife are associated with reduced dementia risk later in life. Nutrients. 2018;10(11):E1649. doi:3390/nu10111649
  7. Laddu D, Hauser M. Addressing the nutritional phenotype through personalized nutrition for chronic disease prevention and management. Prog Cardiovasc Dis. 2019;62(1):9-14. doi:1016/j.pcad.2018.12.004

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