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The evidence base for the functional medicine model continues to expand through the efforts of the many who are conducting and publishing medical research studies. Recently, IFM collaborated with the Functional Medicine Coaching Academy (FMCA) to investigate the impact of functional medicine health coaching on elimination diet adherence and outcomes. The positive and encouraging results from this randomized controlled trial were published in a February 2024 edition of the peer-reviewed journal Medicine.¹

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Health Coaching & the Elimination Diet

If appropriate for a patient’s personalized health intervention, a short-term diagnostic elimination diet is the gold standard approach for identifying non-IgE food sensitivities and intolerances.^2,3 IFM’s comprehensive elimination diet is a three-week program designed to tailor a person’s diet for their unique physiology, clear the body of foods and chemicals that the patient may be sensitive to, reduce inflammation, and support the gut microbiome. During the program, a patient removes specific foods and categories of foods from their diet. After three weeks, a careful and systematic reintroduction of foods can identify previously hidden food triggers that may have been contributing to or amplifying illness or specific disease symptoms.

While the elimination diet can be an effective clinical tool, adherence to the treatment can be challenging due to a range of barriers. A supportive therapeutic partnership, a key element of the functional medicine model, may help patients follow and sustain lifestyle-based treatments. Specifically, studies continue to demonstrate the effectiveness of health coaching in optimizing lifestyle-based treatments and the vital role health coaches play in collaborative care teams.^4-6

In the recent IFM/FMCA study, investigators expanded on the current research. They found that specific to the elimination diet, participants who received support from functional medicine health coaches rather than self-guided materials reported greater treatment adherence and greater improvements in health outcomes among participants who experienced more symptoms at baseline.¹

IFM/FMCA Study Details & Results

The IFM/FMCA randomized controlled trial (RCT) (n=125 healthcare professionals; 89.9% female; 70.5% Caucasian; 87.8% less than 55 years of age) investigated the impact of functional medicine health coaching on elimination diet adherence and subsequent patient-reported global health outcomes compared to self-guided elimination diet controls.¹ Participants were randomized to either the treatment or control group and all participated in the IFM comprehensive elimination diet as described previously. The intervention group received up to five virtual-coaching sessions with a health coach trained in functional medicine for support throughout the elimination diet. The control group followed a self-guided treatment protocol without coaching support. The study culminated after 10 weeks.¹

The RCT used the PROMIS Global Health (GH) questionnaire to measure and compare health status across several physical and mental health areas at baseline and after treatment.¹ According to investigators from the study, this validated survey helps to increase the scientific rigor of the study results and allows for comparison to other bodies of research. By using the PROMIS GH questionnaire, the IFM/FMCA study models and promotes the use of these research instruments for future functional medicine research. Investigators also used a medical symptoms questionnaire (MSQ) to measure symptom severity, and participants used an assessment survey to self-rate how well they followed the diet for adherence measurements.¹

After analysis, investigators found the following statistically significant results:¹

• Adherence with the elimination diet was greater in the functional medicine health coaching intervention group than in the self-guided control group.
• Both study groups reported statistically significant improvements in the PROMIS GH compared to their baseline state. However, the between-group improvements were not statistically significant in their PROMIS GH scores.
• For those participants with poorer symptoms at baseline, participants in the functional medicine coaching group had greater improvement in PROMIS GH – Mental Health domain scores compared to the self-guided elimination diet group.

Overall, this RCT indicates that among a relatively healthy sample of healthcare professionals, functional medicine health coaching enhanced dietary adherence levels, an elimination diet was associated with improvements in patient-reported health outcomes, and those with more extensive symptoms found greater improvements after support from health coaches trained in functional medicine.

IFM recognizes the importance of research initiatives such as this clinical trial that study the functional medicine model, and it aims to catalyze further efforts within the medical research community. These investigations of the functional medicine approach continue to build the functional medicine evidence base through the study of innovative and personalized lifestyle-based therapies and their impact on chronic disease as well as overall health across populations.

Related Content

IFM’s Elimination Diet: Personalized Optimized Nutrition

Health Coaching as a Strategy to Enhance Your Practice 

Building the Functional Medicine Evidence Base  

References

1. D’Adamo CR, Kaplan MB, Campbell PS, et al. Functional medicine health coaching improved elimination diet compliance and patient-reported health outcomes: results from a randomized controlled trial. Medicine (Baltimore). 2024;103(8):e37148. doi:1097/MD.0000000000037148
2. Wood RA. Diagnostic elimination diets and oral food provocation. Chem Immunol Allergy. 2015;101:87-95. doi:1159/000371680
3. Molina-Infante J. Nutritional and psychological considerations for dietary therapy in eosinophilic esophagitis. Nutrients. 2022;14(8):1588. doi:3390/nu14081588
4. An S, Song R. Effects of health coaching on behavioral modification among adults with cardiovascular risk factors: systematic review and meta-analysis. Patient Educ Couns. 2020;103(10):2029-2038. doi:1016/j.pec.2020.04.029
5. Long H, Howells K, Peters S, Blakemore A. Does health coaching improve health-related quality of life and reduce hospital admissions in people with chronic obstructive pulmonary disease? A systematic review and meta-analysis. Br J Health Psychol. 2019;24(3):515-546. doi:1111/bjhp.12366
6. Lin CL, Huang LC, Chang YT, Chen RY, Yang SH. Effectiveness of health coaching in diabetes control and lifestyle improvement: a randomized-controlled trial. Nutrients. 2021;13(11):3878. doi:3390/nu13113878