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Nutritional imbalances are potential contributors or causes of several chronic conditions, and nutrition-based interventions may bring relief or potentially resolve these conditions completely. Proper nutrition is associated with not only disease prevention but surgical recovery as well.1,2 However, clinicians are rarely offered even basic nutritional training in medical school, a systematic review in The Lancet suggests.3 Perhaps unsurprisingly, many patients do not have optimal nutrition,4 are experiencing record levels of chronic disease,5 and are most likely being treated with pharmaceuticals, despite the availability of other highly effective options.6,7
When high-quality nutrition is applied effectively and consistently, it may prevent future chronic disease in adolescents,8 enhance cognition in people with dementia,9 and improve outcomes in patients receiving colorectal and GI oncological surgeries,10 to name a few. Moreover, in patients who have hospital stays for any reason, nutrition support is associated with fewer infectious complications and shorter lengths of stays.
Chronic diseases account for the majority of health concerns in middle-aged and older populations,11 and many of these conditions respond well to nutritional interventions. Risks of obesity, diabetes, hypertension, and cardiovascular disease are strongly linked to lifestyle, especially dietary choices.12,13
Immunonutrition—the potential to modulate the activity of the immune system by interventions with specific nutrients—has also emerged as a clinically important concept, highlighting the importance of nutrients such as vitamins A, C, E, and D, folic acid, beta carotene, and trace elements such as zinc, selenium, manganese, and iron to the gut microbiome.14
There are a variety of approaches for plant-based eating, from Mediterranean-type diets to vegetarian and vegan diets. Plant-based diets aim to maximize the consumption of nutrient-dense plant foods (vegetables, fruits, beans, peas, lentils, and nuts) and minimize processed foods, oils, and animal foods (including dairy and eggs).13 Yet despite the strong body of evidence favoring plant-based diets, including studies showing a willingness of the general public to embrace them, many physicians are not stressing the importance of plant-based diets as a first-line treatment for chronic illnesses.13
In this video, IFM educator Michael Stone talks about functional nutrition and how clinicians can use high-quality foods that are rich in phytonutrients to address their patients’ clinical imbalances:
Specific nutrients and dietary patterns have also been investigated for their neuroprotective properties. Increased diet quality and adherence to dietary guidelines that emphasize consumption of fruits, vegetables, fish, and fiber were related to better cognition among those with and without cognitive impairments in two recent cross-sectional studies.14,15 In addition, specific nutrients such as omega-3 fatty acids and vitamin D, and specific diets such as the Mediterranean and ketogenic diets, have surfaced in recent neurodegenerative disease research with suggested benefits of prevention, slowing disease progression, and improving quality of life for patients.16-22 For an in-depth look at the connection between diet and cognition, please read the following IFM-authored article “Nutrition: A Key Modulator of Cognitive Health.”
Nutrition-based interventions are fundamental components of many therapeutic strategies used to combat chronic illness and restore optimal health. These personalized treatments may include modifiable therapeutic food plans that address nutritional imbalances, and patient-practitioner collaboration is essential for successful implementation and sustainability.
How can clinicians use functional nutrition to effectively prevent and even reverse chronic disease, as well as support general health and wellness? Functional nutrition is integrated into all of IFM’s courses, but it is provided most comprehensively in IFM’s foundational course, Applying Functional Medicine in Clinical Practice (AFMCP). In this five-day course, clinicians will learn evidence-based nutritional strategies to restore patients’ health and improve outcomes.
IFM also offers in-depth training on the clinical applications of the food plans discussed in AMFCP in a new online learning course, Therapeutic Food Plans: A Component of Personalized Nutrition. This course was developed in partnership with the American Nutrition Association to further educate clinicians on personalizing each food plan for the unique health needs of each patient.
- Zhang H, Wang Y, Jiang ZM, et al. Impact of nutrition support on clinical outcome and cost-effectiveness analysis in patients at nutritional risk: a prospective cohort study with propensity score matching. Nutrition. 2017;37:53-59. doi:1016/j.nut.2016.12.004
- Centers for Disease Control, National Center for Chronic Disease Prevention and Health Promotion. Physical activity and good nutrition: essential elements to prevent chronic diseases and obesity 2003. Nutr Clin Care. 2003;6(3):135-138.
- Crowley J, Ball L, Hiddink GJ. Nutrition in medical education: a systematic review. Lancet Planet Health. 2019;3(9):e379-e389. doi:1016/S2542-5196(19)30171-8
- Wanniarachige D. Malnourished patients often unacknowledged. CMAJ. 2015;187(4):242. doi:1503/cmaj.109-4991
- Ward BW, Schiller JS, Goodman RA. Multiple chronic conditions among US adults: a 2012 update. Prev Chronic Dis. 2014;11:E62. doi:5888/pcd11.130389
- Robbins R. Big pharma’s big push to get patients to take their meds. STAT News. Published February 4, 2016. Accessed May 31, 2022. https://www.statnews.com/2016/02/04/big-pharma-medication-adherence
- Cochran A. Does your doctor have ties to big pharma? How you’ll be able to find out. CBS News. Published March 4, 2014. Accessed May 31, 2022. http://www.cbsnews.com/news/does-your-doc-have-ties-to-big-pharma-how-youll-be-able-to-find-out
- Ozdemir A. Macronutrients in adolescence. Int J Caring Sci. 2016;9(2):1162-1166.
- Anderson JG, Lopez RP, Rose KM, Specht JK. Nonpharmacological strategies for patients with early-stage dementia or mild cognitive impairment: a 10-year update. Res Gerontol Nurs. 2017;10(1):5-11. doi:3928/19404921-20161209-05
- Williams JD, Wischmeyer PE. Assessment of perioperative nutrition practices and attitudes—a national survey of colorectal and GI surgical oncology programs. Am J Surg. 2017;213(6):1010-1018. doi:1016/j.amjsurg.2016.10.008
- St Sauver JL, Warner DO, Yawn BP, et al. Why patients visit their doctors: assessing the most prevalent conditions in a defined American population. Mayo Clin Proc. 2013;88(1):56-67. doi:1016/j.mayocp.2012.08.020
- Tuso PJ, Ismail MH, Ha BP, Bartolotto C. Nutritional update for physicians: plant-based diets. Perm J. 2013;17(2):61-66. doi:7812/TPP/12-085
- Wesselman LMP, Doorduijn AS, de Leeuw FA, et al. Dietary patterns are related to clinical characteristics in memory clinic patients with subjective cognitive decline: the SCIENCe project. 2019;11(5):1057. doi:10.3390/nu11051057
- Fieldhouse JLP, Doorduijn AS, de Leeuw FA, et al. A suboptimal diet is associated with poorer cognition: the NUDAD project. 2020;12(3):703. doi:10.3390/nu12030703
- Nolan JM, Mulcahy R, Power R, Moran R, Howard AN. Nutritional intervention to prevent Alzheimer’s disease: potential benefits of xanthophyll carotenoids and omega-3 fatty acids combined. J Alzheimers Dis. 2018;64(2):367-378. doi:3233/JAD-180160
- Calil SRB, Brucki SMD, Nitrini R, Yassuda MS. Adherence to the Mediterranean and MIND diets is associated with better cognition in healthy seniors but not in MCI or AD. Clin Nutr ESPEN. 2018;28:201-207. doi:1016/j.clnesp.2018.08.001
- Power R, Prado-Cabrero A, Mulcahy R, Howard A, Nolan JM. The role of nutrition for the aging population: implications for cognition and Alzheimer’s disease. Annu Rev Food Sci Technol. 2019;10:619-639. doi:1146/annurev-food-030216-030125
- Chai B, Gao F, Wu R, et al. Vitamin D deficiency as a risk factor for dementia and Alzheimer’s disease: an updated meta-analysis. BMC Neurol. 2019;19(1):284. doi:1186/s12883-019-1500-6
- Bianchi VE, Herrera PF, Laura R. Effect of nutrition on neurodegenerative diseases. A systematic review. Nutr Neurosci. 2021;24(10):810-834. doi:1080/1028415X.2019.1681088
- Grodzicki W, Dziendzikowska K. The role of selected bioactive compounds in the prevention of Alzheimer’s disease. Antioxidants. 2020;9(3):229. doi:3390/antiox9030229
- AlAmmar WA, Albeesh FH, Ibrahim LM, Algindan YY, Yamani LZ, Khattab RY. Effect of omega-3 fatty acids and fish oil supplementation on multiple sclerosis: a systematic review. Nutr Neurosci. 2021;24(7):569-579. doi:1080/1028415X.2019.1659560
- Wlodarek D. Role of ketogenic diets in neurodegenerative diseases (Alzheimer’s disease and Parkinson’s disease). Nutrients. 2019;11(1):169. doi:3390/nu11010169