These days, I often identify myself as an integrative nutritionist. But just what does that mean? Technically, many give the words integrative and holistic two different definitions. Integrative suggests the melding of different cultures and belief systems, blending traditional Western medicine with Chinese herbal medicine or acupuncture, for example. And holistic is used to denote an approach that says you cannot separate mind and body and the most productive way to help a patient is to look at all aspects of their being. Both of these imply an alternative approach. For me, these two concepts come together as one under the term integrative, a practice that is simply more practical and productive. Of course you capture more of the picture with a wider lens.
When I assess a patient, I try to learn what constitutes the root causes of her or his problem. It is rarely just one thing or another, a physical matter or a more subtle lifestyle or emotional issue. Most commonly, both physical and psychic or lifestyle issues are linked. Think about diabetes and prediabetes, for example. Elevated blood sugar and the long-term damage it causes is one of the biggest health problems plaguing our country at the moment. About 29 million adults, more than 9% of the population, has diabetes, and roughly 86 million suffer from its precursor, prediabetes. In the majority of cases, these disease states are associated with obesity. Well, along with diet and exercise, stress and lack of sleep have been proven to affect weight gain. Is it holistic if I ask a patient about the stress in their life? Or the quality of their sleep? No, it’s just part of good nutrition counseling. That’s why my new book coming out in November, The Diabetes Solution, written with Dr. Jorge E. Rodriguez, has large sections on stress reduction, improving sleep, and making sure you get enough physical activity to improve your health in addition to all the medical information you will ever need and a sumptuous dietary plan with 100 recipes. Forgive the plug; I worked on that book for a very long time. and it will be an excellent aid to anyone wishing to lower their blood sugar.
I think of integrative nutrition also as pushing the forefront of evidence-based medicine. By that, we mean science that has been shown to be effective or true in studies solid enough to be published in journals reviewed by other professional experts. Often it takes years for information that has been proven by research to enter standard practice, because not everyone reads the latest medical and nutrition journals, and organizations–not to speak of the government–are extremely slow to change, partly because of bureaucracy and partly because of appropriate caution. The Swiss doctor I worked with, Dr. Thomas Rau, lectured me almost a decade ago about the gut microbiome and the tremendous importance of nourishing our good gut bacteria with proper nutrition. That’s a model I’ve followed since I began my practice, even though it’s only become “fashionable” in the past couple of years. And as I’ve learned both in my practice and in my own life, this sort of integrative nutrition practice is powerful and effective.
On the other hand, sometimes integrative, alternative and holistic are used as titles without being backed up with enough training and knowledge. My dog could call himself a holistic nutritionist. There are no regulating bodies or state licensing agencies as there are for registered dietitians. Good nutrition practice is not magic. If you want to improve your health or want to make sure you are practicing the best form of wellness to ensure healthy aging, I hope you’ll look for a registered dietitian nutritionist ( a newer name for an RD who specializes in nutrition), preferably one with an MS or MPH in their credentials, which denotes a masters degree, entailing years of extra scientific study. And given my biases, I suggest you ask them if they have an integrative approach and if so, give it a chance. You’ll be amazed at the power of proper individualized nutrition.