Clinical Nutrition

I’m not sure who originally said, “you are what you eat,” but this idea remains a central theme in my medical practice. As a clinical nutritionist I have two goals: providing my patients with proven solutions for existing conditions and helping them avoid the onset of serious illness in the future. “Food as medicine” is no longer a radical idea. Research has shown that some foods can trigger the onset of disease, even in otherwise healthy individuals. And by the same token, other foods cans help reverse the course of disease and restore health.

The pitfalls of "approved" diets

Over the past 20 years or so, mainstream medicine has come to consider diet a far more important factor for general wellness. A very good thing indeed! Prominent health authorities like the American Cancer Society, The American Heart Association and the US Food and Drug Administration have promoted new, more enlightened diets, reflecting the latest understanding of how certain foods promote good health. For the most part, these generic diets provide a reasonable nutritional foundation for the average person. But they also involve three problems that everyone should understand.

The first problem is simply that not everyone is average. People's nutritional needs can vary tremendously, and even a "recommended" diet rich in fruits, vegetables and fiber may not be providing the nutrients you really need.

The second and third problems have to do with the practices of modern agriculture. After over a century of intensive planting and harvesting, most American farm land has been depleted of key nutrients, especially minerals. If it's not in the soil, it won't be in the plant. Because farm land is fertilized only to promote yield (the bulk of a harvest) and not to assure nutritional value, the broccoli, tomatoes and carrots you eat today lack many of the valuable nutrients they once contained. As if this weren't bad enough, most commercially produced fruits and vegetables now contain high levels of pesticides and other toxins. Even commercially raised fish and livestock are typically treated with hormones and antibiotics. The bottom line: compared to what our great-grandparents ate, the food we buy today usually contains a lot less of what we want and a lot more of what we don't want.

The solution to these problems is testing—the clinical aspect of clinical nutrition. I conduct a broad variety of tests, not only to check for nutrient deficiencies, but also to screen for the presence of toxins, heavy metals, parasites and food allergies. The test results then become a guide for selecting foods and supplements specifically suited to each individual. In this way, people are able to satisfy their own nutritional needs. They are also in a much better position to manage the lack of key nutrients and the presence of unwanted chemicals in most commercially available food.

Nutrition to prevent disease

Most doctors would agree that the onset of disease is usually preceded by subclinical or preclinical changes in the body. Unfortunately, current standards of medical care discourage doctors from looking for these changes, and instead demand that they treat only recognized, manifest disease. With a few exceptions, like pap smears and colonoscopies, doctors do not order medical tests for which there are no existing diagnoses. And when they do, the tests are often denied by insurance companies.

This "If it ain't broke, don't fix it" mentality might be okay for cars and appliances, but it doesn’t make sense for the human body, a mechanism in which problems can exist undetected for years. It also points to a curious contradiction in modern medicine. All doctors agree with the benefits of early diagnosis. And yet, given the practices described above, the unspoken rule seems to be, "But not too early."

My own 30-year study of health care has convinced me that warning signs of cancer, gastrointestinal disease, diabetes and other serious illnesses can be detected far earlier than is generally accepted. Such early detection involves a more refined laboratory analysis. This permits the practitioner to offer patients more subtle, non-pharmacological treatments long before "crisis medicine" becomes the only viable option.

Now, what does this have to do with nutrition? Well, with early detection, the recommended treatment for many diseases is often a nutrient contained in or derived from food. Such “nutraceuticals” have been shown to be highly effective for preventing certain diseases.

Far from being alone in this thinking, I am now part of a growing trend. Recent studies have propelled evidence-based nutritional medicine to the forefront of patient care, prompting a convergence of conventional and alternative medicine. Research now shows clear connections between the causes of disease and deficiencies of essential nutrients, including vitamins, minerals, and amino acids. For example, many people with multiple sclerosis are found to have extremely low levels of vitamin B12, cobalt, iodine, zinc, magnesium or vitamin D, and experience improvement in their symptoms or reduced attacks when their diet is supplemented with these nutrients.

The process of nutritional consultation

The work begins with a prescription for a comprehensive set of laboratory tests. Performed by a certified medical lab, these tests screen for disorders involving the blood, liver, kidney, heart, electrolytes, and endocrine system. I then consult with the patient and in some cases the patient's physician to collect a detailed history and gain a clear understanding of specific symptoms and other medical concerns. Finally, I compare this information with the lab results to develop a nutrition plan individually tailored for each patient. This plan includes both dietary guidelines and recommendations for specific nutritional supplements and homeopathic remedies.

Another issue I address is the potential for interactions between supplements and medications. This subject has not been studied in detail, but some combinations require particular caution. For example, patients taking blood thinning medication should avoid any platelet inhibiting herbs and nutraceuticals. It is in part because of the risk of unexpected interactions that supplements should be used with the same degree of care and precision usually reserved for prescription pharmaceuticals.

Ultimately, clinical nutrition is about empowering patients. I try to give them clear information specific to their own physiology, which they can use every day to make the healthiest possible choices for their diet. For people coping with cancer therapy, I also offer counseling on how to use diet and supplementation to reduce the side effects of radiation and chemotherapy.