What Is Functional Medical Nutrition Therapy?

(DougCookRD.com) Functional Medicine Iceberg


If you’re like most people, you’ve never heard of functional medicine let alone functional nutrition therapy and that’s OK. You’ve never heard of it because it’s not talked about by most health care professionals because they, in turn, have never been taught it.


What is Functional Medicine?

Functional medicine is different from conventional medicine because functional medicine addresses the underlying causes of chronic degenerative diseases which are rooted in our genetic makeup, environmental exposures, and lifestyle choices such as diet, supplement use, stress management, sleep quality, emotional & psychological health, leisure activities, exercise and more. Conventional medicine on the other hand is more reactive in nature. Once symptoms fall within a treatable range, an intervention is given. It’s geared towards treating a symptom without regard for the underlying cause by and large.


Whereas conventional medicine wouldn’t bat an eye at a slowly increasing fasting blood sugar for example, functional medicine would try to understand why. A person may have a fasting blood sugar that falls within the normal range of 4 to 6 mmol for years but which is slowly increasing from say 4.5 mmol, to 5.2 mmol,  to 5.8 mmol etc; a tell tale sign of progressive insulin resistance. Even when the blood sugar moves into the official insulin resistance range of 6.1 to 6.9  mmol, the conventional medicine approach will be ‘you’re blood sugar is a little high, not too high, but we’ll keep an eye on it’.


Translation: there are no interventions in conventional medicine [i.e. drugs] to treat insulin resistance and clinical practice guidelines from the Ministry of Health says not to intervene until the fasting blood sugar is 7.0 mmol or high, a.k.a. type 2 diabetes. Treatment? Metformin.


Sadly, the best time to have intervened would have been during the 6 to 10 years before the type 2 diabetes diagnosis, during the early stages of insulin resistance when there was a greater chance for prevention. This is where functional medicine and functional nutrition therapy is different.


Using this example, the functional medicine/nutrition therapy viewpoint is that anyone who is experiencing this kind of blood sugar change is not ‘functionally’ optimal [i.e. at a cellular or metabolic level] despite looking & feeling fine, not having any outward symptoms, nor meeting any criteria for a medical diagnosis.  Despite this, there are several underlying causes that are driving the real and progressive insulin resistance. This could include a functional [or sub-clinical] deficiency; a state where there isn’t an overt, full-blown nutrient deficiency but one where the underlying physiology or cellular fitness is not functioning at its best. There could be a sub-clinical deficiency of magnesium, vitamin D, chromium, thiamin [B1], or omega-3 fatty acids since all of these are involved in regulating insulin and carbohydrate metabolism. 


Perhaps the insulin resistance is from excess body weight [fat] or because of poor sleep quality and added chronic stress; known risk factors for insulin resistance.


Rather than waiting for treatable symptoms to occur, i.e. high blood, a functional medical approach would be to assess and address underlying causes of insulin resistance before diabetes develops.


Functional medicine and functional nutrition therapy gets to the underlying cause of disease-promoting dysfunction early one by supporting normal physiology, biology and metabolism. It uses a systems-oriented approach which engages the patient and the practitioner in a therapeutic partnership by focusing on the whole person [not the symptom of the day]. Functional medicine understands that disease and dysregulation don’t ‘just happen’ or ‘come out of nowhere’; but rather is in the making for years.


Integrative Model_David Allen MD


A functional nutritionist looks at the foundational way that food & nutrients affect the body on the cellular level and goes beyond simply assessing what you’re eating as compared to a model such as Canada’s Food Guide or Choose My Plate. Functional nutrition therapy is not your grandmother’s nutrition. It’s not about making generic statements about ‘balance, variety or moderation’ nor is it a myopic view on just grams of protein, fat and carbs. A ‘generally healthy diet’ will not hit the mark; rarely to never will it address optimal functionality since nutrient guidelines are designed to prevent overt deficiencies; not to ensure optimal metabolism. Being your best self and having best health requires a more holistic and comprehensive approach.

Three main focuses of functional nutrition therapy

Patient-centered care – truly listening to the patient and learning his or her story. The practitioner includes the patient in the discovery process and tailors the treatment that address’s the individual’s unique needs taking into account the physical, psychological, environmental and not just what the patient is eating.


Evidence-based and integrative – it integrates all the variables that make up the complex web of interactions that influence the patient’s health such as medical history, medication & supplement use, physiology, social supports, lifestyle, physical and social environment, and unique genetic make-up.


Preventative – goes beyond just traditional treatment by combing the best of both worlds of Western medicine [the judicious use of medications as needed and medical procedures when indicated] and with what is sometimes called ‘alternative’ medicine which focuses on nutrition, diet, exercise, minimizing toxin exposures, supplements, therapeutic diets.


* for more, see Dietitians in Integrative & Functional Medicine – a practice group of the Academy of Nutrition & Dietetics

Photo credit: CKNC Wellness, The Joint , David Allen MD

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