What People Are Asking
Q What is clinical nutrition?
A Clinical nutrition is the study of the relationship between food and a healthy body. More specifically, it is the science of nutrients and how they are digested, absorbed, transported, metabolized, stored, and eliminated by the body. Besides studying how food works in the body, nutritionists are interested in how the environment affects the quality and safety of foods, and what influence these factors have on health and disease.
Q What are nutrients?
A Nutrients are substances that the body needs to live and grow. The body requires more than 45 nutrients, and the ways they are used are as different as the molecules, cells, and tissues they help to create. Carbohydrates, proteins, and fats—called macronutrients—are broken down (metabolized) to provide energy. Vitamins and minerals—called micronutrients—are not used for energy themselves, but are needed to help macronutrients be used for energy.
Q What is the history of clinical nutrition?
A The study of nutrition dates back to the 18th century, when the French chemist Lavoisier discovered that there was a relationship between our metabolism of food and the process of breathing. By the early 20th century, scientists had found that diseases—such as beri-beri, rickets, scurvy, and pellagra—were associated with certain diets. By 1912, the Polish chemist Casimir Funk had found a substance (vitamin B1) that actually prevented beri-beri, and he named it "vitamine." Later it was found that these diseases were caused by the lack of specific nutrients—vitamin B1 (thiamine), vitamin D, vitamin C, and vitamin B3 (niacin) respectively.
In the early 1940s, the National Research Council set Recommended Dietary Allowances (RDAs). The RDAs set the minimum amount of a nutrient needed to prevent diseases like beri-beri and rickets.
Researchers and scientists continue to find out more about how individual nutrients can help in the prevention and treatment of disease. But they are also learning how whole foods may allow many nutrients to work together. For example, antioxidants like beta-carotene, selenium, vitamin E, and vitamin C, when consumed in foods, appear to protect against the development of heart disease, cancer, and other chronic degenerative diseases.
The old RDAs have been replaced by Dietary Reference Intakes (DRIs), which show how much of a nutrient we need every day to maximize health and lower the risk of chronic disease (in contrast to RDAs, which listed the minimum amount needed to prevent a deficiency). The field of clinical nutrition is now increasingly incorporated into mainstream medical treatment.
Q What are nutritional supplements?
A The term "nutritional supplement" refers to vitamins, minerals, and other nutrients that are used to support good health and treat illness. For example, plant compounds known as phytochemicals (found in tomatoes and soybeans) have powerful disease-fighting properties. While it's always best to get nutrients through the foods you eat, sometimes taking a supplement can help. For example, taking zinc supplements has been reported to shorten the duration of the common cold and lower the incidence of acute diarrhea in children.
Q How do vitamins and minerals work?
A Vitamins and minerals play an essential role in the body's normal metabolism, growth, and development. For example, while a vitamin is not a source of energy by itself, it can provide the key the body needs to unlock energy stored in food. Some vitamins and minerals work together, such as the mineral zinc and vitamin A. Zinc enables the body to use vitamin A to promote good vision. Not getting enough vitamin A may lead to night blindness, a condition in which the eyes have trouble adjusting to darkness. Zinc supplementation may help prevent this condition by helping the body use vitamin A. Another example is calcium and vitamin D. Calcium, which is very important in bone and heart health, is more readily absorbed if vitamin D is also present.
Taking supplements, however, is not the answer to long-term good health. Combining a healthy diet with regular exercise and a positive mental attitude has been shown to be the best bet for a healthy lifestyle.
Q What constitutes a healthful diet?
A The United States Department of Agriculture (USDA) food pyramid suggests that we use fat "sparingly," and that our daily diet include 2 - 3 servings of dairy products; 2 - 3 servings of meat, poultry, fish, eggs, beans, or nuts; 3 - 5 servings of vegetables; 2 - 4 servings of fruit; and 6 - 11 servings of bread, cereal, rice, or pasta. But the numbers alone don't tell the whole story. Our food needs are influenced by many factors, including age, gender, body size, pregnancy, and health. A clinical nutritionist or nutritionally oriented doctor can help you determine what type of diet is best for you. No matter what, you can improve your diet by adding more fruits and vegetables and cutting back on saturated fat and sugar.
Q What is clinical nutrition good for?
A Studies show that eating habits play a major role in the development of certain chronic diseases, including heart disease, obesity, cancer, and diabetes. Making changes to your diet can help to both prevent and treat these conditions. For example, lowering certain fats and cholesterol and adding whole grains to your diet can help prevent atherosclerosis (plaque build up in the arteries), which can lead to heart disease or stroke. Eat fewer calories will help you lose weight. Cutting down on simple sugars (glucose, sucrose, fructose, and lactose) can help prevent diabetes, and diets high in fiber (especially soluble fiber) can help control diabetes.
Scientists have found many other connections between diet and disease. In a clinical study of 20,000 men, for example, eating one fish meal per week was linked to a 52% reduction in the risk of sudden death from a heart attack. Fish is high in omega-3 fatty acids, which can protect the heart from fatal arrhythmias (abnormal heart rhythm).
In another clinical study of more than 42,000 women, those who ate lots of fruits, vegetables, whole grains, low-fat dairy, and only lean meats lived longer. High intake of fruits, vegetables, and legumes is associated with a lower risk of developing heart disease.
There are many ongoing studies regarding clinical nutrition. Some interesting results show that:
- Diets high in folate (found in leafy greens, dry beans and peas, fortified cereals and grain products, and some fruits and vegetables) may lower risk of stroke and heart disease.
- Eating small amounts of fish when pregnant may protect against early delivery and low birth weight infants. Some fish may contain higher amounts of mercury, and should only be eaten in moderation. Ask your obstetrician which types of fish are best for you when pregnant. Taking iron supplements improves aerobic training ability in iron-depleted women.
- Lutein and zeaxanthin (carotenoids) in the diet may reduce risk of cataracts.
- Lutein from dietary sources (such as kale and spinach) may protect against colon cancer.
- Flavonoids (found in apples, blueberries, broccoli, cabbage, carrots, citrus fruits, onions, and teas) may protect against cancer.
- Omega-3 fatty acids found in cold water fish (such as herring, tuna, and salmon) help reduce inflammation and help prevent certain chronic diseases, such as heart disease, cancer, and arthritis.
- Vitamin E (in the diet from fruits and vegetables) may reduce the risk of angina (chest pain) and heart attack in people with atherosclerosis.
In hospitals, nutrition is used to improve the overall health of patients with a wide range of conditions. Examples of these conditions are AIDS, cancer, osteoporosis, lung disease, obesity, burns, metabolic disorders, and kidney, liver, and pancreatic disorders. Patients who need surgery are also supported with clinical nutrition.
Q Is there anything I should watch out for?
A Some nutritional supplements can interact with medications; it is very important to tell your doctor about any dietary supplements you are considering taking. Always take supplements according to label directions unless otherwise directed by a qualified health care practitioner.
There is little scientific information about the effect of so-called functional foods—foods to which vitamins, minerals, herbs, or other dietary substances are added—despite their growing popularity in the marketplace. Examples include calcium-fortified orange juice or snacks containing Echinacea.
Some common foods, including nuts, wheat gluten, dairy products, fish, shrimp, soy, bananas and eggs, may trigger allergic reactions. Your doctor can test for such possible allergies if he suspects you have them.
Q What exactly do you do?
A I am a certified dietitian-nutritionist. I have been developing nutritional and lifestyle regimens for patients and clients for over 15 years. My education and clinical experience is both integrative and traditionally based. My typical patient presents complex-with multiple co-morbidities that could include one or all of our current health care challenges: diabetes, cardiovascular, cancer, gastro-intestinal, auto-immune, etc. This further solidifies that every individual needs specific diet guidance to fit their needs and lifestyle. One diet regimen most likely doesn't fit all. But more importantly, your diet regimen will need to change over time as you progress through your life cycle. As I have done with thousands of others, I can work on your appropriate diet plan and specifically outline the most beneficial supplements to better your health and prevent life altering complications. If its weight loss, increased energy or decreasing/eliminating your medication regimen you desire, I can help offer you an alternative nutritional approach that will bring your body back to balance and improve the quality of your life.
Q What should I expect during my first consult?
A Prior to our first meeting, I like to set up a phone consultation to get a basic idea of your health concerns and needs. This will help me tailor how our first meeting: the focus, nutritional testing and basic plan. The initial phone conversation typically lasts 5 to 15 minutes. The initial consultation can take anywhere from an hour to 2 hours – depending on the complexity of your condition and nutritional testing required. We will review your medical history, family history, your personal lifestyle, your diet, issues with any systems of your body, exercise habits, laboratory data. I also may want to perform some simple, non-invasive nutritional testing that will establish your baseline at the start of your program and also allow us to track your progress as you incorporate some of the lifestyle changes that I recommend. We will decide on the best regimen that you feel comfortable with and then discuss your follow up plan.
Q What kind of nutritional testing do you do?
A I generally incorporate non-invasive broad spectrum antioxidant testing and bioelectrical impedance analysis. Both tests are simple, quick and offer immediate results that provide me with general insight on your vitamin capacity, immune defense, cellular health, fat mass, lean body mass, total body water, basal metabolic rate or the amount of calories your body requires at rest. These allow me to gage your baseline status and determine the right initial regimen for you. We have measureable results that allow us to track your progress. I also review any laboratory work your doctor orders. If further or more invasive nutritional tests are required, I will make recommendations accordingly.
Q I live far away. Do you do phone consultations?
A Absolutely. I will not be able to perform some of the nutritional testing but can still develop a comprehensive nutritional plan with the information you can provide me. However, in some instances and because we don't have these measureable nutritional baselines, we may have to adjust your plan after implementation so you can achieve your desired results.
Q Do you do home consultations?
A I actually prefer to perform your initial consultation in your home environment. It is not necessary but it allows you to be the most comfortable and open with me. Plus, if you have food items you have been consuming in question or want me to review your pantries or fridge – this is the best place to do it. My office and equipment is mobile and just takes a short moment to set up.
Q Do you do group consultations?
A Yes. I welcome family consultations, businesses, bridal parties or other group settings. Because of the individualization needed, group consultations may have to have follow-up sessions. It is best to discuss the details so we can best fit your needs.
Q Do you travel outside of the state?
A Yes. Scheduling does have to be made in advance and the consultation fee will have to be adjusted to include travel.
Q What do you think of the __________ diet?
A You know I can't tell you how often my clients ask me about this diet or the latest diet craze. Throughout the years, my answer still remains the same. Every diet has its pros and cons. Just because it worked for the majority or your neighbor next door, doesn't mean that it will work for you. Everyone has their own chemical individuality and metabolic make-up. When you start pulling all the pieces to the puzzle together – current symptoms, medical history, diagnosis, laboratory values and anthropometric measurements, lifestyle, diet, etc – it is only then that you can make an educated decision on what will work best for you to improve your health outcomes. Let's face it – the absence of grains and the inclusion of lean proteins and veggies can help almost anyone shrink their waistline. But what I you have a significant cardiovascular or gastrointestinal issue? You may need a tailored version of the paleo diet with the right nutraceutical support o experience optimal health benefits. This is why it's important to work with me so that I can advise you on a plan that will improve the quality of your current life and allow you to age gracefully without complications of severe health problems in your later years. Do you want to spend your retirement traveling, chasing around your grand kids (or wife) or do you want to spend your twilight years in a hospital bed plagued with pain and health problems?
Q I really want to do a cleanse or a detox – which one should I do?
A There is no question that there are many health benefits observed from following a detoxification protocol. However, much of what is advertised in magazines and in the media is not necessarily a good option. A good detoxification program will utilize the body's own ability to transfer and eliminate toxins in 3 phases that encompass the liver, the kidneys, intestines and colon. This process requires a significant amount of energy and is therefore dependent on food and specific nutrients. Many "cleanses" or "fasts" that advertise detoxification and quick weight loss thru the use of fasting with water or juices have shown in clinical studies to be ineffective and dangerous. They promote muscle and organ weakness, the elimination of critical nutrients and the retention of harmful toxins. We only offer effective and safe detoxification programs utilizing the specific nutrients and foods needed for appropriate detoxification.
Q I am on medication for high cholesterol and diabetes – is it possible to come off these medications?
A Yes and No. After we decide on the best nutritional lifestyle plan for you – we will discuss your medications. You are to continue to take your medications as prescribed by your doctor. However, over the course of your plan, you will follow up with your doctor so he can review your progress and make adjustments to your medication regimen as he/she sees fit. Some people have medical conditions that require them to be on a particular medication. However, with some chronic disease states that are nutritional based, it is not uncommon for patients to experience a decreased dose or an elimination of a medication(s) if they incorporate the right nutrition and lifestyle plan.
Q Will this be too expensive?
A No. In fact, this will end up saving you money in the short and long term. I will work with you on consultation fees and offer you the best price for the highest quality supplements. Most people are overspending on their food and grocery bill. The majority of people are overpaying for poor quality and the wrong supplement regimen. I will work with you to tailor your plan that will save you money in the long run and improve the quality of your life for years to come.