Nutritional Therapy Overview
Nutrition and Health
Nutrients and other food components influence the function of the body, protect against disease, restore health, and determine people’s response to changes in the environment. Under certain circumstances and in some individuals, diet can be a serious risk factor for a number of diseases. Common dietary chemicals can act on the human genome, either directly or indirectly, to alter gene expression or structure. The degree to which diet influences the balance between healthy and disease states may depend on an individual’s genetic makeup. Some diet-regulated genes (and their normal, common variants) are likely to play a role in the onset, incidence, progression, and/or severity of chronic diseases. Dietary intervention based on knowledge of nutritional requirement, nutritional status, and genotype (i.e. “personalised nutrition”) can be used to prevent, mitigate or cure chronic disease.
Nutritional Therapy is the application of nutrition science in the promotion of health, peak performance and individual care. Registered Nutritional Therapists use a wide range of tools to assess and identify potential nutritional imbalances and understand how these may contribute to an individual’s symptoms and health concerns. This approach allows them to work with individuals to address nutritional balance and help support the body towards maintaining health. Nutritional Therapy is recognised as a complementary medicine and is relevant for individuals with chronic conditions, as well as those looking for support to enhance their health and wellbeing.
Practitioners consider each individual to be unique and recommend personalised nutrition and lifestyle programmes rather than a ‘one size fits all’ approach. Practitioners never recommend nutritional therapy as a replacement for medical advice and always refer any client with ‘red flag’ signs or symptoms to their medical professional. They will also frequently work alongside a medical professional and will communicate with other healthcare professionals involved in the client’s care to explain any nutritional therapy programme that has been provided. Registered Nutritional Therapists are required to meet the standards of their professional body BANT (British Association for Applied Nutrition and Nutritional Therapy) and are regulated via CNHC (Complementary and Natural Healthcare Council).
Other Nutrition Titles
A number of different titles are used to describe professionals working in the field of nutrition. For the avoidance of doubt, below is a summary of some other nutrition professionals.
Dietitians work principally in the National Health Service and are regulated by the Health and Care Professions Council. Their professional body is the British Dietetic Association. A dietitian uses the science of nutrition to devise eating plans for patients to treat medical conditions. They also work to promote good health by helping to facilitate a positive change in food choices amongst individuals, groups and communities.
NB: Only dietitians and Registered Nutritional Therapists are trained in clinical practice to give one-on-one personal health advice. Both groups must practise with full professional indemnity insurance.
Registered Nutritionists provide evidence-based information and guidance about the impacts of food and nutrition on the health and wellbeing of humans (at an individual or population level) or animals. Registered Nutritionists have a good understanding of the scientific basis of nutrition and work in a range of settings., These can include research, education and policy development.
Nutrition science is defined globally as the study of food systems, foods and drinks, and their nutrients and other constituents; and of their interactions within and between all relevant biological, social and environmental systems. Outside the biological sciences - which are core to practice in nutritional therapy - applied nutritionists have knowledge, skills and understanding which underpin competence in more diverse areas. These may include epidemiology, public health practice, food technology and development, food safety, food law, ecological and environmental sustainability, economics, catering, journalism, politics and social science. The National Occupational Standards (NOS) for Nutritional Therapy cover clinical practice only. Practitioners working in applied nutrition have qualifications, training and experience additional to those required to meet the NOS for clinical practice.
Nutrition Advisor/Dietary Advisor
Other practitioners of complementary therapy may offer general nutrition advice as part of advice on a healthy lifestyle, for weight management or to support another therapy, such as massage therapy. There are many short courses in nutrition advice designed to support other complementary therapies, but they do not meet the National Occupational Standard for nutritional therapy.
Nutritional Therapists will often recommend some form of nutritional supplement as part of their treatment plans. The scientific evidence overwhelming supports the use of nutritional supplementation for the prevention of disease and the support of optimal health. However, supplements should be as the name suggests: 'supplemental' to diet. Diet is always the starting point for any nutritional and lifestyle plan. We are all unique and our lifestyle factors vary from individual to indiviual. The role of the Nutritional Therapist is to identify areas where you may need supplement support and include specific recommendations into a personalised programme plan that will restore balance and wellbeing.
Are Supplements Needed?
Many people think a good diet will provide all of the nutrients that they need. But is this true? Whilst diet is always the starting point, there are many reasons why supplements may also be necessary. Modern lifestyles can be partly to blame, from stressful situations to environmental toxins. Both of which require additional micronutrients to support normal bodily function. And such is our level of exposure to environmental toxins, that it is now impossible for us to avoid them. So, your body is having to work harder than ever to eliminate these harmful toxins to prevent damage.
However, one of the major problems stems from our food chain iteslf. Modern farming practices have changed hugely over the past century. Today's intensive farming practices have resulted in an estimated 75% reduction in the micronutrient content of the soil, which has a signicant knock-on effect on plants grown or animals grazed on that land. Other practices also play a part. Reduced nutrient levels occur as a result of animals that are grain-fed, rather than grass-fed; food processing strips or destroys vital nutrients in the food; whilst the food supply chain itself throws up further problems - once the food is harvested, it sits on trucks, shelves, shop counters and in your fridge for weeks before being eaten, thereby leading to a further deterioration in the nutrient content. Ultimately, the food that we eat now is far inferior in micronutrient content to the food eaten by our ancestors.
There have been many misleading stories in the press over the safety of nutritional supplements, which can lead to confusion as to safety and viability. Often those study results are misinterpreted or misreported and, without access to the original research papers or understanding the context of the claim, it is very hard for you to know the truth. Conversely, numerous reports on how insufficient nutrient intake contributes towards many health problems, as well as the impressive health benefits that result from regular dietary supplementation, are less publicised and often completely ignored. However, the scientific evidence clearly and overwhelmingly supports the use of nutritional supplementation for health and wellbeing.
Levels of supplementation, though, need to be viewed in the context of recommended levels. It is very important to remember that vitamins and minerals are required in small quantities by the body and supplementation in high doses can be toxic. Consequently, saftety levels for specific nutrients have been recommended by various authoritative bodies based on scientific evidenence that have shown those levels to be safe. Good supplement companies and Nutritional Therapists will work within recognised guideline limits when manufacturing or recommending supplement products. Be aware also, that possible interactions can occur with nutritional supplements and medication that could interfere with the effectivness of the medication. Always seek advice from a medical practitioner before consuming any nutritional supplements if you are taking any medication.
RDAs and USLs
The RDA (recommended daily allowance) or the DRF (dietary reference value), as it is now referrred to in the UK, can be misleading. These figures relate to the minimum values required to prevent the occurence of recongised nutritional deficiency diseases, such as scurvy. They are not necessarily values that support optimum health. In recognition of this, nutrition supplement companies and Nutritional Therapists will work in accordance with recognised Upper Safe Levels (USLs). These levels have been set by various authoritative bodies (HFMA, Institute of Medicine, US Food & Nutrition Board, EU Scientific Committee for Food) and are based on available scientific studies that have shown those levels to be safe. For the avoidance of doubt, these USLs are usually way above the country RDA levels.
There are a vast amount of supplement brands on the market, making your choice of product difficult. Be aware that the cheaper the product, the more likely it is that inferior ingredients will have been used, that they will contain a greater number of excipients, and as a consequence, there is a greater likelihood of poor absorption. Your Nutritional Therapist will recommend the best quality supplements for your budget.