Myriad diets, pharmaceuticals, herbal supplements, and surgical treatments are available as potential treatments for obesity and related chronic diseases. Nutrition and diet therapy are critical components of primary care providers’ intervention toolbox, including nurse practitioners. However, only a few are adequately knowledgeable about how nutrition affects health and illness. There are even fewer people who understand the relationship between food and genetic expression, as well as the emerging approaches to nutrition. According to the NIH/NCCAM, novel nutritional therapies include whole food movement, anti-inflammatory diets, body-type diets, and functional nutrition.

Nutrition and diet therapy:

Nutritional sciences are undergoing a paradigm shift. In nutrigenetics/nutrigenomics, the study of gene expression and nutrition, it is proposed that disease can be prevented and reversed by drastically altering the nutritional environment. In general, chronic diseases are genetically predisposed; the environment influences gene expression greatly; whole food, plant-based, nutritionally-dense diets positively influence gene expression and the incidence of chronic diseases. A system of healing based on the belief that food, in its whole and natural form, provides the substance needed to achieve and maintain a vibrant state of health has been developed based on the findings of nutritional medicine and nutrition and diet therapy.

Nutrition and diet therapy use food to prevent and reverse diseases common to western societies, such as diabetes, obesity, heart disease, arthritis, and depression. It is important for foods to be nutrient-dense in order to be therapeutic, as measured by their nutrients and antinutrients.

Nutrients 

Plants and animals provide macronutrients (protein, carbohydrates, fat), micronutrients (vitamins, minerals, phytochemicals, antioxidants, probiotics), and fiber. They include whole, unprocessed vegetables, fruits, beans, legumes, whole grains, and raw nuts/seeds. Grass-fed, free-range, organic meat, dairy, eggs, and wild fish are also acceptable.

Anti-Nutrients

Food products that are not biologically necessary. Despite being edible, these are not considered “food”: high fructose corn syrup, sugars, artificial sweeteners, highly processed and hydrogenated fats, refined flour products, preservatives, and additives. In addition, some nutrients become anti-nutrients when consumed in excess. While our biological salt needs are as low as 250 mg/day, the US recommended daily allowance (RDA) for salt is under 2400 mg, and Americans often consume more than 3500 mg/day. Thus, salt intake within the recommended daily allowance is considered antinutritional.

Nutritional Therapy: The Basics

Nurse practitioners value holistic, safe, and effective approaches to treating the whole person. Patients seeking relief from obesity and chronic illness, as well as those pursuing health promotion and wellness, benefit from nutritional therapy. The following are some basic recommendations:

Processed foods, such as those that are anti-nutrients, should be avoided. Among other things, they contribute to obesity and a wide range of diseases.

Whole foods only: unprocessed, raw vegetables and fruits, beans, legumes, raw nuts, raw seeds, whole grains, free-range, grass-fed organic animal products, and small wild fish.

Rather than paying attention to calories, carbohydrates, and fats, eat a variety of whole foods.

By eating the majority of your calories from the most nutritionally dense foods (micronutrients per calorie), you can determine whether the whole food diet is therapeutic. For example, if a person is trying to reverse a disease, their diet should consist of mostly raw fruits and vegetables, eliminating all animal products. There are some grains and animal products that can be included in a health-promoting diet.

Lastly,

Nutritional therapy critics might argue that these new approaches are radical and that patients cannot maintain dietary changes and recommendations. There is increasing evidence that diets containing nutritiously dense foods with minimal cooking and processing improve sustained weight loss and glycemic biomarkers. A nurse practitioner should be able to educate patients about sound nutritional practices and encourage positive changes in nutritional self-care based on advances in nutrition and diet therapy science and emerging nutritional systems of health promotion and healing.