Focusing on your health and wellbeing is the best medicine you can get. Health care professionals around the world are now incorporating functional medicine into their practice. Functional medicine is personalized care that addresses root causes of disease and focuses on preventative care rather than reactive care. Lifestyle modifications are the foundational aspects of functional medicine.

These lifestyle modifications include sleeping and exercising more, stress reduction, nutrition, and diet. However, while all the above aspects are contributors, nutrition and diet enhance many health outcomes and play a fundamental role in a patient’s health.

Dietary changes alone may not be enough for all patients, but it is an important first step that can empower and motivate patients after improvements they experience.

What is a “Food First” approach? why is it important?

A “food first” approach involves making changes to an individual’s diet before taking medication. Plant-based and Mediterranean diets are rich in vegetables, fruits, beans, peas, and nuts, and they minimize the consumption of processed foods. With the overabundance of processed calories in the American diet, we are starting to see more nutrient deficiencies. Therefore, in addition to educating patients on the importance of diet and its effects on overall health, it is crucial for health professionals to assess and treat nutrient deficiencies.

Surprisingly, it is estimated that 31 percent of people in the United States are at risk for developing one or more nutrient deficiencies.

Common nutrient deficiencies from diet in the United States include vitamin D, vitamin E, magnesium, calcium, vitamin A, and vitamin C. Nutrients are key regulators in our bodies and play a vital role in many functions. Micronutrient deficiencies have been linked to physiological impairments, metabolic disorders, developmental issues, and decreased immune, endocrine, and cognitive function. Therefore, it is of the utmost importance that we consider these concerns in our patients and in ourselves.

What else might lead to nutrient depletion?

In addition to diet, long-term medication use has also been linked to nutrient depletion. Certain medications can cause our body to not fully absorb or benefit from the nutrients we get from food. Some common medications that deplete nutrients include oral contraceptives, anticonvulsants, and proton pump inhibitors.

Oral contraceptives deplete folic acid and magnesium. Anticonvulsants (Diazepam, Gabapentin, Lamotrigine, Levetiracetam, Valproic Acid), which are commonly used for seizures, deplete calcium. Proton pump inhibitors (Esomeprazole, Lansoprazole, Omeprazole) are available over the counter without a prescription and are commonly used to treat heartburn, but long-term use depletes magnesium. Interestingly, it is estimated that 30 percent of drug side effects are due to drug-induced nutrient depletion. This can lead to a phenomenon known as a “prescribing cascade,” which refers to prescribing one drug to treat the side effects of another drug. Taking a deeper look into the causes of side effects from drugs is a key factor in treating the root cause of the problem.

How do we assess for nutrient deficiencies and how can we treat them?

There are many assessment tools to determine nutrition imbalances including the nutrition-oriented physical exam. This is a physical approach that evaluates muscle, fat, fluid retention, functional capacity, and looks at lab values to determine micronutrient deficiencies. During the assessment, it is critical to identify underlying causes of chronic symptoms and conditions.

Functional medicine clinicians use an interprofessional team approach with primary care providers and ensure the patient is fully involved in their treatment plan. The Institute of Functional Medicine has a “Find a Practitioner” tool that allows you to search for certified functional medicine practitioners near you.

After assessment and diagnosis of nutrient deficiencies, treatments can be initiated. Treatment strategies include supplements, new dietary habits that help the patient increase consumption of nutrient rich foods, and a specific food plan tailored to each individual patient. The functional medicine approach gathers patients’ genetics, chronic conditions, and lifestyle choices to make a plan that fits each patient’s specific needs. While functional medicine is not considered mainstream currently, it may be a positive addition to any healthcare provider’s repertoire when considering the treatment of their next patient.