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The Radial: Integrative and Functional MNT

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Integrative and Functional Medical Nutrition Therapy

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Abstract

As the field of integrative and functional nutrition took root, practitioners needed a concrete model to help them gain a deep understanding of this approach. The ability to connect, synthesize, and apply information coherently using an integrated, whole systems-based lens to nutrition care led to the development of the Integrative and Functional Medical Nutrition Therapy (IFMNT) Radial. This conceptual framework, which illustrates practice components for critical thinking and clinical investigation, depicts the multi-dimensional aspects of a systems-based nutrition assessment in delivering medical nutrition therapy (MNT). The term “medical nutrition therapy” is defined as “nutritional diagnostic, therapy, and counseling services for the purpose of disease management, which are furnished by a registered dietitian or nutrition professional.” The counseling component of MNT has been described as a “supportive process to set priorities, establish goals and create individualized action plans which acknowledge and foster responsibility for self-care.” The Radial depicts a person-centered process that allows for the evaluation of complex interactions and interrelationships. The Radial purposefully integrates the evidence-based Nutrition Care Process (NCP) for clinicians to apply an integrative and functional methodology to provide high-quality nutrition care. Recent updates to the IFMNT Radial (referred to as the Radial) were based on emerging data on nutritional science, systems medicine, omics technologies, and the microbiome.

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References

  1. Noland D, Raj S. Academy of nutrition and dietetics: revised 2019 standards of practice and standards of professional performance for registered dietitian nutritionists (Competent, Proficient, and Expert) in nutrition in integrative and functional medicine. J Acad Nutr Diet. 119(6):1019–1036.e47.

    Google Scholar 

  2. U.S. Department of Health and Human Services: Final MNT regulations. CMS-1169-FC. Federal Register, 1 November 2001. 42 CFR Parts 405, 410, 411, 414, and 415.

    Google Scholar 

  3. Morris SF, Wylie-Rosett J. Medical nutrition therapy: a key to diabetes management and prevention. Clin Diab. 2010;28(1):12–18 referencing American Dietetic Association: Comparison of the American Dietetic Association (ADA) Nutrition Care Process for nutrition education services and the ADA Nutrition Care Process for medical nutrition therapy (MNT) services.

    Google Scholar 

  4. “Nutrition Care Process.” Eatrightpro.Org, 2019, www.eatrightpro.org/practice/practice-resources/nutrition-care-process. Accessed 16 June 2019.

  5. Bradley KL USA (Ret), Goetz T and Viswanathan S. Toward a contemporary definition of health. Mil Med. 2018;183(suppl_3):204–7.

    Google Scholar 

  6. McCowan B, Beisner B, Bliss-Moreau E, Vandeleest J, et al. Connections matter: social networks and lifespan health in primate translational models. Front Psychol. 2016;22(7):433. https://doi.org/10.3389/fpsyg.2016.00433. eCollection 2016.

    Article  Google Scholar 

  7. Castle D, Cline C, Daar AS, Tsamis C, Singe PA. Science, society, and the supermarket. The opportunities and challenges of nutrigenomics. Hoboken: Wiley; 2007. p. 3.

    Google Scholar 

  8. Ferguson LR, DeCaterina R, Görman U, Allayee H, et al. Guide and position of the International Society of Nutrigenetics/Nutrigenomics on personalised nutrition: part 1-fields of precision nutrition. J Nutrigenet Nutrigenomics. 2016;9:12–27.

    Article  Google Scholar 

  9. Witkamp RF, van Norren K. Let thy food be thy medicine....when possible. Eur J Pharm. 2018;836:102–14.

    Article  CAS  Google Scholar 

  10. Nordström K, Coff C, Jönsson H, Nordenfelt L, Görman U. Food and health: individual, cultural, or scientific matters? Genes Nutr. 2013;8:357–63.

    Article  Google Scholar 

  11. Cordain L, Eaton SB, Sebastian A, Mann N, et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005;81(2):341–54.

    Article  CAS  Google Scholar 

  12. Katz DL, Meller S. Can we say what diet is best for health? Annu Rev Public Health. 2014;35:83–103.

    Article  CAS  Google Scholar 

  13. Personal communication-biological compatibility, John Bagnulo, PhD, 2018.

    Google Scholar 

  14. Magni P, Bier DM, Pecorelli S, Agostoni C, et al. Perspective: improving nutritional guidelines for sustainable health policies: current status and perspectives. Adv Nutr. 2017;8:532–45.

    PubMed  PubMed Central  Google Scholar 

  15. Ash C. One person’s meat is another’s poison. Science. 2017;356(6344):1243–5.

    PubMed  Google Scholar 

  16. Nordström K, Coff C, Jönsson H, Nordenfelt L, Görman U, Nordstram K, et al. Food and health: individual, cultural, or scientific matters? Genes Nutr. 2013;8:336.

    Google Scholar 

  17. Methylmalonic acidemia diagnosis by laboratory methods. Rep Biochem Mol Biol. 2016;5(1):1–14.

    Google Scholar 

  18. Penberthy WT, Tsunoda I. The importance of NAD in multiple sclerosis. Curr Pharm Des. 2009;15(1):64–99.

    Article  CAS  Google Scholar 

  19. Egger G. In search of a germ theory equivalent for chronic disease. Prev Chronic Dis. 2012;9:E95.

    PubMed  PubMed Central  Google Scholar 

  20. Lee HS, Lee KJ. Alterations of food-specific serum IgG4 Titers to common food antigens in patients with irritable bowel syndrome. J Neurogastroenterol Motil. 2017;23(4):578–84.

    Article  Google Scholar 

  21. Ali A, et al. Efficacy of individualised diets in patients with irritable bowel syndrome: a randomised controlled trial. BMJ Open Gastroenterol. 2017;4(1):e000164.

    Article  Google Scholar 

  22. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, O.B.V., and Choline. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline., Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. National Academies Press (US), 1998.

    Google Scholar 

  23. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington (DC); 1997.

    Google Scholar 

  24. Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academy Press; 2001. https://www.nap.edu/read/10026/chapter/1. Assessed 5.4.2018.

  25. Witkowski M, Hubert J, Mazur A. Methods of assessment of magnesium status in humans: a systematic review. Magnes Res. 2011;24(4):163–8.

    CAS  PubMed  Google Scholar 

  26. Hess SY, et al. Use of serum zinc concentration as an indicator of population zinc status. Food Nutr Bull. 2007;28(3 Suppl):S403–29.

    Article  Google Scholar 

  27. Linus Pauling Institute, Micronutrient Information Center. http://lpi.oregonstate.edu/mic/ Accessed 5 April 2018.

  28. Lee T, et al. Standard values for the urine HVA/VMA ratio in neonates as a screen for Menkes disease. Brain and Development. 2015;37(1):114–9.

    Article  Google Scholar 

  29. Suzuki Y, et al. Level of serum undercarboxylated osteocalcin correlates with bone quality assessed by calcaneal quantitative ultrasound sonometry in young Japanese females. Exp Ther Med. 2017;13(5):1937–43.

    Article  CAS  Google Scholar 

  30. Antony AC. Evidence for potential underestimation of clinical folate deficiency in resource-limited countries using blood tests. Nutr Rev. 2017;75(8):600–15. https://doi.org/10.1093/nutrit/nux032.

    Article  PubMed  Google Scholar 

  31. U.S. National Library of Medicine: FIGLU test MeSH Descriptor Data 2019. https://meshb.nlm.nih.gov/record/ui?name=FIGLU%20Test. Assessed 15 June 2019.

  32. Cooperman JM, Lopez R. The role of histidine in the anemia of folate deficiency. Exp Biol Med (Maywood). 2002;227(11):998–1000.

    Article  CAS  Google Scholar 

  33. Shibata K, Yamazaki M, Matsuyama Y. Urinary excretion ratio of xanthurenic acid/kynurenic acid as a functional biomarker of niacin nutritional status. Biosci Biotechnol Biochem. 2016:1–9.

    Google Scholar 

  34. Shibata K, Sakamoto M. Urinary branched-chain 2-oxo acids as a biomarker for function of B-group vitamins in humans. J Nutr Sci Vitaminol (Tokyo). 2016;62(4):220–8.

    Article  CAS  Google Scholar 

  35. Sergeant S, Ruczinski I, Ivester P, Lee TC. Impact of methods used to express levels of circulating fatty acids on the degree and direction of associations with blood lipids in humans. Br J Nutr. 2016;115(2):251–61.

    Article  CAS  Google Scholar 

  36. Tobias DK, et al. Circulating branched-chain amino acids and incident cardiovascular disease in a prospective cohort of US women. Circ Genom Precis Med. 2018;11(4):e002157.

    Article  CAS  Google Scholar 

  37. Simpson HL, Campbell BJ. Review article: dietary fibre-microbiota interactions. Aliment Pharmacol Ther. 2015;42(2):158–79.

    Article  CAS  Google Scholar 

  38. Relevance of protein fermentation to gut health. Mol Nutr Food Res. 2012;56:184–96; November 1, 2010 vol. 299 no. 5 G1030-G1037.

    Google Scholar 

  39. Yao CK, Muir JG, Gibson PR. Review article: insights into colonic protein fermentation, its modulation and potential health implications. Aliment Pharmacol Ther. 2016;43(2):181–96. Epub 2015 Nov 2.

    Article  CAS  Google Scholar 

  40. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids: Health and Medicine Division. Nationalacademies.Org, 2019, www.nationalacademies.org/hmd/Reports/2002/Dietary-Reference-Intakes-for-Energy-Carbohydrate-Fiber-Fat-Fatty-Acids-Cholesterol-Protein-and-Amino-Acids.aspx.

  41. Ferguson LR, et al. Guide and position of the international society of nutrigenetics/nutrigenomics on personalised nutrition: part 1 - fields of precision nutrition. J Nutrigenet Nutrigenomics. 2016;9(1):12–27.

    Article  Google Scholar 

  42. Parsons K, et al. Novel testing enhances irritable bowel syndrome medical management: the IMMINENT study. Glob Adv Health Med. 2014;3(3):25–32.

    Article  Google Scholar 

  43. Pezzilli R, et al. Exocrine pancreatic insufficiency in adults: a shared position statement of the Italian Association for the study of the pancreas. World J Gastroenterol. 2013;19(44):7930–46.

    Article  Google Scholar 

  44. Fasano A. Zonulin, regulation of tight junctions, and autoimmune diseases. Ann N Y Acad Sci. 2012;1258:25–33.

    Article  CAS  Google Scholar 

  45. Sturgeon C, Fasano A. Zonulin, a regulator of epithelial and endothelial barrier functions, and its involvement in chronic inflammatory diseases. Tissue Barriers. 2016;4(4):e1251384.

    Article  Google Scholar 

  46. Scheffler L, Crane A, Heyne H, Tönjes A, Schleinitz D, Ihling CH, et al. Widely used commercial ELISA does not detect precursor of haptoglobin2, but recognizes properdin as a potential second member of the Zonulin Family. Front Endocrinol (Lausanne). 2018;9:22.

    Article  Google Scholar 

  47. Eicosanoid. Wikipedia, Wikimedia Foundation, 25 May 2019, en.wikipedia.org/wiki/Eicosanoid#/media/File:EFA_to_Eicosanoids.svg. Accessed 16 June 2019.

  48. Das UN. A defect in Δ6 and Δ5 desaturases may be a factor in the initiation and progression of insulin resistance, the metabolic syndrome and ischemic heart disease in South Asians. Lipids Health Dis. 2010;9:130.

    Article  Google Scholar 

  49. Yary T, Voutilainen S, Tuomainen TP, Ruusunen A, Nurmi T, Virtanen JK. Omega-6 polyunsaturated fatty acids, serum zinc, delta-5- and delta-6-desaturase activities and incident metabolic syndrome. J Hum Nutr Diet. 2017;30(4):506–14.

    Article  CAS  Google Scholar 

  50. Tsoukalas D, et al. Application of metabolomics part II: Focus on fatty acids and their metabolites in healthy adults. Int J Mol Med. 2019;43(1):233–42.

    Google Scholar 

  51. Ntambi JM, Miyazaki M. Recent insights into stearoyl-CoA desaturase-1. Curr Opin Lipidol. 2003;14(3):255–61.

    Article  CAS  Google Scholar 

  52. Cho JS, et al. Serum phospholipid monounsaturated fatty acid composition and Delta-9-desaturase activity are associated with early alteration of fasting glycemic status. Nutr Res. 2014;34(9):733–41.

    Article  CAS  Google Scholar 

  53. Breitling R. What is systems biology? Front Physiol. 2010;1:9. Published 2010 May 21. https://doi.org/10.3389/fphys.2010.00009.

  54. Chiauzzi E, Rodarte C, DasMahapatra P. Patient-centered activity monitoring in the self-management of chronic health conditions. BMC Med. 2015;13:77.

    Article  Google Scholar 

  55. Bennet P, et al. Chapter 28 clinical approaches to gastrointestinal imbalances. In: Textbook of functional medicine. 2nd ed: Example Product Manufacturer; 2010.

    Google Scholar 

  56. The 5Rs. Lipski L. Digestive wellness: strengthen the immune system and prevent disease through healthy digestion, 5th ed. McGraw-Hill Education; 2019.

    Google Scholar 

  57. Escott-Stump S. Nutrition & diagnosis-related care. 8th ed. Philadelphia: Wolters Kluwer; 2015.

    Google Scholar 

  58. Sagner M, McNeil A, Puska P, Auffray C, Price ND, Hood L, et al. The P4 health spectrum - a predictive, preventive, personalized and participatory continuum for promoting healthspan. Prog Cardiovasc Dis. 2017;59(5):506–21. Epub 2016 Aug 18.

    Article  Google Scholar 

  59. Lazarus RS. Patterns of adjustment and human effectiveness. New York: McGraw-Hill; 1969.

    Google Scholar 

  60. Langgartner D, Lowry CA, Reber SO. Old friends, immunoregulation and stress resilience. Pflugers Arch. 2019;471(2):237–69.

    Article  CAS  Google Scholar 

  61. Hennig B, et al. Using nutrition for intervention and prevention against environmental chemical toxicity and associated diseases. Environ Health Perspect. 2007;115(4):493–5.

    Article  CAS  Google Scholar 

  62. Substance Priority List | ATSDR. Cdc.Gov, 2017, www.atsdr.cdc.gov/spl/index.html. Accessed 16 June 2019.

  63. ATSDR - Toxicological and Public Health Professionals Home Page. Cdc.Gov, 2011, www.atsdr.cdc.gov/substances/ToxHealthReferences.asp. Accessed 16 June 2019.

  64. Pathogens and Protocols. 2019., www.cdc.gov/microbenet/pathogens-protocols.html. Accessed 16 June 2019.

  65. Hall A, et al. The role of nutrition in integrated programs to control neglected tropical diseases. BMC Med. 2012;10(1):25. www.ncbi.nlm.nih.gov/pmc/articles/PMC3378428/, https://doi.org/10.1186/1741-7015-10-41. Accessed 16 June 2019.

  66. Jenkins HS. A piece of my mind. The morning after. J Am Med Assoc. 2002;287(2):161–2.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Integrative and Functional Nutrition Academy, Saratoga Springs, NY, USA

    Kathie M. Swift

  2. Nutrition Provisions, LLC, Atlanta, GA, USA

    Elizabeth Redmond

  3. Noland Nutrition, Burbank, CA, USA

    Diana Noland

Authors
  1. Kathie M. Swift
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  2. Elizabeth Redmond
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  3. Diana Noland
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Correspondence to Kathie M. Swift .

Editor information

Editors and Affiliations

  1. Noland Nutrition, Burbank, CA, USA

    Diana Noland

  2. Professor Emeritus, School of Medicine, University of Kansas Health System, Kansas City, KS, USA

    Jeanne A. Drisko

  3. Department of Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, KS, USA

    Leigh Wagner

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Swift, K.M., Redmond, E., Noland, D. (2020). The Radial: Integrative and Functional MNT. In: Noland, D., Drisko, J., Wagner, L. (eds) Integrative and Functional Medical Nutrition Therapy. Humana, Cham. https://doi.org/10.1007/978-3-030-30730-1_5

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  • DOI: https://doi.org/10.1007/978-3-030-30730-1_5

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