Nutrition

What is clinical nutrition?

Clinical nutrition is a field that developed in the 1940s to treat individuals with specific nutritional deficiency diseases, like scurvy and pellagra. By the 1960s, however, experts were beginning to recognize that certain doses of nutrients had the power to prevent illness. Today, researchers and scientists continue to uncover the therapeutic role of individual nutrients in the prevention and treatment of disease. For example, antioxidants like beta-carotene, selenium, vitamin E, and vitamin C have been shown to protect against the development of heart disease, cancer, and other chronic degenerative diseases. The field of clinical nutrition has evolved into a practice that is increasingly incorporated into mainstream medical treatment.

What happens during a visit to a clinical nutritionist?

Your first visit to a clinical nutritionist may last from 1½ to 3 hours. During the initial part of the visit, the clinical nutritionist will ask you questions about your medical history, family history, and personal lifestyle. Some clinical nutritionists will ask you to bring to your first meeting a 3-day food diary and any herbs, supplements, or medicines that you take regularly. This way, he or she will get a full picture of your nutritional lifestyle.

During the second part of the visit, the nutritionist will recommend ways that you can fill the gaps and reduce the nutritional "overloads" in your diet. For example, he or she may suggest that you schedule your meals at different times or cut down on the amount of carbohydrates that you eat. He or she will also offer advice on specific nutritional supplements (see below). The nutritionist will then schedule follow-up visits to monitor the progression of your health.

How many visits will I need?

The number of visits depends upon your overall state of health. Generally, nutritionists schedule follow-up visits for once a month after the first visit. These visits become less necessary once your health begins to improve. People with chronic conditions, like obesity, will require more visits than people who need simple nutritional "tune-ups" in their diet.

What are nutritional supplements?

The term nutritional supplements refers to vitamins, minerals, and other food components that are used to support good health and treat illness. For example, plant compounds known as phytochemicals (for example, those found abundantly in tomatoes and soybeans) have powerful disease-battling properties. While it's possible to successfully incorporate nutrients into your diet alone, supplementation can help maintain sufficient levels and produce specific desired effects. For example, supplementation with vitamin E has been shown to provide protection against coronary atherosclerosis, and zinc supplementation has been shown to reduce the duration of the common cold and decrease the incidence of acute diarrhea in children.

How do vitamins and minerals work?

Vitamins and minerals play an essential role in the body's normal metabolism, growth, and development. They do this by helping the body to perform various tasks. For example, while a vitamin is not a source of energy in and of 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. Deficiencies in vitamin A may lead to night blindness, a condition in which the eyes have difficulty adjusting to darkness. Zinc supplementation, therefore, may prevent this condition by keeping vitamin A functioning normally. Supplementation alone, however, is not the answer to long-term good health. Combining a healthful diet with a regular exercise program and a positive mental attitude has been shown, time and again, to be the best bet for a healthy lifestyle.

What constitutes a healthful diet?

The USDA food pyramid suggests that we use fat "sparingly," and that our daily diet include two to three servings of dairy products; two to three servings of meat, poultry, fish, eggs, beans, or nuts; three to five servings of vegetables; two to four servings of fruit; and six to eleven 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 can help you determine what type of diet is best for you.

Is there anything I should watch out for?

Adverse interactions between medications and supplements are common. Vitamins and minerals that exceed recommended dietary allowances may be harmful. Take any supplements according to label directions unless otherwise advised by a qualified practitioner. Some common foods, including nuts, dairy products, fish, and eggs, trigger allergic reactions. Be sure to talk to your doctor about testing for food allergens before adding supplements or making other nutritional changes.

How can I find a certified clinical nutritionist?

To find a clinical nutritionist in your area, contact the American Board of Nutrition at 205-975-8788, the American College of Nutrition at 212-777-1037, or the Clinical Nutrition Certification Board at 972-250-2829. Specialists in many alternative health systems (including Traditional Chinese Medicine, Ayurveda, and naturopathy) also consider food a vital part of preventing and treating illness, but unlike clinical nutritionists, these specialists are generally not as thoroughly trained in nutrition.

How much does a visit cost?

The first visit can range from $70 to $125 and follow-up visits average about $90 per hour.

Will my medical insurance cover visits to clinical nutritionists?

Some managed care plans are now beginning to cover visits to nutritionists. Check with your insurance company to see what your policy offers.