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AAPI’S NUTRITION GUIDE TO OPTIMAL HEALTH: USING PRINCIPLES OF FUNCTIONAL MEDICINE AND NUTRITIONAL GENOMICS Additionally Chinese licorice root, tienchi ginseng root, and astragalus root may have a role in addressing heartburn and mild indigestion (100). Promoting gastrointestinal health through this type of program may have significant impact, not only on localized intestinal inflammatory risk, but also on systemic inflammatory processes associated with the loss of intestinal mucosal integrity. Future Strategies The application of nutritional genomics can create a better understanding of IBD pathology and has focused attention on the interaction between genetic factors and bacteria within the gut. Whether through any of the above genes discussed, increasing scientific evidence supports the notion that inflammatory bowel disease results from a genetic predisposition to abnormal interaction with an environmental stimulant – most probably part of the normal luminal bacterial flora – which in turn leads to excessive immune activation and chronic inflammation. There are many putative bioactive molecules that are being identified every day that can help modulate genetic expression of inflammation, however, many of these components still need to be further tested with in vivo animal models of human disease. A combination of food fractionation, testing in tissue culture models and validation through animal models has been discussed by Sutton as a rationale for developing ‚nutrigenomics‛ based foods (102). Although there is growing wealth of nutritional and medical information to guide an understanding of which nutrients or nutraceuticals should be used for personalized nutritional recommendations, it is an area that still requires much more intercommunication between various medical disciplines in order to obtain a more holistic and global perspective of a patient’s medical and nutritional status and needs. In the past decade, nutrition research has undergone a shift in focus from epidemiology and physiology to molecular biology and genetics. This shift has resulted in a growing realization that we cannot understand the effects of nutrition on health and disease without determining how nutrients act at the molecular level. Muller and Kersten pointed out ‚There has been a growing recognition that both macronutrients and 96 2012 micronutrients can be potent dietary signals that influence the metabolic programming of cells and have an important role in the control of homeostasis‛ (103). As a result, adequately trained health professionals who possess an authentic and experienced understanding of the interconnectedness of the biological systems in the human body, as well as the common underlying mechanisms that cut across many diseases, syndromes, conditions and organ systems, will be required particularly to interpret and communicate this information both to the public and with regulatory officials to responsibly develop, apply and progress this new field. Additionally, this solid background and training will allow for far more personalized preventative care that incorporates a client centered approach, tailored to the patients’ unique needs, (as compared to the current disease centered model which revolves around dissecting the body to arrive to a quick diagnosis, pharmacology and identifying ICD-9 codes), and will help to achieve tremendous success with ‚healing‛ our patients rather than just ‚treating‛ their symptoms. Searching for root cause solutions will be the focus rather than ‚band-aid‛ symptom management. However, the complexity of chronic illness, similar to layers of an onion, will require time, patience and a willingness to ask the questions that will lead us to the answers and understanding of how various human systems function interdependently as well as influence each other. Nutrition-focused practitioners are at a pivotal point in the history of their practice. Kauwell recently stated, ‚Armed with the findings of the Human Genome Project and related research, dietetics practitioners will have the potential to implement more efficient and effective nutrition intervention strategies aimed at preventing and delaying the progression of common chronic diseases.‛ (104) Additionally, because beliefs, attitudes, and motivations can all play a major role in overall wellness, it will be very important to examine and include not just the physical, but the mental, and emotional aspects, at least to a certain extent, of our patients in order to make a more holistic and accurate assessment and care plan of their nutritional needs.
AAPI’S NUTRITION GUIDE TO OPTIMAL HEALTH: USING PRINCIPLES OF FUNCTIONAL MEDICINE AND NUTRITIONAL GENOMICS Vay Liang W. Go (105) explains in an article published in 2005 that ‚with the advent of the postgenomic era, biological and medical research and clinical practice has witnessed an explosion in strategies and goals. This eventually will revolutionize the classical practice of nutrition from the current evidence-based medicine towards genomic-based medicine.‛ But this very explosion can be part of the barrier to realizing the vision for health care professionals. Clinicians today must contend as never before with a massive amount of information emerging from the scientific literature. Furthermore, they must also beware of not falling into the common trap of blindly accepting or rejecting scientific information of any orientation, whether it be Eastern philosophies and/or Western approaches to medicine, or any approach for that matter, just because it is not well understood or because it is someone’s opinion. To do so would be the epitome of injustice to the dietetics profession and to the patient. One thing that can be done now to move this vision ahead will be the unbiased utilization of the already created and available organizational architecture of information that moves beyond the well-established ‚silos‛ of organ system medicine. For example, the effects of chronic inflammation of one organ system does not necessarily stop there. The inflammatory process can operate throughout the patient entirely, affecting multiple systems including the brain, the immune system and the endocrine system. Utilizing this type of ‚functional medicine matrix‛ will allow for a more precise and clear evaluation, formulation and integration of all the information at our disposal to create a systematic, effective and functional nutrition care plan for our patients that can potentially alter the trajectory of their health status forever. SHEILA DEAN is a registered and licensed dietitian, board certified clinical nutritionist, certified diabetes educator and exercise physiologist. She received her undergraduate training through Rutgers University, completed her internship and graduate training with University of Rhode Island and Brown University's teaching hospitals, received doctoral training in nutritional genomics and pharmacology through the University of Medicine and Dentistry of New Jersey 97 2012 (UMDNJ) and completed her Doctorate of Science degree through Hawthorn University. Dr. Dean is a graduate of the Institute for Functional Medicine where she received advanced training in functional medicine and nutritional biochemistry. She has also worked with the Duke University Medical Center's Endocrinology and Metabolism Disorders Clinic and the Joslin Center for Diabetes as a certified diabetes educator. Currently, Dr. Dean is the owner of Palm Harbor Center for Health and Healing, an integrative medicine based nutrition private practice and wellness center based in Palm Harbor, Florida. An educator at heart, she has taught for 15 years as adjunct nutrition science professor at the University of Tampa and currently serves as a doctoral research advisor and content expert on integrative nutrition, functional medicine, and integrative medicine at Saybrook University. She has conducted dozens of local and national public presentations, has written continuing education credit functional medicine modules for both nutritionists and nurses, has authored book reviews and articles for The St. Petersburg Times, Ms. Fitness magazine, Ironmanlive.com website and has appeared on NBC - News Channel 8, NBC-Daytime, CBS- News Channel 10, ABC-News Channel 28, WTVT-TV Fox13-Good Day Tampa Bay, Natural Living-KONK 1500 AM radio, WFTW 1260 am radio, WDBO 580 am radio for dozens of interviews. Dr Dean currently appears regularly on WTSP 10 News for her segment entitled ‚Take 5 with Dr Dean‛. An experienced scientific and technical writer, Dr. Dean is a contributing author of the medical textbook Integrative Gastroenterology published by Oxford University Press and has authored the chapter on Medical Nutrition Therapy for Thyroid Disorders in the clinical nutrition textbook Krause’s Food & Nutrition Therapy- 13 th ed. She is also a contributing editor of the upcoming 4 th edition of The Health Professional’s Guide to Popular Dietary Supplements. Dr. Dean currently serves on the advisory board for the nationally acclaimed Center For Mind-Body Medicine's Food As Medicine professional education course and was the Professional Advancement Director for the Dietitians in Integrative and Functional Medicine dietetic practice group of the American Dietetic Association as well as the recipient of their 2010-2011 ‚Excellence in Practice‛ Award. She's served as the consulting
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