Can Integrative, complementary alternative medicine, and integrative and functional nutrition practices have a place in nutrition management?

Year 2023, Volume: 3 Issue: 4, 105 - 116, 29.10.2023

Fatma Toygar , Hande Bakırhan

https://doi.org/10.56016/dahudermj.1353461

Abstract

Objectives: This study aims to evaluate the attitudes of dietitians and dietitian candidates about integrative complementary and alternative medicine and integrative and functional nutrition.
Methods: This descriptive research was conducted with a self-reported online survey on dietitians and candidates (n = 390). Various questions were asked to evaluate the approach to functional medicine and nutrition, including the terms integrative and functional medicine nutrition therapy radial, medical history, and treatments used to treat chronic disease. The Attitude Towards Holistic Complementary and Alternative Medicine Scale evaluated participants' attitudes toward integrative complementary and alternative medicine.
Results: The majority of the participants know the terms functional medicine (95.4%) and integrative and functional nutrition (85.4%). The attitudes of dietitians towards complementary and alternative medicine were significantly more optimistic when compared to dietitian candidates (38.3±0.53 versus 34.5 ± 0.67, p = 0.002). When the application of the integrative and functional medicine nutrition therapy radial was examined, it was found that the majority of them always consider lifestyle (84.1%), allergens/intolerance (84.1%), negative thoughts and beliefs (80.0%), and system signs and symptoms (71.3%). Dietitians question digestive system health (94.9%), sleep and physical activity (94.4%), stress (93.4%), medication and supplement use (93.9%), and mood variability (86.9%) when taking the individual's anamnesis. The supplements that dietitians found beneficial were probiotic-prebiotic (91.4%), multivitamin-mineral (84.8%), and herbal (75.8%). Dietitian-approved diets were elimination diet (85.4%), FODMAP (80.8%), autoimmune protocol diet (72.2%), GAPS diet (70.7%), and ketogenic diet (69.2%), respectively.
Conclusion: It has been found that dietitians have positive attitudes toward integrative, complementary medicine, and functional nutrition.

Keywords

Integrative complementary alternative medicine, integrative and functional nutrition, functional nutrition practices, dietary approaches, dietitian

References

• Schmidt H. Chronic Disease Prevention and Health Promotion. In: Barrett DH, Ortmann LW, Dawson A, Saenz C, Reis A, Bolan G, eds. Public Health Ethics: Cases Spanning the Globe. Springer Cham; 2016:137-176.
• 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. 2019;119(6):1019-1036.e47.
• Goodman EM, Redmond J, Elia D, Harris SR, Augustine MB, Hand RK. Practice roles and characteristics of integrative and functional nutrition registered dietitian nutritionists. J Acad Nutr Diet. 2018;118(12):2356-2368.e1.
• Kohut DH. Integrative and functional nutrition practices and use of the integrative and functional medical nutrition therapy radial among registered dietitians. Syracuse University, Thesis, USA (New York), 2014.
• Yako MA. Knowledge and beliefs of functional medicine and integrative and functional nutrition of adults with and without diabetes. MS, Kent State University, College and Graduate School of Education, Health and Human Services / School of Health Sciences, Thesis, USA, 2020
• Grace-Farfaglia P, Pickett-Bernard DL, Gorman AW, Dehpahlavan J. Blurred lines: Emerging practice for registered dietitian-nutritionists in integrative and functional nutrition. Complement Ther Clin Pract. 2017;28:212-219.
• Augustine MB, Swift KM, Harris SR, Anderson EJ, Hand RK. Integrative medicine: education, perceived knowledge, attitudes, and practice among Academy of Nutrition and Dietetics Members. J Acad Nutr Diet. 2016;116(2):319-329.
• Hyland ME, Lewith GT, Westoby C. Developing a measure of attitudes: the holistic complementary and alternative medicine questionnaire. Complement Ther Med. 2003;11(1):33–38.
• Erci B. Attitudes towards holistic complementary and alternative medicine: a sample of healthy people in Turkey. J Clin Nurs. 2007;16(4):761-768.
• Aytaç O, Kurtdaş M. Sociological analysis of working women's perspective on alternative medicine. Afyon Kocatepe University Journal of Social Sciences. 2014; 16(2): 1-25.
• Öztürk YE, Akman Dömbekci H, Ünal S. The use of traditional complementary and alternative medicine. Journal of Integrative and Anatolian Medicine. 2020;1(3):23-35.
• IFM Board President of Clinical Affairs Mark Hyman. Functional medicine determines how and why illness occurs and restores health by addressing the root causes of disease for each individual. Accessed April 10, 2023. https://www.ifm.org/functional-medicine/.
• Bland JS. Systems biology meets functional medicine. Integr Med (Encinitas). 2019;18(5):14-18.
• Kalantar-Zadeh K, Moore LW. Functional nutrition, naturopathic nutrition, and integrative and holistic renal nutrition in kidney health and value-based kidney care models. J Ren Nutr. 2022;32(5):493-497.
• Jong MC, van Vliet M, Huttenhuis S, van der Veer D, van den Heijkant S. Attitudes toward integrative paediatrics: a national survey among youth health are physicians in the Netherlands. BMC Complement Altern Med. 2012;12:4
• Flaherty G, Fitzgibbon J, Cantillon P. Attitudes of medical students toward the practice and teaching of integrative medicine. J Integr Med. 2015;13(6):412-415.
• Schouten AEM, Mentink MDC, Timmer-Bonte JANH, Noordman J, van Dulmen S. Perspectives and attitudes of Dutch healthcare professionals regarding the integration of complementary medicine in oncology. Integr Cancer Ther. 2023; 22:15347354231164650.
• Nguyen SA, Oughli HA, Lavretsky H. Complementary and integrative medicine for neurocognitive disorders and caregiver health. Curr Psychiatry Rep. 2022;24(9):469-480.
• Delaunay-Vagliasindi S, Seneff S, Campbell-McBride N. GAPS nutritional protocol: How healing the gut removes the basis for all chronic diseases. J Orthomol Med. 2021; 36(3):1-7.
• Barrett, JS. How to institute the low-FODMAP diet. J Gastroenterol Hepatol. 2017;32(1): 8-10.
• Bellini M, Tonarelli S, Nagy AG, Pancetti A, Costa F, Ricchiuti A, de Bortoli N, Mosca M, Marchi S, Rossi A. Low FODMAP diet: Evidence, doubts, and hopes. Nutrients. 2020; 12(1):148.
• Sheedy K, Patel N, Porter J, Silva H. Cost and accessibility of empiric food elimination dietsfor treatment of eosinophilic oesophagitis. Nutr Diet. 2022;79(2):238-246.
• Ramos-Lopez O, Martinez JA, Milagro FI. Holistic integration of omics tools for precision nutrition in health and disease. Nutrients. 2022;14(19):4074.
• Ng JY, Dhawan T, Dogadova E, Taghi-Zada Z, Vacca A, Wieland LS, Moher D. Operational definition of complementary, alternative, and integrative medicine derived from a systematic search. BMC Complement Med Ther. 2022;22(1):104.
• Wang J, Xiong X. Current situation and perspectives of clinical study in integrative medicine in China. Evid Based Complement Alternat Med. 2012; 2012:268542.
• Gannotta R, Malik S, Chan AY, Urgun K, Hsu F, Vadera S. Integrative medicine as a vital component of patient care. Cureus. 2018;10(8):e3098
• World Health Organization. Traditional, complementary and integrative medicine, 2021. Accessed March 18, 2023. https://www.who.int/health-topics/traditional-complementary-and-integrative-medicine#tab=tab_1.
• World Health Organization. WHO global report on traditional and complementary medicine 2019. Accessed March 28, 2023. https://apps.who.int/iris/handle/10665/312342.
• Sarman A, Uzuntarla Y. Attitudes of healthcare workers towards complementary and alternative medicine practices: A cross-sectional study in Turkey. Eur J Integr Med. 2022; 49:102096.
• Izgu N, Gok Metin Z. Complementary and alternative therapies from the Turkish Physician's perspective: An embedded mixed-method study. Complement Ther Clin Pract. 2020;39:101144.