In functional medicine, we’re always looking for the most “upstream” cause of any dis-ease, and, accordingly, the most upstream way to treat any known cause. This means that a lot of functional treatments are rooted in a person’s daily life activities. By modifying what they’re exposed to in the course of living their lives, we modify what’s causing the problems in their bodies. Food is a double-edged sword; it can be a slow poison or it can be a source of healing. Given that, one of the best places we functional medicine practitioners have an opportunity to make an impact on someone’s health in an upstream fashion is in their diet! Here are a few of my favorite therapeutic diets:
The broad strokes: High in a variety of produce (a minimum 9 servings/day or 50% of the volume of your food intake from fruits and non-starchy veggies), free of processed foods (sometimes with exception for medical foods), emphasis on healthy sources of fat and high-quality protein.
Who might use this: Anyone with any ongoing inflammatory condition (which most health conditions are on some level), or anyone who wants to prevent one.
The broad strokes: Designed to maintain stable blood sugar levels and healthy insulin sensitivity. There are multiple dietary iterations that fall under the general umbrella of “low glycemic,” But the unifying factor is a reduction in carbs and sugar, especially from processed sources.
Who might use this: Anyone trying to control metabolic (blood sugar or cholesterol-related) issues, or anyone trying to prevent having them in the future.
Note: All of us who want to feel good in our bodies and have health mood and hormone balance should be eating diets that largely adhere to anti-inflammatory and low glycemic principles the vast majority of the time—even in the absence of overt metabolic or inflammatory issues.
Elimination (oligo-antigenic) diet.
The broad strokes: This is both a diagnostic and therapeutic tool. It starts with (usually) three weeks of full elimination of several categories of foods that are common “triggers” of sensitivity in the body. Then foods are reintroduced one by one, about three days apart, observing carefully for the emergence of any symptoms that might indicate that the person is reacting to the food. Foods that cause a reaction are removed for a longer period of time (three to six months) to give the immune system a rest and (hopefully) be reintroduced later without causing a reaction. The idea is that removing foods that cause extra burden on the immune system can allow the body to do a better job of regulating its normal functions, thereby reducing or eliminating nagging symptoms.
Who might use this: People who have health conditions that meet one or more of the following criteria: are difficult or complex to control, haven’t responded to traditional therapies, or don’t have clear causes. This might also be used in conjunction with a gastrointestinal healing protocol, such as anti-candida, Specific Carbohydrate Diet, FODMAPS, Body Ecology, or the like. (which is itself a category of therapeutic diets, but I’m not covering here because I tend to make these very individualized).
The broad strokes: This emphasizes including lots of foods that specifically support the chemical pathways in the liver, kidneys, and intestinal tract that are used to eliminate non-usable and/or harmful substances from the body. Of course, if you’re detoxing, you want to make sure you’re not working against yourself, so this diet places even more emphasis than the others on “clean” (organic, non-GMO, grass fed, pasture raised, etc.) sources of food.
Who might use it: People who have known chemical exposure or genetic variants that decrease the ability to process chemicals, or people who aren’t responding as expected to either traditional or integrative medical therapies.
The broad strokes: This is a high-fat, moderate-protein, almost zero carb diet. Although this is technically a low-glycemic diet, it gets its own section because it has some specific therapeutic uses that don’t necessarily occur with a more liberal low-glycemic diet. The goal is to put the body into ketosis, which is a chemical state induced by burning fat as fuel. When done safely, this can be very effective for reducing insulin resistance, reducing the stress hormone cortisol, and improving brain function. It is generally used as a long-term diet strategy, but it can also be used as a short-term intervention to help turn things around for select people with metabolic issues.
Who might use it: People with epilepsy (it’s one of the earliest and still one of the most effective treatments for it), people with major mood stability issues (like bipolar), people looking to get a quick reversal of insulin or blood sugar related issues, or people who need more mental clarity (it’s been execu-branded as the Bulletproof Diet for exactly that reason). There’s also quite a bit of evidence that a ketogenic diet is effective in cancer as either an adjunct treatment or a prevention strategy.
Hey! Why don’t you talk about a vegan or vegetarian diet?!
Because vegan and vegetarian diets aren’t necessarily therapeutic diets. This is true for two main reasons:
The first is that just cutting out animal products and not paying attention to what you replace them with is not necessarily healthy. A plant-based diet has to be essentially anti-inflammatory and low glycemic to confer its benefits. How many of us have known vegetarians who live on Oreos and pasta and can’t remember the last time they ate something green (that wasn’t dyed)? While plant-based diets have been associated with positive outcomes in a variety of health conditions, it’s possible to be a junk food vegetarian or vegan. Just because you don’t eat animal foods doesn’t necessarily make your diet healthy.
The second reason I don’t consider plant-based diets therapeutic is bio-individuality. There’s too wide a variance in the genetically-dictated nutritional needs of humans; not everyone’s genetic profile allows them to thrive on a vegan or vegetarian diet. However, for those who do well on a plant-based diet, most therapeutic plans have enough flexibility to accommodate herbivorous preferences while still conferring their benefits (admittedly, some of the above plans will require quite a bit of commitment to be successfully executed by vegetarians).
What about weight-related issues?
Many times, getting someone’s nutrition back into balance with their true needs (rather than a list of “shoulds and shouldn’ts”) will allow the person to have a more harmonious relationship with their body. Many people with weight issues have developed a deep mistrust of their bodies and can’t imagine being able to “listen to their bodies” or “eat intuitively.” Oftentimes, once the underlying imbalances in the body are addressed and the person is eating in a way that is supportive of their individual needs, the body’s signals become clearer and less confusing, and an intuitive relationship with food—which we are all programmed to have—is once again possible.