WHO NEEDS A NUTRITIONAL THERAPIST?
Even in the developed West, it is estimated that only 5% of the population is able to comprehend the nutritional values of food that they consume. While other technologies have advanced at supersonic speed, mainstream clinical application of research on nutritional medicine remains in the “Stone Age”. Medical schools pay lip service to this modality despite extensive research in nutritional genomics and related sciences. Even in the most technologically advanced countries such as the United States, only 6% of graduating physicians received some formal training in nutritional medicine. Consequently, many conventional medical doctors tend to dismiss the widely proven therapeutic powers of nutrition since they have little or no formal training or clinical exposure in this area. Pharmaceutical companies shy away from nutritional products since they cannot be patented to protect their investment in product development.
Doctors trained in Western orthodox medicine are drug-oriented and they spend most of their time and effort in identifying a disease process so that they can prescribe one or more drugs as part of their treatment plan. Conventional medicine does have its very special strengths in the areas of trauma and emergency. It is vital for any healthcare system to offer the finest in drug/surgical therapies for treating life-threatening acute conditions. However, conventional treatment addresses the symptoms and the disease manifestations, and not the fundamental cause(s) of the disease. Essentially, these treatments are designed to “contain” the symptoms of an illness since symptoms are exactly what patients relate to them in their clinical practice.
The conventional medical treatment model of “waiting for our body to break down before attempting to fix it” may be unacceptable to many in terms of the huge economic costs to the nation as well as the cost of human suffering. In this 21st Century, preventive medicine is poised to transform itself into a force to be reckoned with. Such a medical/health practice was the norm in the Far East centuries’ ago. A rapidly growing middle-class, educated, and IT-literate means a much stronger demand for, among others, medical treatments that inflict fewer or no major harmful side effects, a more personalized partnership between patients and medical therapists/practitioners in solving health/medical problems, and access to a much less intrusive but evidence-based medicine which is reasonably priced.
It is now widely recognised that the strongest defense system against diseases is our bodies? own natural antioxidant and immune systems. In the developed nations, people are spending increasing amounts on less invasive complementary therapies. In Britain, it’s estimated that more than 60% of its population visits complementary medical practitioners. A much higher percentage of the French population does the same.
What’s Nutritional Medicine?
It is a branch of complementary medicine which seeks the ultimate cause(s) of an illness/disease and then prescribes a treatment scheme that is drug-and-surgery free. Usually, this involves the use of highly sophisticated diagnostic tests available to modern science, designing a diet that matches the nutritional/physiological needs of the patient, modifying patient?s lifestyle, detoxifying, and supplementing patients with the required micro-nutrients targeted at specific chronic health issues.
The Association of Nutritional Medicine Practitioners Malaysia (ANMP) defines nutritional therapy as “The application of nutrition and health science to enable individuals to maximize their health potential. It can help treat a wide range of medical conditions and assist in the recovery from many ill-health situations. Nutritional therapists work with clients with chronic health problems and provide advice on prevention and control. These treatment protocols can impact on hormonal, neurological& immune function.” This definition was adapted from The United Kingdom Nutritional Therapy Council (2006), which registers and regulates qualified practitioners on behalf of its Department (Ministry) of Health.
Preventive medicine is also the hallmark of nutritional therapy. It takes years to develop chronic health problems, which are diagnosed and mapped out well before they reach their critical or even ‘terminal’ stages. This is especially true in the case of treatment for heart disease, stroke, hypertension, diabetes, allergies, tumors, and most types of cancer. In treating any life-threatening disease, the nutritional therapist would work closely with other medical practitioners in offering an integrated therapy. There is a national agenda to implement “integrated medicine” in the coming years. In September 2012, the Malaysian Parliament passed the Traditional & Complementary Medical Act (T&CMA) . Currently, there are some eight government hospitals using some form of T&CM modalities, but not nutritional therapy. Recently, the T&CM Division of the Ministry of Health initiated discussions on the proposed introduction of nutritional therapy for the treatment of diabetes and hypertension.
How does a Nutritional Therapist compare to a Nutritionist or a Dietician?
Dieticians tend to restrict themselves to designing diets recommended by orthodox doctors for whom they work. They usually design them for a rather narrow purpose such as a low sodium diet or a low calorie diet. Nutriceuticals are not generally prescribed.
Within the British Commonwealth, there is no generally agreed definition of a “Nutritionist” and many graduates in nutrition, food science/technology, or in related disciplines tend to call themselves as such. Generally, degrees in nutrition do not adequately cover pathophysiology as well as training in medical diagnosis and treatment (therapy) which are prerequisites for practising nutritional medicine. However, some coverage on medical applications of nutrition can be found at the post-graduate levels and in particular the United States master’s or doctorate degrees in nutrition. Holders of these regionally-accredited degrees may apply for accelerated route with the ANMP.
Within the Ministry of Health (MoH), both dietician and nutritionist belong to Allied Health Division whereas nutritional therapist belongs to complementary medicine and is regulated by its T&CM Division. A Certificate of Practice for nutritional medicine is not issued to anyone gainfully employed by any commercial organization involved in marketing or promoting any products.
Nutritional medicine/therapy covers a much wider area of nutrition which has potential for medical applications. Its core curriculum covers anatomy, physiology, biochemistry, pathology of diseases, nutraceuticals, macro-and micro-nutrients, nutritional values of food sources, lifestyle diseases, detoxification, diagnosis and treatment strategies for all major chronic health problems and diseases. To practice as a nutritional therapist would also require a prescribed period of supervised clinical experience in the diagnosis and treatment of patients in hospitals, wellness centers, and/or other approved establishments.
While we wait for comprehensive Gene Therapy to be fully developed from the Human Genome Project, there is already a mountain of scientific evidence from the world’s most prestigious medical/health institutions showing how food, lifestyle and environment directly influence our genetic expression, general health, and aging process. In the past ten years or so, there has been an explosion of published medical literature on the merits in using food, nutraceuticals, and lifestyle in influencing disease outcomes. Students and practitioners are expected to have access to all major medical/health and related websites.
Currently, degrees/professional qualifications meeting the academic requirement for practising the profession include those accredited by the United Kingdom Government-sponsored Nutritional Therapy Council (NTC), as well as the MSc (Nutritional Medicine) (Surrey), DNM/BSc (Nutritional Medicine) (Plaskett Nutritional Medicine College/Thames Valley), Master in Nutritional Medicine (RMIT), and Masters’ Metabolic/Nutritional Medicine (USF). Details on other related qualifications should be submitted to the ANMP for assessment.
What does the Training entail?
The MoH T&CM Division has designated nutritional medicine/therapy alongside chiropractic, osteopathy, hypnotherapy, and psychotherapy as requiring post-graduate training where the basic entry qualification is a JPA-recognised degree. Furthermore, there is no “grand-fathering” clause for practicing nutritional therapy when the T&CM Act is fully implemented. Those interested in receiving training or further training in nutritional medicine should first write to the ANMP (www.anmp.org.my) giving details of their academic and professional background. Currently, an accelerated ANMP certification programme is under development for medical doctors.
Basically, there are three parts to qualifying as a nutritional therapist:
Degree-level training in the combined areas of nutrition, pathophysiology, biochemistry of foods and nutraceuticals;
Training in diagnosis, pathology, and treatment of named medical
Supervised clinical training at an approved center/hospital/clinic. (Medical doctors are exempted from this training).
What Health benefits can Nutritional Medicine offer?
Nutritional Medicine can offer highly useful treatment for today’s chronic health problems. These problems include those of the heart (arteriosclerosis, atherosclerosis), digestive/bowel systems, liver, gall bladder, pancreas, immune system. The therapy may also cover specific problems such as high blood pressure (hypertension), allergies (sinus, skin, food), elevated fasting insulin/ insulin resistance/Syndrome X (hyperinsulinemia), glucose intolerance (pre-diabetes II), elevated blood fat (hyperlipidemia), elevated cholesterol (hypercholesterolemia), chronic stress (elevated cortisol), elevated homocysteine (hyperhomocysteinemia), heavy metal poisoning, yeast-connected (Candida albicans), elevated blood uric acid (hyperuricemia, gout), low metabolism (hypothyroidism), overweight/obesity, poor blood circulation, acne, chronic inflammatory problems (sore throat, hemorrhoids), gum diseases (periodontitis), pre-menstrual syndrome (PMS), back aches, fatigue (hypoadrenia), insomnia, tumor growth, and pre-mature aging. These health problems and diseases are generally the cumulative results of poor diets and lifestyles. In addition, nutritional therapy is being used extensively in many developed countries as adjunct cancer therapy since some 40% of cancer patients die from malnutrition created by their malignant growth.
What’s the Status of this Profession in Malaysia?
With the Parliament passing the Traditional & Complementary Medical Act during September, 2012, nutritional therapy is expected to be gradually integrated into some types of medical treatment in government hospitals. The ANMP is a full member of the MoH-recognised sole umbrella body for complementary medicine, Federation of Complementary & Natural Medical Associations Malaysia (www.fcnmam.org.my). The proposed establishment of a T&CM Council provided by the Act is expected to take full control of complementary medical therapies.
Dato' Steve Yap holds a Fellowship in Integrative Cancer Therapies (A4M) and another Fellowship in Anti-Aging, Regenerative and Functional Medicine (A4M). He is board certified in anti-aging medicine (USA/France), nutritional medicine (France), and nutritional therapy (NTC-UK). Views expressed are his own and may not represent those of the various governmental and professional technical committees on which he serves. This article is for information only. All complementary medical therapies should always be administered by duly qualified practitioners licensed by the T/CM Division, Ministry of Health. No part of this article may be copied or used without proper acknowledgement or express permission from the writer.