Over the past decade (if not longer), there has been some buzz about something called “integrative medicine” (or IM for short). Many assume that IM is something that only “hippies” would take seriously, so you may have never taken it into consideration with your own health. Yet contrary to this belief, there has been a steady increase of interest in IM from the medical community and more studies are conducted every year on its effectiveness and safety.
So what is integrative medicine? You may also recognize IM under one of its many aliases, such as complementary therapies, alternative medicine, or holistic health. Essentially, IM combines conventional medicine and alternative medicine. It not only addresses the specific disease or illness, but also incorporates other less “mainstream” aspects of medicine such as the psychological, social, and spiritual aspects of health. IM treats the symptoms along with the other underlying causes and effects of the disease as an individual state. In other words, IM focuses on the whole picture (thus the term holistic, meaning “the interconnectivity of all of the parts that cannot be separated”). IM also creates a therapeutic bond between patient and the health care team--something that can be sorely lacking in modern medicine. https://nccih.nih.gov/health/integrative-health
One example of the growing interest in this field is how the Mayo Clinic incorporated a complementary and integrative medicine program within their department of medicine in 2001. Duke University has an ever growing IM department that incorporates research into its program. Yale School of Medicine has incorporated an IM curriculum. Even the National Institute of Health (NIH) has created the National Center for Complementary and Integrative Health (NCCIH).
In addition to the burgeoning inclusion of IM curriculum into medical schools, the Academy of Nutrition and Dietetics (AND) has taken an interest in creating standardized curriculum for nutrition programs as well. With all of these credible programs and organizations taking an interest in IM, maybe it’s time to remove the “stigma” from IM and start treating it a bit more seriously.
The National Center for Complementary and Integrative Health (NCCIH) states that the use of IM has grown within care settings across the nation, including hospitals, hospices, and military health facilities. Some of the most common integrative medicine approaches include:
- Natural products (herbs, vitamins, minerals and probiotics)
- Herbs Fact Sheet: https://nccih.nih.gov/health/herbsataglance.htm
- Supplement Fact Sheet: https://ods.od.nih.gov/factsheets/list-all/
- Yoga
- Tai chi
- Meditation
- Massage
- Chiropractic
- Acupuncture
Now, since this is a blog is written by a dietetic intern and future nutrition professional, it’s crucial that I show the evidence to back up this topic (i.e. the scientific approach to show the importance of increased IM education). In 2002, a Complementary and Alternative Medicine (CAM) Task Force was designated by the Academy of Nutrition and Dietetics (AND). The objective of the CAM Task Force was to design measurable educational competencies for dietetic practitioners. They created recommendations for incorporating integrative medicine into dietetic education for nutrition college students and nutrition professionals.
Three years after the CAM Task Force was created, they conducted a survey in 2005. They discovered that integrative medicine education existed in curriculum, but it was inconsistent in content. It was made clear that dietetic educators must include integrative medicine into their curricula so future registered dietitian nutritionists (RDN) can be better prepared and ready to provide proper guidance to their clients and patients. The registered dietitian nutritionist must be competent and confident in all fields of nutrition, and the field of integrative medicine is no different.
More recently (August of 2014), the Academy of Nutrition and Dietetics produced a survey that was geared towards the dietetic approach of integrative medicine. The purpose of the survey was to identify how many dietitians incorporated some sort of integrative medicine into their counseling and education, what type of integrative medicine used, and how much education they received on integrative medicine.
The survey found the most confident and commonly utilized approaches to integrative medicine were vitamin and mineral dietary supplements, functional foods, probiotics, and fatty acids. The survey also revealed that the minimal use of integrative medicine within the dietetics field is due to a lack of education. Educators in didactic programs for dietetics claimed that less than two hours were spent on lectures based on integrative medicine. However, those same educators agreed on the importance of integrative medicine education in curriculum was crucial. It concluded the main reason for the lack of integrative medicine education was time.
The survey also revealed an agreement amongst RDNs that the Accreditation Council for Education in Nutrition and Dietetics (ACEND) should incorporate a standardized curriculum for competencies in didactic programs for dietetics, internships for dietitians, and offer board certification as a specialist in integrative medicine.
Ok, so enough fancy, technical research and science talk! What does this mean for you?? Whether you’re a nutrition student, an RDN, or just an interested individual, IM can (and most likely does) play a role in your life whether you realize it or not!
For the (soon-to-be or established) RDN, it is important to keep one thing in mind: you may or may not decide to have a background or education in IM, but you will be asked questions about vitamins, mineral, supplements, and other IM practices from your clients and patients. No matter your personal beliefs about IM, it is crucial that you can provide the correct information to your client or patient. Like most medical treatments, research is ever growing and evolving, so it is imperative we stay up to date with the most recent findings so we can provide the most accurate and appropriate information and guidance. To see what scientific studies have shown to be effective and safe, reliable sources can be found at nccih.nih.gov
For those that are not in the nutrition field ,but have a genuine interest in expanding or practicing IM, here are a few words of advice:
- Always talk to your health care providers before starting any integrative medicine. Especially dietary or herbal products. You do NOT want an interaction with other medications you may be taking.
- Even though you are a patient or client, you too can stay up to date on scientific studies. It will help when deciding which IM approaches may work best for you. The website nccih.nih.gov is an amazing resource that allows you to search all kinds of different IM practices and the most recent scientific support. Please make sure that your information is coming from a credible source and not a post on Facebook. I have provided a couple of other resourceful links at the bottom of this post.
- Be careful when choosing a complementary health practitioner. Do your research here to to find someone with credentials but be careful, there is no standardized system for credentialing complementary health practitioners. It varies from state to state, so do your research! Maybe your family doctor or other health care provider could give you a recommendation?
- Remember: IM is not just about taking supplements!
- There are many, proven and encouraging studies that tout the benefits of yoga, acupuncture, massage, and natural products. Use the links that were provided above, below each category.
Integrative medicine has been around for millennia, and is not going anywhere. It’s time to get get on board!
Main Article:
Augustine, M. B., Swift, K. M., Harris, S. R., Anderson, E. J., & Hand, R. K. (2016). Integrative Medicine: Education, Perceived KNowledge, Attitudes, and Practice among Academy of Nutrition and Dietetics Members. Journal of the Academy of Nutrition & Dietetics, 116(2), 319-329. doi: 10.1016/j.jand.2015.08.015
Other References and Resourceful Links:
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