NANP Fosters Interdisciplinary Forum on Nutrition

There has never been more public need for well-trained healthcare professionals able to counsel people on how to eat healthfully. Yet in many communities, people have great difficulty finding the help they need and doctors are frequently at a loss to find nutrition professionals to whom they can refer patients.

In part, this is because much of the nutritional know-how is contained in professional "silos," and historically there has been little interdisciplinary collaboration between various nutrition professionals and the medical community.

The National Association of Nutrition Professionals (NANP) hopes to change that.

An emerging organization representing a diverse range of health professionals, NANP grew by more than 30 percent in the last year. Part of the group's mission is to create a strong, supportive community that enables busy medical professionals get access to the best holistic nutrition expertise.

Last Spring, over 250 holistic health professionals gathered for NANP’s annual conference in Del Mar, CA. The event attracted nutrition consultants and holistic physicians from around the world drawn to the conference’s main theme: Holistic Nutrition for the Modern World.

Clara Chorley, opening keynote speaker and Career Satisfaction Coach, summed up the attendees’ energy and passion: “I’m excited about being in a room with a group of people who are doing something they love!” Reflecting on the event, she noted the group’s camaraderie: eating together, connecting, bonding, and sharing stories. “Many of us are isolated in our own environments, so it’s important to step out and be in the energy and creativity of like-minded people.”

“When visiting with attendees, I discovered a diversity of healers,” reveals Lorrie Armitrano, a holistic nurse practitioner. “There are folks making significant impacts to the populations they serve. When a primary care physician collaborates with a holistic nutritionist, they can greatly enhance the synergistic benefit to each patient.” 

From clinical topics such as stress and hormones, to business development sessions on marketing and writing, attendees gained valuable and applicable strategies and insights. “The word that comes to mind is 'caliber,'” adds Armitrano. “The caliber of many of the speakers and sessions were very worthwhile for me as a primary care provider.”

Here are a few highlights from this year’s meeting:

Joint Pain: Think Intestinal Permeability

“How many people in this room – and you all have clean diets – have joint pain?” probed Tom O’Bryan, DC.

Hands shoot up in the air.

“Wow, 75 to 80 percent of you – this is a good topic.”

Dr. O’Bryan, referred to as a “Sherlock Holmes” for chronic disease, is a chiropractor who works from a functional medicine perspective. He focused his talk on the manifestations of gluten sensitivity and other food allergens in the etiology of musculoskeletal conditions.

Most practitioners would agree a gluten-free diet is an essential treatment for celiac disease. But Dr. O’Bryan believes the story does not end there. Why do children diagnosed with celiac have increased risk for many other disorders, and have higher mortality later in life? Shouldn’t they be “cured” on a gluten-free diet?

The answer, he explained, lies in the gut, with the damaged villi that don’t return to normal function. Intestinal permeability, or leaky gut, allows undigested food particles and toxins to enter the bloodstream. The immune system mounts its defense and attacks those toxins, creating inflammation and damage to the areas they reside – an autoimmune response. Toxins, called lipopolysaccharides (LPS), in the muscles and joints lead to joint pain, rheumatoid arthritis, and other conditions.

Resolving these conditions takes time….and patience, Dr. O’Bryan stressed.

He described a case of a 13-year-old girl confined to a wheelchair, suffering with muscle pain and weakness, along with cognitive, digestive, and sleep issues.

After multiple fruitless visits to a number of different physicians, she was finally diagnosed with celiac disease and major translocation of LPS, indicating intestinal permeability. The treatment protocol included a leaky gut diet (milk-free, gluten-free, low-carb), antioxidants, a supplement to treat intestinal permeability (L-glutamine, gamma oryazonal, etc.), and IV immunoglobulins.

After six months of careful adherence, there were no changes to her symptoms. However, the biomarkers indicated a reduction in LPS translocation, which was enough positive feedback to encourage the patient—and her parents--to stay the course.

After 30 months, she was walking, swimming, and doing well in school. The case underscored both the effects of systemic microbial translocation, and the importance of setting expectations about treatment length.

As an aside, Dr. O’Bryan told the group how he responds when people ask him how to stay healthy. “If they’ll only do one thing,” he offered, “I tell them to eat fermented vegetables every day. That has a great impact on creating a healthy gut milieu, and the healthier the gut, the healthier your body.” (For more on fermented vegetables, join www.holisticprimarycare.net and read, Cultures of Healing: Traditional Fermented Foods Find Their Place in the Modern World.)

Optimizing Nitric Oxide

"Nothing is more important than circulation," asserted Carolyn Pierini, CLS, CNC. "We can't get anyone healthy unless we can get oxygen into their cells."

A vital signaling molecule, nitric oxide (NO) is critically important for cardiovascular health – it is a vasodilator that also prevents plaque build-up, abnormal platelet aggregation, and build-up of white blood cells on the endothelial wall. For over 150 years, nitroglycerin has been used for acute agina, but its effects were not fully understood until the discovery that it creates NO.

2014Conf logoMs. Pierini, a medical microbiologist based at the St. Joseph Hospital, Orange, CA, who also works as a nutrition consultant, described the two pathways that form NO. The first requires L-arginine, endothelial nitric oxide synthase, and most importantly, a healthy endothelium. But "by age 40, people already start to show signs of endothelial dysfunction," she said. The pathway based on L-arginine becomes less efficient with age.

The second pathway involves converting foods high in nitrates (e.g., beets, green leafy vegetables) to nitrite, and then to NO. This approach is exemplified by the UK Olympic athletes who drank two cups of beet juice before events, and edged out the competition. Natural “doping” with real food – scandal-free!

That’s an extreme example, but the principle of utilizing nitrate-rich foods to improve nitric oxide output makes good clinical sense. Ms. Pierini encouraged practitioners to assess NO status in patients, and recommend moderate exercise and whole foods containing nitrates to promote well-being. (For more on NO and cardiovascular risk reduction, read our recent feature, A New Angle on Nitric Oxide & CVD Prevention)

Enter the Dragon Whisperer

“Do you have something you want to create for your professional lives?” asked Clara Chorley, CEO of Clarity Unlimited, a business coaching consultancy. “Are all of you doing this for a reason that’s bigger than you?” Following that initial challenge, Chorley launched into an inspiring and interactive session.

Chorley, author of the book, T.U.R.N.™: 4 Ways to Turn it all Around, outlined her process for helping professionals transform counterproductive behaviors into skills for greater clarity, focus, and action.

Her first assignment: Write down your vision – something you want to create or feel that inspires you. Encourage your patients to do the same. “When we’re treating people, we have to find out what’s going on in their lives. (Ask them) “If you didn’t have this problem, what would your life be like?” People change when they can identify something they want more than the pain they're in (and perhaps have become accustomed to).”

Now, what’s this about dragons? The dragons represent what’s standing in the way of achieving your vision – your unrealized potential. Fear of failure, procrastination, isolation – the list goes on. Chorley’s T.U.R.N. process teaches “dragon whispering,” which, she said, happens when you challenge long-standing beliefs, allow time for introspection, trust your intuition, and create a strategic plan to manifest your vision.

“People feel it when you’ve gone through the process of change,” said Chorley. “They see you are living what you are saying, that it’s not just coming from an academic book.”

Looking Ahead: NANP 2014

Reflective of its growing role as a national organization, NANP opted to move its 2013 conference from it’s longstanding home in San Francisco to San Diego. In 2014, the group will meet in Tucson, AZ, April 25-27. The event is open to all health professionals and students interested in advancing their holistic practice.

2013 conference recordings can be purchased at NANP’s website.

Danielle Hart, MS Holistic Nutrition, is the Editor in Chief of ENJI Dailya free online wellness magazine updated daily with the latest research, healthy recipes, and fitness and lifestyle tips. Her mission is to help individuals navigate the vast (and sometimes contradictory) world of wellness information, and to inspire change.

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