What is Nutritional Therapy? Part 2
Welcome back! If you haven’t read the first installment of this series, you should start here. Otherwise, let’s dive right in.
So you’ve filled out the intake forms and you’re preparing for our initial consultation (and I am too!). At this point, we’ve spoken beforehand and I’ve also sent you my other welcome materials (they provide a more succinct overview of this post series) and a pricing summary that spells out all my rates, package options, and bonus information. Again, this can either be in electronic or PDF form.
You now have full transparency about what different nutritional therapy visits will entail, what I will be offering, what the cost of my different services are, and what to expect from an invoice. (As my business changes or grows moving forward, the details of this process may shift with the times, so I will leave those out of this post. I will always provide you the most up-to-date published pricing summary, most likely electronic, before we meet.)
At the time of this post’s publication, I do not have specific office space for Nutritional Foundations and operate as a traveling FNTP -- it’s the business model that makes the most sense for me right now. As a result, we will choose a time and location that best suits both of our needs for the initial consultation. This visit, along with most visits I offer, can be done virtually. (Again at the time of this publication, we’re currently experiencing social distancing restrictions during the COVID-19 outbreak. I’ve been successfully seeing clients virtually and everyone is having a wonderful experience!)
At the beginning of the initial consultation, I will confirm with you your understanding of everything you read in the Disclaimer, and ask if you have any questions or want any further information. Next I will address your Initial Interview Form. I’ll address every section, because all of its details are important in our work together, but the following are some big talking points I like to focus on:
Average hours of work per week: This is probably obvious, but if I notice that this number is unusually high, I will likely want to know more about it -- what are the circumstances that require this much time/how do you find yourself in that situation, do you get properly compensated, how do you feel at the end of the work day, what are the hours per day like, etc. We all have more stress in this modern age than our genes were designed for, and work stress may be somewhere we can mitigate it, so it will be helpful to know these details.
Relationship status: It might not be something that catches my eye, but if it appears to be potentially problematic, it’s likely another source of stress for you that we can discuss in getting your health back on track. Stress can change physiology, and usually not for the better.
Hobbies and activities: This is so crucial! These are the things that will help you bounce back from stressful events in your life and develop your resilience. It’s imperative that we spend SOME time during the day or week doing the things we enjoy, simply because we enjoy them.
Waking up during the night: If you have recurrent issues with this, you likely have some blood sugar dysregulation that we will work on together. Evening out your blood sugar and insulin levels can create both sustainable energy and restful sleep, when each is respectively needed.
Water consumption per day: We all know we should be drinking more water… but how much more? Is it true what they say about everyone needing eight cups per day? How do we consume enough water without running to the bathroom a zillion times? We will talk about all of this, especially in relation to how much caffeine you consume. Many times, without actually measuring, people often underestimate their water consumption. Furthermore, it’s not listed here, but I may also ask you about your daily alcohol consumption, if any -- not because I’m here to tell you to stop, but because this will increase your water needs, which I will discuss with you as well.
Ratio of food cooked at home vs. dining out: We all go to restaurants on weekends or swing by our favorite little place on the way home from work for some takeout to avoid having to cook. I’m with you, more times than I’d like to admit. But there’s a lot of easy ways to make the same foods at home with, likely, better ingredients; it’s impossible to know what oils restaurants cook with, the quality of their food sources, and if you’ve been exposed to anything potentially harmful for you.
Your cookware and cooking fats: What we cook our food in (literally -- either oils or containers) makes a huge difference to our health status. Did you know you can get extra iron in your diet by using a properly-kept cast-iron pan? This, and so much more, can be really useful information to get the best bang for your buck in your next home-cooked meal.
Digestion and appetite: Your answers to this whole section will help show any signs of improper digestion and/or blood sugar irregularities that we can work on together. Either or both of these are good places to start tackling for most of my clients.
Being born vaginally and/or being breastfed: I’m not here to judge -- times are hard for our poor mamas, whose bodies went through trauma just to get us here. But these details can help clue me in on any potential allergies or gut flora dysbiosis going on (sometimes spanning our entire life) that might make digestion that much more difficult for you, indicating more support in this area.
Toxin exposure: If you don’t have anything (or enough) written here, I will likely follow up with some examples of common exposures to see if they fit in your life. Most people are generally unaware of the environmental factors affecting their health, and sometimes need some prompting to dig a little deeper.
Types of movement and relaxation: Some of us don’t move enough to see the results we seek, and others of us work too hard and perpetuate the stress response. There’s a happy medium in there somewhere, and we can find it together.
Average stress level: It’s a single number but it speaks volumes.
Average menstruation experience: If you’re someone actively menstruating, your period basically acts as a vital sign (same with poop, but we’ll get to that later). It can say a lot about potential hormone imbalances, and once we get you less stressed and digesting better, the minerals and healthy fats you absorb should aid in improving this experience.
Average menopausal experience: For the same reasons above, except you will have different needs!
Male urination and life interest: These questions can reflect male hormonal imbalance, and can be addressed similarly to females with supported digestion and stress response.
After we get through the Initial Interview Form, we will go over your Food and Mood Journal (FMJ). I’ll already have written on it myself by way of comments, praise, suggestions, questions, and big picture ideas. I’ll reiterate my mention of this from the first installment of this post series: as much detail as you’re willing and comfortable providing here is highly encouraged. This is my glimpse into what your day-to-day is like.
Sometimes it’s not pretty, and that’s okay. We’re all human and we’ve all suffered from ill health once or twice. There’s nothing you could write in this form that would shock me or make me judge you in any way, shape, or form. I need as much information as possible in order to be the best ally to you in your health journey. If the information is sparse, I will likely have more follow-up questions to get a better idea.
I will also point out some great choices you made or recipes you used, offer some swaps or alternatives to foods that might be irritating you, and provide overarching themes and ideas for you to consider moving forward.
For example, I might applaud your bacon and eggs for breakfast, but suggest an oil alternative to canola or vegetable (likely coconut or avocado oil, in this case, for best flavor and heat exposure). As an overarching theme, I might write “not afraid of fats, but quality can improve.” If your diet actually lacks fats, I might write “low fat, high processed carbs.” You get the idea -- these things will help steer our first few goals to tackle.
I’ll also ask you about your experience putting the FMJ together. Did you begin noticing trends you hadn’t been aware of before, regarding what certain foods or meals do to your energy or digestion? Are you just now understanding how fatigued you are on a daily basis? Are you drawing any other correlations that could be interesting to dig into together? The FMJ really is an eye-opening tool that will help you remain mindful and feeling great on your nutritional therapy journey.
Finally, we’d go over your Nutritional Assessment Questionnaire (NAQ) together. I’ll have already made myself some notes on this form as well, linking some of your more frequent or severe symptoms with potential etiologies.
For example, waking up hours after falling asleep and having difficulty getting back to sleep can be a sign of dysregulated blood sugar or adrenal hormones, which I might note if you circled the highest rating for that symptom.
We won’t go over every single question, but I will address the major ones that stuck out to me, and I will also show you how I used your NAQ responses to generate a symptom burden graph. This visual tool helps us graph what your body is going through on paper and therefore identify its highest priorities. Based on how your graph scores, we will either begin supporting your digestive process or blood sugar handling. As we continue to have more appointments, I will have you complete more NAQs in the future to chart your progress in real time (literally, as each NAQ will form a new symptom burden graph to visualize where you’re at vs. where you started from!). These future NAQs also support the Functional Clinical Assessment, which I will discuss down the line in this post series.
At this point in our initial consultation, we will:
Review your original health concerns and goals for our time together,
Review the symptom burden graph, and
Summarize the big ideas from your FMJ.
I’ll give you what I think are some great starting-off points and, with your help, we will develop a list of diet and lifestyle recommendations specific to the culmination of these things, for you, individually, where you are at this moment in time.
I urge you to remain open-minded and be willing to give your body and your health the chance it deserves. This may mean big changes (or maybe not, everyone is different) and you may need to get comfortable with ambiguity for a little while. Your goals may change as you begin to see improvements, and the number of goals we develop will depend on how much you’re willing to take on or what you’re hoping to accomplish. I’ll be here to guide this decision with you to make sure we set SMART goals -- specific, measurable, achievable, realistic, and timely.
Part of my recommendations process involves providing articles, reference materials, book excerpts, recipes, and examples of food swaps (among other pieces of information). If this is the case, and I do not have these resources with me during the initial consultation (and other appointments), I will add them to your recommendations after the visit is over, and email the entire package to you.
Once we conclude, I will confirm the goals with you to ensure you support the list, and we will determine what kind of return schedule is appropriate. I always tell my clients that I want the time in between our appointments to be long enough to begin seeing benefit from the recommendations we curate, but not too soon that we can’t chart the progress and add to the goals list.
On average, most clients’ return appointments are roughly two to three weeks apart -- this doesn’t have to be your schedule specifically, as I’m happy to meet as often or as little as you request -- but it can sometimes be helpful to know the average to figure out where you fit. We can also set up brief check-in timepoints involving email or text message follow-up to keep you motivated and answer any new questions. These details are also client-dependent, so we will discuss your needs during your specific initial consultation. I’m flexible and will meet you where you are. (This information is also found in my welcome materials.)
Again, if you have any questions at all about this specific visit or others, feel free to comment or reach out to me on any of the below social media platforms or via email. I’m available and eager to get them answered and be as thorough as possible!
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