Functional Nutrition: Andrea Nakayama
Functional Nutrition: Andrea Nakayama
Functional Nutrition: Andrea Nakayama
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nutrition
Introduction 3
Been There, Done That 7
Action Steps 49
My passion for the food we eat started more than two decades
ago, yet it wasn’t until April of 2000 when this culinary curiosity
became a full-blown obsession. It happened when I discovered that
health and flavor have a primary and vital partner: physiology.
When food meets physiology magic happens! It’s the place where you
can get transformed into the steward of knowledge and the seeker of
truth that your clients have been waiting to find. In Holistic Nutrition
Lab, I teach unspoken insights and untaught skills that are needed to
see each person as the unique individual that he or she is, despite their
diagnosis.
Many of you aim for this kind of clinical success and rightfully so!
I’m honored to reveal this high-level wisdom to those who are hungry
to make a difference in service to others. Clearly, we’re on a mission
together.
•••
My journey to nutrition and wellness started with a health crisis, a
moment unique to me, and yet I know we all come to the healing
professions with a story of our own. This is my story: When I was
36 years old, I sat at the side of my husband’s in-house hospital bed that
was located in the sunroom of the house we had bought together only
one year earlier.
No more breath for my beloved, Isamu. No more life for the father of
my 19-month-old son. I lost the love of my life, my biggest fan, and best
friend.
No more will we get confused by diets and dietary theory, putting aside
or overriding that a single food may affect us each differently. The
garlic that’s helpful for your digestion may irritate my gut lining. The
raw kale that I put in my daily smoothie may make you feel sick. The
coconut oil one client eats by the spoonful may cause another to break
out in a rash.
No more.
No more suffering.
No more blatant unknowns.
No more cookie-cutter solutions.
No more patients, sitting in the mystery of their health, feeling like
their own bodies have become impossible riddles to solve.
•••
Holistic Nutrition Lab was born simultaneous of this fierce purpose
and at the requests of many health coaches and holistic professionals.
They wanted to know the tools I was using to support the healing
stories of my nutrition counseling patients. They wanted to be privy to
information that isn’t largely discussed or taught in nutrition school.
With a two-month wait list for new clients, I knew it was time to build a
virtual clinic with a team of hand-picked and hand-trained nutritionists.
That was a milestone for me and also for those who could now operate
with support.
Since I’ve never learned directly in any one program or from any
one teacher, my signature approach has been self-labeled, “The Art
of Functional Practice.” It came from years of training in holistic
nutrition and functional medicine, combined with the opportunity
to have worked with hundreds of one-on-one clients and thousands
of course participants. Their beauty, complexity, and diversity have
been my greatest teachers and most challenging puzzles. And it’s
their physiological distress, along with their unique histories and
personalities, that dictate their care.
Not only did you pour your own heart + soul (and all your
past training) into the course, but you shined a spotlight
on other speakers and perspectives. You left the functional
medicine door ajar for us to peek in and learn.
Each client or patient is like a new language. I’m going to teach you
how to be an interpreter.
These are two perfect examples of when the “what’s going on in there
game” comes in handy. This is when the work becomes fun. That’s right
– FUN! The game begins and instead of feeling paralyzed with that “uh
oh, what now?” pit in your own stomach, what if this was the moment
when you could feel mobilized, inspired, excited? What if you knew that
you had the ability to really make a difference in each of these clients’
lives?
I’d like to teach you to seize that opportunity and that moment for
both your benefit and that of the client or patient seeking your advice.
Put the fear that you don’t know where to go first or what to do next
for these advanced cases aside and rest assured that you can, and will,
have the keys to the kingdom of support right at your fingertips.
Am I about to reveal the cure for Candida overgrowth or the three top
tips for addressing gastroparesis? No, I’m not. What I’m inviting you
into is not a one-size-fits-all approach to every health challenge that
you might encounter. And what you’ll begin to understand as you meet
more people with the same diagnosis is that such a set protocol doesn’t
exist.
As one of my mentors along the way taught me many years ago, even
if you’re working with two different women, both 44 years-old, both
diagnosed with breast cancer, both the same weight and same height,
the roots to one of these women’s diagnoses could be inflammatory in
And get ready. There are also going to be many health challenges
that you may have never heard of — bizarre ones, complicated ones,
even if you’re an RD, ND, NP, or other therapeutically trained health
professional. Yet these people with a variety of health concerns beyond
the mundane also need our help. And there are more of them than you
can imagine! They’re bound to come knocking on your door, as they do
ours, almost daily.
Instead of a cure-all for every condition under the sun, what I’m
inviting you into is a paradigm shift in both your thinking and the
ways in which we address people’s health complaints. While I will
definitely share some clear, actionable steps and tools you can put
into motion with your very next client or patient, it’s more important
to sit and contemplate what’s possible in our collective practice of
healthcare. This is where we really start to shift the system that many
of us have come to believe is broken or lacking. This is where we’re
mobilized to break the silence of the suffering that we’ve seen our
friends, family, clients, and patients experience, and that maybe we
have been burdened with ourselves. It’s with this revamped prototype
for potential that we, collectively, reinstate hope in a population that
is sick, suffering, and has all but surrendered. This may not be the
population you dream of serving, but they will come to you hidden
behind symptoms like brain fog, weight loss resistance, allergies and
more. Your ability to help them no matter how deep the roots of their
pain will determine your own realization of your desire to affect more
people’s lives. The good news is that it’s not as hard to unravel as you
may think.
What if the six-month protocol you’ve been handed doesn’t work or it’s
already been executed by the person seeking your help? Who can you
be for them then?
I’ve learned many lessons along the way. I now know that I’m not the
right teacher or mentor for the person who just wants to be told what
to do. In my opinion, that’s not an effective or sustainable approach. At
Replenish, I teach my clients and customers to understand themselves
better and to be in dialogue with their body’s signs and symptoms. I’ve
come to call it “non-violent communication with self.”
These tactics can enable them to progress forward no matter how grim
the diagnosis or how debilitating the signs and symptoms. I’m aiming
What this means for them is inviting the opportunity to think for
themselves. And this is not only true of my approach with my clients
and course participants in Replenish (or with my parenting tactics!),
but also with my Holistic Nutrition Lab posse. What I teach my
students is the art of the dynamic dance that we need to be in with each
and every client or patient. This is the paradigm shift. This is where
you come into what’s possible — for them and for YOU. This is where
you move out of a one-size-fits-all approach into the true reverence for
bioindividuality.
There are 3 principles that I’d like to introduce you to that can help you
to position yourself in that important place.
Principle #1:
You already know everything you need to know to
help people with their diet.
Let me tell you a story. I had a client, a little girl named Elise, who was
just under two when her parents brought her to see me. Elise could
not sleep. She had eczema all over her body and severe constipation.
Her mom was reduced to giving her an enema about every four days
because she didn’t poop on her own. By the time Elise and her parents
walked in my door, the entire family was in complete distress.
So, what we need to do with our clients is understand that the food
is part of the stimulus, but how that stimulus responds inside their
body is something we need to learn and understand. And that’s where
being a detective and playing the What’s Going On In There? game
are really critical. So, this is where, yes, we know all we need to know
as holistic health counselors to clean up peoples’ diets, but that’s step
one. We need to take it a step further. I know you’re often in situations
where you want to take things a step further and know more about how
you can help a client. What I’m going to teach you in Holistic Nutrition
Lab is that ability to understand what’s going on in there for each
individual client.
We’ve all heard the term bioindividuality. Yet I’d like to take our
understanding of it a step further and talk about biophysiology. How
is it that each of us are really different? How is it that what’s worked for
one client doesn’t work for another client?
There was only one way that I could figure that out and find out how to
help her, and that was by understanding What’s Going On In There?.
Being able to understand that internal biophysiology allowed me to be
the detective and not prescribe to a set protocol, bringing her the kind
of healing that I know you want to deliver to your clients with more
confidence and more know-how.
Principle #3:
Elevate your role in your clients’ healthcare teamS.
It’s important that you know that as a holistic health coach or as the
nutritionist, you do not need to be at the bottom of the tier with the
doctors and acupuncturists and naturopaths that are also on your
You do not need to feel like you do not know enough to help your client
or to help her entire team figure out what’s going on for her. What I’m
proposing here is that your understanding of what’s going on in there
and playing the What’s Going On In There? game enables you to
elevate your role and the ways in which your client looks to you, relies
on you, favors you, and turns to you for advice, recommendations,
and information. You become the trusted resource, and you get their
referrals and their applause for what you’re doing to help them figure
out what’s going on in their body — sometimes things that nobody else
has been able to decipher.
•••
To play the What’s Going On In There? game, to honor the beauty of
bioindividuality and biophysiology, and to elevate your status on your
clients’ healthcare team, continue to follow the practices outlined in
Functional Nutrition 101 and be sure to show up for the opportunity to
take knowledge to practice. (Practice doesn’t make perfect, by the way,
but it does allow for a level of mastery that I just know you’re going to
love!)
www.holisticnutritionlab.com
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nutrition
I want to show you how you can begin to immediately delve deeper into
uncovering the underlying causes for your clients’ health woes. Does
that mean you have to go back to medical school and understand how
to diagnose and prescribe? No. It means that you have to know how to
dig, decipher, and readily enter into a dynamic dance of discovery that
is particular to the person sitting in front of you. Your client or patient
deserves this, and so do you! Let me show you what I mean.
I’d like to reveal, right now, some of my best clinical secrets. Are you
ready? We at Replenish utilize three key tools with each and every
client who comes into our fold. These are strategic tools that I’ve
adapted from Functional Medicine practices to meet our needs as
nutrition professionals. These tools include:
The second and third tools — the Matrix and Timeline — are ones I
share and refer to throughout Holistic Nutrition Lab, as well as in some
of the other classes I teach through Replenish. I sometimes incorporate
them for the customer to utilize for themselves!
In the words of Tom Chi, innovator and creator of Google Glass, “How
can you love your medium enough to create a masterpiece?”
You took the initiative to follow a dream you had, to gain more
knowledge about food, diet, lifestyle and more. Now let’s take that
initiative forward — into your own life, your practice, the health of
others, and, yes, the changeable face of our currently lacking healthcare
system. Let’s make you a master.
I actually love the word “functional.” It means useful and whole. It’s
as medicine should be. And according the Institute of Functional
Medicine, there are some foundational conditions of a functional
practice. First, the goal is to address the underlying cause of any sign,
symptom or disease state — aiming to get to the root of what is not
functioning and preventing a person from feeling his or her best.
There are guidelines or precepts that we can follow that are part of the
functional practice, no matter what our field of expertise. The first of
these precepts — again, a guiding principle of Functional Medicine —
boils down to a number of questions that you can pose to your clients
to help map out your next steps based on their unique history. That’s
right, all those functional doctors out there, from Mark Hyman to
Jeffrey Bland to Amy Meyers, they’re not skipping this step in favor of
doing a bunch of lab testing. Their Intake process and the questions
they pose during that session are key to their success with each and
every patient.
I’m not saying that these practitioners I’ve mentioned don’t ultimately
go the distance — testing blood, saliva and stool (and clinically I might
go there, too), yet they know where to first direct their attention in their
care of the person in front of them. Even knowing which labs to order,
and when, is contingent on a set number of questions in their Intake
Process and what their patients’ answers reveal.
I’m going to say this again, because one of the biggest inquiries I
get from holistic health practitioners is about lab testing. Everybody
wants to know about lab testing as if it’s our only tool to uncover the
root of health issues. Now I love labs, but the person sitting in front
of me — her signs, her symptoms, her history, her relationship to the
story of her life — those are brilliant diagnostic tools too! And believe
it or not, those diagnostic tools, along with an understanding of the
physiological ramifications of those signs, symptoms and history,
are far more revealing than a set of numbers on a sheet of paper.
Ultimately, it’s the former — what the client reports in response to your
targeted questions and Intake — that will allow the lab numbers to
make more sense and become just another piece of the puzzle down the
line.
I’m going to share with you what I have found to be the most important
diagnostically significant questions and how to use them to start to
recognize What’s Going On In There? with your very next patient or
client.
If you consider just one of the questions that I’m going to reveal
today, and you implement that question or technique into either
your Health History or Intake Form, your initial strategy session
or Intake protocol, you’ll find that there will likely be a little
tunnel leading toward that needle in the haystack. You will be
one step closer to knowing how to approach the physiological
breakthroughs that your client needs.
Like I said, I’m sharing my approach with you because so many of you
asked for it, but I’m also sharing because I know what can happen for
you when you have new keys and new pieces to the puzzle. You feel
more empowered and more knowledgeable, and you’re ultimately more
successful in the work you do. This is how we return healthcare to the
individual, where it belongs. This is where we move away from dogma
and embrace the true dharma of distinguished healthcare. This is where
you get to really make the difference you are meant to in people’s lives.
Who would have thought that some of our success could boil down to
a set of QUESTIONS?! Well, it can, and it will. Keep reading and you’ll
see how.
While I know I don’t have the cure for cancer to share with you in these
pages, if I can help arrest or inhibit some of the symptoms that I see
people encounter by upgrading your game — symptoms like I watched
my husband suffer — then I’m determined to do so. I know we can do
this together.
Take a moment, right now, to envision what could be true for you if you
had more fundamental and foundational knowledge in your existing
practice, if even though you didn’t know it all (we never do), you still
felt like you had the tools to find what you needed as new challenges
arose, even in the most complex client cases. What would that look
like?
See it.
What would it mean to have more of the keys to unlock the foundations
of health or to be handed more pieces of the puzzles in the conditions
that seem most perplexing? When you think about that, what are you
able to foresee for yourself?
Can you see yourself being more effective with your clients?
Can you see yourself taking a bigger stance in your field (our field)
overall?
Can you see yourself stepping into more of a role of leadership, either
within your town, your niche, or the entire realm of holistic nutrition?
Can you see yourself bringing your unique gifts to the world?
Take a deep breath into the possibilities you just envisioned for
yourself. I can see all of that for you. I can see that for us! And I’m
devoted to us realizing our potential.
In the Introduction, I relayed a bit about my history and what led to the
development of Replenish. I told you about my husband Isamu’s brain
tumor diagnosis, his illness and his death, which happened two years
later and was the biggest catalyst and inspiration for all that I do in my
work today. I also shared the course of study that led me to essentially
hang my shingle and open the doors of Replenish. That course of study
continues as I attend more seminars and as I now continue to pursue a
Master of Science in Nutrition and Functional Medicine.
I never could have imagined that I’d be doing the work I’m doing right
now, or that my work would touch so many people’s lives. I’m honored,
and I’m inspired. I’ve learned so much through the work itself, the
experiences, and most particularly, through each and every individual.
Bioindividuality really starts to take on a different meaning when you
encounter that many different bioindividuals!
I want to be clear that I don’t share all this with you to brag. I share it
with you because this is possible for you, too. You invest in yourself.
You invest in your future and your knowledge and know-how. You
explore your tools, your education and, yes, your mindset (that mindset
piece might be my biggest personal secret weapon, to be honest). You
see the results. Once again, this is true of our efforts in our relationship
to food, and it’s equally true in our relationship to our practice and our
dreams.
Over the last couple of years, as I’ve stepped more deeply into the
realm of Functional Medicine and having a truly functional practice,
I’ve been working to refine and improve the Health History and Intake
Form that our private clients receive. It has been, and continues to be,
an evolutionary process that I consider with great care as I distinguish
the most critical questions to ask to get the information I need to
best help them. Again, the objective is to use the Intake Process as a
diagnostic tool — perhaps more revealing than the most extensive set
of lab work. Some people see that first session as an opportunity to sell
their services — not so at Replenish. That session, like I said, is one of
your best opportunities for problem solving. That in itself could be a
huge mind shift for you!
Did you love your holistic health training but also feel it left you a
little lacking in practical and clinical knowledge when you entered
the field and started seeing clients?
If you answered “yes” to any one of those questions, this is the book
for you. So let’s get out of our heads and our dreams and into reality —
actionable reality.
Let’s look at that first tool I mentioned — what I’m going to call the “A”
in the ABCs of functional methods — the Health History and Intake
Form. At the back of this book, you will find the most recent iteration of
our Intake Form. We use this as our very first tool, as I’ve learned in my
Functional Nutrition and Medicine Trainings, to help us to determine
what’s going on in there? with each and every client.
I want you to have the fruits of our labors — our testing, our tactics, and
the questions we like to ask our clients to sit with. I want you to have
our Intake Form, so you can pick and choose which questions work for
you. In addition to the version at the back of this book, you can also
Ultimately, what this form and this exploration of the impact of inquiry
mean for you is that you will get further clarity about how to investigate
underlying issues that might be bugging your clients. You will be
able to seek solutions to help them feel better faster, leaving more
opportunity for more clients to come your way. What this also means
for you is you get the tools to start playing the What’s Going On In
There? game right away, with your very next client or potential client.
I wanted to start with these questions because they are the keys into
the kingdom of knowledge. Like I said, with these strategies you can
get started playing the What’s Going On In There? game immediately.
Yet there are most certainly more pieces to the complex puzzle that
each person presents. As I mentioned earlier, there’s that client who has
Candida and comes to you having done everything you already know
how to do. Or how about the client who has gone through your weight
loss program that’s worked for everyone else except her? What’s Going
On In There?
For now, let’s delve into the nitty-gritty. I’d like for you to pretend for
a moment that you’re an investigative journalist — a detective. That’s
right — as nutrition professionals we wear many hats, and the one I’m
asking you to put on right now is that of Sherlock Holmes.
Take a moment and put on that hat. Are you Joan Didion, Barbara
Ehrenreich, Nora Ephron, Walter Cronkite, Susan Sontag, Barbara
Walters or, one of my favorites, Truman Capote? Think about these
outstanding investigators. Their success hung on their ability to ask
the right questions and elicit answers that imparted truths otherwise
untold, weaving together a story that was riveting and revealing.
That response is from our Intake Process alone. The purpose of that
first session together, and the questions that follow, is to get you the
same kind of response.
Are you following me here? The remaining five questions have been
left out of the equation. And because of this, I would posit that the
bioindividuality has been left out, too. So for those with whom the “X
“Humility means they ask questions, and questions mean they get
answers, and answers mean they get points on the checklist.”
“Empathy isn’t just remembering to say that must be really hard — it’s
figuring out how to bring difficulty into the light so it can be seen by
all. Empathy isn’t just about listening. It’s asking the questions whose
answers need to be listened to. Empathy requires knowing you know
nothing. Empathy means acknowledging a horizon of context that
extends perpetually beyond what you see.”
Grace is smart and creative and athletic. She’s conscious of her food
choices. She drinks green smoothies before she runs, eats healthy full-
fat plain yogurt, and makes her own raw desserts. Her family eats well,
buying sustainable pesticide-free produce and hormone-free meats.
They eat dinner together — both parents and all three kids — unless
one of the kids has a game. If given the choice between candy and
vegetables, Grace told me she’d pick the veggies every time.
Grace isn’t the most communicative teenager I’ve met. In fact, I met
with a girl the same age earlier in the same week and had a completely
different, chatty experience. Grace was embarrassed about her
condition, and she’d seen a host of healthcare providers before sitting
down with me. My approach with her in that first visit had to be that
of an investigative journalist. While I didn’t want to probe her, I did
want to open the field for exploration into the reasons that led her
(her in particular, not every other teenage girl with bulimia) into the
behavioral pattern in which she found herself. I didn’t need to lecture
What you can start to gather from the answer to this question is a
timeline. (Oooh, remember I said the Replenish Functional Timeline
was one of the other two tools we use when inviting clients into
our counseling fold? It all starts with the first when question!) You
can begin to create your own functional timeline through a series
of questions that stem from that when question: When did you first
experience X?
Now let’s get back into journalist mode. Remember, you’re not trying to
solve the client’s problem or, in this case, treat the bulimia. You’re with
Grace. When you discover the when, you want to take several factors
into account. These factors are:
What you’re looking for each time you pose the when question is
a chronological portrayal that captures the client’s story. Within
that chronology, you can begin to look for triggers, mediators, and
symptoms. We’ll define triggers as the conditions and situations
around Grace that led to that first occurrence: a breakup with a partner,
parents fighting, not getting the position she wanted on a team, et
cetera. The mediators are the things (conditions, thoughts, emotions)
that instigate the behaviors, making a difference between when she
takes action to binge and purge and when she doesn’t: feeling too large,
feeling out of control, feeling like she doesn’t fit in. The symptoms
are the things she began to feel as a result of that first occurrence:
heartburn, sour stomach, and cravings she had never felt before — both
for foods and for more of the same activity, an activity that helped
certain feel-good brain chemistry to fire.
In Grace’s case, you can clearly see that I’m not treating bulimia with
a Five-Step Approach or Signature System. I don’t have the Top Ten
Tips for Treating Bulimia. Instead, I’m helping Grace by giving her
the opportunity to express her story and also by understanding the
broader context in which the symptom, binging and purging, occurred,
as well as what physiological side-effects she might be experiencing
that could use our attention. In response to her answers, I’m helping
her to make connections that become anchors for her own self
behavior modification, as well as educating her about the physiological
underpinnings of the unwanted symptoms she’s now experiencing.
Think about the power of this when question and all it can do for you.
Think about its ability to invite a personal biography to unfold. Think
about how you might shift that when question or where you might use
it in your initial strategy session with a client. And think about what
associations your client might begin to make — seeing connections
that were previously elusive. This is so simple and yet such an
important nugget.
With Grace, the when question enabled me to discover that she’d been
engaging in the binge and purge behavior since 8th grade, so that’s
three years. It enabled me to track when she was compelled to do it and
how it changed or escalated over time, ultimately becoming its worst
when her parents found out. It tended to occur when she got too hungry
after school and after track practice. She would then come home and
either eat more than she felt was good for her or eat foods that she
clearly knew weren’t good for her. That would make her feel bad about
herself, and then the purging would ensue.
The information I was able to gather from Grace by asking the when
question and developing a timeline with her help enabled me to
understand her triggers and begin to comprehend what was going
on inside her body and brain. It also allowed me to draw information
from a person who was not otherwise as forthcoming about telling
her story. Speaking to someone about a chronological history can be
more effective and more revealing than asking them how they feel, why
they’ve come in to see you, or what’s “new and good” today.
For many of our clients, this open-ended line of questioning can either
lead to a litany of aches and pains or a shrug of the shoulder. It’s much
better to know the plan for your questions. Why are you asking them
and what do you want out of them?
This is all so telling. Let’s think about it. . . At 12 years old, she’s just
budding into her own hormonal response; she would just be getting
ready to stretch out, to push away a bit, to claim some of her own space
in the world. But her natural instincts are thwarted by disturbing and
disruptive occurrences around her, causing a red-hot and angry, yet
unreleased, response within her at a physiological level. Cystic acne is
a bacterial overload that the immune system cannot remedy quickly
enough — it’s inflammation!
With that deeper knowledge obtained about the case from the when
question, I first tell the story back to my client, so I can ask for more
With Grace, if we look at the story she shared, can you see some
obvious functional challenges? I’ll bet you can:
But if I were treating the symptom alone (vomiting after eating), or the
diagnosis, which is bulimia, and not asking the when question to help
me develop that timeline, I likely would not have been able to discern
the complexities of how to get into her particular life patterns and some
of the simplicity of where to go next. I would be addressing this as a
psychological problem alone and not helping to address the underlying
physiological imbalances that trigger that psychological state. We
can’t remove the psychological from the physiological or vice versa —
something we’ll explore in depth in Holistic Nutrition Lab’s Digestive
Intensive.
Again, I realize these can seem like simple questions. But what I
want you to understand is what I’m revealing are top tools within
the Functional Medicine model that have allowed me, and the
practitioners who are adopting this functional approach, to go more
deeply than what my prospective client might put on paper or relay in
a conversation that is just about food, diet, or incoming complaints. I’m
asking questions that will reveal the keys to allow me to better help the
client, and your ability to do the same will help you more than you can
imagine until you actually put it to practice.
Most often people are coming to me because they want to feel better.
I’m guessing this is true of you, too. But how to get them to feel better,
to achieve their goals, and to address their nutrient deficiencies will
likely take an investigative approach that allows the real person to
truly come out and be seen, not just emotionally, but physiologically. .
. functionally. “How have you dealt with this concern in the past?” is a
question that can lead to some interesting information for you!
In the fall, I lead a focus group for women who consider themselves to
be experiencing “resistant weight loss.” Weight loss isn’t something I
usually approach straight-on in my practice, but resistant weight loss
is of interest to me because there are likely underlying or causative
physiological factors at play. (These are those root causes I discussed,
begging for us to “back it up” to uncover why symptoms, like resistant
“How have you dealt with trying to lose weight in the past?” is a
question — THE how question — whose answer tells me a lot about a
client and what I need to know to change the course of her success. It
will report what she’s tried: Weight Watchers, calorie counting, low-fat,
high-fat, Atkins, gluten-free, sugar-free, et cetera. I can then ask, “How
did that work for you?” after each of the techniques she relays. In this
way, I start to build an arsenal of systems that are effective for each
individual and why. I then get to reincorporate aspects of what worked
for her into our more functional protocol, so she can fall into step with
a methodology that already retains some sense of success for her, both
emotionally and physiologically.
I’d like to share with you my biggest belief around this work that we do.
It’s my core belief and the place I move from in all the work I do. It’s the
reason why I’m not just a technical clinician, someone who reads labs
and addresses health from a set of numbers and symptoms (though I’m
able to do that clinical piece as well). It’s why I trust that I’m also an
effective practitioner, one clients can turn to and rely on.
i believe food and nutrition are keys to unlock our full physiological
potential. You may have heard me refer to this as the key-and-lock
approach if you’re familiar with my teachings or you’ve seen my Tedx
Talk, “Action Potential.”
But it doesn’t end there, either! Food and nutrition act as the first
key, unlocking the powers of the body. The powers of the body in full
function act as the second key to unlock the powers of the heart to feel,
love, and express, and of the mind to focus and produce, dream and
innovate. Then the fullness of the expression of the heart and the mind
become the third key to allow us to tap into our BIG purpose — what we
are here to do and how we can fully actualize that potential.
In this way, the body, in its fullest expression and function, becomes,
in essence, a vessel through which pleasure, purpose, and wisdom
move. And in this way, when I’m recommending a specific diet or
reading in between the lines of someone’s labs, I’m not just looking to
remedy a supposed health condition; I’m working toward her ability to
recognize and realize her true self. It’s a lofty belief, I know, and yet I
see it happening time and time again. I see transformation occur when
people begin to pick up and recognize the keys.
What would it feel like for you to witness this transformation in the
people’s lives you touch with your coaching and your care?
This brings us back to the who question. The people who love and
support us the most are often the people who can also see us in our
most true or realized selves. There’s a part of us they “get,” and they’re
rooting for us. This who question, in conversation with your client, is a
gentle way of inviting a commentary on the support he or she will or
will not receive during your counseling. Can you see how the question,
“Who in your family or on your team will be most supportive of you
making dietary change?” can invite an opening of discussion? And
that discussion can reveal quite a lot that will bring you deeper into the
tenor of the healing environment.
In many, if not most, cases, when it comes to kids, I’m able to help
the other parent make a turn. And I must confess that it’s the science
behind what we’re doing that usually does the trick. Sit down with
mom and dad and an anatomy book and clear explanations, and there’s
really no denying physiology. But asking that question and allowing
the complexity of the home, social and relational life to unfold is
what enables me to understand my way IN with the family. My goal
in a situation like this is not to be a therapist or even a coach. I’m a
nutritionist. My goal is to help a child heal. And if that’s my mission,
then one key is getting both parents on board. How I do that might
take some strategizing and educating.
Here’s a good example. I saw a client last week who I’ve seen somewhat
regularly for several months. He actually feels fine. He’s a successful
entrepreneur who wants to feel his best, have more energy, and be able
to perform better in his athletic pursuits. He’s not my usual client. They
typically have more extreme health conditions, but somehow he got
on my schedule and continues to return for periodic visits. His blood
work looks fine; he has nothing to really complain about, but he wants
something more. I can relate to this. I’m always seeking to feel and
perform my best. You too?
Let’s call this guy “Fred.” Fred came to me last week with his Food/
Mood/Poop journal, a document we use regularly to generate deeper
understanding and conversation of daily habits and patterns, and we
were reviewing it for optimization. Something he’s doing regularly is
eating store-bought energy bars. Now there are a few bars I approve
of for regular consumption, and fortunately that list is growing as the
marketplace catches on to our initiative, but there are not many, and
they do not include the ones he was eating. It’s not all that difficult to
whip up a batch of energy, granola, or protein bars, and I’ll happily
I also know, from our previous conversations, that Fred’s wife is not
fully on board with the dietary changes he wants to make for himself.
Her thinking, according to Fred, is, “if it ain’t broke, don’t fix it.” Now
that’s all well and good, except Fred keeps coming back. He wants
something more. He’s seeking an upgrade from his diet, and he wants
something more out of his life. And yet, in his family, he’s like a lone
island. There’s no allegiance and no support. So last week, when I spoke
to Fred and confronted him about going the extra mile for himself, I
also discussed ways in which he could invite his wife into the process
with him. I suggested opportunities that might allow for the two of
them to engage in a transformation together.
You see, the answer to the who question for Fred was, sadly, nobody.
Or it was me. But at this point, given his goals and his existing eating
patterns, which besides the store-bought bars are near perfect for a
middle-aged family man without any obvious health challenges, Fred
doesn’t really need to see me, especially when I have a long wait-list
of people who do (people with unaddressed autoimmune conditions,
SIBO, multiple chemical sensitivities, rare cancers and more!). What
Fred needs is to find an anchor outside of me to join him in the pursuit
of his dietary goals and aspirations. He needs support. And that’s
understandable. We all do!
My son, Gilbert, and I are big fans of the public radio show Radiolab.
Do you know it? One program that really caught our attention was
called “Talking to Machines.” It was super interesting, yet also kind
of freaky. The initial story was about a man who had gone on an
online dating service after divorcing. He struck up a relationship with
someone he thought to be a woman; in fact, she wasn’t a woman at
all but instead was a robotic program. The program responded to his
correspondence with an answer that would goad him on to continue
the conversation. And this man developed a relationship, at least in his
mind, with this supposed woman, until the questions he was asking
and the answers that she gave no longer made sense. He started to
get suspicious, and it was shortly afterward that he figured it out. He
realized this machine did not truly understand him.
Another story on the show revealed a test program that was a robotic
therapist. The planned questions the machine asked truly convinced
the client to open up and have moments of self-discovery.
Let me give you an example: Let’s say the next thing you invite your
client to do is drink green smoothies each morning. You give her some
awesome and tasty recipes — the ones your whole family enjoys. Some
contain coconut milk, others chia seeds. There’s a mocha version with
a gluten-free grain coffee and raw cacao. There are a variety of high-
antioxidant fruits, such as pomegranate and blueberries, and one with
papaya for the great digestive enzymes it contains. All, of course, have
some greens mixed in. You’re super proud of your yummy smoothie
recipes, and you’re excited to share these with your client.
Within just a few days, your client reports that the elimination of
morning oatmeal and the substitution of the green smoothies (which
taste yummy, by the way) are leading to a lot of gas. Each day, 30 or
so minutes after she has her smoothie, she’s so bloated she can’t even
button her pants. She’s taken to wearing yoga pants with tunics over
them every day this week.
When did this first happen? “Well, the first day I had the
smoothie.”
How have you dealt with gas and bloating in the past? “I’ve
never actually experienced it like this!”
Like I said, the when, how, and what questions are critical, and yet
they’re just the beginning. What comes next is what you DO with the
answers and the clues. This is the fun part. And I’m going to show you
how to make it fun. In Holistic Nutrition Lab, I translate the anatomy
and physiology I’ve learned and continue to learn in my trainings and
my practice into terms that are meaningful to your life as a holistic
health professional looking to have a more dynamic relationship with
your client or patient and truly gain a better understanding of where
food meets physiology (and why that might be different for each of
us). I have an inside view into what will enable you to better meet your
clients’ needs.
But before you start practicing, I want to bring our attention back to the
who, what, and why in our client intake and strategy sessions. We’re not
done there yet! I want you to have some tactics to put into action with
your very next client.
2) the second question is: “How have you dealt with this
problem in the past?”
And remember, the answer speaks to you about her compliance, her
successes, and what works and doesn’t work for her. Remember, too,
that what works and doesn’t work for her could be a physiological
cue, a behavioral cue, or a patterned cue.
The answer here indicates where she may need more help to follow
through with your suggestions and where you can help her to
cultivate an environment that supports the results she’s aiming to
achieve.
Before I talk about why this is one of my top five questions and what it
means, I want to point out why it’s here on the form, at the end instead
of at the beginning. I like to ask this question at the end, after clients
have considered all the other questions, because at this point they may
be more acutely in tune with their goals and aspirations. Earlier in the
process of completing a form or when just sitting down to speak with
you, they may not be so open or in depth about their wants and needs,
and it may be harder to articulate what’s possible.
But even when I’m meeting with someone for the first time, I often
find it helpful, depending on the context of the conversation, to ask
this question again, out loud — “What are your health goals and
aspirations?” — after we’ve created an empathetic environment.
A really good example of using this big what question at the end of the
session or Intake Form is a client I have who I’ll call “Melissa.” Melissa
came to me in a bit of perplexed desperation. She’s a hard-working
designer at a top athletic company. Melissa had suffered a surprising
breakup that left her confused and lonely. She had no energy, yet she
got herself to work every day. She ran every day. She ate what we might
consider a healthy, standard American diet (SAD). Melissa didn’t really
care much for food, so cooking wasn’t top on her list.
Melissa had lost a lot of weight. She was thin and somewhat absent
from her own life — as absent as her physical self was becoming. When
she came in, she sort of shrugged her shoulders about why she was
there. She said she just wanted to “feel better.” But after we talked and
I led her through some deeper questions, like the ones I’ve shared with
you, she was able to see by the end that something might actually be
going on with her. Instead of just wanting to “feel better” (a somewhat
nebulous statement), she was actually able to articulate that something
didn’t feel right within her.
Approaching the situation first from the correlation between the gut
and the brain and what appeared to be some depression, I started by
cleaning up Melissa’s diet. We removed gluten and dairy, and I did an
IgG food sensitivity panel to uncover any hidden food triggers that
were affecting her energy and her outlook.
Melissa, by the way, has remained a client for years now. Her condition
is one of the most complex I’ve seen, with multiple underlying
infections including Epstein-Barr Virus (EBV), polyautoimmunity
(including antibodies to her brain), and Superior Canal Dehiscence
in both ears — a broken vestibular system causing extreme vertigo.
For Melissa’s ongoing care, I work in tandem with her naturopathic
physician, her functional neurologist, and even coordinated with her
Now get ready. Some clients might scoff at this question. Some might
take the time to contemplate. But asking this question, here on the
Intake or when you’re with them in person, allows you to explore the
motivation behind their goals and aspirations.
Perhaps you were able to see how the when question led to another
when question that allowed you to create a timeline. The how question
led to another how question that allowed for the formation of historical
context. The why question here, enables you to continue to ask why . . .
Something really important that I want to point out here is that this
line of questions allows you to continue to engage in conversation
with your client. It allows you to demonstrate that you are the trusted
expert for him. You are the one who knows how to ask, how to unravel
more information. Again, this is so he can have a-ha’s, but also so you
can have tiny epiphanies during your client session that enable you to
think on your toes, be the dynamic practitioner that you can be, and
know your next step, the step that’s going to lead him closer and closer
to his designated goals and aspirations, while holding them with the
same importance that he does.
I know that some people liken health issues to a battle. Well there’s
an old war saying that goes, “Time spent in reconnaissance is seldom
wasted.” That’s the exploration, the surveillance, the investigation.
I’d like to add that it’s especially true if you want to come out on the
winning side.
I’ll leave you with one last story, a success story, in fact. “Mary” came
to me blown up like a balloon. She had been in the hospital with an
infection and put on antibiotics and steroids. She was literally twice her
size when she came to see me, showing me a picture from just a couple
of months earlier, before she got sick. She could no longer recognize
herself in the mirror. She could barely walk. And she was desperate.
Mary’s cousin had recommended that she come to see me. I had worked
with her cousin’s 12-year-old daughter, “Allison,” to take her from her
Crohn’s diagnosis (for which the doctor had prescribed surgery and
life-long steroids), to complete avoidance of both the surgery and the
steroids and a thriving (finally), growing, and pain-free tween whose
What did I do with Allison and Mary? I promise to share both of their
stories in the Holistic Nutrition Lab Digestive Intensive, where we
take practice to a whole other level, using the skills we’ve outlined in
Functional Nutrition 101 in tandem with a deeper understanding of
physiology and nutrition therapy to manifest full body, functional,
healing potential.
1. Look over the Intake Form at the back of this book or at www.
holisticnutritionlab.com/intake and start to consider which
questions, perhaps with ones of your own, might produce the
most thorough Intake Form for you.
2. Write the five key questions out for yourself on a piece of paper
and try them out on your very next client or patient, seeing what
unfolds. (Remember, it takes practice, so if it feels awkward the
first, third, or fifth time, keep at it. The results will come and you’ll
start to feel more confident in those conversations and be able to
draw out more important information to help you help them!)
Thank you for taking the time to fill out this form and provide us with details of your health, goals and medical
history. Feel free to save this form to your computer and type in your answers at your convenience. The boxes
where you type your responses will expand to accommodate your text, so you will have as much space as you
need. Please remember to save along the way. Once you are ready to send it back, attach it to an email and
send to katie@replenishpdx.com or fax it to 503.715.0467. Please let us know if you have any questions or need
added support.
Client Information
Name________________________________________________________________________
Address______________________________________________________________________
City_________________________________________________________________________
State________________________________________________________________________
Zip Code_____________________________________________________________________
Phone (day)___________________________________________________________________
Phone (cell)___________________________________________________________________
Phone (night)_________________________________________________________________
Email________________________________________________________________________
Referred by___________________________________________________________________
Statistics
Age _________________________________________________________________________
Gender ______________________________________________________________________
Height ______________________________________________________________________
Blood Type___________________________________________________________________
____________________________________________________________________________
Children: ____________________________________________________________________
____________________________________________________________________________
Occupation: __________________________________________________________________
____________________________________________________________________________
Exercise/Recreation: ___________________________________________________________
___________________________________________________________________________
History
1. Have you lived or traveled outside of the United States? If so, when and where?:
2. Have you or your family recently experienced any major life changes? If so, please comment:
3. Have you experienced any major losses in life? If so, please comment:
4. How much time have you had to take off from work or school in the last year?
□□ 0 to 2 days
□□ 3 to 14 days
□□ more than 15 days
5. What are your main health concerns? (Describe in detail, including the severity of the symptoms):
□□ doctors
□□ self-care
9. What other health practitioners are you currently seeing? List name, specialty and phone # below.
10. Please list the date and description of any surgical procedures you have had.
15. List all vitamins, minerals, herbs and nutritional supplements you are now taking:
16. Have any other family members had similar problems (describe)?
17. Are there any foods that you avoid because of the way they make you feel?
If yes, please name the food and the symptom:
18. Do you have symptoms immediately after eating like bloating, gas, sneezing or hives?
If so, please explain:
19. Are you aware of any delayed symptoms after eating certain foods such as fatigue, muscle aches,
sinus congestion, etc? If so, please explain:
20. Are there foods that you crave? If so, please explain:
□□ ovo-lacto □□ paleo
□□ diabetic □□ blood type
□□ dairy restricted or dairy-free □□ raw
□□ vegetarian □□ refined sugar-free
□□ vegan □□ gluten-free
□□ Other (please describe)
□□ 10 □□ 30 □□ 50 □□ 70 □□ 90
□□ 20 □□ 40 □□ 60 □□ 80 □□ 100
26. Is there anything else we should know about your current diet, history or relationship to food?
Intestinal Status
30. Do you experience intestinal gas? If so, please explain if it is excessive, occasional, odorous, etc:
Medical Status
31. Please check any of the following conditions that apply to your history and briefly describe your
symptoms, chosen treatment(s), and dates.
32. Have you been exposed to any chemicals or toxic metals (lead, mercury, arsenic, aluminum)?
Lifestyle History
36. Have you had periods of eating junk food, binge eating or dieting? List any known diet that you
have been on for a significant amount of time.
37. Have you used or abused alcohol, drugs, meds, tobacco or caffeine? Do you still?
40. How are/were your menses? Do/did you have PMS? Painful periods: If so, explain.
41. In the second half of your cycle do you experience any symptoms of breast tenderness, water
retention or irritability?
42. Have you experienced any yeast infections or urinary tract infections? Are they regular?
43. Have you/do you still take birth control pills: If so, please list length of time and type.
45. Are you taking any hormone replacement therapy or hormonal supportive herbs? If so, please list
again here.
46. Do you have any concerns or issues with your sexual functioning that you’d like to share with us
(pain with intercourse, dryness, libido issues, erectile dysfunction)?
47. Is there anything else about your sexual history that would be helpful for us to know in your
health history?
48. How are your moods in general? Do you experience more than you would like of anxiety? Depres-
sion? Anger?
49. On a scale of 1-10, one being the worst and 10 being the best, describe your usual level of energy.
50. At what point in your life did you feel best? Why?
51. Do you think family and friends will be supportive of you making health and lifestyle changes to
improve your quality of life? Explain, if no.
52. Who in you family or on your health care team will be most supportive of you making dietary
change?
53. Please describe any other information you think would be useful in helping to address your
health concern(s):
55. Though it may seem odd, please consider why you might want to achieve that for yourself: