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Functional Nutrition Intervention Protocols


Anthropometrics Height, weight, BMI
Waist circumference, hip circumference, waist-
to-hip ratio
% body fat, % lean body mass
Conventional CMP, CBC, R/O Helicobacter pylori, parasites;
methylmalonic acid (MMA)

Functional IgG/IgG4 food sensitivity or MRT testing; consider

stool testing to rule out underlying infection

Nutrigenetic None

Clinical Indicators Nutrition-focused physical exam

Diet/Lifestyle Histories Comprehensive intake form

Medical Symptoms Questionnaire

IAGNOSIS Gastroesophageal reflux disease

Core Food Plan Balanced core food plan; weight loss, if indicated

Food Plan Modifications Comprehensive Elimination Diet to R/O food

Avoid foods that relax the lower esophageal
sphincter: high
fat foods, chocolate, alcohol (especially white
wine); avoid
foods that may be irritating to the esophagus:
beverages, citrus fruit/juice, coffee, onions,
garlic, pepper,
spicy foods, peppermint, tomatoes/products,
very hot or
very cold foods; choose foods that dont relax
the lower
esophageal sphincter: low-fat protein foods,
carbohydrate foods; 5-6 small, frequent meals,
drink fluids
30 min before or 60 min after meals
Anti-inflammatory foods: cold water fish; dark
red, black, or
blue fruits/juices; green tea; dark chocolate;

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Functional Nutrition Intervention Protocols
fruits and
vegetables in general

Medical Foods Anti-inflammatory food, if indicated

Dietary Supplements
High quality daily multivitamin with chelated
If using acid blocker, replenish vitamin B12,
folate, minerals
(replace, as indicated: Ca, Cr, Fe, I, Mg, Mn, Se,
Zn; zinc
carnosine recommended)
Transit time modulators: enteric peppermint oil,
also ginger as a modulator
Omega-3s, ~2g/d for inflammation
Melatonin, 0.5 mg 10 mg 1 hr before bed
Aloe vera juice (aloes-free), 50 ml (~6 oz) tid
DGL (deglycyrrhizinated licorice) may be helpful,
200 mg
Ginger root (Zingiber officinale Roscoe), 1-4 g
(maximum 4g/d) or supplement standardized
to gingerol
content; root can also be steeped in hot water
and enjoyed
as a tea

Food/Medication/Dietary Aloe vera may cause hypoglycemia

Physical Activity Daily activity, as tolerated, preferably outdoors

Sleep Full complement, as determined for individual

Elevation of head of the bed; wait at least 2-3 hr
after eating before lying down; avoid sleeping in
the left decubitus position

Psycho-social Encourage social connections, activities that are

and pleasurable for the individual
Smoking cessation
Potential transit time modulators: acupuncture,
hypnosis, music therapy

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Functional Nutrition Intervention Protocols


Follow-up Plan Periodic contact by functional nutrition
Return to clinic in 3 weeks to begin food

Key Resources:
Natural Standard Database or Natural Medicine Comprehensive Database for
supplement information

Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients

with gastroesophageal reflux disease? An evidence-based approach. Arch Intern
Med. 2006;166:965-71.
Li Y, Foundation and clinical research on the effect of traditional Chinese herbs on
gastrointestinal motility. Chin J Integr Med. 2009;15:86-8.
Werbach MR. Melatonin for the treatment of gastroesophageal reflux disease. Altern
Ther Health Med. 2008;14:54-8.

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