Posted by Andrea Nakayama
It’s been over twenty years since my husband Isamu died.
I can remember that morning like it was yesterday. An ending. A beginning. A point in time so clear and finite for each of us—unlike most triggers in our health histories.
One thing I learned, through Isamu’s illness and death, in working with my own autoimmune condition (Hashimoto’s), and through serving thousands of clients in the subsequent years, is that something critical is missing from the way we help the chronically ill in our current medical model.
That something that’s missing is you—the patient.
Functional Nutrition is patient-centered care.
All too often, treatments are based on study evidence—what worked for a small and specific group of people in a controlled setting. One dilemma with studies is that they are subject to a tremendous amount of translation that often gets overlooked in our desire to find validation of our beliefs and our wish for the cure-all.
You can think of this as confirmation-bias.
Media translations of these studies and evidence-based practices can often confuse our collective understanding of the “good” and the “bad”—particularly when it comes to diet and lifestyle modification—creating mass confusion.
The interpretation of studies is subject to several factors:
- the assessments of variability
- methodologies of measurement
- number of subjects
- timing of the study
- confounding variables
- not to mention researcher bias and more
And yet the biggest issue I have with implementing treatment protocols based on studies alone is that they completely disregard what I call personal evidence.
Personal evidence is key in patient-centered care.
Personal evidence is what you’ve noticed, or what you and your health care team uncover about your unique body, history, and experiences in your healing journey to date.
Let’s consider an example:
A study might conclude that eggs are good for brain health and development because of their high concentration of the nutrient choline. Yet for someone who’s taken several rounds of antibiotics in their childhood (like many of us did), and developed an immune response to eggs as a result (as is true for me), eating eggs will not help, but instead hinder my brain health and nervous system— possibly contributing to systemic inflammation.
What studies show as protective can become destructive, in the wrong hands…or body.
No matter what the studies (or books) say, you have to do what works for your own body. Some of those action steps will fall into the collective ‘how to’ and others will be vastly different. Personal. Unique. Prescriptive only for your specific needs.
Personal evidence is the information from your life and your experience. It’s not about what worked for your neighbor, or your friend, or even your twin sister. It’s about your body, your needs, and what’s important to you.
Personal evidence brings bioindividuality out of the realm of theory and puts it into practice. Personal evidence is the key to patient-centered care.
And this brings me back to my husband, Isamu. You see, I advocated for the man I loved, and the work I do is still in response to that memory—a memory of the person I knew so well being treated like a diagnosis alone. Isamu was not a brain tumor. He was not a Glioblastoma Multiforme. He was Isamu. Seeing him put in the box and seen through the narrow lens of pathology was not OK for me. It’s not OK for the patients we see in the Functional Nutrition Alliance Clinic. And it’s not OK for you, or those you serve.
That’s why Functional Nutrition honors personal evidence. Because your unique experience matters. And because patient-centered care brings the patient, and all of their life experiences, back to the center of care.
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