What is a Registered Dietitian?
A Registered Dietitian is a food and nutrition expert who has met academic and professional requirements, including:
- Earned a minimum of a bachelor’s degree (B.S.) with course work that was approved by the Commission on Dietetic Registration
- Completed an accredited, supervised practice program (most unpaid internships are close to a year in length)
- Successfully passed the national Registration Examination for Dietitians (administered by the Commission on Dietetic Registration)
- Completes continuing professional education requirements to maintain registration (75 credits minimum for every 5 year term)
I’ve heard the title “RDN” being used. Who uses it and what does it mean?
The Academy of Nutrition and Dietetics and the Commission on Dietetic Registration announced in March 2013 that there has been the addition of the title “RDN”, which stands for Registered Dietitian Nutritionist. Many people are under the impression that RDs only work in hospitals, but this is certainly not the case! Dietitians can be found working in many different types of venues – wellness programs, food companies, grocery stores, community programs, the media, and so on. “RDN” was created because many people felt that “RD” sounded too clinical. RDs and RDNs fulfill the same academic and professional requirements and dietitians can use either the “RD” or “RDN” title at this time.
What’s the difference between a “dietitian” and “nutritionist”?
“Dietitian” and “nutritionist” are terms that are often used interchangeably, but they are definitely not the same thing! The “RD” and “RDN” credentials are nationally recognized titles that are legally protected and can only be used by practitioners who are authorized by the Commission on Dietetic Registration and the Academy of Nutrition and Dietetics. The definition and requirements for the term “nutritionist,” on the other hand, can vary by location. Some states have licensure laws that define the range of practice for someone using the designation “nutritionist,” but in other states, almost anyone can call themselves a “nutritionist," regardless of education or training.
What are food sensitivities?
In a nutshell, food sensitivities (also referred to as delayed hypersensitivity reactions or Type 3/Type 4 hypersensitivity reactions) are an immune response. Your immune cells are in charge of ridding your body of “invaders” or things that they perceive as a threat. Sometimes the immune cells goof up and think that the foods/food chemicals that you're eating are the “bad guys” and the immune cells do what they can to fight them off. Unfortunately, your body can feel the ramifications of this “fighting”, and you begin to experience inflammation, which results in symptoms. In some people, the symptom might be a migraine, while in others it could be diarrhea, heartburn, inability to concentrate/focus, weight fluctuations, rash, and so on, and most people with food sensitivities often feel a combination of symptoms. When people start to exhibit these symptoms and go to their doctor for help, most conventional doctors will typically prescribe some sort of medication. Unfortunately, these medications usually only work to mask (cover up) symptoms and they don't address the underlying problem (food sensitivities), so inflammation continues to be a problem and symptoms that weren't targeted by medications will remain. Food sensitivities are not well known by much of the medical community, which is why it doesn’t even occur to many physicians to have their patients tested… and because of this knowledge deficit, patients may go on suffering for YEARS, spending thousands of dollars on medications and doctor visits in the process.
What are LEAP and MRT?
LEAP (which stands for Lifestyle Eating and Performance) is a type of oligoantigenic diet and it's a completely individualized anti-inflammatory diet that coordinates with MRT (Mediator Release Test), a blood test that identifies foods that cause an inflammatory reaction (food sensitivities). I'm a Certified LEAP Therapist, which means that I’ve received specialized training in adverse food reactions and completed a certification exam to be able to utilize MRT and LEAP with my clients.
Who benefits from food sensitivity testing?
There are millions of people who could benefit from food sensitivity testing (MRT) and nutrition therapy (LEAP). The following are just some of the common conditions/symptoms that are often associated with chronic inflammation and, therefor, are likely to improve with MRT and LEAP (the list practically grows by the day):
- Irritable Bowel Syndrome
- Migraines and other headaches
- Rheumatoid arthritis
- Crohn’s Disease
- Ulcerative Colitis
- Gastroesophageal Reflux Disease (GERD)
- Chronic sinusitis
- Autism Spectrum Disorders
- Weight fluctuations
- Fatigue (tired, sluggish)
- Insomnia (difficulty sleeping)
- Hyperactive energy
- Anxiety (uneasiness)
- Mood swings
- Lack of concentration
- Joint pain
- Muscle pain
- Water retention
- Food cravings
- and many other conditions and symptoms
In addition to the conditions/symptoms listed above, LEAP is also a great option for those wanting a completely individualized anti-inflammatory diet, regardless of whether symptoms/conditions are present. Inflammation can go unnoticed (it doesn't always produce obvious symptoms) and can lead to chronic health problems down the road, so those wanting to know which foods contribute the least amount of inflammation for their bodies may want to consider LEAP. Many athletes have also utilized LEAP to aid in their athletic performance and to improve recovery.
Tell me more about MRT – why is testing important?
The Mediator Release Test (MRT) is the only blood test of its kind – it identifies delayed hypersensitivity reactions (food sensitivities) by measuring the changes in immune cells that occur when different foods and chemicals are introduced. There are other blood tests out there that claim to identify food sensitivities through different modalities than MRT, however, these tests have been shown to be far less accurate and far less helpful.
MRT is a very important component in identifying food sensitivities. Symptoms of food sensitivities can be delayed 3 to 4 days (sometimes more) and the response is dose-dependent (meaning a small amount may not cause noticeable symptoms, but larger amounts will... and the dose that is needed for YOU to experience symptoms is likely different than what is needed for someone else to experience symptoms). Because of this, it is very difficult and time consuming to determine which food(s) caused the reactions. Also, some people may have sensitivities to a chemical found in certain foods, but not the food itself. One example of this is solanine, which is found in tomatoes, peppers, potatoes, eggplants, and others. For folks reactive to solanine, a little bit of potato may not cause a reaction, but if that potato was consumed along with tomatoes and peppers, they might have a full-blown immune response. Some other unlucky folks may be sensitive to foods/chemicals that are also found in personal care products and household items. One example of this is coconut, which can be found in detergent, soap, shampoo, toothpaste, and other “foamy” items (usually coconut is listed under the names of sodium lauryl sulfate, sodium laureth sulfate, or cocomide in these items). So, even if the person doesn’t eat coconut, in some instances, they could still have a reaction from non-food items that contain a derivative of coconut. Tricky business, I know.
What’s the difference between MRT and ALCAT? How do I know which test I should take?
MRT and ALCAT were invented by the same person (Dr. Pasula), but MRT is a more “advanced” blood test that measures food sensitivities with much more accuracy and reliability. MRT, when utilized appropriately by a qualified LEAP dietitian, helps to produce the best possible outcomes/symptom relief for clients suffering from food sensitivities. ALCAT is a little more well-known because it’s been around longer and because the people who work for ALCAT aggressively market their testing, but this does NOT mean that the ALCAT technology is better. Take a look at MRT vs. ALCAT for more science-y specifics.
How is MRT different than IgG? Should I get IgG testing done if food issues are suspected?
Many health practitioners refer their patients for IgG testing when they suspect a food-related issue. The problem with IgG testing is that IgG levels are typically elevated when the body is “exposed” to a food, whether this exposure is good, bad, or otherwise (it's essentially a really expensive food diary, as it tells you what you ate recently). IgG testing should NOT be used as a diagnostic tool for food-related illnesses for this reason. Take a look at MRT vs. IgG for more information about this.
What’s the difference between food sensitivities and food allergies? Does MRT test for food allergies?
Food sensitivities and food allergies are both immune responses, however, there are different mechanisms and cells involved. Food allergies are mediated by immunoglobulin E (IgE) and involve mast cell activation. Symptoms of food allergy often occur in a matter of 30 minutes or less and the reaction can be very severe. Food sensitivities, on the other hand, are non-IgE immune reactions and can involve a wider range of white blood cells and mechanisms. Symptoms of food sensitivities can be delayed 3-4 days (sometimes more). Due to the different mechanisms and cells involved, MRT does not test for food allergies.
What happens after I get the MRT test done?
Typically, after a client receives their MRT results, they will start on an elimination diet (oligoantigenic diet) program that is tailored to their needs. This program is called LEAP, which stands for Lifestyle Eating and Performance. The first phase of LEAP is the most restrictive, but luckily it usually only lasts for a couple of weeks (this first phase also happens to be where most clients typically experience the greatest reduction in symptoms; depending on the types of symptoms experienced, most see a 50-80% reduction in symptoms during Phase 1). The focus of Phase 1 is to get the client feeling well by only including 20-30 of their low reactive foods. The later phases of the program will gradually add more foods into the diet (usually one new food per day). The reason for the gradual reintroduction of food is to help identify problems more easily (if you add several new foods at the same time and experience symptoms, it is more difficult to determine which food(s) contributed to the symptoms). After 4-6 weeks, if the client is doing well, they can usually start to gradually introduce foods into their diet that were not tested through MRT. One thing to note: MRT only tests for food sensitivities. There could be other things at play besides food sensitivities that may cause/exacerbate symptoms in certain medical conditions. For this reason, the diet may need to be altered further (beyond food sensitivities) to produce optimal outcomes/relief. This is one of the reasons why the services of a dietitian who is also a Certified LEAP Therapist (such as myself) are essential to get desired results. Learn more about my services here.
If MRT showed that I have food sensitivities, will I always have the same sensitivities?
Maybe, maybe not - unfortunately there's not really a simple answer for this. Many people with food sensitivities have found that, months (or longer) down the road (after the immune system has had plenty of time to “calm down”), they can once again enjoy the foods that they were sensitive to, as long as they aren’t over-consumed (particularly if other issues that led to the development of food sensitivities in the first place were identified and taken care of). This is not true for everyone, however. Some people who were sensitive to certain foods may always be sensitive to those foods. It really depends on the person. There is also a possibility that new food sensitivities could develop. One of the most important things that you can do to help prevent new sensitivities from developing is to vary your diet as much as possible. One theory about food sensitivities is that they may develop when the body is bombarded with the same food over and over again. A varied/diverse diet is also important to help ensure that you are receiving a variety of nutrients that your body needs, which, among other things, can help support a healthy immune system.
What type of payment do you accept? Do you take insurance?
I currently accept payments through PayPal (credit card or bank transfer through your PayPal account). Private practice dietitians in my state (Michigan) are unable to accept insurance at this time, unless they're a part of a medical group with an overseeing physician. Even if I could accept insurance, insurance coverage for testing and nutrition counseling is extremely rare – some insurance companies will only cover a very small portion of the testing fees (if that) and very few insurance companies will cover counseling over the phone (and, to my knowledge, none cover nutrition advice through e-mail). The reason testing is rarely covered is because the testing is done in an “out-of-network” lab. If your insurance plan does not include out-of-network coverage or if your deductible for out-of-network coverage is high, you would most likely pay the entire cost out of pocket in either scenario.