Functional Nutrition vs. Dieting: What Actually Works, with Andrea Nakayama

Foreign. Hello, and welcome to this episode of the Feel Freaking Amazing podcast. I'm Wendy Trubo. Your host Ed Levitan is obviously not here today, and we have an amazing guest. As always, I am delighted to introduce Andrea Nakayama. She is the host of the 15 Minute Matrix podcast as well as the founder of Functional Nutrition Alliance. She's leading thousands of students and practitioners around the globe in a revolution to offer better solutions to the growing chronic illness epidemic. And it really is an epidemic. By highlighting the importance of systems biology, root cause methodology, and therapeutic partnership, she helps historically underserved individuals reclaim ownership of their health. Andrea, welcome. I'm delighted to talk about this. This is near and dear to my heart.

I know it is. Thank you for having me, Wendy. I'm excited to be with you.

So how'd you get into this?

Oh, my goodness. So this takes me back to April of 2000. My late husband, Isamu, was diagnosed with a very aggressive brain tumor, a glioblastoma multiforme. At the time, I was really into food. I was looking a lot at how to make my own body feel better. I think I was in those 30 something time, that early 30 something time. Things were changing, things were shifting. In retrospect, I can see it was the beginning of my own autoimmune journey, but I didn't have context for it yet. And that all happened when I got pregnant. And then Isamu, seven weeks after we found out we were pregnant, was diagnosed with a brain tumor. And so that really catapulted me into what I think of as my boot camp. How and where do I look for more information in the realm of what we might now think of as food, as medicine? Back in those days, Wendy, there wasn't a lot. I was looking at Andrew Weil and Michael Lerner, like, there just weren't a lot of tools or resources. It was not like it is today. For better or worse, we can talk about that. But that really led me to see a lot of the gaps in our conventional medical model. He got great treatment, but there were a lot of gaps. And I can speak into those gaps. He lived two and a half years, and after that, I really started to realize this was my calling. Build a career, build a school. I've now trained nearly 9,000 practitioners in 68 countries in the methodologies that I've developed and evolved that are very adjacent to functional medicine.

That's amazing.

Thank you.

And it's not surprising that you got an autoimmune illness right when, when you were in the midst of the, like the vice, you know, the life vice.

And pregnancy being a trigger all on its own. And then you add on top of those hormonal shifts, all the stress of life spice, as you said. And you know, there's the tipping point.

So tell me about what functional nutrition is like. What when you say it, let's make sure we're using the same language. What do you mean when you say that?

I just love that you asked me that because I think it's really gotten quite far away. Functional medicine and functional nutrition from its roots. And I really am a person who upholds the, the foundations of the functional medicine model and then translates them to nutrition. There are three primary tenants of a truly functional practice. That's a therapeutic partnership, meaning both people in the room come with their expertise. The patient has an expertise in themselves that the provider could never have. And we're making room for that deep understanding. So therapeutic partnership looking for the root causes. And I always like to make sure I'm underlying that S in the plural sense. We're talking about multiple multifactorial issues. Not a singular factor that we're searching for to bring everything into resolution. And systems based approach. So that includes systems biology. The gut's connected to the brain. The hormones are connected to the liver, which is connected to the gut. Understanding that everything in the body is connected, but also using systems and frameworks to help us approach the complex challenges that we might experience in health, in our own health or in the health of the people, people we're serving. So three tenants. Therapeutic partnership looking for the roots and a systems based approach. And then the difference that I'm bringing in in functional nutrition versus functional medicine, or I should say in addition to, because they work beautifully together, is really double clicking on the lifestyle factors. Filling in those gaps beyond a protocol or a handout, really understanding the individual and their needs in relation to their body to making dietary to foods. A lot of times we're still in a model of this condition means you do this diet. And in functional nutrition, we do not subscribe to any one dietary theory or lifestyle theory. We are really bringing in the slowed down process of seeing the individual.

You know, you just highlighted something that was so like the core tenet of med school for me was there's only one big problem. Find it, fix it. And it always sat funny. Like there's often lots of issues going on and sure we can take away one thing, but I forget the guy who said, you know, if you're sitting on a tack, no amount of motrin in the world is going to help. And if you're sitting on 10 tacks, taking one away is not going to help. You really have to shift the whole system so that you take away a majority of them until you can notice an improvement. So if I could pinpoint one failing in the medical system, it's that there's one problem, right? One problem. There's usually a number of problems and we have to deal with all of them. So that's really.

Yeah, and I think that's such a good point, Wendy. And I call it the X for Y. And it's also become kind of an issue in functional medicine as well, where people are stuck looking for the test that's going to tell them the one thing. And this multifactorial piece and understanding that it could be from our life or our history could be an epigenetic factor. And the one thing I wanted to add there that helps us understand the difference of function, functional nutrition and functional medicine is I call it a three roots, many branches approach. So the branches are the signs, the symptoms, the diagnosis. And in medicine and as patients, we often get stuck only thinking about the branch. This is the sign I have, this is the symptom I have, this is the diagnosis I have. What do I do? In functional nutrition, we not only recognize that there are three routes always when we're dealing with chronic issues, but our focus is the solution soil those roots live in. So the epigenetic factors, the omic factors, the precision factors, really understanding how we address genes, digestion and inflammation from a broader perspective versus a narrow perspective.

No, that's great. So you've separately offline referred to challenges of having a chronic illness while in midlife. But I think bigger than that is I consider women to be under. And I didn't ask you when you said historically underserved in your bio, are you talking about women or are you talking about what's traditional underserved populations?

Yeah, I'm definitely talking about women and I'm talking about people with chronic health challenges. So I see those who are experiencing chronic health issues as underserved because our, as you know, our conventional medical model is better serving those with acute situations and is applying acute care model to those who have chronic health challenges. So women tend to, I think of it as the 80, 20, Wendy. Like, you know, 20% of people aren't going to get better with all the hacks that are out there for us. And as we age that 80, 20 flips because of so many issues that we experience as we age. As our hormones shift, as our immune system is compromised. So the 20% that doesn't get served is now the 80% as we age.

So when you have these people who show up, what are the top, like, five symptoms that they're experiencing that cue you in that there's an autoimmune component going on here.

So we tend to look at. And the way I teach is really a deep, deep, deep look at a timeline and a matrix that I've adapted from the tools of the Institute for Functional Medicine. So I tend not to lead with these are the symptoms that means this. I'm usually looking at it through the lens of here are all the signs, symptoms, and diagnoses. They could be joint pain, fatigue, brain fog, so many different things that could also be conflated with hormone issues, menopause, perimenopause, other inflammatory issues that aren't autoimmune. Like, there's so many things that can be going on. So I'm taking that opportunity to think about the entire picture, my version of what we call the matrix, and it's aligned with some of your thinking that I've heard you speak into. I call it the story, the soup and the skill. And so when we're talking about symptoms in isolation, they exist in the soup of the body, what's happening physiologically. But I also want to understand the scale. Where are you now? What are you doing? Are there easy changes that we can make? But the story for me is a huge missing piece that has a foundation in the expression of those signs, symptoms, and diagnoses. So I love the question, and I think I'm answering in a roundabout way because for the work I do, it is a bit reductionistic to just look at the signs and symptoms from the approach that we take.

Yeah, that's fair. That's fair. So are you a fan of tracking? Because I'm a huge fan. I'll just acknowledge I'm a huge fan of tracking. I wear a whoop. I just upgraded because I was like, oh, I'll do an EKGM myself and then I don't have to go to my doctor's appointment.

Yes.

By the way, don't do what your doctor does. Go to your doctor. So are you a fan of tracking for women, tracking their data to understand their health more?

I do. I love data tracking. I think sometimes we don't understand the data and we're making assumptions about the data without that full understanding. So I do think. I love data, but I love quantitative and qualitative data both. And I Think once. There are times where we get too connected to the quantitative data without understanding the qualitative nuance. So I'll just give you an example of what I mean by that. There's definitely a trend of wearing a continuous glucose monitor. I think there's a time and a place for a continuous glucose monitor. Love all the tools and the trick. But there are ways in which they're being misused and leading to confused narratives. So, for instance, somebody could be wearing a continuous glucose monitor, start to tell themselves a story about a food they ate because of a spike they're seeing, when in fact they didn't sleep last night. They worked out really heavy the night before, they didn't hydrate appropriately. It's not for their body. It's not just one thing. Our food doesn't exist in isolation. And I worry sometimes that we are becoming very reductionistic about the data we're capturing. So I love tracking. Sometimes the tracking we need to do is very simple just to get a sense of the more gross arena that we're living in versus the fine tuning of the data.

Yeah, I would say if you notice something like that, like you eat something and your blood sugar spikes, then my response is, okay, wait a few days, test it again.

Correct.

If you have the same result, then you can say, okay, yeah, I am not reacting well to this food. But eating it in the same order matters, right?

Correct.

So, yeah, I tested out. I wore CGM for a month. I can't say I wore it for a month. Cause I got an allergic reaction both times. So I wore it twice over the span of a month for 10 days each. That's more accurate. And I found pretty consistently that every time I ate chickpeas, I went through the roof. Didn't seem to matter what order it was in. And I was like, okay, I guess that's real. Yes. But I also found that order mattered a lot. And that was the takeaway that I took was like, eat for me. Eat protein first. Leafy vegetables, carbs last. Because I actually had it on on my birthday last year and. Or a year ago, year and a half ago. And I didn't feel well. It was kind of weird. I didn't feel well. So I had. This is a really weird meal. I had Manchego cheese pucks, like, crispy. They were like Parmesan pucks, but we made them from Manchego sheep cheese. And then I put chopped liver on top of it. And that was what I ate for dinner. It was really a weird dinner. I didn't feel well, I wasn't hungry. And then I had cake because it was my birthday and my blood sugar went nowhere, which was so shocking to me. I was like, I just ate cake. Why is it not spiking? And I just. That was really, for me, like, right in my face of. Okay, I understand order. You know, order matters.

Yes, but.

And generally I would say eat your vegetables and your protein first and then eat your carbs and your sugar. If you're gonna eat your sugar, try not to eat your sugar, but eat it later. Yeah.

And two things in response to that. I mean, I don't subscribe to any one dietary theory, but one of our food principles is fat, fiber, protein at every meal. And then it might be figuring out, like, what is that order? When I used to, early in my career, when my son was young and I would go into the classroom and and teach the kids, I would teach them about a slow train and a fast train. And what you're talking about there are the slow train and the fast train. The fast train can't go any faster than the slow train in front of it. So if you have your protein and fat and fiber before you have your carbs, then you're going to have a slow train in front of the fast train, and you're mitigating the spikes that you might have from fast train first or in isolation.

That's a nice way to think about it, actually. That's really like, a clear methodology. So how does the functional nutrition work with and prevent and slow down neurodegeneration and dementia and Alzheimer's and other degenerative diseases? Like, what's the relationship?

Yeah, I love that you ask that. And it goes back to a thought bubble I had earlier when you were talking about the tax. Right. So Dr. Dale Bredesen, who is one of the foremost researchers in neurodegeneration and very popular in the functional medicine space, has a model called the 36 holes in the roof. It speaks to that multifactorial approach. And what he's done is really map the physiological pathway for each of those potential 36 holes. And somebody who is experiencing neurodegeneration has at least half of those presenting in some way. When you look at those, and I have an article about this on the Functional Nutrition alliance website, when you look at those pathways and get down to the, what is it? Why is it happening? But what do you do now? Most of it, a lot of it is related to dietary and lifestyle modification. And so we can embrace that understanding from the researchers from the medical doctors, but understanding, understand in functional nutrition, at least the way I teach it, the physiological mechanisms that allow us to make a difference in long term results. Again, if I think about it, out of the three roots and that soil that those roots live in and the many branches, Alzheimer's, neurodegeneration, brain fog, any issues that we're having at the neurological level are the branches, they're the extra expression. And if we get down into that soil, we start to shift the expression of those branches, just like the medical doctor is shifting the expression of those branches in a more head on, targeted way. So they work together to say we're coming at the same issue from different vantage points. And it's a huge difference. I mean, sleep, poop, blood sugar balance, which are my non negotiable trifecta, are all going to be helpful in the prevention of neurodegeneration. Right.

And you refer at some point that I was looking at that having a sense of purpose, you know, so we, our business is called Five Journeys because there's five intertwined, unique journeys. But each of them is a core pillar of your health. So your physical body, bones, muscles, ligaments, posture, movement, chemistry, that's the functional medicine. The emotional component, which is your relationship to yourself, your self, talk, the thoughts you have about yourself. Then the social component, which is you in the world, in community, and your spiritual component, which is having a sense of purpose, understanding what your legacy is about. So can you talk a little about why having a sense of purpose helps cognitive decline?

Yeah, I think that's a really great question and a great call out and I love the pillars that you have in those different areas. It really relates to the matrix and there's a lot of beautiful overlap there. My work has really led me, and I'm going to just back up a minute to talk about narrative medicine because when I mention the story, the soup and the skill, there's a piece of our story. Who we are, what led us here, what really sparks us and moves us forward, where we're moved, where we feel a sense of belonging, all of those things have a physiological impact. As an example, there's been a lot of research around loneliness and the impact of loneliness on physiological health on the chemistry. Right. But if we flip that and we think about the power of belonging when we belong, we are actually turning off inflammatory genes at a rate that we can speak about turmeric or curcumin. Right. There's things we can do in life that actually have a physiological impact. And purpose is a huge One, I've been doing a deep dive into the science of longevity. I'm leading a book club where I've been reading a book every two weeks. There's a lot of science, a lot of technology, but without the purpose, without the reason why we're doing the thing, without the thing that fuels us to move forward, it's all for naught. And so purpose at so many levels helps us connect with ourselves. It helps us to resonate internally, it drives us forward to make change, but it also often helps us to feel connected to something larger than ourselves, which has a physiological impact in and of itself.

Yeah, it's funny, I got married a long time ago. I just actually celebrated my 22 year anniversary over the weekend and. And one of my relatives was very overweight and for our wedding lost like £100, which is a feat unto itself. And these are the days before Ozempic. She did this, like, work, you know, food and some movement and after. But she did it for my wedding. And after my wedding, there was no greater purpose. There was no reason to keep the weight off. There was no, like Simon Sinek, start with why. There was no why. And she gained all the weight back. And it broke my heart. I was like, you know that you can lose it and you know that you can feel good in your body, right? It's not about. It's always about the weight. It's never about the weight. Right. So I was like. Because the way the weight is for her, it was mostly in her legs and her lower body. She had a really hard time moving. And when she lost the weight, she was more mobile. So it's so poignant to me that the why is always gonna override the what and the how. And really the why is the reason. Okay, is there anything I haven't asked you that I should ask you?

That's. I mean, there's so many things I think we touched on, like longevity and root causes. I think I want to just leave people with some of the simplifications that I would bring in from a functional medicine perspective in terms of those three dietary principles. And I don't know how Wendy, this aligns with where you are with looking at dietary and lifestyle factors. So, you know, course. Correct me for your audience.

Oh, well, hold on. That's the foundation. Okay, so food is foundational, lifestyle is foundational, because you can't decorate a room that's burning down.

Exactly, exactly. Yeah. And I think that foundation is very unique to all of us. And we live in a culture especially for women. Where we're constantly looking for the diet, the way the thing that works, you know, and we, we really attach to different areas or trends, fads that might be happening. I'm going to be 59 next month. I've watched things go through every permutation of, you know, low fat, high fat, high protein, low protein. And if you even look at the research around intermittent fasting, ketogenic, it's mixed. And even in longevity research it's mixed. There's different information that's still coming out. So we have to recognize that the answers may be more broad than narrow in terms of what we are subscribing to when we're thinking about food for ourselves. And so I really like to get people out of thinking about the healing diets which are there for a reason and should be done with a provider. If you're on a healing diet that is very restricted, it should be done for a limited time because you start to introduce nutrient deficiencies when you limit your dietary intake. So our three dietary principles, one I mentioned already, it's fat, fiber, protein at every meal or snack. Start there before you start measuring your blood sugar. Worrying like just fat fiber, protein at every meal or snack. If you don't know like what's a good fat, there's plenty of information about that, right. And I have it on my website. I'm sure you have tools and resources but like that's the place to start. So we're thinking more broadly. The second place I like to go is to eat the rainbow and that way we're getting a lot of the phytonutrients that we need. They have, have so many benefits, anti inflammatory, help with our oxidative stress, all the things, the neurodegeneration, brain health, they also give us a lot of fiber so they bring in a lot of nutrients. When we're thinking more broadly about color and we're getting super playful. The third principle that I like to bring to the table, so to speak, is what I call the yes, no, maybe list. And this is a great way to set ourselves up for the conversations with our providers who are, are starting us with those foundations. Because we're coming in saying I can eat this and feel great, I cannot eat this and I'm not sure, I'm not sure about this. That's a great starting place because like you Wendy, I'm sure you've seen in the different populations that you serve there's some people who are like, I'm in pain all the time. But it's not My food. So they haven't yet made associations that are going to support them. And on the flip side of that, there's people who are eating three foods and they're coming in saying, I'm not better. And they've developed a kind of conditions, food hypersensitivity, where they're noticing that there's a symptom or a sign that emerges every time they eat and they haven't done the internal healing and there's everything in between. So in our practice, we've seen the people who are making no associations and the people who have limited so far down that they're now so malnourished that their body cannot heal in that state. So I just like to make it a little broader, I think, when we are stuck in that sympathetic, dominant fight or flight, what's the right diet, the right wearable, the right test, the right supplement, the right doctor. I call it pill protocol, practitioners shopping. When we're. We're stuck there, we cannot heal. And so my goal is always, yeah, I can talk to you about the narrow diets, but is there a place where we need to broaden and heal the internal terrain in order for what we eat to be as vast as possible for that period of time, that season of your life and what you're going through as possible? That's always my goal. Now.

That's great. Variety. Variety is key.

Yes. Thousand percent.

Okay, tell me how people can find you.

Thank you for asking. Yeah, you can always find me at Andrea Nakayama on all the places on the web andreanakianama.com Andrea Nakayama on LinkedIn or Instagram. And that will lead you back to the Functional Nutrition Alliance. So there's two different bodies of work there. The Functional Nutrition alliance is where we train practitioners. And in the Andrea Nakayama space, talking a little bit more about longevity and narrative medicine and the intersections with functional nutrition.

This is fantastic. Thank you. I think you can't get away from chronic illness and you can't get away from health without taking into account the things that you're talking about, these foundational impacts on our health. So thank you for, for this.

Yes.

So, okay, this is good. So for the listeners, this is Andrea Nakayama. I'm Wendy Trubo. Thank you for joining us for another episode. And Andrea, thank you for being here and sharing this because I think this will make a difference for people.

Thank you so much, Wendy.

It's been.