November 16, 2017
We are excited to have our first dietetics educator, Dr. Carin Kreutzer, take the stage as our Featured Member for this month! Dr. Kreutzer is an Assistant Professor in the Leonard Davis School of Gerontology where she directs and teaches in the Master’s Degree Coordinated Program in Nutrition, Healthspan and Longevity. She completed a Dietetic Internship at Massachusetts General Hospital, Boston, received a Master’s Degree in Public Health, Health Services Management and Administration from the University of Washington and completed a Doctorate Degree in Urban Education Leadership, with an emphasis in Educational Psychology at University of Souther California (USC), Rossier School of Education. Dr. Kreutzer has been a practicing Registered Dietitian since 1982. She co-directs the obesity intervention program BodyWorks, at Children’s Hospital Los Angeles in the Alta Med Pediatric Clinic. Her areas of research and expertise include obesity prevention and intervention, developmental disabilities and chronic illness, public health and nutrition education, nutrition and health literacy, health systems and health care access and nutrigenomics. She has been the recipient of local, state and federal grants targeting health systems improvement, improved access to care and public health training and education. She currently serves as the Secretary/Treasurer of CAND (2016-2018).
What is your area of practice and how do you incorporate integrative and functional nutrition into your work?
As an educator most of my practice happens in the classroom. In the USC Leonard Davis School of Gerontology I teach GERO 518 Topics in Clinical Nutrition. Students, enrolled in the MS Nutrition, Healthspan and Longevity Coordinated Program, are asked to “spit in the tube” and analyze their own genetic information. Students complete a literature review, researching a single nucleotide polymorphism (SNP) that relates to nutrition. I also incorporated (group) threaded discussions on emerging nutrition topics (e.g. microbiome, CAM, supplementation). In addition, guest speakers and webinars, including DIFM Webinars, help students to explore personalized, integrative and functional nutrition.
As a clinician working with families diagnosed overweight/obese, we do not prescribe diets. We work with families where they are to help them move to healthier eating and lifestyle practices, using grocery store tours to promote whole foods.
My focus right now, working with faculty in the School of Gerontology, is to advance use of nutrigenetics and nutrigenomics into our clinical practice. First we begin with awareness. Thankfully the Accreditation Council for Education in Nutrition and Dietetics (ACEND®) has added a new competency for dietitians and dietetics programs to describe basic concepts of nutritional genomics. We are on our way!
What are some of the results you have seen since integrating functional nutrition into your practice area?
In reference to nutrigenetics and nutrigenomics I have encountered enthusiasm, mistrust and a range of responses in-between. There is still much research needed before we can be in a strong position for most SNPs to make clinical decisions or recommendations. We must continue to rely on laboratory indicators as well as family history. But I do believe we need to begin to educate ourselves so that we don’t get left behind. By default I discovered that my husband did not like cilantro, and when asked why he said “It tastes like soap”. So it was no surprise to find out that he carries the allele rs72921001 (C,C), with the C,C alleles research shows cilantro is more likely to taste like soap. In my own 23 and Me SNP analysis I found out that I am a poor metabolizer of caffeine. While I already knew I should not have coffee late in the day, I did not know that with my family history of cardiovascular disease (CVD) too much caffeine is not a good idea as a slow metabolizer. These reports can potentially tell us information that we may not want to know. I have a number of individuals I have helped review their Promethease results find that they are carrying APOE4 alleles (one or two) with evidence linking the SNP to risk for dementia or Alzheimer’s. You have to be ready to accept any information you may receive. Some people would prefer to not know their disease risk, especially if the scientific research is not definitive.
How does my culture influence practice of integrative and functional nutrition?
I am a California native, as well as my parents. My family ancestry is Irish, German, Scandinavian. We subscribed to the “Western Diet” unfortunately, so I can only say one of my father’s favorite foods was pork chops and sauerkraut. It was through my experience with my dad, diagnosed in his 50’s with CVD, type 2 diabetes, hypertension, overweight and stress, and unable to adopt lifestyle and diet changes that led me to dietetics. My cultural practice regarding diet and lifestyle is very different from my upbringing. As I have learned about integrative and functional nutrition through my work and continuing education, I have adopted practices for myself and my family.
Where have you completed most of your training in integrative and functional nutrition?
I have participated in continuing education through conferences, webinars and reading, seeking to apply integrative and functional nutrition into my own practice (clinical, educator). As a member of DIFM, I have taken advantage of most every opportunity. I am considering additional certification in the future. I joined the International Society of Nutrgenetics and Nutrigenomics (ISNN) to learn more about this field, attending their recent international congress in Los Angeles. I have been reviewing 23 and Me and Promethease reports and advising colleagues and students since 2014. This past summer I was asked to be one of 30 nation-wide educators, brought together by 23 and Me, at their inaugural summit to explore how genomics can be integrated into the classroom.
What advice would you give anyone interested in learning more about integrative and functional nutrition?
Be open to learning, attend conferences, seek additional training, start with yourself. I have always been interested in genetics. At one point I was interested in being a genetic counselor. So learning more about genomics and exploring ancestry along the way became a “weekend and evening endeavor”. I started with me, then asked my family members if they would spit in the tube. While there is much we still do not know, we can become familiar with what is possible. When friends or clients tell me something is working for them, my first response is to find out more and not place judgement, seek to understand. What works for one client may not work for another. The field of nutrition experiences new discoveries every day, moving toward personalized health, that embraces integrative and functional medicine is the future. One size no longer fits all in healthcare.
Thank you, Dr. Kreutzer, for sharing about your unique experience with integrative and functional nutrition!