GLOSSARY

Biomarkers

A substance used as an indicator of a biological state. Such characteristics are objectively measured and evaluated as indicators of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention. Examples of cancer biomarkers include prostate specific antigen (PSA) and carcinoembryonic antigen (CEA).

ChronicCare Model

A care model developed by Wagner and colleagues, the primary focus of which is to include the essential elements of a healthcare system that encourage high-quality chronic disease care. Such elements include the community, the health system, self-management support, delivery system design, decision support, and clinical information systems. It is a response to powerful evidence that patients with chronic conditions often do not obtain the care they need, and that the healthcare system is not currently structured to facilitate such care.

Complementary and Alternative Medicine (CAM)

A group of diverse medical and healthcare systems, practices, and products that are not presently considered to be part of conventional, mainstream medicine. The list of what is considered to be CAM changes frequently, as therapies demonstrated to be safe and effective are adopted by conventional practitioners, and as new approaches to healthcare emerge. Complementary medicine is used with conventional medicine, not as a substitute for it. Alternative medicine is used in place of conventional medicine. Functional Medicine is neither complementary nor alternative medicine; it is an approach to medicine that focuses on identifying and ameliorating the underlying causes of disease; it can be used by all practitioners with a Western medical science background and is compatible with both conventional and CAM methods.

CORE

A mnemonic given to patients to help them take ownership and engage in their healing plan. The mnemonic is a framework to help patients do the following:

Commit to making lifestyle changes that are compatible with their overall health goals (e.g., commit to engaging in physical activity three times per week).
Omit from lifestyle any habits or behaviors that are making it difficult to meet health goals (e.g., omit smoking from the daily routine).
Reduce habits or behaviors that do not align with the health goals identified in partnership with the physician. Some of these habits or behaviors may need to be omitted or eliminated slowly over time (e.g., reduce the intake of carbonated beverages with added sugar from three times per day to once per day; once the patient is comfortable with that level of reduction, reevaluate and assess the need for further reduction).
Eliminate from the diet and environment any foods or substances that may be contributing to negative health symptoms (e.g., undergo an elimination diet to identify any foods that may be triggering GI upset).

Dysbiosis

A condition that occurs when the normal symbiosis between gut flora and the host is disturbed, and organisms of low intrinsic virulence, which normally coexist peacefully with the host, may promote illness. It is distinct from gastrointestinal infection, in which a highly virulent organism gains access to the gastrointestinal tract and infects the host.

Epigenetics

The study of changes in organisms caused by modification of gene expression rather than alteration of the genetic code itself (i.e. a change in phenotype, not in genotype). Epigenetic modifications may occur in response to several factors, including aging, stress, lifestyle, environment, nutrition, and overall health status. Some of the most common mechanisms by which these factors can affect change to gene expression include histone modification and DNA methylation.

Functional Medicine

An approach to medicine that addresses the underlying causes of disease using a systems-oriented, individualized approach, which engages both patient and practitioner in a therapeutic partnership. It reflects a personalized lifestyle medicine approach, and utilizes the Functional Medicine Timeline and Functional Medicine Matrix to help organize the patient’s story and determine appropriate interventions for the prevention and treatment of chronic diseases.

Functional Nutrition Fundamentals

The key foundational aspects related to eating a healthy diet and making positive choices. Our relationship to food is multidimensional, and our choices are impacted by many conscious and unconscious desires. The Functional Nutrition Fundamentals consist of four main ideas about food and nutrition:

Food is energy. At the most basic level, food is a fuel source necessary for the body to function.
Food is information. Byproducts of food convey messages and assist with various processes within the body (e.g., metabolism, cell signaling, detoxification, etc.).
Food is connection. Food brings people together, often serving as a central focus of social gatherings and celebratory events. Additionally, both pleasant and unpleasant memories often incorporate the smell, taste, and texture of foods. The reasons behind food choices, cravings, and aversions aren’t always logical or rational, and these reasons can often be tied back to the connections we have to food.
Food is medicine. We are what we eat. Choosing nutrient-dense foods that send signals to the body for positive gene expression is a key component of optimal health. Foods and food behaviors influence the body and can contribute to underlying causes of disease, and these factors can be adjusted to move an individual toward their greatest state of health and healing.

Genomics

The study of the whole genome of organisms, including interactions between loci and alleles within the genome. Research on single genes does not fall into the definition of genomics, unless the aim of this functional information analysis is to explain the gene’s effect on the entire genome network. Genomics may also be defined as the study of all of a cell or tissue’s genes at the DNA (genotype), mRNA (transcriptome), or protein (proteome) levels.

Integrative Medicine

Medicine that combines treatments from conventional medicine and those from CAM, for which there is high-quality evidence of safety and effectiveness. In a broader sense, integrative medicine is healing-oriented medicine that takes into account the whole person (body, mind, and spirit), including all aspects of lifestyle, and makes use of all appropriate therapies, both conventional and alternative. The field is the only one of the emerging models to explicitly encompass the integration of therapeutics that, until recently, were the sole purview of CAM. Note that Functional Medicine is different from integrative medicine because Functional Medicine emphasizes the evaluation of underlying causes of health and dysfunction, and organizes assessment and treatment using the Functional Medicine Matrix, the Functional Medicine Timeline, and the GO TO IT heuristic.

Lifestyle Medicine

The use of lifestyle interventions to lower the risk for the approximately 70% of modern health problems that are lifestyle-related chronic conditions (e.g., type 2 diabetes, metabolic syndrome, etc.), or for the treatment and management of disease if such conditions are already present. This includes lifestyle interventions such as nutrition counseling, physical activity, stress reduction, and rest. Lifestyle medicine is an essential component of the treatment of most chronic diseases and has been incorporated in many national disease management guidelines.

Modifiable Lifestyle Factors

Health-promoting lifestyle factors that include:

Sleep and relaxation: getting adequate sleep and making time for meaningful relaxation
Exercise and movement: participating in physical activity that is age-appropriate and that can be performed within the parameters of an individual’s health status
Nutrition: maintaining adequate hydration, and eating a diet that is age-appropriate and complementary to genetic background, health conditions, and environment
Stress: reducing overall stress levels and effectively managing existing stress
Relationships: developing and maintaining healthy relationships and social networks, while reducing the impact of noxious relationships These appear along the bottom of the Functional Medicine Matrix. Clinicians and their patients can co-develop an individualized plan for addressing these issues.

Nutrigenomics (Nutritional Genomics)

The study of how different foods may interact with specific genes to increase the risk of common chronic conditions, such as obesity, type 2 diabetes, heart disease, stroke, and certain cancers. It can also be described as the study of the influence of genetic variation on nutrition by correlating gene expression or single nucleotide polymorphisms with a nutrient’s absorption, metabolism, elimination, or biological effects. Nutrigenomics also seeks to provide a molecular understanding of how common chemicals in the diet affect health by altering the expression of genes and the structure of an individual’s genome. The ultimate aim of nutrigenomics is to develop rational means to optimize nutrition for the patient’s genotype.

Patient-Centered Car

Care that is centered on the goals of the patient. This type of care requires the involvement and collaboration of both patient and doctor in working towards health goals. The patient plays an active role in their healthcare, with the underlying goal of promoting optimal health and vitality, rather than simply working toward the absence of disease.

Personalized Medicine (Individualized Medicine)

Medicine that treats each patient as a unique individual and takes into account the totality of personal history, family history, environment and lifestyle, physical presentation, genetic background, and components of mind, body, and spirit. Interventions are tailored to each patient and adjusted based on the patient’s individualized response. This term can also describe the effort to define and strengthen the art of individualizing healthcare by integrating the interpretation of patient data (medical history, family history, signs, and symptoms) with emerging “–omic” technologies like nutrigenomics, pharmacogenomics, proteomics, and metabolomics.

Single Nucleotide Polymorphism (SNP)

A DNA sequence variation occurring when a single nucleotide—A, T, C, or G—in the genome differs between members of a species or between paired chromosomes in an individual. Almost all common SNPs (pronounced “snips”) have only two alleles. These genetic variations underlie differences in our susceptibility to, or protection from, several diseases. Variations in the DNA sequences of humans can affect how humans develop diseases. For example, a single base difference in the genes coding for apolipoprotein E is associated with a higher risk for Alzheimer’s disease. SNPs are also manifestations of genetic variations in the severity of illness, the way our body responds to treatments, and the individual response to pathogens, chemicals, drugs, vaccines, and other agents. They are thought to be key factors in applying the concept of personalized medicine.

Personalized Nutrition Plan

A customized nutrition plan that addresses and takes into account the findings from the Functional Nutrition Evaluation in order to reestablish health in an individual.

Phenotype

Observable traits of an organism resulting from the expression of genes influenced by environmental factors.