The British Association for Nutrition and Lifestyle Medicine (BANT) identifies PNLM as an approach to serve an increasingly diverse population that is accompanied by a range of chronic or non-communicable diseases.
This they say is the result of complex and lifelong interactions between diet, environment, lifestyle, and genes.
“The PNLM approach embraces the uniqueness of each person and places the patient at the centre of care,” the Association writes.
“This approach contrasts with models of care that apply recommendations without regard to individual differences in need, response, or practical ability to apply sustainably.
“A grounding principle for this approach is that diet and lifestyle are recognised as modifiable risk factors and addressing the most relevant risk factors for an individual offers high value.”
Diet and lifestyle advice
Intended to take place in a healthcare environment, nutritional therapy practitioners work with individuals, recognising and understanding their biochemical and lifestyle individuality to provide relevant recommendations for diet and lifestyle.
This is in contrast to the current acute care healthcare model that employs rapid diagnosis and the prescription of short-term interventions and medications to improve symptoms, often with minimal patient engagement, education and coaching.
However, BANT acknowledge both approaches are fundamental to an integrated healthcare model that employs both prevention and treatment.
Personalised Nutrition has often been touted as the way forward to prevent diet-induced chronic disease, aided by the maturing nutrigenomics field as a primary driver.
BANT has previously cited its potential to translate insights into protocols or ‘nutrigenetic counselling’.
Other personalised tools harness technology in the form of tracking tools to monitor body composition and symptoms that could encourage people to focus on individual health concerns.
Accessibility and affordability
Despite the possibilities, BANT raise crucial issues to its accessibility and affordability should the PNLM model become closer to being realised.
For example, the highly personalised one-to-one support from registered nutritional therapists to select, apply and evaluate approaches with the best fit to address health issues and goals for a specific patient are not available via the National Health Service (NHS) nor reimbursable under medical insurance cover, presenting a significant cost barrier to access.
BANT cites this as a reason to make the value and opportunity of these services more accessible to patients and consequently to encourage more practitioners into the profession.
“Nutritional therapy is essentially private health care, and the self-funded direct payment required may well present a significant barrier to access for many individuals that would benefit greatly,” BANT adds.
“The COVID-19 pandemic may have amplified health issues and inequalities and yet it is not only socio-economic factors that are creating barriers. There is also a need to address ethnic, religious and social factors, to expand awareness, appeal and accessibility to a far broader demographic.”
Ethnic and cultural differences
Also core to PNLM’s success is the consideration of ethnic and cultural differences in which the association stresses the importance of practitioners to be 'culturally competent' and have a good understanding of patient background.
“Recommendations need to be culturally sensitive and relevant, embracing rather than excluding the foods different cultures use, and programmes need to be adapted to their needs.
“This involves access to education and resources as well as diversification of the practitioner base.”
In closing BANT adds that the issues highlight the need to make nutritional therapy more accessible and making nutritional therapy services available to the widest possible audience.
Initiatives to be considered includes making services more accessible from a financial standpoint, to ensuring practitioners are equipped to support the unique needs of different groups.
“Personalised Nutrition and Lifestyle Medicine is diverse by nature – they apply evidence-based diet and lifestyle recommendations at an individual level to facilitate and support positive change,” the industry body concludes.
“However, there is work to be done to raise awareness of and access to nutritional therapy amongst a broader audience, from both a practitioner and client point of view.”