Full-Spectrum Health: A Clinical Conversation with Deanna Minich,PhD,and Robert Rountree,MD

Dr. Deanna Minich received her BA in Biology with a minor in English literature. She then went on to complete a MS in Human Nutrition and Dietetics at the University of Illinois at Chicago in 1995. In 1999, she completed her PhD in Human Nutrition and Metabolism in the Department of Medical Sciences at the University of Groningen in the Netherlands. Since then, Dr. Minich has worked for the food and supplement industries, most recently at Metagenics, where she incorporated research, clinical practice, and teaching. Dr. Minich is a certified nutritionist and functional medicine practitioner whose mission is to inspire others with health, wellness, and nutritional medicine. She is also currently faculty for the Institute for Functional Medicine in Federal Way, Washington, and the University of Western States in Portland, Oregon.

Robert Rountree: Could you start by telling our readers a little bit about your journey? You would call yourself a clinical nutritionist, an author, and an educator. Is this what you always wanted to be?

Deanna Minich: When I was seven years old, I said I wanted to be a journalist and a nun. Since then, I have been doing a lot of different things, but I am close to my original interests. I have always done a lot of writing—I have now written six books. As for the nun part, the people who were inspirational to me in school were my teachers. Since I went to Catholic school all my life, my teachers happened to be nuns. So I think I wanted to be them—I wanted to teach. I always looked forward to going to school. I sat in the front of the class whenever I could and was very engaged with the teacher. I always felt that older people had something to offer me, and I was learning from them on multiple levels. In a way, I have truly manifested the school/teacher goal through everything I am doing right now.

I had one teacher in particular that stood out: Miss McCrickard. She was my teacher in sixth grade, and she was so calming. That particular social studies class was experiential. We all had our desks and chairs set up in the usual way, but in the back of the room, she had all these stations set up. We would learn about life in other cultures, for example how silk was made from silkworms in various indigenous traditions. Even though I liked to read books, I was able to learn something beyond the classroom. When I look now, I see my path in the way of really wanting to make things more practical and experiential for people.

I have spent a lot of time throughout my life in my head. Working with people now, I notice that in the capacity of being a teacher, a mentor, a clinician, or a researcher, I want to know how we make it real. How do we affect a change in someone's life? How do we take what we are learning right now into the everyday? I have always been an interface between extremely practical and intellectual. That has followed me everywhere.

The practical side of my nature was what brought me into the clinical piece. If I go back into my journey to when I was an undergrad, I was a pre-med student, wanting to go to medical school, and I was doing a minor in English literature. I was doing everything to prepare for medical school, including getting ready to take the MCAT and working and volunteering in doctors' offices. I was always drawn to the healing arts because we had a lot of chronic disease in my large extended family. However, just as I was about to take the MCAT, I had this revelation that I could not go through with it. After working for various physicians, I felt that medicine was an all-or-nothing profession—that to really immerse myself, I had to believe it. I had to really want to be entrenched in that paradigm. My only experience was Western medicine. At the time, I didn't know what a naturopath or a chiropractor was. So, at the end of my undergraduate studies, when I had to make a choice, I decided that I wanted to do something preventative. I didn't want to work on the side of giving people prescriptions for medications and not really listening to their stories. I decided to go to the University of Illinois for my Master of Science degree in human nutrition, doing research in the field of carotenoids and oxidative stress. Then, I must admit that I never even thought about doing my doctorate until I followed my Dutch boyfriend back to the Netherlands. After four years, I completed my PhD at the University of Groningen in the field of essential fatty acid absorption and metabolism.

My PhD research was aimed to explore better therapeutics for people who were malabsorbing fat. My advisor was an MD/PhD who was a pediatrician. He saw patients with cholestasis, cystic fibrosis, or other issues with maldigestion and poor absorption of fats. I was doing more of the research on the mechanistic side, using different bile emulsions in order to help with fat absorption, and this work continued on after I completed my PhD.

During my graduate work, I was also a teaching assistant. At the University of Illinois, for example, I taught a course in food science. It was fun to teach because it helped me to know whether I really knew something. When you can teach something, it really gives you a different perspective versus just when you think you know something.

Dr. Rountree: During this time in the lab, were you thinking that you wanted to become a consultant for a nutritional company, or were you thinking you wanted to do bench research? How did you end up working with a supplement company?

Dr. Minich: By this time, I knew that there was no way I was going to continue with bench-top research. I was done with being in the lab, working long nights with hexane extractions of fats, taking diapers and analyzing stool samples, and trying to figure out how much these babies and these kids were absorbing. At the time, I just knew that I did not like working in the lab. I felt like I wanted to be around people.

When I finished my PhD in 1999, I wanted to start working at a “real” job. I was tired of doing all that research, even though the PhD was not like school—it was like working. It was very rigorous. It was very experimental. I wanted to get out and start making money and start putting a lot of these things I was learning into use.

The first job I got was with the cardiologist John Cooke, MD, PhD, who had come out with a medical food product. His research was focused on nitric oxide. He was also very ambitious and entrepreneurial, and started a company called Cooke Pharma. He created a medical food called the Heart Bar^®. The bar contained soy and arginine and other factors to assist with the production of nitric oxide in the body. A few months after I started, the company was bought out, and I was out of a job.

I ended up going to work for General Mills. Working there really taught me a lot. I was always very accusatory and blaming of the food industries being on the outside. What I realized once I was there was that it was complicated. The company did their best to accommodate me. My views were becoming more radical and focused on holistic nutrition—I was a bit of an outlier. I was involved with some organic food brands under General Mills. For example, Small Planet Foods has Cascadian Farm and Muir Glen brands under that umbrella. During the time that I was working there, I began to look for other things. Specifically, I was curious about the human body and what I could do clinically. After about three years at General Mills, I moved on.

I eventually ended up working for Metagenics with Jeff Bland, PhD, in 2003 after hearing him speak. I did not really know much about dietary supplements at this point, although I was curious about botanical medicine, and I was exploring East/West traditions and energy medicine. I was using some dietary supplements and had a small part-time practice. When I chose to leave General Mills, my supervisor said that she was very concerned about my professional career and whether I was making the right choice.

Like many others, it was from Dr. Bland that I first heard about functional medicine. I was not originally immersed in that world as a clinician who was seeking another path. I was a standard nutrition scientist person who now was going into the clinical realm. When I first met Dr. Bland, I was wowed. I was not sure how to make sense of what I was hearing in his seminar, but it was fascinating to me. I knew I was on to something being a part of it. I call Dr. Bland the Great Synthesizer because he is extraordinarily good at pattern recognition in the literature. He asks questions and tries to connect the dots. What tends to happen with scientists is that they have blinders on. They have grants to study certain things, and they go down this trajectory of research. The world becomes about the specific thing that they are studying. I think for Dr. Bland, his scope is like looking at stars: he looks at the expanse of literature and starts to connect the dots, almost like a constellation. This was very eye-opening for me—the way he could present application of nutritional concepts in a truly global way.

Dr. Rountree: Was there something specific that Dr. Bland inspired you to do? A direction that you wanted to go?

Dr. Minich: I got to work very closely with Dr. Bland during my 10 years at Metagenics. We were in the same department. He had created a clinic that was connected to the research facility. I began to work at this facility, the Functional Medicine Research Center. It is novel for a dietary supplement company to have a clinic to test company products in case studies or small clinical trials. I was a hybrid person at the organization. I was seeing patients, and I was also on a team creating formulas. I was going out and speaking to health practitioners. I was managing people and projects. I was doing a lot of different things—an exciting time in my life!

One of the things that Dr. Bland introduced me to was detoxification. It was appealing to me because I was not really taught that information when I was at school. Out of all the years that I was studying nutrition, I never came across metabolic detoxification, certainly not in the way that he presented it or its clinical scope. By metabolic detoxification, I mean looking at different biochemical pathways that convert a toxin into a non-toxic substance for excretion. It is a process of taking in toxins from the environment, or even toxins that are internally generated, and making them more hydrophilic for urinary excretion. We use this to remove foreign compounds, such as pharmaceuticals.

Before working with Dr. Bland, I would have seen that as belonging to more of the pharmaceutical realm with respect to pharmacokinetics of drugs. I never really thought too much about how a plate of broccoli is going to change how somebody is transforming toxins through their liver. However, because Dr. Bland was a forerunner in this area, I started to think about it more. Some of the early publications come from the early 1990s. ^1,2 I found it curious that he was creating this archive of articles and thoughts around this concept of metabolic detoxification in ways that I do not think mainstream thought about it. In addition to the science, I was working in a clinic and seeing people go through specific metabolic detoxification clinical regimens. They had some pretty amazing life transformations within a few weeks. We would have people on certain supplements, and it was transformative.

These findings were incredibly interesting to me and interfaced very nicely with what I was always thinking about in terms of the history of medicine or even the history of spirituality. For example, human beings have always felt the need to cleanse or purify, and disease could be an accumulation of toxins in the body—not just environmental toxins, but internally generated toxins associated with stress or lipopolysaccharide from bacteria in our gut, or any number of things. Dr. Bland really expanded how I would see the whole playing field of detoxification.

Dr. Rountree: In mainstream medicine, this idea of detoxification is still thought of as quackery. The idea is that there is still no science. Yet, you have pointed out very solid science in a recent review. Can you discuss this?

Dr. Minich: Yes, there is a lot of science out there. ³ It is just that the term “metabolic detoxification” is not always used. We are referring to these processes in multiple ways, and I think that is how it gets lost. In the trendy, mass media, we hear this word “detox” all the time, and it has multiple meanings. It has very extremist connotations involving things such as cleanses using foods such as a big bolus of fat, maple syrup, and lemon juice. These cleanses are supposed to make you feel more vital. Everybody just seems to have their own approach to how we cleanse the body.

At the same time, some people say that we do not have to cleanse the body. We don't have to engage these pathways because they are always working. However, as we become more sophisticated in science and clinical medicine, we see that people have varying degrees of how efficient they are in getting toxins out of the body.

We also know about the role of phytonutrients in gene expression. As part of a larger team, we were looking at plant compounds involved in the regulation of gene expression. We were investigating these different pathways within the body or looking at different clinical outcomes using different plant extracts.

This really resonated with me—the idea that there was something exciting about phytonutrients, non-nutritive compounds found within the plant kingdom. My focus had always been primarily on carotenoids, which is a family of about 650 different types of compounds. We usually only think of beta carotene, or others such as lutein, lycopene, and alpha-carotene, but the carotenoid family is so broad and vast. ⁴ Only a small number of these actually get converted to vitamin A, so we think they are not important, or we lump them into the antioxidant bucket. There is so much more behind these compounds, such as their cell signaling effects. ⁵ I prefer the term “phytonutrient,” meaning a plant-based compound that has a physiological function and may even have a structural role.

Dr. Rountree: If you look at a nutrition label today for a food product, there is no mention of carotenoids. It is as if they are irrelevant. Where do you see this type of information going in the future?

Dr. Minich: I think right now, we do not know enough about them. The food industry is just not there. They are just warming up to some basic things such as omega-3 fatty acids, whereas I am ready for phytonutrient sensing in foods using different technologies that we can have on our smartphone. Sophisticated methods that can inform us better about the foods that we are eating. I think eventually where medicine and health and healing are moving is into the domain of the person owning their own health in many different ways—being able to make better choices. However, in order to make better choices, we need to have the information at our fingertips.

I have been watching some of these technologies out there because I am intrigued by the world of apps and devices and technologies to help us to bring everything together a little bit better for ourselves. What I can see is that there are a variety of different technologies emerging, or at least being worked on from a research perspective, that could ultimately help us to know.

For example, what if we went to the grocery store on a Saturday night and we had our iPhone. We could be scanning oranges to figure out which one had the most phytonutrients per millimeter or per fruit. These things are being discussed. This would truly enable us to eat smarter.

These technologies might allow the average consumer to be more compelled to buy organic versus non-organic food because they might discover that the organic food has more potassium or folate for example. This might sound very sci-fi for many people, but I feel like technology and food are going to take off in a whole different way.

I am seeing it through the whole domain of personalized nutrition, which is really the forerunning concept in the 21st century, the idea of looking at our genes and epi-genetics. We could be scanning the genetics of the food to have a better understanding of what we are taking in and how that interfaces with us. It is not just about our genetics but about the foods and the different things out there that we are selecting, and what they are comprised of.

Dr. Rountree: Could you talk a little bit more about the issue of how food interacts with our genes? What have you been discovering in your nutritional research about the findings regarding these nutrients and genetic response?

Dr. Minich: Dr. Bland says that “food is information.” I believe that everything we eat, think, feel, and do is information, so it's not just food in my mind. Food just happens to be a big bolus of information at one time. When we sit down to a meal and eat, we start digesting it. We break it down, and we start to assimilate the nutrients. As these components from food circulate through us, they are interacting with receptors on cell membranes, which generate a response into the DNA of that cell. Some nutrients enter the cell and sit on certain parts of the gene or associate with other parts of the cellular machinery. We start to see the DNA responding to these signals. ⁶ The food is sending a message to our being by way of what it contains.

If you look at phytonutrients, they tend to have what we call pleiotropic effects, meaning they work on multiple things simultaneously. If you look at the landscape of a cell and different pathways, what you see is that a lot of these phytonutrients are drilled into a number of different pathways, whether it is insulin sensitization, stress response, or inflammation. ³ These three pathways are key within the cell, and there is crosstalk among them. Phytonutrients seem to key into these pathways specifically. So that is why after every meal, we really are a different person. We are changing our genes. When I am doing patient workshops and groups, I get them to think about the history of the food—where did it come from?—because we become that in some way.

Nutritional xenohormesis is the science of a food responding to certain “foreign” or “stress” signals in the environment. Once the signal is captured, we see it either as a healthful message or as something harmful. Therefore, we are constantly in connection with our environment. This is more of an ancient or an Eastern traditional concept of being one with the environment. Food is one example of something that can give us this sense of being in harmony with our environment. The food that has grown around us, locally and seasonally, would probably be primed for the environment that we live in.

This is what I see as the hub of detoxification—enabling our inner environment to be in sync with what is on the outside. And when things get a little bit too toxic or things are dysregulated, either on the inside or on the outside, we tend to have these dysfunctions and disturbances.

Dr. Rountree: This is not unlike the notion of Shinrin-yoku, the Japanese therapeutic pastime of forest bathing. The idea is that if you take a walk in the woods, or by the seashore, you inhale the phytochemicals or the microbiome of what is in the local air or water. You merge with your environment. It sounds like you are saying that every time you eat a meal, you are interacting with your environment in a much more profound way than you would think. You are not just taking in calories.

Dr. Minich: Yes, absolutely. This is an idea that has been around even in Traditional Chinese Medicine. The idea is that if you eat chicken, look at the qualities of the chicken. How does a chicken act and react in its environment? You take on the energetics of that food. We could ask how the chicken was treated and raised. The act of eating is one of unification. It is profound if you think about it. If you really get into the mindfulness of it and give some general thought and respect to where the food came from, we are taking in an entire lineage every time we eat.

Dr. Rountree: That really puts a lot of pressure to be conscious about food choices, does it not? Do people become overwhelmed when you discuss this with them? How do you work with that?

Dr. Minich: We need to be in that place of being more conscious as much as we can. I try to meet people where they are at. Sometimes, that is not a conversation that I bring out in our first meeting. I like to focus on different aspects of food. Sometimes, it is the “what” of food, or what we are eating. In that case, I might talk more specifically about processed food. Then I might talk about the “when” of food—in other words, what time we are eating. Are we eating more toward the latter half of the day, rather than in the morning? And finally, sometimes, I will focus more on the “how,” talking about mindful eating. Rather than focus on the negative or fear-based messages, I try to move people into a greater sense of awareness of their bodies, a better sense of presence. Then, as people become more aware of how they feel when they eat certain foods, they start to feel less inclined to select those foods naturally. They become more sensitized.

The discussion of toxins and toxicity can result in a very fear-packed message. We can tell people how they can support their healthful decisions by getting a read on how their body is responding to food. That is the place I come to when I start. How does your body feel after you eat a certain food? Do you feel a loss of energy? Do you get a pain in your stomach? Do you get a rash on your arm? Being in tune with one's body is the first step in developing a renewed relationship with food and eating.

Nutrition has its dogma. It is almost a religion. People are always going on the outside for answers, like reading the latest diet book, trying to figure out how they need to be eating based on the latest experts. However, the reality is that everybody in every moment is going to have a different experience with food, and that goes beyond any expert that is writing about a topic in a book.

I have seen a lot of women like myself who have struggled with eating, and they are trying to be perfect. This results in controlled intakes and emotional eating issues. Here is where we start looking at the interface between the physiology and the psychology of eating. By having the conversation about the how of eating, I hope to bring people into the space of avoiding perfectionism—not following a diet book to the letter, but being their own best guide and master of their own bodies.

Dr. Rountree: Can you discuss some of your clinical work? What does the science tell you as you work with people? How do you get them to make changes?

Dr. Minich: Through the experience of working with people, I have found that science does not always have the answers. When I finished school and started doing some clinical work, I became like the nutrition police, and I was very dogmatic. I was very rigid. I thought that was the way to help people to change, not just to be a cheerleader but to get them going. I thought that I had the “right way.” However, I began to realize that changes people make only last for so long, and then they would revert back to what they were doing. At that point, I realized that it was not effective.

I am in the process of trying to figure out behavior change. What helps people to drive long-term healthy habits that will give them a better life? I do not think all of us want to be healthy for the sake of being healthy—we want to be happy. And one of the ways that we do that is by being healthy and having certain habits. Going forward, I think that behavior medicine is the wave of the future as it relates to medicine. I think that is why all these devices are cropping up and people are using apps because these are like point-of-care or in-the-moment measurements of how we are doing so that we can quickly make a shift if we need to.

How can I help a client make a shift in a positive direction in their lives to make them happier? Since I am within the realm of food and lifestyle, that is where I play. If I look back at how sophisticated nutrition is, it is almost humorous how simple it has now become for me. I like to keep it very simple and focus on one thing with the client. If you look at some of the work on behavior change, for example by B.J. Fogg, PhD, at Stanford University, we are now in the age of keeping it super-simple. We need to anchor our habits. Rather than try to figure out how to bring something totally foreign and new into our environment, let us change our environment a little bit to make it easier to do certain things.

I am intrigued by people's behavior and how we can support them. Behavior medicine meets biotechnology meets food and lifestyle. How do we get people living happier, healthier lives? That is the essence of what I believe we are all after.

Dr. Rountree: We have so much information at our fingertips now. We can do elaborate genetic testing in the field of functional medicine. How do you help people navigate through all of that? What do you see as the future for being able to help process all this information?

Dr. Minich: That is the million-dollar question. Ideally, what I would like is to take physical quantifiable measurements, such as single nucleotide polymorphisms and other functional biomarkers, and somehow connect it into behavior because I think just having objective data is a silo.

Just a few weeks ago, I was looking at some of my own lab results and noticing patterns. I have things going on that are interesting to know. But what do we do with the information? It is a snapshot in time. Those results were reflecting who I was at the time they were done. Now, a few weeks later, I am a completely different person. That is one of my frustrations about laboratory science—that it is just not fast enough. If it took two weeks to get something measured, by the time I get the results, I am not even that person anymore. There is something inherent that needs to shift in how we take physical measurements. There was an Israeli study from 2015 where people tracked themselves with biomonitoring devices. ⁷ They saw these small shifts over time when they are doing certain things. They found that we all have different glycemic responses from each other to the same food. Also, each individual had a different response from day to day, depending on their physiology.

So where do we go? Like you asked, how do we work with all of this? Somehow, somewhere, there has to be some way to integrate all of this, whether we are doing that through software or interface. For now, I am trying to get as much information as I can from my 22-page intake form so that I can affect some change, even if it is just one small thing.

Dr. Rountree: Can you discuss your use of color-coding in your clinical work?

Dr. Minich: Science speaks to one part of our brain. However, there is another part of our brain that remains curious, and that is probably the emotional side that is going to get us to do things longer term. I needed to find a way to connect nutrition to something that people were really going to connect with in their everyday life. I came upon this whole idea of color. Color is engaging. It is like food. For people with vision, it is one of the unifying principles of being human. However, as some have told me, even some people that are blind can perceive or feel color. Even just in our line of vision, colors evoke certain emotions in us.

I decided to incorporate this into my clinical work. Now, everything I do is connected into color. Color is a portal to emotions. If we wear red, we see red. We may have a certain emotion that is evoked. If we eat red-colored foods, this may change certain processes in our body. Through that conduit of color, I am bringing in a larger group of people, and I talk about food and eating because now it is fun. It is not all just rigor and science. I have almost tucked away my nutritional training. It is important to know, but what is even more important, I believe, is allowing people to engage, experience, and be excited by these things in their lives that will ultimately get them to where they want to be. And I feel like color can help people to do that.

Dr. Rountree: Could you give us a couple of examples of how you might use color or make a really specific color-based recommendation?

Dr. Minich: At a very basic level, I do a 21-day program that I call Whole Detox. As part of the program, every three days, we focus on a different color, and we essentially go through the rainbow. First, we focus on red, then orange, etc. On those days, we are eating foods that are those colors. I give them recipes with a variety of foods with these colors. For red, it can be everything from raspberries to beets to tomatoes to red kidney beans to meat, if someone eats meat. It can include red teas, red smoothies. We saturate through this experience with one color. I have found that three days is a good time to immerse. At the foundational level, the focus is on food and eating more colorfully. We also discuss feelings. Some people wear the color and feel excited about it. They experience the color. If we are talking about red-colored foods, they just let that “bleed” into their lives. All of a sudden, they see things in their lives that are red—the red stop sign, the red fire hydrant. They start to realize the things that are red.

What ends up happening with a lot of women on the programs is that they have this wake-up. They may realize that they have no bright colors in their wardrobe. We had a woman who realized that her living room was dark, but hadn't noticed it before, and decided to change it to be brighter. Another woman did not like to cook, but after a conversation about her favorite color, sage green, she went home and painted her kitchen. After that, she loved to be in her kitchen. Both her and her kitchen had transformed, and now she wanted to cook.

To Contact Dr. Deanna Minich

Deanna Minich, PhD

E-mail: info@foodandspirit.com

Website: www.deannaminich.com

I do believe that we need to look at healing in a literal and a symbolic way. I have seen that people who are not eating colorful foods tend not to live a colorful life. The moment they wake up to this whole field of colors, they just start living differently. It is amazing how just changing the color of one's walls wherever they spend time or do not spend time can completely overhaul their experience in that room.

I don't have a double-blind trial to confirm what I am seeing, or anything scientific related to this kitchen experience. However, when I wrote my book Whole Detox, I wrote chapters for each color. ⁸ I spent hours going through PubMed and sifting through the field of color science. There is science on color and how it impacts our moods. And if we are impacting our moods, we are impacting our food choices. There is one study in which they were looking at colors of plates. ⁹ People came in and ate from a red plate, a blue plate, and a white plate. The amount of food that they were eating was measured. When they were eating from the red plate, they ate less than when they ate from the white or the blue plate. This type of research is conducted by behavioral scientists or social scientists. For example, Brian Wansink, PhD, at Cornell University conducts studies around the behavior of eating. ¹⁰ This is more like the behavior of color.

Green light can help with heart rate variability. ¹¹ A study from Manchester, United Kingdom, showed that people who were healthy tended to like certain colors. ¹² The number one color was yellow. The people who were anxious and depressed liked gray. So there is some science on color out there.

I am envisioning an app. Eventually, I would like an app that helps people to track their colors through the day and even maybe look at more of a physics angle, looking at nanometers of light, looking at frequencies of different foods. Starting to do some crosstalk among different scientific disciplines within the food category might be fertile ground for emerging concepts.

Dr. Rountree: If our readers want to follow your work, what is the best way for them to do that?

Dr. Minich: They can check my website, which is deannaminich.com. I also have a Facebook page, and I post regularly on that and have all of my events on there. I do different lectures and teaching. I have a small clinical practice where I see people one-on-one or in group programs. Also, the color-coded lifestyle that I described is in the book Whole Detox. ⁸ Even though detox is in the title, it is not a traditional detox book. It is the color-coded system of living. I also came out with a new book in January 2018, called The Rainbow Diet. ¹³    ■