Wisdom from a Functional Nutrition Dietician Interview with Kathie Swift

Marc David, Founder of the Institute for the Psychology of Eating interviews Kathie Swift, a registered dietician, and nutritionist, who has pioneered and directed leading-edge nutrition programs at Dr. Mark Hyman’s UltraWellness Center, at the famous Canyon Ranch Health Resorts, and at Kripalu Center for Yoga and Health.

Kathie speaks about how her personal struggles with fatigue led her to switch gears in college and why she started studying nutrition. Kathie shares how nutrition is not just for the body, but true Nutrition is at a much deeper level. Nutrition is of the mind, spirit, and heart. Learn some of Kathie’s insights on how she helps her clients navigate all the influx of information and technology we have available to us.

Transcript:

Marc: Welcome, everybody. I’m Marc David, Founder of the Institute for the Psychology of Eating. Here we are in The Future of Healing Online Conference. I’m here with a wonderful friend and amazing colleague, Kathie Swift. Welcome, Kathie.

Kathie: Welcome, Marc. It’s a pleasure to be here with you.

Marc: Oh, absolutely, absolutely! You and I go back a long way. I’m super proud of that. Let me say a few words about you for our listeners and viewers so they can get caught up, and then we can jump in.

Kathie Swift is a registered dietician, nutritionist, who was awarded the first­ever Visionary Leadership Award by the Dieticians and Integrative and Functional Medicine Dietetic Practice Group and recognized by Today’s Dietician as a dietician making a difference.

Kathie Swift has pioneered and directed leading­edge nutrition programs at Dr. Mark Hyman’s UltraWellness Center, at the famous Canyon Ranch Health Resorts, at Kripalu Center for Yoga and Health. She’s been the Education Director for the Center for Mind­Body Medicine’s premier Food As Medicine professional training program for 15 years.

Kathie serves on the advisory board for Integrative Medicine: A Clinician’s Journal. She’s a scientific reviewer for military medicine and served on the Institute for Functional Medicine’s nutrition advisory board. Kathie has spoken all over everywhere in the universe. She’s been interviewed in hundreds of articles, published in the U.S. and internationally. She’s also the cofounder of the Integrative and Functional Nutrition Academy, and that’s an online training program for registered dieticians, nurses, all kinds of practitioners and health professionals.

Kathie is the coauthor of The Inside Tract: Your Good Gut Guide to Health. Her latest book is The Swift Diet, and we’ll be able to talk about that as well. You’ve been a busy lady for the last—since you’ve been born it sounds like! You’ve covered a lot of turf and I’m just wondering if you can start out just by sharing how you got on the journey into being a dietician and just specializing in functional nutrition.

Kathie: Well the beginning of my journey, Marc, I started off in my undergraduate in nursing school. By my third year, I think I had compassion fatigue already, and I decided, too,

that there was, perhaps, a better pathway to helping people heal. I felt that doorway was through food and nutrition. I switched gears and started studying nutrition, went on for my Master’s degree at Arizona State University and really then had a life­changing experience with a chronic illness.

That’s when I had to—so I was trained as a traditional registered dietician, and then became unwell and had to figure things out. It was through my own personal health crisis that I began to explore nutrition on a much deeper level, which led me to some of my mentors like Dr. Jeffrey Bland and Dr. Sidney Baker and others. It really made a big difference in my life and how I have been able to help others.

Marc: Kathie, are there any kind of big­picture pieces that you could share with us in terms of here you are, and you’ve been in this field for a while. Any big picture pieces in terms of what you’ve learned over the years as an educator and practitioner when it comes to people and food? Any just kind of broad brushstrokes you can give us from your perspective?

Kathie: Okay, broad brushstrokes. Well, as a nutrition practitioner, people seek my help to manage chronic health conditions, whether it’s autoimmune or a digestive disorder, weight issues. Many of the patients I work with are highly motivated. They’re convinced that food is medicine, and they want personalized nutrition information.

I think that is really key. People are seeking what is right for me? I think that what I’ve learned over the years is that for true healing to take place, it’s nutrition for the physical body, of course, is so important, but nourishment on a deeper level for the mind, the spirit, and the heart, which truly is our greatest teacher, is vitally important.

I’ll just share, if I can, a couple stories of patients come to mind. Of course, the names have been changed, but I think about Rose, who came to me because of irritable bowel syndrome and she’d been struggling with weight issues. She had read my latest book, The Swift Diet, and just really wanted to know exactly what supplements would help her IBS and help her lose weight.

But in the course of our conversation, what I really—her story—what really I uncovered was that she was stuck in a job that she really hated. Interestingly, Marc, her chief compliant, so to speak, was chronic constipation, IBS/constipation predominant. She was constantly sleep deprived. She had, because of her work schedule, a lack of social

connection and friends. It was that shifting of someone who came seeking short­lived solutions to a journey of self­discovery and true healing.

I guess when you say big­picture broad stroke it’s this partnering of both nutrition, the science, and this art of nourishing, nourishment. Just recently I met with another patient who I had actually seen about 10 years ago. Someone had referred to me. She came. I’m going to just call her “Diane.” Diane came to me. She drove over four hours to see me. Just when I met her in the waiting room, I could sense her anxiety, her fear, and she began to ramble very nervously.

When we got to my office, instead of, of course, sitting across from her, which is how the office and this clinic was set up, I sat next to her. I invited her to breathe with me. I think this is another broad stroke, and she really became more relaxed, and it was also important that I, myself, as someone to help facilitate her healing, was centered.

I think those are what I really have gathered as broad strokes for healing to truly take place. It’s important that we integrate mind­body practices along with the nutritional therapies that we know can be so very helpful. I think that’s part of the clinical wisdom that I feel is so important.

Marc: For me, I’ve noticed that the first times ever that I did something like you’re describing. “Okay, Mr. or Mrs. Client. Let’s just breathe together.” I was so scared. I was so scared. I thought, “Okay, this is going to be the death of me. This is going to be the end of my career.” I think what I’ve noticed is that not only didn’t I die, not only didn’t it ruin my life, but people were actually hungrier for it than I could have even guessed.

Kathie: I love it! I, too, had a little trepidation, Marc, in this encounter in starting the session off, but I really felt there could be no better way to help this person. I will say we had a really, really powerful, powerful session. I appreciate you sharing that because even for us these techniques and skill building require an eagerness and a willingness to proceed.

Marc: Yeah, I’m also thinking. Let me make a comment and then just get your thoughts on the comment. It seems like, on the one hand, when people come to a practitioner such as yourself, they’re coming for information, for wisdom, for guidance. “You’re going to help me move in a direction that I don’t really know what I’m doing.” In a sense, you’re the expert, but at the same time, doing something like, “Hey, let’s sit down and breathe

together.” There are these moments where, in a sense, you’re becoming equal with your clients. You’re just sort of sitting alongside them.

It seems like there’s this interesting balance, maybe, between being in the position of leadership with a client or a patient and also letting them know somehow that, “Wait a second. We’re all equals on some levels.”

Kathie: Love it. Absolutely. You’re reminding me even thinking about how this session unfolded was that at another point in time I invited her to do a Qigong movement because we’d been sitting for a while, and she loved that and wanted to explore Qigong. Even though she came seeking, and in fact, in her own words she said to me, “I’m scared. I’m so far gone. I need the right diet, the right diet to help me.” Even though that’s what was part of her expectation, by shifting gears and helping her tap in, appreciate, and access the healer within, it was really powerful and can be life changing. So yes, it really is—it’s relationship­centered care, isn’t it?

Marc: Yeah, let me ask you another big­picture question. Just in your observations working with a patient, client population over the years, have you noticed any greater trends and I’m asking you more from just observational—have you noticed any trends in health?

Like, “Oh, my goodness! I see more people coming in with this complaint than ever before,” or “I see less people coming in with such­and­such complaints.” Anything you’ve tracked that’s caught your attention.

Kathie: Yes, there definitely have been some trends that I’m seeing in practice. These trends, Marc, are quite different than I would say even certainly a decade ago, perhaps even five years ago. I am definitely seeing more individuals with what are referred to as “adverse food reactions and chemical sensitivities.” Adverse food reactions, the umbrella term for food allergies and intolerances.

Interestingly, not something I’m solely observing in my practice, just last week I was at a dinner meeting and was chatting with a woman next to me, and she shared with me that her daughter—she had recently lost her daughter, 27 years old, to a food allergy. She had a lot of fear around food and such.

Yeah, it’s an emerging problem. A few years ago, I think it was in 2011, the Journal of the Academy of Nutrition and Dietetics, the cover story was on this exact topic. I think the World Allergy Organization, the National Institute of Allergy and Infectious Diseases,

they’re really examining this very, very closely, looking at the epidemiology and the diagnosis, the management, the controversies, the gaps in our knowledge. It’s something that I’m definitely, definitely seeing more of.

Another thing that relates to this, as I mentioned, is chemical sensitivities. A couple of my favorite researchers in this area, Claudia Miller at the University of Texas­San Antonio has published some great work. She came up with the TILT hypothesis, which TILT means Toxicant­Induced Loss of Tolerance and how that impacts different individuals and different systems in an individual.

She also came up with what’s called the QEESI. It’s an assessment that can be used even in primary care to evaluate toxic burden. She’s done some great work in this area. Then another one of my favorite researchers in this area, so I follow these people and their work because I think it’s really important that we, as providers, stay up­to­date on this evolving, emerging area.

Stephen Genuis, he’s a Canadian researcher and just published a great paper in behavioral neurology on toxic burden bioaccumulation and cognitive function and dementia.

That’s one thing I’m seeing. Along with that, the other trend and I don’t think it’s just because I’ve written a couple books on digestive health, but is the increase—stealth­like increase in digestive disorders, and along with that, brain health. I put gut and brain together because, of course, we know that they’re intimately connected via the lovely wandering vagus nerve, the brain and the belly and the central nervous system.

I think that the good news in this is that we, through integrative and functional medicine, nutrition therapies, we are definitely seeing ways that we can repair and even reverse some of these really serious conditions. I think the appreciation of what I call the “four domains of the gut,” which are the great wall, the intestinal barrier, the immune system in the gut, and the nervous system in the gut, the enteric nervous system and also, of course, the hottest topic it seems like in medicine and nutrition, the microbiome.

You can see how they all relate. More food allergies, food intolerances, chemical sensitivities because of gut distress and then also brain, mental health disorders. In fact, there was a white paper recently published that was a call to action globally because of

mental health disorders impacting­­I mean one­third of the world’s disability is due to this. I think these are the things I’ve definitely seen an increase.

Some other things that are, of course, changing I think the practice of nutrition is what I would call the quantified self. More and more patients are coming in to our office because of wearables and watches and apps and gadgets and such with a lot of personal data. Data with regard to their food, their dietary intake, their sleep patterns, their stress patterns, their anthropometrics and vitals, and their expectation, of course, is that we can—we, as providers, can interpret this in a realistic and reasonable way, make sense of it, so to speak, with recommendations that are personalized to their condition and their lifestyle. I think we all need to be prepared for that.

I think an important thing that I found is we can get really excited about technology, too, and we have to, I think, be aware of the latest app that we really love came out. Is it a fit for them, for that individual?

Funny, I had a patient just this morning who I’ve been working with and I felt like the FODMAP app, which she had irritable bowel, so we were experimenting with the FODMAP diet. I felt that it would be a good match for her. She said to me this morning. She said, “Kathie, that has been so helpful.” Because how it helped her was some of it is color­coded and she saw that it didn’t mean total exclusion of a particular food. She could have a small amount.

I think that’s changing the practice of nutrition in medicine. Certainly Skyping with patients, tele­medicine, tele­health, the whole landscape is changing, so that’s another trend. Along with that and I didn’t mention as far as with this data is more and more patients just in the last year, Marc, have asked me to interpret their genetic test. Just yesterday at a clinical rounds meeting in a clinic that I work that, that was our discussion. We were evaluating and looking at a number of different genetic tests and the various profiles, whether the profile, for example, weight management, which interestingly they’ve identified some snips, some gene variants that have to do with exercise responsiveness, insulin sensitivity, the satiety, taste. I mean you start reward, the whole dopamine pathway.

I think we are going to see more of that in the future. I know I’m seeing more of that in my practice even right now. I certainly see both the promise and also I guess I also like high­touch, low­tech. I think where genetic information can be useful is it can provide

insights and awareness, but I think that there’s a lot more that we’ll be learning from this as the OMICS revolution continues to unfold.

I think another interesting part of this story is the research that’s looking at various conditions, and again, how personalized treatments, how personalizing even drug therapies can be really, really useful. I’ll mention one other trend that is, I think, a really positive high note and that is the recent data that U.S. adults now over 30% are using complimentary and integrative approaches. In fact, the National Center for Complementary and Alternative Medicine changed their name recently to the National Center for Complementary and Integrative Care, meaning to reflect the evolution that’s happening that alternative medicine is no longer alternative, that a larger umbrella is the entire healthcare landscape, team­based care, a number of different providers.

They do a survey every five years. In this latest survey, interestingly, what they found and they defined two broad categories of integrative approaches. They define them as natural products, supplements, and mind­body practices. I thought it was really interesting that in both adults and children the use of natural products was quite high. Fish oil being the #1 with melatonin and probiotics growing. Then the mind­body practices, everything from spinal manipulation, meditation, Qigong, yoga, stealth­like growth in yoga by both children and adults. I’m really encouraged by that, just as an observation, as a practitioner, too, certainly seeing that in practice.

Marc: It seems like we’re in a time now where there is such an explosion of let’s just say information or information that’s available. I think on the one hand we now have just unbelievable access to endless amounts of information around nutrition, around health. And there seems to be more interest, so there’s more information coming out. I guess my comment/question that I would love to hear your thoughts on is it seems to me a lot of times that people, the average consumer of information, the average person, they’re taking in a lot.

You can read nutrition information because you and I are educated in this realm, so we can at least make our assessments, check it out, do I like this, do I not like it? Wow, is the average layperson exposed to so much! How do you help people navigate that or how do you see your role or even answer the question what can people do to kind of help them digest the different amounts of information?

Kathie: Marc, what’s coming up for me is a quote and I don’t know who said it. “We’re drowning in information and starving for knowledge.” Digest is the perfect metaphor here. I will say it really depends on the person that I’m working with. For some people, I actually encourage a sabbatical from trying to digest so much information. There’s a lot of anxiety and fear, and this has really been a good practice for some.

On the other hand, and I like the use of your term “navigate,” I do help individuals navigate. I think one of the things is they’re coming to me because they trust me and they feel that—and they want help evaluating, whether it’s a new food that they’ve heard has been extolled for health benefits or whether it’s a dietary supplement. It’s my role to be that navigator in a trusting relationship.

For myself and for all of us as providers, I’d learned to kind of distill it down to a few of my favorite resources, and I’m certainly—and even if something, say, for example, you read on a website or from a food blogger or such and you kind of even—as we should. We should have what? The curious mind, the inquiry around it. I would then, first off, go into PubMed and what I’m thinking about was years ago when someone first mentioned—asked me about oil pulling. Well, one of the first things I did—and I always acknowledge if I’m not aware of something. I think it’s good to be honest and authentic, but I want to check that out and I’ll get back to you.

Sure enough, I went into the National Library of Medicine and there were some articles, some research on it. And even in looking at a study, is there bias? Is there disclosure? Who funded it? There are all those things that we learn in research methods, so to speak.

I guess I certainly see myself as a navigator to help people who trusted me to share my opinion on some of the information, often prescribe sabbaticals. It’s an interesting experiment. How did that feel to them? Then distill it down into resources that I’ve found especially helpful in my own life to keep up with the latest information, which it is a tsunami.

Marc: So favorite resources that you would recommend for the layperson who’s educated and wants to stay up on things, educate themselves better in terms of on the Web.

Kathie: Okay, for the consumer. My mind immediately went to some of the ones that I use, which for the consumer, I like MindBodyGreen. One of the reasons I like it is, because as we

know, one of the challenges that many people have is time constraint. People often love their simple style of five ways, 10 things, six.

I found that the information certainly can be backed up. Of course, my colleague Dr. Hyman. I think Dr. Mercola has some very interesting things. I love Science Daily.

Marc: So do I! It’s so great!

Kathie: You do? Yeah.

Marc: Yeah, love it!

Kathie: That one I really look at science that even a layperson can understand, and then there are links for those of us who want to learn more. There’s the journal article or such.

That’s actually one of my favorites. Medscape, I use Medscape. As the member of the Academy of Nutrition, I get a daily newsfeed, and it’s been interesting how many dieticians weren’t aware of this, but it doesn’t include just research journal articles, but it also includes a lot of articles from food bloggers and a lot of consumer information. It’s actually really, really good.

I love SmartBrief. I don’t know if you’re familiar with that one. SmartBrief for nutrition. They also have digestive briefs that I enjoy. Again, these are really nice for the layperson, the consumer.

Marc: Great! Good insights, good info.

Kathie: Another one, Marc, since supplements are certainly on the rise is Consumer Labs. Yeah, Consumer Labs, I think, does a really nice job.

Marc: Yeah, yeah, I totally agree. Tell me about your new book.

Kathie: Well, my new book—it’s The Swift Diet, like The Slow Down Diet. I actually didn’t pick the name—the title, I should say, but it really focuses on the latest research on the gut microbiome. I sat down a few years and thought, “Well, how do I work with individuals to help them with digestive issues and also weight issues? Kind of what I call irritable bowel, irritable weight.” I came up with this acronym when I thought through it and that is what I used in the book. It’s M.E.N.D.S.

The chapter begins, the first chapter, with M, which is for Mind your digestion. It’s about integrating mindfulness into your life to help that enteric nervous system, the brain and the belly. The E stands for—that chapter is on Eliminate. That is for eliminating dietary incitants, foods that may be aggravating your digestive system. N is for Nourish, bringing in, how we can feed our gut garden, our microbes and optimizing our digestion through nourishment. Then D is Dietary supplement chapter. I really honed in on the supplements that I found in my years of practice that have been most helpful for digestive issues. Then the S is really about bringing about—it’s bookends. It’s Supporting practices. I expanded on things like Qigong and yoga and how these practices can be very, very helpful for mind­body­spirit. Thank you for asking.

Marc: Yeah, it’s exciting! Congratulations!

Kathie: Thank you.

Marc: As you were saying when I’d asked you earlier about trends that you were noticing, it seems like not only are we living in a time when digestive challenges seem to be on the increase. At the same time, there’s so much new, fascinating research coming down the pike and new insights into the gut, obviously into the gut microbiome. It almost feels like not a moment too soon is this new information exploding because we need it. It really feels like we need to mind what’s happening in our digestive tract like never before.

Kathie: Absolutely. It is an exciting time. I’m very hopeful that the attention and research on the gut and the microbiome is going to—as we know, I mean I referred to the gut as our highway to health, our pathway to pathology. This is everything from brain health to skin health to every system in the body is affected by the ingestion of food and this journey through the digestive tract. It’s an exciting time, and I really am very grateful for all the scientists that are in the field and in the clinics and in the laboratories that are exploring this.

In fact, when I was just over in the U.K. recently at one of the museums, it was all about the gut and the gut brain. They had a wonderful artificial gut that they’re studying and every single thing that goes on in the gut. It was kind of fun to see in this. so even in our travels we’re going to see…

Marc: You’re still bumping into your own digestive tract, so to speak.

Kathie: Exactly.

Marc: Yeah, it’s so fascinating, because on one level, we sort of know that it’s ground zero intuitively. If your gut is doing fine, you sort of never notice it. You don’t notice it and you don’t complain, and you might never in your entire life talk about it if it’s just functioning fine, but as soon as it’s off, wow, do we know it and are we talking about it, thinking about it, and worrying about it!

Kathie: Yes, 24/7. You bet!

Marc: Right. I like that phrase that you used. What did you say? It’s either the highway to health or the…

Kathie: Pathway to pathology.

Marc: To pathology. How true is that?

Kathie: Yes, yes.

Marc: Either or.

Kathie: You bet! You bet. So hopefully we can employ these nutritional strategies to further the highway to health now.

Marc: Where do you see healing going when it comes to the nutrition profession? When you look into your crystal ball, what are just a couple of pieces that you see unfolding into the future or that you would like to see unfold into the future?

Kathie: Well, what I would like to see unfold in the future, Marc, is #1 what I’m feeling right now is more integration, team­based care. I really think that the patient, our clients, are served best when we are working in teams. I hope to see the delivery of functional medicine in an affordable, in an affordable and accessible way for all patients to take advantage of this. I think that another thing that comes to mind for me is more group.

I think the connection—I love teaching workshops. I teach at Kripalu, and in fact, I have a workshop there next week. There’s so much to be shared and learned, and it’s such a

rich, rewarding experience, the group, the power of the group. I also do work with the Center for Mind­Body Medicine, and that is their whole model, small group work, and just recently experienced it myself in their advanced mind­body medicine training.

All of those things come to mind. Of course, I feel very passionate about the promise of integrative and functional nutrition. So much so that my colleague, Dr. Sheila Dean and I just launched the new academy, the Integrative and Functional Nutrition Academy, with our mission being to transform the practice of nutrition by educating, educating dieticians and others in integrative and functional nutrition therapies.

It’s a bit different than our conventional model. if I take GERD, for example, we may conventionally—GERD diet, right? And avoiding these things, whether it’s spicy foods, citrus, peppermint, you name it. Whereas an integrative and functional approach, we’re going to think about what are the root causes of the dysfunction? What tests might be helpful? Is there a breath test or stool test that might uncover infection or something? H. Pylori or another root cause. Is there a dietary incitant that’s aggravating their system that needs to be removed? We’re thinking about their nervous system in the gut. We’re thinking about are there natural products, DGLs, N­carnosine.

Then mind­body practices that could be integrated, whether it’s imagery or meditation or dancing, who knows? It’s a more holistic approach. I’m really excited about launching this both online and onsite training program. Really!

Marc: Good for you! You have some amazing projects going and I would love for you to share with viewers and listeners how we can keep up with that, how we can learn more, how we can plug into you and your world. Tell us where we go.

Kathie: Thank you, Marc. Well, for any listeners interested in training through the Integrative and Functional Nutrition Academy, going to the website www.ifnacademy.com. They can also send an email to info@infnacademy.com. Then to keep up with things Kathie Swift, www.kathieswift.com and that’s k­a­t­h­i­eswift.com.

Marc: Well, Kathie, I’m just in awe of the body of work that you’ve created over the years and how you really just beautifully blended being a practitioner, being an educator, really diving into the research and just getting a big­picture view from all angles of what nutrition is and isn’t and what works and what doesn’t. To me, you’re one of the icons in

this field and in this universe, so tons of respect and just thank you for all the great work that you’ve done.

Kathie: Thank you, Marc. I really appreciate it.

Marc: You are so welcome and I’m so glad we had this conversation. Very inspiring for me and I’m sure inspiring for a lot of people. Thank you everybody for tuning in. Thank you, Kathie and I’m Marc David, on behalf of The Future of Healing Online Conference. Lots more to come. Take care!

Kathie: Take care. Bye­bye.