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What is Medical Nutrition Therapy?

Medical Nutrition Therapy (MNT) is a way to manage chronic health conditions, especially through weight loss or weight maintenance. This therapeutic approach to health can help you reduce symptoms of certain conditions and prevent further health complications by following a personalized diet and meal plan. To get started with MNT, you need the help of a Registered Dietitian Nutritionist (RDN).

What is the Main Purpose of Medical Nutrition Therapy?

With Medical Nutrition Therapy, patients can work with a physician to ensure the foods they eat improve their overall health, not harm it. Along with routine exercise, most patients feel better and live active lifestyles by monitoring the intake of foods that aggravate their current medical conditions.

What is Medical Nutrition Therapy for Weight Loss?

Medical nutrition therapy is a type of treatment for people who are overweight. Many people find medical nutrition therapy helpful for weight loss. It’s also for people with certain health conditions. During treatment, you will work with a registered dietitian. They will help to make a nutrition plan just for you. A registered dietitian is a type of healthcare provider. They have special training in nutrition. This qualifies them to give counseling on nutrition.

Your dietitian will look closely at your eating habits. They will help you set new nutrition goals. You will meet with your dietitian several times. They will track your progress at each visit. They can help you set realistic weight loss goals. Most people should aim to lose about 1 to 1.5 pounds per week. Your dietitian will tell you how many calories to eat per day to lose weight steadily and safely. They can help you plan a healthy, nutritious diet. This can help you make positive lifestyle changes that last.

Who is an Expert in Medical Nutrition Therapy?

Many healthcare providers have some education in nutrition. However, the registered dietitian has the greatest amount of academic and clinical training in nutrition and food science. The registered dietitian is currently the single identifiable group of healthcare professionals with the standardized education, clinical training, continuing education, and national credentialing requirements necessary to provide nutrition therapy.

How Long Will I Need Medical Nutrition Therapy?

It depends on your situation and the condition you’re managing. Medical nutrition therapy may last several months or years. In some cases, it’s lifelong. Your healthcare team will tell you more about your timeline.

Does MNT Work for Diabetes?

According to the Centers for Disease Control and Prevention, “MNT is a key component of diabetes education and management.” This is in part because of the impact of MNT on hemoglobin A1C levels. Hemoglobin A1C (or A1C for short), is a test that measures your average blood sugar levels over the last few months. This lab value is used to help diagnose diabetes. Lowering A1C is one target in diabetes care and management. Research has shown that when MNT is provided by a registered dietitian, A1C decreases. This decrease has been seen for those with both type 1 and type 2 diabetes.

Does Insurance Cover Medical Nutrition Therapy?

Medical nutrition therapy is covered by a variety of insurance plans. If you have private insurance, check with your insurance plan for specific medical nutrition therapy coverage details. Your plan may cover nutrition counseling for a wide variety of chronic conditions and health concerns, such as heart disease, hypertension, and obesity.

Who Should Seek Medical Nutrition Therapy

Medical Nutrition Therapy aims to manage certain chronic conditions through an individualized nutrition plan. MNT is also called nutritional counseling. Your RDN will work with you to create a nutrition plan that meets your dietary needs while giving you feedback. While many people may feel nervous or reluctant about starting a new diet or meal plan, your dietitian will give you the tools you need to manage your chronic condition through dietary changes. Your doctor may suggest nutritional therapy if you have one of these conditions:

- Diabetes

- Heart disease

- Renal disease

- Obesity 

- Gastrointestinal disorders

- Osteoporosis

- Cancer

- History of heart attack

Potential Benefits of Medical Nutrition Therapy

Medical nutrition therapy can help you:

1. Get the nutrients you need to lessen the symptoms or effects of a medical condition.

2. Get nutrients you aren’t able to take in through foods alone.

3. Get cholesterol, blood sugar, or other numbers to healthy levels to avoid medication or complement the effects of your medication.

4. Nourish your body during a time when your digestive system isn’t working as it should.

5. Learn how to overcome barriers to nutritious eating.

6. Learn ways to build physical activity into your daily life.

7. Take an active role in your healthcare.

10 Medical Conditions That Benefit from MNT

Medical Nutrition Therapy (MNT) is the nutrition assessment and treatment of a condition, illness, or injury that places an individual at risk, involving the assessment of nutrition status and treatment/intervention. This list includes ten medical conditions that benefit from MNT.

1. Diabetes: Meal planning, carbohydrate (CHO) counting, and blood glucose monitoring are the cornerstones in diabetes management. Balancing CHO with medications and exercise assists in blood glucose control and a reduction of complications due to hyperglycemia.

2. Heart Disease: As the leading cause of death in the United States, heart disease is most commonly linked to hyperlipidemia – or high blood cholesterol. MNT for heart disease prevention includes the management of blood cholesterol, including limiting saturated and trans-fats in the diet to improve LDL cholesterol, HDL cholesterol, triglycerides, and total cholesterol levels.

3. Stroke: Strokes are most commonly linked to hyperlipidemia (see above) and hypertension (HTN)–high blood pressure (see below). When a person has a stroke, dysphagia (difficulty swallowing) may be a side effect. MNT for dysphagia may include altered consistency diets and thickened liquids as outlined by the International Dysphagia Diet Standardisation Initiative (IDDSI).

4. Hypertension (HTN): High blood pressure increases the risk for stroke, heart disease, and kidney disease. MNT to improve HTN includes limiting salt/sodium intake and increasing potassium-rich foods. This can be accomplished with the DASH (Dietary Approaches to Stop Hypertension) diet.

5. Cancer: Excess body weight (obesity), poor nutrition, lack of exercise, and alcohol consumption are contributing factors for cancer. Excess weight and obesity alone increase the risk of developing 13 types of cancer. MNT for cancer prevention includes maintaining a healthy weight and a diet rich in fruits, vegetables, fiber-rich beans and peas, and whole grains.

6. Osteoporosis: Osteoporosis means “porous bone” or bones that have lost density and increased risk of fracture. Bones are constantly renewing, so risk prevention includes adequate calcium and vitamin D intake (especially in youth), prevention of eating disorders, and weight-bearing exercise. MNT focuses on the consumption of calcium-rich foods and adequate vitamin D.

7. Obesity: Obesity is a major health problem affecting all ages in the United States. Hallmarks of MNT for obesity treatment include caloric intake, portion control, balancing the diet, food journaling, energy expenditure & exercise, behavior modification, social support, and at times, weight loss surgery.

8. Kidney Disease: Of all the diseases, kidney disease is one of the most complex. The intake of protein, sodium, potassium, phosphorus, and fluids is carefully regulated from day to day. Actual nutrient restrictions are based on age, degree of kidney disease, treatment, and other nutrition factors.

9. Celiac Disease: Celiac disease is an autoimmune disease, which requires a strict gluten-free (GF) diet. Following a GF diet allows for the healing of the villi in the small intestine, allowing for proper absorption of nutrients. The MNT for Celiac Disease focuses on removing gluten from the diet and replacing it with GF items, preventing cross-contact, label reading, and other nutrient deficiencies common with Celiac Disease.

10. Food Allergies: With a food allergy reaction, the body’s immune system overreacts, triggering a histamine response with symptoms ranging from mild to severe - with some instances leading to anaphylaxis. The most common food allergies include eggs, milk, peanuts, tree nuts, fish, shellfish, wheat, and soy. MNT food allergies include strict avoidance of the food, preventing cross-contact, and label reading.

What Does Medical Nutrition Therapy Involve

Dietitians generally follow these steps for medical nutrition therapy. Here’s a closer look at each step:

1. Nutrition Assessment

This is how your dietitian first learns about you and your health. They’ll review your medical history and test results, but this information tells just part of the story. Your voice is also important. Your dietitian will talk to you to learn more about your needs, goals, and preferences. They may ask about:

a. Foods you typically eat.

b. Any allergies or intolerances you have.

c. Lifestyle or cultural factors that influence how and what you eat.

d. Any challenges you face in accessing or preparing foods.

e. Which foods are available or not available to you.

2. Nutrition Diagnosis

This is a nutrition-related issue that your dietitian will focus on treating. A nutrition diagnosis is different than a medical diagnosis (like diabetes). Nutrition diagnoses typically relate to your intake of certain nutrients.

3. Nutrition Intervention

Based on the assessment and diagnosis, your dietitian will create a plan that addresses the nutrition-related issue. Your dietitian will talk to you about your role in the plan — for example, changes to make in your daily life. They’ll also tell you what meetings you can expect, including individual meetings with your dietitian and potentially group meetings. Virtual meetings (telehealth) may be an option in some cases.

4. Nutrition Monitoring and Evaluation

Once the plan is in motion, your dietitian will do regular check-ins to see how things are going. They’ll review test results, talk to you about how you’re feeling, and consult with your other healthcare providers. If you feel something isn’t going well or you have concerns, tell your dietitian. They’ll answer your questions and adjust the plan as needed.

How Medical Nutrition Therapy Works

MNT is based on decades of medical research on the relationship between diet, nutrition, and health outcomes. It’s vastly different from nutrition education, which provides basic nutrition information to the general public and isn’t intended to treat medical conditions.  On the other hand, MNT instructs individuals on how to use their diet to best support their medical conditions. It not only addresses existing medical conditions but also attempts to lower the risk of new complications.

To start this therapy, an RDN first performs a comprehensive nutrition assessment for an individual. They then develop a nutritional diagnosis, goal, and care plan, as well as specific nutrition interventions to help the person better manage or treat their condition. The RDN provides repeated follow-up visits to support the person’s behavioral and lifestyle changes. This involves monitoring and evaluating progress, as well as any health or medication changes.

MNT is only provided by a qualified dietitian and can either be prescribed in a hospital or outpatient setting. It may start during a hospital admission and continue into an outpatient setting, as long as the patient is seeing an RDN. MNT can range in complexity, from designing a reduced calorie diet for weight loss to prescribing a high protein diet to promote wound healing for patients with severe burns. In severe cases, such as for people with cancer, an RDN can recommend tube or intravenous (IV) feeding to prevent malnutrition. The duration of MNT varies. Typically, the therapy stays in place until the initial goal is achieved or the nutrition-related diagnosis is resolved. However, the plan can be adjusted as needed by the RDN and your medical team.

How to Treat Eating Disorders with Medical Nutrition Therapy 

MNT is more than a nutritional plan. MNT as an eating disorder treatment focuses on an individual's behaviors concerning their eating. It's about understanding why a person with an eating disorder eats the way they do or why they avoid certain foods. A dietitian can develop a care plan and help the person with the eating disorder learn new eating habits. 

People with an eating disorder may receive MNT through a hospital or in an outpatient clinic. Some medical professionals also offer telehealth or virtual options. Part of MNT is about nutritional education, or understanding how certain foods affect the body to help someone achieve their health goals. 

When treating someone with an eating disorder such as anorexia nervosa (AN), a dietitian may explain what foods are the most effective for building solid bones or powering organs and what happens to the body when it doesn’t get proper nourishment. A person with avoidant restrictive food intake disorder (ARFID) may learn the benefits of the foods they're avoiding and why the body needs them to function properly. A person with binge eating disorder (BED) may learn how neurotransmitters in the brain and hormones in the body respond to restriction and how restricting can lead to binging because of these chemical reactions.

In addition to educating individuals on their nutritional decisions, MNT also helps people set goals, deconstruct current behaviors, and build new habits. An added piece of MNT as an eating disorder treatment includes the psychodynamics of eating disorders.  A person with an eating disorder often has mental or emotional forces that encourage their relationship to food. To help someone with an eating disorder change their food-related behaviors, a dietitian will also understand the motivations behind a person's behavior.

How to Get Medical Nutrition Therapy

Medical nutrition therapy can only be provided by a dietitian, also known as a registered dietitian (R.D.) or registered dietitian nutritionist (R.D.N.). Anyone can call themselves a “nutritionist,” but only dietitians have a standardized degree from an accredited dietetics program. They are licensed by the state in which they practice and must meet continuing education requirements.

You can contact a dietitian directly and ask about making an appointment, but if you want your health insurance to cover it there may be various rules to consider. If you have private health insurance, it is recommended to contact your provider to find out whether any sessions with a dietitian will be covered. Even if your plan doesn’t cover medical nutrition therapy, you might decide that paying out of pocket for a few sessions is worthwhile.

Sources:

WebMD

Cleveland Clinic

Healthline

Hopkins Medicine

ANFP Online

Summit Healthcare

NIH

Season Health

Conway Regional

Within Health

Health Central