Medical Nutrition Therapy

What is medical nutrition therapy?

Medical nutrition therapy (MNT) is a form of treatment that uses nutrition education and behavioral counseling to prevent or manage a medical condition. A registered dietitian works with you and other members of your healthcare team to identify your health needs and personal goals. Your dietitian then builds a unique nutrition plan that allows you to maximize micro- and macronutrient intake while optimizing your health status. And they help you put that plan into action.

Your primary care provider (PCP) or a specialist may recommend medical nutrition therapy to manage certain chronic conditions, like diabetes or kidney disease. MNT can help support other treatments you’re receiving, like medications, or it may help you avoid medications. MNT is also vital for people who can’t swallow or digest foods in the typical way due to short-term or long-term conditions.

Depending on your needs, MNT might mean:

• Avoiding or limiting certain foods.
• Making sure to get enough of certain foods and nutrients.
• Taking nutritional supplements.
• Receiving nutrients through IV nutrition therapy (parenteral nutrition) or tube feeding (enteral nutrition).

Your healthcare team will tell you more about what you can expect.

What conditions are managed with medical nutrition therapy?

Medical nutrition therapy can help manage many different medical conditions, including but not limited to the following:

• Chronic kidney disease (CKD).
• Chronic obstructive pulmonary disease (COPD).
• Conditions affecting your digestive system, like celiac disease, Crohn’s disease, irritable bowel syndrome (IBS) and ulcerative colitis.
• Diabetes (Type 1, Type 2 and gestational) and prediabetes.
• Heart failure.
• High blood pressure.
• High cholesterol, high triglycerides and other conditions involving an unhealthy balance of lipids in your blood (dyslipidemia).
• Malnutrition, including in people with cancer.
• Overweight and obesity.

Who provides medical nutrition therapy?

In the U.S., registered dietitians (RDs) and registered dietitian nutritionists (RDNs) provide medical nutrition therapy. These medical professionals have specialized training that prepares them to give you credible, safe guidance.

People with the general title of nutritionist or even the title of nutritional therapy practitioner may not have the same level of training. It’s important to make sure you work with an RD or RDN so you can get reliable and medically sound guidance. Plus, your insurance plan may only cover sessions with an RD or RDN.

Your dietitian will work with other healthcare providers, including doctors and nurses, to develop your nutrition plan and help you each step of the way.

What does medical nutrition therapy involve?

Dietitians generally follow these steps for medical nutrition therapy:

• Nutrition assessment: Learning about you and your nutritional needs.
• Nutrition diagnosis: Identifying a nutrition-related issue to address.
• Nutrition intervention: Creating a plan and explaining what you’ll need to do.
• Nutrition monitoring and evaluation: Checking on how things are going and changing the plan as needed.

This process can look different depending on a person’s needs. For example, if you’re hospitalized with a critical illness, you may not be able to play an active role in the process, at least for a while. If your child needs MNT, you may be the one working with their dietitian to coordinate their care.

Here’s a closer look at each step:

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:

• Foods you typically eat.
• Any allergies or intolerances you have.
• Lifestyle or cultural factors that influence how and what you eat.
• Any challenges you face in accessing or preparing foods.
• Which foods are available or not available to you.

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.

For example, you may be taking in too much or not enough of a certain nutrient, like carbohydrates. Your dietitian will identify the root cause of the issue as well as signs (like lab results) and symptoms (like gas and gas pain).

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.

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 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 individual timeline.

What are the potential benefits of medical nutrition therapy?

Medical nutrition therapy can help you:

• Get the nutrients you need to lessen the symptoms or effects of a medical condition.
• Get nutrients you aren’t able to take in through foods alone.
• Get cholesterol, blood sugar or other numbers to healthy levels to avoid medication or complement the effects of your medication.
• Nourish your body during a time when your digestive system isn’t working as it should.
• Learn how to overcome barriers to nutritious eating.
• Learn ways to build physical activity into your daily life.
• Take an active role in your healthcare.

Your dietitian will tell you more about what MNT can offer you according to your specific diagnosis or situation.

What are the risks of this treatment?

Risks vary according to how you’re receiving the nutrition you need. For example:

• IV nutrition therapy (parenteral nutrition) carries a risk of developing a bloodstream infection.
• Tube feeding may lead to an infection at the tube insertion site or gastrointestinal (GI) problems like constipation, nausea or diarrhea.
• Changes to the foods you eat are safe and low risk when you follow your dietitian’s guidance. They’ll tell you if you can expect any changes in how you feel as you adjust your food intake.

Your healthcare team can tell you more about any possible risks and what they can do to manage them.

Is there anything I can do to make this treatment easier on me?

Your dietitian will work with you to make MNT feel manageable. They’ll want to know your preferences. They’ll also want to know if any barriers are getting in the way of you reaching your goals. For example, maybe there are no healthy food options nearby. Or, maybe you work a late shift and are too tired to cook when you get home. Telling your dietitian about any challenges you’re facing can help you work together to find solutions.

It may help to keep a log of typical foods and drinks you consume, and the times for each. Also, make a note of changes you’re willing or not willing to make to your current eating habits.

When should I call my healthcare provider?

Call your dietitian any time you have questions or concerns about your nutrition plan. They’ll help you understand the plan and any steps you need to take to reach your goals. They’ll also schedule regular follow-ups with you to talk about how you’re doing and adjust the plan as needed.

What is artificial nutrition?

People previously used the term artificial nutrition to refer to nutrients you receive through an IV or feeding tube. Now, the preferred terms are parenteral nutrition (for IV nutrition therapy) and enteral nutrition (for tube feeding).

A note from Cleveland Clinic

Medical nutrition therapy may feel like a new journey or chapter of your life. This can be exciting but also a bit scary or even overwhelming. Tell your dietitian how you’re feeling. They’re prepared not only to provide education but also to tailor treatment to your needs. And they’ll do everything they can to help you meet your goals.