BONUS: How a Nutritional Assessment Works, with Melissa Mascitelli

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Hey, hey, welcome back to Real Food Mental Health.This is a bonus episode because it's shorter than usual and also a little bit off topic, but totally relevant to the work that I do professionally.If you've been curious about what it might be like to work with me either for nutritional psychotherapy or my clinical nutrition package, it all starts with the Nutritional Assessment Questionnaire.So this bonus episode is me and a colleague discussing the Nutritional Assessment Questionnaire, what kind of data it generates, and why it's important.But also, if you listen until the end of the episode, I will offer something special for my listeners.I hope you enjoy this bonus.But real quick, I'm going to introduce my guest and colleague today.Her name is Melissa Mascitelli, and she runs her own private practice called Mindful Wellness with Mel based out of New Jersey.She believes that true health begins with mindfulness.And honestly, I have to agree with that.Mindfulness in how we nourish our bodies, manage stress, and embrace the changes that come up with each phase of life.With a deeply personal journey that has shaped her approach, Melissa understands the complexities of hormonal changes, sleepless nights, and the stressors that affect our well-being.So Melissa, you are an NTP, which is a nutritional therapy practitioner, like myself.But I wanted to do this bonus episode because there's this thing that we do called the Nutritional Assessment Questionnaire, or we like to call it the NAC, the NAQ.What is the Nutritional Assessment Questionnaire?Can you talk a little bit about that?Yes, it's actually a wonderful, helpful tool in the platform that we utilize, NutriQ, that allows the client to answer quite a few questions, but kind of gives us a deep dive into their health, into what they've gotten going on a daily basis.And once it takes all of that information, it kind of throws it into an algorithm and gives us an idea of where their body needs the most support.I personally like it just because I can actually see it lay out for me what areas need the most support and kind of work backwards from there.So it's definitely a very helpful tool as an NTP to be able to really look into somebody's health very deeply.Yes, I love it too.In fact, I even fill it out myself once in a while.In fact, I need to do it again because it's been a while since I've done it.But I like to look at that data because it gives me a starting point for like different nutritional things that I need to do, lifestyle changes.Sometimes we're not even really aware that we might have digestive problems, for example, or blood sugar problems.I think that's a huge one.But people just don't know that that's a thing unless you have diabetes.And so once we get this data back, it really gives us a starting point in a clinical setting to start making some more personalized recommendations, rather than simply hearing you complain about your life and us just saying, well, you need to eat and sleep better.And yeah, that probably will be what we say, but it's going to be much more specific to your body's needs and your personal concerns.Yes, I agree.I 100% agree.And I agree as well with the blood sugar regulation.I mean, that comes up usually first and foremost for most people.And they don't, like you said, they don't realize it's actually a thing.They don't realize how it's so tied together between, if your blood sugar regulation is out of whack, it affects your sleep, it affects your digestion, it affects everything and stress levels and whatnot.It all goes hand in hand.And when one item is off, everything's off.And it's really nice to be able to see that picture from the NAC perspective on our end, to be able to see how it truly, where they truly need their support the most, which is, I find, very helpful.This nutritional assessment, it has over 300 questions.And I think that tends to be daunting for a lot of people.Like, I think I've had a few people so far who have started to fill it out and they see how long it is.So they kind of give up because they feel overwhelmed.But if I just fly right through it, I think it maybe takes me 20 minutes.Like, it doesn't really take that long, even though it's a lot of questions.But then to be fair, I've done it a few times.And so I kind of know what it's asking for.And I can anticipate without having to really read the questions.And so when you're doing it your first time, maybe it does take half an hour.But it is so worth it.And the reason I can't give you an exact number of questions is because it depends on your gender, or actually your sex rather.It depends on your sex.So it'll ask questions based on like fertility, or like if you're a female, your menstrual cycles.And so it'll adjust the number of questions based on those specific things.And I think I actually did have somebody who didn't say whether or not they were male or female.And so it gave them all the questions.Well.And I was like, and this isn't a person who I identify as non-binary or anything, like they totally could have narrowed it down a little bit for themselves, but they just went through and they answered all of the questions.I'm actually looking at my own data right now as I talk about this.One of the things that it gives us is it kind of gives us a chart of priorities, particularly on what we as NTPs call the foundations.And so we work from a foundational approach.So digestion, blood sugar regulation, those two are huge, huge pieces.But then there's also stress, sleep, and nutrient-dense diet.I mean, these are the five foundations that we follow.And there's a lot of information that can go into those five.So, I mean, yes, technically you could go online and you could Google these five foundations and maybe get some help.But it's really important to fill out this nutritional assessment so that you can get more individualized help.Another thing I like about it too is that it comes up with we've got a body system's symptom burden graph.And so if you are really into anatomy and physiology, it'll actually break down what systems of your body are struggling the most, which can help prioritize what needs some attention.And then also another one that I find the most helpful is probably the supplements.How do you feel about supplements, Melissa?I mean, I think they're definitely beneficial depending on the person, depending on their issues.I personally am a food first approach person.However, you know, our just basic vitamins and minerals that your body needs on a daily basis, those, that's, I think, first and foremost because you cannot get all of them from food.So that I am definitely a big advocate for is definitely a good multi-vitamin multi-mineral supplement.If there's anything else needed as far as thyroid support or blood sugar support or anything like that.You know, if supplements are needed, then yes, you know, I would definitely recommend them depending on if the client even wants to take supplements.Yeah.And that's the thing.I mean, I'm a food first clinician as well where, like I am a close follower of the Westin A.Price Foundation.And so to me, if it's whole foods, properly prepared, hopefully also in season, we're probably going to get the best bang for our buck that way.But sometimes I'm slowly being converted to the idea of using supplements.And so this is kind of why I wanted to bring this up from, from the NACC is in most cases, people will go to the health food store or even just Walmart or somewhere else and just buy a supplement that they think they need based off of what it says on the label.It's like, oh, this, this supplement is for cognitive function or this supplement is for sleep support or some, some really general generic marketing claim on the label, right?So they go home and they take that.But here's the thing, you might not need that.And so what I love about the Nutritional Assessment Questionnaire is it does give very specific recommendations.Granted, not all the recommendations are accurate.And so that's where we as NTPs get to use our clinical judgment and decide what actually is necessary.But it gives us a starting point.And basically what it does is it gives a list of recommended supplements based on the answers that you give the assessment.So for example, if you've got digestive issues that might be caused by low stomach acid, or we might call that hypochlorhydria, it might suggest taking hydrochloric acid as a supplement.And as a food first clinician, I might say, well, you might do better by starting a little bit milder by using apple cider vinegar in water, or using lemon juice in water, doing something else first before you jump to that supplement.But then in some cases, you actually do need to buy a supplement.And so it can be really helpful in terms of knowing which ones to buy.Okay, this total symptom burden, that is a score.Can you tell us about that, Melissa?The total symptom burden that, if memory serves me correct, it kind of gives you an idea of the top items that need the most work.When we were in class, learning this particular program, they told us the top five would be the ones that you really kind of want to hone in on.But it gives you the percentages of where they're at with those particular items.And it gives an idea of what needs to be worked on first and foremost, I think.But I do believe that it goes off of the questions, how they answered them, kind of giving them a percentage of what's going on in those areas that obviously need the most work.Yeah, and so it does put it in order of priority.And on the client side, you're probably not really going to see this, but it does prioritize things and gives us some even more direction on what recommendations we need to make.Now, I mean, theoretically, we could give individualized recommendations without the neck.And in fact, I think it was even before our cohort at the Nutritional Therapy Association, that that's how it was done.It was actually done on paper.But it was using a lot of the same questions.And this information is coming from a naturopathic doctor named Dickin Weatherby.So it's a book called Signs and Symptoms Analysis from a functional perspective.And so the neck is kind of adapted from that.And it's a very clinical book.I don't have a copy of it, but I know people who do a very clinical book.And I just love the fact that they've made this electronic.So it makes it a lot easier for people to fill out.But another thing, too, is it gives us a total symptom burden score.And I believe this is out of a thousand.So the closer to a thousand, you can get the better.And so I like to have people take this nutritional assessment multiple times over the course of me seeing them, because I want them to see that score change.I agree.You know, having that score change, it is definitely nice when you do the neck through steps, with them, as they progress through whatever program you have, because it allows you and them to see their progress, just like you stated, you know, areas that have improved, areas that may need still some work on, areas that may have, you know, kind of gone a little backwards where you know that that's the next spot that needs to be focused on.And then you could try to figure out why, you know.So, having that comparison is actually extremely helpful, you know, from one point to the next on their journey.Yeah, and there are different nutritional assessments.Like, this is just the one that we use.I think there are like really short ones, which I honestly wouldn't recommend because they're probably not very comprehensive.And there are different versions that you can get in different places, maybe even from an NTP.I know there's one on, there's a software called Whole Practice that a lot of NTPs use, and they have their own nutritional assessment on there.But the reason this is important is to just kind of help narrow things down so that we can give you the best possible recommendations rather than just generic advice that we would give anybody.And we do see that.Sometimes we see that on social media, especially YouTube videos.A lot of people are pretending to be nutritionists when they really don't have very good training.And so this is just one of those tools, one of the many tools that we have, that we can use to help you on a more comprehensive level.Yes, I completely agree with you on that.This tool helps us to see that bigger picture of a person's health, to be able to personalize, you know, recommendations for them on a bio individual basis.A lot of things that you see online these days, they, you know, it's that, you know, one size fits all type, you know, stereotype, I should say, where, you know, whatever they're offering will help everybody and it won't, essentially, will not help everyone, unfortunately.If there was one thing you could change about the way people approach health and wellness, what would it be?Just an education, an education on how food is not our enemy, as long as it's the correct food.You know, I think that that, having that knowledge is key.It's detrimental to just overall good health, you know, between nutrition, which is what we, you know, assist and aid in lifestyle, you know, with just, you know, everyday movement, exercise, you know, just trying to reduce stress.And, you know, it's, I think that education is key for people, you know, and that's something we provide, you know, for people, because I, you know, I believe we've been misguided for a very long time.And, you know, it's, it's, it's time that, you know, people are, have a better, you know, education, a better knowledge on, you know, what's beneficial for our bodies that are just so amazing, you know, and that we can definitely heal through those things.We have been misguided for a very long time.I'm actually, I'm hearing that from so many practitioners lately, from medical doctors, chiropractors, some therapists, I think therapists still have a ways to go with that, but we have been misguided.In fact, I just interviewed a former pharmacist who said that too.And he, his answer to that question was basically similar to what you just said, Melissa, where he said, we basically need to unlearn what we have been taught and start with a clean slate and be open to new education, like maybe some new ideas that we haven't been taught before in school.I know that we tend to think of school education, formal education, of being like this dogmatic source of information.But you have to remember, school is very political.And it's also, in my opinion, pretty outdated.I agree.And so we have to be willing to get new information from other sources that might not be school.So one last thing, Melissa, if people wanted to work with you, where can they find you?They can find me.I do have a website.It is mindfulwellnesswithmel.com.I also am on Instagram and Facebook.Same thing.Instagram is mindful underscore wellness underscore with underscore Mel.And same thing on Facebook.It's just mindful wellness with Mel.Those are the easiest ways to be able to contact me and work with me that way.Great.Thanks so much for joining me today, Melissa.Sure, absolutely.It was a pleasure speaking with you and going over these items today.As promised, here is your bonus for listening to this bonus episode, a free nutritional assessment for a limited time.Normally, I charge $99 for this.So go to beavercreekwellness.com/nutritional-assessment.I'll put a link in the show notes.