In the loftlike Manhattan waiting room of nutritionist Dana James, all is light and serene. Mounds of crystals gleam alongside books such as The Float Tank Cure; the faint scent of a tourmaline smudge spray permeates the air. I have already plowed through 300-plus prompts on James’s Magna Carta–length questionnaire (Do you have a tendency to cry easily? Do you have cracked heels? How often do you eat salmon?), but my nutritional spelunking is only just beginning. After I endure two weeks of a no-grain, no-sugar, no-dairy Paleo diet to “clean out my system,” the next step is a round of lab tests to evaluate my neurotransmitter and mitochondrial function, among other things, in order to assess my body’s metabolic processes.
Triple-certified in nutrition, cogitative behavioral therapy, and functional medicine—the buzzy field that examines the interaction between a person’s genetic, environmental, and lifestyle factors—James is part of a new wave of experts subjecting clients to a battery of blood, saliva, gut, and urine tests that take personalized nutrition to the nth degree. Practitioners measure things like telomeres—the protective caps on chromosomes that supposedly reveal one’s biological age—to locate the source of an ailment or those last stubborn pounds. For me, it all comes back to a protracted case of shingles and frequent carb binges, which I tell James as she grills me on the exact times of day I eat and sleep. Calorie counting this is not.
“If you’re not testing, you’re guessing,” says Katie Mark, R.D., M.P.H., a Miami-based sports dietitian for all levels of athletes, including pro cyclists and NFL players, who rejects the analog mentality of simply eating well and exercising. “When I incorporate specialty functional testing, I’m able to help keep a happy gut, increase immunity, decrease inflammation, and improve symptoms related to food sensitivities, from migraines to digestive issues,” agrees Los Angeles sports dietitian Meg Mangano, R.D.N., C.S.S.D., whose elite roster has included the LA Clippers and the U.S. Men’s National Soccer team. “It’s the future of nutrition,” she says.
This kind of attention does not come cheap. Consultations, which can start in the hundreds of dollars and climb upwards, are usually not covered by insurance, nor are many of the corresponding labs. At my initial visit with James (a mere $525), assistants’ phones buzz with texts from clients, many of whom are not sick but stressed, fatigued, and unable to focus—the vague ailments of modern life often referred to in these circles as “F.L.C.,” or “feel like crap,” syndrome.
James prods my abdomen, still puffy despite my Paleo- induced five-pound weight drop. “If it’s bothering you,” she says, “we’ll run a gut-microbiome test.” This will detect the amount of good bacteria in my system, which can then be bolstered by certain foods, she explains. Columbia University–trained, blonde, and bicoastal, the Aussie sees a gaggle of Victoria’s Secret models, as well as actresses such as Margot Robbie. She scans my urine and saliva results. My mood- and digestion-regulating serotonin levels are high, but motivation-related dopamine is “suboptimal,”which can result in fatigue. Also: Patient exhibits cortisol spikes throughout the day. (Constant deadlines and travel, a young child, and city life come to mind.) Twenty four hours later, a lengthy menu arrives via email, full of cortisol-calming ingredients: bitter greens for vitamin C, magnesium-rich nuts and seeds for “emotional regulation,” oily fish for omega-3s. Just reading through the plan is exhausting. But what if it works?
I’m not alone in my intrigue. The popularity of functional medicine and a trifecta of lifestyle trends (interest in genetic tests; a surge in food allergies, whether real or imagined; and millennials’ preference for personalization) have converged to make an appointment with someone like James hard to come by. There’s also an increased faith in the power of food as health remedy; consumption of once-fringe comestibles, such as medicinal mushrooms that can reportedly lower cholesterol and boost immune response, has more than doubled since last year. If you haven’t heard of reishi and chaga yet, you will.
To do my due diligence—and out of morbid curiosity—I sign up for another round of tests as a temporary client of the Santa Monica– based LifeSpan Medicine, which offers a concierge nutrition service nationwide. For the requisite labs, my veins are tapped from the comfort of my Brooklyn couch by a pink-cheeked nurse, and my blood markers are tested to see how they respond to specific food proteins. I am then overnighted a heaving tome that uses my results to divide seemingly every known food into categories: green (approved), yellow (foods that can be judiciously integrated), and red (inflammatory foods to avoid, which, alarmingly, includes all dairy, plus oats, avocado, and coffee). The company follows up with recipes based on my sanctioned diet, and for four weeks, I dutifully make zucchini pesto noodles and quinoa cod lettuce wraps. Physically, all is well—great, even. I lose two more pounds, my skin is sparklingly clear, and I am sleeping better. My mental state, however, is a different story. I don’t look forward to meals; I avoid social situations because I don’t want to restrict myself; I miss my morning oatmeal. I start drinking coffee again after a week, but I do largely stick with the program, reasoning that if the tests are specific to me, maybe the results will be, too.
Using genetics to determine metabolic predispositions may sound like pseudoscience, but the research is there. Variations in at least 38 genes have already been linked to one’s ability to process alcohol, fatty acids, lactose, vitamin C, and caffeine, which is why people with certain genetic variants thrive on diets high in “good” fats or wheat, while others do not. A 2015 study found blood-sugar levels varied wildly among 800 subjects who had eaten completely identical meals.
Having this information at your fingertips can be a powerful tool for staying on a nutrition program, says Robert C. Green, M.D., M.P.H., a geneticist and professor of medicine at Harvard Medical School. “In some cases, people really are motivated by hearing about something from their own DNA. We all know we have to eat better,” he says, explaining that it may help to think, “This is my data that’s been analyzed, and this is some risk information that really applies to me.” That has certainly been my experience. The hyperspecificity of my plans from James and LifeSpan—Salmon, yes! Corn, no!—acted as an incentive to stop eating processed food, to be mindful that sugar gives me vertiginous mood swings, and to take a more active interest in my health.
Buyers should still beware, though, says Green. “DNA has this cachet of critical scientific thinking and deterministic precision, but when you mix up the profit motive with early science, you get some companies doing a very responsible job, and some that aren’t.” Those gut-microbiome tests, for example, can be effective, but the research, he notes, is still emerging. It’s crucial to do your homework, agrees David Alpers, M.D., co director for the Center for Human Nutrition at Washington University School of Medicine. “Ask for strong scientific evidence—in humans, rather than animals,” he insists. And if you’re told to make a significant lifestyle change, Alpers adds, seek a second opinion from an expert not tied to a product.
As for fitness routines, once a reliable bastion for improving your health, even James isn’t ready to count them out. During a recent appointment, she examined my puffy abdomen again. “Does your stomach usually grow larger throughout the day?” she asked. No, I told her. She was silent for a minute before finally replying, “You might just need Pilates.”
