Looking Back to Look Ahead: Nutrition Perspectives on Cellular Health

The year was 1998 - my fellow classmates and I converged upon our journey in graduate school to become physical therapists. In our first semester, we shouldered a heavy load of coursework and were memorably immersed in a battle between courses taught by our anatomy and histology professors. Both professors claimed stake to the title of teaching the “most important course in the curriculum.” The connection between anatomy and physical therapy was clear and specific. But there were moments when the connection between histology and physical therapy seemed less relevant and the demands from our histology professor obtuse. The battle between courses played out in both the cadaver lab and the histology slide viewing rooms. My classmates and I found ourselves compelled to pour over both anatomy and histology with focused intensity; the figurative competition became a grind.

We shared in collective moans and groans surrounding the challenge of having a histology professor who thought so highly of cellular structure and function and insisted our appreciation of the topic should equal that of learning anatomy. This professor made exceedingly clear to each of us: “You MUST know what a normal cell looks like to understand basic anatomy and physiology. If you don’t know what normal looks like, then you’ll never know what abnormal looks like.”  We studied muscle slides, fibrocartilage slides, hyaline cartilage slides, endothelium slides, neuron slides, bone slides, tendon slides….and on and on and on. We counted mitochondria. We compared normal and abnormal. Over and over again.

Little did I know - our future understanding of health would literally hinge upon such things. Normal and abnormal cellular health. Intra- and Inter-cellular (mis)communication. Inter-cellular barrier integrity. Mitochondrial (dys)function.

In September 2024, Dr. Casey Means shined a spotlight on our country’s health crises by participating in a non-partisan roundtable discussion titled “American Health and Nutrition – a Second Opinion” – elucidating in a national forum the stark reality of the dismal nutrition situation that plagues our country resulting in equally dismal national health statistics. We are all witnesses to this health catastrophe. She also recently published “Good Energy,” a call-to-action she co-authored with her brother Cally Means. In the roundtable discussion and in the book, Dr. Means eloquently describes the driver of all health and disease states - the status of cellular function – and that this is foundationally driven by nutrition or lack thereof. Based on the overwhelming evidence in the literature I’ve read through the years, and compiled to create “Nutrition Perspectives in Pelvic Rehab,” I couldn’t agree with her more.

And I guess this is where I admit our histology professor was on to something.

As rehab professionals, we absolutely care about what cells look like, act like, move like, and feel like. We may not realize it, but cellular health or dysfunction can dictate if our patients have low energy, metabolic dysregulation (diabetes, obesity, fatty liver disease), neurodegenerative diseases like Parkinson’s, Alzheimer’s, dementia & peripheral neuropathy (Qiao et.al., 2024; Sabui et.al., 2022), neurocognitive changes, (Shatalina et.al., 2024) cancer, chronic pain, or even dysregulation of the gut-brain axis (found in conditions such as IBS). Cellular dysfunction is at the foundation of all of these conditions and their sequelae. We also may not realize it, but when we palpate tissue that is painful, inflamed, tense, tight, dyscoordinated, or find joints to be irritated (Seewald et.al. 2023) cellular dysfunction may be making itself manifest. Sarcopenia, muscle degeneration and weakness, also has underpinnings in metabolic and thus cellular dysregulation (Daily &Park, 2022;  Xie & Huang, 2024). Chronic systemic inflammation is by definition cellular dysregulation. (Kharrazian, 2022)

And finally, we also may not fully realize the decidedly negative impact our standard American diet has on each and every condition just listed, or more precisely, on our cellular health. Without normal cellular function our bodies will devolve into chaos - otherwise known as disease states.

As rehab professionals, we need to know all we can about anatomy, biomechanics, and therapeutic intervention. In my journey, it was the requisite histological training combined with my studies in nutritional sciences that allowed me to see how the “peripheral” topics of nutrition, health, and cellular function intersected in vivid clarity early in my career. This fueled my long-standing passion to share this information with other healthcare providers through the creation of “Nutrition Perspectives.”

This intersection should inform our intention as we steer towards solutions to the overarching American health crisis while helping our clients – one conversation at a time. “Nutrition Perspectives in Pelvic Rehab” (NPPR) provides practical steps to navigate a path forward to improve digestive health, gut health, and overall health. First, we must bravely confront the magnitude and complexity of the problem as we equip ourselves with working knowledge of functional nutrition as shared in NPPR.

Optimizing cellular health can positively influence everything we care about as rehab providers. I might argue in this context – that learning about functional nutrition may be equivalent in importance to anatomy and histology! More fairly – the intersection of anatomy, histology & nutrition will be the foundation upon which the future of health and wellness, and hopefully healthcare will eventually be built.

Nutrition Perspectives in Pelvic Rehab is nearing its 10th anniversary– 10 years of sharing profoundly important nutritional concepts that impact each one of us and the clients we serve. As the body of evidence explodes, the essence of the message within NPPR is unwavering and may just become your “most important course in the curriculum.” Nutrition matters deeply – all the way down to the cellular level.

Come learn the hows and whys in an upcoming offering of Nutrition Perspectives in Pelvic Rehab – available in remote format on the following dates:  Dec 7-8, 2024; Feb 22-23, 2025; June 7-8, 2025; Oct 11-12, 2025 & Dec 6-7, 2025.

Resources:

• American Health and Nutrition – A Second Opinion. https://rumble.com/v5fy7bv-american-health-and-nutrition-a-second-opinion.html
• Daily JW, Park S. Sarcopenia Is a Cause and Consequence of Metabolic Dysregulation in Aging Humans: Effects of Gut Dysbiosis, Glucose Dysregulation, Diet and Lifestyle. Cells. 2022 Jan 20;11(3):338. doi: 10.3390/cells11030338. PMID: 35159148; PMCID: PMC8834403.
• Kharrazian D. Functional Medicine Approaches to Neurodegeneration. Phys Med Rehabil Clin N Am. 2022 Aug;33(3):733-743. doi: 10.1016/j.pmr.2022.04.011. PMID: 35989061.
• Means, C;  Means, C. Good Energy – the Surprising Connection between Metabolism and Limitless Health. Avery. May 2024.
• Qiao L, Yang G, Wang P, Xu C. The Potential Role of Mitochondria in the Microbiota-Gut-Brain Axis: Implications for Brain Health. Pharmacol Res. 2024 Sep 25:107434. doi: 10.1016/j.phrs.2024.107434. Epub ahead of print. PMID: 39332752.
• Sabui A, Biswas M, Somvanshi PR, Kandagiri P, Gorla M, Mohammed F, Tammineni P. Decreased anterograde transport coupled with sustained retrograde transport contributes to reduced axonal mitochondrial density in tauopathy neurons. Front Mol Neurosci. 2022 Sep 30;15:927195. doi: 10.3389/fnmol.2022.927195. PMID: 36245925; PMCID: PMC9561864.
• Seewald LA, Sabino IG, Montney KL, Delco ML. Synovial fluid mitochondrial DNA concentration reflects the degree of cartilage damage after naturally occurring articular injury. Osteoarthritis Cartilage. 2023 Aug;31(8):1056-1065. doi: 10.1016/j.joca.2023.03.013. Epub 2023 Apr 6. PMID: 37028640; PMCID: PMC10524327.
• Shatalina E, Whitehurst TS, Onwordi EC, Gilbert BJ, Rizzo G, Whittington A, Mansur A, Tsukada H, Marques TR, Natesan S, Rabiner EA, Wall MB, Howes OD. Mitochondrial complex I density is associated with IQ and cognition in cognitively healthy adults: an in vivo [¹⁸F]BCPP-EF PET study. EJNMMI Res. 2024 Apr 17;14(1):41. doi: 10.1186/s13550-024-01099-1. PMID: 38632153; PMCID: PMC11024075.
• Xie X, Huang C. Role of the gut-muscle axis in mitochondrial function of aging muscle under different exercise modes. Ageing Res Rev. 2024 Jul;98:102316. doi: 10.1016/j.arr.2024.102316. Epub 2024 May 3. PMID: 38703951.

AUTHOR BIO
Megan Pribyl, PT, CMPT, CMTPT/DN, PCES

Megan Pribyl, PT, CMPT, CMTPT/DN, PCES (she/her) is a mastery-level physical therapist at the University of Kansas Health System in Olathe, KS treating a diverse outpatient population in orthopedics including pelvic health, pregnancy, and postpartum rehabilitation – all with integration of health and wellness. She began her PT career in 2000 after graduating from the University of Colorado Health Sciences Center with her Master of Science in Physical Therapy. Prior, she earned her dual degree in Nutrition and Exercise Sciences (B.S. Foods & Nutrition, B.S. Kinesiology) in 1998 from Kansas State University. Later, she obtained her CMPT from the North American Institute of Orthopedic Manual Therapy and became certified in dry needling in 2019. Since 2015, she has been a faculty member of Herman & Wallace Pelvic Rehab Institute and enjoys both teaching and developing content. She created and instructs Nutrition Perspectives for the Pelvic Rehab Therapist offered remotely through Herman & Wallace. She also teaches Pelvic Function – Level 1, Pregnancy Rehabilitation and Postpartum Rehabilitation. She brings many years of experience and insight to all courses. As a content developer, Megan has also contributed to the Herman & Wallace Oncology Series, Pelvic Function Level 2A, as well as the Pelvic Function Series Capstone Course.

Megan’s longstanding passion for both nutritional sciences and manual therapy culminated in her creating Nutrition Perspectives for the Pelvic Rehab Therapist designed to propel understanding of human physiology as it relates to pelvic conditions, pain, healing, and therapeutic response. She harnesses her passion to integrate ancient and traditional practices with cutting-edge discoveries creating a unique experience sure to elevate your level of appreciation for the complex and fascinating nature of clinical presentations in orthopedic manual therapy and pelvic rehabilitation. Clinicians will come away from this course with both simple and practical integrative tools that can be immediately utilized to help clients and providers alike - along their path of healing.

Megan enjoys her many fulfilling roles as an instructor, clinician, wife, and mom to two active teenagers and owner of two rambunctious golden retrievers. She loves to read, cook, be in the great outdoors, travel, and spend time with her family and friends. She has a passion for both the mountains and the beach, exploring scientific literature, and learning all she can about the power of using nature, nurture, and nutrition to heal and sustain health.