Most conventional dietitians and nutritionists are not trained in tissue states or constitutional body types which are traditional diagnostic frameworks used to understand patterns of health and imbalance. Their education typically focuses on macronutrients, micronutrients, standard dietary guidelines. While they may cover some behavior change techniques and motivational interviewing, they often lack the holistic tools to assess how food affects the ecological terrain of the body—such as whether a food has a heating, cooling, moistening, drying, toning or relaxing physiological effect on the organ systems.

This missing layer can be critical. Someone might be following a diet that’s nutritionally sound on paper but still feel fatigued, bloated, anxious, or inflamed because the energetics of the food don’t align with their body’s constitution or imbalance. For example, a cold, dry catabolic person on a raw vegan diet may feel depleted and gassy, while a damp anabolic person on a heavy keto diet may become more sluggish and stagnant. Every diet has contraindications just like herbs do—what nourishes one tissue state may aggravate another. The key is personalizing diet not just to health goals, but to the energetic and constitutional needs of the person.

These insights—how food influences systemic patterns—are typically used by clinical herbalists, Ayurvedic practitioners, TCM doctors, and some holistic or functional nutritionists who have studied beyond standard certifications. They take into account root-cause patterns like wind, cold, damp, or heat—not just lab numbers or symptom checklists. In short, most dietitians and nutritionists are not lacking intelligence or care—they’re working within a biomedical system that’s inherently reductionist, focusing more on isolated nutrients than on the whole-body ecology. If you’re thinking in terms of terrain, tissue state, and body constitution, you’re not behind—you’re ahead.

Most dietitians and nutritionists are missing this lens—not because they’re under-qualified, but because the medical-nutrition model is biochemically reductionist. It focuses on nutrients, not the terrain. Knowing both is a sure way to help understand how to keep your health balanced.