A Skeptical Look at the
Institute for Integrative Nutrition
Stephen Barrett, M.D.
The Institute for Integrative Nutrition (IIN), headquartered in New York City, refers to itself as "the world's largest nutrition school." Founded in 1992, it is said to have an annual enrollment of more than 1,600 students . Its primary offering is a part-time course said to enable graduates to practice as "health counselors." It also offers a distance education program. I have serious doubts about the validity of its teachings.
IIN's founder, director, and primary teacher is Joshua Rosenthal. The biographical sketch in his book Integrative Nutrition states:
He is a highly trained leader who has a Masters of Science degree in Education, specializing in counseling. With more than 25 years of experience in the fields of whole foods, personal coaching, curriculum development, teaching, and nutritional counseling, he is a highly sensitive healer whose enthusiasm shines through in all his work. His simple approach allows people to quickly and successfully reach new levels of health and happiness [2:341].
A 2002 interview in Satya Magazine indicates that IIN was originally named Gulliver's and that before founding it, Rosenthal had operated a "natural food" store in Canada .
In 2008, IIN's primary course extended over an 8-month period and its tuition of $8,950 was said to cover:
Weekend class instruction, lectures given by world-class speakers, a personalized website, one-on-one health counseling, access to our Online Education Forums, Warm Up classes, business cards, handouts, personalized brochures, a comprehensive CD-ROM set to help you organize your practice, books and other materials, an embossed diploma and a party for all students to help beat the winter blues with healthy organic food.
In January 2010, I noted that its course was said to be 10 months long and was offered at an "introductory rate" of $4,995.
The IIN program is open to anyone who is willing to attend and pay tuition. No formal training or nutrition-related knowledge is required. In 2008, I was able to determine that to graduate, students were required to attend at least eight out of ten weekend seminars, complete six "health history consultations," enroll two clients in a 6-month health counseling program, pass three multiple-choice tests, and attend at least five "counseling" sessions . The counselor—typically a recent graduate—provided advice about the student's experience with clients and "modeled" the student for the six-month program. (I assume that this meant that the student goes through the program with the counselor as advisor.) Students also get advice and share ideas and experiences with fellow students through online forums on the IIN Web site. However, the forums are closely monitored and critical comments are usually quickly removed.
Rosenthal's Integrative Nutrition Food Pyramid is adapted from the United States Department of Agriculture Food Pyramid. It includes extra water and a "primary food circle" that symbolizes "healthy relationships, regular physical activity, a fulfilling career, and spiritual practice, all of which are said to "feed our bodies and satisfy our hunger for living."
Each of IIN's weekend seminars includes several guest speakers. The 2007-2008 IIN catalog listed 33 of them, most of whom promote offbeat ideas. Included were Andrew Weil, M.D., Deepak Chopra, M.D., and macrobiotic guru Michio Kushi. In January 2010, the list had 24 names. Colin Campbell, Ph.D., emeritus professor of nutrition at Cornell University, delivered a lecture during the school's early years but felt negatively about what he saw and later asked that his lecture be removed from IIN's Web site. In 2012, he wrote:
Although the audience for my lecture was welcoming and quite interested, I found the program's mission to be most disquieting. . . . The speaker roster included a mixture of professionals and non-professionals, some of whom had serious conflicts of interests and some of whom pretended to be authorities when they were not. There is no question that there is a great need for public nutrition information but I strongly believe that this program does more harm than good. Even though the enrollment fee for the course was exceptionally high, a surprising number of students were nonetheless enrolling, suggesting to me an intense interest in this topic. On the basis of the information that I had at the time, there is no way that this course should receive professional recognition in the teaching of the relationship of diet, nutrition and health. The fact that the students are led to believe that they are credentialed in this subject is a disgrace. I am very much sensitive to the public's participation and interest in this topic but enrolling in this lecture series is, in my opinion, a huge waste of time and money .
IIN graduates receive a "health counselor" certificate and are automatically eligible for "board certification" by the American Association of Drugless Practitioners (AADP). In 2007, for an additional $495, they could also receive a "Certificate in Health Counseling" and 15.5 Continuing Education Units (CEUs) from the Center for Educational Outreach and Innovation at Columbia University's Teachers College, which "partnered" with IIN that year . Columbia terminated its affiliation early in 2008 after receiving complaints about IIN's program. In 2009, a similar "special partnership" was set up with Purchase College, which is part of the State University of New York (SUNY) system. IIN itself is not accredited by an agency recognized by the U.S. Office of Education , which means that its courses cannot be used toward meeting the degree requirements at standard colleges and universities that train nutritionists.
IACET (the International Association for Continuing Education and Training), which sets the standards for continuing education providers, describes CEUs this way:
One Continuing Education Unit (CEU) is defined as ten contact hours of participation in an organized continuing education experience under responsible sponsorship, capable direction, and qualified instruction.
The primary purpose of the CEU is to provide a permanent record of the educational accomplishments of an individual who has completed one or more significant non-credit educational experiences. Awarding the CEU approved by IACET also provides a quality indicator for your continuing education and training programs because it means you have been reviewed and approved for complying with the internationally recognized standard .
It would be interesting to know how Purchase College concluded that IIN's program represents "quality" education, but I don't have the time to investigate.
AADP "certification" has no scientific recognition and is certainly not a sign of professional competence. AADP membership, which automatically includes "certification," is available to "any doctor or practitioner that practices 'drugless' therapies or methodologies."  The basic requirement is payment of $285 and graduation from one of about 65 AADP-approved schools, all of which have unscientific teachings. Membership benefits include "an impressive 8 1/2" x 11" AADP Certificate of Membership." 
Many IIN graduates describe themselves on the Internet as "board-certified" or a "certified holistic health counselor," and a few even describe themselves as having certification from Columbia University, Columbia University Teacher's College, Purchase Collage, and/or SUNY. It would be interesting to know what percentage of IIN graduates are able to earn a living as a "health counselor.' I suspect that the percentage is small.
What Is "Integrated"?
IIN's program focuses on foods and eating choices but contains little about the sciences of biochemistry or physiology on which dietary strategies should be based. The goal appears to be to enable students to find what dietary and activity strategies work best for them and then do the same for clients. The catalog states that IIN teaches more than 100 different dietary therapies and "analyzes the pros and cons of them all." The Dietary Theory chapter of Rosenthal's book discusses about a dozen of these approaches. These include:
- Ayurveda, which bases food choices on alleged body types and the season of the year.
- Blood Type Diet, which claims that optimal diet depends on blood types.
- Five-element theory, which recommends foods based on the ancient Chinese notion that we are surrounded by "energy fields" (wood, fire, earth, metal, and water) that must be balanced to promote "self-harmony."
- Macrobiotics, which advocates foods based on "balancing yin and yang."
These strategies —and most of the rest—not only clash with science but also with each other. But Rosenthal doesn't seem bothered by this because he asserts that "all diet programs contain elements of truth." [2:76] To assist the "integrative process," his book provides a mishmash of facts, opinions, incorrect pronouncements, practical advice, and nonsense. The nonsense includes:
- While understanding one's body type is important, it is by no means the core teaching of Ayurveda. In India, Ayurvedic doctors usually . . . . look at a patient's susceptibility to imbalance." [2:84]
- "If you are eating mostly earth foods, it may help to increase wood foods because woods hold down the earth." [2:88]
- "I've seen a great deal of truth in the Blood Type categories. . . . Type O people often have difficulty metabolizing and digesting wheat." [2:101]
- Drinking more water increases yin." [2:187]
The dietary part of Rosenthal's 12-step integrative plan includes drinking more water, and generally eating more grains and vegetables and less meat and dairy products. He advises implementing one step at a time, seeing what effect it has, and retaining what seems to make you feel best. I am skeptical of this approach. The way people feel can vary considerably from day to day and have many non-dietary influences. With so many possible variables, isolating the impact of fluid intake and dietary patterns would be difficult if not impossible.
In 2013, three women filed a federal class-action complaint accusing Rosenthal and INN of discriminating against female employees on the basis of sex, pregnancy, and marital status and retaliating against employees who complained . The chilling details included these allegations:
- Under Rosenthal's direction, the company considered female employees' maternity status in reviewing their performance.
- In 2012, acting on Rosenthal's instructions, the comppany's human resources department collected information and created a chart projecting the likelihood that each female employee will become pregnant.
- The company has fired or demoted employees who took maternity leave.
The Bottom Line
IIN is flooding the marketplace with graduates who market themselves as "board-certified health counselors." Their training is certainly not based on scientific nutrition as emphasized in the degree programs accredited by the Commission on Accreditation for Dietetics Education. That generally takes 4-7 years and includes basic sciences, dietetics, and closely supervised work with many clients. IIN provides almost none of this. It teaches—in effect—to use your own experience to inspire others.
I personally would not trust someone who lacks scientific training to tailor diets based on dietary needs or who relies on IIN's teachings to counsel patients. Nor do I believe that "counseling" a few clients is enough to enable students to provide quality advice or to know their limitations. Rosenthal's approach might inspire some people to improve their diet by moving closer to the Dietary Guidelines for Americans. However, they may also absorb misconceptions about diet, health, and disease that will ultimately harm them.
Trustworthy Degree and Certificate Programs
- Academy of Nutrition and Dietetics (dietetic programs)
- Tufts University (nutrition science for communications professionals)
- IIN Web site, accessed April 7, 2008.
- Rosenthal R. Integrative Nutrition: Feed Your Hunger for Health & Happiness. New York: Integrative Nutrition Publishing, 2008.
- Starks A. Dietary diversity: The Satya interview with Joshua Rosenthal. Satya Magazine, March 2002.
- Career Advice Forum - Institute for Integrative Nutrition in New York. Indeed Web site, accessed Jan 9, 2010.
- J. Morris Hicks. "Confusion over clarity" at schools of nutrition. Healthy Eating / Healthy World Blog, Juy 6, 2012.
- Student handbook, 2007-2008. New York: Institute for Integrative Nutrition, 2007.
- US Department of Education Office of Secondary Education database searched on April 7, 2008.
- Continuing Education Units (CEUs). IACET Web site, accessed Jan 9, 2010.
- FAQ's. AADP Web site, accessed Jan 9, 2010.
- Rosenthal DA. Invitation. AADP Web site, accessed Jan 9, 2010.
- Complaint. Bailey Stoler et al. againat the Institute for Integrative Nutrition and Joshua Rosenthal. U.S. District Court for the Southern District of New York. Case No. 1:13-cv-01275-RWS, filed Feb 25, 2013.
This article was revised on May 21, 2013.