Rooted in ancient herbal medicine, aromatherapy
is gaining recognition among healthcare professionals as an effective
complementary care technique.
What could be more satisfying than the scent of
freshly baked bread or homemade chocolate chip cookies straight
from the oven? Think about how much the sense of smell affects our
reality, increases comfort, and promotes a sense of well-being.
It is no surprise that aromatherapy is rapidly becoming a widely
recognized complementary therapy, used in conjunction with conventional
medicine, to treat chronic disease and promote health. According
to the National Center for Complementary and Alternative Medicine,
a component of the National Institutes of Health, aromatherapy uses
essential oils (extracts or essences) from flowers, herbs, and trees
to promote health and well-being.1
Aromatherapy is an ancient technique with roots
in herbal medicine—the oldest form of medicine in the world.2
The recent renaissance of aromatherapy has encouraged healthcare
professionals to embrace it as part of mainstream practice. Aromatherapy
is one of the fastest-growing complementary therapies used by nurses
in acute care and long-term care settings in the United States.3
According to the American Journal of Gastroenterology (2004), complementary
and alternative medicine (CAM) was used by up to 40% of patients
in two U.S. national studies.4,5 Nutrition practitioners are beginning
to explore the use of aromatherapy for treating conditions such
as HIV/AIDS, inflammatory bowel disease (IBD), chronic pain, and
stress.
An article in the Journal of the Association of
Nurses in AIDS Care, emphasized a more holistic approach by nurses
with the use of essential oils like eucalyptus, teatree, lavender,
and thyme in treating conditions associated with AIDS, such as candida
albicans and herpes. The encouraging findings were that, unlike
conventional antibiotics, essential oils inhibited vaginal pathogens
without damaging the normal flora.2 In a study of 159 IBD patients
from the University of Manitoba Inflammatory Bowel Disease Clinic
and Research Center, commonly reported symptoms were pain/cramps,
diarrhea, gas/bloating, bloody stools, decreased energy, and stress.
Among the 90 patients using alternative therapies (which included
aromatherapy) to manage IBD symptoms, patients reported that CAM
helped 67% of the time.6 Interestingly, patients reported that lifestyle
changes, such as improved diet and exercise habits, were effective
95% of the time. We can only image the positive outcome possibilities
if both nutrition and complementary therapies were used in tandem.
Patients with IBD have been noted, in particular,
as a population with high usage of CAM for numerous reasons. The
reasons stem from side effects and lack of efficacy of conventional
medications, the presumed safety of CAM, concern regarding surgery,
and feelings of loss of control with conventional medicine.7 Another
rationale is that patients may view CAM therapies as more in line
with their beliefs and values regarding healthcare.
“When using essential oils under the guidance
of a qualified practitioner, such as a registered or certified aromatherapist,
naturopath, or nurse who has been trained in the use of essential
oils, they have no harmful side effects,” explains Lora Cantele,
a registered aromatherapist, in Woodstock, Ill.
Complementary medicine dietitian and Ayurveda instructor,
Jennifer Workman, MS, RD, of The Balanced Approach in Boulder, Colo.,
and author of Stop Your Cravings, regularly uses aromatherapy. “It’s
a great complementary modality for calming and soothing [people],”
explains Workman. The effects are almost immediate because aromatherapy
directly affects the limbic system and, as a result, has an instant
impact on the body’s physiology, according to the Essential
Oils Desk Reference (formerly People’s Desk Reference [PDR]
for Essential Oils). “It is not hocus pocus,” Workman
states confidently. “People respond well to an integrative
medical approach—which includes the use of essential oils.”
Food’s
Aromatic Magic
Since smell is the primary sense when eating, with taste following,
the immediacy of aroma and its connectedness to emotion, memory,
and well-being create the most unforgettable experiences.7,8 Is
it true that cravings can be thwarted by the scents and flavors
of certain foods? Aromatic herbs and spices such as cinnamon, cardamom,
turmeric, cumin, basil, and ginger can help shed pounds and keep
digestion running smoothly, according to Workman’s book. She
reveals that aromatic essences can help alleviate stress and worry
related to food, thus leading to an overall well-balanced diet.
As nutrition professionals, we can teach clients
how to incorporate essential oils in daily cooking and menu planning.
In the book, Aroma: The Magic of Essential Oils in Foods and Fragrance,
Mandy Aftel, a perfumer, and Daniel Patterson, a chef, team up to
create healthy dishes with essential oils, such as rose-infused
steamed bass, peach-jasmine sorbet, and lemon verbena lemonade.
The authors believe that without aroma there is no flavor, and by
focusing on aroma we intensify all aspects of food and immeasurably
enhance the experience of cooking and eating.7,8 Stocking the pantry
with essential oils allows easy access to a whole host of herbs
and spices. Since essential oils capture the quality of the living
plant more strongly than dried herbs, the recommendation is to use
them sparingly, one drop at a time, and always diluted.
Various aromas affect the body and overall health
differently. Aftel and Patterson point out that spearmint, cucumber,
orange, and lemon verbena can refresh the mind and body, whereas
the spicy scents of cinnamon, black pepper, ginger, and cumin can
stimulate the mind and metabolism. Clinical studies have shown that
scents such as lemongrass and eucalyptus have antibacterial, antifungal,
and antiviral effects.2 Many essential oils have been found to have
anti-inflammatory properties and analgesic properties, as well as
being good antimicrobials—for use in chronic diseases, such
as arthritis and bronchitis.9 Two inexpensive, common, and safe-to-use
essential oils—basil and palma rosa—have been effective
in vitro against the bacillus found in the biological weapon anthrax.10
However, medical literature points to some common
contraindications of essential oils, such as pregnancy, contagious
disease, epilepsy, venous thrombosis, varicose veins, open wounds
or skin sites, and recent surgery.11 Another clinical consideration
is that some essential oils can either enhance or hinder the efficacy
of prescribed medications, such as antibiotics, tranquilizers, antihistamines,
anticonvulsants, barbiturates, morphine, and quinidine.7 Thus, an
extensive medical and nutrition assessment, including a pharmacotherapy
inventory, are essential. “An aromatherapist will assess a
client holistically and choose essential oils specifically for that
individual,” Cantele explains. She points to stress as a common
complaint and a usual causative factor in disease. “In many
cases, stress is the root cause of an individual’s illness
or disease,” she says.
Scent Specs
Not all scents are alike—some trigger positive responses and
others evoke negative ones. Aromas such as lavender, rose, and sandalwood
are believed to have calming effects, and citrus scents such as
grapefruit, orange, and lemon are believed to be natural antidepressants.
The actual essential oil is the healing nectar inherent
in the plant. Pure essential oils are the steam distillate of aromatic
plants—not a synthetic, manmade concoction.2 If the oils are
not obtained by steam distillate then they are not essential oils
but extracts. Extracts may contain residues of allergenic solvents
and are therefore not as beneficial for health.8
Essential oils can be administered in a variety
of ways or “carriers”—water, oil, lotion, and
salts. Water requires an emulsifier to allow the essential oil to
disperse; oils such as safflower, canola, olive, and sesame are
most commonly used, and unscented lotions, creams, and aloe vera
gels can be combined with essential oils. Epsom, coarse, or Kosher
varieties of salt are used as conduits of effervescent scents. Diffusers
disperse scents through the air for inhalation methods.
What Does the Research Say?
From a nutrition standpoint, recent literature is revealing that
essential oils can help critically ill patients, such as those on
parenteral nutrition or endocrine-compromised patients with type
1 diabetes, thyroid conditions, or those with cancer. Clinical Aromatherapy:
Essential Oils in Practice by Jane Buckle, PhD, RN, a CAM research
fellow at the Center for Clinical Epidemiology & Biostatistics
at the University of Pennsylvania and director of RJ Buckle Associates,
LLC, focuses on evidenced-based, essential oil remedies for myriad
health problems and highlights hospitals where aromatherapy is used.
The published data on dosing, comparative methods
of administration, and therapeutic outcomes in the use of essential
oils in aromatherapy are limited.12 In one of the few placebo-controlled,
double-blind, randomized clinical trials in the Journal of Clinical
Oncology (2003), the effects of aromatherapy on anxiety were accessed.
In the study, 300 patients undergoing radiotherapy were either randomly
assigned a generic oil or pure essential oil of lavender, bergamot,
and cedarwood. The oil was administered by inhalation. The difference
between psychological questionnaire results at baseline and completion
of treatment were insignificant. In this study design, aromatherapy
did not prove beneficial.
However, another study in the American Journal of
Hospice and Palliative Care, which focused on 17 cancer patients’
responses to humidified water and humidified lavender oil, showed
positive changes in blood pressure, pulse, pain, anxiety, depression,
and sense of well-being after lavender oil treatment.13 Aromatherapy
experts contend that further research needs to be done on many areas,
such as standardizing the acquisition of plant oils and delivery
routes of essential oils, toxicity data, regulation of practice,
and comparison among essential oils.12
Aromatic Buzz
In spite of inconclusive scientific evidence, the revival of the
age-old art of aromatherapy is spreading like wild fire across the
country. “What’s happening in my [aromatherapy] industry
is that a core group of MDs and nurses around the U.S. are finally
embracing aromatherapy and legitimizing this age-old healing art
and making it new again,” says Cantele. She specifically highlights
groups such as Aromatics in Action, a professional organization
for aromatherapists, as a key player helping integrate aromatherapy
into mainstream medical and dental practices. In addition, the National
Association for Holistic Aromatherapy educates the public on the
therapeutic benefits of aromatherapy.
For many aromatherapists, the goal is to empower
patients to heal themselves. As with any clinical treatment, duration
and intensity of aromatherapy is dependent on the reason for treatment
and the individual’s needs.
Smell and Touch
Combining essential oils with the power of touch is another way
to show patients how to take charge of their health. One method
is called Swiss Reflex Therapy—the original Aromatic Reflex
Treatment was created by aromatherapist Shirley Price in 1987. As
the name implies, it involves the reflexes of the foot. After the
initial client or patient assessment, the practitioner prepares
a massage cream with essential oils and massages it into the appropriate
reflexes of the feet. “What is unique here is that the client
is then instructed how to massage the prepared cream into the specific
reflexes so they can continue treatment at home,” says Cantele.
Her experience has taught her that those patients who apply the
oil daily have extraordinarily positive results. Swiss Reflex Therapy
is taught at the Penny Price Academy in England.
Another patented method of structured touch, used
in conjunction with aromatherapy, is the ‘m’ technique.
The gist of the ‘m’ is a series of stroking movements,
which are identified by mnemonic devices—each movement is
repeated a set number of times at a set pressure. This massage technique
was originally devised by Buckle as a communication tool for critical
care nurses. According to the description on her Web site, the technique
has been reported to illicit a “profound relaxation response.”14
Whether clients or patients are seeking nutrition
counseling for weight management, diabetes, gastrointestinal problems,
or hypertension, stress from managing a chronic health problem is
inevitable. When counseling individuals, nutrition professionals
may find it helpful to augment their medical nutrition therapy with
a complementary treatment, such as aromatherapy, to alleviate anxiety
and stress. It is important to consult a registered aromatherapist
who takes the time to fully assess the individual’s needs
and choose the safest, most effective essential oil treatment for
every case. From a culinary perspective, a little essential oil
goes a long way to add distinctive aroma, delicious flavors, and
subsequent health benefits.
— Victoria Shanta-Retelny, RD, LD, is a practicing dietitian
at Northwestern Memorial Wellness Institute in Chicago, a freelance
food and nutrition writer, and a culinary spokesperson.
To locate a registered aromatherapist in your area or training courses
in aromatherapy, visit the following Internet resources:
Aromatherapy Registration Council www.aromatherapycouncil.org
Aromatic in Action
www.aromaticsinaction.org
National Association for Holistic Aromatherapy
www.naha.org
References
1. Get the facts: What is complementary and alternative medicine
(CAM)? National Center for Complementary and Alternative Medicine.
Available at: http://www.nccam.nih.gov.
2. Buckle J. Clinical aromatherapy and AIDS. J
Assoc Nurses in AIDS Care. 2002;13(2):81-99.
3. Perez C. Clinical aromatherapy. Part 1: An introduction
into nursing practice. Clin J Oncology Nursing. 2003;7(5):595-596.
4. Eisenberg DM, Kessler RC, Foster C, et al. Unconventional
medicine in the United States: Prevalence, costs and patterns of
use. N Engl J Med. 1993;328(4):246-252.
5. Astin JA. Why patients use alternative medicine:
Results of a national study. JAMA. 1998;279(19):1548-1553.
6. Burgmann T, Rawsthorne P. Bernstein CN. Predictors
of alternative and complementary use in inflammatory bowel disease:
do measures of conventional health care utilization relate to use?
Amer J Gastroenterol. 2004: 889-893.
7. Moser G, Tillinger W, Sachs G, et al. Relationship
between the use of unconventional therapies and disease-related
concerns: A study of patients with inflammatory bowel disease. J
Psychosom Res. 1996;40(5):503-509.
8. Aftel M, Patterson D. Aroma: The Magic
of Essential Oils in Food and Fragrance. New York: Artisan
Books; 2004.
9. Valnet J. The Practice of Aromatherapy: A Classic
Compendium of Plant Medicines and Their Healing Properties. Rochester,
Vt.: Healing Arts Press; 1982.
10. Ladariya A, Rao J. In vitro antimicrobial studies
of the essential oils of Cyperus scariosus and Ocimum basilicum.
Indian Drugs. 1979;16(7):150-152.
11. Ernst E (Ed.). A Desktop Guide to Complementary
and Alternative Medicine: An Evidence-based Approach. London,
United Kingdom: Mosby, Inc.; 2001: 33-35.
12. Lee C. Clinical aromatherapy. Part II: Safe
guidelines for integration into clinical practice. Clin J
Oncology Nursing. 2003;7(5):597-598.
13. Louis M, Kowalski SD. Use of aromatherapy with
hospice patients to decrease pain, anxiety, and depression and to
promote an increased sense of well-being. Amer J Hospice Palliative
Care. 2002;19(6):381-386.
14. What is the 'm' technique®? Why is it an
important addition to Health Care and a valuable tool to the Care
Giver? Available at: http://www.rjbuckle.com
