INTERNAL HEALTH: A Chiropractic Specialty Increased Referrals by Solving Problem Cases
Written by Howard F. Loomis, Jr., D.C., F.I.A.C.A.   
Monday, 21 February 2011 17:26

n presenting the concept of internal health—a chiropractic specialty—I have been advocating an examination approach that recognizes that muscle contraction accompanied inevitably with loss of range of motion can be caused not only by a structural problem but visceral function as well. In other words, they should not be separated when we attempt to establish the cause of chronic recurring subluxation patterns. Those of you who have been reading my articles for years know that I believe that chiropractors are the only healers that have been trained to simultaneously integrate the anatomy, physiology, and neurology involved with a patient’s symptoms before making a treatment plan. To have a treatment plan be successfully concluded, you must start by finding the cause.loomischartfeb

That brings us to an important consideration: What tests can you perform in your office that other practitioners do not? Unfortunately, I have found that most chiropractors do not include a periodic postural screening of their patients. What better way to begin screening for muscle contraction and then find its cause? A visual inspection only takes about one minute and is one of the most effective means of patient education available to you. No expensive equipment is needed, except perhaps a full length mirror. Once postural deviations are identified and related to their symptoms, the patient can recognize when they need to return to your office—before their symptoms return.

In my two previous columns, I described how to quickly determine the structural side of weakness—be it on the left, right or, if the stress crosses over affecting the organs of the lower abdomen. In December, I discussed how to determine spinal flexibility, whether the patient can tolerate compression or decompression (traction).

The chart on this page lists the various organs in the body.  Each shares spinal innervation with a set of muscles and a specific surface area on the skin. These connections were developed during the third week of embryonic life from the ectoderm, mesoderm, and endoderm germinal layers and can provide a very accurate diagnostic system when properly employed.

Here is a suggestion that may help you to find if a visceral problem is the cause of a patient’s chronic, recurring subluxation pattern. Identify the chronic spinal subluxation and then palpate the muscles that share the innervation for contraction, soreness and pain. Most of these will be located on the anterior of the body. Next, adjust the spinal innervation. Now repalpate for the anterior contraction(s). If they are gone, the cause was structural; but, if they are still present, the cause is visceral. Who else can do that?

As you make your spinal corrections, can you name the effects that each has on the affected organ? Do you attempt to correlate the patients’ symptoms to this chart and then palpate within the affected muscles to determine if the cause of the structural subluxation or misalignment came from a visceral stress?

Once learned, this system of diagnosis adds very little time to an office call, but experience has taught me that it may very well double your referrals and income in a short period of time. That should be worth a small investment of your time.  How many of the spinal innervations and autonomic effects have you committed to memory from the following list?

Successful doctors treat the cause of the problem, not the symptoms.

Successful doctors treat the cause of the problem, not the symptoms.  They are able to quickly and accurately determine the source of the patient’s stress, devise a plan of treatment, and confidently convey their findings to the patient. They specialize in helping problem cases—the ones no one else can help. They solve these cases by identifying the specific cause(s) of the patients’ symptoms that have not been identified elsewhere.

I would suggest that to enhance your practice you need the following:


  1. An examination that identifies the exact cause of your patient’s symptoms, be it anatomical, physiological, or neurological.
  2. Absolute confidence that your examination will stand the light of scientific scrutiny and will yield information quickly and accurately.
  3. A ceremony that both educates and inspires your patient. Ceremonies are important and you already have one.  It is your office procedure.

It is my intention to continue this series by offering a series of 24 articles, one each month, each dealing with a specific visceral syndrome. I will discuss symptoms and muscle contraction patterns and related structural problems that may have become chronic because the underlying visceral dysfunction has not been identified.

What are the Health Benefits of Supplementing with the Amino Acid L-arginine?
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Written by Robert Anderson M.D. and Perry Chinn, D.C.   
Monday, 21 February 2011 17:11


here has been a flurry of discussion, speculation and even hard to believe health claims surrounding the supplementing of the amino acid L-arginine.

L-arginine is considered a conditionally-essential amino acid, meaning that it is not found in sufficient levels in the “normal” human diet. Amounts that produce the clinical effects suggested by research highlighted below must be received in supplement form.  In 1998 the Nobel Prize for physiology or medicine was awarded to three scientists for their discovery of the signaling properties of nitric oxide on the cardiovascular system.

L-arginine stimulates the natural production of nitric oxide (NO) in the cardiovascular system. The formation of nitric oxide is dependent on the action of endothelial nitric oxide synthase (eNOS) on its substrate L-arginine.1 Nitric oxide’s enhancement of blood vessel compliance manifests its salutary effect in hypertension, decreased peripheral vascular resistance and enhanced cardiac function.2,3 Downstream metabolites of nitric oxide improve vasocompliance and enhance capillary circulation, enhance inflammation control and cognitive function, and equilibrate neurotransmitter function.  Some research is indicating that nitric oxide might be one of the most important signaling molecules of the body.

This nitric oxide science went on to be used in the synthesis of the family of male enhancement drugs while the major natural heart health benefits were largely ignored.

NO concentrations are also known to decrease with advancing age.4 Food sources of L-arginine include wheat germ, oat flakes, cheese, cottage cheese, eggs, whole milk, chocolate, yogurt, pork, chicken and turkey and avocado.5

To date, L-arginine has been used primarily as a supplement to enhance muscle mass in athletes as well as increasing circulation.  More recently, in concert with other amino acids (including L-citrulline)6 and other nutrients, the more significant effects of nitric oxide health are becoming more evident.

The rationale behind recommending an L-arginine nutrient blend to patients is based on its ability to support optimal cardiovascular function and control inflammation, two very significant players in virtually every metabolic process in the body.


L-Arginine and heart health:  The Science

The benefits of good nitric oxide levels supported by sufficient intake of an L-arginine product include greatly decreased risk of a cardiovascular event. Endothelial damage is crucial for the progress of atherosclerosis; risk factors for atherosclerosis represent crucial factors associated with endothelial dysfunction. Patients with cardiovascular disease are characterized by impaired endothelial function and several agents have been proposed as potential modulators include antioxidants and L-arginine.7

L-arginine stimulates the natural production of nitric oxide (NO) in the cardiovascular system.

Asymmetric dimethylarginine (ADMA) inhibits production of nitric oxide by competing with arginine for nitric oxide synthase binding. Since ADMA has been implicated as a cardiovascular risk factor in congestive heart failure,8 increased carotid artery intima-medial thickening,9 chronic kidney disease,10 L-arginine supplementation has therefore been indicated as a treatment in cardiac diseases.8

Nitric oxide synthase, the enzyme responsible for nitric oxide formation, has been found in the hypothalamus and pituitary gland itself.  Nitric oxide down-regulates the release of corticotrophin releasing hormone from the rat hypothalamus in vitro, suggesting its role in regulating the secretion of pituitary ACTH and of corticosteroids from the adrenal cortex. These results are direct evidence that endogenous NO significantly inhibits the HPA response to central stimulation under in vivo conditions.11 In socially organized mammals, the predominating stressors are not physical events but arise from the immediate social environment. In laboratory rats, social stress inhibits the modulating nitric oxide effect on the corticotrophin releasing hormone-induced ACTH response.12



Because the combination of high stress and suboptimal nutrition contributes to increased cardiovascular risk, the importance of reducing that risk with supplementation with L-arginine is even more advisable for our patients.  The science supporting the benefits of supplemental L-arginine is underscored by almost two decades of research and thousands of scientific papers and articles.  This humble amino acid, properly combined with a supporting blend of nutrients, can provide a very powerful tool to strengthen the body’s resistance to one of the highest health risks of modern day life.


Dr. Chinn is a 1986 Life graduate (Marietta) and has been practicing in Seattle for 24 years and is a board member of the Gonstead Clinical Studies Society.  He is the co-creator of the nutritional cardiovascular formula Acctrix, co-founder of Unisal Wellness Technologies and is the author of Symphony of Wellness and Soaring Beyond Fear.  His book Symphony of Wellness focuses on the science and benefits of L-arginine and nitric oxide for cardiovascular health.  He can be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Bob Anderson, M.D., University of Washington Medical School, is the founding president of the American Board of Integrative Holistic Medicine and an Adjunct Faculty Instructor at Bastyr University.  He is the chief medical consultant for Unisal Wellness and contributing advisor for Unisal Wellness. He is the author of several books, including Clinician’s Guide to Holistic Medicine, published in 2001.



1.  Joshi, MS, et al.  Receptor-mediated activation of nitric oxide synthesis by arginine in endothelial cells.  Proc Natl Acad Sci U S A 2007; 104:9982

2.  Davies, SA, et al. Neuropeptide stimulation of the nitric oxide signaling pathway in Drosophila melanogaster Malpighian tubules.   Am J Physiol 1997; 273:R823

3.  Yin H, et al.   Nitric oxide mediates cardiac protection of tissue kallikrein by reducing inflammation and ventricular remodeling after myocardial ischemia/reperfusion. Life Sci 2008; 82:156

4.  Dumitriu IL, et al. [New insight into nitric oxide involvement in regulation of airways smooth muscle tone] in Romanian. Rev Med Chir Soc Med Nat Iasi 2007; 111:454.

5.  Braverman, ER, Pfeiffer, CC. The Healing Nutrients Within. New Canaan, CT, Keats Publishing, 1987  p. 169.

6.  Romero, M, et al.  Therapeutic use of citrulline in cardiovascular disease. Cardiovasc Drug Rev 2006; 24:275

7.  Tousoulis, D, et al.  Endothelial dysfunction: potential clinical implications.  Minerva Med 2010; 101:271.

8.  Visser, M, et al. The role of asymmetric dimethylarginine and arginine in the failing heart and its vasculature. Eur J Heart Fail 2010; 12:1274.

9.  Riccioni, G et al. Relationship between asymmetric dimethylarginine and asymptomatic carotid atherosclerosis. J Biol Regul Homeost Agents 2010; 24:351

10. Mihout F, et al. Asymmetric dimethylarginine (ADMA) induces chronic kidney disease through a mechanism involving collagen and TGF-β1 synthesis. J Pathol 2011; 223:37

11. Bugajski J, et al. Mediation by nitric oxide of the carbachol-induced corticosterone secretion in rats. J Physiol Pharmacol 1997; 48:277.

12. Bugajski J.  Social stress adapts signaling pathways involved in stimulation of the hypothalamic-pituitary-adrenal axis.  J Physiol Pharmacol 1999; 50:367.

Sports Nutrition: A Perspective on Prevention
Written by David R. Seaman, D.C., M.S., D.A.B.C.N., D.A.C.B.N.   
Monday, 24 January 2011 16:57

athleteeatingMental state or supplements for an improved performance?

There is little evidence to support the notion that we can take nutritional supplements and improve performance or increase strength in a significant fashion. In all likelihood, the mental state of the athlete is the deciding factor. An example of this was a placebo study that involved the perceived use of anabolic steroids. Wilmore and Costill describe this study in their exercise physiology text (1). Fifteen male athletes who had been heavily involved in weight-lifting for the previous volunteered for a weight-training experiment. They were told that those who made the greatest strength gains over the preliminary 4-month training period would be selected for the second phase of study in which they would receive Dianabol.

Six subjects were enrolled in the second phase of the study, which consisted of a 4-week period of training. At then end of the second phase, the strength gains achieved during the last seven weeks of the competition phase were compared to the 4-week placebo period during which the subjects thought they were getting the anabolic steroid. There was only a 2% improvement in strength during the last seven weeks of the competition phase compared to a 10% improvement in just four weeks during the placebo phase.

A personal example takes me back to my high school days. I was a high jumper and my best jump was 6’2” at the time of our county championships during my senior year. At that point I was working 3 nights per week to make money so I could pay for a bike trip that coming summer. A buddy and I decided to pedal from our town in New Jersey to Daytona Beach.

The night before the county championship I bussed tables for 8 hours until after midnight and only got about 4 hours sleep, which was highly irregular for me during my intensely heavy sleeping high school years. So I show up to the event too tired to worry about my performance and fully not expecting to do well, so I was relaxed, carefree and unattached to the outcome. To my surprise, and everyone else, I jumped 6’6”, won the championship, and was told that I cleared 6’5” by at least six inches.

If they only made bottles of “relaxed, carefree, and unattached to the outcome” pills, I would likely have done much better in other high school sports and probably often shoot in the low 70’s when I play golf now.

Eating better for performance?

Between games they would munch on various snacks, including soda, candy, chips, and the like.

A friend of mine helped to coach his daughter’s weekend lacrosse team. They would often play two games in a row and most of the girls on both teams were dragging by the middle of the second game. Between games they would munch on various snacks, including soda, candy, chips, and the like.

So, one season he changes the between-meal dining option to vegetables, fruit and nuts, and educates the girls and parents to similarly avoid the unhealthy elsewhere. By the third weekend, his team was plowing through the second game without fatigue, which was associated with more victories. I realize this is an anecdote, however, it is certainly worth a try and has overall health benefits that have been established.

Avoiding the pro-inflammatory state and reducing injuries?

Dyslipidemia has been associated with tendinopathy expression. For example, lipid deposition is known to occur in tendons, high cholesterol levels have been observed among individuals with Achilles tendon rupture, and the esterified fraction of cholesterol is elevated in biopsies from Achilles tendinopathy subjects (2).

In another study, anthropometric measures were determined in elite level volleyball players over the age of 18 with patella tendinopathy. Male players with a waistline of greater than 33 inches appear to at greater risk for developing tendinopathy. The authors state that the additional weight may excessively load the patella tendon and also suggest that, “as waist girth is an accurate anthropometric surrogate for abdominal adipose tissue, free fatty acids and cytokines released by abdominal adipose tissue may have a role in tendon pathology” (3).

Whether due to excess body weight or increased inflammation, or both, maintaining appropriate abdominal girth appears to be important for male volleyball players looking to avoid patella tendinopathy. The fashion in which this may apply to other sports and types of injuries is not presently known; however, this should not stop of from getting patients to maintain appropriate abdominal girth.

The best operational approach to nutrition for athletes

A diet that is rich in nutritious foods, including vegetables, fruit, nuts, lean meat, fish, tubers, and certain seeds such as chia and hemp appears to be the best option. This approach reduces inflammation and prevents cardiovascular disease and diabetes (4). Supplements that help to reduce inflammation and support metabolism include a multivitamin, magnesium, fish oil, and vitamin D (5-9). Vitamin D may be of special importance for athletic performance, especially during winter months (10).


Dr. David Seaman is a Professor of Clinical Sciences at NUHS-St Pete and is a Clinical Consultant for Anabolic Laboratories. He has written numerous articles on the treatment options for chronic pain patients, with a focus on nutritional management.

He can be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


1.  Wilmore JH, Costill DL. Physiology of sport and exercise. Champaign, IL: Human Kinetics. 1994: p.321-322.

2.  Gaida JE et al. Dyslipidemia in Achilles tendinopathy is characteristic of insulin resistance. Med Sci Sports Exerc. 2009;41(6):1194-97.

3.  Malliaras P, Cook JL, Kent PM. Anthropometric risk factors for patellar tendon injury among volleyball players. Br J Sports Med 2007;41:259-63.

4. O’Keefe JH, Gheewala NM, O’Keefe JO. Dietary strategies for improving post-prandial glucose, lipids, inflammation, and cardiovascular health. J Am Coll Cardiol. 2008;51:249-55.

5. Ames BN. Increasing longevity by tuning up metabolism. To maximize human health, lifespan, scientists must abandon outdated models of micronutrients. EMBO Rep. 2005;6(S1):S20-S24.

6. Church TS, Earnest CP, Wood KA, Kampert JB. Reduction of C-reactive protein levels through use of a multivitamin. Am J Med. 2003;115:702–707.

7. King DE, Mainous AG, Geesey ME, Egan BM, Rehman S. Magnesium supplement intake and C-reactive protein levels in adults. Nutr Res. 2006;26:193-96.

8. Simopoulos AP. The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med. 2008;233:674-88.

9. Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008;87(suppl):1080S-86S.

10. Cannell JJ, Hollis BW, Sorenson MB, Taft TN, Anderson JJ. Athletic performance and vitamin D. Med Sci Sports Exerc. 2009;41(5):1102-10.

The Future of Chiropractic Services in America
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Written by Christopher Fuzy, M.S., R.D., L.D.   
Friday, 21 January 2011 11:54

cornucopiahealthydietMy New Year’s Resolution—Is Now the Time to Build or Elevate My Practice with Nutrition? A Clinical Nutritionist’s Expectation

A majority of your patients committed themselves to a health related New Year’s Resolution on January 1st. Studies show they will implement a nutrition or exercise program in the next 3 months as a result of their desire to improve their health. Are you and your staff ready to grab a piece of this multi-billion dollar industry yet? Most likely, if you’re a chiropractor in America, you will eventually have to incorporate a multitude of services to leverage your practice, just to be able to survive. Due to insurance cutbacks, shrinking income, and a genuine desire to be a well-rounded holistic practitioner, chiropractors are aggressively searching for new clinical services and approaches to wellness to Incorporate into their practices. In the next decade, I predict that the chiropractic profession will continue to emerge as major providers for wellness and nutritional therapies. Recently, I see more chiropractors incorporating lifestyle counseling and long term (behavior modification) nutrition programs into their practices for their patients, in addition to providing nutritional supplements and detoxification therapies that many offer now.

I predict that the chiropractic profession will continue to emerge as major providers for wellness and nutritional therapies.

Having trained over 700 physician practices with Lifestyle counseling programs in the past 20 years, I have experienced many changes within the chiropractic profession. Chiropractors (and most medical professionals) are getting frustrated with insurance company cutbacks and are now aggressively diversifying their practices with nutrition. Nutritional supplement companies heavily market to chiropractors and, as a result, many are becoming vitamin dispensers. Network marketing companies jump at the chance to incorporate chiropractors as their distributors, since many see a high quantity of weekly patients and are looked at as "wellness" providers by their patients. Also, chiropractors, compared to most health practitioners, have a good business sense about them and often are natural "marketers". The challenge with any medical professional is to have a balance between your patients’ clinical needs and your practice’s business needs, with effective patient outcomes based on valid research.

Looking at the multitude of health practitioners in America, chiropractors have been well trained in musculoskeletal, and neurophysiology systems of the human body, which naturally provides a strong clinical foundation to be able to run with nutrition in your practice, if you desire to do so. With advanced nutritional training and certifications available, many chiropractors have obviously specialized in nutrition with their chiropractic practices to be able to have an edge on their competition.

Generally, practitioners have varied nutritional approaches to nutritional counseling, and many are continuously looking for the next "magic bullet", especially your patients! Traditional medical doctors predominantly use medications, appetite suppressants, B12 injections, meal replacements, and bypass surgeries to promote weight loss and disease management. Also, many MDs provide their patients with generic pharmaceutical diet sheets. DOs, like chiropractors, have traditionally been trained to incorporate physical medicine and obviously some holistic nutrition and conventional pharmaceutical approaches to weight loss and disease prevention. Acupuncturists and naturopaths specialize in homeopathy, herbal and energy medicine with some physical medicine and incorporating an Eastern Medicine philosophy. Lastly, personal trainers have incorporated nutrition counseling in their services, often focusing on supplements and a basic elementary "diet" with stringent food restrictions for fat reduction and weight loss, usually with little emphasis on disease prevention or management.

The 2011 Whole Food Approach to Holistic Nutrition Counseling Based on Evidence-based Research

Which health practitioner in the US now effectively specializes in Holistic nutrition counseling using real food as it pertains to disease prevention and weight loss with a program that addresses the relationship that individuals have with eating? Commercial weight loss companies have turned this into a multibillion dollar industry; the average cost to lose 20 lbs. is $1,000-$1,600 in America. Nutri-System, Jenny Craig and now many "medical" programs focus on delivering packaged foods to patients for weight loss that are filled with preservatives and additives that are contra indicated for wellness and disease prevention. Programs that just focus on point counting and food restrictions may create a psychological hardship which typically increases hunger and cravings and could lead to food dependency or even a food obsession over time. Dietitians, such as myself, are traditionally trained to focus nutrition counseling with food and teach patients how to scientifically and intuitively eat. The traditional dietetic training has a conventional approach rather than a homeopathic, complimentary approach to counseling and, in the past, did not incorporate many of the holistic philosophies that chiropractors often recommend for their patients. However, many dietitians, chiropractors, and physicians have advanced their training through certifications and courses to include homeopathic, nutraceutics, and detoxification and energy medicine, which I feel has its place with nutritional counseling for many patients in America and will have a positive effect on patient outcomes in practice income.

healthyfoodOur philosophy is as a result of private counseling with patients in our clinics, and consulting with doctors nationwide. We incorporate a proprietary metabolic analyzer and software that your assistant, CA or a "wellness coach" can customize a sliding scale nutrition and exercise program based on the patient’s metabolic rate, age, height, weight, lean mass and activity level for weight loss, gain or maintenance. Our focus is to manage patient blood sugar swings effectively, without having to count carb grams, food groups or calories or providing unnecessary food restrictions. Managing blood sugars effectively usually decreases hunger, cravings, or fatigue. Our program can accommodate most patient or physician philosophies, such as Atkins, Zone, Paleolithic, Fibromyalgia or even the HCG diet protocol.

We also provide clinical protocols for hyperlipidemias, pre-diabetes, metabolic syndrome, fatty liver disease, sports nutrition, pain management, chronic fatigue, migraines, etc., which incorporate conventional and alternative approaches, including specific nutritional supplements and quantities recommended to help manage medical or nutritional challenges naturally.

The key to motivating your patients to embrace changing their eating habits and adopting a new lifestyle is to provide 4-12 weekly nutritional sessions that spell out in detail what and why patients should eat at home, in restaurants, or while traveling or entertaining. For our patients, we provide specific weekly goals, shopping lists, simple recipes, menus and the specific name brand foods that we recommend for each and every patient based on their food preferences, lifestyle, medical/nutritional needs and budget.

Lifestyle counseling programs based on patients’ eating real food are significantly less expensive to the patient, more profitable for the doctor, and market very well in today’s economic climate. Many of the chiropractors that we have consulted feel that patients like to eat whole healthy natural food and appreciate not being obligated to purchase diet products. Also, they feel focusing on long term lifestyle changes is personally rewarding to the doctor and effectively builds loyal, happy, referring patients within their practices.


Christopher Fuzy, M.S., R.D., L.D., is the Founder of, has a Master’s Degree in Clinical & Sports Nutrition, and has offices in Ft. Lauderdale and Boca Raton, FL. Over the past 20 years, he has trained over 700 physicians nationwide in the implementation of his Lifestyle Nutrition Counseling Program®. For more information or to try your own nutritional program, visit or call 1-800-699-8106.

Provide Far-Reaching Benefits Using a Lifestyle Nutrition Counseling Program
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Written by Howard Berg, D.C., C.C.S.P., and Christopher Fuzy, M.S., R.D, L.D/N.   
Wednesday, 22 September 2010 13:32

Provide Far-Reaching Benefits Using a Lifestyle Nutrition Counseling Program

by Howard Berg, D.C., C.C.S.P., and Christopher Fuzy, M.S., R.D, L.D/N.


As chiropractors, most of the nutritional counseling programs we offer our patients focus on nutritional supplements. Occasionally, meal replacements or packaged foods are recommended. Go to the weight management section in your local yellow pages. Everybody is advertising medications, packaged foods, meal replacements or expensive, network marketing weight loss and detox products. Typically, our patients would buy those products and/or foods; they would lose some weight, eventually stop taking the products, and then gain that weight back, plus some.

Some of our patients have tried menu-planning web sites that send recipes and general menus weekly. But a recent study, performed by the University of Pennsylvania’s Department of Weight & Eating Disorders Program, found that these "one-size-fits-all" meal plans are not that effective. The study, published in the Obesity Research Journal, followed forty-seven women over the course of a year.

The women were provided one year of intensive motivational menus, e-mails (two to three times per week), articles, food recipes, food journals, calorie-logging and exercise suggestions. The results of the study found that the internet counseling participants only lost about four percent of their body weight after one year of counseling. The authors concluded, "These findings suggest that consumers are unlikely to achieve clinically significant weight loss by using internet programs that provide primarily information about diet and physical activity."1 We are learning that face to face individualized health risk assessments, office-based nutritional counseling and wellness programs are more effective and generate significantly more nutritional referrals than internet based nutrition counseling programs.

Personalizing Nutritional Seminars & Corporate Wellness Programs Using Health Risk Assessments

Nutritional Workshops can be a great tool for driving new patients to your door. Who doesn’t want to lose weight? With a little leg work, a power-point presentation that reviews, and an effective program that can deliver accurate, individualized nutrition counseling and health risk assessment to groups or individuals, the process can be fairly simple. Effective workshops can be done either in your office, locally at hotels or corporations, at community gatherings or at local small businesses.

You can use a power point presentation that corresponds to the client’s health risk assessment report. First, you distribute the Health Risk Assessment forms to all your attendees at the beginning of the workshop. By reviewing each page, while the clients have reports that provide specific lifestyle recommendations, it will make them feel that the seminar is individualized for them. This is the most personalized way to deliver nutrition counseling and health risk assessment to groups. Also, any reports you provide to your clients should carry the practice name and phone number on it, to make follow-up office appointments for chiropractic or nutrition counseling.

The Secret of Generating Significant Chiropractic Referrals to Your Practice

Here’s the secret! You must offer something to the community that your competition is not. In this time of financial awareness, people are looking for more value for their dollars. If you can offer customized and personal nutritional programs to each patient, that has been validated by the University of Southern California, without selling nutritional products and giving them unrealistic food restrictions, and still get results—you will be very busy!

One of the keys will be to provide a program, based on the patient’s food preferences, metabolic rate, age, height, weight, lean mass and activity level. You can be assured that the patients will get the clinical results they are looking for—without hunger or fatigue. When you provide a program which is based on education and long-term behavior modification techniques, and your patients are seeing results, your office will be flooded with referrals.

You can teach your chiropractic assistant to do quick Health Risk Assessments and patients will jump at the opportunity to receive one. The Consumer Center for Public Interest (CSPI) conducted a study, which showed the average commercialized weight loss program in America costs from $960 to $1,600 per client to lose 20 pounds. These programs were not physician supervised and, generally, patients regained the weight they had lost after they stopped buying the nutritional products.

Depending upon your market, you can charge anywhere from $395 to $495 for a four to six session package of individualized weekly nutritional sessions, or approximately $295 per client, for group workshops that focus on eating real food. This means, that you can offer a program, based out of your office that costs less than one-third of the national average for a nutrition/weight-loss program. When your patients see the value of this, not only will they be more likely to participate, they will be more likely to refer, as well.



Howard BergHoward Berg, D.C., C.C.S.P., graduated from Life Chiropractic College in 1997. He holds certifications as both a Golf Fitness Instructor and Yoga Instructor. Dr. Berg is the owner of Island Chiropractic and Wellness Center, located on St. Simons Island, Georgia.


Chris FuzyChristopher Fuzy, M.S, R.D., L.D., has a Masters degree in Clinical & Sports Nutrition and undergraduate degrees in nutrition and chemistry and has implemented and trained over 700 physicians nationwide with the Lifestyle Nutrition program in the past nineteen years.For more information or a Practice Consultation, go to or call 1-800-699-8106.


1. Obesity Research Journal, 2004 Jun;12(6):1011-8.


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