Physical Activity and Good Nutrition
It’s a sad fact that chronic disease accounts for seven of every ten U.S. deaths, and for more than 60% of medical care expenditures. The prolonged illness and disability associated with many chronic diseases decrease quality of life for millions of Americans.
The chiropractic profession long has taken the stance that, with proper intervention and education, most chronic diseases are preventable. Physical inactivity and unhealthy eating contribute to obesity, cancer, cardiovascular disease, and diabetes. Together, they are responsible for at least 300,000 deaths each year. Only tobacco use causes more preventable deaths in the United States. Chiropractors, with a wellness orientation, teach their patients to avoid the behaviors that increase their risk for chronic diseases so that they can live healthier and longer lives.
Obesity has reached epidemic proportions in the United States where over 45 million adults are classified as obese. A disturbing trend shows that this epidemic is not limited to adults. The percentage of young people who are overweight has more than doubled in the last twenty years! 10%-to-15% of Americans ages six-to-seventeen years—about eight million young people—are considered overweight.
More and more patients are seeking the trusted advice of their doctors of chiropractic in matters of nutrition. It’s a fact that chiropractors receive significantly more hours of education in the subject of nutrition than their medical colleagues. Chiropractors must take an active role in promoting regular exercise and healthy eating.
Lack of Exercise
Exercise substantially reduces the risk of dying of coronary heart disease, the nation’s leading cause of death. It has also been shown to decreases the risk of colon cancer, diabetes, and high blood pressure. Exercise also helps to control weight; contributes to healthy bones, muscles, and joints; reduces falls among the elderly; helps to relieve the pain of arthritis; reduces symptoms of anxiety and depression; and is associated with fewer hospitalizations, physician visits, and use of medications.
Exercise does not need to be strenuous to be beneficial. People of all ages benefit from moderate physical activity, such as thirty minutes of brisk walking, five or more times a week. However, despite the proven benefits of physical activity, more than 60% of American adults do not get enough exercise to provide health benefits. More than 25% are not active at all in their leisure time.
As with obesity, insufficient exercise is not limited to adults. More than a third of young people in grades 9-12 do not regularly engage in vigorous exercise. Daily participation in high school physical education classes dropped from 42% in 1991 to 29% in 1999.
Although Americans are gradually adopting healthier diets, a large gap remains between recommended dietary patterns and what Americans actually eat. Only about one-fourth of U.S. adults eat the recommended five or more servings of fruits and vegetables each day. Poor eating habits are often established during childhood. More than 60% of young people eat too much fat, and less than 20% eat the recommended five or more servings of fruits and vegetables each day.
Vegetables without Vitamins
Even when your patients do consume the recommended servings of fruit and vegetables, often what they eat is devoid of nutritional value. When a nutritionist recently went to check out the latest US Department of Agriculture food tables, he found that some vegetables had extraordinarily low levels of vitamins. The explanation he received was that the nutrient drain should be put in context. It was explained that the 78% decrease in calcium content of corn was not significant because no one eats corn for calcium! Furthermore, he was told, the problem may not even exist at all. The apparent nutrient dips result from the testing procedures. For example, changes in the public’s perception of what the edible portion is may determine what parts have been analyzed over time. In other words, back when the old food tables were made up, people may have been eating the corncob, too, so they got more nutrients. So now you know why people need their vitamins!
Many chiropractors are contemplating whether or not they should offer vitamin and nutritional supplements to their patients. One thing is clear, whatever doctors think of it, your patients have already made up their minds!
Nutritional supplements are big business, and a significant proportion of the population is taking them. It’s estimated that about half of all Americans regularly use nutritional supplements not prescribed by their doctors. A quick trip to the local health food store will reveal tablets with every imaginable combination of nutrients, vitamins, herbs, homeopathic remedies, whole food products, neutraceuticals, and more, in countless doses and formulations. And it’s not just the health food store. These days, the local pharmacist and even the supermarket offer much the same spectacle. Vitamin companies spend millions of dollars in advertising hoping to convince the consumers to buy their brand. Catchy phrases and fancy buzzwords are used to entice, stimulate and often mislead the general public.
More doctors are selling health-related products and, for this reason, it is important that you select reputable nutritional supplement companies. Chose companies that use an FDA approved laboratory, conduct regular ingredient assays, and those that manufacture nutritional supplement formulas that make sense. A word of caution: Prior to dispensing nutritional supplements to your patients, you should check the scope of chiropractic practice in your state. The scope of practice varies from state to state when it comes to dispensing supplements. The chiropractic scope of practice in the state of New Jersey, for example, does not allow chiropractors to “sell, dispense or derive any financial benefit form the sale of vitamins, food products or nutritional supplements.” By contrast, the chiropractic scope of practice of the state of New York allows chiropractors to perform “nutritional counseling, including the dispensing of food concentrates, food extracts, vitamins, minerals, and other nutritional supplements.”
When prescribing supplements to your patients, be sure to perform a thorough drug and dietary history. Many supplements can produce unwanted side effects when taken in combination with prescription and over-the-counter drugs. For example, one popular herbal remedy, Saint John’s Wort, is now known to interfere with the action of a wide variety of prescription medications. To help keep you up to date about the nutritional supplement market, the publishers of the Physicians’ Desk Reference recently released the PDR for Nutritional Supplements, which provides scientific analyses of the health benefits—or lack of—for hundreds of over-the-counter products ranging from vitamins to shark cartilage.
A good relationship with the supplement company’s sales representatives can also be very helpful. An effective sales representative will keep you informed of the latest advances in their product line and will also provide you with useful patient education materials. Some nutritional supplement companies provide physicians with nutritional surveys and assessments that are helpful in determining the supplementation needs of your patients. Others provide seminars with credentialed experts on a variety of nutrition-oriented topics. Those doctors who are considering adding nutritional supplements to their practice would do well to sharpen their clinical skills with continuing education courses on the subject. Those chiropractors who become passionate about the possibilities of nutrition can also complete a 300-hour course of studies toward a Diplomate through the American Board of Chiropractic Nutrition.
Chiropractic care does not exist in a vacuum. Good nutrition plays an integral role in the maintenance of optimal health. When properly researched, and effectively managed, advising your patients to include nutrition as part of their overall approach to wellness makes good sense. TAC
Dr. Mark Sanna is the CEO of Breakthrough Coaching, LLC, the leading resource for personal coaching to chiropractic and multidisciplinary practices throughout the country.
He can be reached at Breakthrough Coaching, LLC, by calling 1-800-7-ADVICE.