Written by Dr. Dick Versendaal
Tuesday, 25 June 2013 21:11
r. Dick Versendaal trains chiropractors to offer solutions for obesity based upon uncovering the root cause for each individual patient. The solutions are based upon supporting the body as it works together as a whole—structurally, nutritionally, and emotionally.
Over the past 50 years he has found that the body will twist, turn, swell, and even “hold on to” excess fat and fluid as a means to protect itself or compensate for a lack of support—nutritionally, structurally, and/or emotionally—in another area. If left unchecked, this constant state of compensatory stress creates a domino effect of imbalance and dis-ease that spreads throughout the entire body. The body is tired. The brain is tired. The heart is tired. When the heart is tired, the body swells with fluid. Tired bodies crave heavy foods, sugary foods… anything that will help them function one moment longer. Weight is gained and difficult, if not impossible to lose until the cause is corrected.
Because of this domino effect, by the time a person becomes obese multiple system and organ imbalances are involved. The most common are structures, heart, bladder and kidneys, digestive system, and emotions. In order to restore balance to the body, these systems need to be supported and brought back to optimal function so the body can heal and be free to release the excess fat and fluid.
Dr. Versendaal begins by reinforcing the structural balance of the body with CRA-Flex® orthotics by FootLevelers. CRA-Flex® orthotics are designed to support the heart, adrenals, thyroid and brain through the feet. Fully functioning feet work as both shock absorbers protecting the structures and as energy pumpers to the heart and brain. To further balance the structures he focuses on weekly adjustments of the spine T6-T10, which innervates the digestive and elimination organs.
To support the balance, restoration and function of the other systems of the body, Dr. Versendaal uses the professional quality nutritional protocols and pure essential oils of VerVita Products. These are free of wheat, soy, sugar, shell fish and dairy—those things that overwhelm an already tired body. The formulas are designed to support systems of the body along with their backup systems as they work together as a whole. For obesity, the nutrition and essential oil of choice is Cir-Q Tonic® and Immune Harmony® for the kidneys and bladder. For the digestive system it is Klenz, GastroDigest II® and Black Cumin essential oil.
Along with a healthy diet of real food, real portions and moderate activity, getting the body back into balance and sustainable wellness is not only a possibility, but a reality for those who not only want to shed pounds, but to be healthy in all aspects of life.
Written by Ron Grisanti, DC, D.A.B.C.O., D.A.C.B.N., MS and Rick Bramos
Tuesday, 25 June 2013 20:33
verwhelmingly, research studies are delivering staggering statistics: approximately two-thirds of the American population is overweight, and nearly half of those folks are obese.
The causes of obesity are assumed to be well known: too much food and too little exercise. As healthcare professionals, we have an obligation to help our patients by educating them on the right course of action to reverse the trend. We also have an opportunity to move past the generic recommendation of “exercise and eat right.” We must challenge ourselves to explain what constitutes good nutrition and effective exercise for this population.
We recommend a three-pronged approach for our obese patients. It tackles the key areas that often combine to produce failure. Our goal as healthcare professionals is to enable our patients to be successful in their weight loss goals. The three components include:
- Identify what constitutes good/proper nutrition.
- Incorporate a realistic strength training program that doesn’t overwhelm or over-complicate.
- Educate patients on up-to-date research that sheds the truth on salt, sugar (especially fructose), and saturated fats.
While lack of exercise is constantly cited as a major cause of obesity, the facts do not support this sweeping generalization. We have come to realize that the majority of people who rely on exercise to lose weight are extremely frustrated with the results.
Numerous studies over the last three decades show that exercise, in general, is not particularly effective at reducing fat stores. We know people who spend a lot of time in the gym, on the treadmill or stair stepper, who never see any lasting benefits. We also all know people who have lost weight on an effective eating plan without exercise.
The healthcare system’s bland and undocumented recommendation to be “active” is a simplistic and ineffective approach to obesity. So, what can we offer our patients as a realistic “single-pronged” approach to better health and fitness?
We need to tell our patients that the most essential part of a weight loss program is maintaining glycemic control or maintaining normal blood sugar and brain sugar levels. We need to explain that clearly by impressing the fact that reducing the consumption of refined starches and sugars—especially fructose—will result in weight loss and lower blood pressure, both of which will reduce the likelihood of diabetes.
The fructose phenomenon
There is compelling new evidence linking fructose consumption to increased uric acid levels, which is intricately linked to obesity and associated health problems such as diabetes and hypertension. Fructose is the most pernicious type of sugar. It contributes to glycation, a pathological aging process, more than any other sugar. The oxidative damage caused by glycation, and its cascading effect on the tissues of the vascular system, renal capillaries (kidneys), joints, retinal capillaries, and the skin (wrinkles), will surely grab our patients’ attention.
Dr. Mehmet Oz and others proclaim that Americans should add more fruit to their diets. The blanket statement that fruit is always an acceptable part of the diet does not hold true for those with a problem regulating blood sugars. Fructose content is particularly high in some fruits, such as raisins, grapes, prunes, plums, figs, dates, cherries, pears, bananas, berries, apples, and watermelon, as well as honey, ordinary sugar, and corn syrup. Is that to say no one should eat fruit? Of course not. Everyone has an individual tolerance for fruit.
For those who proudly claim they are juicers, the concentration of fructose is even higher than in whole fruit. There is nothing natural about consuming large quantities of juice. You may have heard or know someone who has lost weight juicing. More than likely, the weight loss was a result of a dramatic reduction in the total amount of sugars and carbohydrates they were consuming before juicing.
The skinny on fat
At the other end of the nutritional spectrum, educating patients on the importance of fats, especially saturated fats, is often more challenging.
Fats are one of the body’s most important nutrients. Scientific research clearly shows that saturated fat does not cause degenerative diseases; it actually protects against them. Fats are essential for hormone production and for slowing down the aging process.
For more than forty years, Americans have been duped into believing that fats are the culprits in their weight loss failures. However, groundbreaking studies show that a high fat intake upregulates key enzymes (lipase), which break down dietary fat and body fat. It seems counterintuitive to most Americans, but a high fat intake can actually lower body fat!
The body is an amazing organism: highly regulated and fine-tuned. Making changes across the board is important because switching to a high fat diet without limiting or removing carbohydrates will result in body fat accumulation. If we emphasize how foods affect hormones and fat storage, we de-emphasize the requirement to compensate for bad dietary choices with excessive exercise.
Working out the time to work out
Time is a very relative factor for most people when trying to work exercise into a hectic lifestyle. The recommendation to exercise for at least 30 minutes a day for five, six, or seven days usually has a negative effect on compliance for obese and overweight patients.
The goal is to set your client up for success. Don’t overwhelm and stress out the non-athletic, overweight, and obese population with formulas for failure. A successful exercise program must show immediate, incremental accomplishment and be as stress-free as possible.
Our expertise with the obese/overweight population clearly demonstrates that a new approach to fitness is necessary. First, it’s important to make a realistic assessment of immediate needs. It is critical to understand the extremely different exercise protocols available to this group, and the relative effectiveness each has on influencing weight loss. Making an exercise protocol accessible and doable is an important part of the equation.
Based on the tremendous clinical improvement we have witnessed with the obese market, we firmly are convinced that the healthcare system has overcomplicated exercise for the population interested in only health and fitness. Trainers are overemphasizing endurance training, such as running and aerobics, for the obese and overweight population, which is not prudent or appropriate. This kind of training does little to promote muscle, and provides little metabolic stimulus post-workout.
Because muscle is where fats and sugars are metabolized, it should be a priority for this group to maintain and build muscle as it helps normalize blood sugars seven days a week.
With years of experience under his belt, Rick Bramos believes the average overweight person does not need the endurance of an athlete, but instead needs to engage in strength training to wake up dormant muscle fiber and even add a few pounds of this metabolically active tissue. Because muscle is where fats and sugars are metabolized, it should be a priority for this group to maintain and build muscle as it helps normalize blood sugars seven days a week.
Resistance training is inherently safe for all fitness levels regardless of age or gender. It packs a potent post-workout punch when executed properly.
Putting it all together
We believe that once your patients understand that losing weight (fat) is primarily impacted by what you eat, not necessarily how much, then all you need is two strategically planned workouts a week to stay fit and healthy for the rest of your life. Research has shown that someone can achieve and maintain sufficient gains in muscle and strength with only two workouts a week.
Two workouts a week are doable and that dramatically improves compliance, which leads to more positive clinical outcomes.
The following is a simple guide to present to patients who have issues with their weight:
- Keeping insulin levels low is the key to losing weight. With low insulin levels, exercise will accelerate weight (fat) loss because the body has access to the fatty acids that are stored in the fat cell. This is accomplished by limiting sugars and refined carbohydrates.
- Managing stress has a profound effect on weight gain because cortisol has an upregulating effect on the LPL receptors of the fat cells.
- Sleeping soundly is necessary for adequate growth hormone production.
- Matching the training approach with the patient’s goals and available time will improve long-term compliance, which supports normalized blood sugar levels.
- Addressing the biochemical glitches such as thyroid, environmental toxins that disrupt fat metabolism, and nutrient deficiencies.
Addressing obesity requires a multifaceted approach that meets the patient’s needs. A simple solution to our country’s chronic obesity problem is to pay greater attention to the root of the problem: the food that we eat.
As healthcare professionals, we can educate our patients by presenting them with the facts and solutions that truly work.
- Brooks G, Fahey T, Baldwin T, Exercise Physiology: Human Bioenergetics and Its Applications, McGraw-Hill Humanities, 4 edition (September 17, 2004)
- Brooks D, Effective Strength Training: Analysis and Technique for Upper-Body, Lower-Body, and Trunk Exercises, Human Kinetics; 1 edition (June 29, 2001)
- Faigenbaum AD, Milliken LA, Loud RL, Burak BT, Doherty CL, Westcott WL.Comparison of 1 and 2 days per week of strength training in children., Res Q Exerc Sport. 2002 Dec;73(4):416-24.
- Buchheit M, Laursen PB.High-Intensity Interval Training, Solutions to the Programming Puzzle, Sports Med. 2013 Mar 29.
- Westcott WL, Annesi JJ, Skaggs JM, Gibson JR, Reynolds RD, O'Dell JP., Comparison of two exercise protocols on fitness score improvement in poorly conditioned Air Force personnel., Percept Mot Skills. 2007 Apr;104(2):629-36.
- Reiser & Hallfrisch. "Metabolic Effects Of Dietary Fructose," CRC Press, 1987
- Ravinskov, Journal of American Physicians and Surgeons 8, No 3 (2003), 94-95. The retreat of the diet heart hypothesis. Journal of American Physicians and Surgeons 8, No 3 (2003), 94-95.
- Ling, P., et al. "Evaluation Of Protein Quality Of Diets Containing Medium and Long Chain Tryglicerides In Healthy Rats," Journal Of Nutrition 116, 343-9, 1986.
- Laitinen, M., et al., "Effects of Dietary Cholesterol Feeding On The Membranes Of Liver Cells And On The Cholesterol Metabolism In The Rat," International Journal Of Biochemistry 14 (3) 239-41, 1982
- Gary Taubes, Good Calories Bad Calories, Anchor Books, 2007
- Gary Taubes, Why We Get Fat, Alfred A. Knopf, 2011
- Michael Aziz, The Perfect 10 Diet, Cumberland House 2010
Ronald Grisanti D.C., D.A.B.C.O., M.S., is medical director of Functional Medicine University. If interested in improving your diagnostic skills and increasing your community reputation and recognition, we strongly recommend subscribing to our Free Clinical Rounds Series. These challenging case studies will give you the unique opportunity to test your clinical skills and, at the same time, improve your ability to handle many of the most difficult cases. Go to the following link to get your free access: www.ClinicalRounds.com.
Rick Bramos is a 35 year fitness veteran. He has successfully trained thousands of obese individuals using the latest scientific research on losing fat and getting fit. He is the author of the breakthrough book, 2 Days to Fitness (www.2DaystoFitness.com). He has had the privilege of sharing his experience and knowledge with a growing number of chiropractors. In turn, his fitness and training philosophy is making a significant impact on thousands of patients in the US and abroad.
Written by Eric Kaplan, D.C.
Friday, 01 June 2012 22:36
erry Seinfeld, in his bestselling book, 'Sein Language', states, “Everyone wants to be healthy, but no one knows where to begin.” We begin here-now-today.
My objective in life became making a difference in the Healthcare Crisis. The adulation of drugs and surgery that dominates our country’s consciousness needs to be changed. We need to stop treating the symptoms; we need to treat and remove the cause. Sublimations are key to our practice, but obesity is sweeping across our nation. More than one-third of U.S. adults (35.7%) are obese. Approximately 17% (or 12.5 million) of children and adolescents aged 2-19 years are obese. During the past 20 years, there has been a dramatic increase in obesity in the United States and rates remain high. In 2010, no state had a prevalence of obesity less than 20%. Thirty-six states had a prevalence of 25% or more; 12 of these states (Alabama, Arkansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Oklahoma, South Carolina, Tennessee, Texas, and West Virginia) had a prevalence of 30% or more.
My background is simple, I wrote my first book, LIFESTYLE OF THE FIT & FAMOUS, and appeared on almost every Good Morning show in America. Weight loss was an important part of my practice, but that was just the beginning. I later became President, COO, of Complete Wellness Centers, on (NASDAQ) Wall Street, where we acquired 50% of the weight loss company Nutrisystem. Yes, weight loss is big business, and I got to see firsthand the business structure. Just note this: how many commercials do you see on television for Nutrisystem, Jenny Craig, Weight Watchers? How many do you see for Chiropractic? Yet weight loss is something every chiropractor can provide in their office.
Recently, I had the pleasure to appear on the Dr. Oz Show. What a delightful man, what a unique experience. Prior to the taping we sat and talked about the changing landscape of health care in our world today. Dr. Oz, a Harvard trained surgeon, believes in prevention, and believes and acknowledges chiropractic. He believes in most aspects of alternative health care. We agreed that the best way to treat disease and reduce health care costs was to change the paradigm of treatment. We must stop just treating symptoms and start attacking the cause. Often the cause is our environment, the goods we eat. We live in a toxic world. The first key is to remove your body of these toxins. Dr. Oz believes an educated patient is the key to our success in this country.
Just imagine, last year 300,000 people died as a result of obesity. It is the #2 preventable cause of death in our country. Obesity is related to a poor health paradigm. It is your job as a physician to explore a patient’s health history. Yet this is something we can provide to our patients. Weight loss is big business, a billion dollar industry, one that we as doctors should tap into.
Patients come in to lose weight for two basic reasons:
Unfortunately, cosmetic reasons motivate the patients more than health. It is the physician’s job to explore the latter. By providing weight loss with chiropractic care, you can build your practice. To make it simple we recently started Palm Beach Slim as a marketing avenue for chiropractors wanting to do weight loss, http://www.palmbeachslim.com/. Weight loss, smoking cessation, chiropractic care, and physical therapy are all under the scope of our license. All are keys to preventive care and wellness care. As the captain of your vessel, you must direct the patient toward wellness care. The symptom surveys/ intake forms they fill out on their first visit are your map. Find out where the patient is and navigate them in the best direction.
Obesity and health problems are a modern-day fact of life in our country... Obesity is prevalent in so many symptoms we see in our practice daily, from back pain, muscle pain, joint pain, as well as a host of other health issues, especially heart disease. No intelligent person could argue that obesity and disease are not related. Weight loss and obesity are big business. A proven fact is that the health-related cost of obesity has been estimated to exceed $80 billion per year. Worse, health-related problems are a collection of the most severe medical conditions and diseases. We are in the prevention business, and obesity ranks second to smoking as America's most preventable cause of death... here's why!
Many heart attacks are the result of obesity, which is a precursor to heart disease. This condition occurs when fatty plaque builds up in the arteries, restricting blood flow to the body's organs. Obesity doubles the risk of heart disease.
TYPE 2 DIABETES
80% of people with type 2 diabetes are overweight or obese. Diabetes is a major cause of death and leading contributor to heart disease, stroke, kidney disease and blindness. If you want an obesity definition defined by a single disease, type 2 diabetes is it. An obesity disease if there ever was one.
- 25.8 million Americans have diabetes - 8.3 percent of the U.S. population. Of these, 7 million do not know they have the disease.
- In 2010, about 1.9 million people ages 20 or older were diagnosed with diabetes.
- The number of people diagnosed with diabetes has risen from 1.5 million in 1958 to 18.8 million in 2010, an increase of epidemic proportions.
- It is estimated that 79 million adults aged 20 and older have prediabetes. Prediabetes is a condition where blood glucose levels are higher than normal but not high enough for diabetes.
Stroke can paralyze or even kill its victim. Obesity is one of many causes of stroke. Obesity can lead to fat deposits in the arteries. These may form blood clots that travel to the brain, blocking blood and oxygen flow and causing stroke.
The health effects of obesity cannot be disputed. Obesity significantly raises the risk factor for these and other diseases like sleep apnea and colon, breast, and gallbladder cancer. Obesity and disease is real, affecting not only your physical condition but your emotional and psychological health as well.
So let’s start here and now with the basics. We learned in physiology that constant add on of calories and excessive sugar and fats in our bodies leads to obesity. Unhealthy eating habits with little exercise will lead to our bodies not burning enough calories at the pace we consume them. Combine this with a sedentary life that many patients who work daily lead and you are looking at major factors that contribute to one’s obesity. Apart from these, age, gender, genetics, environmental factors, physical activity, psychological factors, illnesses and medication are some other aspects that add to an increase in BMI index.
Good nutrition involves understanding what our body needs in terms of proteins, vitamins and minerals. Once we understand what our body’s, or our patient’s body’s, requirements are, we can then develop or provide the patient with a diet plan to suit their needs and help them stay physically fit. Weight loss, combined with nutrition and chiropractic, is the essence of a wellness practice. In developing a wellness practice, providing weight loss and fitness protocols will teach the patient about eating healthy. Now, once you combine this with proper diet and routine exercise you will have the patient begin to maintain a healthy lifestyle. Remember, if you offer massage, have your therapist do a cellulite analysis. Cellulite is the result of excessive fat that is deposited under our skin, which in turn gives it a dimpled look. Now combine this with lactic acid, which will also result in sore muscles; see the wellness connection? Overweight people more often than not have spinal problems and have to deal with them on an everyday basis. Weight loss will add new patients to your practice.
Remember the body works in cycles, similar to nature. The key is balance. Putting on weight is the body’s warning sign. Even our digestive tract sometimes needs a vacation. The key is never feeling too full, which can also be called stomach overload. Stomach overload occurs when more food is eaten than the body can efficiently utilize. When this excess food is digested and absorbed into the bloodstream, it will cause a systematic overload. This in turn creates stress, which affects the glandular system. Moderation is the key to any successful diet. Occasional overeating is not what causes people to develop a weight problem; however, I have seen many patients who insist that their weight problems result from over indulgence on weekends. I’ve frequently had patients tell me, “Doc. I gained five pounds this weekend.” This seems unlikely in view of the fact that one pound represents 3,500 calories; in order to gain five pounds, a person must consume five times this amount, or 17,500 calories. Not very realistic, I’m afraid. Weight accumulates slowly. If you eat an extra 100 calories per day, you will gain 10 pounds in one year or 30 pounds in three years.
Help your practice by helping your patients understand obesity. Don’t lose patients, help them lose weight. I share the secrets to health, happiness and success in my new book, The 5 Minute Motivator. What makes this book so unique is that it allows the reader to take control of their lives “5 Minutes” at a time.
To learn more about how to change your life “5 Minutes” at a time go to: www.5minutemotivator.com.
Dr. Eric S. Kaplan, a former President COO of a NASAQ traded public company, which included Nutrisystem, Currently he is CEO of Concierge Coaches, Inc., www.conciergecoaches.com, a comprehensive coaching firm with a successful, documented history of assisting doctors create profitable practices nationwide, providing over 30 New Patient marketing Programs. Teaching doctors nationally how to develop a successful business in the health care industry of today. Dr. Kaplan is the best selling author of Dying to be Young, and Lifestyle of the Fit and Famous and Co-developer and President of Discforce and Palm Beach Massage Centers, www.pbmassage.com, the next Generation Chiropractic Practices, massage and Spinal decompression For more information on coaching or spinal decompression, call 1-561-626-3004.
Written by Christopher Fuzy, M.S., R.D., L.D., Clinical/Sports Nutritionist
Friday, 01 June 2012 21:58
fter 21 years of nutritionally counseling patients in our clinics and implementing hundreds of nutrition counseling programs with doctors nationwide, most health care practitioners agree about the challenges we face with advising our patients on how to improve their lifestyles. The standard American diet is inflammatory, oxidative and high glycemic, and high in trans fats and sugar, promoting many diseases, pre-diseases and problems that your patients seek guidance for.1 The prevalence of hyperlipidemias, insulin resistance, weight gain, obesity, pre-diabetes, fatigue, arthritis and pain management are negatively impacted by a poor diet.2 As practitioners we are faced with contradictory research, and nutritional counseling is typically time consuming and it can be difficult to determine the best approach to guide patients to make short- and long-term lifestyle changes to achieve their desired results. Lastly, many practitioners have implemented various nutritional counseling programs in the past without adequate long-term effectiveness and many are disheartened with many nutritional counseling programs.
Interestingly, tougher economic times produce more job, environmental and relationship stresses, which often produce more emotional and comfort eating that result in consumers choosing less healthy foods.3 According to the Center for Science in the Public Interest (CSPI) it costs an average of $1,400 to lose 20 pounds of weight in the US. Most commercialized weight loss programs often use expensive packaged foods, meal replacements, diet products, and supplements and are not medically supervised. Nutritional programs incorporating a patient’s food preferences and incorporating healthy supermarket food are often less expensive for patients, and are more effective than most commercial weight loss programs (CSPI).4 Traditional approaches to nutritional counseling have typically used generic diet sheets and meal plans to instruct patients, which can be overwhelming and too restrictive for most people to follow. Furthermore, patients interpret programs using generic diet sheets, meal replacements and packaged foods as “dieting” instead of a true behavioral lifestyle program, which can also contribute to patients relapsing and lead to yoyo dieting syndrome.
The Psychology Behind Guiding Your Patients To Eat Healthy Food
Effective nutritional counseling programs should include a combination of components to facilitate patient compliance, including accurate assessment of individual metabolic profile, 5 personalized food preferences,4 patient education,6 contracts,7, 8 self-monitoring,9, 10 social support,11 telephone contact,12 and tailoring,13 for management of weight loss, wellness, disease management and prevention.
Nutritional Compliance, Metabolic Profiling and Patient Food Preferences
It is paramount for patient compliance to provide tailored sliding scale meal plans which can change the amount of carbohydrate, fat and protein for each patient’s metabolic profile and activity level. Using a sliding scale meal plan based on the patient’s metabolic profile, activity level and lean muscle mass assures we provide the patient with adequate carbohydrate for: glucose; muscle glycogen and energy utilization; protein for muscle anabolism; and healthy fat for anti-inflammation and satiety. This approach along with exercise has helped decrease the least insulin resistance, hyperlipidemias, fatigue, diabetes, and cardiac and cancer risk factors which are prevalent in America.17
This approach significantly decreases hunger, appetite, and fatigue and your patients will embrace your suggestions and look forward to learning more. Clients are substantially more motivated and receptive to learn how to properly balance their blood sugars rather than just counting calories or dieting. We encourage patients to become more aware of the improvement of their energy levels, stamina, and focus. As a result, overall well-being improves rather than just the number on the scale. By quantifying caloric expenditure based on lean muscle mass and anaerobic and aerobic calorie expenditure, you can be more effective with weight loss, insulin resistance, fatigue, and lean muscle mass increases.15
Most current and traditional metabolic equations used to perform metabolic assessments, such as Harris Benedict, World Health Organization (WHO) or Mifflin St Jeor equations, are often inaccurate because they are based on the body weight of patients instead of lean body muscle mass, which is significantly more metabolically active than adipose.5 When counseling clients with varying activity levels, genetic predispositions and metabolism profiles it is important to modify your nutritional recommendations accordingly for each patient.
By using a metabolic analyzer and customizing each patient’s nutritional program based on their specific muscle mass and including anaerobic and aerobic exercise, we can now provide a sliding scale of carbohydrates, fats and protein into the meal plan. We use a proprietary metabolic analyzer and simple software to provide custom meal plans which are based on a patient’s sex, height, weight, age, lean muscle mass and activity level. Having the ability to train your CA to act as a wellness coach to formulate custom meal plans and counsel the patients is the key to allowing the program to be much more cost effective in a busy chiropractic practice. Often, doctors or CAs do not have the time or the knowledge to formulate custom meal plans in a busy practice. However, technology and software have helped to quickly and easily provide meal plans such as Paleolithic, sports nutrition, vegan, South Beach, zone or even those for chronic fatigue or diabetes for patients based upon their food preferences. For example: a muscular, active, young, athletic patient will receive a very different nutritional program than a 45-year-old peri-menopausal insulin and weight loss resistant patient who is sedentary all day. A customized program based on lean mass activity level, age and specific exercises will reduce a patient’s hunger level and insulin overload without causing fatigue. Patients now adopt lifestyle changes in a positive way and look forward to their weekly nutritional sessions so they can incorporate long-term behavior modification, which is crucial to decreasing the likelihood for relapse.
By providing patients with exact name brand food suggestions to incorporate incrementally and strategically into their hectic lifestyles on a weekly or bi-monthly basis, and spelling out for them in detail what to do, patients are more receptive and achieve greater compliance than with generic diet sheets, carb or fat gram counting food groups or food pyramids which have been commonly used in the past for nutritional counseling. In order for patients to be successful each week, nutritional sessions should include succinct nutritional goals, exact name brand foods, shopping lists with enough detail so that it is 100% clear how and what a patient is expected to do. Each weekly nutritional session’s goals and food recommendations should change and build upon the prior week’s set of goals. Food preferences should be individualized for the doctor’s clinical philosophy and patient demographic. Some patients may require shopping lists with foods that can be purchased at a Whole Foods or Trader Joes Supermarket, and others may be purchasing foods at a Wal-Mart or Costco.
It is also important to point out to patients that being 100% compliant is unrealistic and not expected of them. If they eat healthy 80-90% of the week, this is acceptable and realistic. Patients also need to be reminded it’s not their fault they are faced with these nutritional challenges; it is a widespread problem throughout the US and a concern with most Americans living in our country. When patients realize and understand that capitalism and profits have changed the way we farm, grow, process and market our food in grocery stores and restaurants, they become more vigilant about the desire to understand nutrition and how it affects their overall health.
Understanding Nutritional Counseling Is a Psychological Process Is Key
The secret to implementing a nutrition counseling program in a clinical practice is to remember that guiding your patients to make positive lifestyle changes is a psychological process. Different patients are motivated with different concerns. Some patients are motivated by wellness or anti-aging. Some patients desire to eliminate a medication that may be giving them undesirable side effects, and others have self-esteem issues with their body and desire weight loss. Not all doctors and staff members are therapists, or have the time or skills to deal with these issues. It is imperative that the nutritional program you choose incorporates behavioral modification tools and has been used extensively by many doctors and patients from different cultural and socioeconomic backgrounds.
Explaining to patients up front that they need to commit to a series of 3-12 weekly or bi-monthly nutritional consultations focusing on food and exercise is also paramount for them to be successful and perceive the program as a lifestyle and not a diet. We require that our patients commit to a contract for a minimum number of visits based on their nutrition, medical goals and the typical food recall they provide us during their initial consultation. Signing a contract and making a commitment for a series of visits is very important for patients to be able to enjoy and comply with making strategic lifestyle changes incrementally at home, in restaurants and in social settings.7,8 The number of visits usually depends on the clinical and economic goals of the patient.
In our first nutritional session, we just focus on breakfast and snack foods and introduce regular exercise. We teach our patients how to food combine for their metabolic needs, and they learn the fundamentals of glycemic load by eating specific food combinations we suggest for them. In our second nutritional session we recommend various lunch and dinner proteins, detox soup, high fiber foods and teach the fundamentals of eating volumetric foods to decrease appetite in combination with the low glycemic load principles we covered in session I. Keep in mind that patients have not received a complete meal plan yet and are following our specific recommendations and making changes without having a meal plan. They are actually learning to decrease their appetites and fatigue while increasing their energy levels by eating the healthy foods we recommend, without having to measure, weigh or count calories. Studies show that by strategically adding higher protein, higher fiber breakfast and snack combinations, and eating every 3-4 hours, patients naturally on their own decrease their lunch and dinner portion sizes. By the time they receive their custom meal plan on their 3rd nutritional session, they already have incorporated 25-30 foods and food combinations based on their personal food preferences. By adding foods into a patient’s nutritional program initially, instead of restricting foods, they view their lifestyle program as a positive experience rather than one of deprivation.
During the third nutritional session (approximately the 3rd week of counseling) we present the patient’s meal plan to them. By now, patients have incorporated many lifestyle modifications and are ready to embrace their meal plan, instead of resenting it as they would with traditional approaches to nutrition counseling.
Our fourth nutritional session builds upon their meal plan with more food examples, explains how to eat in restaurants and airports, and recommends healthier fast foods and even suggests how to eat in a convenience store if necessary. At this point most patients are experiencing less hunger, cravings, decreased appetite and more energy and stamina, so we can begin to teach them how to intuitively eat using a hunger scale. This is when clients really start to understand the difference between biochemical eating because they are physically hungry and emotional eating due to stress, boredom, or for comfort or reward. We even provide our clients with a “Craving Satisfaction Hit List” if they need more suggestions. Clients realize our society, family, restaurants, and advertising companies often encourage us to overeat unhealthy foods and food combinations which create hunger and are truly motivated to live a healthier lifestyle.
A key component to relapse prevention following rapid weight loss detoxification programs, pharmacologic or HCG rapid weight loss is to provide patients with detailed guidelines as to the reintroduction of real food back into the their lifestyle, so patients do not revert back to old habits and regain the weight they lost. Often, lean muscle mass and metabolic profiles change after weight loss, so retesting a patient’s metabolism and lean mass is critical in order to provide the correct maintenance program.
Finding an Effective Program Will Be Personally and Financially Rewarding
Chiropractors have been well trained in musculoskeletal and neurophysiology systems of the human body, providing a strong foundation to effectively offer nutrition counseling to patients if they desire to do so. With advanced nutritional training and certifications available, many chiropractors have obviously added or specialized with nutrition in their chiropractic practices and have a competitive advantage over their peers.
An effective nutritional program should include behavioral and metabolic aspects and have the clinical flexibility to support and accommodate various patient backgrounds with different clinical needs. Long-term patient compliance will occur as a result, with periodic follow-up visits and/or telephone support. Taking the time to find and evaluate a nutritional program with most of the essential ingredients for patient assessment and compliance is paramount. You will find that introducing an efficacious nutrition counseling program to your patients and community will be a positive, lucrative, rewarding experience for you and your patients. Finally, 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.
- Antioxidant nutrients and chronic disease: use of biomarkers of exposure and oxidative stress status in epidemiologic research. The Journal of Nutrition. 2011;93:284–296.
- Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006;444:840–846.
- Heightened sensitivity to cheap, high-calorie food is linked with obesity. Science Daily. 2012 Apr. 5.
- Food preferences: Influence on the dietary compliance of women with NIDDM. Topics in Clinical Nutrition. 1990 Apr;5(2):15-25.
- Validation of several established equations for resting metabolic rate in obese and nonobese people. Journal of the American Dietetic Association. 2003;103(9):1152-1159.
- Morisky DE, Levine DM, Green LW, Shapiro S, Russell RP, Smith CR. Five-year blood pressure control and mortality following health education for hypertensive patients. Am J Public Health. 1983;73:153-162.
- Oldridge NB, Jones NL. Improving patient compliance in cardiac rehabilitation: Effects of written agreement and self-monitoring. Journal of Cardiopulmonary Rehabilitation. 1983;3:257-262.
- Swain MA, Steckel SB. Influencing adherence among hypertensives. Res Nurs Health. 1981;4:213-222.
- Baker RC, Kirschenbaum DS. Self-monitoring may be necessary for successful weight control. Behavior Therapy. 1993;24:377-394.
- Edmonds D, Foerster E, Groth H, Greminger P, Siegenthaler W, Vetter W. Does self-measurement of blood pressure improve patient compliance in hypertension? J Hypertens Suppl. 1985;3:S31-S34.
- Daltroy LH, Godin G. The influence of spousal approval and patient perception of spousal approval on cardiac participation in exercise programs. Journal of Cardiopulmonary Rehabilitation. 1989;9:363-367.
- Taylor CB, Houston-Miller N, Killen JD, DeBusk RF. Smoking cessation after acute myocardial infarction: Effects of a nurse-managed intervention. Ann Intern Med. 1990;113:118-123.
- Haynes RB. A critical review of the `determinants' of patient compliance with therapeutic regimens. In: Sackett DL, Haynes RB, eds. Compliance With Therapeutic Regimens. Baltimore (MD): Johns Hopkins University Press; 1976.
- Interrelationships among postprandial satiety, glucose and insulin responses and changes in subsequent food intake. Eur J Clin Nutr. 1996 Dec;50(12):788-97.
- Glycemic index, glycemic load, and chronic disease risk—a meta-analysis of observational studies. American Journal of Clinical Nutrition. 2008 Mar;87(3):627-637.
Christopher Fuzy, MS, RD, LD is the Founder and President of Lifestyle Nutrition Inc. and PhysicianWellnessProgram.com, has a Master’s Degree in Clinical & Sports Nutrition with 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 www.PhysicianWellnessProgram.com or call 800-699-8106.
Written by Susan Blackard, R.N., N.D.c., M.H.A., F.N.P.c.
Saturday, 25 June 2011 22:23
O besity is most often identified with diets high in fat and sugar, combined with a lack of physical activity. It’s not as easily accepted that obesity may be directly related to addiction. The obvious pound-packing obesity culprits tend to be high amounts of trans-fats, refined carbohydrates and white sugar. While high doses of fat and sugar trigger dopamine in the brain and become addictive, it’s the unnoticed ingredients in these foods (and even in some branded “healthy” foods) that are most likely fueling a desire for and even addiction to these foods. Yes, Americans are unknowingly addicted.
The purpose of this article is to expose the truth about how processed foods are driving cravings and causing obesity in our country. The shocking, yet inspiring, truth with obese patients is that it’s not their fault. How can this be?
The purpose of this article is to expose the truth about how processed foods are driving cravings and causing obesity in our country.
Let’s take a common American staple, diet soda. How many thin people do you really see drinking diet soda? Not many! Is it because they “cheat” in other areas, thinking that they make up for it with the diet soda? Maybe. I position that it’s mainly due to one very insidious ingredient in diet soda: aspartame, now also known as neotame. According to Dr. Roberts of St. Mary's Hospital and Good Samaritan Hospital in Florida, “The habitual consumption of diet products containing the chemical aspartame not only risks aspartame disease but, also, clinical addiction. Thirty-three (5.6 percent) of 540 aspartame reactors in the author's recent series found it difficult or impossible to discontinue them because of severe withdrawal effects.”1 People are craving diet soda for a very real and very dangerous reason, aspartame.
Another common food additive is MSG. While the holistic medical community recognizes the dangers of MSG to the brain, the direct link between MSG affecting the hypothalamus resulting in weight gain is often overlooked. In his book, Excitotoxins, Dr. Russell Blaylock directly relates MSG consumption with increasing obesity. “Early exposure in life to high doses of glutamate, or the other excitotoxins, could theoretically produce a whole array of disorders much later in life, such as obesity, impaired growth, endocrine problems….”
Not only does the presence of these chemicals contribute to obesity, the simple lack of living nutrition in our food physiologically changes metabolism and hunger. The more a person deprives their body of vitamins and minerals, the more cravings they will experience. For example, eating a bowl of strawberries tastes great! But, after a certain point, a person will feel full. The strawberries eventually won’t taste as good as the first bite, and a person would put the bowl down and be done. A nutrient deficient food, such as highly processed potato chips, would not trigger the same feeling of satisfaction and “doneness”. Take the Lay’s slogan for example, “Betcha can’t eat just one!” I bet you can’t either! There’s a reason for that.
The simple lack of living nutrition in our food physiologically changes metabolism and hunger.
Fresh fruits and vegetables lower the levels of ghrelin in the stomach (a hormone that triggers hunger). Junk foods, on the other hand, increase this hormone causing more cravings, hunger, and less satisfying fullness after meals.3
So, not only are the additives in processed foods causing cravings in unaware consumers, the lack of nutrition in the food, itself, causes our body to ask for more and more, louder and louder, asking for real, whole foods!
What is the unifying link between these little known obesity contributors? It’s the “brain’s brain”, the “master and commander,” or the hypothalamus (also referred to as diencephalon). Well known functions of the hypothalamus include regulation of body temperature, hunger, thirst, sexual behavior, reproduction and even emotional response. The regulation of hunger is often what determines weight in the typical overweight person. According to Dr. Simeons, “It has long been known that the destruction of the diencephalic center produces a voracious appetite and a rapid gain in weight in animals which never get fat spontaneously.”
Dr. ATW Simeons researched the role of the hypothalamus in obesity and concluded the following: “If obesity is always due to one very specific diencephalic deficiency, it follows that the only way to cure it is to correct this deficiency.”4 A person needs to simply balance the hypothalamus.
The first and most important step is to avoid dangerous food additives.
How in the world does one go about balancing this very specific part of the brain? The first and most important step, as prefaced above, is to avoid dangerous food additives. “It is important to emphasize that there is ample experimental evidence that glutamate and aspartame both affect the neurological development of the hypothalamus. This can result in permanent alteration of the anatomy, as well as the function, of this most important brain organ.” Another study by Pizzi quoted in Blaylock’s book states, “Again, they found that the mice exposed to MSG were obese…similar findings have been seen in all other species of animals tested, which means that the toxic effect of MSG….is not a peculiarity of mice or rats.2
The second crucial element in balancing the hypothalamus is to eat plenty of organic, nutritious, whole foods. First, reduce the toxic load from additives, preservatives and pesticides. Second, FLOOD the body with what it needs to repair itself. A dietary deficiency cannot be corrected with drugs, nor should doctors even be made to try something so ludicrous. Only the missing nutrients, of which the lack caused the disease in the first place, can bring about optimal healing. “The body will make do with what it has to work with. If your body is starving nutritionally by a lack of essential vitamins and minerals, what will the new cells be made of?”5
Let your patients know it’s not their fault! Help them balance and heal their brain and, in turn, heal their body.
Susan Blackard, R.N., N.D.c, M.H.A., F.N.P.c, is an expert on obesity, weight loss and detoxification at the Rejuvenation Weight Loss. For more information, visit www.dc-weightloss.com or call 866.95.ANEWYOU.
1. Roberts, H.J., MD. The "Townsend Letter for Doctors and Patients", January, 2000 (pp. 52-57)
2. Blaylock, R., MD (1997) Excitotoxins The Taste That Kills. Santa Fe: Health Press.
3. McCance, K. & Huether, S. (2010) Pathophysiology (6th ed). Canada: Mosby Elsevier.
4. Simeons, ATW. Pounds and Inches, A New Approach to Obesity. Retrieved from http://www.hcginfoonline.com/ORIGINAL_Dr_Simeons_Pounds_and_Inches.htm
5. Kettler, J. http://www.undergroundnotes.com/health.htm
Page 1 of 2