Nutrition – Page 10 – The American Chiropractor

Iron Deficiency and Innate Intelligence

One of my fondest memories of my chiropractic education occurred following a particular lecture on the Philosophy of Chiropractic. I remember leaving the classroom full of resolve and enthusiasm, believing that all I needed to get sick people well was the chiropractic philosophy and a system of specific spinal adjustments. I expressed this idea to a classmate who asked what I would do for a patient who was iron deficient. He asked, “Are you going to put a rusty nail on your pisiform contact and drive the iron into them?”

His question may well have changed my life, because I began to wonder if iron deficiency produced specific subluxation patterns. If so, where and how?

It took me years to determine the answer, and its pursuit led me down a remarkable path of discovery and appreciation for the concept of universal intelligence, not as a philosophical ideal but as an absolute reality—a reality that can be measured and examined and is consequently scientifically sound and legally defensible.

I need no equipment or fancy gadgets to make my determination. All I need is a patient evidencing the symptoms that may suggest iron deficiency, such as fatigue, pallor, and exertional dyspnea. I need my basic science and chiropractic education, and I especially need my hands with which to palpate for both somato-visceral and viscero-somatic involvement.

Iron does not produce subluxation patterns, but the body’s organs do when they are unable to properly digest, absorb, transport and utilize iron. In other words, once we know how the body metabolizes iron, it is quite simple to identify the source of the problem in either the stomach, intestine, spleen, or liver. Obviously, we must begin with a case history with particular emphasis on dietary selections. Innate intelligence is basic science.

Anemia

Anemia is defined by Dorland’s Illustrated Medical Dictionary, 27th edition, as either:

· A deficiency of circulating red blood cells;
· A deficiency of hemoglobin contained within the red blood cells; or,
· A deficiency of the number of packed red blood cells within 100 ml. of blood (hematocrit).

Anemia may be identified by a related nutritional deficiency. These include iron, folate, and vitamin B-12. In this article, we will deal exclusively with iron deficiency, although other factors such as vitamin B-6, vitamin C, and copper may be involved.

Iron Deficiency Anemia

Iron deficiency is the most common cause of anemia, and it is estimated to affect 10-to-20% of the population. The most common causes are:

1. Increased iron requirements for growth that occur not only during infancy and puberty, but during pregnancy and lactation as well.
2. Low dietary intake of iron-containing foods. Often these foods are also high in protein, such as liver, tofu, beans and lentils, some cheeses, and molasses.
3. Obviously, unidentified chronic blood loss can account for iron deficiency. This is particularly true in the gastrointestinal tract. Ulcerations and malignancy can be especially insidious.
4. A less commonly recognized form of anemia occurs when there is a deficient release of iron into the plasma from iron stores. This occurs in chronic inflammation and is not considered to be a true iron deficiency. Nevertheless, it has considerable importance within your practice.

Traditional Recognition of Iron Deficiency

Fatigue is universally considered to be the earliest sign of iron deficiency. However, fatigue has never been correlated with decreased hemoglobin levels. Fatigue, weakness, and anorexia are much more likely to be caused by the depletion of iron-containing enzymes. A small amount of total body iron is incorporated into tissue enzymes. In a dietary deficiency, the level of these tissue enzymes drops BEFORE the hemoglobin level drops.

It takes some time before the clinical manifestations of iron deficiency become evident in the epithelial tissues:

1. Finger nails become thin and flat. Eventually they will become spoon-shaped (koilonychia).
2. The papillae of the tongue will atrophy and will be followed by increased redness and burning. In severe cases, the tongue takes on a smooth and waxy appearance.
3. Inflamed cracks will appear at the corner of the mouth (angular stomatitis).
4. The conjunctiva of the eyes may also appear to pale.

Palpation Findings in Iron Deficiency

Palpation, when properly appreciated, is an incredibly accurate diagnostic science. I don’t mean affixing a medical diagnosis so the indicated drug(s) can be prescribed; I mean ascertaining those very early signs of deviation from normal function that can be appreciated long before evidence of disease can be found. I have written previously that palpatory examinations need not, and should not, be limited to musculoskeletal therapeutics. Nor should they be undervalued; they are much too valuable for recognizing early signs of dysfunction for that.

For example, one very reliable and early sign of impending iron deficiency is muscle contraction of the transverse abdominal muscle on the left side of the abdomen. This occurs immediately below the rib cage and immediately in front of the anterior border of the lumbo-dorsal fascia. This taut and tender muscle contraction (not spasm) has visceral connections with the spleen and the spinal musculature between T6 and T8. While it may be true that spinal subluxation(s) within these segments are responsible, the abdominal finding is more likely found when the spleen cannot furnish adequate red and white blood cells or platelets to maintain normal body function. It is then incumbent upon the practitioner to ascertain the cause, and that can often be surmised by signs and symptoms before a complete blood count would reflect significant changes!

Let’s take a look at how the body metabolizes iron, and then correlate that with findings that appear when normal physiological function is impaired.

Iron Assimilation

The daily requirement of iron is about 1 mg in adult males and may be as high as 3-to-4 mg in pregnant women or young menstruating girls. A matching amount should be absorbed from an average dietary intake of 10-to-20 mg per day. On average, everyone loses about 1-to-1.5 mg of iron per day in the feces and urine. Growth, menstruation, and pregnancy obviously increase the amount to be replaced. The average red blood cell lives about 120 days. Therefore, about 1/120th of the total number of red blood cells must be replaced each day. When the old cell breaks, its hemoglobin is recycled into new cells because it would be impossible to replace that much from daily dietary sources.

Dietary iron occurs in food primarily in its oxidized (Fe+++), or ferric, form. A few foods contain it in a reduced (Fe++), or ferrous, form. Animal foods contain iron as hemoglobin (combined with protein).

Digestion

Before dietary iron can be assimilated, it must be removed from its protein connection. Ferric iron must be reduced or put into its ferrous form by stomach acid and is then combined with vitamin C (ascorbate), carbohydrates and amino acids. This process prevents precipitation of the iron as pH rises in the upper intestine. Ascorbate also serves to reduce ferric to ferrous iron, the optimal form for absorption. The heme compound is absorbed and the iron liberated within the mucosal cell.

Iron absorption is decreased whenever the amount of stomach acid is inadequate. This decrease is also found in diseases of the proximal intestinal mucosal surface. Conversely, iron absorption is increased in pancreatic insufficiency by an unknown mechanism.

Any digestive inadequacy will produce palpatory findings in the muscles sharing innervation with the stressed visceral organ. Stomach and biliary problems related to insufficient stomach acid and biliary dysfunction can be palpated under the right costal arch. Pancreatic insufficiency will produce palpatory findings under the left costal arch.

These relationships are very important, because virtually all iron in the body (about one teaspoon) is combined with protein. It is this relationship that allows us to exchange oxygen and carbon dioxide in every cell of the body. A digestive problem interfering with protein will also adversely affect iron metabolism.

Ferritin and Iron Absorption

Once inside the mucosal cell, iron combines with ferritin, a protein. In fact, iron absorption is regulated by available ferritin. When mucosal ferritin is saturated, iron absorption is decreased. On the other hand, when mucosal ferritin is unsaturated, iron is absorbed to fill the gap.

Therefore, blood levels of ferritin can be used to measure iron storage. Low ferritin levels are found in iron deficiency and protein deficiency. High levels of ferritin (iron overload) are considered pathological and may be associated with hemochromatosis, hemosiderosis, megoblastic anemia, alcoholic or inflammatory liver disease, Hodgkin’s disease, breast cancer, and CHRONIC INFLAMMATION (enzyme deficiency). Any chronic condition evidenced by heat (fever), redness, swelling, pain, and aberrant motion can, and usually does, produce iron deficiency anemia!

Serum Iron

When assaying iron levels in the body, we often look only at hemoglobin levels. But we must consider not only ferritin levels, but also serum iron, to understand the entire picture. Low levels of serum iron indicate nutritional iron deficiency. High levels of serum iron are associated with protein deficiency and can be associated with abnormal deposits of iron in the tissues that can damage the liver, heart, lungs, and pituitary. It will cause bronzing of the skin and is referred to as hemochromatosis.

Abnormal deposits of iron in the tissues from multiple transfusions and excess iron administration do not cause damage. This is referred to as hemosiderosis. Hemolytic disease (abnormal destruction of red blood cells) can increase serum iron levels.

Conclusion

There is more to the story of iron, but I have covered the key points for you. Understanding iron metabolism and its relationship to diet, digestion, and inflammation can be very helpful to any clinician. TAC

Howard F. Loomis, Jr., DC, President of Enzyme Formulations, Inc., has an extensive background in enzymes and enzyme supplementation. As president for fifteen years of 21st Century Nutrition (now the Loomis Institute of Enzyme Nutrition), he has forged a remarkable career as an educator, having conducted over 400 seminars to date, in the United States and internationally, on the diagnosis and treatment of food enzyme deficiency syndromes. The Loomis System, Dr. Loomis’ system of evaluation, is recognized as a legitimate and proven method of determining a patient’s nutritional stresses. Call 1-800-662-2630 for more information and a free video.

Innate Enhancement via Oral Chelation and Ionic Detoxification

Our modern day environment has drastically disturbed the body’s ionic balance, critically important for innate intelligence and communication. Excessive positive ionization, a result of water, food, and air pollution, causes what Albert Krueger, MD (the late University of California (UC), Berkeley, researcher) termed “positive ion poisoning.” Russian scientists (supported by over 5,000 scientific studies) report that systemic ionization with negative ions has a wide range of positive health effects.

It is well known that accumulated toxins, free radicals (oxidative stress), chaotic interferences, and electron instability of the Electron Transport Chain (ETC), responsible for all cellular energy, determine the functional status of the body’s electromagnetic systems. Practitioners of the Quantum Repatterning Technique (QRT) employ oral chelation and detoxification to improve and augment multiple channels of innate communication. Why? Because unstable electrons and nerve-interfering neurotoxicants must be cleared from the nervous and circulatory systems to fully activate innate. ETC abnormalities, acidosis, and chronic thoracic subluxations (T3 to T8) are commonly found in positive ion toxicity.

Innate communication involves a “galaxy” of billions of small neural cells that form our brain and DNA-guided meridian energetics. As such, innate communicates predominately via biophoton flashes from the DNA to the meridian circuits of the body. High concentrations of negative ions are essential for high ETC energy transmission and optimal function of innate’s communication pathways. Dr. Marian Diamond, neuroanatomy professor at UC, Berkeley, has found that negative ions relate to healthy levels of serotonin in the brain, alleviating depression, drowsiness, and increase mental agility.

If your patients are feeling groggy, lethargic, sleepy or depressed, or your adjustments are not activating innate healing, it may be that their bodies are overloaded with positively charged (ions) toxins. In areas of higher pollution, systemic overload with positively-charged toxins creates chronic nerve interference that locks up structure into holding patterns where the spine curves to accommodate the stress on the nervous system. When this happens, adjusting the body may become extremely difficult, if not impossible.

The Chiropractic Detoxification Breakthrough of the Century

Our research has revealed that oral supplementation with Quantum Detox™ consisting of negatively charged minerals, a 200:1 aloe concentrate, and other herbal synergists has a powerful regulatory effect on innate intelligence. When coupled with QRT flexoelectric protocols, sacral clearance is dramatic with one QRT treatment, resulting in clearance of brain proprioceptive interferences from the following muscle-organ-meridian sequences: Fascia Lata-Colon-Large Intestine; Gastrocnemius-Adrenals-Triple Warmer; Gluteus Maximus and Medius-Gonads-Conception Vessel; Hamstrings-Colon-Large Intestine; Piriformis-Gonads-Conception Vessel; Quandratus Lumborum-Spine-Large Intestine; Sartorius-Adrenals-Triple Warmer; and Supraspinatus-Brain-Conception Vessel.

Detoxification of neural toxicants occurs with ease and without crisis or extreme cleansing reactions, common with other detoxification approaches. Once these toxicants are removed via negative ionization in the digestive tract, it is amazing how innate communication perks up, allowing the non-responsive or treatment-resistant patient to heal and get well.

Chiropractors applying QRT in their practice marvel at how quickly the body’s structure improves and how a patient they had difficulty adjusting for years will suddenly adjust with ease after a few QRT therapies. QRT enhances innate so that its full range of healing powers are turned on. It is important to note that, in cases where innate fails to activate after an adjustment, erroneous information causes innate’s response to be inappropriate or ineffective.

Microscopic live cell analyses of blood taken from individuals who have detoxified with this unique form of oral chelation therapy reveal that it removes toxins that poison the endocrine, immune and nervous regulatory functions of the body. Positive-charged toxicants and free radicals are attracted to the negative ionic minerals and carried safely out of the body (other methods of chelation pull toxins into the blood stream where they can jam up innate, immune and excretory systems or bind nutritious minerals, interfering with thiol metabolism). The unique mineral complexes in this formulation are treated with bioresonant frequencies to release electrons repeatedly, thus improving the functional status of all innate’s electrical systems.

The key to unlocking the full power of innate intelligence is related to the organism’s ability to store and maintain coherent energy. If the body’s energetic anatomy is not repatterned from the segmented proprioceptive interferences of stressors, innate becomes short-circuited or inefficient. The foundational principles of QRT rest upon my multi-disciplinary research, brain proprioception, decades of experience with electroacupuncture, chiropractic (D.D. Palmer; George Goodheart, DC; M.T. Morter, DC; Wally Schmidt, DC; and D.A. Versendaal, DC) and osteopathic (William Upledger, DO) techniques. Any statements regarding QRT should not be interpreted as criticism of these techniques or of these brilliant pioneering practitioners. Two decades of correlating electroacupuncture data to kinesiologic-physiologic findings with 100% cross-correlation has yielded protocols that balance the sacrum and quickly identify and clear the sequence of aberrant nervous/meridian dysfunction in specific organs or systems. QRT provides an accurate tool for assessing the individualized pattern of functional disturbances and the underlying stressors that induce and promote illness. TAC

For more information, email Dr. Yanick at [email protected].

To Reduce Osteoporosis: Put a Little Fat in Your Bones

Osteoporosis is an extremely costly condition; the expense for treating osteoporosis-induced fractures reaches about $38 million per day.¹ Consider this in light of the fact that calcium fortification and supplementation is at a premium. One day of shopping at Sam’s Club, as an example, leads to the realization that countless bottles of calcium are sold on a monthly basis.

What does the literature tell us regarding calcium consumption and the reduction of osteoporosis and related fractures? In short, the data demonstrates that less bone fractures occur in populations wherein women consume less calcium than females in United States.² In other words, in spite of the modest consumption of calcium that is supported by considerable supplementation of calcium…fracture rates are higher compared with populations that ingest less calcium. While the details of this relationship are very involved and not fully understood, an emerging trend is appearing that needs to be examined more closely.

In the past, I have written columns about the importance of omega-3 (n3) fatty acids for reducing inflammation, pain, and chronic diseases like cancer, heart disease, and Alzheimer’s.³ As it turns out, n3 fatty acids can help to prevent and reduce bone loss.

Osteoporosis is a chronic inflammatory condition

It may seem a bit surprising that osteoporosis is described herein as an inflammatory condition. We typically think of inflammation in the context of our education from texts like Guyton’s Physiology and Robbins’s Pathology. The impression we get from these books is that inflammation is a frank, obvious presentation…obvious pain, swelling, and fever as an example. Well, this is not the whole story about inflammation.

Consider that heart disease, cancer and other degenerative diseases are known to be driven by chronic inflammation. I reviewed this literature in a recent article.³ As it turns out, subclinical chronic inflammation develops and persists without our awareness, and manifests clinically when sufficient fibro-proliferative changes have occurred, i.e., when a lump is found during breast exam or a heart attack occurs due to atherosclerotic plaguing. Similarly, women develop osteoporosis without symptoms; they find out about it when they fracture, or when they get X-rays in a chiropractic office, or when they have a bone density test. What women do not find out is that a subclinical chronic inflammatory state helps to drive osteoporosis in an asymptomatic fashion.

The emerging literature points to bone loss and osteoporosis being promoted by a dietary excess of omega-6 fatty acids and a deficiency of omega-3 fatty acids, which creates a subclinical chronic condition. Bruce Watkins at Purdue University is leading the research movement in this important area.^4-7 For those interested, you can go to www.pubmed.gov and down load PDF files of references 6 and 7, which are excellent review articles. In brief, a diet rich in n6 fatty acids (from grains, seed oils, grain-fed animal products and eggs) stimulate osteoclasts and inhibit osteoblasts, the outcome being bone loss.

Grains may be the biggest culprit behind the insidious development of osteoporosis. While grains are not high-fat foods, their ratios of n6:n3 average about 20:1; below 4:1 is considered to be the healthy ratio. Grains are also acidic, and tissue acidity drives osteoclast activity and inhibits osteoblast activity, just like n6 fatty acids. Grains also contain phytates that bind calcium and reduce its absorption. Not surprisingly, whenever grains have become a staple food in a population’s diet, there is an increased incidence of osteomalacia, rickets and osteoporosis.⁸

What should yo do to help protect your patients’ bones?

Significantly reduce or eliminate grain consumption. Increase fruit and vegetable consumption, to take the place of grain reduction. Fruits and veggies have n6:n3 ratios that are 3:1 or better and they promote tissue alkalinity. Try to eat fresh fish and grass fed animal products. A visit to www.eatwild.com will allow patients to find a number of grass fed farms to choose from. Eating n3 eggs is very easy to do, as numerous eggs are available; I buy them at Super Walmart and Publix.

Particularly, supplements are omega-3 fatty acids. EPA/DHA is the supplement of choice and it is found in fish oil. In addition to the dietary focus mentioned above, I would also suggest supplementing with 1-2 grams per day of EPA/DHA. Calcium is also important; however, it should not be thought of as more important than magnesium. Magnesium supplementation has been effective in improving bone formation. When it comes to supplements, I suggest providing a 1:1 ratio of magnesium and calcium. This means up to 1000-1500 mg of magnesium per day to match the calcium. Calcium in the form of hydroxyapatite is thought to be superior for osteoporotic patients. Also, do not forget to provide a multivitamin/mineral, as all cells, including bone cells, need an appropriate nutrient supply.

These suggestions are simple to follow and will help to provide an environment that is healthy and supportive for boney tissue. Patients should not find this too challenging. TAC

Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession. He is on the faculty of Palmer College of Chiropractic Florida and on the postgraduate faculties of several other chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient. Dr. Seaman believes that chiropractors should be thinking like chiropractors, while providing nutritional recommendations. Doctors and patients who follow his programs report improved feelings of well-being, weight loss, dramatic increases in energy, and significant pain reduction. Dr. Seaman can be reached by e-mail at [email protected].

References:

1. Siris ES, Miller PD, Barrett-Connor E, et al. Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women. Results from the national osteoporosis risk assessment. J Am Med Assoc 2001;286:2815-2822
2. Hegsted DM. Fractures, calcium and the modern diet. Am J Clin Nutr 2001; 74:571-73
3. Seaman DR. The diet-induced proinflammatory state: a cause of chronic pain and other degenerative diseases? J Manipulative Physiol Ther. 2002;25(3):168-79
4. Watkins BA, Lippman HE, Le Bouteiller L, Li Y, Seifert MF. Bioactive fatty acids: role in bone biology and bone cell function. Prog Lip Res 2001; 40:125-48
5. Reinwald S, Li Y, Moriguchi T, Salem N Jr, Watkins BA. Repletion with (n-3) fatty acids reverses bone structural deficits in (n-3)-deficient rats. J Nutr. 2004; 134:388-94
6. Watkins BA, Li Y, Seifert MF. Nutraceutical fatty acids as biochemical and molecular modulators of skeletal biology. J Am Coll Nutr. 2001; 20(5 Suppl):410S-416S
7. Watkins BA, Li Y, Lippman HE, Seifert MF. Omega-3 polyunsaturated fatty acids and skeletal health. Exp Biol Med. 2001; 226(6):485-97
8. Cordain L. Cereal grains: humanity’s double edge sword. World Rev Nutr Diet 1999; 84:19-73.

The Five Stages of Pregnancy – Part III

Lactation and Depression
Once the joyous day arrives and the healthy and happy baby has been delivered, it is time to address the postpartum nutritional requirements for both the mother and the baby.

The American Academy of Pediatrics has long advocated the use of breast milk as the primary food source for full-term infants. In 1997, this advisory was extended to include premature infants. The Academy recommends that mothers breast-feed their babies for at least one year. There are two reasons for this:

1. Breast-feeding reduces infant illnesses.
A recent study published in Pediatrics (Hylander, Strobino, et al., 1998) has shown that breast-feeding significantly reduces the occurrence of common infant illnesses such as respiratory tract infections, pneumonia, ear infections, and gastrointestinal disorders. In this two-year study of 977 babies, the number of babies who developed pneumonia in the first year of life declined by 33% and the cases of gastroenteritis decreased by 15%.

2. Breast milk is best for premature infants.
Many experts believe breast milk contains a number of compounds that “jump-start” an infant’s immune system and help fight off infections. It is interesting to note that many of the immune-enhancing agents normally found in breast milk are found in higher concentrations in mothers who deliver prematurely.

Preterm infants fed breast milk developed significantly fewer infections (Wright, Bauer, et al. 1998). In the study of 212 preterm infants with very low birth weights (under three pounds), it was determined that. after adjusting for all other factors, the infants who were fed breast milk dramatically decreased their odds of infection by 57%.

The Mother’s Fatty Acid Deficiencies

It is important to remember that many troubled pregnancies stem from fatty acid deficiencies. Essential fatty acids are precursors for prostaglandins, and I place great emphasis on their role in promoting conception, preventing spontaneous abortion, and allowing the mother to initiate labor and commence lactation after delivery. Women generally have difficulty digesting and absorbing protein and lipids. If the new mother cannot lactate or produce a sufficient quantity of breast milk, the nutritional cause is invariably a fatty acid deficiency. This deficiency may even manifest in soreness and cracking of the nipple region. An old, yet successful, remedy is to massage the area with cocoa butter.

Fat-Soluble Vitamin Deficiencies

Research has shown that vitamin A can reduce a child’s risk of death from measles (Hussey and Klein, 1990; D Souza and D Souza, 2002). According to a study on Brazilian children, it can also help treat severe diarrhea (Barreto, Santos, et al., 1994).

Vitamin D deficiency is most common when the mother is a vegetarian or lacks adequate sun exposure. Mothers who breast-feed should spend at least 15 minutes in the sunlight daily to increase their vitamin D levels.

Vitamin K deficiency may occur in some infants and neonates, including those with malabsorption disorders. This may lead to unexpected hemorrhagic disease. Babies are often given intramuscular vitamin K shots at birth to prevent this condition.

Other Nutritional Factors

The B-vitamins pass from the mother to the baby via breast milk. Deficiency is more common in mothers who are vegetarians. In these cases, supplementation is necessary for mother and child.

Iron deficiency, according to the American Academy of Pediatrics, may be related to feeding cow’s milk to infants under the age of one year. Frequent ear infections are found in these children as well. Most baby formulas now contain iron to prevent such problems. Iron deficiency is often related to protein deficiency.

Zinc deficiencies are common in premature infants and children with malabsorption syndromes. Deficiencies are generally not found in breast-fed infants with non-deficient mothers. However, it is believed that the entire human race is borderline zinc deficient.

Nutritional references list the signs of zinc deficiency as diarrhea, growth failure, alopecia, irritability, and anorexia. Zinc deficiency is also implicated in skin lesions, such as diaper rash and candida manifestations. These are also signs of fatty acid deficiency and excessive u u sugar intake. Individuals who do not digest lipids consume excessive sugars.

Postpartum Depression

Postpartum depression is a condition that describes a range of physical and emotional changes that many mothers encounter after having a baby. The appearance of any symptom signals exhaustion of the body’s ability to maintain homeostasis. This means that normal functions are no longer occurring appropriately. The functions are now occurring too fast, too slow, or incompletely because they are forced to compensate for stress.

Symptoms related to autonomic nervous system imbalance can be understood on the basis of whether the cell is becoming deficient in K+ and OH- (alkaline), or Ca++ and H+ (acid). For example, a deficiency of Ca++ and H+ inside the cell produces symptoms of parasympathetic dominance and can be related nutritionally to the inability to adequately digest and assimilate protein and fats. However, a deficiency of K+ and OH- inside the cell produces symptoms of sympathetic dominance and can be related nutritionally to excessive ingestion of refined white sugar and flour products.

The nutritional component of postpartum depression is serotonin deficiency. Its symptoms include increased feelings of stress and tension, an exaggerated reaction when startled, a decreased ability to concentrate, and loss of appetite. These symptoms are also consistent with sympathetic dominance. The common nutritional component in both clinical syndromes is exhaustion of intracellular alkaline minerals, primarily potassium. Both conditions are nutritionally related to the inability to properly digest and assimilate fatty acids, with compensation coming in the form of excessive ingestion of foods high in white sugar and flour.

Nutritional Etiology

The body produces three neurotransmitters directly from the food we eat. Two amino acids, tyrosine and tryptophan, are used to produce the neurotransmitters that control the mood. Dopamine and norepinephrine are alertness chemicals that use the amino acid tyrosine as a precursor. Serotonin, a calming chemical, uses the amino acid tryptophan as a precursor.

Almost all protein foods contain much larger amounts of tyrosine than tryptophan. There are a limited number of receptor sites for these amino acids. Due to the abundance of tyrosine, these amino acids are not consumed in equal proportions. Eating protein provides plenty of tyrosine for alertness chemical production; however, an insufficient amount of tryptophan is provided for calming chemical production. Fortunately, after a protein meal, any unused tryptophan is attached to albumin and continues to be carried in the blood. Then, when a high carbohydrate meal is eaten, insulin is released and allows tryptophan to attach to the receptor sites. This increases serotonin production, which exerts a calming effect.

A study in the late 1980’s measured reflex times and memory of geriatric patients. The factors were measured before and after the ingestion of separate protein and carbohydrate test meals. The study confirmed that reflex times and alertness can be significantly improved within 30 minutes of digesting only protein. It also confirmed that serenity and memory can be improved within 30 minutes of ingesting only carbohydrates.

Continual Reflex Arc

Patients who have difficulty digesting lipids suffer from hydrochloric acid deficiencies and biliary stasis. Invariably they consume excessive amounts of refined simple sugars and function quite well in this state until the symptoms of alkaline mineral deficiency, sympathetic dominance, and serotonin deficiency become evident.

Digestion begins in the mouth with the chewing of food and the addition of saliva that contains water, enzymes, and the alkaline minerals—sodium and potassium. However, these salivary secretions are reduced during periods of emotional stress and psychic conditions, such as fear and anger.
It is plain to see that the body is locked in a continual reflex arc and its nutritional components must be addressed. Improved protein and fat digestion, accompanied by reduced consumption of white sugar and flour, is the key to healthy mothers and babies.

Howard F. Loomis, DC, president of Enzyme Formulations, Inc., has an extensive background in enzymes and enzyme formulations. As president of 21st Century Nutrition, Inc., for fifteen years, he has forged a remarkable career as an educator, having conducted over 400 seminars to date, in the United States, Canada, Germany, and Australia, on the diagnosis and treatment of enzyme deficiency syndromes. Call 21st Century Nutrition at 1-800-662-2630 for more information.

Type II Diabetes, Inflammation, and Disc Degeneration

Type II diabetes represents a significant health risk. Individuals with diabetes are at greater risk for developing cardiovascular disease and other chronic diseases. Insulin resistance represents part of the pre-diabetic state and it is thought that some 40 million Americans have insulin resistance, which means that numerous individuals are at risk for developing diabetes (isoma). Isomma states (, “the insulin resistance syndrome constitutes a major challenge for public health professionals in the field of preventive medicine since more than 40 million U.S. adults seem to be affected by the syndrome. Lifestyle changes could have a profound influence on the syndrome and its development.”

Inflammation is a potent driver of insulin resistance. Recent research has demonstrated that tumor necrosis factor (TNF), a potent pro-inflammatory cytokine, can block the insulin receptor and cause hyperinsulinemia and insulin resistance (2). TNF is classically viewed as a mediator released by white cells, however, it is known that adipose tissue can also produce TNF and this production is significant in overweight individuals. So, losing body fat is an excellent way to reduce TNF production. TNF is also known to be a potent nociceptor irritate and driver of inflammation. Research indicates that we can reduce TNF with omega-3 fatty acids, so supplementing with fish oil and flaxseed oil is an excellent choice (3).

The health-compromising effects of insulin resistance should not be underestimated. A study was initiated to evaluate the hypothesis that insulin resistance would predict the development of chronic degenerative diseases, including hypertension, heart disease, stroke, cancer, and type II diabetes (4). The researchers selected apparently healthy individuals for this prospective study that involved 4 to 11 years of observation. The most striking finding was that none of the chronic diseases developed in the third of the subjects that were most insulin-sensitive. The authors stated this finding is “truly remarkable,” which is a comment that is not customarily used by researchers.

As mentioned earlier, heart disease is a serious condition that is driven by diabetes. Most people are now aware that the LDL cholesterol fraction is considered to be a potent atherogenic factor. In particular, the problem really develops fully when LDL particles become oxidized. Free radicals are responsible for the oxidation various cellular structures, which results in cell damage, dysfunction, and cellular death. Researchers set out to see if supplementation with beta-carotene (24 mg/day) and vitamins C (1000 mg/d) and E (800 IU/d) would prevent LDL oxidation in diabetic patients. The study lasted 12 weeks, and the results indicate that supplementation with antioxidants significantly reduces LDL oxidation.

Making dietary changes can be exceedingly difficult for many patients. But most are willing to begin by making some minor changes. Cutting sugar and flour intake by 50% is a good place to start. Replacing these calories with fruits and vegetables is easy to do. Also have such patients take a multivitamin, an extra anti-oxidant, 500 mg of magnesium and 1 gram of EPA/DHA is also very doable.

A chiropractor recently contacted who is suffering from type II diabetes and being urged by his medial doctor to take medication. He desperately wants to avoid the meds, so he became more devoted to an anti-inflammatory diet and supplementation. Within 6 weeks this chiro was able to drop 8 pounds and reduce his morning blood sugar from 180 to 120. He has much more energy and feels considerably better.

Helping colleagues and patients with potentially serious conditions can be very rewarding. As most medications ultimately have undesirable side-effects, making lifestyle modifications is a far safer choice…regular exercise, chiropractic adjustments, and nutritional adjustments are in great need. We chiropractors are in a great position to offer such lifestyle changes, and such positive changes can directly impact the tissues we address.

Research has shown that diabetes patients have altered proteoglycan metabolism in their intervertebral discs, which may promote a weakening of annular fibers and disc prolapse (6). Indeed, the tissues with which we DCs are most intimately associated are at risk for injury in diabetic patients. Making appropriate nutritional recommendations to prevent diabetes, should also be viewed as a recommendation to protect the spine and reduce subluxations.

1. Isomaa B. A major health hazard: the metabolic syndrome. Life Sci 2003;73:2395-411

2. Grimble RF. Inflammatory status and insulin resistance. Curr Opin Clin Nutr Metab Care 2002; 5:551-559

3. Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr 1999; 70(3 Suppl):560S-569S

4. Facchini FS, Hua N, Abbasi F, Reaven GM. Insulin resistance as a predictor of age-related diseases. J Clin Endocrinol Metab 2001; 86: 3574–3578

5. Anderson JW et al. Antioxidant supplementation effects on low-density lipoprotein oxidation for individuals with type 2 diabetes mellitus. J Am Coll Nutr 1999; 18:451-61

6. Robinson D, Mirovsky Y, Halperin N, Evron Z, Nevo Z. Changes in proteoglycans of intervertebral disc in diabetic patients. A possible cause of increased back pain. Spine. 1998; 23:849-55

The Five Stages of Pregnancy, Part II

In this, the second of a three-part series of articles, Dr. Howard Loomis discusses the five stages of pregnancy and their special nutritional requirements. In the January/February issue of TAC, he focused on the first stage—conception. This issue, he focuses on stages two, three, and four—the pregnancy itself.

Stage Two: First Trimester

Proper nutritional planning should be part of essential care before, during, and after pregnancy. Fatty acids are the precursors of prostaglandins and control the ability to impregnate, conceive, prevent spontaneous abortion, induce labor appropriately, and commence lactation.

Objective tests are routinely performed to determine specific nutritional needs of a mother-to-be. The nutritional status of the woman prior to conception must be known in order to determine her nutritional requirements for pregnancy. Physicians often use general nutritional guidelines that are based on national averages to make nutritional recommendations for pregnant women. The farther from average the expectant mother is, the more inappropriate those recommendations tend to be.

As a healthcare practitioner, you can have a tremendous impact on the health of expectant parents and their children. Begin with the standard nutritional recommendations and modify them to meet the needs of each individual. Remember, it is not only the components of the diet that count, it is what the patient can digest and assimilate that is important.

Calories and Weight Gain

A pregnant woman does not have to eat for two. Ideally, the diet should be adequate enough to nourish the fetus without extensive modification. Certainly there must be slight increases in calories, and especially in protein. On average, caloric intake should be increased by 300 calories per day. Ideally, an average healthy woman should gain 22 to 29 pounds during pregnancy. It is imperative to pay special attention to protein and fat digestion, an area of weakness in most women.

In the first trimester, the pregnant woman may not gain weight; especially if she is suffering from morning sickness. The mother-to-be commonly begins to gain weight during the third month and the most weight is gained between the fifth and seventh months. Care should be used to ensure that weekly weight gain does not exceed 2.2 pounds.

Nutritional Requirements

Many of the hormonal and pregnancy problems encountered during the first months may be related to protein deficiency. Protein requirements increase only slightly during this period, yet protein digestion and assimilation may be the key to many of the problems encountered. Various nutrition textbooks recommend to increase daily protein intake to 70-100 grams. This represents a large increase for most women, especially if they already have sluggish biliary function accompanied by low levels of stomach acid. Adequate protein digestion depends on the presence of stomach acid needed to activate the protein-digesting enzyme pepsin in the stomach. Unless enough stomach acid enters the duodenum, its rate of flow is reduced and bile thickens.

Iron supplementation should be increased from 30 to 38-40 mg per day. It is usually recommended that vitamin C also be taken to aid iron absorption. An adequate amount of acid must be present to ionize the iron in the stomach. This is essential for absorption. Protein is essential for iron absorption and transportation, even after iron is ionized.
Calcium intake needs to be increased to at least 1000 mg per day. This is important for calcification of the baby’s bones and teeth and to protect the mother from calcium depletion. It is recommended that vitamin D be used to enhance the absorption of calcium. Inadequate stomach acid severely reduces calcium absorption. The unemulsified fat then binds with calcium, making it insoluble.

Symptoms Associated
with Digestion and Assimilation Problems

A certain amount of nausea or morning sickness is considered “normal” during the first three months of pregnancy. Clinical experience has taught me that morning sickness simply indicates that the kidneys are stressed and unable to adequately cleanse the blood. Plasma proteins are responsible for detoxifying and transporting waste. Thus, nutritional support to the kidneys and the lymphatic system will nearly eliminate morning sickness.

Edema is also a common problem associated with pregnancy. The usual advice is to elevate the legs and mildly reduce salt intake. However, with improved protein digestion and assimilation, the problem will be eliminated altogether.

Stage Three:
Second Trimester

Protein requirements increase even more during the second trimester. Additional protein and calcium are needed to meet the rapid growth of the fetus; the enlargement of the uterus, mammary glands, and placenta; and the increase in maternal blood volume. Even though the demand increases, do not expect the ability to digest protein to improve. Most females do not tolerate large increases in dietary protein.

I have already mentioned that calcium and vitamin D intake must be increased because they are both dependent on protein/fat assimilation. Poor digestion accounts for the old wives’ tale that a woman loses a tooth for every baby she has.

The second trimester becomes challenging when the excitement of becoming pregnant has waned, and everyone is now awaiting the baby’s arrival. The only real excitement comes with the baby’s first kick. The mother-to-be begins to lose her figure as she gains weight and has a difficult time fitting into her clothes. Hormonal changes surface and are accompanied by the inevitable “emotional roller coaster.”

The Hormonal System

The anterior pituitary gland directs the endocrine system and enlarges at least 50 percent during pregnancy. This allows it to increase its production of hormones that stimulate the adrenal and thyroid glands.

Improved nutritional support of the adrenal glands is crucial during pregnancy. In addition to its many hormonal responsibilities before pregnancy, the adrenals must now produce an androgenic steroid that is carried to the placenta and converted to estrogen and progesterone. It is imperative that this process be in place by the 12th week to replace the role of human chorionic gonadotrophin.

These hormones prevent spontaneous abortion, loosen the ligaments of the sacroiliac pubis, and prepare breast tissue for lactation.
Adrenocortical secretion is moderately increased throughout pregnancy. It helps mobilize amino acids from the woman’s tissues to be used for synthesis of tissues in the fetus, an obvious need for improved protein ingestion, digestion, and assimilation. A deficiency here probably accounts for another old wives’ tale that the mother loses two years of her life for every child.

Aldosterone secretion is increased three-fold. This causes the retention of excessive amounts of sodium and water, often leading to hypertension. Aldosterone monitors water volume in the extracellular fluids. Because protein also holds water, aldosterone secretion can be reduced significantly with improved protein digestion, thus preventing the occurrence of hypertension.

Secretions by the Thyroid Gland

The thyroid gland enlarges about 50 percent during pregnancy and increases the secretion of thyroxine by approximately the same amount. The placenta and the pituitary both secrete thyroid-stimulating hormones. You may recall that the thyroid requires iodine (transported by fatty acids) and protein to produce thyroxine. The use of caffeine and white sugar greatly increases the need for additional thyroxine—a need the mother-to-be can hardly meet.

Secretion by the Parathyroid Glands

The parathyroid glands enlarge during pregnancy, especially if the mother is calcium (protein) deficient. This causes calcium resorption from the mother’s bones. Parathyroid secretion is greatly increased during lactation because the newborn baby requires more calcium than it did as a fetus.

It is apparent that proper nutritional planning should be part of essential care before, during, and after pregnancy. Unfortunately, it is also apparent that improved protein and fat ingestion and digestion are seldom part of the planning.

Stage Four: Third Trimester

Many things happen during the final twelve weeks—much of it having to do with weight of the baby and of the mother. Most of the critical fetal formation is already finished, or at least well advanced, by the beginning of the final trimester. The baby begins to gain weight rapidly. The mother, on the other hand, gained most of her weight between the fifth and the seventh months.

As mentioned previously, an average healthy woman should gain only 22 to 29 pounds during pregnancy. Care should be taken to ensure that weekly weight gain is not excessive. Sugar cravings play a prominent role here and are related to poor fat digestion and absorption. The women who have digestive issues prior to becoming pregnant struggle with weight during pregnancy because their already stressed system now has even greater metabolic needs to meet. Protein and fat digestion are of paramount importance.

Edema is a common problem in the latter part of pregnancy and should be carefully monitored to rule out pregnancy-induced hypertension. Edema is normally kept under control with adequate protein intake, digestion, and absorbtion.

Frequent urination is another problem because the enlarging uterus exerts pressure against the bladder, resulting in the urge to urinate. It is important that fluid intake not be reduced. However, caffeine and cola drinks should be avoided because they increase urination.

Constipation is common during pregnancy. This may be due to hormonal changes or because the heavy uterus compresses the intestine. However, a diet high in refined sugar and white flour is more often the cause. Plant enzyme supplements will improve digestion of protein and fat, thereby curbing sugar cravings and making a diet of whole grains, fresh fruits and vegetables more tolerable. Desserts, caffeine, cola drinks, and alcohol should be avoided.

There are several consequences of ignoring diet, digestion, and assimilation. Severe toxicity, diagnosed medically as toxemia of pregnancy or eclampsia, is a life-threatening condition that can develop in the second half of pregnancy. It has no known etiology, although some believe it is a result of poor nutrition. In the early stages (preeclampsia), signs include high blood pressure, protein in the urine, and excessive edema (not always present).

While the exact etiology may not be known, it is obvious that the organs of detoxification are severely stressed. This includes the liver, the kidneys, and the spleen—in other words, the reticuloendothelial system (macrophages). This can result from poor dietary choices and enzyme deficiencies. The protein-digesting enzymes are of critical importance in this area. All nutritional planning during pregnancy should revolve around the prevention of the symptoms of preeclampsia; this requires understanding the critical role that protein, including its digestion and assimilation, plays in the creation and maintenance of life.

In the next issue of The American Chiropractor, we’ll address the postpartum nutritional requirements for both the mother and the baby, including the effect on lactation and postpartum depression.

Howard F. Loomis, Jr., DC, president of Enzyme Formulations, Inc., has an extensive background in enzymes and enzyme formulations. As president of 21st Century Nutrition, Inc., for fifteen years, he has forged a remarkable career as an educator, having conducted over 400 seminars to date, in the United States, Canada, Germany, and Australia, on the diagnosis and treatment of enzyme deficiency syndromes. Call 21st Century Nutrition at 1-800-662-2630 for more information.

Inflammation and Diet: A growing concern

The January 1st issue of the New England Journal of Medicine (NEJM) contained an editorial entitled, “From asthma to atherosclerosis–5-lipoxygenase, leukotrienes, and inflammation.” Inflammation is something we are all aware of, and I have written about in most of my TAC articles this past year. What about 5-lipoxygenas and leukotrienes; what are they?

Our cell membranes are made up of fat; they are made up of cholesterol and phospholipids, which are sort of like triglycerides. There are two fatty acids in a phospholipid, and one is reserved for dietary fatty acids. In other words, our body is programmed to place a dietary fatty acid in every cell membrane phospholipid, and we have multiple 100’s of trillions of phospholipids; so we literally “are what we eat.”

If you eat inflammatory fats, you make inflammatory cells that drive chronic pain and other chronic inflammatory diseases, such as cancer, heart disease, and Alzheimer’s disease. The reason fatty acids can be inflammatory has to do with what the body does to them after cell injury. The fatty acids from our diet are released from phosopholipids when cells are injured. The most common fatty acid found in cell membranes is arachidonic acid, which we get indirectly from grains, seeds, seed oils (corn, safflower, sunflower, and soybeans), margarine, most salad dressings, and from nearly all packaged foods. We also get arachidonic acid preformed from the animal products we eat, assuming they were fed grains. Arachidonic acid and its precursor, linoleic acid, are both known as omega-6 fatty acids.

When arachidonic acid (AA) is released from injured cell membranes, the AA is acted upon by certain enzymes that create inflammatory eicosanoids. If AA is acted on by cyclooxygenase, or COX2, we get prostaglandin E2, which goes on to drive inflammation and nociception. If AA is acted on by lipoxygenase, or LOX, we get leukotrienes, which also go on to drive inflammation and nociception. There are many leukotrienes, including leukotriene A4, B4, C4, D4, and E4, and they all have inflammatory properties. The difference between COX and LOX is that LOX is mostly expressed in immune cells such as neutrophils, monocytes, macrophages, dendritic cells and mast cells.
The recent editorial in NEJM focuses on lipoxygenase and leukotrienes. Leukotrienes are involved in the promotion of rheumatoid arthritis, inflammatory bowel disease, psoriasis, allergic rhinitis, asthma, and atherosclerosis. These are very different diseases, yet they have a common etiology…chronic subclinical inflammation, which is driven by leukotrienes that are produced by diet-derived arachidonic acid.

As it turns out, omega-3 fatty acids, from green vegetables, flaxseeds, fish, and grass-fed beef and chickens, are anti-inflammatory. They produce prostaglandins and leukotrienes that do not promote inflammation. We should have a 1:1 ratio of omega-6 to omega-3 fatty acids in our diet; however, we currently tip the scales with a 20:1 or greater ratio. This is exceedingly pro-inflammatory and likely a major cause of most chronic diseases.

What do Americans currently do to defend against the inflammatory barrage created by our 20:1 ratio? We literally live on aspirin and nonsteroidal anti-inflammatory drugs (NSAID’s). The problem with these drugs is that they only act on the COX enzyme, which allows all the arachidonic acid to be potentially acted upon by LOX, which results in excessive production of leukotrienes. A clinical example of this problem is aspirin-induced asthma. More recently, and yet to be published, was a long term study with nurses who took aspirin or NSAID’s. It turns out that those taking the meds had a significantly greater chance of developing pancreatic cancer. I contacted the author who told me that this outcome was likely due because the meds blocked COX and diverted the AA to LOX, which resulted in leukotriene production.

The key to this problem is avoiding the abovementioned omega-6 foods and eating more omega-3 foods. Taking fish and flaxseed oil supplements is also wise. Natural inhibitors of COX and LOX include ginger, turmeric, and bioflavonoids, which can also be taken as supplements. These are simple dietary and supplement modifications we all can make, and represent what I have longtime referred to as “a nutritional adjustment.” Make sure to give your patients chiropractic and nutritional adjustments.

Syndrome X and Subluxation

Some 40 million Americans are thought to have syndrome X,¹ and there are likely to be several million who are rapidly moving in that direction. Syndrome X is thought to be a driver of heart disease, hypertension, cancer, diabetes mellitus, obesity, depression, and other diseases.² Syndrome X refers to an abnormal metabolic state that is characterized by insulin resistance, hyperinsulinemia, hypertriglyceridemia, small dense LDL’s, decreased HDL’s, postprandial lipemia and some other changes.² More recently, other metabolic abnormalities have been associated with syndrome X, including an increase in inflammatory markers such as C-reactive protein (CRP), plasminogen activator inhibitor (PAI), fibrinogen, and interleukin-6 (IL-6).³

An increase in plasminogen activator inhibitor and fibrinogen results in an increase in fibrin deposition, which ultimately correlates to an increase in fibrous tissue deposition…certainly an enemy to joints and muscles and long thought to be associated with reduced joint motion and subluxation. Indeed, research suggests that with certain patients, their back pain is due to excessive fibrin deposition that leads to spinal tissue fibrosis and chronic pain.⁴ So, it seems quite possible that syndrome X promotes joint dysfunction and back pain in certain patients.

Most docs and many lay people are aware of the term “glycemic index,” which generally refers to the blood sugar response to a given food. Foods with a high glycemic index (GI), such as glucose and white bread, produce elevated levels of blood sugar, compared to foods with a low GI, such as most vegetables, meats, and most fruits. If people eat high GI foods, the result will be an increase in blood sugar and increased levels of insulin, that is hyperinsulinemia.

It is thought that eating high GI foods over time will drive syndrome X. Diets that are high in carbohydrates and low in protein and fat are also thought to the drive syndrome X. Several other nutritional factors are thought, though, to promote hyperinsulinemia, and syndrome X, including deficiencies in magnesium, chromium, biotin, potassium, and vitamin E; elevated ratios of omega-6 to omega-3 fatty acids; physical inactivity; and even stress (elevated cortisol and reduced DHEA).²

It is reasonable to assume that any patient who has the nutritional imbalances listed above, has an increased chance of developing syndrome X. To be sure about one’s sugar handling capability and insulin status, you can perform a glucose tolerance test.

Assuming a patient does not have diabetes, the treatment approach is straight-forward. Patients must eat low GI foods. It is best to eat five small meals per day, or three moderately sized meals and 2-3 low GI snacks. Water is the preferred beverage. This dietary regimen will help reduce body fat, which is a key goal in the fight against syndrome X. It is known that fat cells release tumor necrosis factors that can block the insulin receptor, thereby promoting hyperinsulinemia and syndrome X.⁵

As several vitamins and minerals are involved in glucose handling, it also makes sense to take a multivitamin and a magnesium supplement. Omega-3 fatty acids help to stabilize blood sugar, so a fish oil supplement is also a wise measure to consider.

Most people in America literally begin a dietary mission to reach the goal of syndrome X by the time they reach forty years of age. Our dietary habits are abysmal in America, a land in which abundant health is a viable option. In early December of 2003, ABC television aired a special show about diet in America. Sugar foods and fast foods are the most common foods consumed in America. In the era of “fat free” foods, Americans still managed to pack on additional pounds; the reason for this…sugar replaced the fat, in fat-free foods.

While many patients and doctors are not interested in preventing syndrome X, heart disease, cancer, back pain, subluxation, and the like, there are many patients who very much want to be free of their health burdens. The approach described in this short article is very easy to follow. If you want to motivate your kids and younger patients, let them know that acne is driven by hyperinsulinemia⁶, which should get their attention.

References:

Isomaa B. A major health hazard: the metabolic syndrome. Life Sci 2003;73(19):2395-411
Seaman DR. Clinical nutrition for pain, inflammation, and tissue healing. Hendersonville (NC): NutrAnalysis; 1998: p.89-100
Sakkinen PA, Wahl P, Cushman M, Lewis MR, Tracy RP. Clustering of procoagulation, inflammation, and fibrinolysis variables with metabolic factors in insulin resistance syndrome. Am J Epidemiol 2000;152(10):897-907
Jayson MI. Chronic inflammation and fibrosis in back pain syndromes. In Jayson M. Ed. The lumbar spine and back pain. 3^rd ed. New York: Churchill Livingstone; 1987: p.411-418
Grimble RF. Inflammatory status and insulin resistance. Curr Opin Clin Nutr Metab Care 2002; 5:551-559
Cordain L, et al. Acne vulgaris: a disease of western civilization. Arch Dermatol 2002; 138:1584-90

Nutrition, For a Healthier Practice

Nutrition can be a healthy addition to your chiropractic or multidisciplinary practice and help your patients achieve greater well-being. Nutrition is low-cost, easy to implement and can make your treatments more effective. A happy, healthy patient will refer friends and family.

It has never been easier to test for the deficiencies or nutritional needs of your patients. Nutrition companies have classes to teach you about using their products to help your patients. Many have entire programs with CLIA (Clinical Laboratory Inprovement Act) waived test kits, blood work analysis, muscle testing programs or even extensive patient questionnaires designed to allow you to develop a logical approach in adding nutrition to a patient treatment program. All of these make it very easy to use nutrition in a busy practice. The products have been extensively researched and compiled to treat many specific disorders/diagnoses, such as formulas for degenerative joint disease, fibromyalgia, hypercholesterolemia etc. More importantly, you can learn how to augment many patients current treatment regimens with nutrition.

We have a multidisciplinary team in my practice and see a variety of health issues on a daily basis ranging from musculoskeletal to internal medicine. Nutrition is extremely important to the recovery of musculoskeletal patients. Many chemical processes can be given assistance; collagen fibers need extra vitamin C; minerals such as magnesium and manganese, protein, also B-complex, glucosamine and chondroitin sulfate are perfect to help these patients in their recovery. Fibromyalgia patients, as well as others with any form of fibrous tissue, scar tissue or chronic musculoskeletal problems can benefit from systemic enzyme therapy. And how about the many patients on some of the prescription acid blockers for digestive upsets. A digestive enzyme could get to the root of the problem and your patient may find the problems of indigestion are over. Homeopathic remedies are my favorite with pediatric and pregnant patients, because of the safety and effectiveness of these products.

Many times, too, we are called upon to help treat and council nutrition with diabetic patients. Some of the many demands made on the bodies of diabetics include poor healing, sugar handling issues, early onset of artherosclerosis and cardiomyopathy complications. These individuals need extensive nutritional help, not only with portion control and carbohydrate monitoring, but also the use of B-complex, zinc, CoQ10 and chromium, to name just a few nutrients. Patients who are on some form of cardiac or hypertension medication can be educated about the benefits of supplementation with Co-enzyme Q10. This vital nutrient is depleted from the body by these life-saving medications.

The use of nutrition in my practice developed in an eclectic manner. Over the years we found products and brands that work well, are tolerated well by patients and are reasonable in cost. I look for products that are sold only in physicians’ offices, so I don’t compete with the local health food stores. We have been able to utilize many of the nutritional supplements with patients because of new testing procedures that allowed us to diagnose or detect some deficiencies.

Nutrition can be used to effectively treat or co-manage every health issue that walks in your door! The addition of nutrients to your practice will add to the health of your patients and their families. This will translate into greater income for your office, more regular follow up with patients and many more referrals. It is a daily occurrence for a patient to come to my facility and ask to be evaluated and treated medically or with chiropractic, and to end up being treated nutritionally also. The patient has a happier, healthier outcome and a real plan for wellness when they are finished with their visit.

Most patients are interested in nutrition and supplements, but need educated assistance and products they can be assured are safe. Most health food stores don’t provide the level of help they require. You can easily fill this need for them. Get some education on the implementation of these nutritional products and the tests for deficiencies and nutritional indicators. It’s simple, fun, helpful to your patients and profitable for the practice. TAC

Dr. Lupo is the president and clinic director of First Care Injury Centers for urgent care and physical medicine in Tampa, Florida. He is a 1985 graduate from Life Chiropractic College. He is a senior consultant for Practice Perfect, one of the nations most reputable and largest consulting firms for holistic DC/MD/PT integrated services. He can be reached at [email protected].

The Five Stages of Pregnancy Part I

Nutritional planning during pregnancy is pretty straightforward, isn’t it? An extensive amount of literature has been written about the topic. The problem is that it is broad, overwhelming, and, frankly, a bit boring. For this reason, many of the solutions to pregnancy-related problems go untreated and often unnoticed.
This is a topic that will affect many of your adult patients. My intent is to pull the quality information out of this quantity of knowledge and apply my personal experience to make the topic straightforward and user-friendly.

Planning Parenthood

Parents-to-be should begin the following routine three months prior to attempting to start a family:

Get plenty of sleep, at least seven to eight hours per night. If more sleep is not possible, rest.
Drink lots of water; it is necessary to cleanse the body.
Exercise. Do what you can and, at the very least, go for walks.
Eat a healthy and balanced diet. Many people believe they are eating well and only have minor cravings from time-to-time. The problem is that cravings signify nutritional problems.
Stop smoking and drinking.

Creating a healthy baby comes down to lifestyle. How many future mothers and fathers meet the above recommendations? Most patients believe that they eat well. So, how do you explain to them how their vitamin and mineral deficiencies have developed?
The average American diet is not deficient in nutrients; it may not be balanced, but it is rarely deficient. The 1988 Surgeon General’s Report on Health and Nutrition emphatically stated that the overwhelming problem in nutrition is nutrient excess rather than deficiency. Thus, the problem must stem from nutrient assimilation, which begins with digestion and absorption.

Stage One—Conception

The comedian George Carlin has used oxymorons, such as “jumbo shrimp” and “twelve-ounce pound cake,” as a part of his stand-up act for years. Another example of this seemingly self-contradiction is giving prenatal vitamins and minerals to a woman after she becomes pregnant. If possible, prenatal nutrition should start several months before conception to prepare the bodies of both parents for a baby. A nutrient deficiency in either parent will influence child development before and after birth. If there is a pre-existing deficiency in the mother when she becomes pregnant and nutritional support (prenatal vitamins) does not arrive until roughly another month after conception, it will be difficult, if not impossible, to play catch-up. This is because some of the most important fetal development happens within the first month.
Good prenatal nutrition is not confined to a bottle labeled “prenatal multiple vitamin and mineral supplement,” for three reasons:

Many prenatal vitamin and mineral products contain ingredients of the cheapest quality that can be legally sold. Many of the supplements create a feeling of nausea in expectant mothers because they cannot properly digest or assimilate the products.
“Prenatal” means prior to birth, not prior to conception. The standard prenatal recommendation is to supplement folic acid to prevent neural tube defects in the baby. The problem is that the neural tube develops within the first three weeks of pregnancy and the mother-to-be often does not even know she is pregnant at that time.
More emphasis should be placed on the importance of lipid digestion and assimilation for both males and females in order to prepare for the conception and development of the fetus.

Essential Fatty Acids (EFA’s)

Fatty acids are the “problem” with problem pregnancies. In this day of great technological research and advances in artificial insemination, fertility pills, and in-vitro fertilization, essential nutrients take a backseat to the latest and greatest pharmaceutical development and are even, more commonly, forgotten entirely. So what makes the essential nutrients essential?

The Three Essential Fatty Acids (EFA’s)

Linoleic acid, an 18-carbon fatty acid with two double bonds, cannot be produced by the body and, therefore, must be included in the diet. It promotes growth and heals dermatitis and can be found in vegetable and seed oils, such as safflower, sunflower, corn, soybean, cottonseed, sesame, and peanut.
Arachidonic acid is a 20-carbon polyunsaturated fatty acid with four double bonds. It is not essential because it can be converted from linoleic acid. Arachidonic acid is found in animal fat and prevents dermatitis, but does not promote growth. It can also be found in Omega-6 oils in red meat, dairy fat, and shellfish.
Linolenic acid, the 18-carbon fatty acid with three double bonds, cannot be synthesized by humans. It does not prevent dermatitis but does promote growth. It can be found in oatmeal, evening primrose, borage, and black currant.

Tantamount is digestion and assimilation of the nutrients. That’s where enzymes play a role. If the woman cannot digest meat very well (symptoms of gas, bloating, constipation/diarrhea), she isn’t getting the benefit of the nutrients provided by it. That’s why so many women become vegetarians (beyond religious reasons)—because they feel bad or “yucky” after eating meat. Avoiding something doesn’t really fix the problem, though, does it?
The three essential fatty acids are precursors for prostaglandins. This is a critical consideration because the hormone-like substances are produced and used within a tissue rather than transported to other tissues. They affect blood pressure by stimulating the contraction of smooth muscle in blood vessels and regulating the transmission of nerve signals. In regard to pregnancy, EFA’s promote conception, prevent spontaneous abortion, and allow the woman to initiate labor and commence lactation after delivery.
The male’s nutritional status, equally as important as the female’s during conception, is often overlooked. Males need more EFA’s than females. This is why nutrients such as fat-soluble vitamins A, D, and E are often used in the treatment of prostate problems and low sperm counts.
Females have greater difficulty digesting fats and are more susceptible to biliary stasis than males. Therefore, women with problem pregnancies should never supplement oils at mealtime. Oils coat the food and make the food very difficult to emulsify and digest. It is better to supplement oils between meals or in a dry form whenever possible. A low-fat diet is a problem for a fat-deficient woman that desires pregnancy.
The solution is better digestion with plant enzymes and improved dietary habits.
Other lipid-related substances such as phospholipids and cholesterol are also essential in these cases. Phospholipids are water-soluble. They increase the solubility of fats and keep them in an emulsified state, an incredibly important point concerning problem pregnancies. Lecithin, a necessary ingredient in cell walls, is the most common phospholipid. One of the most important supplements you can recommend for women with problem pregnancies is a good source of wheat germ that is not in oil form and not defatted.
Sterols are lipid-related substances that include cholesterol and vitamin D. Cholesterol plays an important role in the maintenance of the myelin sheath surrounding nerve fibers. It is also essential for the formation of sex hormones and bile salts—functions that must be supported during pregnancy. Today, the tendency is to use prescription drugs such as statins that have the opposite effect.
Cholesterol is found in animal fats and is absent in vegetable fats. Dietary restriction is useless because the body is able to synthesize cholesterol, simply producing what its homeostatic mechanisms dictate. The problem lies in delivery of cholesterol to the target tissues. The key to lowering high cholesterol levels is to improve protein digestion. I predict it will not be long before this idea is mainstream.
In the next issue of The American Chiropractor, we will explore the special nutritional requirements of the mother-to-be throughout her pregnancy. TAC