Chiropractic Economics' March Webinar Q&A

Experts answered your questions from Chiropractic Economics’ March 3 Webinar titled “Growing your practice with nutrition.” Please check the Web site frequently for answers to upcoming Webinars.

Q. How do you know if a supplement is carbon-form?

A. If it has carbon in it. This is in my opinion marketing hype. Our stool has carbon in it for example. (Bruce Bond, DC, DABCN)

Q. If some are on the 21-day SP Purification program and have one day of some junk food, will it totally stop the purification system with it not being able to continue?

A. No, but I never put a patient on the program unless they committed to do the three weeks. If they do it once talk to them and work out why they deviated. Behavior is a result of ones thoughts. (Bruce Bond, DC, DABCN)

Q. Do patients feel ill during body purification?

A. The only issue I found was headaches if they were a heavy coffee drinker. In these cases I weaned them off coffee before doing the program. (Bruce Bond, DC, DABCN)

Q. Do you have experience with bromelain as a systemic enzyme?

A. No, I am not sold that these enzymes make it through the digestive tract and small intestinal brush border intact. If they do then I would suspect a gut lining issue. (Bruce Bond, DC, DABCN)

Q. In January I conducted a month-long group detox program with great results for patients. Registering participants was easy. However, I tried to get another group detox going in March with new participants and enthusiasm was far less. My marketing was much the same, but participants were far fewer in number.  Is there a “sure fire, can’t miss, bonded, insured, guaranteed” way to get them in the door?

A. The first one was probably due to the failed New Years Resolution most make.  I would recommend not only focusing on Detox, but a healthy weight loss program.  Sixty-five percent of Americans are overweight so the market is huge. Once they see the benefits from this many will get involved in other things you have to offer. (Bruce Bond, DC, DABCN)

Q. What about fighting off genetic dispositions that run in the family? For example: My father has two brothers and everyone got angina and had heart surgery. There is now a scientific breakthrough that identifies genetic defects and creates a customized nutrition supplement that has had 14 years of clinical documentation. It is a publicly traded company called Genwize Life Sciences.

A. What people inherit are bad habits not bad genes. Genetic expression is the result of the environment we bath our genes in. (Bruce Bond, DC, DABCN)

Q. Are these slides available for use in lay-lecture application?

A. No, better to make your own up. You will feel more comfortable doing the presentation and it will force you to review. Remember, LUCK is when preparedness meets opportunity. Keep the presentation slides basic. They are to give you an outline to follow and to make specific points. Most lay lectures turn into data dumps, which is not good. They don’t need to know all that you know; they just need to know that you know. (Bruce Bond, DC, DABCN)

Q. Regarding the Detox Program, can patients on medications do the detox?  If so, what are the modifications, if any?

A. If you are using fish oil then those on anticoagulants may be an issue as well as due to the increased consumption of green vegetables. If you are unsure regarding meds, I use a Web site called Drugs.com. Very good info. (Bruce Bond, DC, DABCN)

Q. What is a food source for systemic enzyme support?

A. Papayas, figs, for example and fermented foods such as Natto, Miso, and Tempeh. (Bruce Bond, DC, DABCN)

Q. Do you have tips on how to better communicate to patients?

A. Study from those who you know are able to convey the message. I still spend a lot of time studying the great speakers, etc. (Bruce Bond, DC, DABCN)

Q. Where can I find the evidence that Optimal Health Allowance is better than RDA?

A. You won’t. In fact the RDA is old terminology. They’re using something now called adequate intake for those nutrients not studied for their RDA value. Taking one supplement that has high doses of only the known vitamins, minerals, and certain phytochemicals is not feeding. Show me a supplement that has all the Glucosinolates such as found in Kale and I will be glad to talk to the manufacturer so they can show me that the plant constituents are equal to what was initially in the food to begin with. Man cannot duplicate what nature made. (Bruce Bond, DC, DABCN)

Q. What research is the Optimal Daily Allowance based on?

A. It is using high dosages of vitamins and minerals but at a level below toxicity levels. No real research behind it. (Bruce Bond, DC, DABCN)

Q. Thus far in practice, whenever ingested proteases have dramatic effects on extra-GI tissue, e.g. inflammation in ankle from trauma, subsequent testing has found gut permeability/gut mucosal barrier skew (so-called “leaky gut”).  That makes me wonder if the huge molecules of proteases are being absorbed because of gut excessive permeability and if gut permeability were optimal then proteases would not have the results being claimed for trauma etc.

A. As you know, the small intestine maintains a fine balance between under-absorption (malabsorption) and over-absorption (hyper-permeability).

The healthy small intestine is able to absorb protein molecules that are larger than commonly believed. In addition to intestinal absorption of amino acids, there is also intestinal absorption of proteins and small molecular weight peptides, and proteases [see Lake-Bakaar reference below].

An earlier study described two differen
t transmucosal pathways, one of low permeability for molecules > 30 kDa, in which the molecular weight was of minor importance for the passage, and another more permeable one in the 1- to 30-kDa range, in which the passage was highly influenced by the molecular weight. [http://www.ncbi.nlm.nih.gov/pubmed/7680488]. Chymotrysin has a molecular weight of 25 kDA, tryspin is 24 kDA.

There is less absorption of alpha-amylase because of its higher molecular weight of about 51kDA, since proteins with molecular weight above 40kDA preferentially enter the lymphatics.

It also appears that the electrical charge on protein regulates, at least partially, its absorption from the small intestine. [http://ajpgi.physiology.org/cgi/content/full/282/4/G711]

Chymotrypsin and trypsin absorption can also be represented by entro-hepatic recirculation (or reabsorption) of digestive enzymes, which is similar to the well known reabsorption of bile salts.

A classic paper which discusses protease reabsoprtion is “Origin of circulating serum immunoreactive trypsin in man” by Lake-Bakaar et al, which can be accessed at:

http://www.springerlink.com/content/q53g650222674106/

Their abstract ends with “We conclude that circulating serum trypsin is derived, at least in part, from intestinal reabsoprtion.”

As a whole, the paper also discussed protease interaction with alpha-a-macroglobulin as well. It also has a number of other good references that discuss protease absorption.

In conclusion, absorption of proteases across the small intestine is a normal physiological process.  The effectiveness of Wobenzym® N and Wobenzym® PS is due in part to their ability to deliver high-grade proteases to the small intestine, where they are absorbed systemically, and then able to activate alph-2-macroglobulin. Wobenzym® PS delivers 144 mg of trypsin per 3 tablets. (Joseph J. Collins, RN, ND)