Take a patient-centered approach
There is usually more than one way to get a job accomplished. For example, when painting a room, one person may cut in the edges of the walls first and then paint the broader areas, while another person may approach the room in the opposite way. Neither is right or wrong; they are just different ways of approaching the same task. Helping individuals become healthier through good nutrition practices is no different; health care providers can, and most likely will, have different approaches.
Some chiropractors advocate for a whole-foods nutrition approach while others complement whole-food intake with supplementation of macro- and micronutrients. Neither approach is right or wrong, just different. The decision to treat one way or another is based on many factors and should be patient-centered. Patients are as unique as their fingerprints — bringing different dietary habits, food behaviors, religious food practices, medical history and genetics to the equation for the chiropractor to consider in their nutritional treatment approach.
Whole food approach
A whole food is defined as a food that has been processed or refined as little as possible and is free from additives or other artificial supplements. A whole-food diet typically comprises fruits and vegetables, whole grains, nuts, seeds, legumes and minimally-processed proteins. If patients do not have access to grocery stores that specialize in whole foods, they can be advised to shop the perimeter of their grocery stores, where most whole foods closest to their natural form are typically found.
Standard Process is an example of a company bridging the gap between whole-food nutrition and supplements to help chiropractors and their patients achieve optimal health benefits. Standard Process was founded in 1929 by Royal Lee, DDS, whose whole-food philosophy and goal was to make high-quality therapeutic supplements using vital nutrients as found in nature.
Today the third-generation, family-owned company carries on Lee’s legacy and grows more than 80 percent of the raw plant product ingredients at the Standard Process-certified organic farm in Palmyra, Wisc. Unique in the industry, the supplement-manufacturing process begins at the farm to ensure product nutrient density.
“Guided by Dr. Lee’s remarkable philosophy and vision, our company remains dedicated to making exceptional whole-food solutions, growing certified organic specialty crops and using state-of-the-art manufacturing processes to retain vital nutrients within each ingredient,” says Charlie DuBois, Standard Process president and CEO. “Thanks to our valued partnership with chiropractors over the last 90 years, together we are changing patients’ lives through whole-food nutrition.”
Health-promoting nutrients and more
The benefit of consuming whole foods is the inclusion of naturally-occurring substances beyond macro- and micronutrients. Fiber, phytochemicals, carotenoids and flavonoids (exogenous antioxidants) have all been found to be beneficial for supporting overall health.
Fiber helps support and maintain bowel health as well as lower serum cholesterol levels. Fiber can also help control blood glucose levels. Exogenous antioxidants help prevent or slow the cell damage from free radicals — oxygen-containing molecules with an uneven amount of electrons. An uneven number of electrons allows these free radicals to easily react with other molecules, causing large chain chemical reactions or oxidation. Oxidative stress is an imbalance between free radicals and antioxidants in the body and can cause serious damage at the cellular level. Antioxidants donate electrons to free radicals, causing the free radical stabilization.
These beneficial substances have been found to have a positive impact on a person’s nutritional well-being, and research continues to strive to identify even more substances and active compounds in foods that may provide further benefits. However, it is important to note that not all individuals can get their nutritional needs met through consuming foods, even if they are whole, nutritious foods.
Additional needs
A subset of individuals may have additional nutritional needs that can be met through supplements.
Women who are looking to become pregnant, or are pregnant, have an increased need for folic acid, a B vitamin, to reduce the risk of spina bifida or neural tube defects. Individuals living with malabsorption disorders such as celiac disease need to avoid gluten and oftentimes need to fortify their intake of iron, calcium, magnesium, zinc, vitamin D and the B vitamins folate, niacin, riboflavin and cobalamin, vitamins and minerals found in whole grains naturally or cereal grain foods.
Bariatric surgery patients also have an increased need for vitamins and minerals such as vitamin B12, vitamin D, calcium, zinc and copper. The surgery itself leads to malabsorption, and the smaller amounts of food these patients consume do not always meet their nutritional needs.
Access to healthy food
In 2017, an estimated one in eight Americans were “food insecure,” equating to 40 million Americans, including more than 12 million children. The United States Department of Agriculture defines food insecurity as a lack of consistent access to quality food for an active, healthy life1.
One “bad month” can be enough to plunge many households into food insecurity. Layoffs at work, unexpected car maintenance or an accident on the job can suddenly force a family to choose between food and paying bills. Working families across America face countless situations that can result in food insecurity and hunger. 1,
Supplementing nutrition
Supplementing food intake with additional vitamins and minerals can be very beneficial for individuals who have specific deficiencies, disorders or medical conditions that require a specific nutrient in greater quantities.
For example, older individuals, people with limited sun exposure, obese individuals and people with inflammatory bowel disease are all at higher risk for vitamin D deficiency. Vitamin D deficiency can lead to softening of the bones, referred to as rickets in children and osteomalacia in adults. Treatment for this deficiency is dependent on the level of vitamin D. Treatment dosing is typically 3,000 to 6,000 IU per day or as high as 50,000 IU once a week for several weeks.
Ten to 30 percent of individuals over the age of 30 do not properly digest and absorb naturally-occurring vitamin B12 from foods. ,This is typically due to the decreased activity or absence of a glycoprotein that lives in the stomach. Vegetarians typically need supplements of B12, which is found in animal sources of protein.
Supplements for chronic conditions
Supplementation is also helpful in the management of certain diseases such as inflammatory bowel disease (IBD). A recent meta-analysis published in the Journal of Food Medicine shows that curcumin, a compound found within turmeric, interacts with receptors, growth and transcription factors, cytokines, enzymes and genes, leading to inhibitory effects on molecules associated with inflammatory processes. These molecules are critical factors in the positive regulation of inflammatory cytokines in inflammatory diseases, suggesting that curcumin may be considered a new therapeutic agent for patients with IBD. Curcumin is a natural anti-inflammatory agent that represents an attractive, safe and inexpensive alternative for the treatment of IBD.
Post-bariatric surgery patients are challenged to meet high protein (macronutrient) goals for safe, effective weight loss. These patients start out with a post-operative diet that progresses from all liquids to semi-soft food and then solid food, but with very limited portion sizes along the progression. For these individuals to reach their protein goals they must rely on protein and meal replacement drinks that are high in protein.
Whole food-based science
Whole-food supplement manufacturers continue to make ongoing investments in new technologies to develop new products and demonstrate improved bioavailability.
John Troup, PhD, Standard Process vice president of clinical science, education, innovation, research and development, says, “The major issue affecting America’s health profile and increasing incidence of chronic health problems is difficult access to food with more nutrient and phyto-density, higher quality carbohydrate forms and lower sugar levels. We’ve lost sight and awareness of selecting nutrient-rich whole foods and the health advantages they offer.”
Troup says that since so little of America’s farmlands are dedicated to organic, sustainable farming of nutrient-dense specialty crops, Standard Process grows and processes their own crops to ensure nutrient and phyto-dense whole food products.
“Our goal is to deliver whole foods as nature intended,” says Troup. “From soil to supplement, we begin the manufacturing process at our certified organic farm shortly after harvest, extracting nutrients and phytoactives in a manner that leaves the whole-food matrix unchanged. This allows us to offer nutrient-dense, high-quality products while limiting the need to source and transport crops, which significantly depletes nutrient values and health benefits.”
Last spring Standard Process reaffirmed its commitment to whole-food science and nutrition by opening a Nutrition Innovation Center. Located at the Kannapolis, N.C., research campus, the state-of-the art facility is the only active clinical research center dedicated to whole-food science, nutrition and the clinical care of patients through integrative and functional health care approaches.
The center’s team of integrated practitioners and clinicians leverage new and emerging technologies and academic and clinical partnerships on campus and across the country to accelerate whole-food product development and commercialization to help change health care in America, and improve health outcomes for the patients they serve. Additional work is underway that demonstrates how nutrition provides supportive care as co-therapy with chiropractic treatment approaches, leading to accelerated improvements in patient outcomes.
The center also coordinates and offers leading training opportunities with continuing education credits for chiropractors and other health care practitioners, fueling their goal to provide patients the latest proven, whole-food nutrition information.
FDA regulations and supplements
Regulation of supplements is conducted by the U.S. Food & Drug Administration (FDA). The FDA regulates prescription and non-prescription drugs similarly, as both must be tested and proven to be safe and effective before they reach the marketplace or consumer.
The FDA and other governmental agencies also regulate and inspect dietary supplements manufacturers. For example, Standard Process’ certified organic manufacturing facility employs nationally and internationally recognized quality testing, food sanitation and safety methods, complying with and exceeding the FDA’s good manufacturing practices. A practitioner’s brand, Standard Process encourages patients to visit chiropractors or other health care practitioners who understand the value of whole-food nutrition for help in determining which supplements may best support their health needs and goals. This consultation prior to starting any supplement regimen helps avoid possible side effects, including medication interactions.
The bottom line
Chiropractors treat a host of issues and conditions involving the overall body, and nutrition can play a paramount role in the chiropractic treatment plan. Whether the approach is whole foods, complementing food intake with quality supplementation or both, it is important to tailor nutrition recommendations to each patient’s needs.
Tammy Hutchisen, RD, LDN, is a registered, licensed dietitian who has worked in bariatric medicine for more than 20 years. She currently lives in Maine and is a consultant to bariatric practitioners. She is a member of the Academy of Nutrition and Dietetics, the Weight Management Dietetic Practice Group, the Georgia Academy of Nutrition and Dietetics, and the Maine Academy of Nutrition and Dietetics. She can be reached at thutchisen@gmail.com.
References
- www.ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional
- www.ods.od.nih.gov/factsheets/VitaminD-HealthProfessional
- www.feedingamerica.org
- Coleman-Jensen, M.P. Rabbitt, C.A. Gregory, and A. Singh. 2018 Household Food Security in the United States in 2017, ERR-256, U.S. Department of Agriculture, Economic Research Service.
- www.hungerandhealth.feedingamerica.org/understand-food-insecurity
- Mazieiro, R; Frizon, RR; Barbalho SM; Goulart RA: Is Curcumin a Possibility to Treat Inflammatory Bowel Diseases? J Med Food. 2018 Nov;21(11):1077-1085. doi: 10.1089/jmf.2017.0146. Epub 2018 Jun 29
- Wooltoron, Eric; Too much of a good thing? Toxic effects of vitamin and mineral supplements. CMAJ. 2003 Jul 8; 169(1): 47–48.
- Oakley GP. Eat right and take a multivitamin. N Engl J Med 1998;338:1060-1.
- www.aca.org
- Whole Food Nutrient Solutions. www.standardprocess.com
- www.celiac.org
