By Phil Maffetone, DC, and Scott Cuthbert, DC
It's almost hard to believe that not long ago, people smoked cigarettes on airplanes, in restaurants and bars, at their worksites and even inside hospitals. In fact, medical doctors often appeared in tobacco print ads in the '50s. And long before that, even Olympic athletes endorsed cigarettes. But the transition from a smoking society to one that places even more strict restrictions on where one can smoke, including parks, schools, theaters, and multi-family apartments, has been slow and litigious, despite decades-old knowledge of how harmful tobacco can be.
Could a similar process be used for better or healthier eating? With a concerted effort, it's possible to make a mass transition to improve people's dietary habits. Certainly, smoking and junk food share similar unhealthy aspects. This is one reason why some of the warriors from the legal battle to ban smoking in many locations, a war that was essentially won in many countries, are now poised to take on the bad food giants of the industry. But a new front has formed.
A recent issue of the Journal of the American Medical Association1 included a commentary on the health of medical doctors, in particular their eating habits. The authors, three MDs headed by Lenard Lesser of the Palo Alto Medical Foundation Research Institute, make the claim that the medical profession was significantly influential in reducing the problem of smoking throughout the U.S. and that the same could be done for diet. By eating better, doctors would be setting an example for their patients and, like their influence on smoking, the positive power would overflow into the general population.
But is the medical profession adequately trained and knowledgeable to accomplish this task? Certainly doctors are not immune to being unhealthy; perhaps half are over fat and at least as many have poor fitness by leading sedentary, non-active lives.2 In 2009, the Archives of Internal Medicine reported that 31 percent of medical doctors were also "burned out" and 51 percent wouldn't recommend the profession to their children.3 Detailed questioning of 8,000 U.S. surgeons found that 40 percent were burned out, 30 percent had symptoms of depression, and 28 percent had "mental-quality-of-life" scores below the general population.4
When lecturing, it's easy to pick out the people in an audience who are less healthy, especially after eating junk food, particularly those who get sleepy or lose concentration. In fact, the JAMA authors noted that doctors consuming high-glycemic, unhealthy foods are adversely affected in terms of learning, attentiveness and patient care.
Is it possible that poor health and nutrition contributed to findings in the 2010 New England Journal of Medicine study that revealed 25 percent of all hospitalized patients will experience a preventable medical error of some kind?5 In addition to positively influencing patients, doctors who improve their diet would no doubt significantly increase their own overall health, longevity and productivity.6
It's bad enough when a family medical doctor suffers from poor health, but too many chiropractors are just as guilty, and often while emphasizing healthy lifestyles to their patients. But who is better equipped than the chiropractic profession to change the world through healthy eating? Many chiropractic colleges and large numbers of approved scientifically-based nutrition courses and programs, including those for license renewal, are available throughout the year all over the U.S. In addition, chiropractic college curricula are well-oriented toward teaching healthy eating and nutrition, and diplomate programs in nutrition are an important component in the profession's development of integrative best-practices. Holtzman & Burke also report that in New York alone, 80 percent of surveyed chiropractors employed clinical nutrition in their practices.7 These important traits don't exist in mainstream medicine.
It's not just DCs, but all health care professionals associated with a chiropractic office or clinic who could help lead the way for a healthier world by setting an example for all to see.
And who better to influence the wide spectrum of patients than chiropractors? Bus drivers, pilots, commuters and others who operate machinery often find themselves in situations in which post-meal loss of concentration could result in human error. With improved diets, better brain function could be significant, with the potential for fewer accidents, bad judgment and other problems, improving health and saving lives and billions of dollars.
If we really wanted to change an entire population's eating habits, which could be as profound as those associated with the dramatic reductions in cigarette smoking over the past decade or two, real changes would have to made, albeit simple ones. The JAMA article emphasized that doctors eat too many calories and that a low-calorie diet might be an answer to improving overall health. But this is not good enough. Exchanging one junk food meal for a lower-calorie junk food version will not solve the problem. This proverbial step-in-the-right-direction is akin to smoking low-tar cigarettes instead of quitting altogether.
In fact, there are no "diets" that work — everyone knows that. There is, however, adequate scientific information and reasonably good consensus about the basic ingredients of a healthy diet. It includes avoiding junk food, especially sugar and processed flour, eating lots of fresh fruits and vegetables, and consuming adequate protein and essential fats. (There are, however, many specific details about foods that most experts would be unable to agree upon, but these should not be significant enough to prevent the average consumer from making adequate dietary changes.)
By eliminating taxes on healthy, fresh foods and adding it to unhealthy choices, governments could actually participate in the process along with chiropractors in helping people make the necessary dietary changes. In 2006, Mayor Bloomberg made New York City the first to ban artificial trans fats in restaurants – from the corner pizzeria to high-end bakeries.
South African health and exercise-science researcher Timothy Noakes, MD, recently discovered he was carbohydrate intolerant, and made the necessary dietary changes that resulted in significant health benefits. By avoiding refined carbohydrates, eating more protein and healthy fats, "I am at my lightest weight in 20 years and I am running faster than I have in 20 years," he said in an interview in Discover magazine.
Dr. Noakes now challenges the conventional dietary guidelines of a low-fat, carbohydrate-based diet, detailing it in the second edition of his book, Challenging Beliefs. But some of his peers have openly complained about his recommending so-called unconventional dietary advice.
So, not all doctors would be on board with saving the world through dietary improvements, just like the no-smoking campaign had opponents (some, no doubt, were doctors). This despite the many billions of dollars that could be saved in health care costs beginning the first year. Just look at the advisory board for the corn syrup lobby; it's filled with medical professionals. Others might even be adamant that it's none of our business what they personally do, health wise. Fair enough — we won't include these individuals in our quest.
If chiropractic professionals can change the world, they can also do it by helping patients who are teachers, who educate young people on how to be better adults. Lecturing in schools is an excellent way to help children and to develop a child-based practice. We literally are what we eat. And parents too — we all want the best for the world's children. In fact, why not the sanitation workers, cab drivers, office workers, CEOs and law enforcement officers? These and others are the foundation of a chiropractic practice, which can lead the charge by passing on valuable information to patients, and by taking the challenge to eat well and be well.
The fact is we all have differences when it comes to our particular dietary needs. Fortunately, these differences are relatively minor. That's why suggesting an off-the-shelf "diet" won't work. However, helping patients to easily figure out how best to eat and exercise for their particular needs is a reality. This involves education, one important feature of a chiropractor's ongoing education and practice.
The medical profession's claim that it helped reduce smoking in America has merit, and its call to do the same with diet may be respectable, but there are more fronts forming that infringe on chiropractic's long-standing expertise. A recent New England Journal of Medicine8 article highlights the need to "re-engineer" true preventive care in the U.S., not just screen for disease. Chiropractic engineered this long ago. Mayo Clinic's Michael Joyner writes in the Journal of Applied Physiology9 that reductionism has failed medicine, and in its place will be systems biology — the new term for holistic. Can mainstream medicine be holistic?
By coming together as a profession, chiropractors can easily lead the charge to a better health care environment and more strongly represent their philosophically holistic, clinical and scientific approaches to patient care.
- Lesser LI, Cohen DA, Brook RH. Changing eating habits for the medical profession. JAMA, 2012;308(10):983-984.
- Ajani UA, et al. Body mass index and mortality among US male physicians. Ann Epidemiol, 2004;14(10):731-9.
- Dyrbye LN, et al. Work / home conflict and burnout among academic internal medicine physicians. Arch Intern Med, 2011;171(13):1207-9.
- Shanafelt TD, et al. Burnout and career satisfaction among American surgeons. Ann Surg, 2009;250(3):463-71.
- Landrigan CP, et al. Temporal trends in rates of patient harm resulting from medical care. N Engl J Med, 2010;363(22):2124-34.
- Shils ME, et al. Modern Nutrition in Health and Disease, 10th Edition. Lippincott, Williams & Wilkins; 2005.
- Holtzman D, Burke J. Nutritional counseling in the chiropractic practice: a survey of New York practitioners. J Chiropr Med, 2007 Mar;6(1):27-31.
- Marvasti FF, Stafford RS. From sick care to health care — reengineering prevention into the U.S. system. N Engl J Med, 2012;367:889-891.
- Joyner MJ. Giant sucking sound: can physiology fill the intellectual void left by the reductionists? J Appl Physiol, 2011;111(2):335–342.
Dr. Philip Maffetone is a 1977 graduate of National University of Health Sciences, former chairman of the International College of Applied Kinesiology, and has written more than 15 books / textbooks on sports, fitness and health. Contact him with questions and comments via his Web site, www.philmaffetone.com.
Dr. Scott Cuthbert, author of two textbooks on applied kinesiology (in press) and more than 50 peer-reviewed research articles, practices in Pueblo, Colo. (www.pueblochiropracticcenter.com).