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Silly Chiropractic Advice
about Obesity Prevention

Stephen Barrett, M.D.


The American Chiropractic Association (ACA) likes to pretend that the scope of chiropractic is very broad and that its members are qualified to play a major role in preventive public health. On April 7, 2003, in line with this objective, the ACA issued a a news release through PRNewswire that provided tips for lifestyle and dietary changes and suggested that chiropractors be used for nutritional advice. Here is the ACA release with my comments added in boldface red type.


American Chiropractic Association Responds to
Epidemic of Obesity in the United States
ACA is Official Partner in National Public Health Week

The American Chiropractic Association ACA and public health officials across the country are using National Public Health Week, April 7-13, to call attention to the prevalence of obesity among Americans. The ACA warns that the number of Americans who are overweight or obese is steadily increasing at epidemic proportions, and immediate intervention is critical to the health of our country. The Centers for Disease Control and Prevention CDC has indicated that the rate of obesity has increased in all 50 states over the past year. Additionally, childhood obesity has reached its highest level in 30 years. Contributing to these figures is the fact that Americans are exercising less and eating less healthy foods than ever before. According to ACA President Daryl D. Wills, DC, "We need to call attention to this life-threatening epidemic."

In observance of National Public Health Week, the ACA offers the following nutrition tips to help combat this growing problem: [Most of the tips are not relevant to weight-control. The news release seems to be an attempt to create visibility for ACA. The American Public Health Association Web site invites organizations to become National Public Health Week partner by filling out a one-page application which indicates how the applicant and the project can publicize each other.]

Lifestyle Changes

* Get active! Try to exercise for 20-30 minutes at least 3-4 days a week. [Appropriate exercise can provide many health benefits and should be part of any weight-control program. Several major organizations have issued research-based guidelines that depend on the individual's goals. The ACA's advice is simplistic and less than ideal for weight-control purposes.]

* Eat out more sparingly. Since food preparation methods in restaurants often involve high amounts -- and the wrong types -- of fat and sugar, give preference to home-cooked food. [Moderation of fat and sugar intake is part of standard medical/nutritional advice. Eating at home does not guarantee that the diet will be more healthful.]

* Limit your intake of alcohol, and quit smoking. [This is standard medical advice.] Drinking alcohol excessively and/or smoking can hinder your body's ability to absorb nutrients from your food. [Nutrient shortages related to alcoholism are usually related to inadequate food intake rather than poor absorption. Smoking does not hinder absorption of nutrients.]

Dietary Changes

* Eat more raw foods. Cooking and canning destroys much of the nutrition in foods that can be eaten raw. [This statement is misleading because food processing has little impact on overall diet. Only a few nutrients are heat-sensitive, and these are readily obtainable from the average American diet.]

* Select organically grown foods when possible. They have lower amounts of toxic elements than foods that are not grown organically. [Except for price (organics are higher), the differences between "organic" and conventionally produced foods are insignificant (1). Neither contains high levels of "toxic elements."]

* Eat whole foods. Much of the nutrition available to us in fruits and vegetables can be found in its skin, so don't peel it off and throw it away, unless it has been waxed or dyed. [Is the ACA suggesting that people should eat the skins of banana, citrus fruits, pineapples, and melons? With apples and potatoes, some vitamin C would be wasted if the peel is not eaten, but the amount would be irrelevant in most people's diet. Some people prefer to peel apples because undigestible carbohydrates in an under the skin can cause flatulance. The only dyed foods I can think of are maraschino cherries and some pistachio nut shells.]

Stay hydrated! Drink eight to ten 8-ounce glasses of water a day. [The amount of water people need depends on their activity level, environmental conditions, and various other factors. For most people, thirst is an adequate guide to an appropriate fluid intake (2), but most people will not benefit from adding two quarts of water per day to their diet. The ACA's advice also fails to take into account that foods and other beverages contain water.]

* Consume 25-30 grams of fiber per day. [The Institute of Medicine's recommended daily intake for adults up to age 50 is 38 grams for men and 25 grams for women. For those over 50, because of decreased food consumption, it is 30 grams for men and 21 grams for women (3).] Whole-grain breads and cereals, beans, nuts and some fruits and vegetables are good sources of fiber.

For Vegetarian Dieters

* Don't rely on fruits and vegetables at the expense of grains and legumes. The repetition of fruits and vegetables can narrow your food choices, thus narrowing the variety of nutrients you consume. [This advice is silly. First, legumes (peas and beans) are vegetables. Second, in contrast to science-based food guides, this item provides no information about the number of servings of fruits, vegetables, or grains. Third, very few people who eat vegetarian diets are inclined to skimp on grains.]

* Tiredness, malaise, and anemia can be signs of deficiencies. [True, but they are more likely to be caused by other things.] Those who have been on a vegetarian diet for some time should have their B12 and iron levels checked at least once a year. [It would be more prudent to discuss how to prevent B12 and iron deficiency than to check for it. In addition, the only vegetarians who are at risk for B12 deficiency are those who avoid all animal products.]

* Consume fortified foods or take supplements to obtain the nutrients you no longer get from animal-based products. [True, but it would be more prudent to identify the nutrients that are at risk. Since the list is a short one, the ACA could have identified the nutrients in their press release. Why do you suppose they did not?]

* Before eliminating animal products from the diet, it is important to get information about how to do it right. Children, pregnant and breast-feeding women, and people recovering from illness should consult their doctor e.g. DC, MD, DO. [It would be wise to be well-informed. However, registered dietitians (RDs) are probably the most qualified professionals to consult, and MDs and DOs are generally more qualified than DCs.]

Dr. Wills explains that, "Unfortunately, consumers are not sure where to turn for nutritional advice. Many people do not realize that, as part of their training, doctors of chiropractic learn overall wellness and healing, with proper nutrition playing a significant part in that approach." [This statement is untrue. Chiropractors have very little training in clinical nutrition, and their textbooks and journals say very little about science-based nutrition (4). Most chiropractors who give nutrition advice make inappropriate recommendations for supplements.]

In fact, the ACA has released its vision for a wellness-based model of health care that stresses disease prevention rather than disease management. For more information on ACA's wellness initiative, visit: http://www.acatoday.com/about/policies.shtml#99. [Except for "spinal hygiene" (whatever that is), the long lists under the heading "Wellness Model consist mainly of standard medical topics. I am not aware of any data showing that consulting a chiropractor for such advice is advisable or cost-effective.]

References

  1. Barrett S. "Organic" foods: Certification does not protect consumers. Quackwatch, revised March 29, 2003
  2. Valtin H. "Drink at least eight glasses of water a day." Really? Is there scientific evidence for "8 X 8"? American Journal of Regulatory, Integrative and Comparative Physiology 283:R993-R1004, 2002.
  3. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients) (2002) Washington, DC: National Academy Press, 2002.
  4. Magner GJ III. Nutrition-related nonsense. In Chiropractic: The Victim's Perspective. Amherst, New York: Prometheus Books, 1995, pp 97-112.

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This article was revised on April 13, 2003.