Chiropractic Nutrition

Nutrition Forum, May, 1999 by Samuel Homola

The good, the bad, and the patently false

Chiropractic is based the notion that most ailments are the result of spinal problems. Its "discovery" was announced in 1895 by Daniel David Palmer, a grocer and "magnetic healer" who allegedly restored the hearing of a partially deaf janitor by "adjusting" a bump on his spine. Soon afterward he declared that the basic cause of disease is "nerve interference" caused by misaligned spinal bones ("subluxations"). Most of today's 60,000+ chiropractors still regard subluxations as a direct or underlying cause of ill health and maintain that spinal "adjustment" can restore and promote good health.

Chiropractic surveys suggest that at least 80 percent of chiropractors are giving nutrition advice to their patients. Some chiropractors are able to counsel their patients about sensible eating, weight control, and other nutrition-related health matters. Many, however, are engaged in questionable nutrition practices.

All chiropractic colleges teach courses in basic and clinical nutrition. Although most courses rely on standard nutrition textbooks, it is not clear whether students put what they learn to good use. Practicing chiropractors have little exposure to science-based nutrition. Chiropractic journals, magazines, and textbooks provide very little nutrition information, and most of what they provide is not valid. Postgraduate seminars are available, but the vast majority are sponsored by supplement distributors for the purpose of boosting sales. During my 43-year career, I have seen hundreds of advertisements for such seminars. I cannot recall a single one that appeared to provide valid teachings. Many state chiropractic associations promote similarly questionable seminars that yield credits toward license renewal. Many exhibitors at chiropractic conventions hawk supplements that are sold in chiropractic offices. Some exhibitors promote inappropriate diagnostic tests, and some even distribute literature stating which products supposedly are effective against various diseases.

Chiropractors interested in science-based nutrition can pick up the basics from other sources or by studying on their own. It is not difficult to learn enough to answer the questions patients typically ask about food composition, dietary balance, osteoporosis prevention, exercise principles, low-fat eating, and other dietary strategies. However, many chiropractors mix nutrition and subluxation theory, use dubious tests, or engage in bizarre treatment systems that result in inappropriate use of supplement products.

Supplement Promotion

Chiropractors can greatly augment their income by selling nutritional products to their patients. More than 50 companies market them primarily or exclusively through chiropractors. Some handle just a few products, while others sell hundreds. These products are typically sold for two to three times what the chiropractor pays for them.

Many chiropractors become distributors for multilevel companies that sell supplements, herbs, and/or homeopathic products. Multilevel marketing (MLM) is a form of direct sales in which "independent distributors" can buy products "wholesale," sell them "retail," and recruit other distributors who can do the same. When enough distributors have been enrolled, the recruiter is eligible to collect a percentage of their sales. During the past 20 years, Dr. Stephen Barrett has investigated over a hundred health-related MLM companies and found that every one of them has marketed products that were overpriced, misrepresented, or both.

To persuade patients to buy nutritional products, chiropractors may use several dubious tests:

* Functional Intracellular Analysis (FIA), formerly called Essential Metabolits Analysis (EMA), is a test in which a sample of the patient's blood is sent to a laboratory that isolates the patient's lymphocytes (a type of white blood cell) and places them into petri dishes containing various concentrations of certain nutrients. Company literature states that the procedure can find hidden "functional" nutrient deficiencies in nearly everyone. Although properly performed lymphocyte cultures have a legitimate role in testing for certain deficiencies, they are not appropriate for screening as advocated by the laboratory.

* Hair analysis is done by clipping a sample of the patient's hair--usually from the nape of the neck--and sending it to a laboratory for analysis. The lab then issues a report (often with a copy for the patient) stating the concentrations of various minerals and how these amounts compare to the lab's reference values. Some reports also contain specific recommendations for supplements. The scientific viewpoint is that hair tests of this sort do not provide a valid basis for determining the body's nutritional state or for making supplement recommendations.

* Live blood analysis--also called live cell analysis, nutritional blood analysis, and Hemaview--is done by placing a drop of the patient's blood on a microscope slide and using a glass cover slip to keep it from drying out. The slide is then viewed with a special microscope that forwards the image to a television monitor that the practitioner and patient can view. Although certain blood characteristics (such as the relative size of the red cells) are visible with this setup, live-cell analysts invariably misinterpret other things, such as the extent of red blood cell clumping and changes in the shape of the cells that occur as the blood sample dries. The results are then used as a basis for prescribing supplements. Chiropractors using this approach typically advise patients to take vitamins and/or enzyme pills and to return periodically for checkups. The Web site of one imaginative chiropractor advises that, "By checking the blood, we check the oil of the body. It can tell us a great deal about the body, and whether or not it is able to keep up with the stress of everyday life, or if it is on its way to problems down the road."