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Dynamic Chiropractic – May 20, 2008, Vol. 26, Issue 11

Offering Nutritional Wellness Protocols in Your Practice

The Powerful Why and the Easy How

By Donald Hayes, DC

The average consumer knows that to be well, they must address a number of lifestyle issues such as diet, supplements, exercise, posture, eliminating unhealthy habits and being pain free without the use of over-the-counter drugs.

Some doctors offer a complete wellness package, while others need to learn that wellness should include other concepts that support their treatment.

The Powerful Why to Add Nutrition

Why should you offer nutritional wellness protocols? In my opinion, it all began in 1926 when Harvard physician and physiology professor Walter Cannon, MD, coined the term homeostasis in his book The Wisdom of the Body.  He defined homeostasis as having two pathways for balance: an electrical pathway that is similar to (structure) and a biochemical pathway that relates to (function). Cannon stated that in order to have 100 percent homeostasis, one must have 100 percent balance in both channels.

Homeostasis, as we all know, is am actual medical term. I have taken the liberty of using the term as the modern-day definition of wellness. When I ask doctors to define wellness, most stumble for an answer. I submit that the concept of homeostasis is as good a fit as we'll find, and a sensible way to measure it.

Cannon had a student in his classroom who became the greatest physiologist the world has ever known. This doctor is more than likely the author of the textbook you studied in school; his name is Arthur Guyton, MD.

In 1971, Guyton further defined homeostasis. He stated that regulation of pH is one of the most important aspects of homeostasis. To maintain it, you should look first to alkalize the body.

Three questions come to mind: How does a change in pH affect homeostasis (wellness), at what age does it occur, and what causes it? According to research published by Anthony Sebastian, MD, in TheNew England Journal of Medicine, the age is 40 and the cause is the standard American diet. Sebastian's research, titled "Standard American Diet and Blood Acid Levels," showed that as we age, our blood acid increases and our alkaline bicarbonate reserves decrease. Sebastian's research concluded that by age 40, the average American has lost all alkaline reserves. These findings warrant consideration that acidosis may be a cause of degenerative disease.

All chiropractors have a solution for inflammatory "acidic" physical stressors. But what about the other channel? What about the biochemical/functional channel? What about the inflammatory "acidic" chemical stressors? As Cannon stated, you can't have 100 percent homeostasis without balance in both channels. The message is loud and clear from Cannon, to Guyton to Sebastian: Don't forget the chemical/nutritional pathway.

The Best Way to Offer Nutrition

That brings us to the best way to offer nutrition. In my opinion, you have two choices: vitamin pill therapy or whole-food nutrition. Let's look at both.

Vitamin Pill Therapy. By definition, vitamin pill therapy is the use of an isolated nutrient to effect a physiological change. It doesn't matter if the vitamin is derived from natural or synthetic sources; when it's a vitamin, it's inert. That doesn't mean it's bad; it just means there's no such thing as a whole-food vitamin.

Whole-Food Nutrition. Whole-food nutrition is the application of living foods and their ability to promote health, energy and vitality while preventing disease. This is the true meaning of the concept of "Food is your best medicine."

I suggest we leave pill-selling to sales clerks and focus our attention on the true definition of nutrition. I'm not saying doctors can't use some vitamins to effect a physiological change. I'm merely suggesting that when we do, it's not really practicing nutrition.

How to Add Nutrition to Your Practice

The easiest and most beneficial way to offer nutrition in practice is using a concept that links "whole-food" products to treatment recommendations. In my experience, regardless of philosophical differences, 90 percent of all chiropractors practice alike. In fact, I'll bet 90 percent of all alternative providers do. I feel this is due to the pathophysiology of tissue healing known as the "Three Phases of Healing." Physiologists have determined that tissue heals in three phases: acute, subacute and chronic. Because of this, many professions including chiropractic have divided treatment recommendations into three phases of care: relief, correction and wellness.

Based on the three phases of healing, I created an algorithm that offers nutrition for each phase of care called the "Three Phases of Nutrition." Because third-party pay is still an important part of many practices, I also linked it to a 12-visit protocol.

Relief Care Nutrition. The goals of relief care nutrition begin on the patient's first visit and are twofold. The first goal is to comply with the American Heart Association statement that suggests doctors change the way they recommend over-the-counter pain relievers from a first choice to recommending nonpharmacologic treatment. Patients should be asked to consider switching their OTC pain relievers for a safe and natural alternative. Obviously, patients are never taken off any prescribed medications.

The second goal is to recommend alkalizing products that improve outcomes as quickly as possible. The most effective approach is to use products that help manage the inflammatory process and support the acute phase of healing. Consider recommending a two-step approach: a systemic inside-out product and a corresponding outside-in topical cream.

Most doctors who offer the relief care nutrition protocol on the first visit report a significant improvement in patient outcomes. They manage to get the patient off OTC pain relievers that may act as "adaptogens" and actually create pain, they get the patient to start taking "alkalizing" products, and add mechanical therapy or adjustments.

Corrective Care Nutrition. On or about the fourth visit, most patients have improved and typically enter the second phase of healing known as the subacute phase. This is commonly referred to as corrective care and is the ideal time to recommend corrective care nutrition.

The goals of corrective care nutrition are two-old: Provide nourishment to the tissues during repair and alkalize the body during this critical time of healing.

Have patients drink an alkalizing breakfast meal-replacement shake that combines all three macronutrients: protein in the form of high-quality amino acids, complex carbohydrates in the form of organic fruits and vegetables, and a serving of healthy oils that provides the necessary nutrient density required to further promote proper healing. Since many patients tend to eat poorly, also recommend a healthy afternoon energy-drink mix they can consume instead of reaching for a cola or coffee drink.

Wellness Care Nutrition. On or about the 12th visit, most patients have either completely recovered or become asymptomatic and entered into what we were taught in physiology as the chronic phase of healing. Of course, we call this wellness or maintenance care. This is the time when we can do a lot of good from a nutritional perspective. Now that the tissues are no longer inflamed, we can use cleansing products that help the body rid itself of deep-seated acids and toxins.

Use some type of gentle herbal active-cleanse product coupled with an all-natural rice-bran fiber that will carry waste products safely out of the body. In addition, help the patient restore their alkaline reserves by recommending a product that contains potassium bicarbonate. Sebastian's work involved giving postmenopausal women oral potassium bicarbonate. Within two weeks, there was evidence that new bone had formed. The wellness care nutritionals should be products patients can continue to use on a quarterly basis to maintain their health and vitality.


Remember, the average consumer knows that to be well, they must address a number of lifestyle issues including taking nutritional supplements. Don't let your patients fall victim to discount vitamin chains and Internet vitamin scams. If you have not already done so, consider adding a high-quality nutritional wellness program to your practice. It can add a significant amount of profit to your bottom line and substantially improve patient outcomes, which will translate into more referrals.

Dr. Donald L. Hayes, DC is a clinician, educator and author of several books, including Lifestyle Wellness and, along with Michael E. Gerber, The E-Myth Nutritionist: Why Most Healthcare Practices Don't Work and What to Do About It. He is founder and president of the Greens First line of nutritional products and the Lifestyle Wellness Total Health Improvement Program. He can be reached at 866-410-1818 or through

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