Dynamic Chiropractic - November 30, 1998, Volume 16, Issue 25|
Commonly Asked Questions of 1998
by Douglas Andersen, DC, DACBSP, CCNAs I've done in past years, this is a summary of the most common questions I received in 1998. With the exception of question number three, regular readers of this column will recognize a very familiar tone.
Question: What do you think about glucosamine? Does it work?
Answer: DCs not investigating glucosamine are doing their patients a great disservice. I recommend that you read the three articles I wrote about glucosamine earlier this year. If those don't answer all your questions, part III of the series included a list of books and periodicals that will most likely answer any additional questions you may have.1,2,3
Q: I want to add nutrition to my practice, but don't know where to start.
A: I have also written about this topic before.4,5,6 Please see those articles. To make it short and sweet, if you have the average practice that is over 90 percent neuromusculoskeletal acute, subacute, and chronic conditions, here are the four basic formulas you should carry and their key ingredients:
Anti-inflammatory formula: proteolytic enzymes, trypsin, chymotrypsin, papain and bromelain.
Antispasmodic formula: calcium, magnesium, valerian, passiflora, kava kava.
Osteoarthritis formula: glucosamine sulfate and/or hydrochloride. Chondroitin sulfate optional.
Osteoporosis formula: calcium, vitamin D, magnesium, manganese, boron and zinc.*
Q: What do you think about androstenedione, the muscle enhancer that home-run champ Mark McGwire takes?
A: Two summers ago, in July of 1997, I wrote about this substance.7 Androstenedione is not an anabolic steroid, but is classified as an androgen or prohormone. Standing alone, it does not have much activity and must be converted by the body to testosterone. Because this conversion is tightly regulated by the body, taking large amounts of androstenedione is not the same as taking large amounts of preformed testosterone. The body's feedback mechanism limits the amount of "andro" that is converted to testosterone. Therefore, it is wrong to state that androstenedione is as dangerous as testosterone.
Androstenedione will cause a temporary increase in testosterone levels which, if a person is training hard and ingesting adequate calories, may result in accelerated muscular growth and/or recovery. Any prohormonal substance your patients elect to use should be done with care and caution. Any patients who want to use androstenedione or a close derivative (which are now appearing on the market) should abstain from its use until more research is in if they have any medical conditions that could be negatively affected by increases in testosterone.
Q: What do you think is the best diet for losing weight: high protein, 40/30/30, low fat or low sugar?
A: There are an infinite amount of combinations of protein, carbohydrate and fat one can consume and still lose weight. The most common thread in all successful weight-loss programs is that patients consume fewer calories than burned. Regardless of what some diet experts say, calories do count. The trick is to find which way is easier for the patient to consume fewer calories than desired. When total calories are reduced, some people will have less hunger and cravings eating a larger percent of protein, while others will do better with more carbohydrates; still others do better with a little more fat. Any percentage will work as long as total calories are low. The healthiest way to lose weight is to keep the diet balanced. A very basic, simple to follow food recommendation I employ for the average overweight patient (10-30 pounds) is as follows:
Carbohydrate 50-60 Ń- Fat Ńłł
In my practice, obese patients will receive an individual program tailored to their unique metabolic needs coupled with their health risks. For more information on weight loss, including natural weight-loss supplements available to the DC, I refer you to the obesity series published in the spring of 1997.8,9,10,11