The Great Food Debate

I've been embroiled in a debate on different eating habits for a few weeks. It's been a heated debate. Information has been passed back and forth, but the science is a hard sell for those that don't know or understand it. I say, science, because it's not just the facts about Paleo, gluten-free, Mediterranean, or whatever eating patterns/diets, but about nutrition in general. It's about how our bodies handle food and what they need to be healthy.

There are a million and one (and probably more) "diets" out there. Right now, Paleo and gluten-free seem to be trending the most. Celebrities are using them to "get healthy." People are using them for weight loss or to control the symptoms of one disease or another. Some are using them to lower their inflammatory levels. But few seem to know the actual science behind any of it.

2014-07-11_words
Image source: www.towelmate.com

I'm admittedly biased. I've been a diagnosed Celiac, and gluten free for 16 years. The more information that I learn about grains, etc. -- the more I'm glad that I don't eat gluten. But the general public doesn't have the information that I have. In fact, it seems that most professionals don't either. But that's not the purpose of this posting.

When I started out writing this, I thought about my friend and how vehemently she adheres to her beliefs about "nutrition" and eating. She's a registered dietician. We've argued back and forth about grains, about how she thinks that Paleo/Mediterranean is bad for athletes, about how impossible it is to follow, and about how there's a lot of "false" science/claims about that particular eating pattern. The whole experience has been a major illustration on the adherence to beliefs that people have -- not just for her, but for me. It's also been an exercise in frustration.

I can only "recommend" what science (and anecdotal evidence -- but that's another story) shows to be true. For example, I can explain that zonulin destroys tight junctions in the gut, brain, and reproductive organs, and that the main sources of tight junction destroying proteins are grains and legumes. I can quote studies all day long (and all night long) -- and I have. I can distill the science down to very simple words that anyone could understand by using pictures, analogies, and more broad terms. I can do all of these things, but that doesn't mean it's going to change anyone's mind, and it also doesn't mean that they're going to be willing to put it into practice.

We're very steeped in our beliefs. Usually, those beliefs have absolutely nothing to do with evidence. My friend, for example, focuses on athletes and sports nutrition. The concept of carb-loading with pasta or the use of sports drinks is very much a part of her reality. She's concerned about having energy available for use. She's not concerned about inflammation, overall health and well-being, the prevention of disease, or whether or not someone might develop cancer or an autoimmune disorder. She wants to run marathons, or play 4-hour-long matches. Her reality and mine are very, very different. Chances are, that no matter what I say or provide her with, she will always adhere to her thoughts about nutrition. It will always be about the quick fix. My hope is that she'll come across a difficult case and be forced to broaden her concept of what healthy eating is.

Patients aren't any different. Some may have more or less information than my friend. They may be coming in with a copy of some new fad diet book, or a cookbook of recipes that their Aunt Sally said worked really great to help her lose weight. People may walk into the office carrying a well-worn copy of the all-carrot diet, asking what to do about their increasingly orange skin. They'll be emphatic about drinking their diet coke, eating their bowl of pasta, or consuming 3 Tablespoons of apple cider vinegar before every meal.

2014-07-11_comic
Image source: msmomofosho.wordpress.com

It will be our job to walk them through their questions, hopefully bring some experience and education to the table, and talk them through ideas and possibilities that will help them find some form of healthy, sustainable ground. They may resist with everything that they have in them. As I write this, I'm thinking about how much I struggle with sugar or eating rice, and how hard it has been for me to give them up; I'm not there yet. It's our job to work with them, using their limitations (even if those are beliefs), and our education to help them get to someplace healthier.

My friend and I will probably continue to argue about what we should or shouldn't be eating. The only thing we've been able to agree on so far, I think, is that there's no one single "right" way. There's no perfect way that everyone should be eating. We're all human, and each body is different. The science may figure out that everything we "know" is wrong, and everything must be changed. I may never be able to fully give up sugar or rice. But whatever happens, we'll all hopefully be happier and healthier because of what we learn -- about food, about our relationship with it, and our relationships with each other.

Have a great week, everybody.

Happy Summer, Everybody!

Summer is in full swing here (not that it hasn't been for several months). The temperatures are consistently over 90; the daily Florida rainstorms are happening; and we're expecting our first Tropical Storm/Hurricane tomorrow. By the way, I'm not even remotely worried.

White Coat Ceremony

I had the great joy of being a part of the White Coat Ceremony for the 1st Trimester students. It's such a different experience to be on the opposite side of the stage. As an 8th trimester student, I'm looking at this from the other side of Basic Sciences, Phase 2 Clinical Sciences, and the first round of boards. I know that I didn't have any idea what was in store for me when I was on that stage. I was nervous, excited, and scared. I didn't know how hard of a road it was going to be, how much I would learn, and what challenges I would face. If I could give one piece of advice to incoming students and students in the early tris, it would be this: be dedicated; be tenacious; but be kind to yourself. This is a long, hard road--but all the stress, work, and pain is worth it.

2014-07-03_wcc

Educating the Uneducated

I want to revisit a topic that I've touched on before: education about the profession. Misconceptions about chiropractic, our education, and what we do run rampant in society. Just yesterday, I received a graphic on Facebook from a very popular site that listed us as "Quacks." They've published similar graphics/articles before. I'm not going to name them, because I don't want to endorse; that's not the point here. There is still the misconception out there, that we're all trying to alter "the force," and that by believing the body has the ability to heal itself, we're a bunch of lunatics. A large portion of the public believes that we only associate well-being with the spine, and that we only treat the spine. They're uneducated about how extensive our training in physiology, microbiology, pathology, pharmacology, biochemistry, and nutrition (to name a few) actually is. They don't know that many of us are evidence-based, research-oriented, internal medicine-focused students and practitioners.

This is a call to arms, my friends and colleagues. We have to change this; right now. Chances are that if your friends and family have kept touch with you during your educational escapades, that they're familiar with what you're doing, and probably support you. For those reading the blog that aren't students (or prospective students), chances are you're reading this blog because you support the institution or someone involved in it. So I realize, by saying all of this, that I'm preaching to the choir. But what about everybody else? What about the people we meet on the street? What about our Facebook friends that live far and wide? What about all of the misconceptions floating around about who we are and what we do?

The American Chiropractic Association lobbies in Washington for chiropractic legislation, but we don't have a cohesive organization that handles education of the public. We are it. We are the educators.

I'm going to challenge each and every one of you, to go out there and share what you do, what your training is, how our education is different, and how we are making a difference in health and well-being. For those that are supporters of the field, I thank you for that. I'm going to challenge you as well, to share your knowledge and experience of the field of chiropractic with those around you. Let them know how we're making a difference.

Have a great week everybody, and a safe and happy 4th of July.

Another Week, Another Blog Posting

How are everyone's midterms going? I'm on break from the master's program. I had finals last week. I'm glad to have a couple of weeks off to catch up on a few things, including all the reading that I didn't get done during the quarter. My pile is still astronomically large. We'll see how much I can get done. I figure if I don't get it done before classes start there again, it's probably a lost cause.

Last weekend, my friend and classmate Julia, went to homecoming at the main campus in Lombard. I want to say, to everyone there in Lombard, thanks for taking such great care of her! She had glowing remarks for everyone that she met. There were meetings and events, information sessions, etc. She was able to meet Dr. James Cox (of Cox flexion-distraction fame), and many of our illustrious alumni.

2014-06-25_hc
Dr. Strauss and Florida students with Dr. Cox at Homecoming

Julia was able to reassure us students about one of the issues that we find frustrating. We are always hearing that we'll not be able to find jobs or make a decent salary. Even though I've yet to meet anyone at school that's "in it for the money," we're all hoping that we'll be able to make enough to at least pay back our student loans, and maybe have enough for food. Even speakers that have come to the school (non-alumni) have commented that it would be tough for us to make a living.

The problem is, with all of my research, and all of the alums that I've spoken to and heard from indirectly, this is FAR from the case. Julia confirmed this when she spoke with alumni at homecoming. She said that everyone that was doing VERY well for themselves. People were not only successful and able to pay back their loans, but also contribute back to the school. It was inspirational for her that not only would we be out and in the community, but thriving. I'm glad she shared that with me, because I needed the inspiration as well.

We're finally starting to see the light at the end of the tunnel. It's halfway through 8th Tri. In a few months, we'll only be in the clinic. No more classes. No more random exams. No more quizzes, papers, or random presentations. It's been REALLY easy to lose track of time this tri. Alarmingly easy. I've been caught up with patients, in my own stuff, with the master's, and classes. I honestly can't wait for classes to be over.

I was asked today how I liked clinic. I've said this before, and I'll say it again -- I love it. I love the idea of being able to do this every day. Even with the challenging cases (my favorites), the idea of being challenged to learn all the time is exciting. I never know what I'm walking into, and I find that absolutely enthralling. I can't imagine any kind of job, ever, that would be anything like this. When I'm in clinic working, I am more than pleased with my choice.

Have a great week everybody!

Patients and Patience

You're not behind the desk, you're sitting in the chair next to it. Waiting. Waiting, for what seems like FOREVER for them to come look at you, examine you, swab, cut, bleed, sample, whatever you. They're taking forever. You feel wretched. Everything aches, stings, hurts. You're tired from staying up all night worrying, hurting, stressing. You only want to know what's going on and you feel like you're simply the only person on the face of the planet, and no one is able or willing to help you.

I'm trying to explain what it feels like to be sick -- to be frustrated with the status of the medical profession and confused and angry and scared. I'm trying to explain what it feels like, no matter how melodramatic it may be, to feel like someone else has control over your health, what's wrong, and if and when you'll get better. There's a feeling of being completely helpless that comes with being sick -- when there's pain, when there's no observable pattern or relatively easy diagnosis, or when it just seems to drag on forever. It's a feeling that no one seems to understand -- like being held hostage by something or someone and being powerless to do anything about it. And it doesn't go away -- that feeling -- until there's some grasp over the problem, like some answer, lab result, diagnosis, something, ANYTHING that seems to give some control over the situation.

If you, as a person, have never felt this way, count yourself lucky. But many others can't say that. Our patients likely can't say that. They come to us hoping for understanding and compassion, and the willingness and ability to find out what's wrong. I only hope that they find it.

It's hard to be the patient when you're used to being the physician. It's also hard to be a physician when you've never been a patient. William Hurt, in a 1991 movie called "The Doctor" illustrated just this. Having been an important, influential physician, he finds himself with cancer -- and realizes just how horrible of a physician (no matter how skilled) he (and some of his colleagues) could be.

People come to us in their worst conditions. They're not always in a good mood. They're not always understanding of our limitations as physicians (or students). They come to us seeking help and advice -- and of course, our expertise. Finding answers is what we're supposed to do. It's what our training is based in and what we've been working towards for our academic/professional careers.

But all of that training only provides a fraction of what our patients need from us. They need our compassion and understanding. This isn't taught in school. It comes from within, and unfortunately, it comes from experience.

2014-06-17_words
(Image source: hopeinhealingblog.wordpress.com)

For some of us, it's been sickness that has made us this way -- or abuse, or poverty, or just LIFE. For others, it's those things that are in the process of making them that way.

Be kind to each other this week, Everybody. Have a great one.

Food for Thought

Surely you've heard the phrase: "Eat to live, not live to eat." It seems that our relationship with food is extremely complicated. It turns out, it's not just our mindset right now, but also every attitude that we've had about food from our childhood that affects how, what and why we eat. Did you ever make cookies with your grandmother, or have a special birthday dinner? Was there some treat that you only had on special occasions? Did you go trick-or-treating for Halloween? Unless we've somehow managed to avoid all of those things, food has become a reward and measure of comfort in our lives.

Of course, there's nothing wrong with this. But we have to be aware of it. As we go through our lives running crazy, working ourselves ridiculous hours, studying, going from obligation to obligation, taking on way too much, it's really easy to seek consolation in our food.

2014-06-11_brain

Of course, there's more to it than that. Eating these things ignites reward chemistry in our brains. Dopamine is produced leading to the sensation of pleasure. Serotonin, which most people recognize as the hormone affecting depression, is dramatically affected. In fact about 95% of the serotonin is produced in the gut. This not only regulates how much food we eat, but how we feel about how much food we eat. It has direct impact on our mood about food.

There are other, seemingly less interesting, hormones involved with food intake. Leptin, produced in adipose tissue, regulates food intake and fat storage. Deficits or defects in it lead to overeating. Another hormone, CCK, which is released from the small intestine while you eat, provides negative feedback about the quantity of food. Deficits in it (or damage to the small intestine) lead to overeating. Ghrelin, insulin, cortisol, and glucagon are also involved. *Whew!*

You see, we treat food as medicine, not just because of the hormones it induces, but because of the nutrients it provides. We can use food to medicate or nourish our bodies.

We need those nutrients to live. They provide the building blocks of everything that we are, the chemicals that sustain us, and the energy that keeps us going.

I've been doing some reading (in all my spare time) about the psychology of eating. It turns out there's a whole Institute for the Psychology of Eating. I've been exploring the ideas of why people eat; how much food we really need to live; and how we can nourish ourselves body/mind/spirit without overindulging. The topic itself is absolutely fascinating, and challenging in ways beyond all of the science.

It's food for thought.

Everybody have an amazing week!

For more information on the psychology of eating and hormonal control of eating, check out: