Many of my patient's continue to refer to the Paleo Diet it as the "caveman diet," but I prefer the "ancestral diet." The Paleo diet is pretty simple: eat meat, vegetables and seasonal fruit. Avoid bread, pasta, rice, corn and refined sugar because these were foods our body was not meant to eat.
Reconnection
The Paleo diet is an opportunity for clients to reconnect to a more natural diet. But how do you tell a patient who has tried 10 different diets and failed at all of them that if they just try this Paleo food list and start making some lifestyle changes for 30 days, they will feel better? No one in their right mind would believe that. They hope that is true, but a much larger part of who they are definitely wouldn't believe that this (Paleo) is going to work.
Begin by explaining what the diet actually is.
The Paleo Diet is based on foods we ate prior to agriculture and animal husbandry (meat, fish, shellfish, eggs, tree nuts, vegetables, roots, fruit, berries, etc.). Foods that result from agriculture or animal husbandry (grains, dairy, beans, potatoes, sugar and fake foods) are not eaten.
Sometimes, clients will say, "but how can you live without grain and dairy?" I point out that the two most metabolic common food disorders are lactose (dairy) intolerance and Gluten (grain) intolerance. Shouldn't that tell you something? Grain has only been a part of the modern human diet for a relatively short time. As our ancestors settled into farms and with the introduction of grain, typical cities developed, and we no longer needed to be the hunter-gatherers that we once were. This led to limited physical movement (exercise) and a poor diet.
Our ancestors mostly ate foods that were easiest to hunt or gather at a specific locale and season. As nomads, we would have adapted to various mixes of foods. When I introduce a patient to the Paleo concept, I give them a food list and tell them, "if it is on the list, you can have it." In the beginning, the quantities consumed of each "on the list " food are entirely up to individual. You can make it meat heavy if you want, or vegetable heavy if you prefer, as long as the foods you eat are on the Paleo list.
Acceptable oils should be restricted to those from fruits (olive, avocado) or nuts (coconut, walnut, almond, hazelnut, macadamia). No high-tech seed oils could have existed back then. Grass-fed is preferred for meat to get the proper balance of Omega 3s and 6s. For everything else, organic is preferred. The only beverage that is truly Paleo is water.
Common Struggles
I believe the biggest hurdle almost every chiropractor struggles with in getting into this healthy aging/weight, loss/rehab practice thing, is that they don't know how to keep it simple and time efficient. For me and my practice, it has become easy. I use three things to keep this simple.
First, I create a simple realistic food list, a template if you will.
Second, I encourage body movement and I ask patients to wake up 15 minutes early and just start walking around their home. Once they are accustomed to waking up 15 minutes earlier, I start teaching them exercises to do during that time.
And third, I use a computer driven software system that measures body fat, lean muscle mass and hydration. Some patients use the software to calculate total calories eaten per day, and the number of calories burned per day. I can follow a client's food diaries online and I know when a client misses a workout.
If I choose, I can send my client an email, text message or call them on the phone and talk to them when they don't follow the program. When people know they are being watched and are being held accountable, behavior changes for the better. Accountability gives us our greatest gift: consistency. Once we consistently do that which we know is right (but sometimes hard), change begins to happen.
A simple part of the Paleo concept is community. We are social people and want to feel like we are part of something. A good way to build consistency is to belong to something that is bigger than you, in this case, a thriving office community that is committed to the change you are looking to make. Through belonging, belief is nurtured. Belonging satisfies one of our most basic primal needs. We have lived in communities or been part of a tribe for millions of years. My answer to solve this is to have small group exercise classes in your office as this creates community.
Patients shouldn't have to tackle the weight loss or health issues on their own. We have always solved our problems within the context of a group or tribe that is committed to our well-being. A mom can lose two jean sizes on the Paleo diet, her husband can get off high cholesterol medications and their kid can lower his/her risk of getting diabetes. Everyone seems to do well on the program. It inspires others. This will motivate the mom even more. How awesome is that?
I am seeing patients in their 50's get in better shape than when they were in their 40's. Create your group using the software and work patients out in your office until they can join a gym. Slowly, start to talk to patients about nutrition. They think they know it all! If you can encourage them to do a 30 day trial and they take the challenge to eat their best, you can help grade their food journal and offer suggestions/changes to make improvements.
The hardest part for patients is getting them off wheat and dairy. I pose a challenge to get off all dairy for two weeks. Once clients try it and feel better, the joints hurt less and mobility improves because there is less inflammation, the weight starts coming off and moods improve.
Paleo is everything in moderation. Some people can do the 30-day strict Paleo kickoff, but others need to make gradual changes. Pasta, bread, rice and sugar are usually the hardest to get off. So for week one, suggest they reduce bread intake by 50%. For week two, continue with 50% bread reduction, but add a vegetable with one meal. Then add veggies with two meals. Then cut bread back by 75%. Start adding more salads and opt for balsamic vinaigrette dressing. Some people need the small and slow change approach. I just keep reminding them that what you eat today, dictates how you feel tomorrow.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
Some pundits say that the upcoming presidential and congressional races, and many local races, might be the most consequential in our country’s history. We do not have the choice of sitting on the sidelines and hoping our patients will carry our water. Unlike other medical professions such as physical therapists, podiatrists, nurses, etc., the health care class (AMA) will not protect us. We must be in the game.
The most common condition affecting the shoulder is rotator-cuff disease. From acute tears to chronic tendinopathy, it’s common and needs a thorough workup. In fact, even asymptomatic shoulders can have full-thickness rotator-cuff rears in up to 40% of instances. Let’s look at additional conditions that can present to the office with weakness, loss of motion and pain in the shoulder beyond rotator-cuff tears.
