Great Source for Reliable Information on Nutritional Supplements

Have you ever found yourself tuning out information about nutritional supplements because it all seems confusing and contradictory? If yes, you are not alone. One headline says 'get more X' the next headline says 'be careful about too much X' and another says 'X supplementation not necessary at all'. Headlines are meant to sell newspaper and magazines. They report on what's new not necessarily what is backed by the most evidence. And, the stories are often selected based on findings that are contrarian or against conventional wisdom. After all, who is going to buy a magazine with the headline, "No change in guidelines ñ eating more plant-based foods is still good for you."

Consumers really need a reliable source of evidence-based recommendations for nutritional supplements. Since these are not regulated by the FDA, there isn't a government run website that you can count on to be unbiased. There are several private companies, non-profits and even individuals that claim to offer comprehensive unbiased information on nutritional supplements, but who has the time to sift through all of these to figure out whose information is the best?

At the risk of offending a number of other great sources, this article is a plug for the Linus Pauling Micronutrient Information Center at Oregon State University at http://lpi.oregonstate.edu/infocenter. Chances are this is a source you've never heard of or looked at, but you should.

The website describes the Linus Pauling Institute as a ìsource for scientifically accurate information regarding the roles of vitamins, minerals, other nutrients, dietary phytochemicals and some foods in preventing disease and promoting healthî. As you can see from the description, their mission extends beyond nutritional supplements to also include whole foods. This is critically important because sometimes nutrients are more potent together (as in a food) than they are separately.

When you visit the website, you'll have a chance to subscribe to the newsletter near the top of the page. Do it. This isn't another email newsletter but rather a printed, bound newsletter sent to your house containing all of the Institute's latest research.

The folks at OSU are doing excellent work to bring us all trustworthy, evidence based recommendations on the tens of thousands of nutrients in our foods. Take some time to look at their website, bookmark it and share it with others. If there are concepts or terms you don't understand, feel free to ask us during your next appointment or send us an email.

Straight Talk About Foot Orthotics

Good spinal health is built from the ground up, starting with the feet. For years medical researchers and healthcare providers have recognized that problems there can cause posture changes that eventually trigger a variety of musculoskeletal issues in other parts of the body (particularly the ankle, knee, hip and back). Studies have also shown that even slight foot problems can negatively affect athletesí performance and predispose them to a broad range of sports-related injuries.
What Are Orthotics and How Can They Help?
Orthotics are shoe inserts that are specially designed and manufactured to correct an abnormal or irregular walking pattern by promoting proper alignment and balance. Theyíve improved the quality of life for millions of people, and itís become very common for physicians to recommend them to address many different patient needs:
ï Reducing pain and/or fatigue
ï Providing targeted foot support
ï Relieving pressure or stress on an injured or sensitive area
ï Preventing or limiting deformity
ï Improving foot positioning and function
ï Restoring balance
ï Reinforcing or supplementing other therapies (particularly chiropractic adjustments)
Foot orthotics are medical devices that can significantly change the way a person stands, walks and runs (and therefore the way his or her body absorbs and distributes related forces). For this reason, itís important that the person wearing them clearly understand their benefits, risks and limitations. Itís also important that the person use them correctly.
What Every Patient Should Know About Orthotics
1. There is no ìone-size-fits-allî answer when it comes to orthotics. What works for another family member or neighbor will probably not work for you! Getting the right prescription for your particular needs is all about working effectively with your healthcare provider to define your own goals and develop a complete understanding of your footís unique structure and function. For instance, orthotics can be very sport-specificóthe performance requirements of a hiker will not be the same as those of a skier or a football player.

2. Not all orthotics are created equal, and the differences matter. The prefabricated orthotics that can be purchased at shoe stores, pharmacies and sporting goods stores are not the same as the custom orthotics prescribed by a healthcare provider. Do not confuse them! Mass-produced products are tailored for the ìtypicalî foot and are unlikely to address problems specific to any one individualís foot. In some situations, such products can actually make a medical condition worse, cause new problems or increase the risk of injury. So while theyíre usually less expensive than custom orthotics, they may not actually solve your particular problem.

3. Orthotics donít actually correct foot or ankle problems. They are intended to realign the structures of the foot to improve function, reduce pain and decrease the risk of injury.

4. Needs can change over time and your orthotics should too. The structure and function of the foot can change as people age. So too can peopleís lifestyle and priorities. Your healthcare provider can work with you to ensure that your prescription is still the right one for you.

5. Long-term use of orthotics may pose its own risks. Any time that you provide outside help to the structures normally responsible for supporting and moving parts of your body (casts or braces are good examples), you are essentially asking them to do less. And if you provide that help over a sufficiently extended period, you run the risk that your bones, muscles and connective tissues may become weaker as a result. The unintended consequence is that you may actually become less capable and more reliant on your devices to do the work your body used to do. Your healthcare provider will talk with you about how to use your orthotics correctly and manage any long-term risk that he or she believes may exist.

6. Prescribing orthotics is arguably as much an art as a science. Donít underestimate the role of professional in prescribing orthotics. Experts acknowledge that there are few widely-accepted standards and that we canít always predict successfully how an individual will respond to a particular prescription. In fact, recent research has demonstrated that individuals with the same condition can respond very differently to identical orthotic therapy. Thereís even evidence that the same patient can respond to a prescription inconsistently or can respond just as favorably to two entirely different (even contrary) prescriptions. This means that some trial and error may be necessary to get the results both you and your healthcare provider are looking for and that good communication is critical. Without accurate and timely feedback about how well your orthotics are doing their job, itís impossible to make the adjustments that will eventually lead to success.

How Your Chiropractor Can Help
Thereís a close relationship between the way your feet work and the way the rest of your musculoskeletal system supports your body. So even if your feet themselves donít actually hurt, they could be contributing to other health problems that youíre experiencing. After your chiropractor has examined you carefully and talked with you about your situation, he or she can help you decide whether foot orthotics should be part of your broader treatment plan. Call our office today to learn more.

References and Resources
Gina Kolata, Close Look at Orthotics Raises a Welter of Doubts. Orthotic Shoe Inserts May Work, but Itís Not Clear Why. New York Times Fitness and Nutrition. January 17, 2011. Accessed August 2011.
http://www.nytimes.com/2011/01/18/health/nutrition/18best.html?pagewanted=all
Nigg, BM et. al., Effect of Shoe Inserts on Kinematics, Center of Pressure, and Leg Joint Movements During Running. Medicine & Science in Sports & Exercise. February 2003. Accessed August 2011.
http://journals.lww.com/acsm-msse/Abstract/2003/02000/Effect_of_Shoe_Inserts_on_Kinematics,_Center_of.21.aspx
Best Foot Forward with Chiropractic. Journal of the American Chiropractic Association. January 2001. Accessed August 2011.
http://www.acatoday.org/pdf/focus_january2001.pdf

Does Chiropractic Help Back Pain Associated with Pregnancy?

If you are pregnant and suffering from low back pain, a neighbor or a friend has probably suggested you visit a chiropractor because a chiropractor was able to help them during their pregnancy. The discussion probably left you curious, is that good advice or just a single success story? Additionally, you may be wondering whether chiropractic is safe during pregnancy and how much low back pain improvement the average pregnant woman can expect to get.

After looking at several scientific publications on these exact topics, the appropriate conclusion seems to be that ìchiropractic evaluation and treatment during pregnancy may be considered a safe and effective means of treating common musculoskeletal symptoms that affect pregnant patients. The scarcity of published literature warrants further research.î (Borggren, 2007)

So basically the answers are:
ï Yes, chiropractic is safe during pregnancy.
ï Yes, chiropractic helps common musculoskelatal probelms during pregnancy (including back pain).
ï Your friends experience isnít just one womanís story. Many women are finding relief and the results are being sporadically published in medical journals too.
ï More research under more controlled conditions is needed for the purposes of educating primary care physicians and obstetricians about chiropractic care during pregnancy.

Here are a few additional details about the prevalence of low back pain during pregnancy and the number of women being referred for treatment.
ï 57 ñ 69% of women complain of low back pain during pregnancy
ï Only about 32% of women report these symptoms to their primary doctor
ï Only about 25% of primary doctors recommend seeking treatment for the pain.

Clearly this is a big problem with 2 in 3 having pregnancy-related back pain. Also a big problem is that they are generally not talking to their obstetricians and primary care physicians about it and that these professionals are not referring them to effective treatment options.

Chiropractic treatments can be quite effective for pregnancy-related back pain with just a few visits for the majority of women seeking help. In a small study of 17 women:
ï Sixteen of 17 (94%) saw clinically important improvements in low back pain with chiropractic care.
ï The average pain rating went down from 5.9 to 1.5 (on a scale of 0 to 10).
ï It took an average of 1.8 visits and 4.5 days to get clinically important pain relief.

We hope this article gave you hope that many pregnant women do get significant, rapid relief from low back pain. If you are currently pregnant with low back pain, you probably have many questions not answered by this article. Perhaps youíve never had chiropractic care before or you want to know how we adjust our techniques to work with pregnant patients. The best way to get answers to your questions is with an initial consultation. The only way for us to know whether you are a good candidate is for you to come see us, so call for an initial appointment today.


Bibliography
Borggren, C. L. (2007, Spring). Pregnancy and chiropractic: a narrative review of the literature. J Chiropr Med, 6(2), 70-74.
Khorsan, R., Hawk, C., Lisi, A., & Kizhakkeveettil, A. (2009, Jun). Manipulative therapy for pregnancy and related conditions: a systematic review. Obstet Gynecol Surv, 64(6), 416-27.
Lisi, A. (2006, Jan-Feb). Chiropractic spinal manipulation for low back pain of pregnancy: a retrospective case series. J Midwifery Womens Health, 51(1), 7-10.
Stuber, K., & Smith, D. (2008, ul-Aug). Chiropractic treatment of pregnancy-related low back pain: a systematic review of the evidence. J Manipulative Physiol Ther., 31(6), 447-54.

Shortening the Road to Recovery After an Automobile Injury: Your Chiropractor Can Help.

It's a great success story that most of us probably havenít heard very much about. America's roads have become far safer across the past 20 years. By just about any measure, travelers are much less likely to be injured or killed in a motor vehicle accident than they were in the late 1980s and early 1990s.

Fast Facts: Motor Vehicle Accidents by the Numbers
Vehicle Miles Driven. Americans traveled 2,172 billion miles in 1991 and 2,979 billion miles in 2009. That's a 37% increase.
Motor Vehicle Accidents. During the same 1991-2009 period, the number of accidents on U.S. roads actually decreased by 10%, dropping from 6,117,000 to 5,505,000. So even though weíre traveling more miles, we're having fewer accidents.
Occupant Fatalities. The number of motor vehicle occupants killed in accidents during 1991 was 31,934. That number declined by 23% to 24,474 in 2009. The fatality rate per 1,000 accidents dropped from 5.2 to 4.4 persons. That means that when we do have an accident, itís become less likely that someone traveling in the vehicle will be killed.
Occupant Injuries. The statistics show an even more positive trend with respect to injuries. The number of occupants injured in accidents fell 29% from 2,850,000 in 1991 to 2,011,000 in 2009. The injury rate per 1,000 accidents declined from 465.9 persons to 365.3. Simply put, our motor vehicle accidents seem to be injuring fewer drivers and passengers when they do occur.
It's likely that this general trend toward safer roads is being driven by a combination of factors. It could be the way we're driving that's producing fewer, less serious crashes. It could be the way our roads are designed, maintained or policed. It could also be the active and passive safety features now included in many of our vehicles. But whatever the reasons, we can all agree that this is good (if under-reported) news for our nation's travelers.

But What if I'm One of the Two Million Unlucky Ones this Year?

As encouraging as this trend is, it obviously means little to you if you or someone you care about is actually injured in a car accident. Even in cases where drivers and passengers walk away from a wreck believing they're uninjured, accidents can have profound, long-lasting health consequences for those involved. It's not uncommon for some types of symptoms to appear only gradually days or weeks after the event itself, delaying effective diagnosis and treatment. Symptoms may also come and go intermittently, making it more difficult to associate them with the accident.
Fortunately, there are things you can do to safeguard your health and improve your chances of a more rapid, complete recovery following an auto accident. Clinical studies have demonstrated that chiropractic care can shorten recovery time and decrease the amount of permanent physical damage sustained in a collision.
Take Care of First Things First.
Always address any life-threatening injuries first. If you experience (or have reason to suspect) significant bleeding or bruising, broken bones, internal pain, difficulty breathing, loss of consciousness, or shock, you should seek immediate help from healthcare professionals who specialize in treating trauma injuries.
Recognize Signs that You May Be at Increased Risk of Developing Chronic Problems.
Be sure to tell your doctor if any of the following warning signs apply:
ï A prior history of back, neck or shoulder problems (including previous injury).
ï Distinct numbness, tingling or pain immediately following an accident.
ï Increased muscle tension or reduced range of motion after the crash.
ï You were involved in a rear-end collision.
ï Your head was turned at the moment of impact.
ï You have symptoms that don't resolve or that become generalized.

Visit your Chiropractor as Soon as Possible After an Accident.
Do this even if you don't think you've been hurt very badly. Research has shown that early intervention in the form of chiropractic adjustment, massage and supervised exercise and stretching programs can make a big difference in longer-term function.
Stay Active.
Activity encourages blood flow to the injured area and promotes healing. It also helps prevent or reduce scar tissue formation and maintain range of motion.
Strengthen the Affected Area(s) as Directed by your Chiropractor.
Exercise and stretching programs are designed to help prevent future injuries and are an important part of a balanced treatment plan.
An auto accident can affect your health (and your lifestyle) for years if you donít receive the proper treatment. So if you or someone you care about has been injured in a collision, please call our office and make an appointment today. Chiropractic care can help put your recovery in the fast lane!

References and Resources
A Compilation of Motor Vehicle Crash Data from the Fatality Analysis Reporting System and the General Estimates System. Traffic Safety Facts 2009 Early Edition. U.S. Department of Transportation National Highway Traffic Safety Administration. Accessed August 2011.
http://www-nrd.nhtsa.dot.gov/Pubs/811402EE.pdf
Mayo Clinic Comprehensive Guide to Diseases and Conditions: Whiplash and Alternative Medicine. Accessed August 2011.
http://www.mayoclinic.com/health/whiplash/DS01037/DSECTION=alternative-medicine
Berglund A, et. al., The influence of prognostic factors on neck pain intensity, disability, anxiety and depression over a 2-year period in subjects with acute whiplash injury. Pain. December 2006.
Jull G, et. al., Does the Presence of Sensory Hypersensitivity Influence Outcomes of Physical Rehabilitation for Chronic Pain? A preliminary RCT. Pain. May 2007.
Karnezis IA, et. al., Factors Affecting the Timing of Recovery from Whiplash Neck Injuries: Study of a Cohort of 134 Patients Pursuing Litigation. Archives of Orthopeadic and Trauma Surgery. October 2007.
Peolsson M, et. al., Generalized Pain is Associated with More Negative Consequences than Local or Regional Pain: A Study of Chronic Whiplash-Associated Disorder. Journal of Rehabilitation Medicine. April 2007.
Rosenfeld M., et. al., Active Intervention in Patients with Whiplash-Associated Disorders Improves Long-Term Prognosis. Spine. November 2003.
Sterling M., et. al., Physical and Psychological Factors Maintain Long-Term Predictive Capacity Post-Whiplash Injury. Pain. May 2006.

What Exactly Are the B Complex Vitamins?

The B group of vitamins is probably the most commonly misunderstood of the vitamins, simply because the B vitamins are several distinct vitamins lumped together. Additionally, the fact that the vitamins in this group are known by both letter, number and name is confusing to many people. Here is a quick list of the B vitamins found in the Vitamin B complex group.
ï B1 is also thiamin
ï B2 is also riboflavin
ï B3 is also niacin
ï B5 is also pantothenic acid
ï B6 is also pyridoxine
ï B7 is also biotin
ï B9 is also folic acid
ï B12 is also cobalamin
You should note that there are four additional substances in the B complex group, though they are not known as vitamins. They are choline, lipoic acid, PABA and inositol. When you purchase B complex vitamins, these four will not be included. Furthermore, one or two of the recognized B vitamins may also be omitted. B5 and B7 are so widely available in food that most people get plenty of these vitamins even if they arenít eating a healthy diet.
There are gaps in the numbers of the B vitamins because our understanding of them has evolved over time. Initially there was only a single B vitamin. Later it was recognized that what had been referred to as a single vitamin, actually had many components. These component parts where numbered 1,2,3,4, etcÖ Even later it was determine that some of these components (such as B4) did not meet the criteria of being a vitamin and they were dropped. Thatís how we ended up with 8 B-vitamins with non-sequential numbers.
One thing that all the B vitamins share is that they are water soluble. Any excess vitamin B is not stored, but rather is excreted in the urine. That means that all the B vitamins need to be constantly replenished from our diets.
B vitamins are found in whole unprocessed foods including grains, meats and vegetables. In general, the more processed that food is, the lower the content of all the B vitamins. A daily multi-vitamin is a great way to ensure that you are getting all the B complex Vitamins your body needs on a daily basis.
One of the most commonly recognized uses of the B vitamins is an energy booster. Many popular energy drinks that claim a natural boost of energy without sugar or caffeine are high in B vitamin complex.
There are too many components in the Vitamin B complex to discuss the health benefits, deficiencies and Recommended Daily Allowance for the whole group in a single article. Look for future articles about each of these important nutrients.
If you have questions about your current nutrition and supplement plan, just ask. We are here to help!

Bibliography
B Vitamins MedlinePlus. (n.d.). Retrieved 8 10, 2011, from National Institutes of Health: http://www.nlm.nih.gov/medlineplus/bvitamins.html
Micronutrient Information Center. (n.d.). Retrieved 8 11, 2011, from Linus Pauling Institute at Oregon State University: http://lpi.oregonstate.edu/infocenter/vitamins.html

Is Going Barefoot Really a Prescription for Fewer Running-Related Injuries?

The latest in performance footwear isn't on display at America's elite university track programs. Nor will you find it on the pitch at professional soccer games. You won't see it on the baseball diamond, basketball court or football field either. Why not? Because the most recent innovation in athletic shoes (at least among a small but growing community of hardcore running enthusiasts) is... not wearing any at all!

The Reasons Behind the "Back to Basics" Movement
For a majority of runners either considering or actively experimenting with barefoot running, it's not about trying to rediscover their inner caveman. Rather, these individuals are looking for ways to improve comfort, reduce wear and tear on their bodies and add years to their running lives. A 2009 bestselling book called ìBorn to Runî, written by Christopher McDougall, evangelizes barefoot running and ties many of our species' running-related maladies to the use of shoes. But does running barefoot actually solve the problem? And do the obvious risks outweigh the potential benefits?

What Does Science Say About Running Barefoot?
The idea is controversial among medical researchers and healthcare providers as well as among runners themselves. At the center of the debate is our understanding of the musculoskeletal system and the biomechanics of running, and it's fair to say that the evidence today doesn't point clearly in one direction or the other. In fact, the leading researchers on the topic at Harvard Universityís Skeletal Biology Lab are careful to point out that none of the information they present is meant to answer questions about how people should run and whether running barefoot or with shoes is any more likely to cause(or prevent) any particular type of injury. So if you're thinking about adopting the barefoot running lifestyle yourself, it's worth considering a handful of points about which there seems to be some general agreement:
1. We run much differently when we wear shoes. For example, long-time shoe wearers (that's most Americans) tend to take longer strides and land further back on the foot, producing a harder heel strike that would be uncomfortable or painful without shoes. Shoe wearers also generally lean forward more. By contrast, experienced barefoot runners are far more likely to have a forefoot or midfoot strike and will tend to run in a more upright position.

2. The differences in running style mean that impacts and stresses are distributed and absorbed differently by the body. Research suggests that the hard heel strike creates a higher-frequency impact that tends to move upward through a runner's bones, while the lower-frequency impact of landing on the forefoot travels through the muscles and soft tissue.

3. The fact that most Americans wear shoes from an early age means that our bodies adapt to it. And we probably adapt in a couple of different ways. Not only do we learn to move differently when we have shoes to absorb the impact and protect us from cuts and scrapes, we also strengthen (or weaken) different parts of our bodies in the process. If youíve ìgrown upî running in modern athletic shoes (which enable long strides and hard heel strikes), itís unlikely that your feet and calves have the same muscle strength as a those of an experienced barefoot runner. Itís also unlikely that you have the same sorts of calluses.

4. Just because weíve walked and run in shoes for most of our lives doesn't mean we can't do something different, but it does mean that we should be smart about making a change. The last thing you want to do is to inadvertently increase the risk of some types of injury in the course of trying to prevent others (upping the odds of sprains, strains and tendonitis to reduce the likelihood of stress fractures, for instance). It takes time for a runner to adjust his or her form and for the body to make its own adjustments. For this reason, itís important to make a gradual change and pay close attention to your running technique. Your own body will provide some feedback on your progress, but education and common sense should play a central role in helping you set appropriate goals and expectations.

5. Whether you choose to run in shoes or to run barefoot, good form matters. And it matters a lot. Countless coaches and trainers have gone on the record saying that bad form contributes to more running-related injuries than any other single factor. Dr. Daniel Lieberman recently provided a wonderful quote to Gretchen Reynolds of the New York Times:

ìHumans may have been built to run barefoot, but we did not evolve to run barefoot with bad form.î
If you're a runner looking for a healthier approach--especially if you are experiencing pain or have a history of injury, your chiropractic physician can help! As experts in diagnosing, treating (and, even better, preventing) muscular and skeletal problems, chiropractors use a variety of proven techniques to relieve pain, promote healing and improve performance. Best of all, they can help keep you running at your best! Call our office today to make an appointment.

References & Resources
Lieberman, D., et. al., Biomechanics of Foot Strikes & Applications to Running Barefoot or in Minimal Footwear. Harvard University Skeletal Biology Lab. Accessed August 2011.
http://barefootrunning.fas.harvard.edu/
McDougall, Christopher, ìBorn to Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seenî 2009.
Reynolds, Gretchen, ìAre We Built to Run Barefoot?î. The New York Times. June 8, 2011. Accessed August 2011.
http://well.blogs.nytimes.com/2011/06/08/are-we-built-to-run-barefoot/

Can I Use My Flexible Spending Account for Chiropractic Care?

As of the time this article is being written ñ Yes you can use your FSA account to pay for chiropractic services.

Bear in mind that exactly what is and is not eligible inside a Flexible Spending Account is ultimately determined by the IRS. The rules covering FSAs can and do change year-to-year and there is some gray area which is open for interpretation.

The relevant IRS publications to consult for all the details are Publication 969: Health Savings Accounts and Other Tax-Favored Health Plans and Publication 502: Medical and Dental Expenses. You can find both of these online at http://www.irs.gov/pub/irs-pdf/p969.pdf and http://www.irs.gov/pub/irs-pdf/p502.pdf

This article isn't intended to provide tax advice or address your specific situation, but it will give you a broad overview and direct you to resources where you can learn more. Now that the disclaimer is out of the way, here is what consumers should know.

IRS Publication 502 clearly states - ìYou can include in medical expenses fees you pay to a chiropractor for medical care.î This rather short statement covers the core things we do such as exams, diagnostic tests and spinal adjustments. Good news for you!

It also states that ìYou can include in medical expenses amounts paid for transportation primarily for, and essential to, medical care.î This includes gas for your own car and also public transportation fees you pay in order to come to our office. Just keep track of your mileage, commuting routes or receipts in a log book.

The IRS draws a distinction between medical care and general health. Most purchases intended to keep you healthy or enhance your health don't qualify. This includes nutritional supplements, exercise equipment and health club memberships. Weight loss programs also don't qualify unless you are under medical supervision for a disorder such as diabetes or cardiovascular disease where weight loss is part of the disease treatment program.

Note that there are two players for every FSA plan in the IRS and the benefits company
providing the plan. In most cases the benefits company will allow everything the IRS allows, but some may have additional restrictions of their own. If in doubt about whether a specific service we provide is eligible, consult your corporate benefits administrator.