Michael Glab MS, RD, LDN
Stay In Your Lane - Leave The Nutrition Advice To The Professionals
I’ve heard several stories about chiropractors giving their clients nutrition advice. While it may seem harmless to do so, I’d like to dig deep and explain why chiropractors (or anyone else not licensed to practice nutrition for that matter) should stay in their lane.
A 17 year old female is seeing the chiropractor for scoliosis. She is slightly underweight for her height and age, but she is active and pays close attention to her diet. During her session, the chiropractor asked her what she eats daily. She told the chiropractor that she generally has a rice cake with peanut butter and banana or a fruit smoothie with spinach and chia seeds for breakfast. The chiropractor then made a comment about the rice cake having too many carbohydrates and that adding the banana was carbohydrate overload.
Not only is this wildly inappropriate advice to be giving a slightly underweight, yet otherwise normally health teenage girl, but it is factually inaccurate. A plain rice cake generally contains 4-5 grams of carbohydrate (or in other words 20 calories). Also there is absolutely nothing wrong with eating a banana daily, especially if you are a healthy teenager. There are no clinical indications in this scenario to encourage a low carbohydrate diet. Not only is this bad advice, but it could possibly influence a young person to have a negative relationship with food.
That same chiropractor also recommended that she take a multivitamin and a calcium-complex supplement sold by the chiropractor. I am not sure why a chiropractor is recommending a multivitamin to a teenage girl with no significant medical history other than scoliosis. The calcium-complex supplement I could maybe understand as this girl doesn’t consume a lot of dairy. However I am confident the chiropractor did not do a professional nutrition assessment to derive this information before making his "recommendations". Basically this chiropractor is pushing supplements to pad his bottom line. This is very inappropriate and unethical professional behavior in my opinion.
I have also heard of two instances of chiropractors recommending red yeast rice (RYR) to patients. RYR is a very powerful cultured yeast that may contain monacolin K, which may lower cholesterol similar to a statin (a prescription drug used to lower cholesterol). However, a high level of monacolin K needs to be present and most RYR supplements sold do not contain a therapeutic dose. There is no reliable way to know how much monacolin K they contain.
RYR has potentially dangerous side effects including muscle pain, muscle weakness, rhabdomyolysis (muscle breakdown that releases toxins into bloodstream) and liver toxicity. RYR may interact with other drug to increase the risk of rhabdomyolysis. It should also not be taking by women pregnant or breastfeeding. Finally RYR may cause kidney failure or genetic damage if it contains too much of a substance called citrinin. Supplements, like RYR, sold in America are not federally regulated or checked for purity. Some brands independently have outside entities like NSF or USP check for purity, but those are the exception and not the rule.
Anyone can give out general nutrition advice, which is why there are so many “experts” in nutrition. For example, your aunt who does that juice cleanse and swears by it, is not a licensed nutrition professional. Neither is that yoga instructor who fasts for 36 hours and tells all her yogi clients to do it too. Neither are the chiropractors in the examples above. Finally, most people don’t realize that most medical doctors only take one nutrition course during medical school. I have also heard of doctors preaching low carbohydrate diets when they are not indicated.
The point of all this is to help you, the consumer of health and wellness services, realize that professional advice should be given by someone who is trained and certified to provide services in a particular field. In these cases the correct professional to see regarding nutrition issues would be a Registered Dietitian. To be clear, I have nothing but utmost respect for all medical and wellness professionals, which is why I would never overstep my professional boundaries and make recommendations outside of my professional scope. I kindly ask that they do the same and stay in your lane :).