Prescriptive Dietary Recommendations

Prescriptive Dietary Recommendations

May 8, 2012

In recent years our knowledge of the huge role played by dietary choices has exploded.  Yes, there remain lots of unresolved opinions as well, and we have also discovered that different emphasis is important for different people, but still…most North Americans are eating regularly in ways that pretty well ensure the onset of chronic disease.  We can drug and operate away the symptoms – sometimes – but there is a mother lode of both preventative and remedial effectiveness in simply changing the basics of diet for most of our patients.

Of course many have assumed that just changing diet would ensure adequate nutrients and overall balance, but there are many reasons for questioning that assumption.  Our available food sources have changed dramatically over the years.  Cooking and processing alter foods from their original state.  Our own genetics have changed over the centuries.  So, it’s likely that added nutrients will be essential even assuming an optimal diet.  Given all that, however, we simply can’t underestimate the therapeutic value of a truly balanced diet.

Why, then, do most practitioners continue to offer vague platitudes when it comes to recommendations for diet?  Would we say, when prescribing a drug or a supplement, “Oh, just take some of these if and when you think of it.”  No, we’re likely to be quite specific about amounts, times and duration.  Why should we be less specific when it comes to diet?

There are probably a number of reasons for this.  The very idea of making any significant change in diet is a daunting thing to many patients.  That makes it daunting for doctors as well, because they have to hold the line in an uncomfortable situation.  Easier, it seems, to make a general pronouncement, even though both doctor and patient knows that the generality will make it meaningless in the long run.

To address this area more effectively there are several elements to consider:

  • Do you have permission from the patient to make specific dietary prescriptions?  You may be surprised to discover that people will often comply more fully than you would imagine, particularly if things are spelled out specifically.
  • Do you have a number of prepared dietary guidelines that can be modified for individual needs and handed out to them in a straightforward, easy-to-follow format?
  • Have you set up a specific mechanism for follow-up so that patients report in on their success or their limitations with their dietary recommendations?
  • Do you have a way patients can note and quantify their progress at regular stages?
  • Do you utilize partners in the healing arts who can assist with specific aspects of the process of changing habits (colon hydro-therapists, psychologists if needed, diet planners)?
  • Do you employ a reliable cleansing and balancing program for initiating a new dietary regimen?

Of course there are broad strokes and fine strokes to be considered.  For most patients, just limiting or eliminating foods such as refined sugars and starches, non-organic meats and most dairy products will make a massive difference.  However, there are lots of individual factors in terms of sensitivities, metabolic types, genetic predispositions, etc.  One size doesn’t really fit all in this sense, and yet there are many common sense steps that can be taken to de-stress digestion, elimination and metabolism.

My point in this article is not to detail the dietary plans you would recommend to your patients, because that is going to vary significantly depending on your training and the patents’ needs.  What I wish to emphasize here is that dietary recommendations should be given in the spirit of a prescriptive approach rather than a non-specific suggestion.  Some bad examples?  “You need to cut down on snacks.”  “Don’t eat so much sugar.”  “Dairy’s probably not so great for you.”  “Try to eat more vegetables.”  “You could lose some weight.” These kinds of statements will never find fulfillment!  Some weak efforts may be made, followed quickly by forgetfulness or resignation with rapid reversion to the habits already established.

What are some more effective alternatives?

  • Ask questions to determine what goals are reasonable and desirable for the patient.  What do they want to accomplish and what are they willing to do to accomplish their goals?
  • Determine family dynamics and how they will affect the outcome of your plan
  • Present the plan in clear, exact terms.  Examples: “These foods are out of bounds.” “ These can be utilized once per week.”  We’re going to follow this program for one month, have a look at the results and then modify as needed.” “ Fill this container with water and drink it all over a four hour period.”
  • Make sure the guidelines are written down and that the patient agrees to them all
  • Make it clear that he or she will be reporting on the next office visit, and set that visit today
  • Make sure basic supplementation is included as appropriate in order to maximize utilization and elimination and to speed the process overall
  • Optionally, you may wish to offer a regular education program on diet in order to inspire patients and to draw them and their family and friends into a more conscious participation in their own therapy.

Breaking habits requires something specific – clear guidelines with accountability, specific alternatives that are reasonable, attractive and attainable.  Patients need to see both the goals and the progress.  And they need to see you as their partner in a cycle of success.

Implementing a program like this can enhance your practice in many ways:

  • Far greater success in both acute and chronic outcomes
  • More referrals from those looking to lose weight or counter chronic problems
  • Enhanced compliance with your other treatments and protocols
  • Shifting your practice from episodic care to cycles of healing

Grant Clarke | Energetix

One comment

  1. Thanks for this Grant!
    I will be certain my dad reads this, and will assist in implementing the protocol, with the patients we serve!
    Josh.

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