Chiropractic + Naturopathic Doctor • December 2015 • News And Events

Processed meat linked to cancers, red meat ‘probably’ is too, WHO research says

PARIS – It’s official: Ham, sausage and other processed meats can lead to colon, stomach and other cancers. Red meat is probably cancer-causing, too.

While doctors have long warned against eating too much meat, the World Health Organization’s cancer agency gave the most definitive response yet recently about its relation to cancer – and put processed meats in the same danger category as cigarettes or asbestos.

A group of 22 scientists from the WHO’s International Agency for Research on Cancer in Lyon, France, evaluated more than 800 studies from several continents about meat and cancer.

Based on that evaluation, they classified processed meat as “carcinogenic to humans” and red meat as “probably carcinogenic.”

Meat industry groups protest the classification. The North American Meat Institute argued in a statement that “cancer is a complex disease not caused by single foods” and stressed the importance of lifestyle and environmental factors.

Doctors have warned that a diet loaded with red meat is linked to cancers, including those of the colon and pancreas. The American Cancer Society has long urged people to reduce consumption of red meat and processed meat.

The researchers defined processed meat as anything transformed to improve its flavour or preserve it – including salting, curing or smoking.

They noted that red meat contains important nutrients but said it was associated with some cancers in several studies. Their report said grilling, pan-frying or other high-temperature methods of cooking red meat produce the highest amounts of chemicals suspected to cause cancer.

VICTORIA – Chiropractors in British Columbia are hoping for legislation to expand their scope of practice, including the ability to order diagnostic imaging covered by provincial health care.

The B.C. Chiropractic Association (BCCA) has been engaging the provincial government for better integration of the profession into primary care.

At the association’s recent annual general meeting, BCCA president Dr. Jay Robinson said association executives have met with members of the legislative assembly to explore ways chiropractic can help solve some of the province’s health-care challenges.

“We’re starting to integrate better into the healthcare system, and we now have a very strong case to be able to be players in the health-care system,” Robinson told Canadian Chiropractor.

Widening the chiropractic scope of practice to allow Dcs to prescribe diagnostic imaging for patients, Robinson said, will help patients get the right care they need at the right time.

Currently, B.C. patients need to get a referral from their family doctor for diagnostic imaging. A patient who’s had an injury or suffering from musculoskeletal pain, for example, would have to wait weeks to get appropriate treatment. Few who are willing to pay out of pocket to get x-ray right away could get the right care quicker, but the majority would prefer the government pick up the tab on this health-care service, Robinson noted.

“If (chiropractors) refer the patient directly for x-ray, they can go that day or the next day, the result comes back, then they go back to the chiropractor – if it’s applicable – and they get treated. They are getting treated within a couple of days instead of a couple of months.” Members of B.C.’s legislative assembly were generally receptive to the chiropractic cause, according to Robinson, adding the government is increasingly becoming aware of the need for more collaboration among health-care providers to increase efficiencies in the health-care system.

Association executives hit a snag, however, when they met with B.C. Health Minister Terry Lake. Robinson said the meeting was to obtain the minister’s support for expanded scope of practice for chiropractic and increasing chiropractic involvement in the health-care system.

“He didn’t want to hear about it, and didn’t want to talk about it,” Robinson said.

Lake, a veterinarian by profession, told BCCA officials he has a “bias,” allegedly, but the minister gave no further clarification.

The minister’s office has since reconnected with the BCCA and relayed that the “minister regrets his comments” and is willing to meet with the BCCA again, Robinson reported. No word yet on when that next meeting would be.

Canadian Chiropractor attempted to get clarification from Lake about what transpired at the meeting with the BCCA. As of this writing, the minister was unavailable for interview.

The minister’s office did provide an e-mail response to this writer’s inquiry, in which it called Lake’s encounter with the BCCA officials a “productive meeting.” “The Minister did meet with the association earlier this year. They had a productive meeting; however, there are currently no plans at this time to extend MSP coverage to chiropractic care,” the statement said.

CASE FOR SPINE CARE One important role chiropractors can play in interprofessional primary care is as spinal care provider, according to Vancouver chiropractor Dr. Dean Greenwood, citing this expertise is currently an urgent health care need. Greenwood was one of the speakers at the BCCA’s annual chiropractic convention.

One in eight people suffer from a spinal disorder and musculoskeletal disability is on the rise, Greenwood said.

“With an aging population, there is urgent need for further research to better understand spinal pain,” he told conference attendees.

Greenwood, who is cofounder of the Vancouver Spine Care Centre, urged chiropractors to consider pursuing additional education and advanced learning to further increase chiropractors’ credibility as spinal care experts.

In addition to his doctor of chiropractic degree, Greenwood has a Master of Science in Advanced Clinical Practice from National University Health Sciences.

“Clinical expertise and professional authority are essential (for chiropractors) to be included in integrated spinal care,” Greenwood stressed.

It may seem counterintuitive that exercise could help people with arthritis and other musculoskeletal conditions, but a new study finds that a low-impact exercise program is improving quality of life for many older adults with these conditions.

The program, offered by Hospital for Special Surgery (HSS) in senior centers in New York City’s Chinatown and Flushing, Queens communities, has helped decrease pain, improve mobility and enhance the overall health of many participants.

The study, titled, “The Effectiveness of a Low-Impact Exercise Program on Musculoskeletal Health of Asian Older Adults,” was presented at the American College of Rheumatology/ Association of Rheumatology Health Professionals annual meeting on November 9 in San Francisco.

“Getting seniors to be active in any way will generally improve their quality of life and help them function better in their everyday activities,” said Linda Russell, a rheumatologist and chair of the public and patient education advisory committee at Hospital for Special Surgery (HSS). “People believe that if you have arthritis you shouldn’t exercise, but appropriate exercises actually help decrease pain.” Fifty per cent of adults aged 65 and older have received a diagnosis of arthritis, according to the U.S. Centers for Disease Control and Prevention.

Previous studies have shown that participation in low-impact physical activity can improve pain, function, mood and quality of life without worsening arthritis symptoms or disease severity.

In 2010, 25 per cent of Asian seniors aged 65 and older in New York City lived in poverty and were affected by musculoskeletal conditions.

“To help those in underserved communities better manage these conditions, Hospital for Special Surgery developed its Asian Community Bone Health Initiative in 2011,” said Sandra Goldsmith, senior director of education and academic affairs at HSS. “The goal is to help seniors decrease musculoskeletal pain, stiffness and fatigue; improve balance; reduce falls; and increase physical activity.” The eight-week low-impact exercise program, led by bilingual, certified instructors, is held once a week in community-based organizations largely serving older Asian adults. Between September 2011 and July 2015, 370 individuals took part in the program, and 204 participants completed surveys both before and after taking the exercises classes. Ninety per cent of respondents were female, and 76 per cent were between the ages of 65 and

In the survey, many respondents reported that they experienced less pain and were better able to perform activities of daily living after participating in the exercise program. Participants reported that their muscle and joint pain was significantly reduced by 32 per cent.

• 96 per cent of participants felt more confident that exercising would not make their symptoms worse “The study results indicate that the hospital’s Bone Health Initiative has a positive impact on the musculoskeletal health of the Asian senior population,” said Huijuan Huang, program coordinator.

“Providing free exercise programs to the community can play an important role in helping adults manage musculoskeletal conditions.”

VICTORIA – True interprofessional health care happens when multiple health practitioners and disciplines collaborate on the care of one patient. And that, according to speakers at the 2015 B.C. Chiropractic Convention, starts in the education level.

Training future health-care practitioners to work alongside other health disciplines, in mutual respect of each other’s respective skills and knowledge, is a significant win for collaborative, patient- centred care.

“You cannot force collaborative practices, you have to build it from the ground up. You have to educate them on collaboration,” stressed Dr. Deborah Kopansky- Giles, chiropractor and clinician- scientist on staff in the department of family and community medicine at Toronto’s St. Michael’s Hospital (St. Mike’s).

Giles oversees the chiropractic program at St. Mike’s and cochairs the department’s interprofessional education committee with Dr. Judith Peranson, a family physician. Giles and Peranson discussed the St. Mike’s model of collaborative primary health care at the BC chiropractic convention.

“Education helped drive our team forward. Learning together as a team has been a major contributor to interprofessional collaboration,” said Peranson.

St. Mike’s department of family and community medicine has 12 health-care professionals, including three chiropractors. They look after the health care of more than 35,000 patients in a collaborative fashion.

Giles noted St. Mike’s “interprofessional team” does not just mean co-location or referrals. The practitioners work on a “one patient, one chart” model, which Provides practitioners a universal view of a patient’s records.

Although there are only a handful of models of interprofessional primary health care in Canada, the trend towards creating new generations of collaborative health professionals is increasing. In 2009, the University of Toronto has declared it mandatory for all students in the health professions programs to fulfill a required number of credits on interprofessional education t h rough its Centre for Interprofessional Education.

Giles urged proponents of B.C.’s planned chiropractic educational institution to consider interprofessional education. She also challenged practitioners to consider attending continuing education conferences outside of chiropractic.

“Get a little bit outside of your own comfort zone for your own professional development.” Switzerland is one country that may have integrative health care collaboration figured out. Swiss chiropractors enjoy the same privileges, rights and responsibilities as medical doctors, according to Dr. Kim Humphreys, a professor in the medical faculty and head of the chiropractic medicine program at the University of Zurich.

The chiropractic medicine program is part of the university’s Faculty of Medicine. During the first three years of the nine-year doctor of chiropractic medicine program, chiropractic students are required to take medical courses, Humphreys said, noting medical and chiropractic students also have the same requirements for admission.

Such integrated education has “facilitated discussions and mutual respect” between the two professions, Humphreys said. “Medicine has not diminished our role. In fact, I found the opposite; they try to expand it.” Humphreys, a Canadian born in

B. C., also spoke at the chiropractic convention. The four-day event, hosted by the B.C. Chiropractic Association, was held in Victoria,

Toronto chiropractor Dr. Luigi Nalli will soon be hitting the airwaves to host a new television show aimed at “demystifying” pain.

The show, called Doctor Pain, will feature expert interviews and discussions about various aspects and symptoms related to pain.

According to data from the Canadian Pain Society, about one in five Canadian adults suffer from chronic pain.

“Pain is probably the least understood symptom by health-care professionals,” said Nalli, who was a 2014 recipient of the Ontario Chiropractic Association’s Recent Graduate Award. “With a media outlet like TV, you can reach a much larger population and give them the right knowledge.” Nalli’s brother Anthony Nalli, the show’s creator and executive producer, calls the new series a “fusion of good ideas.” “I found a lot of interest in the things that (Luigi) was doing and the things that he was growing more and more enthusiastic about. I actually found myself learning a great deal,” said Anthony.

Through the show, the Nalli brothers want to educate people about pain. “I think that kind of information is very interesting and very useful... so how do we give it to people in a way that is entertaining, in a way that they will accept and welcome and absorb.” Doctor Pain targets a “more youthful” demographic, 26 to 45 years old.

According to a press release, the 30-year-old chiropractor host will be “presented as not only a knowledgeable professional but also a cool motorcycle enthusiast and adventurous young family man well in-tune with the lifestyle and needs of the young and not-so-young alike.” Graduating cum laude from the Canadian Memorial Chiropractic College, Luigi has been in practice for three years and has a special focus on pain management in his practice. He attributes his relative success in practice to his constant effort to educate people.

“One of the things I was doing largely to help grow my practice was a lot of outreach stuff,” Luigi noted. “I was basically getting in front of people and sharing my knowledge and I found that was really what got people in the door. Give someone really good information, something that we’re very well trained on, and the people tend to come in.” Luigi’s interest in talking to people is what attracted him to consider participating in the TV show. In addition to helping people understand and make sense of pain, the Toronto DC also believes this endeavor can help raise the profile of the chiropractic profession in the public eye and help educate them about what chiropractic is really about.

He said people often ask him how chiropractic is different from physiotherapy or massage therapy. And the difference, Luigi said, is the body of knowledge regarding differential diagnosis of pain disorders.

“That is where I would like to raise awareness of the public for the profession – that chiropractors may be the best practitioners out there to answer your painbased questions,” Luigi said.

Doctor Pain will be a halfhour show, covering two or three topics and different subject matter experts each episode.

The show is currently in pre-production with principal shooting targeted for next spring and summer.

Anthony said his team aims to launch the new series by end of next year, airing across Canada on Bell TV and in the U.S. on PBS. The series will also be available on iTunes.