Omnivorous vs Vegan & SMT For Chronic Neck Pain

The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

CF 314: Omnivorous vs Vegan & SMT For Chronic Neck Pain Today we’re going to talk about Omnivorous vs Vegan & SMT For Chronic Neck Pain But first, here’s that sweet sweet bumper music

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [e-mail] If you haven’t yet I have a few things you should do.

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You have found yourself smack dab in the middle of Episode #314 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 5). Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Let’s start by giving Dr. Steven Brown out in Gilbert, AZ a shoutout. If you listened last week, we had a paper that was just the abstract. It was a paper that the WHO is using in part to help them formulate their opinion that SMT is recommended but at very low confidence. The paper used orthopedic manual physical therapy, whatever the hell that is. “The protocol consisted of accessory mobilizations (posteroanterior), traction of the lumbar region, mobilization with movement in the coxofemoral joint, and global techniques of neural mobilization of the lumbar spine. The duration of the orthopedic manual physical therapy was 20–25 minutes per session.” Dr. Brown says, “They did not get actual lumbar spine, SI joint, or hip manipulation at all. Just 20-25 minutes of mobilization.” So, there you have it from one of last week’s papers. I think as we go through them, it’s getting clearer and clearer that the WHO may have an agenda. Which chiropractors expect, honestly. When you have MDs running the show, they’re going to be super slow to promote SMT to the MainStage for anything. Using papers like we’ve been seeing to make their determination is just, quizzical. For lack of a better word. It’s perplexing when we know there is more current and more impactful research in favor of SMT. Moving on this week, I just got back from Jupiter, FL and the MCM Mastermind with Dr. Kevin Christie, Dr. Brett Winchester, Dr. Lindsey Mumma, and many more. Florida wasn’t warm. It was in the 50s and 60s but we were in a classroom most of the time anyway. We had some fine dining at The Woods, which is Tiger Woods’ restaurant. No Tiger sightings but none were expected. Lots of Bentleys, Mercedes, Lambos, and the like. It’s always a little crazy in Florida when you consider the amount of money strolling around those towns. Lots of great discussions, lots of thoughts and plans. Now to have the time to organize the thoughts and take action on them. One fun one came from my little friend, Dr. Tiffany Armstrong from Iowa. Her and her husband have a great practice out there and are adding a gym to the mix. Fun fun. She was talking about Storybrand and what are your Big 3? She said patients and clients can’t really keep up with more than three things. It got me to thinking and here’s what I came up with:

1. Pain Relief
2. Function, Stability, Strength
3. Performance Care

That’s why you join a mastermind. That was a little comment on a discussion that we had in class. Nothing game changing but enough to give me some clarity and direction with some things I’ve been wanting to tweak and change. Imagine how many of those little comments and conversations we have over the weekend. Lots of direction this morning outside of the. Podcast so I’m hopping into it Item #1 Our first one today is called, “Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins: A Randomized Clinical Trial” by Landry et. Al and published in JAMA Network Open November 30, 2023. Kapow! It’s hottern’ a teapot! Remember, the citations can be found at chiropractscforward.com under this episode. Landry MJ, Ward CP, Cunanan KM, et al. Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(11):e2344457. doi:10.1001/jamanetworkopen.2023.44457 Why They Did It Increasing evidence suggests that, compared with an omnivorous diet, a vegan diet confers potential cardiovascular benefits from improved diet quality (ie, higher consumption of vegetables, legumes, fruits, whole grains, nuts, and seeds). The researchers wanted to compare the effects of a healthy vegan vs healthy omnivorous diet on cardiometabolic measures during an 8-week intervention. How They Did It This single-center, population-based randomized clinical trial of 22 pairs of twins randomized participants to a vegan or omnivorous diet (1 twin per diet). Participant enrollment began March 28, 2022, and continued through May 5, 2022. The date of final follow-up data collection was July 20, 2022. This 8-week, open-label, parallel, dietary randomized clinical trial compared the health impact of a vegan diet vs an omnivorous diet in identical twins. Twin pairs were randomized to follow a healthy vegan diet or a healthy omnivorous diet for 8 weeks. Diet-specific meals were provided via a meal delivery service from baseline through week 4, and from weeks 5 to 8 participants prepared their own diet-appropriate meals and snacks. The primary outcome was difference in low-density lipoprotein cholesterol concentration from baseline to end point (week 8). Secondary outcome measures were changes in cardiometabolic factors, plasma vitamin B₁₂ level, and body weight. Exploratory measures were adherence to study diets, ease or difficulty in following the diets, participant energy levels, and sense of well-being. A total of 22 pairs of twins What They Found After 8 weeks, compared with twins randomized to an omnivorous diet, the twins randomized to the vegan diet experienced significant mean (SD) decreases in low-density lipoprotein cholesterol concentration, fasting insulin level, and body weigh Wrap It Up In this randomized clinical trial of the cardiometabolic effects of omnivorous vs vegan diets in identical twins, the healthy vegan diet led to improved cardiometabolic outcomes compared with a healthy omnivorous diet. Clinicians can consider this dietary approach as a healthy alternative for their patients. Item #2 OK, the last one this week is called, “A systematic review and meta-analysis of randomized controlled trials of manipulative therapy for patients with chronic neck pain” by Liu et. Al. published in Complementary Therapies in Clinical Practice in August of 2023 and it’s just hot enough! Zhen Liu, Jiao Shi, Yubo Huang, Xingchen Zhou, Huazhi Huang, Hongjiao Wu, Lijiang Lv, Zhizhen Lv, A systematic review and meta-analysis of randomized controlled trials of manipulative therapy for patients with chronic neck pain, Complementary Therapies in Clinical Practice, Volume 52, 2023, 101751, ISSN 1744-3881, https://doi.org/10.1016/j.ctcp.2023.101751. Why They Did It An increasing number of people suffer from chronic neck pain due to increased telecommuting. Manual therapy is considered a safe and less painful method and has been increasingly used to alleviate chronic neck pain. However, there is controversy about the effectiveness of manipulation therapy on chronic neck pain. Therefore, this systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to determine the effectiveness of manipulative therapy for chronic neck pain. How They Did It A search of the literature was conducted on seven databases from the establishment of the databases to May 2022. This study included RCTs on chronic neck pain managed with manipulative therapy compared with sham, exercise, and other physical therapies. The retrieved records were independently reviewed by two researchers. Further, the methodological quality was evaluated using the PEDro scale. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment was used to evaluate the quality of the study results. Seventeen RCTs, including 1190 participants, were included in this meta-analysis. What They Found Manipulative therapy showed better results regarding pain intensity and neck disability than the control group. Manipulative therapy was shown to relieve pain intensity and neck disability. However, the studies had high heterogeneity, which could be explained by the type and control interventions. In addition, there were no significant differences in adverse events between the intervention and the control groups. Wrap It Up Manipulative therapy reduces the degree of chronic neck pain and neck disabilities. Hurry, someone run and the the World Health Organization that we got a new paper to add to their crap recommendations…. More on the papers they’re using to recommend SMT at very low confidence in next week’s Part 6 of that series. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. Store Remember the evidence-informed brochures and posters at chiropracticforward.com.

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The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website

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