For the last several decades low carb advocates have pitched their diet as means to weight loss, better glycemic control, and even life extension. Many avid fans, like Noakes and Attia, have thrown around several low level studies or short term studies to support the low carb dietary pattern. Meanwhile, the data for more plant focused, carb rich diets like the Mediterranean and Whole food plant based diets have been gleaning more and more support. From prospective trials to population and epidemiology data, such plant focused diets seem to be the ideal pattern for physical therapists (PTs) to recommend to many clients. Let's take a look a recent National Institute of Health (NIH) trial comparing a low carb animal based diet to a high carb plant focused diet.

Published in Nature Medicine, the NIH trial was relatively small and focused on short term results. Researchers housed the participants in a NIH controlled facility, proving to increase the internal validity and controls of the st...

Emerging evidence is revealing how Vitamin D can help patients with COVID-19, commonly known as the Coronavirus.  Vitamin D is known as the "sunshine vitamin" as it is produced in the skin with sun exposure. Most Americans are deficient in Vitamin D, possibly due to the lack of optimal sun exposure and/or their poor diets. In order to get peak Vitamin D levels from sun exposure, a person must remain in direct sun with most the body exposed for 20 minutes under peak sun (usually 11am to 1pm). Vitamin D can be found as a fortification in many foods such as cereals, dairy milk, plant-based milks, while it is found naturally in some mushrooms. The specific Vitamin D in focus would be D3, also known as cholecalciferol.

So what's the data on Vitamin D and COVID-19? Well, randomized trials and cross sectional studies have shown that ~60% of patients with COVID-19 were vitamin D deficient upon hospitalization, with men in the advanced stages of COVID-19 pneumonia showing the greatest deficit....

The holidays are here and our clients are busy hanging decorations and eating lots of holiday food. Most of this holiday food is loaded with extra calories from added sugars, fat, and processed junk. After climbing their ladders, lifting the boxes, and the stress of traveling and seeing family, they come crawling into our clinics or gyms with extra weight and a sore back.

What can we do as Doctors of Physical Therapy (DPTs)? Aside from our traditional physical therapy treatments like manual therapy and exercise, we should be using patient education for weight loss. Here are some of our top tips for PTs and weight loss.

Journal Your Foods

Holidays bring big emotions and lots of junk food. Many of this junk food is eaten without our clients' being aware they are eating hundreds, if not thousands, of extra calories. These calories add up quickly promoting weight gain, reducing glycemic control, and stimulating inflammation.

To improve your PT outcomes and shed some pounds, data show t...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

If you were reading the news last week then you might have seen an article that sounds something like: "Good News, Meat May Protect You from Heart Disease." While this sounds exciting and promising, many of the published media articles just don't dive into the science enough to give citizens and clinicians an educated viewpoints. Let's examine the new evidence, its science, and what impact it should have on physical therapy practice.

The Article

The main research paper the media is slinging around can be found in mSystems, an open access journal. The authors, Kivenson and Giovanni, published the paper title An Expanded Genetic Code Enables Trimethylamine Metabolism in Human Gut Bacteria, which full-text can be found here. Both Kivenson and Giovanni are researchers at Oregon State University and their primary focus is in microbiology.

mSystems is a relatively new journal. Overall it has an impact factor of 6.28...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

The Holidays Are Coming!

We have Halloween, Thanksgiving, Christmas/Passover/Kwanza, and New Years coming. Data show that most Americans will on average gain about 0.4% of body fat during this time, most coming just after Christmas. While 0.4% does not seem like much fat, consider some quick math: a 175 lb man would essentially gain 3/4ths of a pound during the holidays. This small weight gain seems insignificant unless you add this weight gain with other gaining periods in the year, and compound the weight gain every holiday season. In other words, consider if this 175 lb 20 year old gained 0.4% every year for the next 20 years. This would equate to an extra 7 lbs of fat just gained in a few months over 20 years!

How does any of this matter for physical therapy practice? Time and time again my team and I are asked, how can we as physical therapists (PTs) educate our clients to lose weight? We are also told: I ...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

Sports Nutrition

One of the hottest terms in the last decade: sports nutrition. Ask any exercise scientists, personal trainer, or athletic trainer, and they will say that sports nutrition has become a booming topic of interest and a huge market. Physios may be behind the curve a bit on this topic, so we thought we'd offer a nice review of sports nutrition specific to sports physical therapy practice.

For PTs, the 3 main areas of sports nutrition we should be focused on would include:

1. Recovery
2. Immunonutrition
3. Performance enhancement

Let's dive into each of these and see what PTs need to consider from a dietary perspective.

Recovery

Helping athletes rehabilitate after an injury is an important role of a sports physio -- but what about recovering from resistance training, practice, or competition? Recovering from training and competition can translate into athletes gaining more strength, playing better, ...

By Dr. Sean M. Wells

Many facets of nutrition can impact older adults' function and health. The focus on this blog article will be to highlight how inflammation, which can be mediated via diet, impacts older adult function and health. 

Using the Dietary Inflammatory Index (DII), physical therapists can quantify the amount of inflammation a client's diet is provoking. Essentially the score ranges from as low as -5 to as high as 5, with a "fast food diet being reported at 4 and a macrobiotic diet being listed at -5. Probably the best diets on the DII are vegetarian Indian diets and other Asian diets rich in vegetables and spices. Another way of "scoring" or ranking the inflammation cause by a diet is to use an A-F system. An "A" score would be ideal and the most negative (e.g. close to -5, which is the least inflammatory), while "F" is the most inflammatory (e.g. most positive, 5). An average, or "C" score, would be a 0. 

 Using the DII, PTs can see how diet impacts health and functio...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

Continuing our series on gut health and the gut microbiome, we are going to talk about a new finding in the ever-expanding gut bacteria research: a gut biome health score.

Similar to how we have credit scores, which can denote whether a person has good or bad credit history, a gut biome health score may give physios and other healthcare providers insight into many facets of a patient's lifestyle.

Recall the gut biome is the bacteria, archaea, fungi, and some viruses that live within our small and mostly large intestines. These small bugs live in a symbiotic relationship with our bodies and:

• Help to produce neurotransmitters (90% of serotonin is made by gut bacteria)
• Process foods to make health short chain fatty acids (SCFA) which can improve cardiovascular health
• Modulate the immune system response

The last factor likely has the biggest implications for physical therapists (PTs). As rehabilitation prof...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT CNPT, Cert-DN

The gut biome has been all the rage for the last several years. If you haven't heard about the gut biome, then you either live under a rock or haven't researched about how your body works. The gut biome, often interchangeably called the gut microbiota or flora, are trillions of small bacteria, archaea, and fungi that live in your intestines. We have these critters all over our body (e.g. nose, hands, mouth) but the most reside in our gut. What these small bugs do for us is truly amazing.

Data show the microbiome is capable of protecting our immune system, producing healthy short-chain fatty acids, and could be linked to many disease states like cancer, heart disease, and allergies. Recently I began listening to a great podcast by Dr. Will Bulsiewicz on gut health on the Rich Roll Podcast. Dr B, as he's commonly known as, pronounced easy methods to protecting and nurturing our gut. Some of his top tips:

• Eat a v
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By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT CNPT, Cert-DN

Physical therapists (PTs) are stepping up their game and focusing on important in the clients' lives: social determinants of health (SDOH), wellness, alcohol and drug use, sleep, and nutrition. As we venture into a newer world of PT practice, clinicians need to be armed with useful tools and resources to help them along the way. Let's outline some of our team's favorite nutrition apps that have helped us help many clients.

Nutrition Guide for Clinicians

Published by the well-known Physicians' Committee for Responsible Medicine (PCRM), the Nutrition Guide for Clinicians is a simple app that all Doctors of Physical Therapy (DPT) should have installed on their phones. The app allows a clinician to easily look up a condition or diagnosis, and then scroll through easily summarized data on simple nutrition tips that can contribute or treat the disease. Authors of the app list copious studies in their references for PT...