A Guide to Processed Foods for PTs

Mar 07, 2023

A Guide to Processed Foods for PTs

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

Physical therapists are leading the charge to help clients improve not only their rehabilitation status but also their health problems. Many of these chronic health problems stem from poor lifestyle choices like poor sleep patterns, excessive stress, and bad nutrition. One key element in nutrition that Doctors of Physical Therapy can make a big impact on is education around reducing processed foods. 

In the past my team and I have recommended using Dr. Greger’s stoplight method for limiting processed foods. The system was easy to understand and convey during patient education; plus, Dr. Greger loves his information being spread in order to improve health. Now, a new method of categorizing processed foods has emerged: NOVA.

NOVA is a food classification system that groups foods based on the extent of processing they undergo. The system was developed by researchers in...

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Best Practices in PT for Hip and Knee OA Includes Dietary Interventions

Nov 03, 2022

Best Practices for Hip and Knee OA Includes Dietary Interventions

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

A few months back a major article was published regarding osteoarthritis treatment guidelines from 6 major professional organizations. Physical therapists (PTs), athletic trainers (ATs), occupational therapists (OTs), and Physicians use these professional guidelines to help direct our care. As many of us know, OA  can lead to great loss of function, increased pain, and higher expenses. As such, having the most current and best evidence is vitally important to helping our patients move better, have less pain, and reduce costs.

For years the mainstay treatment in physical therapy has been exercise and manual therapy. Obviously these treatments depend on the specific joint, as many DPTs often use aquatic therapy to help with hip osteoarthritis. Lately the utilization of dry needling has helped patients with knee OA. The use of other therapies...

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Top 3 Diets to Reduce Processed Foods In Patients' Diets

Sep 14, 2022

Top 3 Diets to Reduce Processed Foods In Patients' Diets

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

Recently there has been a lot of press regarding the negative effects of processed foods. From early cognitive decline to the chances of catching COVID-19 more easily, ultra-processed foods definitely have a negative impact on our health: both in the medium and long-term. Despite knowing this, how do we as physical therapists educate our patients on eliminating processed foods? 

One of the best ways of doing this is to recommend a specific dietary pattern. A dietary pattern is a way for patients to follow a set of guidelines on what and how much to eat, as well as how to prepare their food. Dietary patterns that promote the least amount of processed foods include:

  1.  Whole food plant-based diet. This dietary pattern is rich in whole foods, like fresh vegetables, fresh fruits, whole grains, and limited meat consumption. The diet is rich in...
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Junk Plant-based Diets and What PTs Need to Know

Aug 31, 2022

Junk Plant-based Diets and What PTs Need to Know

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

Over the last several years we have seen the literature explode in regards to the health benefits of eating a predominantly plant-based diet. From lower rates of heart disease, diabetes, and even cancers, it would seem that plant-based diets can really make a significant impact in our physical therapy patients. Unfortunately, big agriculture and corporations have seen this growth as a potential new market for them to gain more money. As such, many major food producers are now producing many of the common unhealthy foods in their own plant-based type variety.

For example, it has been long known that sausage and hamburger meat can promote atherosclerosis and possibly even gastrointestinal cancers. Much of this has to do with the fact that they are loaded in saturated fats, contain minimal fiber and other phytonutrients, and may contain carcinogens. Despite this,...

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Best Nutrition Guide for PTs

Apr 08, 2022

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

Physical therapists (PTs) are direct care providers who help people across many settings and with various pathologies and functional losses. From cardiac issues, metabolic dysfunction, cancer, neurological deficits, and musculoskeletal disorders, PTs can help a variety of patients get stronger, move with more confidence, and feel better. One key tool that can help with PT's treatments is nutrition.

Nutrition is in the scope of practice of Doctors of PT (DPTs), according to the American Physical Therapy Association (APTA). Nutrition is linked with inflammation, recovery, pain, psychological well being, and quality of life. Plus, most of our clients are taking supplements or simply want to get better, faster with any approach possible -- as such, PTs need more quality dietary info.

One of the best evidenced-based resources for nutrition is Examine.com. Examine offers copious research, great summaries, and...

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Healthy Living Medicine and PT

Mar 09, 2022

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

I was excited to see a recent publication in our APTA’s PTJ titled Precision Medicine and Physical Therapy: A Health Living Medicine Approach for the Next Century. I have been following the primary author, Rich Severin, on Twitter for some time now and enjoy his perspectives. Overall the article dives into much of what my team and I practice – I earnestly hope it is something other PTs  (physical therapists) begin to practice too. In this light, I’d like to discuss some of the important topics in this article.

First, it goes without saying that general health has an impact on physical therapy, functioning, and quality of life. Chronic health conditions like heart disease, high blood pressure, and diabetes makes healing difficult and are linked with other disease states that cause physical damage to other tissues (e.g. high blood pressure damages the kidneys). Functionally clients struggle...

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Calorie Restriction and Physical Therapy

Oct 20, 2021

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

Diet crazes come and go in the hopes to correct health issues and for weight loss. Many diets are merely fads, not backed by evidence, and/or offer only short-term solutions. One dietary pattern that stands out from the pack is calorie restriction (CR), especially in regards to data on longevity. I have 2 peer-review publications in the area of CR and intermittent fasting, so I can share both the data and experiences of this diet. Let's take a quick look at calorie restriction and what physical therapists (PTs) need to know!

Calorie restriction is a dietary regimen where a person consumes typically 25-40% less calories than usual. In order to accomplish this calorie deficit a person must know their total daily caloric needs over several days. Calculating 25-40% of this total calorie needs a client can then reduce their calorie content of each meal in order to hit their calorie deficit. Usually there is not...

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Should PTs Use a New Model for Weight Loss?

Sep 16, 2021

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

For decades the predominant model that dictated weight gain, loss, or maintenance was the energy balance model (EBM). The EBM is rooted in one of the basic laws of thermodynamics. It goes without saying that food contains energy and it is typically measured in a unit known as calories (kilocalories in the dietary world). As a person consumes food it provides energy to do work such as exercise, activities of daily living (ADL), physical therapy, basic living functions, or even sport. Energy can come from recently consumed food or stored energy (e.g. fat, glycogen, or protein) from previously eaten food. 

Clinicians often explain weight loss to patients as “calories-in versus calories-out” or CICO, which directly relates to the EBM. In brief, CICO helps rehab professionals to explain to clients the balance between the energy coming into their body versus the energy they expend: too much food...

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Naysayers of Nutrition and Physical Therapy

Feb 16, 2021

"D" in the in professional abbreviation DPT stands for Doctor, as in Doctor of Physical Therapy. Our profession has made great leaps and bounds in its stride to becoming experts in movement, the neuromuscular system, and wellness. Much of our success has been through diligent efforts to improve the educational standards of our PT students. We've also continually raised the bar by encouraging most States to enact stricter continuing education standards, licensing, and rigorous specializations and fellowships. Such training and advanced education, along with our doctorate, prepares us to provide care in direct access, primary care, wellness centers, rehab facilities, hospital, gyms, and sports complexes to name a few. We are managing simple injuries now without much of the red tape and bureaucracy, while helping those with devastating diseases and ailments get better. Despite all the progress I feel we still have a stock of PTs that are holding us back, especially in...

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Should PTs Advocate for a Low Carb Animal Diet or a High Carb Plant Based Diet?

Jan 28, 2021

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...

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