Screen Time

You Are What You Eat & Screen Time For Kids

CF 236: You Are What You Eat & Screen Time For Kids Today we’re going to talk about what you eat and mental health and we’ll talk about screen time for kids.  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 making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and patients. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Facebook page, 
  • Join our private Facebook group, and then 
  • Review our podcast on whatever platform you’re listening to 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com
You have found yourself smack dab in the middle of Episode #236 Now if you missed last week’s episode , we talked about about the inflammatory response’s protection from chronic pain, which is fascinating.. and we talked about where patients should be starting their journey for low back pain.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Struggles and challenges in my personal space. See if you recognize any of my struggles in your life and clinic.  Some are so busy they can’t see straight. I have to say that the last few weeks have been a bit slow for me compared to where I normally am, numberswise. I typically will see 180+ appointments per week, 23 or so NP per week included in that number, and around 650 or so total appointments per month by myself.  Lately, it’s more like 145 or so per week.  In my mind, it’s the economy. It’s gas prices. It’s uncertainty. I keep good stats and this is just not normal for me. I didn’t make anyone in town mad. I didn’t go out and kick the mayor’s dog or anything. My name and reputation hasn’t changed. We’re good.  So why the slow down? COVID isn’t really around to take the blame this time. And, in the past, any time there’s been a slow down, it’s either back to school in August or it’s the holidays. So, outside of those factors what else is working people’s brains these days? Uncertainty. The inability to afford extras because of the price of food and gas and real estate and vehicles and everything else y ou can think of.  I cannot wait until the post-COVID wreck finally settles and life starts to click normally once again. No more excuses about inflation, gas, supply chains, price gouging, or anything else. Just normal life. I can’t wait.  In the meantime, I’m still looking for an associate. I’m a go getter. I’m a do-er. If you are too and you need a great place to work, be mentored, and maybe even buy out one of these days, email me at creekstonecare@gmail.com, I want to start a conversation with you.  Before we get ot the research,  I’ve been telling you about a system that once obtained will help you get more  PI cases.  This system was created by an attorney who exclusively handles accident cases. He got tired of lame approaches by doctors wanting his referrals, so he created this system to teach you how to get the attention and then the love of PI attorneys.  You know these cases are the GOLD of our business.  Very few no-shows, full payment … not health insurance caps or Medicare or Medicaid. Go to: http://www.gettingpicases.com/cs Over 500 doctors nationwide are now using this system…. don’t be left out…  improve your practice, gain free time because of the added income you’ll realize, and appreciate that the attorney, Paul Samakow, is still offering a 100% Money Back Guarantee …  if you give his ideas a fair shake and it doesn’t work, he’ll refund your money…  you have nothing to lose here… Go to: http://www.gettingpicases.com/cs Item #1 This first one is an article that covers a paper. The article is called “Your mental health may depend on what’s in your diet” by the staff (Staff 2021) at Study Finds. It was published in September of 2021 and that’s just steamy enough! It’s an article so here is the summary of the info within:
  • “There is increasing evidence that diet plays a major role in improving mental health, but everyone is talking about a healthy diet,” says Lina Begdache, an assistant professor of health and wellness studies and co-author of the study
  • There is not one healthy diet that will work for everyone. There is not one fix
  • Results indicated that eating breakfast daily, getting moderate exercise frequently, and keeping fast food and caffeine consumption down improved the mental health of young women. In mature women, the same applied with the addition of high consumption of fruits daily.
  • In young men, daily exercise coupled with dairy and meat consumption increased mental health, along with a low intake of fast food and caffeine. The same applied to mature men with an additional intake of nuts daily.
  • “I have found it in my multiple studies so far, that men are less likely to be affected by diet than women are. As long as they eat a slightly healthy diet they will have good mental well-being. It’s only when they consume mostly fast food that we start seeing mental distress,”
  • “Women, on the other hand, really need to be consuming a whole spectrum of healthy food and doing exercise in order to have positive mental well-being. These two things are important for mental well-being in women across age groups.”
Interesting stuff there. Food for thought…..pun intended.  See what I did there? And….you’re welcome Before getting to the next one, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! It’s live again. Use the code HOTSTUFF upon purchase at droprelease.com to get $50 off your purchase. Y’all, it makes a world of difference. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. My patients love it and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Hear me now and believe me later. Item #2 The last one today is called “Association Between Screen Time Trajectory and Early Childhood Development in Children in China” by Zhao et. al. (Zhao J 2022) and published in JAMA Pediatrics on June 6, 2022. Aye yaye….muy caliente! Why They Did It Screen time has become an integral part of children’s daily lives. Nevertheless, the developmental consequences of screen exposure in young children remain unclear. The authors wanted to investigate the screen time trajectory from 6 months to 72 months of age and its association with children’s development at age 72 months in a prospective birth cohort. That’s 6 years old for those that don’t like brain math. Basically – Is early screen exposure associated with children’s cognitive, language, and social-emotional development? How They Did It
  • Women in Shanghai were recruited for this cohort study. 
  • Their children were followed up at 6, 9, 12, 18, 24, 36, 48, and 72 months of age. 
  • Children’s screen time was classified into 3 groups at age 6 months: 
  • continued low (ie, stable amount of screen time), 
  • late increasing (ie, sharp increase in screen time at age 36 months), and 
  • early increasing (ie, large amount of screen time in early stages that remained stable after age 36 months). 
  • Cognitive development was assessed by specially trained research staff in a research clinic. 
  • Of 262 eligible mother-offspring pairs, 152 dyads had complete data regarding all variables of interest and were included in the analyses. 
  • Data were analyzed from September 2019 to November 2021.
Wrap It Up The findings of this study suggest that both the duration and the onset of screen exposure matters in terms of children’s cognitive and social-emotional development. It found that excessive screen time in early years was associated with poor cognitive and social-emotional development. This finding may be helpful in encouraging awareness among parents of the importance of onset and duration of children’s screen time. Parents…..listen up. I wished I had this information when I was a young parent. I think some of the stuff we did would be 180 degrees different.    No doubt in my mind. And for those of you that don’t understand on Facebook how research like this is chiropractic, you don’t get it and probalby never will. We are a profession. Not a spinal manipulative therapy modality. We are a profession and kids mental health and development is as much a part of the health and well being of our patients as is low back pain.  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.   

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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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
Home
Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger   Bibliography Staff (2021). “Your mental health may depend on what’s in your diet.” StudyFinds.   Zhao J, Y. Z., Sun X, (2022). “Association Between Screen Time Trajectory and Early Childhood Development in Children in China.” JAMA Pediatr.    

Living With Chronic Pain, Screen Time, & Low Back Pain Delivery

CF 169: Living With Chronic Pain, Screen Time, & Low Back Pain Delivery

Today we’re going to talk about living well with chronic pain, screen time, and changing the delivery of low back pain care.

But first, here’s that sweet sweet bumper music

 

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers.

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

If you haven’t yet I have a few things you should do. 

  • Like our Facebook page, 
  • Join our private Facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. 

You have found yourself smack dab in the middle of Episode #169

Now if you missed last week’s episode, we were joined by a couple of key players in the Texas Chiropractors’ fight against the Texas Medical Association for the right to diagnose patients, treat the Neuromusculoskeletal system rather than just the musculoskeletal system, and the right to perform VONT testing. All in one court attack. And we won after losing twice. It’s crazy. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

I’ve talked in the last 3-4 weeks how my life has become complicated and how I’m working through it slowly. This week feels like it’s leveling out a little. I hate to say that and jinx it but I’m a glass is a half full type of dude. 

Let’s start with a new one though that’s stressing me out a little and may pertain to some of you as well. I’ve started getting some trickles of complaints here and there on one of my staff members. A key staff member. Now, what do you do when that happens? First, it probably depends on the complaints, wouldn’t you agree?

If they’re egregious, well then they gotta go. These aren’t. These are more personality conflicts and they’re from females. I’ve never had a male complain about her. So, what’s going on there?

Second, if they’re not necessarily fire-able offenses, what do we do to correct them? Are they just strictly personality-driven and there’s nothing we can do to change the inherent behavior of a person? Or….can she be trained to suppress a certain aspect of her nature? If it’s built into her nature that is.

I buy into staff. I care about staff. On this, I’m in no hurry to get rid of an employee. Not at all. Mostly because she’s really good at a lot of key aspects of her job. Like….REALLY good. I’m rooting for her. I want her to succeed. 

For that reason, I have found some training for her to do. I want her to have every tool at her disposal that I can provide to give her the chance to succeed and do well. Not everyone is a natural. Sometimes we need training. Sometimes people don’t even realize certain aspects of their personality are off-putting to others. 

I’m sure I have certain off-putting parts of my personality. Just nobody ever tells me about it. Either because I’m the doctor in the office, or I’m the boss in the office, or because I’m 6’4” and big as hell. 

Anyway, we are getting her some training, supporting her, and keeping our fingers crossed because she’s a hard worker, she’s smart, and I think she can be a valuable part of our team.

Now, for the good stuff…..Last week I mentioned my pickup dying. 

Always get a second opinion on your vehicle when they tell you that you need a new engine for $6500 because I remembered a good friend of mine is a mechanic. We took it to him and it turns out it just need an oil pump and parts and labor ran us about $800. No sweat. I’m back up and running. 

The computer that contained my entire life was able to be backed up just before its demise so the new one is getting up and running. My old programs are getting up and running. And my life is returning to some sense of normal as more and more of the computer and the software starts to behave the way it is supposed to behave. 

So, yes, we have valleys and peaks but hold on and try to enjoy the ride. We are going through the medical integration slowly but surely. We have found our medical director. He’s been one of my long-time friends and actually used to be a chiropractor so it’s perfect. He knows me well, knows how I treat patients, and knows how I approach healthcare. I think it’s an amazing fit. 

Now, we are searching for a nurse practitioner to help us make it all happen. Here’s the key on that though, it has to be someone that fits my personality and my approach. It has to be an NP that doesn’t mind learning from a damn chiropractor if you know what I mean. If it’s someone that sees chiropractors as lowly servants, well that won’t work out at all now, will it? I’d rather lose $20,000 than put up with something like that. 

But if it’s someone that is open and eager to learn about the biopsychosocial aspect of pain, communicating correctly with patients, and things of that nature, then we probably have a fit. For example, some NPs can be told that the Canadian Medical Association Journal published a systematic review where 13 of 14 papers showed no effect for using gabapentin in radiculopathy. They can get that info and ignore it. That’s not the NP for me. 

On the other hand, they can see the paper and say to themselves, “Maybe we don’t want to prescribe anti-convulsants for radicular pain after all.” THAT’S my kind of NP.  That’s who I’m looking for. As always, I’ll let you know how it goes. 

But, the long and short of it is, we’re getting past the loss of the office manager, all of the big oopsies are starting to get sorted out, we have big stuff still on the worry plate but life is starting to retreat from the danger zone. The crisis zone if you will. It’s still on high alert but the alarm bells are going silent again. Thank God. 

CHIROUP ADVERTISEMENT

Item #1

Our first one today is called ““Living Well with Chronic Pain”: Integrative Pain Management via Shared Medical Appointments” by Znidarsic et. Al. (1) and published in Pain Medicine in January of 2021….dammit, it’s hot. 

I want to point out that the first three listed authors on this paper were a DO and two PhDs and out of 18 authors, there was only one DC on the list. In addition, several of the authors were MDs. Three of them to be exact. 

Why They Did It

To evaluate the effectiveness of a multidisciplinary, nonpharmacological, integrative approach that uses shared medical appointments to improve health-related quality of life and reduce opioid medication use in patients with chronic pain.

How They Did It

  • Retrospective, pre-post review of “Living Well with Chronic Pain” shared medical appointments (August 2016 through May 2018)
  • The appointments included eight 3-hour-long visits held once per week at an outpatient wellness facility.
  • It included patients with chronic, non–cancer-related pain.
  • Patients received evaluation and evidence-based therapies from a team of integrative and lifestyle medicine professionals, as well as education about nonpharmacological therapeutic approaches, the etiology of pain, and the relationship of pain to lifestyle factors
  • Experiential elements focused on the relaxation techniques of meditation, yoga, breathing, and hypnotherapy, while patients also received acupuncture, acupressure, massage, cognitive behavioral therapy, and chiropractic education
  • Patients self-reported data via the Patient-Reported Outcomes Measurement Information System (PROMIS-57) standardized questionnaire.
  • 178 participants completed the PROMIS-57 questionnaire at the first and the last visits

What They Found

  • Statistically significant improvements in all domains were observed between the pre-intervention and post-intervention scores
  • Average opioid use decreased nonsignificantly over the 8-week intervention, but the lower rate of opioid use was not sustained at 6 and 12 months follow-up.

Wrap It Up

Patients suffering from chronic pain who participated in a multidisciplinary, nonpharmacological treatment approach delivered via shared medical appointments experienced reduced pain and improved measures of physical, mental, and social health without increased use of opioid pain medications.

Item #2

This one is called “Association Between Screen Time and Children’s Performance on a Developmental Screening Test” by Madigan et. al. (2) and published in JAMA Pediatrics on January 28, 2019. Not all that hot. Little steamy but not enough for my favorite soundbite. Unfortunately. 

I’ve highlighted some of these screen time posts before because they just make me crazy and I have to say, I’m guilty of having my kid on electronics years ago. And I’ve spent the last 15 or so years trying to keep them off of the electronics. We all make mistakes and turning our kids over to electronics is one of the biggest I think.

Why They Did It

The authors wanted to answer the question, “Is increased screen time associated with poor performance on children’s developmental screening tests?”

How They Did It

  • This was a longitudinal cohort study using a 3-wave, cross-lagged panel model in 2441 mothers and children in Calgary, Alberta, Canada, drawn from the All Our Families study.
  • Data were available when children were aged 24, 36, and 60 months.
  • Data were collected between October 20, 2011, and October 6, 2016. So…5 years.
  • At age 24, 36, and 60 months, children’s screen-time behavior (total hours per week) and developmental outcomes (Ages and Stages Questionnaire, Third Edition) were assessed via maternal report.

What They Found

A random-intercepts, cross-lagged panel model revealed that higher levels of screen time at 24 and 36 months were significantly associated with poorer performance on developmental screening tests at 36 months and 60 months.

Wrap It Up

The results of this study support the directional association between screen time and child development. Excessive screen time can impinge on children’s ability to develop optimally; it is recommended that pediatricians and health care practitioners guide parents on appropriate amounts of screen exposure and discuss potential consequences of excessive screen use.

Item #3

This last one is called “Transforming low back pain care delivery in the United States” by George et. al. (3) and published in Pain in December of 2020 and that’s a stout stack of steam stuff right there. This paper has our friend and previous guest, Dr. Christine Goertz, on it. She is amazing so I can only assume the rest of these authors are as well.

They say, “Low back pain (LBP) continues to be a challenging condition to manage effectively. Recent guideline recommendations stress providing non-pharmacological care early, limiting diagnostic testing, and reducing exposure to opioid pain medications. However, there has been little uptake of these guideline recommendations by providers, patients or health systems, resulting in care that is neither effective nor safe. This paper describes the framework for an evidence-based pathway that would transform service delivery for LBP in the United States by creating changes that facilitate the delivery of guideline adherent care.”

They’re saying that the guidelines and the recommendations are there but people aren’t listening. On both sides in my estimation. You have MDs going straight to shots and surgery and even the ones that are open to referral are just going straight to the PT. If the PT fails, then it’s shots and surgery rather than spinal manipulative therapy, or laser, or yoga, or maybe the PT wasn’t good at diagnosing the issue and providing targeted exercise. 

On the other hand, we have chiropractors moving bones when they should be stabilized. Or ordering x-rays over and over and over. Or treating 100 times for a curve problem that probably isn’t that big of a problem. 

They go on to say, “An evidence-informed clinical service pathway would be intentionally structured to include; a) direct linkages to community and population-based resources that facilitate self-management, b) foundational LBP care that is appropriate for all seeking care, c) individualized LBP care for those who have persistent symptoms, and d) specialized LBP care for instances when advanced diagnostics and intensive treatments are indicated.”

“There is an urgent need to transform LBP care by optimizing clinical care pathways focused on multiple opportunities for non-pharmacological treatments, carefully considering the escalation of care, and facilitating self-management.” 

We have chiropractors telling people to come to see them weekly to ward off disease, build the immune system, and things of that nature. That’s creating dependency on the clinic and it is not supported by any research. Certainly not in the context that so many vitalist chiropractors yell out and are so obnoxious about. Patients need to be taught at-home self-management techniques to deal with their pain. The rest is unnecessary noise. 

They close with this, “Such approaches have the potential to increase patient access to guideline adherent LBP care as an alternative to opioids, unwarranted diagnostic tests, and unnecessary surgery.”

Alright, that’s it. Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourselves and everyone around you. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it.

Let’s get to the message. Same as it is every week. 

Store

Remember the evidence-informed brochures and posters at chiropracticforward.com. 

 

Chiropractic evidence-based products

Integrating Chiropractors

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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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About the Author & Host

Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

 

Bibliography

  1. Josie Znidarsic, DO, Kellie N Kirksey, PhD, Stephen M Dombrowski, PhD, Anne Tang, MS, Rocio Lopez, MS, Heather Blonsky, MAS, Irina Todorov, MD, Dana Schneeberger, PhD, Jonathan Doyle, MCS, Linda Libertini, Starkey Jamie, LAC, Tracy Segall, LMT, Andrew Bang, DC, Kathy Barringer, LISW, Bar Judi, CYTERYT 500, Jane Pernotto Ehrman, MEd, RCHES, Michael F Roizen, MD, Mladen Golubić, MD, PhD, “Living Well with Chronic Pain”: Integrative Pain Management via Shared Medical Appointments, Pain Medicine, Volume 22, Issue 1, January 2021, Pages 181–190, https://doi.org/10.1093/pm/pnaa418
  2. Madigan S, Browne D, Racine N, Mori C, Tough S. Association Between Screen Time and Children’s Performance on a Developmental Screening Test. JAMA Pediatr. 2019;173(3):244–250. doi:10.1001/jamapediatrics.2018.5056
  3. George SZ, Goertz C, Hastings SN, Fritz JM. Transforming low back pain care delivery in the United States. Pain. 2020 Dec;161(12):2667-2673. doi: 10.1097/j.pain.0000000000001989. PMID: 32694378; PMCID: PMC7669560.