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Chiropractic Board of Clinical Nutrition

Course Topic Guidelines

The following Course Topic Guidelines lists most of the topics that may be covered in the diplomate examination. You may consider these topics when submitting official transcript hours in the Grandfathering process if you never held a diplomate in nutrition. These topics are covered in nutrition diplomate programs or nutrition courses given through chiropractic colleges or other institutions of higher learning. Many of these topics are covered in continuing education classes which can also generate an official transcript.

Introduction to the Study of Nutrition, Assessment and Evaluation

a. Why is the study of nutrition important
b. Nutrition and its relation to health
c. Trends in the American diet
d. Adequacy of the American diet
e. Cultural, age and economic factors
f. Clinical appraisal of patient, questionnaires and forms
g. Psychological evaluation, stress and other questionnaires
h. Physical examination of nutrition patient - how it differs from medical and musculoskeletal examination examples shown
i. Laboratory testing
j. Information on how to choose supplement companies
k. Risk management issues including the nutrition informed consent

Laboratory I

Introduction to laboratory analysis for the nutrition practice including routine blood chemistries and organ profiles

a. Urinalysis
b. Hair analysis
c. Salivary testing
d. Stool analysis
e. Nutrient level determination

Nutritional Aspects in Gastrointestinal Disease

1. Organs
      a. Mouth
          Tooth decay
          Bleeding gums
          Periodontal
      b. Stomach
          Dyspepsia
          Gastritis
          Ulcers
          Hiatal hernia
     c. Gallbladder
     d. Intestine
         Dysbiosis
         Irritable bowel syndrome
         Malabsorption syndrome
         Parasitic infections
         Infectious diarrhea
         Colitis
         Leaky gut syndrome
         Diverticulitis
         Constipation
         Hemorrhoids
2. Functional laboratory testing for GI disorders
3. Diets for specific GI disorders

Nutrient-Nutrient and Drug-Nutrient Interactions, Contraindications and Risk Management

Risk management for the clinical nutritionist includes knowledge of
      Nutrient-nutrient interactions and reactions
      Nutrient-drug interactions and reactions

Metabolism I

      Carbohydrates
      General considerations
      Dietary significance
      Monosaccharide
      Disaccharides
      Polysaccharides
      Digestion and absorption
      Fats
      General considerations
      Composition, classification and characteristics
      Functions
      Digestion and absorption
      Metabolism
      Cholesterol, Prostaglandins, phospholipids
      Essential fatty acids and triglyceride
      Protein
      General considerations
      Composition, classification and characteristics
      Functions
      Digestion and absorption
      Metabolism
      Enzymes
      Energy Metabolism

Female Nutrition

     Common female diseases and syndromes
     PMS
     Osteoporosis
     Menopause
     Vaginitis
     Candidiasis
     Endometriosis
     Cystitis
     PCOS
     Estrogen Dominance Syndrome
     Pregnancy
     Lactation
     Functional laboratory testing for female disorders
     Diets for specific female disorders

Nutrition in Infancy and Adolescence

     Infancy
     Growth
     Nutritional requirements
     Feeding considerations
     Alternatives to processed baby foods
     Supplementary foods
     Allergies
     Specific health issues
     Colic
     Ear Infections
     Iron deficiency anemia
     Adolescence
     Growth and development
     Evaluation of the child’s nutritional state
     Age group need differences
     Food habits
     School lunch program
     Nutrition education
     Specific health issues
     Dentition and nutrition
     Obesity
     ADD and ADHD
     Autism
     Functional laboratory testing for infant and adolescent disorders
     Diets for specific infants and adolescents

Nutrition Practice and Risk Management, Research Paper Presentation, and Examination

General nutrition practice management tools will be covered including:
      incorporating nutrition into an existing practice
      redirecting patient dollars already spent on supplements
      risk management

Submit and present 1 literature research paper suitable for publication, typed in proper format with a minimum of 25 references

Musculoskeletal Nutrition

Nutrition consideration should always be included in the complete management of soft tissue injuries or complaints and those of bone tissue also. Satisfactory repair of injured tissue and the maintenance of strong, healthy soft tissue will decrease the frequency and severity of injury.

Soft Tissue Nutrition
     a. Acute injury
     b. Disc
     c. Chronic sprain/strain
     d. Myofascial / Fibromyalgia
     e. Carpal tunnel
Bone and Joint Nutrition
     a. Fractures
     b. Osteopenia, osteoporosis, osteomalacia
     c. Arthritis
Functional laboratory testing for musculoskeletal disorders
Diets for specific musculoskeletal disorders

The Role of Vitamins, Macro and Trace Minerals as Nutrients, Water

     Vitamin
     Minerals
     Trace minerals
     Water

Geriatrics and Longevity

     Characteristics of aging including
          Vision loss
          Hearing loss
          Dry skin
          Constipation/diarrhea
          GERD
          Dysphagia
          Arthritis
          Sarcopenia/osteopenia
          Anemia
          Physiologic and metabolic changes
          Memory loss/Alzheimer’s disease
          Multiple medication side effects
    Functional testing
          BIA, grip strength, albumin, metabolic markers

     Nutritional and diet requirements
     Obtaining adequate calorie intake
     Dentition complications
     Drug-nutrient interactions

Hyperimmunity – Nutritional considerations for allergies, autoimmune disorders and dermatology

     Allergies
         a. Acute and latent allergies
         b. Nutritional considerations in autoimmune disorders
         c. The role of the GI tract in both problems
         d. Food additives and preservatives

     Dermatology
     Functional laboratory testing for hyperimmune disorders
     Diets for specific hyperimmune disorders

Hypoimmunity - Phytochemicals, Immunology, HIV/AIDS, and Cancer

     a. Understanding phytochemicals and their role in nutrition
     b. Nutritional support for the immune system
     c. Nutrition for HIV/AIDS support
     d. Diet, nutrition and cancer prevention
     e. Discussion on alternative cancer therapies

Herbal Medicine: Introduction and Clinical Applications

     a. Basic introduction to and understanding of herbology
     b. Understanding the various preparations and when to use
     c. Dosage for pediatric, adult and geriatric patients
     d. Use of herbs in the treatment of common illnesses

Risk management issues including government regulations, manufacturing practices and standardization, herb-nutrient and herb-drug interactions

Nutrition in Blood Diseases, Infections and Metabolic Disorders

     a. Blood disorders
         Anemia
         Leukemia
    b. Acute and chronic infections
        Antibody and hormonal response
    c. Metabolic Disorders
        Metabolic Syndrome
        Diabetes mellitus and gestational diabetes
        Thyroid dysfunction
        Adrenal disorders
        HPA axis dysfunction
        Rheumatoid arthritis

Functional laboratory testing for metabolic disorders
Diets for specific disorders

Stress Management, Research Paper Presentations

Adrenal hormone and stress management protocols including relaxation exercises and techniques

Each participant will be expected to submit and present to the class a written case history in the format given.

Nutritional Considerations in Cardiovascular Health

     a. General considerations
         Coronary risk factors
         Role of diet
         Diet prescriptions
         Patient education
     b. Atherosclerosis
     c. Peripheral vascular disease
     d. Hypertension
     e. Ischemic heart disease
     f. Rheumatic heart disease
     g. Pulmonary heart disease

Functional laboratory testing for cardiovascular disorders
Diets for specific cardiovascular disorders

Laboratory diagnosis using computer program analysis

Functional approach to tests on blood, stool, urine, saliva to access nutrient recommendations
Show standard clinical as well as optimal nutritional ranges
Profile analysis for
     Heart disease
     Liver disease
     Kidney disease
     Gall Bladder disease
     Metabolic disease and diabetes
     Reporting, documentation and follow up testing

Use of Homeopathic Preparations in Nutrition Practice

This is an overview of homeopathy and the use of OTC products in clinical nutrition. Risk management issues will be covered including ethics and legalities.

Homeopathic material medica
Potency and frequency
Specific items for constitutional vs first aid
Common preparations used in practice

Sports Nutrition for the Athlete, Bariatrics and Eating Disorders

     a. Diet for optimum athletic performance
     b. Proper nutritional supplementation for the athlete
     c. Anorexia
     d. Bulimia
     e. Obesity

Functional laboratory testing for sports disorders
Diets for specific sports disorders and training

Nutritional Aspects of Neurological and Psychiatric Disorders

     a. Headache
     b. Neuromuscular disorders
     c. Toxicity H
     d. Depression
     e. Hyperactive / manic states
     f. Stress management
     g. Attention deficit

Functional laboratory testing for neurological and psychiatric disorders
Diets for specific neurological and psychiatric disorders

Diseases of the Urogenital System and Male Problems

     Urogenital
          a. Glomerulonephritis
          b. Nephrosis
          c. Kidney failure
          d. Principles of dietary treatment

     Conditions of the male reproductive organs
          a. Prostate
          b. Infertility

Functional laboratory testing for urogenital disorders
Diets for specific urogenital disorders

Metabolism III Interrelationships and pathways. Inborn errors of metabolism.

Show anabolism and catabolism of carbohydrates, fats and proteins, redox reactions for energy and antioxidant systems and the integration of metabolism. Integration of endocrine and other messengers for regulation of metabolism including genetic/inborn errors of metabolism will be covered.

X-ray Findings in Metabolic Disorders, Case Histories

Volume 2 Chapter 14 in Essentials of Radiology by Yokum and Rowe or like information.

In addition to the written and practical examinations, each participant in some nutrition diplomate programs will be required to submit three (3) case histories typed in proper format with supporting documentation to present and defend orally.