CAM therapy and Nutrition in Australia
It is a natural human response to seek more information and alternative advice when faced with a significant health problem and a positive sign that you are motivated to improve your health.
Unfortunately it can be very challenging to decipher the quality of information you are being presented with and this seems particularly challenging in Nutrition. The goal of our section on complementary and alternative therapies and nutrition is to help you make an informed choice in what is becoming a busy space.
Alternative and complementary medicine such as herbs and supplements have been around for a significant amount of time. Unfortunately regulatory systems face a significant challenge to adequately keep pace with an industry that according to some sources accounts for 4 billion dollars in revenue per year in Australia alone.(1)
Complementary and alternative therapies (CAM)
CAM refers to complementary and alternative medicine which essentially refers to two different health support methods. Complementary therapies refer to those therapies that do not replace or preclude conventional medical therapies and are generally used in conjunction with conventional medical treatments. Alternative therapies are treatment options outside the orthodox range that may be used in place of conventional treatments.(2)
There are many different CAM providers in Australia including but not limited to Alexander technique, Aromatherapy, Herbal medicine, Homeopathy, Naturopathy, Nutritional medicine ( to be honest i am not sure what Nutritional Medicine is although it certainly sounds fancy) and Reiki.
It is open to conjecture as to which treatment would be viewed as complementary or alternative and may be dependent on the practitioners health philosophy more so than the practitioners background. This may also be impacted on by the reality that many practitioners offer a wide variety of services with varying evidence and effectiveness as an example one practitioner may offer and be qualifications in Reiki, Naturopathy, Herbal medicine and Homeopathy so therefore could offer some services that are complementary and some that would be alternative
It is common for CAM practitioners to offer nutritional advice and many also refer to themselves as nutritionists however the level of their nutritional knowledge is not known or standardised across courses and as such may be extremely variable. Unlike the term Accredited Practicing Dietitian which is protected by law Nutritionist is an unprotected term which means any individual can refer to themselves as a nutritionist regardless of their skills or knowledge.
CAM providers overview
There is a wide variety of CAM practitioners operating in Australia currently however the market is significantly dominated by Naturopathy, Homeopathy, Traditional Chinese medicine and Herbalists. It is not known how many CAM practitioners there are in Australia only that there has been a significant growth in this area. One major natural health training college reports that it has had over 20,000 graduates by itself which indicates the numbers may be very high (3)
Naturopathy is a system of healing that aims to provide holistic or whole body health care by drawing on treatment methods from several traditional systems of medicine. Naturopathy seeks to use the natural healing powers of the body to cure itself. It focuses on treating the cause of a disease rather than the symptoms themselves.
What therapies do naturopaths use?
As well as nutrition, naturopaths may use herbal medicines, homeopathy, nutrition therapy and massage and some naturopaths are trained in counselling skills. Bach flower remedies and iridology — a technique in which the iris of the eye is examined and is said to give information about a person’s tendency to develop disease — may also be used by some naturopaths.
Homeopathy is an “alternative medicine” invented in the early 19th century by German doctor Samuel Hahnemann. Despite numerous experiments showing homeopathy to have no effect, it has become a multi-million dollar international industry with its own special rules in advertising law.
Regulation of complementary therapists
In Australia, state governments regulate complementary therapists. There are a number of efforts underway to look at greater regulatory control of this sector from both outside and inside the sector however at this stage little is know about the overall quality and safety of CAM this means that the laws differ from one state to the next. For example:
- The complementary therapy industry in Australia is largely self-regulated.
- It is assumed that complementary therapists are affiliated with a professional association but nobody actually knows if this is true.
- Membership may require that therapists maintain a certain standard of care but weather these standards are consistent across disciplines is unknown.
- However, membership is usually voluntary, which means there is no legal obligation.
Naturopaths have been termed the the largest unregulated ‘primary care’ health workforce in Australia by some but it is very difficult to get an accurate picture of those working in this field. The lack of a centrally regulated, monitored system and undocumented nature of regulation itself means precise numbers are difficult to come by – estimates had range anywhere between 3,000 and 15,000 practitioners. Evidence form the recent VET fee HELP scheme review has shown an alarming trend in growth in this area and preliminary data suggests there have been tens of thousands of enrollments in the CAM area across between 2009-2015. As an example there were 7149 individuals enrolled in nutritional medicine by private providers between 2013-2015 alone and that figure excluded other providers. One individual noted in a recent review into this area that the difficulty in establishing numbers and regulation issues is exacerbated by the fact there are over 90 associations purporting to represent naturopaths – dropping to ‘just’ 28 when reduced to those the government actually recognises. (4)(5)
Moves to develop a national register are continuing led by (ARONAH) the Australian Register of Naturopaths and Herbalists. ARONAH opened it national registration on July 2013 unfortunately as at 20.08.2016 some three years after initial registration ARONAH lists only 56 members on its find a practitioner service.
Evidence for CAM therapies
Many Australian access CAM therapies and have reported positive experiences and outcomes. The vast majority of these practitioners are dedicated individuals that strongly believe in what they are doing who have embarked on a course to help improve the health of their clients.
Considerable research is being undertaken into the effectiveness of these treatments and practitioners and some research initially indicated potential benefit. Unfortunately when these techniques and therapies are assessed against quality research standards they have been found to lack credible evidence .
One significant review was commissioned by the federal government in 2014 to ensure that natural therapies were underpinned by a credible evidence base that demonstrated clinical efficacy, cost-effectiveness and safety and quality. This major review released its findings in 2015 on 17 natural therapies including Aromatherapy Ayurveda , Buteyko, Feldenkrais , Herbalism /Western Herbalism , Homeopathy ,Iridology, Kinesiology and Naturopathy it was unable to conclude that any worked.
As with any Health professional if you choose to include a CAM professional in your care seek an individual that aligns with you view of health is well qualified and is a member of a major regulatory organisation.
Many of the basic underling nutritional principles of proposed by individuals working in CAM such as consumption of less processed foods and increased consumption of fresh, raw fruits, vegetables, wholegrain, seeds and nuts fits well with conventional medicine and nutrition therapy.
Concepts such as those in naturopathy which states that it seeks to use the natural healing powers of the body to cure itself focusing on treating the cause of a disease rather than the symptoms themselves is something that we all want to hear as is the idea of holistic care and unfortunately this want to believe can cloud our judgment .
All health professionals seek greater learning of natural processes to heal the body and I applaud the great work that has been undertaken in Naturopathy in particular to find alternative avenues and cures to improve health outcomes.
If your mainstream diabetes team are not supportive and holistic in their practice find ones that are there are plenty of high quality mainstream health professionals out there that treat the whole person complementary health providers did not invent holistic care.
Unfortunately this industry may be poorly regulated and much of the science is being openly questioned as not evidence based. From a nutrition perspective we have no way of knowing if a particular CAM practitioner has standardised knowledge or even if practitioners are taught the same information at different training institutions
Some CAM practitioners are now university trained which will hopefully lead to a greater integration of their skills and ideally produce some evidence for their practice but unfortunately others may have as little as 2-3 weeks nutrition training.
I look forward to learning from CAM practitioners and researchers but believe the best way to achieve that is by high quality research at major research Universities and starndardised high level courses. Sadly rather than supporting this to occur we appear to have supported mass access to multiple mid level training organisations.
Nutrition is a complex area and requires a significant skill set in understanding physiological processes and scientific methodology.
The vast majority of individuals practicing in this area that i have had contact with appear caring dedicated individuals that really want to help. Unfortunately the evidence suggests that much of what they do is not backed by science
The key risk is that these some in these professions appear to be relying on unproven techniques to diagnose things like allergies, intolerance’s and nutritional deficiencies which in most cases do not exist or are inconsequential.
A few tests to be wary of
- Hair analysis (Hair analysis is not reliable for evaluating the nutritional status of individuals)
- Vega (electro-diagnostic) testing (Evidence Level II: inaccurate test)
- Cytotoxic testing (“Bryan’s test”) and the Alcat test (Evidence Level II: inaccurate test)
- Iridology (Evidence Level II: inaccurate test)
- Kinesiology (Evidence Level II: inaccurate test)
- IgG food antibody testing and other techniques (Evidence Level II: inaccurate test)
- VoiceBio©TM (Evidence Level: no evidence)
- Zinc Tally test (dosent work not specific or sensitive)
disorders that may not exist
Pyroles have been accused of practically all of societies ills and there is no question we have pyroles and they can be found in the urine . Weather there is any such thing as a pyrole disorder however if very debatable. Testing for pyroles if you have a particular set of symptoms tells you nothing about the cause of the symptoms or if the pyrols are the cause or just a handy marker to blame. The science behind this test dosent stand up to rational scientific scrutiny
And the list go on and on . We all suffer minor symptoms and irritations as part of life such as tiredness and bloating . If you have an issue and need to find out what is causing it go to your GP
You may walk away from a CAM consultation with some good basic nutrition advice unfortunately you may also walk away with a pile of expensive vitamins and minerals you do not need for a deficiency you do not have which has been assessed by a technique that doesn’t work .
Unfortunately I cannot recommend them be very wary looking after and preventing diabetes requires lifelong dedication to sound nutrition and lifestyle changes.
Many CAM practitioners sell an easy answer to complicated nutritional and behavioral problems in a concept we all want to hear the natural healing powers of the body to cure itself. This is a great concept and the mind is very powerful even the placebo effect is quite amazing I just think we need to separate the fact from fiction and there is far too much fiction being taught
This site is very informative although i note as it is someone elses view i do not necessarily endorse all its content View of a former Natropath
Chiropractor evidenced based or CAM ?
Chiropractic is a health care discipline based on the scientific premise that the body is a self-regulating, self-healing organism. Chiropractors are five year university trained, government regulated and government registered health care professionals and have gained recognition from both private health groups and Medicare as health care providers. Significant debate continues over the effectiveness of chiropractic treatment in Australia and other countries. Many studies of treatments used by chiropractors have been conducted, with conflicting results. Collectively, research has suggested that manual therapies commonly used by chiropractors are only effective for the treatment of low back pain, neck pain, some forms of headache and some extremity joint conditions.
Unfortunately there is a school of thought that chiropractors Belief that the body is a self-regulating, self-healing organism can also include significant unproven nutritional concepts by some in this field .
Are now registered Health Professionals under APHRA and as such are now expected to adhere to evidence based practice . If you find yourself questioning why your chiropractor is giving you advice on things he or she might not be trained in or if your concerned with the information you are getting feel free to contact APHRA.
i have no knowledge if chiropractic is a problem area for providing non evidence based information but i do note many champions of evidence based practice have openly queried it .
Below are a number of examples
- Alternative health Therapies in Australia: Market Research Report. IBIS World industry research provider. Alternative Health Therapies Market Research Report | ANZSIC X0015 | May 2016 accessed 20.8.2016. http://www.ibisworld.com.au/industry/default.aspx?indid=1914
- Complementary, Alternative, or Integrative Health: What’s In a Name? : National Center for Complementary and Integrative Health (NCCIH) https://nccih.nih.gov/health/integrative-health Accessed 20.8.2016.
- Endeavour college of natural health http://www.studiesinaustralia.com/profile/endeavour-college-of-natural-health More information about Endeavour College of Natural Health. Assessed 20.8.2016
- The Practice and Regulatory Requirements of Naturopathy and Western Herbal Medicine a summary report. School pf public health Latrobe university 2005
- Unregulated naturopaths putting lives at risk Jon Wardle Director of the Network of Researchers of Public Health in Complementary and Alternative Medicine at the University of Queensland.
Source abc news accessed 20.8.2016 http://www.abc.net.au/news/2010-10-21/unregulated_naturopaths_putting_lives_at_risk/40276