This month we will attempt to define nutrition and take a look at the way dietary supplements are used by clinicians. I examined two university level texts of nutrition seeking that definition. Surprisingly neither offered one.

My Webster's dictionary provided the following: "the process of providing or receiving nourishing substances; food, nourishment; the study of nutrients and nutrition."

Not much help there. Exasperated, I turned to my trusty "Stedmen's" which defined nutrition as follows: "A function of living plants and animals, consisting in the taking in and assimilation through chemical changes of material (metabolism) whereby tissue is built up and energy liberated; its successive stages are known as digestion, absorption, assimilation, and excretion; in highly organized animals digestion is preceded by mastication and deglution, and excretion is affected by expiration, perspiration, urination, and defecation."

Just in case this point is not clear, let us turn to one more definition, my favorite, which is more succinct.

The Council on Food and Nutrition for the American Medical Association defines nutrition as: "The science of food, the nutrients and other substances therein, their action, interaction, and balance in relation to health and disease and the processes by which the organism ingests, digests, absorbs, transports, utilizes and excretes food substances."

By the above definitions how many of us use nutrition in our practices? What percentage of the supplements we routinely use are actually foods that require digestion? This begs the question "if the dietary supplements we use are not foods and do not require digestion, what are they?"

According to the Food and Drug Administration, acting in accordance with the Food and Cosmetic Act of 1913 and subsequent modifications, they are drugs. They define food as anything humans normally ingest as part of the diet, unless medical claims are made for it, then it is considered to be a drug.

Additionally, they state that only drugs can alter the normal functioning of the human body, not foods. By the way, Webster's dictionary defines a drug as "a substance other than food, intended to affect the structure or function of the body of a man or other animal." Webster refers to "the science which deals with the study of drugs in all its aspects" as pharmacology.

I believe chiropractors attempt to use dietary supplements as magic bullets for the alleviation of symptoms, mimicking the medical model. The patient comes in the office with a "cold" and states "I must give an important sales presentation in seven days. There is a speech to write and other preparations to make, and this is no time for me to be slowed down by a cold."

We recommend a large dose of the latest form of ascorbic acid along with our adjustment. The patient calls the next day to say the Vitamin C is not working. We recommend the patient continue the ascorbic acid and add a Vitamin A supplement because we have heard it has anti--viral properties and is useful in cleaning up free radicals.

The patient calls a couple days later, somewhat irritated, and reports the "cold is worse" and seems to be settling in the chest. He or she is really concerned about the meeting. We decide that adrenal function is not up to par and recommend a beef or pork adrenal tissue supplement with our assurances that this will work in time to allow a successful presentation.

Finally, the patient calls the night before the "big" sales meeting and complains that the supplements have not worked, and worse he is now constipated! So, we recommend an herbal laxative or lactobacillus preparation and tell the patient to come in for a complete work-up after the meeting so we can determine the true cause of the symptoms.

I am sure situations like this have never happened to you, but they have frustrated many of our colleagues, some of whom have given up the practice of "nutrition" believing it to be at best inconsistent or ineffective, and at worse unethical. My point is that the above description of nutritional supplementation is not the practice of nutrition, but technically the practice of pharmacology.

It may be a bit of a stretch to think of ascorbic acid or a-tocopherol as drugs, but remember they enter the body and are absorbed without undergoing hydrolysis (digestion).

The body does not have a voice in accepting or rejecting them, or seeking the best avenue of absorption, whether from the stomach, duodenum, jejunum, ileum, or colon. It must accept them regardless, and process them without being allowed a voice in the decision as to the best way, as it would if the substance had undergone digestion.

In fact, the entire history of the development of dietary supplement technology has been to ignore normal digestion in an effort to get the substance absorbed in higher and higher amounts. This has been due in part to the desire of the supplement companies to improve sales by changing the product, but also because the substances have not delivered the desired effects in lower dosages and increasing potency appeared to be the only solution.

The history of the dietary supplement business has been to improve technology in efforts to increase absorption of isolated chemical compounds across the gut wall into the blood. Yet, it has not been able to provide consistent results and certainly does not provide a philosophy or methodology of delivery the clinician can rely on except treatment by symptoms.

In future columns I will discuss why this system has failed to achieve respect within the healing arts and whether the art and science of chiropractic has a place for nutritional supplements.