In recent years, vegetarianism has increased in popularity due to the availability of fresh vegetables all year and the increasing influence of cuisines that are largely plant-based. Is it healthy? Continue reading to find out the benefits and risks of eating a vegetarian diet and how you can ensure your body gets enough nutrients to support optimal health.
Vegetarian Diet: Risks and Advantages
Vegetarian diets can vary from one person to the next. They can be as healthy or unhealthy as meat-containing diets. However, there are certain areas that should be considered, such as bone health and the possibility of hip fracture.
Risques for Bone and Muscle Health
BMC Medicine did a study to determine if eating vegetarians is associated with hip fractures. Researchers looked at middle-aged women. They found that those who ate vegetarians had a 33% higher chance of getting a fracture than those who ate meat occasionally, fish but no meat, or those who ate meat frequently. This is the first study to use hospital records to confirm hip fractures in vegetarians or omnivores, which are people who eat all foods except meat.
James Webster (School of Food Science and Nutrition, University of Leeds) said that the study highlighted potential concerns about hip fractures in vegetarian women. It is not advising people to stop eating vegetarian food. It is important to know your personal situation and which nutrients are necessary for a healthy, balanced lifestyle.
Vegetarian diets tend to have lower intakes for nutrients that are related to bone and muscle health. These nutrients are of particular concern to vegetarians:
- Vitamin B12
- Vitamin D
- Omega-3 fatty acids
- Calcium
- Iron
- Zinc
A low intake of these nutrients can result in lower bone mineral density, muscle mass, and hip fracture risk. It is therefore important to understand the factors that contribute to increased risk for vegetarians.
A vegetarian diet may meet current recommendations for nutrients, supplements, and fortified food, such as soy milk or almond yogurts and calcium-settofu. However, this can help to avoid nutritional deficiency.
Vegetarian diets tend to be low in cholesterol and saturated fat, as well as high in dietary fiber. Even though studies show many health benefits to vegetarian diets, it doesn’t guarantee good health just because you eat less animal products.
It is important to be familiar with basic nutrition information, as it is essential for any type of eating plan.
Low Body Mass Index (BMI), a risk
BMC Medicine’s research team discovered that vegetarians had a slightly lower BMI than regular meat-eaters. Studies in the past have shown that a lower BMI could indicate that someone is underweight. This can lead to poor bone and muscle health and a higher chance of hip fracture.
“This study is only one part of a larger picture of diet and healthy bone and muscle in older age,” Dr Darren Greenwood (a biostatistician at the School of Medicine in Leeds) said.
More research is required to determine if low BMI is a cause of hip fractures in vegetarians.
Vegetarian Diet Advantages: What Key Nutrients Should You Be Watching For
Many vegetarian diets lack the following nutrients. Make sure to eat a variety of foods to ensure your body gets the nutrition it needs.
Vitamin B12
Vitamin B12 deficiencies are more common among vegans, who eat only animal products, but also in ovo-lacto vegetarians. No matter what type of plant-based diet, ensure that you are getting sufficient vitamin B12 by:
- Eat fortified foods at least two to three times per day in order to obtain at least three micrograms (mcg, ug) of vitamin B12.
- OR, you can take a B12 supplement every day that contains at least 10 micrograms
- OR, you can take a weekly supplement of B12 that provides at least 2000 micrograms.
Omega-3 fatty acids
Omega-3 fatty acid are traditionally sourced from fish. They are also readily available in many plant-based foods like:
- Walnuts
- Flaxseeds
- Chia seeds
- Hemp seeds
- Edamame
- Seaweed
- Algae
- Even though they are in lower quantities, green leafy vegetables can be eaten.
- Beans in smaller quantities
Vitamin D
Vitamin D is essential for bone health. Vitamin D is made by our bodies when we are exposed to sunlight. It can be found in red meats like beef and lamb.
It’s a good idea not to use sunscreen too much, but spend time outside every day to ensure you get enough vitamin D. Take a vitamin D supplement during winter, and eat vitamin-fortified foods such as soy, rice, almond milk, orange juice, and fortified whole-grain cereals.
Protein
Proteins are an essential nutrient found in meat and the building blocks of our bodies. Proteins are an essential part of our diet. A balanced diet should contain a minimum of 0.8g of protein per two pounds.
Vegetarians have many options for protein rich foods that rival the protein content in meat products. These are some great options:
- Peanut butter
- Nuts and seeds such as almonds cashews and sunflower seeds
- Black beans, kidney beans, pinto beans, pinto beans and lentils are all legumes.
- Brown rice
- Quinoa
- Seitan (a wheat-based substitute for meat)
- Soybeans, soy products such as tofu or soy milk
- Vegetable protein derived from a cultivated vegetable
Iron
Low iron is another major disadvantage of a vegetarian diet. Anemia can occur when you don’t get enough iron. This can lead to fatigue, headaches and restless legs syndrome (RLS), as well as heart problems and pregnancy problems.
You can ensure that you get enough iron by eating foods high in this essential nutrient such as:
- Lentils, soybeans and tempeh are all legumes.
- Fortified cereals, brown rice and quinoa are all grains.
- Pumpkin, squash, pumpkin, pear, pistachios, sunflower, cashews and unhulled sesame are all examples of nuts and seeds
- Vegetables such as collard greens and swiss-chard can be used in place of tomato sauce.
- Blackstrap Molasses and prune Juice are also available.
Calcium
Because of its importance for bone health, calcium is an important nutrient that vegans and vegetarians should consider. Even though there is some calcium in plant-based food, it can be hard to absorb enough for optimal nutrition.
Consume lots of calcium-rich, cholesterol-free foods such as:
- Almonds
- Broccoli
- Orange juice with calcium-fortified ingredients
- Great northern beans
- You can find greens such as kale, mustard greens, and collard greens.
- Black, navy, pinto, kidney and navy beans are all available.
- Sesame seeds
- Soybeans and soy milk. Tofu
- Vegetable protein derived from a cultivated vegetable
Vegetarian Diets: Benefits
Some studies show that vegetarians have lower bone density. However, others have found contradictory results. One team of researchers examined the bone health and diets of people who had been following a lacto vegetarian diet. This is a diet that includes vegetables, eggs, dairy, meat, and fish for at least twenty years. The study showed that participants who had been eating a vegetarian diet for at least 20 years had less bone mineral loss than those who ate a non-vegetarian meal.
Vegetarian diets are also known to help with weight loss, cholesterol improvement, and lower the risk of certain types of cancer. According to some studies, switching to a plant-based diet instead of an omnivorous one can reduce your chance of developing diabetes by 53%. On average, vegetarians can lose 4.5 pounds more in 18 weeks than omnivores.
A plant-based diet is very healthy. It all depends on what you eat.
As Vegetarian Diets Gain Popularity, More Research is Required
It is becoming more popular to eat a vegetarian diet. The market for plant-based foods reached new heights in 2020, and will increase 6.2% by 2021. This brings the total market value of the market to $7.4 billion.
Neal Barnard is a doctor and teacher at George Washington University School of Medicine. He believes this is due COVID-19 lockdowns. This meant that many people were left at home eating more. Many people gained weight because of this. Then they decided to change. Barnard states that they were trying to improve their health. “In addition, they had the time to look at health information that they may have neglected before.
People are also trying to reduce their consumption of meat and other animal products. This is done to combat climate change and improve animal welfare. This huge increase in plant-based diets has made it more important to understand hip fractures and other risks associated with vegetarian diets.
Hip fracture is a serious global health problem that has significant economic consequences. It can affect your independence and quality of your life.
Even though there is more research needed to determine the link between vegetarian diets, hip fractures, and other health problems, it’s important that you choose plant-based diets with care. To increase your bone density and muscle mass, eat a variety of healthy foods and do strength training regularly.
References:
(1) Female vegetarians are at higher risk of hip fracture
(2) Health effects and nutrition concerns of vegetarian diets
(3) 2021 U.S. RETAIL SALES DATA – PLANT-BASED FOODS INDUSTRY
(4) What Every Vegan Needs to Know About Vitamin B12
(5) Omega-3 Fatty Acids & Plant-Based Diets
(6) Basic Information for Vegans
(7) Top Foods Rich in Iron for Vegans
(8) The top vegan sources of calcium
The Pros and Cons of Being a Vegetarian. What to Eat
Effects of vegetarian diet on bone density – PMC
The American Journal of Clinical Nutrition
DECEMBER 2019
A Meta-Analysis Of Randomized Controlled Trials on Vegetarian Diets and Weight Reduction
A vegan diet plan for primary and second prevention of cardiovascular disease – PMC
Vegetarian diets have both health benefits and risks.
Relationship between weight, height, and body mass index with fracture risk at different sites in postmenopausal women: The Global Longitudinal Study of Osteoporosis In Women (GLOW) – PMC
Effects of vegetarian diet on bone density – PMC
A systematic review and meta-analysis of vegetarian diets and diabetes glycemic control: Vegetarian diets – PMC
https://pubmed.ncbi.nlm.nih.gov/26138004/
Protein for Life: A Review of Optimal Protein Consumption, Sustainable Dietary Resources and the Effects on Appetite in Aging Adults
Current Developments in Nutrition
Iron Status of Vegetarian Adults – A Review of Literature – PMC
PMC – Nutrients and Dietary patterns related to Osteoporosis
Review: Complications of hip fractures – PMC
PMC: Effects of resistance exercise on bone health
NHLBI, NIH.
The post Is it healthy to eat a vegetarian diet? Alternative Medicine Magazine published the article Pros and Con of Going Plant-Based.
Frequently Asked Questions
What are some of the benefits of complementary or alternative medicine?
Complementary and alternative medicine (CAM) is an umbrella term for medical practices used by people who believe they are not getting adequate help from allopathic medicine. These therapies include herbs, mind-body treatments such as acupuncture and massage therapy. Because they don’t fit within the traditional medical system of diagnosis or treatment, CAM practitioners often choose to use “alternative” treatments. Many CAM therapies can also be integrated with elements of mainstream medicine. For example, some forms of acupuncture are performed with needles, while others involve acupressure or moxibustion with heat.
Some CAM therapies can help with anxiety, stress management, pain relief, relaxation, sleep disorders, insomnia, and stress management. They may also improve your general sense of well-being and reduce fatigue. Some CAM therapies are used to treat specific conditions, including fibromyalgia. Other CAM therapies may simply be enjoyable experiences.
Although there is no one definition of CAM, most definitions include at minimum one of these:
- A holistic approach that includes both the body, mind, spirit, environment, and everything in between
- The belief, that mind and body influence and interact
- An individual’s belief that illness is due to an imbalance in his/her environment.
- It is important to treat the whole person, not just the symptoms.
- Combination of Western science and Eastern philosophy
- Methods that treat mind, body, spirit in a holistic way
- Natural products can be used instead of synthetic chemicals
- A healing touch
- Mindfulness
- Meditation
- Acupuncture
- Yoga
- Herbal remedies
- Homeopathy
- Chiropractic care
- Massage therapy
- Hypnotherapy
- Spiritual healing
- Biofeedback
- Nutritional counseling
- Energy healing
Certain CAM therapies may not offer all the benefits. There are also risks. Some therapies can cause serious harm or even death if practiced incorrectly. Other therapies have potential side effects which must be considered against the perceived benefits. Discuss these concerns with your doctor before you decide to use any CAM.
Who uses holistic healing?
Holistic medicine treats the whole person and not only specific symptoms. It is concerned with both the physical and mental aspects of well-being.
Holistic medicine includes acupuncture, massage therapy, chiropractic treatment, nutritional counseling, yoga, and other complementary therapies.
The majority of holistic medicine patients have had their conditions addressed.
What are alternatives to medicine?
Alternative medicine is a treatment that does not fit the criteria of mainstream medicine. These include traditional Chinese medicine as well homeopathy, chiropractic care, acupuncture, nutritional therapy and reiki.
Alternative medicine could also refer to any practice that has not been supported by scientific evidence but is used in clinical practice. These include yoga, meditation, aromatherapy, reflexology and flower essences.
Statistics
- The concept of regression toward the mean implies that an extreme result is more likely to be followed by a less extreme result. (en.wikipedia.org)
- According to a 2005 book by a US [116]Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically. (en.wikipedia.org)
- According to the World Health Organization, 80% of people use herbal medicine worldwide. (webmd.com)
- The use of alternative medicine in the US has increased, with a 50 percent increase in expenditures and a 25 percent increase in the use of alternative therapies between 1990 and 1997 in America. (en.wikipedia.org)
- category.[111]Edzard Ernst characterized the evidence for many alternative techniques as weak, nonexistent, or negative and in 2011, published his estimate that about 7.4% were based on “sound evidence.” However, he believes that may be an overestimate. (en.wikipedia.org)
External Links
doi.org
ncbi.nlm.nih.gov
- BIOFEEDBACK TRAINING FOR TENSION-TYPE HEADACHE–PubMed
- PubMed. The Effect of Foot reflexology on Hospital Anxiety, Depression and Suffering in Older Women: A Randomized Controlled Test – PubMed
pubmed.ncbi.nlm.nih.gov
- PubMed: The rise and rise in complementary and alternative medicine: A sociological perspective
- PubMed: Holistic medicine – PubMed
cam.cancer.gov
How To
How to make a career in Holistic Medicine
The field holistic medicine is expanding at an unimaginable rate. You can choose to pursue this career in many ways. If you are serious about this career, it is best to return to school.
There are many schools that offer courses in holistic medicine. These include the National College for Complementary Medicines (NCCM), which offers both undergraduate and postgraduate degrees. They also have several programs designed specifically for medical professionals who wish to enter the field.
Many online universities also offer holistic health classes. One such program is called the Institute of Integrative Nutrition (IIN). This institution provides students with various holistic health education tools and resources.
You can also enroll in a four-year college. Many colleges offer holistic healthcare courses. The University of California, for example, offers a Bachelor’s degree in holistic health sciences.
If you’re interested in a career in holistic medical, it is worth taking a nutrition class. NCCM recommends to students that they study nutrition before embarking upon any professional training. It is important to understand nutrition science in order to practice integrative medicine, according to the NCCM.
Because holistic medicine focuses on treating the whole person rather than just focusing on symptoms, it requires more knowledge and skill than conventional medicine does. Holistic medicine requires that people who are interested in it understand how to assess different types of illnesses from a nutritional perspective.
According to the NCCM, nutritionists often collaborate with doctors to offer dietary advice to patients. Some may even recommend diets or supplements that are specific to the patient’s needs based on their assessment.
This is why holistic practitioners must understand the basics of nutrition. This includes understanding what foods are healthy and which ones are not. It also means identifying nutrient deficiencies and other problems that may be causing them.
It is important that holistic practitioners are not all trained in nutrition. Some specialize in herbal therapies, while others are more focused on acupuncture. Some people combine these two approaches into a single treatment.
However, most holistic practitioners recommend a diet rich in fruits, vegetables, nuts, seeds, and grains. They also emphasize eating plenty of fish and seafood. They advise avoiding processed food products and fast food restaurants. Instead, they recommend eating organic produce whenever possible.
One thing that holistic practitioners agree upon is that a balanced diet will help prevent disease. There are however some things they disagree on. They don’t believe gluten is the cause of celiac disease. Instead, they believe that a lack in nutrients is responsible for the disorder’s onset.
However, they all agree that certain foods can cause allergic reactions. They say peanuts and shellfish can cause anaphylaxis. They also caution against excessive caffeine consumption.
While many holistic practitioners use herbs to treat various illnesses, they avoid using pharmaceutical drugs. This is because they feel that such substances only mask the problem instead of solving it. Therefore, natural remedies are preferred.
Holistic practitioners offer a range of alternative therapies and often employ complementary methods. These include:
- Acupuncture – In Chinese medicine, acupuncture involves strategically inserting needles into the skin. This is believed to stimulate the body’s healing mechanisms.
- Herbal therapy – Holistic practitioners often use herbs to treat a variety of disorders. Ginseng is one common herb that can be used to treat this condition.
- Homeopathy – Another form of traditional Chinese medicine, homeopathy is based on the principle of like cures. You might experience a similar symptom when you are suffering from the same condition as someone else. In such cases, it’s important to find a remedy with the same ingredients that the original medication.
- Massage therapy – Many holistic practitioners offer massage therapy to promote relaxation and reduce stress. They claim it improves blood circulation, increases energy levels, and relieves muscle tension.
It is important to find a practitioner who meets your needs when choosing one. A nutritionist who has a degree will be able to provide nutritional counseling. You can also learn more about acupuncture by contacting a practitioner who is certified by the American Association of Oriental Medicine.
If you have any questions regarding holistic health care, ask your doctor before making any decisions. To find out what services your insurance covers, you might also want to consult with your doctor.
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This blog is a source of general information and discussion on health and related topics. Information and materials on this blog, on the website, or in any of the connected materials are not intended to replace or used as a substitute for the advice of a medical professional, diagnosis, or treatment. This blog does not represent the application of any nursing, medical or other health professional advice or diagnosis. We are unable to diagnose health conditions, offer second opinions or provide specific treatment recommendations via this blog or on our website.
If you or another person is suffering from a medical issue and you are concerned, consult your doctor or seek out other medical professional treatment as soon as possible. Do not disregard medical advice from a professional or delay seeking it due to information you seen on the blog or website or in any of the linked materials. If you’re experiencing an emergency medical situation, dial 911 or seek emergency medical assistance on the closest phone immediately.
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By: Dick Benson
Title: Is It Healthy to Eat a Vegetarian Diet? Pros and Cons of Going Plant-Based
Sourced From: alternativemedicine.com/conditions/bone-joint-health/vegetarian-diets-can-be-healthy-or-unhealthy/
Published Date: Wed, 01 Mar 2023 23:25:50 +0000
Frequently Asked Questions
What are some of the benefits of complementary or alternative medicine?
Complementary and alternative medicine (CAM) is an umbrella term for medical practices used by people who believe they are not getting adequate help from allopathic medicine. These therapies include herbs, mind-body treatments such as acupuncture and massage therapy. Because they don’t fit within the traditional medical system of diagnosis or treatment, CAM practitioners often choose to use “alternative” treatments. Many CAM therapies can also be integrated with elements of mainstream medicine. For example, some forms of acupuncture are performed with needles, while others involve acupressure or moxibustion with heat.
Some CAM therapies can help with anxiety, stress management, pain relief, relaxation, sleep disorders, insomnia, and stress management. They may also improve your general sense of well-being and reduce fatigue. Some CAM therapies are used to treat specific conditions, including fibromyalgia. Other CAM therapies may simply be enjoyable experiences.
Although there is no one definition of CAM, most definitions include at minimum one of these:
- A holistic approach that includes both the body, mind, spirit, environment, and everything in between
- The belief, that mind and body influence and interact
- An individual’s belief that illness is due to an imbalance in his/her environment.
- It is important to treat the whole person, not just the symptoms.
- Combination of Western science and Eastern philosophy
- Methods that treat mind, body, spirit in a holistic way
- Natural products can be used instead of synthetic chemicals
- A healing touch
- Mindfulness
- Meditation
- Acupuncture
- Yoga
- Herbal remedies
- Homeopathy
- Chiropractic care
- Massage therapy
- Hypnotherapy
- Spiritual healing
- Biofeedback
- Nutritional counseling
- Energy healing
Certain CAM therapies may not offer all the benefits. There are also risks. Some therapies can cause serious harm or even death if practiced incorrectly. Other therapies have potential side effects which must be considered against the perceived benefits. Discuss these concerns with your doctor before you decide to use any CAM.
Who uses holistic healing?
Holistic medicine treats the whole person and not only specific symptoms. It is concerned with both the physical and mental aspects of well-being.
Holistic medicine includes acupuncture, massage therapy, chiropractic treatment, nutritional counseling, yoga, and other complementary therapies.
The majority of holistic medicine patients have had their conditions addressed.
What are alternatives to medicine?
Alternative medicine is a treatment that does not fit the criteria of mainstream medicine. These include traditional Chinese medicine as well homeopathy, chiropractic care, acupuncture, nutritional therapy and reiki.
Alternative medicine could also refer to any practice that has not been supported by scientific evidence but is used in clinical practice. These include yoga, meditation, aromatherapy, reflexology and flower essences.
Statistics
- The concept of regression toward the mean implies that an extreme result is more likely to be followed by a less extreme result. (en.wikipedia.org)
- According to a 2005 book by a US [116]Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically. (en.wikipedia.org)
- According to the World Health Organization, 80% of people use herbal medicine worldwide. (webmd.com)
- The use of alternative medicine in the US has increased, with a 50 percent increase in expenditures and a 25 percent increase in the use of alternative therapies between 1990 and 1997 in America. (en.wikipedia.org)
- category.[111]Edzard Ernst characterized the evidence for many alternative techniques as weak, nonexistent, or negative and in 2011, published his estimate that about 7.4% were based on “sound evidence.” However, he believes that may be an overestimate. (en.wikipedia.org)
External Links
doi.org
ncbi.nlm.nih.gov
- BIOFEEDBACK TRAINING FOR TENSION-TYPE HEADACHE–PubMed
- PubMed. The Effect of Foot reflexology on Hospital Anxiety, Depression and Suffering in Older Women: A Randomized Controlled Test – PubMed
pubmed.ncbi.nlm.nih.gov
- PubMed: The rise and rise in complementary and alternative medicine: A sociological perspective
- PubMed: Holistic medicine – PubMed
cam.cancer.gov
How To
How to make a career in Holistic Medicine
The field holistic medicine is expanding at an unimaginable rate. You can choose to pursue this career in many ways. If you are serious about this career, it is best to return to school.
There are many schools that offer courses in holistic medicine. These include the National College for Complementary Medicines (NCCM), which offers both undergraduate and postgraduate degrees. They also have several programs designed specifically for medical professionals who wish to enter the field.
Many online universities also offer holistic health classes. One such program is called the Institute of Integrative Nutrition (IIN). This institution provides students with various holistic health education tools and resources.
You can also enroll in a four-year college. Many colleges offer holistic healthcare courses. The University of California, for example, offers a Bachelor’s degree in holistic health sciences.
If you’re interested in a career in holistic medical, it is worth taking a nutrition class. NCCM recommends to students that they study nutrition before embarking upon any professional training. It is important to understand nutrition science in order to practice integrative medicine, according to the NCCM.
Because holistic medicine focuses on treating the whole person rather than just focusing on symptoms, it requires more knowledge and skill than conventional medicine does. Holistic medicine requires that people who are interested in it understand how to assess different types of illnesses from a nutritional perspective.
According to the NCCM, nutritionists often collaborate with doctors to offer dietary advice to patients. Some may even recommend diets or supplements that are specific to the patient’s needs based on their assessment.
This is why holistic practitioners must understand the basics of nutrition. This includes understanding what foods are healthy and which ones are not. It also means identifying nutrient deficiencies and other problems that may be causing them.
It is important that holistic practitioners are not all trained in nutrition. Some specialize in herbal therapies, while others are more focused on acupuncture. Some people combine these two approaches into a single treatment.
However, most holistic practitioners recommend a diet rich in fruits, vegetables, nuts, seeds, and grains. They also emphasize eating plenty of fish and seafood. They advise avoiding processed food products and fast food restaurants. Instead, they recommend eating organic produce whenever possible.
One thing that holistic practitioners agree upon is that a balanced diet will help prevent disease. There are however some things they disagree on. They don’t believe gluten is the cause of celiac disease. Instead, they believe that a lack in nutrients is responsible for the disorder’s onset.
However, they all agree that certain foods can cause allergic reactions. They say peanuts and shellfish can cause anaphylaxis. They also caution against excessive caffeine consumption.
While many holistic practitioners use herbs to treat various illnesses, they avoid using pharmaceutical drugs. This is because they feel that such substances only mask the problem instead of solving it. Therefore, natural remedies are preferred.
Holistic practitioners offer a range of alternative therapies and often employ complementary methods. These include:
- Acupuncture – In Chinese medicine, acupuncture involves strategically inserting needles into the skin. This is believed to stimulate the body’s healing mechanisms.
- Herbal therapy – Holistic practitioners often use herbs to treat a variety of disorders. Ginseng is one common herb that can be used to treat this condition.
- Homeopathy – Another form of traditional Chinese medicine, homeopathy is based on the principle of like cures. You might experience a similar symptom when you are suffering from the same condition as someone else. In such cases, it’s important to find a remedy with the same ingredients that the original medication.
- Massage therapy – Many holistic practitioners offer massage therapy to promote relaxation and reduce stress. They claim it improves blood circulation, increases energy levels, and relieves muscle tension.
It is important to find a practitioner who meets your needs when choosing one. A nutritionist who has a degree will be able to provide nutritional counseling. You can also learn more about acupuncture by contacting a practitioner who is certified by the American Association of Oriental Medicine.
If you have any questions regarding holistic health care, ask your doctor before making any decisions. To find out what services your insurance covers, you might also want to consult with your doctor.
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