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Nutrition

Back Clinic Nutrition Team. Food provides people with the necessary energy and nutrients to be healthy. By eating various foods, including good quality vegetables, fruits, whole-grain products, and lean meats, the body can replenish itself with the essential proteins, carbohydrates, fats, vitamins, and minerals to function effectively. Nutrients include proteins, carbohydrates, fats, vitamins, minerals, and water. Healthy eating does not have to be hard.

The key is to eat various foods, including vegetables, fruits, and whole grains. In addition, eat lean meats, poultry, fish, beans, and low-fat dairy products and drink lots of water. Limit salt, sugar, alcohol, saturated fat, and trans fat. Saturated fats usually come from animals. Look for trans fat on the labels of processed foods, margarine, and shortenings.

Dr. Alex Jimenez offers nutritional examples and describes the importance of balanced nutrition, emphasizing how a proper diet combined with physical activity can help individuals reach and maintain a healthy weight, reduce their risk of developing chronic diseases, and promote overall health and wellness.


Glycogen: Fueling the Body and the Brain

Glycogen: Fueling the Body and the Brain

For individuals who are getting into exercise, fitness, and physical activity, can knowing how glycogen works help in workout recovery?

Glycogen: Fueling the Body and the Brain

Glycogen

When the body needs energy, it draws on its glycogen stores. Low-carbohydrate, ketogenic diets and intense exercise deplete glycogen stores, causing the body to metabolize fat for energy. Glycogen is supplied through carbohydrates in an individual’s diet and is used to power the brain, physical activity, and other bodily functions. The molecules made from glucose are mainly stored in the liver and muscles. What is eaten, how often, and the activity level influence how the body stores and uses glycogen.  Restoring glycogen after physical activity or working out is a vital part of the recovery process.  The body can quickly mobilize glycogen from these storage sites when it needs fuel. Eating enough carbohydrates to reach health goals and activity levels is essential for success.

What Is It

  • It is the body’s stored form of glucose or sugar.
  • It is stored in the liver and muscles.
  • It is the body’s primary and preferred energy source.
  • It comes from carbohydrates in foods and drinks.
  • It is made from several connected glucose molecules.

Production and Storage

Most carbohydrates eaten are converted to glucose, which becomes the body’s main energy source. However, when the body doesn’t need fueling, the glucose molecules become linked chains of eight to 12 glucose units, forming a glycogen molecule.

Process Triggers

  • Eating a carbohydrate-containing meal will raise blood glucose levels in response.
  • Increasing glucose signals the pancreas to produce insulin, a hormone that helps the body’s cells take up glucose from the bloodstream for energy or storage.
  • Insulin activation causes the liver and muscle cells to produce an enzyme called glycogen synthase, which links glucose chains together.
  • With enough glucose and insulin, glycogen molecules can be delivered to the liver, muscles, and fat cells for storage.

Since most glycogen is found in the muscles and liver, the amount stored in these cells varies depending on activity level, how much energy is burned at rest, and the foods eaten. The muscles primarily use glycogen stored in the muscles, while glycogen stored in the liver is distributed throughout the body, mainly to the brain and spinal cord.

Body Usage

The body converts glucose to glycogen through a process called glycogenesis. During this process, various enzymes help the body break down glycogen in glycogenolysis so the body can use it. The blood has a set amount of glucose ready to go at any given time. The insulin levels also drop when the level begins to decline, either from not eating or burning glucose during exercise. When this happens, an enzyme known as glycogen phosphorylase starts breaking the glycogen down to supply the body with glucose. Glucose from liver glycogen becomes the body’s primary energy. Short bursts of energy use glycogen, whether during sprints or heavy lifting. (Bob Murray, Christine Rosenbloom, 2018) A carbohydrate-rich pre-workout drink can provide energy to exercise longer and recover quicker. Individuals should eat a post-workout snack with a balanced amount of carbohydrates to replenish glycogen stores. The brain also uses glucose for energy, with 20 to 25% of glycogen going toward powering the brain. (Manu S. Goyal, Marcus E. Raichle, 2018) Mental sluggishness or brain fog can develop when not enough carbohydrates are consumed. When glycogen stores are depleted through exercise or insufficient carbs, the body can feel fatigued and sluggish and perhaps experience mood and sleep disturbances. (Hugh S. Winwood-Smith, Craig E. Franklin 2, Craig R. White, 2017)

Diet

What foods are eaten and how much physical activity an individual does also influence glycogen production. The effects can be acute if one follows a low-carb diet, where carbohydrates, the primary source of glucose synthesis, are suddenly restricted.

Fatigue and Brain Fog

  • When first starting a low-carb diet, the body’s glycogen stores can be severely depleted and individuals may experience symptoms like fatigue and brain fog. (Kristen E. D’Anci et al., 2009)
  • The symptoms begin to subside once the body adjusts and renews its glycogen stores.

Water Weight

  • Any amount of weight loss can have the same effect on glycogen stores.
  • Initially, individuals may experience a rapid drop in weight.
  • Over time, weight may plateau and possibly increase.

The phenomenon is partly due to glycogen composition, which is also water. Rapid glycogen depletion at the onset of the diet triggers the loss of water weight. Over time, glycogen stores are renewed, and the water weight returns. When this happens, weight loss can stall or plateau. Fat loss can continue despite the short-term plateau effect.

Exercise

If undertaking a strenuous exercise routine, there are strategies to help avoid decreased performance that may be helpful:

Carbo-loading

  • Some athletes consume excessive amounts of carbohydrates before working out or competing.
  • Extra carbohydrates provide plenty of fuel.
  • The method has fallen out of favor as it can lead to excess water weight and digestive issues.

Glucose Gels

  • Energy gels containing glycogen can be consumed before or as needed during an event to increase blood glucose levels.
  • For example, energy chews are effective supplements for runners to help increase performance during extended runs.

Low-Carb Ketogenic Diet

  • Eating a diet high in fat and low in carbohydrates can put the body in a keto-adaptative state.
  • In this state, the body begins to access stored fat for energy and relies less on glucose for fuel.

At Injury Medical Chiropractic and Functional Medicine Clinic, our providers use an integrated approach to create personalized care plans for each individual, often including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to restore health and function to the body.


Sports Nutrition and Sports Dietician


References

Murray, B., & Rosenbloom, C. (2018). Fundamentals of glycogen metabolism for coaches and athletes. Nutrition reviews, 76(4), 243–259. doi.org/10.1093/nutrit/nuy001

Goyal, M. S., & Raichle, M. E. (2018). Glucose Requirements of the Developing Human Brain. Journal of pediatric gastroenterology and nutrition, 66 Suppl 3(Suppl 3), S46–S49. doi.org/10.1097/MPG.0000000000001875

Winwood-Smith, H. S., Franklin, C. E., & White, C. R. (2017). Low-carbohydrate diet induces metabolic depression: a possible mechanism to conserve glycogen. American journal of physiology. Regulatory, integrative and comparative physiology, 313(4), R347–R356. doi.org/10.1152/ajpregu.00067.2017

D’Anci, K. E., Watts, K. L., Kanarek, R. B., & Taylor, H. A. (2009). Low-carbohydrate weight-loss diets. Effects on cognition and mood. Appetite, 52(1), 96–103. doi.org/10.1016/j.appet.2008.08.009

A Comprehensive Guide to Almond Flour and Almond Meal

A Comprehensive Guide to Almond Flour and Almond Meal

For individuals practicing a low-carbohydrate eating style or want to try an alternative flour, can incorporating almond flour help in their wellness journey?

A Comprehensive Guide to Almond Flour and Almond Meal

Almond Flour

Almond flour and almond meal are gluten-free alternatives to wheat products in certain recipes. They are made by grinding almonds and can be bought prepared or made at home with a food processor or grinder. The flour is higher in protein and lower in starch than other gluten-free flour.

Almond Flour and Almond Meal

The flour is made with blanched almonds, meaning the skin has been removed. Almond meal is made with whole or blanched almonds. The consistency for both is more like corn meal than wheat flour. They can usually be used interchangeably, although using the blanched flour will produce a more refined, less grainy result. Superfine almond flour is great for baking cakes but is difficult to make at home. It can be found at grocery stores or ordered online.

Carbohydrates and Calories

A half cup of commercially prepared flour contains about:

  1. The glycemic index of almond flour is less than 1, which means it should have little effect on raising blood glucose levels.
  2. The high glycemic index of whole wheat flour is 71, and rice flour is 98.

Using Almond Flour

It is recommended for making gluten-free quick bread recipes, such as gluten-free:

  • Muffins
  • Pumpkin bread
  • Pancakes
  • Some cake recipes

Individuals are recommended to start with a recipe already adapted for almond flour and then make their own. A cup of wheat flour weighs around 3 ounces, while a cup of almond flour weighs almost 4 ounces. This will make a significant difference in baked goods. The flour is beneficial for adding nutrients to foods.

Almond Meal

  • Almond meal can be cooked as polenta or grits such as shrimp and grits.
  • Cookies can be made gluten-free with almond meal.
  • Almond meal biscuits can be made, but pay attention to the recipe.
  • Almond meal can be used to bread fish and other fried foods, but it must be taken care of so as not to burn.
  • Almond meal is not recommended for breads that require true dough with a developed gluten structure, like wheat flour.
  • More eggs are needed when baking with almond meal to provide the structure gluten in flour creates.

Adapting recipes to substitute almond meal for wheat flour can be a challenge that requires plenty of trial and error.

Sensitivities

Almonds are a tree nut, one of the eight most common food allergies. (Anaphylaxis UK. 2023) While peanuts are not tree nuts, many with peanut allergies can also have an almond allergy.

Making Your Own

It can be made in a blender or food processor.

  • Care must be taken not to grind it too long, or it will become almond butter, which can also be used.
  • Add a little at a time and pulse until it is ground into meal.
  • Store unused flour immediately in the refrigerator or freezer because it will go rancid quickly if left out.
  • Almonds are shelf-stable, and almond flour is not, so it is recommended that you grind only what is needed for the recipe.

Store Bought

Most health food stores sell almond flour, and more supermarkets are stocking it as it has become a popular gluten-free product. Packaged flour and meal will also go rancid after opening and should be kept in the refrigerator or freezer after opening.


Integrative Medicine


References

USDA FoodData Central. (2019). Almond Flour. Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/603980/nutrients

Anaphylaxis UK. (2023). Allergy Factsheets (Anaphylaxis UK A brighter future for people with serious allergies, Issue. www.anaphylaxis.org.uk/factsheets/

Atkinson, F. S., Brand-Miller, J. C., Foster-Powell, K., Buyken, A. E., & Goletzke, J. (2021). International tables of glycemic index and glycemic load values 2021: a systematic review. The American journal of clinical nutrition, 114(5), 1625–1632. doi.org/10.1093/ajcn/nqab233

Peppermint: A Natural Remedy for Irritable Bowel Syndrome

Peppermint: A Natural Remedy for Irritable Bowel Syndrome

For individuals dealing with digestive issues or bowel disorders, can adding peppermint to a nutrition plan help manage symptoms and digestion?

Peppermint: A Natural Remedy for Irritable Bowel Syndrome

Peppermint

First grown in England, peppermint’s medicinal properties were soon recognized and are cultivated today in Europe and Northern Africa.

How It Is Used

  • Peppermint oil can be taken as a tea or in capsule form.
  • Consult a physician or licensed healthcare professional to determine the proper dosage for the capsule form.

For Irritable Bowel Syndrome

Peppermint is taken as a tea to treat general digestive problems. It is known to reduce the production of gas in the intestine. Today, researchers recognize peppermint as effective for irritable bowel syndrome when used in oil form. (N. Alammar et al., 2019) Peppermint oil has been approved for use by IBS patients in Germany. However, the FDA has not approved peppermint and oil to treat any condition, but it has listed peppermint and the oil as generally safe. (ScienceDirect, 2024)

Interactions With Other Medications

  • Individuals who take lansoprazole to reduce stomach acid may compromise the enteric coating of some commercial peppermint oil capsules. (Taofikat B. Agbabiaka et al., 2018)
  • This can happen using H2-receptor antagonists, proton pump inhibitors, and antacids.

Other potential interactions include: (Benjamin Kligler, Sapna Chaudhary 2007)

  • Amitriptyline
  • Cyclosporine
  • Haloperidol
  • Peppermint extract may increase serum levels of these medications.

It is recommended to discuss medication interactions with a healthcare provider before starting supplements if taking any of these medications.

Pregnancy

  • Peppermint is not recommended for use during pregnancy or by nursing individuals.
  • It is unknown if it could affect a developing fetus.
  • It is unknown if it can affect a nursing baby.

How To Use The Herb

It is not that common, but some individuals are allergic to peppermint. Peppermint oil should never be applied to the face or around mucous membranes (National Center for Complementary and Integrative Health. 2020). Using more than one form, such as tea and oil, is not recommended because it could lead to side effects.

  • Because the FDA does not regulate supplements like peppermint and others, their contents may be varied.
  • Supplements may contain harmful ingredients or not contain the active ingredient at all.
  • This is why seeking reputable brands and informing an individual’s healthcare team of what is being taken is highly recommended.

It has the potential to worsen certain conditions and should not be used by:

  • Individuals who have chronic heartburn. (National Center for Complementary and Integrative Health. 2020)
  • Individuals who have severe liver damage.
  • Individuals who have inflammation of the gallbladder.
  • Individuals who have obstruction of bile ducts.
  • Individuals who are pregnant.
  • Individuals with gallstones should consult their healthcare provider to see if it is safe.

Side Effects

  • The oil may cause an upset stomach or burning.
  • Enteric-coated capsules may cause a burning sensation in the rectum. (Brooks D. Cash et al., 2016)

Children and Infants

  • Peppermint was used to treat colic in infants but is not recommended today.
  • The menthol in the tea may cause infants and small children to choke.
  • Chamomile could be a possible alternative. Consult a healthcare provider to see if it is safe.

Beyond Adjustments: Chiropractic and Integrative Healthcare


References

Alammar, N., Wang, L., Saberi, B., Nanavati, J., Holtmann, G., Shinohara, R. T., & Mullin, G. E. (2019). The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC complementary and alternative medicine, 19(1), 21. doi.org/10.1186/s12906-018-2409-0

ScienceDirect. (2024). Peppermint Oil. www.sciencedirect.com/topics/nursing-and-health-professions/peppermint-oil#:~:text=As%20a%20calcium%20channel%20blocker,as%20safe%E2%80%9D%20%5B11%5D.

Agbabiaka, T. B., Spencer, N. H., Khanom, S., & Goodman, C. (2018). Prevalence of drug-herb and drug-supplement interactions in older adults: a cross-sectional survey. The British journal of general practice : the journal of the Royal College of General Practitioners, 68(675), e711–e717. doi.org/10.3399/bjgp18X699101

Kligler, B., & Chaudhary, S. (2007). Peppermint oil. American family physician, 75(7), 1027–1030.

National Center for Complementary and Integrative Health. (2020). Peppermint oil. Retrieved from www.nccih.nih.gov/health/peppermint-oil#safety

Cash, B. D., Epstein, M. S., & Shah, S. M. (2016). A Novel Delivery System of Peppermint Oil Is an Effective Therapy for Irritable Bowel Syndrome Symptoms. Digestive diseases and sciences, 61(2), 560–571. doi.org/10.1007/s10620-015-3858-7

Khanna, R., MacDonald, J. K., & Levesque, B. G. (2014). Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. Journal of clinical gastroenterology, 48(6), 505–512. doi.org/10.1097/MCG.0b013e3182a88357

Unleash the Power of Nopal for Health and Wellness

Unleash the Power of Nopal for Health and Wellness

Can incorporating nopal or prickly pear cactus into one’s diet help individuals trying to lower blood glucose, inflammation, and risk factors associated with heart and metabolic diseases?

Unleash the Power of Nopal for Health and Wellness

Nopal

Nopal, also known as prickly pear cactus, is a versatile vegetable that can be added to nutrition plans to increase fiber intake, vitamins, minerals, and plant-based compounds.  It grows in the U.S. Southwest, Latin America, and the Mediterranean. The pads, or the nopales or cactus paddles, have a texture like okra and slight tartness. The prickly pear cactus fruit, referred to as tuna in Spanish, is also consumed. (University of Arizona Cooperative Extension, 2019) It is often used in fruit salsas, salads, and desserts and is available as a supplement in tablet and powder form.

Serving Size and Nutrition

One cup of cooked nopales, around five pads, without added salt, contains: (U.S. Department of Agriculture, FoodData Central, 2018)

  • Calories – 22
  • Fat – 0 grams
  • Sodium – 30 milligrams
  • Carbohydrates – 5 grams
  • Fiber – 3 grams
  • Sugars – 1.7 grams
  • Protein – 2 grams
  • Vitamin A – 600 international units
  • Vitamin C – 8 milligrams
  • Vitamin K – 8 micrograms
  • Potassium – 291 milligrams
  • Choline – 11 milligrams
  • Calcium – 244 milligrams
  • Magnesium – 70 milligrams

It is generally recommended that most individuals consume 2.5 to 4 cups of vegetables per day. (U.S. Department of Agriculture, MyPlate, 2020)

Benefits

Nopal is highly nutritious, low in calories, free of fat, sodium, or cholesterol, and full of fiber, vitamins, minerals, and betalains. (Parisa Rahimi et al., 2019) Betalains are pigments with anti-inflammatory properties. The variety of fibers creates a low glycemic index (measures how much a specific food raises blood sugar levels after consumption) of about 32, a recommended addition to a diabetes-friendly diet. (Patricia López-Romero et al., 2014)

Compounds

  • Nopal contains a variety of beneficial carbohydrates, vitamins, and minerals.
  • Nopal has soluble and insoluble fiber, which benefits blood sugar.
  • It also contains vitamin A, carotenoids, vitamin C, calcium, and plant-based compounds like phenols and betalains. (Karina Corona-Cervantes et al., 2022)

Blood Sugar Regulation

Research has evaluated regular nopal consumption and supplementation for blood sugar control. A study on blood sugar evaluated adding nopal to a high-carbohydrate breakfast or a breakfast high in soy protein in Mexican individuals with type 2 diabetes. The study found that consuming nopales, about 300 grams or 1.75 to 2 cups before a meal, could reduce after-meal/postprandial blood sugars. (Patricia López-Romero et al., 2014) An older study had similar results. (Montserrat Bacardi-Gascon et al., 2007) Individuals were randomly assigned to consume 85 grams of nopal with three different breakfast options:

  • Chilaquiles – a casserole made with corn tortilla, vegetable oil, and pinto beans.
  • Burritos – made with eggs, vegetable oil, and pinto beans.
  • Quesadillas – made with flour tortillas, low-fat cheese, avocado, and pinto beans.
  • The groups assigned to eat nopales had reductions in blood sugar. There was a:
  • 30% reduction in the chilaquiles group.
  • 20% decrease in the burrito group.
  • 48% reduction in the quesadilla group.

However, the studies were small, and the population was not diverse. so further research is needed.

Increased Fiber

The combination of soluble and insoluble fiber benefits the gut in various ways. Soluble fiber can act as a prebiotic, feeding beneficial bacteria in the gut and assisting in removing low-density lipoprotein (LDL) cholesterol from the body. Insoluble fiber increases transit time, or how quickly food moves through the digestive system and promotes bowel regularity. (Centers for Disease Control and Prevention, 2022) In a short-term randomized clinical control trial, researchers found an improvement in irritable bowel syndrome symptoms in individuals supplemented with 20 and 30 grams of nopal fiber. (Jose M Remes-Troche et al., 2021) For individuals not used to consuming fibrous foods, it may cause mild diarrhea, so it is recommended to increase intake slowly and with adequate water to prevent gas and bloating.

Plant Based Calcium

One cup of nopal provides 244 milligrams or 24% of daily calcium needs. Calcium is a mineral that optimizes bone and teeth health. It also assists in blood vessel contraction and dilation, muscle function, blood clotting, nerve transmission, and hormonal secretion. (National Institutes of Health. Office of Dietary Supplements 2024) Individuals who follow diets that exclude dairy products can benefit from plant-based calcium sources. This includes cruciferous vegetables like kale, collards, and arugula.

Other Benefits

Studies done in animals and test tubes suggest that fresh nopal and extracts may assist in reducing triglycerides and cholesterol in metabolic dysfunction-associated steatotic liver disease or when unhealthy amounts of fat accumulate in the liver. (Karym El-Mostafa et al., 2014) Other potential benefits with limited evidence include:

Consult a Dietician or Healthcare Provider

Unless individuals are allergic to it, most can eat whole nopal without a problem. However, supplementing is different because it provides a concentrated source. Individuals taking medication to manage diabetes and consuming nopal regularly may contribute to an increased risk of developing hypoglycemia or low blood sugar. Dermatitis has also been reported from contact with the cactus spines. (U.S. Department of Agriculture, FoodData Central, 2018) There have been rare reports of bowel obstruction in individuals who consume large amounts of the seeds found in the fruit. (Karym El-Mostafa et al., 2014) Ask a registered dietitian or primary healthcare provider if nopal can provide safe benefits.


Nutrition Fundamentals


References

University of Arizona Cooperative Extension. Hope Wilson, M. W., Patricia Zilliox. (2019). Prickly pear cactus: food of the desert. extension.arizona.edu/sites/extension.arizona.edu/files/pubs/az1800-2019.pdf

U.S. Department of Agriculture. FoodData Central. (2018). Nopales, cooked, without salt. Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/169388/nutrients

U.S. Department of Agriculture. MyPlate. (2020-2025). Vegetables. Retrieved from www.myplate.gov/eat-healthy/vegetables

Rahimi, P., Abedimanesh, S., Mesbah-Namin, S. A., & Ostadrahimi, A. (2019). Betalains, the nature-inspired pigments, in health and diseases. Critical reviews in food science and nutrition, 59(18), 2949–2978. doi.org/10.1080/10408398.2018.1479830

López-Romero, P., Pichardo-Ontiveros, E., Avila-Nava, A., Vázquez-Manjarrez, N., Tovar, A. R., Pedraza-Chaverri, J., & Torres, N. (2014). The effect of nopal (Opuntia ficus indica) on postprandial blood glucose, incretins, and antioxidant activity in Mexican patients with type 2 diabetes after consumption of two different composition breakfasts. Journal of the Academy of Nutrition and Dietetics, 114(11), 1811–1818. doi.org/10.1016/j.jand.2014.06.352

Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. doi.org/10.3390/nu14051008

Bacardi-Gascon, M., Dueñas-Mena, D., & Jimenez-Cruz, A. (2007). Lowering effect on postprandial glycemic response of nopales added to Mexican breakfasts. Diabetes care, 30(5), 1264–1265. doi.org/10.2337/dc06-2506

Centers for Disease Control and Prevention. (2022). Fiber: the carb that helps you manage diabetes. Retrieved from www.cdc.gov/diabetes/library/features/role-of-fiber.html

Remes-Troche, J. M., Taboada-Liceaga, H., Gill, S., Amieva-Balmori, M., Rossi, M., Hernández-Ramírez, G., García-Mazcorro, J. F., & Whelan, K. (2021). Nopal fiber (Opuntia ficus-indica) improves symptoms in irritable bowel syndrome in the short term: a randomized controlled trial. Neurogastroenterology and motility, 33(2), e13986. doi.org/10.1111/nmo.13986

National Institutes of Health (NIH). Office of Dietary Supplements. (2024). Calcium. Retrieved from ods.od.nih.gov/factsheets/Calcium-HealthProfessional/

El-Mostafa, K., El Kharrassi, Y., Badreddine, A., Andreoletti, P., Vamecq, J., El Kebbaj, M. S., Latruffe, N., Lizard, G., Nasser, B., & Cherkaoui-Malki, M. (2014). Nopal cactus (Opuntia ficus-indica) as a source of bioactive compounds for nutrition, health and disease. Molecules (Basel, Switzerland), 19(9), 14879–14901. doi.org/10.3390/molecules190914879

Onakpoya, I. J., O’Sullivan, J., & Heneghan, C. J. (2015). The effect of cactus pear (Opuntia ficus-indica) on body weight and cardiovascular risk factors: a systematic review and meta-analysis of randomized clinical trials. Nutrition (Burbank, Los Angeles County, Calif.), 31(5), 640–646. doi.org/10.1016/j.nut.2014.11.015

Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. doi.org/10.3390/nu14051008

Understanding Egg Substitutes: What You Need to Know

Understanding Egg Substitutes: What You Need to Know

Can using egg substitutes or replacements be safe for individuals with an egg allergy?

Understanding Egg Substitutes: What You Need to Know

Substitutes and Replacements

Individuals should not assume either is safe unless they carefully read the label.

  • Egg substitutes may contain eggs.
  • Egg replacement products may be egg-free.
  • Look for alternatives labeled vegan or egg-free to ensure there are none.

Substitutes May Contain Eggs

Liquid egg substitutes in grocery store dairy aisles are made from eggs.  The following all contain eggs and are not safe for individuals with egg allergies:

  • Generic liquid egg substitutes in cartons
  • Egg Beaters
  • Powdered egg white products

Replacements Are Safe Alternatives

  • Special replacement products that do not contain eggs are available.
  • They are labeled vegan egg substitutes.
  • They are usually sold in powdered form.
  • They are useful for baking.
  • They cannot be used as a replacement for eggs in foods like a quiche.

Egg-Free Commercial Replacements

Always check the ingredients on the label before purchasing a product sold as a substitute or replacement to ensure it is completely free.

  • These products may also contain soy, dairy, or other food allergens.
  • Vegan – contains no animal products, which includes eggs and dairy.
  • Vegetarian – may contain eggs as they are not meat but an animal product.

Unaware of Foods With Eggs

Stay aware of eggs hidden in other food products, such as cakes, breads, pastries, noodles, crackers, and cereals.

  • The federal Food Allergen Labeling and Consumer Protection Act requires that all packaged food products that contain eggs as an ingredient must list the word egg on the label. (U.S. Food & Drug Administration. 2022)

Other ingredients that indicate eggs are in the product include:

  • Albumin
  • Globulin
  • Lysozyme
  • Lecithin
  • Livetin
  • Vitellin
  • Ingredients starting with – ova or ovo.

Allergy Symptoms

Symptoms may consist of: (John W. Tan, Preeti Joshi 2014)

  • Skin reactions – hives, rash, or eczema.
  • Allergic conjunctivitis  – itchy, red, watery eyes.
  • Angioedema – swelling of the lips, tongue, or face.
  • Airway symptoms – wheezing, coughing, or a runny nose.
  • Gastrointestinal symptoms – nausea, stomach pain, diarrhea or vomiting.
  • Severe reactions – such as anaphylaxis, can cause multiple organ system failure.
  • Anaphylaxis is an emergency and requires immediate medical treatment.

A Guide For Food Allergies, Hypersensitivity and Intolerances


References

U.S. Food & Drug Administration. (2022). Food Allergen Labeling and Consumer Protection Act (FALCPA). Retrieved from www.fda.gov/food/food-allergensgluten-free-guidance-documents-regulatory-information/food-allergen-labeling-and-consumer-protection-act-2004-falcpa

Tan, J. W., & Joshi, P. (2014). Egg allergy: an update. Journal of paediatrics and child health, 50(1), 11–15. doi.org/10.1111/jpc.12408

Mayonnaise: Is It Really Unhealthy?

Mayonnaise: Is It Really Unhealthy?

For individuals who want to eat healthier, can selection and moderation make mayonnaise a delicious and nutritious addition to a low-carbohydrate diet?

Mayonnaise: Is It Really Unhealthy?

Mayonnaise Nutrition

Mayonnaise is used in various recipes, including sandwiches, tuna salad, deviled eggs, and tartar sauce. It is often considered unhealthy, as it is mostly fat and, as a result, calorie-dense. Calories and fat can quickly add up when not paying attention to portion sizes.

What Is It?

  • It is a blend of different ingredients.
  • It combines oil, egg yolk, an acidic liquid (lemon juice or vinegar), and mustard.
  • The ingredients become a thick, creamy, permanent emulsion when blended slowly.
  • The key is in the emulsion, combining two liquids that would otherwise not naturally come together, which turns the liquid oil into a solid.

The Science

  • Emulsification happens when an emulsifier – the egg yolk – binds the water-loving/hydrophilic and oil-loving/lipophilic components.
  • The emulsifier binds the lemon juice or vinegar with the oil and does not allow separation, producing a stable emulsion. (Viktoria Olsson et al., 2018)
  • In homemade mayonnaise, the emulsifiers are mainly the lecithin from the egg yolk and a similar ingredient in mustard.
  • Commercial mayonnaise brands often use other types of emulsifiers and stabilizers.

Health

  • It contains health-promoting properties, such as vitamin E, which improves heart health, and vitamin K, which is important for blood clotting. (USDA, FoodData Central, 2018)
  • It can also be made with healthy fats like omega-3 fatty acids, which maintain brain, heart, and skin health.
  • It is mostly an oil and high-fat calorie-dense condiment. (H R Mozafari et al., 2017)
  • However, it is mostly unsaturated fat, which is a healthier fat.
  • To maintain nutrition goals in mind when selecting mayonnaise.
  • For individuals on a low-fat or low-calorie diet, portion control is important.

Oil

  • Almost any edible oil can be used to make mayonnaise, making the oil the biggest factor in the recipe’s healthfulness.
  • Most commercial brands are made with soy oil, which some nutrition experts believe can be problematic because of the high levels of omega-6 fats.
  • Canola oil has a lower omega-6 content than soy oil.
  • Individuals who make the mayonnaise can use any oil, including olive or avocado oil.

Bacteria

  • The concern about bacteria comes from the fact that homemade mayonnaise is usually made with raw egg yolks.
  • Commercial mayonnaise is made with pasteurized eggs and is produced in a way that keeps it safe.
  • The acids, vinegar, or lemon juice can help keep some bacteria from contaminating the mayonnaise.
  • However, a study found that homemade mayonnaise may still contain salmonella bacteria despite the acidic compounds. (Junli Zhu et al., 2012)
  • Because of this, some prefer to pasteurize an egg in 140°F water for 3 minutes before making the mayonnaise.
  • Regardless of the type of mayonnaise, food safety guidelines should always be followed (United States Department of Agriculture, 2024).
  • Mayonnaise-based dishes should not be left outside refrigeration for more than two hours.
  • Opened commercial mayonnaise should be stored in the refrigerator after opening and discarded after two months.

Reduced-Fat Mayonnaise

  • Many nutritionists recommend reduced-fat mayonnaise for individuals on a low-calorie, low-fat, or exchange diet. (Institute of Medicine (US) Committee on Dietary Guidelines Implementation, 1991)
  • While reduced-fat mayonnaise has fewer calories and less fat than regular mayonnaise, the fat is often replaced with starches or sugar to improve texture and flavor.
  • For individuals watching carbohydrates or sugar in their diet, check the nutrition label and ingredients before deciding on the right mayonnaise.

Body In Balance: Chiropractic, Fitness, and Nutrition


References

Olsson, V., Håkansson, A., Purhagen, J., & Wendin, K. (2018). The Effect of Emulsion Intensity on Selected Sensory and Instrumental Texture Properties of Full-Fat Mayonnaise. Foods (Basel, Switzerland), 7(1), 9. doi.org/10.3390/foods7010009

USDA, FoodData Central. (2018). Mayonnaise dressing, no cholesterol. Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/167736/nutrients

Mozafari, H. R., Hosseini, E., Hojjatoleslamy, M., Mohebbi, G. H., & Jannati, N. (2017). Optimization low-fat and low cholesterol mayonnaise production by central composite design. Journal of food science and technology, 54(3), 591–600. doi.org/10.1007/s13197-016-2436-0

Zhu, J., Li, J., & Chen, J. (2012). Survival of Salmonella in home-style mayonnaise and acid solutions as affected by acidulant type and preservatives. Journal of food protection, 75(3), 465–471. doi.org/10.4315/0362-028X.JFP-11-373

United States Department of Agriculture. Food Safety and Inspection Service. (2024). Keep Food Safe! Food Safety Basics. Retrieved from www.fsis.usda.gov/food-safety/safe-food-handling-and-preparation/food-safety-basics/steps-keep-food-safe

Institute of Medicine (U.S.). Committee on Dietary Guidelines Implementation., Thomas, P. R., Henry J. Kaiser Family Foundation., & National Cancer Institute (U.S.). (1991). Improving America’s diet and health : from recommendations to action : a report of the Committee on Dietary Guidelines Implementation, Food and Nutrition Board, Institute of Medicine. National Academy Press. books.nap.edu/books/0309041392/html/index.html
www.ncbi.nlm.nih.gov/books/NBK235261/

Exploring the Benefits of Green Powder Supplements

Exploring the Benefits of Green Powder Supplements

“For individuals that have difficulty getting plenty of fruits and vegetables, can incorporating green powder supplements increase nutritional levels for a balanced diet?”

Exploring the Benefits of Green Powder Supplements

Green Powder Supplements

Meeting daily nutrient needs through whole, unprocessed foods can’t always be met when access is limited or for other reasons. A green powder supplement is a great way to fill in the gaps. Green powder supplements are a daily supplement that helps increase vitamin, mineral, and fiber intake and enhances overall health. Green powders are easy to mix in water with a favorite beverage or smoothie or bake into a recipe. They can help:

  • Increase energy
  • Nourish the immune system
  • Improve digestion
  • Promote mental clarity
  • Contribute to healthy blood sugar levels
  • Reduce the risk of chronic disease
  • Promote optimal liver and kidney function

What Are They?

  • Green powder supplements are forms of vitamins, minerals, fiber, antioxidants, phytochemicals, and other bioactive compounds.
  • They are derived from fruits, vegetables, herbs, and algae to combine ingredients into a convenient supplement. (Giulia Lorenzoni et al., 2019)

Nutrients

Because most green powders comprise a combination of ingredients, the nutrient density is high. Green powder supplements can be considered a vitamin and mineral product. They typically contain:

  • Vitamins A, C, and K
  • Iron
  • Magnesium
  • Calcium
  • Antioxidants

The recommended daily intake of vitamins and minerals can be helpful for individuals with limited access to produce or who want to supplement their diet with additional nutrients.

Energy

The phytochemicals found in fruits and vegetables have been shown to improve energy levels. Studies on their effects on physical performance and endurance have resulted in positive outcomes. Researchers found that phytonutrients like those in green powders helped to increase energy, improve agility, reduce fatigue perception, improve memory, and decrease recovery time. (Nicolas Monjotin et al., 2022)

Digestive Health

Green powders are rich in soluble and insoluble fiber, which contribute to feeling full and satisfied after a meal and are important for healthy digestion and regular bowel movements. Eating fiber-rich foods is associated with optimal blood sugar control and improved gut microbiota diversity. These factors are important for maintaining a healthy body weight and decreasing the risk of chronic disease, for example, type 2 diabetes. (Thomas M. Barber et al., 2020) Phytochemicals, including flavonoids, have been shown to have therapeutic effects on gas, bloating, constipation, and diarrhea associated with IBS. Other phytonutrients have been shown to reduce certain symptoms of ulcerative colitis. (Nicolas Monjotin et al., 2022)

Immune System Function

Supplemental green powder supplements have shown the ability to maintain a healthy immune system and reduce inflammation by their antioxidant content. Green powders containing seaweed or algae are rich in phytochemical and poly-unsaturated fatty acids that have antioxidant properties to reduce inflammation and prevent oxidative damage to cells. (Agnieszka Jaworowska, Aliza Murtaza 2022) A randomized trial found that a fruit, berry, and vegetable powder concentrate blend decreased oxidation and reduced inflammation, attributed to the phytochemicals found in fruits and vegetables.(Manfred Lamprecht et al., 2013)

Detoxification

The liver and kidneys are the main organs of natural detoxification. The liver helps the body absorb nutrients from consumed foods and removes waste and toxins through the kidneys. (National Library of Medicine. 2016) Plants are packed with antioxidants and phytochemicals that protect the liver and kidneys from free radical damage and oxidative stress. (Yong-Song Guan et al., 2015) The green powder supplements are made from these plants. When drinking green powders, fluid intake naturally increases as a standard serving of green powder is mixed with 8 to 12 ounces of water.

Whether mixed, blended, or made into a shake, powdered greens are a convenient and efficient way to get the daily dose of antioxidants, vitamins, minerals, and other nutrients.


The Healing Diet: Combat Inflammation, Embrace Wellness


References

Lorenzoni, G., Minto, C., Vecchio, M. G., Zec, S., Paolin, I., Lamprecht, M., Mestroni, L., & Gregori, D. (2019). Fruit and Vegetable Concentrate Supplementation and Cardiovascular Health: A Systematic Review from a Public Health Perspective. Journal of clinical medicine, 8(11), 1914. doi.org/10.3390/jcm8111914

Monjotin, N., Amiot, M. J., Fleurentin, J., Morel, J. M., & Raynal, S. (2022). Clinical Evidence of the Benefits of Phytonutrients in Human Healthcare. Nutrients, 14(9), 1712. doi.org/10.3390/nu14091712

Barber, T. M., Kabisch, S., Pfeiffer, A. F. H., & Weickert, M. O. (2020). The Health Benefits of Dietary Fibre. Nutrients, 12(10), 3209. doi.org/10.3390/nu12103209

Jaworowska, A., & Murtaza, A. (2022). Seaweed Derived Lipids Are a Potential Anti-Inflammatory Agent: A Review. International journal of environmental research and public health, 20(1), 730. doi.org/10.3390/ijerph20010730

Lamprecht, M., Obermayer, G., Steinbauer, K., Cvirn, G., Hofmann, L., Ledinski, G., Greilberger, J. F., & Hallstroem, S. (2013). Supplementation with a juice powder concentrate and exercise decrease oxidation and inflammation, and improve the microcirculation in obese women: randomised controlled trial data. The British journal of nutrition, 110(9), 1685–1695. doi.org/10.1017/S0007114513001001

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the liver work? 2009 Sep 17 [Updated 2016 Aug 22]. Available from: www.ncbi.nlm.nih.gov/books/NBK279393/

Guan, Y. S., He, Q., & Ahmad Al-Shatouri, M. (2015). Complementary and Alternative Therapies for Liver Diseases 2014. Evidence-based complementary and alternative medicine : eCAM, 2015, 476431. doi.org/10.1155/2015/476431