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Wellness

Clinic Wellness Team. A key factor to spine or back pain conditions is staying healthy. Overall wellness involves a balanced diet, appropriate exercise, physical activity, restful sleep, and a healthy lifestyle. The term has been applied in many ways. But overall, the definition is as follows.

It is a conscious, self-directed, and evolving process of achieving full potential. It is multidimensional, bringing together lifestyles both mental/spiritual and the environment in which one lives. It is positive and affirms that what we do is, in fact, correct.

It is an active process where people become aware and make choices towards a more successful lifestyle. This includes how a person contributes to their environment/community. They aim to build healthier living spaces and social networks. It helps in creating a person’s belief systems, values, and a positive world perspective.

Along with this comes the benefits of regular exercise, a healthy diet, personal self-care, and knowing when to seek medical attention. Dr. Jimenez’s message is to work towards being fit, being healthy, and staying aware of our collection of articles, blogs, and videos.


The Benefits of Sleeping with a Pillow Between the Legs

The Benefits of Sleeping with a Pillow Between the Legs

For individuals with back pain, can sleeping with a pillow between or under their knees help bring relief during sleep?

The Benefits of Sleeping with a Pillow Between the Legs

Sleep With A Pillow Between The Legs

Healthcare providers may recommend that individuals with back pain due to pregnancy or conditions like a herniated disc and sciatica sleep with a pillow between their legs. Sleeping with a pillow between the legs may help relieve back and hip pain, as the position helps maintain pelvis and spinal alignment. Proper spinal alignment can help relieve back stress and pain.

The Benefits

Some potential benefits of sleeping with a pillow between the knees.

Reduce Back and Hip Pain

When sleeping on the side, the spine, shoulders, and hips may twist to maintain the position because the center of gravity is elevated, causing instability. (Gustavo Desouzart et al., 2015) Placing a pillow between the knees may help maintain stability and reduce back and hip pain. (Gustavo Desouzart et al., 2015) The pillow neutralizes the position of the pelvis by slightly elevating the leg on top. This decreases the pressure on the lower back and hip joints, which may help reduce pain and allow for improved sleep.

Reduce Sciatica Symptoms

Sciatica nerve pain travels from the lower back down one leg due to a compressed spinal nerve root in the lower back. (American Academy of Orthopaedic Surgeons, 2021) Sleeping with a pillow between the knees may help reduce symptoms and sensations. A pillow between the legs can help prevent twisting the back, rotating the spine, or tilting the pelvis during sleep.

Reduce Herniated Disc Symptoms

A herniated disc can pressure the spinal nerves, leading to pain and numbness. (Penn Medicine. 2024) Sleeping on the side can worsen herniated disc pain; however, placing a pillow between the knees keeps the pelvis in neutral alignment and prevents spinal rotation. Sleeping on the back with a pillow under the knees can also help reduce pressure on the disc. (University of Central Florida. N.D.)

Improve Posture

Maintaining healthy posture while sitting or standing is important to neuromusculoskeletal health and injury prevention. Proper alignment during sleep can help improve posture (Doug Cary et al., 2021). According to one study, individuals spend more than half of their time sleeping in a side-lying posture. (Eivind Schjelderup Skarpsno et al., 2017) Sleeping on the side with the top leg frequently falls forward, bringing the pelvis into a forward tilt that places added pressure on the hips and spine connective tissues. This position disrupts the body’s natural alignment. (Doug Cary et al., 2021) Placing a pillow between the knees improves sleeping posture by lifting the top leg and prevents forward shifting. (University of Rochester Medical Center. 2024)

Pregnancy

Pregnancy pain in the back and pelvic girdle is due to: (Danielle Casagrande et al., 2015)

  • Increased weight leads to increased pressure on joints.
  • Significant change in the center of gravity.
  • Hormonal changes make connective tissues more lax.

Pregnant women with hip or back pain are often recommended to sleep with a pillow between their knees to relieve pain and discomfort. Doctors agree that lying on the left side is the best sleep position during the second and third trimesters. This position ensures optimal blood flow for the mother and baby and helps kidney function. (Standford Medicine, 2024) Placing a pillow between the knees can help reduce the pressure on the joints and also help maintain the left-side lying position. (O’Brien LM, Warland J. 2015) (Standford Medicine, 2024) Larger maternity pillows supporting the abdomen and lower back can provide more comfort.

Consult a healthcare provider about sleeping with a pillow between the knees to see if it is right for you.


What Causes Disc Herniation?


References

Desouzart, G., Matos, R., Melo, F., & Filgueiras, E. (2015). Effects of sleeping position on back pain in physically active seniors: A controlled pilot study. Work (Reading, Mass.), 53(2), 235–240. doi.org/10.3233/WOR-152243

American Academy of Orthopaedic Surgeons. (2021). Sciatica. OrthoInfo. orthoinfo.aaos.org/en/diseases–conditions/sciatica

Penn Medicine. (2024). Herniated disc disorders. Penn Medicine. www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/herniated-disc-disorders

University of Central Florida. (N.D.). The best sleeping position for lower back pain (and the worst). UFC Health Services. ucfhealth.com/our-services/lifestyle-medicine/best-sleeping-position-for-lower-back-pain/

Cary, D., Jacques, A., & Briffa, K. (2021). Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study. PloS one, 16(11), e0260582. doi.org/10.1371/journal.pone.0260582

Skarpsno, E. S., Mork, P. J., Nilsen, T. I. L., & Holtermann, A. (2017). Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms. Nature and science of sleep, 9, 267–275. doi.org/10.2147/NSS.S145777

University of Rochester Medical Center. (2024). Good sleeping posture helps your back. Health Encyclopedia. www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4460

Casagrande, D., Gugala, Z., Clark, S. M., & Lindsey, R. W. (2015). Low Back Pain and Pelvic Girdle Pain in Pregnancy. The Journal of the American Academy of Orthopaedic Surgeons, 23(9), 539–549. doi.org/10.5435/JAAOS-D-14-00248

Standford Medicine. (2024). Sleeping positions during pregnancy. Standford Medicine Children’s Health. www.stanfordchildrens.org/en/topic/default?id=sleeping-positions-during-pregnancy-85-P01238

O’Brien, L.M., Warland, J. (2015). Maternal sleep position: what do we know where do we go? BMC Pregnancy Childbirth, 15, Article A4 (2015). doi.org/doi:10.1186/1471-2393-15-S1-A4

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

Acupuncture for Eczema: A Promising Therapy Option

Acupuncture for Eczema: A Promising Therapy Option

For individuals dealing with eczema, can incorporating acupuncture into a treatment plan help manage and reduce symptoms?

Acupuncture for Eczema: A Promising Therapy Option

Acupuncture for Eczema

Eczema is a chronic skin disorder that causes intense itching, dry skin, and rashes. Common treatment options for eczema include:

  • Moisturizers
  • Topical steroids
  • Prescription medications

Some research suggests that acupuncture may also help individuals with eczema. In recent years, researchers have looked at acupuncture as a possible treatment option and found that it can reduce symptoms.

Acupuncture

Acupuncture involves inserting thin metallic needles in specific acupoints in the body. It is believed that by stimulating specific points, the body’s central nervous system activates and releases certain chemicals designed to enable healing. Ailments that are treated using acupuncture include: (Johns Hopkins Medicine. 2024)

  • Headaches
  • Back pain
  • Nausea
  • Asthma
  • Osteoarthritis
  • Fibromyalgia

Treatment

Studies have found that acupuncture could be a treatment option depending on the severity of the condition and the intensity of the itching sensations. (Ruimin Jiao et al., 2020) The needles are placed at various points associated with relieving the condition. These points include: (Zhiwen Zeng et al., 2021)

LI4

  • Located at the base of the thumb and index finger.
  • It has been shown to help reduce inflammation and irritation.

LI11

  • This point is located within the elbow to reduce itchiness and dryness.

LV3

  • Located on the top of the foot, this point reduces stress on the nervous system.

SP6

  • The SP6 is on the lower calf above the ankle and can help reduce inflammation, redness, and skin irritation.

SP10

  • This point is located adjacent to the knee and reduces itchiness and inflammation.

ST36

  • This point is located below the knee on the back of the leg and is used to improve overall well-being.

Benefits

There are various benefits of acupuncture, including (Ruimin Jiao et al., 2020)

  • Dryness and itchiness relief.
  • Itchiness intensity reduction.
  • Affected area reduction.
  • Improved quality of life.
  1. Eczema flare-ups are also linked to stress and anxiety. Acupuncture has been shown to reduce anxiety and stress, which can also help relieve eczema symptoms (Beate Wild et al., 2020).
  2. Acupuncture helps repair skin barrier damage or the outer part of the skin designed to protect the body. (Rezan Akpinar, Saliha Karatay, 2018)
  3. Individuals with eczema tend to have a weakened skin barrier; this benefit can also improve symptoms. (National Eczema Association. 2023)
  4. Individuals with eczema often have an overactive immune system contributing to the disorder.
  5. According to research, acupuncture can also help in regulating the immune system. (Zhiwen Zeng et al., 2021)

Risks

Acupuncture is generally considered safe, but there are some risks to be aware of. These risks include: (Ruimin Jiao et al., 2020)

  • Swelling where the needles are inserted.
  • Red spots on the skin.
  • Increased itchiness.
  • A rash known as erythema – occurs when small blood vessels are injured.
  • Hemorrhages – excessive bleeding.
  • Fainting

Individuals Who Should Avoid Acupuncture

Not all individuals can be treated with acupuncture. Individuals who should avoid acupuncture treatment include individuals who (National Eczema Association. 2021) (Johns Hopkins Medicine. 2024)

  • Are pregnant
  • Have a bleeding disorder
  • Have an increased risk of infection
  • Have a pacemaker
  • Have breast implants

Effectiveness

Most studies on acupuncture for eczema show positive results that prove it can aid in relieving symptoms. (SeHyun Kang et al., 2018) (Ruimin Jiao et al., 2020) However, individuals should talk to their healthcare provider to see if it’s a safe option.


Unlocking Wellness


References

Johns Hopkins Medicine. (2024). Acupuncture (Health, Issue. www.hopkinsmedicine.org/health/wellness-and-prevention/acupuncture

Jiao, R., Yang, Z., Wang, Y., Zhou, J., Zeng, Y., & Liu, Z. (2020). The effectiveness and safety of acupuncture for patients with atopic eczema: a systematic review and meta-analysis. Acupuncture in medicine : journal of the British Medical Acupuncture Society, 38(1), 3–14. doi.org/10.1177/0964528419871058

Zeng, Z., Li, M., Zeng, Y., Zhang, J., Zhao, Y., Lin, Y., Qiu, R., Zhang, D. S., & Shang, H. C. (2021). Potential Acupoint Prescriptions and Outcome Reporting for Acupuncture in Atopic Eczema: A Scoping Review. Evidence-based complementary and alternative medicine : eCAM, 2021, 9994824. doi.org/10.1155/2021/9994824

Wild, B., Brenner, J., Joos, S., Samstag, Y., Buckert, M., & Valentini, J. (2020). Acupuncture in persons with an increased stress level-Results from a randomized-controlled pilot trial. PloS one, 15(7), e0236004. doi.org/10.1371/journal.pone.0236004

Akpinar R, Karatay S. (2018). Positive Effects of Acupuncture on Atopic Dermatitis. International Journal of Allergy Medications 4:030. doi.org/10.23937/2572-3308.1510030

National Eczema Association. (2023). Skin barrier basics for people with eczema. What is my skin barrier? nationaleczema.org/blog/what-is-my-skin-barrier/

National Eczema Association. (2021). Get the facts: acupuncture. Get the facts: acupuncture. nationaleczema.org/blog/get-the-facts-acupuncture/

Kang, S., Kim, Y. K., Yeom, M., Lee, H., Jang, H., Park, H. J., & Kim, K. (2018). Acupuncture improves symptoms in patients with mild-to-moderate atopic dermatitis: A randomized, sham-controlled preliminary trial. Complementary therapies in medicine, 41, 90–98. doi.org/10.1016/j.ctim.2018.08.013

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

Reversing Aging Naturally: The Benefits of Cosmetic Acupuncture

Reversing Aging Naturally: The Benefits of Cosmetic Acupuncture

For individuals wanting to improve or maintain skin health, can incorporating acupuncture help improve skin and fight the aging process?

Reversing Aging Naturally: The Benefits of Cosmetic Acupuncture

Cosmetic Acupuncture

Cosmetic acupuncture follows the traditional acupuncture practice of needle insertion. The objective is to reverse signs of aging and improve skin health.  It is sometimes referred to as acupuncture facial rejuvenation, which has been used as an alternative to surgical facelifts and other conventional procedures. Preliminary studies have examined how it can help remove age spots, lift droopy eyelids, and reduce wrinkles. (Younghee Yun et al., 2013)

How Acupuncture Works

In traditional Chinese medicine or TCM, acupuncture has long been used to improve the flow of energy – qi or chi – throughout the body. This energy is believed to circulate through energy pathways known as meridians. When health problems occur, according to TCM, there are obstructions or blockages in the circulation.
Acupuncturists can restore optimal circulation/flow and improve health by inserting needles into specific acupoints. (National Institutes of Health, 2007)

Cosmetic Acupuncture

Cosmetic acupuncture is said to improve skin health and act as an anti-aging treatment by stimulating the production of collagen. This protein is a major component of the skin.  The skin’s inner layer loses collagen and firmness as the body ages.  However, further research is needed to support the claim that acupuncture can promote collagen production. Some suggest cosmetic acupuncture helps rejuvenate the skin by improving the body’s overall energy. One study found individuals saw improvements after five sessions of facial cosmetic acupuncture. (Younghee Yun et al., 2013) However, it is recommended that ten treatments be performed once or twice a week for optimum results. After that, maintenance treatments are done every four to eight weeks.  Unlike Botox or dermal fillers, cosmetic acupuncture is not a quick fix. The focus is to create long-term changes in the skin and body, which means improved:

When the needles are inserted into the skin, they create wounds known as positive microtraumas. The body’s natural healing and repairing abilities activate when it senses these wounds. These punctures stimulate the lymphatic and circulatory systems, which deliver nutrients and oxygen to the skin cells, nourishing them from the inside out.

  • This helps even out complexion and promotes skin radiance.
  • The positive microtraumas also stimulate the production of collagen.
  • This helps improve elasticity, minimizing lines and wrinkles.

Alternatives

Several natural remedies may help improve skin health and offer anti-aging benefits. Ceramides are a fat molecule found naturally in the top layer of the skin and an ingredient used in skin-care products. These may protect against aging-related dryness in the skin. (L Di Marzio 2008) Preliminary research suggests that applying white tea to the skin may fight the breakdown of collagen and elastin – a protein that supports skin elasticity and prevents sagging). There’s also evidence that natural substances such as argan oil, borage oil, and sea buckthorn may offer moisturizing benefits that could improve skin.(Tamsyn S A Thring et al., 2009)

While further evidence of cosmetic acupuncture is needed, integrating acupuncture can help manage stress and enhance overall health. Individuals considering cosmetic acupuncture should consult their primary healthcare provider to see if it is right for them.


Enhancing Health Together: Embracing Multidisciplinary Evaluation and Treatment


References

Yun, Y., Kim, S., Kim, M., Kim, K., Park, J. S., & Choi, I. (2013). Effect of facial cosmetic acupuncture on facial elasticity: an open-label, single-arm pilot study. Evidence-based complementary and alternative medicine : eCAM, 2013, 424313. doi.org/10.1155/2013/424313

The National Center for Complementary and Alternative Medicine. (2007). Acupuncture: An Introduction. National Center for Complementary and Alternative Medicine Website. choimd.com/downloads/NIH-info-on-acupuncture.pdf

Kuge, H., Mori, H., Tanaka, T. H., & Tsuji, R. (2021). Reliability and Validity of Facial Check Sheet (FCS): Checklist for Self-Satisfaction with Cosmetic Acupuncture. Medicines (Basel, Switzerland), 8(4), 18. doi.org/10.3390/medicines8040018

Di Marzio, L., Cinque, B., Cupelli, F., De Simone, C., Cifone, M. G., & Giuliani, M. (2008). Increase of skin-ceramide levels in aged subjects following a short-term topical application of bacterial sphingomyelinase from Streptococcus thermophilus. International journal of immunopathology and pharmacology, 21(1), 137–143. doi.org/10.1177/039463200802100115

Thring, T. S., Hili, P., & Naughton, D. P. (2009). Anti-collagenase, anti-elastase and anti-oxidant activities of extracts from 21 plants. BMC complementary and alternative medicine, 9, 27. doi.org/10.1186/1472-6882-9-27

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/