Back Clinic Functional Medicine Team. Functional medicine is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, functional medicine addresses the whole person, not just an isolated set of symptoms.
Practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, functional medicine supports the unique expression of health and vitality for each individual.
By changing the disease-centered focus of medical practice to this patient-centered approach, our physicians are able to support the healing process by viewing health and illness as part of a cycle in which all components of the human biological system interact dynamically with the environment. This process helps to seek and identify genetic, lifestyle, and environmental factors that may shift a person’s health from illness to well-being.
For individuals wanting to eat pancakes regularly, are there ways to increase pancake nutrition and lower the calorie and carb counts so they can be included in a balanced diet?
Pancake Nutrition
This high-carbohydrate meal can provide enough energy to fuel a day’s physical activity.
Nutrition
The following nutrition information is provided for:
Pancakes made with whole-wheat flour offer more fiber and protein. The following is nutrition info for two or three whole-wheat pancakes (150g) made from a mix. (Child Nutrition Recipe Box. 2023)
Calories – 348
Fat – 15g
Sodium – 594mg
Carbohydrates – 45g
Fiber – 6g
Sugars – 6g
Protein – 12g
Carbohydrates
Pancakes will increase carbohydrate intake. The body uses carbohydrates as a primary fuel source, making them an important nutrient. However, most nutritionists suggest that individuals get their daily carbohydrates from nutrient-dense sources. Pancakes typically don’t fall into this category. White flour pancakes do not provide much fiber, and around 60 grams of carbohydrates are consumed in this meal. Substituting whole-wheat flour changes the amount to around 6g of fiber or 20% of the daily recommended value.
Fat
Pancakes can include dairy and eggs and are topped with butter that contributes a significant amount of fat. Pancake mix may contain trans fat. Some brands include partially hydrogenated oils. Health experts recommend that individuals limit or completely avoid foods containing trans fat. If the label ingredient list contains partially hydrogenated ingredients, it is recommended to avoid it. (MedlinePlus. 2022)
Protein
Pancakes may provide some protein, which varies based on the type of flour used. Some brands add protein powder to increase intake.
Vitamins and Minerals
Pancakes and ready mixes are generally made from enriched flour. Enriched foods are those that have had nutrients added during the manufacturing process. In most cases, the nutrients, vitamins, and minerals are stripped away, and then some are added back in during processing. Constantly eating enriched bread products limits diet-friendly fiber and nutrients. The enriched flour in pancakes and added sugar and syrup raise blood sugar levels rapidly and then generate hunger shortly afterward.
Calories
Total nutrition numbers also depend on serving size. The numbers on the label only apply to a single serving which is just two medium pancakes. Many individuals consume 3-4 medium pancakes and double the amount of butter and syrup as well. This can add up to more than 1,000 calories.
Benefits
Whole-wheat pancakes made with whole-grain flour are more nutritious than pancakes made with white flour and can be a delicious way to eat more whole grains. They can be topped with berries or other fruits for added fiber and nutrients.
Digestion
Whole-wheat pancakes made with whole-grain flour provide significant fiber for healthy digestion. Fiber helps with waste evacuation and has prebiotic compounds that fuel beneficial gut bacteria. (Joanne Slavin. 2013)
Improves Hunger Satisfaction
Whole-grain pancakes taste heartier and include fiber that keeps the body fuller longer than pancakes made with faster-digesting refined flour.
Decreases Risk of Heart Disease
A review of studies examining whole grain consumption and heart disease found that eating whole grains was associated with a reduced risk of heart disease. (Dagfinn Aune, et al., 2016)
Reduces Risk of Obesity
Research suggests that whole grain intake reduces the risk of obesity and could help individuals maintain a stable weight. (Katrina R. Kissock et al., 2021) The fiber will also help keep the fuller longer after the meal.
Slavin J. (2013). Fiber and prebiotics: mechanisms and health benefits. Nutrients, 5(4), 1417–1435. doi.org/10.3390/nu5041417
Aune, D., Keum, N., Giovannucci, E., Fadnes, L. T., Boffetta, P., Greenwood, D. C., Tonstad, S., Vatten, L. J., Riboli, E., & Norat, T. (2016). Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ (Clinical research ed.), 353, i2716. doi.org/10.1136/bmj.i2716
Kissock, K. R., Neale, E. P., & Beck, E. J. (2021). Whole Grain Food Definition Effects on Determining Associations of Whole Grain Intake and Body Weight Changes: A Systematic Review. Advances in nutrition (Bethesda, Md.), 12(3), 693–707. doi.org/10.1093/advances/nmaa122
Centers for Disease Control and Prevention. (2022). Folic acid.
For individuals watching their food intake during the Thanksgiving holiday, can knowing the nutritional value of turkey help maintain diet health?
Nutrition and Benefits
Minimally processed turkey can be a beneficial source of protein, vitamins, and minerals. However, processed turkey can be high in sugar, unhealthy fats, and sodium.
Sarcopenia, or muscle wasting, commonly leads to frailty in elderly individuals.
Getting enough protein at every meal is essential for older adults to maintain muscle mass and physical mobility.
Turkey can help meet guidelines suggesting lean meat consumption 4-5 times a week to maintain muscle health with aging. (Anna Maria Martone, et al., 2017)
Reduces Diverticulitis Flare-Ups
Diverticulitis is inflammation of the colon. Dietary factors that influence the risk of diverticulitis include:
Fiber intake – lowers risk.
Processed red meat intake – raises risk.
Intake of red meat with higher total fat – raises risk.
Researchers studied 253 men with diverticulitis and determined that replacing one serving of red meat with a serving of poultry or fish reduces the risk of diverticulitis by 20%. (Yin Cao et al., 2018)
The study’s limitations are that the meat intake was recorded in men only, the intake was self-reported, and the amount consumed at each eating episode was not recorded.
It may be a helpful substitution for anyone at risk for diverticulitis.
Turkey is a lean alternative to other low-sodium meats, especially if the skin is removed and cooked fresh.
Turkey is also high in the amino acid arginine.
Arginine can help keep arteries open and relaxed as a precursor to nitric oxide. (Patrick J. Skerrett, 2012)
Allergies
Meat allergies can happen at any age. A turkey allergy is possible and may be associated with allergies to other types of poultry and red meat. Symptoms can include: (American College of Allergy, Asthma & Immunology. 2019)
Martone, A. M., Marzetti, E., Calvani, R., Picca, A., Tosato, M., Santoro, L., Di Giorgio, A., Nesci, A., Sisto, A., Santoliquido, A., & Landi, F. (2017). Exercise and Protein Intake: A Synergistic Approach against Sarcopenia. BioMed research international, 2017, 2672435. doi.org/10.1155/2017/2672435
Cao, Y., Strate, L. L., Keeley, B. R., Tam, I., Wu, K., Giovannucci, E. L., & Chan, A. T. (2018). Meat intake and risk of diverticulitis among men. Gut, 67(3), 466–472. doi.org/10.1136/gutjnl-2016-313082
For individuals suffering from allergies, could using acupuncture help relieve and manage symptoms?
Acupuncture Can Help With Allergies
Acupuncture is becoming a more respected alternative treatment for various medical issues, from anxiety to fibromyalgia to weight loss. There is evidence that acupuncture can help with allergies by alleviating symptoms and improving the quality of life. (Shaoyan Feng, et al., 2015) The American Academy of Otolaryngology-Head and Neck Surgery Foundation recommends doctors offer acupuncture to patients looking for nonpharmacological treatments for their allergies or refer them to an acupuncturist. (Michael D. Seidman, et al., 2015)
Acupuncture
Acupuncture is a traditional Chinese medicine/TCM practice in which extremely thin needles are inserted into the body at specific points, creating a network of energy pathways known as meridians.
These pathways circulate vital life energy/chi or qi.
Each meridian is associated with a different body system.
Needles are placed to target the organs associated with the condition being treated.
Acupuncture can help with allergies by targeting several meridians, including the lungs, colon, stomach, and spleen. These meridians are believed to circulate defensive life energy or a type of immunity energy.
A backup of defensive energy or a deficiency can cause allergy symptoms like swelling, watery eyes, runny nose, sneezing, allergic eczema, and conjunctivitis. (Bettina Hauswald, Yury M. Yarin. 2014)
The objective is to stimulate the points to restore balance in the energies and relieve symptoms.
Scientific Theories
One theory is the needles work directly on nerve fibers, influencing messages to the brain or the autonomic nervous system and transmission of signals within the body, including the immune system. (Tony Y. Chon, Mark C. Lee. 2013)
Another is the needles influence certain activities of cells, particularly the transport, breakdown, and clearance of bioactive mediators.
The combination of these actions is thought to decrease inflammatory conditions like allergic rhinitis – hay fever, in which the inside of the nose becomes inflamed and swollen after breathing in an allergen. (Bettina Hauswald, Yury M. Yarin. 2014)
A 2015 review concluded there have been high-quality randomized controlled trials demonstrating acupuncture’s efficacy in treating seasonal and perennial allergic rhinitis. Smaller studies have shown some preliminary benefits of acupuncture when compared with antihistamines, but more research is needed. (Malcolm B. Taw, et al., 2015)
Treating Allergies
Some individuals who choose acupuncture are seeking alternatives to standard treatment like medications, nasal sprays, and immunotherapy.
Others are looking for ways to enhance the effectiveness of medications already being taken, such as antihistamines or nasal sprays, or shorten how long or how frequently they are needed.
Initial treatment usually involves weekly or twice-weekly appointments over several weeks or months, depending on symptom severity.
Improperly administered acupuncture needles can cause serious side effects that range from infections, punctured organs, collapsed lungs, and injury to the central nervous system. (National Center for Complementary and Integrative Health. 2022) Before trying acupuncture, consult your primary healthcare provider, allergist, or integrative medicine specialist to make sure it’s a safe and viable option and the best way to integrate it into overall allergy care.
Fighting Inflammation Naturally
References
Feng, S., Han, M., Fan, Y., Yang, G., Liao, Z., Liao, W., & Li, H. (2015). Acupuncture for the treatment of allergic rhinitis: a systematic review and meta-analysis. American journal of rhinology & allergy, 29(1), 57–62. doi.org/10.2500/ajra.2015.29.4116
Seidman, M. D., Gurgel, R. K., Lin, S. Y., Schwartz, S. R., Baroody, F. M., Bonner, J. R., Dawson, D. E., Dykewicz, M. S., Hackell, J. M., Han, J. K., Ishman, S. L., Krouse, H. J., Malekzadeh, S., Mims, J. W., Omole, F. S., Reddy, W. D., Wallace, D. V., Walsh, S. A., Warren, B. E., Wilson, M. N., … Guideline Otolaryngology Development Group. AAO-HNSF (2015). Clinical practice guideline: Allergic rhinitis. Otolaryngology–head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 152(1 Suppl), S1–S43. doi.org/10.1177/0194599814561600
Hauswald, B., & Yarin, Y. M. (2014). Acupuncture in allergic rhinitis: A Mini-Review. Allergo journal international, 23(4), 115–119. doi.org/10.1007/s40629-014-0015-3
Taw, M. B., Reddy, W. D., Omole, F. S., & Seidman, M. D. (2015). Acupuncture and allergic rhinitis. Current opinion in otolaryngology & head and neck surgery, 23(3), 216–220. doi.org/10.1097/MOO.0000000000000161
Individuals with digestive problems that cannot be diagnosed could be experiencing functional gastrointestinal disorders. Could understanding the types help in developing effective treatment plans?
Functional Gastrointestinal Disorders
Functional gastrointestinal disorders, or FGDs, are disorders of the digestive system in which the presence of structural or tissue abnormality cannot explain symptoms. Functional gastrointestinal disorders lack identifiable biomarkers and are diagnosed based on symptoms. (Christopher J. Black, et al., 2020)
Rome Criteria
FGDs used diagnoses of exclusion, meaning that they could only be diagnosed after organic/identifiable disease was ruled out. However, in 1988, a group of researchers and healthcare providers met to devise strict criteria for the diagnosis of the various types of FGDs. The criteria is known as the Rome Criteria. (Max J. Schmulson, Douglas A. Drossman. 2017)
Vomiting and Aerophagia – cyclic vomiting syndrome, adolescent rumination syndrome, and aerophagia
Abdominal Pain-Related Functional GI Disorders include:
functional dyspepsia
IBS
Abdominal migraine
Childhood functional abdominal pain
Childhood functional abdominal pain syndrome
Constipation – functional constipation
Incontinence – nonretentive fecal incontinence
Diagnosis
Although the Rome criteria allow the diagnosis of FGDs to be symptom-based, a healthcare provider may still run standard diagnostic tests to rule out other diseases or look for structural problems resulting in symptoms.
Treatment
Although no visible signs of disease or structural problems may be identified as causing the symptoms, it does not mean that they are not treatable and manageable. For individuals who suspect they may have or have been diagnosed with a functional gastrointestinal disorder, it will be essential to work with a healthcare provider on a working treatment plan. Treatment options can include: (Asma Fikree, Peter Byrne. 2021)
Physical therapy
Nutritional and dietary adjustments
Stress management
Psychotherapy
Medication
Biofeedback
Eating Right To Feel Better
References
Black, C. J., Drossman, D. A., Talley, N. J., Ruddy, J., & Ford, A. C. (2020). Functional gastrointestinal disorders: advances in understanding and management. Lancet (London, England), 396(10263), 1664–1674. doi.org/10.1016/S0140-6736(20)32115-2
Schmulson, M. J., & Drossman, D. A. (2017). What Is New in Rome IV. Journal of neurogastroenterology and motility, 23(2), 151–163. doi.org/10.5056/jnm16214
Sperber, A. D., Bangdiwala, S. I., Drossman, D. A., Ghoshal, U. C., Simren, M., Tack, J., Whitehead, W. E., Dumitrascu, D. L., Fang, X., Fukudo, S., Kellow, J., Okeke, E., Quigley, E. M. M., Schmulson, M., Whorwell, P., Archampong, T., Adibi, P., Andresen, V., Benninga, M. A., Bonaz, B., … Palsson, O. S. (2021). Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gastroenterology, 160(1), 99–114.e3. doi.org/10.1053/j.gastro.2020.04.014
Hyams, J. S., Di Lorenzo, C., Saps, M., Shulman, R. J., Staiano, A., & van Tilburg, M. (2016). Functional Disorders: Children and Adolescents. Gastroenterology, S0016-5085(16)00181-5. Advance online publication. doi.org/10.1053/j.gastro.2016.02.015
Fikree, A., & Byrne, P. (2021). Management of functional gastrointestinal disorders. Clinical medicine (London, England), 21(1), 44–52. doi.org/10.7861/clinmed.2020-0980
For individuals looking to increase their antioxidant, fiber, and vitamin intake, can adding pomegranates to their diet help?
Pomegranates
Pomegranates can amplify various dishes, from breakfasts to sides to dinners, with their balanced blend of mild sweetness, tartness, and crunch from their seeds.
Health Benefits
The fruit has been found to be a healthy source of vitamins, fiber, and antioxidants. A medium-sized fruit contains:
FoodData Central. U.S. Department of Agriculture. (2019) Pomegranates, raw.
Zarfeshany, A., Asgary, S., & Javanmard, S. H. (2014). Potent health effects of pomegranate. Advanced biomedical research, 3, 100. doi.org/10.4103/2277-9175.129371
For individuals with digestive and other health issues, could resistant starch provide health benefits?
Resistant Starch
Typical starchy foods are simple starches that are rapidly digested. This sends their sugars into the bloodstream, contributing to weight gain and increasing the risk of diabetes and heart disease. (Erik E. J. G. Aller, et al., 2011) Resistant starch is a food component that is a type resistant to digestion. This means that it passes into the large intestine and interacts with the gut flora. Foods that contain resistant starch pass through the stomach and small intestine without being absorbed. In the large intestine, they are fermented by the gut bacteria which releases substances that are beneficial to health.
Health Benefits
Studies on the health benefits are ongoing. Scientists are researching how it can help with weight management and colon health:
Weight Management
Research is beginning to show indications that foods with resistant starch can help with weight loss and the ability to help offset the diseases associated with weight gain that include: (Janine A. Higgins. 2014)
High cholesterol
Diabetes
Metabolic syndrome
Cardiovascular disease
Colon Health
In addition, researchers are finding preliminary evidence indicating that resistant starch might possibly help with: (Diane F. Birt, et al., 2013)
A prebiotic that encourages a healthy balance of gut flora.
Inflammatory bowel disease symptom improvement.
Prevention of colon cancer.
Protection against diverticulitis.
However, more research is needed.
Consumption Amount
Estimates on how much should be consumed range from a minimum of 6 grams to a maximum of 30 grams. It is estimated that most individuals consume less than 5 grams per day, (Mary M. Murphy, et al., 2008). As individuals increase their intake, it is recommended to do so slowly, to minimize unwanted gas and bloating.
Bananas
Bananas are a healthy source of resistant starch.
They have the maximum amount when they are unripe.
The resistant starch content reduces as the banana ripens.
If green/unripe bananas are not appealing, making a smoothie can help with the taste.
Potatoes
Potatoes have their highest level of resistant starch when raw.
However, individuals can maximize their intake by allowing the potatoes to cool before eating.
Rice
Levels of resistant starch depend on whether the rice is white or brown.
Similar to potatoes, intake can be maximized from rice by allowing the rice to cool.
Oats
Cooking oats in water, as most are accustomed to making oatmeal, diminishes the resistant starch content.
Rolled or steel-cut oats are recommended as dependable sources of resistant starch.
Chickpeas
Chickpeas, also known as garbanzo beans, are nutritional powerhouses.
They are a healthy source of dietary fiber, along with many vitamins and minerals, and resistant starch.
Cooked and/or canned chickpeas contain high levels of resistant starch.
They go with salads or as a side dish or snack.
For individuals with IBS, well-rinsed canned chickpeas are considered to be low in FODMAPs or carbohydrates that can contribute to symptoms. (Anamaria Cozma-Petruţ, et al., 2017)
It is recommended to keep the serving size to a 1/4 cup.
Lentils
Lentils serve as a healthy source of plant-based protein.
Cooked they can provide resistant starch.
They can be prepared in soups or side dishes.
From a can, they can be IBS-friendly by being well-rinsed and limited to a 1/2 cup serving.
Bread
Various breads offer varying levels of resistant starch.
Pumpernickel bread contains high levels.
Breadsticks and pizza crusts have high levels.
Individuals with IBS may be reactive to the FODMAP fructan or the gluten protein.
Other recommended high-resistant starch options are corn tortillas or artisanal sourdough bread that is traditionally prepared.
Green Peas
Green peas, even when cooked, are a healthy source of resistant starch.
They can be prepared in soups or as a side dish.
However, green peas have been found to be high in the FODMAP GOS and could be problematic for individuals with IBS. (Anamaria Cozma-Petruţ, et al., 2017)
Beans
Most types of cooked and/or canned beans are recommended sources of resistant starch.
The highest levels are found in white and kidney beans.
They can be served in soups, as a side dish, or mixed with rice.
Beans are a high-FODMAP food and could contribute to digestive symptoms in individuals with IBS.
Body In Balance: Chiropractic Fitness and Nutrition
References
Aller, E. E., Abete, I., Astrup, A., Martinez, J. A., & van Baak, M. A. (2011). Starches, sugars and obesity. Nutrients, 3(3), 341–369. doi.org/10.3390/nu3030341
Higgins J. A. (2014). Resistant starch and energy balance: impact on weight loss and maintenance. Critical reviews in food science and nutrition, 54(9), 1158–1166. doi.org/10.1080/10408398.2011.629352
Birt, D. F., Boylston, T., Hendrich, S., Jane, J. L., Hollis, J., Li, L., McClelland, J., Moore, S., Phillips, G. J., Rowling, M., Schalinske, K., Scott, M. P., & Whitley, E. M. (2013). Resistant starch: promise for improving human health. Advances in nutrition (Bethesda, Md.), 4(6), 587–601. doi.org/10.3945/an.113.004325
Murphy, M. M., Douglass, J. S., & Birkett, A. (2008). Resistant starch intakes in the United States. Journal of the American Dietetic Association, 108(1), 67–78. doi.org/10.1016/j.jada.2007.10.012
Cozma-Petruţ, A., Loghin, F., Miere, D., & Dumitraşcu, D. L. (2017). Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients!. World journal of gastroenterology, 23(21), 3771–3783. doi.org/10.3748/wjg.v23.i21.3771
It can be difficult for individuals and athletes to stay motivated, manage stress and prevent becoming overwhelmed. Can mental toughness and a positive attitude help increase potential and performance levels?
Mental Toughness
Athletes and fitness enthusiasts work on conditioning, skills training, and perfecting techniques. Physical training can take individuals far but another necessary part of maximizing athletic potential is building mental toughness and having the right attitude. Like anything, mental training takes time, effort, and regular adjustments to find ways to shift a losing or bad attitude into a positive one that can bring out the best.
Attitude Is Important
If negativity begins to set in like dealing with an injury, getting rid of self-limiting beliefs can be difficult, as well as generate optimism to rise up and succeed. For athletes or individuals who enjoy competitive sports, developing a positive mental attitude will help with:
Emotions that can affect cognitive functioning strategies.
Energy levels.
Other aspects of physical performance.
Mental Strategies
Mood Improvement
Individuals frustrated by a pessimistic perspective tend to dwell on problems or issues. To shift into a positive mood do something to lift your spirits, even if you don’t think it will help.
Listen to your favorite or uplifting music.
Watch an inspirational movie.
Read a sports psychology book.
Get together or call a teammate or friend that are cheerful and upbeat.
Play different games just for fun.
Take a break, go to the park, walk around, and meditate.
Get into hobbies.
Relax with a therapeutic massage.
Positive Self Talk
Continuing sports psychology research shows that practicing positive self-talk can improve athletic performance. (Nadja Walter, et al., 2019) Sports psychologists describe this through the idea that thoughts create beliefs, that drive actions.
Positive self-talk can take different forms.
For some reciting a specific phrase, sentence, or a single word can effectively manage thoughts, push out the negativity, and focus on taking care of business. Anything that inspires can include:
Focus
Remember the fundamentals!
You know what to do!
You can do it!
You got this!
Research shows that positive self-talk reduces anxiety and increases self-confidence, optimization, efficacy, and performance. (Nadja Walter, et al., 2019) However, self-talk needs to be practiced and part of a regular routine to be effective.
Visualization
Another strategy is using visualization exercises.
This could be using all the senses to imagine the venue where the tournament is taking place, the sound of the crowd, the smells, how the ground or court feels, and/or how the ball or specific sports object feels.
The wisdom is if you can think it, you can do it, once that is determined apply strategies to get there.
Sports Injury Rehabilitation
References
Walter, N., Nikoleizig, L., & Alfermann, D. (2019). Effects of Self-Talk Training on Competitive Anxiety, Self-Efficacy, Volitional Skills, and Performance: An Intervention Study with Junior Sub-Elite Athletes. Sports (Basel, Switzerland), 7(6), 148. doi.org/10.3390/sports7060148
Reiser, M., Büsch, D., & Munzert, J. (2011). Strength gains by motor imagery with different ratios of physical to mental practice. Frontiers in psychology, 2, 194. doi.org/10.3389/fpsyg.2011.00194
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