Back Clinic Diets. The sum of food consumed by any living organism. The word diet is the use of specific intake of nutrition for health or weight management. Food provides people with the necessary energy and nutrients to be healthy. By eating various healthy 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.
Having a healthy diet is one of the best things to prevent and control various health problems, i.e., types of cancers, heart disease, high blood pressure, and type 2 diabetes. Dr. Alex Jimenez offers nutritional examples and describes the importance of balanced nutrition throughout this series of articles. In addition, Dr. Jimenez emphasizes how a proper diet combined with physical activity can help individuals reach and maintain a healthy weight, reduce their risk of developing chronic diseases like heart disease, and ultimately promote overall health and wellness.
For individuals looking to maintain wellness or begin their wellness journey like increasing antioxidants, protection against cancer, immune system support and other health benefits, can adding onions be a nutritious way to improve overall health?
Onions
Onions are nutritious vegetables like garlic, chives, leeks, and shallots. The most common types are red, white, yellow, and Spanish onions. They have antifungal, antibacterial, anti-inflammatory, and other healthful properties.
Whichever way they are prepared they do lose some of their nutritional value when cooked.
They contain flavonoids, glutathione, selenium compounds, vitamin E, and vitamin C.
When selecting onions, look for those without blemishes or discoloration, that are firm, and have dry, papery skins.
Benefits
They contain phytochemicals – compounds plants produce to fight off harmful bacteria, viruses, and fungi. These phytochemicals provide health benefits when consumed and provide the following properties: (Xin-Xin Zhao, et al., 2021)
Protect the cardiovascular, digestive, respiratory, reproductive, and neurological systems.
Protect against liver disease.
Support a healthy immune system.
Types and Varieties
They belong to the Allium plant genus which includes plants like garlic, leeks, and chives. (Oregon State University. 2022)
They vary in flavor and can be sweet, tangy, and sour.
Different varieties combined with farming practices contribute to the flavor profile of onions.
There are many varieties of onions.
The most common and widely available are red, white, yellow, and Spanish.
Other types include cipollini, pearl, and Vidalia.
Raw or Cooked
They are beneficial whether eaten raw or cooked, cooking them reduces the number of thiosulfinates – compounds that provide antimicrobial, antifungal, and antibiotic properties.
Boiling and frying onions has been shown to cause the most significant loss in nutritious value.
Other preparation methods that decrease health benefits include sautéing, steaming, and microwaving.
Baking onions is shown to increase flavonoid levels.
Consuming dried, powdered onions can also provide nutritious value to foods, especially if the powder is freeze-dried. (Damini Kothari, et al., 2020)
Nutrition Facts
Onions can contribute to a healthy diet. The flavonoids, glutathione, selenium compounds, vitamin E, and vitamin C, contribute to the antioxidant properties of the vegetable. (Holly L. Nicastro, et al., 2015) The nutrition information for one medium onion: (U.S. Department of Agriculture. N.D.)
Total calories: 44
Total fat: 0 grams
Cholesterol: 0 milligrams
Carbohydrates: 10 grams
Dietary fiber: 2 grams
Total sugars: 5 grams
Protein: 1 grams
Calcium: 2 milligrams
Sodium: 4 milligrams
Iron: 1 milligrams
Vitamin D: 0 micrograms
When Selecting
Onions can contain pesticide residue, heavy metals, microbial contamination, and nitrate accumulation. Knowing where the onions come from can help ensure there was no incorrect use of pesticides or that the soil they were grown in was not enriched with heavy metals. When possible, purchase from reputable sources with transparent farming practices, like the farmers markets. (Xin-Xin Zhao, et al., 2021)
Onions found in environments that have not been effectively sterilized have an increased risk of growing harmful bacteria.
To avoid contamination of Escherichia. coli or E. coli, salmonella, and mold, it’s safest to purchase whole onions and cut them at home rather than purchasing pre-chopped onions. (Xin-Xin Zhao, et al., 2021)
Select those that feel firm, have little to no bruises or discolored spots, and have dry papery skin.
Avoid those that show evidence of mold, like white or black spots on the surface or inside the layers, and those with green shoots, which means the onion is still edible but won’t last that long.
Hypertension Diet
References
Zhao, X. X., Lin, F. J., Li, H., Li, H. B., Wu, D. T., Geng, F., Ma, W., Wang, Y., Miao, B. H., & Gan, R. Y. (2021). Recent Advances in Bioactive Compounds, Health Functions, and Safety Concerns of Onion (Allium cepa L.). Frontiers in nutrition, 8, 669805. doi.org/10.3389/fnut.2021.669805
Nicastro, H. L., Ross, S. A., & Milner, J. A. (2015). Garlic and onions: their cancer prevention properties. Cancer prevention research (Philadelphia, Pa.), 8(3), 181–189. doi.org/10.1158/1940-6207.CAPR-14-0172
Kothari, D., Lee, W. D., & Kim, S. K. (2020). Allium Flavonols: Health Benefits, Molecular Targets, and Bioavailability. Antioxidants (Basel, Switzerland), 9(9), 888. doi.org/10.3390/antiox9090888
Individuals need to eat more fiber for optimal gut health. Can adding avocado to their diet help improve the gut microbe diversity?
Avocado Gut Support
A diverse gut microbiome is beneficial to overall health. According to a recent study, eating one avocado a day can help maintain the gut microbes healthy, diverse, and balanced. (Sharon V. Thompson, et al., 2021) The researchers observed positive changes in gut bacteria and increased bacterial diversity in individuals who consumed an avocado every day for 12 weeks. (Susanne M Henning, et al., 2019)
Gut Diversity
The gut microbiome refers to the microorganisms living in the intestines. There are around 100 trillion microorganisms, including bacteria, viruses, fungi, and more, exist in the gastrointestinal tract. (Ana M. Valdes, et al., 2018) Having a diverse microbiome means that the body has a range of different organisms that offer various health benefits. Not having enough bacterial diversity has been linked to: (Ana M. Valdes, et al., 2018)
Arthritis
Obesity
Type 1 diabetes
Type 2 diabetes
Inflammatory bowel disease
Celiac disease
Arterial stiffness
Atopic eczema
Why Avocados?
The Institute of Medicine recommends a daily fiber intake ranging from 19 grams to 38 grams per day, depending on various factors like age. (Diane Quagliani, Patricia Felt-Gunderson. 2016)
Including foods like avocados in a healthy diet can help meet daily fiber requirements.
Fruit fiber like pectin, has been shown to promote a healthy gut microbiome as well. (Beukema M, et al., 2020)
Researchers suggest this could be because of pectin’s positive effect on beneficial probiotics.(Nadja Larsen, et al., 2018)
Although further research is needed fiber is believed to help protect the lining of the colon by increasing the bulk and weight of stool and expediting elimination.
Fiber also adds bulk to an individual’s diet and slows the speed of digestion, which makes the body feel fuller longer.
Improved Gut
Individuals can support a healthy microbiota by making small adjustments in their diet, including:
Eating a variety of fruits and vegetables with the skin, as this is where a majority of the nutrition is.
Fermented foods like yogurt, kombucha, sauerkraut, kimchi, and kefir.
Limiting consumption of processed foods, sugar, and artificial sweeteners.
If there are more avocados that can be eaten before they overripen, they can be frozen.
Peel and slice them first, then place them in freezer bags to have year-round.
They are rich in healthy fat, however, in moderation, they are not likely to contribute to weight gain.
Individuals can work toward having a diverse gut microbiome by paying attention to the foods they eat. Specific foods and dietary patterns can influence the different types of bacterial diversity which can support health.
Smart Choices, Better Health
References
Thompson, S. V., Bailey, M. A., Taylor, A. M., Kaczmarek, J. L., Mysonhimer, A. R., Edwards, C. G., Reeser, G. E., Burd, N. A., Khan, N. A., & Holscher, H. D. (2021). Avocado Consumption Alters Gastrointestinal Bacteria Abundance and Microbial Metabolite Concentrations among Adults with Overweight or Obesity: A Randomized Controlled Trial. The Journal of nutrition, 151(4), 753–762. doi.org/10.1093/jn/nxaa219
Henning, S. M., Yang, J., Woo, S. L., Lee, R. P., Huang, J., Rasmusen, A., Carpenter, C. L., Thames, G., Gilbuena, I., Tseng, C. H., Heber, D., & Li, Z. (2019). Hass Avocado Inclusion in a Weight-Loss Diet Supported Weight Loss and Altered Gut Microbiota: A 12-Week Randomized, Parallel-Controlled Trial. Current developments in nutrition, 3(8), nzz068. doi.org/10.1093/cdn/nzz068
Valdes, A. M., Walter, J., Segal, E., & Spector, T. D. (2018). Role of the gut microbiota in nutrition and health. BMJ (Clinical research ed.), 361, k2179. doi.org/10.1136/bmj.k2179
Quagliani, D., & Felt-Gunderson, P. (2016). Closing America’s Fiber Intake Gap: Communication Strategies From a Food and Fiber Summit. American journal of lifestyle medicine, 11(1), 80–85. doi.org/10.1177/1559827615588079
Beukema, M., Faas, M. M., & de Vos, P. (2020). The effects of different dietary fiber pectin structures on the gastrointestinal immune barrier: impact via gut microbiota and direct effects on immune cells. Experimental & molecular medicine, 52(9), 1364–1376. doi.org/10.1038/s12276-020-0449-2
Larsen, N., Cahú, T. B., Isay Saad, S. M., Blennow, A., & Jespersen, L. (2018). The effect of pectins on survival of probiotic Lactobacillus spp. in gastrointestinal juices is related to their structure and physical properties. Food microbiology, 74, 11–20. doi.org/10.1016/j.fm.2018.02.015
“For individuals looking to improve their quality of life, can substituting healthy meal ingredients be a simple step toward better health?”
Food Substitutions
Eating well does not mean having to give up favorite foods. Part of the enjoyment of home cooking is putting one’s own style on each dish. Individuals soon discover they prefer healthy food substitutions to the original high-fat, high-sugar, or high-sodium ingredients. Healthy swaps can be introduced gradually to allow the taste buds to adapt. It is possible to reduce:
Calories
Unhealthy fats
Sodium
Refined sugars
Simply making smart swaps that replace some ingredients with more beneficial ones.
Ingredients for Healthier Meals
Recipes are the sum of their parts. A dish made with multiple ingredients adds its own nutrition for healthy or unhealthy. Ingredients high in calories, saturated fat, added sugars, and/or sodium can make a dish less nutritious. By making strategic food substitutions, individuals can transform a high-calorie, high-fat, sugary dish into something more nutritious. When done regularly this adjustment leads to long-term healthy behavior changes. Making small adjustments leads to improvements in weight management, heart health, and risk of chronic diseases.
Substituting Unhealthy Fats and Oils
Fat is a necessary nutrient, however, diets high in saturated fat have been linked with an increased risk of coronary artery disease, (Geng Zong, et al., 2016)
and high cholesterol levels. (American Heart Association. 2021)
Foods like butter, coconut oil, and lard are some of the most used saturated fats.
Conversely, research shows that eating more unsaturated fats is usually associated with better cardiovascular health and lower overall mortality. (Harvard T.H. Chan School of Public Health. 2016)
Instead of baking with butter, try using applesauce, mashed avocados, or mashed bananas.
These plant-based alternatives don’t overload the body with saturated fat.
Try using half butter and half an alternative to cut calories and fats.
For cooking, try sautéing, roasting, or pan-frying in olive or avocado oil.
Both contain healthy monounsaturated fats.
These oils can be used for dipping bread with dinner or for a quick snack.
Fresh herbs or a dash of balsamic vinegar can add flavor.
Refined Sugars
Enjoying sweets can be healthy, but the objective is to be mindful of how much-refined sugar is consumed. Sweet flavors send signals to the reward centers in the brain, increasing positive associations with sugar. However, eating high amounts of sugar can lead to:
An array of other herbs and spices can amplify the flavor of meals.
Purchase or create various flavor blends.
For example, cumin, chili powder, oregano, and red pepper flakes can spice up a dish or a blend of thyme, paprika, garlic powder, and onion powder can add savory notes.
A study found that adding lemon juice to recipes could reduce sodium content and add tanginess. (Sunkist Growers. 2014)
Whole Grains
Individuals don’t have to choose brown rice or whole wheat pasta for every meal but try to select whole grains half of the time. Food substitutions that can help achieve the halfway point include:
Popcorn or whole wheat crackers instead of refined flour crackers.
Whole wheat pizza crust instead of regular crust.
Substitute brown rice for white in stir-fries or casseroles.
Oatmeal instead of refined grain cereal.
Whole wheat pasta for spaghetti and meatballs or other pasta dishes.
Quinoa as a side dish instead of white rice or couscous.
More whole grains equals more fiber and B vitamins to help sustain energy, prevent blood sugar spikes, and promote digestive health. Eating more whole grains has been linked with a reduced risk of heart disease (Caleigh M Sawicki, et al. 2021) and a lower risk of colon cancer. (Glenn A. Gaesser. 2020)
Finding the right combination of each of these substitutions takes time. Go slow and taste often to see how each substitution affects a recipe’s taste and texture.
Boost Metabolism
References
Zong, G., Li, Y., Wanders, A. J., Alssema, M., Zock, P. L., Willett, W. C., Hu, F. B., & Sun, Q. (2016). Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies. BMJ (Clinical research ed.), 355, i5796. doi.org/10.1136/bmj.i5796
American Heart Association. Saturated fat.
Harvard T.H. Chan School of Public Health. Different dietary fat, different risk of mortality.
Faruque, S., Tong, J., Lacmanovic, V., Agbonghae, C., Minaya, D. M., & Czaja, K. (2019). The Dose Makes the Poison: Sugar and Obesity in the United States – a Review. Polish journal of food and nutrition sciences, 69(3), 219–233. doi.org/10.31883/pjfns/110735
Harvard Health Publishing. The sweet danger of sugar.
American Heart Association. How much sugar is too much?
Centers for Disease Control and Prevention. How to Reduce Sodium Intake.
Sunkist Growers. Sunkist Growers and Chefs from Johnson & Wales University Release New S’alternative® Research.
Sawicki, C. M., Jacques, P. F., Lichtenstein, A. H., Rogers, G. T., Ma, J., Saltzman, E., & McKeown, N. M. (2021). Whole- and Refined-Grain Consumption and Longitudinal Changes in Cardiometabolic Risk Factors in the Framingham Offspring Cohort. The Journal of nutrition, 151(9), 2790–2799. doi.org/10.1093/jn/nxab177
Gaesser G. A. (2020). Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies. Nutrients, 12(12), 3756. doi.org/10.3390/nu12123756
For individuals with peanut allergies, can finding a peanut alternative be as satisfying as a real creamy or crunchy peanut butter sandwich?
Peanut Butter Sandwich Alternatives
For individuals who are unable to have a peanut butter sandwich due to an allergy, there are healthy satisfying alternatives. Tree nut butter, seed butter, and deli meats can all satisfy sandwich cravings and provide nutrition. Here are a few healthy, nutritious alternatives to try out:
Sunflower Seed Butter and Jam, Jelly, or Preserves
It can be substituted for a PBJ with jam, jelly, and preserves.
Ham and Cheese, Grainy Mustard on Rye Bread
Getting ham and cheese from the deli can potentially have cross-contamination with allergens during slicing and packaging.
Prepackaged and sliced ham and cheese is a safer bet in terms of allergens.
It is recommended to read the ingredient label for potential allergens, as processing in facilities can have cross-contamination issues. (William J. Sheehan, et al., 2018)
Turkey, Tomato, Lettuce, and Hummus on Whole Grain Bread
The same is true for turkey and is recommended to buy prepackaged and sliced.
Check the ingredients for possible allergens.
Hummus is made from chickpeas/garbanzo beans and tahini/ground sesame seeds.
Hummus comes in a variety of flavors that can be used as a dip or spread.
Although chick peas’ are a member of the legume family, hummus can be tolerated with peanut allergies. (Mathias Cousin, et al., 2017)
Check with a healthcare provider if unsure.
Pita Pocket with Salad and Hummus
Pita pockets are great with hummus stuffed with vegetables.
This is a delicious crunchy pocket sandwich loaded with protein, fiber vitamins, and minerals.
Cashew butter on a hot English muffin with raisins on top for a boost of iron is reminiscent of a cinnamon roll.
Pumpkin Seed Butter and Honey Sandwich
Pumpkin butter is made from the orange flesh of the pumpkin.
Pumpkin seed butter is made by roasting pumpkin seeds and grinding them to a butter consistency.
The seed butter can be spread on bread and drizzled with some honey on top for a nutritious and delicious snack.
There are tasty healthy peanut butter alternatives that can be mixed, matched, and reinvented into various satisfying sandwiches. Individuals are recommended to consult their healthcare provider or a dietician or nutritionist to find what works for them.
Smart Choices, Better Health
References
Lavine, E., & Ben-Shoshan, M. (2015). Allergy to sunflower seed and sunflower butter as a proposed vehicle for sensitization. Allergy, asthma, and clinical immunology: Official Journal of the Canadian Society of Allergy and Clinical Immunology, 11(1), 2. doi.org/10.1186/s13223-014-0065-6
U.S. Department of Agriculture: FoodData Central. Seeds, sunflower seed butter, with salt added (Includes foods for USDA’s Food Distribution Program).
Sheehan, W. J., Taylor, S. L., Phipatanakul, W., & Brough, H. A. (2018). Environmental Food Exposure: What Is the Risk of Clinical Reactivity From Cross-Contact and What Is the Risk of Sensitization. The journal of allergy and clinical immunology. In practice, 6(6), 1825–1832. doi.org/10.1016/j.jaip.2018.08.001
Gorrepati, K., Balasubramanian, S., & Chandra, P. (2015). Plant-based butters. Journal of food science and technology, 52(7), 3965–3976. doi.org/10.1007/s13197-014-1572-7
Cousin, M., Verdun, S., Seynave, M., Vilain, A. C., Lansiaux, A., Decoster, A., & Sauvage, C. (2017). Phenotypical characterization of peanut-allergic children with differences in cross-allergy to tree nuts and other legumes. Pediatric allergy and immunology: Official publication of the European Society of Pediatric Allergy and Immunology, 28(3), 245–250. doi.org/10.1111/pai.12698
Almond Board of California. Nutrient comparison chart for tree nuts.
American Academy of Allergy, Asthma and Immunology. Everything you need to know about a tree nut allergy.
The brain and body need macronutrients that include carbohydrates, fats, and protein in the right amounts to energize the body. About half of the calories should come from carbohydrates, 30% from fat, and 20% from protein. Food energy density is the amount of energy, represented by the number of calories, in a specific weight measurement.
Food Energy Density
Energy density is determined by the proportion of macronutrients – protein, fat, carbohydrates, fiber, and water.
Energy-dense foods are high in calories per serving.
Foods with large amounts of fiber and water have a lower density.
Foods high in fat have an increased energy density.
An example of a high-energy-density food is a donut because of the high-calorie count from the sugar, fat, and small serving size.
An example of a low-energy-density food is spinach because it only has a few calories in a whole plate of raw spinach leaves.
Energy Dense Foods
Energy-dense foods contain a high number of calories/energy per gram. They are typically higher in fat and lower in water. Examples of energy-dense foods include:
Full-fat dairy
Butter
Cheese
Nut butter
Fatty cuts of meat
Starchy vegetables
Thick sauces
Nuts
Seeds
Less nutrient-dense foods include:
Sweets
Deep-fried foods
French fries
Pasta
Crackers
Chips
Foods like soups and beverages can be either high or low energy density depending on the ingredients. Broth-based soups with vegetables usually have low density while creamed soups are energy-dense. Non-fat milk is less dense than regular milk, and diet soda is less dense than regular soda.
Low Energy Dense Foods
Foods with low energy density include high-fiber green and colorful vegetables.
Foods with low energy density are often nutrient-dense, which means they have plenty of nutrients per serving size.
Many fruits, berries, and vegetables are low in calories, high in fiber, and packed with vitamins and minerals.
Foods high in water content like citrus fruits and melons are usually less energy-dense.
Low-calorie foods often have a low energy density, but not always.
It’s important to read nutrition labels to know how many calories are being provided daily.
Weight Management
Weight management is about watching how many calories are taken in and how many calories are burned.
Filling up on foods with low energy density will cause the body to feel satisfied while eating fewer high-density calories.
Plan all meals so they include foods with a low energy density and high in nutrients.
However, the opposite can happen if individuals eat mostly low-energy-dense foods, will need a larger volume of food to fill up, and as a result, will take in more calories.
This is not ideal for losing weight, but it could be helpful if trying to gain weight.
High-energy-dense foods that are nutritious include avocados, nuts, and seeds.
Adjustment Recommendations
Add More Fruits and Vegetables To The Plate
At least half of a plate should be covered with low-calorie fruits and vegetables.
Berries are sweet and delicious and provide antioxidants
Leave a quarter of the plate for the protein, and the remaining quarter can hold a serving of starchy foods like pasta, potatoes, or rice.
Eating more fruits and vegetables will partially fill the body leading to eating less high-energy-dense foods.
Picky eaters should try various recipes, sooner or later, they will discover something they enjoy.
Start With Salad or a Bowl of Clear Broth Soup
Soups and salads will fill the body before the main energy-dense course like pasta, pizza, or another high-calorie food.
Avoid heavy cream-based salad dressings and creamed soups.
Water has zero calories and drinking a few glasses can help suppress the hunger until the next meal, or a low-density snack.
Fernandez, Melissa Anne, and André Marette. “Potential Health Benefits of Combining Yogurt and Fruits Based on Their Probiotic and Prebiotic Properties.” Advances in nutrition (Bethesda, Md.) vol. 8,1 155S-164S. 17 Jan. 2017, doi:10.3945/an.115.011114
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Prentice, A M. “Manipulation of dietary fat and energy density and subsequent effects on substrate flux and food intake.” The American Journal of clinical nutrition vol. 67,3 Suppl (1998): 535S-541S. doi:10.1093/ajcn/67.3.535S
Slesser, M. “Energy and food.” Basic life sciences vol. 7 (1976): 171-8. doi:10.1007/978-1-4684-2883-4_15
Specter, S E et al. “Reducing ice cream energy density does not condition decreased acceptance or engender compensation following repeated exposure.” European Journal of clinical nutrition vol. 52,10 (1998): 703-10. doi:10.1038/sj.ejcn.1600627
Westerterp-Plantenga, M S. “Effects of the energy density of daily food intake on long-term energy intake.” Physiology & behavior vol. 81,5 (2004): 765-71. doi:10.1016/j.physbeh.2004.04.030
A satisfying salad is a great way to get more fruits and vegetables high in vitamins, minerals, and fiber. A salad using the right ingredients can be a filling meal. With the summer heat kicking in, making a quick, satisfying salad using your favorite ingredients can help cool off, rehydrate, and refuel the body.
Making A Satisfying Salad
Leafy Greens
Start with leafy greens.
They’re low in calories and a healthy source of fiber.
Different varieties include iceberg lettuce, leaf lettuce, spinach, escarole, romaine, kale, and butter lettuce.
Starchy vegetables like roasted sweet potatoes or cooked butternut squash.
These provide fiber, complex carbohydrates, vitamins, and minerals.
Fruit
Fruits or berries, blueberries, raspberries, blackberries, pomegranate seeds, apple slices, oranges, dates, and raisins can add vitamins, fiber, and antioxidants.
One-half cup of apple slices has 30 calories.
One-half cup of berries has about 40 calories.
Protein
A hard-boiled egg is an excellent source of protein.
A serving of lean beef, cooked shrimp, tuna, chicken breast, cheese strips, beans or legumes, hummus, tofu, or cottage cheese.
Be mindful of portion size.
A quarter cup of chopped chicken meat or one egg will add 75 calories.
Half a can of tuna adds about 80 calories.
Depending if it is low fat, two ounces of cubed or shredded mozzarella or cheddar cheese can add 200 calories.
Nuts or Seeds
Almonds, cashews, walnuts, pecans, sunflower, pumpkin, or chia seeds are great for added crunch.
All nuts add protein and heart-healthy polyunsaturated and monounsaturated fatty acids.
One-eighth cup of nuts adds around 90 calories.
Walnuts contain omega-3 fatty acids.
Salad Dressing
Add salad dressing.
One tablespoon of regular commercial salad dressing adds 50 to 80 calories.
Low-fat and reduced-calorie dressings are available.
Adding beans will increase fiber, protein, and total carbohydrates.
Body Signals Decoded
References
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Sebastian, Rhonda S., et al. “Salad Consumption in the U.S. What We Eat in America, NHANES 2011-2014.” FSRG Dietary Data Briefs, United States Department of Agriculture (USDA), February 2018.
Yen, P K. “Nutrition: salad sense.” Geriatric nursing (New York, N.Y.) vol. 6,4 (1985): 227-8. doi:10.1016/s0197-4572(85)80093-8
Dr. Jimenez, D.C., presents how to find the right diet for cardiometabolic syndrome in this 2-part series. Many environmental factors often play a role in our health and wellness. In today’s presentation, we continue discussing how genes play with the cardiometabolic diet. Part 1 looked at how every body type is different and how the cardiometabolic diet plays its role. We mention our patients to certified medical providers that provide available therapy treatments for individuals suffering from chronic conditions associated with metabolic connections. We encourage each patient when it is appropriate by referring them to associated medical providers based on their diagnosis or needs. We understand and accept that education is a marvelous way when asking our providers’ crucial questions at the patient’s request and acknowledgment. Dr. Alex Jimenez, D.C., uses this information as an educational service. Disclaimer
Omega-3s & Genes
Dr. Alex Jimenez, D.C., presents: We’ve found that fish oils or omega-3s can lower triglycerides, small-density LDL, and sometimes lower LDL and keep HDL regulated. But these studies were back when they were supplementing with more of an even DHA/EPA ratio. But that’s something to be observant of; the study showed that giving them fish oil lowers their small density LDL and triglycerides. They also found that if they gave them a lower fat food plan, and a lower fat diet, they found it lowered their LDL and small density LDL. A moderate fat diet reduced their LDL, but it increased their small density LDL. And they found that average alcohol consumption lowered their HDL and increased their LDL. So that’s not a good sign when that happens. So the opposite of what you want to occur with a moderate alcohol consumption diet or food plan.
So going back to APO-E4 in the body, how would this gene be affected when dealing with viral infections like herpes or cold sores? So research studies have revealed that APO-E4 and herpes simplex one viruses can affect the brain’s cerebral tissues. So the research also indicates that patients with APO-E4 are more susceptible to getting the herpes virus. And remember, herpes simplex one virus is what causes cold sores. What about HSV and dementia? How would that correlate with the body? The research indicates that HSV increases the risk of dementia. And what the thought is is that just like the herpes virus can come out and cause cold sores, it can internally manifest, and you can get these episodes where HSV becomes active in the brain, which can cause some of the pathogenesis of dementia or Alzheimer’s disease.
APO-E & Finding The Right Diet
Dr. Alex Jimenez, D.C., presents: And there was a study that showed that if you gave patients with dementia antivirals, it decreased the risk of getting dementia. So what do we do with the APO-E genotype? If you have APO-E2, APO-E3, or APO-E4, you can start them on the cardiometabolic food plan. If they’re on the SAD diet, the standard American diet, then putting them on the cardiometabolic food plan is just a good idea. It’s going to start shifting them in the right direction. What about additional consideration if they have APO-E3/4 and APO-E4/4? There are a couple of reasons you should jump in on this. They like it more when you customize a diet to a patient’s genetics. So if you can say, listen, we have your genes, and we know that you would do better if you had lower saturated fat, or if you don’t do so well on alcohol X, Y, or Z, it makes them pay attention more.
Because now it’s personalized. It’s not like, “Hey, everybody, just eat healthily.” It’s more personalized to your genetics. So, that would be a reason to start this from the get-go. But get them on the cardiometabolic food plan, and they should begin to feel better. But we would start by putting the whole thing in perspective that this APO-E3/4 and APO-E4/4 is not a death sentence. It’s a clue of how you respond to your environment and what we need to watch out for. It does not mean that you are going to get Alzheimer’s. The majority of people with Alzheimer’s do not have APO-E4. You have a higher risk of getting Alzheimer’s if you have APO-E4. And that’s where functional medicine comes in to risk-stratify them.
Finding The Right Diet For You
Dr. Alex Jimenez, D.C., presents: We recommend a lower simple carbohydrate diet or a higher glycemic index diet. And diet and food plan interchangeably, but patients call it a food plan because diet has negative connotations. So we avoid the word diet because when people hear or speak it, some people are triggered by it. You have people with food disorders and people with bad experiences with diets. A lower fat and a lower saturated fat food plan or recommendation is something to consider and be more aggressive with omega-3s. And if you start giving omega-3s to the patients, it is best to check their omega-3 levels and see if they begin to fluctuate. If they start shifting for the better, then we strongly advise against alcohol and monitor these patients for cognitive decline; there are different tools that you can use.
When it comes to omega-3s, it is best to do a cognitive test to keep an eye on their mentation. So if it starts to decline, you’re jumping in way before you have a major problem. And because of the issue of them not being able to deal with viral infections like herpes. And because the herpes virus may play a role in getting dementia, you may consider lysine supplementation. Arginine can deplete lysine. So if you end up eating a lot of pumpkin seeds and a lot of almonds and whatnot that have higher amounts of arginine, you can counteract that with lysine. And the research suggested that you need about two grams of lysine daily. But remember, every patient is different, so don’t just throw everybody on lysine if they have APO-E3/4, APO-E4, or APO-E44 3 but just something to consider.
So final thoughts on APO-E and nutrition. There are many pieces to the puzzle. Do not be dogmatic and say you have these genes, so you must do this. Just realize there are so many different genes, so many other variabilities, and recognize that it’s not that race can have something to do with how APO-E is affected. For example, they did a study that found that people in Nigeria had higher amounts of APO-E4, and the APO-E4 four did not increase their risk of dementia. So there are other pieces of the puzzle, monitor biomarkers and continue to adjust the plan. Next, we will discuss dealing with people with high triglycerides and high LDL.
What To Do With Abnormal Lipids?
Dr. Alex Jimenez, D.C., presents: So how do you take the abnormal lipid findings that you see on your profiles of your patients, those biomarkers, as all of us check? And how do you adjust the cardiometabolic food plan? What of the highlights of a cardiometabolic food plan that you will do for your patient in response to their lipids? Let’s first review a few things we know about how to modulate the diet’s lipids. First, we know that if you go from a standard American diet to the cardiometabolic food plan. You remove the trans fatty acids, and if you remove the trans fatty acids, then you will see a decrease in LDL cholesterol triglycerides. You’ll get an improvement in HDL; to say it another way, if your diet is high in trans fatty acids, you’ll have a higher LDL you have, you’ll have more elevated triglycerides, and you’ll have lower HDL.
How To Modulate Your Diet
Dr. Alex Jimenez, D.C., presents: What else about modulating the diet? If you have longer chain fatty acids that are not polyunsaturated, you’ll have an increase in your LDL and triglycerides and an increase or no change in your HDL cholesterol. On the other hand, we focus a lot on the shorter chain fatty acids and functional medicine. So if you have shorter chain fatty acids that are less than ten carbons, you’ll have lower LDL cholesterol triglycerides and increased HDL. So you can see with the cardiometabolic food plan, by addressing with the patient, their fat source, you can begin to impact LDL cholesterol without anti-triglycerides, without any other modulation other than dietary habit. And then finally, we know the data early and some of the most recent meta-analyses of changing simple sugars in the diet.
We know that that can, in its own right, increase LDL cholesterol triglycerides, and you get a lowering of HDL. So let’s put this all in context. What do we want to do for our patients to decrease the risk of coronary artery disease or atherosclerosis fat disease? We want their LDL cholesterol to be in a lower range. We do not wish for that LDL to be oxidized. We want the HDL to be higher. And if we can get triglycerides down through dietary change, then that gives us a clue that they might not be dysfunctional in the insulin metabolism. Then finally, with omega-3 fatty acids or adding omega-3 fatty acids or mono-concentrated fatty acids, we’ll lower LDL cholesterol triglycerides, and we’ll get an increase in HDL cholesterol. This is associated with a reduction in cardiovascular risk independent of lipid levels.
Conclusion
Dr. Alex Jimenez, D.C., presents: How is that affecting the body? It is because you have inflammatory drivers independent of your serum lipids that will increase your risk of atherosclerosis disease. It comes to saturated fat and fat content. Balancing the proteins, and the fat, you don’t have as much oxidative stress associated with inflammation after a meal. Thus, even if you have an elevated LDL level, you have less chance of having an increased oxidized LDL. Incorporating fibrous foods, antioxidants, lean meats, dark leafy greens, and supplements into a healthy diet can help lower LDL and fatty acids in the body and reduce all these comorbidities causing issues to your health and wellness.
So, those are just some tips and tricks for diet prescription to reduce cardiometabolic syndrome. And we encourage your patients to add more greens, legumes, nuts, and seeds, making the plant-based diet a mainstay for their heart health.
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