Back Clinic Nutrition Team. Food provides people with the necessary energy and nutrients to be healthy. By eating various foods, including good quality vegetables, fruits, whole-grain products, and lean meats, the body can replenish itself with the essential proteins, carbohydrates, fats, vitamins, and minerals to function effectively. Nutrients include proteins, carbohydrates, fats, vitamins, minerals, and water. Healthy eating does not have to be hard.
The key is to eat various foods, including vegetables, fruits, and whole grains. In addition, eat lean meats, poultry, fish, beans, and low-fat dairy products and drink lots of water. Limit salt, sugar, alcohol, saturated fat, and trans fat. Saturated fats usually come from animals. Look for trans fat on the labels of processed foods, margarine, and shortenings.
Dr. Alex Jimenez offers nutritional examples and describes the importance of balanced nutrition, emphasizing how a proper diet combined with physical activity can help individuals reach and maintain a healthy weight, reduce their risk of developing chronic diseases, and promote overall health and wellness.
Can fruit help with a sweet craving for individuals trying to limit sugar?
Fruits Low In Sugar
Fruits and their natural sugars: Whether following a low-carbohydrate diet or having diabetes and watching your A1C, many have heard that fruit is either bad or okay because of its natural sugars. Sugars in fruit are natural. How they affect blood sugar depends on various factors, like which foods they’re paired with and if diabetes is a factor. Counting carbs or noting the glycemic index or glycemic load of foods being eaten, understanding low-sugar fruits can help make choices that best fit your dietary needs. Certain fruits are considered lower in sugar because they contain fewer carbohydrates and sugar, allowing you to consume a larger portion.
One serving of fruit has about 15 grams of carbohydrates.
A serving is one small apple, half a medium-sized banana, or a cup of berries.
Fruits like berries can be eaten in more significant portions for the same amount of carbohydrates but less sugar.
Fruits
Low-sugar fruits include:
Lemons and Limes
Rhubarb
Apricots
Cranberries
Guava
Raspberries
Blackberries
Kiwi
Figs
Tangerines
Grapefruit
Natural Sugar
How much fruit an individual eats may differ if they follow a specific low-carb meal plan or are counting or modifying their carbohydrate intake because of diabetes. Adults should consume two cups of fruit or juice or a half-cup of dried fruit daily. (U.S. Department of Health and Human Services and U.S. Department of Agriculture, 2015) Most fruits have a low glycemic index/GI because of the amount of fiber they contain and because the sugar is mostly fructose. However, dried fruits like raisins, dates, sweetened cranberries, melons, and pineapples have a medium glycemic index. Sweetened dried fruits have an even higher glycemic index.
Fruits from Lowest to Highest Content
Fruits are a healthy way to satisfy a sweet craving. The fruits listed are ranked from lowest to highest sugar content, providing a quick way to assess sugar content. The fruits lowest in sugar have some of the highest nutritional values, plus antioxidants and other phytonutrients.
Limes and Lemons
Limes contain:
1.1 grams of sugar
7 grams of carbs
1.9 grams of fiber per fruit
Lemons contain:
1.5 grams of sugar
5.4 grams of carbs
1.6 grams of fiber per fruit
Rhubarb
Rhubarb contains:
1.3 grams of sugar
5.5 grams of carbs
2.2 grams of fiber per cup
Apricots
Apricots contain:
3.2 grams of sugar
3.8 grams of carbs
0.7 grams of fiber per small apricot
Apricots are available fresh in spring and early summer. They can be eaten whole, skin and all. However, watch portions of dried apricots as they shrink when dried.
Cranberries
Cranberries contain:
3.8 grams of sugar
12 grams of carbs
3.6 grams of fiber per cup when fresh.
While they’re low in sugar, be aware that they are usually sweetened when dried or used in a recipe.
Guavas
Guava contains:
4.9 grams of sugar
7.9 grams of carbs
3 grams of fiber per fruit
They can be sliced or dipped in salty sauce, including the rind.
Berries
These fruits generally have the lowest sugar content and are among the highest in fiber, antioxidants, and other nutrients. Berries, lemon, and lime can be added to flavor water.
Raspberries
Raspberries contain:
5.4 grams of sugar
14.7 grams of carbs
8 grams of fiber per cup
Eat a handful, or use them as a topping or ingredient. Fresh in summer or frozen year-round.
Blackberries
Blackberries contain:
7 grams of sugar
13.8 grams of carbs
7.6 grams of fiber per cup
Strawberries contain:
7.4 grams of sugar
11.7 grams of carbs
3 grams of fiber per cup
Berries are excellent choices for a snack, a fruit salad, or an ingredient in a smoothie, sauce, or dessert.
Blueberries
Blueberries contain:
15 grams of sugar
21 grams of carbs
3.6 grams of fiber per cup
While blueberries are higher in sugar than other berries, they’re packed with powerful antioxidants.
Kiwis
Kiwis contain:
6.2 grams of sugar
10.1 grams of carbs
2.1 grams of fiber per kiwi
Kiwis have a mild flavor, and the seeds and skin can be eaten.
Figs
Figs contain:
6.5 grams of sugar
7.7 grams of carbs
1.2 grams of fiber per small fig
These figures are for fresh figs, and it may be harder to estimate for dried figs of different varieties, which can have 5 to 12 grams of sugar per fig.
Tangerines
Tangerines contain:
8 grams of sugar
10.1 grams of carbs
1.3 grams of fiber per medium fruit
These low-sugar citrus fruits have less sugar than oranges and are great for salads. They are also portable, making them healthy additions to packed lunches and snacks.
Grapefruit
Grapefruit contains:
8.5 grams of sugar
13 grams of carbs
2 grams of fiber per half fresh grapefruit
Individuals can enjoy fresh grapefruit in a fruit salad or by itself, adjusting the amount of sugar or sweetener.
Low-Carb Diets
Individuals following a low-carb eating plan should remember that while some popular diet plans factor in the glycemic index or glycemic load of foods, others only factor in the number of carbohydrates.
20 Grams of Carbohydrates or Less
Individuals will likely not consume fruit or rarely substitute it for other food items with less than 20 grams of carbohydrates daily.
Nutrients are obtained from vegetables.
Some diets don’t even allow low-sugar fruits in the first phase.
20-50 Grams of Carbohydrates
These eating plans allow 20 to 50 grams of carbs daily, allowing room for one daily fruit serving.
50-100 Grams of Carbohydrates
If the eating plan allows 50 to 100 grams of carbs per day, individuals may be able to follow the FDA guidelines for two fruit servings a day, as long as other resources of carbohydrates are limited.
Other popular plans, like the Paleo diet and Whole30, don’t place a limit on fruit.
Although not necessarily a low-carb diet, Weight Watchers also allows fruit.
In general, individuals following a low-carb diet are recommended to try to eat fruits low in sugar.
Diabetes
Fruit choices when managing diabetes will depend on the type of diet being followed. For example, when counting carbohydrates, individuals should know that 1/2 cup of frozen or canned fruit has about 15 grams of carbohydrates.
Enjoy 3/4 to 1 cup of fresh berries, melon, or 17 grapes for the same carbs.
If using the plate method, add a small piece of whole fruit or 1/2 cup of fruit salad to the plate.
When using the glycemic index to guide food choices, remember that most fruits have a low GI and are encouraged.
Melons, pineapples, and dried fruits have medium GI index values, so watch portion size.
Individuals with diabetes may want to consult their primary doctor or a registered dietitian to help design an eating plan that incorporates fruit appropriately.
Body In Balance: Chiropractic, Fitness, and Nutrition
References
U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at health.gov/dietaryguidelines/2015/guidelines/
Can knowing the difference between butter and margarine help Individuals looking to improve cholesterol levels?
Butter and Margarine
Individuals watching their cholesterol levels and switching from butter to margarine may have heard that it may be worse for heart health. What research has to say about the healthiest spread and the butter and margarine debate?
History
Butter was shown to be associated with an increased risk of heart disease because of its saturated fat content when margarine was developed as a substitute. Margarine is made from plant-based oils like canola, palm fruit, and soybeans. Nutritionists and researchers saw it as a healthier alternative. It is lower in saturated fat and has no cholesterol but contains high levels of trans fats, which raise unhealthy LDL cholesterol levels and lower healthy HDL cholesterol levels. (Ginter, E., and Simko, V. 2016)
Margarine Trans Fat and Butter Saturated Fat
Most of margarine’s unsaturated fats undergo hydrogenation, creating harmful trans fats. Trans fat raises unhealthy LDL cholesterol levels more than saturated fat. The trans-fatty acids solidify and maintain margarine consistency at room temperature. Stick margarines, the hardest type, contain the most trans fats and are still sold despite what is known about the damage they can do. (Brouwer, I. A. et al., 2010) Clinical studies showed these trans fats are associated with a 28% increased risk of death from heart disease and a 34% increased risk of death. (de Souza, R. J. et al., 2015)
Margarine Types
Some softer and liquid margarine products contain less trans fat than stick versions. They are low in saturated fat and high in unsaturated fat. Individuals can determine how much trans fat the margarine has by its softness. Those that are more solid at room temperature contain more trans fats than those in a tub, which are softer. However, some soft options can contain trans fats. If the label has partially hydrogenated oil, it’s recommended to avoid it. (Garsetti, M. et al., 2016) Some newer margarines are enriched with plant sterols, which block cholesterol absorption and help lower LDL levels. These are healthy choices if trying to lower LDL. (Ras, R. T. et al., 2014)
Butter
Butter is primarily made up of saturated fat and cholesterol and comes in a stick and spread. One tablespoon of butter contains around 30 milligrams of cholesterol and 7 grams of saturated fat. The maximum amount allowed daily is 200 milligrams and 10 milligrams, respectively. Both types of fat are linked to rising cholesterol levels and the risk of heart disease. Butter from grass-fed cows is higher in omega-3 fatty acids, essential for heart health, making it far more nutritional than the more widely used butter from conventionally-fed cows. (Hebeisen, D. F. et al., 1993)
Other Options
Butter or margarine are not the healthiest options. Olive, avocado, and other vegetable-based spreads are the most heart-healthy options. (Yubero-Serrano, E. M. et al., 2019) Use avocado oil as a cooking oil when sautéing or roasting vegetables. Consider substituting applesauce, nut butters, or squash purees in baked goods. Look for soft versions of margarine as a bread spread that contain plant sterols and no hydrogenated oils.
Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach to create personalized care plans for each patient to restore health and function to the body through Nutrition and Wellness, Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.
Enhancing Health Together: Multidisciplinary Evaluation and Treatment
References
Ginter, E., & Simko, V. (2016). New data on harmful effects of trans-fatty acids. Bratislavske lekarske listy, 117(5), 251–253. doi.org/10.4149/bll_2016_048
Brouwer, I. A., Wanders, A. J., & Katan, M. B. (2010). Effect of animal and industrial trans fatty acids on HDL and LDL cholesterol levels in humans–a quantitative review. PloS one, 5(3), e9434. doi.org/10.1371/journal.pone.0009434
de Souza, R. J., Mente, A., Maroleanu, A., Cozma, A. I., Ha, V., Kishibe, T., Uleryk, E., Budylowski, P., Schünemann, H., Beyene, J., & Anand, S. S. (2015). Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ (Clinical research ed.), 351, h3978. doi.org/10.1136/bmj.h3978
Garsetti, M., Balentine, D. A., Zock, P. L., Blom, W. A., & Wanders, A. J. (2016). Fat composition of vegetable oil spreads and margarines in the USA in 2013: a national marketplace analysis. International journal of food sciences and nutrition, 67(4), 372–382. doi.org/10.3109/09637486.2016.1161012
Ras, R. T., Geleijnse, J. M., & Trautwein, E. A. (2014). LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies. The British journal of nutrition, 112(2), 214–219. doi.org/10.1017/S0007114514000750
Hebeisen, D. F., Hoeflin, F., Reusch, H. P., Junker, E., & Lauterburg, B. H. (1993). Increased concentrations of omega-3 fatty acids in milk and platelet rich plasma of grass-fed cows. International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition, 63(3), 229–233.
Yubero-Serrano, E. M., Lopez-Moreno, J., Gomez-Delgado, F., & Lopez-Miranda, J. (2019). Extra virgin olive oil: More than a healthy fat. European journal of clinical nutrition, 72(Suppl 1), 8–17. doi.org/10.1038/s41430-018-0304-x
Can incorporating tonic water benefit individuals who want to drink more water?
Tonic Water
Tonic water is more than just water. Its bitter taste comes from quinine, a natural substance found in the bark of the Peruvian cinchona tree. Most store-bought tonic water contains quinine, with natural or artificial flavors from fruits or herbs to temper the bitterness, varying from brand to brand.
Tonic water calories can be high. Some brands can have up to 114 calories per bottle. The reason is they use a sweetener. Some brands have a diet version with zero calories and no sugar but may contain more sodium.
Fats and Protein
There is no fat or protein in tonic water.
Sugar
Some brands use high fructose syrup, while others use cane sugar or sugar from the other ingredients. For example, adding an alcoholic ingredient to make a tonic cocktail can significantly increase the calorie count.
Sodium
Depending on the variety and the amount drunk, tonic water can be a source of sodium. However, sodium intake should be 1500 milligrams per day.
Carbohydrates
There are 33 grams of carbohydrates per serving with the estimated glycemic load or the numerical value that estimates how much a food will raise an individual’s blood sugar to around four.
Micronutrients
There are no significant vitamins or minerals but a small amount of sodium, zinc, and copper.
Health
Quinine is FDA-approved in specific doses to treat malaria. However, the quinine in tonic water is less than prescribed for medicinal purposes. (Achan, J. et al., 2011) Some individuals have tried to use quinine for leg cramps. However, the FDA has warned that this is not recommended and can cause harm. (U.S. Food and Drug Administration. 2017)
Other Water Beverages
There are other water alternatives to reduce calories, sodium, and added sugar.
Seltzer
Seltzer is carbonated water, similar to club soda, with no calories or added sweeteners.
Add lemon or other fruit for flavor.
Mineral water
Mineral water tastes like seltzer, but the carbonation is usually natural.
Flavored water
Flavored water provides some nutrients and antioxidants from the vegetables and fruits.
It is a great alternative if the other options don’t work.
Allergies
It is possible to have an allergy to quinine that could cause a reaction when drinking tonic water. (Winter F. D., Jr. 2015) In these cases, the research suggests, the allergy may cause:
Individuals can make tonic water with online recipes using different herbs and flavors. Tonic water made at home may or may not be lower in calories than store-bought brands, but the ingredients can be controlled to create beverages that cater to personal tastes. Using tonic or sparkling water, keep the bottled water tightly capped and chilled to maintain carbonation and ready to serve.
Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans to restore health and function to the body through Nutrition and Wellness, Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. If the individual needs other treatment, they will be referred to a clinic or specialist best suited for them, as Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.
Achan, J., Talisuna, A. O., Erhart, A., Yeka, A., Tibenderana, J. K., Baliraine, F. N., Rosenthal, P. J., & D’Alessandro, U. (2011). Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria. Malaria journal, 10, 144. doi.org/10.1186/1475-2875-10-144
Howard, M. A., Hibbard, A. B., Terrell, D. R., Medina, P. J., Vesely, S. K., & George, J. N. (2003). Quinine allergy causing acute severe systemic illness: report of 4 patients manifesting multiple hematologic, renal, and hepatic abnormalities. Proceedings (Baylor University. Medical Center), 16(1), 21–26. doi.org/10.1080/08998280.2003.11927884
Winter F. D., Jr (2015). Immune thrombocytopenia associated with consumption of tonic water. Proceedings (Baylor University. Medical Center), 28(2), 213–216. doi.org/10.1080/08998280.2015.11929233
Can understanding night cravings help individuals who constantly eat at night plan meals that satisfy and choose nutritious snacks?
Eating At Night
Snacking after dinner and eating at night is common and not bad; however, snacking mindfully can help one truly enjoy and savor snacks. Consider some of the reasons why you might be hungry or not completely satisfied after dinner. Improving the nutritional value of nighttime snacks can make late-night hunger work toward meeting nutritional needs. Common reasons include:
Not meeting the right macronutrient balance during dinner.
Not being completely satisfied with dinner.
Dehydration.
Macronutrient Profile
Getting the right amount of carbohydrates, fat, and protein during dinner is integral to feeling satisfied. Adults need 130g of carbohydrates, 56g of protein, and 3.7L of water daily. The amount of fat required varies, but monounsaturated and polyunsaturated fats are the most healthy fats to consume, helping the body feel satisfied. Several studies show that eating protein during a meal reduces hunger and decreases cravings. (Kohanmoo, A. et al., 2020)
Unsatisfying Dinner
Another reason individuals eat at night is that they are unsatisfied with dinner. Eating satiating foods can help the mind and body feel full throughout the evening.
Satiety is the sense of satisfaction from food.
Foods high in fiber and healthy fats are known to help produce satisfaction.
When the body is full and satisfied, it produces hormones that signal to the brain there is no need to continue eating.
Try to plan healthy meals that are genuinely exciting to eat.
Create time to cook and make and eat meals you can genuinely enjoy.
Dehydration
Sometimes, when the body is dehydrated, it can have difficulty distinguishing thirst from hunger. As a result, some may eat in reaction to dehydration. This isn’t always bad, as some foods, specifically water-rich foods like melon and other fruits, can provide hydration. But sometimes, individuals don’t realize they are misreading their body’s thirst for hunger, and they reach for any food. They are still dehydrated, so they keep eating. If hunger persists after dinner, drink a glass of water and wait 20 minutes to see if that impacts hunger.
Maximize Nutrition
Snacking at night is not bad, but it is wise to plan to ensure the body gets the right balance of nutrients.
Satisfy Cravings
Many crave something sweet after dinner or later on. Eating healthy foods that satisfy cravings will help trigger hormones that tell the body it is done eating. Keep your favorite fruits and vegetables for a quick bite to get some sweetness and fiber. Vegetables like red bell peppers and carrots provide sweetness and crunchiness and can be satisfying. One small red pepper provides 100% of the daily recommended Vitamin C in 20 calories. (U.S. Department of Agriculture. Agricultural Research Service. 2018)
Foods that Promote Sleep
The foods chosen can affect sleep. Whole grains, walnuts, cherries, and kiwi increase serotonin and decrease the stress hormone cortisol. Complex carbohydrates contain melatonin, a hormone responsible for feeling sleepy. A whole-grain snack is a healthy choice before going to bed. (Nisar, M. et al., 2019) Some research shows that dark chocolate is rich in magnesium and can help promote deep sleep. However, it also contains caffeine, which can inhibit sleep. If dark chocolate is a favorite, make sure to eat it early enough in the evening.
Alternative Nighttime Routine
Some people eat out of boredom at night. To curb this, individuals in this category should change their routines. Here are a few tips to help adjust nighttime habits.
Healthy After-Dinner Activities
Go for a quick walk after dinner. 10 to 20 minutes can help, as physical activity signals the shift from dinner to other evening activities.
It also gives the body a chance to feel the fullness sensation.
Hobbies and other light meditative activities can help take the mind off eating.
Watch TV Mindfully
Many individuals eat more at night because snacking can go on and on in front of the television.
Use smart and healthy snacking strategies like portion control.
Remember to take a drink of water in between snacking.
Stay active – simple chores or activities while watching TV can help avoid overeating.
Rest and Sleep
Not getting enough sleep has been linked with increased appetite. (Hibi, M. et al., 2017)
Engage in activities to encourage rest.
Meditation can help calm down the mind and body.
Consider going to bed earlier.
Using an integrated approach, Dr. Jimenez’s Functional Medicine Team aims to restore health and function to the body through Nutrition and Wellness, Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. We focus on what works for the individual through researched methods and total wellness programs.
Eating Right to Feel Better
References
Kohanmoo, A., Faghih, S., & Akhlaghi, M. (2020). Effect of short- and long-term protein consumption on appetite and appetite-regulating gastrointestinal hormones, a systematic review and meta-analysis of randomized controlled trials. Physiology & behavior, 226, 113123. doi.org/10.1016/j.physbeh.2020.113123
Nisar, M., Mohammad, R. M., Arshad, A., Hashmi, I., Yousuf, S. M., & Baig, S. (2019). Influence of Dietary Intake on Sleeping Patterns of Medical Students. Cureus, 11(2), e4106. doi.org/10.7759/cureus.4106
Hibi, M., Kubota, C., Mizuno, T., Aritake, S., Mitsui, Y., Katashima, M., & Uchida, S. (2017). Effect of shortened sleep on energy expenditure, core body temperature, and appetite: a human randomised crossover trial. Scientific reports, 7, 39640. doi.org/10.1038/srep39640
For individuals with diabetes or who are watching their sugar intake, is sugar-free candy a healthy choice?
Sugar-Free Candy
Sugar-free candies can be an option for individuals with diabetes and those watching their sugar intake. Different types of sweeteners are used in sugar-free candies, with pros and cons and possible side effects.
Ingredients
Sugar-free candies use artificial sweeteners or sugar substitutes to generate a sweet taste. Most of these sweeteners have fewer calories and carbohydrates than sugar, but not all are calorie or carb-free. Some sugar substitutes on labels include:
Aspartame
Saccharin
Sucralose
Aspartame, saccharin, stevia, and sucralose are calorie-free and carb-free.
Stevia is a non-alcoholic, non-artificial sugar substitute made from plant leaves.
Sugar alcohols – erythritol, xylitol, maltitol, lactitol, and sorbitol contain some carbohydrates.
Pros
Pros over candies sweetened with sugar.
Satisfies Cravings
Sugar-free candies can satisfy sweet cravings with less impact on blood sugar than their full-sugar counterparts.
For some individuals, especially with irritable bowel syndrome/IBS, sugar alcohols can cause unpleasant gastrointestinal side effects like bloating and diarrhea. (Mäkinen K. K. 2016)
It is recommended to avoid large amounts, especially for individuals with a sensitive stomach. (Evert, A. B. et al., 2019)
Taste
There may be an irregular or unfamiliar taste that can require getting used to.
Try other types and brands.
Carbohydrates
Always read the label.
The sweetener may contain some or none.
Other ingredients may have added carbohydrates.
For example, sugar-free chocolates may be high in saturated fat from ingredients like cocoa butter.
Appetite stimulants
Zero-calorie sweeteners may stimulate appetite, leading to eating more, which can be counterproductive to dietary goals. (Azad, M. B. et al., 2017)
Options
Choosing which types are best depends on personal taste and health goals.
Because of fatty ingredients, sugar-free chocolates may not be recommended if heart problems exist or fat intake must be limited.
Hard candies may be a better option.
Sugar alcohols can have an impact on blood sugar levels, which may make the candies less than ideal for those with diabetes. Digestive side effects can make them less appealing as well.
Some artificial sweeteners may cause discomfort. Learning the body’s response will help when choosing.
When it comes to taste, note what the preferred candy is sweetened with, as well as other ingredients, to guide future purchases.
Choose a snack that blends something sweet with other healthy ingredients, like fiber or protein, whole grains, nuts, or dried fruit. For example, strawberries with dark chocolate or apple slices with peanut butter.
Dr. Jimenez Functional Medicine Team. Healthy eating does not have to be hard. Using an integrated approach, we aim to restore health and function to the body through Nutrition and Wellness, Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. If the patient needs other treatment, they will be referred to a clinic or physician best suited for them, as Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments. We focus on what works for you and strive to better the body through researched methods and total wellness programs.
Mäkinen K. K. (2016). Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals. International journal of dentistry, 2016, 5967907. doi.org/10.1155/2016/5967907
Evert, A. B., Dennison, M., Gardner, C. D., Garvey, W. T., Lau, K. H. K., MacLeod, J., Mitri, J., Pereira, R. F., Rawlings, K., Robinson, S., Saslow, L., Uelmen, S., Urbanski, P. B., & Yancy, W. S., Jr (2019). Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes care, 42(5), 731–754. doi.org/10.2337/dci19-0014
Azad, M. B., Abou-Setta, A. M., Chauhan, B. F., Rabbani, R., Lys, J., Copstein, L., Mann, A., Jeyaraman, M. M., Reid, A. E., Fiander, M., MacKay, D. S., McGavock, J., Wicklow, B., & Zarychanski, R. (2017). Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 189(28), E929–E939. doi.org/10.1503/cmaj.161390
Can knowing the serving size help lower sugar and calories for individuals who enjoy eating dried fruits?
Dried Fruits
Dried fruits, like cranberries, dates, raisins, and prunes, are great because they last a long time and are healthy sources of fiber, minerals, and vitamins. However, dried fruits contain more sugar and calories per serving because they lose volume when dehydrated, allowing more to be consumed. This is why the serving size matters to ensure one does not overeat.
Serving Size
Fruits are dried in dehydrators or left in the sun to dehydrate naturally. They are ready once most of the water has disappeared. The loss of water decreases their physical size, which allows individuals to eat more, increasing sugar and calorie intake. For example, around 30 grapes fit in a single measuring cup, but 250 raisins can fill one cup once dehydrated. Nutritional information for fresh and dried fruit.
Thirty raisins have 47 calories and under 10 grams of sugar.
Grapes’ natural sugar content varies, so different types can be subject to nutritional value assessments.
Some fruits, like cranberries, can be very tart, so sugar or fruit juices are added during drying.
Ways to Use
Fresh fruit may be higher in certain vitamins, but mineral and fiber content are retained during drying. Dried fruits are versatile and can be made part of a healthy, balanced diet that can include:
Lightly sweeten oatmeal with a small serving of dried fruits for a hearty and healthy breakfast.
Salads
Toss dark, leafy greens, fresh apple slices, dried cranberries or raisins, and cheeses.
Main Course
Use dried fruit as an ingredient in savory entrees.
Protein Bar Substitutes
Raisins, dried blueberries, apple chips, and dried apricots are convenient and last longer than fresh fruit, making them perfect when protein bars are unavailable.
At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for you to achieve improvement goals and create an improved body through research methods and total wellness programs.
For individuals who are getting into exercise, fitness, and physical activity, can knowing how glycogen works help in workout recovery?
Glycogen
When the body needs energy, it draws on its glycogen stores. Low-carbohydrate, ketogenic diets and intense exercise deplete glycogen stores, causing the body to metabolize fat for energy. Glycogen is supplied through carbohydrates in an individual’s diet and is used to power the brain, physical activity, and other bodily functions. The molecules made from glucose are mainly stored in the liver and muscles. What is eaten, how often, and the activity level influence how the body stores and uses glycogen. Restoring glycogen after physical activity or working out is a vital part of the recovery process. The body can quickly mobilize glycogen from these storage sites when it needs fuel. Eating enough carbohydrates to reach health goals and activity levels is essential for success.
What Is It
It is the body’s stored form of glucose or sugar.
It is stored in the liver and muscles.
It is the body’s primary and preferred energy source.
It comes from carbohydrates in foods and drinks.
It is made from several connected glucose molecules.
Production and Storage
Most carbohydrates eaten are converted to glucose, which becomes the body’s main energy source. However, when the body doesn’t need fueling, the glucose molecules become linked chains of eight to 12 glucose units, forming a glycogen molecule.
Process Triggers
Eating a carbohydrate-containing meal will raise blood glucose levels in response.
Increasing glucose signals the pancreas to produce insulin, a hormone that helps the body’s cells take up glucose from the bloodstream for energy or storage.
Insulin activation causes the liver and muscle cells to produce an enzyme called glycogen synthase, which links glucose chains together.
With enough glucose and insulin, glycogen molecules can be delivered to the liver, muscles, and fat cells for storage.
Since most glycogen is found in the muscles and liver, the amount stored in these cells varies depending on activity level, how much energy is burned at rest, and the foods eaten. The muscles primarily use glycogen stored in the muscles, while glycogen stored in the liver is distributed throughout the body, mainly to the brain and spinal cord.
Body Usage
The body converts glucose to glycogen through a process called glycogenesis. During this process, various enzymes help the body break down glycogen in glycogenolysis so the body can use it. The blood has a set amount of glucose ready to go at any given time. The insulin levels also drop when the level begins to decline, either from not eating or burning glucose during exercise. When this happens, an enzyme known as glycogen phosphorylase starts breaking the glycogen down to supply the body with glucose. Glucose from liver glycogen becomes the body’s primary energy. Short bursts of energy use glycogen, whether during sprints or heavy lifting. (Bob Murray, Christine Rosenbloom, 2018) A carbohydrate-rich pre-workout drink can provide energy to exercise longer and recover quicker. Individuals should eat a post-workout snack with a balanced amount of carbohydrates to replenish glycogen stores. The brain also uses glucose for energy, with 20 to 25% of glycogen going toward powering the brain. (Manu S. Goyal, Marcus E. Raichle, 2018) Mental sluggishness or brain fog can develop when not enough carbohydrates are consumed. When glycogen stores are depleted through exercise or insufficient carbs, the body can feel fatigued and sluggish and perhaps experience mood and sleep disturbances. (Hugh S. Winwood-Smith, Craig E. Franklin 2, Craig R. White, 2017)
Diet
What foods are eaten and how much physical activity an individual does also influence glycogen production. The effects can be acute if one follows a low-carb diet, where carbohydrates, the primary source of glucose synthesis, are suddenly restricted.
Fatigue and Brain Fog
When first starting a low-carb diet, the body’s glycogen stores can be severely depleted and individuals may experience symptoms like fatigue and brain fog. (Kristen E. D’Anci et al., 2009)
The symptoms begin to subside once the body adjusts and renews its glycogen stores.
Water Weight
Any amount of weight loss can have the same effect on glycogen stores.
Initially, individuals may experience a rapid drop in weight.
Over time, weight may plateau and possibly increase.
The phenomenon is partly due to glycogen composition, which is also water. Rapid glycogen depletion at the onset of the diet triggers the loss of water weight. Over time, glycogen stores are renewed, and the water weight returns. When this happens, weight loss can stall or plateau. Fat loss can continue despite the short-term plateau effect.
Exercise
If undertaking a strenuous exercise routine, there are strategies to help avoid decreased performance that may be helpful:
Carbo-loading
Some athletes consume excessive amounts of carbohydrates before working out or competing.
Extra carbohydrates provide plenty of fuel.
The method has fallen out of favor as it can lead to excess water weight and digestive issues.
Glucose Gels
Energy gels containing glycogen can be consumed before or as needed during an event to increase blood glucose levels.
For example, energy chews are effective supplements for runners to help increase performance during extended runs.
Low-Carb Ketogenic Diet
Eating a diet high in fat and low in carbohydrates can put the body in a keto-adaptative state.
In this state, the body begins to access stored fat for energy and relies less on glucose for fuel.
At Injury Medical Chiropractic and Functional Medicine Clinic, our providers use an integrated approach to create personalized care plans for each individual, often including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to restore health and function to the body.
Sports Nutrition and Sports Dietician
References
Murray, B., & Rosenbloom, C. (2018). Fundamentals of glycogen metabolism for coaches and athletes. Nutrition reviews, 76(4), 243–259. doi.org/10.1093/nutrit/nuy001
Goyal, M. S., & Raichle, M. E. (2018). Glucose Requirements of the Developing Human Brain. Journal of pediatric gastroenterology and nutrition, 66 Suppl 3(Suppl 3), S46–S49. doi.org/10.1097/MPG.0000000000001875
Winwood-Smith, H. S., Franklin, C. E., & White, C. R. (2017). Low-carbohydrate diet induces metabolic depression: a possible mechanism to conserve glycogen. American journal of physiology. Regulatory, integrative and comparative physiology, 313(4), R347–R356. doi.org/10.1152/ajpregu.00067.2017
D’Anci, K. E., Watts, K. L., Kanarek, R. B., & Taylor, H. A. (2009). Low-carbohydrate weight-loss diets. Effects on cognition and mood. Appetite, 52(1), 96–103. doi.org/10.1016/j.appet.2008.08.009
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