Clinic Wellness Team. A key factor to spine or back pain conditions is staying healthy. Overall wellness involves a balanced diet, appropriate exercise, physical activity, restful sleep, and a healthy lifestyle. The term has been applied in many ways. But overall, the definition is as follows.
It is a conscious, self-directed, and evolving process of achieving full potential. It is multidimensional, bringing together lifestyles both mental/spiritual and the environment in which one lives. It is positive and affirms that what we do is, in fact, correct.
It is an active process where people become aware and make choices towards a more successful lifestyle. This includes how a person contributes to their environment/community. They aim to build healthier living spaces and social networks. It helps in creating a person’s belief systems, values, and a positive world perspective.
Along with this comes the benefits of regular exercise, a healthy diet, personal self-care, and knowing when to seek medical attention. Dr. Jimenez’s message is to work towards being fit, being healthy, and staying aware of our collection of articles, blogs, and videos.
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
For individuals who are dealing with constant constipation due to medications, stress, or lack of fiber, can walking exercise help encourage regular bowel movements?
Walking For Constipation Assistance
Constipation is a common condition. Too much sitting, medications, stress, or not getting enough fiber can result in infrequent bowel movements. Lifestyle adjustments can regulate most cases. One of the most effective ways is to incorporate regular moderate-vigorous exercise, encouraging the bowel muscles to contract naturally (Huang, R., et al., 2014). This includes jogging, yoga, water aerobics, and power or brisk walking for constipation alleviation.
The Research
A study analyzed middle-aged obese women who had chronic constipation over a 12-week period. (Tantawy, S. A., et al., 2017)
The first group walked on a treadmill 3 times a week for 60 minutes.
The second group did not engage in any physical activity.
The first group had greater improvement in their constipation symptoms and quality of life assessments.
A gut bacteria imbalance is also linked to constipation issues. Another study focused on the effect of brisk walking versus exercises that strengthened core muscles like planks on intestinal microbiota composition. (Morita, E., et al., 2019) The results showed that aerobic exercises like power/brisk walking can help increase intestinal Bacteroides, an essential part of healthy gut bacteria. Studies have shown a positive effect when individuals engage in at least 20 minutes of brisk walking daily. (Morita, E., et al., 2019)
Exercise Can Help Decrease Colon Cancer Risks
Physical activity can be a significant protective factor in decreasing colon cancer. (National Cancer Institute. 2023) Some estimate the risk reduction to be 50%, and exercise can even help prevent recurrence after a colon cancer diagnosis, also 50% in some studies for patients with stage II or stage III colon cancer. (Schoenberg M. H. 2016)
The best effects were obtained through moderate-intensity exercise, such as power/brisk walking, about six hours per week.
Mortality was reduced by 23% in individuals who were physically active for at least 20 minutes several times a week.
Inactive colon cancer patients who began exercising after their diagnosis had significantly improved outcomes than individuals who remained sedentary, showing that it is never too late to start exercising.(Schoenberg M. H. 2016)
The most active patients had the best outcomes.
Exercise-Related Diarrhea Prevention
Some runners and walkers experience an overly active colon, resulting in exercise-related diarrhea or loose stools, known as runner’s trots. Up to 50% of endurance athletes experience gastrointestinal problems during intense physical activity. (de Oliveira, E. P. et al., 2014) Prevention steps that can be taken include.
Not eating within two hours of exercising.
Avoid caffeine and warm fluids before exercising.
If sensitive to lactose, avoid milk products or use Lactase.
Ensure the body is well-hydrated before exercise.
Hydrating during exercise.
If exercising in the morning:
Drink about 2.5 cups of fluids or a sports drink before bed.
Drink about 2.5 cups of fluids after waking up.
Drink another 1.5 – 2.5 cups of fluids 20-30 minutes before exercising.
Drink 12-16 fluid ounces every 5-15 minutes during exercise.
If exercising for over 90 minutes:
Drink a 12 – 16 fluid-ounce solution containing 30-60 grams of carbohydrates, sodium, potassium, and magnesium every 5-15 minutes.
Professional Help
Periodic constipation may resolve with lifestyle adjustments like increased fiber intake, physical activity, and fluids. Individuals who are experiencing bloody stools or hematochezia, have recently lost 10 pounds or more, have iron deficiency anemia, have positive fecal occult/hidden blood tests, or have a family history of colon cancer need to see a healthcare provider or specialist to perform specific diagnostic tests to ensure there aren’t any underlying issues or serious conditions. (Jamshed, N. et al., 2011) Before engaging in walking for constipation assistance, individuals should consult their healthcare provider to see if it is safe for them.
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. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Poop Testing: What? Why? and How?
References
Huang, R., Ho, S. Y., Lo, W. S., & Lam, T. H. (2014). Physical activity and constipation in Hong Kong adolescents. PloS one, 9(2), e90193. doi.org/10.1371/journal.pone.0090193
Tantawy, S. A., Kamel, D. M., Abdelbasset, W. K., & Elgohary, H. M. (2017). Effects of a proposed physical activity and diet control to manage constipation in middle-aged obese women. Diabetes, metabolic syndrome and obesity : targets and therapy, 10, 513–519. doi.org/10.2147/DMSO.S140250
Morita, E., Yokoyama, H., Imai, D., Takeda, R., Ota, A., Kawai, E., Hisada, T., Emoto, M., Suzuki, Y., & Okazaki, K. (2019). Aerobic Exercise Training with Brisk Walking Increases Intestinal Bacteroides in Healthy Elderly Women. Nutrients, 11(4), 868. doi.org/10.3390/nu11040868
Schoenberg M. H. (2016). Physical Activity and Nutrition in Primary and Tertiary Prevention of Colorectal Cancer. Visceral medicine, 32(3), 199–204. doi.org/10.1159/000446492
de Oliveira, E. P., Burini, R. C., & Jeukendrup, A. (2014). Gastrointestinal complaints during exercise: prevalence, etiology, and nutritional recommendations. Sports medicine (Auckland, N.Z.), 44 Suppl 1(Suppl 1), S79–S85. doi.org/10.1007/s40279-014-0153-2
Jamshed, N., Lee, Z. E., & Olden, K. W. (2011). Diagnostic approach to chronic constipation in adults. American family physician, 84(3), 299–306.
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
Can knowing which foods to eat help individuals recovering from food poisoning restore gut health?
Food Poisoning and Restoring Gut Health
Food poisoning can be life-threatening. Fortunately, most cases are mild and short-lived and last only a few hours to a few days (Centers for Disease Control and Prevention, 2024). But even mild cases can wreak havoc on the gut, causing nausea, vomiting, and diarrhea. Researchers have found that bacterial infections, like food poisoning, can cause changes in gut bacteria. (Clara Belzer et al., 2014) Eating foods that promote gut healing after food poisoning may help the body recover and feel better faster.
Foods to Eat
After food poisoning symptoms have resolved, one may feel that returning to the usual diet is fine. However, the gut has endured quite an experience, and even though acute symptoms have subsided, individuals may still benefit from foods and drinks that are easier on the stomach. Recommended foods and beverages after food poisoning include: (National Institute of Diabetes and Digestive and Kidney Diseases. 2019)
Gatorade
Pedialyte
Water
Herbal tea
Chicken broth
Jello
Applesauce
Crackers
Toast
Rice
Oatmeal
Bananas
Potatoes
Hydration after food poisoning is crucial. Individuals should add other nutritious and hydrating foods, like chicken noodle soup, which helps because of its nutrients and fluid content. The diarrhea and vomiting that accompany the illness can leave the body severely dehydrated. Rehydrating beverages help the body replace lost electrolytes and sodium. Once the body is rehydrated and can hold down bland foods, slowly introduce foods from a regular diet. When resuming the usual diet after rehydration, eating small meals frequently, every three to four hours, is recommended instead of eating a large breakfast, lunch, and dinner meal daily. (Andi L. Shane et al., 2017) When choosing Gatorade or Pedialyte, remember that Gatorade is a sports-rehydrating drink with more sugar, which could irritate an inflamed stomach. Pedialyte is designed for rehydrating during and after illness and has less sugar, making it a better option. (Ronald J Maughan et al., 2016)
When Food Poisoning Is Active Foods To Avoid
During food poisoning, individuals typically do not feel like eating at all. However, to avoid worsening the illness, Individuals are recommended to avoid the following while actively ill (Ohio State University. 2019)
Caffeinated drinks and alcohol can further dehydrate.
Greasy foods and high-fiber foods are hard to digest.
Foods and beverages high in sugar can cause the body to produce high glucose levels and weaken the immune system. (Navid Shomali et al., 2021)
Recovery Time and Resuming Regular Diet
Food poisoning doesn’t last long, and most uncomplicated cases are resolved within a few hours or days. (Centers for Disease Control and Prevention, 2024) Symptoms depend on the type of bacteria. Individuals may become ill within minutes of consuming contaminated food up to two weeks later. For example, Staphylococcus aureus bacteria generally cause symptoms almost immediately. On the other hand, listeria may take up to a couple of weeks to cause symptoms. (Centers for Disease Control and Prevention, 2024) Individuals can resume their usual diet once symptoms are gone, the body is thoroughly hydrated and can hold down bland foods. (Andi L. Shane et al., 2017)
Recommended Gut Foods Post Stomach Virus
Gut-healthy foods can help restore the gut microbiome or all the living microorganisms in the digestive system. A healthy gut microbiome is essential for immune system functioning. (Emanuele Rinninella et al., 2019) Stomach viruses can disrupt the balance of gut bacteria. (Chanel A. Mosby et al., 2022) Eating certain foods may help restore the gut balance. Prebiotics, or indigestible plant fibers, can help break down in the small intestines and allow the beneficial bacteria to grow. Prebiotic foods include: (Dorna Davani-Davari et al., 2019)
Beans
Onions
Tomatoes
Asparagus
Peas
Honey
Milk
Banana
Wheat, barley, rye
Garlic
Soybean
Seaweed
In addition, probiotics, which are live bacteria, may help increase the number of healthy bacteria in the gut. Probiotic foods include: (Harvard Medical School, 2023)
Pickles
Sourdough bread
Kombucha
Sauerkraut
Yogurt
Miso
Kefir
Kimchi
Tempeh
Probiotics can also be taken as a supplement and come in tablets, capsules, powders, and liquids. Because they contain live bacteria, they need to be refrigerated. Healthcare providers sometimes recommend taking probiotics when recovering from a stomach infection. (National Institute of Diabetes and Digestive and Kidney Diseases, 2018) Individuals should consult their healthcare provider to see whether this option is safe and healthy.
At Injury Medical Chiropractic and Functional Medicine Clinic, we treat injuries and chronic pain syndromes by developing personalized treatment plans and specialized clinical services focused on injuries and the complete recovery process. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Belzer, C., Gerber, G. K., Roeselers, G., Delaney, M., DuBois, A., Liu, Q., Belavusava, V., Yeliseyev, V., Houseman, A., Onderdonk, A., Cavanaugh, C., & Bry, L. (2014). Dynamics of the microbiota in response to host infection. PloS one, 9(7), e95534. doi.org/10.1371/journal.pone.0095534
Shane, A. L., Mody, R. K., Crump, J. A., Tarr, P. I., Steiner, T. S., Kotloff, K., Langley, J. M., Wanke, C., Warren, C. A., Cheng, A. C., Cantey, J., & Pickering, L. K. (2017). 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 65(12), e45–e80. doi.org/10.1093/cid/cix669
Maughan, R. J., Watson, P., Cordery, P. A., Walsh, N. P., Oliver, S. J., Dolci, A., Rodriguez-Sanchez, N., & Galloway, S. D. (2016). A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index. The American journal of clinical nutrition, 103(3), 717–723. doi.org/10.3945/ajcn.115.114769
Shomali, N., Mahmoudi, J., Mahmoodpoor, A., Zamiri, R. E., Akbari, M., Xu, H., & Shotorbani, S. S. (2021). Harmful effects of high amounts of glucose on the immune system: An updated review. Biotechnology and applied biochemistry, 68(2), 404–410. doi.org/10.1002/bab.1938
Rinninella, E., Raoul, P., Cintoni, M., Franceschi, F., Miggiano, G. A. D., Gasbarrini, A., & Mele, M. C. (2019). What is the Healthy Gut Microbiota Composition? A Changing Ecosystem across Age, Environment, Diet, and Diseases. Microorganisms, 7(1), 14. doi.org/10.3390/microorganisms7010014
Mosby, C. A., Bhar, S., Phillips, M. B., Edelmann, M. J., & Jones, M. K. (2022). Interaction with mammalian enteric viruses alters outer membrane vesicle production and content by commensal bacteria. Journal of extracellular vesicles, 11(1), e12172. doi.org/10.1002/jev2.12172
Davani-Davari, D., Negahdaripour, M., Karimzadeh, I., Seifan, M., Mohkam, M., Masoumi, S. J., Berenjian, A., & Ghasemi, Y. (2019). Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods (Basel, Switzerland), 8(3), 92. doi.org/10.3390/foods8030092
For individuals practicing a low-carbohydrate eating style or want to try an alternative flour, can incorporating almond flour help in their wellness journey?
Almond Flour
Almond flour and almond meal are gluten-free alternatives to wheat products in certain recipes. They are made by grinding almonds and can be bought prepared or made at home with a food processor or grinder. The flour is higher in protein and lower in starch than other gluten-free flour.
Almond Flour and Almond Meal
The flour is made with blanched almonds, meaning the skin has been removed. Almond meal is made with whole or blanched almonds. The consistency for both is more like corn meal than wheat flour. They can usually be used interchangeably, although using the blanched flour will produce a more refined, less grainy result. Superfine almond flour is great for baking cakes but is difficult to make at home. It can be found at grocery stores or ordered online.
Carbohydrates and Calories
A half cup of commercially prepared flour contains about:
The glycemic index of almond flour is less than 1, which means it should have little effect on raising blood glucose levels.
The high glycemic index of whole wheat flour is 71, and rice flour is 98.
Using Almond Flour
It is recommended for making gluten-free quick bread recipes, such as gluten-free:
Muffins
Pumpkin bread
Pancakes
Some cake recipes
Individuals are recommended to start with a recipe already adapted for almond flour and then make their own. A cup of wheat flour weighs around 3 ounces, while a cup of almond flour weighs almost 4 ounces. This will make a significant difference in baked goods. The flour is beneficial for adding nutrients to foods.
Almond Meal
Almond meal can be cooked as polenta or grits such as shrimp and grits.
Cookies can be made gluten-free with almond meal.
Almond meal biscuits can be made, but pay attention to the recipe.
Almond meal can be used to bread fish and other fried foods, but it must be taken care of so as not to burn.
Almond meal is not recommended for breads that require true dough with a developed gluten structure, like wheat flour.
More eggs are needed when baking with almond meal to provide the structure gluten in flour creates.
Adapting recipes to substitute almond meal for wheat flour can be a challenge that requires plenty of trial and error.
Sensitivities
Almonds are a tree nut, one of the eight most common food allergies. (Anaphylaxis UK. 2023) While peanuts are not tree nuts, many with peanut allergies can also have an almond allergy.
Making Your Own
It can be made in a blender or food processor.
Care must be taken not to grind it too long, or it will become almond butter, which can also be used.
Add a little at a time and pulse until it is ground into meal.
Store unused flour immediately in the refrigerator or freezer because it will go rancid quickly if left out.
Almonds are shelf-stable, and almond flour is not, so it is recommended that you grind only what is needed for the recipe.
Store Bought
Most health food stores sell almond flour, and more supermarkets are stocking it as it has become a popular gluten-free product. Packaged flour and meal will also go rancid after opening and should be kept in the refrigerator or freezer after opening.
Anaphylaxis UK. (2023). Allergy Factsheets (Anaphylaxis UK A brighter future for people with serious allergies, Issue. www.anaphylaxis.org.uk/factsheets/
Atkinson, F. S., Brand-Miller, J. C., Foster-Powell, K., Buyken, A. E., & Goletzke, J. (2021). International tables of glycemic index and glycemic load values 2021: a systematic review. The American journal of clinical nutrition, 114(5), 1625–1632. doi.org/10.1093/ajcn/nqab233
For individuals with back pain, can sleeping with a pillow between or under their knees help bring relief during sleep?
Sleep With A Pillow Between The Legs
Healthcare providers may recommend that individuals with back pain due to pregnancy or conditions like a herniated disc and sciatica sleep with a pillow between their legs. Sleeping with a pillow between the legs may help relieve back and hip pain, as the position helps maintain pelvis and spinal alignment. Proper spinal alignment can help relieve back stress and pain.
The Benefits
Some potential benefits of sleeping with a pillow between the knees.
Reduce Back and Hip Pain
When sleeping on the side, the spine, shoulders, and hips may twist to maintain the position because the center of gravity is elevated, causing instability. (Gustavo Desouzart et al., 2015) Placing a pillow between the knees may help maintain stability and reduce back and hip pain. (Gustavo Desouzart et al., 2015) The pillow neutralizes the position of the pelvis by slightly elevating the leg on top. This decreases the pressure on the lower back and hip joints, which may help reduce pain and allow for improved sleep.
Reduce Sciatica Symptoms
Sciatica nerve pain travels from the lower back down one leg due to a compressed spinal nerve root in the lower back. (American Academy of Orthopaedic Surgeons, 2021) Sleeping with a pillow between the knees may help reduce symptoms and sensations. A pillow between the legs can help prevent twisting the back, rotating the spine, or tilting the pelvis during sleep.
Reduce Herniated Disc Symptoms
A herniated disc can pressure the spinal nerves, leading to pain and numbness. (Penn Medicine. 2024) Sleeping on the side can worsen herniated disc pain; however, placing a pillow between the knees keeps the pelvis in neutral alignment and prevents spinal rotation. Sleeping on the back with a pillow under the knees can also help reduce pressure on the disc. (University of Central Florida. N.D.)
Improve Posture
Maintaining healthy posture while sitting or standing is important to neuromusculoskeletal health and injury prevention. Proper alignment during sleep can help improve posture (Doug Cary et al., 2021). According to one study, individuals spend more than half of their time sleeping in a side-lying posture. (Eivind Schjelderup Skarpsno et al., 2017) Sleeping on the side with the top leg frequently falls forward, bringing the pelvis into a forward tilt that places added pressure on the hips and spine connective tissues. This position disrupts the body’s natural alignment. (Doug Cary et al., 2021) Placing a pillow between the knees improves sleeping posture by lifting the top leg and prevents forward shifting. (University of Rochester Medical Center. 2024)
Increased weight leads to increased pressure on joints.
Significant change in the center of gravity.
Hormonal changes make connective tissues more lax.
Pregnant women with hip or back pain are often recommended to sleep with a pillow between their knees to relieve pain and discomfort. Doctors agree that lying on the left side is the best sleep position during the second and third trimesters. This position ensures optimal blood flow for the mother and baby and helps kidney function. (Standford Medicine, 2024) Placing a pillow between the knees can help reduce the pressure on the joints and also help maintain the left-side lying position. (O’Brien LM, Warland J. 2015) (Standford Medicine, 2024) Larger maternity pillows supporting the abdomen and lower back can provide more comfort.
Consult a healthcare provider about sleeping with a pillow between the knees to see if it is right for you.
What Causes Disc Herniation?
References
Desouzart, G., Matos, R., Melo, F., & Filgueiras, E. (2015). Effects of sleeping position on back pain in physically active seniors: A controlled pilot study. Work (Reading, Mass.), 53(2), 235–240. doi.org/10.3233/WOR-152243
Cary, D., Jacques, A., & Briffa, K. (2021). Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study. PloS one, 16(11), e0260582. doi.org/10.1371/journal.pone.0260582
Skarpsno, E. S., Mork, P. J., Nilsen, T. I. L., & Holtermann, A. (2017). Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms. Nature and science of sleep, 9, 267–275. doi.org/10.2147/NSS.S145777
Casagrande, D., Gugala, Z., Clark, S. M., & Lindsey, R. W. (2015). Low Back Pain and Pelvic Girdle Pain in Pregnancy. The Journal of the American Academy of Orthopaedic Surgeons, 23(9), 539–549. doi.org/10.5435/JAAOS-D-14-00248
O’Brien, L.M., Warland, J. (2015). Maternal sleep position: what do we know where do we go? BMC Pregnancy Childbirth, 15, Article A4 (2015). doi.org/doi:10.1186/1471-2393-15-S1-A4
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