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Using Acupuncture for Pain Management

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Acupuncture Therapy, Injury Care

For individuals dealing with injuries and pain conditions, can incorporating acupuncture into a treatment plan help alleviate and manage pain?

Acupuncture Pain Management

Pain management techniques include physical therapy, medications, cold therapies, chiropractic, and massages. One method that is growing is acupuncture. (World Health Organization. 2021) According to a report by the World Health Organization, acupuncture is the most commonly used form of traditional medicine practiced globally. (World Health Organization. 2021) More than 10 million acupuncture treatments are administered annually in the U.S. (Jason Jishun Hao, Michele Mittelman. 2014)

What Is It?

Acupuncture is a medical practice that involves placing solid but super thin needles at specific points in the body to treat certain health issues. They can be used on their own or stimulated with electric currents, called electroacupuncture. Acupuncture originated in China about 3,000 years ago and is known as traditional Chinese medicine or TCM. In more recent years, the practice has gained acceptance and demand worldwide. (Jason Jishun Hao, Michele Mittelman. 2014)

How Does It Work?

Acupuncture pain management works by balancing the flow of qi/chi/energy, which moves through meridians, or channels in the body. By inserting needles into specific points along these channels, balance is reestablished for overall health and well-being. When the energy is imbalanced due to internal and external stressors that can include injuries, underlying conditions, unhealthy diet, and stress, individuals can present with symptoms and illness. Using diagnostic techniques and comprehensive interviews, practitioners can determine which organ systems and meridian channels need addressing to restore function. There are more than 2,000 acupoints in the body. (Johns Hopkins Medicine. 2024) Each point has its own purpose and function: some increase energy, others decrease it, helping balance the body to support healing and recovery. Acupuncture pain management goes beyond energy healing and can help alleviate pain by stimulating nerves, muscles, and fascia/connective tissue, regulating immune response, nervous system response, lymphatic flow, and increasing muscle relaxation.

Types

Different types of acupuncture have been modified in training and styles, but all involve needling into certain points and include:

Orthopedic/Dry Needling

This technique combines Traditional Chinese Medicine and structure manipulation to treat pain, tissue injuries, imbalances in the body, and other general systemic disorders.

Five Element Style

This is a spiritual and emotional technique that uses the five elements of nature, including wood, fire, earth, metal, and water, to transfer energy, creating balance in the body.

Japanese Style

uses similar techniques to TCM but uses a more subtle approach, such as using fewer needles or inserting them at lower depths in the body.

Korean

This technique uses both techniques from Chinese and Japanese acupuncture.
Practitioners may use more needles and different kinds of needles, like a copper variety, instead of the standard stainless steel type.
This type of acupuncture uses only acupoints on the hand to treat different areas of the body.

Auricular

This is similar to Korean acupuncture but relies on certain points in the ear to treat other areas of the body.
The goal is to overcome imbalances and disharmonies.

Distal

This technique treats pain indirectly.
Practitioners place needles in spots other than the area of discomfort.
For example, practitioners may place needles around the elbows for knee pain or the lower legs for shoulder pain.

Acupressure

This form of therapy stimulates different acupoints without using needles.
Practitioners use precise finger placements, hands, or other tools and essential oils to apply pressure over specific points to enhance energy flow.

Providers can combine and use various forms based on an individual’s needs.

Conditions

One analysis of more than 2,000 scientific reviews of acupuncture therapies found it to be effective for post-stroke aphasia, neck, shoulder, lower back pain, muscle pain, fibromyalgia pain, lactation issues after delivery, vascular dementia symptoms, and allergy symptoms. (Liming Lu et al., 2022) A study on mice by neuroscientists found that electroacupuncture can decrease inflammation. (Shenbin Liu et al., 2020) The National Center for Complementary and Integrative Health found that acupuncture can be helpful for: (National Center for Complementary and Integrative Health. 2022)

Carpal tunnel syndrome
Back and neck pain
Sciatica
Myofascial pain syndrome
Chronic pelvic pain syndrome
Fibromyalgia
Osteoarthritis
Improves sleep
Stress
Headaches
Migraines
Menopausal hot flashes
Post-surgery pain
Cancer pain
Nausea and vomiting in cancer patients undergoing treatment
Chronic prostatitis
Digestion
Irritable bowel syndrome
Seasonal allergies
Urinary incontinence
Infertility
Asthma
Quitting smoking
Depression

Safety

When the treatment is performed by a highly trained, licensed, and certified acupuncturist, it is very safe. The most common serious adverse events were pneumothorax/collapsed lung, cardiovascular problems, and fainting, which in some cases caused trauma, like fractures. (Petra Bäumler et al., 2021) There are some short-term risks associated with acupuncture, including:

Pain
Bleeding
Bruising
Drowsiness
Dizziness for individuals that have not eaten or fear of needles.

Serious side effects associated with acupuncture, like a punctured lung or infection, are very rare. For individuals that have a metal allergy, infection, or open wound in the area where the needles will be inserted, it is recommended to avoid acupuncture. Individuals who have a bleeding disorder, are taking any medicines like an anticoagulant, or are pregnant, should talk to the acupuncturist before beginning a treatment plan.

What to Expect

Everyone’s visit will be tailored to their specific needs, and the first visit will likely last an hour or two. The initial evaluation will include a full medical/health history. The individual will spend a few minutes discussing concerns and health goals with the acupuncturist. Individuals will be asked to lie on the treatment table so the practitioner can access their limbs, back, and abdomen. After inserting needles, they will stay in place for about 20 to 30 minutes. At this time, individuals can relax, meditate, sleep, listen to music, etc. The practitioner may monitor if and how the pulse has changed and add or remove needles. After the needles are removed, the practitioner will determine the course of treatment. Depending on how chronic or severe the condition is, they may recommend several acupuncture pain management treatments over the course of several weeks.

Chiropractic Care For Healing After Trauma

References

World Health Organization. (2021). WHO benchmarks for the practice of acupuncture.

Hao, J. J., & Mittelman, M. (2014). Acupuncture: past, present, and future. Global advances in health and medicine, 3(4), 6–8. https://doi.org/10.7453/gahmj.2014.042

Johns Hopkins Medicine. (2024). Acupuncture.

Lu, L., Zhang, Y., Tang, X., Ge, S., Wen, H., Zeng, J., Wang, L., Zeng, Z., Rada, G., Ávila, C., Vergara, C., Tang, Y., Zhang, P., Chen, R., Dong, Y., Wei, X., Luo, W., Wang, L., Guyatt, G., Tang, C., … Xu, N. (2022). Evidence on acupuncture therapies is underused in clinical practice and health policy. BMJ (Clinical research ed.), 376, e067475. https://doi.org/10.1136/bmj-2021-067475

Liu, S., Wang, Z. F., Su, Y. S., Ray, R. S., Jing, X. H., Wang, Y. Q., & Ma, Q. (2020). Somatotopic Organization and Intensity Dependence in Driving Distinct NPY-Expressing Sympathetic Pathways by Electroacupuncture. Neuron, 108(3), 436–450.e7. https://doi.org/10.1016/j.neuron.2020.07.015

National Center for Complementary and Integrative Health. (2022). Acupuncture: what you need to know.

Bäumler, P., Zhang, W., Stübinger, T., & Irnich, D. (2021). Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies. BMJ open, 11(9), e045961. https://doi.org/10.1136/bmjopen-2020-045961

Health Benefits of Oven Roasted Potatoes

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Health, Nutrition

For a hearty side of potatoes, can oven roasting and paying attention to portion size make for a healthy meal?

Oven Roasted Potatoes

Potatoes are starchy, but that does not make them unhealthy. This is where individuals need to take portion size into consideration. Starchy foods like potatoes should take up around a quarter of the plate, with room for vegetables and a protein source.

Potatoes can provide a good source of vitamin C, calcium, magnesium, potassium, folate, and fiber.
Potatoes are almost fat-free. (U.S. Department of Agriculture. 2019)
Potatoes contain certain antioxidants – lutein and zeaxanthin.
These antioxidants help protect eyesight and help lower the risk of macular degeneration, which can lead to vision loss. (Umesh C. Gupta Subhas C. Gupta 2019)

Ingredients

2 pounds red or white potatoes, with skin left on.
2 tablespoons olive oil.
2 tablespoons fresh minced rosemary.
1 teaspoon garlic, chopped.
1/2 teaspoon salt.
1/4 teaspoon black pepper.

Preparation

Preheat the oven to 425F.
Wash the potatoes and let them dry.
The potatoes don’t need to be peeled, but cut out surface blemishes.
Cut large potatoes into 2-inch pieces.
If using small potatoes, they can be left whole.
Place on a baking dish in a single layer.
Drizzle olive oil.
Add the rosemary, garlic, salt, and pepper.
Toss the potatoes until they are evenly coated.
Roast uncovered for 45 minutes to 1 hour, turning occasionally.
The potatoes are done when easily pierced with a fork.

Variations and Substitutions

Dried rosemary can be used instead of fresh rosemary, but not as much is needed.
2 teaspoons will suffice.
If there is no rosemary, thyme or oregano can be used.
Another option is using a combination of favorite herbs.

Cooking and Serving

When roasting, don’t over-crowd the potatoes on the baking pan, as this can cause them to cook unevenly or become mushy.
Ensure the potatoes are spread out and distributed in a single layer.
Choose potatoes that are firm and don’t have a green tint.
Green-tinted potatoes contain a compound called solanine.
Solanine has a bitter flavor and can be harmful if eaten in large amounts. (U.S. Department of Agriculture. 2023)
The potatoes can be spiced up to add more flavor. Try with spicy ketchup, hot sauce, or aioli.
Oven-roasted potatoes are great with vegetarian meals.
Serve with Swiss chard, black beans, or chickpeas for a healthy, balanced meal.

Eating Right To Feel Better

References

U.S. Department of Agriculture. FoodData Central. (2019). Potatoes.

Umesh C. Gupta, Subhas C. Gupta. (2019). The important role of potatoes, an underrated vegetable food crop in human health and nutrition. Current Nutrition & Food Science. 15(1):11-19. doi:10.2174/1573401314666180906113417

U.S. Department of Agriculture. (2023). Are green potatoes dangerous?

Boost Your Metabolism with NEAT Non-Exercise Activities

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Health, Weight Loss

For individuals looking to improve overall health and wellness, how can paying attention to non-exercise activities help burn more calories and improve metabolic rates?

Non-Exercise Activity Thermogenesis – NEAT

Non-exercise activity thermogenesis, or NEAT, describes the calories burned by daily movements and activities. These physical movements are not planned or structured exercises, workouts, or sports. It is also referred to as non-exercise physical activity or NEPA. Examples include activities like:

Cleaning
Cooking
Shopping
Playing a musical instrument
Small movements like fidgeting
When buying a few items, carry a basket instead of a shopping cart.
Take the stairs instead of the elevator or escalator.

While these movements might not seem like a lot, they can have a substantial impact on metabolic rates and calorie expenditures. A study followed over 12,000 women for 12 years and found that fidgeting can reduce the risk of death associated with excessive sedentariness. (Gareth Hagger-Johnson et al., 2016)

Calories Burned

The amount of calories burned varies from person to person. A study reported that the number of calories burned from non-exercise activity thermogenesis varies up to 2000 kilocalories a day between two individuals of similar size. (Christian von Loeffelholz et al., 2000). A number of factors can account for this difference, including environment and genetics. Individuals’ occupations and lifestyles can also influence non-exercise activity thermogenesis. For example, two individuals with similar body mass indexes or BMIs but different jobs, sedentariness versus activity, will burn different calorie amounts.

Improving Health

Non-exercise activity thermogenesis is thought to be one of the ways the body manages weight. When gaining weight, NEAT tends to increase, whereas when losing weight, NEAT decreases with individuals sitting more without moving as much. A research review noted that the benefits of non-exercise go well beyond the extra calories expended. (Pedro A. Villablanca et al., 2015). Increasing non-exercise activity thermogenesis reduces the risk of metabolic syndrome, cardiovascular issues, and other health problems. Plus, research shows that inactivity can negate the time and effort put into structured exercise. (John D. Akins et al., 2019). Combating sedentary behavior with non-activity thermogenesis helps increase the benefits of regular workouts.

Incorporating NEAT

There are small ways to incorporate non-exercise activity thermogenesis at work and at home. This could be using a standing desk or stability ball. According to the National Academy of Sports Medicine, a 145-pound person can approximately burn:

102 calories an hour while sitting at work.
174 calories if standing at work.
72 calories extra may not seem like a lot, but it can add up to more than 18,000 calories burned per year, leading to an approximate 5-pound weight loss.

If waiting in line or sitting in traffic, finding small ways to move, like tapping the hands or feet or moving the head to music, helps the body take advantage of non-exercise activity thermogenesis. Making more conscious efforts to move can go a long way in improving health.

Is Motion Key To Healing?

References

Hagger-Johnson, G., Gow, A. J., Burley, V., Greenwood, D., & Cade, J. E. (2016). Sitting Time, Fidgeting, and All-Cause Mortality in the UK Women’s Cohort Study. American journal of preventive medicine, 50(2), 154–160. https://doi.org/10.1016/j.amepre.2015.06.025

von Loeffelholz, C., & Birkenfeld, A. L. (2022). Non-Exercise Activity Thermogenesis in Human Energy Homeostasis. In K. R. Feingold (Eds.) et. al., Endotext. MDText.com, Inc.

Villablanca, P. A., Alegria, J. R., Mookadam, F., Holmes, D. R., Jr, Wright, R. S., & Levine, J. A. (2015). Nonexercise activity thermogenesis in obesity management. Mayo Clinic proceedings, 90(4), 509–519. https://doi.org/10.1016/j.mayocp.2015.02.001

Akins, J. D., Crawford, C. K., Burton, H. M., Wolfe, A. S., Vardarli, E., & Coyle, E. F. (2019). Inactivity induces resistance to the metabolic benefits following acute exercise. Journal of applied physiology (Bethesda, Md. : 1985), 126(4), 1088–1094. https://doi.org/10.1152/japplphysiol.00968.2018

Understanding Healthy Spinal Rotation

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Spinal Hygiene, Spine Care

For individuals trying to maintain a healthy spine, can understanding the causes and prevention of rotated vertebrae help protect the spine from harmful rotation of vertebrae?

Spinal Rotation

Healthy spine rotation is an important aspect of injury prevention, and rotated vertebrae or a twisted spine can result from spine, nerve, or muscle disease or certain movements.

Normal Spine Twisting Capability

The spine can move in several ways. Spine movements include:

Bending – Rounding forward
Extending – Arching backward
Tilting sideways is powered by muscles that aid in twisting.

Although the spine can move in many directions, there are limits to how far it can and should go. (Xinhai Shan et al., 2013). This is especially true with twisting. The spinal column is made of 26 interconnected bones called vertebrae. When moving, each vertebrae bone moves accordingly. Rotated or twisted vertebrae, especially when bending forward like lifting heavy objects, are associated with a risk of back injuries like strain and herniated discs.

How Rotation Works

Rotation is a basic movement in which individuals can turn their spinal column. When twisting, the spine also bends to the side. The muscles involved in spine rotation include:

The internal oblique abdominals and the external oblique abdominals don’t directly attach to the spine but are the primary muscles responsible for powering spinal rotation in the lower back.
Intrinsic muscles, including the multifidus and longissimus, contribute to twisting movement as well.
The multifidus helps the spine twist when one side is contracted/activated and extends the lumbar spine when both sides contract.
The multifidus helps control the movement, and the longissimus provides the movement with some extension.

Age and The Spine

As individuals age, the body accumulates tension and/or weakness in the oblique abdominal and other trunk muscles. Sedentary habits primarily bring on these changes. (Pooriput Waongenngarm et al., 2016)

Chronically tight back and abdominal muscles impair the range of motion of the trunk, as well as twisting ability.
Muscle weakness and tightness affect spinal movements.
Weakened muscles can decrease support for spinal movement and decrease overall trunk stability.

Spinal Rotation and Scoliosis

Scoliosis is a common condition that causes a lateral curve of the spine. Some of the vertebrae become displaced to the side. Often, abnormal vertebral rotation underlies this displacement. Treatment often focuses on controlling vertebral rotation with medical guidance and physical therapy. (John P. Horne et al., 2014)

Over-Rotating The Spine

Many individuals over-rotate their spines with manual work, which can increase the risk of back injuries. (National Institutes of Health. 2020). Over-rotation can happen with activities like digging or shoveling.

Exercise For A Healthy Spine

A recommended way to achieve optimal rotation of the spine is with daily back exercises. (National Spine Health Foundation. 2015). An effective back exercise program will consist of movements in every direction.

Yoga is recommended because it places emphasis on developing flexibility and strength in all directions.
Pilates does the same.
An injury prevention exercise program will work the hip and pelvic muscles as well.
Individuals with a spine condition should consult their healthcare provider or physical therapist about how to exercise the spine safely, as rotation exercises could worsen back problems like bulging or herniated discs.

Core Strength For A Pain-Free Back

References

Shan, X., Ning, X., Chen, Z., Ding, M., Shi, W., & Yang, S. (2013). Low back pain development response to sustained trunk axial twisting. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 22(9), 1972–1978. https://doi.org/10.1007/s00586-013-2784-7

Waongenngarm, P., Rajaratnam, B. S., & Janwantanakul, P. (2016). Internal Oblique and Transversus Abdominis Muscle Fatigue Induced by Slumped Sitting Posture after 1 Hour of Sitting in Office Workers. Safety and health at work, 7(1), 49–54. https://doi.org/10.1016/j.shaw.2015.08.001

Horne, J. P., Flannery, R., & Usman, S. (2014). Adolescent idiopathic scoliosis: diagnosis and management. American family physician, 89(3), 193–198.

National Institutes of Health. (2020). Low Back Pain Fact Sheet.

National Spine Health Foundation. (2015). Breaking Down The Exercises That Break Down Your Spine.

Discover the Benefits of Oat Milk: A Complete Guide

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Gut and Intestinal Health, Nutrition

For individuals switching to non-dairy and plant-based diets, can oat milk be a beneficial substitute for non-dairy milk drinkers?

Oat Milk

Oat milk is a dairy-free, lactose-free alternative nearly free of saturated fats, has more protein than most nut-based kinds of milk, adds fiber, and offers a healthy dose of B vitamins and minerals. It contains steel-cut or whole oats soaked in water that are then blended and strained with a cheesecloth or special milk bag that is cheaper to make than almond milk and is environmentally friendly.

Nutrition

Individuals can acquire 27% of daily calcium, 50% of daily vitamin B12, and 46% of daily B2. The nutritional information is for one serving of 1 cup of oat milk. (USDA FoodData Central. 2019)

Calories – 120
Fat – 5 grams
Sodium – 101 milligrams
Carbohydrates – 16 grams
Fiber – 1.9 grams
Sugars – 7 grams
Protein – 3 grams
Calcium – 350.4 milligrams
Vitamin B12 – 1.2 micrograms
Vitamin B2 – 0.6 milligrams

Carbohydrates

According to the United States Department of Agriculture, the number of carbohydrates in a cup of oat milk is 16, higher than other milk products.
However, the carbohydrates come from fiber and not fat.
Because oat milk is made from steel-cut or whole oats, there is more fiber per serving than cow’s milk, which offers no fiber, and almond and soy, which only contain one gram of fiber per serving.

Fats

Oat milk contains no fatty acids, no total saturated fat, and no total trans fats.
The milk does have 5 grams of total lipid fats.

Protein

Compared to cow’s and soy milk, oat milk has less protein, with only 3 grams per serving.
But compared to other substitutes, like almond milk and rice milk, oat milk provides more protein per serving.
This is beneficial for individuals following a vegan or dairy-free diet.

Vitamins and Minerals

Oat milk contains thiamin and folate, both B vitamins necessary for energy production.
The milk also has minerals, including copper, zinc, manganese, magnesium, and trace amounts of vitamins and minerals such as vitamin D, A IU, riboflavin, and potassium.
Most commercial oat milk is fortified with vitamins A, D, B12, and B2.

Calories

One serving of oat milk, about 1 cup, provides approximately 120 calories.

Benefits

Dairy Milk Alternative

Dairy allergies are common.
Around 2 to 3% of children younger than three years old are allergic to milk. (American College of Allergy, Asthma & Immunology. 2019)
80% outgrow the allergy, but the remaining 20% still deal with the allergy into adulthood, making dairy alternatives necessary.
An alternative to dairy milk for:
Allergies to dairy
Lactose intolerance
Following a vegan/dairy-free diet
Oat milk offers some of the same health benefits as cow’s milk, that include:
Protein to build and repair tissues.
Maintain hair and nail health.
Calcium for strong bones.
Macronutrients like folate help make red and white blood cells.

Lowers Cholesterol

A review determined that consuming oats and oat products has a profound effect in lowering total and LDL cholesterol levels. (Susan A Joyce et al., 2019)
The researchers found significant support between oat beta-glucans and blood cholesterol levels, showing that adding oats to one’s diet can help lower the risk of cardiovascular disease.

Cancer Fighting Properties

According to a review of plant-based milk alternatives, oat milk may contain anti-cancer properties and high nutritional value. (Swati Sethi et al., 2016)

Bowel Movement Regulation

Because a great deal of carbohydrates in oat milk come from fiber, it is also higher in fiber than regular milk.
Fiber can help because the nutrient absorbs water to regulate bowel movements and decrease constipation.
Only 5% of the population acquires daily fiber recommendations, making oat milk a healthy option. (Diane Quagliani, Patricia Felt-Gunderson. 2017)

Eco Friendly

Today the world is more mindful of the environmental impacts of farming. (American Society for Nutrition. 2019)
Spending on alternative milk has risen, and the consumption of dairy milk has dropped, not only for the benefits and taste but because of environmental concerns.
Dairy milk uses nine times more land to make one liter compared to rice milk, soy milk, almond milk, or oat milk.

Allergies

Oat milk is a beneficial alternative for individuals who are lactose intolerant or suffer from any other type of dairy allergy or those who have a nut allergy and can’t drink almond milk.
However, individuals should be careful of intake if they have celiac disease or any type of wheat allergy/sensitivity.
Individuals can still drink oat milk, but the labels need to be read to make sure the product contains gluten-free wheat.
Oats are gluten-free, but manufacturers often process them using the same equipment as other wheat products, which could cause a reaction.

Adverse Effects

Oat milk can contain acidity-regulating phosphates, which are common additives in processed foods and are linked to kidney disease.
Individuals will want to watch oat milk intake if they are prone to kidney stones. (Girish N. Nadkarni, Jaime Uribarri. 2014)
Individuals who eat a lot of processed foods might want to rotate with another non-dairy alternative milk to limit phosphate consumption.

Varieties

Many companies have their own oat milk, which is available at grocery and health food stores.
Additionally, the milk may come in multiple flavors, including vanilla and chocolate.
Several companies have also used their milk to create dairy-free ice creams.
Oat milk is available year-round.
Once opened, place store-bought oat milk in the refrigerator that will last 7 to 10 days.

Preparation

Individuals can make their own oat milk.
Use rolled or steel-cut oats with water, blend together, and strain.
Place the oats in a large bowl, cover them with water, and soak for at least four hours.
The next day, drain, rinse, blend in cold water, strain, and whisk.

Functional Medicine’s Influence Beyond Joints

References

USDA FoodData Central. (2019). The Original Oat-Milk.

American College of Allergy, Asthma & Immunology. (2019). Milk & Dairy.

Joyce, S. A., Kamil, A., Fleige, L., & Gahan, C. G. M. (2019). The Cholesterol-Lowering Effect of Oats and Oat Beta Glucan: Modes of Action and Potential Role of Bile Acids and the Microbiome. Frontiers in nutrition, 6, 171. https://doi.org/10.3389/fnut.2019.00171

Sethi, S., Tyagi, S. K., & Anurag, R. K. (2016). Plant-based milk alternatives an emerging segment of functional beverages: a review. Journal of food science and technology, 53(9), 3408–3423. https://doi.org/10.1007/s13197-016-2328-3

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. https://doi.org/10.1177/1559827615588079

American Society for Nutrition. (2019). Going nuts about milk? Here’s what you need to know about plant-based milk alternatives.

Nadkarni, G. N., & Uribarri, J. (2014). Phosphorus and the kidney: What is known and what is needed. Advances in nutrition (Bethesda, Md.), 5(1), 98–103. https://doi.org/10.3945/an.113.004655

The Essential Guide to Taking a Workout Break

by Dr Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP | Fitness, Health

For athletes, fitness enthusiasts, and individuals getting into regular exercise, can taking a workout break be beneficial if structured properly?

Workout Break

Giving oneself permission to take a break from exercising is necessary, especially to maintain a current fitness level. To stay fit at every level and injury-free, the body needs rest and recovery, especially to progress in performance levels. Regular exercise is important for:

Building endurance
Improving strength
Losing and maintaining weight
Relieving stress