Can incorporating nopal or prickly pear cactus into one’s diet help individuals trying to lower blood glucose, inflammation, and risk factors associated with heart and metabolic diseases?
Nopal
Nopal, also known as prickly pear cactus, is a versatile vegetable that can be added to nutrition plans to increase fiber intake, vitamins, minerals, and plant-based compounds. It grows in the U.S. Southwest, Latin America, and the Mediterranean. The pads, or the nopales or cactus paddles, have a texture like okra and slight tartness. The prickly pear cactus fruit, referred to as tuna in Spanish, is also consumed. (University of Arizona Cooperative Extension, 2019) It is often used in fruit salsas, salads, and desserts and is available as a supplement in tablet and powder form.
Nopal is highly nutritious, low in calories, free of fat, sodium, or cholesterol, and full of fiber, vitamins, minerals, and betalains. (Parisa Rahimi et al., 2019) Betalains are pigments with anti-inflammatory properties. The variety of fibers creates a low glycemic index (measures how much a specific food raises blood sugar levels after consumption) of about 32, a recommended addition to a diabetes-friendly diet. (Patricia López-Romero et al., 2014)
Compounds
Nopal contains a variety of beneficial carbohydrates, vitamins, and minerals.
Nopal has soluble and insoluble fiber, which benefits blood sugar.
It also contains vitamin A, carotenoids, vitamin C, calcium, and plant-based compounds like phenols and betalains. (Karina Corona-Cervantes et al., 2022)
Blood Sugar Regulation
Research has evaluated regular nopal consumption and supplementation for blood sugar control. A study on blood sugar evaluated adding nopal to a high-carbohydrate breakfast or a breakfast high in soy protein in Mexican individuals with type 2 diabetes. The study found that consuming nopales, about 300 grams or 1.75 to 2 cups before a meal, could reduce after-meal/postprandial blood sugars. (Patricia López-Romero et al., 2014) An older study had similar results. (Montserrat Bacardi-Gascon et al., 2007) Individuals were randomly assigned to consume 85 grams of nopal with three different breakfast options:
Chilaquiles – a casserole made with corn tortilla, vegetable oil, and pinto beans.
Burritos – made with eggs, vegetable oil, and pinto beans.
Quesadillas – made with flour tortillas, low-fat cheese, avocado, and pinto beans.
The groups assigned to eat nopales had reductions in blood sugar. There was a:
30% reduction in the chilaquiles group.
20% decrease in the burrito group.
48% reduction in the quesadilla group.
However, the studies were small, and the population was not diverse. so further research is needed.
Increased Fiber
The combination of soluble and insoluble fiber benefits the gut in various ways. Soluble fiber can act as a prebiotic, feeding beneficial bacteria in the gut and assisting in removing low-density lipoprotein (LDL) cholesterol from the body. Insoluble fiber increases transit time, or how quickly food moves through the digestive system and promotes bowel regularity. (Centers for Disease Control and Prevention, 2022) In a short-term randomized clinical control trial, researchers found an improvement in irritable bowel syndrome symptoms in individuals supplemented with 20 and 30 grams of nopal fiber. (Jose M Remes-Troche et al., 2021) For individuals not used to consuming fibrous foods, it may cause mild diarrhea, so it is recommended to increase intake slowly and with adequate water to prevent gas and bloating.
Plant Based Calcium
One cup of nopal provides 244 milligrams or 24% of daily calcium needs. Calcium is a mineral that optimizes bone and teeth health. It also assists in blood vessel contraction and dilation, muscle function, blood clotting, nerve transmission, and hormonal secretion. (National Institutes of Health. Office of Dietary Supplements 2024) Individuals who follow diets that exclude dairy products can benefit from plant-based calcium sources. This includes cruciferous vegetables like kale, collards, and arugula.
Other Benefits
Studies done in animals and test tubes suggest that fresh nopal and extracts may assist in reducing triglycerides and cholesterol in metabolic dysfunction-associated steatotic liver disease or when unhealthy amounts of fat accumulate in the liver. (Karym El-Mostafa et al., 2014) Other potential benefits with limited evidence include:
Unless individuals are allergic to it, most can eat whole nopal without a problem. However, supplementing is different because it provides a concentrated source. Individuals taking medication to manage diabetes and consuming nopal regularly may contribute to an increased risk of developing hypoglycemia or low blood sugar. Dermatitis has also been reported from contact with the cactus spines. (U.S. Department of Agriculture, FoodData Central, 2018) There have been rare reports of bowel obstruction in individuals who consume large amounts of the seeds found in the fruit. (Karym El-Mostafa et al., 2014) Ask a registered dietitian or primary healthcare provider if nopal can provide safe benefits.
Rahimi, P., Abedimanesh, S., Mesbah-Namin, S. A., & Ostadrahimi, A. (2019). Betalains, the nature-inspired pigments, in health and diseases. Critical reviews in food science and nutrition, 59(18), 2949–2978. doi.org/10.1080/10408398.2018.1479830
López-Romero, P., Pichardo-Ontiveros, E., Avila-Nava, A., Vázquez-Manjarrez, N., Tovar, A. R., Pedraza-Chaverri, J., & Torres, N. (2014). The effect of nopal (Opuntia ficus indica) on postprandial blood glucose, incretins, and antioxidant activity in Mexican patients with type 2 diabetes after consumption of two different composition breakfasts. Journal of the Academy of Nutrition and Dietetics, 114(11), 1811–1818. doi.org/10.1016/j.jand.2014.06.352
Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. doi.org/10.3390/nu14051008
Bacardi-Gascon, M., Dueñas-Mena, D., & Jimenez-Cruz, A. (2007). Lowering effect on postprandial glycemic response of nopales added to Mexican breakfasts. Diabetes care, 30(5), 1264–1265. doi.org/10.2337/dc06-2506
Remes-Troche, J. M., Taboada-Liceaga, H., Gill, S., Amieva-Balmori, M., Rossi, M., Hernández-Ramírez, G., García-Mazcorro, J. F., & Whelan, K. (2021). Nopal fiber (Opuntia ficus-indica) improves symptoms in irritable bowel syndrome in the short term: a randomized controlled trial. Neurogastroenterology and motility, 33(2), e13986. doi.org/10.1111/nmo.13986
El-Mostafa, K., El Kharrassi, Y., Badreddine, A., Andreoletti, P., Vamecq, J., El Kebbaj, M. S., Latruffe, N., Lizard, G., Nasser, B., & Cherkaoui-Malki, M. (2014). Nopal cactus (Opuntia ficus-indica) as a source of bioactive compounds for nutrition, health and disease. Molecules (Basel, Switzerland), 19(9), 14879–14901. doi.org/10.3390/molecules190914879
Onakpoya, I. J., O’Sullivan, J., & Heneghan, C. J. (2015). The effect of cactus pear (Opuntia ficus-indica) on body weight and cardiovascular risk factors: a systematic review and meta-analysis of randomized clinical trials. Nutrition (Burbank, Los Angeles County, Calif.), 31(5), 640–646. doi.org/10.1016/j.nut.2014.11.015
Corona-Cervantes, K., Parra-Carriedo, A., Hernández-Quiroz, F., Martínez-Castro, N., Vélez-Ixta, J. M., Guajardo-López, D., García-Mena, J., & Hernández-Guerrero, C. (2022). Physical and Dietary Intervention with Opuntia ficus-indica (Nopal) in Women with Obesity Improves Health Condition through Gut Microbiota Adjustment. Nutrients, 14(5), 1008. doi.org/10.3390/nu14051008
Can using egg substitutes or replacements be safe for individuals with an egg allergy?
Substitutes and Replacements
Individuals should not assume either is safe unless they carefully read the label.
Egg substitutes may contain eggs.
Egg replacement products may be egg-free.
Look for alternatives labeled vegan or egg-free to ensure there are none.
Substitutes May Contain Eggs
Liquid egg substitutes in grocery store dairy aisles are made from eggs. The following all contain eggs and are not safe for individuals with egg allergies:
Generic liquid egg substitutes in cartons
Egg Beaters
Powdered egg white products
Replacements Are Safe Alternatives
Special replacement products that do not contain eggs are available.
They are labeled vegan egg substitutes.
They are usually sold in powdered form.
They are useful for baking.
They cannot be used as a replacement for eggs in foods like a quiche.
Always check the ingredients on the label before purchasing a product sold as a substitute or replacement to ensure it is completely free.
These products may also contain soy, dairy, or other food allergens.
Vegan – contains no animal products, which includes eggs and dairy.
Vegetarian – may contain eggs as they are not meat but an animal product.
Unaware of Foods With Eggs
Stay aware of eggs hidden in other food products, such as cakes, breads, pastries, noodles, crackers, and cereals.
The federal Food Allergen Labeling and Consumer Protection Act requires that all packaged food products that contain eggs as an ingredient must list the word egg on the label. (U.S. Food & Drug Administration. 2022)
Other ingredients that indicate eggs are in the product include:
Can participating in a favorite sport several days a week help individuals trying to get fit or maintain a certain level of health?
Sports For Fitness
Spending hours in the gym can sometimes feel like a chore, especially for individuals who prefer competitive or recreational sports over traditional cardiovascular and resistance training. Various sports activities require only time, energy, sufficient apparel, and the willingness to play. Here are a few sports for fitness that can help improve overall health and wellness.
Cycling and Mountain Biking
Cycling is one of the best sports for fitness. Whether on roads or trails, fast or slow, it is a fantastic aerobic workout and benefits the leg muscles, specifically the quads, glutes, and hamstrings. Research has shown that, especially for those with diabetes, cycling can lower the risk of premature mortality. (Mathias Ried-Larsen et al., 2021)
There are appropriate bikes for all ages and stages.
Beginners start with paved trails.
Intermediate to advanced levels can engage in road cycling and mountain biking.
Road or mountain bike races for individuals looking to compete.
Racket Sports
Racket sports players range from all ages and fitness levels, entry-level to highly competitive, and all provide intense workouts.
Racket sports target the muscles in the back, shoulders, arms, chest, quads, glutes, hamstrings, and core.
Racquet sports have also been shown to lower the risk of cardiovascular disease mortality. (Pekka Oja et al., 2017)
Combine that with the endurance, speed, balance, and agility required to compete, and individuals will quickly see how these two sports can give a phenomenal workout while also burning a ton of calories.
Golf
For golf to be a fitness sport, individuals must walk all the holes while carrying or pushing the clubs.
What is needed is a supportive pair of shoes.
Walking the course can have multiple health benefits, including cardiovascular and respiratory health. (A. D. Murray et al., 2017)
Golf is a sport individuals can participate in at any life stage.
Water Sports
Paddleboarding, rowing, kayaking, and canoeing can provide a fitness solution for individuals who enjoy the outdoors. These sports increase heart rate, improve muscular endurance and strength, and burn serious calories. (Thomas Ian Gee et al., 2016)
Swimming
Activities that require upper and lower body muscles to work together rank high in sports for fitness. Swimming is the perfect full-body workout for anyone looking for an intense and competitive outlet that requires strength and endurance.
Swimming can be a year-round sport with various levels of competition.
Triathlon Training
Triathlon training is for lifelong athletes looking to improve endurance and strength and exercise beginners who need a goal; it is the ultimate sport for fitness.
Running, biking, and swimming together challenges every muscle and significantly increases aerobic and anaerobic fitness. (Naroa Etxebarria et al., 2019)
There’s something for every fitness level, from short sprint competitions to full Ironman events.
Basketball and Volleyball
Basketball and volleyball offer the physical benefits of a hard workout. These sports require sprinting, pivoting, and jumping, which engages the cardiovascular system and strengthens every muscle. Playing volleyball in the sand makes the muscles work harder.
Both sports are appropriate for most levels of fitness.
Beginners are recommended to learn the basic skills and go through drills before moving to games or matches.
Both sports require constant movement, increasing the risk of injury, so it is important to learn the fundamentals.
Talk to a healthcare provider before starting a new exercise routine or adding a new activity to an exercise regimen.
Lumbar Sports Injuries
References
Ried-Larsen, M., Rasmussen, M. G., Blond, K., Overvad, T. F., Overvad, K., Steindorf, K., Katzke, V., Andersen, J. L. M., Petersen, K. E. N., Aune, D., Tsilidis, K. K., Heath, A. K., Papier, K., Panico, S., Masala, G., Pala, V., Weiderpass, E., Freisling, H., Bergmann, M. M., Verschuren, W. M. M., … Grøntved, A. (2021). Association of Cycling With All-Cause and Cardiovascular Disease Mortality Among Persons With Diabetes: The European Prospective Investigation Into Cancer and Nutrition (EPIC) Study. JAMA internal medicine, 181(9), 1196–1205. doi.org/10.1001/jamainternmed.2021.3836
Oja, P., Kelly, P., Pedisic, Z., Titze, S., Bauman, A., Foster, C., Hamer, M., Hillsdon, M., & Stamatakis, E. (2017). Associations of specific types of sports and exercise with all-cause and cardiovascular-disease mortality: a cohort study of 80 306 British adults. British journal of sports medicine, 51(10), 812–817. doi.org/10.1136/bjsports-2016-096822
Murray, A. D., Daines, L., Archibald, D., Hawkes, R. A., Schiphorst, C., Kelly, P., Grant, L., & Mutrie, N. (2017). The relationships between golf and health: a scoping review. British journal of sports medicine, 51(1), 12–19. doi.org/10.1136/bjsports-2016-096625
Ian Gee, T., Caplan, N., Christian Gibbon, K., Howatson, G., & Grant Thompson, K. (2016). Investigating the Effects of Typical Rowing Strength Training Practices on Strength and Power Development and 2,000 m Rowing Performance. Journal of human kinetics, 50, 167–177. doi.org/10.1515/hukin-2015-0153
Lo, G. H., Ikpeama, U. E., Driban, J. B., Kriska, A. M., McAlindon, T. E., Petersen, N. J., Storti, K. L., Eaton, C. B., Hochberg, M. C., Jackson, R. D., Kwoh, C. K., Nevitt, M. C., & Suarez-Almazor, M. E. (2020). Evidence that Swimming May Be Protective of Knee Osteoarthritis: Data from the Osteoarthritis Initiative. PM & R : the journal of injury, function, and rehabilitation, 12(6), 529–537. doi.org/10.1002/pmrj.12267
Etxebarria, N., Mujika, I., & Pyne, D. B. (2019). Training and Competition Readiness in Triathlon. Sports (Basel, Switzerland), 7(5), 101. doi.org/10.3390/sports7050101
For individuals who want to eat healthier, can selection and moderation make mayonnaise a delicious and nutritious addition to a low-carbohydrate diet?
Mayonnaise Nutrition
Mayonnaise is used in various recipes, including sandwiches, tuna salad, deviled eggs, and tartar sauce. It is often considered unhealthy, as it is mostly fat and, as a result, calorie-dense. Calories and fat can quickly add up when not paying attention to portion sizes.
What Is It?
It is a blend of different ingredients.
It combines oil, egg yolk, an acidic liquid (lemon juice or vinegar), and mustard.
The ingredients become a thick, creamy, permanent emulsion when blended slowly.
The key is in the emulsion, combining two liquids that would otherwise not naturally come together, which turns the liquid oil into a solid.
The Science
Emulsification happens when an emulsifier – the egg yolk – binds the water-loving/hydrophilic and oil-loving/lipophilic components.
The emulsifier binds the lemon juice or vinegar with the oil and does not allow separation, producing a stable emulsion. (Viktoria Olsson et al., 2018)
In homemade mayonnaise, the emulsifiers are mainly the lecithin from the egg yolk and a similar ingredient in mustard.
Commercial mayonnaise brands often use other types of emulsifiers and stabilizers.
Health
It contains health-promoting properties, such as vitamin E, which improves heart health, and vitamin K, which is important for blood clotting. (USDA, FoodData Central, 2018)
It can also be made with healthy fats like omega-3 fatty acids, which maintain brain, heart, and skin health.
While reduced-fat mayonnaise has fewer calories and less fat than regular mayonnaise, the fat is often replaced with starches or sugar to improve texture and flavor.
For individuals watching carbohydrates or sugar in their diet, check the nutrition label and ingredients before deciding on the right mayonnaise.
Body In Balance: Chiropractic, Fitness, and Nutrition
References
Olsson, V., Håkansson, A., Purhagen, J., & Wendin, K. (2018). The Effect of Emulsion Intensity on Selected Sensory and Instrumental Texture Properties of Full-Fat Mayonnaise. Foods (Basel, Switzerland), 7(1), 9. doi.org/10.3390/foods7010009
Mozafari, H. R., Hosseini, E., Hojjatoleslamy, M., Mohebbi, G. H., & Jannati, N. (2017). Optimization low-fat and low cholesterol mayonnaise production by central composite design. Journal of food science and technology, 54(3), 591–600. doi.org/10.1007/s13197-016-2436-0
Zhu, J., Li, J., & Chen, J. (2012). Survival of Salmonella in home-style mayonnaise and acid solutions as affected by acidulant type and preservatives. Journal of food protection, 75(3), 465–471. doi.org/10.4315/0362-028X.JFP-11-373
Institute of Medicine (U.S.). Committee on Dietary Guidelines Implementation., Thomas, P. R., Henry J. Kaiser Family Foundation., & National Cancer Institute (U.S.). (1991). Improving America’s diet and health : from recommendations to action : a report of the Committee on Dietary Guidelines Implementation, Food and Nutrition Board, Institute of Medicine. National Academy Press. books.nap.edu/books/0309041392/html/index.html www.ncbi.nlm.nih.gov/books/NBK235261/
Could pita bread be a possible option for individuals trying to eat healthier?
Pita Bread
Pita bread is a yeast-leavened, round flatbread made with wheat flour. When baked, the dough turns into two layers. These layers create a pocket that can be filled with vegetables, meats, or vegetarian proteins. Pita bread offers health benefits because of its low carbohydrate count, the amount of nutrients in one serving, and the use of wheat flour.
The carbohydrate count for pita bread is 17 grams per serving or a little more than one carb count – 15 grams, used in meal planning for individuals with diabetes.
Non-keto bread is around 20 grams of carbohydrates per serving or slice.
Pita bread has a lower carbohydrate count than most breads.
Fats
Pita breads are relatively low in fat content.
The total lipid fat is under 2 grams, only 2% of the recommended daily amount or RDA.
The bread contains no fatty acids or trans or saturated fat.
Protein
Four grams of protein are in one serving of pita bread.
The protein content is found in the wheat flour.
Vitamins and Minerals
Other minerals in pita bread include:
Calcium, with 60.1 milligrams per serving.
Iron with 1.08 milligrams per serving – helps the body create hemoglobin, a protein in red blood cells that carries oxygen from the lungs. (National Institute of Health, 2023)
Sodium with 120 milligrams.
According to the Federal Drug Administration, this is a low amount of sodium. However, individuals should stay aware of sodium intake and limit it to no more than 2,300 milligrams per day.
Pita bread for a sandwich contains fewer calories than two slices of regular bread.
Benefits
Potential health benefits include the following:
Glucose Levels Lowered
Whole wheat can be beneficial to glucose levels.
The American Diabetes Association suggests that choosing bread with whole wheat grains, like pita bread, instead of white bread, can work to keep blood sugar levels from spiking. (American Diabetes Association 2024)
Digestion Support
Whole-grain pita bread fiber content can benefit the digestive system by regulating bowel movements.
Complex carbohydrates are digested slower than simple carbohydrates, keeping the body fuller for longer and assisting in weight management. (Harvard Health 2022)
Protein Source
Pita bread provides a healthy amount of protein.
A serving contains around 8% of protein.
Consuming the proper amount of protein helps in muscle repair. (Harvard Health 2024)
Allergies
Major allergies or intolerances can cause individuals to pass on the bread. What individuals need to know.
Celiac Disease
Celiac disease is a heredity autoimmune disease that occurs in genetically predisposed individuals.
Individuals with the disease cannot ingest gluten – a protein found in wheat – which can lead to small intestinal damage.
Individuals who experience gastrointestinal distress when eating wheat should consult a healthcare professional to get tested. (Celiac Disease Foundation 2023)
Wheat Allergy
A wheat allergy may mimic celiac disease symptoms, but they are different allergies.
The allergy occurs when the body produces antibodies to wheat proteins.
For individuals considering acupuncture for sciatica relief and management, can knowing how it works and what to expect during a session help in making the decision?
Acupuncture Sciatica Treatment Session
Acupuncture for sciatica is a safe and effective medical treatment to relieve and manage pain symptoms. Studies suggest it is as effective as other treatment strategies and causes fewer side effects. (Zhihui Zhang et al., 2023) The frequency of acupuncture to relieve sciatica pain depends on the severity of the condition and injury, but many report improvement within two to three weeks. (Fang-Ting Yu et al., 2022)
Needle Placement
Circulation problems can cause the body’s energy to stagnate in one or more meridians/channels, leading to pain in and around the surrounding area. (Wei-Bo Zhang et al., 2018)
The objective of acupuncture is to restore optimal circulation by stimulating specific points in the body called acupoints.
Thin, sterile needles stimulate the acupoints to activate the body’s natural healing abilities and relieve pain. (Heming Zhu 2014)
Some practitioners use electroacupuncture – a gentle, mild electrical current is applied to the needles and passes through the tissues to activate the nervous system. (Ruixin Zhang et al., 2014)
Acupoints
Acupuncture sciatica treatment involves specific acupoints along the bladder and gallbladder meridians.
Bladder Meridian – BL
The bladder meridian/BL runs down the back along the spine, hips, and legs. The acupoints within the meridian for sciatica include: (Fang-Ting Yu et al., 2022)
BL 23 -Shenshu – Location on the lower back, near the kidney.
BL 25 – Dachangshu – Location on the lower back.
BL 36 – Chengfu – Location on the back of the thigh, just below the buttocks.
GB 30 – Huantiao – Location on the back, where the buttocks meet the hips.
GB 34 – Yanglingquan – Location on the outside of the leg, below the knee.
GB 33 – Xiyangguan – Location lateral to the knee, on the side.
Stimulating acupoints in these meridians increases blood flow to the area, reduces inflammation, and releases endorphins and other pain-relieving neurochemicals to relieve symptoms. (Ningcen Li et al., 2021) The specific acupoints vary depending on symptoms and the root cause. (Tiaw-Kee Lim et al., 2018)
Example Patient
An example of acupuncture sciatica treatment session: A patient with persistent shooting pain extending down the back and side of the leg. A standard treatment consists of the following:
The acupuncturist thoroughly goes over the patient’s medical history and symptoms and has the patient point to where the pain is located.
Then, they palpate on and around the area to find where the pain worsens and lessens, communicating with the patient as they go along.
Depending on the site and severity, they may start placing needles at the lower back, focusing on the site of the injury.
Sometimes, the sacrum is involved, so the acupuncturist will place needles on those acupoints.
They then move to the back of the leg and insert needles.
The needles are retained for 20-30 minutes.
The acupuncturist leaves the room or treatment area but regularly checks in.
The patient may feel a warmth, tingling, or mild heaviness, which is a normal response. This is where patients report a calming effect. (Shilpadevi Patil et al., 2016)
The needles are carefully removed.
The patient may feel deeply relaxed and will be advised to get up slowly to avoid dizziness.
There may be soreness, redness, or bruising at the needle insertion site, which is normal and should resolve quickly.
The patient will be given recommendations as to avoiding strenuous activity, properly hydrating, and performing gentle stretches.
Acupuncture Benefits
Acupuncture has been shown to be a complementary therapy for pain relief and management. The benefits of acupuncture:
Improves Circulation
Acupuncture stimulates blood circulation, which nourishes damaged or irritated nerves and promotes healing.
This helps relieve sciatica symptoms, like numbness, tingling, and pain. (Song-Yi Kim et al., 2016)
Releases Endorphins
Acupuncture triggers the release of endorphins and other natural pain-relieving chemicals, which help relieve pain. (Shilpadevi Patil et al., 2016)
Regulates the Nervous System
Acupuncture rebalances the sympathetic and parasympathetic responses, which reduces stress, tension, and pain. (Xin Ma et al., 2022)
Relaxes the Muscles
Nerve pain often accompanies muscle tension and spasms.
Acupuncture relaxes tight muscles, reducing pressure and providing relief. (Zhihui Zhang et al., 2023)
From Symptoms to Solutions
References
Zhang, Z., Hu, T., Huang, P., Yang, M., Huang, Z., Xia, Y., Zhang, X., Zhang, X., & Ni, G. (2023). The efficacy and safety of acupuncture therapy for sciatica: A systematic review and meta-analysis of randomized controlled trails. Frontiers in neuroscience, 17, 1097830. doi.org/10.3389/fnins.2023.1097830
Yu, F. T., Liu, C. Z., Ni, G. X., Cai, G. W., Liu, Z. S., Zhou, X. Q., Ma, C. Y., Meng, X. L., Tu, J. F., Li, H. W., Yang, J. W., Yan, S. Y., Fu, H. Y., Xu, W. T., Li, J., Xiang, H. C., Sun, T. H., Zhang, B., Li, M. H., Wan, W. J., … Wang, L. Q. (2022). Acupuncture for chronic sciatica: protocol for a multicenter randomised controlled trial. BMJ open, 12(5), e054566. doi.org/10.1136/bmjopen-2021-054566
Zhang, W. B., Jia, D. X., Li, H. Y., Wei, Y. L., Yan, H., Zhao, P. N., Gu, F. F., Wang, G. J., & Wang, Y. P. (2018). Understanding Qi Running in the Meridians as Interstitial Fluid Flowing via Interstitial Space of Low Hydraulic Resistance. Chinese journal of integrative medicine, 24(4), 304–307. doi.org/10.1007/s11655-017-2791-3
Zhu H. (2014). Acupoints Initiate the Healing Process. Medical acupuncture, 26(5), 264–270. doi.org/10.1089/acu.2014.1057
Zhang, R., Lao, L., Ren, K., & Berman, B. M. (2014). Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology, 120(2), 482–503. doi.org/10.1097/ALN.0000000000000101
Perreault, T., Fernández-de-Las-Peñas, C., Cummings, M., & Gendron, B. C. (2021). Needling Interventions for Sciatica: Choosing Methods Based on Neuropathic Pain Mechanisms-A Scoping Review. Journal of clinical medicine, 10(10), 2189. doi.org/10.3390/jcm10102189
Li, N., Guo, Y., Gong, Y., Zhang, Y., Fan, W., Yao, K., Chen, Z., Dou, B., Lin, X., Chen, B., Chen, Z., Xu, Z., & Lyu, Z. (2021). The Anti-Inflammatory Actions and Mechanisms of Acupuncture from Acupoint to Target Organs via Neuro-Immune Regulation. Journal of inflammation research, 14, 7191–7224. doi.org/10.2147/JIR.S341581
Lim, T. K., Ma, Y., Berger, F., & Litscher, G. (2018). Acupuncture and Neural Mechanism in the Management of Low Back Pain-An Update. Medicines (Basel, Switzerland), 5(3), 63. doi.org/10.3390/medicines5030063
Kim, S. Y., Min, S., Lee, H., Cheon, S., Zhang, X., Park, J. Y., Song, T. J., & Park, H. J. (2016). Changes of Local Blood Flow in Response to Acupuncture Stimulation: A Systematic Review. Evidence-based complementary and alternative medicine : eCAM, 2016, 9874207. doi.org/10.1155/2016/9874207
Patil, S., Sen, S., Bral, M., Reddy, S., Bradley, K. K., Cornett, E. M., Fox, C. J., & Kaye, A. D. (2016). The Role of Acupuncture in Pain Management. Current pain and headache reports, 20(4), 22. doi.org/10.1007/s11916-016-0552-1
Ma, X., Chen, W., Yang, N. N., Wang, L., Hao, X. W., Tan, C. X., Li, H. P., & Liu, C. Z. (2022). Potential mechanisms of acupuncture for neuropathic pain based on somatosensory system. Frontiers in neuroscience, 16, 940343. doi.org/10.3389/fnins.2022.940343
For individuals looking to improve their diet, can knowing the different salt types help in food preparation and health?
Salt Types
Salt brings out the natural flavor of foods and can be used as a preservative. Salt types come in various colors and textures for cooking, flavor, and health. Some are considered healthier compared to regular table salt, like pink Himalayan salt and different sea salts. Some individuals prefer them because most go through less processing and can have more trace minerals like magnesium and potassium. However, all salts are healthy in moderation, as sodium is a necessary part of a balanced diet. Although essential for the body, sodium can be harmful when too much is consumed. A study examining consumer-grade pink Himalayan sea salts available in Australia determined that to receive the additional health benefits of the minerals from this type of salt, individuals must consume so much that it elevates the amount of sodium in the body to dangerous levels. (Flavia Fayet-Moore et al., 2020)
Salt
Salt is a mineral made from the combined elements:
Sodium – Na
Chlorine -Cl
Together, they form crystallized sodium chloride NaCl.
The majority of salt production comes from evaporated seawater and salt mines. Many salts used in food preparation are iodized. Iodine is added to various refined salt products to help meet nutritional requirements. Iodine intake levels that fall below the recommended values could result in a deficiency and develop goiter. Goiter is associated with hypothyroidism. (Angela M. Leung et al., 2021) Lack of iodine can also have adverse effects on growth and development. (National Institutes of Health Office of Dietary Supplements. 2023)
Essential for Health
Salt sustains life and optimal bodily function. Sodium and chlorine are important elements that maintain:
Cellular balance
Circulation
Blood sugar levels
Sodium is a mineral and an electrolyte. Common electrolytes include potassium, calcium, and bicarbonate. Without adequate sodium levels, the brain cannot send the necessary impulses to the rest of the body to function properly. However, consuming too much salt can cause health issues.
Higher salt intake in individuals who are sensitive to salt can increase blood pressure.
Doctors usually recommend that individuals with hypertension reduce sodium intake or follow a low-sodium diet.
Elevated sodium levels also cause water retention – considered a protective response as the body works to regulate serum sodium levels concentration in the blood to maintain balance.
If levels are too high, a condition known as hypernatremia can develop, which can cause:
Excessive thirst
Vomiting
Infrequent urination
Diarrhea
Sodium levels that are too low can lead to hyponatremia, which can cause:
Though there are different types of salt, they all contain roughly the same amount of sodium.
Types
The average sodium intake by adults is around 3,393mg per day, ranging between 2,000–5,000mg. Guidelines recommend a maximum intake of 2,300mg per day. (U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2020) Whether from unhealthy dietary choices like processed foods or incorrect knowledge of sodium content when cooking, an American Heart Association survey showed that more than half of respondents inaccurately stated that sea salt had a lower sodium content than table salt. (American Heart Association. 2024)
Refined – Table Salt
Refined/iodized salt is finely granulated and commonly used in cooking. This type is highly refined to remove impurities and eliminate trace minerals often found in specialty salts. Because the salt is finely ground, anti-caking agents are added to ensure the salt doesn’t clump. Some table salts also have added sugar and other additives.
Refined table salt is about 97–99% sodium chloride (NaCl).
Iodine is added to prevent iodine deficiency.
Individuals trying to reduce sodium intake but meet iodine levels can do so with foods like eggs, dairy products, and fish.
Kosher
Kosher salt is coarse and flakey and can add a crunchy texture to dishes and drinks. Pure kosher salt does not contain additives like anti-caking agents and iodine. The size of the salt crystals is ideal for drawing out moisture.
Per teaspoon, kosher salt generally has less sodium than 1 teaspoon of table salt.
Because it has a coarser grain, less salt fits in the measuring spoon.
Sea Salt
Sea salt is produced from evaporated seawater and comes as fine grains or large crystals. Examples include:
Black Sea
Celtic
French – fleur de sel
Hawaiian sea salt
Sea salt can have trace amounts of minerals like iron, potassium, and zinc, which can produce different flavors in cooking but no additional health benefits with normal consumption. Some sea salts may also contain trace amounts of microplastics. However, research indicates these amounts are too low to warrant public health concerns. (Ali Karami et al., 2017)
Himalayan Pink Salt
Himalayan pink salt is mined in the red salt range in Pakistan, the second-largest salt mine in the world, and in the Andes mountains of Peru. Trace amounts of iron oxide make the salt pink. It is typically used at the end of cooking to add flavor and a crunch. Himalayan salt is popular for its health benefits and mineral properties. However, using Himalayan salt over other types has no known health advantages. Researchers concluded that the potential health benefits provided by the higher nutrient content would be counteracted by the large amount of sodium that would need to be consumed. (Flavia Fayet-Moore et al., 2020)
Substitutes
Salt substitutes contain some or all sodium and potassium, magnesium, or other minerals. Substitutes can be half sodium chloride and half potassium chloride. Monosodium glutamate/MSG can also be used as an alternative. A study found that substituting salt with MSG is safe and comparable to salt flavor. (Jeremia Halim et al., 2020) Individuals often use substitutes on a sodium-restricted diet but should check with their doctor before using these products, especially if they have kidney conditions.
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References
Fayet-Moore, F., Wibisono, C., Carr, P., Duve, E., Petocz, P., Lancaster, G., McMillan, J., Marshall, S., & Blumfield, M. (2020). An Analysis of the Mineral Composition of Pink Salt Available in Australia. Foods (Basel, Switzerland), 9(10), 1490. doi.org/10.3390/foods9101490
Leung, A. M., Braverman, L. E., & Pearce, E. N. (2012). History of U.S. iodine fortification and supplementation. Nutrients, 4(11), 1740–1746. doi.org/10.3390/nu4111740
Karami, A., Golieskardi, A., Keong Choo, C., Larat, V., Galloway, T. S., & Salamatinia, B. (2017). The presence of microplastics in commercial salts from different countries. Scientific reports, 7, 46173. doi.org/10.1038/srep46173
Halim, J., Bouzari, A., Felder, D., & Guinard, J. X. (2020). The Salt Flip: Sensory mitigation of salt (and sodium) reduction with monosodium glutamate (MSG) in “Better-for-You” foods. Journal of food science, 85(9), 2902–2914. doi.org/10.1111/1750-3841.15354
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