The Gut "Connections to Health & Disease"

Can kimchi benefit individuals trying to incorporate more fermented foods into their diet?

Kimchi

Kimchi is a flavorful and nutritious food packed with nutritious vegetables. It is high in vitamin C, vitamin A, and iron. It is made of salted, fermented vegetables and typically served as a side dish that starts with cabbage as the base. Other varieties use different vegetables, like radish, cucumber, and onion. It has minimal calories, a low carb count, zero fat, and health benefits like an abundance of probiotics from its fermentation process.

Nutrition

Kimchi is an excellent source of vitamin C and vitamin A. A typical half-cup of kimchi is 85 grams and provides the following. (U.S. Department of Agriculture. 2017)

• Calories - 20
• Fat - 0g
• Sodium - 290 milligrams
• Carbohydrates - 4 grams
• Fiber - 1 grams
• Sugars - 2 grams
• Protein - 1 grams
• Vitamin C - 18 milligrams
• Iron - 1.08 milligrams
• Vitamin A - 375 micrograms
• Calcium - 40 milligrams

Calories

• A half-cup serving provides 20 calories, about 53% of which are carbohydrates, 21% are protein, and 26% are fat.

Carbohydrates

• Kimchi comprises 4 grams of carbohydrates per serving, with 1 being fiber.
• However, many kimchi recipes add sweeteners, like honey or fruit juice, to balance the sourness.
• More sweeteners means more carbohydrates.

Fats

• Because it is primarily vegetables, it is naturally fat-free.

Protein

• Kimchi isn’t exactly a protein-power player.
• A half-cup serving provides just 1 gram of plant-based protein from veggies.
• However, recipes that include seafood like shrimp or squid will contain higher amounts of this macronutrient.

Vitamins and Minerals

• Vitamins and minerals vary depending on the vegetables used.
• A Napa cabbage-based kimchi includes abundant vitamins C and K and smaller amounts of iron, calcium, copper, and potassium.
• A recipe with carrots will contain significant vitamin A.
• A recipe with radishes will supply folate, potassium, and riboflavin.
• All varieties are made with salt, so sodium is a mineral to watch.
• A half-cup serving may provide nearly 300 milligrams or 13% Daily Value of sodium.

Benefits

Kimchi is a versatile food that can provide health benefits.

Digestion

• The lactic acid that ferments the cabbage also provides healthy gut bacteria.
• Consuming probiotics through kimchi promotes healthy digestion and helps alleviate constipation problems. (Higashikawa, F. et al., 2010)

Compatible with Special Diets

• With simple plant-based ingredients it can be suitable for specialized diets.
• It suits vegan, vegetarian, low-carb, gluten-free, and dairy-free diets.

Immune System Support

• The probiotics in fermented foods improve digestion and may help improve immune function.
• Research has suggested that when individuals stop eating fermented foods, their immune response decreases. (Olivares, M. et al., 2006)
• Vitamin C is recognized to increase immune system health. (National Institutes of Health Office of Dietary Supplements. 2021)

Decrease Inflammation

• Researchers isolated a compound in kimchi called HDMPPA - 3-(4'-hydroxyl-3',5'-dimethoxyphenyl) propionic acid -
  and studied its interaction with inflammatory proteins.
• They discovered that HDMPPA counteracted the proteins' inflammatory effect.
• It is not enough to conclude that kimchi readily reduces inflammation, but further research could help confirm its ability. (Jeong, J. W. et al., 2015)

Improve Asthma Symptoms

• A study of Korean adults with asthma found that the more kimchi they consumed, the less likely they were to experience an asthma attack.
• Further research is needed, but the results are promising. (Kim, H. et al., 2014)

Allergies

• Commercial and home-prepared kimchi is often free of all top eight food allergens—but check ingredient labels to be sure.
• Some preparations, for example, may contain fish sauce, shrimp, or shrimp paste, which are a no-go for those with a fish or shellfish allergy.

Adverse Effects

• Kimchi may have adverse effects on some individuals depending on its preparation.
• It could be high in sodium, which may not be recommended for individuals on a heart-healthy or sodium-restricted diet.
• With high levels of probiotics, it could cause bloating or an upset stomach.
• Individuals sensitive to strong flavors may not enjoy the taste.

Varieties

Traditionally, kimchi is made from cabbage, but a wide variety of vegetables can be substituted for or combined with recipes that use alternative vegetables, spices, or other additions. Some recipes include fish or meat to turn it inta a main dish. Water kimchi is a soup version served in broth. But what makes kimchi is its base of fermented vegetables.

Storage and Safety

Fermentation can be tricky when it comes to food safety. Store-bought or homemade kimchi properly canned in a sterilized jar can be kept at room temperature for up to a week after opening. Stored in the refrigerator, it will stay fresh for three to six months. The beneficial bacteria working and fermentation process is ongoing, making the taste increasingly sour and texture mushier over time. This does not mean the jar has gone bad as long as it has no odd smell or mold.

Preparation

The process is not that complex.

• Select a recipe with vegetables like cabbage, radish, and carrots.
• Slice the vegetables into chunks and rub with salt.
• Leave the vegetables in salt; some recipes include water for several hours to allow fermentation.
• Drain the excess water, then add flavoring ingredients like sweeteners and spices.
• Serve as a side dish with fried rice or noodles, or make it a main course by adding fish, meat, or tofu.

Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, to restore health and function to the body through Nutrition and Wellness, Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them, 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.

The Healing Diet

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, don't hesitate to contact Dr. Alex Jimenez or us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

U.S. Department of Agriculture. FoodData Central. (2017). Kimchi. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/516912/nutrients

Higashikawa, F., Noda, M., Awaya, T., Nomura, K., Oku, H., & Sugiyama, M. (2010). Improvement of constipation and liver function by plant-derived lactic acid bacteria: a double-blind, randomized trial. Nutrition (Burbank, Los Angeles County, Calif.), 26(4), 367–374. https://doi.org/10.1016/j.nut.2009.05.008

Olivares, M., Paz Díaz-Ropero, M., Gómez, N., Sierra, S., Lara-Villoslada, F., Martín, R., Miguel Rodríguez, J., & Xaus, J. (2006). Dietary deprivation of fermented foods causes a fall in innate immune response. Lactic acid bacteria can counteract the immunological effect of this deprivation. The Journal of dairy research, 73(4), 492–498. https://doi.org/10.1017/S0022029906002068

National Institutes of Health Office of Dietary Supplements. (2021). Vitamin C: Fact sheet for health professionals. Retrieved from https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/

Jeong, J. W., Choi, I. W., Jo, G. H., Kim, G. Y., Kim, J., Suh, H., Ryu, C. H., Kim, W. J., Park, K. Y., & Choi, Y. H. (2015). Anti-Inflammatory Effects of 3-(4'-Hydroxyl-3',5'-Dimethoxyphenyl)Propionic Acid, an Active Component of Korean Cabbage Kimchi, in Lipopolysaccharide-Stimulated BV2 Microglia. Journal of medicinal food, 18(6), 677–684. https://doi.org/10.1089/jmf.2014.3275

Kim, H., Oh, S. Y., Kang, M. H., Kim, K. N., Kim, Y., & Chang, N. (2014). Association between kimchi intake and asthma in Korean adults: the fourth and fifth Korea National Health and Nutrition Examination Survey (2007-2011). Journal of medicinal food, 17(1), 172–178. https://doi.org/10.1089/jmf.2013.3013

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

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

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

For individuals with digestive and other health issues, could resistant starch provide health benefits?

Resistant Starch

Typical starchy foods are simple starches that are rapidly digested. This sends their sugars into the bloodstream, contributing to weight gain and increasing the risk of diabetes and heart disease. (Erik E. J. G. Aller, et al., 2011) Resistant starch is a food component that is a type resistant to digestion. This means that it passes into the large intestine and interacts with the gut flora. Foods that contain resistant starch pass through the stomach and small intestine without being absorbed. In the large intestine, they are fermented by the gut bacteria which releases substances that are beneficial to health.​

Health Benefits

Studies on the health benefits are ongoing. Scientists are researching how it can help with weight management and colon health:

Weight Management

Research is beginning to show indications that foods with resistant starch can help with weight loss and the ability to help offset the diseases associated with weight gain that include: (Janine A. Higgins. 2014)

• High cholesterol
• Diabetes
• Metabolic syndrome
• Cardiovascular disease

Colon Health

In addition, researchers are finding preliminary evidence indicating that resistant starch might possibly help with: (Diane F. Birt, et al., 2013)

• A prebiotic that encourages a healthy balance of gut flora.
• Inflammatory bowel disease symptom improvement.
• Prevention of colon cancer.
• Protection against diverticulitis.

However, more research is needed.

Consumption Amount 

Estimates on how much should be consumed range from a minimum of 6 grams to a maximum of 30 grams. It is estimated that most individuals consume less than 5 grams per day, (Mary M. Murphy, et al., 2008). As individuals increase their intake, it is recommended to do so slowly, to minimize unwanted gas and bloating.

Bananas

• Bananas are a healthy source of resistant starch.
• They have the maximum amount when they are unripe.
• The resistant starch content reduces as the banana ripens.
• If green/unripe bananas are not appealing, making a smoothie can help with the taste.

Potatoes

• Potatoes have their highest level of resistant starch when raw.
• However, individuals can maximize their intake by allowing the potatoes to cool before eating.

Rice

• Levels of resistant starch depend on whether the rice is white or brown.
• Similar to potatoes, intake can be maximized from rice by allowing the rice to cool.

Oats

• Cooking oats in water, as most are accustomed to making oatmeal, diminishes the resistant starch content.
• Rolled or steel-cut oats are recommended as dependable sources of resistant starch.

Chickpeas

• Chickpeas, also known as garbanzo beans, are nutritional powerhouses.
• They are a healthy source of dietary fiber, along with many vitamins and minerals, and resistant starch.
• Cooked and/or canned chickpeas contain high levels of resistant starch.
• They go with salads or as a side dish or snack.
• For individuals with IBS, well-rinsed canned chickpeas are considered to be low in FODMAPs or carbohydrates that can contribute to symptoms. (Anamaria Cozma-Petruţ, et al., 2017)
• It is recommended to keep the serving size to a 1/4 cup.

Lentils

• Lentils serve as a healthy source of plant-based protein.
• Cooked they can provide resistant starch.
• They can be prepared in soups or side dishes.
• From a can, they can be IBS-friendly by being well-rinsed and limited to a 1/2 cup serving.

Bread

• Various breads offer varying levels of resistant starch.
• Pumpernickel bread contains high levels.
• Breadsticks and pizza crusts have high levels.
• Individuals with IBS may be reactive to the FODMAP fructan or the gluten protein.
• Other recommended high-resistant starch options are corn tortillas or artisanal sourdough bread that is traditionally prepared.

Green Peas

• Green peas, even when cooked, are a healthy source of resistant starch.
• They can be prepared in soups or as a side dish.
• However, green peas have been found to be high in the FODMAP GOS and could be problematic for individuals with IBS. (Anamaria Cozma-Petruţ, et al., 2017)

Beans

• Most types of cooked and/or canned beans are recommended sources of resistant starch.
• The highest levels are found in white and kidney beans.
• They can be served in soups, as a side dish, or mixed with rice.
• Beans are a high-FODMAP food and could contribute to digestive symptoms in individuals with IBS.

Body In Balance: Chiropractic Fitness and Nutrition

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Aller, E. E., Abete, I., Astrup, A., Martinez, J. A., & van Baak, M. A. (2011). Starches, sugars and obesity. Nutrients, 3(3), 341–369. https://doi.org/10.3390/nu3030341

Higgins J. A. (2014). Resistant starch and energy balance: impact on weight loss and maintenance. Critical reviews in food science and nutrition, 54(9), 1158–1166. https://doi.org/10.1080/10408398.2011.629352

Birt, D. F., Boylston, T., Hendrich, S., Jane, J. L., Hollis, J., Li, L., McClelland, J., Moore, S., Phillips, G. J., Rowling, M., Schalinske, K., Scott, M. P., & Whitley, E. M. (2013). Resistant starch: promise for improving human health. Advances in nutrition (Bethesda, Md.), 4(6), 587–601. https://doi.org/10.3945/an.113.004325

Murphy, M. M., Douglass, J. S., & Birkett, A. (2008). Resistant starch intakes in the United States. Journal of the American Dietetic Association, 108(1), 67–78. https://doi.org/10.1016/j.jada.2007.10.012

Cozma-Petruţ, A., Loghin, F., Miere, D., & Dumitraşcu, D. L. (2017). Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients!. World journal of gastroenterology, 23(21), 3771–3783. https://doi.org/10.3748/wjg.v23.i21.3771

For individuals with stomach issues, can maintaining gut flora balance promote and improve gut health?

Gut Flora Balance

Maintaining gut flora balance is part of optimal digestive health. Gut microbiota, gut microbiome, or gut flora, are the microorganisms, including bacteria, archaea, fungi, and viruses that live in the digestive tract. The type and amount of bacteria present depend on their location in the body which could be the small intestine and colon. This is the storage housing for waste/stool, and the colon comprises hundreds of different types of bacteria, which have specific jobs and functions.

Unhealthy Flora

The more common pathogens are bacteria that can cause illness if left unchecked, including germs like streptococcus/strep throat or E. coli/urinary tract infections and diarrhea. Other common germs found in the colon include: (Elizabeth Thursby, Nathalie Juge. 2017)

Clostridioides Difficile

• C. diff overgrowth can cause watery foul-smelling stools daily, and abdominal pain and tenderness.

Enterococcus Faecalis

• Enterococcus faecalis is a cause of post-surgical abdominal and urinary tract infections.

Escherichia Coli

• E. coli is the most common cause of diarrhea in adults.
• This bacteria is present in almost every healthy adult’s colon.

Klebsiella

• Klebsiella overgrowth is associated with a Western diet that consists of various meat and animal products.

Bacteroides

• Bacteroide overgrowth is associated with colitis, which causes painful inflammation of the colon.

Healthy Flora

Healthy bacteria like Bifidobacteria and Lactobacillus, help maintain gut flora balance and keep the unhealthy bacteria in check. Without healthy flora, the entire colon can become overrun by bad flora, which can result in symptoms like diarrhea and/or illness. (Yu-Jie Zhang, et al., 2015) These protective, microscopic germs have important functions that include:

• Assisting with vitamin synthesis - vitamins B and K in the small intestine.
• Increases immune system function.
• Maintaining regular bowel movements.
• Maintaining a clean colon naturally without the need for colon cleansers.
• Destroying the unhealthy bacteria.
• Preventing unhealthy bacteria overgrowth.
• Breaking up gas bubbles from food fermentation.

Bacterial Dismantling

Whether labeled as healthy bacteria or unhealthy, they are both single-celled organisms that can be destroyed quite easily. Sometimes, it is necessary, like when having to take antibiotics to kill a strep throat infection. However, the antibiotics also kill the beneficial bacteria, which can lead to compounding problems that can include: (Mi Young Yoon, Sang Sun Yoon. 2018)

• Bowel irregularity - diarrhea and constipation.
• Yeast overgrowth - can cause itching, burning around the anus and lead to vaginal and oral yeast infections.
• Dysbiosis - the technical name for a lack of healthy bacteria or a bacterial imbalance.
• Complications for individuals suffering from irritable bowel syndrome.

There are different ways to destroy bacteria including.

• Individuals who need to take antibiotics to cure an infection. (Eamonn M M Quigley. 2013)
• Chronic laxative use.
• Fiber supplementation overuse.
• Prolonged diarrhea - can flush out the bad and good bacteria.
• Stress
• Completing a bowel prep, like those required for a colonoscopy.

Diagnosing Gut Flora Issues

Many times, problems with gut flora will correct themselves, and no action is required. However, individuals facing chronic bowel problems, like colitis or inflammatory bowel disease, may require medical intervention of their colon's bacteria.

• Comprehensive Digestive Stool Analysis/CDSA is a stool test that checks what type and amount of bacteria are present, nutrient absorption rates/digestion speed, and how well food is digested.
• If there is a significant difference in the proportion of unhealthy versus beneficial bacteria, a healthcare provider may suggest taking a probiotic or a live microbial supplement to help repopulate and maintain gut flora balance.

Gut Dysfunction

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Thursby, E., & Juge, N. (2017). Introduction to the human gut microbiota. The Biochemical journal, 474(11), 1823–1836. https://doi.org/10.1042/BCJ20160510

Zhang, Y. J., Li, S., Gan, R. Y., Zhou, T., Xu, D. P., & Li, H. B. (2015). Impacts of gut bacteria on human health and diseases. International journal of molecular sciences, 16(4), 7493–7519. https://doi.org/10.3390/ijms16047493

Yoon, M. Y., & Yoon, S. S. (2018). Disruption of the Gut Ecosystem by Antibiotics. Yonsei medical journal, 59(1), 4–12. https://doi.org/10.3349/ymj.2018.59.1.4

Quigley E. M. (2013). Gut bacteria in health and disease. Gastroenterology & hepatology, 9(9), 560–569.

The digestive system breaks down the foods eaten so the body can absorb the nutrients. During digestion, the unnecessary parts of these foods are turned into waste/stool, which is evacuated during a bowel movement. When the digestive system stops functioning properly due to factors such as diet change, eating unhealthy foods, lack of physical activity/exercise, medications, and certain health conditions, can cause constipation. Constipation occurs when the body cannot have a regular bowel movement. The distention, gas, bloating and not being able to have a bowel movement cause irritability and stress, which can worsen constipation. Incorporating recommended nutrition can help restore regular bowel movements and gut function.

Recommended Nutrition For Constipation

Symptoms like abdominal pain, bloating, and difficult bowel movements are common. Diet and proper hydration have a significant role in digestive health, especially in relieving and preventing constipation. High-fiber foods, prebiotics, and adequate hydration from foods and beverages are essential for healthy bowel movements.

• Fiber is found in whole grains, starches, fruits, and vegetables.
• Soluble and insoluble fiber are important for digestive health.
• Focusing on incorporating high-fiber fruits, vegetables, and whole grains.
• Foods rich in prebiotics like fermented foods are recommended when constipated.

The recommended nutrition for constipation, according to a dietitian includes.

Avocados

• Avocados can be paired with just about anything and are full of nutrients and fiber.
• One avocado contains around 13.5 grams of fiber.
• One avocado will provide almost half daily fiber needs.
• Other high-fiber fruits: pomegranates, guava, raspberries, blackberries, and passionfruit.

Figs

• Figs can be eaten fresh and dried.
• Figs are considered a laxative and have been shown to treat and reduce constipation.
• They contain antioxidants, polyphenols, polyunsaturated fatty acids, and vitamins.
• Other fruits similar to a fig: dried apricots, prunes, and plums.

Plums

• Plums, prunes dried plums are packed with fiber and prebiotics that have a natural laxative effect.
• Sorbitol - a sugar found in plums and prunes, acts as an osmotic laxative that retains water.
• The added H2O makes the stools softer and easier to pass.
• Natural fruit juices, like pear, apple, or prune are often prescribed for constipation.
• Other fruits that aid in bowel movements: peaches, pears, and apples.

Kefir

• Fermented foods like kefir are rich in beneficial bacteria that work to maintain digestive system health.
• It can be consumed on its own or used in smoothies, cooking, and baking recipes.
• Other fermented foods: kombucha, yogurt, sauerkraut, kimchi, miso, and tempeh.

Oat Bran

• Oat bran is oatmeal that has not had the bran removed.
• The bran contains beneficial nutrients including fiber, antioxidants, vitamins, and minerals.
• Oat bran contains soluble and insoluble fiber, as well as beta-glucan/non-starchy polysaccharides.
• All improve the composition of gut bacteria and promote healthy bowel movements.
• Other beneficial grains: oatmeal, wheat bran, rye, and barley.

Incorporating Gut-Beneficial Foods

How to incorporate recommended nutrition gut-beneficial foods into a regular menu:

Smoothie

• Use kefir or yogurt as a base then balance it out with fiber-rich fruits like mango, blueberries, and kiwi.

Snacks

• Diversify snacks with a plate of fiber and prebiotics.
• Nuts, cheese, crackers, fruit, and a yogurt or avocado dip.

Oatmeal

• Try oat bran to increase fiber.
• Sprinkle a serving of flaxseeds, chia seeds, or hemp seeds for added fiber and healthy fats.

Parfait

• Yogurt parfaits can maximize nutrients, flavor, and textures in a bowl.
• Layer up on a favorite yogurt with granola, nuts, fruit, and seeds.

Grain Bowl

• Fiber found in whole grains and seeds like barley, farro, and quinoa, helps promote healthy digestion.
• Make a bowl with a grain base, then top with a protein, fresh or grilled veggies, avocado, and dressing.

Talk with a registered nutritionist or other healthcare provider to discuss recommended nutrition plan options.

Balancing Body and Metabolism

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Arce, Daisy A et al. “Evaluation of constipation.” American family physician vol. 65,11 (2002): 2283-90.

Bharucha, Adil E. “Constipation.” Best practice & research. Clinical gastroenterology vol. 21,4 (2007): 709-31. doi:10.1016/j.bpg.2007.07.001

Gray, James R. “What is chronic constipation? Definition and diagnosis.” Canadian Journal of Gastroenterology = Journal Canadien de Gastroenterology vol. 25 Suppl B, Suppl B (2011): 7B-10B.

Jani, Bhairvi, and Elizabeth Marsicano. “Constipation: Evaluation and Management.” Missouri medicine vol. 115,3 (2018): 236-240.

Naseer, Maliha, et al. “Therapeutic Effects of Prebiotics on Constipation: A Schematic Review.” Current clinical pharmacology vol. 15,3 (2020): 207-215. doi:10.2174/1574884715666200212125035

National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms and Causes of Constipation.

National Institute of Diabetes and Digestive and Kidney Disease. Your Digestive System and How It Works.

Sinclair, Marybetts. “The use of abdominal massage to treat chronic constipation.” Journal of bodywork and movement therapies vol. 15,4 (2011): 436-45. doi:10.1016/j.jbmt.2010.07.007

The human body is about 60% to 75% water. Adequate hydration is necessary to flush toxins from the body, is essential for cognition, prevents dehydration, and provides energy. It can reduce headache onset and aid in weight management. With the summer heat kicking in, it is imperative to replenish the body's systems from lost sources with water, other rehydrating beverages, and fruits and vegetables. It can be difficult for individuals to drink enough water, making it feel like a chore. Drinking lime water by adding a slice of lime or lime juice can add flavor with beneficial properties for everyday health, nutritional properties, and only a trace amount of sugar.

Lime Water

Citrus fruits offer anti-oxidative and anti-inflammatory effects and can help protect the cardiovascular system. Limes can provide a sour boost and a refreshing twist to a cold glass of water.

Lime Nutrition 

Limes provide an excellent source of antioxidants that protect the body by preventing or stopping cell damage caused by free radicals or chemicals. Limes contain:

• Calcium
• Potassium
• Magnesium
• Vitamins A, B, C, and D

Digestion and Gut Health

Drinking lime water improves digestion.

• The acidic nature of limes causes salivation, which is good for breaking down food for better digestion.
• Flavonoids in limes stimulate the secretion of digestive juices to regulate different gut physiology in the gastrointestinal tract. They also stimulate the secretion of:
• Gut hormones
• Digestive juices
• Gut microbiota
• These play an important role in immune function to fight the growth of certain harmful bacteria that can lead to infection.
• The acidity of limes can clear the excretory system and stimulate bowel activity for individuals experiencing constipation.
• For individuals with frequent heartburn or acid reflux, drinking a glass of warm water with two teaspoons of lime juice 30 minutes before meals can help prevent reflux symptoms.

Fight Infections

The body's risk of infection is higher during cold and flu season.

• Vitamin C and antioxidants can strengthen the immune system to help the body fight off infections like the cold and flu virus.
• Individuals who take vitamin C regularly may see milder symptoms and shorten the duration of a cold.

Improve Cardiovascular Health

Limes are a good source of magnesium and potassium for heart health.

• Potassium can naturally lower blood pressure and improve blood circulation, which reduces the risk of a heart attack and stroke.
• Research is ongoing on lime compounds called limonins that could help reduce cholesterol levels.

Lower Blood Sugar

Limes can be helpful for individuals with diabetes.

• Limes have a low glycemic index.
• They help regulate how the body absorbs sugar into the blood.
• As a result, individuals may experience fewer spikes.

Reduce Inflammation

Arthritis, gout, and other joint problems are caused by inflammation.

• Vitamin C can reduce inflammation to help relieve symptoms of arthritis and similar conditions that cause joint pain and stiffness.
• Limes can help reduce uric acid levels.
• A waste product the body produces when breaking down foods that contain purines.
• High levels can cause gout.

Weight Loss

• Citric acids increase metabolism, helping the body burn more calories and store less fat.
• Regular physical activity is necessary for at least 30 minutes 3-4 days a week.
• Food portion control is important for weight control.
• Make one-half of all meals fruits and vegetables.
• To start the day and increase metabolism, drink a glass of lime water in the morning or have the juice of a lime wedge before meals.

Nutrition Fundamentals

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Bucher A, White N. Vitamin C in the prevention and treatment of the common cold. Am J Lifestyle Med. 2016;10(3):181-183. doi:10.1177/1559827616629092

Fan, Shunming et al. “Limonin: A Review of Its Pharmacology, Toxicity, and Pharmacokinetics.” Molecules (Basel, Switzerland) vol. 24,20 3679. 12 Oct. 2019, doi:10.3390/molecules24203679

Iorgulescu, Gabriela. “Saliva between normal and pathological. Important factors in determining systemic and oral health.” Journal of Medicine and Life vol. 2,3 (2009): 303-7.

Oteiza PI, Fraga CG, Mills DA, Taft DH. Flavonoids and the gastrointestinal tract: Local and systemic effects. Mol Aspects Med. 2018;61:41-49. doi:10.1016/j.mam.2018.01.001

Panche, A N et al. “Flavonoids: an overview.” Journal of nutritional science vol. 5 e47. 29 Dec. 2016, doi:10.1017/jns.2016.41

Pattison, D J et al. “Vitamin C and the risk of developing inflammatory polyarthritis: a prospective nested case-control study.” Annals of the rheumatic diseases vol. 63,7 (2004): 843-7. doi:10.1136/ard.2003.016097

Peyrot des Gachons, Catherine, and Paul A S Breslin. “Salivary Amylase: Digestion and Metabolic Syndrome.” Current diabetes reports vol. 16,10 (2016): 102. doi:10.1007/s11892-016-0794-7

USDA, FoodData Central. Lime, raw.

Viruses, bacteria, fungi, and protozoa are the microorganisms that naturally live in the digestive tract. Sleep affects gut health and vice versa. A healthy gut microbiota consists of all kinds of microorganisms that produce thousands of compounds and coexist harmoniously. A healthy diet and lifestyle are the biggest factors influencing bacteria variety, and maintaining a varied diet preserves microbiota diversity. Everybody's gut microbiome is different; the more diverse the gut microbiome, the healthier sleep will be. The Injury Medical Chiropractic and Functional Medicine Clinic Team can develop a personalized nutritional plan to improve gut health and sleep patterns.

Sleep Affects Gut Health

Not having a diverse gut microbiome has been linked to autoimmune diseases, Parkinson's disease, and mental health issues like anxiety and depression. Not getting healthy sleep is associated with many diseases and disorders, including:

• Gastrointestinal disorders
• Infections
• Diabetes
• Cardiovascular disease
• Neurological disorders
• Anxiety
• Depression
• Cancer

Changes in sleep patterns influence the central nervous system and the immune system, which affect different organ systems. For example, studies have shown some gastrointestinal disorders, like irritable bowel syndrome - IBS could be associated with increased REM sleep or the fourth part of the sleep cycle when vivid dreaming occurs. In Crohn’s disease or ulcerative colitis, long-term immune response activation can result in poor sleep, insufficient quality sleep, or other sleep problems. The deepest stages of sleep are when the brain and gut communicate to repair the body, restore nutrients, and remove and release toxins.

Sleep Cycle

During sleep, the immune system produces proteins called cytokines that perform functions during the inflammatory response, either by increasing or blocking inflammation, depending on the body's needs. Cytokines help promote sleep, fight infection, or stop inflammation in chronic inflammatory diseases like Crohn’s disease or ulcerative colitis.

• Insufficient sleep significantly alters cytokine production, and infection-fighting cells decrease in numbers when sleep deprived, making it harder for the body to fight infections and lessening protection. This increases the inflammatory response and keeps the immune system on.
• Chronic or long-term immune response activation can result in sleep disturbances or disorders.
• Some disorders include small intestinal bacterial overgrowth and inflammation caused by microbiome abnormalities or dysbiosis.
• The gut barrier function begins to malfunction, leading to bacteria and pathogens leaking into blood circulation/leaky gut, triggering immune responses.

Ways to Improve Sleep

One of the main ways to improve sleep quality and gut microbiome health is to practice healthy sleep hygiene. According to the National Sleep Foundation, individuals should:

Nap Smart

• Naps can be a great way to refresh the mind and body and replenish energy levels during the day.
• Naps don't make up for little sleep at night.
• Keep naps to 20-30 minutes for optimal benefits without disrupting nighttime sleep.

Optimal Sleep Environment

• Comfortable ergonomic mattress and pillows.
• Blackout curtains.
• Temperature between 60 and 67 degrees.

Quit Electronics Before Bed

• The bright lights from phones and screens can make it difficult to fall asleep fully.
• Use an alarm clock with a soft night light and keep the bedroom tech-free.

Create Sleep Routine

• Take a warm shower, read a book, or do light stretches.
• Create a wind-down routine to relax before bed to signal the body that it's time for sleep.

Avoid Caffeine and Alcohol Before Bed

• These substances make it harder for the mind and body to fall or stay asleep.

Food As Medicine

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Chabé, Magali et al. “Gut Protozoa: Friends or Foes of the Human Gut Microbiota?.” Trends in parasitology vol. 33,12 (2017): 925-934. doi:10.1016/j.pt.2017.08.005

Deng, Feilong, et al. “The gut microbiome of healthy long-living people.” Aging vol. 11,2 (2019): 289-290. doi:10.18632/aging.101771

Gut Bacteria Research: Physicians' Committee for Responsible Medicine. (2019). "Gut Bacteria: Optimize Gut Health With a Plant-Based Diet,"

Ianiro, Gianluca, et al. “How the gut parasitome affects human health.” Therapeutic advances in gastroenterology vol. 15 17562848221091524. 30 Apr. 2022, doi:10.1177/17562848221091524

Lozupone, Catherine A et al. “Diversity, stability and resilience of the human gut microbiota.” Nature vol. 489,7415 (2012): 220-30. doi:10.1038/nature11550

Sleep and Gut Microbiome Study: PLoS One. (2019). "Gut microbiome diversity is associated with sleep physiology in humans.

Sleep Hygiene Information: National Sleep Foundation. (2019). "Sleep Hygiene."

Vaishnavi, C. “Translocation of gut flora and its role in sepsis.” Indian journal of medical microbiology vol. 31,4 (2013): 334-42. doi:10.4103/0255-0857.118870

The body needs food for fuel, energy, growth, and repair. The digestive process breaks down food into a form the body can absorb and use for fuel. The broken-down food gets absorbed into the bloodstream from the small intestine, and the nutrients are carried to the cells throughout the body. Understanding how the organs work together to digest food can help with health goals and overall health.

The Digestive Process

The organs of the digestive system are the following:

• Mouth
• Esophagus
• Stomach
• Pancreas
• Liver
• Gallbladder
• Small intestine
• Large intestine
• Anus

The digestive process starts with the anticipation of eating, stimulating the glands in the mouth to produce saliva. The digestive system's primary functions include:

• Mixing food
• Moving food through the digestive tract - peristalsis
• The chemical breakdown of food into smaller absorbable components.

The digestive system converts food into its simplest forms, which include:

• Glucose - sugars
• Amino acids - protein
• Fatty acids - fats

Proper digestion extracts nutrients from food and liquids to maintain health and function properly. Nutrients include:

• Carbohydrates
• Proteins
• Fats
• Vitamins
• Minerals
• Water

Mouth and Esophagus

• The food is ground up by the teeth and moistened with saliva to swallow easily.
• Saliva also has a special chemical enzyme that starts breaking down carbohydrates into sugars.
• Muscular contractions of the esophagus massage the food into the stomach.

Stomach

• The food passes through a small muscle ring into the stomach.
• It gets mixed with gastric chemicals.
• The stomach churns the food to break it down further.
• The food is then squeezed into the first part of the small intestine, the duodenum.

Small Intestine

• Once in the duodenum, the food mixes with more digestive enzymes from the pancreas and bile from the liver.
• The food passes into the lower parts of the small intestine, called the jejunum and the ileum.
• Nutrients are absorbed from the ileum, lined with millions of villi or thread-like fingers that facilitate the absorption.
• Each villus is connected to a mesh of capillaries, which is how nutrients get absorbed into the bloodstream.

Pancreas

• The pancreas is one of the largest glands.
• It secretes digestive juices and a hormone called insulin.
• Insulin helps regulate the amount of sugar in the blood.
• Problems with insulin production can lead to conditions like diabetes.

Liver

The liver has several different roles that include:

• Breaks down fats using bile stored in the gallbladder.
• Processes proteins and carbohydrates.
• Filters and processes impurities, medications, and toxins.
• Generates glucose for short-term energy from compounds like lactate and amino acids.

Large Intestine

• A large reservoir of microbes and healthy bacteria live in the large intestine and play an important role in healthy digestion.
• Once the nutrients have been absorbed, the waste is passed into the large intestine or bowel.
• Water is removed, and the waste gets stored in the rectum.
• It is then passed out of the body through the anus.

Digestive System Health

Ways to keep the digestive system and the digestive process healthy include:

Drink More Water

• Water helps the food flow more easily through the digestive system.
• Low amounts of water/dehydration are common causes of constipation.

Add More Fiber

• Fiber is beneficial to digestion and helps with regular bowel movements.
• Incorporate both soluble and insoluble fiber.
• Soluble fiber dissolves in water.
• As soluble fiber dissolves, it creates a gel that can improve digestion.
• Soluble fiber may reduce blood cholesterol and sugar.
• It helps your body improve blood glucose control, which can aid in reducing your risk for diabetes.
• Insoluble fiber does not dissolve in water.
• Insoluble fiber attracts water into the stool, making it softer and easier to pass with less strain on the bowels.
• Insoluble fiber can help promote bowel health and regularity and supports insulin sensitivity which can help reduce the risk of diabetes.

Balanced Nutrition

• Eat fruit and vegetables daily.
• Choose whole grains over processed grains.
• Avoid processed foods in general.
• Choose poultry and fish more than red meat and limit processed meats.
• Cut down on sugar.

Eat Foods with Probiotics or Use Probiotic Supplements

• Probiotics are healthy bacteria that help combat unhealthy bacteria in the gut.
• They also generate healthy substances that nourish the gut.
• Consume probiotics after taking antibiotics that often kill all the bacteria in the gut.

Eat Mindfully and Chew Food Slowly

• Chewing food thoroughly helps to ensure the body has enough saliva for digestion.
• Chewing food thoroughly also makes it easier for nutritional absorption.
• Eating slowly gives the body time to digest thoroughly.
• It also allows the body to send cues that it is full.

How The Digestive System Works

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

GREENGARD, H. "Digestive system." Annual review of physiology vol. 9 (1947): 191-224. doi:10.1146/annurev.ph.09.030147.001203

Hoyle, T. "The digestive system: linking theory and practice." British journal of nursing (Mark Allen Publishing) vol. 6,22 (1997): 1285-91. doi:10.12968/bjon.1997.6.22.1285

https://www.merckmanuals.com/home/digestive-disorders/biology-of-the-digestive-system/overview-of-the-digestive-system

https://www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works

Martinsen, Tom C et al. "The Phylogeny and Biological Function of Gastric Juice-Microbiological Consequences of Removing Gastric Acid." International journal of molecular sciences vol. 20,23 6031. 29 Nov. 2019, doi:10.3390/ijms20236031

Ramsay, Philip T, and Aaron Carr. "Gastric acid and digestive physiology." The Surgical clinics of North America vol. 91,5 (2011): 977-82. doi:10.1016/j.suc.2011.06.010

Yogurt is a dairy product made by the bacterial fermentation of milk. The bacteria used are called yogurt cultures, which ferment lactose, which is the natural sugar found in milk. This process produces lactic acid that causes milk proteins to curdle, giving yogurt its flavor and texture. It can be made from all types of milk. Although research is ongoing, the benefits of adding yogurt to one's nutrition plan can improve overall health, including improved bone health, circulation, immune system function, and probiotics/healthy bacteria that improve digestion and gut health.

Dr. Alex Jimenez and Dr. Mario Ruja discuss the reasons why functional medicine is important and how it can safely and effectively improve overall health and wellness in a person.

Why Choose Functional Medicine?

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.

Serving Size and Nutrition

One cup of cooked nopales, around five pads, without added salt, contains: (U.S. Department of Agriculture, FoodData Central, 2018)

• Calories - 22
• Fat - 0 grams
• Sodium - 30 milligrams
• Carbohydrates - 5 grams
• Fiber - 3 grams
• Sugars - 1.7 grams
• Protein - 2 grams
• Vitamin A - 600 international units
• Vitamin C - 8 milligrams
• Vitamin K - 8 micrograms
• Potassium - 291 milligrams
• Choline - 11 milligrams
• Calcium - 244 milligrams
• Magnesium - 70 milligrams

It is generally recommended that most individuals consume 2.5 to 4 cups of vegetables per day. (U.S. Department of Agriculture, MyPlate, 2020)

Benefits

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:

• Inflammation and pain reduction.
• Body mass index (BMI), systolic, and diastolic blood pressure reduction. (Igho J Onakpoya et al., 2015)
• Positive changes in the gut microbiota and weight loss. (Karina Corona-Cervantes et al., 2022)

Consult a Dietician or Healthcare Provider

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.

Nutrition Fundamentals

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

University of Arizona Cooperative Extension. Hope Wilson, M. W., Patricia Zilliox. (2019). Prickly pear cactus: food of the desert. https://extension.arizona.edu/sites/extension.arizona.edu/files/pubs/az1800-2019.pdf

U.S. Department of Agriculture. FoodData Central. (2018). Nopales, cooked, without salt. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/169388/nutrients

U.S. Department of Agriculture. MyPlate. (2020-2025). Vegetables. Retrieved from https://www.myplate.gov/eat-healthy/vegetables

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. https://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. https://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. https://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. https://doi.org/10.2337/dc06-2506

Centers for Disease Control and Prevention. (2022). Fiber: the carb that helps you manage diabetes. Retrieved from https://www.cdc.gov/diabetes/library/features/role-of-fiber.html

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. https://doi.org/10.1111/nmo.13986

National Institutes of Health (NIH). Office of Dietary Supplements. (2024). Calcium. Retrieved from https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/

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. https://doi.org/10.3390/molecules19091487

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. https://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. https://doi.org/10.3390/nu14051008

For individuals wanting to eat pancakes regularly, are there ways to increase pancake nutrition and lower the calorie and carb counts so they can be included in a balanced diet?

Pancake Nutrition

This high-carbohydrate meal can provide enough energy to fuel a day's physical activity.

Nutrition

The following nutrition information is provided for:

• Two regular pancakes made with white flour - 154g. (USDA Food Data Central. 2019)
• Butter - 1 teaspoon, unsalted. (USDA Food Data Central. 2019)
• Syrup - 1 tablespoon. (USDA Food Data Central. 2019)

1. Calories - 430.8
2. Fat - 18.77g
3. Sodium - 693.9mg
4. Carbohydrates - 55.9g
5. Fiber - .75g
6. Sugars - 8.6g
7. Protein - 8.64g

Pancakes made with whole-wheat flour offer more fiber and protein. The following is nutrition info for two or three whole-wheat pancakes (150g) made from a mix. (Child Nutrition Recipe Box. 2023)

1. Calories - 348
2. Fat - 15g
3. Sodium - 594mg
4. Carbohydrates - 45g
5. Fiber - 6g
6. Sugars - 6g
7. Protein - 12g

Carbohydrates

Pancakes will increase carbohydrate intake. The body uses carbohydrates as a primary fuel source, making them an important nutrient. However, most nutritionists suggest that individuals get their daily carbohydrates from nutrient-dense sources. Pancakes typically don't fall into this category. White flour pancakes do not provide much fiber, and around 60 grams of carbohydrates are consumed in this meal. Substituting whole-wheat flour changes the amount to around 6g of fiber or 20% of the daily recommended value.

Fat

Pancakes can include dairy and eggs and are topped with butter that contributes a significant amount of fat. Pancake mix may contain trans fat. Some brands include partially hydrogenated oils. Health experts recommend that individuals limit or completely avoid foods containing trans fat. If the label ingredient list contains partially hydrogenated ingredients, it is recommended to avoid it. (MedlinePlus. 2022)

Protein

Pancakes may provide some protein, which varies based on the type of flour used. Some brands add protein powder to increase intake.

Vitamins and Minerals

Pancakes and ready mixes are generally made from enriched flour. Enriched foods are those that have had nutrients added during the manufacturing process. In most cases, the nutrients, vitamins, and minerals are stripped away, and then some are added back in during processing. Constantly eating enriched bread products limits diet-friendly fiber and nutrients. The enriched flour in pancakes and added sugar and syrup raise blood sugar levels rapidly and then generate hunger shortly afterward.​

Calories

Total nutrition numbers also depend on serving size. The numbers on the label only apply to a single serving which is just two medium pancakes. Many individuals consume 3-4 medium pancakes and double the amount of butter and syrup as well. This can add up to more than 1,000 calories.

Benefits

Whole-wheat pancakes made with whole-grain flour are more nutritious than pancakes made with white flour and can be a delicious way to eat more whole grains. They can be topped with berries or other fruits for added fiber and nutrients.

Digestion

Whole-wheat pancakes made with whole-grain flour provide significant fiber for healthy digestion. Fiber helps with waste evacuation and has prebiotic compounds that fuel beneficial gut bacteria. (Joanne Slavin. 2013)

Improves Hunger Satisfaction

Whole-grain pancakes taste heartier and include fiber that keeps the body fuller longer than pancakes made with faster-digesting refined flour.

Decreases Risk of Heart Disease

A review of studies examining whole grain consumption and heart disease found that eating whole grains was associated with a reduced risk of heart disease. (Dagfinn Aune, et al., 2016)

Reduces Risk of Obesity

Research suggests that whole grain intake reduces the risk of obesity and could help individuals maintain a stable weight. (Katrina R. Kissock et al., 2021) The fiber will also help keep the fuller longer after the meal.

Helps Prevent Birth Defects

Whole-wheat flour is fortified with folic acid, an important B vitamin during pregnancy. Folic acid decreases the risk of neural tube defects, which can affect the development of the brain or spine. (Centers for Disease Control and Prevention. 2022)

Variations

Nutrients for regular pancakes will vary based on the size.

One made-from-scratch small pancake - 3" across provides:

• 30 calories
• 1 gram of protein
• 5 grams of carbohydrate
• 0 grams of fiber
• 1 gram of sugar

One made-from-scratch medium pancake - 5" across provides:

• 93 calories
• 2 grams of protein
• 15 grams of carbohydrate
• 0 grams of fiber
• 2 grams of sugar

One made-from-scratch large pancake - 7" across provides:

• 186 calories
• 4 grams of protein
• 30 grams of carbohydrate
• 1 gram of fiber
• 5 grams of sugar

Making Pancakes

If pancakes are part of a weekly meal plan, try to keep them lower in sugar, fat, and calories.

1. Make pancakes from scratch without the mix to avoid any trans fats.
2. Use whole wheat flour to get fiber to increase hunger satisfaction.
3. Instead of frying the pancakes in oil or butter, use a quality non-stick pan to reduce fat intake.
4. Use syrup with no sugar.
5. Top the pancakes with blueberries, raspberries, or strawberries.

Eating Right to Feel Better

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

USDA Food Data Central. (2019). Pancakes, plain, prepared from recipe.

USDA FoodData Central. (2019). Butter, without salt.

USDA FoodData Central. (2019). Syrups, table blends, pancake.

Child Nutrition Recipe Box. (2023). Pancakes - USDA recipe for schools.

MedlinePlus. (2022). Facts about trans fat.

Slavin J. (2013). Fiber and prebiotics: mechanisms and health benefits. Nutrients, 5(4), 1417–1435. https://doi.org/10.3390/nu5041417

Aune, D., Keum, N., Giovannucci, E., Fadnes, L. T., Boffetta, P., Greenwood, D. C., Tonstad, S., Vatten, L. J., Riboli, E., & Norat, T. (2016). Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ (Clinical research ed.), 353, i2716. https://doi.org/10.1136/bmj.i2716

Kissock, K. R., Neale, E. P., & Beck, E. J. (2021). Whole Grain Food Definition Effects on Determining Associations of Whole Grain Intake and Body Weight Changes: A Systematic Review. Advances in nutrition (Bethesda, Md.), 12(3), 693–707. https://doi.org/10.1093/advances/nmaa122

Centers for Disease Control and Prevention. (2022). Folic acid.

Individuals need to eat more fiber for optimal gut health. Can adding avocado to their diet help improve the gut microbe diversity?

Avocado Gut Support

A diverse gut microbiome is beneficial to overall health. According to a recent study, eating one avocado a day can help maintain the gut microbes healthy, diverse, and balanced. (Sharon V. Thompson, et al., 2021) The researchers observed positive changes in gut bacteria and increased bacterial diversity in individuals who consumed an avocado every day for 12 weeks. (Susanne M Henning, et al., 2019)

Gut Diversity

The gut microbiome refers to the microorganisms living in the intestines. There are around 100 trillion microorganisms, including bacteria, viruses, fungi, and more, exist in the gastrointestinal tract. (Ana M. Valdes, et al., 2018) Having a diverse microbiome means that the body has a range of different organisms that offer various health benefits. Not having enough bacterial diversity has been linked to: (Ana M. Valdes, et al., 2018)

• Arthritis
• Obesity
• Type 1 diabetes
• Type 2 diabetes
• Inflammatory bowel disease
• Celiac disease
• Arterial stiffness
• Atopic eczema

Why Avocados?

• The Institute of Medicine recommends a daily fiber intake ranging from 19 grams to 38 grams per day, depending on various factors like age. (Diane Quagliani, Patricia Felt-Gunderson. 2016)
• Approximately 95% of adults and children do not consume the recommended amount of fiber. (Diane Quagliani, Patricia Felt-Gunderson. 2016)
• Including foods like avocados in a healthy diet can help meet daily fiber requirements.
• Fruit fiber like pectin, has been shown to promote a healthy gut microbiome as well. (Beukema M, et al., 2020)
• Researchers suggest this could be because of pectin's positive effect on beneficial probiotics.(Nadja Larsen, et al., 2018)
• Although further research is needed fiber is believed to help protect the lining of the colon by increasing the bulk and weight of stool and expediting elimination.
• Fiber also adds bulk to an individual's diet and slows the speed of digestion, which makes the body feel fuller longer.

Improved Gut

Individuals can support a healthy microbiota by making small adjustments in their diet, including:

• Eating a variety of fruits and vegetables with the skin, as this is where a majority of the nutrition is.
• Fermented foods like yogurt, kombucha, sauerkraut, kimchi, and kefir.
• Limiting consumption of processed foods, sugar, and artificial sweeteners.
• More whole-grain foods.

Ways to eat more avocados include adding them to:

• Smoothies
• Salads
• Sandwichs
• Guacamole
• If there are more avocados that can be eaten before they overripen, they can be frozen.
• Peel and slice them first, then place them in freezer bags to have year-round.
• They are rich in healthy fat, however, in moderation, they are not likely to contribute to weight gain.

Individuals can work toward having a diverse gut microbiome by paying attention to the foods they eat. Specific foods and dietary patterns can influence the different types of bacterial diversity which can support health.

Smart Choices, Better Health

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Thompson, S. V., Bailey, M. A., Taylor, A. M., Kaczmarek, J. L., Mysonhimer, A. R., Edwards, C. G., Reeser, G. E., Burd, N. A., Khan, N. A., & Holscher, H. D. (2021). Avocado Consumption Alters Gastrointestinal Bacteria Abundance and Microbial Metabolite Concentrations among Adults with Overweight or Obesity: A Randomized Controlled Trial. The Journal of nutrition, 151(4), 753–762. https://doi.org/10.1093/jn/nxaa219

Henning, S. M., Yang, J., Woo, S. L., Lee, R. P., Huang, J., Rasmusen, A., Carpenter, C. L., Thames, G., Gilbuena, I., Tseng, C. H., Heber, D., & Li, Z. (2019). Hass Avocado Inclusion in a Weight-Loss Diet Supported Weight Loss and Altered Gut Microbiota: A 12-Week Randomized, Parallel-Controlled Trial. Current developments in nutrition, 3(8), nzz068. https://doi.org/10.1093/cdn/nzz068

Valdes, A. M., Walter, J., Segal, E., & Spector, T. D. (2018). Role of the gut microbiota in nutrition and health. BMJ (Clinical research ed.), 361, k2179. https://doi.org/10.1136/bmj.k2179

Quagliani, D., & Felt-Gunderson, P. (2016). Closing America's Fiber Intake Gap: Communication Strategies From a Food and Fiber Summit. American journal of lifestyle medicine, 11(1), 80–85. https://doi.org/10.1177/1559827615588079

Beukema, M., Faas, M. M., & de Vos, P. (2020). The effects of different dietary fiber pectin structures on the gastrointestinal immune barrier: impact via gut microbiota and direct effects on immune cells. Experimental & molecular medicine, 52(9), 1364–1376. https://doi.org/10.1038/s12276-020-0449-2

Larsen, N., Cahú, T. B., Isay Saad, S. M., Blennow, A., & Jespersen, L. (2018). The effect of pectins on survival of probiotic Lactobacillus spp. in gastrointestinal juices is related to their structure and physical properties. Food microbiology, 74, 11–20. https://doi.org/10.1016/j.fm.2018.02.015

Should individuals with existing gastrointestinal problems eat bananas?

Bananas

• Bananas can be easy to digest and are often recommended for nausea and diarrhea, however, not everyone can tolerate them. (MedlinePlus. 2021)
• Bananas are high in fructose, sorbitol, and soluble fiber, which makes them a common trigger for gastrointestinal problems.
• Additionally, individuals not used to eating a high-fiber diet may find it helpful to gradually increase fiber and drink more water to alleviate unpleasant symptoms.
• If there is a suspicion of intolerance, IBS, or malabsorption, it is recommended to speak with a healthcare provider for an evaluation.
• Bananas can make the stomach hurt due to:
• Irritable bowel syndrome (IBS)
• Cramping
• Gas
• Bloating
• Other gastrointestinal (GI) problems.
• Individuals can experience stomach discomfort if there is a fructose intolerance or a rare banana allergy.

Stomach Pain

• Bananas are used to replenish potassium and other essential nutrients lost from vomiting or diarrhea.
• Some individuals can experience bloating and gas after eating them.
• One reason is because of their soluble fiber content.
• Soluble fiber dissolves in water and is more readily fermented in the colon than insoluble fiber.
• This can lead to gas and bloating. (Jackson Siegelbaum Gastroenterology. 2018)
• Bananas also contain sorbitol - a naturally occurring sugar that acts as a laxative and can cause gas, bloating, and diarrhea when consumed in large amounts. (U.S. Food and Drug Administration. 2023)

Irritable Bowel Syndrome - IBS

• Bananas can be a common trigger food for individuals with IBS.
• This is because as bananas break down in the stomach, they can generate excess gas. (Bernadette Capili, et al., 2016)
• Bananas are also high in fructose/simple sugar especially when they have overripened.
• Individuals who have IBS are advised to avoid bananas because they can trigger many of the same side effects as undigested lactose/sugar in milk. (Johns Hopkins Medicine. 2023)
• Ripe bananas are considered to be high in FODMAPS - fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
• Individuals following a low FODMAP diet to manage IBS may want to avoid or limit consumption.
• Unripe bananas are considered to be low-FODMAP food. (Monash University. 2019)

Allergy

• Banana allergies are rare and affect less than 1.2% of the global population.
• Many individuals with a banana allergy are also allergic to pollen or latex because of similar protein structures. (Dayıoğlu A, et al., 2020)
• An individual with a banana allergy may experience wheezing, narrowing of the throat, or hives within minutes of eating.
• They can also experience nausea, abdominal pain, vomiting, and diarrhea. (Family Medicine Austin. 2021)

Fructose Intolerance

• An individual with fructose intolerance has difficulty digesting fructose.
• Individuals with this intolerance should restrict or limit fructose. (UW School of Medicine and Public Health. 2019)
• Fructose malabsorption is when the body cannot digest or absorb fructose correctly. This causes bloating gas and abdominal discomfort.
• Hereditary fructose intolerance is very rare. It happens when the liver cannot assist in the breakdown of fructose.
• This condition often causes more severe symptoms and requires additional treatment besides removing fructose from an individual's diet. (UW School of Medicine and Public Health. 2019)
• Most can tolerate small amounts of fructose found in fruits like bananas.
• There is often more difficulty tolerating large fructose amounts found in honey and high fructose corn syrup. (UW School of Medicine and Public Health. 2019)

Prevent GI Symptoms

• If experiencing gas, bloating, or abdominal discomfort after eating bananas, consider limiting the portion size.
• For example, instead of eating one or more bananas a day, try eating half of a banana to see if symptoms resolve.
• Alternatively, if there is a belief that there is fructose malabsorption, try temporarily removing all high-fructose foods.
• If the body begins to feel better, slowly add foods that contain fructose.
• This can help you pinpoint the foods that are causing the problem. (UW School of Medicine and Public Health. 2019)
• If you're eating bananas that are too green or unripe, you may also experience stomach discomfort.
• Unripened bananas contain high amounts of resistant starch. In large quantities, this can cause mild symptoms like gas and bloating. (Jennifer M Erickson, et al., 2018)
• Resistant starch ferments slowly, so it usually does not cause as much gas as other fiber types. (The Johns Hopkins Guide to Diabetes. 2020)
• Ripe or cooked bananas have less starch and more simple sugars, making them easier to digest. (University of Hawaii. 2006)
• Drinking more water and gradually increasing fiber intake can also reduce GI side effects. (The Johns Hopkins Guide to Diabetes. 2020)

Gut Dysfunction

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

MedlinePlus. Bananas and nausea.

Jackson Siegelbaum Gastroenterology. Colon gas and flatus prevention.

U.S. Food and Drug Administration. Sorbitol.

Capili, B., Anastasi, J. K., & Chang, M. (2016). Addressing the Role of Food in Irritable Bowel Syndrome Symptom Management. The journal for nurse practitioners: JNP, 12(5), 324–329. https://doi.org/10.1016/j.nurpra.2015.12.007

Johns Hopkins Medicine. 5 foods to avoid if you have IBS.

Monash University. Bananas re-tested.

Dayıoğlu A, Akgiray S, Nacaroğlu HT, Bahçeci Erdem S. The clinical spectrum of reactions due to banana allergy. BMB. 2020;5(2):60-63. doi: 10.4274/BMB.galenos.2020.04.013

Family Medicine Austin. Banana allergy.

UW School of Medicine and Public Health. Fructose-restricted diet.

Erickson, J. M., Carlson, J. L., Stewart, M. L., & Slavin, J. L. (2018). The Fermentability of Novel Type-4 Resistant Starches in In Vitro System. Foods (Basel, Switzerland), 7(2), 18. https://doi.org/10.3390/foods7020018

The Johns Hopkins Guide to Diabetes. What is resistant starch?

The University of Hawaii. Cooking banana.

Before the body can benefit from consumed nutrients, the gastrointestinal tract has to digest and absorb the foods. Before eating, the body needs to feel hungry. However, hunger is not the same as appetite. Hunger is a physical reaction caused by hormonal and chemical changes in the body when fuel is needed. Appetite is more of a desire to eat and can be a learned response. It is one reason why individuals can eat when they are not hungry. The body comprises different hormones that regulate hunger, digestion, and appetite.

Hunger Digestion Regulating Hormones

Hunger Hormones

Hunger is the feeling when the body needs food. When the body has enough, hunger should subside. That's because various hormones regulate hunger.

Leptin

• Leptin is a hormone secreted by adipose tissue/fat into the bloodstream.
• The more fat in the body, the higher the blood levels of leptin.
• Leptin level also increases with food intake and is higher in females than males, but overall, it lowers with age.
• Increased leptin levels trigger the hypothalamus to reduce hunger.

Ghrelin

• Ghrelin is a hormone produced by the stomach and small intestine when the stomach is empty.
• Like leptin, it also works with the hypothalamus.
• However, instead of suppressing hunger, it increases hunger.

Insulin

• The pancreas produces this hormone.
• It is mostly known for regulating blood sugar levels.
• It also suppresses hunger.

Adiponectin

• Adiponectin is a hormone secreted by fat cells.
• As body fat levels go down, this hormone goes up.
• If fat levels go up, adiponectin levels go down.

Cholecystokinin

• Cholecystokinin is a hormone produced in the small intestine during and after a meal.
• It triggers the release of bile and digestive enzymes into the small intestine.
• These suppress hunger and make the body feel full.

Peptide YY

• This hormone suppresses appetite for about 12 hours after eating.
• Made by both the large and small intestines after eating.

Glucocorticoids

• Adrenal glands make these hormones, and their primary function is to regulate inflammation and other processes, but they also impact hunger.
• A cortisol deficiency reduces appetite, but excessive amounts of glucocorticoids increase hunger.

Digestion Hormones

Digestion is coordinated and regulated by hormones.

Gastrin

• Gastrin is a hormone the stomach and the small intestine release when eating.
• Gastrin stimulates the release of hydrochloric acid and pepsinogen in the stomach to speed up digestion.
• Gastrin stimulates glucagon, which works with insulin to regulate blood sugar.

Secretin

• Secretin is a hormone made by the small intestine.
• It is secreted into the bloodstream when the acidic chyme from the stomach enters the small intestine.
• Secretin stimulates the pancreas to release bicarbonate digestive liquids into the small intestine.
• The bicarbonate neutralizes the acidity.
• Secretin acts on the stomach to trigger the production of pepsinogen to help break down proteins.

Cholecystokinin - CCK

• The small intestine makes and releases CCK into the bloodstream.
• Essential fat digestion stimulates the gallbladder to release bile into the small intestine.
• It also triggers the pancreas to release various digestive enzymes so they can break down fats, carbohydrates, and proteins.

Motilin

• The small intestine makes Motilin.
• Motilin speeds up activity in the stomach and small intestine.
• It also stimulates the stomach and pancreas to release various secretions and causes the gallbladder to contract.

Glucose - Dependent Insulinotropic Peptide - GIP

• Sometimes called a gastric inhibitory peptide.
• The small intestine makes this hormone.
• It stimulates the pancreas to release insulin and slows down stomach digestive activity.

Peptide YY and Enterogastrone

• Released by the small intestine, two more hormones slow digestion down and decrease the production of digestive secretions.

Chiropractic Care and Metabolism

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Chandra, Rashmi, and Rodger A Liddle. "Cholecystokinin." Current Opinion in Endocrinology, diabetes, and Obesity vol. 14,1 (2007): 63-7. doi:10.1097/MED.0b013e3280122850

Davis, Jon. “Hunger, ghrelin and the gut.” Brain Research vol. 1693, Pt B (2018): 154-158. doi:10.1016/j.brainres.2018.01.024

Gupta K, Raja A. Physiology, Gastric Inhibitory Peptide. [Updated 2022 Sep 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546653/

Konturek, S J et al. “Brain-gut axis and its role in the control of food intake.” Journal of Physiology and Pharmacology: an official journal of the Polish Physiological Society vol. 55,1 Pt 2 (2004): 137-54.

Prosapio JG, Sankar P, Jialal I. Physiology, Gastrin. [Updated 2023 Apr 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534822/

Rix I, Nexøe-Larsen C, Bergmann NC, et al. Glucagon Physiology. [Updated 2019 Jul 16]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279127/

Suzuki, Keisuke, et al. "The role of gut hormones and the hypothalamus in appetite regulation." Endocrine Journal vol. 57,5 (2010): 359-72. doi:10.1507/endocrine.k10e-077

Tack, Jan, et al. "The gastrointestinal tract in hunger and satiety signaling." United European gastroenterology journal vol. 9,6 (2021): 727-734. doi:10.1002/ueg2.12097

Zanchi, Davide, et al. "The impact of gut hormones on the neural circuit of appetite and satiety: A systematic review." Neuroscience and biobehavioral reviews vol. 80 (2017): 457-475. doi:10.1016/j.neubiorev.2017.06.013

Body misalignment can cause various symptoms to be experienced, ranging from headaches, neck and back pain, sore feet, discomfort in the joints, muscles, or nerves, and digestive problems. Improperly aligned vertebrae can press against nerves, pinching or compressing them, causing the nerve signals of the digestive system, including those in the stomach and intestines, to misfire or fail to transmit at the appropriate moment. This can cause the organs to malfunction, resulting in heartburn, gas, constipation, cramping, diarrhea, and other symptoms. Chiropractic realignment adjustments are an effective treatment option for frequent stomachaches, reflux, constipation, and other gastrointestinal conditions.

Body Misalignment Digestive Problems

There are over a million nerve cells within the digestive system. A collection of nerves branch out from the lower part of the spinal cord and travels to the stomach and intestines. Nerve transmission plays an essential role in the following:

• Digestion.
• Movement of food through the gastrointestinal system.
• Absorption of nutrients and minerals.
• Removal of waste products.

Misalignments of the vertebrae are known as subluxations. Pressure on nerve roots caused by misalignment can interfere with the function of the bowel and other organs, which can lead to gastrointestinal issues. Muscle tension in the abdomen can also contribute to digestive problems, whether because of stress or sitting for long hours daily.

Misalignment Symptoms

When the body is out of alignment, symptoms of discomfort begin to appear. The most common include:

• Fatigue.
• Stiff neck.
• Sore shoulders.
• Chronic headaches.
• Sore muscles.
• Pain throughout the back.
• Joint pain throughout the body.
• Chronic aches.
• Tight hips.
• Difficulty walking.
• Tingling, pins and needles, and numbness nerve sensations - sciatica.
• Constantly getting sick.

Healthy Gut

A balanced healthy gut will have less difficulty processing food and eliminating waste, leading to reduced and eventually alleviated symptoms. The following show healthy gut function:

• Regular, consistent energy levels.
• Increased mental clarity.
• Regular and healthy bowel movements.
• No pain or discomfort symptoms.
• A normal amount of gas and bloating.
• Healthy stress levels.

Chiropractic

Chiropractic care will realign the body to its proper form, improving gastrointestinal issues. The chiropractic team will use various tools and techniques to guide and correct any subluxations, relax the muscles, and increase nerve and blood circulation.

Healthy Diet and Chiropractic

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to get in touch with Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Ernst, Edzard. “Chiropractic treatment for gastrointestinal problems: a systematic review of clinical trials.” Canadian Journal of Gastroenterology = Journal canadien de Gastroenterologie vol. 25,1 (2011): 39-40. doi:10.1155/2011/910469

Hills, Ronald D Jr, et al. “Gut Microbiome: Profound Implications for Diet and Disease.” Nutrients vol. 11,7 1613. 16 Jul. 2019, doi:10.3390/nu11071613

Hornbuckle, William E., et al. “Gastrointestinal Function.” Clinical Biochemistry of Domestic Animals (2008): 413–457. doi:10.1016/B978-0-12-370491-7.00014-3

Leeming, Emily R et al. “Effect of Diet on the Gut Microbiota: Rethinking Intervention Duration.” Nutrients vol. 11,12 2862. 22 Nov. 2019, doi:10.3390/nu11122862

Li, Yuanyuan, et al. “The Role of Microbiome in Insomnia, Circadian Disturbance, and Depression.” Frontiers in psychiatry vol. 9 669. 5 Dec. 2018, doi:10.3389/fpsyt.2018.00669

Redwood, Daniel. “Chiropractic and visceral disorders.” Journal of Alternative and complementary medicine (New York, N.Y.) vol. 13,5 (2007): 479-80. doi:10.1089/acm.2007.7146

Valdes, Ana M et al. “Role of the gut microbiota in nutrition and health.” BMJ (Clinical research ed.) vol. 361 k2179. 13 Jun. 2018, doi:10.1136/bmj.k2179

Digestive disorders affect millions of individuals and cover a variety of diseases ranging from mild to severe. These conditions involve the digestive tract, also known as the gastrointestinal or GI tract. The digestive disorders of heartburn, acid reflux, and gastroesophageal reflux disease/GERD are related and have similar symptoms but are different. Accurately diagnosing digestive disorders involves a thorough medical history, imaging and lab tests, and physical examination to develop the proper treatment plan.

Digestive Disorders

The gastrointestinal tract includes the esophagus, liver, gallbladder, stomach, pancreas, and large and small intestines.

Heartburn

Heartburn has nothing to do with the heart but describes a burning sensation in the chest. Individuals experience heartburn when stomach acid flows back into the esophagus. Occasional heartburn after eating spicy foods or foods an individual is not used to is common and is no cause for alarm. Most can manage the discomfort symptoms with lifestyle adjustments and over-the-counter medications. Chronic heartburn that interferes with daily/nightly routines could indicate a more serious condition requiring medical care. Symptoms include:

• The burning discomfort sensations in the stomach and chest regions are usually worse after eating a meal, bending down, at night, and when lying down.
• A bitter or acidic taste.

Acid Reflux

The esophagus comprises mainly smooth muscle that extends from the throat down through the chest cavity and past the abdomen, where it connects with the stomach. When swallowing, the esophagus opens and squeezes food down to the bottom, where a valve (lower esophageal sphincter LES) separates it from the stomach. The valve is normally closed. When swallowing, it opens so that food can pass through and then closes up. Acid reflux is a disorder that causes the valve to open when it's not supposed to. This allows stomach contents like acid, digestive juices, enzymes, and food to flow backward from the stomach into the esophagus, causing heartburn symptoms. This usually happens when the lower esophageal sphincter is under added pressure, weakened, or malfunctioning. Symptoms can be caused by:

• Overeating.
• Eating spicy or acidic foods that can trigger symptoms.
• Eating right before going to bed.
• Medications.
• Over alcohol consumption.
• Exercising after eating.
• Pregnancy.
• Smoking.

Acid reflux and heartburn affect everyone, but most can handle the discomfort by taking antacids and avoiding the foods that brought it on. Occasional acid reflux can be treated with over-the-counter medication, including:

• Antacids.
• H-2-receptor blockers.
• If signs and symptoms worsen, or nausea, vomiting, or difficulty swallowing occurs, consult a doctor.
• Prescription medications could be recommended.

GERD

Acid reflux can progress to gastroesophageal reflux disease, a more serious form of acid reflux that lasts longer. GERD is frequent heartburn that happens two or more times a week. Other signs and symptoms can include:

• Regurgitation of food or sour liquid.
• Difficulty swallowing.
• Inflammation of vocal cords.
• A sensation of a lump in the throat.
• Coughing to clear throat constantly.
• Asthma-like symptoms.
• Chest pain, especially when lying down at night.

Various factors can cause GERD, that include lifestyle and physiological. It can develop as a result of the following:

• Delayed stomach emptying.
• Being overweight or obese.
• Medications.
• Pregnancy.
• Hiatal hernias.
• Smoking.
• Connective tissue disorders like scleroderma.

Some individuals with digestive disorders may need more extensive diagnostic evaluations, including GI endoscopy, laboratory tests, and imaging.

Chiropractic Treatment

Body misalignments, unhealthy posture, and restrictive positions can contribute to digestive disorders that put pressure on the stomach and chest, triggering symptoms. A chiropractor can realign the body and take the stress off the joints and spine, relieving the pressure on the nerves. They can also strengthen the muscles through adjustments that help alleviate pressure on the stomach. A chiropractor designs a treatment plan that suits the individual's needs, including stretches and exercises, nutrition, and health coaching to achieve and manage a healthy weight.

Chiropractic Precision

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Carvalho de Miranda Chaves, Renata, et al. “Respiratory physiotherapy can increase lower esophageal sphincter pressure in GERD patients.” Respiratory medicine vol. 106,12 (2012): 1794-9. doi:10.1016/j.rmed.2012.08.023

Harding, Susan M. “Acid reflux and asthma.” Current opinion in pulmonary medicine vol. 9,1 (2003): 42-5. doi:10.1097/00063198-200301000-00007

Kahrilas, Peter J. “Regurgitation in patients with gastroesophageal reflux disease.” Gastroenterology & hepatology vol. 9,1 (2013): 37-9.

Pope, C E 2nd. “Acid-reflux disorders.” The New England journal of medicine vol. 331,10 (1994): 656-60. doi:10.1056/NEJM199409083311007

Fermentation is a process where bacteria and yeast are used to break down foods. The fermentation process has been around for centuries and was initially produced to preserve foods, improve flavor and eliminate toxins. Research has found that eating fermented foods can also increase the beneficial bacteria/probiotics in the gut. Functional medicine practitioners recommend these foods for their health benefits, including improved digestion, increased immunity, and weight loss and maintenance.

Fermented Foods

Fermented foods and beverages undergo controlled microbial growth and fermentation in which microorganisms like yeast and bacteria break down food elements like sugars/glucose into other products like organic acids, gases, or alcohol. The process gives fermented foods unique taste, aroma, texture, and appearance. There are many different types of fermented foods, including:

• Wine
• Kombucha
• Yogurt
• Cultured milk
• Cider
• Sauerkraut
• Fermented sausage
• Kimchi
• Miso

Whole foods like vegetables, fruits, cereals, dairy, meat, fish, eggs, legumes, nuts, and seeds can go through fermentation. These foods are nutritious in their original form, but through fermentation, they can provide probiotic and prebiotic health benefits.

Probiotics

Probiotics are live microorganisms that benefit the gut by creating a more favorable digestive environment. This helps:

• Digest food easier.
• Support a healthy immune system.
• Support organ health - lungs, reproductive organs, skin.
• Improves mood.

However, not all fermented foods contain probiotics, especially commercially produced foods that are pasteurized, killing bacteria and their associated health benefits.

Prebiotics

Prebiotics are food ingredients that the microorganisms like gut bacteria consume to grow and live, leading to improving the digestive environment. These include:

• Milk
• Honey
• Tomato
• Garlic
• Onions
• Asparagus
• Wheat
• Barley
• Rye

However, most fruits, vegetables, and legumes contain prebiotics.

The Benefits of Fermented Foods

Fermented foods' health benefits include reduced risk of:

• Diabetes
• Inflammation
• High blood pressure
• Cardiovascular disease
• Obesity

They have also been linked to:

• Better weight management
• Improved brain activity
• Increased bone health
• Faster recovery after exercise and physical activity

There are currently no official guidelines regarding how often individuals should eat fermented foods. It is recommended to consult a nutritionist or dietician to figure out the best nutrition plan for the individual and their needs.

The Science

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Aslam, Hajara, et al. "Fermented foods, the gut, and mental health: a mechanistic overview with implications for depression and anxiety." Nutritional neuroscience vol. 23,9 (2020): 659-671. doi:10.1080/1028415X.2018.1544332

Dimidi, Eirini, et al. "Fermented Foods: Definitions and Characteristics, Impact on the Gut Microbiota and Effects on Gastrointestinal Health and Disease." Nutrients vol. 11,8 1806. 5 Aug. 2019, doi:10.3390/nu11081806

King, Sarah, et al. "Effectiveness of probiotics on the duration of illness in healthy children and adults who develop common acute respiratory infectious conditions: a systematic review and meta-analysis." The British journal of nutrition vol. 112,1 (2014): 41-54. doi:10.1017/S0007114514000075

Kok, Car Reen, and Robert Hutkins. "Yogurt and other fermented foods as sources of health-promoting bacteria." Nutrition reviews vol. 76, Suppl 1 (2018): 4-15. doi:10.1093/nutrit/nuy056

Parker, Elizabeth A et al. "Probiotics and gastrointestinal conditions: An overview of evidence from the Cochrane Collaboration." Nutrition (Burbank, Los Angeles County, Calif.) vol. 45 (2018): 125-134.e11. doi:10.1016/j.nut.2017.06.024

Şanlier, Nevin, et al. "Health benefits of fermented foods." Critical reviews in food science and nutrition vol. 59,3 (2019): 506-527. doi:10.1080/10408398.2017.1383355

Dr. Alex Jimenez and Dr. Mario Ruja discuss the importance of the body’s genetic code and how micronutrients provide the necessary functional nutraceuticals that the body needs to promote overall health and wellness. 

Personalized Medicine

The mitochondrion is a (THE) vital cellular organelle that orchestrates multiple metabolical pathways. Therefore, while we eat to produce energy, create connections, and receive information, the mitochondria enable these actions. Consequently, we create a therapeutic environment where foods can be our medicine when we have a food plan that encourages anti-inflammatory and antioxidant foods to ingest. In addition, the combination with other dietary habits, such as intermittent fasting and low-glycemic food ingestion, promote a better mitochondrial function, ultimately resulting in better metabolic health, more energy, and less pain.

What is a personalized mito food plan?

Mitochondrial health depends directly on the quality and quantity of food we ingest from our diet. Evidence supports that a personalized dietary approach that reduces oxidative stress, counteracts toxin exposure, and reduces insulin resistance may support mitochondrial function. Furthermore, this can reduce the risk of developing Alzheimer’s disease. In addition, a more ketogenic diet can ease symptoms like fatigue and pain, commonly associated with cognitive disorders.

Indeed, cardiac, neural, muscular, and connective tissue cells have high mitochondrial concentrations, making them susceptible to premature decline. Supporting mitochondrial health through diet is critical to improving cellular energy production and a healthy aging process. 

A crucial benefit of encouraging our patients to follow a diet with a low-glycemic impact, a healthy dietary fat composition, anti-inflammatory, and antioxidant foods is the production of brain-derived neurotrophic factor (BDNF). 

BDNF: Brain-derived neurotrophic factor acts as a growth hormone for neurons. The proper function and synthesis of BDNF contribute to higher levels of brain function due to its effects as a neuronal protector and promotor. 

How does the mito food plan improve BDNF?

The mito food plan is a dietary approach to improve mitochondrial function by introducing and combining therapeutic foods and dietary patterns. Consequently, the benefits reflect a higher BDNF function, a better blood-barrier permeability, and a delay in aging. 

• Healing foods for energy: Mitochondrial needs macronutrients as fuel to create energy, and it also needs cofactors for enzymatic function. Indeed, these cofactors are micronutrients like vitamin B complex, Coenzyme Q 10, and antioxidants supplied by our diet. Therefore, the introduction of phytonutrients and the adequate consumption of healthy dietary fats are needed to counteract oxidative stress and improve the quality of the inner mitochondrial membrane. Consequently, the combination of these mechanisms improves ATP production by increasing mitochondrial performance.
•  Protective antioxidants:  The metabolic processes to produce ATP need oxygen, creating byproducts called reactive oxygen species (ROS). Consequently, a higher concentration of ROS causes oxidative stress, resulting in DNA damage that contributes to more significant tissue dysfunction, pain, fatigue, neurologic and chronic diseases. Increasing nutrient-dense foods improve antioxidant supply. This, in turn, promotes the synthesis of glutathione, which is essential for detoxification and neutralize oxidative stress.
• Anti-inflammatory nutrients:  The mito food plan focuses on increasing the number of fruits and vegetables (8 to 12 servings per day) to increase dietary fiber, phytonutrients, minerals, and vitamins. Furthermore, increasing cruciferous vegetables, blueberries, strawberries, and walnuts positively influence cognitive function and are potent anti-inflammatory foods. In addition, the use of spices like curry and turmeric has a positive effect on cognitive function, as turmeric is a promoter of anti-inflammatory cascades. 
• High-quality fats: The interaction between following a low-glycemic diet and high-quality fats has positive effects in reducing neuroinflammation and promoting neuronal communication. Furthermore, the dietary players of these mechanisms are DHA found in egg yolks, seaweed, and fish such as mackerel, cod, sardines, and salmon. In addition, foods like avocados, extra-virgin olive oil, and coconut oil promote mitochondrial fat metabolism and are packed with vitamins, minerals, and phytonutrients that promote detoxification.
• Low-glycemic impact/low-grain and gluten-free: The mito food plan introduces vegetables as the primary source of dietary fiber and carbohydrates. Furthermore, it encourages patients to consume fewer grains and gluten-containing foods, reducing insulin resistance, blood glucose, and inflammation. Also, as this diet is low in carbohydrates, it improves fat utilization instead of glucose, leading to ketosis. 

Improving and maintaining mitochondrial health is the cornerstone to increase energy production, lessen pain, and improve brain function. The combination of these foods, dietary patterns, micronutrient ingestion, and macronutrient modifications are intended to enhance BDNF. – Ana Paola Rodríguez Arciniega, MS

References:

The Institute of Functional Medicine (2020). “Mito Food Plan Comprehensive Guide.”

Additional Online Links & Resources (Available 24/7)

Online Appointments or Consultations: https://bit.ly/Book-Online-Appointment

Online Physical Injury / Accident Intake Form: https://bit.ly/Fill-Out-Your-Online-History 

Online Functional Medicine Assessment: https://bit.ly/functionmed

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*