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Tag: nutrition

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By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Physio, Therapy , , , , , , , , , , , , , , , , , , ,

Pigeon Toed: Causes and Treatment Options

Children walking with their toes pointed in may be pigeon-toed. What are the causes, conditions associated with it, and treatments?

Pigeon-toed Walking

If a child walks with their feet turned inward at the toes, it is usually described as being pigeon-toed. This pointing inward of the feet occasionally occurs as a child learns to walk and may continue through toddlerhood. It is noticed more often in children than adults, but older individuals can experience it. Pigeon-toed walking is rarely a major orthopedic problem and usually disappears without treatment. However, there are times when it may impact a child’s lower extremities and hips. Bracing or surgery may be necessary in these cases to correct the problem. (Paramanandam V. et al., 2019) This condition is common and typically is caused by abnormal birth positions in utero. Sometimes, slight issues may lead to noticeable functional characteristics. Mild changes in bone shape and positioning usually cause pigeon toes. Often, it subsides in a few years as the child continues to develop.

What Does It Mean?

There is usually no need to worry, as this condition is likely not permanent and will go away in a few years. (Paramanandam V. et al., 2019) However, it is recommended that you check in with your healthcare provider to ensure the child is developing normally. Some adults walk with their toes turned in. This may be due to a birth defect, a weakness, or a rare case of pigeon-toed walking as a youth that was left untreated or did not go away.

Causes

There are various reasons for pigeon-toed walking. To determine the cause, a healthcare provider can assess the child’s condition and make a diagnosis, including:

Metatarsus Adductus

  • A condition where the front part of the foot is turned inward.
  • The metatarsals are the long bones of the forefoot.
  • This is when the bones of the foot point inward, leading to pigeon-toed walking.
  • A clinical examination and X-ray can confirm the metatarsus adducts as a cause of pigeon-toed walking.

Tibial Torsion

  • A twisted shinbone (tibia) can cause the feet to turn inward in younger children.
  • The shinbone/tibia in some children may be slightly twisted.
  • The tibia can either turn outward or inward.
  • When it twists inward, it may manifest as a pigeon-toed gait.
  • Tibial torsion may accompany femoral anteversion.
  • It is diagnosed with an X-ray.
  • Children with tibial torsion typically grow out of the problem, and the pigeon-toed disappears by age 4. (Uden H., & Kumar S. 2012)

Femoral Anteversion

  • A common cause, especially in older children, is when the thighbone/femur is twisted inward.
  • If the femur turns inward and forward unnaturally, where the femoral neck meets the body of the femur, it is called femoral anteversion.
  • An outward and backward rotation of the femur is called femoral retroversion.
  • This occurs in about 10% of children. (Scorcelletti M. et al., 2020)
  • Many children with femoral anteversion appear knock-kneed with a large gap between their feet when standing with knees together, and when they walk, they appear pigeon-toed.
  • A clinical examination and X-ray diagnose it.

Symptoms

In most cases, the child does not complain of any pain. However, if pain is felt, it can include:

  • Tightness in the calf muscles
  • Aching on the outer edges of the feet
  • Knee pain

Usually, parents will notice pigeon-toes when their child is first learning to walk. Rest assured, the child most likely is not experiencing pain. They have feet and knees that turn inward when they walk and run. (Uden H., & Kumar S., 2012)

A pediatrician or primary care provider can assess the situation and make recommendations. Most pigeon-toed children begin walking and running normally after age 3 or 4, so a watch-and-wait approach is used. Parents may have to take their child to a specialist, like an orthopedic surgeon, if they complain of pain while walking. A specialist may be referred if the child cannot walk due to the inward turn of their feet.

Risk Factors

Pigeon-toed walking is not a preventable condition but rather one that develops during pregnancy. Causes may include: (Scorcelletti M. et al., 2020)

  • A pregnancy with twins or multiple births
  • Large fetus
  • Breech position in utero when the baby is positioned feet first.
  • Not enough amniotic fluid

Muscle Weakness in Adults

Adolescents or adults who notice their knees turn in and walk pigeon-toed may have weakness in the hip and leg muscles that control the position of their legs when they walk. Strengthening those muscles can help. (Scorcelletti M. et al., 2020)

Treatment

Typically, a normal gait will appear by the age of 3 or 4. Other treatments may include:

Physical Therapy Exercises and Gait Training

  • Exercises to stretch tight lower extremity muscles and strengthen hip and leg muscles can help improve walking gait.
  • See a pediatric specialist before starting, as research shows that parental stretching of a newborn with metatarsus adductus offers little benefit. (Eamsobhana P. et al., 2017)

Bracing or Casting 

  • Braces
  • Serial casting is a procedure that helps children improve their range of movement and may be done to place their lower extremities in an optimum position as they develop. (Uden H., & Kumar S., 2012)

Surgery

  • For cases in which tibial torsion is the cause, osteotomy surgery, which involves cutting and/or removing bone, may be recommended to correct the structural deformity of the shinbone.

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Foot Pronation

References

Paramanandam, V., Lizarraga, K. J., Soh, D., Algarni, M., Rohani, M., & Fasano, A. (2019). Unusual gait disorders: a phenomenological approach and classification. Expert review of neurotherapeutics, 19(2), 119–132. https://doi.org/10.1080/14737175.2019.1562337

Uden, H., & Kumar, S. (2012). Non-surgical management of a pediatric “intoed” gait pattern – a systematic review of the current best evidence. Journal of Multidisciplinary Healthcare, 5, 27–35. https://doi.org/10.2147/JMDH.S28669

Scorcelletti, M., Reeves, N. D., Rittweger, J., & Ireland, A. (2020). Femoral anteversion: significance and measurement. Journal of Anatomy, 237(5), 811–826. https://doi.org/10.1111/joa.13249

Eamsobhana, P., Rojjananukulpong, K., Ariyawatkul, T., Chotigavanichaya, C., & Kaewpornsawan, K. (2017). Does the parental stretching programs improve metatarsus adductus in newborns?. Journal of Orthopaedic Surgery (Hong Kong), 25(1), 2309499017690320. https://doi.org/10.1177/2309499017690320

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Exercises , , , , , , , , , , , , , , , ,

Pregnancy Indoor Cycling: Stay Active and Strong

During pregnancy, is indoor cycling a safe and recommended way to maintain fitness?

Pregnancy Indoor Cycling

Exercising during pregnancy is highly recommended for both the parent and the baby. Staying physically active can:

  • Increase blood circulation
  • Increase energy
  • Reduce backaches
  • Improve digestion and sleep
  • Enhance mood
  • Help manage weight
  • Promote muscle tone, strength, and endurance. (Hinman, S. K. et al., 2015)

The American College of Obstetricians and Gynecologists, or ACOG, advises pregnant individuals to exercise regularly during pregnancy. (The American College of Obstetricians and Gynecologists, 2024) The guidelines indicate that individuals who regularly engage in vigorous-intensity aerobic exercise before pregnancy should continue these activities during their pregnancy. (Syed H., Slayman T., & DuChene Thoma K. 2021) According to ACOG, observational studies of pregnant individuals who exercise show benefits such as:

  • The reduced risk of gestational diabetes mellitus
  • Cesarean birth
  • Operative vaginal delivery
  • Reduced postpartum recovery time
  • Exercise can also help prevent postpartum depression. (Syed H., Slayman T., & DuChene Thoma K. 2021)

Stationary cycling has been extensively studied in pregnancy and found safe and beneficial (American College of Obstetricians and Gynecologists, 2024).

Safety

Indoor cycling is ideal because individuals won’t have to deal with balance challenges or generate a heavy impact on their joints. There are many indoor cycling workouts to try, whether spin or on-demand classes. Indoor cycling is safer during pregnancy than outdoor cycling, which is not recommended because of the risk of falls from traffic and weather conditions. Although indoor cycling is generally considered safe during pregnancy, individuals should get clearance from their OB/GYN if they have any underlying medical conditions that might limit physical activity options.

Cycling Classes

Taking cycling classes during pregnancy is safe if a healthcare provider has no concerns. It’s important to take precautions.

  • It’s recommended to continue with any exercise you were doing before pregnancy rather than start a new routine.
  • Remember that this is an exercise for two, so the heart rate will elevate quickly and become overheated more easily.
  • Take it easier on the bike, and don’t push too hard.

Consult With the Instructor

It’s recommended to seek out an instructor with some prenatal exercise training. Individuals may benefit from sticking with the same instructor whenever possible to get to know them and familiarize themselves with their modifications and needs. Whether or not you’re showing, tell the instructor that you’re pregnant before the class starts. This way, they can monitor progress and will not push too hard. The instructor can also give important pointers on modifying the ride to suit your needs.

Modify Bike Set-Up

Individuals may need to adjust the saddle position and raise the handlebars to stay comfortable as their bodies change. Sitting more upright is recommended to relieve strain on the lower back, and increasing the handlebars and bringing them closer instead of leaning forward is another goal. Another goal is to keep the weight more evenly distributed between the hands and body. Also, avoid movable indoor bikes that mimic outdoor riding. They can lean sideways, which might cause a fall.

Dial Down Intensity

With indoor cycling, it’s best to exercise moderately during pregnancy. Consider wearing a heart rate monitor to ensure a safe intensity. It’s also helpful to pay attention to the Rating of Perceived Exertion scale/RPE. Even if the heart rate isn’t too high, slow down or stop exercising immediately if you’re gasping for breath or feeling lightheaded. ACOG guidelines indicate that 13-14 “somewhat hard” on the Borg RPE scale is a safe and acceptable level of exertion. The guidelines also state that RPE is a better gauge of exertion than heart rate and that the talk test (holding a conversation while exercising) can indicate safe workout intensity.

Stay Cool and Properly Hydrated

Wear comfortable, breathable clothing to help you stay cool and a bra with plenty of support. Drink lots of water throughout the workout, actually more than usual. Overheating and dehydration are common during pregnancy and can be dangerous for both parents and babies. Carrying an extra 20 to 30 pounds and having 40% more blood pumping through the body toward the end of pregnancy makes you likely to sweat more and can easily lead to dehydration. Using a fan for home gyms is highly recommended.

Avoid Standing and Stay In a Seated Position

During the early months, you may be able to ride in a standing position without any problems. But as the belly grows, it changes the body’s center of gravity, putting more pressure on the joints and making it difficult to ride standing. Joints are looser or more flexible during pregnancy, which makes standing while cycling more difficult and risky. It is still a healthy workout if you stay seated the whole time—and, most importantly, avoid overdoing it or injuring yourself.

Body Signs

Listen to the body while exercising. If you get winded, dizzy, or unwell while riding, take a break or reduce your effort by a few notches. If a 45-to-60-minute class is too intense, feel free to depart early; just let the instructor know you’re OK. Energy will likely ebb and flow during pregnancy, so pay attention to the body’s signals and take care of them accordingly. Stop exercising if you experience any of the following (Syed H., Slayman T., & DuChene Thoma K. 2021)

  • Abdominal pain
  • Dyspnea: shortness of breath before exertion
  • Headache
  • Dizziness
  • Calf pain or swelling
  • Muscle weakness affects balance
  • Chest pain
  • Amniotic fluid leakage
  • Regular painful contractions
  • Vaginal bleeding

Call your doctor if you experience sharp pain, contractions, a surge of fluid, a sudden severe headache, prolonged swelling, or decreased baby movement.

Injury Medical Chiropractic & Functional Medicine Clinic

It’s important to exercise wisely during the nine months to accommodate body changes, the extra weight, the increasingly relaxed ligaments, and the shift in the center of gravity. The stationary bike provides a personalized, low-impact workout. You get to control the intensity and the duration of the ride. Monitor your heart rate and/or RPE to avoid overdoing it. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Chiropractic Lower Back Pain Pregnancy Treatment

References

Hinman, S. K., Smith, K. B., Quillen, D. M., & Smith, M. S. (2015). Exercise in Pregnancy: A Clinical Review. Sports Health, 7(6), 527–531. https://doi.org/10.1177/1941738115599358

The American College of Obstetricians and Gynecologists. (2024). Exercise during pregnancy. https://www.acog.org/womens-health/faqs/exercise-during-pregnancy?utm_source=redirect&utm_medium=web&utm_campaign=int

Syed, H., Slayman, T., & DuChene Thoma, K. (2021). ACOG Committee Opinion No. 804: Physical Activity and Exercise During Pregnancy and the Postpartum Period. Obstetrics and gynecology, 137(2), 375–376. https://doi.org/10.1097/AOG.0000000000004266

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Diet , , , , , , , , , , , ,

Tofu Benefits: Nutrition and Cooking Tips

Uncover the health benefits of tofu. This nutritious ingredient is great for both your taste buds and your well-being.

Introduction

As a nurse practitioner with over two decades of clinical experience in physical and functional medicine, I’ve witnessed firsthand the transformative power of food as medicine. In particular, the role of plant-based proteins like tofu has grown increasingly significant in evidence-based interventions aimed at reducing cardiovascular risk.

From managing hypertension and dyslipidemia to reducing systemic inflammation, a heart-healthy diet is one of the most accessible and sustainable lifestyle changes patients can make. One often-underappreciated food with robust cardioprotective properties is tofu. In this article, we’ll explore the science-backed benefits of tofu, its role in functional cardiovascular care, and practical ways to integrate it into a heart-smart diet.

Why Functional Nutrition Matters for Cardiovascular Health

The heart doesn’t function in isolation—it works in concert with every other system in the body. Functional medicine recognizes that cardiovascular issues often stem from a constellation of root causes: chronic inflammation, oxidative stress, hormonal imbalances, dysregulated blood sugar, and nutrient deficiencies, just to name a few.

Rather than isolating nutrients or treating lab values in a vacuum, functional nutrition focuses on synergy—how whole foods interact with body systems to optimize health. Tofu, with its impressive nutrient density and anti-inflammatory profile, fits seamlessly into this paradigm.

What Is Tofu? A Nutritional Powerhouse from the Soybean

Tofu, also known as bean curd, is a protein-rich food derived from soybeans. It has been a staple in East Asian diets for over 2,000 years and is gaining popularity in the West for good reason.

To produce tofu, soybeans are soaked, blended, and strained into a soy milk, which is then coagulated using calcium or magnesium salts and pressed into blocks. This process preserves the soybean’s rich content of protein, calcium, iron, and bioactive compounds.

Unlike ultra-processed meat substitutes, tofu is a minimally processed, whole food source of plant protein that aligns with the foundational principles of a heart-healthy, anti-inflammatory diet.

Nutritional Profile of Tofu (Per 116g Serving of Firm Tofu)

  • Calories: 88
  • Protein: 9g
  • Fat: 6g (mostly unsaturated)
  • Saturated Fat: 0.8g
  • Carbohydrates: 2.2g
  • Fiber: 0.3g
  • Sodium: 8mg
  • Potassium: 140mg
  • Iron: 34% Daily Value (DV)
  • Calcium: 40% DV
  • Magnesium: 8% DV
  • Vitamin B6: 5% DV

Tofu also contains all nine essential amino acids, making it a complete protein—an important consideration for those transitioning away from animal products.

The Healing Diet: Combat Inflammation & Embrace Wellness- Video

The Cardiovascular Benefits of Tofu: What the Science Says

1. Lowering LDL Cholesterol

A pivotal meta-analysis published in the Journal of Nutrition (Messina, 2016) confirmed the LDL-lowering effects of soy protein. Tofu, being rich in soy protein, can help reduce low-density lipoprotein (LDL) cholesterol, often referred to as “bad” cholesterol. By displacing saturated fat and dietary cholesterol from animal proteins, tofu supports healthier lipid profiles.

2. Anti-Inflammatory and Antioxidant Properties

Tofu is rich in isoflavones, naturally occurring phytoestrogens found in soybeans. Isoflavones like genistein and daidzein have antioxidant properties and may inhibit inflammation at the endothelial level—critical for patients with atherosclerosis or at risk for coronary artery disease. According to Rizzo et al. (2023), these compounds help maintain vascular flexibility and may inhibit platelet aggregation, reducing clot risk.

3. Blood Pressure Regulation

Magnesium, potassium, and calcium—key electrolytes found in tofu—are all essential for regulating blood pressure. These nutrients support vascular tone and optimize endothelial function. Additionally, substituting animal-based protein with tofu helps reduce overall sodium intake, further supporting blood pressure goals.

4. Weight and Metabolic Control

With only 88 calories per serving and a high satiety value, tofu is a strategic food for weight management—an important factor in controlling cardiovascular risk. The protein-fiber-fat ratio makes it ideal for glycemic regulation and preventing insulin resistance.

5. Improved Lipid Profiles and Reduced Coronary Risk

Longitudinal studies have demonstrated that plant-based diets rich in soy protein improve HDL/LDL ratios and reduce triglycerides, especially when tofu is used to replace red meat or processed meats. According to Erdman (2000), soy-based interventions can reduce coronary heart disease risk by as much as 20% over time when combined with other healthy lifestyle changes.

Types of Tofu and Their Culinary Uses

Tofu’s versatility is one reason it’s so easy to integrate into a heart-healthy diet. Understanding its different textures can help patients and practitioners alike explore creative and satisfying meal planning.

  • Silken Tofu: Soft, custard-like texture. Excellent in smoothies, sauces, and desserts.
  • Soft Tofu: Slightly firmer than silken. Ideal for soups and gentle sautés.
  • Firm Tofu: Maintains structure well. Great for stir-fries, curries, and grilling.
  • Extra-Firm Tofu: Dense and chewy. Best for baking, frying, or as a meat substitute in hearty recipes.
  • Fermented Tofu: A flavorful condiment used in East Asian dishes. Contains probiotics and can support gut health.

Each form can be marinated, baked, crumbled, or pureed—making tofu a culinary chameleon and nutrient-rich addition to any cardiovascular prevention strategy.

Is Tofu a Reliable Protein Source for Cardiovascular Patients?

Yes—and not just for vegans or vegetarians. One of the biggest concerns in reducing animal protein intake is whether patients will meet their protein needs. Tofu alleviates this concern by offering a complete amino acid profile.

Furthermore, because tofu contains very little saturated fat and zero dietary cholesterol, it aligns with AHA (American Heart Association) guidelines for protein sources that support cardiac health. Tofu also promotes lean muscle maintenance, critical for older adults at risk for sarcopenia—a condition that compounds cardiovascular vulnerability.

Functional Medicine Tips: How to Add Tofu to a Heart-Healthy Diet

Transitioning to a more plant-based approach doesn’t have to be intimidating. Here are simple, evidence-informed ways to incorporate tofu:

  1. Tofu Scrambles: Replace eggs with crumbled firm tofu, turmeric, and vegetables for a cholesterol-free breakfast.
  2. Stir-Fries: Toss cubed tofu with olive oil, garlic, and cruciferous vegetables like broccoli or bok choy.
  3. Tofu Bowls: Combine baked tofu with quinoa, avocado, leafy greens, and tahini for a nutrient-dense lunch.
  4. Soups and Stews: Add soft tofu to miso or vegetable-based soups for added protein and satiety.
  5. Smoothies: Blend silken tofu with berries, flaxseed, and almond milk for a protein-packed snack.
  6. Marinated and Grilled: Let tofu absorb anti-inflammatory marinades (like ginger-garlic-tamari) before grilling.

Encourage patients to explore international cuisines—particularly Japanese, Korean, and Thai recipes—that have normalized tofu as a central protein source for centuries.

Addressing Common Concerns About Soy

Despite its benefits, soy has faced scrutiny—largely due to misconceptions around phytoestrogens. However, clinical research consistently shows that moderate soy intake is safe and beneficial for most populations, including breast cancer survivors and men with prostate concerns.

In fact, population studies in East Asia demonstrate lower rates of hormone-sensitive cancers and cardiovascular disease in populations consuming soy regularly. As with any food, balance and moderation are key.

Final Thoughts: Tofu as a Functional Ally for Cardiovascular Health

Tofu isn’t just a trend—it’s a time-tested, nutrient-dense, cardioprotective food with substantial clinical value. As healthcare providers, we should not underestimate the power of simple dietary substitutions. Replacing saturated fat-rich meats with plant-based proteins like tofu can reduce cardiovascular burden, support metabolic resilience, and enhance quality of life.

From a functional medicine lens, tofu exemplifies the concept of food as a therapeutic tool. Its ability to modulate inflammation, support endothelial function, and provide sustainable, complete protein makes it a cornerstone in any heart-healthy nutrition plan.

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with cardiovascular issues and are looking for natural alternatives to incorporate plant-based foods into a healthy diet. When asking important questions to our associated medical providers, we advise patients to incorporate tofu into their diet to reduce the effects of cardiovascular disorders related to the body. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.

References

Dang, Y., Ren, J., Guo, Y., Yang, Q., Liang, J., Li, R., Zhang, R., Yang, P., Gao, X., & Du, S. K. (2023). Structural, functional properties of protein and characteristics of tofu from small-seeded soybeans grown in the Loess Plateau of China. Food Chem X, 18, 100689. https://doi.org/10.1016/j.fochx.2023.100689

Erdman, J. W., Jr. (2000). AHA Science Advisory: Soy protein and cardiovascular disease: A statement for healthcare professionals from the Nutrition Committee of the AHA. Circulation, 102(20), 2555-2559. https://doi.org/10.1161/01.cir.102.20.2555

Eze, N. M., Okwume, U. G., Eseadi, C., Udenta, E. A., Onyeke, N. G., Ugwu, E. N., Akubue, B. N., Njoku, H. A., & Ezeanwu, A. B. (2018). Acceptability and consumption of tofu as a meat alternative among secondary school boarders in Enugu State, Nigeria: Implications for nutritional counseling and education. Medicine (Baltimore), 97(45), e13155. https://doi.org/10.1097/MD.0000000000013155

Messina, M. (2016). Soy and Health Update: Evaluation of the Clinical and Epidemiologic Literature. Nutrients, 8(12). https://doi.org/10.3390/nu8120754

Montgomery, K. S. (2003). Soy protein. J Perinat Educ, 12(3), 42-45. https://doi.org/10.1624/105812403X106946

Rizzo, J., Min, M., Adnan, S., Afzal, N., Maloh, J., Chambers, C. J., Fam, V., & Sivamani, R. K. (2023). Soy Protein Containing Isoflavones Improves Facial Signs of Photoaging and Skin Hydration in Postmenopausal Women: Results of a Prospective Randomized Double-Blind Controlled Trial. Nutrients, 15(19). https://doi.org/10.3390/nu15194113

Disclaimer

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Diet , , , , , , , , , , , , , , , , ,

Bread Crumbs: Tips for Cooking and Substitutes

When you don’t have breadcrumbs or want to try something else, what are healthy substitutes for breadcrumbs that may yield similar results without sacrificing flavor or texture?

Bread Crumbs

Various recipes call for bread crumbs. Adding bread crumbs to sauces and other dishes helps bind and thicken wet ingredients while sprinkling bread crumbs on top of casseroles can add a crispy, crunchy texture. Individuals who follow low-carb or gluten-free meal plans or those with allergies to wheat may choose to avoid bread crumbs and dishes made with them. Wheat-free substitutes can replace bread crumbs in recipes with similar results, though the recipe may vary slightly.

Why Use Substitutes?

Individuals with food allergies or dietary restrictions may seek a substitute for bread crumbs since they may contain common allergens like wheat and gluten. Wheat is among the most common food allergies in the U.S. (Asthma and Allergy Foundation of America, 2022)

For those with allergies or sensitivities, gluten- and wheat-free bread crumbs are available to purchase at some stores, and some use alternatives out of preference. Crushing different varieties of chips, crackers, and pretzels can be used instead of bread crumbs, adding a unique flavor and texture. However, these substitutes may not be an option for recipes that call for bread crumbs to bind or thicken wet ingredients.

Nutrition

Nutrition information for 1 ounce (28.35 grams) of unseasoned bread crumbs. (USDA, FoodData Central, 2018)

  • Calories – 112
  • Fat – 1.5 grams
  • Sodium – 208 milligrams
  • Carbohydrates – 20.4 grams
  • Fiber – 1.28 grams
  • Sugars – 1.76 grams
  • Protein – 3.8 grams

Bread products like bread crumbs can be part of a balanced diet. Guidelines recommend between 3 and 5 servings of whole grains daily for adults, including whole-wheat bread. (United States Department of Agriculture, 2025)

  • The main macronutrient in bread crumbs is carbohydrates.
  • Bread crumbs are usually consumed in small amounts because they are not the main ingredient.

Substitutes

Rolled Oats or Oat Flour

Oats and oat flour are often used as gluten-free alternatives to wheat in baking. Oats by weight are:

  • Lower in calories
  • Provide more complex carbohydrates.
  • They are a richer source of dietary fiber than bread crumbs.

Like regular flour, oats can be a binder in meat-based recipes. For example, if a recipe for meatloaf or meatballs calls for bread crumbs, rolled oats or oat flour can be successfully substituted.

Ensure the oats are gluten-free for individuals with gluten allergies, celiac, or gluten sensitivity. Though oats are inherently gluten-free, they may be processed on shared equipment and exposed to cross-contamination.

Cornflakes

  • Cornflakes can also add a crunchy texture to baked recipes. While corn is inherently gluten-free, cornflakes may not be. For individuals who have allergies or sensitivities, ensure you use gluten-free cornflakes. To use cornflakes, crunch them up by adding them to a ziplock bag and pressing them on the outside.

Nuts

  • Try nuts like almonds, walnuts, pecans, and cashews to add crunch and nutrients to a recipe. They are rich in healthy fats, protein, vitamins, and minerals. Plain nuts are also gluten-free, but roasted nuts may contain a wheat-based coating. Be sure to read the labels before using them.

Seeds

  • Seeds are a nutritious substitute.
  • They offer a different crispy, crunchy texture.

Shredded Coconut

Shredded or desiccated coconut can be used for sweet or rich recipes. It is perfect for adding to baked goods, especially gluten-free varieties. The recipe may need to be adjusted slightly because coconut has more moisture than regular bread crumbs. Do a small sample first to see how the coconut works in the recipe.

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, electroacupuncture, and integrated medicine protocols. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Hypertension? There’s a Diet for That

References

Asthma and Allergy Foundation of America. (2022). Food allergies. https://aafa.org/allergies/types-of-allergies/food-allergies/

United States Department of Agriculture, FoodData Central. (2018). Bread crumbs, dry, grated, plain. Retrieved from https://fdc.nal.usda.gov/food-details/174928/nutrients

United States Department of Agriculture. Dietary Guidelines for Americans 2020-2025. (2020). Dietary Guidelines for Americans, 2020-2025. Retrieved from https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Diet, Gut Health , , , , , , , , , , , , , , , , , ,

Enzymes and Their Role in Biological Functions

Enzymes’ function is to help trigger bodily processes ranging from digestion to blood clotting to growth. What is the best way to support enzyme production?

Enzymes

Enzymes are proteins that act as biological catalysts. They cause and speed up crucial chemical reactions and help the body complete necessary chemical reactions. They are vital for many biological processes, including digestion, metabolism, and molecule building and breaking down. This includes breaking down food, facilitating growth, and forming blood clots. Too little of a certain type can lead to serious health implications like a fatal buildup of toxins. Individuals missing a certain kind of enzyme or having too little of it can develop serious health conditions.

Function

They help speed up chemical reactions in the body (National Human Genome Research Institute, 2025). They facilitate chemical reactions in everything from digesting food to muscle growth. Enzymes facilitate this by binding to a cell, creating the reactions needed. With enzyme binding, chemical reactions can occur without destroying the cell. (Nemours KidsHealth, 2023) Each cell in the body has thousands of enzymes to help facilitate all the complex reactions to maintain health. (National Human Genome Research Institute, 2025)

Factors Affecting Production

In healthy individuals, the body produces the enzymes it needs. However, metabolic disorders can occur if the body does not produce enough of a certain type. (Kennedy Krieger Institute, 2025) These disorders can be serious and are usually caused by a genetic malfunction that impacts production.

Types

There are thousands of different types. Digestive enzymes, for example, aid in the breakdown of food and convert it into energy. Common enzymes that are critical for health include (Nemours KidsHealth, 2023)

Amylase

  • Digestive helps break down starches.

Aspartate aminotransaminase (AST) and Alanine Aminotransaminase (ALT)

  • Help the liver convert sugar into energy.

Creatine Kinase (CK)

  • Helps muscles create energy.

DNA Polymerase

  • Facilitates growth by allowing DNA to duplicate.

Glucose-6-Phosphate Dehydrogenase

  • Keeps red blood cells healthy by preventing damage to the cell.

Lipase

  • A digestive enzyme that helps break down fats and oils.

Protease

  • Digestive helps break down proteins.

Thrombin

  • Causes blood to clot.

Deficiencies

If the body doesn’t make enough of a certain enzyme, it cannot undergo the bodily processes that the enzyme helps facilitate. This can lead to a variety of symptoms. Some are minor, like not being able to eat lactose. Others are serious, like developmental delays caused by the build-up of toxins. (Kennedy Krieger Institute, 2025) Usually, these deficiencies are caused by genetics.

Types

There are various deficiencies. Some are very rare, while others can lead to conditions such as: (Nemours KidsHealth, 2023)

Lactose Intolerance

  • This is caused by not having enough of the enzyme that breaks down lactose, a sugar found in milk, leading to gas and bloating.

Tay-Sachs Disease

  • An often fatal disease caused by a missing hexosaminidase, which is responsible for breaking down fats

Gilbert’s Syndrome

  • This is caused by a missing enzyme that removes waste product (bilirubin) from the blood, leading to bilirubin buildup and
  • Jaundice or yellowing of the skin and whites of the eyes

Galactosemia

  • This leads to slow growth and trouble gaining weight, which is caused by the missing galactose-1-phosphate uridylyltransferase (GALT), which helps break down a sugar called galactose.

Phenylketonuria (PKU)

  • This is caused by having too little phenylalanine hydroxylase, which breaks down a protein called phenylalanine, causing brain damage.

Morquio Syndrome

  • This is caused by having too few enzymes that break down glycosaminoglycans, a type of sugar molecule.
  • This leads to bone and growth abnormalities.

Wilson’s Disease

  • A liver disease is caused by a missing protein that helps break down copper in the body.

Enzyme Production Support

Eat a healthy, well-balanced diet of fruits and vegetables to support enzyme production. Avoid processed foods, especially those that are very fatty (Johns Hopkins Medicine, 2025). The body produces all the necessary enzymes unless the individual has a genetic condition. Supplements aren’t usually required, but they can help with lactose intolerance or digestion in cystic fibrosis patients. (Nemours KidsHealth, 2023)

One supplement type, pancreatic enzyme replacement therapy (PERT), is available. PERT is an FDA-regulated prescription medication prescribed to patients with serious illnesses such as cystic fibrosis. (U.S. Food and Drug Administration, 2019)

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Chiropractic Care and Metabolism: The Hidden Link

References

National Human Genome Research Institute. (2025). Enzyme. Retrieved from https://www.genome.gov/genetics-glossary/Enzyme

Nemours KidsHealth. (2023). Enzymes. https://kidshealth.org/en/parents/enzymes.html

Kennedy Krieger Institute. (2025). Metabolic disorders. https://www.kennedykrieger.org/patient-care/conditions/metabolic-disorders

Johns Hopkins Health. (2025). Digestive enzymes and digestive enzyme supplements. https://www.hopkinsmedicine.org/health/wellness-and-prevention/digestive-enzymes-and-digestive-enzyme-supplements#:~:text=You’re%20better%20off%20building,your%20diet,%20especially%20fried%20foods.

U.S. Food and Drug Administration. (2019). FDA approves new breakthrough therapy for cystic fibrosis. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-new-breakthrough-therapy-cystic-fibrosis

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Therapy , , , , , , , , , , , , , , ,

Complex Regional Pain Syndrome: A Patient’s Guide

Individuals dealing with chronic pain following a minor injury, surgery, or trauma could be experiencing complex regional pain syndrome. What are the symptoms, diagnosis, and treatments available?

Complex Regional Pain Syndrome

Reflex sympathetic dystrophy syndrome (RSDS), more commonly known as complex regional pain syndrome (CRPS), is a chronic pain condition where a person experiences severe, persistent pain in a limb, usually following an injury, that is significantly more profound than from the initial trauma. It is considered a neuroinflammatory disorder in which the body’s response to injury is dysregulated. The condition is characterized by severe burning pain, often in an arm or leg, that can occur following a minor injury, surgery, or trauma. It is associated with abnormal changes in skin temperature, swelling, and sensitivity to touch, usually affecting the affected area’s nerves, skin, muscles, blood vessels, and bones. Other names it is known by include:

  • Causalgia
  • Shoulder-Hand Syndrome
  • Sudeck’s Atrophy

Causes

CRPS is a chronic pain condition believed to result from dysfunction in the central or peripheral nervous systems (National Institute of Neurological Disorders and Stroke, 2017). It involves irritation and abnormal excitation of nervous tissue, leading to abnormal impulses along nerves that affect blood vessels and skin. Animal studies indicate that norepinephrine, a catecholamine released from sympathetic nerves, acquires the ability to activate pain pathways after tissue or nerve injury, resulting in CRPS. Another theory is that CRPS, which follows an injury, is caused by triggering an immune response and continuous inflammation symptoms (swelling, redness, warmth). (Goh E. L., Chidambaram S., & Ma, D. 2017) It is believed to have multiple causes producing similar symptoms.

Triggers

There can be numerous triggers, including:

Symptoms

CRPS usually affects one of the extremities (arm, leg, hand, or foot). The primary symptom is intense, continuous pain. (National Institute of Neurological Disorders and Stroke, 2017) Other symptoms can include

  • Burning pain
  • Swelling
  • Increased skin sensitivity
  • Extreme sensitivity to touch, often causing significant disability in the affected limb.
  • Stiffness and swelling in affected joints
  • Skin color changes – blotchy, purple, pale, red.
  • Skin temperature changes – warmer or cooler than the opposing extremity.
  • Skin texture changes – shiny, thin, sweaty.
  • Changes in nail and hair growth patterns.
  • Pain can spread, for example, from the finger to the entire arm and the opposite extremity or from the left to the right arm.
  • Emotional stress can cause symptoms to worsen.

Some experts suggest three stages during which progressive changes occur in the affected area’s skin, muscles, joints, ligaments, and bones (Harvard Health Publishing, 2023). However, further research is needed.

Stages

Stage One

  • Lasts 1 to 3 months
  • Severe, burning pain
  • Muscle spasm
  • Joint stiffness
  • Rapid hair growth
  • Skin color and temperature changes (Stanford Medicine, 2025)

Stage Two

  • Lasts from 3 to 6 months
  • Pain becomes more intense
  • Swelling
  • Decreased hair growth
  • Nails are cracked, brittle, grooved, spotty
  • Softened bones
  • Stiff joints
  • Weak muscle tone

Stage Three

  • Pain is continuous
  • Muscle atrophy
  • Severely limited mobility
  • Irreversible changes to skin and bone
  • Contractions of muscles and tendons – limbs may be twisted

Diagnosis

  • A patient’s clinical history – signs and symptoms are the major factor in diagnosis.
  • The diagnosis is difficult because many symptoms overlap with other conditions. (Goh E. L., Chidambaram S., & Ma, D. 2017)
  • There is no specific blood test or other diagnostic tests.
  • X-rays may show osteoporosis, and nuclear bone scans may show characteristic uptake patterns that help diagnose.

Treatments

Treatment focuses on relieving painful symptoms and can include: (Goh E. L., Chidambaram S., & Ma, D. 2017)

  • Physical therapy and exercise
  • Psychotherapy to alleviate stress, anxiety, and depression
  • Sympathetic nerve blocks
  • Surgery
  • Spinal cord stimulation
  • Intrathecal drug pumps

Medications

These can include:

  • Topical analgesics
  • Anti-seizure drugs
  • Antidepressants
  • Corticosteroids
  • Opioids

It is estimated that there are 50,000 new cases every year in the United States. (Tajerian M., & Clark J. D. 2016)

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

The Root Causes of Pain

References

National Institute of Neurological Disorders and Stroke. (2017). Complex regional pain syndrome fact sheet. Retrieved from https://www.ninds.nih.gov/sites/default/files/migrate-documents/CRPS_FactSheet-E_508C.pdf

Goh, E. L., Chidambaram, S., & Ma, D. (2017). Complex regional pain syndrome: a recent update. Burns & Trauma, 5, 2. https://doi.org/10.1186/s41038-016-0066-4

Bruehl S. (2015). Complex regional pain syndrome. BMJ (Clinical research ed.), 351, h2730. https://doi.org/10.1136/bmj.h2730

Harvard Health Publishing. (2023). Complex Regional Pain Syndrome (CRPS). https://www.health.harvard.edu/a_to_z/complex-regional-pain-syndrome-crps-a-to-z

Stanford Medicine. (2025). Complex Regional Pain Syndrome (CRPS). https://med.stanford.edu/pain/about/chronic-pain/crps.html

Tajerian, M., & Clark, J. D. (2016). New Concepts in Complex Regional Pain Syndrome. Hand Clinics, 32(1), 41–49. https://doi.org/10.1016/j.hcl.2015.08.003

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Diet, Gut Health , , , , , , , , , , , , , , , , ,

Dates: Why You Should Include Them in Your Diet

Can adding dates to one’s diet be nutritious and provide various health benefits for individuals looking for a naturally sweet snack?

Dates

Dates are a type of dried fruit from the date palm tree. Dates are a healthy source of fiber, calcium, magnesium, potassium, niacin, folate, vitamin A, beta-carotene, lutein, and selenium. They can be a healthier alternative to refined sugar because they have a low glycemic index and do not cause a rapid spike in blood sugar levels. They are a rich source of nutrients, including:

  • Fiber: High in fiber, which promotes good digestion and helps keep you feeling full.
  • Potassium: This is essential for heart health and muscle function.
  • Magnesium: supports bone health and energy production.
  • Antioxidants: which protect the body from damage caused by free radicals.
  • Vitamins: a good source of vitamins B6, K, and A.

Consuming them in moderation is recommended, especially for individuals who are trying to lose weight or have diabetes. They are high in sugar, so individuals need to be mindful to avoid or limit additional sources of sugar. Nutritionists and dieticians recommend a modest dose of two large or three small dates, which is around 50 grams and provides half the sugar and calories.

Benefits

Lower Cholesterol

Research has shown that eating dates may also help lower cholesterol and triglyceride levels. However, further research is needed as the current evidence is still inconclusive. (Mirghani H. O. 2024) A recent meta-analysis also showed no significant effect on LDL cholesterol but reduced total cholesterol in individuals with type 2 diabetes.

Help Regulate Blood Sugar

Pitted dates generally don’t contain added sugars but can still contain a significant amount of natural sugars in sucrose, glucose, or fructose. Although their high sugar level may prevent individuals from eating dates as a healthy snack, a key difference between dates and sugary drinks, snacks, or other processed foods is that they contain high levels of fiber. Because of the fiber, which slows glucose absorption in the bloodstream, they also have a low glycemic index, which causes a smaller spike in blood sugar levels. (Mirghani H. O. 2021) Using dates as a sweetener can also be a healthier alternative to refined sugar and can be used in recipes to replace sugar. However, portion control is important.

Support Gut Health

Since dates are high in fiber, they can help the gastrointestinal tract but should be eaten in moderation as part of a balanced, healthy diet. However, they are recommended to be eaten with other fiber-rich foods, specifically those with lower sugar, that includes:

  • Leafy greens
  • Non-starchy vegetables
  • Whole grains
  • Legumes
  • Nuts
  • Seeds

Adding these foods to a diet can also benefit the microbiome. Dates and other fruits can improve the ratio of beneficial gut microbiota. (Eid N. et al., 2015) Eating too many dates could also cause diarrhea, but eating a few daily can help constipation.

Alternatives

  • Other dried fruits, such as prunes, figs, and apricots, are alternatives, but fresh fruits are an even better choice as they are much lower in calories.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and integrated medicine protocols. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Personalized Medicine and Wellness

References

Mirghani H. O. (2024). Effect of dates on blood glucose and lipid profile among patients with type 2 diabetes. World journal of diabetes, 15(6), 1079–1085. https://doi.org/10.4239/wjd.v15.i6.1079

Mirghani H. O. (2021). Dates fruits effects on blood glucose among patients with diabetes mellitus: A review and meta-analysis. Pakistan journal of medical sciences, 37(4), 1230–1236. https://doi.org/10.12669/pjms.37.4.4112

Eid, N., Osmanova, H., Natchez, C., Walton, G., Costabile, A., Gibson, G., Rowland, I., & Spencer, J. P. (2015). Impact of palm date consumption on microbiota growth and large intestinal health: a randomised, controlled, cross-over, human intervention study. The British journal of nutrition, 114(8), 1226–1236. https://doi.org/10.1017/S0007114515002780

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Chiropractic Care, Therapy , , , , , , , , , , , , , , , , , ,

Walking Backward to Alleviate Back Pain

Can walking backward on a treadmill aid in treating conditions and injuries, improving strength, gait, and mobility in the lower extremities and knee, hip, and ankle range of motion (ROM)?

Walking Backward On A Treadmill

Walking backward is often used in physical therapy to treat multiple conditions and injuries and help improve strength, gait, balance, and mobility in the lower extremities. It is also used to improve knee, hip, and ankle range of motion and lower back pain and burn calories.

The Difference Backward vs. Forward

The difference from forward walking is that certain motions are normal gait characteristics.

  • First, the leg swings through the air, and the heel lands on the ground.
  • Then, the straight knee bends slightly as you roll from heel to toe.
  • As this occurs, the opposite leg rolls from the toes and up into the air.
  • This heel-to-toe motion repeats, and normal walking takes place.

Reverse walking creates the opposite gait process.

  • The leg swings through the air and reaches backward with a bent knee.
  • The toes contact the ground, and the bent knee straightens as you roll from toe to heel.
  • Then, the heel leaves the ground with the knee straight, repeating the process.
  • The toe-to-heel gait can provide various benefits. (Cha H. G., Kim T. H., & Kim M. K. 2016)

Benefits

Walking backward on a treadmill benefits include:

  • Improved range of motion in the knee
  • Hamstring flexibility and mobility
  • Quadriceps strengthening

Walking backward also helps burn calories, improve heart function, and improve balance and stability. (Cha H. G., Kim T. H., & Kim M. K. 2016)

Knee Range of Motion

  • Reverse walking can help increase knee extension range of motion. (Zhang M. et al., 2022)
  • Individuals with knee injuries, surgeries, or arthritis may lose their knee extension or the knee’s ability to straighten.
  • The bent knee straightens fully when walking backward, moving from the toes onto the heel.
  • This helps to improve the range of motion into knee extension.

Quadriceps Function

  • Reverse walking can improve the function of the quadriceps muscles in the upper thighs. (Alghadir A. H. et al., 2019)
  • The quads are active when straightening the knee.
  • Exercises like quad sets, short arc quads, and straight leg raises increase quad strength.

Hamstring Flexibility

  • The hamstrings are located in the back of the upper thighs and work to bend the knees and extend the hips.
  • For individuals with tight hamstrings, a therapist may have you walk backward on the treadmill to improve the flexibility of the muscle group. (BBC, 2023)
  • When walking backward, the hamstring contracts to bend the knee as it swings through the air.
  • Then, the hamstring is stretched from the toe to heel movement, and the knee straightens.

Balance, Gait, and Mobility

  • Reverse walking can improve gait characteristics after an injury, surgery, or illness. (Balasukumaran T., Olivier B., & Ntsiea M. V. 2019)
  • Walking backward can help reset one’s gait and improve one’s ability to walk forward.
  • A study on stroke patients found that backward walking training was superior to standing balance training for improving balance and walking speed. (Rose, D. K. et al., 2018)

Burns Calories

  • Backward walking has been found to burn more calories than forward walking.
  • Walking backward uses up about 40% more calories per minute than forward walking at the same speed. (Cha H. G., Kim T. H., & Kim M. K. 2016)

Heart and Lung Function

  • Walking backward on a treadmill can also benefit heart and lung health.
  • Backward walking is more challenging and forces the individual to work harder.
  • Research shows it requires more oxygen and places more demands on the cardiovascular system. (Thomas K. S., Hammond M., & Magal M. 2018)
  • As a result, it improves heart and lung health better.

Conditions That Benefit

Individuals with a lower extremity impairment that results in loss of normal walking mobility may benefit from reverse walking. Common conditions that may help include: (BBC, 2023) (DelMastro H. M. et al., 2023)

  • Hamstring strain
  • Sciatica with tightness in hamstrings
  • Hip, knee or ankle surgery
  • Lower extremity fracture
  • Cerebral palsy
  • Multiple sclerosis
  • Parkinson’s disease
  • Stroke

A physical therapist will decide if an individual’s condition warrants reverse walking as part of a rehabilitation program.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Control Foot Motion and Posture

References

Cha, H. G., Kim, T. H., & Kim, M. K. (2016). Therapeutic efficacy of walking backward and forward on a slope in normal adults. Journal of Physical Therapy Science, 28(6), 1901–1903. https://doi.org/10.1589/jpts.28.1901

Zhang, M., Pang, J., Lu, J., Kang, M., Chen, B., Jones, R. K., Zhan, H., & Liu, A. (2022). The Immediate Effect of Backward Walking on External Knee Adduction Moment in Healthy Individuals. Journal of Healthcare Engineering, 2022, 4232990. https://doi.org/10.1155/2022/4232990

Alghadir, A. H., Anwer, S., Sarkar, B., Paul, A. K., & Anwar, D. (2019). Effect of 6-week retro or forward walking program on pain, functional disability, quadriceps muscle strength, and performance in individuals with knee osteoarthritis: a randomized controlled trial (retro-walking trial). BMC musculoskeletal disorders, 20(1), 159. https://doi.org/10.1186/s12891-019-2537-9

BBC. (2023). Why walking backwards can be good for your health and brain. https://www.bbc.com/future/article/20231110-why-walking-backwards-can-be-good-for-your-health-and-brain

Balasukumaran, T., Olivier, B., & Ntsiea, M. V. (2019). The effectiveness of backward walking as a treatment for people with gait impairments: a systematic review and meta-analysis. Clinical Rehabilitation, 33(2), 171–182. https://doi.org/10.1177/0269215518801430

Rose, D. K., DeMark, L., Fox, E. J., Clark, D. J., & Wludyka, P. (2018). A Backward Walking Training Program to Improve Balance and Mobility in Acute Stroke: A Pilot Randomized Controlled Trial. Journal of Neurologic Physical Therapy: JNPT, 42(1), 12–21. https://doi.org/10.1097/NPT.0000000000000210

Thomas, K. S., Hammond, M., & Magal, M. (2018). Graded forward and backward walking at a matched intensity on cardiorespiratory responses and postural control. Gait & posture, 65, 20–25. https://doi.org/10.1016/j.gaitpost.2018.06.168

DelMastro, H. M., Ruiz, J. A., Simaitis, L. B., Gromisch, E. S., Neto, L. O., Cohen, E. T., Wong, E., Krug, R. J., & Lo, A. C. (2023). Effect of Backward and Forward Walking on Lower Limb Strength, Balance, and Gait in Multiple Sclerosis: A Randomized Feasibility Trial. International journal of MS care, 25(2), 45–50. https://doi.org/10.7224/1537-2073.2022-010

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Diet , , , , , , , , , , , , , , , , , ,

Bone Broth Health: Benefits for Your Body

Can bone broth help individuals with gut issues or chronic conditions like inflammatory bowel disorder?

Bone Broth Health

Bone broth is a nutrient-rich beverage made by simmering animal bones, typically from beef, chicken, or fish, in water for an extended period (24-72 hours). It can be used as a beverage or as a base for soups, stews, and sauces.

Process

  • Bones are roasted or boiled to release flavor.
  • Bones are placed in a pot with water, vegetables (such as onions, carrots, and celery), herbs (such as parsley and thyme), and spices.
  • The mixture is simmered over low heat for a long time, allowing the bones to release their nutrients and collagen.
  • The broth is strained to remove the bones and solids.

Nutrients

Bone broth is a healthy source of:

Collagen

  • A protein that supports skin, hair, and joint health.

Minerals

  • Including calcium, magnesium, phosphorus, and silicon.

Amino acids

  • Essential for building and repairing tissues.

Bone Broth Health Benefits

While there is limited research on the health benefits, the nutrients in bone broth can be beneficial for:

  • Joint health
  • Bone density
  • Digestion
  • Gut health
  • Muscle growth and recovery
  • Hydration
  • Reduce inflammation
  • Improve skin elasticity and appearance
  • Boost immune system

While research on bone broth’s benefits is still limited, it’s a nutritious and hydrating beverage that supports gut health and recovery after a tough workout. It can be drunk on its own or used in cooking. Bone broth is a delicious way to replenish electrolytes and stay hydrated, whether recovering from a flare-up or an intense workout. It is especially helpful for those dealing with gut issues or chronic conditions like inflammatory bowel disorder.

Nutrient-Rich

  • Bone broth is rich in minerals, including calcium, magnesium, potassium, phosphorus, and iodine.

Joint Health

  • Collagen is the main source of protein found in bones, tendons, and ligaments.
  • Research suggests that collagen may support joint health, protect the tissues in joints, and improve symptoms of osteoarthritis. (Martínez-Puig D. et al., 2023)

Anti-Inflammatory

Protein-Rich

  • Incorporating bone broth into one’s diet can help meet protein goals.
  • One cup of bone broth contains four to 20 grams of protein.

Digestion and Gut Health

  • Colostrum is the first milk produced after giving birth, and some research suggests this may offer immune-boosting benefits and gut repair, but more research is needed. (Playford R. J., & Weiser M. J. 2021)
  • Bone broth contains glutamine, an amino acid that can reduce inflammation in the gut, strengthen the gut lining, and maintain a healthy microbiome.
  • It also contains glycine, which may help quell digestive issues such as acid reflux or GERD, though research is limited. (Wang B. et al., 2015) (Nagahama K. et al., 2012)

Many bone broths are high in sodium and may not be suitable for individuals on low-sodium diets. It is recommended to consume less than 2,300 milligrams of sodium per day to support a healthy heart, reduce the risk of high blood pressure, look for other sources of sodium, and incorporate bone broth accordingly. (American Heart Association, 2024) Also, because of the polysaccharides that may leach from the cartilage and the garlic and onions usually present in the bone broth, it’s not suitable for those with a digestive disorder like small intestinal bacterial overgrowth (SIBO) or individuals following a low-FODMAP diet.

What To Look For

Quality

  • When possible, choose a bone broth that’s grass-fed and organic.
  • Quality matters because the process of simmering the bones with water pulls all the nutrients, collagen, and protein into the broth.
  • Starting with the highest quality ingredients ensures it will be as nutritious as possible.

Type

  • Various types include chicken, beef, turkey, and bison varieties.

Packaging

  • Bone broth comes in various packaging, including shelf-stable, frozen, or fresh.
  • When selecting, consider how often it is used, how much is needed, and storage space.
  • For individuals who drink bone broth daily, buying it in bulk and storing it in the pantry or freezer may be more budget-friendly.

Consistency

  • Generally, bone broth is a thick, slightly viscous beverage.
  • Individuals who prefer a thinner liquid should try a shelf-stable broth, which is usually less gelatinous than frozen bone broths.
  • Powdered bone broth is also a great option for those who prefer a lighter beverage.
  • Individuals can choose a low-sodium bone broth to limit sodium intake.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and integrated medicine protocols. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Reducing Inflammation In The Body

References

Martínez-Puig, D., Costa-Larrión, E., Rubio-Rodríguez, N., & Gálvez-Martín, P. (2023). Collagen Supplementation for Joint Health: The Link between Composition and Scientific Knowledge. Nutrients, 15(6), 1332. https://doi.org/10.3390/nu15061332

Chen, S., Kim, W., Henning, S. M., Carpenter, C. L., & Li, Z. (2010). Arginine and antioxidant supplement on performance in elderly male cyclists: a randomized controlled trial. Journal of the International Society of Sports Nutrition, 7, 13. https://doi.org/10.1186/1550-2783-7-13

Razak, M. A., Begum, P. S., Viswanath, B., & Rajagopal, S. (2017). Multifarious Beneficial Effect of Nonessential Amino Acid, Glycine: A Review. Oxidative medicine and cellular longevity, 2017, 1716701. https://doi.org/10.1155/2017/1716701

Playford, R. J., & Weiser, M. J. (2021). Bovine Colostrum: Its Constituents and Uses. Nutrients, 13(1), 265. https://doi.org/10.3390/nu13010265

Wang, B., Wu, G., Zhou, Z., Dai, Z., Sun, Y., Ji, Y., Li, W., Wang, W., Liu, C., Han, F., & Wu, Z. (2015). Glutamine and intestinal barrier function. Amino acids, 47(10), 2143–2154. https://doi.org/10.1007/s00726-014-1773-4

Nagahama, K., Nishio, H., Yamato, M., & Takeuchi, K. (2012). Orally administered L-arginine and glycine are highly effective against acid reflux esophagitis in rats. Medical science monitor: international medical journal of experimental and clinical research, 18(1), BR9–BR15. https://doi.org/10.12659/msm.882190

American Heart Association. Association, A. H. (2024). Lifestyle & Risk Reduction, High Blood Pressure. https://www.heart.org/-/media/files/health-topics/answers-by-heart/why-should-i-limit-sodium.pdf

By Dr. Alex Jimenez DC, APRN, FNP-BC, CFMP, IFMCP 0 Comments Diet , , , , , , , , , , , , , , , ,

Cheddar Cheese Nutritional Value Explained

While cheddar cheese’s high-calorie count and saturated fat content have nutritional drawbacks, can a moderate amount be an enjoyable part of a healthy diet?

Cheddar Cheese

Cheddar is a hard, cow’s milk cheese known for its dense, layered texture and nutty flavor. It is a favorite cheese served in quesadillas, mac and cheese, or on burgers. However, cheddar cheese nutrition isn’t considered ideal.

Nutrition

Nutrition information for 1 ounce/28 grams of cheddar cheese. (U.S. Department of Agriculture, 2019)

  • Calories – 120
  • Fat – 10 grams
  • Sodium – 190 milligrams
  • Carbohydrates – 0 grams
  • Fiber – 0 grams
  • Sugars – 1 grams
  • Protein – 7 grams
  • Calcium – 201.6 milligrams
  • Vitamin A – 95.7 micrograms
  • Vitamin B12 – 0.3 micrograms

Carbohydrates

  • Cheddar contains zero carbohydrates, meaning it has no fiber and little sugar.

Fats

  • Most health concerns focus on fat and saturated fat content. (Lordan R. et al., 2018)
  • Whole-milk cheddar is high in total fat – 10 grams per ounce.
  • Saturated fat – 6 grams per ounce.
  • Traditionally, nutrition recommendations have advised consuming a diet low in saturated fat to reduce the risk of cardiovascular disease.
  • However, research suggests saturated fat in whole foods like cheese may not harm heart health. (Astrup A., Geiker N. R. W., & Magkos F. 2019)
  • Further research is needed to determine the pros and cons of saturated fat in dairy. (Hirahatake K. M. et al., 2020)

Protein

  • It provides 7 grams per 1-ounce serving, and protein accounts for over 30% of cheddar’s calories.
  • This can significantly add to one’s daily intake.

Vitamins and Minerals

  • Calcium is a micronutrient at 200mg (or 20% of daily value) per ounce.
  • One ounce provides 10% daily vitamin A recommendation and 14% phosphorus, plus small amounts of zinc, selenium, and riboflavin.
  • Cheddar cheese can be relatively high in sodium at 190mg per ounce if trying to cut down on salt. (U.S. Department of Agriculture, 2019)

Health Benefits

Builds Healthy Bones

Builds Muscle

  • Protein performs a variety of functions in the body.
  • Protein helps build muscle; it’s necessary to produce enzymes, give structure to cells, maintain fluid balance, and more. (Carbone J. W., & Pasiakos S. M. 2019)

Calorie-Dense

  • Cheddar is calorie-dense, which increases its satisfaction factor.

May Help Weight Loss

  •  There is the belief that cheese causes weight gain; however, the full-fat dairy paradox, which goes against dietary guidelines, is the idea that full-fat dairy products may be healthier than low-fat or fat-free dairy,
  • Research now suggests removing fat from dairy products may make them more likely to cause weight gain, making full-fat the better choice for weight management. (Soltani S., & Vafa M. 2017)

Compatible With Keto and Low-Carb Diets

  • Because of cheddar’s high fat percentage, it’s compatible with high-fat nutrition plans.
  • With zero carbohydrates, cheddar also fits well in low-carb diets.

Low Lactose

  • Cheddar is one of the harder, aged cheeses that’s quite low in lactose.
  • This means lactose-intolerant individuals can often eat it without unpleasant symptoms like bloating, stomach upset, and gas.

Allergies

  • Although it is low in lactose, cheddar still contains casein and whey, two components that can trigger an immune response in individuals with a dairy allergy. (He, M. et al., 2017)

Storage and Safety

Cheddar does not technically require refrigeration. However, storing it in the fridge will help it last longer. According to the USDA, unopened cheddar can last up to six months in the refrigerator, and opened packages can last three to four weeks. Because it’s a hard cheese, cheddar even takes well to freezing, but this will not extend its life more than refrigeration. The USDA estimates cheddar can be frozen for about six months.

Preparation

Cheddar can be added to any number of cheesy dishes or, of course, served alone with crackers. It doesn’t require high heat to become nice and melty. Try adding a whole-grain base and veggies to increase the nutrients in dishes like cheesy casseroles, Mexican dishes, sandwiches, or pasta.

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Osteoporosis

References

U.S. Department of Agriculture. FoodData Central. (2019). Cheddar Cheese. Retrieved from https://fdc.nal.usda.gov/food-details/494681/nutrients

Lordan, R., Tsoupras, A., Mitra, B., & Zabetakis, I. (2018). Dairy Fats and Cardiovascular Disease: Do We Really Need to be Concerned?. Foods (Basel, Switzerland), 7(3), 29. https://doi.org/10.3390/foods7030029

Astrup, A., Geiker, N. R. W., & Magkos, F. (2019). Effects of Full-Fat and Fermented Dairy Products on Cardiometabolic Disease: Food Is More Than the Sum of Its Parts. Advances in nutrition (Bethesda, Md.), 10(5), 924S–930S. https://doi.org/10.1093/advances/nmz069

Hirahatake, K. M., Astrup, A., Hill, J. O., Slavin, J. L., Allison, D. B., & Maki, K. C. (2020). Potential Cardiometabolic Health Benefits of Full-Fat Dairy: The Evidence Base. Advances in nutrition (Bethesda, Md.), 11(3), 533–547. https://doi.org/10.1093/advances/nmz132

Malmir, H., Larijani, B., & Esmaillzadeh, A. (2020). Consumption of milk and dairy products and risk of osteoporosis and hip fracture: a systematic review and Meta-analysis. Critical reviews in food science and nutrition, 60(10), 1722–1737. https://doi.org/10.1080/10408398.2019.1590800

Carbone, J. W., & Pasiakos, S. M. (2019). Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit. Nutrients, 11(5), 1136. https://doi.org/10.3390/nu11051136

Soltani, S., & Vafa, M. (2017). The dairy fat paradox: Whole dairy products may be healthier than we thought. Medical journal of the Islamic Republic of Iran, 31, 110. https://doi.org/10.14196/mjiri.31.110

He, M., Sun, J., Jiang, Z. Q., & Yang, Y. X. (2017). Effects of cow’s milk beta-casein variants on symptoms of milk intolerance in Chinese adults: a multicentre, randomised controlled study. Nutrition journal, 16(1), 72. https://doi.org/10.1186/s12937-017-0275-0