Food as Medicine: Arugula (Eruca sativa, Brassicaceae)

History and Traditional Use

Range and Habitat

Arugula (Eruca sativa, Brassicaceae), also known as rucola and rocket, is a weedy annual that is drought-tolerant and prefers a hot, dry climate. The name “arugula” is a modern American designation and likely derives from the Italian term “rucola.” The name “rocket” is more common in British English, as is roquette in France. Both rucola and roquette are diminutives of the Latin eruca, which means “caterpillar” and may refer to the fuzzy appearance of the young stems. The different names for arugula demonstrate the wide area where it grows, in a swath of the northern Mediterranean and the near east that stretches from Portugal to Afghanistan. It has been naturalized in northern Europe and North America.

Arugula is distinguished by its upright stem, which can have four-petaled white, yellow, or purple flowers, as well as its green, aromatic, serrated leaves. It’s thin, narrow fruit is a pod filled with small, oil-rich seeds. Although it is commonly thought of as a relative of spinach or lettuce, it is actually a cruciferous vegetable of the family Brassicaceae, which includes broccoli, Brussels sprouts, kale, and cabbage.

arugula flowerThe leaves and seeds of arugula are both edible. The leaves boast an aromatic, peppery, and mustard-like flavor and are mainly consumed raw in salads. Young leaves are tenderer and have a milder flavor, while mature leaves are larger, woodier, and more bitter. The seeds can be pressed for oil.

Phytochemicals and Constituents

As a leafy green vegetable and a member of the family Brassicaceae, arugula is an extremely nutrient-dense food. It is low in calories and rich in vitamins A, C and K, folate, magnesium, and calcium. Calcium, magnesium, and potassium help controls blood pressure and maintains bone health. It also provides riboflavin, potassium, copper, iron, and zinc. Arugula’s health benefits are a potent combination of cruciferous vegetable and leafy green, as it contains compounds found in both: glucosinolates, a group of compounds which exert powerful anticancer and detoxifying mechanisms, and antioxidant phytochemicals such as carotenes and chlorophyll. Compared to other brassica plants, arugula has one of the highest beta-carotene, kaempferol, and quercetin contents.

Arugula seed oil, commonly called taramira or Jamba oil, is likewise rich in glucosinolates. It also contains high amounts of erucic and gadoleic acids, which have more commercial than health benefits, as detailed in the following section.

Historical and Commercial Uses

Ancient and modern practitioners interpret arugula’s peppery taste as a fiery, “lively” quality, which lends itself to a variety of different uses. In the ancient world, the Romans and the Egyptians considered arugula to be a potent aphrodisiac which was used to “restore vigor to the genitalia,” and planted it at the base of statues of the god Priapus, who was considered the god of fertility, livestock, and gardens. Its reputation as an aphrodisiac was widespread and persistent, and some monasteries banned its cultivation on their grounds, citing its “hotness and lechery.”

Arugula had widespread use in Greco-Arab and Islamic medicine practices, primarily for its antimicrobial and anti-inflammatory properties. It was taken orally as a general tonic for wellness and as an aid to digestion and kidney function. Additionally, records exist of a physician’s prescribing a topical treatment of ground seeds mixed with cream for acne. Evidence of arugula use and cultivation dates back to the Hellenistic Period in Greece (323 BCE – 31 BCE).

Due to its high vitamin A and C content, arugula has been used as a therapeutic food for eye infections and night blindness, and its sharpness and astringency reveals its stimulant, diuretic, and antiscorbutic (effective against scurvy) properties. Many of its modern and traditional uses overlap with dandelion greens, to which it is very similar in taste and nutritional profile. The leaves have also been used topically as a rubefacient (drawing blood to the surface of the skin) to improve circulation.

The fresh leaves of arugula have been consumed and favored as a salad green in Mediterranean countries for centuries. With the growing popularity of the Mediterranean cuisine, its consumption continues to grow in the United States as well as the rest of the world. Arugula is best consumed raw or very lightly cooked, as many of its beneficial compounds (chlorophyll, glucosinolates, and isothiocyanates) degrade quickly when heated.

In India, Pakistan, and Iran, arugula is grown as a commercial oilseed crop. Due to its high erucic acid content, taramira oil and similar oils are used as commercial lubricants and as massage oils. The seed matter left behind after oil processing is used as livestock fodder. Where it is popular, including India, taramira oil also has a widespread culinary use, though it must age for six months after processing to mellow its initial overwhelming acrid taste. Once aged, the oil can be used in salads and for cooking purposes and is a traditional ingredient in pickles and mustard.

Modern Research

As a member of the Brassicaceae family, arugula shares the extensively-studied effects of its relatives, such as broccoli and kale.

Cruciferous vegetables are excellent sources of antioxidants and are highly regarded for their anti-inflammatory, antimicrobial, chemo-preventive, and cardioprotective effects. They have high levels of sulfur-containing compounds called glucosinolates which, when crushed or chewed, turn into indoles and isothiocyanates. These two bioactive constituents have been shown to be potent cancer-fighters, protecting against many forms of cancers, including breast, prostate, and colorectal cancer.

Arugula can be a valuable addition to the diet of people with Crohn’s disease and other gastrointestinal conditions, providing valuable vitamins, minerals, and insoluble fiber. Those who suffer from Crohn’s disease are at higher risk for vitamin deficiencies and malnutrition as a result of a limited diet; however, in a 2012 clinical study, almost 80% of subjects reported no change in their symptoms after consuming steady amounts of arugula. Though cruciferous vegetables are considered off-limits to people following a low-FODMAP diet (which seeks to eliminate fermentable oglio-, di-, and monosaccharides and polyols due to a bacterial imbalance in the gut), arugula was well tolerated and also should be considered as a nutrient-dense addition for people with these sensitivities.


Nutrient Profile


Macronutrient Profile:
(Per 1 cup arugula leaves)

5 calories
0.52 g protein
0.73 g carbohydrate
0.13 g fat

Secondary Metabolites: (Per 1 cup arugula leaves)

Excellent source of:
Vitamin K: 21.7 mcg (27.13% DV)

Good source of:

Vitamin A: 475 IU (9.5% DV)
Vitamin C: 3 mg (5% DV)
Folate: 19 mcg (4.75% DV)
Vitamin E: 0.09 mg (4.48% DV)
Calcium: 32 mg (3.2% DV)

Also provides:
Magnesium: 9 mg (2.25% DV)
Potassium: 74 mg (2.11% DV)
Iron: 0.29 mg (1.61% DV)
Dietary Fiber: 0.3 g (1.2% DV)
Riboflavin: 0.02 mg (1.18% DV)
Vitamin B6: 0.02 mg (1% DV)
Phosphorus: 10 mg (1% DV)

DV = Daily Value as established by the US Food and Drug Administration, based on a 2,000 calorie diet.

Recipe: Arugula and Walnut Pesto

Ingredients:

  • 1/2 cup raw, unsalted walnuts halves
  • 2 cups fresh arugula leaves
  • 1-2 garlic cloves, peeled and roughly chopped
  • 1/2 cup grated Parmesan cheese
  • 1/2 cup extra virgin olive oil
  • Salt to taste

Directions:

  1. In a dry, nonstick skillet over medium heat, toast walnuts until lightly browned and fragrant. Be careful not to burn. Remove from the heat.
  2. In a food processor, combine arugula, walnuts, and garlic and pulse until roughly chopped. Continue pulsing, drizzling in olive oil in a steady stream until combined. Stir in Parmesan cheese and add salt to taste.
  3. Alternatively, this recipe can be made with a mortar and pestle. Roughly chop the arugula leaves and toast walnuts as described, then combine nuts, salt, and garlic in a mortar and grind until smooth. Then add the cheese, olive oil, and arugula, and continue grinding until smooth.

Best Ice Cream for Type 2 Diabetes

Ice cream does not have to be strictly off limits for people with type 2 diabetes. While it is still best to enjoy ice cream in moderation, there are ice cream and frozen yogurt choices out there that will not derail a healthful diet.

People with type 2 diabetes have more to think about than simply ruining their diet with ice cream. Their main concerns are about how ice cream will affect their blood sugar levels, since controlling this is critical to managing diabetes.

While people with diabetes can include ice cream as part of their healthful diet, it is important for them to make informed decisions about what ice creams they should eat.

Understanding ice cream sugar servings

[ice cream cheers]
Ice cream can be a delicious treat, but people with diabetes need to be particularly careful about which ice cream they eat.

Most ice cream has a lot of added sugar, making it something a person with diabetes should avoid. Because of this, one of the first things they should consider when choosing an ice cream is the sugar content.

People with diabetes need to understand how their ice cream indulgence fits into their overall diet plan. Here are a few facts for people with diabetes to consider:

  • Every 4 grams (g) of sugar is equivalent to 1 teaspoon. The more sugar that is in the ice cream, the more carbohydrates it has.
  • An ice cream serving with 15 g of carbohydrates is equal to 1 serving of carbohydrates. Any carbohydrates in ice cream will count towards the total carbohydrate goal for the day, which will be different for each person.
  • Protein and fat found in ice cream can help slow absorption of sugar. Choosing an ice cream higher in protein and fat may be preferable to choose a lower fat option.
  • A suitable portion of ice cream for somebody with diabetes is very small, usually half a cup. But most people serve much more than this. It is crucial that a person with diabetes sticks to the proper portion size, so they know exactly how many carbohydrates they are eating.

Things to look out for when choosing an ice cream

When it comes to picking out ice cream, the number of choices offered at a grocery store can be overwhelming. There are a number of brands and dozens of flavors to choose from. Here are some considerations for picking out ice cream at the local store:

Low sugar

The best ice cream for a person with diabetes has the lowest sugar content per serving without relying on artificial sweeteners. To check the amount of sugar in ice cream, look at the total number of carbohydrates on the nutrition label and the ingredient list.

For someone with diabetes, the best choice is an ice cream with less than 20 g total carbohydrates in a half- cup serving.

[reading a label at the grocery store]
Labels can be confusing or even deliberately misleading, so it is important to read them carefully.

Confusing labels

Almost every brand of ice cream has lots of marketing information on the container, which is designed to catch the eye.

People with diabetes may find a product that says reduced sugar or half the calories of regular ice cream. Although the claims may be true that the particular product has less sugar than another variety, the actual sugar content may still be much higher than recommended per serving amount.

Fat and protein level

The amount of protein and fat in the ice cream can have a direct impact on how fast sugar is absorbed in the body. In general, if the fat and protein contents are higher than average, the sugar from each serving will be absorbed more slowly.

Best ice creams for people with diabetes to eat

With so many brands to choose from, it can be hard to determine which are best for people with diabetes. The following are a few brands and flavors to choose from that are better overall choices:

  • Blue Bunny Ice Cream offer two options – vanilla and chocolate. Both contain less than 20 g of carbohydrates per serving.
  • Breyers offer a vanilla ice cream called Smooth and Dreamy ½ Fat Creamy Vanilla Ice Cream. It contains minimal fat and 17 g of total carbohydrates. Breyers offer a similar product in chocolate as well, also with 17 g of total carbohydrates. Breyers also offer some no-sugar-added flavors. However, these varieties contain multiple artificial sweeteners and are not recommended.
  • Schwan’s offer a chocolate ice cream flavor, which contains 18 g of total carbohydrates.
  • Edy’s offer several varieties of their slow-churned ice creams, which contain around 20 g or less of carbohydrates per serving.
  • Halo Top offer ice cream flavors with additional protein. The addition of protein helps to slow down the absorption of sugar into the blood, making it a good choice for people with diabetes.

How to make room for ice cream in a diet

A recommended serving of carbohydrates in ice cream is 20 g or less. This equates to roughly one serving of carbohydrates in a day.

People with diabetes who are following a strict diet where carbohydrate servings count, must count every carbohydrate they eat. Those planning on eating a serving of ice cream for dessert should make sure they eat one less carbohydrate serving during the day. Substituting a sandwich with a lettuce wrap or salad could do this.

Saturated fat content is also high in some ice cream brands and flavors. Since people with diabetes have a higher risk of heart disease, it is a good idea to limit other saturated fat-containing foods on the day they plan to eat ice cream.

If eating ice cream is going to be a daily treat, it is important to talk to a dietitian about how to fit it into a dietary plan.

Other sweets and dessert options

Diabetes-friendly desserts are available in most stores and can be made at home as easily as any other desserts. Some things to consider when looking for other sweet options include:

  • Total carbohydrate contents per serving: Just 15-20 g is considered one daily serving of carbohydrates.
  • Total protein: The amount of protein in a dessert can help slow the absorption of sugar into the bloodstream.
  • Use of natural sweeteners: Although artificial sweeteners are readily available in most stores and in many light and no-sugar-added ice cream options, they are not highly recommended in the medical community.

Some ready-to-eat options for dessert include:

Frozen yogurt

[frozen yogurt with berries]
While frozen yogurt may seem like a more healthful option, it often contains just as much sugar as regular ice cream.

Some people consider frozen yogurt and ice cream to be the same, while others recognize their differences. Frozen yogurt is often sold in fat-free varieties, which is a good option when compared to some ice creams where a single serving can be around a third of total fat needs.

However, the nutritional information in frozen yogurt needs to be looked at carefully. Frozen yogurt may also contain just as much, if not more sugar and therefore carbohydrates, as ice cream. This may be to make up for the lack of flavor and texture that the fat would give it.

Pudding and gelatin

There are many brands that offer sugar-free or fat-free versions of these dessert options, although they may still contain artificial sweeteners. It is important to check the nutritional facts to see how they fit into the overall diet for the day.

Homemade baked goods made with stevia

Many baked goods, such as cookies, brownies, cakes, and so on, use stevia in place of sugar in their recipes.

This natural, zero-calorie sweetener offers a great substitute for sugar that can reduce the carbohydrate impact of a favorite baked treat.

Conclusion

When it comes to ice cream, the best advice for people with diabetes is to understand carbohydrate serving sizes, the amount in a serving of ice cream, and how much impact it is going to have on the day.

It is always a good idea to take a walk after eating a dessert to help lower post-meal blood sugar.

For people working with dietitians to develop a meal plan, it is important to talk about possible issues with adding ice cream to the diet, or ways to make it work. In any case, with the right research and sacrifices, ice cream can be a part of a regular diet.

Food as Medicine: Anise (Pimpinella anisum, Apiaceae)

Anise or aniseed (Pimpinella anisum, Apiaceae) is a herbaceous annual that grows to almost a meter (3.3 feet) in height. The lower leaves of the plant are dark green, heart-shaped, and shallowly lobed, while the upper leaves are feathery. In the summer, the plant produces small, white flowers in an umbrella-shaped head, and, in the fall, these flowers produce aromatic fruits that are three to four millimeters in length. These fruits, called “anise seeds” in the market and referred to in the rest of this article as “seeds,” are the medicinal and culinary portion of the plant.

The cultivation of anise, which is native to the Anatolian peninsula, Greece, and Egypt, has spread to other countries. The plant grows well in warm, frost-free climates. Anise should not be confused with fennel (Foeniculum vulgare, Apiaceae), licorice (Glycyrrhiza glabra, Fabaceae), or star anise (Illicium verum, Schisandraceae), which have similar flavors but different medicinal effects.

Phytochemicals and Constituents

Anise contains a number of biologically important substances, in particular, its essential oil. The most abundant constituent of aniseed essential oil is trans-anethole, which makes up 80-90% of the oil.

Other components found in anise include a variety of coumarins (scopoletin, umbelliferone, umbelliprenine, and bergapten), flavonoids (quercetin, apigenin, luteolin, and their glycosides), and other aromatic oil compounds (estragole, anise ketone, and beta-caryophyllene). Some coumarins have anticoagulant (blood-thinning) properties and increase blood flow while decreasing capillary permeability. Certain flavonoids, such as quercetin, have antioxidant activities that may reduce the risk of cardiovascular disease and various types of cancer.

Historical and Commercial Uses

Anise has been used in culinary and medical applications for more than 3,000 years. The gray-brown, ovoid seeds are known for their gastrointestinal benefits, relieving distention and cramping due to gas, and for being a mild cough reliever and expectorant. A folk remedy for hiccups calls for a few seeds taken with water.

The earliest recorded medicinal use of anise seed dates back to 1500 BCE in Egypt, as mentioned in the Ebers Papyrus as a medicine for flatulence. The use of anise spread through trade and became a common medicine throughout the Mediterranean, East Asia, and Europe. The Greek physician Dioscorides described anise in his 70 CE medical treatise De materia medica as warming and drying and recommended it as a vermifuge as well as for bad breath, headaches, low milk supply in nursing mothers, colds, and to aid digestion. Around the same time period, Roman statesman Pliny the Elder wrote in his Naturalis Historia that the best anise came from Crete, and that “it is generally thought that there is nothing in existence more beneficial to the abdomen and intestines than anise.”9 Pliny also described the use of anise for convulsions and seizures.

Traditional Chinese medicine indicated anise as a remedy for a cough and gastrointestinal upset, and the Indian Ayurvedic system of medicine noted anise as a gas reliever and aromatic spice. Native Amazonians used it as a gentle remedy for children with stomach aches. In traditional Iranian medicine, anise has been used as an analgesic for migraines and as a carminative, aromatic, disinfectant, and diuretic. In some traditional texts, anise is mentioned as a remedy for melancholy, nightmares, and as a treatment for epilepsy and seizures. The German Commission E monographs list the internal use of anise seed decoction or essential oil for dyspepsia, sore throats, and coughs, and the inhalation of preparations containing 5-10% essential oil for sore throats and coughs. The monographs of the European Medicines Agency (EMA), which is the medicine authority for the European Union, indicate the oral use of anise preparations for the symptomatic treatment of mild, spasmodic gastrointestinal complaints, including bloating and flatulence, and as an expectorant in a cough associated with cold.

The seeds are mildly estrogenic and promote milk production. In the Netherlands, anise seed cookies are a traditional gift given to new mothers to ensure a plentiful milk supply. Although the whole seed is generally considered a safe addition to a postpartum diet, there have been two reported cases of nursing mothers who drank large amounts (2 liters per day) of fennel and anise tea, which caused weakness and vomiting in their newborns. Symptoms resolved quickly after consumption of the tea was discontinued, with no known long-term effects for mothers or infants.

Currently, anise seeds are a popular flavoring for liquor, desserts, and other culinary applications. Almost every culture around the globe has a liquor made from anise, including Middle Eastern arak; Greek ouzo; Turkish rakı; French absinthe, anisette, and pastis (and, it is rumored, part of the herbal mélange in Chartreuse); German Jägermeister; Swiss Appenzeller Alpenbitter; Italian sambuca; Dutch Brokmöpke; Bulgarian and Macedonian mastika; Portuguese, Peruvian, and Spanish anísado and Herbs de Majorca; Colombian aguardiente; and Mexican Xtabentún.

Modern Research

Human trials have shown relief of constipation consistent with the historical role of anise in resolving gastrointestinal complaints. A double-blind, randomized study of 107 subjects found that three grams of anise powder after every meal was effective in relieving the symptoms of functional dyspepsia, and a smaller study of 25 subjects in hospice and palliative care found that an aromatherapy treatment using a blend of oils, including anise oil, reduced the symptoms of nausea. A multi-herb decoction of anise, fennel, elderflower (Sambucus nigra, Adoxaceae), and flowers of the stimulant, laxative herb senna (Senna alexandrina, Fabaceae) was found to be a safe and effective treatment for chronic constipation in a small randomized, crossover, placebo-controlled trial.

Human trials have also investigated anise as a therapy for symptoms of menopause, likely due to its phytoestrogen content. A randomized, controlled trial found that 300 mg of an anise extract taken daily was effective at reducing the number and intensity of hot flashes in menopausal women.

Animal studies have investigated anise’s anticonvulsant activity. Anise oil was shown to reduce epileptic seizures and seizure-related brain damage in rats by increasing the time between seizures and decreasing seizure severity. An additional study indicated that the effect on mice was dose-dependent and “more satisfactory” than conventional anti-seizure drug phenobarbital in delaying death.

In vitro tests on anise oil and extract are uncovering new possible medicinal applications. Trans-anethole and its derivatives may help reduce tumor development and progression by blocking the activation of genes involved in inflammation, cell survival, cell proliferation, and blood vessel development. Water and alcohol extracts of anise seeds have been evaluated for antioxidant activity using different antioxidant tests, with both extracts showing strong antioxidant activity. Anise’s antioxidant, antimicrobial, and antifungal properties indicate that it may have used as a food additive to prevent the growth of foodborne pathogens and spoilage.

Consumer Considerations

Great care should be taken with the internal use of essential oils. Ingestion of one to five milliliters of anise essential oil can cause nausea, vomiting, seizures, and pulmonary edema. However, at low levels, trans-anethole is efficiently broken down by the body. The coumarins present in anise oil may cause photosensitivity in excessive doses. Anise essential oil may also interfere with acetaminophen and caffeine, making these substances less bioavailable in the body and compromising their efficacy. Those with an allergy to anise or other plants in the Apiaceae family (fennel, caraway [Carum carvi], celery [Apium graveolens], coriander [Coriandrum sativum], dill [Anethum graveolens], etc.) should avoid the use of anise.

Nutrient Profile

Macronutrient Profile: (Per 1 tablespoon anise seeds [approx. 6.7 grams])

23 calories

1.18 g protein

3.35 g carbohydrate

1.07 g fat

Secondary Metabolites: (Per 1 tablespoon anise seeds [approx. 6.7 grams])

Very good source of:

Iron: 2.48 mg (13.8% DV)

Good source of:

Manganese: 0.15 mg (7.5% DV)

Also, provides:

Calcium: 43 mg (4.3% DV)

Dietary Fiber: 1 g (4% DV)

Phosphorus: 29 mg (2.9% DV)

Magnesium: 11 mg (2.8% DV)

Potassium: 97 mg (2.8% DV)

Vitamin C: 1.4 mg (2.3% DV)

Vitamin B6: 0.04 mg (2% DV)

Thiamin: 0.02 mg (1.3% DV)

Riboflavin: 0.02 mg (1.2% DV)

Niacin: 0.21 mg (1.1% DV)

DV = Daily Value as established by the US Food and Drug Administration, based on a 2,000-calorie diet.

Recipe: Citrus Salad with Anise Syrup

Adapted from Gourmet

Ingredients:

  • 1/3 cup sugar
  • 1/3 cup water
  • 3 tablespoons anise seed
  • 5 large ruby red or pink grapefruit
  • 4 blood oranges

Directions:

  1. Dissolve sugar in water in a small saucepan over medium heat, stirring frequently.
  2. Add anise and simmer five minutes. Remove from heat and let steep, covered, for 30 minutes.
  3. Cut peel, including white pith, from fruit with a sharp knife.
  4. Cut segments free from membranes into a bowl. Squeeze juice from membranes into bowl.
  5. Add anise syrup to fruit and juice and stir gently. Note: Can be made ahead and chilled.

Smoothies for People with Diabetes

Smoothies may seem like a healthful option, but they can be a very bad choice for people who have diabetes.

Many people with diabetes are well-informed about what they can and cannot eat. They know also that choosing premade meals, snacks, and drinks can be challenging. People with diabetes have to be very careful when ordering smoothies in restaurants, as these often contain far too much sugar and not enough protein and fat.

With some modifications, however, smoothies can be enjoyed either at home or at a restaurant.

Things to consider when making a smoothie

People with diabetes must pay careful attention to their carbohydrate intake. Avoiding low-quality carbohydrates, such as sugar or white flour, and using dietary fiber as their guide in choosing carbohydrates, are the best dietary options for them.

A person with diabetes should consider some of the following:

Extra fat can be a good thing

[avocado cucumber and chia seed smoothie]
There are many sources of healthful fats that can be used in smoothies, such as avocado and chia seeds.

The debate can be very confusing between good and bad fat, what is good and bad cholesterol, and the ever-changing guidelines on what offers the best balance between them.

However, in short, some fats are very beneficial to people with diabetes, as they help slow down the speed at which sugar enters the blood.

Some sources of fat that can be added to a morning smoothie include:

  • almond or peanut butter
  • chia seeds
  • avocado
  • raw pecans
  • raw walnuts
  • coconut oil

Include extra protein

Similarly to fat, protein offers many health benefits that are particularly important to people with diabetes. For example, high-protein content slows the absorption of food, which reduces the speed at which sugar enters the bloodstream.

Protein does not always need to come from an animal or animal byproduct. Many foods contain high amounts of protein, and adding them to a smoothie in the morning will offer great benefits.

Some proteins to include in a smoothie include:

  • plain Greek yogurt
  • hemp seeds, and other seeds
  • almonds
  • pea protein
  • whey protein
  • milk

Make the smoothie high in fiber

Soluble fiber found in some carbohydrates is ideal for people with diabetes to consume. Unlike sugar and simple carbohydrates, which cause dangerous spikes and crashes in blood sugar, fiber is much more like protein and fat in that it is harder to breakdown.

[spinach smoothies on a wooden table]
Adding leafy greens like spinach can ensure that a smoothie is nutritious and high in fiber.

This slow digestion means that fiber, along with sugar from carbohydrates, enters the bloodstream over a period of time rather than in quick bursts.

Foods high in fiber that might work well in a smoothie include:

  • most fruits, including raspberries, oranges, nectarines, peaches, and blueberries
  • vegetables, including leafy greens, such as spinach and kale
  • nuts
  • chia seeds

Avoid adding extra sugar

Most people with diabetes know that adding extra sugar to their diet should be avoided. Many foods already have sugar in them, and many others have hidden sugars. For example, canned fruits are preserved in sugar-filled syrups, and honey and maple syrup are also, basically, sugar.

Some alternatives to milk, such as almond or soy milk, may also contain added sugar. When making a smoothie, it is important not to add extra sugar or sweetened ingredients. However, there are ways to make it more flavorful.

Limit carbohydrate servings to three or less

When making a smoothie, a person with diabetes must make sure they know the amount of carbohydrate they are putting it. In general, people with diabetes should look to include 45 grams (g) or less of carbohydrates. Using measuring cups, spoons and the diabetes exchange list, is a good way to measure how many carbohydrates to put in the smoothie.

Low-GI level fruits and vegetables

The glycemic index (GI) measures how quickly a food item will raise blood sugar. Generally, a lower-scoring food means that sugar in it will absorb more slowly than a food with a higher GI.

All fruits and vegetables have different GI scores, as they all contain different amounts of sugar and fiber. Generally, foods with a rating of around 50 or less are considered good.

Glycemic load (GL) is also calculated to compensate for how many grams of carbohydrates are in a typical serving. This gives a more accurate picture of how the food will actually affect people’s blood sugar levels. A GL of less than 10 is low, while a GL greater than 20 is high.

Good smoothie fruits

In terms of making a fruit smoothie, people with diabetes should use fruits that have low GI and GL levels.

[cherry smoothie bowl]
Cherries have a low GI score, making them a delicious and healthful addition to a smoothie.

Here are a few examples of fruits with low GI scores:

  • cherries have a GI Score of 22, and a GL of 3
  • grapefruits have a GI Score of 25 and a GL of 3
  • pears have a GI Score of 38 and a GL of 4.2
  • apples have a GI Score of 38 and a GL of 5.7
  • plums have a GI Score of 39 and a GL of 5.7
  • strawberries have a GI Score of 40 and a GL of 3.8
  • oranges have a GI Score of 42 and a GL of 5.9
  • raspberries have a GI Score of 32 and a GL of 2.6

Good smoothie vegetables

Vegetables also have different GI scores.

Here are a few examples of low scoring vegetables that would be good in a smoothie:

  • green peas have a GI Score of 54 and a GL of 4
  • carrots have a GI Score of 71 but a GL of 6
  • pumpkin has a GI Score of 75 but a GL of 3
  • spinach has a GI Score of 15 and a GL of 0
  • broccoli has a GI Score of 10 and a GL of 0
  • cabbage has a GI Score of 10 and a GL of 0
  • kale has a GI Score of 2-4 and a GL of 0

Other good ingredients to use

A good smoothie often contains more than just fruits, vegetables, and a fat source. Other ingredients can add both flavor and nutrition. Some additional ingredients to think about include:

[raw almond milk in a glass bottle]
Unsweetened almond or soy milk is a good alternative to regular milk for people looking to avoid dairy.
  • unsweetened almond or soy milk
  • ice for extra chill
  • reduced-fat or whole milk
  • a small amount of oatmeal
  • extracts, such as vanilla or almond
  • cinnamon
  • cocoa powder
  • black coffee
  • natural peanut butter (no sugar added)
  • nutmeg
  • ginger
  • turmeric

Considerations for people with diabetes and another health condition

People with diabetes may have other existing conditions to contend with, such as high blood pressure, obesity, celiac disease, and lactose intolerance. These other conditions may limit what kinds of ingredients can be used in a smoothie.

Lactose intolerance

People who are lactose intolerant should avoid adding dairy milk or any byproducts of dairy milk, such as yogurt, to a smoothie. Almond milk or soy milk are good alternatives, and they can be used instead of milk in nearly any smoothie recipe.

Celiac disease

People who have celiac disease are unable to eat anything that contains gluten, a protein found in wheat, rye, and barley. Most smoothies do not contain wheat naturally, but for people who like to add whey protein to their smoothie, it may become an issue.

Whey itself is gluten-free, but some manufacturers add fillers with gluten in them. Either check the label before buying or try other, plant-derived proteins.

Obesity

People who are overweight or obese will need to control their calorie level and emphasize plant foods and fiber. In general, a smoothie that is suitable for a person with diabetes will probably be suitable for a person who is overweight.

High blood pressure

People who have high blood pressure should avoid coffee-based smoothies and stick to vegetable and fruit smoothies instead. There are many foods that people with high blood pressure can eat, including beets, nuts, seeds, vegetables, and fruits. All of these can be good additions to a smoothie.

People with high blood pressure should also avoid foods that contain excess salt.

Other health benefits of smoothies

Smoothies can offer a complete liquid meal. Often drunk at the beginning of the day, they can contain enough protein, carbohydrates, fiber, and fat to keep a person satisfied.

In addition, smoothies can be a good source of vitamins, minerals, and other nutrients that the body needs. The more nutrients a person gets, the better their overall health. Proper nourishment can improve a person’s cholesterol levels, reduce fat, build muscle, promote healthier nervous and circulatory systems, and improve energy levels.

Food as Medicine: Butternut Squash (Cucurbita moschata)

History and Traditional Use

Range and Habitat

Cucurbita moschata— often referred to as winter or pumpkin squash — is a trailing annual with lobed leaves that produce yellow flowers. Mature fruits that are peanut- or bottle-shaped are harvested for their rich orange flesh and edible seeds. Native to tropical and subtropical America, butternut squash requires warmer climates for cultivation as it is intolerant of cold temperatures.

Curcurbita moschata grows best in a rich and well-drained soil in full sun. It can be stored for extended periods and, in fact, has one of the longest shelf lives of the squash family.

Phytochemicals and Constituents

Winter squashes, such as the butternut, are high in complex carbohydrates and provide vitamin C, potassium, iron, riboflavin, and magnesium. Additionally, butternut squash is an excellent source of vitamin A and carotenoids such as α-carotene, β-carotene, β-cryptoxanthin, lutein, and zeaxanthin, which contribute to its claimed anti-cancer properties. While it is a low-fat food, butternut squash does contain some healthy fats in the form of alpha-linoleic acid, a beneficial omega-3 fatty acid that the body does not produce naturally. Omega-3s possess a variety of health benefits, including anti-inflammatory properties.

The vitamin C retention in butternut squash after cooking is unusually high compared to other vitamin C-containing vegetables, and this is thought to contribute to its potential antioxidant activity. About 80% of the vitamin C in butternut squash is retained after cooking the pulp for 30 minutes at 95°C (203°F). For comparison, cooking degrades vitamin C content in potatoes by 30%, and, after maintaining heat for one hour, levels decrease by another 10%.

Boiled butternut squash has an intermediate glycemic index value at 66 (compared to the reference glucose reference of 100). Despite its relatively high glycemic index value, butternut squash’s complex carbohydrate content slows the breakdown of carbohydrates into simple sugars, thereby delaying the release of insulin.

The edible seeds of the squash, which have nutritional value on their own, can be roasted like pumpkin (C. pepo) seeds. Roasting lightly for a short period of time preserves the healthy oils — including linoleic acid, a polyunsaturated omega-6 fatty acid, and oleic acid, which is plentiful in olive oil — that make up approximately 75% of the fat found in the seeds. Cucurbita moschata seeds contain a higher amount of carotenoids as well as α-, β-, and γ-tocopherol than C. maxima and other pumpkin seeds. The seeds are a good source of vitamin E, which also may contribute to the plant’s antioxidant activity.

Historical Uses

Cucurbita moschata cultivation dates back more than 10,000 years to Central America. The use of the plant spread to the north and south, with evidence of use from 4,900 BCE in southern Mexico and 3,000 BCE in coastal Peru. Centuries later, Christopher Columbus and other European explorers brought squash from the Americas to Europe.

Squash were initially cultivated for their seeds; in early varieties, the sparse flesh was bitter and inedible. Pumpkin or squash seeds have been used for treating enlarged prostate glands and intestinal parasites.

In Traditional Chinese Medicine (TCM), squash seeds have been used since at least the 17th century. TCM practitioners consider squash to be a warming food that aids digestion, improves qi (energy) deficiency in the spleen/pancreas, and alleviates pain. Application of fresh squash juice may reduce inflammation and relieve burns, and its slightly acidic nature led to its incorporation as an ingredient in bone marrow or “longevity” soup. In Ayurveda, winter squash has a history of use to reduce vata (conditions that are dry and cold) and pitta (conditions that are inflammatory and hot). Winter squash are considered therapeutic foods beneficial for diabetics due to their complex carbohydrate content.

Modern Research

Butternut squash pulp produced as a byproduct of the manufacturing process is thought to be a potential source for the production of prebiotics used in functional food and nutraceutical products. In 2010, butternut squash pulp oligosaccharides were analyzed to determine their potential for prebiotic production. Prebiotics must withstand digestion to ultimately reach the colon and stimulate the growth of bacteria or microbiota. The oligosaccharides demonstrated resistance to hydrolysis by artificial human gastric juice and α-amylase when compared to inulin, a reference prebiotic. These oligosaccharides also stimulated the growth of lactobacilli in comparison to inulin.

Research on the therapeutic properties of butternut squash has been limited to human cell studies and animal studies. Analyses of bioactive compounds have focused on cucurmosin, which has been isolated from the fleshy part of the fruit. Cucurmosin inhibits the proliferation of cancer cells by inducing apoptosis (programmed cell death). A 2012 study showed that cucurmosin inhibits cell proliferation in a time- and dose-dependent manner and induces apoptosis specifically in human pancreatic cancer BxPC-3 cells. Cucurmosin down-regulates, or decreases the quantity of, epidermal growth factor receptor (EGFR) protein expression, which is associated with overexpression that may promote pancreatic tumor growth and metastasis. Researchers also found that cucurmosin inactivated the PI3K/Akt/mTOR signaling pathway in human pancreatic cancer cells.

In a separate study, human liver carcinoma cells (HepG2 cells) were treated with cucurmosin, which resulted in an increase of cell apoptosis in a concentration-dependent manner. Additional studies, particularly human clinical trials, are needed to assess the potential therapeutic potential of butternut squash in greater detail.

Nutrient Profile


Macronutrient Profile:
(Per 1 cup raw butternut squash cubes)

Calories: 63
Protein: 1.4 g
Carbohydrates: 16.4 g
Fat: 0.14 g

Secondary Metabolites: (Per 1 cup raw butternut squash cubes)

Excellent source of:

Vitamin A: 14,882 IU (298% DV)
Vitamin C: 29.4 mg (49% DV)

Very good source of:

Manganese: 0.38 mg (19% DV)
Potassium: 493 mg (14% DV)
Magnesium: 48 mg (12% DV)
Vitamin B6: 0.22 mg (11%DV)
Dietary Fiber: 2.8 g (11% DV)

Good source of:

Folate: 38 mcg (9.5% DV)
Thiamin: 0.14 mg (9.3% DV)
Niacin: 1.68 mg (8.4% DV)
Phosphorus: 46 mg (4.6% DV)
Vitamin K: 1.5 mcg (1.9% DV)
Riboflavin: 0.03 mg (1.8% DV)

DV = Daily Value as established by the US Food and Drug Administration, based on a 2,000 calorie diet.


Recipe: Creamy Butternut Squash Soup

Courtesy of Sarah Edwards

Ingredients:

  • 1 whole head of garlic, cloves separated and peeled
  • 2 medium butternut squash
  • 2 medium carrots, peeled and chopped
  • 1 medium onion, peeled and quartered
  • 4 tablespoons of extra virgin olive oil
  • 1 teaspoon salt
  • 8 cups vegetable broth
  • 2 teaspoons of freshly minced ginger
  • 1/8 cup coconut milk (or more, to taste)
  • 1 bunch cilantro, chopped (for garnish)

Directions:

  1. Preheat oven to 350°F. Slice butternut squash in half, peel, and scoop out the seeds.
  2. Cut off the bulbous ends where the seeds have been scooped out and place peeled whole cloves of garlic in each cavity. Place squash face down in a large baking dish.
  3. Peel and cut the rest of the squash into large cubes and place in the baking dish with onion and carrot. Drizzle with olive oil and season with salt. Roast for 1 hour until tender.
  4. Heat broth in a large pot over medium heat. Add the butternut squash sections and garlic into the saucepan along with the roasted vegetables and minced ginger, then bring to a boil and simmer for 10 minutes.
  5. Stir in the coconut milk and allow to cool slightly. Blend the soup in batches in a blender or in the pot with an immersion blender until thick and creamy. Garnish with cilantro or roasted butternut squash seeds.

Dawn Phenomenon: How to Control High Morning Blood Sugars

The dawn phenomenon is a normal, natural rise in blood sugar that occurs in the early morning hours, between roughly 4 and 8 a.m. The shift in blood sugar levels happens as a result of hormonal changes in the body.

All people experience the dawn phenomenon to one level or another, which can vary day by day. People without diabetes may never notice it happening, as a normal body’s insulin response adjusts for the rise without intervention.

A person with diabetes is more likely to experience symptoms from the rise in blood sugar levels, however.

How does it affect people with diabetes?

Dawn phenomenon is a normal rise in blood sugar released by the liver. The release happens as the person’s body is preparing to wake for the day.

The rise in blood sugar is normally handled with insulin. For people with diabetes, insulin is not produced in high enough quantities, or the body is unable to use the insulin properly.

[woman feeling ill in bed with a glass of water]
Symptoms of the dawn phenomenon include nausea, weakness, and extreme thirst roughly between 4 and 8 a.m.

As a result, a person with diabetes will feel the effects of having high sugar levels in the blood.

These effects can include:

  • faintness
  • nausea
  • vomiting
  • weakness
  • disorientation
  • feeling tired
  • extreme thirst

Managing the dawn phenomenon

Managing blood sugar levels is nothing new to most people with diabetes. A combination of diet, exercise, and medication often help keep the symptoms and problems under control.

In the case of dawn phenomenon, there are some additional changes that may help prevent issues caused by the spike in blood sugar.

Some steps people with diabetes can take to manage the dawn phenomenon include:

  • changing medication entirely or making adjustments with a doctor on existing medication
  • avoiding skipping meals or medication doses
  • avoiding carbohydrates around bedtime
  • taking medication closer to bedtime and not at dinner time

Other steps include eating dinner earlier in the evening. After dinner, some light physical activity, such as going for a walk, jogging, or yoga, is encouraged.

It is likely that a person with diabetes will experience high morning blood sugar levels from time to time. Occasional, mild issues from dawn phenomenon are not too worrisome. However, if the frequency becomes much more regular, then it’s time to call a doctor.

Complications

[elderly woman with diabetes at the doctor]
People who experience the dawn phenomenon regularly should talk to their doctor as it can lead to serious complications.

If blood sugar levels spike too high as a result of dawn phenomenon, the effects can range from mild to a life-threatening medical emergency.

Some complications that a person with diabetes may experience as a result of dawn phenomenon include:

  • nerve damage
  • damage to blood vessels
  • organ damage
  • ketoacidosis, an extremely dangerous buildup of acid in the bloodstream

People who experience repeated high blood sugar levels due to dawn phenomenon should see a doctor to prevent these consequences.

Do options differ between type 1 and type 2 diabetes?

Differences in dealing with dawn phenomenon depend more on the individual person than what type of diabetes they have or what their treatment plan is.

A person with type 1 diabetes may adjust the dosage or type of insulin to account for any changes overnight. In other cases where the person wears an insulin pump, they may adjust the pump to deliver extra insulin in the morning.

What is the Somogyi effect?

Unlike in the dawn phenomenon, the Somogyi effect occurs when blood sugar levels drop too low. This causes the growth hormones, cortisol, and catecholamines, to release into the blood.

For example, if a person who takes insulin or medication to lower blood sugar levels does not eat a regular bedtime snack, their blood sugar levels may drop during the night.

This person’s body then responds to the low blood sugar levels by releasing hormones that trigger sugar levels to go back up. This may cause blood sugar levels to be higher than normal in the morning.

How can you tell the difference?

The major difference between dawn phenomenon and the Somogyi effect is that the latter can occur any time there is extra insulin in the body.

[clock at ten past two]
Checking blood sugar levels between 2 and 3 a.m. can help indicate whether a person is experiencing the dawn phenomenon or the Somogyi effect.

The easiest way to rule out the Somogyi effect is to check blood sugar levels at bedtime, around 2 to 3 a.m., and after waking up for several nights and mornings.

Some people may choose to wear a continuous glucose monitor, which can record the sugar levels throughout the day and night, allowing the user to track the trends.

Here are two possible results and what they might mean:

  • If the blood sugar level is low at or between 2 to 3 a.m., there is a good likelihood the Somogyi effect is the cause.
  • If the blood sugar level is normal or high at or between 2 to 3 a.m., it is more likely that the cause is the dawn phenomenon.

Treatments, home remedies, and prevention

The best treatment is prevention. Treatment for the dawn phenomenon is likely to be the same type that they would use to treat a spike in blood sugar.

Some people may have to inject insulin while others might have specific medication to target increases in blood sugar.

Each person with diabetes should discuss with their doctor what to do when their blood sugar levels spike, regardless of whether it is the dawn phenomenon or not.

Home remedies

Home remedies do not use medication to lower blood sugar. People with diabetes should speak with their doctor before trying any home remedies or stopping their medications.

Some common remedies that do not require medicine include:

  • eating less refined sugar and avoiding items with added sugar
  • increasing activity and getting regular exercise
  • taking alpha lipoic acid supplements, a natural antioxidant that can be bought over the counter
  • eating more cinnamon
  • drinking green tea
  • taking chromium supplements help the body regulate blood sugar levels

Another potential remedy is eating more protein. Some people consider whey protein to be particularly helpful as it helps control blood sugar levels.

If dawn phenomenon occurs regularly, people with diabetes should seek advice from a doctor for the best options to help prevent the serious consequences of high blood sugar levels.

Fast food and Diabetes: Tips and Options for Eating Out

To manage diabetes effectively, people need to follow a healthful diet. Fast food has a bad reputation for being unhealthy and highly processed.

Like junk food, fast food should be avoided most of the time. However, with a bit of know-how, people with diabetes can eat fast food in moderation without putting their health and wellness at risk.

Tips for eating fast food out and about

It is important for people with diabetes to approach fast food options with some caution, and when possible, be prepared for what might be on offer.

Before going to a favorite fast food restaurant, people with diabetes should consider some of these tips:

[young woman on her laptop in the kitchen ]
Menus and calorie counts can often be found online, which can help people with diabetes make sure there is a meal option for them.
  • Do not go when overly hungry. Starting any meal on an empty stomach can cause even those with the best intentions to overeat and make less healthy choices. When possible, people with diabetes should plan to eat a fast food meal after having a healthful snack, such as an apple, to avoid overeating.
  • Know before going. Due to popular demand, many fast food restaurants have calorie counts on their menus and nutrition information on their websites. In other cases, independent websites might offer reviews and food facts. No matter the source, it is a good idea for people to look at the menu options and have a meal planned out ahead of the trip, whenever possible, to limit impulse orders.
  • Drink water, not soda. People with diabetes should avoid soda due to the high sugar content and the risk of causing a spike in blood sugar levels. Swapping soda for water can help avoid unnecessary calories and blood sugar spikes, and help reduce the feeling of hunger.
  • Eat slowly. It takes the brain at least 15 minutes to register that the stomach is satisfied. Eating slowly helps the brain catch up with what the stomach is feeling. This technique can help a person avoid too large a meal.
  • Limit the number of visits. Most health and wellness professionals recommend limiting the number of times anyone, including people with diabetes, eats fast food. It is best to keep visits rare, no more than once to twice a month, for best health.
  • Keep it small. When the counter clerk asks about upping the order size, it is generally a good idea to say “no.” There will still be plenty of calories in the smaller meal, but the smaller portion is at least less than what the super-size or large size has to offer.
  • Beware of the value meal options. A fast food venue is not going to push a person to buy a single burger because it is far more cost-effective to bundle and sell a more expensive option. It is better to eat the sandwich with a side salad and bottle of water instead of a pre-packaged burger, fries, and fountain drink meal.
  • Watch the salads. Salads can be worse than the value meal, so people should use caution when ordering. People should avoid salads that contain deep-fried taco shells, fried chicken, fatty dressings, cheese, and croutons that can add calories and affect blood sugar levels. Instead, people should look for salads with light dressings, grilled chicken, limited or no cheese, and no croutons.
  • Fried is bad. It is best to avoid deep-fried foods, such as chicken strips, fries, and taco shells.
  • Swap the sides. When available, people should choose side salads, fruits, vegetables, or other sides that are more healthful than fries.

Tips on what to order

Fast food has branched out considerably from some of the original burger, fries, and milkshake options of years ago. Now, it is possible to find fast food from many different cultural backgrounds. This can make it harder for people with diabetes to know what is and is not a good choice for them.

The following are some popular fast food types and some general suggestions of what to look for in each.

[meatballs with basil in a wooden bowl]
Meatballs without the pasta will help people keep within their carbohydrate goals.

Italian

Fast food pizza places often offer a small variety of Italian dishes.

When Italian is the option available, people with diabetes should steer clear of deep-dish pizza and pasta, with its high carbohydrate count.

Instead, choices such as meatballs, salads, and grilled chicken offer better options for people with diabetes to choose from.

Chinese

When ordering Chinese, the healthiest choices are often the steamed ones.

People should choose steamed broccoli and chicken with sauce on the side over brown rice, instead of chicken over white rice.

Most Chinese noodle dishes, such as lo mein, should also be avoided due to their high carb count.

American

Brothy vegetable or bean soups, salads with grilled fish, tofu or chicken, lettuce wrapped burgers, and sides of steamed or roasted vegetables will beat a typical fast food cheeseburger, fries, and soda meal any day.

Mexican

[grilled chicken salad with radishes and avocado]
Salad with grilled chicken and healthful fats such as avocado is a good replacement for Mexican dishes high in carbohydrates.

Mexican fast food venues typically offer tacos, burritos, and tortilla chips. Similar to many of the burger fast food spots, they have started to offer salads and other seemingly healthful options.

A grilled chicken salad with beans, avocado and salsa as dressing and served without a deep-fried shell is a good option.

Grilled chicken tacos on soft corn tortillas with limited or no cheese, avocado and grilled vegetables can typically still be ordered while staying within carbohydrate meal goals.

Beware of fried taco shells that are low fiber, yet high fat and high calorie.

Questions to ask staff

When in doubt, people with diabetes should not be afraid to ask the staff questions about their dietary needs.

Here are some questions that may help people with diabetes to make healthful choices when eating out:

  • Are there any lighter calorie options available?
  • Are there special menu items for people on restricted diets?
  • Can I see the nutritional information?
  • Are there substitutions that are more healthful, such as veggie sticks over fries?
  • Can I order a burger without a bun (as I want to avoid simple carbohydrates)?

Summary

Fast foods are not the best option for people with diabetes, as they offer a number of foods high in sugar, salt, and fat. Even healthier options are often still highly processed. People should check their blood sugar 2 hours after a fast food meal to see how it has affected them. This can help guide food choices in the future.

Although they should be avoided except on rare occasion, it is still possible to visit a fast food restaurant and order options that will have minimal impact on overall diet and health.

When eaten in moderation and with some planning, fast food can be a tasty treat or make do as a quick meal if needed.

Cinnamon: Health Benefits

Cinnamon is a spice that comes from the branches of wild trees that belong to the genus “Cinnamomum” – native to the Caribbean, South America, and Southeast Asia.

There are two main types of cinnamon:

  • Ceylon cinnamon (Cinnamomum Verum), often considered being “true cinnamon”
  • Cassia cinnamon or Chinese cinnamon (Cinnamomum aromaticum), which originates from southern China, is typically less expensive than Ceylon cinnamon.

Due to the fact that Ceylon cinnamon is very expensive, most foods in the USA and Western Europe, including sticky buns, bread, and other products use the cheaper Cassia cinnamon (dried Cassia bark). These days cinnamon is regarded as the second most popular spice, next to black pepper, in the United States and Europe.

Cinnamon has been consumed since 2000 BC in Ancient Egypt, where it was very highly prized (almost considered to be a panacea). In medieval times doctors used cinnamon to treat conditions such as coughing, arthritis, and sore throats.

Modern research indicates that cinnamon may have some beneficial health properties. Having said that, it is important to recognize that more research and evidence is needed before we can say conclusively that cinnamon has these health benefits.

Possible health benefits of cinnamon

Cinnamon sticks
Cinnamon sticks or quills

According to the U.S. National Library of Medicine, Cinnamon can be used to help treat muscle spasms, vomiting, diarrhea, infections, the common cold, loss of appetite, and erectile dysfunction (ED).

Cinnamon may lower blood sugar in people with type 1 or type 2 diabetes, according to Diabetes UK.1 However high-quality research supporting the claim remains scarce.

Fungal infections

According to the National Institutes of Health, cinnamaldehyde – a chemical found in Cassia cinnamon – could help fight against bacterial and fungal infections.

Diabetes

Cinnamon may help improve glucose and lipids levels in patients with type 2 diabetes, according to a study published in Diabetics Care.

The study authors concluded that consuming up to 6 grams of cinnamon per day “reduces serum glucose, triglyceride, LDL cholesterol, and total cholesterol in people with type 2 diabetes.” and that “the inclusion of cinnamon in the diet of people with type 2 diabetes will reduce risk factors associated with diabetes and cardiovascular diseases.”

In addition, a certain cinnamon extract can reduce fasting blood sugar levels in patients, researchers reported in the European Journal of Clinical Investigation.

Alzheimer’s disease

Tel Aviv University researchers discovered that cinnamon may help prevent Alzheimer’s disease. According to Prof. Michael Ovadia, of the Department of Zoology at Tel Aviv University, an extract found in cinnamon bark, called CEppt, contains properties that can inhibit the development of the disease.

HIV

A study of Indian medicinal plants revealed that cinnamon may potentially be effective against HIV. According to the study authors, “the most effective extracts against HIV-1 and HIV-2 are respectively Cinnamomum cassia (bark) and Cardiospermum helicacabum (shoot + fruit).”

Multiple Sclerosis

Cinnamon may help stop the destructive process of multiple sclerosis (MS), according to a neurological scientist at Rush University Medical Center. Cinnamon could help eliminate the need to take some expensive and unpleasant drugs.

Lower the negative effects of high-fat meals

Penn State researchers revealed that diets rich in cinnamon can help reduce the body’s negative responses to eating high-fat meals.

Treating and healing chronic wounds

Research published in the journal ACS Nano suggests that scientists have found a way to package antimicrobial compounds from peppermint and cinnamon in tiny capsules that can both kill biofilms and actively promote healing.

Nutritional profile of cinnamon

According to the U.S. Department of Agriculture, ten grams of ground cinnamon contains:

  • Energy: 24.7 kcal
  • Fat: 0.12 g
  • Carbohydrates: 8.06 g
  • Protein: 0.4 g.

Risks and precautions

Some people who are sensitive to cinnamon may be at an increased risk of liver damage after consuming cinnamon-flavored foods, drinks, and food supplements.

This is likely due to the fact that cinnamon contains coumarin, a naturally occurring flavoring substance, which has been linked to liver damage. Cassia cinnamon powder (commonly used in foods in the USA and Western Europe) contains more coumarin than Ceylan cinnamon powder. A 2010 German study found that on average, Cassia cinnamon powder had up to 63 times more coumarin compared to Ceylon cinnamon powder, while Cassia cinnamon sticks contained 18 times more coumarin than Ceylon cinnamon sticks.

How much cinnamon should I eat?

A study carried out in Norway and published in the journal Food and Chemical Toxicology in 2012 suggested establishing a Tolerable Daily Intake (TDI) for coumarin of 0.07mg per kg of bodyweight per day. The researchers commented that by sprinkling cinnamon on oatmeal porridge or drinking cinnamon-based tea regularly, adults and children can very easily exceed this amount.

Based upon the conclusion of this study, if the average weight of an American male is 191 pounds (86.6kg), it could mean a maximum Tolerable Daily Intake of 6mg of coumarin. For an average American female (159 pounds or 72.1kg) it could mean a maximum of 5mg of coumarin per day.

In a document published in 2006, the German Federal Institute for Risk Assessment (BFR) suggested that 1kg of (cassia) cinnamon powder contains between 2.1 and 4.4g of coumarin. If you estimate that powdered cassia cinnamon weighs approximately 0.56 g/cm, a kilo of cassia cinnamon powder would equal 362.29 teaspoons. This suggests that a single teaspoon of cassia cinnamon powder could contain between 5.8 and 12.1mg of coumarin (which may be above the Tolerable Daily Intake for a smaller individual).

Systematic review: Cinnamon may be beneficial for diabetic patients

Consumption of cinnamon is associated with a statistically significant decrease in levels of fasting plasma glucose, total cholesterol, low-density lipoprotein cholesterol and triglyceride, and an increase in high-density lipoprotein cholesterol.

A meta-analysis of 10 randomized controlled trials evaluating the effects of cinnamon use in 543 patients with type 2 diabetes at doses of 120 mg/d to 6 g/d for four to 18 weeks found reduced levels of fasting plasma glucose (-24.6 mg/dL; 95 percent CI, -40.5 to -8.7), total cholesterol (-15.6 mg/dL, -29.8 to -1.4), LDL-C (-9.4 mg/dL; 95 percent CI, -17.2 to -1.6) and triglycerides (-29.6 mg/dL; 95 percent CI, -48.3 to -10.9). Cinnamon also increased levels of HDL-C (1.7mg/dL; 95 percent CI, 1.1 to 2.2). No significant effect on hemoglobin A1c levels was seen. High degrees of heterogeneity were present for all analyses except HDL-C.

Despite the generally positive results, the authors advise caution in applying the results of this analysis to patient care because of the uncertainty of the dose and duration of cinnamon use and uncertainty of the ideal patient population.

Cinnamon Use in Type 2 Diabetes: An Updated Systematic Review and Meta-Analysis
http://www.annfammed.org/content/11/5/452.full
By Olivia J. Phung, PharmD, et al
Western University of Health Sciences, Pomona, Calif.

Cinnamon and diabetes

People with diabetes often face dietary restrictions to control their blood sugar and prevent complications.

Although research is in a preliminary stage, cinnamon may help fight some symptoms of diabetes. It is also unlikely to cause blood pressure spikes or disrupt blood sugar. So, people with diabetes who miss a sweet pop of flavor may find that cinnamon is a good replacement for sugar.

Can cinnamon affect blood sugar?

cinnamon
Studies suggest that as a treatment tool for diabetes, cinnamon may be useful. It may also be used as a healthful alternative to sugar and salt.

Cinnamon has shown promise in the treatment of blood sugar, as well as some other diabetes symptoms.

Research on the effects of cinnamon on blood sugar in diabetes is mixed and in the early stages. Most studies have been very small, so more research is necessary.

People with diabetes who are interested in herbal remedies, however, may be surprised to learn that doctors are serious about the potential for cinnamon to address some diabetes symptoms.

A 2003 study published in Diabetes Care, compared the effects of a daily intake of 1, 3, and 6 grams (g) of cinnamon with a group that received a placebo for 40 days.

All three levels of cinnamon intake reduced blood sugar levels and cholesterol. The effects were seen even 20 days after participants were no longer taking cinnamon.

A small 2016 study of 25 people, published in the Journal of Intercultural Ethnopharmacology, found that cinnamon may be beneficial for people with poorly controlled diabetes. Participants consumed 1 g of cinnamon for 12 weeks. The result was a reduction in fasting blood sugar levels.

However, a 2013 study published in the Journal of Traditional and Complementary Medicine had a different result. The study, which used a more reliable method, had slightly more participants, at 70. The researchers found that 1 g of cinnamon per day for 30 days and 60 days offered no improvements in blood sugar levels.

A 2016 analysis published in the Journal of the Academy of Nutrition and Dietetics, attempted to bring together existing research on the role of cinnamon in blood sugar reductions.

The authors looked at 11 studies of cinnamon in the treatment of diabetes. All 11 produced some reductions in fasting blood sugar levels. Studies that measured HbA1C levels also achieved modest reductions.

However, only four of the studies achieved reductions in line with the American Diabetes Association’s treatment goals. This suggests that cinnamon may be a useful treatment tool, but is not a replacement for traditional diabetes treatments.

An earlier analysis published in 2011 in the Journal of Medicinal Food, also points to the potential for cinnamon to lower blood sugars. Researchers comparing the results of eight previous studies, found an average blood sugar level reduction of 3-5 percent.

There is no research that suggests cinnamon negatively affects blood sugar. That means that it is a safe bet for people with diabetes who want a more healthful alternative to sugar, salt, and other diabetes-unfriendly flavoring agents.

Other health benefits of cinnamon for diabetes

Cinnamon has also shown promise in addressing other diabetes symptoms. The 2003 Diabetes Care study also found a reduction in blood fat levels and so-called “bad” cholesterol. The levels remained lower even 20 days after participants had stopped consuming cinnamon.

A 2016 study published in Blood Pressure, compared the effects of various intake levels of cinnamon to cardamom, ginger, and saffron. Cinnamon and the other herbs did not affect blood pressure, body measurements, or body mass index.

Tips for using cinnamon

Before trying new diabetes remedies people should speak to their doctor.

The studies done so far on cinnamon’s effects on diabetes have used small quantities of cinnamon – usually a teaspoon or less.

People interested in trying cinnamon as a supplement to traditional diabetes medication should start small, with about 1 g per day (about ¼ to ½ teaspoon).

Just as different diabetes medications produce varying results and side effects in different patients, cinnamon won’t work for everyone. Some people may even experience side effects.

Some strategies to improve the chances of success while lowering risk include:

  • Keeping a food log.
  • Sticking with normal diabetes care plans. Cinnamon is not a substitute for blood sugar monitoring, a healthful diet, or diabetes drugs.
  • Speaking to a doctor before trying any new diabetes remedies, including cinnamon and other herbal remedies.
  • Using cinnamon as a flavoring agent for healthful foods, such as oatmeal and muesli. People should avoid eating cinnamon rolls, sticky buns, or other sugary foods that are rich in cinnamon.
  • It’s also possible for people who dislike the taste of cinnamon to purchase cinnamon herbal supplements.

Who should avoid cinnamon?

Cinnamon is a safe flavoring for most people with diabetes. However, people with liver disease or who believe they are at risk from liver disease may need to avoid cinnamon, particularly in large amounts.

Cinnamon comes in two forms: Ceylon and cassia. Cassia is commonly used in the United States and contains small amounts of a substance called coumarin. Some people are sensitive to this chemical and, if they take it in large doses, they can develop liver disease. People who already have liver disease are especially at risk.

Most research on the role of coumarin in liver failure looks at significantly larger quantities of cinnamon than are recommended for diabetes management. This highlights the importance of starting with very small quantities of cinnamon.

People should consider also using a Ceylon cinnamon supplement rather than the more readily available cassia cinnamon.

Interactions with other drugs and herbs

Cinnamon is safe to take with most drugs and herbal remedies. People taking another remedy should always consult their doctor first. Even natural remedies such as cinnamon can trigger negative interactions.

People with diabetes who take a drug that can harm the liver should consult their doctor before using cinnamon. They should also consider Ceylon instead of cassia cinnamon.

Cinnamon may also interact with anti-blood clotting drugs, such as warfarin, and some blood pressure medications.

To reduce the risk of negative interactions and other side effects, people with diabetes should keep a log of any new or unusual symptoms. People with diabetes should also report any side effects to a doctor as soon as they appear. This helps people with diabetes to make good medication decisions and avoid potentially serious side effects.

Cinnamon May Reduce the Harms of a High-Fat Diet

A diet high in fat is considered a major risk factor for cardiovascular disease, as it can lead to weight gain, diabetes, and other harmful conditions. New research, however, suggests that it may be possible to offset some of this risk by incorporating cinnamon in the diet.
Researchers suggest that cinnamon may offset some of the damage caused by a high-fat diet.

Researchers found that rats fed a high-fat diet supplemented with cinnamon for 12 weeks gained less weight and abdominal fat and had healthier blood levels of fat, sugar, and insulin when compared with rodents fed a high-fat diet without cinnamon.

Study co-author Vijaya Juturu, Ph.D., of OmniActive Health Technologies Inc in Morrison, NJ, and colleagues recently presented their findings at the American Heart Association’s Arteriosclerosis, Thrombosis and Vascular Biology/Peripheral Vascular Disease 2017 Scientific Sessions, held in Minneapolis, MN.

Cardiovascular disease (CVD) is an umbrella term for conditions that affect the heart and blood vessels, including heart attack, stroke, and heart disease.

Heart disease is the leading cause of death for men and women in the United States, killing around 610,000 people every year.

Diet plays a major role in CVD. An unhealthful diet – such as one high in fat – can cause obesity, type 2 diabetes, high cholesterol, and other conditions that raise the risk of poor cardiovascular health.

According to Juturu, research has shown that cinnamon – a spice derived from the bark of trees from the Cinnamomum genus – contains a polyphenol that has anti-inflammatory and antioxidant properties, which may reduce some of the risk factors for CVD caused by poor diet.

For their study, the researchers set out to investigate whether cinnamon might help to reduce the harms associated with a high-fat diet.

Cinnamon protects against inflammation, oxidative stress

For 12 weeks, the researchers fed rats a high-fat diet supplemented with cinnamon and compared them with rodents that were fed a high-fat diet without the spice (the controls).

The team found that rats whose diets were supplemented with cinnamon weighed less and developed less abdominal fat than those fed a high-fat diet without the spice. Rats fed a high-fat diet with cinnamon also had healthier blood glucose and insulin concentrations, as well as better lipid profiles, than the controls.

Additionally, the researchers found that rats that received cinnamon had fewer molecules associated with the storing of fat, as well as increased levels of anti-inflammatory and antioxidant molecules.

Antioxidants protect against oxidative stress,, which is an imbalance of free radicals that has been associated with numerous health conditions, including heart attack and heart disease.

Based on their findings, Juturu and colleagues believe that cinnamon may decrease the damaging effects of a high-fat diet.

The team concludes:

“These results suggest CNM [cinnamon] supplementation reduces hyperlipidemia, inflammation, and oxidative stress through activating transcription factors (SREBP-1c, LXR-α, NF-κB, and Nrf2) and anti-oxidative defense signaling pathway.”

Dinner Ideas for People with Type 2 Diabetes

Every 23 seconds, someone in the United States is diagnosed with diabetes. But although diabetes is widespread, public awareness and understanding of the disease can be limited.

The Centers for Diseases Control and Prevention (CDC) report that 29 million Americans currently have diabetes, but a quarter of them do not know it. Another 86 million adults have prediabetes, with 90 percent of them being unaware.

Diabetes is a serious disease that can, if uncontrolled, lead to loss of eyesight, cardiovascular problems, kidney damage, and even amputation of lower limbs. The good news is, it can be managed and these serious health problems can be avoided.

Diet techniques for diabetes

[Empty White Plate]
Using the simple “diabetic plate” rule can help people with diabetes plan meals.

The even better news is that diabetes can be managed through a combination of exercise, health care, and diet. Despite popular belief, a diet can be varied, tasty, and fulfilling.

The “diabetic plate”

Maintaining a consistent, well-balanced diet can help people with diabetes keep their blood sugar levels under control.

Portion control is also important, which is where the “diabetic plate” comes in.

Endorsed by several organizations, including the American Diabetes Association, the “diabetic plate” can be very helpful when planning dinners.

Follow these simple steps:

  • Draw an imaginary line down the center of your plate.
  • Divide one-half into two further sections, so that your plate is now divided into three.
  • Fill the biggest section with non-starchy vegetables, such as spinach, green beans, salsa, mushrooms, broccoli, or others.
  • Use proteins to fill one of the smaller sections. Good options are skinless chicken, salmon, shrimp, tempeh or tofu, eggs, and much more. Legumes can fit in either the protein or the starch section because they provide both protein and carbohydrate.
  • Grains, legumes and starchy vegetables can go in the remaining quarter. These could be corn, lima beans, sweet potatoes, quinoa, whole grain bread, and more.
  • Complete the meal with a serving of fruit, or dairy.

Carbohydrate counting

Carbohydrate counting is also an essential part of healthful eating for people with diabetes. A number of carbohydrates an individual can eat in a day will vary based on health, activity level, and treatment plans.

Knowing the carbohydrate content of foods can help individuals eat appropriate amounts at each meal or snack, and still enjoy a varied and satisfying diet.

Glycemic index

The glycemic index (GI) can help people with diabetes distinguish between carbs that will help or hurt their blood sugar and can provide essential support when planning healthful dinners.

In essence, the higher the GI rating of a food, the more rapidly it will raise blood sugar. However, this does not mean that people with diabetes should avoid all high GI foods since some are full of nutritional value. The important thing is to balance these foods with low GI foods, and monitor portion size.

Portion control

Perhaps the biggest challenge to eating healthful dinners is portion control. This is particularly true when meals are eaten on the go.

According to the National Heart, Lung, and Blood Institute, portion sizes in American restaurants have increased by 200-300 percent in the past 20 years and may be a factor in the country’s rising obesity rates.

These giant servings can spell trouble for people with diabetes. They should ask servers about the size of the portions. They could also ask for some of the food to be boxed up, or they could share it with friends.

Alcohol

[People drinking beer]
Alcohol must be closely monitored by people with diabetes.

Drinking alcohol is an important part of a dining experience for many people. But people with diabetes need to be very cautious about drinking alcohol because it can seriously affect blood sugar levels.

However, one drink per day for women and two drinks per day for men may be acceptable if consumed with food.

People should check their blood sugars, and check with their doctor and dietitian to find out whether any amount of alcohol is acceptable within their treatment plan.

Dinner ideas suitable for diabetes

Following a healthful diet does not have to mean that people with diabetes have to give up their favorite foods. The key is eating appropriate amounts and making sure there is a balance between proteins, carbohydrates, and fats, with an emphasis on fiber.

The following are classic American foods that are suitable for a person with diabetes:

  • Steak: Stick to 3 ounces (oz) portions and do not cook it in butter. Choose center-cuts for less marbling and fat. The Harvard School of Public Health and many other agencies recommend that people eat red meat no more than once per week.
  • Baked potato, or sweet potato: Skip the high-fat add-ons, such as bacon. Substitute sour cream for Greek yogurt for protein and healthy bacteria.
  • Garden salad: Add vinaigrette for taste.
  • Salmon: Baked or grilled wild salmon is a good option.
  • Steamed asparagus: Steaming is a healthful way to prepare vegetables.
  • Turkey: Roasted turkey or chicken is a good choice.
  • Corn on the cob: Avoid butter or other high-fat toppings.
  • Burgers: Simply wrap the patty in lettuce, or only eat half the bun to keep the carbohydrates in check.

Tips for quick healthful meals

The following tips may help people with diabetes create healthful and interesting dinners:

  • Keep a supply of frozen vegetables, low-sodium canned tomatoes, and low-sodium canned beans.
  • Consider serving salad as an entrée.
  • Remember that eggs can be for dinner, too.
  • Prepare a batch of slow-cooker chili that you can store and eat over several days.
  • Combine frozen vegetables with pasta, toss into a stir-fry, or add to a frozen whole-wheat pizza crust.
  • Make tacos with rotisserie chicken, vegetables, salsa, and nonfat Greek yogurt.

Recipe ideas

People with diabetes do not have to limit themselves to boring, bland foods. The following meal ideas illustrate a wide range of ideas for healthful dinners with less than 3 servings or 45 grams (g) of carbohydrates:

  • 1 cup Spanish-style brown rice mixed with pinto beans, chicken, and salsa.
  • Cod fillets with puttanesca sauce, green beans, and quinoa.
  • Tempeh or tofu stir-fry with Asian vegetable mix.
  • Caribbean red snapper, a small baked sweet potato, and vegetables.
  • North African Shakshuka.
  • Dijon chicken, baked sweet potato fries, and steamed broccoli.
  • Skillet whole-wheat or corn tortilla pizza.
  • Bean and wild rice burgers with spinach and avocado salad.
  • Asian salmon fillets, shredded cabbage and peanut ginger sauce, zucchini, and chickpea or bean noodles.
  • Shrimp tacos, using 100 percent corn tacos, pineapple salsa, jicama (yam bean), and carrot and bell pepper slaw.

Cooking for others who have diabetes

Although they can eat most things, people with diabetes need to ensure they keep their blood sugar, blood pressure, and cholesterol levels in their target range.

The first step in planning healthful dinners for people with diabetes is balancing the levels of proteins, carbohydrates, and fats while providing ample fiber.

By using the “diabetic plate” method to plan the basic framework of a meal, it is much easier to produce healthful and flavorful options that will appeal to everyone. As well as the examples listed above, the American Diabetes Association offers an extensive listing of recipe ideas.

Dinner options for people eating out

People with diabetes have lots to think about when eating out:

  • How the food is prepared: People with diabetes should find out how the meat or fish is cooked. Order grilled, roasted, or baked meats, poultry, and fish, or go for a vegetarian option.
  • What is in a sauce or soup: Choose broths over cream-based soups. Ask for sauces and salad dressing to be served on the side.
  • Ratios of different ingredients: It is important to identify how the meal is balanced between vegetables and carbohydrates. Request steamed vegetables, when possible.
  • Cuts of meat used: Lean cuts of meat are best for people with diabetes.
  • Making substitutions: Instead of choosing french fries or potatoes, opt for non-starchy beans, cooked vegetables, or a salad.
  • What types of carbohydrates to choose: Always select whole grain options, such as whole-wheat bread and pasta, if possible. Legumes and fruits are higher in fiber and are great carbohydrate choices for people with diabetes.

Foods to avoid

There are some foods and drinks that a person with diabetes should avoid or strictly limit. These include:

  • fried foods
  • sweets
  • sweetened beverages, such as blended coffee drinks, soda, sweet tea, or juice
  • white rice and white bread
  • “loaded” anything, as in baked potatoes or nachos
  • dishes with rich sauces
  • alcoholic beverages

Other dietary tips

Other tips that may help a person with diabetes maintain a healthful diet include:

  • eating a variety of fruits and vegetables every day
  • increasing the amount of fiber consumed to 25-38 g per day
  • reducing sugar and salt intake found in sweetened beverages, canned foods, and processed meats
  • replacing saturated fats, such as those in red meat and butter, with mono- and polyunsaturated fats, such as those in fish and olive oil
  • using alcohol sparingly, if at all
  • aim for a low salt diet of fewer than 2,300 milligrams of sodium daily

Learn your ABC

One of the most important general tips for managing diabetes comes from the CDC, as well as other health experts, who advise people with diabetes to “know their ABCs.” This acronym helps individuals monitor measurements that are essential for keeping their diabetes in check: These include:

  • A1C test: This test measures a 3-month average of blood glucose scores, which should be less than 7.
  • Blood pressure: The targeted measurement is below 130/80.
  • Cholesterol: The targeted levels for LDL (bad cholesterol) should be below 100 and HDL (good cholesterol) should be above 40 for men and 50 for women.

Tips to keep in mind

When it comes to planning dinners, people with diabetes should keep the following tips in mind:

  • A measured plate: Rough amounts for the “diabetic plate” method would include 2 cups of vegetables, 3-4 oz of protein, and a half to 1 cup of complex carbohydrates.
  • Be willing to trade: Healthful dinners do not have to mean no dessert. Simply hold back on carbohydrate-rich foods, such as bread or pasta during the main part of the meal and spend the “saved” carbohydrates on a small serving of dessert. Make sure to check your blood sugar 2 hours after you eat, so you know how much the dessert raised it.
  • Add extra vegetables: Use a spiralizer to make zucchini “noodles,” try cauliflower “rice,” or use squash instead of pasta.
  • Plan a walk: Exercising after meals can reduce blood sugar because muscles remove glucose from the bloodstream and don’t need insulin. This is especially helpful when you do consume the occasional sweet.
  • Check your blood sugar: The common times recommended to check blood sugar levels are first thing in the morning after fasting, and two hours after meals. This will help a person to see how well they are managing their blood sugars, and how the food they are eating is affecting them. This can help people make better choices in the future.