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January 24, 2012

Comments

Chris O'Keefe

I agree Smoothies are bad - IF you're having drugstore high-fructose Vanilla or Chocolate instant mixes, and/or adding nothing but fruit!

But for me, it's the only way I'm going to eat: 2 cups of fresh greens, chia seed, spirulina, wheat germ, hemp protein, acai powder - OK, with a handful of frozen berries and half a bananna to make it palatable. Is it better I NOT have that each day? I don't think so...

I am totally for green smoothies - to me, it's the greatest discovery since the wheel, and is the one and only way I'm going to get this stuff into me and especially into my husband!

GO SMOOTHIES!

OL

I have been doing green smoothies since August 2009--inspired by the wonderful information on Healthy Librarian. I know that I have noticed huge improvements in my overall health and sense of well being. I also have objective proof. My blood tests (lipids, blood sugar, as well as very low C-reactive protein), blood pressure and heart rate are also excellent. I agree with the other comments that the smoothies have to be mostly greens. My smoothies are not sweet. They contain lots of greens (kale--different types, collards, watercress, chard, dandelion leaves)some frozen raspberries, a few chunks of pineapple, and blueberries and fresh ginger. I don't mix the greens. I have chard one day, dandelion the next etc. I make it fresh every morning drink half before breakfast (gluten free oatmeal and chia and cinnamon) then I have the other half with dinner. Over time my tastebuds have adapted and I now like the taste of greens. I miss my smoothies on the odd day that I don't get them. The beans idea sounds very interesting. I will give it a whirl.

Dawn

Healthy Librarian--Thank you for this post. I don't have smoothies on a daily basis. More like twice a week. I have been trying to decide if they "help" me or not--you know, how do I feel? Was that too sweet? More veggies? Not hungry? Hungrier?, etc, etc, etc
So this was an interesting read. I have been adding half a frozen banana to my smoothies--Mostly spinach--other greens as I have them. Flax, chia. No juice. No non-dairy milk. Just water or ice. I think now I will stop using banana as it is very sweet and switch to berries and citrus. It is hard to eat "enough" greens some days without drinking some of them in a smoothie.
Thanks again for the info.

Joy Weese Moll

I'm with Anna, drinking vegetables is my idea of diet hell. I see a beautiful salad and I can't imagine why anyone would want to put that in a blender when you could eat it with a fork. And, so I do. I'm glad that smoothies help so many people, but I'll stick to my one or two giant salads a day.

Ellyn Wolf

I have been reading recently that raw kale has a negative impact on the function of the thyroid gland (it contains goitrogens that inhibit the absorption of iodine). This actually concerns me more that the excess fruit. Goitrogens are destroyed by the cooking process.

Natala

As I said - for people who are thin and healthy - like I'm guessing most of the people posting here, it might be fine. But to suggest for anyone who is sick, obese, has diabetes (especially T2) , heart disease or high BP is just dangerous and. Every reputable doctor advises against them, so why argue with that? They all have great explanations as to why. As far as there being more evidence? Green smoothies are a recent fad, we can only go based on what is known when people drink their calories vs. chew their calories as far as scientific research, and all that points to chewing being the best for us. Dr. Klapper has a GREAT presentation about this in which he takes you through the entire digestive process, if you are ever in Santa Rosa and can visit him at True North, I highly recommend it - he is the best Dr. on digestion I've met.
But in the end, for people who are in the public eye, maybe making a clarification - just like I'm sure a lot of thin, healthy people can get away with the occasional junk food and be just fine - it shouldn't be recommended for people battling obesity, t2 diabetes or heart disease.
We have to be careful when we make opinions (which is what this all comes down to) online. Since it is the advice (based on many facts dealing with our biology) of every doctor I trust not to drink them - I won't.
As an aside - I work with the E2 immersions program, we do not teach people to drink smoothies (nor do programs like True North, Pritikin, Esselstyn's program in OH or McDougall) . However when they go home many think they are a healthy thing to drink. I worked with most of the T2 diabetics at the immersion as a coach - when they decided to drink smoothies (even as you describe, heavy on veggies) their sugar went up - every single time. I know this is true for myself, but seeing it in the 10 people I coached convinced me even more- drinking calories, especially for T2 diabetics is simply not wise advice and really just dangerous advice for some.

Healthy Librarian

@Ellyn Wolf: This is from World's Healthiest Foods:

Kale as a "Goitrogenic" Food

Kale is sometimes referred to as a "goitrogenic" food. Yet, contrary to popular belief, according to the latest studies, foods themselves — kale included — are not "goitrogenic" in the sense of causing goiter whenever they are consumed, or even when they are consumed in excess.

In fact, most foods that are commonly called "goitrogenic" — such as the cruciferous vegetables (including kale, broccoli, and cauliflower) and soyfoods — do not interfere with thyroid function in healthy persons even when they are consumed on a daily basis.

Nor is it scientifically correct to say that foods "contain goitrogens," at least not if you are thinking about goitrogens as a category of substances like proteins, carbohydrates, or vitamins. With respect to the health of our thyroid gland, all that can be contained in a food are nutrients that provide us with a variety of health benefits but which, under certain circumstances, can also interfere with thyroid function. The term "goitrogenic food" makes it sound as if something is wrong with the food, but that is simply not the case. What causes problems for certain individuals is not the food itself but the mismatched nature of certain substances within the food to their unique health circumstances. For more, see an An Up-to-Date Look at Goitrogenic Substances in Food.

Here's the link: http://whfoods.org/genpage.php?dbid=38&tname=foodspice

The link for so-called "Goitrogenic Foods" http://whfoods.org/genpage.php?tname=george&dbid=250

Hope this helps.

claire

interesting discussion, especially as concerns the fruit in general. is anyone following the 10 prunes/day for bone health? how does this figure in terms of overall fruit consumption?

Dan Kleinman

I just read that whole thing. I already knew this stuff was good for you, but I never have the wherewithal to put it together. So the question is, is it worth buying for $6 or $7, a large plastic glass of the food from the local juice guy, and how many times a week should I do so?

Kate Scott

Interesting post HL. You mention lots of good reasons why the concern over smoothies, at least green smoothies, is misplaced. I would like to add one more, which is I think a really important one. I credit Joel Furhman with this info, but I have read quite a lot of the research independently. The brassica veges (kale, broccoli etc) are very good for us as we know, because they contain chemicals called glucosinolates which are then broken down to into bioactive molecules (isothyiocyanates) that seem to have a range of health-promoting properties. That break down process is initiated by an enzyme in the plant cell wall called myrosinase. This enzyme has to be released from the cell wall by crushing, chewing, blending etc in order for it to start that process. The thing is, myrosinase is mostly killed upon cooking, so to get the benefits of the brassicas, it is best to consume them raw. (Or, if you want to consume them cooked, finely slice or shred them and let them sit for 30 mins or so before cooking to let the myrosinase do its job - the glucosinolates are not affected by heat). So the question is, just how much raw broccoli or kale can you consume in a salad? Not as much as in a smoothie I would guess.

The other comment I would make is that surely people following a plant based diet with lots of fruit, veg and legumes don't really need to be concerned about extracting every tiny last bit of fibre from their food. If anything I think this diet borders on too high in fibre.

I have a green/purple smoothie most days, with kale, berries, flaxseed (the fat boosts absorption of the carotenoids) and with the liquid provided by usually a combination of pomegranate and grape juice. JUICE! A sin, I know, but it makes the kale palatable (especially for other members of the family who are not quite the kale fans I am).

Pam Wright

I think green smoothie decisions need to be made on a case-by-case basis - one size won't fit all.

My first green smoothies were based on the HL's recipe. I don't have a Vitamix (it's on the wish list) so I use a standard blender. It wasn't able to process all the ingredients at once- especially kale, collards and carrots - so I tried a different strategy. I put the greens and carrots in in a large microwave safe container, covered it, and heated for 45-60 seconds. This wilted and softened the vegetables slightly - just enough for the blender to do its job.

I don't think the smoothies lose nutrients or value after they are microwaved for a short time ... but I may be wrong. Thoughts?

The Healthy Librarian

@Kate: Thank you so much for your wise & balanced comment! I completely agree with all your have said--and personally, I'd rather drink my brassicas--sweetened up a bit with a little fruit--than eat it raw. I hate the taste of raw broccoli! And raw kale I'll only eat in a salad with a good dressing & some raisins & cranberries.

I didn't know that bit about the "myrosinase" enzyme--or that it is "killed" when heated. Very interesting!

I really appreciate that you shared this comment--BTW, I always used to add about 1/3 of a cup of pomegranate or cherry or blueberry juice to my smoothies, too. Just stopped after hearing Dr. Lustig's lecture about juice--but, when I make one for my grandson---you better believe I add the juice--especially grape!

As for the fiber--I still don't think it's somehow separated or destroyed (as in "disappears" by blending veggies & fruits in a Vitamix. And you're right--we already are getting a huge amount of fiber.

The Healthy Librarian

@Pam: Good idea about heating the veggies up first. I don't have an exact answer on whether the raw or microwaved are the same. Heating actually helps break down the cell walls to make the nutrients more available---but, read Kate Scott's comment about the enzyme in kale--& it's effect when heated. Who knows? But, bottom line" it's good to eat more greens--any way you can.

The Healthy Librarian

@Dan: Love the shirt! Not sure I understand your question. $6-&7 sounds like a lot to pay for what will end up as 1/2 gallon of green smoothie--about 2 days worth. Find a cheaper source--and if you can manage making a smoothie 3 times a week I bet you'll notice a difference. Check it out yourself and decide. My grown-up sons are huge fans--and for the younger one--it was probably the most nutritious meal he got in grad school. He's not much for making salads or cooking vegetables.

PGYx / MG

Thanks for sharing my smoothie recipe, HL! I completely agree with your smoothie philosophy and strongly favor increasing vegetable consumption through smoothies. Although I have a lot more time to eat this year, my smoothies still frequently double as a meal replacement (even for a couple of meals in a row) as they're filling, hydrating, and give me plenty of energy to do my work. I can't wait to try Dr. Maring's V-7 juice!

As many express concern about the effects of even vegetable-rich smoothies on blood glucose, I would like to share an anecdotal account from my first boyfriend, MM -- a type I insulin-dependent diabetic who makes veggie smoothies. His exclusive use of short-acting insulin (via pump) gives him a unique opportunity to know exactly how much insulin he requires for a given type/quantity of food (or how much his blood sugar will rise if he undershoots). He is also intimately familiar with the time pattern of blood sugar spikes and dips following various types of food with an appropriate insulin dose. He has used an insulin pump for nearly 15 years and I can personally verify he has it down to a science. Here's what he says:

"With fruits what happens is: if I [dose insulin] based on the actual carbohydrate count, my blood sugar still spikes but then crashes. I tried taking half the normal bolus but that created a higher spike while avoiding the hypoglycemia afterward. I can say conclusively that the veggie smoothies don't meaningfully affect my blood sugar."

Now of course this is anecdotal, and an insulin pump does not precisely mimic pancreatic insulin secretion, but MM's experience is very much in line with our understanding of basic human pancreatic physiology and glucose metabolism. Of course every person is different, there are many factors impacting metabolism, and MM has not experimented with adding just a small amount of low sugar fruits to his smoothies. He's going to try it and let me know how it goes.

PGYx / MG

Ah, I *just* saw your follow up comment regarding the type 1 diabetic whose blood sugars are unaffected by the veggie smoothies. Add MM's experience to the mix!

PGYx / MG

Re: kale as goitrogen -- http://www.nejm.org/doi/full/10.1056/NEJMc0911005#t=article highlights a case of a patient with myxedema coma (a severe form of hypothyroidism) precipitated by daily intake of 2.2-3.3 lbs of raw bok choy (relative to kale, cabbage, broccoli, and others in the Brassica family).

I doubt eating raw Brassica vegetables in moderation is hazardous for most people, but it's probably not a great idea to eat large amounts on a chronic basis (side note - this is probably true for all foods). At a minimum, individuals with known hypothyroidism should monitor their thyroid function as clinically appropriate and listen to their bodies/symptoms.

Dan Kleinman

@The Healthy Librarian, thanks. I just bought a bag of cleaned and cut fresh kale today. And other healthy foods. Even Ezekial bread! Thanks to you!

Debbi

I love my green smoothies - and they never take it from the fridge at work! I make mine with mostly greens with either an orange or pear and berries, carrots and lots of greens (usually kale & spinach mixed). When I need something mid morning and mid afternoon it's my go to snack (and I try to chew it, remembering that digestion begins in the mouth).

Stacy

I don't use it to replace salads or veggies, but a veggie-heavy smoothie in the afternoon has replaced my afternoon coffee or diet soda. It has very few empty calories; satisfies cravings that might otherwise go towards potato chips, and has also turned into a great way to introduce my kids to the tastes of various veggies. I find it hard to see any downside to this (sorry, Dr. Esselstyn). If the few ounces of fruit juice that go into the mix are my biggest vice, so be it!

The Healthy Librarian

@Stacy: Yes, yes, yes! That mid-afternoon time is always when I reach for my smoothie--and on the long ride home after work. I love that your kids are joining in, too. I agree with you 100%--I cannot see any downside to the veggie-heavy smoothie! Thanks for saying it so well! I think there's a disconnect between what people think a "smoothie" is. We aren't talking about an "ice cream" like treat.

Cynthia Bailey MD

I bought a Vitamix for my office last fall, and now my staff and I make green smoothies about 3 days a week. We all feel better than ever, there's no sugar rush, and all of us agree that it's cut down on cravings. My staff aren't ready for a hardcore kale heavy smoothie yet, but they're transitioning and more kale is getting added slowly over time. Plus, they're definitely getting more fresh veggies into their diet than ever before. Right now we use frozen blue berries, an apple, carrots, cucumber and my garden kale (from my year round California veggie garden). Yes, I agree that chewing veggies is probably better, but it's not going to happen at their desks - drinking a green smoothie does. Honestly, the Quiznos and Starbucks has disappeared in the office and has been swapped for green smoothies. I think even Drs. Esselstyn and Campbell would approve.

Barbara

This was a very interesting post to read. Judging from all the comments, lots of people, me included, have been wondering about the Great Smoothie Controversy.

By coincidence, there's a comment on Dr. Greger's "Ask the doctor" today by someone who developed kidney stones as a result of putting fresh turmeric in her smoothies: http://nutritionfacts.org/blog/2012/01/28/ask-the-doctor-qa-with-michael-greger-m-d-17/ (it's in the comments at the end.)

Also, I have always wondered how many nutrients could be left in stored smoothies. I just looked it up, and, at least according to this article, it looks like they'll last a few days as long as they're in the refrigerator. Good to know. This article doesn't have any specific links but it seems reputable enough to me: http://eatandbeatcancer.wordpress.com/2011/12/20/crucifers-to-fight-cancer-cooking-tips-take-two/

Barbara

Ninufar

Well there's more than the applesauce study, there's the remarks about particle size here:

http://jn.nutrition.org/content/141/5/1011S.full

..in a link I followed from your earlier post about whole grains and abdominal fat. (Thanks very much for that, btw!! it was chock-full of useful information.) And I am not sure, but I remember a glycemic index chart suggesting that, say, rice cakes have a very different effect on blood sugar than the same kind of rice, steamed.

Another thing is this - with dark green leafy veggies, we get more nutrients out of them when they are cooked. Now, if you whir them around in the VitaMix long enough, they will get heated up, so maybe it's a best-of-both-worlds situation.

Raw vegetables frequently disagree with me, esp cruciferous ones, while on the other hand cooked cruciferous veggies, well-cooked beans, etc. work great. Perhaps there are some individual differences that factor in here, as well.

The main factor I thought LM's post might have omitted is context.

If folks are using a green smoothie as a meal replacement, and they'd otherwise skip breakfast entirely & then go get a midmorning pastry 'cause they're so hungry, then the smoothie would be a total win!

For myself, though, I'm with Natala. Grateful for my hot grain mush that fuels me so well!

Lani Nuelrath, Plant-Based Health & Fitness

Hi HL,

Thank you for your fine analysis and good discussion.

Many people come to me who have challenges with their weight and health. It is incumbent upon me to point out details of their dietary and exercise practices that may have a bearing on their health profile. For those who struggle with their weight, smoothies can - notice I said 'can' and never said 'do' - slow things down. I also never said no one should ever have a smoothie, though it seems that is being read into the article, or that they were 'bad' for you. Or that all smoothies are created the same, of course they aren't.

However, if one finds their blood sugar and calorie load is sensitive to them, then just as I suggest, they might want to take a closer look at the smoothies they are consuming.

The study with the ad libitum meals after eating apples in various stages of preparation is quite useful information for those who may be eating too much blended or juiced food for their calories. Applesauce can be blended whole food, too.

What I'd like people to take away from my article is a look at the role of smoothies in their diet. If they are having trouble losing weight, this may be a contributor. Maybe not. The article is an invitation to explore for oneself and I make that clear.

Apparently, this is exactly what has happened as there is quite a bit of lively discussion and an opportunity to investigate smoothies more closely, such as you have done in your report. I have also received several emails, postings on my blog and via facebook with commentary from responders about gain and blood sugar problems since starting smoothie consumption and how they had never considered that there might be a connection. This is exactly the kind of situation in which I hoped to make a difference.

As I said in blog responses, controversy is not a bad thing – it helps us analyze the data, look at our own results, and make decisions about our health. It's not necessary to become polarized on smoothies, it's an opportunity to take a closer look. If smoothies are working for you – for example, they can be a great tool for athletes who are very active and need to find quick ways to get in more calories, or for people who are otherwise unable to chew or digest whole foods – then use that as feedback for your own choices. But if some of these other problems that blended drinks have been shown to present are part of one’s experience, then this provides liberating feedback.

Thank you,

Lani Muelrath
http://www.plantbasedfitnessexpert.com

Davida Slobody

Finally made a Green Smoothie that did not make me gag.

It was, actually, refreshing. Thanks Debbie for encouraging me to experiment.

I used 8 cups spinach, 1 juice orange, 1 cup mixed berries (frozen organic blueberries and strawberries, 1 cup parsley and 3 cups water.
Next, I will try locinto kale - As you said it is less bitter.

Shanna

A little late here, but precise research on this would be awesome as my practical real life experience has been great. What on earth does apple sauce and juice have to do with 6 cups of greens and some seeds? After reading some of the debate I got a little nervous and basically have been skipping breakfast altogether because I usually have a Green (not fruity) smoothie with chia or hemp seeds. I like how you say your smoothie grew up because that is what mine did too!

I would like to pose another argument. Some of the greens are very expensive! Upland cress is $4 for a small bunch! From reading Dr. Furhman's book I think a person could get more bang for their buck from pulverizing a small amount of amazing greens like cress, mustard or wheat grass and getting 100% of their powerful nutritional benefits. It is just not practical for most of us to absolutely fletcherize a portion of greens each day in this way. I think a smoothie could deliver a very beneficial portion of a wide variety of these diffiult to use greens in a cheap, user-friendly manner.

I also think scaring off newbies to smoothies with this kind of stuff is bad. This could be the only time in their whole life raw super veggies like kale or chard have ever passed their lips! It has to be better than a white bagel with cream cheese and fancy sugary coffee-right?

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