Strawberry Banana Oat Milk Smoothie
- 1 cup oat milk
- 1 cup strawberries frozen
- 1/2 1 banana frozen
- Add milk, berries and banana and blend on high until smooth.
What is Vitamin B12?
Vitamin B12, also known as cobalamin, plays a crucial role in many important functions in the body. It is essential for nervous system fuction, blood cell formation, metabolism of folic acid, and synthesis of DNA (1). In the diet vitamin B12 is typically obtained through consumption of meat or milk. The best source of vitamin B12 can be found in clams and liver, with a 3 oz portion of clams providing 1400% of the Daily Value!(1,2).
The digestion and absorption of vitamin B12 relies on certain factors to be present in order to be successful. The high acidity of the stomach is an important part of the digestive process because it allows for proteins surrounding vitamin to break free, continuing digestion (2). Different transporters and chaperones are required for absorbtion by the cells. Because there are many steps in the process of digestion and absorption, there are many areas that can go wrong if not all that is required is present.
Does Taking Metformin Increase Risk of Vitamin B12 Deficiency?
Metformin is the most commonly prescribed drug to individuals with type 2 diabetes and is also used for insulin resistant conditions like polycystic ovarian syndrome (PCOS) (4). Metformin has many benefits for those with insulin resistance, and is prescribed as a first line of treatment. However in a systematic review of multiple research studies, it was concluded that long term use of metformin had a significant impact on a reduction of vitamin B12 concentrations (3). Studies show the prevelance of vitamin B12 deficiency to be has high as 30% in patients with type 2 diabetes taking metformin (5).
Groups At Risk For Vitamin B12 Deficiency
- older adults
- vegetarian or vegan diets
- use of proton pump ihibitors (PPIs)
- gastrointesntial disorders (Crohns diease and celiac disease)
- history of gastrointenstial surgery
What Are The Risks Of Vitamin B12 Deficiency?
People with type 2 diabetes are at an increased risk for cardiovascular complications as well as peripheral neuropathy, and having low vitamin B12 levels increases this risk(2). Elevated cardiovascular disease risk is due to the role vitamin B12 plays in metabolism of an amino acid called homocysteine. Without B12, homocysteine levels stay elevated, which can increase your risk of heart disease (2,3). Peripheral neuropathy is a condition in which multiple symptoms can be present including pain, numbness, tingling in hands or feet, and sensory loss (7). With a vitamin B12 deficiency, damage can occur to myelin sheaths that surround nerves. The myelin sheaths protect nerves and without this protection, neuropathy can develop (7).
If you are at increased risk for vitamin B12 deficiency you should talk to your doctor or dietitian about a supplement. According to the Institute of Medicine vitamin B12 is not known to cause any adverse side effects at high doses, meaning the risks of supplementing are likely low (6). Studies suggest supplements may be beneficial for certain groups but you will want to make sure you are taking the correct dose and from of the vitamin for the greatest result. (2,3).
Peanut Butter Banana Nice Cream
- food processor
- 4 frozen bananas
- 2 tbsp chunky peanut butter
- 2 tbsp dark chocolate chips
- 1 tbsp milk
- Break the frozen bananas into quarters and place into the food processor.
- Blend until smooth stopping to scrape down the sides as needed.
- Once almost smooth add the peanut butter and blend until smooth.
- Add chocolate chips and pulse until combined.
Tuna Pita Pocket Minis
- 1 can tuna packed in water
- 1/2 cup chopped celery
- 1/2 cup chopped red onion
- 1 tsp dill
- kosher salt to taste
- ground pepper to taste
- 3 tbsp 2% greek yogurt
- 6 mini pita pockets
- Drain tuna and add to mixing bowl
- Combined remaining ingredients and mix thoroughly
- Cut mini pita pockets in half
- Scoop small portion of tuna into each half pocket and serve
How Can Foods Lower Cholesterol?
With an estimated 1 out of 3 American adults with high cholesterol levels, it’s no surprise that questions about diet changes to lower cholesterol come up often. If you have been diagnosed with high cholesterol taking a look at your diet is a great place to start because there are actually a few different ways foods can lower cholesterol levels.
What Is Cholesterol?
Cholesterol is a waxy substance produced in the liver and essential to human health. We often think of cholesterol in a negative light but it has important functions in the body including serving as a structural component of hormones, nerve impulse conductivity, and the endogenous production vitamin D. In addition to what is made in the body, cholesterol can also be absorbed from food sources.
What Does It Matter If Cholesterol Is High?
Having high cholesterol increases the risk of atherosclerotic cardiovascular disease (ASCVD) which is when plaque builds up in the blood vessels of the heart, brain, and peripheral arteries. According to the Center for Disease Control, heart disease and stroke are the first and fifth leading cause of death in the United States.(1) It’s recommended that healthy adults have their cholesterol checked every 4 to 6 years. For those at greater risk or with a history of heart disease more frequent checks may be needed.
What To Eat If You Want to Lower Your Cholesterol?
1. Increase Soluble Fiber
Soluble fiber works to decrease cholesterol by binding bile salts in the digestive tract. Bile salts are made in the liver using cholesterol and play an important role in digestion and absorption of food. When they are bound and excreted with the soluble fiber it helps to reduce reabsorption and regulates cholesterol levels in the body. Aim for a daily goal of at least 10 grams of soluble fiber. This makes up around one- third of your total daily goal of 25-30 grams. Good sources of soluble fiber with at least 2 grams per serving include oatmeal, mango, figs, black beans, oat bran, and brussels sprouts.
2. Add Plant Sterols
Cholesterol plays several important roles in the human body including cell wall structure, while plants don’t have cholesterol they do have a similar compound known as phytosterols. Phytosterols are so structurally similar to cholesterol that they compete for absorption sites in the intestines and can limit cholesterol absorption from foods. The Food and Drug Administration has approved a health claim stating that 1.3 grams of plant sterol esters daily may reduce the risk of heart disease. (2) The National Cholesterol Education Program recommends adding 2 grams of phytosterols daily for people with high cholesterol.(3) Food sources include avocados, nuts, and vegetable oils. It is also possible to use foods fortified with phytosterols such as margarine spreads and juices.
3. Choose Foods Higher in Monounsaturated Fatty Acids More Often
A study published in the American Journal of Clinical Nutrition found that a diet higher in monounsaturated fatty acids (MUFAs) successfully reduced LDL cholesterol by 14% without raising triglycerides or lowering protective HDL cholesterol.(5) The diet higher in MUFAs was concluded to have greater cardiovascular risk-lowering benefits as compared to a low-fat diet due to these protective effects. If you are looking to add more MUFAs to your diet avocados, nuts, and olive oil are great sources.
4. Limit Saturated Fat
We used to think that eating cholesterol in the diet had the greatest impact on serum cholesterol levels however recent research doesn’t support this as the primary contributor. As it turns out it’s the saturated fat in foods that appears to have a greater influence. If you are watching your cholesterol levels it’s best to limit saturated fat to no more than 7% of total daily calories. For a typical 2000 calorie diet, this would equate to about 15 grams a day. This may seem like quite a bit but if you choose to have a hamburger with a slice of cheese and modest 1/2 cup serving of Ben and Jerry’s vanilla ice cream that would bring you up to about 19 grams of saturated fat. Other foods high in saturated fat include whole milk and yogurt, butter, cream, fatty cuts of beef and pork, sausages, poultry with the skin, coconut and palm oils.
Considerations For People With Diabetes
When managing type 2 diabetes we tend to focus blood sugars however people with diabetes are also at greater risk for dyslipidemia. It’s recommended to have cholesterol levels checked annually and aim to keep LDL cholesterol < 70 mg/dL.(4) Knowing your personal trends and targets is part of knowing your “ABCs” or A1C, blood pressure and cholesterol goals to reduce the risk of diabetes-related complications.