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Should We Consume Smoothies?
15 Jul 2020
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Are smoothies encouraged in WFPB guidelines? What should smoothies be made of? Should we gulp down our smoothie or 'chew' our smoothie? How should a smoothie be served to encourage chewing? Turns out that WFPB doctors have differing opinions when it comes to smoothies. Understanding the pros and cons of smoothies is a worthwhile exercise because it helps us understand the overall subject of nutrition better!
Dr Caldwell Esselstyn

Dr Esselstyn FAQ says:

Question: How about smoothies? I love them!

Answer by Dr Esselstyn: "Avoid smoothies."

(1) "When the fiber is pureed, it is not chewed and does not have the opportunity to mix with the facultative anaerobic bacteria which reside in the crypts and grooves or our tongue. These bacteria are capable of reducing the nitrates in green leafy vegetables to nitrites in the mouth. When the nitrites are swallowed, they are further reduced by gastric acid to nitric oxide which may now enter the nitric oxide pool."

(2) "Furthermore, when chewing fruit the fructose is bound to fiber and absorption is safe and slow. On the other hand, when fruit is blenderized, the fructose is separated from the fiber and the absorption is very rapid through the stomach. This rapid absorption tends to injure the liver, glycates protein and injures the endothelial cells."

Note that Dr Esselstyn offers two distinct concerns: his first concern applies to leafy greens; his second concern applies to fruits. Note that Dr Esselstyn is a former heart surgeon. His focus is on fortifying our endothelium for heart health. Both of his concerns explains how our endothelium is impacted if we puree fruits and veggies. To understand the leafy greens → nitrates → NO connection, please study Plant Nitrates.

(6 mins) Dr Esselstyn on Juicing & Smoothies
Dr Joel Fuhrman

Dr Fuhrman: In his book Eat for Health — Vol 1 (535 pages, 2008), he first explains that Dr Greger calls Wall Off Your Calories, and then applies the concept to smoothies and juices:

Juicing & Blending:

"All plants are composed of cells whose walls consist mainly of cellulose, a type of carbohydrate. Humans do not have the enzyme capable of breaking down cellulose, so we cannot utilize cellulose as an energy source. The only way we can break down these walls and release the most nutrients possible from the cells into the blood is by thoroughly chewing fruits and vegetables."

"However, when we chew a salad, we often don't do an efficient job of crushing every cell; about 70-90 percent of the cells are not broken open. As a result, most of the valuable nutrients contained within those cells never enter our bloodstream and are lost. They just travel through our bodies until they are excreted. This is one of reasons why practicing the chewing exercises detailed in Phase One is so important to the Eat for Health plan."

"An even more efficient way to ensure you receive these needed nutrients is using a blender to puree raw, leafy greens. The blending process aids your body in the work of breaking down and assimilating nutrients. It guarantees that a higher percentage of nutrients will be absorbed into your bloodstream."

"Making "green smoothies" or "blended salads" is also a delicious and convenient way to pump up your consumption of greens. It is amazing how many people love the taste of these liquefied mixtures of raw greens and fruit that can be made in a high-powered blender. While you sip or eat a creamy smooth blended salad with a spoon, think about all of the nutrients that are now powering your body to restore and maintain optimal health. Savory blended salads can be made with endless combinations of vegetables & fruits."

Dr Brooke Goldner

Dr Goldner's healing protocol for autoimmune conditions is centered around copious amounts of green smoothies daily. In her videos, she mentions that she has communicated to Dr Esselstyn that her patients show remarkable recovery from autoimmune conditions with green smoothies.

(2020) Anti-Inflammatory Diet for Lupus

(5 mins) Transcript. Dr Greger's summary: "Green smoothies are put to the test for the autoimmune disease SLE (lupus)." This video mentions a publication by Dr Brooke Goldner:

Case series: Six Week Raw Vegan Nutrition Protocol Rapidly Reverses Lupus Nephritis: A Case Series by Dr Brooke Goldner, Intl J Disease Reversal and Prevention, Vol 1, No 1, 2019.

Dr Michael Klaper

In this 7-min video (also embedded below), Dr Klaper explains that leafy greens are great! However, he used to stay away from smoothies because when we gulp them down, we bypass chewing. Of late, he's bought into the idea. Why? Because we eat a LOT more greens this way. Still, he encourages us to consume our 32 oz giant cup o smoothie slowwwwly over the course of several hours in a day by storing it in fridge and splitting it into several 4 to 6 oz portions, for example. And he encourages us to consume even a 6 oz portion over several minutes, not gulp it down at once.

(7 mins) Green Smoothie - Eat or Drink Your Greens, Which Is Better?
Dr Greger: Summary

The 7-part smoothie infopic series was shared on Instagram.

Dr Michael Greger

"Wall Off Your Calories": When it comes to smoothies, it would help to grasp this concept: Wall Off Your Calories, the title of a section on page 542 in the book How Not To Diet (608 pages, 2019) by Dr Greger.

Video Series: Dr Greger has a 5-part video series on smoothies in which he goes into great details on their pros and cons. Dr Greger is okay with the idea of smoothies. In fact, one of his videos is about a veggie smoothie that he loves! In this article, Dr Greger says,

Fruits and vegetables are the most nutrient-dense foods on the planet, and dark green leafy vegetables lead the pack. Each of the top five so-called powerhouse fruits and vegetables were greens.

If we blend them up in a smoothie (or soup or sauce), we’re taking the food with the most nutrition and breaking all the cells to dump that nutrition into our bloodstream. Chewing is good, but blending is better in terms of digestive efficiency and nutrient absorption.

In this article, Dr Greger mentions another interesting aspect of smoothies:

Smoothies also allow us to eat parts of fruits and vegetables we might not otherwise. If instead of lemon juice, here in the Mayo Clinic's basic green smoothie recipe, you used a little wedge of lemon, you might get some seeds and peel, which, in vitro at least, appear to suppress both breast cancer and colon cancer cell growth. [See this article: Citrus Peels]

Articles by Dr Greger:

Videos by Dr Greger:

(2015) Are Green Smoothies Good for You?

(5 mins) Transcript. Dr Greger's summary: "Smoothies (and blended soups and sauces) offer a convenient way to boost both the quantity and quality of fruit and vegetable intake by reducing food particle size to help maximize nutrient absorption."

(2015) Are Green Smoothies Bad for You?

(5 mins) Transcript. Dr Greger's summary: "Eating intact grains, beans, and nuts (as opposed to bread, hummus, and nut butters) may have certain advantages for our gut flora and blood sugar control, raising questions about blending fruits and vegetables."

(2019) Green Smoothies — What Does the Science Say?

(4 mins) Transcript. Dr Greger's summary: "Might disrupting the fiber by blending fruit result in overly rapid sugar absorption?"

(2015) Liquid Calories: Do Smoothies Lead to Weight Gain?

(9 mins) Transcript. Dr Greger's summary: "If our body doesn't register liquid calories as well, why are blended soups more satiating than the same ingredients eaten in solid form?"

(2015) The Downside of Green Smoothies

(7 mins) Transcript. Dr Greger's summary: "Concerns about smoothies and oxalic acid, nitrate availability, dental erosion, and weight gain are addressed."

(2021) Dr. Greger in the Kitchen: My New Favorite Beverage

(9 mins) Transcript.

V-12 Vegetable Blast is a variation of the recipe in the video.

These recipes are also found in Dr Greger's How Not To Die (272 pages, 2017).

This FaceBook page is a great personal narrative by "The Healthy Librarian" who experimented with this recipe. How does the final preparation taste? The article says, "It's like a spicy non-alcoholic Bloody Mary, if that's your jam."

Forks Over Knives

Page 54 of The Forks Over Knives Plan (352 pages, 2017) explains:

It is important not to 'drink' your calories or food whenever possible, especially if you are trying to lose weight or reverse certain diseases like diabetes. Liquid calories lack sufficient bulk to fill you up. We think a little plant milk or juice is fine on cereal or to flavor foods when cooking. However, we recommend that you avoid drinking glasses of extracted juices, plant milks, sodas, energy drinks, and other sweetened beverages. Smoothies, unlike juices, contain all parts of the food, although they still provide less bulk due to the blending process. As such, smoothies can be enjoyed occasionally, if desired, but should not be a major part of the diet.

Dr Peter Rogers
(8 mins, 2022) Are Veggie Smoothies & Juices A Good Idea?
What do I do?

First, I had to answer to myself, "Why do I need a green smoothie at all? Can I live without them?" After all, preparing a green smoothie requires a new machine at home: a blender. Turns out that leafy green intake is a challenge for me, just like it is for many others. Green smoothies are a great way to boost leafy green intake!

Next, I wondered, "How may we combine the guidelines of Dr Esselstyn, Dr Goldner, Dr Greger, Dr Klaper and Dr Fuhrman?" to get the best of all worlds! Here is my approach:

  1. Blended greens open up more cells (by breaking their cell walls) for a plethora of micronutrients in leafy greens, than is possible by chewing alone. Is that a good thing? For leafy greens, yes! "Leafy greens are the best veggies", explains Dr Greger. Leafy greens are low calorie density; they are not carbohydrate rich, so they don't cause sugar spikes. It's okay to blend them, break as many cell walls as possible and consume the nutritional goodness packed in leafy greens. Yay!
  2. Coarse smoothie to encourage chewing: Dr Esselstyn recommends that we chew leafy greens in our mouth, instead of swallowing them quickly. Towards that goal, a coarsely ground smoothie should help. And we don't need the best modern high speed blender for preparing coarse smoothies. Also, serving coarsely ground smoothies in a cup n a saucer, with a spoon by the side, is helpful — it suggests to us that we're drinking a soup, spoonful by spoonful.
  3. Serve in a bowl, with a spoon by the side! If we serve a smoothie in a tumbler, we're encouraged to drink it like a liquid. However, if we serve it in a bowl, with a spoon by the side, we are encouraged to consume it like a soup, spoonful by spoonful :)
  4. Avoided fruit blends; add soft fruits as toppings! Dr Esselstyn's FAQ discourages fruit blending. So I prefer to sprinkle soft fruits like berries, freshly chopped bananas or mangoes on top of a coarse smoothie… to be eaten like a soup over several minutes, using a spoon. This way, easily chewable fruits like berries and bananas will be chewed in our mouth instead of being blended by a machine. If I add something chewy like pomegranate seeds, then I have to surely chew the overall smoothie for much longer!
  5. Rinse our mouth after smoothie! A useful guideline that I found by watching Dr Greger's videos. Rinsing our mouth after consuming smoothies protects our enamel.

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