Juicing and Smoothies

1. Juicing and Smoothies Gabrielle Sherer PRIME Outpatient Care Erin Arra MS RD LD

2. I heard about… In the news Dr. Oz Infomercials Books Blogs Supermarkets -Naked Businesses -Jamba Juice -Smoothie King

3. Health Claims • Nutrient extraction • Testimonials claiming improvement : • Quality of life in aging • Fibromyalgia • High cholesterol • Sports performance • Hypertension • Acid reflux • Migraines • Perimenopause • Cancer recovery • Weight loss • Crohn’s • Colitis • NAFLD • Acne • Osteoarthritis • Diabetes

4. Juicing Versus Smoothies • Removes pulp • Option for cold press • Leaves pulp • Heat from pulverization may damage enzymes/nutrients • Can add dairy, protein, nuts, seeds etc

5. PROS and CONS • Increased fruit and vegetable intake • Increased dairy intake • Homemade almond/cashew milk/butter • Can become very high in kcal • Concentrated form of large portions • Added sugar/fat etc • Pancreatic stress • Tooth decay • Decreased fiber • Dangers of detoxing/cleanses • Variance in ingredients

6. MILKS

7. Costs • Nutribullet $160 (2 for 1) • Vitamix $400-480 • Ninja $100-200 • Omega Juicers $200-430 • Breville Juicers $100-400 • Naked $4.79 • Jamba Juice $4.29-6.09

8. Consumer knowledge, attitudes and beliefs around the nutritional content of smoothies • Smoothies- blended drinks consisting of a number of ingredients: fruit, vegetables, fruit juice, ice, yoghurt and milk. • Types: fruit only, fruit and dairy, and functional • Functional smoothies: contain probiotics, extra protein, added vit/min supplement, etc. • commonly sold as: drink, snack or meal alternative • Available: ready-made or made-to-order

9. Design • 1,002 participants in ROI and 1,011 participants in NI participated in the survey • 11-item questionnaire • Omnibus survey- face-to-face, in-home survey asked of a representative • Sample of adults aged 15+ years living in ROI and 16+ living in NI • Sample - quota controlled in terms of: gender, age, social class and region, to reflect the actual demographics of the adult population • One third of participants drank smoothies • Smoothie drinkers were generally more likely to be students, those aged under 35, single, female

11. Frequency of smoothie consumption: • Two to five times a week (31%) • Once a week (23%) • A couple of times a month (17%) • Once a day or more (12%), • Once a month (9%) Types of smoothies purchased: • Made-to-order from smoothie/juice bars or café/restaurants (58%) • Ready-to-drink/ pre-packaged smoothies (47%) • Made their own (43%)

12. Responses to the question ‘Can you tell me how many portions, if any, of your recommended intake of fruitare typically contained in smoothie “C” on this card?’ Quantities of smoothies normally consumed • Regular glass: • 200ml (34%) • Small bottle/container: • 250ml (30%) • Dome container: • 400ml+ (28%)

15. The role of dietary fiber in satiety, glucose, and insulin: studies with fruit and fruit juice • Previous studies: whole apples vs apple juice suggested fiber present in fruit reduces insulin response and prevents rebound hypoglycemia. • Healthy volunteers 20-43 yo • Determined fiber content of each fruit and available CHO from fruit and fruit juice • Test meals: • 339 g of grapes • 323 ml grape juice • 626 g oranges • 610 ml orange juice • Participants consumed fruit, then 1 mo later consumed juice taking aprox same amount of time for consumption • Satiety subjectively measured using 2 different scales pre meal, and 60, 120, and 180 min post • blood collected in fasting state and 10, 20, 30, 40, 50, 60, 75, 90, 105, • 120, 150, and 180 min post meal

19. Antioxidant Activity of Pomegranate Juice and Its Relationship with Phenolic Composition and Processing • Antioxidant activity of pomegranate juices evaluated by four different methods • ABTS, DPPH, DMPD, and FRAP • Compared to those of red wine and a green tea infusion • Commercial pomegranate juices: antioxidant activity (18−20 TEAC) • activity higher in commercial juices from whole pomegranates than juices obtained from the arils only (12−14 TEAC) • pomegranate industrial processing extracts some of the hydrolyzable tannins present in the fruit rind

20. Conclusions and Clinical Implications • People perceive smoothies to be healthy and to contain more fruit than they actually do • Eating whole fruit is more beneficial to satiety and BG levels than juice • Nutrient content varies based on parts of the fruit you use • Would not recommend juicing, particularly to those with DM or at risk • Need to INDIVIDUALIZE specific recommendations regarding smoothies • Cost • Ingredients to include/avoid based on pt needs • Stress that there are no promised health benefits • Studies show improved health with increased intake of fruits and vegetables

21. Future Research • Quality of fiber content remaining in smoothies vs whole fruit • Comparing absorption of nutrients in smoothie/juice form to absorption from whole fruit

22. References Bolton RP, Heaton KW, Burroughs LF. The role of dietary fiber in satiety, glucose, and insulin: studies with fruit and fruit juice. Am J ClinNutr. 1981; 34 (2): 211-217. Consumer knowledge, attitudes and beliefs around the nutritional content of smoothies. Safe Food. 2009; 4-24. Gil MI , Tomás-Barberán FA , Hess-Pierce B, et al. Antioxidant Activity of Pomegranate Juice and Its Relationship with Phenolic Composition and Processing. J Agr and Food Chem. 2000; 48 (10): 4581-4589.

23. Non-professional References • http://www.nutribullet.com/site/testimonials • http://www.wcax.com/story/22455703/juicing-pros-cons • http://www.amazon.com • https://secure.vitamix.com • https://www.omegajuicers.com/ • http://www.brevilleusa.com/beverages/juicers.html • http://www.doctoroz.com/videos/healing-properties-juicing • http://nutritiondata.self.com/facts/dairy-and-egg-products/7578/2 • http://www.ninjakitchen.com