Juicing vs. Smoothies: The Health Pro's and Con's

August 25, 2019

"Even though juicing sounds like a great way to get all the fruits and vegetables, and all the necessary vitamins and minerals, juicing presents some problems."

Juicing fruits and vegetables is an increasingly popular way to get energy and healthy nutrients. But it comes with its own set of issues. On today's Inside Health with Dr. Keller Wortham, MD, explore the potential problems with juicing, and find out what Dr. Keller recommends!

Video Highlights:

  • 01:09: Statistics on Juicing
  • 02:08: Some Surprising News: Juicing Can be Dangerous
  • 02:24: If You’re Taking Medications
  • 04:30: If Your Diabetic or at Risk for Diabetes
  • 05:30: If You Have Kidney Issues
  • 06:26: Juices are Calorically Dense
  • 07:25: Juice is Low in Fiber
  • 13:08: Juicing vs. Smoothies
  • 14:40: Smoothie Basics
  • 17:52: Dr. Keller’s Healthy PB & J Smoothie Recipe
  • 23:20: One Note of Caution

Today we are talking about juicing. And it is a crazy phenomenon, as more and more people use it as a method to get their recommended daily amount of fruits and vegetables. But even though juicing sounds like a great way to get all the fruits and vegetables, and all the necessary vitamins and minerals, juicing presents some problems that Dr. Keller thinks you should be aware of. We’re not talking about juice fasting here — that’s a whole other topic! Today we're just going to talk about the art of juicing, what benefits you might get, and what the problems might be.  

Statistics About Juicing

Juicing fruits and vegetables has recently become a cultural phenomenon. You've probably been to the supermarket and seen entire sections with all these different rainbow colors of kale, mango, spinach and celery, and all kinds of different combinations with spices like ginger and cayenne and. Over a hundred million gallons of juice have been sold every year in the last several years, and that number is just going up as companies provide cold pressed, and organic options, and charge $10 to $12 sometimes for an 8-ounce bottle of cold pressed juice.

So, is it really worth it your investment?  Are you really getting the benefits of it and are there some health concerns you should be aware of? Let’s find out! 

Some Surprising News: Juicing Can be Dangerous  

Yes, it can outright be dangerous, if not done right. Let’s go over a few scenarios where you really might want to think about whether juicing is the right thing for you. 

If You’re Taking Medications

Juicing can be very dangerous if you're on a medication. Certain medications can interact with some of the vitamins and minerals that you find in juice, and not in a great way.  When you juice some things, you're taking a very high quantity of that fruit or vegetable and pulverizing it to get a lot of liquid out, which means that you could be in fact consuming a lot more of that particular vitamin or mineral at least in higher quantities than if you had just eaten that vegetable or fruit by itself.  For example, spinach — spinach is great in salads and meals. But if you juice spinach, the volume of spinach that you have to put in is so high that you might be getting a much higher dose of vitamin K than you would with just eating some normal spinach, and vitamin K is something that could have an interaction with a medicine like Coumadin. If there's any of you out there who are on a blood thinner (maybe you had a pulmonary embolism or a blood clot and as a result have been prescribed a blood thinner), having that much vitamin K could totally throw off your levels of Coumadin.  And there are other medicines that it can interact with as well. Grapefruit is wonderful, but if you put a lot of grapefruit through a juicer and get a lot of grapefruit juice it can actually have a negative effect on the absorption and the activity of a lot of other medicines that you might be taking. Grapefruit juice interacts in the liver and changes some of the enzyme pathways. So, it could mean that certain blood pressure medications, cholesterol medications, antibiotics, and even certain birth control medications can all be altered and become potentially less effective. So, that's one way that consuming a lot of nutrients through juice can actually throw your body off. So be cautious about juicing if you're on medications. 

If Your Diabetic or at Risk for Diabetes

How many of you out there are dealing with high blood sugar, or worried that you might be creeping towards diabetes? There are huge numbers of people today who are prediabetic and borderline diabetics, and many of these people may be starting to practice juicing in an attempt to get healthier get diabetes under control. But juice (especially fruit juice) can be really high in sugar, because again the volume of fruit you use to make a juice is much higher than what you’d consume by just eating fruit. In our country there over 80 million people with prediabetes and that juicing scenario just might be enough to push them over the edge into actual diabetes. In fact, just consuming high amounts of juice can increase your risk of diabetes by up to 20%. So, if you're someone out there worried about your blood sugar, juicing might not be the best thing for you.

If You Have Kidney Issues

Juicing can contribute to potential kidney issues. The kidneys are very important to balancing our electrolytes. But if you've got delicate kidneys — either because you were born with a kidney disorder or disease, or because of diabetes or high blood pressure — your kidneys are weaker, which means you need to be very careful with juicing.  Kale, for example, has a lot of potassium in it. Eat some kale salad and you're going to be fine, but it takes up to 4 ½ cups of kale to make just one 8-ounce glass of juice. Those 4 ½ cups of kale when juiced and consumed, contain so much potassium that it could be enough to throw fragile kidneys off, and lead to a serious problem like kidney failure. So, again, approach juicing with caution if you have delicate kidneys.

Juices are Calorically Dense

When you make fruit and vegetable juice, you are taking a lot of material and concentrating it down, so you end up with a lot of sugar and a lot of calories in a small volume. An issue with small volumes is that your stomach might not feel that you've really had enough, so you can really have a whole glass of juice and get all of the sugar, and a lot of calories consumed but not feel full. So, someone might add a whole bunch of juice to their meal and think of it as an additive, when really it has enough nutrients for a whole meal in itself.  You might be getting a lot more calories in your day, and a lot more sugars... and that's not great, especially for things like weight loss, diabetes and some of the other issues we've been discussing.

Juice is Low in Fiber

Fiber is a magic molecule. It's great for the colon, and for lowering cholesterol. Fiber is the molecule in food that makes it chewy and gives it bulk. And when you juice something, you're really wiping out most of the fiber in it and that creates a major problem. So if you start with a juicer and add some carrots and an orange, you’ll end up with a delicious tasting juice. There's a lot of really good flavor in carrots (especially natural organic carrots), and of course, who doesn't love orange juice?  So taste-wise, an orange carrot juice can really hit the spot. The problem is, we've got a lot of liquid from those different fruits, but we don't have much else. We've got a lot of sugar, we've probably got the vitamins coming from it, but we’ve gotten rid of all the bulk — and that’s where the fiber is.

So, when we do that, we end up with this product that is very low in fiber and very high relatively in sugar. What does that mean to our body? Well, fiber slows down the absorption of sugar calories in the digestive tract. So, if you eat a whole carrot or an orange, including all of the fibrous material that's in it, when it gets down into your stomach it takes a while for your stomach to break it down. So the amount of sugar might be the same amount, if you eat a carrot or if you juice a carrot, but the way it enters your bloodstream, it takes much longer as the body kind of breaks through all that fiber when it’s eaten whole. So you don't get a big spike of sugar. It's a much more delicate and slow process. Whereas if you juice it, it tastes amazing, but the sugar gets into your bloodstream much faster.

And when sugar enters your bloodstream really fast, it causes insulin to skyrocket. Insulin is this molecule that basically tells your body to store fat, and it’s the thing that is involved in diabetes. People with diabetes don't have enough insulin, or maybe they're on insulin, but insulin’s main job is to get sugar from your bloodstream and store it as fat. If you're trying to make too much insulin to handle a big sugar rush like this, you can burn out your pancreas and that can put you at risk for diabetes. So the main issue with juicing is not getting any fiber in the liquid that you're consuming. Given the choice, it’s better to eat the carrots and the whole orange than to drink them and miss all of that great fiber. 

Juicing vs. Smoothies

So, what if you just aren’t able to eat enough fruits and vegetables? Maybe you’re on the go and it takes too much time to cook them, and juicing just feels more convenient. So what’s the alternative? If you don't want to spend all that time eating the fruits and vegetables or just don't think you're going to get them in your diet, try making a smoothie! 

A smoothie is basically blending something, not juicing it. So, you might be getting those same fruits and you're putting them into a blender and you're blending them up but you're not throwing away all this fiber, and because the bulk is included, you need less quantity of each fruit or vegetable. Now granted, it's hard to throw a carrot in a blender.  But in a smoothie, you’re not throwing away the great, fiber-dense portion of what you’re eating. 

Smoothie Basics

There is, believe it or not, a right and a wrong way to make a smoothie, so we’re going to go over a few basic tips!  

Choose Low Glycemic Index Fruits

Fruits are a great way to start a smoothie, but make sure you opt for the lower glycemic index fruits. The glycemic index is a way to look at how much sugar versus how much fiber is in a fruit, and there are some fruits with much better sugar-to-fiber ratios than others. Berries are great, for example. Berries have relatively low amount of sugar, and they're really rich in antioxidants. And their glycemic index is actually lower than a lot of other fruits, so they’re great for smoothies.

Choose Fruits and Veggies that Make You Feel Full

Banana is a great little fruit to choose because a banana has a certain substance in it that helps promote satiety, meaning it makes you feel full. So try to add a banana to or half a banana, chia seeds, or avocadoes because it helps you feel full for longer. 

Add Protein 

Protein is great for building muscle, and also helps slow down the absorption of sugars. There are lots of ways to get protein. Dairy is one way, if you are a dairy person. Try adding a little bit of Greek yogurt to your smoothie. If you don't eat dairy, you can get protein from things like nut butter, nuts themselves, or you can add a protein powder.

Add Healthy Fats 

Healthy fats promote satiety, and they are great for your brain. You can get healthy fats from things like nuts, or nut butters, like raw almond butter. You can also get it from avocados.  Some people even put salmon in their smoothies, adding lemon to mask the fish flavor.

Include Fiber

You can make sure that you're adding fiber from more fibrous fruits and vegetables. A lot of people like to put spinach into their smoothies. Spinach is very easy to blend it up, and you can disguise the taste of it with a little lemon to help counteract the bitterness of the spinach.  It's a great way to add bulk to your smoothie, and again that fiber is going to help slow down the absorption of all the sugars and make you feel full longer. 

Other Great Smoothie Tips

Try a couple of these other tips to make your smoothie delicious! 

  • Add spices, like ginger and cinnamon, or cayenne if you're doing more of a spicy veggie smoothie
  • Add cocoa nibs. Cocoa nibs are a great antioxidant — chocolate has so many health benefits. If you get a good cocoa product, you can add chocolate without any added sugar.

Dr. Keller’s Healthy PB & J Smoothie Recipe

Here’s what you’ll need:

  • Water as a base, because you need a liquid (or you can use apple juice, grapefruit juice, or orange juice if you prefer)
  • Strawberries and blueberries (low glycemic index fruits that are high in antioxidants)
  • ½ banana (it’s high in potassium, will make your smoothie creamy, and make you feel full!)
  • A spoonful of Greek yogurt (or chocolate protein powder if you don’t want dairy). It’s up to you what protein powder you choose, but we recommend avoiding soy powders.
  • Almond butter, for healthy fats.
  • Raw, natural honey (optional)
  • Cocoa nibs (optional)
  • Cinnamon or Ginger (optional)
  • Ice (or frozen berries instead of fresh)

Simply blend all ingredients until smooth and creamy.

You’ve now got a smoothie, that’s a bit like a liquid version of a childhood PB&J, but with much less sugar because you’re using fresh berries instead of jam. You’ve got fiber, protein, healthy fats, and antioxidants, and it’s delicious.

One Note of Caution

Now, there is a caveat.  Just make sure that you know when you do a smoothie like this, there are a lot of calories in it. You need to think of smoothies as a meal replacement or an after-workout snack, not an addition to a full meal. If you do your smoothie right, you'll feel full after that and you won't need a meal right after it. And if you really want to do less sugary smoothies, then opt for more vegetables, like cucumbers, celery, or spinach. You can blend those up for more fiber into your smoothie, and lower sugar content.  

We hope you enjoyed the little tutorial on the difference between juicing and smoothies. Whether you decide juicing is for you or not, it’s important to make an educated decision!

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