What is the Best feeding tube formula?

Best Feeding Tube Formula?

What is the Best Feeding Tube Formula?

Not all feeding tube formulas are created equal, and not even all blenderized feeding tube formulas are the same. Commercial formulas generally do not contain any whole foods and many blenderized feeding tube formulas contain only some degree of whole foods.

Real, whole foods provide an abundance of natural nutrients including important vitamins, minerals, polyphenols, and phytonutrients needed in order for your body to thrive.  When food is refined or reduced, the many beneficial properties of a whole food are stripped away.   Why should people on a feeding tube receive anything less than oral eaters?  That is why at Functional Formularies, we offer food as it should be. We are committed to providing the highest quality nourishment possible for those living with feeding tubes.

What Makes a Feeding Tube Formula the Best?

Just read the ingredients, the difference is clear! On top of the importance of whole foods, eliminating added sugar and highly refined carbohydrates found in most commercial formulas is a big part of the proposed solution for a better-for-you feeding tube formula. To date, however, only Functional Formularies has addressed this need by producing a family of formulas optimized for both adults and pediatrics with these characteristics.

Best Feeding Tube FormulaAdditionally, many other formulas contain casein, soy protein, or milk protein concentrates as their primary source of protein. These can delay gastric emptying in some children causing GERD (gastroesophageal reflux disease) and can cause malabsorption issues in others.

Lastly, the balance between omega 6 and omega 3 fatty acids is essential. The imbalanced, higher ratio of omega 6 to 3 fatty acids favor inflammation, increased blood pressure, and metabolic syndrome. Other feeding tube formulas contain industrial, processed seed oils, such as sunflower oil, as a leading ingredient which are high in omega 6 fatty acids. Whereas Functional Formularies uses organic flaxseed oil rich in omega 3 fatty acids in order to aid in optimal health.

Why Functional Formularies Has The Best Feeding Tube Formula for You

If you are looking for the best tube feeding formula option for yourself or a loved one, talk to your doctor or dietitian about starting a blenderized diet. Functional Formularies offers the best feeding tube formulas that contain only real, whole food, plant-based ingredients that have been sourced from the cleanest growers. We believe it is a fundamental human right for anyone, even those on feeding tubes, to choose the type and source of nutrition they want. How wonderful is it that the clinical nutrition world is now offering patients these choices?

Fatty Acid Webinar

Fatty Acids – What is the Ideal Ratio of Omega 6 to Omega 3 for Optimal Health

How to Achieve an Ideal Omega 6 to 3 Ratio for Optimal Health?

As a follow-up to our recent webinar on July 14th, 2022 titled “Fatty Acids: What is the Ideal Ratio of Omega 6 to 3 for Optimal Health?”, we wanted to take a minute to provide a brief summary and answer questions that were not answered during the live webinar. If you missed our live webinar, head on over to our Continuing Education Center and watch the recorded version which has been approved for 1 Continuing Professional Education (CPE) credit for Registered Dietitians by the Commission on Dietetic Registration (CDR).

Omega-6’s vs Omega-3s: What’s the Big Deal?

Let’s start this discussion with a basic overview of the molecular structures of fatty acids! Both omega-6 and omega-3 fatty acids are considered polyunsaturated fats meaning they have more than one double bond (“poly”) linking 2 carbon molecules somewhere in their molecular structure. Specifically, omega-6 fatty acids have a double bond on the 6th carbon and omega-3 fatty acids have a double bond on the 3rd carbon to round out the naming game! Regarding other fats, monounsaturated fats have only one double bone (“mono”) between carbon molecules and saturated fats do not have any double bonds in their chemical structure which is what makes them different from polyunsaturated fats.

The omega-3 family is best known for marine sources- eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found in fatty fish. A lesser-known omega-3, alpha-linolenic acid (ALA), is a plant-based source and found in large quantities in flaxseed, chia seeds, and walnuts.

Omega-6 fatty acids include arachidonic acid (ARA) and linoleic acid (LA) which are found in many oils (sunflower, safflower, soybean, canola, corn), meat and eggs.

Both omega-3’s and omega-6’s play an important role in health. Concerns begin to arise with the large imbalance of omega-6’s to omega-3’s in the typical American diet. For example, calories from vegetable oil consumption have dramatically increased over the past 50 years leading to a rise of omega-6 consumption. Elevated ratios of omega-6 to omega-3 fatty acids are associated with inflammation that can be associated with various chronic diseases. The US average ratio is 30:1 (omega-6 to omega-3), a ratio of 3:1 may prevent inflammation, and a 1:1 ratio may reduce inflammation. While it may be difficult with our modern diets, achieving ratios where omega-3s exceed omega-6’s (in combination with a variety of monounsaturated and saturated fats) may provide even more health benefits.


 So how do we start moving away from so much omega-6 consumption and lowering the ratio back to a healthier level?

Here are 4 recommendations to get started on today!

Consume at least 1000 mg of omega-3 fatty acids daily.  Try and eat 6-8 oz of seafood weekly. Keep in mind that when it comes to salmon the canning process does not destroy the omega-3s while canned tuna does have less omega-3 content compared to fresh. Why the difference? For salmon – raw salmon is put into the can and then cooked but for tuna – it is cooked before canning. When it comes to cooking, omega-3 fatty acids do break down at high heats including grilling and smoking. When cooking fish, try the poaching method (which is done around 212°F) for the best nutrient integrity.

Fish isn’t your thing? No problem! Add chia and/or flaxseeds to oatmeal, yogurt, smoothies & salads. For optimal absorption, eat them ground. While whole flax and chia seeds pack a nutritional punch, some may pass through your digestive tract undigested; therefore, making it difficult to get the full nutritional benefit.

Another easy way to boost your omega-3 consumption is snacking on English walnuts which have a sweet and mild taste. English walnuts have a higher omega-3 content at 2.5 grams in 14 halves compared to black walnuts which contain 1.5 grams in the same volume; however, I would not let this discourage you from eating black walnuts as 1.5 grams is still a significant amount of omega-3s. Try to avoid roasting or using high heats on walnuts which will destroy the omega-3s.

In an effort to decrease omega-6 consumption, make saturated and/or monounsaturated fats the foundation of your diet and leading sources of calories. Ideal monounsaturated fat choices include olives, almonds, avocados, & macadamia nuts. Saturated fat options would be butter and coconut oil. Coconut oil has certainly grown in popularity the past several years – touting a variety of health benefits due to its large amount of medium chain triglycerides (MCTs) but as with all things- moderation is important. Aim for 2 tablespoons or less per day.

Wait, isn’t saturated fat bad? The PURE study is a large epidemiological study that looked at the relationship between macronutrients and cardiovascular disease and enrolled over 100,000 adults. This study found that a high carbohydrate intake was associated with higher risk of total mortality. Both the total fat intake and type of fat (including saturated) were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality. In fact, saturated fat had an inverse association with stroke.

At the end of the day, it’s about balance! Should you eat only saturated fat? No of course not – it’s important to eat a balance of omega-3 polyunsaturated fats, monounsaturated fats and saturated fats to lower your omega-6 to omega-3 ratio for optimal health.

Make smart choices with your cooking oils.  Choose monounsaturated and saturated fat options for cooking as their smoke points are generally higher and less susceptible to oxidation. For high heat cooking (450°F +), avoid vegetable oil blends which are often a mix of high omega-6 fats and choose avocado oil or clarified butter (ghee) instead. For medium high heat cooking (400°F) such as baking and sautéing, choose olive oil. Medium heat cooking (350°F) such as light sautéing does best with extra virgin olive oil, butter or coconut oil.

Avocado oil – like avocado- is rich in monounsaturated fats with about 70% of the fat source being monounsaturated, 13% polyunsaturated and 12% saturated (very similar to olive oil). While it does not contain the fiber and as many of the micronutrients as eating a raw avocado, it certainly can be a great option for high heat cooking.

Flaxseed oil has the highest amount of the omega-3 ALA by weight and is a great way to get more omega-3 in your diet. Unfortunately, flaxseed oil has a very low smoke point at ~225°F and should not be used for most cooking. Don’t fret though- it’s a superb option for dressings and cold dips.

Limit the use of omega-6 dominant seed oils such as sunflower, safflower, soybean, canola, corn and vegetable oil blends. Another way to reduce your omega-6 consumption is (when possible) to focus on more grass-fed animals including beef and chicken. Meat from grass-fed animals has 2-4 times more omega-3 fatty acids than meat from grain fed animals.

Overall, the goal is not to label certain fats “bad” or “good” – the goal is to eat a balance of all the different types of natural fat sources – omega-3 polyunsaturated, omega-6 polyunsaturated, saturated and monounsaturated fats. Over the decades the typical American diet has been overrun by omega-6 fatty acids – and while these are polyunsaturated fats and as a large category of fats considered a good option – the issue is the imbalance of omega 6’s to omega 3’s. It’s not necessary or realistic to eliminate all omega-6 polyunsaturated fats from our diets. We can focus on correcting the imbalance by either reducing our omega-6 consumption OR increasing the omega-3 consumption – or a bit of both! Switching your cooking oil from a vegetable oil blend to avocado or olive oil will reduce your omega-6 consumption and eating 14 walnut halves a few times a week will boost your omega-3 intake – two great places to start!


Daley C, et al. A review of fatty acid profiles and antioxidant content in grass-fed and grain-fed beef. Nutr J. 2010;9:10. https://pubmed.ncbi.nlm.nih.gov/20219103/

Dehghan M, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. The Lancet. 2017;390(10107):2050-2062. https://pubmed.ncbi.nlm.nih.gov/28864332/.

DiNicolantonio JJ, et al. Omega-6 vegetable oils as a driver of coronary heart disease: the oxidized linoleic acid hypothesis. Open Heart. 2018. https://pubmed.ncbi.nlm.nih.gov/30364556/.

Harris WS, et al. The Omega-3 Index: a new risk factor for death from coronary heart disease? Preventive Medicine. 2004. July;39(1):212-220. https://pubmed.ncbi.nlm.nih.gov/15208005/.

Pischon T, et al. Habitual Dietary Intake of n-3 and n-6 Fatty Acids in Relation to Inflammatory Markers Among US Men and Women. Circulation. 2003;108(2):155-160. https://pubmed.ncbi.nlm.nih.gov/12821543/.

Taha AY. Linoleic acid–good or bad for the brain?. npj Sci Food 4, 1(2020). https://www.nature.com/articles/s41538-019-0061-9.



Blackberries - Whole Food Ingredients

Benefits of Polyphenols and a Low Fructose Diet

Benefits of Polyphenols and a Low Fructose Diet

As a follow-up to our recent webinar on June 8th, 2022 titled “The Benefits of Polyphenols and a Low Fructose Diet”, we wanted to take a minute to provide a brief summary and answer some questions we were unable to get to during the webinar. If you were unable to attend our webinar and are interested in learning more about polyphenols and fructose, please check out our Continuing Education Center for a recorded version of the webinar. If this is your first time accessing our Continuing Education Center, you will need to create a new registration account.

What’s All This Hype about Polyphenols?

Polyphenols are phytochemicals only found in plants and play a very important role in human health due in part to their high antioxidant value. They can help preserve cellular health through protecting the mitochondrial and cell membrane as well as DNA within cells. In addition, polyphenols can inhibit cyclo-oxygenase series II (Cox-2) activity which in turn helps reduce inflammation. A lesser-known ability of polyphenols is their ability to foster a healthy microbiome by feeding beneficial bacteria and reducing pathogenic populations.

All Things Turmeric

During the webinar Dr. Bagnulo talked in detail about turmeric and curcumin, which is a more isolated form of the most potent polyphenol found in turmeric. Curcumin is unique in that it becomes more bioavailable with heat and when combined with a fat source such as olive oil or coconut oil. Curcumin has limited bioavailability because it has low solubility in water – curcuminoids want to attach to fat for better gut absorption. This remains true regardless of if you are using turmeric in the spice form or a supplemental form. We aren’t talking high heat- simply 185°F does the trick – so not necessarily boiling. Even just simmering turmeric/curcumin with a small amount of oil for 5 minutes will increase the absorption rate significantly. Cooking with turmeric in a curry dish is another great option – short cooking times (under 15 minutes) will not destroy the turmeric and will give a bioavailability boost. The bioavailability change with heat and oil may be one reason why studies evaluating the benefits of turmeric/curcumin are mixed as not all studies heated the herb/supplement and/or included a fat source.

Another commonly asked question is surrounding the relationship between black pepper and turmeric/curcumin. Piperine, a compound in black pepper, has been shown to make curcumin more bioavailable by protecting curcumin from the digestive enzymes that are actively trying to remove it from the blood stream; therefore, boosting the absorption. A great cooking combination that is not only tasty but also healthy is turmeric, black pepper and oil!

The discussion of heat to increase the bioavailability of turmeric/curcumin then leads to the question – do all polyphenols need to be heated to achieve optimal absorption? Unfortunately, the answer is not clean-cut. Some polyphenols such as curcumin found in turmeric and lycopene found in tomatoes are better absorbed with heat while other polyphenols such as anthocyanins found in berries are not heat tolerant and are best consumed frozen or fresh. Check out the articles in the reference section from Perez-Jimenez et al. and Oszmianski et al. to learn more details of heat-tolerant versus non-heat tolerant polyphenols!

Here at Functional Formularies, we encourage getting as many nutrients from whole, real foods as possible. While turmeric and curcumin supplements are in abundance in health food stores and on-line, focusing on using the whole turmeric root in cooking is ideal. Keep in mind that turmeric is more than just curcumin – there are over 100 compounds in the turmeric root which have potential health benefits. If getting in turmeric in its most natural state is not possible, then certainly choosing a quality supplement from a reputable company is another option.

Optimizing Polyphenol Intake Summary

  • Try to incorporate 4 major families of plants daily – root-derived spices, herbs, dark berries and dark green leafy vegetables for example.
  • Choose whole, minimally processed brightly colored vegetables and fruits.
  • Use extra virgin olive oil for most cooking and flaxseed oil for salad dressings and non-heated meals.
  • Choose organically grown sources when possible.

So What About Fructose?

Fructose is a monosaccharide; often referred to us as a “simple” sugar. It’s important to consider that not all sugars are created equal. While they may all provide the same calories per gram, they are metabolized differently in the human body. Human physiology has the most difficult time metabolizing fructose in a safe and healthy fashion compared to other sugars. The reason being is that fructose, before it can be used by our bodies, has to be phosphorylated for liver metabolism. During this process uric acid is generated leading to an increased level of serum uric acid and excretion in the urine. Uric acid has been tied to inflammation and hepatic burden. In addition, fructose generates significantly higher levels of triglycerides and small dense LDLs (a cardiovascular risk factor) in comparison to glucose. We often think of fructose and simply avoid high fructose corn syrup, fruit juice and concentrated fructose as a sweetener, but ultimately there is a wide variability of fructose in whole fruits as well.

High Fructose Fruits

  • Peach: 8 grams
  • Banana: 10 grams
  • Apple: 10 grams
  • Pear: 12 grams
  • Grapes: 12.5 grams
  • Mango: 32 grams
  • Raisins: 42 grams

Note: Fructose grams are per 1 cup. 

Low Fructose Fruits

  • Limes & Lemons: 0 grams
  • Cranberries: 0.5 grams
  • Raspberries: 3 grams
  • Clementine: 3 grams
  • Blackberries: 3.5 grams
  • Strawberries: 4 grams
  • Nectarine: 5 grams
  • Blueberries: 6.5 grams

Note: Fructose grams are per 1 cup. 


A good resource to use to identify high and low fructose fruits would be the USDA FoodData Central database. You may see some slight variations between the different varieties of fruit- for example 100 grams of a Gala apple contains 8 grams fructose while a Granny Smith variety has 6 grams in the same portion.

 Fructose Recommendations

  • Overall try and avoid the use of sweeteners including honey and agave syrup.
  • Choose whole, lower fructose containing fruits such as berries and citrus fruits and limit high fructose containing fruits including fruit juice and dried fruits.
  • Read labels and avoid foods and condiments that contain high fructose corn syrup – looking at you ketchup.

Research suggests that most adults should limit their fructose to no more than 10 grams per meal and 25 grams per day. The 2020-2025 Dietary Guidelines for Americans recommends 1 ½ to 2 cups of fruit/day for adult women and 2 to 2 ½ cups a day for men. So how do we meet our daily fruit goal but not exceed the fructose goal suggested?

Start your day by eating 1 banana for breakfast which provides a 1 cup serving of fruit and 10 grams of fructose. While this may be considered a high fructose fruit- you can balance out the fructose by choosing lower fructose fruits for the rest of your daily fruit servings. Top a salad with 1 cup of cut strawberries at lunch and then snack on a ½ cup of blueberries before bed.  This still only brings your total amount of fructose to 17 grams for the day but provides 2 1/2 cups of fruits and still leaves you with 8 extra grams of fructose for those hidden fructose containing foods such as bread and other grains or condiments such as ketchup.


Oszmianski J, et al. Dietary Plant Polyphenols: Effects of Food Processing on Their Content and Bioavailability. Molecules. 2021 May:26(1);2959. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8156030/.

Perez-Jimenez J, et al. Identification of the 100 richest dietary sources of polyphenols: an application of the Phenol-Explorer Database. Eur J Clin Nutr. 2010. Nov 3;2010:S112-S120. https://www.nature.com/articles/ejcn2010221.

Serafini M, et al. Functional Foods for Health: The Interrelated Antioxidant and Anti-Inflammatory Role of Fruits, Vegetables, Herbs, Spices and Cocoa in Humans. Curr Pharm Des. 2016:22(44):6701-6715. https://pubmed.ncbi.nlm.nih.gov/27881064/.

Softic S, et al. Fructose and Hepatic Insulin Resistance. Crit Rev Clin Lab Sci. 2020 Aug;57(5):308-322. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774304/.

Taskinen MR, et al. Dietary Fructose and the Metabolic Syndrome. Nutrients. 2019 Aug 22;11(9):1987. https://pubmed.ncbi.nlm.nih.gov/31443567/

Tizabi Y, et al. Relevance of the anti-inflammatory properties of curcumin in neurodegenerative disease and depression. Molecules. 2014. Dec 12:19(12):20864-79. https://pubmed.ncbi.nlm.nih.gov/25514226/.

Wang J, et al. Connection between Systemic Inflammation and Neuroinflammation Underlies Neuroprotective Mechanism of Several Phytochemicals in Neurodegenerative Diseases. Oxid Med Cell Longev. 2018. Oct 8;2018:1972714. https://pubmed.ncbi.nlm.nih.gov/30402203/.





Why Functional Formularies is Non-GMO And How to Avoid Glyphosates

By: Dr. John Bagnulo, Director of Nutrition

Let’s start from the beginning: Genetically Modified Organisms (GMOs) are plants or animals that have had genetic material inserted into their inherent or natural DNA. These processes can create new traits in the food or offer a plant a new level of resistance to a chemical used for weed or pest control. In some cases, as with Bt crops, this addition of genetic material allows a pesticide found in certain bacteria to be produced directly by the plant. Continue reading


Critical Concepts in the Nutritional Support of Mitochondria

The Role of Mitochondria in Health

Mitochondria are small organelles located in each cell that are responsible for producing the majority of energy in the body through the Kreb’s cycle. Because of their central role in energy production, the health of mitochondria is key to properly functioning cells and central to human health. The organs that have the highest density of mitochondria are those that require the largest amount of energy – the brain, heart, liver, and kidneys. Healthy mitochondria can support the metabolic activity of these organs; however, if mitochondria are damaged, their ability of these tissues to function may suffer. Loss of functioning mitochondria can create widespread implications. (1-3)

How Can Mitochondria Become Damaged?
It is not one factor, at one point in time that creates mitochondrial damage. Rather, there are a multitude of influential factors that, if not corrected over time, may cause healthy mitochondria to become damaged. (4) These factors include:

  • Lipid Peroxidation
    The membrane that surrounds the mitochondria is composed of lipids, largely based on dietary fat consumption. The sources of fat in the average American diet are excessive in omega 6 fatty acids and too low in omega 3 fatty acids. Mitochondrial membranes that are comprised of predominantly omega 6 fatty acids may be unstable, promote inflammation, and eventually could damage the mitochondria. (4-8)
  • Excessive ROS
    When generating energy, mitochondria produce substances knows as reactive oxygen species (ROS). While some amount of ROS in the body is normal, excessive amounts may be harmful. The appropriate balance of ROS is dependent on adequate endogenous and dietary antioxidants . If there are not enough antioxidants available to the mitochondria, damage to the mitochondria may occur. (1, 2)
  • Environmental Toxins and Gut Microbial Infections
    Widespread exposure to environmental agrichemicals and microbial toxins including pesticides, herbicides, and blue-green algae are known to lead to mitochondrial loss. Specific environmental exposures have been associated with neurodegenerative conditions as well as changes in pediatric brain development. (9-10)
  • Metabolites of Fructose Metabolism
    Dietary fructose consumption is at unprecedented levels due to its increased availability and the presence of sweeteners such as HFCS and agave. Yet there is a limited amount of fructose that can be properly metabolized by the body. When consumed above this amount, fructose metabolism generates biproducts, such as methylglyoxal, that may be harmful to overall health. (11-16)


How to Maintain or Improve Mitochondrial Health (17)

    1. Get an “oil change”
      Support your mitochondrial membrane by removing omega 6 rich industrial seeds oils and making monounsaturated and saturated fats the foundation of your dietary fat intake. Polyunsaturated fats should be balanced with an omega 3 to omega 6 ratio of 1:1 or greater, with omega 6 fatty acids comprising only 5% of calories or less. Choose olive oil, coconut oil, avocado oil, and omega 3 rich foods like flax oil and oily fish.

    2. Go organic
      Consumption of organic vegetables and fruit is associated with a significantly lower toxic burden and better health indices. This is especially important for more susceptible populations including children, the critically ill, and the elderly. Refer to the Environmental Working Group “Dirty Dozen” and “Clean 15” list for guidance on purchasing.

    3. Be mindful about seafood
      Choose cold water marine fish and shellfish. Avoid seafood from areas with cyanobacteria (blue green algae) blooms.
    4. Choose low fructose carbohydrates
      Limit fructose to 10 grams per meal and 25 grams total per day. Eliminate fruit juices, fruit juice concentrate, and sweeteners. Choose moderate to low fructose containing fruit, especially berries and citrus.
    5. Focus on plant-based diets made of whole, unrefined foods
      Diets that are centered around whole foods will offer more protection and a lower glycemic burden than those comprised of refined ingredients.


Katherine Wohl, RDN, LD, IFNCP



  1. Miriam Valera-Alberni et al. Mitochondrial stress management: a dynamic journey. Cell Stress, Vol. 2, No. 10, pp. 253 – 274.
  2. Cohen PM et al. Mitochondria as a Target for Mitigating Sarcopenia. Front. Physiol., 10 January 2019.
  3. Seyfried and Shelton. Cancer as a metabolic disease. Nutrition and Metabolism Jan 2010.
  4. Morris, G., Berk, M. The many roads to mitochondrial dysfunction in neuroimmune and neuropsychiatric disorders. BMC Med 13, 68 (2015).
  5. Taha, A.Y. Linoleic acid–good or bad for the brain?. npj Sci Food 4, 1 (2020). https://doi.org/10.1038/s41538-019-0061-9
  6. Schuster S, Johnson CD, Hennebelle M, et al. Oxidized linoleic acid metabolites induce liver mitochondrial dysfunction, apoptosis, and NLRP3 activation in mice. J Lipid Res. 2018;59(9):1597-1609
  7. Pepe S et al. PUFA and aging modulate cardiac mitochondrial membrane lipid composition and Ca2+ activation of PDH. American Journal of Physiology. Jan 1, 1999.
  8. Ghosh S, Kewalramani G, Yuen G, et al. Induction of mitochondrial nitrative damage and cardiac dysfunction by chronic provision of dietary omega-6 polyunsaturated fatty acids. Free Radic Biol Med. 2006;41(9):1413-1424.
  9. Chen T, Tan J, Wan Z, et al. Effects of Commonly Used Pesticides in China on the Mitochondria and Ubiquitin-Proteasome System in Parkinson’s Disease. Int J Mol Sci. 2017;18(12):2507. Published 2017 Nov 23.
  10. Virginia A. Rauh, Frederica P. Perera, Megan K. Horton, Robin M. Whyatt, Ravi Bansal, Xuejun Hao, Jun Liu, Dana Boyd Barr, Theodore A. Slotkin, Bradley S. Peterson. Brain anomalies and pesticide exposure. Proceedings of the National Academy of Sciences May 2012, 109 (20) 7871-7876.
  11. Gugliucci A. Formation of Fructose-Mediated Advanced Glycation End Products and Their Roles in Metabolic and Inflammatory Diseases. Adv Nutr. 2017;8(1):54-62. Published 2017 Jan 17.
  12. Lakshmishri Ramachandra Bhat et al. Methylglyoxal – An emerging biomarker for diabetes mellitus diagnosis and its detection methods. Biosensors and Bioelectronics. Volume 133, 15 May 2019, Pages 107-124.
  13. C. G. Schalkwijk and C. D. A. Stehouwer. Methylglyoxal, a Highly Reactive Dicarbonyl Compound, in Diabetes, Its Vascular Complications, and Other Age-Related Diseases. Physiology Reviews. 3 DEC 2019.
  14. Nigro C et al. Dicarbonyl Stress at the Crossroads of Healthy and Unhealthy Aging. Cells 2019, 8(7), 749.
  15. Softic S, Meyer JG, Wang GX, et al. Dietary Sugars Alter Hepatic Fatty Acid Oxidation via Transcriptional and Post-translational Modifications of Mitochondrial Proteins. Cell Metab. 2019;30(4):735-753.e4.
  16. White SJ, Carran EL, Reynolds AN, Haszard JJ, Venn BJ. The effects of apples and apple juice on acute plasma uric acid concentration: a randomized controlled trial. Am J Clin Nutr. 2018;107(2):165-172.
  17. Nicolson GL and Ash ME. Lipid Replacement Therapy: A natural medicine approach to replacing damaged lipids in cellular membranes and organelles and restoring function. Biochimica et Biophysica Acta (BBA) – Biomembranes. Volume 1838, Issue 6, June 2014, Pages 1657-1679.

Additional References

  1. Henkel J, Alfine E, Saín J, et al. Soybean Oil-Derived Poly-Unsaturated Fatty Acids Enhance Liver Damage in NAFLD Induced by Dietary Cholesterol. Nutrients. 2018;10(9):1326.
  2. Shrestha N, Cuffe JSM, Holland OJ, Perkins AV, McAinch AJ, Hryciw DH. Linoleic Acid Increases Prostaglandin E2 Release and Reduces Mitochondrial Respiration and Cell Viability in Human Trophoblast-Like Cells. Cell Physiol Biochem. 2019;52(1):94-108.
  3. García-Berumen CI, Ortiz-Avila O, Vargas-Vargas MA, et al. The severity of rat liver injury by fructose and high fat depends on the degree of respiratory dysfunction and oxidative stress induced in mitochondria. Lipids Health Dis. 2019;18(1):78. Published 2019 Mar 30.
  4. Cioffi F, Senese R, Lasala P, et al. Fructose-Rich Diet Affects Mitochondrial DNA Damage and Repair in Rats. Nutrients. 2017;9(4):323. Published 2017 Mar 24.
  5. Boland ML, Oldham S, Boland BB, et al. Nonalcoholic steatohepatitis severity is defined by a failure in compensatory antioxidant capacity in the setting of mitochondrial dysfunction. World J Gastroenterol. 2018;24(16):1748-1765.
  6. Picca, A., Mankowski, R.T., Burman, J.L. et al. Mitochondrial quality control mechanisms as molecular targets in cardiac ageing. Nat Rev Cardiol 15, 543–554 (2018).


The Ketogenic Diet: How and Why Ketogenic Interventions Can Improve Outcomes

The Ketogenic Diet: How and Why Ketogenic Interventions Can Improve Outcomes

The ketogenic diet refers to a high fat, low carbohydrate style of eating. In recent years nutritionists and other professionals have begun recognizing the potential clinical benefit of ketogenic interventions. To many though, its implementation and use still raises concern – often because it is used incorrectly, misunderstood, or like other eating styles, may be followed in an unhealthy way. It is important to understand what constitutes a true ketogenic diet, how it is impacting the body, where might it be beneficial, and especially emphasize the importance of maintaining quality food choices. Continue reading