Let’s Talk About Smoothies!
Smoothies are all the rage these days, but are they really all they’re cracked up to be? From the green vegetable variety to the more-like-milkshake fare, we’ve got the skinny on smoothies here.
Do you want to boost your health, energy, and mood with a simple and delicious drink? If so, you might want to try smoothies! Smoothies are not only tasty, but also packed with benefits for your body and mind. In this column, you will learn how smoothies can help you improve your nutrition, digestion, immunity, cognition, and more. You will also discover how to avoid the common pitfalls of commercial smoothies that are loaded with sugar and artificial ingredients. And you will get some tips and resources from Dr. Bray, an expert in integrative nutrition and wellness coaching. Read on to find out why smoothies are the ultimate power drink for your health and happiness!
Smoothie Power: The Benefits of Blending
- Increase nutrient absorption.1-43
- Prevent nutritional deficiencies.2-22
- Supplement nutritional gaps.2-22
- Enable nutritional gains.2-22
- Maximize quality nutrition.2-22
- Increase overall nutritional self-efficacy.2-5
- And more!
This is especially true for those with snack or mealtime limitations. For individuals with:
- Limited meal options.2-21
- Limited time for meal preparation.2-21
- Short mealtimes.2-5
- Dietary Restrictions.2-21,23,24,30,38-40
But the benefits don’t stop there! A variety of research demonstrates smoothie consumption packs a punch of health benefits, including improvements in:
- Antioxidant Status.6,9,11,14,16,19,22-39
- Appetite/Satiety.40,43-48
- Attention, Focus, & Concentration.22,49
- Cardiovascular Health.12,13,36,40,50,51
- Cognitive Function.22,49
- Cholesterol.24,30,52,53
- Diabetes Management.15,24,25,34,35,41,42,50,51,53-63
- Digestion.11,19,23,24,30,38-40
- Food Attitudes (e.g., in children,3,17,18,20,22 elderly,18,19 and disordered eating populations18).3,17-20,22
- Glucose & Insulin Sensitivity.15,24,25,34,35,41,42,50,51,53-63
- Hydration Status.64
- Hyperlipidemia.6,56,65
- Immune Function.8,26
- Inflammation.8,23,28,36
- Nutritional Status.2-21
- Mental Health & Addiction Recovery!66
- Metabolic Syndrome.26,46,63,67
- Probiotic and Gut Microbiome Health.8,19,30,35,39,41-43
- Sports Recovery & Muscle Repair.29,64
- Supplementation.2-21
- Vascular Function.28,40,67
- Weight Optimization & Management.25,28,37,45,46,48,50,60,63,68
- And More!
Sugary Scams & Milkshake Masquerades
The growing variety of content currently referred to as “a smoothie” severely jeopardizes the integrity of the word, causing many smoothies and smoothie powders to resemble little more than glorified milkshakes experienced by the body as “liquid sugar.”1,69-73
For example, many commercial smoothies these days are:
- Void of fiber.1
- Laden with artificial sugars or sweeteners.1,69-73
- Closer to milkshakes than smoothies.1
- Perceived by the body as “liquid sugar.”1
It can be tempting to associate this deadly combination with negative health outcomes, including
- Blood glucose and insulin spikes (that can lead to):
- Insulin resistance.74
- Pre-diabetes and Diabetes.74
- Inflammation.74
- Weight gain.74
- And a host of other ailments.74
The associations between low-fiber, high-sugar smoothies and negative health outcomes could occur from a combination of two main factors:
- High glycemic index (GI) ingredients (e.g., sugars or sugary ingredients that cause or enable a large load of sugar to rapidly enter the bloodstream).1,69-73
- Lack of fiber (which can act as a buffer for sugars, enabling slower release into the bloodstream15,41,42,51,53,54,56-58,61,75).1,69-73
This could theoretically cause many smoothies to act in the body as milkshakes or sugar, inducing insulin spikes that can lead ultimately to insulin resistance, diabetes/prediabetes, inflammation, weight gain, and host of other ailments.1,15,41,42,51,53,54,56-58,61,74,75
However, this possibility is not supported by existing research.
Research on Glycemic Index:
- Short-term outcomes (e.g., satiety).74
- Long-term health outcomes (e.g., weight, cardiovascular disease, and type 2 diabetes).74
The strongest intervention studies typically found little relationship between GI/glycemic response (GR) and physiological measures of disease risk, including:
- Body weight.74
- Cardiometabolic disease risk,74 including:
- Diabetes.74
- Cardiovascular disease risk.74
Thus, the authors concluded “it is unlikely that the GI of a food or diet is linked to disease risk or health outcomes.”74 Rather, “other measures of dietary quality – such as fiber or whole grains – may be more likely to predict health outcomes.”74
Important Caveats:
Before you swear off smoothies altogether, there are some important caveats to consider. Most importantly, Vega-López’ 2018 data (described above) was funded by Mars Inc. (the candy bar manufacturing conglomerate) as part of a larger scope literature review into the science of the glycemic index.74 This potential conflict of interest could bias the findings.
Nevertheless, an abundance of research does show that high glycemic food options are not always bad. For example, many athletes will consume simple sugars (or straight glucose) during and directly after long bouts of exercise, when:
- The body needs glucose or other energy options to fuel and repair the exercise (e.g., Jeukendrup 2004).76
- Insulin receptors are up-regulated, ensuring the energy taken in goes directly to the muscles for use/repair (rather than fat storage)(e.g., Kojima et al., 2022;Borghouts & Keizer 2000).77,78
Happy Blending!
References
- Bray B. Let’s Talk About Smoothies. In. Brenna Bray, PhD. Vol 2023. https://www.brennabray.com/2023/12/19/lets-talk-about-smoothies/: Brenna Bray, PhD, LLC; 2024.
- Tips for healthy food on the go. Batch cooking, smoothies, and lots of planning pay off when you’re in a hurry. Harv Health Lett. 2014;39(6):6.
- Bates D, Price J. Impact of Fruit Smoothies on Adolescent Fruit Consumption at School. Health Educ Behav. 2015;42(4):487-492.
- Dilrukshi SHB, Senarath HPS. Development and Quality Evaluation of Freeze-Dried Instant Green Smoothie Powder. Int J Food Sci. 2021;2021:6634764.
- Mehta D, Kumar MHS, Sabikhi L. Development of high protein, high fiber smoothie as a grab-and-go breakfast option using response surface methodology. J Food Sci Technol. 2017;54(12):3859-3866.
- Torabian S, Haddad E, Rajaram S, Banta J, Sabaté J. Acute effect of nut consumption on plasma total polyphenols, antioxidant capacity and lipid peroxidation. J Hum Nutr Diet. 2009;22(1):64-71.
- Fayet-Moore F, Cassettari T, McConnell A, Kim J, Petocz P. Australian children and adolescents who were drinkers of plain and flavored milk had the highest intakes of milk, total dairy, and calcium. Nutr Res. 2019;66:68-81.
- Meng H, Ba Z, Lee Y, et al. Consumption of Bifidobacterium animalis subsp. lactis BB-12 in yogurt reduced expression of TLR-2 on peripheral blood-derived monocytes and pro-inflammatory cytokine secretion in young adults. Eur J Nutr. 2017;56(2):649-661.
- de Oliveira Ribeiro L, Almeida ACS, de Carvalho CWP, et al. Effect of Processing on Bioactive Compounds, Physicochemical and Rheological Characteristics of Juçara, Banana and Strawberry Smoothie. Plant Foods Hum Nutr. 2018;73(3):222-227.
- Copado CN, Ixtaina VY, Tomás MC. Enrichment of a fruit-based smoothie beverage with omega-3 fatty acids from microencapsulated chia seed oil. J Sci Food Agric. 2023.
- Narai-Kanayama A, Yokosaka SI, Seo Y, Mikami K, Yoshino T, Matsuda H. Evidence of increases of phytol and chlorophyllide by enzymatic dephytylation of chlorophylls in smoothie made from spinach leaves. J Food Sci. 2023;88(6):2385-2396.
- Martin L, Zarn D, Hansen AM, Wismer W, Mazurak V. Food products as vehicles for n-3 fatty acid supplementation. Can J Diet Pract Res. 2008;69(4):203-207.
- Sandgruber F, Höger AL, Kunze J, et al. Impact of Regular Intake of Microalgae on Nutrient Supply and Cardiovascular Risk Factors: Results from the NovAL Intervention Study. Nutrients. 2023;15(7).
- Castillejo N, Martínez-Hernández GB, Goffi V, et al. Natural vitamin B12 and fucose supplementation of green smoothies with edible algae and related quality changes during their shelf life. J Sci Food Agric. 2018;98(6):2411-2421.
- Fuller S, Beck E, Salman H, Tapsell L. New Horizons for the Study of Dietary Fiber and Health: A Review. Plant Foods Hum Nutr. 2016;71(1):1-12.
- Razola-Díaz MDC, Guerra-Hernández EJ, García-Villanova B, Verardo V. New Insight on Phenolic Composition and Evaluation of the Vitamin C and Nutritional Value of Smoothies Sold on the Spanish Market. Molecules. 2022;27(23).
- Yi S, Kanetkar V, Brauer P. Nudging food service users to choose fruit- and vegetable-rich items: Five field studies. Appetite. 2022;173:105978.
- Romaniw OC, Rajpal R, Duncan AM, Keller HH, Duizer LM. Nutrition in Disguise: Effects of Food Neophobia, Healthy Eating Interests and Provision of Health Information on Liking and Perceptions of Nutrient-Dense Foods in Older Adults. Foods. 2020;10(1).
- Zhang JY, Lo HC, Yang FL, Liu YF, Wu WM, Chou CC. Plant-Based, Antioxidant-Rich Snacks Elevate Plasma Antioxidant Ability and Alter Gut Bacterial Composition in Older Adults. Nutrients. 2021;13(11).
- Rollins BY, Stein W, Keller KL, Savage JS. Preschoolers will drink their GREENS! Children accept, like, and drink novel smoothies containing dark green vegetables (DGVs). Appetite. 2021;162:105148.
- Whole-food smoothies. A potent blend of good nutrition. Mayo Clin Health Lett. 2014;32(5):4-5.
- Whyte AR, Cheng N, Butler LT, Lamport DJ, Williams CM. Flavonoid-Rich Mixed Berries Maintain and Improve Cognitive Function Over a 6 h Period in Young Healthy Adults. Nutrients. 2019;11(11).
- Kuntz S, Kunz C, Herrmann J, et al. Anthocyanins from fruit juices improve the antioxidant status of healthy young female volunteers without affecting anti-inflammatory parameters: results from the randomised, double-blind, placebo-controlled, cross-over ANTHONIA (ANTHOcyanins in Nutrition Investigation Alliance) study. The British journal of nutrition. 2014;112(6):925-936.
- Tkacz K, Wojdyło A, Turkiewicz IP, Nowicka P. Anti-diabetic, anti-cholinesterase, and antioxidant potential, chemical composition and sensory evaluation of novel sea buckthorn-based smoothies. Food Chem. 2021;338:128105.
- Stull AJ, Cash KC, Johnson WD, Champagne CM, Cefalu WT. Bioactives in blueberries improve insulin sensitivity in obese, insulin-resistant men and women. J Nutr. 2010;140(10):1764-1768.
- Nair AR, Mariappan N, Stull AJ, Francis J. Blueberry supplementation attenuates oxidative stress within monocytes and modulates immune cell levels in adults with metabolic syndrome: a randomized, double-blind, placebo-controlled trial. Food Funct. 2017;8(11):4118-4128.
- Škegro M, Putnik P, Bursać Kovačević D, et al. Chemometric Comparison of High-Pressure Processing and Thermal Pasteurization: The Nutritive, Sensory, and Microbial Quality of Smoothies. Foods. 2021;10(6).
- Alqurashi RM, Galante LA, Rowland IR, Spencer JP, Commane DM. Consumption of a flavonoid-rich açai meal is associated with acute improvements in vascular function and a reduction in total oxidative status in healthy overweight men. The American journal of clinical nutrition. 2016;104(5):1227-1235.
- McLeay Y, Barnes MJ, Mundel T, Hurst SM, Hurst RD, Stannard SR. Effect of New Zealand blueberry consumption on recovery from eccentric exercise-induced muscle damage. J Int Soc Sports Nutr. 2012;9(1):19.
- Yusuf EH, Wojdyło A, Bourbon AI, Nowicka P. Fruit-Carrot-Based Smoothies as Innovative Products with a Complex Matrix of Bioactive Compounds Effected on Activities of Selected Digestive Enzymes and Cholinesterases In Vitro. Antioxidants (Basel). 2023;12(4).
- Ottaviani JI, Ensunsa JL, Fong RY, et al. Impact of polyphenol oxidase on the bioavailability of flavan-3-ols in fruit smoothies: a controlled, single blinded, cross-over study. Food Funct. 2023;14(18):8217-8228.
- Ribeiro LO, Pinheiro ACB, Brígida AIS, et al. In vitro gastrointestinal evaluation of a juçara-based smoothie: effect of processing on phenolic compounds bioaccessibility. J Food Sci Technol. 2019;56(11):5017-5026.
- Buniowska M, Arrigoni E, Znamirowska A, Blesa J, Frígola A, Esteve MJ. Liberation and Micellarization of Carotenoids from Different Smoothies after Thermal and Ultrasound Treatments. Foods. 2019;8(10).
- Kidoń M, Uwineza PA. New Smoothie Products Based on Pumpkin, Banana, and Purple Carrot as a Source of Bioactive Compounds. Molecules. 2022;27(10).
- Greenway F, Wang S, Heiman M. A novel cobiotic containing a prebiotic and an antioxidant augments the glucose control and gastrointestinal tolerability of metformin: a case report. Benef Microbes. 2014;5(1):29-32.
- Perzia B, Ying GS, Dunaief JL, Dunaief DM. Once-Daily Low Inflammatory Foods Everyday (LIFE) Smoothie or the Full LIFE Diet Lowers C-Reactive Protein and Raises Plasma Beta-Carotene in 7 Days. Am J Lifestyle Med. 2022;16(6):753-764.
- Quitete FT, Almeida Santos GM, de Oliveira Ribeiro L, et al. Phenolic-rich smoothie consumption ameliorates non-alcoholic fatty liver disease in obesity mice by increasing antioxidant response. Chem Biol Interact. 2021;336:109369.
- Hurtado A, Guàrdia MD, Picouet P, Jofré A, Ros JM, Bañón S. Stabilization of red fruit-based smoothies by high-pressure processing. Part A. Effects on microbial growth, enzyme activity, antioxidant capacity and physical stability. J Sci Food Agric. 2017;97(3):770-776.
- Kuntz S, Rudloff S, Asseburg H, et al. Uptake and bioavailability of anthocyanins and phenolic acids from grape/blueberry juice and smoothie in vitro and in vivo. The British journal of nutrition. 2015;113(7):1044-1055.
- Nepovinnykh NV, Lyamina NP, Ptichkina NM. [Assessment of functional food of general version of diet in cardiac hospital]. Vopr Pitan. 2015;84(1):38-43.
- Ojo O, Feng QQ, Ojo OO, Wang XH. The Role of Dietary Fibre in Modulating Gut Microbiota Dysbiosis in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Nutrients. 2020;12(11).
- Livesey G, Taylor R, Livesey HF, et al. Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies. Nutrients. 2019;11(6).
- Freeland-Graves JH, Nitzke S, Academy of N, Dietetics. Position of the academy of nutrition and dietetics: total diet approach to healthy eating. J Acad Nutr Diet. 2013;113(2):307-317.
- Rogers PJ, Shahrokni R. A Comparison of the Satiety Effects of a Fruit Smoothie, Its Fresh Fruit Equivalent and Other Drinks. Nutrients. 2018;10(4).
- Myers C, McCartney D, Desbrow B, Khalesi S, Irwin C. Consumption of a smoothie or cereal-based breakfast: impact on thirst, hunger, appetite and subsequent dietary intake. Int J Food Sci Nutr. 2021;72(1):123-133.
- Byrne CS, Chambers ES, Preston T, et al. Effects of Inulin Propionate Ester Incorporated into Palatable Food Products on Appetite and Resting Energy Expenditure: A Randomised Crossover Study. Nutrients. 2019;11(4).
- Brunstrom JM, Brown S, Hinton EC, Rogers PJ, Fay SH. ‘Expected satiety’ changes hunger and fullness in the inter-meal interval. Appetite. 2011;56(2):310-315.
- Harrold J, Breslin L, Walsh J, Halford J, Pelkman C. Satiety effects of a whole-grain fibre composite ingredient: reduced food intake and appetite ratings. Food Funct. 2014;5(10):2574-2581.
- Rosander U, Rumpunen K, Olsson V, Åström M, Rosander P, Wendin K. Methodological considerations in a pilot study on the effects of a berry enriched smoothie on children’s performance in school. Food Nutr Res. 2017;61(1):1409063.
- Tuccinardi D, Perakakis N, Farr OM, Upadhyay J, Mantzoros CS. Branched-Chain Amino Acids in relation to food preferences and insulin resistance in obese subjects consuming walnuts: A cross-over, randomized, double-blind, placebo-controlled inpatient physiology study. Clinical nutrition (Edinburgh, Scotland). 2021;40(5):3032-3036.
- Reynolds AN, Akerman A, Kumar S, Diep Pham HT, Coffey S, Mann J. Dietary fibre in hypertension and cardiovascular disease management: systematic review and meta-analyses. BMC Med. 2022;20(1):139.
- Lestiani L, Chandra DN, Laitinen K, Ambarwati FD, Kuusisto P, Lukito W. Double-Blind Randomized Placebo Controlled Trial Demonstrating Serum Cholesterol Lowering Efficacy of a Smoothie Drink with Added Plant Stanol Esters in an Indonesian Population. Cholesterol. 2018;2018:4857473.
- Hagander B, Asp N-G, Efendić S, Nilsson-Ehle P, Scherstén B. Dietary fiber decreases fasting blood glucose levels and plasma LDL concentration in noninsulin-dependent diabetes mellitus patients. The American journal of clinical nutrition. 1988;47(5):852-858.
- Sun J, Wang J, Ma W, Miao M, Sun G. Effects of Additional Dietary Fiber Supplements on Pregnant Women with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. Nutrients. 2022;14(21).
- Saltaouras G, Shaw PK, Fraser AC, et al. Glycaemic index, glycaemic load and dietary fibre characteristics of two commercially available fruit smoothies. Int J Food Sci Nutr. 2019;70(1):116-123.
- Riccardi G, Rivellese AA. Effects of dietary fiber and carbohydrate on glucose and lipoprotein metabolism in diabetic patients. Diabetes care. 1991;14(12):1115-1125.
- Reynolds AN, Akerman AP, Mann J. Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses. PLoS medicine. 2020;17(3):e1003053.
- Post RE, Mainous AG, 3rd, King DE, Simpson KN. Dietary fiber for the treatment of type 2 diabetes mellitus: a meta-analysis. J Am Board Fam Med. 2012;25(1):16-23.
- O’Connor LE, Campbell WW. A novel fiber composite ingredient incorporated into a beverage and bar blunts postprandial serum glucose and insulin responses: a randomized controlled trial. Nutr Res. 2016;36(3):253-261.
- Mongkolsucharitkul P, Pinsawas B, Surawit A, et al. Diabetes-Specific Complete Smoothie Formulas Improve Postprandial Glycemic Response in Obese Type 2 Diabetic Individuals: A Randomized Crossover Trial. Nutrients. 2024;16(3).
- Giacco R, Parillo M, Rivellese AA, et al. Long-term dietary treatment with increased amounts of fiber-rich low-glycemic index natural foods improves blood glucose control and reduces the number of hypoglycemic events in type 1 diabetic patients. Diabetes care. 2000;23(10):1461-1466.
- Crummett LT, Grosso RJ. Postprandial Glycemic Response to Whole Fruit versus Blended Fruit in Healthy, Young Adults. Nutrients. 2022;14(21).
- Bell L, Lamport DJ, Butler LT, Williams CM. A study of glycaemic effects following acute anthocyanin-rich blueberry supplementation in healthy young adults. Food Funct. 2017;8(9):3104-3110.
- Escalona Navarro R, Gómez Martín M, Rodríguez de Cepeda A, Vázquez García R, Espejo Garrido J. The importance of smoothies in hydration. Nutricion hospitalaria. 2015;32 Suppl 2:10295.
- Young AJ, Marriott BP, Champagne CM, et al. Blood fatty acid changes in healthy young Americans in response to a 10-week diet that increased n-3 and reduced n-6 fatty acid consumption: a randomised controlled trial. The British journal of nutrition. 2017;117(9):1257-1269.
- Fadnes LT, Furulund E, Druckrey-Fiskaaen KT, et al. Effect of fruit smoothie supplementation on psychological distress among people with substance use disorders receiving opioid agonist therapy: protocol for a randomised controlled trial (FruktBAR). BMC Nutr. 2022;8(1):97.
- Stull AJ, Cash KC, Champagne CM, et al. Blueberries improve endothelial function, but not blood pressure, in adults with metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial. Nutrients. 2015;7(6):4107-4123.
- Frestedt JL, Young LR, Bell M. Meal Replacement Beverage Twice a Day in Overweight and Obese Adults (MDRC2012-001). Curr Nutr Food Sci. 2012;8(4):320-329.
- Smith V, Green-Petersen D, Møgelvang-Hansen P, Christensen RH, Qvistgaard F, Hyldig G. What’s (in) a real smoothie. A division of linguistic labour in consumers’ acceptance of name-product combinations? Appetite. 2013;63:129-140.
- Dickinson KM, Watson MS, Prichard I. Are Clean Eating Blogs a Source of Healthy Recipes? A Comparative Study of the Nutrient Composition of Foods with and without Clean Eating Claims. Nutrients. 2018;10(10).
- Da Silva-Mojón L, Pérez-Lamela C, Falqué-López E. Smoothies Marketed in Spain: Are They Complying with Labeling Legislation? Nutrients. 2023;15(20).
- Cioffi CE, Figueroa J, Welsh JA. Added Sugar Intake among Pregnant Women in the United States: National Health and Nutrition Examination Survey 2003-2012. J Acad Nutr Diet. 2018;118(5):886-895.e881.
- Boulton J, Hashem KM, Jenner KH, Lloyd-Williams F, Bromley H, Capewell S. How much sugar is hidden in drinks marketed to children? A survey of fruit juices, juice drinks and smoothies. BMJ Open. 2016;6(3):e010330.
- Vega-López S, Venn BJ, Slavin JL. Relevance of the Glycemic Index and Glycemic Load for Body Weight, Diabetes, and Cardiovascular Disease. Nutrients. 2018;10(10):1361.
- de Leeuw JA, Jongbloed AW, Verstegen MW. Dietary fiber stabilizes blood glucose and insulin levels and reduces physical activity in sows (Sus scrofa). The Journal of nutrition. 2004;134(6):1481-1486.
- Jeukendrup AE. Carbohydrate intake during exercise and performance. Nutrition (Burbank, Los Angeles County, Calif). 2004;20(7-8):669-677.
- Kojima C, Ishibashi A, Ebi K, Goto K. Exogenous glucose oxidation during endurance exercise under low energy availability. PloS one. 2022;17(10):e0276002.
- Borghouts L, Keizer H. Exercise and insulin sensitivity: a review. International journal of sports medicine. 2000;21(01):1-12.
Dr. Brenna Bray, a local health and wellness coach, stress researcher, associate professor, and avid ultra-marathon mountain runner, holds PhDs in Biomedical Science, Neuroscience, and Complementary and Integrative Health. Her journey through an eating disorder fuels her dedication to coaching, merging personal experiences with scientific expertise. Through her practice, Bray empowers clients to access and harness their innate healing abilities and achieve remarkable health and wellness transformations. Committed to community engagement and holistic well-being, Dr. Bray shapes a brighter, healthier future for all. Learn more about Dr. Bray at www.brennabray.com.