Nutrition A Radical Approach to Health Linda Diane Feldt With credit to Coco Newton MPH, RD, CCN for slides 4-10, 12-17, 19-20, 23-25, 30-36, 38-45, 49,

NutritionNutrition

A Radical Approach to HealthA Radical Approach to Health

Linda Diane FeldtLinda Diane Feldt

With credit toWith credit to

Coco Newton Coco Newton MPH, RD, CCNMPH, RD, CCNfor slides 4-10, 12-17, 19-20, 23-25, 30-36, 38-45, 49, 51for slides 4-10, 12-17, 19-20, 23-25, 30-36, 38-45, 49, 51

OutlineOutline

Food that promotes healthFood that promotes health Food that hurts usFood that hurts us Controversial dietsControversial diets Dietary related illnessesDietary related illnesses Organic and sustainableOrganic and sustainable The good newsThe good news

What food can do for usWhat food can do for us

Anti-inflammatoryAnti-inflammatory AntioxidantAntioxidant Cell repairCell repair Decrease insulin resistanceDecrease insulin resistance Hormonal balancingHormonal balancing EnergyEnergy

PhytonutrientsPhytonutrients

LignansLignansFlavonoidsFlavonoidsIsoflavonesIsoflavonesPolyphenolsPolyphenolsTerpenesTerpenesPlant sterolsPlant sterolsComplex phospholipidsComplex phospholipidsCarotenoidsCarotenoidsAmino acidsAmino acidsPeptidesPeptides

Most thoroughly studied foodsMost thoroughly studied foods:: Cruciferous vegetablesCruciferous vegetables SoySoy Green leafy veggies Green leafy veggies Red-orange fruits/veggiesRed-orange fruits/veggies CitrusCitrus GarlicGarlic

Free RadicalsFree Radicals

Free radicalsFree radicals are by-products of oxidation- the process by which body uses are by-products of oxidation- the process by which body uses OO22 to burn food as fuel, producing energy, and to destroy harmful chemicals. to burn food as fuel, producing energy, and to destroy harmful chemicals.

Excess free radicals produced by nuclear radiation, pollution, smoking, Excess free radicals produced by nuclear radiation, pollution, smoking, alcohol, sunburn, stressalcohol, sunburn, stress

The fires of oxidation can produce chemical “sparks” that fly off and start The fires of oxidation can produce chemical “sparks” that fly off and start fires where they aren’t wanted. Those “sparks” are fires where they aren’t wanted. Those “sparks” are free radicalsfree radicals..

Normally electrons spin in pairs in opposite directions at 186,000 miles/sec. Normally electrons spin in pairs in opposite directions at 186,000 miles/sec. Free radicalsFree radicals are unpaired electrons that “rip each other off” in chain rxn are unpaired electrons that “rip each other off” in chain rxn

Free radicalsFree radicals damage tissue, blood, bile, cells, and DNA damage tissue, blood, bile, cells, and DNA

AntioxidantsAntioxidants are protective enzymes and circulating chemicals that protect are protective enzymes and circulating chemicals that protect the body’s cells from harmful oxidation and the body’s cells from harmful oxidation and limit free radicallimit free radical damage.damage.

Top Dietary Sources of AntioxidantsTop Dietary Sources of Antioxidants

Foods generally rich in antioxidantsFoods generally rich in antioxidantsRedRed, , yellowyellow, and , and greengreen vegetables, raw nuts and seeds, legumes, vegetables, raw nuts and seeds, legumes, whole grains, garlic, shrimp, scallopswhole grains, garlic, shrimp, scallops

Foods rich in carotenoidsFoods rich in carotenoidsApricots, broccoli, cantaloupe, carrots, collards, dandelion greens, Apricots, broccoli, cantaloupe, carrots, collards, dandelion greens, kale red peppers, mustard greens, papaya, pumpkin, sea kale red peppers, mustard greens, papaya, pumpkin, sea vegetables, spinach, sweet potatoes, Swiss chard, tomatoes, winter vegetables, spinach, sweet potatoes, Swiss chard, tomatoes, winter squashsquash

Foods rich in bioflavanoidsFoods rich in bioflavanoidsBeets, black cherries, blackberries, blueberries, buckwheat, Beets, black cherries, blackberries, blueberries, buckwheat, cranberries, asparagus tips, green tea, purple corn, purple onion, cranberries, asparagus tips, green tea, purple corn, purple onion, radishes, raspberries, red cabbage, red grapes, rhubarb, sweet radishes, raspberries, red cabbage, red grapes, rhubarb, sweet potatoes, spices (ginger, parsley, rosemary, sage, thyme, turmeric)potatoes, spices (ginger, parsley, rosemary, sage, thyme, turmeric)

AntioxidantsAntioxidants

DIETARY SOURCES: vit E, vit C, vit A, carotene, related DIETARY SOURCES: vit E, vit C, vit A, carotene, related carotenoids, bioflavanoids, selenium, manganese, copper, zinc, carotenoids, bioflavanoids, selenium, manganese, copper, zinc, sulfursulfur

Inhibit free radicals directly by quenching “sparks”Inhibit free radicals directly by quenching “sparks”

Inhibit free radicals indirectly by activating liver detoxification Inhibit free radicals indirectly by activating liver detoxification enzymes (cytochrome Penzymes (cytochrome P450450 system) that convert them into less system) that convert them into less destructive compoundsdestructive compounds

Need balanced anti-oxidant defense system to protect Need balanced anti-oxidant defense system to protect mitochondria (energy center of cell)mitochondria (energy center of cell)

CarotenoidsCarotenoids

Carotenoids are fat soluble compounds Carotenoids are fat soluble compounds that provide the light that provide the light yellowyellow to deep to deep orangeorange colors to fruits and vegetables. colors to fruits and vegetables.

Beta-carotene, alpha-carotene, lutein, Beta-carotene, alpha-carotene, lutein, lycopene, xanthinslycopene, xanthins

Foods, not individual supplements, fight Foods, not individual supplements, fight cancer, macular degenerationcancer, macular degeneration

BioflavanoidsBioflavanoids

Bioflavanoids are potent antioxidants that provide the Bioflavanoids are potent antioxidants that provide the bright bright yellowyellow to deep to deep purplepurple colors to fruits and colors to fruits and vegetables, and spices.vegetables, and spices.

Quercitin, proanthocyanadins (grape seed extract, pine bark Quercitin, proanthocyanadins (grape seed extract, pine bark extract), epigallo-catechin galactate (DGCG) found in green teaextract), epigallo-catechin galactate (DGCG) found in green tea

Protect against cancer, heart disease, allergies, circulatory Protect against cancer, heart disease, allergies, circulatory disorders, inflammationdisorders, inflammation

Stimulate immunity by increasingStimulate immunity by increasing• NK cell activity NK cell activity • Interleukin 2 (T-cells, lymphocytes)Interleukin 2 (T-cells, lymphocytes)

Cruciferous VegetablesCruciferous Vegetables

Broccoli, cauliflower, brussels sprouts, bok choy, Broccoli, cauliflower, brussels sprouts, bok choy, and cabbage are potent cancer fighting foods:and cabbage are potent cancer fighting foods:

SulphoraphanesSulphoraphanes anti-oxidants that stimulate release of detoxification enzymes in anti-oxidants that stimulate release of detoxification enzymes in

liverliver may inhibit early tumor growthmay inhibit early tumor growth

Indole-3 CarbinolIndole-3 Carbinol supports detoxification of estrogens and xenoestrogens supports detoxification of estrogens and xenoestrogens

(pollutants that mimic estrogen activity in body) (pollutants that mimic estrogen activity in body) promotes formation of beneficial estrogen metabolite promotes formation of beneficial estrogen metabolite

(2 hydroxy estrone)(2 hydroxy estrone)

Healthy Eating PyramidHealthy Eating PyramidHarvard School of Public HealthHarvard School of Public Health

Carbs, fats, proteinsseparated by quality

Multi vitamin recommended

Option calcium supplement

Fatty AcidsFatty Acids Omega 9 fatty acidsOmega 9 fatty acids

Olive, canola (oleic acid)Olive, canola (oleic acid)

Omega 3 fatty acidsOmega 3 fatty acidsflax seeds, flax oil, fish oil ( alpha-linolenic acid, eicosapentanoic flax seeds, flax oil, fish oil ( alpha-linolenic acid, eicosapentanoic

acid)acid)

Omega 6 fatty acidsOmega 6 fatty acidscorn, safflower, sunflower, sesame (linoleic acid)corn, safflower, sunflower, sesame (linoleic acid)evening primrose oil, borage oil, black currant seed oil (gamma evening primrose oil, borage oil, black currant seed oil (gamma linolenic acid)linolenic acid)

Optimal Omega-3: Omega-6 Ratio is Optimal Omega-3: Omega-6 Ratio is 1:31:3SStandard tandard AAmerican merican DDiet iet (SAD)(SAD) is is 1:251:25

Omega 3 Fatty AcidsOmega 3 Fatty Acids

precursors of prostaglandinsprecursors of prostaglandins

Prostaglandins are chemical messengers in Prostaglandins are chemical messengers in every cell of the body, regulating the every cell of the body, regulating the rhythm and inflammatory process.rhythm and inflammatory process.

Omega 3 Fatty Acids Omega 3 Fatty Acids BenefitBenefit

Heart disease-Heart disease- homocysteine, VLDL, Apo B, increases HDL homocysteine, VLDL, Apo B, increases HDL

HypertensionHypertension- avg - avg of 3.5mm diastolic, 5.5 mm systolic of 3.5mm diastolic, 5.5 mm systolic

Cancer-Cancer- growth of precancerous cells, tumor initiation, tumor growth, enhances growth of precancerous cells, tumor initiation, tumor growth, enhances chemotherapychemotherapy

Brain-Brain- low omega-3 assoc. with ADD, depression, bipolar, schizophrenia, learning low omega-3 assoc. with ADD, depression, bipolar, schizophrenia, learning disorders, Alzheimer’s, disorders, Alzheimer’s,

Rheumatoid Arthritis-Rheumatoid Arthritis- inflammatory leukotrienes inflammatory leukotrienes

Digestion-Digestion- inflammatory leukotrienes (Crohn’s , Ulcerative Colitis) inflammatory leukotrienes (Crohn’s , Ulcerative Colitis)

Dysmenorrhea-Dysmenorrhea- pain after 2 months pain after 2 months

Diabetes-Diabetes- insulin resistance, obesity, triglycerides, blood glucose insulin resistance, obesity, triglycerides, blood glucose

NSAIDSNSAIDS

Blocks all prostaglandinsBlocks all prostaglandins, even the beneficial ones, , even the beneficial ones, thereby suppress body’s own anti-inflammatory thereby suppress body’s own anti-inflammatory responseresponse

Blocks intestinal lining repair (every 3-5 days)Blocks intestinal lining repair (every 3-5 days)

Causes intestinal permeability “Leaky Gut”Causes intestinal permeability “Leaky Gut”

Increases risk for stomach and duodenal ulcersIncreases risk for stomach and duodenal ulcers

Increases risk for dysbiosisIncreases risk for dysbiosis

For the love of chocolateFor the love of chocolate

Cocoa contains procyanidins and Cocoa contains procyanidins and phytosterolsphytosterols

total cholesterol, LDL cholesteroltotal cholesterol, LDL cholesterol high in Mg, Cu, Ca, P, Fe, Zn high in Mg, Cu, Ca, P, Fe, Zn (magnesium, copper, calcium, phosphorous, iron, zinc)(magnesium, copper, calcium, phosphorous, iron, zinc) Fatty acids oleic, stearic, palmitic pose no harm Fatty acids oleic, stearic, palmitic pose no harm

Nutritional CrisisNutritional Crisis

35 % of Americans are overweight35 % of Americans are overweight 26% of Americans are obese26% of Americans are obese

1990- 1990- 40%40% fat in diet fat in diet 2000- 2000- 34%34% fat in diet fat in diet

1960- 1960- 31003100 calories/day calories/day1990- 1990- 37003700 calories/day calories/day

68% of all deaths are associated 68% of all deaths are associated with imbalances in diet and with imbalances in diet and

nutritionnutrition1988 Surgeon Generals Report1988 Surgeon Generals Report

Diet changes in conjunction with physical activity and normal BMI

could reduce cancer incidence by 30–40%.

1997, The World Cancer Research Fund and the American Institute for Cancer Research report,

"Food, Nutrition and the Prevention of Cancer: A Global Perspective"

20% of deaths from heart disease could be avoided by reducing fats and increasing fruits, vegetables, breads, cereals, and legumes (dry beans and

peas).

The 1989 National Academy of Sciences report, Diet and Health: Implications for Reducing Chronic Disease Risk

USDA 1988-89 Americans USDA 1988-89 Americans each ate on average/yeareach ate on average/year

638 serv soda pop (ages 12-29)638 serv soda pop (ages 12-29)134 lbs. sugar134 lbs. sugar 90 lbs. fats-oils90 lbs. fats-oils 63 doz donuts63 doz donuts 82 lbs. cakes, cookies, candy82 lbs. cakes, cookies, candy 23 gallons ice cream23 gallons ice cream 15 lbs chips15 lbs chips2.65 gallons pure alcohol= 2.65 gallons pure alcohol=

50 gallons beer 50 gallons beer 20 gallons wine 20 gallons wine 4 gallons distilled liquor4 gallons distilled liquor

$$$$$$$$ spent on supplements spent on supplements

$1.7 billion/year on vitamins/minerals$1.7 billion/year on vitamins/minerals

$3.8 billion/year on herbs$3.8 billion/year on herbs

$33 billion/year on weight control products$33 billion/year on weight control products

Center for Disease Control and PreventionCenter for Disease Control and PreventionFDA Consumer ReportsFDA Consumer Reports

Illusion of the Perfect DietIllusion of the Perfect Dietone size does not fit allone size does not fit all

Blood typeBlood type Metabolic typeMetabolic type Raw foodsRaw foods VegetarianVegetarian VeganVegan Macrobiotic Macrobiotic High protein, low carbHigh protein, low carb Low fat, high carbLow fat, high carb USDA pyramidUSDA pyramid Asian pyramidAsian pyramid Harvard pyramidHarvard pyramid Etc……… Etc………

The Myth of FastingThe Myth of Fasting

The body does a good job of “purifying” every The body does a good job of “purifying” every dayday

The colon is a muscle that does not need to restThe colon is a muscle that does not need to rest ““set point” change is a real danger of fastingset point” change is a real danger of fasting There is no evidence for the claim that the colon There is no evidence for the claim that the colon

is caked with a rubbery residueis caked with a rubbery residue Healing systems that routinely require fasting Healing systems that routinely require fasting

and purifying are rarely evidence basedand purifying are rarely evidence based Fasting can affect adrenal function and other Fasting can affect adrenal function and other

systems, creating feelings of euphoria systems, creating feelings of euphoria

*Fasting for spiritual reasons has a different purpose and effect*

1987 National Academy of 1987 National Academy of Sciences ReportSciences Report

20,000 cases of cancer per year can be 20,000 cases of cancer per year can be linked to US pesticide uselinked to US pesticide use

The biggest dietary offenders are meats, The biggest dietary offenders are meats, dairy, and producedairy, and produce

Environmental Toxins in Food Environmental Toxins in Food

PesticidesPesticides HerbicidesHerbicides FungicidesFungicides RodenticidesRodenticides HormonesHormones AntibioticsAntibiotics

A Research News Release on A Research News Release on March 3, 2003March 3, 2003

Fruits and vegetables grown organically have Fruits and vegetables grown organically have significantly higher levels of cancer fighting anti-significantly higher levels of cancer fighting anti-oxidants than conventionally grown foods.oxidants than conventionally grown foods.

The research suggests that pesticides and The research suggests that pesticides and herbicides actually thwart the production of herbicides actually thwart the production of phenolics- chemicals that act as a plant’s natural phenolics- chemicals that act as a plant’s natural defense and are good for our healthdefense and are good for our health

Parkinson’s and FruitsParkinson’s and Fruits

Correlation between high fruit and fruit Correlation between high fruit and fruit juice intake and risk of Parkinson’s juice intake and risk of Parkinson’s diseasedisease

““We speculate that this increased risk may be We speculate that this increased risk may be due to plant borne toxins, pesticides, or due to plant borne toxins, pesticides, or herbicides, rather than the fruit itself.”herbicides, rather than the fruit itself.”

American Academy of Neurology Annual Meeting in Honolulu, March 29 – April 5, 2003American Academy of Neurology Annual Meeting in Honolulu, March 29 – April 5, 2003

Pesticides in Children’s DietsPesticides in Children’s DietsOrganic vs. ConventionalOrganic vs. Conventional

Children fed predominantly organic produce/juice had Children fed predominantly organic produce/juice had one-sixthone-sixth the level of pesticides compared to children fed the level of pesticides compared to children fed conventional produce/juice.conventional produce/juice.

EPA risk levels above for conventional and negligible for EPA risk levels above for conventional and negligible for organicorganic

Environmental Health Perspectives, March 2003Environmental Health Perspectives, March 2003Cynthia Curl, et al (University of Washington) “Organophosphorus pesticide Cynthia Curl, et al (University of Washington) “Organophosphorus pesticide exposure of urban and suburban preschool children with organic and exposure of urban and suburban preschool children with organic and conventional diets”conventional diets”

NIH National Children’s StudyNIH National Children’s Study

Examining the relationship between Examining the relationship between environmental exposures and health and environmental exposures and health and development by following more than 100,000 development by following more than 100,000 children from birth to 21yrschildren from birth to 21yrs

Hypothesis: pre-conceptual, prenatal, and/or Hypothesis: pre-conceptual, prenatal, and/or early childhood exposure to pesticides and other early childhood exposure to pesticides and other environmental contaminants increases neuro-environmental contaminants increases neuro-developmental disorders developmental disorders

““Well run organic farms often Well run organic farms often match conventional ones for match conventional ones for productivity, even beat them productivity, even beat them when water is scarce. when water is scarce. Creating a sustainable food Creating a sustainable food supply may well require supply may well require advanced technology as well advanced technology as well as ecological awareness. But as ecological awareness. But an organic ethic could be the an organic ethic could be the very key to our survival.”very key to our survival.”

Newsweek Sept. 30, 2002Newsweek Sept. 30, 2002

RDARDA = = RReally eally DDumb umb AAllowancesllowances

Based on the “normal” 70 kg man Based on the “normal” 70 kg man

a statistical construct, a mythical mana statistical construct, a mythical man

The mean requirement of a nutrient increased by 2 standard The mean requirement of a nutrient increased by 2 standard deviations deviations

Nutritional needs of “practically all healthy people”- no relevance to Nutritional needs of “practically all healthy people”- no relevance to individualindividual

Use Optimal Daily Intake: 10 – 100X RDAUse Optimal Daily Intake: 10 – 100X RDAHalf way between RDA and Upper Limit (UL)Half way between RDA and Upper Limit (UL)UL = highest level that poses no adverse effects in general populationUL = highest level that poses no adverse effects in general population

Stages of Nutrient DepletionStages of Nutrient Depletion

1.1. Dietary inadequacyDietary inadequacy2.2. Diminished tissue reservesDiminished tissue reserves3.3. Decreased body fluid levelsDecreased body fluid levels4.4. Decreased functional levels in tissuesDecreased functional levels in tissues5.5. Decreased activity of nutrient dependent enzymesDecreased activity of nutrient dependent enzymes6.6. Functional changeFunctional change7. Clinical symptoms7. Clinical symptoms8. Anatomical Signs8. Anatomical Signs9. DISEASE9. DISEASE

1 – 61 – 6 functional/nutritional medicine functional/nutritional medicine 7 – 97 – 9 conventional medicineconventional medicine

Surfing the Nutrition WEBSurfing the Nutrition WEBgastrointestinal gastrointestinal

Gut is the most important Gut is the most important gateway to your body’s gateway to your body’s health.health. Look here first! Look here first!

Protective barrierProtective barrier

60% of immune system 60% of immune system (GALT-gut associated (GALT-gut associated lymphatic tissue)lymphatic tissue)

Enteric nervous system- Enteric nervous system- our 2our 2ndnd brain brain

Surfing the WEB- G.I.Surfing the WEB- G.I.

Approx 26 feet longApprox 26 feet long 2 + lbs of bacteria 2 + lbs of bacteria

Normal g.i. tract 85-90% good, 10-15% badNormal g.i. tract 85-90% good, 10-15% bad

symbioticsymbiotic- acidophilus, bifidobacteria, eubacteria- acidophilus, bifidobacteria, eubacteria commensalscommensals- e.coli, streptococcus- e.coli, streptococcus villainsvillains- clostridium, salmonella, staphylococcus, - clostridium, salmonella, staphylococcus,

proteus, campylobacter, listeria, pseudomonas, proteus, campylobacter, listeria, pseudomonas, klebsiellaklebsiella

Too many villains cause Too many villains cause dysbiosis.dysbiosis.

Major Causes of DysbiosisMajor Causes of Dysbiosis

Poor dietPoor diet Poor nutritional statusPoor nutritional status Antibiotic/drug therapyAntibiotic/drug therapy Decreased immune statusDecreased immune status Decreased gut motilityDecreased gut motility MaldigestionMaldigestion Intestinal infectionIntestinal infection XenobioticsXenobiotics Increased intestinal pHIncreased intestinal pH

Major Effects of DysbiosisMajor Effects of Dysbiosis• Vitamin B vitamin deficiencyVitamin B vitamin deficiency• SteatorrheaSteatorrhea• Irritable bowel syndromeIrritable bowel syndrome• Inflammatory bowel diseaseInflammatory bowel disease• Auto-immune disordersAuto-immune disorders• ArthritisArthritis• Colon and breast cancerColon and breast cancer• PsoriasisPsoriasis• EczemaEczema

• Cystic acneCystic acne• Chronic fatigueChronic fatigue• Fibromyalgia Fibromyalgia • HeadachesHeadaches• Food allergiesFood allergies• Weight gainWeight gain• Candida albicansCandida albicans• Emotional Emotional • Elevated cholesterol Elevated cholesterol

““Leaky Gut” is to blameLeaky Gut” is to blame

““Leaky Gut”Leaky Gut”

Excess toxins pass through damaged intestinal wall to Excess toxins pass through damaged intestinal wall to blood stream and are carried to liverblood stream and are carried to liver

Liver must detoxify, yet is overworkedLiver must detoxify, yet is overworked

Liver has Liver has KupfferKupffer cells which transfers immunological cells which transfers immunological message from liver to rest of body that toxins are coming message from liver to rest of body that toxins are coming from gi tractfrom gi tract

““TOXIN ALERT”-TOXIN ALERT”- overactive immune system causes overactive immune system causes toxic response systemically (auto-immune, arthritis, etc.)toxic response systemically (auto-immune, arthritis, etc.)

Some Foods to Support G.I. Some Foods to Support G.I. HealthHealth

Rice carbohydrates and proteinRice carbohydrates and protein

Dietary fiber (best are rice bran and barley bran)Dietary fiber (best are rice bran and barley bran) Friendly bacteria ferment them to short chain fatty acids which nourish Friendly bacteria ferment them to short chain fatty acids which nourish

intestinal cells.intestinal cells.

Probiotics and prebiotics in foodsProbiotics and prebiotics in foods

For hypoallergenic and anti-inflammatory effect:For hypoallergenic and anti-inflammatory effect: Avoid gluten-containing flours, dairy, eggs, soy, peanuts, caffeine, sugar, Avoid gluten-containing flours, dairy, eggs, soy, peanuts, caffeine, sugar,

alcohol, shellfisalcohol, shellfis Include ample vegetables, fruitsInclude ample vegetables, fruits

Candida overgrowthCandida overgrowth

Popularized by “The Yeast Connection” by William Popularized by “The Yeast Connection” by William Crook, MD requires a strict elimination diet.Crook, MD requires a strict elimination diet.

An alternative is to crowd out candida by An alternative is to crowd out candida by encouraging healthy intestinal flora.encouraging healthy intestinal flora.

Tempeh, miso, pickles, yogurt, and other Tempeh, miso, pickles, yogurt, and other fermented products are used as well as fermented products are used as well as acidophilus and probioticsacidophilus and probiotics

Sinful Side of SugarSinful Side of Sugar

DM, CHD, cancer (breast and colon), DM, CHD, cancer (breast and colon), obesity, ADD, tooth decay, nutritional obesity, ADD, tooth decay, nutritional deficiencies, Candida albicansdeficiencies, Candida albicans

immune function, B vits, Cr, Cu, Mbimmune function, B vits, Cr, Cu, Mb

Caffeine and CoffeeCaffeine and Coffee

Toxins used in growing and processingToxins used in growing and processing Decaf worse- uses chemical solventsDecaf worse- uses chemical solvents Stress hormones- adrenalin, cortisolStress hormones- adrenalin, cortisol

Stress hormones make glucose availableStress hormones make glucose available Stress hormones inhibit fat burningStress hormones inhibit fat burning

Adrenal exhaustionAdrenal exhaustion B vitamin, calcium, magnesium, potassium, B vitamin, calcium, magnesium, potassium,

and zinc absorptionand zinc absorption Homocysteine Homocysteine plaque, clotting plaque, clotting blood pressureblood pressure

Ambo