Mango - a sweet treat with anti-cancer potential

Mango is the world’s most widely eaten fresh fruit. Mango originated from India and southeast Asia, but is now grown in the Americas, the Caribbean, Africa, and Australia as well – today, Mexico is the world’s largest mango exporter. Mangoes were introduced in the U.S. in the late 1800s, and some are still grown in California and Florida. Mango is part of a nutrient dense family – its relatives include cashews and pistachios, but unlike its family members, the seed of a mango is inedible.

There are over 50 different varieties of mango, and we see about five of these in the U.S. Color varies – green, yellow, orange, red, or a combination. Although unripe mangoes are usually green, the best test of ripeness is how hard or soft the fruit is. A mango that indents in response to gentle pressure is ripe. Tart, unripe green mangoes are used in several ethnic cuisines, and are sometimes sliced and dipped in salt (but not by nutritarians!). Ripe mangoes, however, are extremely sweet and tasty.1-2 

A great deal of research has been done on the health benefits of high antioxidant fruits – blueberries, goji berries, pomegranates, acai – but the mango has been somewhat ignored by scientists because its antioxidant capacity is not quite as high as these other fruits. Mangoes’ low level of antioxidants are reflected in Dr. Fuhrman’s ANDI scores – mango scores 51, while blueberries score 128. Atulfo mangoes – the smaller, yellow mangoes often sold in Asian supermarkets – have the greatest antioxidant content of the five common varieties found in the U.S. Also, the orange flesh of mangoes is full of beta-carotene and vitamin C.3-4

Mangoes

A new study has revealed that mango, despite its low level of antioxidant activity, may have potent anti-cancer properties. Researchers treated cells derived from several common cancers – colon, breast, leukemia, and prostate – with mango polyphenol extract. Breast and colon cancer cells were most significantly affected – the cell cycle was disrupted and they underwent programmed cell death in response to the mango extract. Normal colon cells, however, remained alive and undamaged. The researchers suggest that gallotannins, the most abundant antioxidant polyphenols contained in mango, were responsible for the anti-cancer effects.5

Fresh mango is delicious all on its own. If you haven’t quite yet figured out how to cut a mango, here’s one way. Another is to slice lengthwise on each side of the pit, score the flesh, and then turn each side inside out, as illustrated here

Frozen and dried mango can make a great treat too:

Dr Fuhrman’s Fantastic Mango Ice Cream

Serves: 4

Ingredients:

1/2 cup unsweetened shredded coconut, reserving 1 tablespoon for garnish

1/2 cup hemp, almond or soy milk

1/2 teaspoon lemon juice

1 10-ounce bag frozen mango

4 slices dried mango, unsweetened and unsulfured

Instructions:

Soak dried mango in the plant-milk until soft (overnight or one hour in advance). Then blend all ingredients, including the soaking milk, in a Vita-Mix or other high-powered blender until smooth and creamy. Garnish with reserved coconut.

 

References:

  1. http://en.wikipedia.org/wiki/Mango
  2. http://homecooking.about.com/od/foodhistory/a/mangohistory.htm
  3. Manthey JA et al. Influences of harvest date and location on the levels of beta-carotene, ascorbic acid, total phenols, the in vitro antioxidant capacity, and phenolic profiles of five commercial varieties of mango (Mangifera indica L.). J Agric Food Chem. 2009 Nov 25;57(22):10825-30.
  4. http://www.nutritiondata.com/facts/fruits-and-fruit-juices/1952/2
  5. http://www.sciencedaily.com/releases/2010/01/100111154926.htm

Eggs and poultry with skin double prostate cancer recurrence risk

Eggs

Approximately 1300 men who had been diagnosed with prostate cancer were followed for two years to document their dietary patterns and recurrence or progression of their disease. In this study, two specific animal foods were found to be risky - the men that ate the most eggs or poultry with skin were twice as likely to have their disease recur or progress.1

This study makes three important points.

  1. Diet does matter, even after a prostate cancer diagnosis.
  2. There is something in chicken, specifically in the crispy outer portion and skin that is powerfully cancer-inducing. Heterocyclic amines, carcinogenic compounds that are formed when meat is cooked at high temperatures, are a probable culprit. A November 2009 study of 175,000 men showed an increase in prostate cancer risk with consumption of barbequed and grilled meat.2
  3. Consumption of eggs and egg whites is not without risk. Eggs are high in animal protein, which has been linked to cancers. Our populations’ idea that more protein is favorable and that egg (whites) are the perfect food does not hold up to scrutiny. Eggs also could affect prostate cancer due to their high choline content – egg consumption increases the amount of choline in the plasma, and high plasma choline increases prostate cancer risk.3 

Four previous studies implementing a plant-based diet and exercise following prostate cancer diagnosis found a decrease in prostate cancer progression rates.4 

Dietary strategy for prostate health 

 

References:

1. Richman EL et al. Intakes of meat, fish, poultry, and eggs and risk of prostate cancer progression. Am J Clin Nutr. 2009 Dec 30. [Epub ahead of print]

2. Sinha R et al. Meat and meat-related compounds and risk of prostate cancer in a large prospective cohort study in the United States. Am J Epidemiol. 2009 Nov 1;170(9):1165-77. Epub 2009 Oct 6.

3. http://www.foodnavigator.com/Science-Nutrition/Meat-not-linked-to-prostate-cancer-recurrence-risk

4. R. W.-L. Ma, K. Chapman. A systematic review of the effect of diet in prostate cancer prevention and treatment. J Hum Nutr Diet, 22, pp. 187–199 

Diet high in omega-6 fats increases risk for ulcerative colitis

Ulcerative colitis falls under the category of inflammatory bowel diseases (IBD). It is an autoimmune disease in which excessive inflammation kills cells in the lining of the colon, leaving ulcers behind. Ulcerative colitis is a chronic condition that commonly causes abdominal pain and bloody diarrhea, and it carries with it an increased risk of colorectal cancer. In some severe cases, the colon must be surgically removed. Clearly, this condition also causes a great deal of emotional trauma.1

Recent studies have identified dietary patterns that may predispose individuals to ulcerative colitis. High intake of fats, refined sugars, and fried potato products were positively associated with ulcerative colitis, and fruit consumption was found to be protective.2

Fruit

Most recently, omega-6 fatty acids have been investigated. Omega-6 fatty acids are essential fatty acids, meaning that we must obtain them from our diet for good health, but the typical American diet contains an excessive amount of omega-6, which can produce a pro-inflammatory environment in the body.

Linoleic acid is an omega-6 fat that is highly concentrated in red meat, cooking oils, and margarines. In the digestive system, linoleic acid is metabolized into arachidonic acid, which incorporates into cell membranes of the colon. When arachidonic acid is broken down further, its products are pro-inflammatory – these products are found in excess in the intestinal cells of patients with ulcerative colitis. For these reasons, scientists believed that excess linoleic acid might be linked to ulcerative colitis risk.

Fries

A prospective study of over 200,000 men and women in Europe found that the subjects who consumed the highest levels of omega-6 linoleic acid were 2.5 times more likely to be diagnosed with ulcerative colitis. The researchers also found a negative association between the omega-3 fatty acid DHA and ulcerative colitis – subjects in the highest level of DHA intake decreased their risk by 77%.3

Avoiding excess levels of linoleic acid is simply accomplished by eating a diet that is based on whole plant foods and limits animal products and added fats. A diet of natural whole foods provides us with omega-6 fatty acids in appropriate amounts - not in excess – producing an anti-inflammatory environment.

For those who already have ulcerative colitis, it is important to know that the condition can be improved and sometimes completely resolved with dietary changes – conventional treatment of IBD often includes immunosuppressive drugs with dangerous side effects.  Dr. Fuhrman outlines specific dietary recommendations for sufferers of IBD in his Inflammatory Bowel Disease newsletter

References:

1. http://www.nlm.nih.gov/medlineplus/ulcerativecolitis.html#cat59

2. Shah S. Dietary Factors in the Modulation of Inflammatory Bowel Disease Activity. MedGenMed 2007; 9(1):60

3. Tjonneland A et al. Linoleic acid, a dietary n-6 polyunsaturated fatty acid, and the aetiology of ulcerative colitis: a nested case-control study within a European prospective cohort study. IBD in EPIC Study Investigators. Gut. 2009 Dec;58(12):1606-11. Epub 2009 Jul 23.

http://www.reuters.com/article/idUSTRE5B15S720091202

For breast cancer survivors, soy is protective and alcohol is harmful

 Two new studies have examined the effects of certain dietary factors on recurrence of breast cancer in survivors. Soy had protective effects, and alcohol had detrimental effects.  Read the full article on DrFuhrman.com.

Soy and breast cancer recurrence

Edamame

Some individuals suspected and even promoted the idea that soy was potentially dangerous with regard to breast cancer risk, because of the phyto-estrogenic compounds it contains. However, in Asian countries where soy is a staple food, rates of breast cancer were much lower than those in the U.S. This paradox launched much debate and hundreds of studies on the relationship between soy and breast cancer.

A review of the most recent clinical studies on this subject supports a protective effect of soy:

  •  2006: A meta-analysis in the Journal of the National Cancer Institute examining data from 18 studies on soy and breast cancer that were published between 1978 and 2004 concluded that soy overall has a protective effect.1
  • 2008: A meta-analysis in the British Journal of Nutrition compiling data from 8 different studies (not included in the 2006 meta-analysis) also concluded that soy consumption decreases breast cancer risk. These effects were dose-dependent – a 16% reduced risk for each 10 mg of soy isoflavones consumed daily.2

In spite of these clear documented results, the myth that soy contributes to breast cancer has persisted. Plus, many scientists and physicians continue to doubt the safety of soy for current or previous breast cancer patients, because of soy’s phytoestrogen content.

A new study of breast cancer survivors has shown that these doubts are unwarranted too. Premenopausal breast cancer survivors who consumed more soy had a 23% reduced risk of recurrence.3

Which soy products are most beneficial?

Cruciferous vegetables are the most powerful anti-cancer foods. In addition, Dr. Fuhrman also recommends consuming a variety of beans, including soybeans, as components of an anti-cancer diet. Soybeans may be consumed as edamame (whole soybeans), or in minimally processed forms such as unsweetened soymilk, tofu, and tempeh. As little as 10 mg of soy isoflavones consumed per day has a protective effect with regard to breast cancer – this equates to approximately 1 ounce of one of these soy foods.

 

Alcohol and breast cancer recurrence

Wine

In contrast to the mainstream assumption that alcohol is heart healthy, even moderate amounts of alcohol are associated with increased risk for breast cancer.4

The current study of breast cancer survivors showed that women who consumed 3-4 alcoholic drinks per week were 34% more likely to experience a recurrence than the women who had less than 1 drink per week. This study was presented last week at the San Antonio Breast Cancer Symposium.5

Alcohol has no beneficial effect on the cardiovascular system, it only inhibits the blood’s clotting mechanisms. Since breast cancer is the second leading cause of death in women (second to cardiovascular disease), Dr. Fuhrman recommends minimizing alcohol consumption in order to reduce this risk.

Read the full article here.

Read “Dr. Fuhrman on Breast Cancer” to learn more diet and lifestyle strategies for breast cancer prevention.

 

References:

1. Trock BJ et al. Meta-analysis of soy intake and breast cancer risk. J Natl Cancer Inst. 2006 Apr 5;98(7):459-71.

2. Wu AH et al. Epidemiology of soy exposures and breast cancer risk. British Journal of Cancer (2008) 98, 9– 14

3. Guha N et al. Soy isoflavones and risk of cancer recurrence in a cohort of breast cancer survivors: the Life After Cancer Epidemiology study. Breast Cancer Res Treat. 2009 Nov;118(2):395-405. Epub 2009 Feb 17.

4. Lew JQ et al. Alcohol and risk of breast cancer by histologic type and hormone receptor status in postmenopausal women: the NIH-AARP Diet and Health Study. Am J Epidemiol. 2009 Aug 1;170(3):308-17. Epub 2009 Jun 18.

5. http://www.medpagetoday.com/MeetingCoverage/SABCS/17444


 

Dr. Fuhrman warns: DO NOT take multivitamins or prenatal vitamins that contain folic acid

Folic acid supplementation is dangerous – especially for pregnant women

In a 10-year study,1,2 scientists found that women who take multivitamins containing folic acid increase their breast cancer risk by 20-30%.

Even more alarming are the associations between supplemental folic acid during pregnancy and death from breast cancer,8 and asthma and respiratory tract infections in children.5-6

Read full article

broccoli

Folic acid is the synthetic form of folate, a B vitamin, which is abundant in green vegetables. Folate protects against birth defects known as neural tube defects (NTDs). Pregnant women could safely increase their folate status and prevent NTDs by eating green vegetables, but instead they are instructed to take folic acid supplements, putting them and their children at risk. Folic acid supplements are not a substitute for folate-containing green vegetables – there are inverse associations between maternal vegetable intake and childhood cancers.12-13

Unlike synthetic folic acid, folate obtained from food sources – especially green vegetables – protects against breast and prostate cancer.

There is inverse relationship between dietary folate intake and breast and prostate cancer.14,3 Chemical differences between folate and folic acid translate into differences in uptake and processing of these two substances by the cells in the intestinal wall – excess folic acid in the circulation can occur. Luckily, folate from food comes naturally packaged in balance with other micronutrients and the body regulates its absorption.9

Rich sources of food folate

As a reference point, the U.S. RDA for folate is 400μg. Below is the approximate folate content for a 100-calorie serving.8

Spinach, raw

843 μg

Romaine lettuce

800 μg

Asparagus, cooked

750 μg

Mustard greens, raw

700 μg

Collards, raw

550 μg

Broccoli, cooked

300 μg

Edamame

225 μg

Chickpeas

150 μg

Papaya

90 μg

Orange

70 μg

Blackberries

55 μg

Avocado

50 μg

Sunflower seeds

40 μg

Quinoa, cooked

35 μg

Additional foods listed in full article

Clearly, we do not need synthetic folic acid supplements to meet our daily folate requirements.

Dr. Fuhrman’s Gentle Care Formula Multivitamin does not contain folic acid

Supplemental folic acid has also been linked to prostate cancer3, colorectal cancer4, and overall cancer mortality.7 Because folate is abundant in the nutritarian diet, and synthetic folic acid is so potentially dangerous, folic acid is not included in Dr. Fuhrman’s Gentle Care multivitamin.

Dr. Fuhrman does not recommend prenatal vitamins because of the potentially harmful ingredients, such as folic acid.

Dr. Fuhrman’s special recommendations for pregnant women:

(See full article for references)

 

Antibiotic overuse is a danger to public health, and especially dangerous for pregnant women

 The European Center for Disease Prevention and Control (ECDC) is warning the public that antibiotic overuse has the potential to cripple the entire modern medical system.1

spilled pills

Despite public awareness campaigns about responsible use of antibiotics, antibiotics continue to be prescribed for colds, flu, sinusitis and bronchitis. Medical authorities continually warn doctors that antibiotics should NOT be prescribed for routine bronchitis and sinusitis. The scientific studies show that they do not improve outcome.  These are infections that, except in rare instances, are caused by viruses, not bacteria. Plus, these infections resolve by strengthening the immune system with excellent nutrition, not weakening it and creating more serious future infections that can develop as a result of antibiotic use

As inappropriate use of antibiotics continues, more and more resistant microbes will spread, and antibiotics will consequently become less effective. Drug-resistant bacteria emerge from mutations – microbes are constantly mutating, and these mutations eventually cause resistance to antibiotics.

Drug-resistant infections kill about 19,000 people each year in the U.S., and are a significant cost to the healthcare system.1 Drug-resistant bacteria have the potential to compromise our ability to perform procedures for which antibiotics are crucial.

"If this wave of antibiotic resistance gets over us, we will not be able to do organ transplants, hip replacements, cancer chemotherapy, intensive care and neonatal care for premature babies."

- Dominique Monnet, ECDC scientific advice unit1

The dangers of antibiotic overuse extend further than infection alone – all drugs have side effects, and antibiotics are especially toxic, and their side-effects are significant. . Antibiotics kill bacteria indiscriminately – therefore they disrupt our microbial balance, killing the beneficial flora that aid in digestion and absorption of nutrients and keep other microbes at bay. Children who are prescribed more antibiotics in the first year of life are more likely to be diagnosed with asthma and allergies during childhood.3  Antibiotic use has even been linked to a higher incidence of breast cancer.4   

Antibiotics are one of the most common medications taken by pregnant women, and a new study has made connections between antibiotics use during pregnancy and incidence of birth defects. Sulfonamides and nitrofurantoins were each associated with several birth defects – women who took these classes of antibiotics while pregnant were 2-4 times as likely to give birth to a baby with a heart defect. The more commonly used penicillins, eythromycins, and cephalosporins were each associated with at least one birth defect.2  

Antibiotics are not harmless medications and should be reserved for severe (and carefully documented) bacterial infections - infections that would seriously threaten the health of the patient if left untreated. We have powerful immune systems which, when supported by excellent nutrition, will clear the more moderate infections without help from drugs. 

 

References:

  1. http://www.reuters.com/article/healthNews/idUSTRE5A927820091110
  2. Crider KS et al. Antibacterial medication use during pregnancy and risk of birth defects: National Birth Defects Prevention Study. Arch Pediatr Adolesc Med. 2009 Nov;163(11):978-85.
  3. Foliaki S et al. Antibiotic use in infancy and symptoms of asthma, rhinoconjunctivitis, and eczema in children 6 and 7 years old: International Study of Asthma and Allergies in Childhood Phase III. J Allergy Clin Immunol. 2009 Nov;124(5):982-9.
  4. Velicer CM et al. Antibiotic Use in Relation to the Risk of Breast Cancer. JAMA. 2004;291:827-835.

 

Excess body fat responsible for over 100,000 cancer cases per year

 

obese man

(Image credit: Tobyotter @Flickr)

The American Institute for Cancer Research is currently holding their annual conference on Food, Nutrition, Physical Acitity, and Cancer in Washington D.C. Yesterday AICR held a news conference and announced new estimates based on the work of their researchers - that excess body fat is responsible for 100,500 cancer cases in the U.S. each year. 

 

100,500 – this equates to:

49% of endometrial cancers

35% of esophageal cancers

24% of kidney cancers

21% of gallbladder cancers

17% of breast cancers

9% of colorectal cancers

ALL preventable!

 

Also in this news conference, AICR expressed their concerns about the lack of public awareness about the link between obesity and cancer.

Scientists suggest that this link between obesity and cancer is due to excess fat increasing levels of sex steroids and other hormones that promote cancer growth. Also the reduced immune function and elevated oxidative stress associated with excess body fat may contribute to the initiation of cancer by damaging DNA.

AICR presented additional data showing that overweight and obesity also decrease rates of survival in those already diagnosed with cancer.

Overall, the message is that maintaining a healthy weight with nutritional excellence and exercise will dramatically (even more dramatically than previously thought) reduce your risk of cancer.

 

Reference: http://www.aicr.org/site/News2/153571380?abbr=pr_&page=NewsArticle&id=17333&news_iv_ctrl=1102

 

Breast cancer and prostate cancer: Early detection saves lives?

If breast and prostate cancer were detected early, via mammograms and PSA tests, treatment could begin earlier, and lives would be saved – right?

Wrong, according to a recent article in the Journal of the American Medical Association that examined incidence and mortality rates for breast and prostate cancer over the past 20 years.1

Why? The authors think that we are in a state of “overdiagnosis” – that many slow-growing, non-threatening tumors are being detected and treated; at the same time, the more dangerous and aggressive cancers may be missed because they can grow and become lethal in the time interval between screenings, and by then treatment will not work. Overall, the mortality rates of breast and prostate cancer have not decreased significantly in the past 20 years.

Still, are there sound reasons to skip these screenings altogether? You decide…

Mammograms: Following detection of a tumor, 80% of biopsies are negative, and the risk of false positives is very high in women under 50.2 This equates to thousands and thousands of unnecessary surgical procedures are performed on women after they have had a suspicious mammogram result. In a recent review, it was estimated that for every 2000 women screened, one will benefit, more than 200 will have a false positive result, and 10 healthy women will be treated unnecessarily.3 And those women who are treated for cancers earn many chemotherapy-related deaths counterbalancing any life-span enhancements in those treated.4 PSA tests: About 70% of men who have elevated PSA levels do not actually have cancer.1 And the side effects of the associated treatments include bowel, urinary, and sexual dysfunction.5 Additionally, a 9-year study in Sweden showed that men who had undergone endocrine treatment for prostate cancer were at a 20-30% increased risk of cardiovascular diseases and death from myocardial infarction.6 

With both of these tests, detection of low-risk cancers also causes much undue emotional trauma to patients and their families.

woman crying

 

(image credit: Samat Jain @Flickr)

The American Cancer Society now advises:

“There are some cancers for which we don’t currently recommend screening, such as prostate cancer, because the benefits are unclear or unproven.”7 

The authors of the JAMA article offer strategies for the scientific and medical communities: to find specific biomarkers that can differentiate high-risk from low-risk cancers, and to target high-risk individuals with preventive treatments.

I offer a strategy to you: Be proactive – reduce your risk of breast and prostate cancer. Practice prevention by maintaining a healthy weight and eating an anti-cancer diet - a high-nutrient diet rich in protective phytochemicals from cruciferous vegetables, leafy greens, and berries, and minimizing or eliminating browned foods, animal products, and refined flour and sugar. Taking sufficient Vitamin D is also important. You can read more about the strong connections between diet and cancer in my article “Eat for Health – the Anti-Cancer Diet."

 

References:

1. Esserman L, Shieh Y, Thompson I. JAMA. 2009 Oct 21;302(15):1685-92. Rethinking screening for breast cancer and prostate cancer.

2. Wright CJ, Mueller CB. Screening mammography and public health policy: the need for perspective. Lancet 1995;346(8966(:29-32.

3. Gøtzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD001877.

4. Rock E, De Michele. A Nutritional approaches to late toxicities of adjuvant chemotherapy in breast cancer survivors. J Nutr 2003 Nov;133(11 Suppl 1):3785S-3793S.  

5. Albertsen PC, Hanley JA, Fine J. 20-year outcomes following conservative management of clinically localized prostate cancer. JAMA 2005;293 (17):2095-2101

6. M. Van Hemelrijck et al. 1BA Increased cardiovascular morbidity and mortality following endocrine treatment for prostate cancer: an analysis in 30,642 men in PCBaSe Sweden. EJC Supplements - September 2009 (Vol. 7, Issue 3, Page 1, DOI: 10.1016/S1359-6349(09)72024-5)

7.http://www.cancer.org/docroot/MED/content/MED_2_1x_A_Special_Message_from_CEO_John_Seffrin_PhD_on_Cancer_Screening.asp)

 

Insulin May Pose Increased Cancer Risk for Diabetics

Image of a hand holding a insulin needle with a yellow tip.

Diabetics who take insulin-type drugs appear to be more prone to increased rates of cancer diagnosis, according to several prominent researchers who spoke at a press conference at the annual meeting of the European Association for the Study of Diabetes. The concerns were first raised by German researchers in a data base analysis submitted in 2008, which linked an insulin-based medication to increased cancer risk. The researchers generally agreed that insulins may promote cancer through their actions as growth factors.

The message here is that when you follow my nutritarian diet-style and protocols for diabetes, a Type 2 diabetic would not need an insulin-based medication. In fact, over 60% of diabetics who follow my protocol no longer need any medication at all. A Type 1 diabetic following my nutritarian diet-style would only have half the insulin requirements, without the highs and lows, which would signifacantly extend their lifespan and reduce complications.

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Walnuts are So Good for You (and Mice)

A diet high in walnuts may significantly decrease a person's risk of breast cancer, according to a study conducted by researchers from the Marshall University School of Medicine and presented at a conference of the American Association for Cancer Research.

A chemical analysis showed that omega-3 fatty acids, antioxidants and phytosterols contained in walnuts all contributed to the mice's tumor resistance.

"The omega-3 fatty acid, the phytosterols and antioxidants individually have been shown to prevent or delay cancers" Hardman said. "So if you add them all together, it looks like it may be really good."

In another study, Hardman found that feeding mice a diet enriched with the same omega-3 content as that contained in the walnut dose given in the current study was not as effective as eating the whole walnut.

"It did reduce cancer incidents," she said, "but not as dramatically as the walnut-containing diet did. So it's something else other than the omega-3 in the walnut that's contributing to the suppression of cancers."

Hardman noted that the effect of the whole food was probably greater than the sum of its parts.

With dietary interventions, you see multiple mechanisms when working with the whole food, she said.

For 20 years, I’ve been telling people to eat walnuts as a superfood; now we know it’s good for mice too.

Nuts and seeds contain plant sterols and other phytochemical compounds that we are just beginning to understand their benefits. Eating the whole food guarantees we are getting all of the known and unknown beneficial micronutrients contained in these superfoods.

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