Body fat and disease: How much body fat can I lose in one day?

Body fat is not an inert deposit of energy. It can be seen as a distributed endocrine organ. Body fat cells, or adipocytes, secrete a number of different hormones into the bloodstream. Major hormones secreted by adipose tissue are adiponectin and leptin.

Estrogen is also secreted by body fat, which is one of the reasons why obesity is associated with infertility. (Yes, abnormally high levels of estrogen can reduce fertility in both men and women.) Moreover, body fat secretes tumor necrosis factor-alpha, a hormone that is associated with generalized inflammation and a number of diseases, including cancer, when in excess.

The reduction in circulating tumor necrosis factor-alpha and other pro-inflammatory hormones as one loses weight is one reason why non-obese people usually experience fewer illness symptoms than those who are obese in any given year, other things being equal. For example, the non-obese will have fewer illness episodes that require full rest during the flu season. In those who are obese, the inflammatory response accompanying an illness (which is necessary for recovery) will often be exaggerated.

The exaggerated inflammatory response to illness often seen in the obese is one indication that obesity in an unnatural state for humans. It is reasonable to assume that it was non-adaptive for our Paleolithic ancestors to be unable to perform daily activities because of an illness. The adaptive response would be physical discomfort, but not to the extent that one would require full rest for a few days to fully recover.

Inflammation markers such as C-reactive protein are positively correlated with body fat. As body fat increases, so does inflammation throughout the body. Lipid metabolism is negatively affected by excessive body fat, and so is glucose metabolism. Obesity is associated with leptin and insulin resistance, which are precursors of diabetes type 2.

Some body fat is necessary for survival; that is normally called essential body fat. The table below (from Wikipedia) shows various levels of body fat, including essential levels. Also shown are body fat levels found in athletes, as well as fit, “not so fit” (indicated as "Acceptable"), and obese individuals. Women normally have higher healthy levels of body fat than men.

If one is obese, losing body fat becomes a very high priority for health reasons.

There are many ways in which body fat can be measured.

When one loses body fat through fasting, the number of adipocytes is not actually reduced. It is the amount of fat stored in adipocytes that is reduced.

How much body fat can a person lose in one day?

Let us consider a man, John, whose weight is 170 lbs (77 kg), and whose body fat percentage is 30 percent. John carries around 51 lbs (23 kg) of body fat. Standing up is, for John, a form of resistance exercise. So is climbing stairs.

During a 24-hour fast, John’s basal metabolic rate is estimated at about 2,550 kcal/day. This is the number of calories John would spend doing nothing the whole day. It can vary a lot for different individuals; here it is calculated as 15 times John’s weight in lbs.

The 2,550 kcal/day is likely an overestimation for John, because the body adjusts its metabolic rate downwards during a fast, leading to fewer calories being burned.

Typically women have lower basal metabolic rates than men of equal weight.

For the sake of discussion, we expect each gram of John’s body fat to contribute about 8 kcals of energy, assuming a rate of conversion of body fat to calories of about 90 percent.

Thus during a 24-hour fast John burns about 318 g of fat, or about 0.7 lbs. In reality, the actual amount may be lower (e.g., 0.35 lbs), because of the body's own down-regulation of its basal metabolic rate during a fast. This down-regulation varies widely across different individuals, and is generally small.

Many people think that this is not much for the effort. The reality is that body fat loss is a long term game, and cannot be achieved through fasting alone; this is a discussion for another post.

It is worth noting that intermittent fasting (e.g., one 24-hour fast per week) has many other health benefits, even if no overall calorie restriction occurs. That is, intermittent fasting is associated with health benefits even if one fasts every other day, and eats twice one's normal intake on the non-fasting days.

Some of the calories being burned during John's 24-hour fast will be from glucose, mostly from John’s glycogen reserves in the liver if he is at rest. Muscle glycogen stores, which store more glucose substrate (i.e., material for production of glucose) than liver glycogen, are mobilized primarily through anaerobic exercise.

Very few muscle-derived calories end up being used through the protein and glycogen breakdown pathways in a 24-hour fast. John’s liver glycogen reserves, plus the body’s own self-regulation, will largely spare muscle tissue.

The idea that one has to eat every few hours to avoid losing muscle tissue is complete nonsense. Muscle buildup and loss happen all the time through amino acid turnover.

Net muscle gain occurs when the balance is tipped in favor of buildup, to which resistance exercise and the right hormonal balance (including elevated levels of insulin) contribute.

One of the best ways to lose muscle tissue is lack of use. If John's arm were immobilized in a cast, he would lose muscle tissue in that arm even if he ate every 30 minutes.

Longer fasts (e.g., lasting multiple days, with only water being consumed) will invariably lead to some (possibly significant) muscle breakdown, as muscle is the main store of glucose-generating substrate in the human body.

In a 24-hour fast (a relatively short fast), the body will adjust its metabolism so that most of its energy needs are met by fat and related byproducts. This includes ketones, which are produced by the liver based on dietary and body fat.

How come some people can easily lose 2 or 3 pounds of weight in one day?

Well, it is not body fat that is being lost, or muscle. It is water, which may account for as much as 75 percent of one’s body weight.

References:

Elliott, W.H., & Elliott, D.C. (2009). Biochemistry and molecular biology. New York: NY: Oxford University Press.

Fleck, S.J., & Kraemer, W.J. (2004). Designing resistance training programs. Champaign, IL: Human Kinetics.

Large, V., Peroni, O., Letexier, D., Ray, H., & Beylot, M. (2004). Metabolism of lipids in human white adipocyte. Diabetes & Metabolism, 30(4), 294-309.

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Asparagus tips madam? We do composting tips too...

 

Market trader Julie Lightly at Queens Market in Newham, east London

Photo credit: Geoff Caddick/PA

Interesting research from WRAP reveals that over forty percent of us believe that because food is biodegradable, it is harmless when it gets thrown out and sent to landfill and are not aware that it can produce methane, a powerful global warming gas which damages the environment.  Of course the same waste composted at home produces no methane and provides free fertiliser and soil improver for our gardens.

In a drive to raise awareness, market traders across the country are to back a campaign to get Britain composting, thanks to a partnership between Recycle Now and the National Market Traders’ Federation that launched this week at Queen’s Market in Newham.  From today, traders will be offering green tips to their customers along with their purchases, to encourage them to compost household waste such as fruit and vegetable peelings, instead of throwing it away.  The  "Ask me about composting" programme will then roll out across the UK over the next few months.

Julie Lightly, a fruit and vegetable market trader at Queen’s Market said:

“It’s great that we are now talking to our customers about composting. At Queen’s Market we already talk to customers about other green issues such as recycling, so this is a natural progression. I am sure customers will really warm to the advice we will be giving as many are already very interested in helping to do their bit for the environment. We hope to turn our market into the greenest in the country and show other markets and their traders how simple it is to offer our customers a little bit extra.”

Well I for one will be keeping a close eye on when the initiative reaches Bury St Edmunds and will catch up with my favourite fruit and veg stall - pictured below - nearer the time,  

If you haven't been to our local market,  I'd recommend it, especially as it was listed in The Guardian's 10 of the best markets in England.  It really does come highly recommended.

 

In the meantime anyone wishing to find out more about composting and how to get started should visit www.recyclenow.com/compost or call their infoline on 0845 600 0323.

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A four-leafed clover for Suffolk's 'Green Oscars'

A very large four leafed clover, from a secret location in Suffolk.

It might just come in handy for March.

I am really proud to share the exciting news that I've been shortlisted for one of Suffolk's prestigious Creating the Greenest County awards.

So how excited am I!

Well, I know I said I'm proud...but the truth is I am totally chuffed to bits.

Affectionately called the Green Oscars, the Creating the Greenest County awards are now in their third consecutive year, celebrating the efforts of individuals, businesses and communities who support Suffolk's aspirations to engage the whole county in responding to climate change.  And I've been shortlisted in the Community: Communication and Events category.

At first I felt rather shy about entering the awards.  Then my husband reminded me about the number of times I've forgotten to wash his pants because instead of getting on with things at home, I've been off doing things like this:

and trekking around the region to do this

or going on a sponsored bin round to do this

and helping my local community do this..

...and helping other lovely people achieve this

..then talking about it in places like this!

Phew! But why?

It's because I want to encourage more people to reduce the amount of this!

and commit to making best use of places like this

I hoped that by entering the awards, it would help raise the profile of waste reduction in Suffolk, encouraging individuals and communities to rise to the occasion by boosting our expectations of what our society is capable of achieving.

So after such a busy year promoting practical ways of reducing waste, it really is a privilege to have been shortlisted for the Creating the Greenest County awards. However, as far as the results are concerned, I'm afraid I'm going to have to leave you on tenterhooks because they won't be announced until three weeks time, at a Gala dinner on the 18th March when I'll get to mingle with the Suffolk's "greenerati" .

In the meantime, I've got plenty to get on with, including our street's Waste Reduction Fortnight that kicks off on Monday.  As well as my own challenge, I'll be helping our local school tackle their rubbish too.

And I'll also be talking even more rubbish later, chatting with BBC Radio Suffolk's forever effervescent James Hazell  (pictured below with his studio recycling bin and producer Sal, who is just as sparkly ).  If all goes to plan it should be about 9.40am this morning.

I still haven't quite got used to this radio lark you know.  I may not be as nervous as I once was, but I still have to take my shoes off for fear of the audience hearing me pacing up and down my living room.

And I promise, once the interview is over I will finally get around to this week's laundry.....otherwise it won't be just my husband who's demanding clean pants....the kids will be in tow too.

At least I'm reducing their carbon footprint, well that's my excuse anyway.  It's far easier doing the laundry in one go in the style of just-in-time delivery.

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For more information about all the shortlisted entrants, please visit www.greensuffolk.org.

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The Rubbish Diet Challenge: Week 7, The Big Declutter

Whoopadey woo, I've finally made it out from my piles upon piles and onto the blog to give you the big declutter update.  And look at the treasure I've found, a pair of sparkly shoes, which were stashed away in a box on top of the wardrobe.  They were placed there for safe keeping, but I forgot where I put them and have spent the last two years scratching my head wondering if I'm going mad.

We only live in a three bedroom house,  so there's hardly any room for stuff to go amiss, yet in the last couple of weeks, I've also uncovered one of my favourite umberellas, three more pairs of shoes, an MP3 player and a radio alarm.  It really is like Christmas all over again.

Now that I've found my rewards from my decluttering manoeuvres, it's over to you to see what you can find in your own little treasure trove of stuff that's tucked away or piled up high behind every cupboard and door in your home.

Yes, welcome to Week 7 of the Rubbish Diet challenge, where after six weeks of tackling your everyday rubbish, it's time to uncover the things that are wasting away in your clutter hotspots.

You'll find all you need in this week's guide, which is now published online at:

http://tinyurl.com/TheRubbishDietWeek7

My goodness, can it really be Week 7 already.  That can only mean one thing... that there's just one week to go until I ask you to attempt a Zero Waste Week.

Cor blimey!  Well, I wouldn't worry about that now, you'll be far too busy working out what to do with the bits and bobs you discover in your big sort out.

And as for me, I'm going to slip on my sparkly shoes and treat myself to a nice glass of wine then read the book that I rescued from a pile of stuff that had been crammed into a cupboard in the bedroom.

You'll never guess what it's called.....here's a clue!

You might snigger but it's never too late.  I might have made great progress already but Clare Baker from ClutterClearing writes on her website that as I've kept hold of  my clutter for a  year, it could take me 3 months to completely clear and organise it.   It's worth popping over to see how long yours will take too...assuming you've got some of course.

Oh well, it looks like I'll be busy for another month yet.  See you next week then, when I'll be sure to pop up for air!

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Fill and go with Holland & Barrett

Wandering through the town centre today in Bury St Edmunds, I noticed that the health food and natural remedies store Holland & Barrett had finally moved from their side-street location into a prime hotspot in the Buttermarket, slap bang next to Marks & Spencer.

Despite being in a rush, I couldn't resist popping in to see what they had on offer and I'm glad I did, because as I browsed the shelves, I was delighted to see their brand new refill concept called "Fill and Go", which is a self-service facility for dried cereals as well as a fabulous range of olive oils and vinegars.

Empty bottles are available for customers to fill with their choice of olive oil and vinegar and customers are encouraged to return their empty bottles in exchange for a discount on their next purchase, which is brilliant news.  Plastic containers are also provided for  loose cereal products and fruits.  And even though these are the more flimsy "disposable" type, there's no reason why they can't be returned for a top-up when empty.

The "Fill and Go" service is currently a pilot project that is unique to Bury St Edmunds' brand-new store and if successful it will be rolled out elsewhere.

However, Holland & Barrett has also introduced wider changes that will please the waste-free consumer, including the decision to become a plastic bag-free zone across all stores in the UK.

Having said goodbye to plastic bags, customers are now encouraged to use their own reusable bags each time they shop or to buy one of the store's bags-for-life, the profits of which go to The Large Blue butterfly project, a conservation programme to help reintroduce the Large Blue butterfly species back into the UK.

Isn't it amazing what you find out from just popping into a shop for a bit of a rece and the above examples are just some of the more obvious changes that are taking place in-store.  Talking to the area manager today,  subtle differences have been  introduced too, with decisions to incorporate recycled plastic into Holland & Barrett's products as well as shrinking the size of  labels and ensuring that all their consumer packaging is recyclable by 2012.  The organisation's Plan-it-Green policy illustrates even more examples of sustainable operations elsewhere in the business from head office through to store management.

It really is encouraging to witness such changes on the high street and it is no surprise that with Holland & Barrett's history of ethical purchasing that they are one of the forerunners in the revolution to reduce waste.

I now hope that lots more high-street retailers - including national chains and independents - will continue to raise their game too.  It would be great to think that what I saw today is a realistic glimpse of the future.

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What should be my HDL cholesterol?

HDL cholesterol levels are a rough measure of HDL particle quantity in the blood. They actually tell us next to nothing about HDL particle type, although HDL cholesterol increases are usually associated with increases in LDL particle size. This a good thing, since small-dense LDL particles are associated with increased cardiovascular disease.

Most blood lipid panels reviewed by family doctors with patients give information about HDL status through measures of HDL cholesterol, provided in one of the standard units (e.g., mg/dl).

Study after study shows that HDL cholesterol levels, although imprecise, are a much better predictor of cardiovascular disease than LDL or total cholesterol levels. How high should be one’s HDL cholesterol? The answer to this question is somewhat dependent on each individual’s health profile, but most data suggest that a level greater than 60 mg/dl (1.55 mmol/l) is close to optimal for most people.

The figure below (from Eckardstein, 2008; full reference at the end of this post) plots incidence of coronary events in men (on the vertical axis), over a period of 10 years, against HDL cholesterol levels (on the horizontal axis). Note: IFG = impaired fasting glucose. This relationship is similar for women, particularly post-menopausal women. Pre-menopausal women usually have higher HDL cholesterol levels than men, and a low incidence of coronary events.

From the figure above, one can say that a diabetic man with about 55 mg/dl of HDL cholesterol will have approximately the same chance, on average, of having a coronary event (a heart attack) as a man with no risk factors and about 20 mg/dl of HDL cholesterol. That chance will be about 7 percent. With 20 mg/dl of HDL cholesterol, the chance of a diabetic man having a coronary event would approach 50 percent.

We can also conclude from the figure above that a man with no risk factors will have a 5 percent chance of having a coronary event if his HDL cholesterol is about 25 mg/dl; and about 2 percent if his HDL cholesterol is greater than 60 mg/dl. This a 60 percent reduction in risk, a risk that was low to start with because of the absence of risk factors.

HDL cholesterol levels greater than 60 are associated with significantly reduced risks of coronary events, particularly for those with diabetes (the graph does not take diabetes type into consideration). Much higher levels of HDL cholesterol (beyond 60) do not seem to be associated with much lower risk of coronary events.

Conversely, a very low HDL cholesterol level (below 25) is a major risk factor when other risk factors are also present, particularly: diabetes, hypertension (high blood pressure), and familial hypercholesteromia (gene-induced very elevated LDL cholesterol).

It is not yet clear whether HDL cholesterol is a cause of reduced cardiovascular disease, or just a marker of other health factors that lead to reduced risk for cardiovascular disease. Much of the empirical evidence suggests a causal relationship, and if this is the case then it may be a good idea to try to increase HDL levels. Even if HDL cholesterol is just a marker, the same strategy that increases it may also have a positive impact on the real causative factor of which HDL cholesterol is a marker.

What can one do to increase his or her HDL cholesterol? One way is to replace refined carbs and sugars with saturated fat and cholesterol in one’s diet. (I know that this sounds counterintuitive, but seems to work.) Another is to increase one’s vitamin D status, through sun exposure or supplementation.

Other therapeutic interventions can also be used to increase HDL; some more natural than others. The figure below (also from Eckardstein, 2008) shows the maximum effects of several therapeutic interventions to increase HDL cholesterol.

Among the therapeutic interventions shown in the figure above, taking nicotinic acid (niacin) in pharmacological doses, of 1 to 3 g per day (higher dosages may be toxic), is by far the most effective way of increasing one’s HDL cholesterol. Only the niacin that causes flush is effective in this respect. No-flush niacin preparations may have some anti-inflammatory effects, but do not cause increases in HDL cholesterol.

Rimonabant, which is second to niacin in its effect on HDL cholesterol, is an appetite suppressor that has been associated with serious side effects and, to be best of my knowledge, has been largely banned from use in pharmaceutical drugs.

Third in terms of effectiveness, among the factors shown in the figure, is moderate alcohol consumption. Running about 19 miles per week (2.7 miles per day) and taking fibrates are tied in forth place.

Many people think that they are having a major allergic reaction, and have a panic attack, when they experience the niacin flush. This usually happens several minutes after taking niacin, and depends on the dose and whether niacin was consumed with food or not. It is not uncommon for one’s entire torso to turn hot red, as though the person had had major sunburn. This reaction is harmless, and usually disappears after several minutes.

One could say that, with niacin: no “pain” (i.e., flush), no gain.

Reference:

von Eckardstein, A. (2008). HDL – a difficult friend. Drug Discovery Today: Disease Mechanisms, 5(3), 315-324.

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Knock Knock: Who's there? It's a rubbish blogger in Brandon!

So today was the day I volunteered to help promote the Seven Suffolk Streets waste reduction project in Crown Street, Brandon, which is the area that's taking part in the Forest Heath district of Suffolk.

And it was a cold, wet and snowy day, certainly not the weather for walking the streets.

But it was a case of simply wrapping up warm and getting on with the job in hand, which was to knock on strangers' doors to raise awareness of the waste reduction project that's taking place in two weeks time.

Despite having my official's badge, I must say it was rather a daunting task.  I might have got used to presenting at conferences and doing radio interviews about ways to reduce waste, but knocking on doors is different.  It's a little more intimate and it's difficult to know how people will react, so I can only admire the other door-knockers who have been pounding the streets over the last two weeks on behalf of the Suffolk Waste Partnership.


But as with most fears, I needn't have worried, because most people who answered my rata-tat-tats or ring-a-ding-dings of the doorbells were interested in the issues and keen to take part.  And in certain cases the team - which was made up of me and David whom I introduced last week - got a very warm welcome indeed, with residents being happy to talk about waste issues that affected them.  It was also a great opportunity to introduce new services that had been rolled out at the local household waste recycling centres.

So after a day out on the streets, I am now glad to be tucked up in the warmth of my home and would like to wish Crown Street lots of luck in the challenge ahead.  I also hope that it's a lot sunnier when David and the other regular door-knockers return to visit the rest of the street soon.

I'll certainly be thinking of them... from the comfort of my blog! 

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Large LDL and small HDL particles: The best combination

High-density lipoprotein (HDL) is one of the five main types of lipoproteins found in circulation, together with very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL), and chylomicrons.

After a fatty meal, the blood is filled with chylomicrons, which carry triglycerides (TGAs). The TGAs are transferred to cells from chylomicrons via the activity of enzymes, in the form of free fatty acids (FFAs), which are used by those cells as sources of energy.

After delivering FFAs to the cells, the chylomicrons progressively lose their TGA content and “shrink”, eventually being absorbed and recycled by the liver. The liver exports part of the TGAs that it gets from chylomicrons back to cells for use as energy as well, now in the form of VLDL. As VLDL particles deliver TGAs to the cells they shrink in size, similarly to chylomicrons. As they shrink, VLDL particles first become IDL and then LDL particles.

The figure below (click on it to enlarge), from Elliott & Elliott (2009; reference at the end of this post), shows, on the same scale: (a) VLDL particles, (b) chylomicrons, (c) LDL particles, and (d) HDL particles. The dark bar at the bottom of each shot is 1000 A in length, or 100 nm (A = angstrom; nm = nanometer; 1 nm = 10 A).

As you can see from the figure, most of the LDL particles shown are about 1/4 of the length of the dark bar in diameter, often slightly more, or about 25-27 nm in size. They come in different sizes, with sizes in this range  being the most common. The smaller and denser they are, the more likely they are to contribute to the formation of atherosclerotic plaque in the presence of other factors, such as chronic inflammation. The larger they become, which usually happens in diets high in saturated fat, the less likely they are to form plaque.

Note that the HDL particles are rather small compared to the LDL particles. Shouldn’t they cause plaque then? Not really. Apparently they have to be small, compared to LDL particles, to do their job effectively.

HDL is a completely different animal from VLDL, IDL and LDL. HDL particles are produced by the liver as dense disk-like particles, known as nascent HDL particles. These nascent HDL particles progressively pick up cholesterol from cells, as well as performing a number of other functions, and “fatten up” with cholesterol in the process.

This process also involves HDL particles picking up cholesterol from plaque in the artery walls, which is one of the reasons why HDL cholesterol is informally called “good” cholesterol. In fact, neither HDL nor LDL are really cholesterol; HDL and LDL are particles that carry cholesterol, protein and fat.

As far as particle size is concerned, LDL and HDL are opposites. Large LDL particles are the least likely to cause plaque formation, because LDL particles have to be approximately 25 nm in diameter or smaller to penetrate the artery walls. With HDL the opposite seems to be true, as HDL particles need to be small (compared with LDL particles) to easily penetrate the artery walls in order to pick up cholesterol, leave the artery walls with their cargo, and have it returned back to the liver.

Interestingly, some research suggests HDL particles that are larger in size, when compared with other HDL particles (not with LDL particles), seem to do a better job than very small HDL particles in terms of reducing risk of cardiovascular disease. It is also possible that a high number of larger HDL particles in the blood is indicative of elevated levels of "effective" HDL particles; i.e., particles that are effective at picking up cholesterol from the artery walls in the first place.

Another interesting aspect of this cycle is that the return to the liver of cholesterol picked up by HDL appears to be done largely via IDL and LDL particles (Elliott & Elliott, 2009), which get the cholesterol directly from HDL particles! Life is not that simple.

Reference:

William H. Elliott & Daphne C. Elliott (2009). Biochemistry and Molecular Biology. 4th Edition. New York: NY: Oxford University Press.

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The Rubbish Diet Challenge, Week 6: Up close and personal

One of these bottle is made from 100% recycled plastic.  Can you spot which one?

Welcome back to the Rubbish Diet Challenge.  It's week 6 already and if you've been busy sorting out how you can reduce waste in the garden, you'll be grateful for an opportunity to relax and pamper yourself indoors.

And there will be the chance to pamper yourself this week, plus time to browse the shelves for some beautiful cosmetics that are kinder to your bin as well as your complexion.  However, there are some hard decisions to make too, thinking about the kinds of things that would normally make you blush.

This week's guide discusses all sorts of things from make-up, to toilet paper and even sanitary products.  And for any guys who are looking in, don't worry, it's not all girlie business: if you have teeth and need to shave,  there are some ideas that might appeal to you too.

Indeed, there should be something for everyone, including tots, kids, the middle-youth and elderly.  And as ever, if you can't recycle it, this guide encourages you to find a reuse for it.   

You'll be surprised what you can reuse these days.  Even toothpaste tubes can be reused, as Mrs Green over at MyZeroWaste discovered recently.  She's even launching a collection point at her local Sainsburys and Tesco this week and will send them to a charity called the Philippines Community Fund.  See her blog for details.

And did you know, surgeries across the UK have the opportunity to collect unused and unopened medicines for medical aid in Africa?  It's all above board and will keep valuable drugs from being buried or burned.

You'll find details about this and lots more in the new online guide for Week 6, called Up close and personal, which is available now at:

http://tinyurl.com/TheRubbishDietWeek6

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Want to improve your cholesterol profile? Replace refined carbs and sugars with saturated fat and cholesterol in your diet

An interesting study by Clifton and colleagues (1998; full reference and link at the end of this post) looked at whether LDL cholesterol particle size distribution at baseline (i.e., beginning of the study) for various people was a determinant of lipid profile changes in each of two diets – one low and the other high in fat. This study highlights a few interesting points made in a previous post, which are largely unrelated to the main goal or findings of the study, but that are supported by side findings:

- As one increases dietary cholesterol and fat consumption, particularly saturated fat, circulating HDL cholesterol increases significantly. This happens whether one is taking niacin or not, although niacin seems to help, possibly as an independent (not moderating) factor. Increasing serum vitamin D levels, which can be done through sunlight exposure and supplementation, are also known to increase circulating HDL cholesterol.

- As one increases dietary cholesterol and fat consumption, particularly saturated fat, triglycerides in the fasting state (i.e., measured after a 8-hour fast) decrease significantly, particularly on a low carbohydrate diet. Triglycerides in the fasting state are negatively correlated with HDL cholesterol; they go down as HDL cholesterol goes up. This happens whether one is taking niacin or supplementing omega 3 fats or not, although these seem to help, possibly as independent factors.

- If one increases dietary fat intake, without also decreasing carbohydrate intake (particularly in the form of refined grains and sugars), LDL cholesterol will increase. Even so, LDL particle sizes will shift to more benign forms, which are the larger forms. Not all LDL particles change to benign forms, and there seem to be some genetic factors that influence this. LDL particles larger than 26 nm in diameter simply cannot pass through the gaps in the endothelium, which is a thin layer of cells lining the interior surface of arteries, and thus do not induce plaque formation.

The study by Clifton and colleagues (1998) involved 54 men and 51 women with a wide range of lipid profiles. They first underwent a 2-week low fat period, after which they were given two liquid supplements in addition to their low fat diet, for a period of 3 weeks. One of the liquid supplements contained 31 to 40 g of fat, and 650 to 845 mg of cholesterol. The other was fat and cholesterol free.

Studies that adopt a particular diet at baseline have the advantage of departing from a uniform diet across conditions. They also typically have one common characteristic: the baseline diet reflects the beliefs of the authors about what an ideal diet is. That is not always the case, of course. If this was indeed the case here, we have a particularly interesting study, because in that case the side findings discussed below contradicted the authors’ beliefs.

The table below shows the following measures for the participants in the study: age, body mass index (BMI), waist-to-hip ratio (WHR), total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol, and three subtypes of high-density lipoprotein (HDL) cholesterol. LDL cholesterol is the colloquially known as the “bad” type, and “HDL” as the good one (which is an oversimplification). In short, the participants were overweight, middle-aged men and women, with relatively poor lipid profiles.

At the bottom of the table is the note “P < 0.001”, following a small “a”. This essentially means that on the rows indicated by an “a”, like the “WHR” row, the difference in the averages (e.g., 0.81 for women, and 0.93 for men, in the WHR row) was significantly different from what one would expect it to be due to chance alone. More precisely, the likelihood that the difference was due to chance was lower than 0.001, or 0.1 percent, in the case of a P < 0.001. Usually a difference between averages (a.k.a. means) associated with a P < 0.05 will be considered statistically significant.

Since the LDL cholesterol concentrations (as well as other lipoprotein concentrations) are listed on the table in mmol/L, and many people receive those measures in mg/dL in blood lipid profile test reports, below is a conversion table for LDL cholesterol (from: Wikipedia).

The table below shows the dietary intake in the low and high fat diets. Note that in the high fat diet, not only is the fat intake higher, but so is the cholesterol intake. The latter is significantly higher, more than 4 times the intake in the low fat diet, and about 2.5 times the recommended daily value by the U.S. Food and Drug Administration. The total calorie intake is reported as slightly lower in the high fat diet than in the low fat diet.

Note that the largest increase was in saturated fat, followed by an almost equally large increase in monounsaturated fat. This, together with the increase in cholesterol, mimics a move to a diet where fatty meat and organs are consumed in higher quantities, with a corresponding reduction in the intake of refined carbohydrates (e.g., bread, pasta, sugar, potatoes) and lean meats.

Finally, the table below shows the changes in lipid profiles in the low and high fat diets. Note that all subtypes of HDL (or "good") cholesterol concentrations were significantly higher in the high fat diet, which is very telling, because HDL cholesterol concentrations are much better predictors of cardiovascular disease than LDL or total cholesterol concentrations. The higher the HDL cholesterol, the lower the risk of cardiovascular disease.

In the table above, we also see that triglycerides are significantly lower in the high fat diet, which is also good, because high fasting triglyceride concentrations are associated with cardiovascular disease and also insulin resistance (which is associated with diabetes).

However, the total and LDL cholesterol were also significantly higher in the high fat compared to the low fat diet. Is this as bad as it sounds? Not when we look at other factors that are not clear from the tables in the article.

One of those factors is the likely change in LDL particle size. LDL particle sizes almost always increase with significant increases in HDL; frequently going up in diameter beyond 26 nm, and thus passing the threshold beyond which an LDL particle can penetrate the endothelium and help form a plaque.

Another important factor to take into consideration is the somewhat strange decision by the authors to use the Friedewald equation to estimate the LDL concentrations in the low and high fat diets. Through the Friedewald equation, LDL is calculated as follows (where TC is total cholesterol):

    LDL = TC – HDL – Triglycerides / 5

Here is one of the problems with the Friedewald equation. Let us assume that an individual has the following lipid profile numbers: TC = 200, HDL = 50, and trigs. = 150. The calculated LDL will be 120. Let us assume that this same individual reduces trigs. to 50, from the previous 150, keeping all of the other measures constant. This is a major improvement. Yet, the calculated LDL will now be 140, and a doctor will tell this person to consider taking statins!

By the way, most people who do a blood test and get their lipid profile report also get their LDL calculated through the Friedewald equation. Usually this is indicated through a "CALC" note next to the description of the test or the calculated LDL number.

Finally, total cholesterol is not a very useful measure, because an elevated total cholesterol may be primarily reflecting an elevated HDL, which is healthy. Also, a slightly elevated total cholesterol seems to be protective, as it is associated with reduced overall mortality and also reduced mortality from cardiovascular disease, according to U-curve regression studies comparing mortality and total cholesterol levels in different countries.

We do not know for sure that the participants in this study were consuming a lot of refined carbohydrates and/or sugars at baseline. But it is a safe bet that they were, since they were consuming 214 g of carbohydrates per day. It is difficult, although not impossible, to eat that many carbohydrates per day by eating only vegetables and fruits, which are mostly water. Consumption of starches makes it easier to reach that level.

This is why when one goes on a paleo diet, he or she reduces significantly the amount of dietary carbohydrates; even more so on a targeted low carbohydrate diet, such as the Atkins diet. Richard K. Bernstein, who is a type 1 diabetic and has been adopting a strict low carbohydrate diet during most of his adult life, had the following lipid profile at 72 years of age: HDL = 118, LDL = 53, trigs. = 45. His fasting blood sugar was reportedly 83 mg/dl. Click here to listen to an interview with Dr. Bernstein on the The Livin' La Vida Low-Carb Show.

The lipid profile improvement observed (e.g., a 14 percent increase in HDL from baseline for men, and about half that for women, in only 3 weeks) was very likely due to an increase in dietary saturated fat and cholesterol combined with a decrease in refined carbohydrates and sugars. The improvement would probably have been even more impressive with a higher increase in saturated fat, as long as it was accompanied by the elimination of refined carbohydrates and sugars from the participants’ diets.

Reference:

Clifton, P. M., M. Noakes, and P. J. Nestel (1998). LDL particle size and LDL and HDL cholesterol changes with dietary fat and cholesterol in healthy subjects. J. Lipid. Res. 39: 1799–1804.

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Decluttering: Poultry efforts in the garden

A scattering of snow doesn't quite cover the mud patch.

Have I ever told you about my guilty pleasure? If I haven't perhaps now is the time to divulge and see if I can get you on board too.

It involves Tom, Barbara, Margot and Jerry and I have to say I love them all. Now before you start thinking it involves anything dodgy like swapping car keys at parties, let me reassure you that it's all clean good fun. Well apart from the odd bit of dirt that is.

I'm referring of course to the comedy series The Good Life, which I started watching thirty five years when I was just six or seven years old. I absolutely adored that series. I loved Margot in her long posh maxi dresses and how she was regularly shocked over Tom and Barbara's latest escapades in growing their own and raising animals in their suburban back garden. I always felt really cosy whenever I watched it.

Fast forward to a 21st century Sunday morning when sat on the sofa in my pyjamas with the laptop to hand, I discovered the series had been uploaded onto YouTube. Well there are some things that are just too hard to resist when everyone else is tucked up in bed, so I immersed myself in the original episodes over a cup of tea. I was quickly joined by my youngest son who's an early bird too, both up us tucked under a blanket, watching the episode of Tom and Barbara raising chickens for the very first time.

For a moment I was distracted by a movement outside and I could see our own hens beating the boundaries for their early morning forage. I then looked over towards our lawn, which now resembles a mud patch and it crossed my mind whether our neighbours could consider us to be the new Tom and Barbara of modern day suburbia. We don't quite have a big veg patch in our garden, but having given the chickens free rein all winter, since they worked out a way to escape the run, it is now looking very much like a farmyard, especially as all our grass has been pecked at and covered in stones and dirt from their scratching habits.

Memories of grass

So what has this episode got to do with cluttering, you might ask yourself.

Well, given that decluttering is about better organisation and tidying up as well as getting rid of surplus things, this weekend I decided to take the bull by the horns and sort out the garden and our crazy chickens. We brushed the scattered stones back into position, raked the mud patch and tidied away leaves and twigs that covered the ground. I even gathered all the kids' broken plastic toys that were used for outdoor play and took them to the recycling centre.

And if by chance you are wondering about the fortune of the chickens, don't worry, although we've decluttered them, we haven't rehomed them or anything like that. They're too adorable and obviously far too useful in the egg laying department. They just needed putting in their place that's all. So we've improved the small matter of security in the chicken run, raising the height of the fence that surrounds it and finding an alternative way of securing the gate. You can just see the new fence at the back of the photo shown below. Hopefully it will now keep the chooks at bay.



So, as we work our way through February with a much neater backdrop, my attention now turns to the dilemma of the mud patch lawn. We had initially considered restoring it, but since watching The Good Life, I am now really inspired to ditch the idea of turf and use the space to grow more vegetables instead.

But the soil in that area is not great, very poor in fact, so I'm going to give serious consideraton to installing a raised bed. It seems a very appealing idea. After all, I'd best be careful. If I take too many tips from The Good Life, I've a feeling my neighbours might complain. To see what I mean, check out the YouTube clip below:

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On an entirely different subject, if you're listening into BBC Radio Suffolk's James Hazell show later, you'll find me joining in the conversation at around 10:10am about whether we have too many bags for life. I know I have lots, but they all come in handy at different times. What about you? Are you a keen collector of bags for life? If so, listen in later, or catch it on Listen Again.

*UPDATE* The radio debate has been postponed until Thursday 18th feb. Same time, same place, but with a difference face. It'll be with the lovely Georgina Wroe, who's stepping in for James.

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On the street where I live

David & Halle, promoting the Seven Suffolk Streets project

It's always great to see a friendly face when you're out and about and as it happens, just as I was arriving home yesterday, I bumped into David and Halle, a couple of our local master composters, who are promoting the Seven Suffolk Streets project on behalf of the Suffolk Waste Partnership.

If you haven't heard of the project before, it's one of the Zero Waste places announced by Defra last year and which has received funding from BREW to help reduce the amount of waste across the county.

Each of the seven districts in Suffolk has selected one street to be the focus of the waste reduction campaign and as you can guess, my very own street is one of the lucky few, as chosen by St Edmundsbury Borough Council.

In November residents received a letter outlining the project as well as a questionnaire about their rubbish and over the last couple of weeks, door-knockers have been visiting homes to introduce the idea in more detail and to offer additional knowledge if needed.

It's all leading up to Waste Reduction Fortnight, which will take place in March, encouraging residents, businesses and schools to have a go at reducing their rubbish by 50%. And the best news is, no extra bins are needed, just extra signposting to local facilities that exist nearby.

Waste Reduction Fortnight kicks off in our street on 1st March, when our previous rubbish will be weighed for the very first time on bin day. To measure the success of the project, the bins will be weighed for the second and final time two weeks later on 15th March.

So far, it seems that residents have been very happy to take part, which is brilliant, not just regarding waste reduction, but also because there will be prizes for the streets that perform the best too! So, we could be onto a real winner for our neighbourhood!

And I am glad that people have responded positively, because I'm going to be doing a bit of door-knocking too, not on my home patch, but joining the crew in Brandon. So if you live up that way, look out because very soon I could be coming to a street near you.

All I can say is, I hope the weather warms up because yesterday I had to rescue David and Halle from a hailstorm that fell thick and fast soon after I took the photo. So keep your fingers crossed, as I don't fair well in the cold.

More information about the Seven Suffolk Streets project can be found at the Suffolk Recycling website: www.suffolkrecycling.org.uk.
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Lucy was a vegetarian and sapiens an omnivore: Plant foods as natural supplements

Early hominid ancestors like the Australopithecines (e.g., Lucy) were likely strict vegetarians. Meat consumption seems to have occurred at least occasionally among Homo habilis, with more widespread consumption among Homo erectus, and Homo sapiens (i.e., us).

The figure below (from: becominghuman.org; click on it to enlarge) shows a depiction of the human lineage, according to a widely accepted theory developed by Ian Tattersall. As you can see, Neanderthals are on a different branch, and are not believed to have been part of the human lineage.

Does the clear move toward increased meat consumption mean that a meat-only diet is optimal for you?

The answer is “perhaps”; especially if your ancestors were Inuit and you retained their genetic adaptations.

Food specialization tends to increase the chances of extinction of a species, because changes in the environment may lead to the elimination of a single food source, or a limited set of food sources. On a scale from highly specialized to omnivorous, evolution should generally favor adaptations toward the omnivorous end of the scale.

Meat, which naturally comes together with fat, has the advantage of being an energy-dense food. Given this advantage, it is possible that the human species evolved to be exclusively meat eaters, with consumption of plant foods being mostly optional. But this goes somewhat against what we know about evolution.

Consumption of plant matter AND meat – that is, being an omnivore – leads to certain digestive tract adaptations, which would not be present if they were not absolutely necessary. Those adaptations are too costly to be retained without a good reason.

The digestive tract of pure carnivores is usually shorter than that of omnivores. Growing a longer digestive tract and keeping it healthy during a lifetime is a costly proposition.

Let us assume that an ancient human group migrated to a geographical area that forced them to adhere to a particular type of diet, like the ancient Inuit. They would probably have evolved adaptations to that diet. This evolution would not have taken millions of years to occur; it might have taken place in as little as 396 years, if not less.

In spite of divergent adaptations that might have occurred relatively recently (i.e., in the last 100,000 years, after the emergence of our species), among the Inuit for instance, we likely have also species-wide adaptations that make an omnivorous diet generally optimal for most of us.

Meat appears to have many health-promoting and a few unhealthy properties. Plant foods have many health-promoting properties, and thus may act like “natural supplements” to a largely meat-based diet. As Biesalski (2002) put it as part of a discussion of meat and cancer:

“… meat consists of a few, not clearly defined cancer-promoting and a lot of cancer-protecting factors. The latter can be optimized by a diet containing fruit and vegetables, which contain hundreds of more or less proven bioactive constituents, many of them showing antioxidative and anticarcinogenic effects in vitro.”

Reference:

Biesalski, H.K. (2002). Meat and cancer: Meat as a component of a healthy diet. European Journal of Clinical Nutrition, 56(1), S2-S11.

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The Rubbish Diet Challenge: Week 5, Dig for victory

Tomato seedlings on the windowsill in 2009

Can you believe we're now at Week 5 of the Rubbish Diet challenge. How time flies. It doesn't seem that long ago, since I was challenging you to your first weigh-in. I hope all is going well with your efforts to slim your bin and that you're enjoying the mini-challenges.

This week I hope to inspire you to make further inroads into your household waste by doing some extra things around the garden. That is if you happen to be blessed with a small patch to call your own. Even if you don't have a garden, you can still join in if you've only got a windowsill going spare around your home.

This week's guide will get you thinking about how you can reduce waste whilst gardening and how you can use your garden to reduce waste too, helping you to find ways to avoid packaging and divert your kitchen scraps away from the rubbish bin. There are lots of ideas to encourage you to grow your own and includes a mini-guide to composting as well as an introduction to keeping chickens for those who fancy taking their self-sufficiency a little bit further.

So there should be something for everyone this week and even if you're not that much of a keen gardener, I hope you'll get in the spirit and consider planting up at least one small container of your favourite herb, vegetable or fruit-bearing plant.

And if you want to be inspired to compost a bit more, don't just take my word for how easy it is. I've gathered a few examples that have been sent in over the last few months from some of my blogging and Twitter friends, both old and new.

For example, here's how Susanna at A Modern Mother collects her kitchen peelings, in a convenient caddy for transferring to her compost bin in the garden. She's blogged about her composting experiences to help share the knowledge over at
http://www.amodernmother.com/2010/02/how-to-compost.html



And here's an example of how the professionals do it too, thanks to expert gardener Claire Brown from PlantPassion, who saw my plea for photos last year via her Twitter account @PlantPassion. The photo on the left shows the contents from a wooden compost bin, revealing much better quality compost than I make.

Claire sent an example of her plastic dalek composter and new tumbler as well. No doubt, this set up will have some readers browsing with envy.

Claire also sent me a link to a fabulous blogpost she's written about compost bins and rats and includes useful advice, whether you are a novice composter or have been at it for some time. Visit : http://plant-passion.typepad.com/plant_passion/2009/05/could-my-compost-bin-attract-rats.html.


Fellow tweeter and blog reader @MrsBYork sent in a photo of York Rotters' demonstration bin, showing which types of items can go in it. To see a larger version, just click on the photo.







The photo to the right shows Mrs B's compost set up at home, which shows you don't really need much space at all.






Sarah Barnard, author, blogger and Twitter user @ethicstrading, has a couple of dalek type bins and revealed how she managed to get one of them free from her local Frecycle Group. As she says, not bad for a freebie eh! Too right, especially as I had to pay around £20 for mine, which is exactly the same as Sarah's.

Of course if you've got enough land you don't even need to worry about having a container to put it in. You can simply create your own compost heap in a suitable spot that takes your fancy.

So I really don't think I could finish today's introduction to this week's online guide without showing you the king of domestic compost heaps, brought to my attention by fellow Twitter user and composter @MartinCampbell2. Here it is in all its woodland glory. I can only dream of such space and consider it a rather spectacular specimen.



Now it's all very well composting, but eventually you also need to do something with it. Here's an example of what blogger AllGrownUp does with her compost, proving that you don't even need a huge veg patch to justify going to the trouble. In her blogpost she describes what it's like to "harvest" your compost for the very first time and how it's great to have free stuff made from what would otherwise be rubbish.

http://allgrownup06.blogspot.com/2009/05/in-garden.html.

And if you're looking for even more examples of composting, Mrs Green at MyZeroWaste wrote a guide for beginners, which she published on her blog last week: http://myzerowaste.com/2010/02/beginners-guide-to-compost

So with enthusiasm like that, I hope we've all been able to inspire you to get out into whatever space you have and start digging for victory in your war against waste.

Of course you may just fancy putting your feet up until it gets a bit warmer and I can't say I blame you. So let's take advantage with a nice cuppa and grab a moment to read more about this week's Rubbish Diet challenge. You'll find everything you need now online at: http://tinyurl.com/TheRubbishDietWeek5

And when you're finished do go and see how other bloggers are getting on with their own challenges. Share some support and say hi to the following waste watchers: Carol at New Mummy Tips; Pippa at A Mother's Ramblings and Tepary at Grow Family Grow. So far, it looks like they're doing brilliantly. Maybe very soon I'll mention those three little words "Zero Waste Week". Well I might as well start hinting now and it's not as scary as it sounds.

Thanks to everyone who's sent photos and links. It really is appreciated. It's always useful to have a whole range of real-life examples that can be shared with others.

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Vitamin D levels: Sunlight, age, and toxicity

Calcidiol is a pre-hormone that is produced based on vitamin D3 in the liver. Blood concentration of calcidiol is considered to be a reliable indicator of vitamin D status. In the research literature, calcidiol is usually referred to as 25-Hydroxyvitamin or 25(OH)D. Calcidiol is converted in the kidneys into calcitriol, which is the active form of vitamin D.

The table below (from: Vieth, 1999; full reference at the end of this post; click on it to enlarge), shows the average blood vitamin D levels of people living or working in sun-rich environments. To convert from nmol/L to ng/mL, divide by 2.496. For example, 100 nmol/L = 100 / 2.496 ng/mL = 40.1 ng/mL. At the time of this writing, Vieth (1999) had 692 citations on Google Scholar, and probably more than that on Web of Science. This article has had, and continues having, a high impact among researchers.

The maximum average level of blood (or serum) vitamin D shown in the table is 163 nmol/L (65 ng/mL). Given that the human body produces vitamin D naturally from sunlight, it is reasonable to assume that those blood vitamin D levels are not yet at the toxic range. In fact, one of the individuals, a farmer in Puerto Rico, had a level of 225 nmol/L (90 ng/mL). That individual had no signs of toxicity.

Several studies show that pre-sunburn full-body exposure to sunlight is equivalent to an oral vitamin D intake of approximately 250 µg (10,000 IU).

In spite of claims to the contrary, vitamin D production based on sunlight does not cease after 40 years of age or so. Studies reviewed by Vieth suggest that among the elderly (i.e., those aged 65 or above) pre-sunburn full-body exposure to sunlight is equivalent to an oral vitamin D intake of 218 µg (8,700 IU).

Sunlight-induced vitamin D production does seem to decrease with age, but not dramatically.

Post-sunburn sunlight exposure does not increase vitamin D production. Since each person is different, a good rule of thumb to estimate the number of minutes of sunlight exposure needed to maximize vitamin D production is the number of minutes preceding sunburn. For a light-skinned person, this can be as little as 7 minutes.

Vitamin D accumulation in the body follows a battery-like pattern, increasing and decreasing gradually. The figure below, from Vieth’s article, shows the gradual increase in blood vitamin D concentrations following the start of daily supplementation. This suggests that levels start to plateau at around 1 month, with higher levels reaching a plateau after 2 months.

While sunlight exposure does not lead to toxic levels of vitamin D, oral intake may. Below is a figure, also from Vieth’s article, that plots blood levels of vitamin D against oral intake amounts. The X’s indicate points at which intoxication symptoms were observed. While typically intoxication starts at the 50,000 IU intake level, one individual displayed signs of intoxication at 10,000 IU. That individual received a megadose that was supposed to provide vitamin D for an extended period of time.

Non-toxic levels of 10,000 IU are achieved naturally through sunlight exposure. This applies to modern humans and probably our Paleolithic ancestors. Yet, modern humans normally limit their sun exposure and intake of vitamin D to levels (400 IU) that are only effective to avoid osteomalacia, the softening of the bones due to poor mineralization.

Very likely the natural production of 10,000 IU based on sunlight was adaptive in our evolutionary past, and also necessary for good health today. This is consistent with the many reports of diseases associated with chronic vitamin D deficiency, even at levels that avoid osteomalacia. Among those diseases are: hypertension, tuberculosis, various types of cancer, gingivitis, multiple sclerosis, chronic inflammation, seasonal affective disorder, and premature senescence.

Reference:

Reinhold Vieth (May 1999). Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. American Journal of Clinical Nutrition, Vol. 69, No. 5, 842-856.

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