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About two-thirds of Americans are overweight. Getting them to lose weight has had grim results. Recently, people were polled about barriers they had to losing weight. Topping the list was dislike of exercise (22%), followed by enjoying junk food too much (21%), inability to afford a successful weight loss program (20%), insurance not covering weight-loss programs (19%), lack of willpower to stick to a plan (15%), and inability to figure out the best way to lose weight (14%). Most barriers can be dissolved or resolved one way or another if motivation is there. Many solutions to overweight have been offered; many are marketed. Some are helpful; others are not. Some are drastic, merely fads, or harmful. Others are sensible, enduring, and healthful. i
Surgery is drastic. Yet more people, especially the morbidly obese, are having surgery performed as an answer to excess weight. Gastric bypass (or bariatric) surgery is now a routine operation. One method reduces the stomach size to a small pouch and attaches the small intestine to the pouch. This compels the patient to eat less. There are frequent complications and damaging side effects including injuries to the spleen, esophagus, vagus nerve, pancreas, liver, or colon; a leak from the pouch (the "most lethal complication if not identified and treated quickly"); constriction of the stomach-to-intestine connection; intestinal obstruction; gallstone disease; and gastrointestinal bleeding. More than a quarter of patients develop complications, about half of which require surgical intervention. As if this were not enough, the surgery does not work for some people; as many as 25% regain most of their lost weight after about 5 years. Similar procedures have failure rates (a loss of less than half excess pounds) as high as 80%. Surgery does NOT deal with the causes of obesity. It may jump-start weight loss, but "major lifestyle changes must follow to keep the pounds off." Worse of all, surgery ends up causing reduced absorption and assimilation of nutrients, contributing to the chief reason for being overweight! (The medical model of treating symptoms only.)
Liposuction is a form of localized plastic surgery, NOT a way to lose weight. It was meant for people of normal weight who have localized areas of stubborn fat (hips, buttocks, thighs, knees, arms, neck, or face), NOT for people who are generally overweight. There is a low risk of complications (infection, sudden lowering of blood pressure, slowed heart rate, irregular menstrual periods in women, pulmonary embolism), and post-operative pain can be severe. Commonly, there is disappointment with the results; if the skin does not contract enough after surgery, the new contours may not please any better than the old. Removing fat by liposuction may improve the ability of extremely overweight people to walk and be more physically active, or make obese people feel better about themselves so they will be more motivated towards a better diet or lifestyle. Yet about HALF of patients gain back most of the fat at the site that had been suctioned. Those who keep the weight off change their habits relating to diet and exercise. Better living, not surgery, accounts for slimmer figures! ii
Since the fen-phen fiasco (drugs causing cardiac valve disorders and lung damage, withdrawn from the market in 1997), the race has been on to develop other weight loss drugs. Only two drugs are currently FDA approved for long-term use in weight loss: Meridia (subutramine) and Xenical (orlistat). Meridia affects the appetite-control center of the brain, acting somewhat like an antidepressant. It decreases appetite by blocking reuptake of neurotransmitters (norepinephrine, serotonin, and dopamine) in the brain. Possible side effects include high blood pressure (monitoring is required), abnormal heart rhythms, high pulse rate, headache, nervousness, back pain, constipation, insomnia, even death. Xenical blocks digestion of about 30% of the fat consumed in meals. The fat is passed through the digestive tract and excreted. When it blocks fat, it also blocks fat-soluble vitamins like A, D, E, K, and beta-carotene. Other nutrients and food components are also lost with the fat. Adverse effects include oily spotting, gas with discharge, fatty/oily stools, fecal urgency, and frequent bowel movements. Both drugs achieve only slight weight loss in the short term (an average of just over 19 pounds a year), but "may" help maintain loss with long-term treatment of several years. Both drugs can cause rebound weight gain. Phentermine is approved for weight loss, but not long-term use. Other drugs are used but not approved for this use - including antidepressants, diabetic drugs, and anti-epileptic drugs.
None are getting the desired results and all have bad adverse effects. Though drugs may initially help prevent catastrophic events like heart attacks in extremely obese persons, they are NOT a solution. They do not improve nutritional status or biochemical balance and they may do just the opposite. They do not approach the cause. Use of drugs only adds to the unhealthy attraction for quick, easy answers to a chronic, complex problem. iii
IN THE SEARCH
Recent research (often seeking a weight-loss drug) has uncovered incredible information about the intricate inner workings of the body. Some examples are:
*The complexity and activities of fat (adipose) cells that were previously considered only passive storage containers for fats.
*Identification of many hormonal and intercellular messaging molecules and their interrelationships.
*The release of molecules from the nervous system that influence appetite as a result of stress and other external cues.
*The influence of foods - depending on type, amount, makeup and form - on nerve and hormone messages that modify metabolism and fat deposition.
*Factors that influence the function of the digestive tract which affect messages that reach the brain and influence the way foods are processed in the body.
*Hormone imbalances that relate to secretion of insulin, insulin sensitivity, glucose transport and removal, and more.
*Nutrition, environment, and lifestyle that affect the activity of mitochondria (cellular power plants) and their influence on burning calories.
*Specific proteins that are produced in response to specific diet, lifestyle, environment, and genetic tendencies.
Fat cells produce and secrete leptin, a hormone that helps control fat storage and appetite. It helps regulate how much glucose the liver manufactures, performs actions in reproduction, development, to balance blood pressure, heal wounds, form bones, form blood cells, and create blood vessels. Leptin levels increase during infection and inflammation, giving it an immune function. But it is leptin's role in regulating body weight that caught the attention of scientists. Leptin sends signals to the brain, telling it to boost or curb appetite. The more fat in the body, the more leptin will circulate. In THEORY, excess leptin should reduce appetite and help burn more calories. But obese people do not seem to respond to their own circulating leptin. When a large amount of weight is quickly lost by a very low-calorie diet, leptin levels drop, the brain interprets this as evidence of starvation, and hunger sets in. And circulating leptin concentrations differ considerably among people with the same amount of fat mass. Biochemical individuality as well as differences in nutrient levels, tissue health, toxic load, and other factors come into play. Leptin drugs have not become the "anti-blubber" solution hoped for; they do not curb appetite or burn more calories. To reestablish proper leptin signaling, one doctor recommends preventing leptin surges with a "strategic diet" that avoids foods that result in blood sugar spikes (such as refined carbohydrates and artificial sweeteners), emphasizes good fats, and includes supplements that supply vitamin B complex, E complex, magnesium, calcium, alpha lipoic acid, and fish oil (containing omega-3 fatty acids which ‘down-regulate' leptin expression), among others. Food seems to help where drugs fail!
The stomach and intestines release ghrelin, a hormone that acts as a chemical mediator of energy metabolism, regulating food intake and calorie ‘burning.' The concentration in the blood rises rapidly just before a meal (when hunger is peeking) and falls once food is eaten. After a low-calorie diet and subsequent weight loss, ghrelin levels rise substantially all during the day, making the dieter hungry all the time. It is even involved in binge eating. Ghrelin levels normally fluctuate, not only in synchrony with meals, but are influenced by the composition of the meal. Leptin and ghrelin work together as a regulatory arm in the feedback communication involving glands, nerves, and more. Could a nutrient-poor diet combined with an already-deficient overweight body induce body chemicals to increase appetite in an attempt to obtain needed food components? Very possibly.
The intestines produce the hormone peptide YY3-36 (PYY), normally released into the blood after a meal, which gives people the feeling that they have had enough to eat. Artificially introduced PYY tested on a small number of lab animals and humans seemed to reduce food consumption for up to 12 hours. But much is still unknown. Adiponectin, a protein secreted by fat cells, is high in lean people but low in overweight people, especially those who are insulin resistant. Insulin admits blood sugar (glucose) into cells where it is stored or used as fuel. Many overweight people produce plenty of insulin (sometimes too much), but the insulin loses it functional punch. Insulin resistance can lead to high blood sugar levels. Adiponectin may help regulate insulin sensitivity.
These are but a FEW of the numerous compounds in the body that influence weight control or are disrupted with weight gain. There are so many substances, complexities, and interrelationships that the aim of developing effective drugs by synthetic versions of one or two compounds seems foolish. Drugs ONLY stimulate or suppress a biochemical reaction and nothing else; therefore they cannot cure excess weight. Overweight involves too many factors including under-nourishment, malnutrition, chronic poisoning, insufficient physical activity, imbalances involving nerves, glands, the digestive tract, and more. Feeding the body all the known and unknown food components can help keep all the biochemical players functioning properly. Drugs do not tackle the causes. At best they cover over a symptom; at worst they cause more imbalances. iv
A calorie is an amount of ENERGY in terms of heat. It is used to measure the amount of energy your body gets by metabolizing or processing food. A NUTRITIONAL calorie is actually a kilocalorie (1000 calories), though the word ‘calorie' is commonly used. A calorie is the amount of heat needed to raise the temperature of a pint of water by 3.8°F. If metabolizing a food or meal produces more ‘energy' (calories) than you use up in physical activity and the basic energy expenditure of simply living, the body stores the excess ‘energy' as fat. Fat is a concentrated storehouse of energy; when it is ‘burned,' it gives off lots of heat. However, our bodies, mercifully, do not use actual flames to release energy; they use metabolism (which is slower than combustion).
Scientists think in terms of chemical and thermodynamic laws:
*Energy cannot be created or destroyed, but only transformed.
*Food plus oxygen produces energy and various reaction products.
*If the initial and final substances are the same, then the amount of energy given off is the same, regardless of how the reaction took place.
The PROBLEM is that humans are not a pile of mere inert chemicals. They are much more complicated and come with innumerable variables. Foods are not digested or ‘burned' completely in the body, so we get ‘out' of them less than the total amount of energy they would release if they were burned in oxygen in a laboratory. Proteins, carbohydrates, and fats differ in the number of calories they produce. On average, we get about 9 calories of energy from each gram of fat and 4 calories from each gram of carbohydrate or protein. A body's normal basal metabolism rate (the minimum amount of energy used up by breathing, circulating blood, digesting food, repairing tissues, keeping body temperature normal, keeping organs and glands functioning, etc.) is about 1 calorie per hour for every kilogram (2.2 pounds) of weight. That's about 1,600 calories a day for a 150-pound male. Yet this varies considerably depending on gender (women usually require about 10% less), age, health, body size, shape, body composition, activity level, etc. Thus, the actual number of calories an individual can consume before gaining excess weight varies and can change. Yet experts say that to lose weight, you have to cut calories. You can over-eat any kind of food and put on pounds, but do calories count?
Much depends on whether they are ‘empty' calories or ‘full' calories. If foods are processed or manufactured so that they are stripped of most nutrients; altered so that nutrients are changed, no longer available for beneficial use, or become toxic; or if they contain ingredients the body does not recognize as real food, then there is little that can be done with them - they are ‘empty'. The content of nutrients and other food components in real food - vitamins, minerals, trace minerals, enzymes, phytonutrients, etc., makes ‘full' calories. For example, a handful of raw nuts and a piece of cake may contain the same number of calories. But one is a real food rich in protein, minerals, vitamin complexes, and important fatty acids; the other has very little if anything to offer the body other than calories. The body can use the nuts in many ways. The cake has little to give, so must be ‘burned,' excreted, or stored as fat. Since the cake is not real food, it may even contribute to biochemical disruptions. So, how much of a food is just burned, excreted, or stored because it offers little or nothing to benefit health? How much is eating, not feeding? ‘Empty' calories contribute far more to weight gain than ‘full' calories.
In some respects calories are like paper money which has real worth IF it is backed up by something valuable. Paper money is not complete in itself, though it plays a role and can be useful. Without the precious metals or other valuable assets it is supposed to represent, the paper becomes almost worthless and a house full can be easily accumulated. Of course, some of it could be burned, but otherwise, it does not give much service. The same applies to calories. The issue is not whether they count, but the ROLE they play and the WORTH that is supposed to come WITH them - FOOD VALUE. Does the food support bodily well-being and function? Or is it nonfood, not accompanied by precious assets needed for health and weight control? Many components of real, natural, valuable foods help the body lose or maintain weight. Empty calories - not ‘backed up' with natural food components - can only be burned or stored. Do you want a counterfeit nonfood or the REAL thing? Your body knows the answer. Calorie-counting ignores the importance of quality and nutrient density in food as well as freshness, flavor, and wholesomeness. Nonfood fails to truly satisfy the appetite because it fails to deliver what the body needs. People are overweight because they are not getting ENOUGH REAL FOOD. They eat (sometimes too much) but do not get sufficient food elements as found in real, quality natural foods. Obesity is the result of starvation for real food.
Eating real food often lowers calorie density anyway. You can eat the same amount and feel just as full, but take in fewer calories. Water-rich foods, for example, can be eaten in bigger portions for the same number of calories as other items. Not water, but water-rich foods. Water on its own empties out of the stomach rather quickly; and evidently, the brain controls hunger and thirst by different mechanisms (although sometimes people may think they are hungry when they are actually thirsty). Soups, stews, or other dishes that include water will result in consumption of fewer calories (without making up for it later) and more satisfaction. The dynamics are complex, but one factor is that water bound into food stays in the stomach longer while being digested. And you feel like you are getting more food, there is more sensory stimulation, and you are eating longer. Vegetables and fruits are about 90% water and have "a huge impact on the calorie density of the diet." They provide lots of nutrients and phytochemicals - food value. So they are "free" foods even when you are trying to lose weight. They can be eaten whenever you want and as much as you want. Beginning each meal with a raw vegetable and/or fruit salad can greatly assist weight loss efforts. Studies have already shown that people eating more fruits, vegetables, and soups can eat MORE food and lose MORE weight than people eating smaller portions.
Fruits, vegetables, legumes, and whole grains contain FIBER - another factor missing from refined and most processed nonfoods. This, too, helps reduce calorie intake. Whole foods with intact fiber take more chewing, are slower to pass through the digestive tract, and may stimulate satiety hormones that signal the brain to stop eating. Reducing FATS excessively may lower calories, but people do not enjoy their food and don't stay with it. Plus, we NEED natural fats to lose and maintain weight. Eliminate altered or refined fats and oils, trans fats, and fake fats. Skip fried foods. But eat foods that naturally contain moderate amounts of fats such as organically-raised meats and poultry (preferably grass-fed or free-range which are lower in fat anyway than commercially-raised counterparts), deep-water fish and seafood, certified grade-A raw milk products (also preferably from pasture-fed animals), raw nuts and seeds, whole grains, avocados, olives, and so on.
HIGH QUALITY is MORE important than lower calories. Eating natural whole foods is essentially self-limiting anyway - the appetite is usually satisfied sooner since more nutrients, more water, more fiber, unaltered fats, and more healthful value is present. Don't count calories. Count NUTRIENT DENSITY. v
There is only room for about 1.2 micrograms of fat per cell. The cells can get a little bigger, but not big enough to store, say, 3 micrograms of fat. If people continue to consume empty calories (little or no nutritional value) or excessive calories after their fat cells are filled to capacity, they make MORE fat cells. While the loading of a fat cell with more fat is quite reversible, once additional fat cells are made, they will be around for a long time - a few years or, in some cases, forever. If a person goes on "a diet," the amount of fat stored in cells may be reduced, but not necessarily the number of fat cells.
"Dieting" (reducing calories) results in a temporary reduction in metabolism (less calorie-burning) as well as disruption of sleep patterns and nocturnal body temperature. Low calorie diets can suppress fertility and sexual behavior, result in bone loss, and may decrease activity of the adrenergic system (nerve fibers that release epinephrine which stimulates metabolism). Dieting makes it more difficult to lose weight! Although weight is often lost while "on" a diet, it does not stay off. About 95% of people who lose weight on a diet do NOT keep it off permanently. People who follow major commercial programs will probably regain 50% or more of weight lost within two years. Ads for weight-loss programs are often highly exaggerated, deceptive, or misleading with promises like: weight loss regardless of how much is eaten, quick weight loss, permanent weight loss, weight loss in selective areas of the body, consumer testimonials, clinically-proven or doctor-approved programs, etc. Some popular diets are connected with certain people from Atkins to Ornish, Sommers to Oprah, South Beach to the Zone. Some are extreme. Most overweight people have been through many of these diets. They drop out, not only because dieting is hard, but also because there is a confusing - and always a new - array of diets and choices. The primary message gets lost in the hype or unique twist and in the search for a quick fix.
The truth is that weight loss is not easy. It requires effort; it is not fast; and there is no magic diet or magic bullet. The low fad approach pays attention to NUTRITIONAL VALUE - to feeding the body's cells so that they, and all the tissues, organs, and glands they comprise, function as well as possible. REAL nutrition will eventually balance the appetite and, in most cases, the weight. People often have some idea about the nutrition component, but they may need to learn what good food really is. They may also need help to decompress, deal with their anxiety around food, develop a new relationship with food, and get a particular goal weight they have set for themselves placed on the back burner. People who diet often have an all-or-nothing mentality. Diet results are seen as either a success or failure. Most people on diets stop losing weight after around 20 weeks. If they have not yet reached their weight goal, they may consider themselves or the diet a failure and slide back into old eating patterns. They end up frustrated, unhappy, and even more inclined to overindulge. They comfort themselves with food. Once they think they have blown it, anxiety makes them want to eat even more. In some studies, dieters actually gained MORE weight per year than non-dieters, even if the dieters were more active and consumed fewer calories than the non-dieters. Slower metabolism, binge eating, and most of all, eating for calories rather than for nutritional value, are the usual culprits. Dieting ultimately leads to weight gain.
"Dieting doesn't work because no one can eat that way for long." What WORKS is making changes in diet and lifestyle that can be followed - stuck to - forever. Experts urge dieters to stop starving themselves (calorie-wise) and learn to eat healthfully with nutrient-dense foods. Don't let a diet book do the thinking for you. Everyone is unique so you must find out what is best for you. The only "rule" is to eat real, natural, whole foods prepared in healthful ways. What proves out is recognizing good foods and being able to choose them consistently. Instead of bouncing from one fad diet to the next, become committed to a healthy lifestyle. The longer you stick to it, the less effort and attention will be required to maintain weight. Yes, some SELF-CONTROL is needed, especially at first. Most weight-loss programs don't want to mention limiting one's gratification. "Eat all the foods you like" - even junk foods with paltry nutritional value and oodles of nonfood content - "and still lose weight." It doesn't work. Neither does counting calories without considering real food value. Eating a balanced, HEALTHFUL diet for the long term not only supplies more needed nutrients and other food components, but it gradually adjusts the appetite, tastes, and desires so that REAL food is preferred over depleted, mutilated, incomplete, disruptive substitutes masquerading as food. vi
Are there any supplemental ‘magic bullets' for quick or effective weight loss? Since the overweight person is malnourished, a comprehensive food supplement protocol in addition to a wholesome diet and regular physical activity can be helpful over the long-term. But the search for a "natural drug" to "fix" overweight fast is useless. Billions of dollars are spent on supplements that promise to get rid of unwanted fat and keep it off. Marketers may use testimonials, qualified health claims, and other tactics to convince people to buy their products. Many deceptive claims are made for products such as inducing weight loss without having to change eating habits or increase activity levels, shedding excess pounds while sleeping, reducing food cravings, diminishing appetite, coaxing the body to burn more fat or carbohydrates, and so on and so on, ad infinitum.
Bitter orange may increase thermogenesis (generation of heat from burning fat). One of its components, synephrine, is chemically similar to ephedra and biologically similar to epinephrine. It also contains octopamine which is similar to norepinephrine. These compounds raise metabolism and suppress appetite. But high doses and/or isolated compounds may cause side effects such as high blood pressure and might increase blood levels of many drugs. Bitter orange, tea, kola nuts, mate, and guarana contain significant amounts of caffeine, which has some thermogenic effects. But it does not really help burn more calories and can cause nervousness and jitteriness. Green tea may modulate calorie and fat burning through specific nerve chemicals, adrenal glands, and the sympathetic nervous system. Its thermogenic stimulation is not accompanied by an increase in heart rate or blood pressure. Yet only a small number of extra calories gets burned (average of 266 a day), though this may help over time. Since green tea can inhibit decomposition of fat, in large doses it theoretically could cause a decrease in absorption of needed fatty acids and fat-soluble vitamins.
Hydroxycitrate (from the rind of brindleberry fruit) inhibits fatty acid synthesis and suppresses appetite. But study results have been conflicting. This isolated extract may cause headache, gastrointestinal and respiratory symptoms. Chitosan, an extract from the exterior skeletons of crustaceans like crabs and shrimp, forms a gel in the stomach that can bind to fats. The gel becomes insoluble in the intestines, taking the fat out of the body. But the fat-trapping effects are negligible. Chili peppers and cayenne may stimulate carbohydrate oxidation a tad. These peppers as well as black pepper, ginger, and turmeric may increase metabolism slightly. Guar gum has benefit as a fiber but does not reliably reduce body weight. Psyllium, yohimbine, yerba mate, ginseng, licorice, dandelion, cascara, spirulina, guggul, and country mallow may all have health benefits, but have not been shown to be effective for weight reduction. Glucomannan is supposed to increase satiety since it absorbs water and occupies space in the stomach. A purified substance from Hoodia gordonii suppresses the appetite of lab rats. The hope of developing drugs from isolated chemical compounds raises questions about safety and efficacy issues AND fails to approach the real CAUSES of overweight. 5-HTP (5-hydroxytryptophan) may help boost brain levels of serotonin, a neurotransmitter involved in mood regulation. Serotonin levels may affect appetite, and easing depression may help offset cravings and binging. But 5-HTP is more effective when used with tyrosine (for dopamine production) and other amino acids. Thus, high quality protein with a complete array of amino acids may be best. A water extract of white kidney beans inhibits the digestive enzyme alpha-amylase, blocking some digestion of carbohydrates. It can cause gas, diarrhea, abdominal pain, and bloating. This and other starch blockers have only moderate enzyme-blocking effects and do not lead to weight loss.
Chromium has been shown in a few studies to slowly help reduce body fat and increase lean body mass. However, many trials found no significant benefit. The form and source of chromium may be involved. In food form, chromium may assist craving of sweets, balancing blood sugar, and insulin sensitivity. But it should be part of a more comprehensive nutritional program. For example, B vitamins and their natural-food associates (of which chromium is one) are supportive. Studies indicate that B6, B12, pantothenic acid, and other B vitamins may aid weight control. Some carotenoids (such as alpha- and beta-carotene and B-cryptoxanthin) are low in overweight people. Vitamin C status is low when body mass is high. Individuals with adequate vitamin C status ‘burn' (oxidize) 30% more fat during moderate exercise than individuals with low levels. So vitamin-C depleted people may be more resistant to fat mass loss. Supplementing with carotene-rich and vitamin C complex-rich foods may be prudent. Various fatty acids may assist weight loss. GLA (gamma linolenic acid) may help reduce body fat by increasing the metabolism of brown adipose tissue (underactive in overweight people) and affecting enzymes involved in the metabolism of fat and glucose. Fish oil, rich in omega-3 fatty acids as well as vitamin complexes A and D, may increase fat oxidation. CLA (conjugated linoleic acid), found in red meats and dairy (primarily pasture-fed animals) helps reduce fat mass while maintaining lean body mass, though not substantially. Unfortunately, many studies use separate isomers of CLA (there are at least 25) and many supplements are low quality or contain contaminants. Real food is the best source - grass-fed beef and lamb; dairy foods from grass-fed animals. When animals are not grass fed, CLA is decreased about 80%.
Numerous studies have associated calcium with regulating energy metabolism and balancing body weight. An increased intake ups excretion of fats and calories. Significant reductions in fat tissue mass in obese people are noted when dietary calcium is enhanced. Weight loss elevates calcium demands, so obtaining extra calcium when losing weight is essential. Calcium supplements may help, but non-food (inorganic) calcium supplements like calcium citrate and especially calcium carbonate do not seem to affect weight or fat like food sources. Foods exert markedly greater effects "which are most likely attributable to additional bioactive compounds" in foods that act synergistically with the calcium. One of these synergists is vitamin D complex, an insufficiency of which is associated with obesity.
No magic. No one miracle pill. But real, wholesome natural foods will supply what the overweight body wants and needs. Same ‘ole story: eat the way Nature intended - not as an instant cure - but as a mighty effective one if it becomes a permanent part of the lifestyle. vii
To be continued...
This website has excellent nutritional protocols for weight control which are available in conjunction with the Symptom Survey. Take the Symptom Survey to discover specifically what nutrition you need for your individual health problems. I want to emphasize that the whole-food nutrition I recommend CANNOT be purchased in any retail store: so-called "health food" store, drug store, super market, etc. The nutrition I recommend will help rebuild your body and help restore your health. Those other products will only give you a pharmaceutical (drug) effect. They will attempt to deal with your symptoms, which is the ONLY thing any drug can do, while leaving the state of your health unchanged.
i Nutrition Week, 23 May 2005, 35(11): 8.
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Originally published as an issue of Nutrition News and Views, reproduced with permission by the author, Judith A. DeCava, CNC, LNC.