Empathy And Compassion

"Empathy is the ability to feel what others feel, to know another person's experience because you can connect it with your own.

"Compassion is understanding what others feel and using that understanding to respond to them with love and kindness.

"Empathy and compassion favor communication and social bonding. They strengthen community and mitigate interpersonal strife and violence. To hurt or kill another human being, one must first define that person as "other" - different from you in some essential way. Empathy prevents that."

- Dr. Andrew Weil
________ Photo of katydid taking a drink this morning.

Study Of Hunter-Gatherers Reveals Diet, Not Lifestyle, Governs Weight

Did hunter-gatherers expend more energy than contemporary Westerners? This study investigated total energy expenditure (TEE) in the Hadza, "a population of hunter-gatherers living in a savannah-woodland environment in Northern Tanzania."

Hunter-Gatherer Energetics and Human Obesity, PLOS One, July 25, 2012

"As expected, physical activity level, PAL, was greater among Hadza foragers than among Westerners. Nonetheless, average daily energy expenditure of traditional Hadza foragers was no different than that of Westerners after controlling for body size. The metabolic cost of walking (kcal kg−1 m−1) and resting (kcal kg−1 s−1) were also similar among Hadza and Western groups. The similarity in metabolic rates across a broad range of cultures challenges current models of obesity suggesting that Western lifestyles lead to decreased energy expenditure."

So, relatively, we're not any less active that our forebears, yet we weigh more and have more body fat. Why? This study suggests that modern man's weight problem is more a result of overeating or poor diet than of inactivity.

In fact, these authors hypothesized that energy expenditure "may be a relatively stable, constrained physiological trait for the human species, more a product of our common genetic inheritance than our diverse lifestyles."

From: Hunter Gatherer Clue To Obesity, BBC

Dr. Herman Pontzer of the department of anthropology at Hunter College, New York, said everyone had assumed that hunter gatherers would burn hundreds more calories a day than adults in the US and Europe. ... The data came as a surprise, he said.

"This to me says that the big reason that Westerners are getting fat is because we eat too much - it's not because we exercise too little," said Dr Pontzer.

"Being active is really important to your health but it won't keep you thin - we need to eat less to do that."

"Daily energy expenditure might be an evolved trait that has been shaped by evolution and is common among all people and not some simple reflection of our diverse lifestyles."

What do you think? I think that diet does play a bigger role in weight than exercise. Interestingly, this study revealed a trend towards more body fat for those expending the most energy, although it did not reach a level of significance. That reminds me of a quote by Gary Taubes: "Expending more energy than we consume does not lead to long-term weight loss; it leads to hunger."

Hadza diet, from Wikipedia:

"Hadza men usually forage individually, and during the course of day usually feed themselves while foraging, and also bring home some honey, fruit, or wild game when available. Women forage in larger parties, and usually bring home berries, baobab fruit, and tubers, depending on availability.

Men and women also forage co-operatively for honey and fruit, and at least one adult male will usually accompany a group of foraging women.

During the wet season, the diet is composed mostly of honey, some fruit, tubers, and occasional meat. The contribution of meat to the diet increases in the dry season, when game become concentrated around sources of water.

The Hadza are highly skilled, selective, and opportunistic foragers, and adjust their diet according to season and circumstance. Depending on local availability, some groups might rely more heavily on tubers, others on berries, others on meat."

________Photo of Hadza from Wikipedia.

Vegetarians Show Reduced Risk For Cataracts

Dr. Greger mentioned this study in his last post:
Diet, Vegetarianism, And Cataract Risk, American Journal of Clinical Nutrition, May 2011

It was an analysis of one of the large EPIC* trials (EPIC-Oxford), and included "27,670 self-reported nondiabetic participants aged ≥40 years."

It found:

"In this cohort of predominantly health-conscious British residents, there was a strong association between diet group and cataract with a progressive decrease in cataract risk in high meat eaters to low meat eaters, fish eaters, vegetarians, and vegans. This progressive decrease in cataract risk was seen for both men and women but appeared to be confined to participants aged ≥65 years at recruitment. Overall, compared with meat eaters who consumed ≥100 grams (~3.5 ounces) meat and meat products/day, fish eaters, vegetarians, and vegans had approximately 20%, 30%, and 40% lower risk of cataract, respectively."
...
"We showed that vegetarians and vegans had a significantly lower risk of cataract than did meat eaters, predominantly in the elderly, with a progressive decrease in risk in parallel with the amount of meat and other animal products in the diet."
...
"We found no difference in cataract risk between regular dietary supplement users and other participants."

So, compared to people who ate the equivalent of about a hamburger a day (and no other meat - no bacon, deli meat, chicken, etc.):

• Fish-eaters (pescatarians) had a 20% lower risk
• Vegetarians had a 30% lower risk
• Vegans (no eggs or dairy) had a 40% lower risk

They only assessed diet once, at recruitment, and the study progressed over about 10 years. It's a weakness, although the large population, the large number of cataract cases, and the large differences in risk between groups add credence to the association.

Here's Greger's video:



* European Prospective Investigation into Cancer and Nutrition (EPIC)
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Ketosis Linked To Brain Swelling

At least in rats:
Effects of Hyperglycemia and Effects of Ketosis on Cerebral Perfusion, Cerebral Water Distribution, and Cerebral Metabolism, Diabetes, July 2012

Low-carb diets, at least if the carbs are low enough, cause ketosis - elevated ketones in the blood. Long fasts cause ketosis. Insufficient insulin, commonly seen in type 1 diabetes, causes ketosis. Anything that depletes glycogen stores over an extended period of time causes ketosis.

This study found that ketosis:

• Changed water distribution in the brain, "indicating brain cell swelling."
• Reduced cerebral blood flow.
• Reduced levels of cerebral ATP, a high-energy compound used to propel metabolic reactions.

Ketones are acidic and would cause our blood to become too acidic were it not for buffering mechanisms. If ketones get high enough they can overwhelm these mechanisms and lead to coma. Type 1 diabetics know this as DKA - diabetic ketoacidosis. DKA can also occur in type 2 diabetes, especially if it's not well managed.

Atkins said the ketosis associated with his low-carb diet was "benign."
________Photo of Bayer's Ketostix, used to test urine for ketones, from Wikipedia.

Michael Phelps' 12,000 Calorie Diet

The Daily Mail is saying that Olympic swimmer Michael Phelps eats 12,000 calories a day, and that his medal-earning performances are, according to Phelps, down to his high-calorie diet.

Breakfast

• Three fried-egg sandwiches
• Three chocolate chip pancakes
• A five-egg omelette
• Three sugar-coated slices of French toast
• A bowl of corn grits (maize porridge)

Lunch

• Half a kilogram (one pound) of pasta
• Two large ham and cheese sandwiches covered in mayonnaise
• Gallons of energy drinks

Dinner

• Half a kilogram (one pound) of pasta
• Pizza
• Energy drinks

It must be difficult for athletes to transition to a non-performance diet. I wonder if he eats broccoli. I bet he eats broccoli. He's not coming clean about the broccoli.

They also say that his "arms span 6 feet 7 inches (201 cm) — disproportionate to his height of 6 feet 4 inches (193 cm)." He's like an underwater bird.
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Omega-3s On A Vegan Diet

More people around me are deciding to eat vegan. The latest question has been, "Is it possible to get enough Omega 3s on a vegan diet?" The short answer, from my reading, is maybe not.

There are 2 parts to this question:

1. Which type of omega-3?
2. How much is "enough?"

The term "omega-3" represents a class of compounds or fatty acids with varying chain lengths and degrees of saturation. Different types perform different functions. Here are three omega-3s (n-3s):

ALA Alpha-Linolenic acid 18:3, n-3
EPA Eicosapentaenoic acid 20:5, n-3
DHA Docosahexaenoic acid 22:6, n-3

I'll call ALA "short-chain" (18 carbons in the chain) and EPA and DHA "long chain" (20 and 22 carbons in the chains).

Short-Chain

Many plants are good sources of the short-chain omega-3 (ALA), e.g. flax, walnuts, and greens like spinach, romaine, and kale if you eat a lot. (Omega-3s are polyunsaturated fatty acids and so can be found in higher concentrations in fatty plant foods.) Just 7 walnut halves provide about 1.3 grams of ALA.

The Institute of Medicine (IOM) has set an Adequate Intake (AI) for undifferentiated (short- and long-chain n-3s lumped together) n-3 of 1.6g/day/men and 1.1g/day/women.

For differentiated (ALA only): "An AMDR for α-linolenic acid is estimated to be 0.6 to 1.2 percent of energy. The lower boundary of the range meets the AI for α-linolenic acid."

So, 0.6% of a 2000 calorie diet is 12 calories or 1.3 grams, 1.2% of a 2000 calorie diet is 2.7 grams. Those 7 walnut halves (or a couple teaspoons of ground flax) should do it for most people for short-chain n-3. You'll get even more with the rest of the day's food.

Long-Chain

Since animal foods, particularly seafood, are a better source of the longer-chain omega-3s (EPA and DHA) than plant foods, vegans may have difficulty getting enough. But what is enough? The IOM (in 2002) did not set an AI for EPA and DHA. Our body can convert some of the short-chain ALA to the more potent EPA and DHA but it's variable and inefficient. Many things affect the conversion, including age, gender (women convert more than men), health, and other things eaten including possibly the amount of omega-6 fatty acid. (I'll have more to say about this omega-6:omega-3 ratio in an upcoming post.)

This workshop in 1999:
Workshop on the Essentiality of and Recommended Dietary Intakes for Omega-6 and Omega-3 Fatty Acids, Journal of the American College of Nutrition, 1999

Said 0.65 grams of EPA+DHA a day were an adequate intake.

This study:
Is Docosahexaenoic Acid (DHA) Essential? Lessons from DHA Status Regulation, Our Ancient Diet, Epidemiology and Randomized Controlled Trials, Journal Of Nutrition, 2004

Says that DHA is probably essential, meaning we don't convert enough short-chain ALA for health (brain and retina) and we need to eat it directly. (We're better at making EPA from ALA.)

This workshop:
Towards Establishing Dietary Reference Intakes for Eicosapentaenoic and Docosahexaenoic Acids, Journal of Nutrition, 2009

Recommended that the IOM set a DRI for EPA+DHA of about 0.50 grams.

The only plant sources I know of for the longer chain n-3s are:

• Purslane which contains EPA but not DHA (0.01mg/g which is not very much).
• Mustard greens/red leaf lettuce/buttercrunch lettuce which contain DHA but not EPA (but at very low concentrations, 0.001/0.002/0.001 mg/g respectively).
• Seaweeds which can contain very small amounts of EPA and DHA depending on the type.

If we would benefit from consuming EPA, DHA, and other long-chain omega-3 fatty acids in the range of about a half gram a day, a vegan may need to supplement. Jack Norris RD (who co-authored "Vegan For Life" with Virginia Messina RD) says that vegans should take a DHA supplement of 300mg/day every few days.
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"If People Could See How Their Food Is Produced, They Would Change How They Eat" - Michael Pollan

Michael Pollan, in an interview from 2008 said:

"I visited an industrialized potato farm in Idaho and saw how freely pesticides were used. The farmers had little patches of potatoes by their houses that were organic. They couldn't eat their field potatoes out of the ground because they had so many systemic pesticides. They had to be stored for six months to off-gas the toxins."
- Michael Pollan Interview, The Progressive, November, 2008

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Music: Bob Dylan and Sam Cooke Sing Of Change

Bob Dylan "The Times They Are a-Changin." Recorded in the Fall of 1963.



Sam Cooke "A Change Is Gonna Come." Recorded in December, 1963. Cooke wrote the song shortly after hearing Dylan's "Blowin In The Wind." The serious and personal tone was a departure for him.


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Cranberries Protect Against Urinary Tract Infections

Cranberries are moving out of the realm of folklore for prevention of bladder infections. Here's a meta-analysis, a review of past studies - in this case all randomized controlled trials, the gold standard of studies:

Cranberry-Containing Products For Prevention Of Urinary Tract Infections In Susceptible Populations: Systematic Review And Meta-analysis of Randomized Controlled Trials, Archives Of Internal Medicine, 9 July 2012

It reviewed 13 trials, 1616 subjects, and found:

"Our findings indicate that cranberry-containing products are associated with protective effect against urinary tract infections (UTIs)."

Reading this gives me a greater appreciation for the effort behind study design. When do you count someone as having a UTI? When their urine sample contains 1,000 colony-forming units or 10,000? Or do you just look at symptoms? What do you use as a placebo? If you use something that is colored red and add some ascorbic acid for tartness, perhaps the ascorbic acid also prevents UTI. If the placebo is not also a beverage, just the extra hydration from drinking cranberry juice could be protective (in fact, staying hydrated with just water has shown to be protective). How much do you give, and how long do you give it?

To me, trying to make sense of all these variables puts the fun into science. And science here has revealed there is at least one type of compound in cranberries, proanthocyanidins, that prevent E. coli bacteria from sticking to the walls of the bladder and urinary tract.

But the effect is temporary, lasting maybe 8 hours. You have to ingest cranberry at least twice a day, every day. And this study found that cranberry juice was better than cranberry capsules or tablets, so the cranberry you ingest comes packaged, likely, with a lot of sweetener. You're up against the cost in both dollars and calories, and of course getting it down someone who doesn't like the taste. In some people cranberry juice causes gastrointestinal distress.

If you can get past these obstacles, you have yourself a pretty tasty (to me) and effective way to prevent UTIs. It should be the beverage of choice in care homes!
________Photo is of my frozen cranberries. I use them to make cranberry sauce that I dip into more often than is probably good for me. Here's my recipe: Lazy Man's Cranberry Sauce. I cringe when I read these old posts. By the way, that old post said blueberries contain the same beneficial compounds.

Music: Bob Dylan "Blowin' In The Wind"

Dylan recorded this song on July 9, 1962, almost 50 years ago to the day. He was 21 years old. It struck me how relevant it still is.



In June 1962, shortly before he recorded it, Dylan said:

"There ain’t too much I can say about this song except that the answer is blowing in the wind. It ain’t in no book or movie or TV show or discussion group. Man, it’s in the wind – and it’s blowing in the wind. Too many of these hip people are telling me where the answer is but oh I won’t believe that. I still say it’s in the wind and just like a restless piece of paper it’s got to come down some ...But the only trouble is that no one picks up the answer when it comes down so not too many people get to see and know . . . and then it flies away. I still say that some of the biggest criminals are those that turn their heads away when they see wrong and know it’s wrong. I’m only 21 years old and I know that there’s been too many . . . You people over 21, you’re older and smarter."

________

Music: Offenbach "The Tales of Hoffmann"

From Offenbach's opera Les Contes D'Hoffmann, sung by sisters Irina Iordachescu (soprano) and Cristina Iordachescu (mezzosoprano).


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Olive Oil Contains Saturated Fat

- 2 tablespoons of olive oil have 28 grams of fat, 4 grams of saturated fat, and 238 calories.*
- 2 tablespoons of olive oil have the same amount of saturated fat as is in 2 eggs or a cubic inch of cheddar cheese.
- The saturated fat in olive oil consists mostly of palmitic acid, the same saturated fatty acid found in meat, cheese, butter, and other dairy products.

If, for example, I was following the advice of the American Heart Association and keeping my saturated fat intake to below 7% of the day's calories, I would be eating less than 14 grams of saturated fat (for an 1800 calorie intake).

If I was eating:

• 1 ounce cheddar cheese (6g)
• 1 ounce potato chips (2g) (hydrogentated soybean oil)
• 2 tablespoons olive oil (4g)
• 2 tablespoons peanut butter (3g)

I would be eating more saturated fat than the AHA recommends.

* Source: NutritionData: Olive Oil

________

Music: Saint-Säens "Mon Coeur S'ouvre A Ta Voix"

This is an aria from Saint-Säens opera Samson and Delilah, sung by Marilyn Horne.


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Zinc On A Vegan Diet

A new study found that infants who aren't given meat (which is a good source of zinc) or zinc-fortified food don't meet zinc requirements:

Comparison Of Complementary Feeding Strategies To Meet Zinc Requirements Of Older Breastfed Infants, American Journal of Clinical Nutrition, July 2012

At 5 months of age, 45 breast-fed babies received one of the following as their complementary food for about 5 months:

• Commercially available pureed meats
• Iron-and-zinc–fortified infant cereal (IZFC)
• Whole-grain, iron-only–fortified infant cereal (IFC)

They found:

"Only intakes in meat and [zinc fortified] groups met estimated average requirements [for zinc]."

Intakes aren't the same as what gets absorbed though. Unfortunately, not only did the non-zinc group have low intake, it also had low absorption. The total zinc absorbed (from breast milk plus food) was highest in the meat group (0.80 mg/d), next highest in the zinc-fortified group (0.71 mg/d), and lowest in the iron-only group (0.52 mg/d).

"Conclusion: Zinc requirements for older breastfed-only infants are unlikely to be met without the regular consumption of either meats or zinc-fortified foods."

So, is zinc difficult to get on a vegan diet? The National Institutes of Health in their Fact Sheet on Zinc say:

"The bioavailability of zinc from vegetarian diets is lower than from non-vegetarian diets because vegetarians do not eat meat, which is high in bioavailable zinc and may enhance zinc absorption. In addition, vegetarians typically eat high levels of legumes and whole grains, which contain phytates that bind zinc and inhibit its absorption."
...
"Vegetarians sometimes require as much as 50% more of the RDA for zinc than non-vegetarians."

The RDA for adult men is 11mg, women 8mg. So, vegans may want to shoot for: men 16.5mg, women 12mg.

How Americans Spend Their Time

The Bureau of Labor Statistics released the results of their time use survey for 2011:
American Time Use Survey - 2011 Results

The data was collected by phone on about 12,500 individuals age 15 or older.

This was the first year they collected data on eldercare, that is, time spent providing unpaid care to someone over 65 "who needed help because of a condition related to aging." Almost 40 million people (39.8), 16% of the adult population, provided eldercare in the last 3 months. The majority of those (56%) were women. And when eldercare was provided, "persons spent an average of 3.1 hours providing this care."

While I was looking at the data, I created this chart of how American spend their time:


Source: Table 1. Time spent in primary activities. Hours a day:
Sleeping 8.71
Leisure/Sports (Includes TV/PC) 5.21
Working 3.57
Eating/Drinking 1.24
Housework 1.21
Personal Care 0.78
Buying (Goods, Services) 0.72
Caregiving 0.72
Food Prep/Cleanup 0.56
Education (Class and Study) 0.47
Religious/Civic Activities 0.35
Other 0.29
Phone/Mail/Email 0.16

There's so much to talk about here, but one figure jumped out. How much time does the average American spend each day on "food preparation and cleanup?" A little over half an hour (0.56 hours).

Women spent more time doing it than men (0.79 hours vs. 0.31 hours). But that's still an average; it blends together those who do no food prep with those that do. How many hours a day do people spend if they're the one doing it? ... a little over an hour (1.04).

How much time do you spend in a day preparing food and cleaning up?
________

2 Million-Year-Old Prehuman Ate Trees: Fruit, Leaves, Bark

This story in the New York Times last week...
Some Prehumans Feasted on Bark Instead of Grasses

... Described an investigation of the remains of an early human ancestor called Austalopithecus sediba. Au. sediba lived about 2 million years ago in southern Africa, and decided, as "a matter of choice, not necessity," to forgo the grasses that the rest of its hominin relations were enjoying at the time and to venture into the woods to eat "almost exclusively a diet of leaves, fruits, wood and bark."

I was going to include the story in my recent post, Diet Of Early Man: Grain, but didn't because it described an ancestor that was, in my opinion, too far removed from who we are today. Its brain was smaller, its skeleton and intestinal tract different. Wikipedia says that the entire genus, Australopithecus, became extinct about 2 million years ago. The researchers themselves are still pondering "how or if [Au. sediba] is related to modern humans and just where it fits on the hominin family tree."

I'm not a paleoanthropologist or evolutionary biologist or anything of the sort. I don't know how the diet of these much older relatives impacts modern humans' diet, except for my casual reading. (I enjoyed Wrangham's "Catching Fire," a good popular book on the topic.) I don't mean to sound flippant but if it's found that prehumans ate something not sold at the grocery store, I'm probably not going to eat it. Not that everything sold in grocery stores is something I eat. Although I would like to try sorghum.

Nonetheless, Don Matesz, the author of a blog I've been reading recently called Primal Wisdom, did post about it:
Study: Autralopithecus Diet "Almost Exclusively" Plant Food – Researcher Says "Humans Are Basically Grass-Eaters"

He said the findings support his hypothesis that "humans evolved as primarily plant- and probably, grass-product eaters."

Don Matesz has an interesting blog. He followed a more meat-based paleo diet for about 14 years but gave it up last summer for "a plant-dominated, high-carbohydrate diet supplying significantly less than 30% of energy from fat:" Farewell To Paleo.
________The photo is from the NYTs: "the left anterior premolar of the Australopithecus sediba." Tooth enamel and tartar were studied to determine diet. Those are some fine teeth. Do you think they brushed?

When You Hear "Carb," What Food Comes To Mind?

Returning to that James McWilliams article:
The Evidence for a Vegan Diet, The Atlantic, January 18, 2012

Where he said:

"Here is a comprehensive list of what I ate, in one form or another, on the day I wrote this:

Kale, mustard greens, carrots, celery, onions, mushrooms, quinoa, amaranth, pinto beans, beets, parsnips, turnips, yellow peas, brown rice, kimchi, purple cabbage, butternut squash, blueberries, a banana, hemp seeds, flaxseed oil, snap peas, an apple, cashews, almonds, pumpkin seeds, pistachio nuts, garlic, broccoli, raisins, granola, avocado, polenta, salsa, a few saltines, a piece of raisin toast with apricot jam, tofu, coffee, olive oil, harisa, chickpeas, tomatoes, a small handful of chocolate chips, a couple of beers ... and a vitamin."

About that list, he said:

"Forty-three discrete plant foods, a couple of processed items, a little alcohol and caffeine, very few carbs, a B-12 pill."

About that "very few carbs" point he made, do you agree with him? That he ate very few carbs?

I've run into this at work and on a few forums. Some people equate, say, bread with carbs. Or cookies, pancakes, muffins, pretzels, pasta. Those are carbs. But an apple? Even though 95% of its calories come from carbohydrates, some people don't think of it as a carb. Pure lemon juice is 95% carbs. Carrots and tomatoes are about 90% carbs. Cabbage is 85% carbs. Even greens like kale get about three quarters of their calories from carbs. A vegan diet, especially a low-fat one, is in all likelihood a high-carbohydrate diet. I get into trouble when I say high-carb diets can be healthful because some people think I'm saying it's healthful to eat a lot of processed grain products.
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Vitamin B12 On A Vegan Diet

Say you decide to eat no animal products, which are the primary source for vitamin B12 in the human diet. How long will it take for your B12 status to fall below normal?¹

Here's a study from the USDA archives:
Vitamin B12 Studies In Total Vegetarians (Vegans), Journal of Nutritional Medicine, 1994

I can only see the abstract and it's difficult to follow the group(s) they studied, but they describe:

"In 10 who changed from a lacto-ovo-vegetarian (LOV) diet to a TVD,² the mean serum B12 level dropped 35% from 415 +/- 187 to 268 +/- 75 pg ml-1 p<0.005) 2 months after starting the TVD. ... Serum B12 levels decreased noticeably within 2 months on a [vegan diet]."

So, after 2 months, the group's average was hovering close to what the IOM considers a lower limit. After a year:

"61% of those on the [vegan diet] for 1 year or more had serum B12 levels below normal."

Looks like they used 200 pg/ml as the cutoff for normal. All well and good but the IOM says, "a serum B12 value above the cutoff point does not necessarily indicate adequate B12 status," because "as deficiency develops, serum values may be maintained at the expense of B12 in the tissues."

They also looked at the prevalence of low B12 status in vegans. In 78 vegans, 47 were below normal. Even the remaining 31 had levels only reaching 293 +/- 85.

Everyone is different. Some people may be very efficient at reabsorbing any B12 they secrete into the small intestine via bile.³ But reabsorption is not 100%. And there is some loss of B12 after this point anyway, from cells that break off in the large intestine. Without some B12 input, there will be net loss over time. And anyone with absorption problems in the area of their distal small intestine where B12 is taken up (or if this part of the intestine is absent from, say, cancer or Crohn's surgery), and anyone with inflammatory issues in the stomach where intrinsic factor (IF) is secreted (IF assists in B12 absorption) will most definitely face B12 deficiency without some treatment.

So, how long will it take to fall below normal? From this data, somewhere between a few months to a few years depending on the health of the GI tract.

If I was eating a vegan diet, I would definitely supplement with vitamin B12, and/or eat B12 fortified food.

One more point from this study, about supplementing:

"The serum B12 level of seven of 16 adults with a low serum B12 who chewed a 100 microgram tablet of B12 once a week for 6 weeks increased by 150%, whereas the serum B12 level increased by only 12% in the nine who gulped down the tablets (with water)."

________ ¹ The Institute of Medicine (IOM) says that, "the lower limit is considered to be approximately 120 to 180 pmol/L (170 to 250 pg/mL) for adults."
² TVD: Total Vegetarian Diet, i.e. Vegan Diet
³ How much we lose in bile depends in part on how much fat we eat, since bile is secreted to emulsify dietary fat. Still, this is not a lot, maybe 0.5 to 1 mcg/day say the IOM.

Music: Delibes' The Flower Duet

From the opera Lakmé by Léo Delibes.
Sopranos: Joan Sutherland and Jane Berbie.


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