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  • The Safety of Keto Diets  | NutritionFacts.org

    The Safety of Keto Diets  | NutritionFacts.org

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    What are the effects of ketogenic diets on nutrient sufficiency, gut flora, and heart disease risk? 

    Given the decades of experience using ketogenic diets to treat certain cases of pediatric epilepsy, a body of safety data has accumulated. Nutrient deficiencies would seem to be the obvious issue. Inadequate intake of 17 micronutrients, vitamins, and minerals has been documented in those on strict ketogenic diets, as you can see in the graph below and at 0:14 in my video Are Keto Diets Safe?

    Dieting is a particularly important time to make sure you’re meeting all of your essential nutrient requirements, since you may be taking in less food. Ketogenic diets tend to be so nutritionally vacuous that one assessment estimated that you’d have to eat more than 37,000 calories a day to get a sufficient daily intake of all essential vitamins and minerals, as you can see in the graph below and at 0:39 in my video


    That is one of the advantages of more plant-based approaches. As the editor-in-chief of the Journal of the American Dietetic Association put it, “What could be more nutrient-dense than a vegetarian diet?” Choosing a healthy diet may be easier than eating more than 37,000 daily calories, which is like putting 50 sticks of butter in your morning coffee. 
     
    We aren’t just talking about not reaching your daily allowances either. Children have gotten scurvy on ketogenic diets, and some have even died from selenium deficiency, which can cause sudden cardiac death. The vitamin and mineral deficiencies can be solved with supplements, but what about the paucity of prebiotics, the dozens of types of fiber, and resistant starches found concentrated in whole grains and beans that you’d miss out on? 
     
    Not surprisingly, constipation is very common on keto diets. As I’ve reviewed before, starving our microbial self of prebiotics can have a whole array of negative consequences. Ketogenic diets have been shown to “reduce the species richness and diversity of intestinal microbiota,” our gut flora. Microbiome changes can be detected within 24 hours of switching to a high-fat, low-fiber diet. A lack of fiber starves our good gut bacteria. We used to think that dietary fat itself was nearly all absorbed in the small intestine, but based on studies using radioactive tracers, we now know that about 7 percent of the saturated fat in a fat-rich meal can make it down to the colon. This may result in “detrimental changes” in our gut microbiome, as well as weight gain, increased leaky gut, and pro-inflammatory changes. For example, there may be a drop in beneficial Bifidobacteria and a decrease in overall short-chain fatty acid production, both of which would be expected to increase the risk of gastrointestinal disorders. 
     
    Striking at the heart of the matter, what might all of that saturated fat be doing to our heart? If you look at low-carbohydrate diets and all-cause mortality, those who eat lower-carb diets suffer “a significantly higher risk of all-cause mortality,” meaning they live, on average, significantly shorter lives. However, from a heart-disease perspective, it matters if it’s animal fat or plant fat. Based on the famous Harvard cohorts, eating more of an animal-based, low-carb diet was associated with higher death rates from cardiovascular disease and a 50 percent higher risk of dying from a heart attack or stroke, but no such association was found for lower-carb diets based on plant sources.  
     
    And it wasn’t just Harvard. Other researchers have also found that “low-carbohydrate dietary patterns favoring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favored plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain bread, were associated with lower mortality…” 
     
    Cholesterol production in the body is directly correlated to body weight, as you can see in the graph below and at 3:50 in my video

    Every pound of weight loss by nearly any means is associated with about a one-point drop in cholesterol levels in the blood. But if we put people on very-low-carb ketogenic diets, the beneficial effect on LDL bad cholesterol is blunted or even completely neutralized. Counterbalancing changes in LDL or HDL (what we used to think of as good cholesterol) are not considered sufficient to offset this risk. You don’t have to wait until cholesterol builds up in your arteries to have adverse effects either; within three hours of eating a meal high in saturated fat, you can see a significant impairment of artery function. Even with a dozen pounds of weight loss, artery function worsens on a ketogenic diet instead of getting better, which appears to be the case with low-carb diets in general.  

    For more on keto diets, check out my video series here

    And, to learn more about your microbiome, see the related videos below.

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    Michael Greger M.D. FACLM

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  • Can You Sustain Weight Loss on Ketosis?  | NutritionFacts.org

    Can You Sustain Weight Loss on Ketosis?  | NutritionFacts.org

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    Might the appetite-suppressing effects of ketosis improve dietary compliance? 

    The new data are said to debunk “some, if not all, of the popular claims made for extreme carbohydrate restriction,” but what about ketones suppressing hunger? In a tightly controlled metabolic ward study where the ketogenic diet made things worse, everyone ate the same number of calories, but those on a keto diet lost less body fat. But, out in the real world, all of those ketones might spoil your appetite enough that you’d end up eating significantly less overall. On a low-carb diet, people end up storing 300 more calories of fat every day. Outside of the laboratory, though, if you were in a state of ketosis, might you be able to offset that if you were able to sustainably eat significantly less? 
     
    Paradoxically, as I discuss in my video Is Weight Loss on Ketosis Sustainable?, people may experience less hunger on a total fast compared to an extremely low-calorie diet. This may be thanks to ketones. In this state of ketosis, when you have high levels of ketones in your bloodstream, your hunger is dampened. How do we know it’s the ketones? If you inject ketones straight into people’s veins, even those who are not fasting lose their appetite, sometimes even to the point of getting nauseated and vomiting. So, ketones can explain why you might feel hungrier after a few days on a low-calorie diet than on a total zero-calorie diet—that is, a fast. 
     
    Can we then exploit the appetite-suppressing effects of ketosis by eating a ketogenic diet? If you ate so few carbs to sustain brain function, couldn’t you trick your body into thinking you’re fasting and get your liver to start pumping out ketones? Yes, but is it safe? Is it effective? 
     
    As you can see below and at 1:58 in my video, a meta-analysis of 48 randomized trials of various branded diets found that those advised to eat low-carb diets and those told to eat low-fat ones lost nearly identical amounts of weight after a year.

    Obviously, high attrition rates and poor dietary adherence complicate comparisons of efficacy. The study participants weren’t actually put on those diets; they were just told to eat in those ways. Nevertheless, you can see how even just moving in each respective direction can get rid of a lot of CRAP (which is Jeff Novick’s acronym for Calorie-Rich And Processed foods). After all, as you can see in the graph below and at 2:37 in my video, the four largest calorie contributors in the American diet are refined grains, added fats, meat, and added sugars. 

    Low-carb diets cut down on refined grains and added sugars, and low-fat diets tend to cut down on added fats and meat, so they both tell people to cut down on donuts. Any diet that does that already has a leg up. I figure a don’t-eat-anything-that-starts-with-the-letter-D diet could also successfully cause weight loss if it caused people to cut down on donuts, danishes, and Doritos, even if it makes no nutritional sense to exclude something like dill. 

    The secret to long-term weight-loss success on any diet is compliance. Diet adherence is difficult, though, because any time you try to cut calories, your body ramps up your appetite to try to compensate. This is why traditional weight-loss approaches, like portion control, tend to fail. For long-term success, measured not in weeks or months but in years and decades, this day-to-day hunger problem must be overcome. On a wholesome plant-based diet, this can be accomplished thanks in part to calorie density because you’re just eating so much food. On a ketogenic diet, it may be accomplished with ketosis. In a systematic review and meta-analysis entitled “Do Ketogenic Diets Really Suppress Appetite,” researchers found that the answer was yes. Ketogenic diets also offer the unique advantage of being able to track dietary compliance in real-time with ketone test strips you can pee on to see if you’re still in ketosis. There’s no pee stick that will tell you if you’re eating enough fruits and veggies. All you have is the bathroom scale. 

    Keto compliance may be more in theory than practice, though. Even in studies where ketogenic diets are being used to control seizures, dietary compliance may drop below 50 percent after a few months. This can be tragic for those with intractable epilepsy, but for everyone else, the difficulty in sticking long-term to ketogenic diets may actually be a lifesaver. I’ll talk about keto diet safety next. 

    The keto diet is in contrast to a diet that would actually be healthful to stick to. See, for example, my video series on the CHIP program here
     
    This was the fourth video in a seven-part series on keto diets. If you haven’t yet, be sure to watch the others listed in the related videos below. 

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    Michael Greger M.D. FACLM

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  • Can You Lose Weight on a Keto Diet?  | NutritionFacts.org

    Can You Lose Weight on a Keto Diet?  | NutritionFacts.org

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    Let’s dive into ketogenic diets and their $33-billion gimmick. 

    The carbohydrate–insulin model of obesity, the underlying theory that ketogenic diets have some sort of metabolic advantage, has been experimentally falsified. Keto diet proponents’ own studies showed the exact opposite: Ketogenic diets actually put you at a metabolic disadvantage and slow the loss of body fat. How much does fat loss slow down on a low-carb diet?  

    As I discuss in my video Keto Diet Results for Weight Loss, if you cut about 800 calories of carbohydrates from your diet a day, you lose 53 grams of body fat a day. But if you cut the same number of fat calories, you lose 89 grams of fat a day. Same number of calories cut, but nine butter pats’ worth of extra fat melting off your body each day on a low-fat diet, compared to a low-carb one. Same number of calories, but about 80 percent more fat loss when you cut down on fat instead of carbs. You can see a graph of these results below and at 1:07 in my video. The title of the study speaks for itself: “Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss Than Carbohydrate Restriction in People with Obesity.” 

    Just looking at the bathroom scale, though, would mislead you into thinking the opposite. After six days on the low-carb diet, study subjects lost four pounds. On the low-fat diet, they lost less than three pounds, as you can see in the graph below and at 1:40 in my video. So, according to the scale, it looked like the low-carb diet wins hands down. You can see why low-carb diets are so popular. What was happening inside their bodies, however, tells the real story. The low-carb group was losing mostly lean mass—water and protein. This loss of water weight helps explain why low-carb diets have “been such a persistent theme for authors of diet books and such ‘cash cows’ for publishers,” going back more than the last 150 years. That’s their secret. As one weight-loss expert noted, “Rapid water loss is the $33-billion diet gimmick.” 

    When you eat carbohydrates, your body bulks up your muscles with glycogen for quick energy. Eat a high-carbohydrate diet for three days, and you may add about three pounds of muscle mass onto your arms and legs, as you can see below and at 2:34 in my video. Those glycogen stores drain away on a low-carb diet and pull water out with it. (The ketones also need to be flushed out of the kidneys, pulling out even more water.) On the scale, that can manifest as four more pounds coming off within ten days, but that “was all accounted for by losses in total body water”—that is water loss. 

    The bottom line: Keto diets just don’t hold water. 

    The thrill of seeing the pounds come off so quickly on the scale keeps many coming back to the low-carb altar. When the diet fails, the dieters often blame themselves, but the intoxication of that initial, rapid weight loss may tempt them back, like getting drunk again after forgetting how terrible the last hangover was. This has been dubbed the “false hope syndrome.” “The diet industry thrives for two reasons—big promises and repeat customers,” something low-carb diets were built for, given that initial, rapid water loss. 

    What we care about is body fat. In six days, the low-fat diet extracted a total of 80 percent more fat from the body than the low-carb diet. It’s not just one study either. As you can see below and at 3:54 in my video, you can look at all of the controlled feeding trials where researchers compared low-carb diets to low-fat ones, swapping the same number of carb calories for fat calories or vice versa. If a calorie is just a calorie, then all of the studies should have crossed that zero line in the middle, straddling “favors low-fat diet” and “favors low-carb diet,” and indeed six did. One study showed more fat loss on a low-carb diet, but every other study favored the low-fat diet—more loss of body fat eating the same number of calories. When you put all of the studies together, we’re talking 16 more grams of daily body fat lost on the low-fat diets. That’s like four more pats of butter melting off your body on a daily basis. Less fat in the mouth means less fat on the hips, even when you’re taking in the same number of calories. 

    This is the third installment of my seven-part series on keto diets. 

    This keto research came from the deep dive I took for my book How Not to Diet. (All proceeds I receive from my books are donated to charity.) You can learn more about How Not to Diet and order it here. Also please feel free to check out some of my popular weight-loss videos in related videos below. 

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    Michael Greger M.D. FACLM

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  • How To Relieve Sore Muscles: Expert-Backed Methods & Tips

    How To Relieve Sore Muscles: Expert-Backed Methods & Tips

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    If you want to build muscle and gain strength, muscle soreness is inevitable. Yet everywhere you look, someone is promoting the latest and greatest hack for relieving sore muscles quickly. We reached out to exercise physiologists to get the scoop on which of these tools and techniques are actually effective—and which ones are overhyped with little science to back them up.

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  • Testing the Keto Diet Theory  | NutritionFacts.org

    Testing the Keto Diet Theory  | NutritionFacts.org

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    Do low-carb and ketogenic diets have a metabolic advantage for weight loss? 

    When you don’t eat enough carbohydrates, you force your body to burn more fat. “However, this rise in fat oxidation [burning] is often misconstrued as a greater rate of net FM [fat-mass] reduction” in the body, ignoring the fact that, on a ketogenic diet, your fat intake shoots up, too. What happens to your overall body fat balance? You can’t empty a tub by widening the drain if you’re opening the faucet at the same time. Low-carb advocates had a theory, though, the “carbohydrate–insulin model of obesity,” which I discuss in my video Keto Diet Theory Put to the Test 

    Proponents of low-carb diets, whether a ketogenic diet or a more relaxed form of carbohydrate restriction, suggested that decreased insulin secretion would lead to less fat storage, so even if you were eating more fat, less of it would stick to your frame. We’d burn more and store less, the perfect combination for fat loss—or so the theory went. To their credit, instead of just speculating about it, they decided to put it to the test. 

    Gary Taubes formed the Nutrition Science Initiative (NuSI) to sponsor research to validate the carbohydrate–insulin model. He’s the journalist who wrote the controversial 2002 New York Times Magazine article “What If It’s All Been a Big Fat Lie?” which attempted to turn nutrition dogma on its head by arguing in favor of the Atkins diet with its bunless bacon cheeseburgers based on the carbohydrate–insulin model. (Much of Nina Teicholz’s book The Big Fat Surprise is simply recycled from Taubes’ earlier work.)  

    In response, some of the very researchers Taubes cited to support his thesis accused him of twisting their words. One said, “The article was incredibly misleading…I was horrified.” Said another, “He took this weird little idea and blew it up, and people believed him…What a disaster.” It doesn’t matter what people say, though. All that matters is the science. 

    Taubes attracted $40 million in committed funding for his Nutrition Science Initiative to prove to the world that you could lose more body fat on a ketogenic diet. NuSI contracted noted researcher Kevin Hall from the National Institutes of Health to perform the study. Seventeen overweight or obese men were effectively locked in what’s called a metabolic ward for two months to allow researchers total control over their diets. For the first month, they were placed on a typical high-carbohydrate diet (50 percent carbs, 35 percent fat, 15 percent protein), then were switched to a low-carb ketogenic diet (only 5 percent of calories from carbohydrates and 80 percent fat) for the second month. Both diets had the same number of daily calories. So, if a calorie is a calorie when it comes to weight loss, there should be no difference in body fat loss on the regular diet versus the ketogenic diet. If Taubes was right, though, if fat calories were somehow less fattening, then body fat loss would become accelerated on a keto diet. Instead, in the very study funded by the Nutrition Science Initiative, researchers found that body fat loss slowed during the ketogenic diet. 

    Why do people think the keto diet works if it actually slows fat loss? Well, as you can see in the graph below and at 3:40 in my video, if you looked only at the readings on bathroom scales, the ketogenic diet would seem like a smashing success. Participants went from losing less than a pound a week on the regular diet during the first two weeks of the study to losing three and a half pounds within seven days after switching to the ketogenic diet. What was happening inside their bodies, however, told a totally different story: Their rate of body fat loss was slowed by more than half. So, most of what they were losing was just water weight. It’s presumed the reason they started burning less fat on a ketogenic diet was because, without the preferred fuel of carbohydrates, their bodies started burning more of their own protein—and that’s exactly what happened. Switching to a ketogenic diet made them lose less fat mass and more fat-free mass. Indeed, they lost more lean mass. That may help explain why the leg muscles of CrossFit trainees placed on a ketogenic diet may shrink as much as 8 percent. The vast lateralis, the biggest quad muscle in your leg, shrunk in thickness by 8 percent on a ketogenic diet. 

    Yes, the study subjects started burning more fat on the ketogenic diet, but they were also eating so much more fat on the keto diet that they ended up retaining more fat in their body, despite the lower insulin levels. This is “diametrically opposite” to what the keto crowd predicted, and this is from the guy Nutrition Science Initiative paid to support its theory. In science-speak, “the carbohydrate–insulin model failed experimental interrogation.” 

    In light of this “experimental falsification” of the low-carb theory, the Nutrition Science Initiative effectively collapsed but, based on its tax returns, not before Taubes and his co-founder personally pocketed millions of dollars in compensation. 

    This is the second installment in my seven-part series on keto diets. In case you missed them, check out the other related videos below.  

    The more things change, the more they stay the same. I created a whole website about the Atkins Diet, but, sadly, people keep falling into the low-carb trap. You can find some of my older videos on low-carb diets listed below. 

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    Michael Greger M.D. FACLM

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  • Keto Diet to Effectively Fight Cancer?  | NutritionFacts.org

    Keto Diet to Effectively Fight Cancer?  | NutritionFacts.org

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    What does the science say about the clinical use of ketogenic diets for epilepsy and cancer? 

    Blood sugar, also known as blood glucose, is the universal go-to fuel for the cells throughout our bodies. Our brain burns through a quarter pound of sugar a day because “glucose is the preferred metabolic fuel.” We can break down proteins and make glucose from scratch, but most comes from our diet in the form of sugars and starches. If we stop eating carbohydrates (or stop eating altogether), most of our cells switch over to burning fat. Fat has difficulty getting through the blood-brain barrier, though, and our brain has a constant, massive need for fuel. Just that one organ accounts for up to half of our energy needs. Without it, the lights go out…permanently. 

    To make that much sugar from scratch, our body would need to break down about half a pound of protein a day. That means we’d cannibalize ourselves to death within two weeks, but people can fast for months. What’s going on? The answer to the puzzle was discovered in 1967. Harvard researchers famously stuck catheters into the brains of obese subjects who had been fasting for more than a month and discovered that ketones had replaced glucose as the preferred fuel for the brain. Our liver can turn fat into ketones, which can then breach the blood-brain barrier and sustain our brain if we aren’t getting enough carbohydrates. Switching fuels has such an effect on brain activity that it has been used to treat epilepsy since antiquity. 

    In fact, the prescription of fasting for the treatment of epileptic seizures dates back to Hippocrates. In the Bible, even Jesus seems to have concurred. To this day, it’s unclear why switching from blood sugar to ketones as a primary fuel source has such a dampening effect on brain overactivity. How long can one fast? To prolong the fasting therapy, in 1921, a distinguished physician scientist at the Mayo Clinic suggested trying what he called “ketogenic diets,” high-fat diets designed to be so deficient in carbohydrates that they could effectively mimic the fasting state. “Remarkable improvement” was noted the first time it was put to the test, efficacy that was later confirmed in randomized, controlled trials. Ketogenic diets started to fall out of favor in 1938 with the discovery of the anti-seizure drug that would become known as Dilantin, but they’re still being used today as a third- or fourth-line treatment for drug-refractory epilepsy in children. 

    Oddly, the success of ketogenic diets against pediatric epilepsy seems to get conflated by “keto diet” proponents into suggesting a ketogenic diet is beneficial for everyone. Know what else sometimes works for intractable epilepsy? Brain surgery, but I don’t hear people clamoring to get their skulls sawed open. Since when do medical therapies translate into healthy lifestyle choices? Scrambling brain activity with electroshock therapy can be helpful in some cases of major depression, so should we get out the electrodes? Ketogenic diets are also being tested to see if they can slow the growth of certain brain tumors. Even if they work, you know what else can help slow cancer growth? Chemotherapy. So why go keto when you can just go chemo? 

    Promoters of ketogenic diets for cancer are paid by so-called ketone technology companies that offer to send you salted caramel bone broth powder for a hundred bucks a pound or companies that market ketogenic meals and report “extraordinary” anecdotal responses in some cancer patients. But more concrete evidence is simply lacking, and even the theoretical underpinnings may be questionable. A common refrain is that “cancer feeds on sugar.” But all cells feed on sugar. Advocating ketogenic diets for cancer is like saying Hitler breathed air so we should boycott oxygen. 

    Cancer can feed on ketones, too. Ketones have been found to fuel human breast cancer growth and drive metastases in an experimental model, more than doubling tumor growth. Some have even speculated that this may be why breast cancer often metastasizes to the liver, the main site of ketone production. As you can see below and at 4:59 in my video Is Keto an Effective Cancer-Fighting Diet?, if you drip ketones directly onto breast cancer cells in a petri dish, the genes that get turned on and off make for much more aggressive cancer, associated with significantly lower five-year survival in breast cancer patients, as you can see in the following graph and at 5:05 in my video. Researchers are even considering designing ketone-blocking drugs to prevent further cancer growth by halting ketone production.  

    Let’s also think about what eating a ketogenic diet might entail. High animal fat intake may increase the mortality risk among breast cancer survivors and potentially play a role in the development of breast cancer in the first place through oxidative stress, hormone disruption, or inflammation. This applies to men, too. “A strong association” has been found “between saturated fat intake and prostate cancer progression and survival.” Those in the top third of consumption of these kinds of fat-rich animal foods appeared to triple their risk of dying from prostate cancer. This isn’t necessarily fat in general either. No difference has been found in breast cancer death rates based on total fat intake. However saturated fat intake specifically may negatively impact breast cancer survival, increasing the risk of dying from it by 50 percent. There’s a reason the official American Cancer Society and American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline recommend a dietary pattern for breast cancer patients that’s essentially the opposite of a ketogenic diet. It calls for a diet that’s “high in vegetables, fruits, whole grains, and legumes [beans, split peas, chickpeas, and lentils]; low in saturated fats; and limited in alcohol consumption.” 

    “To date, not a single clinical study has shown a measurable benefit from a ketogenic diet in any human cancer.” There are currently at least a dozen trials underway, however, and the hope is that at least some cancer types will respond. Still, even then, that wouldn’t serve as a basis for recommending ketogenic diets for the general population any more than recommending everyone get radiation, surgery, and chemo just for kicks. 

    “Keto” has been the most-searched keyword on NutritionFacts.org for months, and I didn’t have much specific to offer…until now. Check out my other videos on the topic in related videos below. 

     For an overview of my cancer work, watch How Not to Die from Cancer. 

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    Michael Greger M.D. FACLM

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  • An RD Shares 3 Energy-Boosting Pre-Workout Snack Recipes

    An RD Shares 3 Energy-Boosting Pre-Workout Snack Recipes

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    If you’ve struggled to achieve balance with your pre-workout snack (some make you feel weighed down, others low on energy), consider this your guide to perfecting the craft. I asked registered dietician and founder of Real Nutrition Amy Shapiro, R.D. for three pre-workout snack recipes that fit every craving and the benefits that come with them. 

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    Hannah Frye

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  • Protein Powder For Weight Loss: Why It Works & Pro Tips

    Protein Powder For Weight Loss: Why It Works & Pro Tips

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    If weight loss is your goal, squeezing extra protein into your diet might be beneficial. That’s because a higher protein diet can increase feelings of fullness, which can help prevent overeating, according to Rachel Adamkowski, MPH, RD, a sports dietitian and Assistant Director of Football Nutrition for the University of Florida.

    Research also suggests that protein could alter levels of certain hormones in the body that control hunger and appetite, which may translate to decreased food intake.

    Stacy Sims, MSC, PhD, an exercise physiologist who specializes in nutrition science for women, tells mindbodygreen that increasing your intake of protein could also improve your body composition by reducing fat mass while preserving lean body mass. “With higher protein intake, even if [your] calorie intake is too low, the circulating amino acids stimulate the brain to keep and build lean mass,” she explains, noting that this can lead to the breakdown of fat.

    Plus, Sims says that protein can also boost your energy expenditure, or the number of calories that you burn each day at rest, which is partly because protein requires more energy to digest than carbs or fat. “Protein intake [also] prevents a decrease in fat-free mass, which helps maintain resting energy expenditure despite weight loss,” notes Sims.

    Of course, loading your plate with plenty of protein isn’t a sure-fire solution for weight loss. This is because there are lots of other factors at play, including how much you’re eating and moving, and what the rest of your diet looks like.

    At the very minimum, individuals should be getting 0.8 grams of protein per kilogram of body weight (g/kg/bw), which is the recommended dietary allowance (RDA) for protein. However, this is likely far short of what active individuals will need. Many experts now recommend getting roughly 1.2 to 2.0 g/kg/bw. This comes out to upwards of 100 grams of protein a day for most people.

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    Rachael Ajmera, MS, RD

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  • How A Celeb RD Fits 30 Grams Of Protein Into Every Breakfast

    How A Celeb RD Fits 30 Grams Of Protein Into Every Breakfast

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    Like so many of us, LeVeque was taught that overnight oats, chia pudding, and egg scrambles are the epitome of healthy breakfast foods.

    While these dishes can be nutrient-dense and delicious, she notes that most of them don’t hit the 30-gram threshold she’s looking for to activate muscle protein synthesis and get her on her way to her goal of consuming 1.2 to 2.0 grams of protein per kilogram of body weight a day (upward of 100 grams daily). A large egg contains around 6 grams of protein, for example, so she’d need to eat at least five of them to hit this breakfast target.

    It’s a lot easier to make a high-protein breakfast using complete animal-based proteins like steak, chicken, salmon, turkey, bison, and lamb, she notes. Bioavailable animal proteins also contain important fat-soluble vitamins and tend to be higher in leucine—an essential amino acid that kick-starts muscle building and repair.

    Another nice thing about these proteins is you don’t need to do much to make them taste good. Case in point: The morning LeVeque and I connected for this piece, she said she’d just consumed some ground beef straight out of a glass container in her fridge for breakfast. And after the call, before running to her next appointment, she’d probably have some leftover chicken from the night before with carrots, cucumbers, and whatever condiments she had on hand.

    Eating this type of breakfast might sound a little weird but, she explains, “When you eat enough protein, you really don’t care what the other stuff you’re eating is. You’re so satisfied that the cravings hit the floor.”

    Since introducing more protein to her breakfast—in the form of whole animal proteins and her go-to smoothie (which also features a serving of protein powder)—she’s noticed that her strength has skyrocketed, her digestion has improved, and her cravings and mood have steadied. “I feel stronger and lighter than ever,” she says, noting that some of her celeb clients like Jennifer Garner and Halle Berry have had similar results on a higher-protein diet.

    Here’s the breakdown of how LeVeque fits in at least 30 grams of protein each morning using whole-food ingredients.

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    Emma Loewe

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  • Lentil & Mushroom Ragu: A Plant-Based Pasta Sauce With Protein

    Lentil & Mushroom Ragu: A Plant-Based Pasta Sauce With Protein

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    I tried to keep the flavor profile similar to an Italian beef or veal ragu by using a base soffritto of celery, onion, and carrot plus a grating of nutmeg and some bay leaves for that all-is-well-with-the-world homely lasagne taste. The other crucial ingredient was some hidden blitzed mushrooms, a vegetable Leo generally hates but that add meatiness here without actually tasting mushroomy. There is sweetness from Marsala (or use the dregs of a bottle of port or dessert wine if that’s what you have), and I decided to use red lentils instead of Le Puy or green because they cook down quicker and have a mushy nursery-food charm.

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    Bee Wilson

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  • Say Goodbye To Bland Salmon With This Hibiscus Honey Mustard Recipe

    Say Goodbye To Bland Salmon With This Hibiscus Honey Mustard Recipe

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    Used in plant medicine for its diuretic and antimicrobial properties, hibiscus takes this honey mustard marinade up a notch.

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    Klancy Miller

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  • Americans Eat Obscene Amounts of Protein. Is It Enough?

    Americans Eat Obscene Amounts of Protein. Is It Enough?

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    For years, the American approach to protein has been a never-ending quest for more. On average, each person in the United States puts away roughly 300 pounds of meat a year; we are responsible for more than a third of the multibillion-dollar protein-supplement market. Our recommended dietary allowance, or RDA, for protein is 0.8 grams per kilogram of body weight per day—a quota that a 160-pound person could meet with a couple of eggs in the morning and an eight-ounce steak at night. American adults consistently eat well above that amount, with men close to doubling it—and recent polls show that millions of us want to increase our intake.

    The American appetite for protein is, simply put, huge. And still, Jose Antonio thinks we’re getting nowhere near enough.

    The RDA of 0.8 grams per kilogram is “nothing, literally nothing,” Antonio, a health-and-human-performance researcher at Nova Southeastern University, in Florida, told me. “Most of my friends get that at breakfast.” In an ideal world, Antonio said, totally sedentary adults should consume at least twice that; people who seriously exercise should start with a minimum of 2.2 grams per kilogram, and ramp their levels up from there. (Antonio is also a co-founder of the International Society of Sports Nutrition, which has received sponsorships from companies that sell protein supplements.)

    In Antonio’s pro-protein world, people would be fitter, more energetic, and suffer less chronic disease; they’d build muscle more efficiently, and recover faster from workouts. There is no definitive cap, in his view, on how much protein people should strive for. The limit, he said, is “How much can a human consume in a single day?”

    Among nutritionists, Antonio’s viewpoint is pretty fringe. There is, other experts told me, such a thing as too much protein—or at least a point of rapidly diminishing returns. But researchers don’t agree on how much protein is necessary, or how much is excessive; they’ve reached no consensus on the extent of its benefits, or whether eating extra servings can send our health into decline. Which leaves Americans with no protein ceiling—and plenty of room for our protein hunger to grow, and grow, and grow.

    Not having enough protein is clearly very bad. Protein is essential to the architecture of our cells; we rely on it for immunity and hormone synthesis, and cobble it together to build muscles, skin, and bone. Among the three macronutrients—the other two being carbohydrates and fat—protein is the only one that “we need to get every day,” Joanne Slavin, a nutrition researcher at the University of Minnesota, told me. Nearly half of the 20 amino-acid building blocks that make up protein can’t be produced in-house. Go without them for too long, and the body will start to break its own tissues down to scavenge the molecules it needs.

    That state of deficiency is exactly what the protein RDA was designed to avoid. Researchers decided the threshold decades ago, based on their best estimations of the amount of protein people needed to balance out their loss of nitrogen—a substance that’s in amino acids but that the body can’t itself make. The average person in the study, they found, needed 0.66 grams of protein per kilogram of body weight to avoid going into the red. So they set the guidelines at 0.8, a level that would keep the overwhelming majority of the population out of the deficiency zone. That number has stuck in the many years since, and Slavin, who has sat on the Dietary Guidelines Advisory Committee, sees no reason for it to change. People who are expending extra energy on growth, or whose muscles are taxed by exercise or aging, might need more. But for the typical American adult, Slavin said, “I think 0.8 is the right number.”

    Others vehemently disagree. The current standard is “not enough to support everyday living,” Abbie Smith-Ryan, a sports-nutrition expert at the University of North Carolina at Chapel Hill, told me. Adults, she and others told me, should be getting more like 1.2 or 1.6 grams per kilogram at baseline. Their beef with the RDA is twofold. For one, the original nitrogen analyses oversimplified how the body metabolizes and retains protein, Stuart Phillips, a protein researcher at McMaster University, in Canada, told me. And second, even if the 0.8 number does meet our barest needs, “there’s a much more optimal amount we should be consuming” that would further improve our health, Katie Hirsch, an exercise physiologist at the University of South Carolina, told me. (I reached out to the USDA, which helps develop the U.S.’s official Dietary Guidelines, about whether the RDA needed to change; a spokesperson referred me to the National Academy of Sciences, which said that the RDA was last reviewed in 2002, and was expected to be reviewed again soon.)

    If Hirsch and others are right, even people who are slightly exceeding the government guideline might not be maximizing their resilience against infections, cardiovascular disease, metabolic issues, muscle loss, and more. People who are working out and still eating the measly 0.8 grams per kilogram per day, Antonio told me, are also starving themselves of the chance to build lean muscle—and of performance gains.

    But the “more” mentality has a limit. Experts just can’t agree on what it is. It does depend on who’s asking, and their goals. For most people, the benefits “diminish greatly” past 1.6 grams per kilogram, Phillips told me. Smith-Ryan said that levels around 2.2 were valid for athletes trying to lose weight. Antonio is more liberal still. Intakes of 3.3 or so are fair game for body builders or elite cyclists, he told me. In one of his studies, he had athletes pack in 4.4 grams of protein per kilogram of body weight for weeks—a daily diet that, for a 160-pound person, would require three-plus pounds of steak, 16 cups of tofu, or 89 egg whites.

    That is … a lot of protein. And most of the other experts I spoke with said that they didn’t see the point, especially for Americans, who already eat more protein than people in most other countries. “There’s very little evidence that more is better,” Marion Nestle, a nutrition researcher at New York University, told me.

    The worry isn’t necessarily that tons of protein would cause acute bodily harm, at least not to people who are otherwise in good health. Over the years, researchers have raised concerns that too much protein could damage the kidneys or liver, leach calcium from the bones, or even trigger cancer or early death—but the evidence on all fronts is, at best, mixed. In Antonio’s high-protein studies with athletes, he told me, their organs have remained in tip-top shape. The known drawbacks are more annoying than dangerous: High-protein diets can raise the risk of bloating, gas, and dehydration; burning through tons of protein can also make people feel very, very hot. Roughly a quarter of the participants in Antonio’s ultra-high-protein study dropped out: Many of them felt too full, he told me, and no longer enjoyed food. One volunteer was so plagued by night sweats by the close of the trial, he said, that she could no longer fall asleep.

    Whether many years of an ultrahigh-protein lifestyle could be harmful is less clear. Native communities in the Arctic have healthfully subsisted on such diets for generations, but they’ve had a long time to adapt; those in Western society might not fare the same.

    Over the years, it’s gotten easy to interpret protein’s apparent lack of immediate downsides as permission to reach for more. But for now, many experts would rather err on the side of moderation. “Would I feed that much to one of my relatives? I would not,” Susan Roberts, a nutrition researcher at Tufts University, told me. Even if protein itself turns out not to be hard on the body, the foods it comes in still might be, including processed meats or sugary “high-protein” powders, shakes, cookies, chips, and bars. People pounding protein also risk squeezing other nutrients out of their diet, Roberts told me—whole grains, nuts, fruits, and vegetables, all of them packed with fiber, a vital ingredient that nutritionists actually do agree we lack.

    Plus, Slavin argued, there’s a point at which excess protein becomes a straight-up waste. When people eat more than about 20 to 40 grams of protein in a single sitting, their protein-processing machinery can get overwhelmed; the body eliminates the nitrogen as waste, then treats the rest as it would a carbohydrate or fat. “You can get fat on proteins just like you can get fat on carbohydrates,” Slavin told me. Which makes overdoing protein, in her eyes, “expensive and stupid.”

    The excess can have consequences beyond what our own bodies endure. Meat production drives greenhouse-gas emissions and uses up massive tracts of land. And Maya Almaraz, a food-systems researcher at Princeton, has found that the majority of the nitrogen pollution in wastewater is a by-product of our diets. The more protein we eat, the more we might be feeding toxic algal blooms.

    There’s no denying that protein deficiency is a problem in many parts of the world, even within the United States. Protein sources are expensive, putting them out of reach of poor communities. Meanwhile, many of the people who worry most about getting enough of it—the wealthy, the ultra-athletic, the educated—are among those who need to supplement the least. Experts, for now, may not agree on how much protein is too much for individuals. But if appetite is all we have to curb our intake, going all in on protein might create problems bigger than anything we’ve had to stomach so far.

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    Katherine J. Wu

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  • 3 Tips To Build Lean Muscle, From A Dietitian & Fitness Coach

    3 Tips To Build Lean Muscle, From A Dietitian & Fitness Coach

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    Finally, you’ll want to pair these workout tips with adequate protein intake in order to reap the benefits. 

    The Recommended Dietary Allowance of protein is 0.8 gram per kilogram of body weight1 per day. This is the minimum amount of protein a sedentary person needs to meet their nutritional requirements; meaning, it’s conservative and not exactly applicable for those looking to build muscle or working out frequently.

    If you’d rather not count down to every last gram, leading protein and amino acid requirements researcher Don Layman, Ph.D., previously told mindbodygreen that getting around 100 grams a day is a solid goal for most women.

    You’ll want to spread that out throughout the day by consuming around 25 to 30 grams of protein during breakfast, lunch, and dinner, and eating a protein-rich snack or two when possible. 

    Protein shakes can be a helpful addition to fulfill this goal, which, according to Baxter, can be consumed within an hour before or after your workout for maximum muscle benefits. 

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    Hannah Frye

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  • A Gut Expert’s Filling Breakfast Smoothie Recipe

    A Gut Expert’s Filling Breakfast Smoothie Recipe

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    “Depending on how much time I have in the day, I have two main alternating breakfasts,” board-certified internist, gut health expert, and mbg Collective member Vincent Pedre, M.D., tells us on the mindbodygreen podcast. On slower mornings, he loves a hearty avocado toast (we share the recipe here, if you’re interested). But on busy days when he needs to grab and go, frying up a perfect, sunny-side-up egg sounds less than ideal. 

    That’s why Pedre has a filling, gut-supporting smoothie on lock: “A smoothie, when I’m in a rush, is a great breakfast,” he says. “I can pack a lot of nutrition into that.” Below, his go-to blend. 

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    Jamie Schneider

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  • Ancient Nutrition Unpaid Review, From A Well-Being Editor

    Ancient Nutrition Unpaid Review, From A Well-Being Editor

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    In its rapidly-growing array of products, Ancient Nutrition now offers collagen, protein, probiotics, vitamins, herbal supplements, greens powders, and more, with a slew of touted benefits. The brand’s website allows you to shop by focus, with use cases including everyday health, gut and digestion, immune support, joint health, stress and sleep, energy and concentration, fitness, beauty, and prenatal.

    For this Ancient Nutrition review, I tested the Organic SuperGreens powder, Organic SuperGreens + Collagen powder, Multi-Collagen Protein Beauty Within powder, Matcha Collagen powder, and the brand’s signature Bone Broth Protein powder (in chocolate, of course).

    I was pleased to find that the brand uses a concise list of clinically studied ingredients without any alarming additives. The SuperGreens powders are made with a blend of greens, fruits, and vegetables, such as organic alfalfa leaf juice, organic chlorella, and organic kale leaf; digestion supporting ingredients like organic flax seed, organic chia seed, and probiotics; and other superfoods like ashwagandha, reishi, turmeric, and ginger.*

    Ancient Nutrition’s bone broth protein uses sustainably-sourced chicken bone broth concentrate from non-GMO, U.S.-farmed chickens—and the brand also makes a vegan protein made with a mix of seven superfood seeds.

    The collagen powders use the brand’s proprietary fermented eggshell membrane ingredient, which is meant to absorb faster to provide speedy results. Like the bone broth, the collagen comes from non-GMO, pasture-raised and grass-fed, cage-free sources.

    My one qualm with the Ancient Nutrition ingredients is that the powders do contain “natural flavors” (i.e., flavoring chemicals), xanthan gum, and stevia, which I personally prefer to limit. I will say, though, the matcha powder was the only product I truly tasted the stevia in.

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    Carleigh Ferrante

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  • The Best Foods To Reduce Menopause Symptoms, From An RD

    The Best Foods To Reduce Menopause Symptoms, From An RD

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    Anita Mirchandani is a registered dietitian nutritionist, prenatal and postnatal exercise specialist, and certified fitness professional. She focuses on building a balanced and integrative approach to health. By combining appropriate and tailored nutrition and fitness elements, she provides a personalized plan for her clients. Her favorite part about counseling clients and being a virtual dietitian is breaking down the science and applying health and nutrition in a more practical, meaningful approach.

    When she’s not in her nutrition world, you will find Anita engaging in some form of an active adventure with her two sons – from biking on the Bronx River Pathway to exploring new trails in Westchester county. She also loves to cook, bake and drink wine (in moderation, of course)! Follow her at @fitnutanita.

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    Anita Mirchandani, MS, RD

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  • This Unexpected “Appetizer” Can Help Balance Your Blood Sugar

    This Unexpected “Appetizer” Can Help Balance Your Blood Sugar

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    Whey protein is beneficial for more than just muscle gains.

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    Molly Knudsen, M.S., R.D.N.

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  • Anchovies vs. Sardines: The Difference & Which One Is Healthier

    Anchovies vs. Sardines: The Difference & Which One Is Healthier

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    There are various types of sardines and anchovies caught around the world—from the Engraulis encrasicolus anchovies of Europe and Africa to the Sardinops melanostictus sardines of Japan—and each has unique qualities. In general, though, sardines (6-12 inches) are larger than anchovies (4-10 inches). They also tend to be lighter silver in color, while anchovies can have darker scales tinged with blue or green.

    Sardines and anchovies have a similar nutrition profile, though sardines tend to be slightly higher in protein, fat, and calories1.

    Both fish have a mild fishy flavor and firm texture when eaten fresh. However, “as soon as you can them, they become different products,” Bart van Olphen, the co-founder of Sea Tales and author of The Tinned Fish Cookbook, tells mindbodygreen.

    That’s because while sardines are lightly smoked or cooked before going in the can, anchovies are cured in salt for months. This salt curing is what gives canned anchovies their brown appearance and salty bite: When eaten fresh from the water, they’re actually more comparable to sardines.

    You can find anchovies and sardines canned in water or oil (most often olive oil or vegetable oil), served whole or as boneless, skinless filets—sometimes with added flavorings like garlic or chili.

    Canned sardines have a shelf life of upward of four to five years, while cured anchovies tend to last about a year. Because of their curing process, van Olphen notes that anchovies should be stored in the refrigerator, not the pantry.

    Canned sardines should be enjoyed within a day of opening2, but opened anchovies will stay good for up to two months.

    Here’s a deeper dive into each fish and how to use it.

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    Emma Loewe

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  • The 6 Best Nuts For Keto & 3 That Will Take You Out Of Ketosis

    The 6 Best Nuts For Keto & 3 That Will Take You Out Of Ketosis

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    Many nuts fit right into the keto diet’s high-fat macronutrient prescription.

    “Nuts can make a great addition to a keto diet since they are low in carbs and high in healthy fats,” says Haley Bishoff, RDN, a registered dietitian and owner of Rūtsu Nutrition. Bishoff adds that nuts are also loaded with vitamins, minerals, antioxidants, and fiber.

    As if those benefits weren’t enough to get crunching, nuts have also been well-researched for their ability to help lower cholesterol and triglycerides1, improve blood sugar, and reduce inflammation2. These cardiometabolic bonuses could add to the big picture of healthy weight loss while on keto.

    Of course, if you’re looking to lose weight, it can’t be a nut festival all day, every day. But here are some intriguing (and, frankly, pretty awesome) news: research shows that eating nuts in moderation doesn’t contribute to weight gain3. In fact, the body doesn’t even typically absorb all the calories from nuts4, according to research from the USDA. Eaten in their whole form, nuts like almonds could contribute up to 32% fewer calories than listed on their nutrition label due to their bioavailability and how the body absorbs their nutrients.

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    Sarah Garone, NDTR

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  • The Top 7 Health Benefits Of Almonds & Serving Size Tips

    The Top 7 Health Benefits Of Almonds & Serving Size Tips

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    Though they are often referred to as a nut, almonds are technically a type of seed derived from almond trees. These trees are native to western Asia, but are now grown and cultivated around the globe. Compared to some other types of nuts, almonds come with a slightly steeper price tag, which is due to both their popularity and the labor-intensive harvesting processes required.

    In terms of appearance, almonds are light brown and oval-shaped, with a smooth outer shell. They have a rich, nutty flavor that lends itself well to a wide range of recipes, adding an extra crunch to salads or bringing a tender texture to baked goods. They also make a healthy snack as is and can be enjoyed roasted, raw, or salted.

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    Rachael Ajmera, MS, RD

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