It's that time: time to test your blood. Most blood tests include a fasting lipid panel to assess one's risk of cardiovascular disease. A lipid panel is a test that measures fats and fatty substances used as a source of energy in the body. Lipids include cholesterol, triglycerides, high-density lipoprotein (HDL) and low-density lipoprotein (LDL).
What Are Triglycerides?
Triglycerides are a powerful cardiovascular risk marker. Elevated triglyceride levels are a hallmark of too many carbohydrates in the diet.
60 percent of fructose is shunted toward the liver, where it is converted to triglycerides (which causes heart disease) (Gundry, 2017). In fact, fructose, which is the sugar found in most processed foods (often in the form of high-fructose corn syrup) can only be metabolized by your liver. If you eat a typical Western-style diet, you consume high amounts of it. The overload of fructose ends up damaging your liver in the same way alcohol and other toxins do (Mercola, 2017).
What about Cholesterol?
Our culture is obsessed with cholesterol levels, to the point that one in four adults in the U.S. take a statin drug to lower cholesterol levels. Nevertheless, elevated cholesterol levels are rarely a risk factor for heart disease, although elevated triglycerides clearly are. Fortunately, elevated triglycerides can easily be corrected and lowered to an ideal level of below 75 with the proper lifestyle interventions. The following tests can give you a far better assessment of your heart disease risk than your total cholesterol alone:
Influence of Triglycerides on Leptin
High triglyceride levels (over 100 mg/dL) is known to cause leptin resistance. Leptin is a hormone located in fat cells, and like most hormones, it's function is complex. Leptin is tied to the coordination of our metabolic, hormonal, and behavioral response to starvation. Leptin essentially controls mammalian metabolism. Leptin decides whether to make us hungry and store more fat or burn fat. In other words, when your stomach is full, fat cells release leptin to tell your brain to stop eating. This is why people with low levels of leptin are prone to overeating.
One study observed participants with a 20 percent drop in leptin experienced a 24 percent increase in hunger and appetite, influencing their cravings for calorie-dense, high-carbohydrate foods, especially sweets, salty snacks, and starchy foods. The researchers discovered the drop in leptin was caused by sleep deprivation.
Leptin is also a pro-inflammatory molecule - it controls the creation of other inflammatory moleciles in your fat tissue throughout your body. This explains why overweight individuals are susceptible to inflammatory problems. Leptin is ranked highly on the body's chain of command, so imbalances tend to spiral downward and wreak havoc on virtually every system of the body beyond those directly controlled by leptin. Leptin, like insulin, is negatively influenced by carbohydrates. The more refined and processed the carbohydrate, the more imbalanced leptin levels become. When the body is overloaded and overwhelmed by substances that cause continuous surges in leptin, leptin receptors begin to turn off and you become leptin resistant. So even though leptin is now elevated, it doesn't work - it won't signal to your brain that you're full so you can stop eating.
Not a single drug or supplement can balance leptin levels. But better sleep, as well as better dietary choices will (Perlmutter, 2013).
Causes of High Triglycerides
The main culprit
Preventing cardiovascular disease involves reducing chronic inflammation in your body, and a proper diet is an absolute cornerstone. Although saturated fat has taken the blame for causing heart disease for the last several decades, the primary culprit in heart disease is sugar consumption.
A 2015 study published in the Journal of the American Medical Association concluded that there is " a significant relationship between added sugar consumption and increased risk for cardiovascular mortality." the 15-year study, which included data for 31,000 Americans, found that those who consumed 25 percent or more of their daily calories as added sugars were more than twice as likely to die form heart disease as those who got less than 10 percent of their calories from sugar. On the whole, the odds of dying from heart disease rose in tandem with the percentage of added sugar in the diet regardless of the age, sex, physical activity level, and body mass index (Dhurandhar & Thomas, 2014).
A 2014 study came to very similar conclusions. Here, those who consumed the most sugar - about 25 percent of their daily calories - were twice as likely to die form heart disease as those who limited their sugar intake to 7 percent of their total calories (Yang et al., 2013).
A 2013 study, published in the Journal of the Academy of Nutrition and Dietetics, looked at the differing effects of high-fat diets versus low-fat diets on blood lipid levels. The study included 32 studies and found that high-fat diets resulted in significantly greater improvements in reductions of total cholesterol, LDL cholesterol, and triglycerides and benificial increases in HDL cholesterol (Schwingshackl et al., 2013).
How to Lower Triglycerides
Consider a Detox
The Dangers of Statins
So, why are we all obsessed with total cholesterol and LDL cholesterol when we know they aren’t the primary culprits for heart attacks? Because a multi-billion dollar drug industry exists behind the number-one best-selling class of drugs on the market: Statins.
Of course, the choice to take medications, if referred by your physician is, and should, always be your choice. However, you have the right to be fully informed of the side effects of consuming anything. With this in mind, it is important to be aware of the unintended side effects of taking statins.
A study published in Clinical Cardiology concluded that "Statin therapy is associated with decreased myocardial [heart muscle] function," which often leads to heart failure. The study did not address causes, but it's widely known that statins lower your CoQ10 levels by blocking the pathway involved in cholesterol production -- the same pathway by which Q10 is produced. Statins also reduce the blood cholesterol that transports CoQ10 and other fat-soluble antioxidants. The loss of CoQ10 leads to loss of cell energy and increased free radicals which, in turn, can further damage your mitochondrial DNA, effectively setting into motion an evil circle of increasing free radicals and mitochondrial damage (Mercola, 2011).
Moreover, for those at risk of heart disease taking statins who are unwilling or unable to bring down their cholesterol and/or triglyceride levels naturally with dietary changes, the potential for liver or muscle damage should be acknowledged. In addition, the potential for brain-related side effects, such as memory loss and confusion, as well as Parkinson’s-like symptoms is of concern. Statin drugs also appeared to increase the risk of stroke and developing diabetes. In 2013, a study of several thousand breast cancer patients reported that long-term use of statins may as much as double a woman's risk of invasive breast cancer.
There are 71 diseases that may be associated with these drugs, and this is only the tip of the iceberg. There are actually over 900 studies showing the risks of statin drugs, which include:
Plant-based diets have been shown to lower cholesterol just as effectively as first-line statin drugs, but without the risks. In fact, the "side effects" of healthy eating tend to be good - less cancer and diabetes risks and protection of the liver and brain (Gregor, 2015).
What Should you Eat?
Baker, A. (2012). What's the real driver of elevated cholesterol? hint: it's not saturated fat! - Nourish Holistic Nutrition. [online] Nourish Holistic Nutrition. Available at: nourishholisticnutrition.com/whats-the-real-driver-of-elevated-cholesterol/ [Accessed 8 Feb. 2019].
Dhurandhar, N. and Thomas, D. (2015). The Link Between Dietary Sugar Intake and Cardiovascular Disease Mortality. JAMA, 313(9), p.959. https://doi.org/10.1001/jama.2014.18267 [Accessed 8 Feb. 2019].
Gregor, M. (2015) How Not to Die. London: Pan Books
Gundry, S. (2017). The Plant Paradox. New York, NY: Harper Wave
Hyman, M. (2016). 7 Ways to Optimize Cholesterol. [online] Dr. Mark Hyman. Available at: https://drhyman.com/blog/2016/01/14/7-ways-to-optimize-cholesterol/ [Accessed 8 Feb. 2019].
Mercola, J. (2017). Fat for Fuel. Carlsbad, CA: Hayhouse Inc.
Mercola, J. (2011). New Study Shows Using Statins Actually Harms Heart Function. [online] Mercola.com. Available at: https://articles.mercola.com/sites/articles/archive/2011/06/22/new-study-show-using-statins-actually-worsens-your-heart-function.aspx [Accessed 8 Feb. 2019].
Mercola, J. (2015). Conventional Heart Disease Advice May Make Matters Worse. [online] Mercola.com. Available at: https://articles.mercola.com/sites/articles/archive/2015/08/02/heart-disease-risk-factors.aspx [Accessed 8 Feb. 2019].
Perlmutter, D (2013). Grain Brain. New York, NY: Little Brown
Ray, K. et al. (2010). Statins and All-Cause Mortality in High-Risk Primary Prevention. Archives of Internal Medicine, 170(12), p.1024. Available at: https://doi.org/10.1001/archinternmed.2010.182 [Accessed 8 Feb. 2019].
Rubinstein, J., Aloka, F. and Abela, G. (2009). Statin Therapy Decreases Myocardial Function as Evaluated Via Strain Imaging. Clinical Cardiology, 32(12), pp.684-689. Available at: https://doi.org/10.1002/clc.20644 [Accessed 8 Feb. 2019].
Schwingshackl, S., et al. (2013). Comparison of Effects of Long-Term Low-Fat vs High-Fat Diets on Blood Lipid Levels in Overweight and Obese Patients: A Systematic Review and Meta-Analysis. Journal of the Academy of Nutrition and Dietetics, 113(12), pp. 1640-61. Available at: https://doi.org/10.1016/j.jand.2013.07.010 [Accessed 8 Feb. 2019].
Wallerwellness.com. (2019). Understanding Triglycerides. [online] Available at: https://www.wallerwellness.com/health-and-aging/understanding-triglycerides [Accessed 8 Feb. 2019].
Williams, J. (2017). How To Lower Dangerously High Triglyceride Levels. [online] Renegade Health. Available at: http://renegadehealth.com/blog/2017/03/31/how-to-lower-dangerously-high-triglycerides-levels [Accessed 8 Feb. 2019].
Yang, Q., et al. (2014). Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults. JAMA Internal Medicine, 174(4), pp.516-24. Available at: https://doi.org/10.1001/jamainternmed.2013.13563 [Accessed 8 Feb. 2019].
Despite food manufacturers claiming that refined vegetable oils were healthy, Americans experienced an up-rise in heart disease during the early 20th century. Like many new inventions, few questions were initially posited. Unfortunately, an alternate nutrient took the blame due to the research of a single scientist.
In 1951, American physiologist and professor Ancel Keys went to Europe in search of the cause of cardiovascular disease. In his quest, he went to observe the eating habits of individuals living Naples, Italy due to reports of a low prevalence of heart disease.
During this time, post-war conditions resulted in finite and unusual circumstances in regards to agriculture and infrastructure. Therefore what Keys perceived as a cultural tradition was dubbed the "Mediterranean diet".
Keys observed the residents in Naples consumed primarily pasta and plain pizza, with vegetables, olive oil, cheese, fruit for dessert, a moderate amount of wine, and very little meat (except among individuals belonging to a higher socioeconomic status).
Through an informal study measuring cholesterol serum levels among Rotary club members (those who could not afford meat, but could afford cheese) conducted by Keys's wife, whom at the time was a medical technologist, Keys deduced that avoiding meat resulted in a lower incidence of heart attacks.
Ancel Keys continued on his biased search for proof that a diet high in saturated fat is correlated with a higher risk of cardiovascular disease. He eventually compiled data from six more countries with high rates of heart disease and diets typically high in saturated fat. At first glance, Keys's research seemed logical and compelling. The evidence was based on the premise that individuals in America, who consumed high amounts of saturated fat, died from heart disease at a higher rate than individuals in Japan, who consumed low amounts of saturated fat.
Unfortunately, Keys had gained the interest of people in positions of power. Upon President Eisenhower's heart attack in 1955, Keys proposed his theory to the president's primary care physician, Paul Dudley White. Days following, White began to advise to the public to reduce the consumption of saturated fat and cholesterol in an effort to prevent cardiovascular disease.
Through his connections and influence, Keys soon joined the nutrition committee of the American Heart Association (AHA) which, based on Keys's research, released a report in 1961 that advised patients with a high risk of cardiovascular disease to reduce their consumption of saturated fat. (Interestingly enough, the AHA began its rise to prominence in 1948, the same year Proctor & Gamble donated over $1.7 million to the organization - resulting in the AHA indebted to Crisco.)
In 1961, Time magazine placed Ancel Keys on the front cover touting him as "the twenthiest century's most influential nutrition expert."
By 1970, Keys published the Seven Countries Study, which detailed his original research - this study has now been cited in over a million other scientific publications. While Keys associative observations between saturated fat and cardiovascular disease never proved causation, he had won the battle of public opinion.
With the help of Ancel Keys, the American medical community and mainstream media has advised consumers to stop eating the animal products that have been consumed for centuries, replacing them with bread, pasta, margarine, low-fat dairy, and vegetable oil. This was the dietary shift that was codified by the United States government in the late 1970s.
Central Committee for Medical And Community Program of the American Heart Association. (1961). Dietary Fat and Its Relation to Heart Attacks and Strokes. Circulation [online] 23, pp.133-36. Available at: https://circ.ahajournals.org/content/circulationaha/23/1/133.full.pdf [Accessed 26 Jan. 2019]
Keys, A. (1953). Atherosclerosis: A Problem in Newer Public Health. Journal of Mt. Sinai Hospital, [online] 20(2), pp.118-39.
Keys, A. (1970). Coronary Heart Disease in Seven Countries. Circulation. 41 (1), pp.1186-95.
Keys, A. (1995). Mediterranean Diet and Public Health: Personal Reflections. American Journal of Clinical Nutrition, [online] 61 (6), pp.1321S-1323S. Available at: https://dx.doi.org/10.1093/ajcn/61.6.1321s [Accessed 26 Jan. 2019]
Marvin, H. (1964). The 40 Year War on Heart Disease. New York: American Heart Association.
Mercola, J. (2017). Fat For Fuel. Carlsbad, California: Hay House.
Teichholz, N. (2014). The Big Fat Surprise. New York: Simon & Schuster, pp.32-33.
The environment that we live in is toxic. It is worrisome to think that the status quo has occurred with the help of corporations knowingly dumping harmful chemicals into the environment.
The Environmental Working Group (EWG) has studied the current state of our world in great detail and has discovered that before a child is even born they already have approximately 287 toxins in their blood and tissues. These results came from 10 newborns whose parents gave permission to have their toxins measured at birth.
The results of this study indicate that an average of 200 chemicals was found in each newborn. Of the toxins tested, 47 were consumer ingredients such as cosmetics, 212 were industrial and pesticide byproducts. In this study, only around 400 total chemicals were actually tested for - thousands of others may have been found if larger parameters were used.
Many of the toxins measured in the newborns included plastics, flame retardants, and other chemicals that disrupt brain function, IQ, hormones, and the nervous system of the child. Some of the toxins observed like DDT, have actually been banned since 1972 (over 3 decades ago), but are still being measured in laboratory samples. Certain chemicals never fully degrade in the environment.
So, there is not question about it, the environment we live in is toxic. All of us have disease-creating toxins inside of our bodies, the question boils down to which ones and how much.
But there are some solutions: lab tests and detoxification.
Researchers have established that processed food is addictive, can make you extremely unhappy and will prematurely kill you. Is there a chance that food manufacturers been able to deceive the world about these facts? Dr. Robert Lustig has written a new book, “The Hacking of the American Mind: The Science Behind the Corporate Takeover of Our Bodies and Brains,” in which he explains how and why this occurred.
He is perhaps most well-known for his brilliant research into sugar and obesity, and his previous book, “Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity and Disease,” was a New York Times Best Seller. Lustig is an emeritus professor of pediatrics in the division of endocrinology at the University of California, San Francisco, a member of the Institute for Health Policy Studies, and he’s also completed a master’s in public health law.
Tryptophan, which is the precursor for serotonin, is one of the rarest amino acids in our diet. But it’s a mistake to think the answer to depression is as simple as taking tryptophan to boost serotonin. The reason for this is because most of the tryptophan is converted to serotonin in your gut, and it does not freely travel into your brain. Lustig explains:
“Tryptophan is the only amino acid that can be converted into serotonin. Tryptophan is the rarest amino acid in our diet. Eggs have the most. Certain poultry and other avian species have some [tryptophan]. There’s very little in vegetables. Obviously, carbohydrates have virtually no tryptophan whatsoever.
It’s actually pretty hard to get tryptophan into your body to start with. Take processed food on top of that, then it’s even harder because it tends to be tryptophan-depleted. [Moreover], 99.9 percent of the tryptophan you ingest either gets turned into serotonin in the gut for your gut’s purposes, or it goes into your platelets to help your platelets help you clot. [So] very little tryptophan actually gets to the brain.
Top that off with the fact that tryptophan has to share an amino acid transporter with two relatively common amino acids: phenylalanine and tyrosine, which, by the way, are the precursors for dopamine. You can see that the more processed food you eat, the more dopamine you will make because you will have the precursors for that.
They will actually crowd out the ability to get tryptophan across the blood-brain barrier … Yet, serotonin is the nidus of contentment, of happiness. It explains why diet is so problematic … ”
Many try to bolster their happiness through certain food choices, but this actually does not work, and Lustig provides compelling arguments that the foods you crave drive up dopamine and drive down serotonin. Rather, it’s experiences that make you happy. People can make you happy. You can make yourself happy. In his book, Lustig outlines a number of different strategies to become happier.
“Ultimately, the goal is [to increase] your serotonin,” he says. There are four ways to boost your serotonin, and they’re all free. They’re also things your grandmother likely told you to do. First and foremost is making human connections.
“Turns out that Facebook does not count as connection. When we’re talking about interpersonal connection, we’re talking about eye-to-eye,” Lustig says. “The facial emotions of the person you’re talking with activate a set of neurons in your brain called ‘mirror neurons,’ which are the drivers of empathy and specifically linked to serotonin.To be able to generate a feeling of empathy, which ultimately turns into contentment/happiness, you actually have to connect. You can’t do it over the internet. You can’t have a connection with ‘anonymous.’ It just doesn’t work.”
On the contrary, social media generate dopamine, associated with pleasure, and hence can drive addiction. The main problem is that when dopamine goes up, serotonin goes down. So, online communication is actually a major causative factor of unhappiness.
Lustig also elaborates on how companies — both food manufacturers and electronics companies — capitalize on the biology of dopamine versus serotonin to get us addicted to their products. There’s even a book on this topic written by Nir Eyal, called, “Hooked: How to Build Habit-Forming Products.”
Dopamine Versus Serotonin
It’s important to realize that the dopamine (or reward-generating) pathway is the same no matter what your source of pleasure is. It can be a substance, such as nicotine, alcohol, heroin or junk food; or it can be behavior, such as internet surfing, shopping or pornography. The problem, in a nutshell, is that dopamine is an excitatory neurotransmitter, and in excess is neurotoxic.
When dopamine is released, and the neuron on the other side accepts the signal, it can damage that neuron. Over time, excitatory neurotransmitters can cause cell death. To protect itself from damage, the postsynaptic neuron employs a self-protective mechanism — it downregulates its receptors.
By having fewer receptors, the dopamine cannot do as much damage. So, each time you get a “hit” or rush of dopamine, the number of receptors decrease. As a result, you need increasingly larger doses or “hits” to get the same rush. Eventually, you end up with tolerance, a state where even a large dose produces no effect. Once the neurons start to actually die off, you’re a full-blown addict.
“The point that you need to know is that it takes three weeks for the receptors to repopulate. The cravings can go on for upwards of a year when you’re addicted. This is a long-term process that sometimes requires medical intervention and medical management by physicians who understand addiction medicine,” Lustig says.
Serotonin, on the other hand, is not an excitatory neurotransmitter. When it acts on the serotonin-1a receptor (the “contentment” receptor), no damage occurs. Hence, happiness does not lead to addictive behavior. Keep in mind that dopamine downregulates serotonin, so it’s basically impossible to achieve happiness (related to serotonin) through pleasure-seeking behavior (related to dopamine).
One of the cheapest pleasures that stimulates dopamine is sugar. Many reach for sweet junk food when they feel down, thinking it’ll help them feel better, but neurochemical science reveals this simply cannot happen. Add the stress hormone cortisol to the mix, which downregulates the serotonin-1a receptor, and you have a recipe for both addiction and depression. “That’s what we’re seeing throughout all of civilized society, not just in America, but around the world,” Lustig says.
There are three other ways, besides connecting, that boost serotonin and happiness. The remaining three of the four C’s are:
1. Contribute: Meaning the act of contributing to something greater than yourself; making a contribution to society. “You can get happiness and contentment from your job, but there are certain criteria that have to be met,” Lustig says. “Most people, unfortunately, have a boss who is not contributing to their happiness. The workplace is not usually the best place to achieve meaningful contentment.”
2. Cope: Lack of sleep, insufficient exercise and multitasking are all causes of unhappiness. Sleep is extremely important for healthy serotonin production. Here, avoiding exposure to electronic screens is important, as blue light inhibits melatonin production, thereby making sleep more elusive. Electronics will also disrupt your sleep and deteriorate your health by exposing you to unnecessary microwaves, discussed in this recent article on depression.
3. Cook: If you cook, you’re likely going to increase your tryptophan, reduce your refined sugar intake, and increase your omega-3 fats (anti-inflammatory) and fiber. Overall, this will result in improved gut health, which has tremendous impact on your mood and mental health.
“Numerous investigators … have shown that your gastrointestinal flora tell your brain what they want through signals that go through the bloodstream, and potentially even neural ones as well. If you do not feed your bacteria, you cannot get happy. Eating real food you prepare yourself is super important,” Lustig says.
The High Cost of Added Sugar
Processed fructose, mostly in the form of corn syrup, has become a major contributor to the $3 trillion health care budget in the United States, and there’s clear data linking sugar consumption to de novo lipogenesis — a disease process associated with fat accumulation in the liver, causing insulin resistance, hyperinsulinemia, metabolic syndrome and associated diseases. That includes Type 2 diabetes, hypertension, lipid problems, cardiovascular disease, cancer and dementia.
“We have the mechanism by which this occurs. In fact, our paper in Gastroenterology1 demonstrates that if you take sugar out of the diet of children with metabolic syndrome and substitute starch — calorie for calorie exchange, glucose for fructose exchange with no change in calories … — in 10 days, you can reverse metabolic syndrome.
You can reverse the insulin resistance. You can reverse the liver fat. You can reverse the burden on the pancreas. Basically, all of the metabolic perturbations go away. This is the smoking gun,” Lustig says. “In addition, we have a paper in BMJ Open2 which models what could happen in terms of health care expenditures and disease rates if we reduced our sugar consumption by 20 percent, which is what taxes would do.
Or if we reduce sugar consumption by 50 percent (which is what the United States Department of Agriculture suggested we do), for nonalcoholic fatty liver disease alone … the United States, over the next 20 years, could save $103 billion, just on that disease alone. Ultimately, this is where the money goes. This is why health care will be defunct. This is why Medicare will be broke by the year 2026 …
We have to deal with health. Health is going down the tubes. There’s no amount of health care that can fix what’s wrong with our diet, unless we fix the diet first … The bottom line is we are in trouble. But you can’t fix a problem until you recognize what the problem is. This book, ‘The Hacking of the American Mind,’ demonstrates how the science, how the biology, ultimately has influenced not just our health, but in fact, our policy.”
A Solution: Eat Real Food
As mentioned, a big part of the happiness equation is to increase serotonin by optimizing tryptophan. However, the dilemma is that most of the serotonin produced in the gut is used there locally. It does not enter your brain. Lustig explains:
“There are many diversions for tryptophan away from the brain. It can be metabolized in the intestine itself. It can be metabolized in the platelets. It can be turned into kynurenine, which is a secondary metabolite in the liver. It may not be transported across the blood-brain barrier because of phenylalanine and tyrosine taking up the aromatic amino acid transporter.
In addition, of course, your serotonin neurons must be functional. There are things that will kill off serotonin neurons, including party drugs. For instance, MDMA, or Ecstasy, is a famous dopamine and serotonin killer … Once you’ve lost those serotonin neurons, it’s pretty hard to get any sort of happiness signal.”
So, how do you boost systemic tryptophan? One of the keys is to eat real food, and to make sure you include high-tryptophan foods, the highest of which is egg whites. You also need omega-3 fatty acids, especially DHA, which is a component of every cell in your body. More than 90 percent of the omega-3 fat found in brain tissue is DHA.
“Omega-3s are probably the single most beneficial thing you can put in your body. They are anti-inflammatory. They are anti-Alzheimer’s. They increase membrane fluidity. Therefore, they increase neuronal distensibility, which means it’s less likely that any given neuron will die,” Lustig says.
“The problem, of course, is that when we took the fat out of the food, we took ALL the fat out of the food. It’s been a real chore to get the medical cognoscenti to turn around on this. I do want to do a shoutout to the American Heart Association, because they have now debunked their long-standing cholesterol-fat hypothesis.
They now recognize that saturated fat was not the demon they made it out to be, and that there are seven classes of fats, and that you actually have to consume omega-3s. You have to consume monounsaturated fats. In fact, you do have to consume some saturated fat because it’s a major component of membranes.”
Mercola, J. (2017). How Corporations Took Over Our Bodies and Brains. [online] Mercola.com. Available at: http://articles.mercola.com/sites/articles/archive/2017/09/10/processed-foods-health-effects.aspx [Accessed 11 Sep. 2017].
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