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Processed Meat and Carcinogens

When the World Health Organization listed processed meat as a group 1 human carcinogen in 2015, I became terrified of processed meat and didn’t to eat any meat for an entire month. My fear caused me to not even conduct research on what a group 1 human carcinogen is, the studies supporting the World Health Organizations’ decision to list processed meat as a human carcinogen, and whether or not I could still consume processed meat. I have dedicated this blog post to answering some of the previous concerns I had about consuming processed meat in the hopes that it will inform others to make rational decisions about eating or not eating processed meats.

Before delving into the research concerning processed meat, there should be an understanding of what is considered processed meat, and what the group 1 human carcinogen categorization means. The World Health Organization defines processed meat as “meat that has been transformed through salting, curing, fermentation, smoking, or other processes to enhance flavor or improve preservation.” Examples of processed meats are bacon, sausage, salami, hot dogs, processed deli meats, cured ham, and corned beef. The group 1 categorization of processed meats means the World Health Organization deems there is an acceptable amount of evidence supporting the link between the consumption of processed meat and cancer risk. While reading through a number of studies about processed meat and cancer risk, I noticed the results in a majority of the studies showed positive associations between the consumption of meat and cancer risk. A study published in the British Journal of Cancer is a slight exception to these studies. The research is a case control study completed in Uruguay between 1996-2004. 6, 060 subjects with a variety of cancers, including lung, oral cavity, stomach, colon, female breast, and prostate, were interviewed via food frequency questionnaires about their consumption of 64 different food items. The processed meats on the food frequency questionnaire are bacon, sausage, mortadella, salami, saucisson, hot dog, ham, and air-dried and salted lamb. An unconditional linguistic multiple regression was used to determine the relative risks of having cancer by using ORs (odds ratio). The results showed that all of the processed meats in the study, except for bacon and sausage, were associated with high relative risks. However, the discussion of this study interpreted all processed meats increasing cancer risk. This research cast doubts about overgeneralizing that all processed meats are carcinogens, and more studies should be conducted on specific processed meats to determine if only certain ones are cancer inducers.

Although studies have shown that the consumption of processed meats increases the risk of cancer, I do not believe there is any harm in sparingly eating a piece of bacon or any other processed meat.

*Note: An odds ratio is a statistical measure used to determine if an outcome will occur based on the presence or absence of an exposure.

Works Cited:

  1. Stefani, E. De, P. Boffetta, A. L. Ronco, H. Deneo-Pellegrini, P. Correa, G. Acosta, M. Mendilaharsu, M. E. Luaces, and C. Silva. “Processed Meat Consumption and Risk of Cancer: A Multisite Case–control Study in Uruguay.” Br J Cancer British Journal of Cancer9 (2012): 1584-588. Web. 13 Mar. 2016. 
  2. Chan, Doris S. M., Rosa Lau, Dagfinn Aune, Rui Vieira, Darren C. Greenwood, Ellen Kampman, and Teresa Norat. “Red and Processed Meat and Colorectal Cancer Incidence: Meta-Analysis of Prospective Studies.” PLoS ONE6 (2011): n. pag. Web. 13 Mar. 2016.
  3. “Q&A on the Carcinogenicity of the Consumption of Red Meat and Processed Meat.” World Health Organization. N.p., Oct. 2015. Web. 14 Mar. 2016. 
  4. Mccullough, M. L., S. M. Gapstur, R. Shah, E. J. Jacobs, and P. T. Campbell. “Association Between Red and Processed Meat Intake and Mortality Among Colorectal Cancer Survivors.” Journal of Clinical Oncology22 (2013): 2773-782. Web. 14 Mar. 2016.
  5. Lam, T. K., A. J. Cross, D. Consonni, G. Randi, V. Bagnardi, P. A. Bertazzi, N. E. Caporaso, R. Sinha, A. F. Subar, and M. T. Landi. “Intakes of Red Meat, Processed Meat, and Meat Mutagens Increase Lung Cancer Risk.” Cancer Research3 (2009): 932-39. Web. 14 Mar. 2016.
  6. Choi, Yuni, Sujin Song, Yoonju Song, and Jung Eun Lee. “Consumption of Red and Processed Meat and Esophageal Cancer Risk: Meta-analysis.” World Journal of Gastroenterology : WJG. Baishideng Publishing Group Co., Limited, n.d. Web. 14 Mar. 2016.

Misconceptions about Nutrition During Pregnancy

I learned that there will be a new addition to my family because one of my cousins is pregnant. After hearing the news, I called my cousin to congratulate her and her partner, and she discussed her excitement in being able to eat exceptionally large portions of food because she is now “eating for two.” When I heard this statement, I immediately informed my cousin of my concern with her nescience on healthy eating patterns during pregnancy, and I begin to wonder about the lack of knowledge some pregnant women have on their nutritional requirements during gestation. So, I created this blog post to provide a paucity of information on nutritional needs for pregnant women during gestation.

Two common dietary misconceptions about pregnant women are pregnant women should “eat for two” people and avoid consuming fish. I have provided a concise explanation for why each of these statements are incorrect below.

Misconception 1: Pregnant women can consume a larger amount of calories because they are “eating for two.”

Pregnant women do need to consume more calories during their pregnancy because they are providing nutrients for themselves and their offspring, but the number of excess calories needed for a healthy pregnancy is not as large as most people assume. The increased caloric intake of pregnant women is often divided into the three trimesters of pregnancy. During the first trimester, a pregnant woman with normal BMI (between 18.5 and 24.9) does not need to consume any additional calories because her digestive system increases the amount of absorption of some nutrients and decreases her rate of digestion to allow for more nutrient absorption. Although the first trimester of pregnancy does not require a greater caloric intake, pregnant women should consume 340 more calories (than she consumed prior to her pregnancy) from nutritionally dense foods (complex carbohydrates, polyunsaturated and monounsaturated fats, fiber, protein, etc.) in the second trimester. The third trimester of pregnancy requires an extra 450 calories than a pregnant woman with a normal BMI consumed prior to her pregnancy; this means a pregnant woman only needs to consume 110 more calories than she consumed during her second trimester. While pregnant women need to consume more calories during their second and third trimesters, the “eating for two” statement implies that pregnant women should consume a greater amount of calories than the actual caloric requirements for pregnancy, leading to overeating and excessive weight gain during gestation.

Misconception 2: Pregnant women should avoid consuming fish during pregnancy

There is a concern for pregnant women consuming fish because fish absorb mercury into their bodies where the mercury is then converted into methyl mercury, a compound causing brain development problems in infants and children. According to a study published in the Archives of Pediatrics and Adolescents Medicine Journal, consuming fish during pregnancy has beneficial effects. The eight-year long study tested maternal hair samples ten days postpartum to determine their mercury exposure during their pregnancy and gathered data via food frequency questionnaires to determine their fish consumption during pregnancy. Study questionnaires were then completed to collect data on the the inattentive and impulsive behaviors of the mothers’ infants when the infants were two weeks old and during the infants’ eight-year examination. The results of the study are pregnant women who were exposed to low levels of mercury prior to their pregnancy had children with a greater risk of Attention Deficit/Hyperactivity Disorder (ADHD)- related behavior, but the consumption of fish two times or less per week during pregnancy protected the children against ADHD-related behavior. The high concentration of DHA in fish is also a reason to include it in a pregnant woman’s diet (see my previous blog post to learn more about DHA).

Before believing common misconceptions about nutrition during pregnancy, please consult a knowledgeable healthcare advisor about dietary intake before, during, and after pregnancy.

Works cited:

  1. Paul, Annie. “16 Pregnancy Myths.” Meredith Women’s Network, n.d. Web. 10 Mar. 2016. 
  2. Blake, Joan Salge. “Life Cycle Nutrition: Pregnancy through Infancy.” Nutrition & You. Third Edition ed. San Francisco: Pearson Benjamin Cummings, 2008. 525-38. Print.
  3. ” Learn About Mercury and Its Effects.” Natural Resources Defense Council, n.d. Web. 11 Mar. 2016. 
  4. Sagiv, Sharon K., Sally W. Thurston, David C. Bellinger, Chitra Amarasiriwardena, and Susan A. Korrick. “Prenatal Exposure to Mercury and Fish Consumption During Pregnancy and Attention-Deficit/Hyperactivity Disorder–Related Behavior in Children.” Arch Pediatr Adolesc Med Archives of Pediatrics & Adolescent Medicine 166.12 (2012): 1123. Web. 11 Mar. 2016. 

Should Parents Raise their children on vegetarian or vegan diets?

If you are the grocery shopper in your household, then you may have notice an increased in the number of food products marketed to vegans and vegetarians, which implies an increase in the number of vegans and vegetarians in the world. According to the Vegetarian Times, there are currently approximately 7.5 million vegetarians in the US, and there is an increasing interest in veganism according to Google Trends. This made me think about a potential increase in the number of vegan and vegetarian parents who also want to raise their children on a vegan or vegetarian diet. There is controversy on raising children on vegan or vegetarian diet, and opposers of both diets for children often make the claims about children not consuming enough micronutrients and macronutrients (mainly protein). There have also been a few horror stories  of feeding children vegan or vegetarian diets, including one story of a toddler having severe iron deficiency anemia, a systolic murmur, an enlargement of his left atrium and ventricle due to his parents feeding him a vegetarian diet. So, is it safe for infants and children to be raised on a vegetarian or vegan diet?

Two articles from the Journal of American Dietetics Association support the safety of feeding children vegan diets as long as parents plan the diets appropriately. However, both articles note micronutrient deficiency concerns in vegan infants and children for calcium, zinc, iron, vitamin D, and vitamin B12. DHA is also a dietary concern for infants fed vegan diets because vegan mothers have a lower level of DHA in their breast milk. A study conducted in Sweden assessed the dietary intake, macronutrient, and micronutrient status of vegan young adults compared to omnivorous young adults (ages 16-20). The results of the study showed vegan young adults were under the average micronutrient requirements for calcium, selenium, vitamin B12, ribloflavin, and vitamin D. The study has confounding variables including the small number of subjects (60 subjects participated in the study), and there was under reporting on the dietary assessments.

An article review in the European Journal of Pediatrics supports the safety of vegetarian diets in infancy and childhood and states that infants and children fed vegetarian diets have normal growth and development. The article also briefly discussed the the benefits of vegetarian diets, such as having a lower BMI (body mass index) than people who consume meat and plant based foods.  However, there is a concern for vitamin B12 deficiency and iron deficiency among vegetarian infants and children. A study conducted in Poland compared the serum iron, ferritin levels, and total iron- binding capacity of 40 Caucasian children. The results of the study show that iron deficiency among vegetarian children is more prevalent than among omnivorous children. Two confounding variables of the study are the small subject size, and lack of information about whether menstrual periods among female subjects was controlled.

Based on the research I have read, it is safe for infants and children to have vegetarian diets if infants and children have regular nutritional status checks and are provided with the appropriate micronutrient supplementation (if needed). I am inconclusive on the safety of vegan diets for children due to the limited current research on vegan diets during infancy and childhood.

Works Cited:

  1. Winckel, Myriam Van, Saskia Vande Velde, Ruth De Bruyne, and Stephanie Van Biervliet. “Clinical Practice: Vegetarian infant and child nutrition.” European Journal of Pediatrics Eur J Pediatr12 (2011): 1489-494. 10 Mar 2016.
  2. Messina, Virginia, and Ann Reed Mangels. “Considerations in Planning Vegan Diets: Infants.” Journal of the American Dietetic Association6 (2001): 670-79. Web. 10 Mar. 2016.
  3. Messina, Virginia, and Ann Reed Mangels. “Considerations in Planning Vegan Diets: Children.” Journal of the American Dietetic Association6 (2001): 661-69. Web. 10 Mar. 2016.
  4. Larsson Christel and Johansson Gunnar. “Dietary intake and nutritional status of young vegans and omnivores in Sweden.” The American Journal of Clinical Nutrition. (2002);76:100–6. Web. 10 Mar. 2016
  5. Gorczyca, Daiva, Anna Prescha, Karolina Szeremeta, and Adam Jankowski. “Iron Status and Dietary Iron Intake of Vegetarian Children from Poland.” Annals of Nutrition and Metabolism Ann Nutr Metab4 (2013): 291-97. Web. 10 Mar. 2016.
  6. MailOnline, Angus Watson for. “How a Strict Vegan Diet Made My Children Ill.” Mail Online. Associated Newspapers, 14 Aug. 2008. Web. 10 Mar. 2016.
  7. Planck, Nina. “Death by Veganism.” The New York Times. The New York Times, 21 May 2007. Web. 10 Mar. 2016.
  8. Giannini, Alberto, Nadia Mirra, and Maria Francesca Patria. “Health Risks for Children Raised on Vegan or Vegetarian Diets.” Pediatric Critical Care Medicine2 (2006): 188. Web. 10 Mar. 2016.

Mono meals: Is it just another diet fad?

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Blueberry Mono Meal Breakfast

While watching Youtube videos, I recently heard about a diet trend that encourages people to consume mono meals (meals only made of one food source). There are currently 32,356 post on Instagram from people proudly sporting their mono meals consisting of half a watermelon or a plate full of fries. The health claims of mono meals are our pre-historic ancestors ate mono meals, meals containing too many ingredients cause too much enzymatic activity in our digestive system, leading to fatigue. There are also health claims about mono meals encouraging people to eat higher quality food, and being easier to digest than foods containing multiple ingredients. Although mono meals may seem appealing to some individuals, does research support mono meal health benefits?

Claim 1: Our pre-historic ancestors ate mono meals

Carla Golden of the Carla Golden Wellness blog supports mono meals because she believes our pre-historic ancestors during the Paleolithic Era regularly consumed mono meals. But, according to a study published in the Scandinavian Journal of Nutrition, “there was no Stone Age diet, and “overall, diets of the past varied greatly.” Also, Carla failed to explain why our ancestors’ diet would benefit our current health.

Claim 2: Multi-ingredient meals generate too much enzymatic activity during digestion, causing lethargy.

There are a variety of enzymes (such as amylases, proteases, and lipases) located in different organs of the digestive tract, and the purpose of digestive enzymes is to break down food into smaller compounds in order for nutrient absorption. Claim 2 does not seem valid since it basically states that multi ingredient meals cause food to be broken down too much during digestion, even though the entire purpose of digestion is to physically and chemically break down foods into compounds our bodies can absorb. Also, a mono meal also leads to a variety of enzymatic activity because one food item most likely contains a combination of carbohydrates, fats, protein, minerals, and vitamins.

Claim 3: Mono meals encourage the consumption of higher quality food

Consuming mono meals does not necessarily encourage people to consume higher quality because people can any food item, such as a bowl of chips or a loaf of bread, and the meal would still be considered a mono meal.

While mono meals may seem like a healthy diet trend to follow, I strongly advise against jumping on this diet fad because the most of the health claims have not been supported in research, and mono meals discourage people from having a high quality diet. High quality diets containing a variety of fruits, vegetables, dietary fiber, and whole grains, and several studies have shown a high quality diet is associated with health benefits, including reduced inflammation and reduced cancer risks. One study conducted in Sweden examined the association between diet quality and several inflammation cellular and soluble biomarkers in 667 people between the ages of 63- 68 in order to determine is systemic inflammation is related to diet quality. The results from the research showed higher quality diets are associated with lower risks of systemic inflammation. The confounding variables from the study are the lack of certain food groups (like dairy) from the dietary quality assessment test, and there was most likely some bias since subjects reported their dietary intake. As always, please do appropriate research on dietary trends and health claims before considering them facts.

Works Cited:

  1. Golden, Carla. “7 Reasons to Love a Monomeal.” Carla Golden Wellness. N.p., 24 June 2013. Web. 9 Mar. 2016.
  2. Wilson, Jessie. “Mono Meals And Mono Diets.” Raw Food Explained. N.p., 16 Aug. 2013. Web. 9 Mar. 2016.
  3. Blake, Joan Salge. “The Basics of Digestion.” Nutrition & You. 3rd ed. San Francisco: Pearson Benjamin Cummings, 2008. 68-86. Print.
  4. Gowlett, J. A. J. What actually was the Stone Age Diet? Journal of Nutritional and Environmental Medicine. 2003; 13(3): 143-147.
  5. Jansen, M, Bueno-De-Mesquita, B, ; Feskens, E, Streppel, M, Kok, F, Kromhout, D. Quantity and variety of fruit and vegetable consumption and cancer risk. Nutrition and Cancer. 2004;48(2):142-148.
  6. Dias, J, Wirfält, E, Drake, I ,Gullberg, B, Hedblad, B, Persson, M, Engström, G, Nilsson, J, Schiopu, A, Fredrikson, G, Björkbacka, H. Atherosclerosis. A high quality diet is associated with reduced systemic inflammation in middle-aged individuals. 2015. 238 (1):38-44

Superfoods Part 2: Are Chia Seeds a Superfood

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Photo of Chia Seeds

The seeds of Salvia Hispanica L., also known as chia seeds, are another superfood that has been widely popularized in recent years due to its macronutrient and micronutrient composition. Chia seeds contain 15-25% protein, 30-33% fat (particulary α-linolenic acid and linoleic acid) 26-41% carbohydrates, 10-30% fiber, and a variety of minerals including Calcium, Iron, and Magnesium. Several health blogs and other sites claim that chia seeds have anti-aging properties, ameliorates digestive health, aids in weight loss, offers cardio protection, and cures diabetes. Chia seeds have also been claimed to increase energy, strengthen bones due to its high calcium concentrations, have anti cancer properties, and provide a good source of plant based protein. With all of the health claims surrounding chia seeds, one can see how the health craze behind these seeds began. I have even jumped on the bandwagon behind incorporating chia seeds into my diet and have been adding them into my oatmeal and yogurt concoctions every morning for the past two years. After a discussion on superfoods in one of my classes, I began to wonder if the claimed benefits of chia seeds are supported by scientific evidence. Today, I will discuss two of the main health claims regarding chia seeds.

 

Claim 1: “Chia seeds aid in weight loss because of their high water retention ability. This ability causes chia seeds to expand in the stomach and increases the feeling of satiety; thus, leading to a smaller intake of food when chia seeds are consumed.”

Although chia seeds have a high water retention ability, there is a limited amount of research on the consumption of chia seeds and weight loss in humans. A study published in the Nutrition Research journal, determined the efficacy of chia seeds in promoting weight loss or changing disease risk in obese individuals. The single blind study consisted of 90 subjects between the ages of 20-70 who had to consume either chia seeds or placebo seed powder every morning over a 12-week period. The results of the study showed that there was not a statistical significance between total body mass or the body composition of individuals who consumed the placebo seed powder compared to chia seeds after the 12-week period ended. Until there is further independently funded research conducted on humans about chia seeds promoting weight loss, I will consider this claim a myth.

Claim 2: Heart Protection

High blood pressure, aka hypertension, high levels of inflammation, and high cholesterol levels (particularly LDL) increase the risk of cardiovascular disease, and according to health claims, chia seeds can decrease blood pressure and reduce inflammation.

However, there are also only few clinical trials conducted on chia seeds having cardio protective abilities. According to a study conducted on overweight individuals (this is the same study mentioned under claim 1), serum CRP, plasma cytokine levels (both of these are inflammation markers), serum lipoprotein, serum glucose, and systolic blood pressure between the placebo group and the chia seed group did not have statistically significant changes over the 12-week period. Alpha linolenic acid serum levels did increase significantly in the chia seed group, but less than 1% of the alpha linolenic acid was converted to EPA or DHA*. I am inconclusive on this health claim until further research is conducted.

While I will continue to consume chia seeds due to their high fiber content, I have become more skeptical of the term superfood in general because consuming one food item cannot solve the health problems prominent in the US today.

*Note: Alpha linolenic acid is an essential fatty acid (our body cannot synthesize the fatty acid on its own) that is converted into eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and EPA and DHA are associated with a decreased the risk of heart disease (Blake, 2008).

Works Cited:

  1. Ali, Norlaily Mohd, Swee Keong Yeap, Wan Yong Ho, Boon Kee Beh, Sheau Wei Tan, and Soon Guan Tan. “The Promising Future of Chia, Salvia HispanicaJournal of Biomedicine and Biotechnology. Hindawi Publishing Corporation, 2012 Nov. 21. Web. 8 Mar. 2016.
  2. “9 Chia Seed Benefits + Side Effects – Dr. Axe.” Dr Axe. N.p., 01 Oct. 2014. Web. 7 Mar. 2016.
  3. Segura-Campos, Maira, Norma Ciau-Solís, Gabriel Rosado-Rubio, Luis Chel-Guerrero, and David Betancur-Ancona. “Chemical and Functional Properties of Chia Seed (Salvia Hispanica L.) Gum.” International Journal of Food Science 2014 (2014): 1-5. 23 Mar. 2014. Web. 7 Mar. 2016.
  4. Nieman DC, Cayea EJ, Austin MD, Henson DA, McAnulty SR, Jin F. Chia seed does not promote weight loss or alter disease risk factors in overweight adults. Nutrition Research. 2009;29(6):414–418. Web. 8 Mar. 2016.
  5. “Inflammation and Heart Disease.” Inflammation and Heart Disease. American Heart Association, 13 Aug. 2015. Web. 8 Mar. 2016.
  6. “Lifestyle Changes for Heart Attack Prevention.” Lifestyle Changes for Heart Attack Prevention. American Heart Association, 2 Sept. 2015. Web. 8 Mar. 2016.
  7. Blake, Joan Salge. “Fats, Oils, and Other Lipids.” Nutrition & You. 3rd ed. San Francisco: Pearson Benjamin Cummings, 2008. 144-52. Print.

 

 

Superfoods Part 1: Are Açaí berries worth the hype?

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Photo of an acai berries

 

What does a health foods store, like GNC, and Starbucks have in common? They both sell product(s) made from acai berries. Acai berries are the small, deep purple fruit of acai palm trees (Euterpe oleracea), which are indigenous to Central and South America. These berries were popularized in the United States after Dr. Nicholas Perricone discussed the health benefits of the berries on the Oprah Winfrey Show, and they are currently considered a superfood in the U.S. and some European countries. If you take a break from reading this blog post and type in acai berries on Google, you will see millions of links discussing and supporting the health the benefits of consuming this miniature berry. Some of the health claims of acai berries are they have antimicrobial properties, have high antioxidant levels which protect against chronic heart diseases, improve weight loss, aid people in maintaining a health weight, aids in digestion, and boost the immune system. There are also health claims of acai berries providing energy, having anti aging effects, and preventing respiratory irritation. Because of the immense amount of popularity acai berries have gained in recent years, one can find a plethora of overpriced juices, smoothies, tablets, powder, and other beverages containing some form of acai berries within them as well as vague, exaggerated health claims, such as “boost energy” and “weight loss support” on the labels of these products. With all of the hype surrounding acai berries, the main questions needing to be addressed are does primary, independently funded research about the health claims of acai berries support or negate the health claims associated with acai berries, and do people really need to consume acai berries to be healthy?

I will address the main health claims of acai berries, including its heart protecting properties, anti aging properties, and weight loss assistance. According to the National Center for Complimentary Health and Integrative Health, “there is no definitive scientific evidence to support the anti aging and weight loss claims some acai berry products have marketed”. This means there is a lack of statistically significant evidence from the studies conducted on acai berries to conclude that acai berries somehow aid in weight loss or have anti aging properties. I could not even find a biochemical explanation for how acai berries provide guidance in promoting weight loss, so I am unaware about how this health claim became popular. As for the anti aging and heart protecting properties of acai berries, both of these claims arose because acai berries do have a variety of antioxidant compounds within them. Antioxidants are compounds that prevent the oxidation of other compounds, and oxidative stress has been linked to a plethora of conditions, including cardiovascular disease and aging. However, as I have previously mentioned, there is not enough evidence to support the health claim of acai berries having anti aging properties because of its antioxidant level. Acai berries may aid in heart protection according to an epidemiological study published in 2010. But, the study did not look at the cardio-protection of only acai berries, and the study did not mention that an increase of fruits and vegetables in general provides protection against several chronic diseases, including cardiovascular diseases.  In conclusion, while acai berries are a healthy alternative snack, there is a lack of evidence to claim they are a superfood, and people do not need to consume acai berries to have good health. Also, before believing all of the health claims associated with certain foods, conduct your own research by reading primary research articles and trusted health sites, such as the CDC and WHO.

Works cited:

1.NCCIH. “Acai”. U.S. Department of Health & Human Services, National Institutes of Health, 01 Mar. 2011. Web. 8 Mar. 2016.

2. Dr. Edward Group. “12 Health Benefits of Acai Berries.” Dr Groups Natural Health Organic Living Blog. Global Healing Center, 14 June 2010. Web. 8 Mar. 2016.

3. Marcason, Wendy. “What Is the Açaí Berry and Are There Health Benefits?” Journal of the American Dietetic Association 109.11 (2009): 1968. 24 Oct. 2009. Web. 8 Mar. 2016.

4. Basu, Arpita, Michael Rhone, and Timothy J. Lyons. “Berries: Emerging Impact on Cardiovascular Health.” Nutrition Reviews 68.3 (2010): 168-77. Http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068482/. Web. 8 Mar. 2016.

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