Nutrition & Physical Activity

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I need an effective, short-term weight loss and toning plan

Dear Annie,

Bravo for incorporating physical activity into your schedule! Regular exercise increases energy levels, improves quality of sleep, and boosts self-esteem. In terms of the effectiveness of your routine, it's difficult to say. Losing weight and toning up is influenced by multiple factors, including height, weight, bone density, genetics, and previous exercise regimen. By "a few pounds," do you mean two or ten or more? When setting out to change your body, it's important to ask yourself if the change you are striving for is realistic. In terms of your desired outcome, first ask yourself, "is this a realistic goal for me?" If you are unsure, it is wise to consult a personal trainer, exercise physiologist, registered dietitian, or your health care provider.

Part of effectively setting and reaching a goal means establishing one, or several, measurement criteria. Are you using a scale to measure body weight? Are you measuring body/fat composition? Strength? Clothes size? Body image? It's important to keep consistent with your indicators to know if you are making progress. If you are using a scale to measure body weight (in pounds), keep a few things in mind:

  • Muscle weighs more than fat.
  • Women especially can be prone to minor weight fluctuations due to menstruation and other types of hormonal activity.
  • Water, an essential nutrient for all sorts of body functions, can tip the scale one way or another.

You can also incorporate some basic guidelines into your plan that will help you maintain an active lifestyle:

  • Start slowly and build over time. It is smart to start off with a goal of running one mile as a workout, with the intention of increasing distance over time. Many people drop out of their exercise program because they go too hard, too fast, too soon. Pacing yourself, especially at the beginning, will help you establish confidence, self-awareness, and a strong fitness base.
  • Incorporate variety into your exercise and eating routine. Including different types of food and activity into your schedule will help to maintain enjoyment and motivation. You mention running and abdominal exercises — are there other types of activities you enjoy? Decreasing body fat and increasing toning or strengthening of muscle requires a balance of cardiovascular and strength training activities. Also, a wide variety of foods will help to ensure that your body is getting the nutrients it needs. Eat plenty of fruits and vegetables and think about decorating your plate as though it were a box of Crayola crayons; that is, aim for foods that are rich in color, such as blueberries, spinach, salmon, and tomatoes.
  • Find a friend. Studies have shown social support plays an important role in exercise motivation and sticking to an activity plan. Recruit friends and/or family to join you on a run, accompany you to lunch, or offer support.
  • Get plenty of rest. Sleep deprivation often makes everything more challenging, and it is especially easy to skip exercise when you feel tired. Sleeping well may help you avoid that trap. Plus, the more you exercise, the more rest your muscles will need to repair and recover.
  • Make it fun. Listening to music, running in the sunshine, or playing a rousing game with friends are all examples of ways to maximize fun and make physical activity something you look forward to and enjoy.

Maintaining a healthy and nutritious diet is an integral part of living a healthy lifestyle and achieving your weight loss goals. Here are a few great tips that may help you achieve your nutrition goals:

  • Keep a food diary.
  • Choose a diet low in fat, saturated fat and cholesterol and moderate in sugars.
  • Eat smaller meals more often — this can help ward off hunger so that you won't overeat at your next meal. Healthy snack options include low fat yogurt, fruit, nuts, vegetables, and whole-grain crackers.
  • Prepare smaller portion sizes.
  • Eat your favorite foods in moderation to help stifle cravings and help you to stick to your diet.
  • Avoid unhealthy fad diets.
  • Eat slowly — this can help you feel more full and avoid overeating.

Above all, the most important thing to remember is that every individual is different. If you feel good about what you are doing and are making progress, keep going until you reach your realistic, healthy goal. You can do it!


Alkaline water — is it better for your body?

Dear Reader,

Filtered water seems to be all the rage these days — your friend is not alone in her enthusiasm for filters of all types. Filter manufacturers claim that alkaline water, which has a higher pH than regular tap water, can neutralize acid in the blood, offer more energy, speed metabolism, and slow the aging process. While studies have shown that alkaline water can lead to a decrease of bone loss in pre-menopausal women, not enough research has been done on alkalizing water filters to know how effective they are in improving a range of health concerns.

A normal blood pH, the measure of acidity vs. alkalinity, is carefully maintained by various systems of the body to stay between 7.35 and 7.45. This is slightly on the alkaline side of neutral (7 on a scale of 1 to 14). Bones store calcium for the body, and also help to regulate the acidity or alkalinity of the blood. When the blood becomes too acidic from a diet high in refined sugar, flour, or lots of dairy or meat, calcium is drawn from the bones to bring the blood's pH back into the normal range. If the blood stays alkaline from a diet rich in fruits and vegetables (or from alkaline water, as the filter manufactures claim), the bones don't need to cede their calcium to the blood, the theory being that this calcium retention makes bones stronger and more dense. In addition to drinking alkaline water, researchers have found that eating a low-acid diet, that is, a diet full of fruits and vegetables and lower in animal protein and grains than the typical American diet, may lead to stronger bones.

Whether your friend would like to raise her blood alkalinity by shelling out for a filter is up to her. If you don't have extra money to drop on a filter that may or may not be effective, but would like to keep the pH of your blood in check, you could try to increase your consumption of fruits and green veggies and shave down your intake of refined sugars, flours, dairy, and meat. And fill up your water bottle at her house!


April 10, 2015

Learned a lot about alkaline water benefits. Thanks for the great information you have provided.
Learned a lot about alkaline water benefits. Thanks for the great information you have provided.

Beta-carotene in produce

Dear Orange you curious too,

Beta-carotene is just one out of hundreds of a family of plant pigments termed carotenoids. You may have heard of some of the other plant chemicals (phytochemicals) — lycopene, lutein, alpha-carotene, and zeaxanthin, among others. In particular, beta-carotene is a provitamin A carotenoid: it can be made into vitamin A by the body. Some research has linked diets high in beta-carotene and vitamin A to lower rates of some kinds of cancer. (Similar studies on beta-carotene supplements haven't shown the same association.) Other carotenoids may have similar health-promoting effects. 

Carotenoids are found in fruits and vegetables that are red, orange, and deep yellow in color, and in some dark green leafy vegetables too. While there are no home tests, if you wish to compare different foods' beta-carotene content, check out the USDA National Nutrient Database for beta-carotene. Be advised that at the moment no DRIs (Dietary Reference Intakes) have been established for any of the carotenoids. However, there are recommended dietary allowances (RDAs) for vitamin A — 3000 IU (900 mcg) a day for men and 2310 IU (700 mcg) a day for women — and foods rich in beta-carotene can help you meet these levels.

It's always a good bet to eat lots of fruits and vegetables — especially ones of all different colors. Trying to include red, green, and orange vegetables or fruits every day can be attractive, tasty, healthy, and fun! For more information about beta-carotene, check out the related Q&As listed below.


Health benefits of fish oils

Dear Curious,

Somthing's fishy about your lab results. The improvement in your cholesterol levels may be due to the foods you replaced with the fish, rather than the fish in and of itself. The fats found in some varieties of fish, omega-3 fatty acids, reduce triglyceride levels in the blood, but generally do not affect cholesterol levels.

However, you're still doing yourself a favor by feasting on fish. Eating fish offers many major health advantages. The primary benefit found from including fish oils in your diet is the lowered risk for sudden cardiac death. This means that fish eaters decrease their chance of dying suddenly from a heart attack (keep in mind that there are different types of heart attacks).

Two mechanisms explain how eating fish reduces the chance of heart attack. First, it seems that fish oil fatty acids reduce blood clotting by decreasing the stickiness of blood platelets. Second, omega-3 oils may play a role in stabilizing heart rhythms. It could be that the electrical impulses that go awry during some heart attacks are preserved in fish eaters. These protective qualities may work together, resulting in the reduced risk of sudden cardiac death that has been observed among fish consumers. Other possible health benefits of omega-3 fatty acids are their potential to help lower blood pressure and protect against some forms of stroke.

Remember, it is possible to have too much of a good thing. There are certain risks associated with eating too much fish. The main risk has to do with the toxicity of environmental contaminants, primarily mercury, which ends up in fish due to environmental pollution. Because of this, women who are pregnant or breastfeeding are often advised to avoid fish. In addition, there are various recommendations for eating fish to avoid consuming dangerous levels of mercury, as its toxicity can damage the brain, kidneys, and lungs. Mercury levels may be especially high in shark, swordfish, king mackerel, and tilefish.

But in moderate amount, fish can be beneficial, especially for people eating a western diet that is often low in omega 3s. Good sources of omega 3 include:

  • Shrimp
  • Salmon
  • Mackerel (watch out for the higher mercury levels in king mackerel)
  • Rainbow and lake trout
  • Sardines
  • Halibut
  • Pollock
  • Oysters
  • Catfish
  • Albacore, blue fin, and yellow fin tuna (including the canned type)
  • Striped sea bass
  • Turbot
  • Swordfish (watch out for higher mercury levels)

Fish oil supplements, on the other hand, contain almost no toxic contaminants and thus are safe. However, they can cause gastric symptoms, so it is best to take them with food. People with low blood pressure or who are taking medication for low blood pressure should also be careful about eating too much fish, since the fish oil could lower blood pressure even more. In very high amounts, fish oils can have some anti-coagulant effects, causing nosebleeds in some people.

Eating these jewels of the sea even once or twice a week may lead to heart healthy benefits. Obviously an all-around healthy diet will provide even more protection from heart disease, and other maladies, too.


A bowl of oatmeal a day keeps the cholesterol at bay?

Dear Haulin' Oats,

According to the 1990 Nutrition Labeling and Education Act, the U.S. Food and Drug Administration (FDA) may authorize a health claim only if there is significant scientific agreement that it is true — meaning that the claim must be accurate and not misleading to consumers. In 1997, the FDA allowed whole oat food manufacturers to make the health claim that their products reduce the risk of heart disease. Scientifically, the basis for this assertion is that the dietary fiber found in oats has been shown to help lower cholesterol, one of the risk factors for cardiovascular disease.

Oats contain beta-glucan, a water-soluble fiber thought to decrease LDL (low density lipoprotein, the harmful cholesterol) and total cholesterol. Since soluble fiber has a high water-holding capacity, it becomes gooey when dissolved in water. This feature allows soluble fiber to travel slowly through the digestive tract and attach to bile acids in the intestine, and then carry the acids out of the body as waste. Since bile acids are made from cholesterol, soluble fiber helps with the absorption of less dietary cholesterol.

In order to put the health claim on the food label, the oat item must be whole oat and provide at least 0.75 grams of soluble fiber per serving. In addition, the health claim must also include the words, "Diets low in saturated fat and cholesterol" rather than “Diets high in oats;” otherwise, consumers may think that eating oats is all they need to do to lower their risk of heart disease.

So, how much oats does a person really need to get the health benefits? Research has shown that two servings of oats daily can reduce cholesterol two to three percent beyond what is achieved with a low-fat diet alone. Other sources of soluble fiber may help instead of, or in addition to, the oats. Some examples of dietary soluble fiber include:

Food Serving Size Soluble fiber (grams)
Kidney beans (cooked) ½ cup 2.0
Pinto beans (cooked) ½ cup 2.0
Brussels sprouts (cooked) ½ cup 2.0
Oat bran (dry) 1/3 cup 2.0
Orange 1 medium 1.8
Oatmeal (dry) 1/3 cup 1.3
Apple 1 medium 1.2
Broccoli (cooked) ½ cup 1.1
Grapefruit ½ medium 1.1
Spinach (cooked) ½ cup 0.5
Brown rice (cooked) ½ cup 0.4
Whole wheat bread 1 slice 0.4
Grapes 1 cup 0.3

To reduce the risk for heart disease further, it is necessary to keep weight, cholesterol, and blood pressure at healthy levels, don't smoke, and exercise regularly. Also it is beneficial to munch on plenty of fruits, veggies, and whole grains. For more information on healthy eating, you can check out the United States Department of Agriculture (USDA) MyPlate website.

Lastly, while oat cereals are part of a healthy eating plan, if you can't stand them, don't force feed yourself. You can incorporate many other strategies and dietary sources of soluble fiber into your lifestyle to achieve better heart health. To life!


Spinning out of control?

Dear Always spinning at 85%,

It's good to hear that you, as the instructor, are attuned to the well-being and safety of your class participants. Finding creative ways to address attitudes and perceptions surrounding exercise can be an ongoing challenge.

The intensity at which an individual chooses to exercise depends on several things, such as health status, current fitness level, and fitness goals. Every body is different, and sometimes, especially in group exercise situations, competitiveness and/or insecurity triggers the group to conform to a norm (in this case, high intensity spinning). Often, though, a lack of accurate information interferes with people's development of useful attitudes and informed opinions about how they themselves need to exercise. You mention that the main goal for your classes is weight control. Exercising regularly at a high intensity level is not necessarily the best way to lose/control body weight.

So first, gather the data you need to teach your clients the facts. In Exercising beyond my maximum heart rate — Is this safe?, the answer explains how the conventional heart rate equation may not truly suit everyone. A more accurate way to determine one's training zone takes his or her resting heart rate (RHR) into account. Although it still is based on the estimated maximal heart rate formula, (220 - age in years), it serves as a better reflection of one's aerobic capacity.

(By the way, the most accurate calculation would directly measure one's functional capacity, or the amount of oxygen consumed during exercise.) For most people, the following calculation, known as the Karvonen formula, is fine. It is:

[(220 - age in years) - Resting Heart Rate] x Exercise Intensity + Resting Heart Rate

So, a forty-year-old with a RHR of 47 beats per minute could work within the 65 - 85 percent of maximum heart rate range of 133 - 160 beats per minute:

220 - 40 = 180
180 - 47 = 133
133 x 65 % = 86
86 + 47 = 133 beats per minute (low end)
220 - 40 = 180
180 - 47 = 133
133 x 85 % = 113
113 + 47 = 160 beats per minute (high end)

Next, perhaps you can learn more about why your clients believe that they need such intensity to "feel like they are getting a workout." What do you suppose is fueling this attitude? Ask some of your clients, something like, "I notice that you ride really hard when you come to class. Do you spin at that intensity all the time? And if so, what is that about? What is it that you want to happen?" Or, strike up a conversation about specific fitness goals.

Once you have the information you need and a better sense of what is motivating your class participants, you'll be in a better position to intervene. What may also help is to start an ongoing dialogue about individual fitness goals related to spinning. For example, you can explain that an "all out" exhaustive workout isn't appropriate for everyone and/or every day. You can encourage your clients to focus on higher intensity activity some days, while other days concentrate on workouts of longer duration at a lower intensity level. You can also explain that exercisers can engage in "active rest," meaning they don't necessarily have to become couch potatoes on their days off. They can go for a walk, practice yoga, jog, swim, bike, or dance at a much more leisurely pace. To help improve overall fitness, encourage cross-training — running, rowing, swimming. And you can explain the benefits of each of these kinds of movement.

Employing different techniques keeps your classes exciting for your class participants, and for yourself, as well. You said that you already vary the classes' intensity. Many instructors incorporate interval training, which changes the intensity during a class. Participants are challenged by the variety. Another option is to offer a longer class at a slightly lower intensity, for a change of pace.

You have the tools and information to help class participants reach their goals, and at least some of these ideas will make a difference, helping you reach your goal of getting your clients to learn more about what "works"!


Eating at night = weight gain: Myth or fact?

Dear Reader,

You and your friends have picked up on a popular debate. One aspect of weight management that is vital to understand is that we gain and lose weight over periods of time — weeks, months, years — not hour by hour. This happens as we take in more calories than we expend. Another important fact of metabolism is that our bodies do not stop working, even when we are sleeping! Hearts are beating, blood is circulating, lungs are functioning, brains are even working. This all takes energy — meaning we are still burning calories.

There is no magic time after which the body stores fat. For instance, if you eat the same exact meal at 6 pm or at 8 pm, is one more caloric than the other? No, each meal has the same number of calories. What really matters is the total amount of food and drink you have over the course of a week, or a month or longer, and how much energy you expend during that timeframe. Excess calories will be stored as fat over time, regardless of whether they are taken in during the day or night.

When it comes to eating late at night and the potential for weight gain, there are several considerations:

  • Portion sizes — waiting to eat could lead to consuming larger portion sizes.
  • Quality of food — after a long day of work or school, a few slices of pizza or a fast burger may seem easier than steamed vegetables and broiled fish.
  • "Mindless snacking" — evenings spent studying, going out, or watching TV may lead to excess calories from fast, sugary, on-the-go options.
  • Health concerns — consistent periods of going without food followed by a large meal can negatively impact the interaction between blood sugar and insulin and make you more vulnerable to Type 2 diabetes.

So, to settle the debate, you are correct that late-night calories won't change your metabolism or magically count more than calories eaten during the day. However, limiting late-night meals and snacks may be an effective weight management strategy for some because it helps them to control their overall calorie intake. Some people find that if they set a time that they can't eat past, it helps minimize or eliminate the possibility of munching on a lot of high calorie foods. Another useful tip may to be to eat four or five smaller meals and snacks spread evenly throughout the day so you don't become overly hungry at any point. Following these tips can keep your energy levels consistent for work and play and can provide some long-term benefits to help you reduce your chances for diabetes or other health issues. 

Bon appétit! 


June 29, 2007

Dear Alice,

Though your metabolism IS constantly at work, it does slow down later in the day, especially if you are just dieting and not exercising. When you exercise your heart rate and...

Dear Alice,

Though your metabolism IS constantly at work, it does slow down later in the day, especially if you are just dieting and not exercising. When you exercise your heart rate and metabolism both increase. In addition it is better to eat more meals and take in the same amount of calories because in doing so you keep your metabolism working. On the other hand if you eat less or worse starve yourself for several hours your metabolism slows down and potentially puts your body into a "starvation mode" where more insulin is released causing the body to store more fat. This is the most simple answer to this question.

Obsessed with building muscle (megarexia)

Dear Interested,

You've heard right. From time to time, many people experience bouts of insecurity about their appearance. However, if these thoughts significantly impact behaviors or habits, serious problems may result. The good news is that treatment can help people build up their self-esteem and overcome body image concerns.

In recent years, clinicians have coined the term "muscle dysmorphia" (MD) to describe a mental health condition experienced by men and women with a distorted perception of their body muscle (specifically a lack thereof). People with MD (also known as bigorexia or megarexia) may feel that their muscles are inadequate, even if their body appears strong to others. Muscle dysmorphia seems to affect men more often than women, perhaps due to social and cultural pressures on men to have beefy bods. MD is characterized by a constant preoccupation with body and muscle size that often results in excessive or compulsive exercise and weight training, even when injuries are present. In order to meet the demands of a rigid exercise routine, people struggling with MD may sacrifice time with friends and family or shirk responsibilities at work or school. Some may even resort to using steroids or other muscle-building medications despite the risk of harmful consequences.

Although muscle dysmorphia shares some of the hallmarks of disordered eating (namely compulsive exercise and weight training), MD does not meet the diagnostic criteria for a specific eating disorder. No definitive standards have been established to diagnose muscle dysmorphia. However, clinicians believe that people with this condition may also experience symptoms of body dysmorphic disorder, obsessive-compulsive disorder, a phobic response, or a state of anxiety.

Since our understanding of MD is still evolving, treatment options vary. A combination of cognitive behavioral therapy (or other counseling techniques) and antidepressant medications has been helpful to some people with muscle dysmorphia. However, acknowledging a problem and seeking help can prove difficult. First, someone with MD may not realize or be willing to admit that her/his thoughts and habits related to weight and body shape are harmful. Second, her/his loved ones may not pick up on the problem since people often associate muscled bodies with healthy eating and exercise practices.

For those with a distorted body image that proves harmful to her/his health or disruptive to daily life, there are many resources available to help. Scheduling a check-up with a health care provider familiar with these issues or speaking with a therapist who works with athletes and body image may be helpful.

Beefing up your understanding of muscle dysmorphia, and sharing your knowledge with others, may help more people recognize when normal concerns about body image, eating, and exercise cross the line.


Unscrambling conflicting info about eggs

Dear Not yet an Eggspert (but hopefully soon-to-be one),

You're right — eggs are a great form of protein, among other nutrients. The reason you hear different recommendations is because they vary depending on a person's health. Each person responds to dietary cholesterol differently, meaning that eggs may have more of an effect raising one person's blood cholesterol than another's. Unfortunately, we can't tell who will be affected in advance. If you're a healthy person, the American Heart Association says you should consume 300 mg or less of dietary cholesterol per day. If you have any of the following risk factors, 200 mg or less is recommended:

  • Family history of heart disease
  • Total cholesterol over 240 mg/dl
  • High blood pressure
  • Diabetes
  • You smoke

One whole egg contains between 213 - 220 mg of cholesterol. The fat, cholesterol, and most of the vitamins and minerals are found in the yolk. By the way, the saturated fat content of an egg is less than 2 grams, which is low. If you are in good health and know that your total blood cholesterol is below 200 mg, it is probably okay to have one whole egg a day if you limit other sources of cholesterol. The American Heart Association recommends 3 - 4 egg yolks per week for healthy individuals, probably because they expect that people will eat other foods that have cholesterol — these include all other animal-based products, some containing more cholesterol than others. To give you an idea:

  Food Item

Dietary Cholesterol (mg)
  whole milk (1 cup)   35
  skim milk (1 cup)   4
  cheese (1 oz.)   20 - 30
  butter (1 T.)   35
  beef (3.5 oz.)   70 - 100
  chicken (3.5 oz.)   75 - 90
  shrimp (3.5 oz.)   215
  cod (3.5 oz.)   65

If you're eating eggs and other high cholesterol foods often, it would be wise to have your blood cholesterol levels checked regularly to be sure that they don't suddenly rise.

Whipping up omelets using one whole egg and two or more egg whites is a good idea. This will give you a nice, fluffy dish with flavor, too. If you're looking for other low-cost nutritious foods, try preparing simple bean dishes. Since the fiber in beans helps to lower blood cholesterol levels, this could be a healthy alternative for egg-less times.

Have an egg-cellent day,


What's up with iodized salt - Is it better for you than regular salt?

Dear Wondering,

Great question! Iodine is a mineral that is added to table salt and found in a variety of foods. It is important for good health and, fortunately, our bodies require it in relatively small quantities. Iodine is part of a hormone, thyroxin, which is responsible for maintaining a person's metabolic rate.

Iodine is found in the sea and in soil that has previously been under the sea. Salt water seafood (e.g., sea trout, lobster, haddock, shrimp, and shark), sea vegetables (such as seaweed, including kelp, hijiki, arame, nori, and laver), vegetables grown in soil containing iodine (found on any land that was previously under the sea), and animals grazing on plants growing in iodine rich soil all are good sources. This mineral also enters the food supply through the use of certain disinfectants called iodophors. These are primarily used in the dairy industry, so milk and cheese, for example, contain a good amount of iodine. In addition, some red dyes contain iodine, as do some dough conditioners (look for an iodized conditioner listed in the ingredient section on the bread package). These sources add considerable amounts of iodine to one's diet.

As you can see, there are many ways to obtain iodine other than through table salt. That was not always the case. Many years ago, when iodine wasn't as plentiful in the food supply and people relied on iodine mainly from the sea, many people in the Great Plains states and Willamette valley in Oregon in the United States, which are situated far from salty waters, had iodine deficiency. Salt fortification was initiated in the U.S. to eliminate goiter, a disease of the thyroid gland resulting from iodine deficiency.

Now, food is manufactured and shipped all over the U.S. and the world. Food containing iodine is available everywhere. It is much less likely for people, even those living far from the ocean, to have goiter nowadays. However, salt is still iodized because iodine levels can vary greatly in foods (as levels of iodine in the soil are quite variable), and fortification offers a margin of safety. Today, goiter is more prevalent in developing countries than in the U.S., because they don't have access to as many foods, such as plant foods, that were grown in iodine-rich soil, they aren't eating seafood, and the populations of some developing countries are malnourished in general.

So, in answer to your question, it sounds as though you and members of your household are probably not taking in much salt if that package lasts forever. If you are eating plenty of seafoods — saltwater fish and/or sea vegetables — you don't need to return your salt. If you are eating a varied diet, you are probably taking in sufficient iodine. However, if you avoid most of the foods mentioned here, you may want to reconsider getting iodized salt, just to be on the safe side.

The Recommended Dietary Allowance (RDA) for iodine is 150 micrograms (µg) a day for adults. Women who are pregnant should consume about 200-300 micrograms because iodine is important for fetal and infant brain development. Iodine content varies widely in foods, as shown in the following examples:

Food source Iodine content (in µg)
Salt, iodized, 1 tsp. 400
Bread, made with iodized conditioner, 1 slice 142
Haddock, 3 oz. 104 - 145
Cottage cheese, ½ cup 26 - 71
Shrimp, 3 oz. 21 - 37
Cheddar cheese, 1 oz. 5 - 23

As a side note — lots of processed foods contain high levels of sodium. This sodium is not iodized, so don't count on meeting your iodine needs through chips and other junk food!


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