Aaron Alizadeh, MD

Aaron Alizadeh, MD

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Reduce Your Risk for Breast Cancer

October 02, 2013

Breast cancer is the most common non-skin cancer in females in the United States and the second most common cause of cancer death in women. One in eight women will develop the disease at some point in her lifetime. Although there are several risk factors you can't control, such as age, family history and race, there are many steps you can take to reduce your risk.

Maintain a Healthy Weight. Being overweight or obese, especially after menopause, has been linked to an increased risk of breast cancer. Exercising is one way that can help you maintain a healthy weight, and growing evidence suggests that regular physical activity may keep cancer at bay. For most healthy adults, the Department of Health and Human Services recommends at least 150 minutes a week of moderate aerobic activity or 75 minutes of vigorous aerobic activity weekly, plus strength training at least twice a week.

Limit alcohol. Habitual alcohol consumption has long been linked to a greater risk of developing breast cancer, particularly for younger women who have yet to have their first child. New research from the Harvard Medical School shows that the more alcohol a female drinks between her first menstrual cycle and her first full-term pregnancy, the higher her risk of developing the disease. If you choose to drink alcohol, limit yourself to no more than one drink a day.

Don't smoke. Developing breast cancer is just one of the many negative health effects of smoking. Accumulating evidence suggests that there is an even higher risk for premenopausal women. If you don't smoke, don't start. If you do smoke, use every resource you can find to help you quit. Secondhand smoke may also pose a threat to non-smokers. Reduce your exposure as much as possible; choose smoke-free restaurants and avoid indoor public places that allow smoking. If you work in a smoke-filled work environment, ask your employer permission to increase ventilation where smoking takes place by opening windows or using exhaust fans.

Limit the use of hormone therapy. Taking combination hormone therapy for more than three years may increase your risk of developing breast cancer. Women taking hormone therapy for menopausal symptoms should ask their doctor if it's possible to manage symptoms without the use of hormones. If hormone therapy is necessary, patients should use the lowest dose possible.

Breast-feed. Among the many benefits that breastfeeding pose for you and your baby, studies that show breastfeeding may reduce your chances of getting breast cancer. The longer you breastfeed, the greater the protective benefits have been shown.

Get Screened. Lastly, perhaps the greatest preventative measure you can take against breast cancer is committing yourself to regular mammograms and screenings. If you don't already, perform monthly breast self-exams. Although they should not replace screening mammograms, breast self exams allow you to become familiar with the normal feel and appearance of your breasts, so that you are able to notice changes easier. Beginning at age 40, schedule annual mammograms. It is important, however, to discuss your individual risk factors with your doctor, including any family history of breast cancer, as this may influence the exact timing and type of breast cancer screening that you may need. Breast cancer is often found on a mammogram years before a lump is felt. Early detection is key in successful survival outcomes. When caught in its earliest stages, breast cancer has a 98 percent likelihood of being cured.

By Kathleen Lambert, MD, Georgia Cancer Specialists

Going Natural this Easter

March 27, 2013

Whether you are a Christian, or simply celebrate Spring this Easter weekend, you may be coloring eggs with your children or grandchildren.

Coloring eggs takes me back to memories of my mom setting up a row of coffee mugs on the kitchen table, each filled with vinegar, water and a PAAS® colored tablet. We’d dip the eggs with the wire holder until they were the color we wanted. On Easter Sunday, the hard boiled eggs were magically transformed into colorful deviled eggs.

But did you know you can use real foods to dye Easter eggs? And why might you want to consider this?

Food dyes - originally made from tar and now petroleum – are not without controversy. A 2010 report from the Center for Science in the Public Interest found that many of the nine currently approved dyes raise health concerns - including links to cancer, hyperactivity in children and hypersensitivity reactions.

To keep perspective, the small amount of dye used to color eggs one time per year is probably not significant enough to have much of an impact on overall health, especially since the dyed shell is removed before eating. And if you don’t eat the colored eggs, then this isn't even an issue.

But what if you want to reduce your overall intake of food dyes? Eat more fresh fruits, vegetables, and whole grains naturally full of color and fewer packaged foods with added food dyes. And should you choose to experiment with a natural way to dye your Easter eggs this week, check out these suggestions from an article in USA Today this week:

  • Orange — Add 2 tablespoons of annatto seeds to a cup of boiling water with a teaspoon of vinegar. Let simmer for 10 minutes. Strain the seeds.
  • Faint pink — Add a can of sliced beets to 2 cups of boiling water with a teaspoon of vinegar. Let simmer for 10 minutes. Strain the beets.
  • Blue — Add a cup of blueberries to 2 cups of boiling water with a teaspoon of vinegar. Let simmer for 10 minutes. Strain the blueberries.
  • Brown — Add a teaspoon of vinegar to a cup of hot coffee. The stronger the coffee, the darker the dye.
  • Purple — Add a teaspoon of vinegar to a cup of boiling grape juice.
  • Light green — Add 2 tablespoons of green tea powder to a cup of boiling water with a teaspoon of vinegar. Let simmer for 10 minutes.
  • Light orange — Add a tablespoon of paprika powder to a cup of boiling water with a teaspoon of vinegar.
  • Bright yellow — Add a tablespoon of turmeric powder to a cup of boiling water with a teaspoon of vinegar.

Five Tips to Spring into Wellness

March 21, 2013

In case you missed the news, yesterday was the first day of Spring. Temperatures dipped below freezing last night, making this fact hard to believe. But before we know it, the heat of Summer in the South will be upon us.

Traditionally, Spring is a season of rebirth, rejuvenation, renewal, resurrection, and growth. No matter where you are in your cancer journey, I challenge you to Spring forward and embrace this season by making some changes in your wellness routine.

What can you do to rejuvenate?

  • Eat local. Choose fresh foods that come from plants, like fruits and vegetables. Eat foods that are grown seasonally and locally by visiting your local farmer’s market. Local fresh produce – organic or not – will taste better and be full of cancer-fighting nutrients!
  • Eat your greens. If you think you don’t like leafy greens, try again. On your next grocery or farmer’s market trip, pick up one bunch of a leafy green you have never tasted before. Try dandelion greens, kale, Swiss chard, endive, spinach, collards, red or green mustard greens, or watercress. You can even steam the greens of beets! Greens are full of vitamin A, vitamin K and fiber. Caution: If you are taking Coumadin, or warfarin, talk with your healthcare team before adding more greens.
  • Take your probiotics. Foods such as miso, sauerkraut, tempeh, yogurt, and kefir add important probiotics (or good bacteria) to aid digestion and reduce inflammation. I like to get mine through a combination of Greek yogurt with fresh berries and a probiotic capsule called Culturelle once daily. Caution: If you are currently on a cancer treatment that may lower your white blood cell count, talk with your healthcare team about adding probiotics.
  • Eat foods to fight seasonal allergies. Along with Spring in Georgia comes the annual dusting of yellow powder, causing watery eyes, sneezing, congestionm and inflammation. Try adding these foods:
    1. Warm fluids. Try sipping tea or chicken soup to help break up congestion.
    2. Fish oils. Omega-3 fatty acids--in tuna, salmon, and mackerel--could lower the risk of developing allergies. Study results are mixed, but it can’t hurt to try.
    3. Yogurt. Some studies show that probiotics may reduce allergy symptoms in children. The jury is still out on this one, but you may get other health benefits even if it doesn't help your allergy symptoms.
    4. Honey. I have a few friends who believe in taking a teaspoon of local honey to ease fall and spring allergies. Studies haven't shown any benefit; however, it probably won’t hurt.
  • Move more. If you don’t have any medical restrictions, step up your exercise routine. Whether you enjoy walking, running, biking, hiking, yoga, or swimming, add an extra 10 minutes to each workout, increase your intensity with an incline or hills or add one more workout per week to your routine. Always talk with your physician if you are new to exercise before starting a new program.

What are you doing to rejuvenate this Spring? Share your ideas!

Image courtesy of Simon Howden / FreeDigitalPhotos.net

Can’t Stand the Heat? Get in Your Kitchen!

March 14, 2013

Inflammation is something we all experience from time to time on the surface of our body as redness, heat, swelling and pain. We cut our finger and it looks red and swollen. Short term inflammation is a good thing – it’s our body’s way of healing.

What we as healthcare professionals are more concerned about – and you should be too – is chronic inflammation that persists and is at the root of many chronic diseases.

What causes chronic inflammation?

Stress, lack of exercise, genetics, exposure to toxins (like secondhand tobacco smoke) and obesity can all contribute to chronic inflammation, but what you eat can play a big role as well.

The good news

Most recently, research has shown that patterns of what we eat and certain foods may help reduce inflammation in our bodies.

What does this mean for you? Whether you are fighting cancer, heart disease, arthritis, or even Alzheimer’s disease, changing your diet may help.

But where do I start?

Making big changes in our diet can be overwhelming. Trust me – I’ve been there. My eating habits since starting to work in cancer care over 10 years ago have morphed tremendously.

Knowledge is power, but it takes trial and error to discover healthy changes that you can live with for the rest of your life.

That being said, be realistic by making one change a week or even one change a month. Even a monthly change in your lifestyle will lead to 12 changes at the end of the year. How great would that feel?

Start with these 5 Strategies to Reduce Inflammation:

  1. Eat more plants. Include at least one fruit or vegetable at every meal. Aim to eventually eat five different fruits and/or vegetables every day. Think it’s too much? Try a smoothie for breakfast with Greek yogurt, skim milk, a banana and some frozen peaches (two servings). Eat a big salad with two cups of vegetables for lunch (two servings), and have grilled fish with two vegetables on the side for dinner (two servings). Voila! You just ate six servings.
  2. Ditch the sugar. The American Heart Association recommends that American women eat no more than 100 calories from added sugars per day, or about 25 grams (6 teaspoons). For men, it’s 150 calories per day, or 37 grams of added sugar (9 teaspoons). Read packaged food labels carefully to track your sugar intake. You’ll be surprised how quickly you reach this limit!
  3. Snack on nuts. Nuts – particularly walnuts that are rich in omega-3 fatty acids that may help fight inflammation. Next time you reach for that 3 p.m. salty snack, consider nuts over crackers or chips.
  4. Spice it up. Spices contain essential oils that may have anti-inflammatory properties. Add turmeric or curry powder to dishes. Use more fresh herbs like cilantro, parsley, and basil in cooking, and experiment with different spices for more flavor. Be sure your spices are still fragrant before using. If they've been in your spice rack for over a year, it may be time to refresh your supply.
  5. Add berries. Strawberries, blueberries, cranberries, and raspberries all have anti-inflammatory properties. Mix berries into a smoothie, add berries to a cup of vanilla yogurt, or put them in a salad. You can’t go wrong with this versatile fruit!
  6. Want more ideas? Give these recipes a whirl.

    Cauliflower Gold

    Strawberry Tostada

    Image courtesy of stockimages / FreeDigitalPhotos.net

Building a Better PB & J

February 27, 2013

Who doesn’t love a PB & J sandwich? I suppose if you have a nut allergy, then it’s not an option, but for me, it’s a classic comfort food.

Yesterday was a long day. I walked in the door at 9:30 p.m. and had not eaten dinner. My saving grace? PB & J.

When my budget gets tight, and I need to watch my spending for a week, PB & J is my go-to lunch or dinner.

If I know I have a long day on the road – for fun or for work – PB & J is a great sandwich to pack for the road that doesn't spoil quickly (especially in the winter or if kept in a cooler bag!)

And P.S. – it also travels well on long days at the doctor’s office, on days when you get chemo, and doesn't have a strong odor that could bother those around you. If you've ever been getting an infusion with someone eating tuna next to you, you know what I mean.

Perhaps you are thinking, “A dietitian is telling me to eat PB & J? Is she crazy?”

Like many popular foods, PB & J can be made better. Just a little more forethought does wonders to pack a nutritional punch to this sandwich.

Where to begin?

  1. Choose a high-quality bread. I personally like Ezekiel bread (in the freezer section) – made from sprouted grains with no added sugar or high fructose corn syrup. It’s a great source of fiber, and the sprouted grains make the nutrients more bio-available! If you want to get more adventurous, toast the bread, and watch the peanut butter melt as you spread. My mouth is watering as I write this. Yum.
  2. Go natural. Buy natural peanut butter.Commercial brands often have unhealthy oils, sugar and salt added. Look for “natural” peanut butter with the oil sitting on top in stores. Read the ingredients to find one that only contains peanuts. There is no need to add other ingredients. And if you can grind it yourself at your local grocery, even better! Intimidated by stirring in the separated oil? Store the jar upside down until you open it and voila - the oil moves to the bottom of the jar making blending a breeze.
  3. Try other nut butters. I have a new love. A recent visit to Whole Foods introduced me to freshly ground almond butter and there’s no turning back. It tastes exactly like crushed almonds – just as it should. If you are a little more adventurous, try making your own nut butter at home in your food processor.
  4. Pick a fruitful jam. My favorite combination is peanut or almond butter with homemade blackberry jam. If you don’t make your own, look for a product at the store with as few ingredients as possible – and preferably one that doesn't have sugar listed as the very first ingredient. I like Smuckers Orchard’s Finest (four ingredients) and Dickinson’s Purely Fruit (four ingredients as well).
  5. Add fruit. Bananas, pears and berries all mix well with nut butters. You can add fruit to your version of PB & J, or substitute the “J” all together with fruit. Want to experiment? Try this Almond Butter & Fruit Sandwich with pears and raspberries from last October’s Health magazine.

What’s your favorite version? Tell us on Facebook!

Image courtesy FreeDigitalPhotos.net

It’s Time to Get Moving

February 19, 2013

After a brief exercise hiatus, I went back to my boot camp class this morning. It was tough. Not nearly as tough as I imagine chemo would be, but I felt as nauseated as I imagine some people feel on chemo.

I only took a few weeks off, but it’s amazing how the body reacts when I push myself physically. Mentally, I still think I’m 18. Physically, my body reminds me that I’m not. And that I need to get back to my routine.

The American Institute For Cancer Research (AICR) recommends getting active for at least thirty minutes every day. According to AICR, regular activity can help you:

  • gain strength
  • relieve stress
  • boost self-esteem
  • reduce anxiety
  • sleep better
  • feel more energetic

And better yet, regular activity can help manage weight and reduce your risk of cancer.

Where to begin?

  • Talk with your physician before starting any exercise program. If you haven’t been active in a while, get clearance from your physician first. You may even benefit from physical therapy first if you are still in recovery from cancer treatments.
  • Start slow. Once your physician gives you approval, start slow. Walking is a good first step that most people are able to do. Try walking outdoors for 10-15 minutes daily. If you are already able to do this, increase your speed, how far you walk, and/or the intensity (i.e. add hills) over time to continue to improve your level of fitness. And no matter how fit you are or become, carry a cell phone with you for emergencies.
  • Be realistic. If you've been on cancer treatment for 6-12 months, starting back may be very difficult. Talk with your healthcare team, an exercise physiologist, or a physical therapist about what is realistic. Pushing yourself too hard may lead to injury, which will only postpone your goals further.
  • Explore activities to find one you really enjoy. Walking bores me unless I’m on the beach or hiking to a destination with a scenic view, like Stone Mountain or Kennesaw Mountain. I love to run, play tennis, and do yoga. Challenge yourself to try new activities. You never know what may end up becoming a new passion.
  • Set a goal. Once you find something you enjoy, set a goal. If you enjoy walking or running, perhaps your goal is to finish a 5K like Race for the Cure that raises money for cancer research. Or walk 10,000 steps every day. Or play in an Atlanta adult tennis league to make new friends. Whatever your goal, make it one that motivates you to get off the couch. Every. Single. Day.

Image courtesy of stockimages / FreeDigitalPhotos.net

Staying Safe & Fighting Cancer with Leafy Greens

February 07, 2013

According to the CDC, food-borne illness sends 128,000 Americans to the hospital each year and kills 3,000 annually. A report released just this week based on 10 years of research links food borne illness to leafy greens. The authors did not cite specific foods (i.e. whether or not kale is worse than spinach).

I know what you may be thinking. But diets rich in leafy greens may help reduce my risk of cancer, are full of fiber, and can help me lose weight! Should I stop eating these cancer-preventative power foods?

Not so fast. The CDC is not recommending that consumers avoid leafy greens, especially healthy choices like produce. Instead, educate yourself, be aware, and be smart about your choices.

But before we go any further, there’s one note I need to make.

If you are currently on cancer treatment – such as oral chemo, IV chemo, or radiation – you may be told at some point by your treatment team to not eat raw fruits and vegetables. This recommendation is sometimes given if one type of white blood cell count in your blood (also referred to as “ANC,” or absolute neutrophil count) gets very low.

I can’t say that this recommendation is science or “evidence-based”, but the belief (as I will call it) is that if your ANC is so low that your body can’t fight off infection, then we shouldn't introduce any raw foods that may be more likely to carry bacteria and make you sick.

This makes sense; however, it’s just not very likely to happen– especially if you are cautious and smart about food preparation.

There are many steps you can take as a consumer and/or cancer fighter to reduce your risk of food-borne illness (no matter what your ANC levels are) and still enjoy leafy greens as part of your meals each week:

  • Wash your hands. I can’t say this enough. This is the easiest step you can take to reduce your risk of many infections. Wash before every meal or snack and before you prepare any food. If you are preparing a variety of foods, wash your hands between each type of food so you can avoid cross-contamination.
  • Wash fresh produce well. Leafy greens have cracks and crevices where dirt and bacteria can hide. Studies show you don’t need to use a special rinse. Just running water and a vegetable brush will work (or just your hands if the greens are fragile). Wash thoroughly.
  • Dry produce after washing. Believe it or not, this extra step can reduce bacteria further. Just be sure to use a clean paper or washable towel!
  • Eat a variety of greens. Each crop may have exposure to different bacteria and production methods. If spinach has an E-Coli breakout, and you have eaten five different greens that week, then you may be less likely to get sick. (I don’t have proof of this, but it just makes sense to me!)
  • Eat less common greens and buy local. Try Bok Choy, Chard, Beet Greens, or another green you haven’t tasted before. Again, I don’t have a reference to back this up, but it would make sense to me that a local, less mass-produced leafy green may be less likely to get contaminated as it doesn’t pass through as many processes and checkpoints.
  • Grow your own greens. I know this isn't possible for everyone, but growing your own gives you more control over the end product. Many times contamination comes from the people picking, packaging and distributing the product.

Want to learn more about food safety? Visit Food Safety.gov.

Image Courtesy: FreeDigitalPhotos.net

Protecting the Prostate

February 01, 2013

A study published this week links eating fried foods to cancer – specifically prostate cancer. This may not be rocket science to you. Fried foods made the news a few years ago when lab tests commissioned by the Center for Science in the Public Interest (CSPI) showed very high levels of a cancer-causing chemical “acrylamide” in french fries and snack chips.

But how does acrylamide get into our food supply?

Acrylamide forms during high-temperature baking or frying of starchy foods. According to CSPI, french fries were shown to have 300 times the amount of acrylamide allowed in one (8oz) cup of drinking water by the U.S. EPA.

The study published last weeklooked at the frequency of eating fried foods – specifically french fries, fried chicken, fried fish, doughnuts, and snack chips – among 1,549 men.

The authors found an increased risk for prostate cancer in those who ate french fries, fried chicken, fried fish, and doughnuts at least one time every week.

So what does this mean for cancer survivors?

According to this study, eating some deep-fried foods every week is associated an increased risk of prostate cancer. What we don’t fully understand yet is if this risk is just with deep-fried foods, or whether it is associated with eating foods exposed to high heat and/or other aspects of our American diets, such as eating fast food.

What can you do to reduce your risk?

Even if you aren’t willing to give up all fried foods yet, there are steps you can take to lower your risk:

  • Toss your deep fryer. Enough said.
  • Make fried foods a treat. Decide what your favorite fried food(s) are and treat yourself to a small serving once a month. Personally, I love fried green tomatoes - but make them a special treat a few times a year.
  • Make your own oven baked fries at home. Slice up your favorite fresh potatoes or sweet potatoes, toss in a light coating of olive or canola oil, spread single layer on a baking sheet and bake at 400°F.
  • Try a healthier oven-fried chicken. This recipe from a Dr. Oz chef has less fat and calories – and may be just the trick to satisfy your craving.
  • Ditch the doughnuts. Bake your own healthy, hearty cherry pecan breakfast muffins full of nuts and dried fruits to reduce the temptation at the office.
  • Image courtesy of artemisphoto / FreeDigitalPhotos.net

Twelve Tips to Boost Your New Year’s Weight Loss Success

January 23, 2013

Have you resolved to shed a few pounds this year?

For cancer survivors finished with treatment, weight loss can be beneficial and may actually reduce your risk of cancer recurrence. But if you are currently on cancer treatment, you should talk with your physician before starting a weight loss plan, as weight loss during treatment may not be recommended in the short-term – especially if the pounds lost are made up of muscle, not fat.

There are hundreds if not thousands of diets to help you succeed in your weight loss journey. But long-term success is based not only on what you put in your mouth, but also on your surroundings and environment.

So aside from what you eat, what other steps can you take to succeed?

Stephanie Rost, a registered dietitian with the new Weight Watchers 360 program, gives some great advice at cnn.com.

And if Stephanie’s tips are not enough, here are five more of mine to help you reach your goals.

  1. Find a weight loss buddy. Studies have shown that people who have strong support systems are more successful at weight loss. Whether you have one BFF or a few friends and family who can help, use these people to keep you on track.
  2. Use a small plate. Eat your meals on a plate no larger than nine inches in diameter. You’ll be amazed at how full your plate will look despite eating smaller portions. Better yet – fill half the plate with fruits and vegetables.
  3. Write it down. Hold yourself accountable by writing down not only what you are eating, but also how many steps you are taking every day. Aim for a long-term goal of 10,000 steps per day. Use a smartphone app or a pedometer to track your daily progress.
  4. Move for 10-15 minutes before each meal. Even if you don’t think you have the time or energy to exercise, everyone has 10 minutes before each meal to take a short walk. Get the blood flowing three times per day and at the end of the day, and guess what? You’ve added 30 minutes of activity to your day.
  5. Have a friend "on call." Have that person you can call when you are about to binge on a box of brownies or a bag of chips that can talk you down from the ledge. Think you don’t have this person in your life? Most of us do, and it’s likely you can do the same for them as well!
  6. Image courtesy of Grant Cochrane / FreeDigitalPhotos.net>/p>

Boost Your Bug Fighting Powers

January 15, 2013

I beat the flu in December, thinking I was in the clear. But apparently, that’s not the case. After spending much of the holiday season traveling in cold snowy weather on planes, trains, and buses, it appears another bug got the best of me. So I went in search of what I can do to give my body a boost to fight any further invaders.

If you are in the midst of cancer treatment, you too may be wondering what you can do to avoid illness or infection. With flu cases in Georgia at what is believed to be their peak right now, it would be completely normal to be a little worried. Even if you don’t get the flu, a cold or virus can easily take a toll on your health during cancer treatment.

Want an immune system powerful enough to take out the bad guys? Take a good look at what you are putting into your body. Although there isn’t one magic food to maximize our germ fighting ability, studies show that what we eat does affect our body’s defense system.

Choose high quality fuel, and your body will thank you. Choose low grade fuel (i.e. junk food), and your body won’t be as effective at waging war on intruders.

Although I don’t agree with everything Dr. Oz says, his show often highlights foods that boost the immune system. And no matter how you feel about the show or Dr. Oz himself, one message is consistent.

Eating more foods that come from plants—in the form of seeds, nuts, fruits, vegetables, fruits, and herbs and spices—is good for all of us, not only for boosting our immune system, but for fighting cancer too. And this message comes from numerous sources—not just a popular TV show.

Although all plant foods are helpful in some way, here are a few (courtesy of the Dr. Oz show) that you might want to grab on your next grocery trip—if they aren’t already in your home.

Tahini is best in the form of hummus with a few raw veggies.

Black Pepper may be helpful, especially in conjunction with other spices. Try adding freshly ground black pepper at dinner every night.

Dried leaf oregano has aromatic oils may help kill up to 30 different germs. Sprinkle on salads, in soups, in casseroles, or on pizza and pasta dishes.

Pumpkin has beta-carotene, which turns into Vitamin A to boost immunity. Roast fresh baking pumpkins (and the seeds) for a side dish or use pureed pumpkin to make soup. If you aren't a pumpkin fan, try sweet potatoes, papaya, or carrots instead.

Garlic is full of allicin that may fight inflammation. Make your own garlic toast with whole grain bread, olive oil, and crushed fresh garlic. Shaking garlic powder on toast may be quick and easy, but isn’t as effective as the real deal (nor does it taste as good!)

Sardines. Okay, sardines aren’t a plant and honestly, I can’t stomach them. But they are rich in healthy anti-inflammatory fats and vitamin D. Low levels of vitamin D in the body may affect immune function. Since sunshine to produce vitamin D is at an all-time low in the winter, sardines are another option.

Not a fan of any of these? Try adding one fruit or vegetable every day that you like until you reach the recommended number of 5-9 servings every day!

Image courtesy of David Castillo Dominici / FreeDigitalPhotos.net

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