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We do not always need a definitive RCT to know what we know; and I make a living running such trials. Suppose you wanted to know with something nearing certainty what specific dietary pattern was best for human health. How would you proceed?

First, you would need to define best in an operational (i.e., measurable) way. Does best mean lowers LDL in the short term, or does it mean raises HDL, or both? Does it mean it lowers inflammatory markers, or insulin, or blood glucose, or blood pressure? Does it mean all of these, or does it mean something else? Is the short term one month, or three, or a year?

I dont think any of these, or anything like them, really satisfies what we think we mean when we say best for health. I think the intended meaning of that is actually rather clear: the combination of longevity, and vitality. Years in life, and life in years, if you will. I think a diet is best for health and yes, I have wrestled with this very issue before if it fuels a long, robust life free of preventable chronic diseases (e.g., heart disease, cancer, stroke, diabetes, dementia, etc.) and obesity, and endows us with the energy both mental and physical- to do all we want and aspire to do. That, I think, is a robust definition of best for health.

We are obligated to wrestle comparably with the operational definition of a specific diet. Low fat, or low carb dont mean much. A low fat diet could be rich in beans and lentils, or made up exclusively of lollipops. A low carb diet could cut out refined starch and added sugar, or exclude all fruits and vegetables. Lets not belabor this, and simply concede that the relevant test to prove that one, specific dietary prescription (e.g., the Ornish diet, or the South Beach diet, or the DASH diet, etc.) is best is to establish optimized versions of the various contenders, from vegan to Paleo, and put them up against one another directly.

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And now our tribulations begin. As we noted at the start, our outcome is the combination of longevity and vitality. To get at longevity, we need a very long trial; in fact, our trial needs to last a lifetime. So, just to get started, we are toying with the notion of a randomized trial running for 80 to 100 years.

Since we are comparing optimal versions of diets reasonably under consideration for best diet laurels, we may anticipate that our study participants are apt to be healthier, and longer-lived in general than the population at large, consuming the lamentable typical American diet.

Thats a problem too. If our entire study sample does well, it raises the bar to show that one of our diets is truly, meaningfully better than another. The smaller the difference we are seeking, the larger the sample size we need to find it. That now means we need not only a RCT unprecedented in length, but unprecedented in size, too. We need to randomize tens of thousands, if not hundreds of thousands to study the effects of competing diets on vitality and longevity at a cost that is staggering to contemplate, and would certainly run into the billions of dollars.

This study has not been done. This study will not be done. But, so what?

Lets contrast our ostensible need for this RCT to how we know what we know about putting out house fires. There has never been, to the best of my knowledge, a RCT to show that water is a better choice than gasoline. Do you think we need such a trial, to establish the legitimacy of the basic theme (i.e., use water) of the right approach? Would you, and your home, be willing to participate in such a trial when you call 911 knowing you might randomly be assigned to the gasoline arm of the study?

I trust we agree that observation, experience, and sense serve to establish beyond the realm of reasonable (or, even, any) doubt that water is generally good for putting out house fires, and gasolinenot so much.

My friends diet is the same. The want of a RCT addressing this kind of water versus that does not mire us in perpetual cluelessness about the basic approach to putting out fires. Sure, we could do RCTs to add to what we know, but the want of such studies does not expunge what we already know based on empirical evidence, long experience, observation, and sense.

A diet comprised principally of minimally processed vegetables, fruits, whole grains, beans, lentils and pulses, nuts, seeds, with plain water preferentially for thirst is the best theme for human and planetary health alike, and runs commonly through all the legitimate, specific contestants, just as water is the best theme when aiming a fire hose. To conclude otherwise is to misconstrue the utility of randomized trials, succumb to their tyranny, and lose our way in a bog of tribulations.

Dr. David L. Katz, http://www.davidkatzmd.com; is founder, True Health Initiative.

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Dr. David Katz, Preventative Medicine: Diet Trial Tribulations - New Haven Register

Serena Wolf, author of a new cookbook called The Dude Diet: Clean(ish) Food for People Who Like to Eat Dirty, lives by the idea that its not impossible to crave healthy food.

One of the most unfortunate misconceptions about healthy eating is that its boring or bland, she said. My underlying goal with The Dude Diet is to prove that meals made with nutrient-dense, whole foods can elicit the same extreme excitement associated with deep dish pizza or delivery Chinese.

Today at 6 p.m., Wolf will be at The Bookworm of Edwards to discuss the recipes from her book and the story that brought them all together. Wolf didnt come from a long line of cooks in her family. In fact, she was truly a visionary when it came to her meals.

Truth be told, its pretty hilarious to my friends and family (and myself) that I ended up in the food world, Wolf said. Nobody in my family cooks, and prior to culinary school, the only thing I had ever cooked was a burnt grilled cheese. I moved to Paris and enrolled in Le Cordon Bleu on a whim after college, and I was only meant to do the basic three-month program before coming home to start my real life.

The early cooking school days were mildly traumatic, but after a couple months, I had become a completely different person. I was gutting and filleting fish, deboning chickens, breaking down whole rabbits and whipping up hollandaise sauce without breaking a sweat. Weirdly, I loved every second of it. Realizing that Id found my (very unexpected) calling, I enthusiastically signed on to complete the full diploma program and never really looked back.

After graduating from Le Cordon Bleu, Wolf found many opportunities to share the passion she had found in Paris. While in school, Wolf started up a website, domesticate-me.com, to share her skills with others with whom she wanted to keep in contact. With fun and accessible takes on recipes, the websites popularity continues to grow.

Inspiration for the dude diet

It wasnt until she met her fiance that she was inspired to compile a book of her experiences.

The Dude Diet was inspired by my wonderful, nutritionally confused fiance, Logan, Wolf said. When I moved in with him five years ago and became privy to his day-to-day eating habits, I was horrified. Id occasionally mention that he might want to eat more healthily, but these suggestions were typically met with shrugs and derogatory comments about vegetables and weird vegan things.

So, when he announced one random Saturday that he wanted to start eating better, I was determined to capitalize on the opportunity. I knew that overhauling the eating habits of someone who comes precariously close to having excitement seizures in the vicinity of finger food, and who regularly trips over himself when running to the door to get his Dominos, wasnt going to be an easy job. But I love a challenge, and I committed myself to helping Logan create better habits by feeding him nutritious, hearty meals that hed be pumped to eat.

Wolf began by creating the categories of recipes she wanted to make sure made it into the book. The book has a versatile selection of recipes, including what to make on game day, a healthy spin on takeout and, of course, cocktails. This book is tailor made for anyone who loves food that tastes incredible and doesnt erase your diet.

Im so excited to talk about my own food and cooking story, the inspiration for The Dude Diet, and to hopefully get people excited about cooking and eating clean(ish), Wolf said. More than five years later, my mission with the blog, my book and my personal brand remains the same: I truly believe that cooking should be accessible, experimental and, most importantly, fun.

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Serena Wolf, author of 'The Dude Diet,' tells her story at The Bookworm - Vail Daily News

Dr. Vijay Bindingnavele joined us on 3 News First Edition to talk about the importance of adding fiber to your diet.

KIII 8:00 AM. CST February 19, 2017

CORPUS CHRISTI (KIII NEWS) - Constipation is a relatively common problem, but one, that can be avoided by sticking to a diet that is high in fresh fruits, vegetables and whole grains.

Dr. Vijay joined us this morning, to talk more about fiber and what is recommended in order to keep things flowing properly.

Dr. Vijay said, there have recently been reports of laxatives causing serious health problems. This can occur particularly if they are used incorrectly or by those who should not be using them. Constipation is a relatively common problem and one that can be avoided by sticking to a diet that is high in fresh fruits and vegetables and whole grains. This would give you the amount of fiber that is recommended and would help greatly in keeping bowel movements regular. When this alone doesn't work, then prunes or prune juice usually does the trick. When this also doesn't work and this problem occurs frequently, then a trip to your physician would be best. He or she may be able to identify changes in your diet that may help regularize your system.

( 2017 KIII)

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Dr. is In: The Importance of adding Fiber to your Diet - KIII TV3

A new study suggests that a gluten-free diet may pose serious health risks, after finding that the eating pattern may raise the risk of exposure to arsenic and mercury.

Study co-author Maria Argos, assistant professor of epidemiology at the University of Illinois at Chicago (UIC), and colleagues recently reported their findings in the journal Epidemiology.

A gluten-free diet excludes foods that contain gluten - a protein found in wheat, barley, and rye, as well as the byproducts of these grains.

For people with celiac disease - an autoimmune condition whereby gluten intake leads to intestinal damage - a gluten-free diet is the only treatment for the condition.

However, according to a 2012 survey, around 28-30 percent of us restrict our gluten intake or avoid consuming the protein completely, even in the absence of gluten sensitivities.

Rice flour is a common substitute for gluten in many gluten-free products. Argos and colleagues point out that rice can bioaccumulate arsenic, mercury, and other potentially harmful toxic metals from water, soil, or fertilizers.

Exposure to these metals has been associated with increased risk of cardiovascular disease, cancer, and other diseases.

"Despite such a dramatic shift in the diet of many Americans, little is known about how gluten-free diets might affect exposure to toxic metals found in certain foods," note the authors.

With the aim of investigating the link between gluten-free diets and toxic metal exposure, Argos and team analyzed the data of 7,471 individuals who were a part of the National Health and Nutrition Examination Survey between 2009 and 2014.

The researchers identified 73 participants aged between 6 and 80 who reported following a gluten-free diet.

Blood and urine samples were taken from all participants and assessed for levels of arsenic and mercury.

The researchers found that levels of each toxic metal were much higher among subjects who followed a gluten-free diet than those who did not eat gluten-free products; mercury levels were 70 percent higher in the blood of gluten-free subjects, while arsenic levels in urine were almost twice as high.

According to Argos, these findings suggest that there may be "unintended consequences of eating a gluten-free diet," though further studies are needed to confirm whether this is the case.

The researchers add that:

"With the increasing popularity of gluten-free diets, these findings may have important health implications since the health effects of low-level arsenic and mercury exposure from food sources are uncertain but may increase the risk for cancer and other chronic diseases.

Although we can only speculate, rice may be contributing to the observed higher concentrations of metal biomarkers among those on a gluten-free diet as the primary substitute grain in gluten-free products."

Argos points out that there are regulations in Europe that limit arsenic levels in food products, and he suggests that the United States might benefit from similar regulations.

"We regulate levels of arsenic in water, but if rice flour consumption increases the risk for exposure to arsenic, it would make sense to regulate the metal in foods as well," he adds.

Learn how a gluten-free diet has gained popularity in the U.S.

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Gluten-free diet may have 'unintended consequences' for health ... - Medical News Today

Psychology Today (blog)

World's First Clinical Trial Finds Diet Works for Depression Psychology Today (blog) Over the past seven years, she published numerous epidemiological (survey-based) studies suggesting that people who report eating an unhealthy diet are more likely to be depressed. However, since these studies were based on questionnaires and weren't ...

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World's First Clinical Trial Finds Diet Works for Depression - Psychology Today (blog)

Scientists have recently become aware there's a connection between our gut and our brain. But just how deep does this connection go? Could we, say, treat depression just by adopting a Mediterranean diet? A new study suggests, yes.

Doctors have been prescribing diets to their patients as a preventative measure against heart disease, cancer, diabetes, and now depression joins that list. We now have real evidence to back up whats good common sense: that eating well doesnt just benefit your body, but it also benefits your brain, says Columbia professor Drew Ramsey, who wrote, Eat Complete.

Ramsey represents a growing group of mental health experts who practice nutritional psychiatry. The idea of a gut-brain connection is one that has been gaining ground in scientific studies and some have started putting these ideas into practice. There's evidence to suggest certain foods influence the bacteria in our gut, which in turn influence mental health.

emeran-mayer-on-depression-and-the-mind-gut-connection

Its also important to note about 95 percent of your bodys serotonin is made in your gastrointestinal tract. Scientists are just beginning to discover this secret life of microbes and how much they influence other aspects of our overall health and wellbeing. But we can influence our microbiome with what we eat.

The brain is also directly affected by diet. Tryptophan is the amino acid that we use to make serotonin and dopamine, Ramseytold uswhen he came to Big Think.These are very, very important mood-regulating and learning-regulating neurotransmitters, or chemicals in the brain. And so the idea is to give people a core set of foods. You know, again, with every bite you're getting all the nutrients that your brain needs.

Researchers from Australias Deakin University led a controlled clinical trial which gives promising results towards suggesting dietary improvement guided by a clinical dietician may provide an efficacious treatment strategy for the management of this highly prevalent mental disorder. The researchers recruited several hundred patients with moderate to severe depression, 67 of whom participated in a 12-week parallel group trial. All participants had poor dietary quality when they entered the trail, meaning they ate empty carbs and nutrient-sparse foods, like pizza, pasta and baked goods what Ramsey terms the "beige diet" or the "12-year-old boy diet".

Ramsey explains the trial result that is exciting for the future of mental health treatment:

"The augmentation effect was quite robust for an adjunctive treatment. In the treatment group, about 32% of patients achieved remission, compared with 8% in the control group. In terms of risk-benefit profiles, a dietary intervention is emerging as a very safe and effective way for us to engage our patients."

The promising meal plan has been coined the Modi-Medi Diet or modified mediterranean diet and consists of legumes, leafy greens, colorful vegetables, a variety of quality seafood, quality lean red meat, fruits, olive oil, and nuts.Ramsey emphasizes that the quality of food, in particular of meat and seafood, is important which is often an area of concern for people trying to make a positive diet change: organic food is expensive. During the trial, the Australian researchers actually found that eating the right foods for optimal brain health is cheaper. "The average Australian spends $138 a week on food. Those who were taking part in the study spent just $112," says Ramsey. What is it about these foods that boost brain function and mental health? They contain nutrients the brain needs, specificallyomega-3 fats, zinc, magnesium, iron, and vitamin B12, which are "highly correlated with a lower risk for depression and dementia."

Its important to note, the field of nutritional psychiatry is still new, so you should not use this diet as a substitute for consulting a therapist if you feel depressed.

drew-ramsey-on-diet-and-depression

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Is Your Diet Fighting Depression or Intensifying It? - Big Think

Forget Whole 30 theres a new fad nutrition plan in town.

Its called The Sirtfood Diet, due to its emphasis on eating foods rich in sirtuin protein, which some researchers saymay activate genetic pathways to burn more caloriesand alsohelp slow down the aging process in animals. The diet became popular in the United Kingdom after nutritionists Aidan Goggins and Glen Matten published The Sirtfood Dietbook in 2016.

There are reports that singer and all-around angel Adele, may have jumped on the diets bandwagonat the influence of her personal trainer, Pete Geracimo, who is a big fanof the program as well.

Dark chocolate and red wine are allegedly sirtfood-approved. This is due to the fact that they contain resveratrol, an antioxidant that may activate sirtuin enzymes. (However, theres some debate in the scientific community as to whether or not thats actually true.)

So, should you be Googling Sirtfood Diet shopping list, immediately?Not so fast.

According to the book, the diet has two phases.Phase one is seven days long. For the first three, the authors encourage you to max out your food intake at 1,000 calories a day, consuming only three green juices and one meal composed of foods rich in sirtuins. This is significantly below the calories recommended even for weight loss, which hover between 1,500-1,600 calories per day for women and 2,000 calories for men, according to the U.S. Department of Health and Human Services.

Phase two is 14 days long. Those following the plan are encouraged to eat three sirtuin-rich meals a day and have one green juice.

According to David Levitsky, professor of nutrition and psychology in the Division of Nutritional Sciences at Cornell University, the research about sirtuin protein shows that it might be possible to burn more calories at a cellular level.

However, heres the catch: Nothing has been proven this effect could occur throughout the body. The cellular level is the very beginning of a process and there is no science that suggests it will change how your body operates. So, in a nutshell, this nutrition plan is nothing more than a low-calorie diet sold with the veneer that a drastic change to your metabolism is happening.

There is no evidence this works at the whole-body level, Levitsky told The Huffington Post. I guarantee you would lose weight. In the end of every diet, it is always about calories. But does that mean its the healthiest choice for you? Probably not.

That being said, some of the Sirtfood Diet-approved meals looked downright delicious. Well take a smoked salmon omelet or a buckwheat pasta saladfor brunch any day of the week. But losing weight and keeping it off can be done on several hundred more calories a day, juice cleansing excluded.

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Should You Try The Adele-Approved Diet Everyone Is Talking About? - Huffington Post

February 17, 2017

BY JACLYN BRICE Ministry Medical Group, Rhinelander

Current dietary guidelines recognize the health benefits of certain oils and call for a moderate intake of fat for most Americans.

If you are looking to lose or maintain weight, there is no denying that fats are higher in calories than proteins or carbohydrates. Thats one reason for moderation. As for cardiovascular health, the American Heart Association (AHA) makes the choice pretty simple, by stating Replacing bad fats (saturated and trans) with healthier fats (monounsaturated and polyunsaturated) is better for your heart.

Non-tropical vegetable oils are better than solid fats such as butter, shortening, lard and hard stick margarine, according to the AHA. The better-for-you oils listed in alphabetical order on its website are canola, corn, olive, peanut, safflower, soybean, sunflower and blends of any of these oils. Tropical oils such as palm and coconut have more saturated fat and, as a result, do not make the AHA list.

Saturated fat tends to increase total cholesterol and LDL, raising your risk of cardiovascular disease. It also increases the risk of type 2 diabetes. Trans fats, usually made from oils through a partial hydrogenation process, are considered hazardous to cardiovascular health.

Solid vs Liquid: Generally speaking, saturated fatsbutter, lard, shorteningare solid at room temperature. Most oils have at least some saturated fatty acids, and the majority of fatty acids in coconut, palm and palm kernel oil are saturated.

Polyunsaturated fats are always liquid, even if you put them in the refrigerator. Monounsaturated fats become cloudy when chilled.

Monounsaturated: Monounsaturated fats have been linked to lower total and LDL cholesterol and higher levels of HDL (the good cholesterol). Subjects whose diets included more than 12 percent monounsaturated fats had lower fat mass and lower blood pressure than those eating less than 12 percent of these fats, according to one study.

Oils that are high in monounsaturated fats include olive, peanut, avocado and canola. Extra virgin olive oil also contains antioxidants (polyphenols) that are associated with good heart health.

Canola oil is more neutral in flavor (a plus for some, a minus for others) and is often highly refined and has fewer antioxidants than olive oil. It does have a relatively long shelf life, however.

Oil that has gone rancid or oxidized has an unpleasant smell and taste and has been found to speed up the process of atherosclerosis. Keep oils in a cool, dark, dry place.

Both canola and peanut oil have high smoke points, the temperature at which oils tend to break down and lose nutrients. This makes them a good choice for cooking over high heat.

Polyunsaturated fats have also been found beneficial to cholesterol and heart health. Oils that are high in polyunsaturated fatty acids include cottonseed, soybean, corn, sunflower, safflower, walnut, grapeseed and flaxseed oil. They do not offer equal health benefits.

Two major types of polyunsaturated fatty acids are omega-3 and omega-6. Both are beneficial, but the American diet contains far more omega-6 fatty acids, primarily from packaged foods, refined plant oils, poultry and eggs.

A European study found a lower incidence of heart disease in countries that have diets high in omega-3 fatty acids and use oils with a high ratio of omega-3 to omega-6 fatty acids.

Sunflower oil is almost entirely omega-6 fatty acids; grapeseed and corn oil also have a high percentage of omega-6 as opposed to omega-3s. Blended vegetable oils usually contain mostly soybean and corn oil, considered two of the least beneficial of oils.

Tropical Oils: The AHA essentially rules out tropical oils such as coconut, palm and palm kernel oils because they are high in saturated fatty acids.

Not everyone agrees. Studies have demonstrated that coconut oil raises total cholesterol but increases HDL even more. Whether or not this matters in terms of cardiovascular health has not yet been determined, but most doctors are reluctant to start recommending coconut oil.

As you make changes in your selection and use of oils, keep in mind that views are undergoing changes as new findings are made available.

One thing is clear: oils have an important place in a good diet. Your goal should be to find the best oils that meet your tastes and your health needs.

Jaclyn Brice is a certified health coach with Ministry Medical Group, part of Ascension.

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Does your diet need an oil change? - Starjournalnow

Italian sausage rolls made up the first of six courses at a birthday luncheon at The Dove III in downtown Melbourne.(Photo: Suzy Fleming Leonard/FLORIDA TODAY)Buy Photo

Is there anything sadder than a food writer on a diet?

OK, OK, there are lots of things. This is a real First World problem. But its mine, and Im trying to come to terms with it.

Knowing this is a journey best embarked upon with company, I joined a program touted by a Well-Known Celebrity just after Christmas with a couple of friends. We decided this wouldnt be a New Years Resolution, so we started early, before 2016 fizzled into the mists of midnight.

Well-Known Celebrity is all over TV talking about the program. Its easy! Its delicious! It works! Its not a diet, its a lifestyle!

When Im hungry, Im tempted to throw a shoe at Well-Known Celebrity.

Dont say that: Cringe-worthy wordplay

The first week was kind of rough.

Note to self: Before starting next diet, go grocery shopping. When trying to lose weight, it helps to have something in the house other than Froot Loops and ButterFingers.

It didnt help that one of my diet buddies was freakishly cheerful about the whole process.

Im never hungry, she said. And everything Im eating is so good!

Note to self: Its mean to slap your friends when they act like they actually enjoy self deprivation.

By the second week, Id stocked up on fresh fruit and baby carrots. Id ditched my afternoon M&Ms break in favor of an apple or Halo orange.

The scale, while not breathing a sigh of relief, no longer groaned when I stepped on it in the mornings. I began to feel the slightest bit of room in the waistband of my favorite jeans.

This white chocolate mousse creation with raspberry jam at Les Chefs de France in Epcot stole my heart on Valentines Day.(Photo: Suzy Fleming Leonard/FLORIDA TODAY)

I started to believe Well-Known Celebrity. This was turning out to be easy.

I even survived a business trip that involved visiting a restaurant that served fried chicken and doughnuts. On the same plate.

For the first five weeks, the numbers on the scale dropped steadily.

Then February hit, bringing with it:

A six-course birthday lunch at The Dove III in downtown Melbourne. Sausage rolled in crusty Italian bread, eggplant snuggled into a perfect bed of tomato sauce and cheese, fish, chicken, cake. It was a great eating day, but not a great diet day.

A cooking lesson with former Brevard caterer Bill Farina. What human who enjoys food could resist buttery, spicy shrimp and grits?

Brevard restaurant owner started 2016 as widower; ended it as newlywed

An early Valentines dinner at The Tides in Vero Beach. I ordered the pompano special. Fish is healthy, right? OK, so no excuse for the potatoes and sticky pudding dessert.

An interview at Epcot that ended with lunch at Les Chefs de France. When Eric Weistroffer, the restaurants director of operations, arrived with treats, it would have been rude to turn them down: Gateau Opera (Opera Cake), a coffee cake with white chocolate coffee, whipped cream and chocolate ganache; and a heart-shaped crimson creation of white chocolate mousse and raspberry jam. Resistance was futile.

And I wont even go into various lunches with girlfriends, the amazing spread at this weeks book club meeting or the upcoming vacation thats sure to hold its share of tasty treats.

Emma Kirkpatrick, manager of Ossorio Cafe & Bakery in Cocoa Village, wasnt sympathetic.

Imagine trying to lose weight when you run a restaurant, she said.

Shes managed to slim down considerably in the past year, and she spends her days surrounded by croissants and cinnamon rolls. I guess shes proof it can be done.

At least Well-Known Celebrity has one thing right. This program is working when I have the willpower to follow it.

Once February is behind me, heres hoping youll be seeing a lot less of me.

Email Leonard at sleonard@floridatoday.com. Follow her on Facebook at /SuzyFlemingLeonard and on Instagram @SuzyLeonard.

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Lamentations of a food writer on a diet - Florida Today

Women's Health

'I Tried Going Vegan For A WeekHere's What Happened' Women's Health As food trends go these days, going vegan is about as cool as you can get. Not only does eating a diet of just plants promise to lower your cholesterol and make your skin look positively glow-y, but its devotees carry a certain aura of righteousness ...

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'I Tried Going Vegan For A WeekHere's What Happened' - Women's Health

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