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By Jonathan V. Wright, M.D. Type 2 (also called “adult-onset”) diabetes is an extremely common problem with potentially serious consequences. Individuals who suffer from it have increased risks of heart attack, vascular disease, kidney failure, cataracts, retinal damage, and accelerated aging. And, even more frightening, it’s estimated that at least one-third of us have a genetic tendency to develop the disease. Although abnormally high blood sugar is a hallmark of this form of diabetes, it’s really only one aspect of a much bigger picture in predicting it. In fact, it isn’t necessary to wait until high blood sugar is actually detected: In the large majority of cases, it’s possible to use other factors to determine whether you’re at risk. If the tendency is there, the next step is to have a glucose-insulin tolerance test done. The glucose-insulin tolerance test, although it has been available since 1975, is often overlooked, despite being a very precise indicator of adult-onset diabetes. This test can predict type 2 diabetes years—even decades—ahead of its actual onset. DO YOU NEED TO PREVENT TYPE 2 DIABETES? There’s no point in trying to prevent a problem not likely to develop, so the first step you should take is to evaluate

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When individuals contract Lyme disease, most think they have the flu, complete with a fever and aching joints. Weeks or months later, this potentially fatal disease can cause persistent arthritis, exhaustion, depression, brain lesions and so many other mysterious symptoms that infected patients are often misdiagnosed as having fibromyalgia, chronic fatigue syndrome, Parkinson’s disease, trigeminal neuralgia, Guillain-Barre syndrome, demyelination or multiple sclerosis. Dogs, horses and other animals are susceptible to Lyme disease; in dogs the leading symptom is sudden-onset lameness, and in advanced cases it can cause kidney failure and death. The illness is caused by Borrelia burgdorferi, a spirochete (pronounced

In 1997 the union representing scientists, engineers and lawyers at the U.S. Environmental Protection Agency (EPA) in Washington, D.C., voted to support a California citizen initiative to stop fluoridation of public drinking water. In 1999 the union’s vice-president released a paper explaining the union’s opposition to fluoridation.1 Fluoridation is the practice of adding fluoride to the public water supply to reduce dental decay. U.S. fluoridation trials began in 1945 and by 1992 approximately 56% of the U.S. public received its water from fluoridated systems.2 Typically, fluoride-containing (or -generating) compounds are added

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ON THE INCREASE, anxiety seems to be cropping up everywhere today. A seemingly permanent xture in many people’s lives, anxiety not only affects the mind but the body as well. Although it is important to discern the difference between a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) diagnosis and

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ONE OF THE MAIN PROBLEMS WE FACE as we age is the inevitable build-up of acidic waste products in our bodies. We have an elegant system for getting rid of acidic waste products through the liver and kidneys, the lungs and the out-breath, the stomach acid, and the bicarbonate buffering system in the pancreas and blood. However, an unhealthy lifestyle can overwhelm the body’s ability to eliminate acids and they can start to accumulate. This acidication of body tissues is the root cause of most health problems

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Reconfigure Your Brain for Maximum Well-Being

Linda Graham, MFT, presents evidence that, because of the brain’s neuroplasticity—its ability to create new neuronal pathways—anyone can achieve healthier responses to stress by focusing their attention in simple ways.

Deep Breathing & Relaxed Eating Improves Digestion Marc David, MA, provides convincing evidence that increasing the amount of oxygen we breathe in during meals can improve our digestion and help us gain more energy from our food.

Stress Can Cause Havoc in Your Mouth Periodontist Alvin Danenberg, DDS, discusses how excessive psychological stress constricts blood vessels and disrupts the healthy bacteria and flow of saliva in the mouth, which can lead to inflammation of the gums, as well as cavities.

Qualities of Happy, Healthy Centenarians Noelle Nelson, PhD, points out that most people strive for a long, healthy, and happy life, and reveals that there are more centenarians living now than five years ago. Many of the long-lived have chosen certain thoughts and attitudes.

The Cost of Malnutrition Debra S. Ben Avram, CAE, finds that a team-based approach to nutrition can help reduce the time malnourished people remain in a hospital setting.

Placebo & the Healing Relationship Lewis Mehl-Madrona, MD, discusses how the placebo effect can be activated by the patient-doctor relationship. He explains that a patient who has a positive experience with their physician is much more likely to recover from their illness than one who has a neutral or negative experience.

Medical Intuition: A Complementary Medicine Shannon McRae, PhD, relates how intuitive knowledge can help in diagnosing health conditions and explains that it has long been part of the practice of medicine.

Loving-Kindness Meditation Meditation leader Rick Heller presents simple, practical exercises that help inspire loving kindness toward oneself and others.

IN BRIEF Walking to Reduce Parkinson’s Symptoms…8; Developing Confidence…17; Love: Chasing and Being Chased…21; Things That Make You Go Hmmm…24; A Look at Books…27; The Cost of Avoiding Conflict…30; Five Ways to Manage Your Doctor…32; Proper Diet and Exercise Fight Inflammation, Promote Longevity…44 Cover photo © istock.com/cebas

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Reconfigure Maximum

By Linda Graham, MFT

ometimes we realize that our learned and conditioned patterns of response to experience are less than fully resilient. We see that stable can mean “stuck.” We may find ourselves blowing our top at the least provocation or slinking away from the dinner table when our spouse reminds us we’ve forgotten to do something as promised—yet again. If we have been dependent on someone else to handle our affairs, we may have no clue whatsoever what to do when we’ve lost our home to a fire or mortgage foreclosure. In order to cope with change, we have to change how we cope. No matter what the external trigger, it’s our internal response, based on our neural wiring, that’s important for resilience. Often we can’t change the external stressors. But we can definitely do something about our internal conditioned responses to those stressors.

How Patterns Can Be Rewired

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If conditioning is the process that encodes stable patterns in our neural circuitry, neuroplasticity is the mechanism that works to alter them, to rewire learned responses to stressors. Technically, neuroplasticity is the lifelong capacity of the brain to create new connections among neurons (neural pathways and circuits). Focusing attention on an experience stimulates the neurons related to that experience to fire. This works for internal experiences, too. When you focus attention on a conditioned pattern such as a fear you want to rewire, you activate the neural networks of that pattern and cause the neurons to fire again. When you know how to harness the neuroplasticity of your brain in that moment, you can alter the pattern. Celebrating 25 years!

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Your Brain for Well-Being “Because of neuroplasticity, we can always create new pathways and circuits that are more resilient and effective in responding to the challenges in our lives.”

If we flare in resentment when someone cuts in front of us at the gas station, for example, we can choose instead to rewire our coping strategies to let go of the resentment. We might make allowances because we can remember a time when we were in such a hurry that we did the same thing. Instead of putting off calling the plumber to fix the leaking showerhead, we can train ourselves to take action as soon as we see the leak. Because of neuroplasticity, we can always create new pathways and circuits that are more resilient and effective in responding to the challenges in our lives. All mental activity creates neural structure. Using neuroplasticity to strengthen brain structure is like working out at the gym to build up our muscles. (Of course, the structures of the brain aren’t actually muscles; they’re densely networked circuits and pathways ever changeable into new responses.) As Norman Doidge says in The Brain That Changes Itself, “If you want to lift a hundred pounds, you don’t expect to succeed the first time. You start with a lighter weight and work up little by little. You actually fail to lift a hundred pounds, every day, until the day you succeed. But it is in the days when you are exerting yourself that the growth is occurring.” Once you’ve increased www.wellbeingjournal.com

the “lifting capacity” of your brain through self-directed neuroplasticity, you can alter any stable (even stuck) patterns of coping that aren’t working. You can recover your resilience. Conditioning and neuroplasticity are mechanisms powerful enough not only to shape the brain’s software—our learned habits—but also to shape its hardware—the structures coordinated by the prefrontal cortex.

Two Essential Catalysts for Self-Directed Brain Change Harnessing neuroplasticity—what Jeffrey Schwartz, a neuropsychiatrist at UCLA, calls “self-directed neuroplasticity”—is essentially about choosing. All mental activity creates new neural structure. Any experience rewires the brain in some way. When we want to direct that rewiring—for example, when we want to rewire specifically for resilience—it’s necessary to carefully choose the new experiences that will help create that new neural structure and rewire old pathways effectively, efficiently, and safely.… See complete issue: https://wellbeingjournal.com/vol-25-no-2marchapril-2016-pdf

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Walking to Reduce Parkinson’s Symptoms N

orman Doidge, MD, received the following letter from John Pepper, a man who had Parkinson’s disease, or PD. Doidge included the letter, written in 2008, in a chapter on Parkinson’s in his new book The Brain’s Way of Healing (2015). Pepper’s letter reads: I live in South Africa and have had Parkinson’s disease since 1968. I do a lot of exercise and have learned to use my conscious brain to control the movements…. I wrote a book about my experience, but it has been rejected by the medical profession without looking into my case, because I no longer look like a PD sufferer. I no longer take PD medication, although I still have most of the symptoms. I walk fifteen miles per week, in three sessions of five miles. The glial-derived neurotrophic factor produced in the brain appears to have restored the damaged cells. However, this does not cure the cause of PD, and if I stop exercising, I go backward.… I’m sure that I can help many newly diagnosed patients, if I can encourage them to do serious regular exercise. Please let me know your thoughts on this matter.

Doidge continues: “My thought was that, as far-fetched as it might seem, Pepper, by battling aspects of Parkinson’s with the low-tech approach of walking, might indeed be triggering neuroplastic change in his brain. The glial-derived neurotrophic factor (GDNF) that

March/April 2016 (Sample Issue)

he referred to is a brain growth factor. It functions like a growth-promoting fertilizer in the brain. GDNF is made by glial cells, one of the major types of cells in the brain.… We know that glial cells are constantly communicating with one another, interacting with neurons and modifying their electrical signals. They are also ‘neuroprotective’ of neurons, helping them to wire and rewire the brain. Frank Collins and his colleagues discovered GDNF in 1993 and found that it contributes to plastic change in the brain by promoting the development and survival of dopamine-producing neurons (the cells that die off in Parkinson’s). “As long as Pepper kept up his walking, he could reverse the main movement symptoms of Parkinson’s. The changes had so helped him that he was no longer suffering from the main disabilities of PD and was living a full life.” Pepper later wrote to Doidge, “I will be ashamed to die with all this information, and not be able to do something for Parkinson’s patients.” Doidge traveled to South Africa to meet with Pepper, and he writes about Pepper’s and his findings with regard to PD in a seventy-six-page chapter in his new book. He states, “When [Pepper] gets going at his normal walking speed, I can’t keep up with him. He’s now going on seventy-seven and has had this illness, which is defined as an incurable, chronic, progressive neurodegenerative disorder, since his thirties.” See review in A Look at Books, page 27 this issue. —From The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity, by Norman Doidge, MD, page 35, Viking Books, 2015.

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By Marc David, MA

reathe in more oxygen and you burn food more efficiently. It’s really that simple. The digestive system is hungry for oxygen. Certain parts of the stomach lining consume more oxygen than any other tissue in the body. The intestinal villi, the site of primary nutrient absorption, are charged with the job of extracting large quantities of oxygen from the blood during the breakdown of a meal. When the blood lacks oxygen for the villi to pick up, absorption decreases. The more we eat, the more the body naturally wants us to breathe. After a meal, the parasympathetic nervous system initiates synchronous changes in breathing, blood circulation, and oxygen uptake. In other words, the brain automatically increases air intake to accommodate the need for more oxygen. If you interfere with the body’s natural switch to deeper breathing because of anxiety or overstimulation, you limit your ability to burn calories. The simple rule here is this: If you eat more, breathe more. To further examine the relationship between oxygen and weight loss, have you ever had the experience of going on a low-calorie diet and not losing any weight, or dieting and losing weight the first week but leveling off despite continuing your low-calorie fare? Many people are perplexed by this mysterious phenomenon, but the reason is quite simple. Your metabolism changed. The body learned to tolerate the meager portions of food you served it by lowering oxygen uptake—decreased oxygen means decreased metabolism. In many cases, weight-loss diets actually teach the body to need less oxygen. So by going on a low-calorie diet, you may think you’re doing what’s right for shedding pounds, but you’re actually working against yourself.… See complete issue: https://wellbeingjournal.com/vol-25-no-2-marchapril-2016-pdf

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Celebrating 25 years!

March/April 2016 (Sample Issue) 5

By Noelle Nelson, PhD

remember both my grandmothers, and both of them were considered old by their late fifties. They were expected to do no more than sit quietly, placidly, while the world moved around them, a role they accepted without protest. My maternal grandmother would crochet little dresses for our dolls. My dad’s mom would “fuss,” as my mother put it. She would squint through her reading glasses, looking for something to dust or rearrange, and get up slowly every so often to do so. The grandmothers were to be spared any hard work or aggravation. “Don’t bother your grandmother!” was the most frequent refrain we children heard during family get-togethers. That has changed, have you noticed? Sixty may not be the new forty, and who knows if seventy is the new fifty, but one thing is for sure: many people are living longer, and more are refusing the sedentary approach to their later years. A long, happy, healthy life—that’s what most of us are aiming for. And yet, our mental picture of anyone over seventy-five is that their quality of life is questionable, and those over eighty, ninety, a hundred, even more so. Television is rife with ads promoting cures or solace for the infirmities that we are all supposedly doomed to as we age: Alzheimer’s, incontinence, diabetic neuralgia, chronic pain, ill health, and the need for wheelchairs and walkers. We are told that without an electronic device slung around our necks to summon help, we will crumple to the ground from a heart attack and die there, wretched, alone, and in agony. It is no wonder that no one wants to grow old, that old age scares the heck out of us. Granted, no one gets out of here alive, but let’s at least live until it’s time to die. Let our emphasis be on how happy we can make ourselves, such that our focus is on “happy and healthy,” with “dead” being but a final punctuation mark.… See complete issue: https://wellbeingjournal.com/vol-25-no-2-marchapril-2016-pdf

March/April 2016 (Sample Issue)

Celebrating 25 years!

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Stress Can Cause Havoc in Your Mouth By Alvin Danenberg, DDS

tress! It can save your life. It can kill you. Stress takes many forms. It can be caused by chemical insults (for example, insecticides and heavy metals) or physical trauma (such as excessive exercise or an accident). It can be biological in origin (such as oxidative stress) or psychological (emotional or mental). The bodily damage from stress does not necessarily manifest itself immediately in obvious ways. Stress builds up over time until it can become the proverbial straw that breaks the camel’s back. As various stressors affect the body, healthy immune and detoxification systems deal with them. But, as stressful event after stressful event occur, a greater and greater load is created. At some point, the total stress load can overpower the natural systems that evolved to deal with it. Clinical manifestations may then raise their ugly heads. I discuss psychological stress—a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances—in this article, although all stress may manifest in the body in similar ways. Stress can be acute and short-lived or chronic and reoccurring.

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A recent study by Barry Oken, et al., found that “25 percent of Americans reported high stress and 50 percent identified a major stressful event during the previous year. Chronic psychological stress increases the risk of health problems and contributes to cardiovascular problems, and neurologic and psychiatric diseases, such as epilepsy, Parkinson’s disease, multiple sclerosis, eating disorders, addictions, post-traumatic stress disorder (PTSD), and sleep difficulties.”1 In addition, stress affects the gut microbiome, the immune system, and even the mouth,2 as is discussed later in this article. When stress occurs, the human body reacts. Nerves and organs release chemicals and hormones during stressful times, and these biological substances prepare the body to either face the actual or perceived threat or flee for safety.… See complete issue: https://wellbeingjournal.com/vol-25-no-2marchapril-2016-pdf

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ÂŠ istock.com/KayTaenzer

Placebo & the Healing Relationship By Lewis Mehl-Madrona, MD, PhD with Barbara Mainguy, MA

cientific researchers are increasingly noting the complexity of the placebo response. New York Times writer Margaret Talbot reported on research at a clinic that studies psychotropic medications. The clinicians take pains to discern the impact of placebo, not only from the substance but also from the physical and even systemic environments. For example, supervisors concerned that the friendliness of the clinic staff was impacting results issued a directive to the workers to wear lab coats when in contact with study participants to assist in creating a formal distance, and, in one case, counseled a staff member that her ability to empathically communicate with people involved in the experiment was a disadvantage, as it might provide a therapeutic experience that could skew the results. Talbotâ&#x20AC;&#x2122;s article ponders the failure of current health care, which seeks to get more bang for the physician buck paid. What if part of the placebo effect is the effect of someone listening to us? Perhaps it is the committed and hopeful attention that is communicated that helps us recover or feel better? For example, researchers conducting clinical studies are invested in retaining participants, so they may be more generous with their time and care, and more enthusiastic about the treatment 8

March/April 2016 (Sample Issue)

being tested than they would be in ordinary clinical practice. Placebos may provide an important context for belief that somebody is at last in league with us against our illness. These studies bring us to the realization that most of the elements of placebo healing happen in the context of the doctor-patient relationship. Better relationships produce more powerful placebo responses. This phenomenon is well known in the psychotherapy-outcome research, where the quality of the therapist-patient relationship explains about two-thirds of the effectiveness of the treatment. It would seem that this phenomenon exists in all medicine. This belies the idea that health care providers are interchangeable. Placebo arises out of the context of the healing relationship, and the expectations for that context fuel the placebo response. New approaches to placebo research are defining placebo as the effect of the meeting between the doctor and the patient and the context in which a specific treatment is given. One of the first studies to demonstrate the importance of the relationship in medical treatment was that of British general practitioner-researcher K. B. Thomas at the University of Southampton. He studied 200 patients with what we

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now call “medically unexplained symptoms.” The term is used in reference to patients who suffer but for whom we can make no diagnosis. He randomly assigned these individuals to one of four groups, who received: (1) a consultation in which the doctor made every effort to be positive and either (a) provided a treatment or (b) did not; (2) a consultation in which the doctor made every effort to be neutral and (a) provided a treatment or (b) did not. Two weeks later, the patients were much happier with the positive consultation than the neutral one, but whether or not a treatment was given didn’t matter: 64 percent of people receiving a positive consultation got better regardless of weather they received treatment or not, while only 39 percent of those receiving the neutral consultation improved; 53 percent of those treated “These studies bring got better compared with 50 percent of those us to the realization not treated. Thomas later wrote in the Lancet: “The that most of the placebo effect in general practice is the power elements of placebo of the doctor alone to make the patient feel better, irrespective of medication. It is one healing happen of the most important factors in the consulin the context of tation, yet generally it is neglected, unrecognized, and untaught. A better appreciation of the doctor-patient this power would change doctors’ attitudes relationship. Better [toward] the consultation and would result in relationships produce the making of less illness, the prescribing of less medication, and a better understanding more powerful by the patient of his or her condition.” In placebo responses.” the introduction to his 1987 study, he wrote, “The doctor himself is a powerful therapeutic agent; he is the placebo and his influence is felt to a greater or lesser extent at every consultation.” Frede Olesen, MD, head of the Research Unit for General Practice at the University of Aarhus, in Denmark, writes that there are three obstacles to doctors’ ability to make more effective use of the placebo effect. He says that doctors neglect the power and usefulness of the placebo effect because they have been indoctrinated to view the placebo as inert—a fake pill that doesn’t do anything—or as something that is even deceptive. Doctors do not like to think of themselves as “merely” placebo physicians. They want to do “real” treatments. Yet, the goal of ensuring maximum symptom relief is gained as a result of both specific treatment with known biological efficacy and a host of other, nonspecific, context-mediated factors, including the impact of the interpersonal encounter between the doctor and the patient. Olesen suggests replacing the term placebo effect with context-mediated effect.… See complete issue: https://wellbeingjournal.com/vol-25-no-2-marchapril-2016-pdf We are brainwashed, but we are almost never “body washed.” When we’re growing up, do any of our role models—parents, teachers, or religious leaders ever give us this advice: Listen to your body? No, instead we’re constantly told: Use your brain. —Alex Kerten in Goodbye Parkinson’s, Hello Life, page 25, Divine Arts Media, 2016

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Sodas Will Never Be Good for You According to soda companies like Coca-Cola, sugary beverages can be safely enjoyed as part of a balanced diet and lifestyle. In essence, they’re promoting the idea that if you eat a healthy diet, you can safely indulge in a little poison every now and then. The idea that junk food can be safely enjoyed in moderation was recently demolished with the publication of a study showing that eating just one junk food treat per day for a month is enough to trigger metabolic syndrome in healthy people. Other studies have shown that regularly eating junk food can lead to obesity. The New York Times reported that “Coca-Cola…is backing a new ‘science-based’ solution to the obesity crisis: to maintain a healthy weight, get more exercise, and worry less about cutting calories.” One scientist at a research organization funded by Coca-Cola said that there is no compelling evidence that fast food and sugary drinks are to blame for obesity. But to claim that evidence is lacking is ludicrous, and Coca-Cola is blatantly ignoring the welldocumented research showing that sugary drinks are a major contributor to obesity, heart disease, and diabetes. —Adapted from “Poison plus nutrition does not equal a balanced diet,” by Joseph Mercola, DO, at: http:// articles.mercola.com.

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Loving-Kindness Meditation By Rick Heller

he Loving-kindness meditation below is similar to one for compassion, except that compassion is concern for the suffering of others. You can have loving kindness for someone who’s in a good place already. The purpose of the loving-kindness meditation is to cultivate a feeling of kindness and to learn how to bring it out in circumstances where it may not be your first inclination. Once you’ve learned to cultivate loving kindness toward people, you can extend the practice by having goodwill toward anything, including your own troubling thoughts and feelings. Although this may sound difficult, once you learn how, it becomes a very positive way to live. Let’s go ahead with the meditation. Afterward, I’ll discuss some of the issues that sometimes come up during the meditation.

March/April 2016 (Sample Issue)

Celebrating 25 years!

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Exercise: Loving-Kindness Meditation Allow 30 minutes for this exercise. Find a chair or cushion to sit on. If you are using a chair, choose one that allows you to sit up straight. A very simple chair without armrests often works best. Make yourself comfortable. Take off your shoes if you wish. Loosen any tight clothing. Sit up fairly straight, but not rigidly so. Sometimes it helps to imagine that you’re a puppet and there’s a cord attached to the top of your head, pulling you up—but gently, not rigidly. If you notice tension in the upper back, tilt your head slightly forward. Close your eyes or, if you prefer, “The purpose of loving lower your eyelids and soften your gaze. kindness meditation is If you’re not sure how to soften your gaze, try hardening your gaze by staring to cultivate a feeling intently at one spot on the floor. Note the of kindness and to tension in your facial muscles. Now, stop staring. Notice how the facial muscles learn how to bring it relax and how your visual field is broader, out in circumstances though perhaps not as sharp. That is where it may not be softening your gaze, and it can be very helpful in getting into a meditative state. your first inclination.” Take a deep breath or two. Relax. The Living Benefactor Now, think of someone who has helped you at some point in your life, someone toward whom you feel real warmth. And for the language below to work, it has to be someone who is alive. This individual, who is often called the benefactor, doesn’t have to be a human being. It could be your cat, dog, or other pet. We’re looking for a living being who brings you warm feelings. If you can visualize the individual, all the better. Imagine they are looking at you with warmth. With this being in mind, I’d like you to recite a few phrases. I’ll use the pronoun you because it’s gender-neutral. But you can substitute him, her, or the individual’s proper name if you prefer. So, with your benefactor in mind, say to yourself: I’d like you to be safe I’d like you to be healthy I’d like you to be happy I’d like you to be at ease in the world…

Decrease Stroke Risk with Diet & Purposeful Life Researchers in a recent study gave over 450 participants annual physical and psychological evaluations, including a standard assessment of purpose in life. Participants were followed until they died, at an average age of 90 years. The research team observed that for every one-point increase in the purpose in life score, the likelihood of having one or more macroscopic infarctions decreased by about 50 percent. Another research team consisting of Xinfeng Liu and colleagues from Nanjing University School of Medicine, in China, completed a meta-analysis of 7 studies with a total of 254,489 participants who were followed for an average of 14 years. The participants with the highest amount of protein in their diets were 20 percent less likely to develop a stroke. The team advised, however, that the protein of choice be fish and that red meat consumption be limited. Fruits and vegetables are rich in key micro- and macronutrients that contribute to healthy blood vessels. Researchers analyzed 20 studies involving 760,629 men and women who had 16,981 strokes. The data revealed that stroke risk decreases by 32 percent with every 200 grams (7 oz) of fruit consumed each day and 11

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percent with every 200 grams (7 oz) of

No one has yet fully realized the wealth of sympathy, kindness, and generosity hidden in

—From “An anti-aging perspective for stroke prevention,” by Ronald Klatz, MD, DO, and Robert Goldman, MD, PhD, DO, FAASP, at http://townsendletter.com.

the soul of the child. —Emma Goldman, in Living My Life, Alfred A. Knopf Inc., 1931

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vegetables consumed daily.

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