I’m iron deficient. Which supplements will work best for me and how should I take them?

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Iron deficiency is common and can be debilitating. It mainly affects women. One in three premenopausal women are low in iron compared to just 5% of Australian men. Iron deficiency particularly affects teenage girls, women who do a lot of exercise and those who are pregnant.

The body needs iron to make new red blood cells, and to support energy production, the immune system and cognitive function. If you’re low, you may experience a range of symptoms including fatigue, weakness, shortness of breath, headache, irregular heartbeat and reduced concentration.

If a blood test shows you’re iron deficient, your doctor may recommend you start taking an oral iron supplement. But should you take a tablet or a liquid? With food or not? And when is the best time of day?

Here are some tips to help you work out how, when and what iron supplement to take.

LittlePigPower/Shutterstock

How do I pick the right iron supplement?

The iron in your body is called “elemental iron”. Choosing the right oral supplement and dose will depend on how much elemental iron it has – your doctor will advise exactly how much you need.

The sweet spot is between 60-120 mg of elemental iron. Any less and the supplement won’t be effective in topping up your iron levels. Any higher and you risk gastrointestinal symptoms such as diarrhoea, cramping and stomach pain.

Three pregnant bellies during a stretching class.
Low iron can especially affect people during pregnancy and women who do a lot of sport. Kamil Macniak/Shutterstock

In Australia, iron salts are the most common oral supplements because they are cheap, effective and come in different delivery methods (tablets, capsules, liquid formulas). The iron salts you are most likely to find in your local chemist are ferrous sulfate (~20% elemental iron), ferrous gluconate (~12%) and ferrous fumarate (~33%).

These formulations all work similarly, so your choice should come down to dose and cost.

Many multivitamins may look like an iron supplement, but it’s important to note they usually have too little iron – usually less than 20 mg – to correct an iron deficiency.

Should I take tablets or liquid formulas?

Iron contained within a tablet is just as well absorbed as iron found in a liquid supplement. Choosing the right one usually comes down to personal preference.

The main difference is that liquid formulas tend to contain less iron than tablets. That means you might need to take more of the product to get the right dose, so using a liquid supplement could work out to be more expensive in the long term.

What should I eat with my iron supplement?

Research has shown you will absorb more of the iron in your supplement if you take it on an empty stomach. But this can cause more gastrointestinal issues, so might not be practical for everyone.

If you do take your supplement with meals, it’s important to think about what types of food will boost – rather than limit – iron absorption. For example, taking the supplement alongside vitamin C improves your body’s ability to absorb it.

Some supplements already contain vitamin C. Otherwise you could take the supplement along with a glass of orange juice, or other vitamin C-rich foods.

A woman pours orange juice into a glass next to a bowl of strawberries and kiwifruit.
Taking your supplement alongside foods rich in vitamin C, like orange juice or kiwifruit, can help your body absorb the iron. Anete Lusina/Pexels

On the other hand, tea, coffee and calcium all decrease the body’s ability to absorb iron. So you should try to limit these close to the time you take your supplement.

Should I take my supplement in the morning or evening?

The best time of day to take your supplement is in the morning. The body can absorb significantly more iron earlier in the day, when concentrations of hepcidin (the main hormone that regulates iron) are at their lowest.

Exercise also affects the hormone that regulates iron. That means taking your iron supplement after exercising can limit your ability to absorb it. Taking your supplement in the hours following exercise will mean significantly poorer absorption, especially if you take it between two and five hours after you stop.

Our research has shown if you exercise every day, the best time to take your supplement is in the morning before training, or immediately after (within 30 minutes).

My supplements are upsetting my stomach. What should I do?

If you experience gastrointestinal side effects such as diarrhoea or cramps when you take iron supplements, you may want to consider taking your supplement every second day, rather than daily.

Taking a supplement every day is still the fastest way to restore your iron levels. But a recent study has shown taking the same total dose can be just as effective when it’s taken on alternate days. For example, taking a supplement every day for three months works as well as every second day for six months. This results in fewer side effects.

Oral iron supplements can be a cheap and easy way to correct an iron deficiency. But ensuring you are taking the right product, under the right conditions, is crucial for their success.

It’s also important to check your iron levels prior to commencing iron supplementation and do so only under medical advice. In large amounts, iron can be toxic, so you don’t want to be consuming additional iron if your body doesn’t need it.

If you think you may be low on iron, talk to your GP to find out your best options.

Alannah McKay, Postdoctoral Research Fellow, Sports Nutrition, Australian Catholic University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • I’ve been diagnosed with cancer. How do I tell my children?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    With around one in 50 adults diagnosed with cancer each year, many people are faced with the difficult task of sharing the news of their diagnosis with their loved ones. Parents with cancer may be most worried about telling their children.

    It’s best to give children factual and age-appropriate information, so children don’t create their own explanations or blame themselves. Over time, supportive family relationships and open communication help children adjust to their parent’s diagnosis and treatment.

    It’s natural to feel you don’t have the skills or knowledge to talk with your children about cancer. But preparing for the conversation can improve your confidence.

    Benjamin Manley/Unsplash

    Preparing for the conversation

    Choose a suitable time and location in a place where your children feel comfortable. Turn off distractions such as screens and phones.

    For teenagers, who can find face-to-face conversations confronting, think about talking while you are going for a walk.

    Consider if you will tell all children at once or separately. Will you be the only adult present, or will having another adult close to your child be helpful? Another adult might give your children a person they can talk to later, especially to answer questions they might be worried about asking you.

    Two sisters
    Choose the time and location when your children feel comfortable. Craig Adderley/Pexels

    Finally, plan what to do after the conversation, like doing an activity with them that they enjoy. Older children and teenagers might want some time alone to digest the news, but you can suggest things you know they like to do to relax.

    Also consider what you might need to support yourself.

    Preparing the words

    Parents might be worried about the best words or language to use to make sure the explanations are at a level their child understands. Make a plan for what you will say and take notes to stay on track.

    The toughest part is likely to be saying to your children that you have cancer. It can help to practise saying those words out aloud.

    Ask family and friends for their feedback on what you want to say. Make use of guides by the Cancer Council, which provide age-appropriate wording for explaining medical terms like “cancer”, “chemotherapy” and “tumour”.

    Having the conversation

    Being open, honest and factual is important. Consider the balance between being too vague, and providing too much information. The amount and type of information you give will be based on their age and previous experiences with illness.

    Remember, if things don’t go as planned, you can always try again later.

    Start by telling your children the news in a few short sentences, describing what you know about the diagnosis in language suitable for their age. Generally, this information will include the name of the cancer, the area of the body affected and what will be involved in treatment.

    Let them know what to expect in the coming weeks and months. Balance hope with reality. For example:

    The doctors will do everything they can to help me get well. But, it is going to be a long road and the treatments will make me quite sick.

    Check what your child knows about cancer. Young children may not know much about cancer, while primary school-aged children are starting to understand that it is a serious illness. Young children may worry about becoming unwell themselves, or other loved ones becoming sick.

    Child hiding in cushions
    Young children might worry about other loved ones becoming sick. Pixabay/Pexels

    Older children and teenagers may have experiences with cancer through other family members, friends at school or social media.

    This process allows you to correct any misconceptions and provides opportunities for them to ask questions. Regardless of their level of knowledge, it is important to reassure them that the cancer is not their fault.

    Ask them if there is anything they want to know or say. Talk to them about what will stay the same as well as what may change. For example:

    You can still do gymnastics, but sometimes Kate’s mum will have to pick you up if I am having treatment.

    If you can’t answer their questions, be OK with saying “I’m not sure”, or “I will try to find out”.

    Finally, tell children you love them and offer them comfort.

    How might they respond?

    Be prepared for a range of different responses. Some might be distressed and cry, others might be angry, and some might not seem upset at all. This might be due to shock, or a sign they need time to process the news. It also might mean they are trying to be brave because they don’t want to upset you.

    Children’s reactions will change over time as they come to terms with the news and process the information. They might seem like they are happy and coping well, then be teary and clingy, or angry and irritable.

    Older children and teenagers may ask if they can tell their friends and family about what is happening. It may be useful to come together as a family to discuss how to inform friends and family.

    What’s next?

    Consider the conversation the first of many ongoing discussions. Let children know they can talk to you and ask questions.

    Resources might also help; for example, The Cancer Council’s app for children and teenagers and Redkite’s library of free books for families affected by cancer.

    If you or other adults involved in the children’s lives are concerned about how they are coping, speak to your GP or treating specialist about options for psychological support.

    Cassy Dittman, Senior Lecturer/Head of Course (Undergraduate Psychology), Research Fellow, Manna Institute, CQUniversity Australia; Govind Krishnamoorthy, Senior Lecturer, School of Psychology and Wellbeing, Post Doctoral Fellow, Manna Institute, University of Southern Queensland, and Marg Rogers, Senior Lecturer, Early Childhood Education; Post Doctoral Fellow, Manna Institute, University of New England

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • The Whole-Body Approach to Osteoporosis – by Keith McCormick

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    You probably already know to get enough calcium and vitamin D, and do some resistance training. What does this book offer beyond that advice?

    It’s pretty comprehensive, as it turns out. It covers the above, plus the wide range of medications available, what supplements help or harm or just don’t have enough evidence either way yet, things like that.

    Amongst the most important offerings are the signs and symptoms that can help monitor your bone health (things you can do at home! Like examinations of your fingernails, hair, skin, tongue, and so forth, that will reveal information about your internal biochemical make-up), as well as what lab tests to ask for. Which is important, as osteoporosis is one of those things whereby we often don’t learn something is wrong until it’s too late.

    The author is a chiropractor, which doesn’t always have a reputation as the most robustly science-based of physical therapy options, but he…

    • doesn’t talk about chiropractic
    • did confer with a flock of experts (osteopaths, nutritionists, etc) to inform/check his work
    • does refer consistently to good science, and explains it well
    • includes 16 pages of academic references, and yes, they are very reputable publications

    Bottom line: this one really does give what the subtitle promises: a whole body approach to avoiding (or reversing) osteoporosis.

    Click here to check out The Whole Body Approach To Osteoporosis; sooner is better than later!

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  • Wouldn’t It Be Nice To Have Regenerative Superpowers?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The Best-Laid Schemes of Mice and Medical Researchers…

    This is Dr. Ellen Heber-Katz. She’s an internationally-renowned immunologist and regeneration biologist, but her perhaps greatest discovery was accidental.

    Unlike in Robert Burns’ famous poem, this one has a happy ending!

    But it did involve the best-laid schemes of mice and medical researchers, and how they did indeed “gang gagly“ (or in the English translation, “go awry”).

    How it started…

    Back in 1995, she was conducting autoimmune research, and doing a mouse study. Her post-doc assistant was assigned to punch holes in the ears of mice that had received an experimental treatment, to distinguish them from the control group.

    However, when the mice were later checked, none of them had holes (nor even any indication there ever had been holes punched)—the experiment was ruined, though the post-doc swore she did her job correctly.

    So, they had to start from scratch in the new year, but again, a second batch of mice repeated the trick. No holes, no wounds, no scarring, not disruption to their fur, no damage to the cartilage that had been punched through.

    In a turn of events worthy of a superhero origin story, they discovered that their laboratory-made autoimmune disease had accidentally given the mice super-healing powers of regeneration.

    In the animal kingdom, this is akin to a salamander growing a new tail, but it’s not something usually found in mammals.

    Read: A New Murine Model for Mammalian Wound Repair and Regeneration

    How it’s going…

    Dr. Heber-Katz and colleagues took another 20 years of work to isolate hypoxia-inducible factor-1a (HIF-1a) as a critical molecule that, if blocked, would eliminate the regenerative response.

    Further, a drug (which they went on to patent), 1,4-dihydrophenonthrolin-4-one-3-carboxylic acid (1,4-DPCA), chemically induced this regenerative power:

    See: Drug-induced regeneration in adult mice

    Another 5 years later, they found that this same drug can be used to stimulate the regrowth of bones, too:

    An injectable hydrogel-formulated inhibitor of prolyl-4-hydroxylase promotes T regulatory cell recruitment and enhances alveolar bone regeneration during resolution of experimental periodontitis

    And now…

    The research is continuing. Here’s the latest, a little over a month ago:

    Epithelial–mesenchymal transition: an organizing principle of mammalian regeneration

    Regrowing nerves has also been added into the list of things the drug can do.

    What about humans?

    Superpowered mice are all very well and good, but when can we expect this in humans?

    The next step is testing the drug in larger animals, which she hopes to do next year, followed eventually by studies in humans.

    Read the latest:

    Regrowing nerves and healing without scars? A scientist’s career-long quest comes closer to fruition

    Very promising!

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  • Seriously Useful Communication Skills!

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    What Are Communication Skills, Really?

    Superficially, communication is “conveying an idea to someone else”. But then again…

    Superficially, painting is “covering some kind of surface in paint”, and yet, for some reason, the ceiling you painted at home is not regarded as equally “good painting skills” as Michaelangelo’s, with regard to the ceiling of the Sistine Chapel.

    All kinds of “Dark Psychology” enthusiasts on YouTube, authors of “Office Machiavelli” handbooks, etc, tell us that good communication skills are really a matter of persuasive speaking (or writing). And let’s not even get started on “pick-up artist” guides. Bleugh.

    Not to get too philosophical, but here at 10almonds, we think that having good communication skills means being able to communicate ideas simply and clearly, and in a way that will benefit as many people as possible.

    The implications of this for education are obvious, but what of other situations?

    Conflict Resolution

    Whether at work or at home or amongst friends or out in public, conflict will happen at some point. Even the most well-intentioned and conscientious partners, family, friends, colleagues, will eventually tread on our toes—or we, on theirs. Often because of misunderstandings, so much precious time will be lost needlessly. It’s good for neither schedule nor soul.

    So, how to fix those situations?

    I’m OK; You’re OK

    In the category of “bestselling books that should have been an article at most”, a top-tier candidate is Thomas Harris’s “I’m OK; You’re OK”.

    The (very good) premise of this (rather padded) book is that when seeking to resolve a conflict or potential conflict, we should look for a win-win:

    • I’m not OK; you’re not OK ❌
      • For example: “Yes, I screwed up and did this bad thing, but you too do bad things all the time”
    • I’m OK; you’re not OK ❌
      • For example: “It is not I who screwed up; this is actually all your fault”
    • I’m not OK; you’re OK ❌
      • For example: “I screwed up and am utterly beyond redemption; you should immediately divorce/disown/dismiss/defenestrate me”
    • I’m OK; you’re OK ✅
      • For example: “I did do this thing which turned out to be incorrect; in my defence it was because you said xyz, but I can understand why you said that, because…” and generally finding a win-win outcome.

    So far, so simple.

    “I”-Messages

    In a conflict, it’s easy to get caught up in “you did this, you did that”, often rushing to assumptions about intent or meaning. And, the closer we are to the person in question, the more emotionally charged, and the more likely we are to do this as a knee-jerk response.

    “How could you treat me this way?!” if we are talking to our spouse in a heated moment, perhaps, or “How can you treat a customer this way?!” if it’s a worker at Home Depot.

    But the reality is that almost certainly neither our spouse nor the worker wanted to upset us.

    Going on the attack will merely put them on the defensive, and they may even launch their own counterattack. It’s not good for anyone.

    Instead, what really happened? Express it starting with the word “I”, rather than immediately putting it on the other person. Often our emotions require a little interrogation before they’ll tell us the truth, but it may be something like:

    “I expected x, so when you did/said y instead, I was confused and hurt/frustrated/angry/etc”

    Bonus: if your partner also understands this kind of communication situation, so much the better! Dark psychology be damned, everything is best when everyone knows the playbook and everyone is seeking the best outcome for all sides.

    The Most Powerful “I”-Message Of All

    Statements that start with “I” will, unless you are rules-lawyering in bad faith, tend to be less aggressive and thus prompt less defensiveness. An important tool for the toolbox, is:

    “I need…”

    Softly spoken, firmly if necessary, but gentle. If you do not express your needs, how can you expect anyone to fulfil them? Be that person a partner or a retail worker or anyone else. Probably they want to end the conflict too, so throw them a life-ring and they will (if they can, and are at least halfway sensible) grab it.

    • “I need an apology”
    • “I need a moment to cool down”
    • “I need a refund”
    • “I need some reassurance about…” (and detail)

    Help the other person to help you!

    Everything’s best when it’s you (plural) vs the problem, rather than you (plural) vs each other.

    Apology Checklist

    Does anyone else remember being forced to write an insincere letter of apology as a child, and the literary disaster that probably followed? As adults, we (hopefully) apologize when and if we mean it, and we want our apology to convey that.

    What follows will seem very formal, but honestly, we recommend it in personal life as much as professional. It’s a ten-step apology, and you will forget these steps, so we recommend to copy and paste them into a Notes app or something, because this is of immeasurable value.

    It’s good not just for when you want to apologize, but also, for when it’s you who needs an apology and needs to feel it’s sincere. Give your partner (if applicable) a copy of the checklist too!

    1. Statement of apology—say “I’m sorry”
    2. Name the offense—say what you did wrong
    3. Take responsibility for the offense—understand your part in the problem
    4. Attempt to explain the offense (not to excuse it)—how did it happen and why
    5. Convey emotions; show remorse
    6. Address the emotions/damage to the other person—show that you understand or even ask them how it affected them
    7. Admit fault—understand that you got it wrong and like other human beings you make mistakes
    8. Promise to be better—let them realize you’re trying to change
    9. Tell them how you will try to do it different next time and finally
    10. Request acceptance of the apology

    Note: just because you request acceptance of the apology doesn’t mean they must give it. Maybe they won’t, or maybe they need time first. If they’re playing from this same playbook, they might say “I need some time to process this first” or such.

    Want to really superpower your relationship? Read this together with your partner:

    Hold Me Tight: Seven Conversations for a Lifetime of Love, and, as a bonus:

    The Hold Me Tight Workbook: A Couple’s Guide for a Lifetime of Love

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  • Tranquility by Tuesday?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    I Know How She Does It: How Successful Women Make The Most of Their Time

    This is Laura Vanderkam, author of “Tranquility By Tuesday” (amongst other books). Her “thing” is spending more time on what’s important, and less on what isn’t. Sounds simple, but she’s made a career out of it, so condensed here for you are…

    Laura’s 7 Keys To Productivity

    Key One: Plan your weeks on Fridays

    You don’t want your Monday morning to be a “James Bond intro” (where everything is already in action and you’re just along for the ride, trying to figure out what’s going on). So, take some time last thing each Friday, to plan ahead for the following week!

    Key Two: Measure what matters

    Whatever that means to you. Laura tracks her use of time in half-hour blocks, and likes keeping track of streaks. For her, that means running daily and keeping a log of it. She also keeps track of the books she reads. For someone else it could be music practice, or a Duolingo streak, or eating fruit each day.

    On which note…

    “Dr. Greger’s Daily Dozen” is simpler than most nutrition trackers (where you must search for everything you eat, or scan barcodes for all ingredients).

    Instead, it keeps track of whether you are having certain key health-giving foods often enough to maintain good health.

    We might feature his method in a future edition of 10almonds, but for now, check the app out for yourself here:

    Get Dr. Greger’s Daily Dozen on iOS / Get Dr. Greger’s Daily Dozen on Android

    Dr. Greger’s Daily Dozen @ Nutrition Facts

    Key Three: Figure out 2–3 “anchor” events for the weekend

    Otherwise, it can become a bit of a haze and on Monday you find yourself thinking “where did the weekend go?”. So, plan some stuff! It doesn’t have to be anything out-of-this-world, just something that you can look forward to in advance and remember afterwards. It could be a meal out with your family, or a session doing some gardening, or a romantic night in with your partner. Whatever makes your life “living” and not passing you by!

    Key Four: Tackle the toughest work first

    You’ve probably heard about “swallowing frogs”. If not, there are various versions, usually attributed to Mark Twain.

    Here’s one:

    “If it’s your job to eat a frog, it’s best to do it first thing in the morning. And if it’s your job to eat two frogs, it’s best to eat the biggest one first.”

    Top Productivity App “ToDoist” has an option for this, by the way!

    ToDoist.com/productivity-methods/eat-the-frog

    ToDoist

    Laura’s key advice here is: get the hard stuff done now! Before you get distracted or tired and postpone it to tomorrow (and then lather rinse repeat, so it never gets done)

    10almonds Tip:

    “But what if something’s really important but not as pressing as some less important, but more urgent tasks?”

    Simple!

    Set a timer (we love the Pomodoro method, by the way) and do one burst of the important-but-not-urgent task first. Then you can get to the more urgent stuff.

    Repeat each day until the important-but-not-urgent task is done!

    The 10almonds Team

    Key Five: Use bits of time well

    If, like many of us, you’ve a neverending “to read” list, use the 5–10 minute breaks that get enforced upon us periodically through the day!

    • Use those few minutes before a meeting/phonecall!
    • Use the time you spend waiting for public transport or riding on it!
    • Use the time you spent waiting for a family member to finish doing a thing!

    All those 5–10 minute bits soon add up… You might as well spend that time reading something you know will add value to your life, rather than browsing social media, for example.

    Key Six: Make very short daily to-do lists

    By “short”, Laura considers this “under 10 items”. Do this as the last part of your working day, ready for tomorrow. Not at bedtime! Bedtime is for winding down, not winding up

    Key Seven: Have a bedtime

    Laura shoots for 10:30pm, but whatever works for you and your morning responsibilities. Your morning responsibilities aren’t tied to a specific time? Lucky you, but try to keep a bedtime anyway. Otherwise, your daily rhythm can end up sliding around the clock, especially if you work from home!

    Want more from Laura Vanderkam? Start Here!

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  • Savory Protein Crêpe

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Pancakes have a bad reputation healthwise, but they don’t have to be so. Here’s a very healthy crêpe recipe, with around 20g of protein per serving (which is about how much protein most people’s body’s can use at one sitting) and a healthy dose of fiber too:

    You will need

    Per crêpe:

    • ½ cup milk (your preference what kind; we recommend oat milk for this)
    • 2 oz chickpea flour (also called garbanzo bean flour, or gram flour)
    • 1 tsp nutritional yeast
    • 1 tsp ras el-hanout (optional but tasty and contains an array of beneficial phytochemicals)
    • 1 tsp dried mixed herbs
    • ⅛ tsp MSG or ¼ tsp low-sodium salt

    For the filling (also per crêpe):

    • 6 cherry tomatoes, halved
    • Small handful baby spinach
    • Extra virgin olive oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Mix the dry crêpe ingredients in a bowl, and then stir in the milk, whisking to mix thoroughly. Leave to stand for at least 5 minutes.

    2) Meanwhile, heat a little olive oil in a skillet, add the tomatoes and fry for 1 minute, before adding the spinach, stirring, and turning off the heat. As soon as the spinach begins to wilt, set it aside.

    3) Heat a little olive oil either in the same skillet (having been carefully wiped clean) or a crêpe pan if you have one, and pour in a little of the batter you made, tipping the pan so that it coats the pan evenly and thinly. Once the top is set, jiggle the pan to see that it’s not stuck, and then flip your crêpe to finish on the other side.

    If you’re not confident of your pancake-tossing skills, or your pan isn’t good enough quality to permit this, you can slide it out onto a heatproof chopping board, and use that to carefully turn it back into the pan to finish the other side.

    4) Add the filling to one half of the crêpe, and fold it over, pushing down at the edges with a spatula to make a seal, cooking for another 30 seconds or so. Alternatively, you can just serve a stack of crêpes and add the filling at the table, folding or rolling per personal preference:

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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    Learn to Age Gracefully

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