What does it mean to be immunocompromised?

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Our immune systems help us fight off disease, but certain health conditions and medications can weaken our immune systems. People whose immune systems don’t work as well as they should are considered immunocompromised.

Read on to learn more about how the immune system works, what causes people to be immunocompromised, and how we can protect ourselves and the immunocompromised people around us from illness.

What is the immune system?

The immune system is a network of cells, organs, and chemicals that helps our bodies fight off infections caused by invaders, such as bacteria, viruses, fungi, and parasites.

Some important parts of the immune system include: 

  • White blood cells, which attack and kill germs that don’t belong inside our bodies. 
  • Lymph nodes, which help our bodies filter out germs. 
  • Antibodies, which help our bodies recognize invaders.
  • Cytokines, which tell our immune cells what to do.

What causes people to be immunocompromised?

Some health conditions and medications can prevent our immune systems from functioning optimally, which makes us more vulnerable to infection. Health conditions that compromise the immune system fall into two categories: primary immunodeficiency and secondary immunodeficiency.

Primary immunodeficiency

People with primary immunodeficiency are born with genetic mutations that prevent their immune systems from functioning as they should. There are hundreds of types of primary immunodeficiencies. Since these mutations affect the immune system to varying degrees, some people may experience symptoms and get diagnosed early in life, while others may not know they’re immunocompromised until adulthood.

Secondary immunodeficiency

Secondary immunodeficiency happens later in life due to an infection like HIV, which weakens the immune system over time, or certain types of cancer, which prevent the body from producing enough white blood cells to adequately fight off infection. Studies have also shown that getting infected with COVID-19 may cause immunodeficiency by reducing our production of “killer T-cells,” which help fight off infections.

Sometimes necessary treatments for certain medical conditions can also cause secondary immunodeficiency. For example, people with autoimmune disorders—which cause the immune system to become overactive and attack healthy cells—may need to take immunosuppressant drugs to manage their symptoms. However, the drugs can make them more vulnerable to infection. 

People who receive organ transplants may also need to take immunosuppressant medications for life to prevent their body from rejecting the new organ. (Given the risk of infection, scientists continue to research alternative ways for the immune system to tolerate transplantation.)

Chemotherapy for cancer patients can also cause secondary immunodeficiency because it kills the immune system’s white blood cells as it’s trying to kill cancer cells.

What are the symptoms of a compromised immune system?

People who are immunocompromised may become sick more frequently than others or may experience more severe or longer-term symptoms than others who contract the same disease.

Other symptoms of a compromised immune system may include fatigue; digestive problems like cramping, nausea, and diarrhea; and slow wound healing.

How can I find out if I’m immunocompromised?

If you think you may be immunocompromised, talk to your health care provider about your medical history, your symptoms, and any medications you take. Blood tests can determine whether your immune system is producing adequate proteins and cells to fight off infection.

I’m immunocompromised—how can I protect myself from infection?

If you’re immunocompromised, take precautions to protect yourself from illness.

Wash your hands regularly, wear a well-fitting mask around others to protect against respiratory viruses, and ensure that you’re up to date on recommended vaccines.

Immunocompromised people may need more doses of vaccines than people who are not immunocompromised—including COVID-19 vaccines. Talk to your health care provider about which vaccines you need.

How can I protect the immunocompromised people around me?

You never know who may be immunocompromised. The best way to protect immunocompromised people around you is to avoid spreading illnesses. 

If you know you’re sick, isolate whenever possible. Wear a well-fitting mask around others—especially if you know that you’re sick or that you’ve been exposed to germs. Make sure you’re up to date on recommended vaccines, and practice regular hand-washing.

If you’re planning to spend time with someone who is immunocompromised, ask them what steps you can take to keep them safe.

For more information, talk to your health care provider.

This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Dopamine Nation – by Dr. Anna Lembke

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    We live in an age of abundance, though it often doesn’t feel like it. Some of that is due to artificial scarcity, but a lot of it is due to effectively whiting out our dopamine circuitry through chronic overuse.

    Psychiatrist Dr. Anna Lembke explores the neurophysiology of pleasure and pain, and how each can (and does) lead to the other. Is the answer to lead a life of extreme neutrality? Not quite.

    Rather, simply by being more mindful of how we seek each (yes, both pleasure and pain), we can leverage our neurophysiology to live a better, healthier life—and break/avoid compulsive habits, while we’re at it.

    That said, the book itself is quite compelling reading, but as Dr. Lembke shows us, that certainly doesn’t have to be a bad thing.

    Bottom line: if you sometimes find yourself restlessly cycling through the same few apps (or TV channels) looking for dopamine that you’re not going to find there, this is the book for you.

    Click here to check out Dopamine Nation, and get a handle on yours!

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  • You can thaw and refreeze meat: five food safety myths busted

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    This time of year, most fridges are stocked up with food and drinks to share with family and friends. Let’s not make ourselves and our guests sick by getting things wrong when preparing and serving food.

    As the weather warms up, so does the environment for micro-organisms in foods, potentially allowing them to multiply faster to hazardous levels. So put the drinks on ice and keep the fridge for the food.

    But what are some of those food safety myths we’ve long come to believe that aren’t actually true?

    Myth 1: if you’ve defrosted frozen meat or chicken you can’t refreeze it

    From a safety point of view, it is fine to refreeze defrosted meat or chicken or any frozen food as long as it was defrosted in a fridge running at 5°C or below. Some quality may be lost by defrosting then refreezing foods as the cells break down a little and the food can become slightly watery.

    Another option is to cook the defrosted food and then divide into small portions and refreeze once it has stopped steaming. Steam in a closed container leads to condensation, which can result in pools of water forming. This, combined with the nutrients in the food, creates the perfect environment for microbial growth. So it’s always best to wait about 30 minutes before refrigerating or freezing hot food.

    Plan ahead so food can be defrosted in the fridge, especially with large items such as a frozen turkey or roll of meat. If left on the bench, the external surface could be at room temperature and micro-organisms could be growing rapidly while the centre of the piece is still frozen!

    Myth 2: Wash meat before you prepare and/or cook it

    It is not a good idea to wash meats and poultry when preparing for cooking. Splashing water that might contain potentially hazardous bacteria around the kitchen can create more of a hazard if those bacteria are splashed onto ready-to-eat foods or food preparation surfaces.

    It is, however, a good idea to wash fruits and vegetables before preparing and serving, especially if they’re grown near or in the ground as they may carry some dirt and therefore micro-organisms.

    This applies particularly to foods that will be prepared and eaten without further cooking. Consuming foods raw that traditionally have been eaten cooked or otherwise processed to kill pathogenic micro-organisms (potentially deadly to humans) might increase the risk of food poisoning.

    Fruit, salad, vegetables and other ready-to-eat foods should be prepared separately, away from raw meat, chicken, seafood and other foods that need cooking.

    Myth 3: Hot food should be left out to cool completely before putting it in the fridge

    It’s not OK to leave perishable food out for an extended time or overnight before putting it in the fridge.

    Micro-organisms can grow rapidly in food at temperatures between 5° and 60°C. Temperature control is the simplest and most effective way of controlling the growth of bacteria. Perishable food should spend as little time as possible in the 5-60°C danger zone. If food is left in the danger zone, be aware it is potentially unsafe to eat.

    Hot leftovers, and any other leftovers for that matter, should go into the fridge once they have stopped steaming to reduce condensation, within about 30 minutes.

    Large portions of hot food will cool faster if broken down into smaller amounts in shallow containers. It is possible that hot food such as stews or soup left in a bulky container, say a two-litre mixing bowl (versus a shallow tray), in the fridge can take nearly 24 hours to cool to the safe zone of less than 5°C.

    Myth 4: If it smells OK, then it’s OK to eat

    This is definitely not always true. Spoilage bacteria, yeasts and moulds are the usual culprits for making food smell off or go slimy and these may not make you sick, although it is always advisable not to consume spoiled food.

    Pathogenic bacteria can grow in food and not cause any obvious changes to the food, so the best option is to inhibit pathogen growth by refrigerating foods.

    Myth 5: Oil preserves food so it can be left at room temperature

    Adding oil to foods will not necessarily kill bugs lurking in your food. The opposite is true for many products in oil if anaerobic micro-organisms, such as Clostridium botulinum (botulism), are present in the food. A lack of oxygen provides perfect conditions for their growth.

    Outbreaks of botulism arising from consumption of vegetables in oil – including garlic, olives, mushrooms, beans and hot peppers – have mostly been attributed to the products not being properly prepared.

    Vegetables in oil can be made safely. In 1991, Australian regulations stipulated that this class of product (vegetables in oil) can be safely made if the pH (a measure of acid) is less than 4.6. Foods with a pH below 4.6 do not in general support the growth of food-poisoning bacteria including botulism.

    So keep food out of the danger zone to reduce your guests’ risk of getting food poisoning this summer. Check out other food safety tips and resources from CSIRO and the Food Safety Information Council, including testing your food safety knowledge.

    Cathy Moir, Team leader, Microbial and chemical sciences, Food microbiologist and food safety specialist, CSIRO

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

    The Conversation

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  • Cherries’ Very Healthy Wealth Of Benefits!

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    Cherry’s Health Benefits Simply Pop

    We wrote recently about some of the health benefits of cherries, in our “This or That” challenge, pitting them against strawberries:

    Strawberries vs Cherries – Which is Healthier?

    We said there that we’d do a main feature on cherries sometime soon, so here it is!

    Sweet & Sour

    Cherries can be divided into sweet vs sour. These are mostly nutritionally similar, though sour ones do have some extra benefits.

    Sweet and sour cherries are closely related but botanically different plants; it’s not simply a matter of ripeness (or preparation).

    These can mostly be sorted into varieties of Prunus avium and Prunus cerasus, respectively:

    Cherry Antioxidants: From Farm to Table

    Sour cherry varieties include morello and montmorency, so look out for those names in particular when doing your grocery-shopping.

    You may remember that it’s a good rule of thumb that foods that are more “bitter, astringent, or pungent” will tend to have a higher polyphenol content (that’s good):

    Enjoy Bitter Foods For Your Heart & Brain

    Juiced up

    Almost certainly for reasons of budget and convenience, as much as for standardization, most studies into the benefits of cherries have been conducted using concentrated cherry juice as a supplement.

    At home, we need not worry so much about standardization, and our budget and convenience are ours to manage. To this end, as a general rule of thumb, whole fruits are pretty much always better than juice:

    Which Sugars Are Healthier, And Which Are Just The Same?

    Antioxidant & anti-inflammatory!

    Cherries are a very good source of antioxidants, and as such they also reduce inflammation, which in turn means ameliorating autoimmune diseases, from common things like arthritis…

    Efficacy of Tart Cherry Juice to Reduce Inflammation Biomarkers among Women with Inflammatory Osteoarthritis (OA)

    …to less common things like gout:

    Cherry Consumption and the Risk of Recurrent Gout Attacks

    This can also be measured by monitoring uric acid metabolites:

    Consumption of cherries lowers plasma urate in healthy women

    Anti-diabetic effect

    Most of the studies on this have been rat studies, and the human studies have been less “the effect of cherry consumption on diabetes” and more a matter of separate studies adding up to this conclusion in, the manner of “cherries have this substance, this substance has this effect, therefore cherries will have this effect”. You can see an example of this discussed over the course of 15 studies, here:

    A Review of the Health Benefits of Cherries ← skip to section 2.2.1: “Cherry Intake And Diabetes”

    In short, the jury is out on cherry juice, but eating cherries themselves (much like getting plenty of fruit in general) is considered good against diabetes.

    Good for healthy sleep

    For this one, the juice suffices (actual cherries are still recommended, but the juice gave clear significant positive results):

    Pilot Study of the Tart Cherry Juice for the Treatment of Insomnia and Investigation of Mechanisms ← this was specifically in people over the age of 50

    Importantly, it’s not that cherries have a sedative effect, but rather they support the body’s ability to produce melatonin adequately when the time comes:

    Effect of tart cherry juice (Prunus cerasus) on melatonin levels and enhanced sleep quality

    Post-exercise recovery

    Cherries are well-known for boosting post-exercise recovery, though they may actually improve performance during exercise too, if eaten beforehand/

    For example, these marathon-runners who averaged 13% compared to placebo control:

    Effects of powdered Montmorency tart cherry supplementation on acute endurance exercise performance in aerobically trained individuals

    As for its recovery benefits, we wrote about this before:

    How To Speed Up Recovery After A Workout (According To Actual Science)

    Want to get some?

    We recommend your local supermarket (or farmer’s market!), but if for any reason you prefer to take a supplement, here’s an example product on Amazon

    Enjoy!

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  • What Matters Most For Your Heart?
  • What Are Nootropics, Really?

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    What are nootropics, really?

    A nootropic is anything that functions as a cognitive enhancerin other words, improves our brainpower.

    These can be sensationalized as “smart drugs”, misrepresented excitingly in science fiction, meme-ified in the mundane (“but first, coffee”), and reframed entirely, (“exercise is the best nootropic”).

    So, clearly, “nootropics” can mean a lot of different things. Let’s look at some of the main categories…

    The neurochemical modulators

    These are what often get called “smart drugs”. They are literally drugs (have a chemical effect on the body that isn’t found in our diet), and they affect the levels of certain neurotransmitters in the brain, such as by:

    • Adding more of that neurotransmitter (simple enough)
    • Decreasing the rate at which we lose that neurotransmitter (re-uptake inhibitors)
    • Antagonizing an unhelpful neurotransmitter (doing the opposite thing to it)
    • Blocking an unhelpful neurotransmitter (stopping the receptors from receiving it)

    “Unhelpful” here is relative and subjective, of course. We need all the neurotransmitters that are in our brain, after all, we just don’t need all of them all the time.

    Examples: modafinil, a dopamine re-uptake inhibitor (mostly prescribed for sleep disorders), reduces the rate at which our brains scrub dopamine, resulting in a gradual build-up of dopamine that we naturally produced, so we get to enjoy that dopamine for longer. This will tend to promote wakefulness, and may also help with problem-solving and language faculties—as well as giving a mood boost. In other words, all things that dopamine is used for. Mirtazaрine, an adrenoreceptor agonist (mostly prescribed as an antidepressant), increases noradrenergic neurotransmission, thus giving many other brain functions a boost.

    Why it works: our brains need healthy levels of neurotransmitters, in order to function well. Those levels are normally self-regulating, but can become depleted in times of stress or fatigue, for example.

    The metabolic brain boosters

    These are the kind of things that get included in nootropic stacks (stack = a collection of supplements and/or drugs that complement each other and are taken together—for example, a multivitamin tablet could be described as a vitamin stack) even though they have nothing specifically relating them to brain function. Why are they included?

    The brain needs so much fuel. Metabolically speaking, it’s a gas-guzzler. It’s the single most resource-intensive organ of our body, by far. So, metabolic brain boosters tend to:

    • Increase blood flow
    • Increase blood oxygenation
    • Increase blood general health
    • Improve blood pressure (this is relative and subjective, since very obviously there’s a sweet spot)

    Examples: B-vitamins. Yep, it can be that simple. A less obvious example might be Co-enzyme Q10, which supports energy production on a cellular level, and good cardiovascular health.

    Why it works: you can’t have a healthy brain without a healthy heart!

    We are such stuff as brains are made of

    Our brains are made of mostly fat, water, and protein. But, not just any old fat and protein—we’re at least a little bit special! So, brain-food foods tend to:

    • Give the brain the fats and proteins it’s made of
    • Give the brain the stuff to make the fats and proteins it’s made of (simpler fats, and amino acids)
    • Give the brain hydration! Just having water, and electrolytes as appropriate, does this

    Examples: healthy fats from nuts, seeds, and seafood; also, a lot of phytonutrients from greens and certain fruits. Long-time subscribers may remember our article “Brain Food: The Eyes Have It!” on the importance of dietary lutein in reducing Alzheimer’s risk, for example

    Why it works: this is matter of structural upkeep and maintenance—our brains don’t work fabulously if deprived of the very stuff they’re made of! Especially hydration is seriously underrated as a nootropic factor, by the way. Most people are dehydrated most of the time, and the brain dehydrates quickly. Fortunately, it rehydrates quickly as well when we take hydrating liquids.

    Weird things that sound like ingredients in a witch’s potion

    These are too numerous and too varied in how they work to cover here, but they do appear a lot in nootropic stacks and in popular literature on the subject.

    Often they work by one of the mechanisms described above; sometimes we’re not entirely sure how they work, and have only measured their effects sufficiently to know that, somehow, they do work.

    Examples: panax ginseng is one of the best-studied examples that still remains quite mysterious in many aspects of its mechanism. Lion’s Mane (the mushroom, not the jellyfish or the big cat hairstyle), meanwhile, is known to contain specific compounds that stimulate healthy brain cell growth.

    Why it works: as we say, it varies so much from on ingredient to another in this category, so… Watch out for our Research Review Monday features, as we’ll be covering some of these in the coming weeks!

    (PS, if there’s any you’d like us to focus on, let us know! We always love to hear from you. You can hit reply to any of our emails, or use the handy feedback widget at the bottom)

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  • How can I stop overthinking everything? A clinical psychologist offers solutions

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    As a clinical psychologist, I often have clients say they are having trouble with thoughts “on a loop” in their head, which they find difficult to manage.

    While rumination and overthinking are often considered the same thing, they are slightly different (though linked). Rumination is having thoughts on repeat in our minds. This can lead to overthinking – analysing those thoughts without finding solutions or solving the problem.

    It’s like a vinyl record playing the same part of the song over and over. With a record, this is usually because of a scratch. Why we overthink is a little more complicated.

    We’re on the lookout for threats

    Our brains are hardwired to look for threats, to make a plan to address those threats and keep us safe. Those perceived threats may be based on past experiences, or may be the “what ifs” we imagine could happen in the future.

    Our “what ifs” are usually negative outcomes. These are what we call “hot thoughts” – they bring up a lot of emotion (particularly sadness, worry or anger), which means we can easily get stuck on those thoughts and keep going over them.

    However, because they are about things that have either already happened or might happen in the future (but are not happening now), we cannot fix the problem, so we keep going over the same thoughts.

    Who overthinks?

    Most people find themselves in situations at one time or another when they overthink.

    Some people are more likely to ruminate. People who have had prior challenges or experienced trauma may have come to expect threats and look for them more than people who have not had adversities.

    Deep thinkers, people who are prone to anxiety or low mood, and those who are sensitive or feel emotions deeply are also more likely to ruminate and overthink.

    Woman holds her head, looking stressed
    We all overthink from time to time, but some people are more prone to rumination.
    BĀBI/Unsplash

    Also, when we are stressed, our emotions tend to be stronger and last longer, and our thoughts can be less accurate, which means we can get stuck on thoughts more than we would usually.

    Being run down or physically unwell can also mean our thoughts are harder to tackle and manage.

    Acknowledge your feelings

    When thoughts go on repeat, it is helpful to use both emotion-focused and problem-focused strategies.

    Being emotion-focused means figuring out how we feel about something and addressing those feelings. For example, we might feel regret, anger or sadness about something that has happened, or worry about something that might happen.

    Acknowledging those emotions, using self-care techniques and accessing social support to talk about and manage your feelings will be helpful.

    The second part is being problem-focused. Looking at what you would do differently (if the thoughts are about something from your past) and making a plan for dealing with future possibilities your thoughts are raising.

    But it is difficult to plan for all eventualities, so this strategy has limited usefulness.

    What is more helpful is to make a plan for one or two of the more likely possibilities and accept there may be things that happen you haven’t thought of.

    Think about why these thoughts are showing up

    Our feelings and experiences are information; it is important to ask what this information is telling you and why these thoughts are showing up now.

    For example, university has just started again. Parents of high school leavers might be lying awake at night (which is when rumination and overthinking is common) worrying about their young person.

    Man lays awake in bed
    Think of what the information is telling you.
    TheVisualsYouNeed/Shutterstock

    Knowing how you would respond to some more likely possibilities (such as they will need money, they might be lonely or homesick) might be helpful.

    But overthinking is also a sign of a new stage in both your lives, and needing to accept less control over your child’s choices and lives, while wanting the best for them. Recognising this means you can also talk about those feelings with others.

    Let the thoughts go

    A useful way to manage rumination or overthinking is “change, accept, and let go”.

    Challenge and change aspects of your thoughts where you can. For example, the chance that your young person will run out of money and have no food and starve (overthinking tends to lead to your brain coming up with catastrophic outcomes!) is not likely.

    You could plan to check in with your child regularly about how they are coping financially and encourage them to access budgeting support from university services.

    Your thoughts are just ideas. They are not necessarily true or accurate, but when we overthink and have them on repeat, they can start to feel true because they become familiar. Coming up with a more realistic thought can help stop the loop of the unhelpful thought.

    Accepting your emotions and finding ways to manage those (good self-care, social support, communication with those close to you) will also be helpful. As will accepting that life inevitably involves a lack of complete control over outcomes and possibilities life may throw at us. What we do have control over is our reactions and behaviours.

    Remember, you have a 100% success rate of getting through challenges up until this point. You might have wanted to do things differently (and can plan to do that) but nevertheless, you coped and got through.

    So, the last part is letting go of the need to know exactly how things will turn out, and believing in your ability (and sometimes others’) to cope.

    What else can you do?

    A stressed out and tired brain will be more likely to overthink, leading to more stress and creating a cycle that can affect your wellbeing.

    So it’s important to manage your stress levels by eating and sleeping well, moving your body, doing things you enjoy, seeing people you care about, and doing things that fuel your soul and spirit.

    Woman running
    Find ways to manage your stress levels.
    antoniodiaz/Shutterstock

    Distraction – with pleasurable activities and people who bring you joy – can also get your thoughts off repeat.

    If you do find overthinking is affecting your life, and your levels of anxiety are rising or your mood is dropping (your sleep, appetite and enjoyment of life and people is being negatively affected), it might be time to talk to someone and get some strategies to manage.

    When things become too difficult to manage yourself (or with the help of those close to you), a therapist can provide tools that have been proven to be helpful. Some helpful tools to manage worry and your thoughts can also be found here.

    When you find yourself overthinking, think about why you are having “hot thoughts”, acknowledge your feelings and do some future-focused problem solving. But also accept life can be unpredictable and focus on having faith in your ability to cope. The Conversation

    Kirsty Ross, Associate Professor and Senior Clinical Psychologist, Massey University

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

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  • The Longevity Project – by Dr. Howard Friedman & Dr. Leslie Martin

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    Most books on the topic of longevity focus on such things as diet and exercise, and indeed, those are of course important things. But what of psychological and sociological factors?

    Dr. Friedman and Dr. Martin look at a landmark longitudinal study, following a large group of subjects from childhood into old age. Looking at many lifestyle factors and life events, they crunched the numbers to see what things really made the biggest impact on healthy longevity.

    A strength of the book is that this study had a huge amount of data—a limitation of the book is that it often avoids giving that concrete data, preferring to say “many”, “a majority”, “a large minority”, “some”, and so forth.

    However, the conclusions from the data seem clear, and include many observations such as:

    • conscientiousness is a characteristic that not only promotes healthy long life, but also can be acquired as time goes by (some “carefree” children became “conscientious” adults)
    • resilience is a characteristic that promotes healthy long life—but tends to only be “unlocked” by adversity
    • men tend to live longer if married—women, not so much
    • religion and spirituality are not big factors in healthy longevity—but social connections (that may or may not come with such) do make a big difference

    Bottom line: if you’d like to know which of your decisions are affecting your healthy longevity (beyond the obvious diet, exercise, etc), this is a great book for collating that information and presenting, in essence, a guideline for a long healthy life.

    Click here to check out The Longevity Project and see how it applies to your life!

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