June 2008, Issue No. 28

 

In this Issue:

• Drugs Can Rob You of More than Money

• How to Cool the Fire Inside You

• A Healthy Heart Plan for Women

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Drugs Can Rob You of More than Money

Popular prescription drugs can rob your body of many essential nutrients, doing you more harm than good.

The problems aren’t limited to a handful of expensive, newly developed blockbusters like Lipitor. Scores of popularly prescribed drugs for all kinds of health problems have been proven to leach important vitamins, minerals, and key enzymes out of your body or prevent it from being able to absorb them. They can also effect metabolism and even make it impossible for your body to use certain nutrients.

 

These Common Culprits May Be in Your Medicine Cabinet

Some of the most commonly used drugs in America today can cause any one of the problems on this list.

Aspirin

You may be surprised to learn that aspirin makes it harder for your body to absorb vitamin C.1 It can also decrease levels of iron and folic acid, leading to anemia, susceptibility to cold and flu, and a host of additional ailments (see above list).2 And it’s not even a prescription drug.

 

Oral Contraceptives

For my women readers, here’s some news that should concern you: oral contraceptives have been shown to drain your body of vitamin B6. This can set a cascade of unwanted side effects in motion, including sleeplessness, mood swings, and depression.

That’s because you need vitamin B6 to make serotonin, melatonin, and tryptophan.3 These natural compounds powerfully affect your sense of contentment in life, your ability to rest, and your overall emotional stability. This is why so many women who come to my clinic complain of becoming someone they don’t recognize while on “the pill” or “the patch.”

What’s more, oral contraceptives also rob you of B12, zinc, and blood magnesium levels, causing diarrhea, poor immune resistance, insomnia—even anorexia.4

Vitamin B12 in particular is vital to optimal health. I can’t say enough how bad it is to be B12-deficient. It’s crucial to brain function and the overall health of your nervous system. It’s the engine behind your body’s ability to make blood. Every cell in your body uses it to convert fuel into energy. It’s also the key to DNA synthesis and regulation, and enables your body to produce life-supporting fatty acids.

I usually put my women patients suffering from these symptoms on supplements to offset nutrient imbalance: vitamin B (usually 50 mg a day), zinc (60 mg), and magnesium (200 mgs).

 

Acid Blockers

Attention men: if you’re taking drugs to relieve heartburn or acid reflux, chances are you’re shortchanging your body of zinc and iron.5,6 You need zinc in abundance for its power to help your body recover from wounds and injury and fight off infectious diseases.

It’s also one of the keys to prostate health, virility and sexual performance. In fact, for men, the prostate gland is where most of the body’s zinc is concentrated. This is one “rock” you can’t do without.

Women ought to worry about acid blockers’ effect on iron levels. We all need iron to enable our blood to deliver oxygen to every cell in our bodies. Most people get enough of it in their diet. Without enough of it, a host of problems set in, including anemia, fatigue, and greater vulnerability to illness. Women are particularly at risk because of blood loss during menstruation.

The ones to watch out for are “proton pump inhibitors” (PPI’s) or “histamine-2 receptor antagonists (H2 blockers). Prevacid (Lansoprazole) is one of the most popular PPIs, for example.

They’ve been linked to vitamin B12 deficiency, lower calcium absorption, and even beta carotene, a critical antioxidant.7

Even worse, they steal one of your body’s most important nutrients–vitamin D. That means you’ll suddenly be missing out on a long list of major health benefits, including:

• Elevated mood and boost your mental performance


• Lower risk types of cancers including prostate, breast and ovarian


• Reduced risk of melanoma, the deadly form of skin cancer


• Prevention of bone diseases, including osteoporosis


• Lower risk of depression and schizophrenia


• Enhanced function of your pancreas


• Increased insulin sensitivity and diabetes prevention


• Weight loss


• Better sleep


• Increased energy and stamina during the day


• Significantly lower blood pressure


• Lower blood sugar levels


• Lower LDL or “bad” cholesterol levels


• Increased white blood cells responsible for immunity

 

Corticosteroids

Prednisone and hydrocortisone are some of the top drugs used to treat lupus, Crohn’s disease, and other autoimmune or inflammatory conditions. Unfortunately, they also leach calcium from your body and increase its elimination, putting you at greater risk of bone fracture and osteoporosis.

Some studies have shown these drugs can also lower levels of key trace elements, including magnesium, selenium, zinc, copper, and potassium. You should be taking supplements to offset the loss of so many important nutrients.

 

Hormone Replacement Drugs

I’ve written about these before. The term “hormone replacement” is totally misleading: the drugs doctors are prescribing to millions every year to offset declining hormone levels aren’t “replacing” anything. That’s because drug makers derive them from animal hormones that are utterly foreign to your body.

They do this for profit, not patient health. They can’t legally patent a naturally-occurring substance, so they deliberately synthesize inorganic compounds your body was never meant to tolerate.

The health hazards range from relatively minor to severe. You may find yourself having trouble getting to sleep. That’s because hormone replacement drugs prevent your body from making melatonin, the sleep hormone.

• Vitamin B2 (Riboflavin)
• Folic acid
• Vitamin B12 (Cobalamin)
• Vitamin C
• Zinc
• Magnesium

 

Anti-Diabetic Drugs

Metformin, one of the most widely used medications to treat the symptoms of diabetes, robs your body of vitamin B12 and folic acid. It can attack heart health over time, partly because it also lowers CoQ10 levels. I’ve written at length about CoQ10. Every cell in your body needs it for metabolism, and it’s especially crucial for the proper function of your vital organs, including the brain, heart and liver. As you age, your body makes less and less of it.

The last thing you need is a drug that will drive CoQ10 levels down even further.

 

Statin Drugs

Again, I’ve been sounding the warning bell on these dangerous drugs for years. Lipitor, Zocor, Mevacor and the like are great at driving your LDL cholesterol levels through the floor; unfortunately, they do the same thing to CoQ10 levels. Here are just a few of the risks you face if you’re taking statins:

• Inability to concentrate


• Depression


• Confusion


• Impotence


• Amnesia


• Lowered sex drive


• Disorientation


• Weakened immune system


• Shortness of breath


• Liver damage


• Fatigue


• Kidney failure


• Nerve pain


• Muscle weakness


• Rhabdomyolysis (painful bursting of muscle cells)


• Death

 

These drugs are hardly worth the risks. And most don’t need to lower their cholesterol in the first place.  It’s more about paying attention to your real risk factors such as homocystein, triglycerides and C-reactive  protein.  You can read more about this in the other article about women and heart disease.

 

Blood Pressure Drugs

Sixty-five million Americans have high blood pressure according to the American Heart Association. If all of them were to take some of the most common drugs to treat hypertension, they’d also be deficient in vitamin B6 and CoQ10.

 

Diuretics

There are two kinds of diuretics: thiazides and loop diuretics. They’re great at lowering blood pressure. Doctors also prescribe them for diseases of the kidney and liver, as well as for heart health.

Don’t Wait For These Health Problems to Crop Up

To sum it all up, here’s a list of prescription drug classes and their effects. (I’ve included information on two more kinds of medication: antibiotics and anti-convulsants. Anti-convulsants work for people suffering from epilepsy, but they’re also widely prescribed to treat bi-polar disorder).

 

Prescription drugs: categories and Nutrient Depletion
Estrogen/progestin (hormone replacement)	Vitamin B2, B6, B12, C, folic acid, zinc, magnesium
Statins	CoQ10
Acid blockers	CoQ10, B12, folic acid, iron, vitamin D, beta carotene, zinc
Corticosteroids	Calcium, magnesium, potassium, zinc, copper, selenium, vitamin C, D
Aspirin	Vitamin C, iron, folic acid
Blood pressure drugs	Vitamin B6, CoQ10
Diuretics	Vitamin B1, B6, C, potassium, magnesium, calcium, zinc
Antibiotics	B vitamins, K, magnesium, potassium, calcium, zinc, iron
Anti-diabetics	Vitamin B12, folic acid, CoQ10
Anti-convulsants	Vitamin B1, B7, B12, folic acid, CoQ10, vitamin D, vitamin K, calcium, carnitine

 

If you’re on any one of these drugs, talk to your doctor about supplements to counter their adverse effects on your nutrition and overall health. Be sure to keep him or her “in the loop” about the amounts you’re taking and any effects you notice over time.

Here’s a list I’ve put together of signs to watch out for. They may mean you’re missing an important nutrient:

 

Medical Malnourishment: Nutrients and Signs to Watch Out For
B1 (Thiamine)	Depression, memory loss, weight loss, fatigue, numbness
B2 (Riboflavin)	Dermatitis, lesions at the corners of the mouth, swollen tongue, vision loss
B3 (Niacin)	Skin lesions, insomnia, depression, aggression, swelling, diarrhea, weakness, “brain fog,” balding
B5 (Pantothenic Acid)	Fatigue, numbness, foot pain
B6 (Pyridoxine)	Depression, fatigue, dermatitis, anemia, glucose intolerance
B7 (Biotin)	Balding, depression, dermatitis, nausea, anorexia
B9 (Folate)	Anemia, fatigue, cervical dysplasia, diarrhea, gingivitis, depression, irritability, insomnia
B12 (Cobalamin)	Anemia, fatigue, poor nerve function, diarrhea, loss of memory
Vitamin C	Liver spots, bleeding at the gums, fatigue
Calcium	Weakened bones and fractures, muscle spasms
Magnesium	Fatigue, irritability, weakness, muscle cramps, insomnia, anorexia
Potassium	Fatigue, irregular heartbeat, irritability, confusion, reduced nerve function.
Iron	Anemia, weakness, fatigue, poor immune function
Zinc	Slow wound healing, decreased immunity, loss of taste and smell, balding, skin disorders, sexual dysfunction
Selenium	Poor immune function, heart disease
CoQ10	Hypertension, fatigue, cardiovascular diseases
Carnitine	Muscle weakness, inability to digest fat, stunted growth in children, poor athletic performance

If you’re not taking supplements and wonder if you should, here are the basics that I recommend to most of my patients.

• Vitamin C: 1,500 mg to 4,000 mg per day


• B Complex: B6 – 150 mg; Folic Acid – 1,600 mcg; B12 – 800 mcg per day


• CoQ10: 200 mg (or 50 mg of my Accel) per day


• Cod Liver Oil: 1 to 2 tablespoons a day

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1 Das et al. “Vitamin C aspirin interaction in laboratory animals.” Journal of Clinical Pharmacology and Therapeutics. 1992. 17(6):343-6.

2 Lawrence et al. “Aspirin and folate binding: in vivo and in vitro studies of serum binding and urinary excretion of endogenous folate.” Journal of Laboratory and Clinical Medicine. 1984. 103(6):944-8.

3 Webb JL. “Nutritional effects of oral contraceptive use: a review.” Journal of Reproductive Medicine. 1980. 25(4):150-6.

4 Bielenberg J. “Folic acid and vitamin deficiency caused by oral contraceptives.” Medizinische Monatsschrift für Pharmazeuten. 1991. 14(8):244-7.

5 Sturniolo et al. “Inhibition of gastric acid secretion reduces zinc absorption in man.” Journal of the American College of Nutrition. 1991. 10(4):372-5.

6 Aymard et al. “Haematological adverse effects of histamine H2-receptor antagonists.” Medical Toxicology and Adverse Drug Experience. 1988. 3(6):430-48.

7 Tang et al. “Gastric acidity influences blood response to a beta-carotene dose in humans.” American Journal of Clinical Nutrition. 1996. 64(4):622-6.

 

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How to Cool the Fire Inside You

By Mark Hyman, MD

Inflammation is part of the body's natural defense system. However, when your immune system shifts out of balance, inflammation can run rampant -- causing a chronic, smoldering fire inside your body that contributes to disease and weight gain. The causes of this type of inflammation are all around you.

The sugar you eat, high doses of the wrong oils and fats in your diet, hidden food allergens, lack of exercise, chronic stress, and hidden infections all trigger a raging, unseen inflammation deep in your cells and tissues.

And this inflammation leads to every one of the major chronic diseases of aging -- heart disease, cancer, diabetes, dementia, and more. It's also by far the major contributor to obesity.

If you don't address inflammation by eliminating hidden food allergens or sensitivities and by eating an anti-inflammatory diet, you will never succeed at effective and permanent weight loss.

Hidden Food Allergies Can Make You Sick

When most people think of food allergies, they usually think of someone eating a peanut and ending up in the emergency room with hives and a swollen tongue.

That's what is called an immediate allergy (also known as an IgE hypersensitivity reaction). This is very serious but not common.

But there is a different type of reaction to foods that is much less dramatic called delayed allergy (or IgG delayed hypersensitivity reaction). This reaction is much more common and creates suffering for millions of people. It's mostly ignored by conventional medicine, yet it plays a HUGE role in many chronic illnesses. This type of delayed allergic reaction can cause symptoms anywhere from a few hours to a few days after ingestion.

It also causes a wide range of problems like weight gain, fluid retention, fatigue, brain fog, irritable bowel syndrome, mood problems, headaches, sinus and nasal congestion, joint pains, acne, eczema, and more.

If you hear someone say dismissively, "Oh, you just lost water weight," they're right (at first), because eating foods you are allergic to causes inflammation, which leads to swelling and fluid retention. Getting rid of this fluid by reducing inflammation is a GOOD thing. It will allow your body to start the healing process so you can achieve optimal health.

Consuming a low-allergy diet for just 1 week will help you eliminate the excess swelling and fluid that accumulates in your tissues from food-induced chronic inflammation. Despite criticisms you may have heard about losing ONLY water weight, this is essential for you body to begin to heal and detoxify. And the side effect is that you lose significant weight -- quickly and safely.

You see, nearly every modern disease -- everything from autoimmune diseases, heart disease, and cancer to obesity, diabetes, and dementia -- is caused by inflammation! These chronic diseases affect 125 million Americans.

While everyone is different, there are some foods that irritate the immune system more than others. The worst are: gluten (wheat, barley, rye, oats), dairy (milk, cheese, butter, yogurt), corn, eggs, soy, nuts, nightshades (tomatoes, bell peppers, potatoes, eggplant), citrus, and yeast (baker's yeast, brewer's yeast, and fermented products).

These foods can also cause acute allergic reactions. But those are rare, generally affecting less than 1 percent of the population. When they occur they are serious and need to be treated seriously. But for more than 50 percent of us, there are some foods that just don't agree with us and prevent vibrant, good health.

Why Do You Become Sensitive or Allergic to Foods?

Simply put, your diet, the way you live, and the medications you take injure your gut.

They change the bacteria and damage the gut's lining, which is the critical barrier that keeps your immune system from having to deal with all the garbage, toxins, and allergens inside your intestinal tract. 

This damage leads to a leaky gut.  Then, food particles "leak" across the damaged barrier and your immune system (60 percent of which is right under that lining) starts to attack these partially digested food particles. That's when you develop food intolerances or allergies.

Finding and Fixing Delayed Food Allergies and Sensitivities

Just because you have a food allergy or intolerance doesn't mean you have to suffer with it. I’m going to show you how to use a simple and well-accepted system called elimination/ provocation. This means you get rid of the top trouble foods for 1 to 4 weeks, then reintroduce them one at a time and see what happens.

When you do these things, you'll be more resilient and able to tolerate a wider range of foods Very quickly -- in a week or less -- people notice dramatic relief from all the symptoms they thought they had to live with the rest of their lives!

This plan is designed to get you started on the road to finding and healing this common obstacle to health and weight loss. Here’s are the basic steps that I recommend to my patients for five day plan.

1. Remove common food allergies and unnecessary medications like aspirin and Advil that can disturb the gut.  Some common foods that trigger allergies include:

• Gluten (barley, rye, wheat, oats, spelt, and kamut)
• Dairy foods
• Eggs
• Corn
• Peanuts
• Citrus Fruits
• Tomatoes
• Peppers
• Eggplants
• Potatoes
  

2. Add probiotics: These include healthy bacterias like acidophilus, bifidus, and lactobacillus.    Health bacteria has been shown to eliminate many sources of inflammation.
   
   
3. Add essential fatty acids to your diet. These include those found in flax seed oil, borage oil, and fish oil.  These oils contain vitamins like zinc and vitamin A, and the B vitamins to help repair the digestive tract.
   
   
4. Get plenty of fiber.  Fiber helps the good bacteria live.  Vegetables, beans, nuts, and seeds are all good sources of fiber.

Just think about giving yourself the gift of a weeklong vacation for your body and soul. You might be surprised by what's on the other side. You'll be following the same simple program that I use with my own patients to eliminate food allergies.

Comments from Dr. Sears:

Eliminating certain foods from your diet or fasting is a good way to cleanse your body of toxins and heal your digestive system.  I do this myself about every three months.  I will typically stick to a light diet for a couple of days consisting of vegetables and plenty of water (usually over a weekend).

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About the Author:

Dr. Hyman is not only a bestselling author, but I consider him an expert in healing and prevention.  His plan for healing your body and ridding it of toxins and inflammation is a good one.  You should check it out on his website www.ultrasimplediet.com.

 

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A Healthy Heart Plan for Women

My female patients routinely ask me how to keep their hearts healthy. That shouldn’t be a surprise to you. While many have the notion that it’s mostly men who have to worry about heart problems, in fact since 1984 more American women have died from heart disease than men.1,2

Heart disease is both the number one killer and leading cause of disability for women in the United States.3 Out of every four women, one will die of heart disease. And two thirds of women who have had a heart attack never fully recover.3

These frightening facts should be all the inspiration you need to better your heart's health. But if you turn to the solutions the big pharmaceutical companies push, you'll end up with a doctor advising you to take statin drugs to lower cholesterol, beta and alpha blockers to lower your blood pressure, anticoagulants to prevent blood clots, or nitrates to increase blood flow.

Statin drugs can cause kidney and liver failure. Beta blockers decondition your heart. And anticogulants can cause uncontrollable bleeding.

Not only are these drugs dangerous, they also fail to treat the major causes of heart disease. While cholesterol and high blood pressure can be factors in heart disease, what you really need to pay attention to are the heart threats C-reactive protein, homocysteine, and triglycerides.

I've developed a four-point plan to safely

• Testing


• Healthy Eating


• Heart-strengthening Exercise


• Recognizing Trouble

Today I'll show you how to put it into action.

Get Screened for Safety's Sake

In order to protect your heart, screening is key. First, ask your doctor for a test that examines the C-reactive protein (or CRP) levels in your blood. When there's inflammation in your body as a result of an injury or an infection, your liver secretes CRP in your blood. An excesss of CRP leads to inflamed arteries.

Those with the highest levels of CRP are more than twice as likely to suffer from heart disease, heart attack and stroke, whether their cholesterol is high or low.4 Knowing your CRP levels is one way to tell your risk for heart attacks and cancer.

Second, get checked for the homocysteine level in your blood. Too much homocysteine in your blood prevents your blood vessels from dilating properly, which can cause both heart attacks and strokes.

Third, have your triglycerides checked.  Doctors routinely test for triglyceride levels, but they often don’t have a clear idea of how to treat high triglycerides or even how much of a risk factor they are, especially in women.  For women in our Wellness Center, reduction of triglycerides has made a huge difference. 

Fourth, have your blood pressure examined. High blood pressure is an even more serious risk factor for women before menopause than after, as recent studies have shown.5

Diabetes can lead to heart disease, so you should have your blood sugar checked with a fasting glucose test. A new study indicates that heightened blood sugar levels increase your risk for heart disease.6

Here’s a test you can do in a matter of minutes to get a better picture of what kind of shape your heart is in.7 The lower your score, the more you need to take action to strengthen your heart.

Eat Wisely for Heart Health

Your kitchen is the best place for fighting the battle against heart disease. A high-fiber diet rich in fruits, whole grains, legumes, vegetables, and nuts can help you combat inflammation of the arteries. Barley, beans, and oats are the best for soluble fiber.8

Despite what you may have heard about the dangers of red meat, it doesn't raise your cholesterol levels. In fact, a recent study proved that eating lean meat helps reduce LDL and raise HDL levels, the "good" cholesterol that fights plaque. Treat yourself to grass-fed red meat, which is higher in omega-3 fatty acids.

If you like Italian or Asian cuisine, you're in luck. Garlic and ginger are excellent for thinning your blood and inhibiting clots.

In terms of foods to avoid, reduce your intake of blood sugar boosting foods, ones that rank low on the Glycemic Index (see Health Alerts 120 and 158). I have seen great success with a low glycemic diet for diabetes and reducing high triglycerides levels.

Eliminate artery-clogging trans fats from you diet. Breaded and fried foods such as French fries and deli chicken, commercially baked crackers and cookies and anything with hydrogenated or partially hydrogenated soybean oil needs to go.

As I am constantly reminding my patients, the average American diet is far too high in starch. Starches in foods such as potatoes, rice, and wheat-based products build up plaque in your arteries. Lower your intake for your heart’s sake.

You should supplement your healthy meals with Vitamin B2 (25 mg), B6 (25 mg), B12 (500 mcg) and folate (800 mcg), which will help lower the level of homocysteine in your blood.

Zinc is mighty tool for reducing plaque buildup in your blood vessels. While it’s present in foods such as red meat, fish, and oysters, I recommend you take 30-60 daily as a supplement.

And you can reduce you CRP levels with L-arginine, Folic Acid, Taurine, Vitamin E and Vitamin C.

Finally, take 100mg of CoQ10 everyday for overall heart health. In one study, approximately 87% of the patients had significant improvement for their various cardiac problems with CoQ10 therapy.9

Exercise the Smart Way

You’ll be happy to know you don’t have to exercise for a long period of time to keep your heart pumping vigorously. In fact, endurance exercising makes your heart smaller and reduces the capacity of your heart to respond quickly to sudden demands on it.

What you need to focus on is short-duration exercise that alternates between intensity and rest. 20 minutes every other day is good. When you first start training, it will take you time to build up your conditioning. Once you get in better shape, you can start taking breaks in between bursts of intensity.

When you begin short-duration training, start with 10 minutes of exercise, followed by 5 minutes rest, then other 10 minutes of exercise.  You can then gradually reduce the amount of time exercising into smaller units, until you are exercising for five minutes or less at a time, with two-minute intervals in between bursts.

Any kind of exercise that gets your heart and lungs going will do, be it biking, running, dancing, or working out on elliptical machines. As long as you keep making the exercise more challenging, your heart will keep expanding its capacity.

Recognizing Trouble is the Key to Survival

Taking care of your heart isn’t just a matter of prevention. If, God forbid, you ever suspect you might be in danger of having a heart attack, getting help can make a huge difference. Be aware signs of heart trouble, which don’t always involve the abrupt pain you might have seen in the movies or on TV.

If you feel any of the following for five minutes or longer, get help quickly by calling 911

• Shortness of breath


• Uncomfortable pressure in your chest


• Discomfort in the arms, back, neck, jaw, or stomach


• Nausea, especially when accompanied by vomiting


• Lightheadedness


• Cold sweats 10

Also, keep in mind that women are more prone than men to experience dizziness, nausea, and anxiety as symptoms of a heart attack.11

Keep Your Smile Brightly for a Healthy Heart

You’re old enough that I don’t have to tell you to brush your teeth, or not to smoke. Smoking is widely known as a major risk factor in heart disease. But did you know that gum disease affects your circulation, and that infrequent brushing can lead to plaque build up in your arteries? Have a heart and be sure to brush and floss twice a day.

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1 “Heart Breakers: Heart disease and women.” abclocal.go.com/wls/story, February 19, 2008.

2 “Go Red For Women Day Is Feb. 15.” chfs.ky.gov/news/chfs021405b.htm, February 15, 2005.

3 “What Is the Heart Truth?” www.nhlbi.nih.gov, accessed April 29, 2008.

4 Obesity is the Cause of Most U.S. Liver Damage: Risk of Disease Fourfold Higher in Obese. Mitchel L. Zoler. Family Practice News. July 1, 2004.

5 “In Heart Disease, the Focus Shifts to Women,” www.nytimes.com, 4/18/06.

6 “High Blood Sugar boosts Women’s Heart Disease Risk,” www.forbes.com, 1/21/08.

7 “Outcomes in Cardiopulmonary Rehabilitation, Scoring the Duke Activity Status Index,” cardiosource.com, accessed April 29, 2008.

8 “Guide to a Healthy Heart, Improve Your Cholesterol Levels&rdquo

www.consumerreports.org, accessed April 29, 2008.

9 Gordon, et. al. High-density lipoprotein as a protective factor against coronary heart disease. The Framingham Study Am J Med 1997 May; 62(5); 707-714

10 “What Are the Warning Signs of a Heart Attack?” www.nhlbi.nih.gov, accessed April 29, 2008.

11 “Symptoms of Heart Attack in Women.” womenshealth.about.com/cs/heartdisease/a/sympofheartatta.htm, accessed May 16, 2008.

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Keep an eye out for your next issue of Health Confidential and...

• Discover Natural Alternatives to Infertility Treatments...
• A New Anti-Aging Breakthrough...
• PACE and Your Heart Rate...

 

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