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3/6/2025

Shedding Light on Vitamin D Deficiency

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In the hustle and bustle of modern life, it's easy to overlook the importance of maintaining a well-balanced diet and getting adequate sunlight exposure. One crucial element that often flies under the radar is vitamin D. Known as the "sunshine vitamin," vitamin D plays a pivotal role in our overall health and well-being. Unfortunately, a growing number of individuals are falling prey to vitamin D deficiency, a silent epidemic with potentially serious consequences.

Vitamin D is a fat-soluble vitamin that is unique in its ability to be synthesized by the body when exposed to sunlight. It is not only essential for maintaining healthy bones and teeth by aiding in calcium absorption but also plays a crucial role in supporting immune function, regulating mood, and promoting overall cardiovascular health.
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Causes of Vitamin D Deficiency:
  • Inadequate Sun Exposure: Modern lifestyles, characterized by increased indoor activities and the widespread use of sunscreen, contribute to inadequate sun exposure
  • Dietary Influences: A diet lacking in vitamin D-rich foods such as fatty fish (salmon, mackerel), mushrooms, and egg yolks.
  • Geographic Location: Individuals living in regions with limited sunlight during certain seasons.
  • Skin Pigmentation: People with darker skin tones have higher melanin levels, which can reduce the skin's ability to produce vitamin D in response to sunlight.
  • Age: Older adults may have reduced skin thickness and kidney function, affecting their ability to synthesize and convert vitamin D efficiently.
  • Inflammation: Living with higher levels of inflammation seems to deplete vitamin D levels. I often see a link between high levels of CRP (a marker of inflammation in the blood and low vitamin D). 
  • Mold Toxicity: Mold exposure and resulting illness can lead to reduced ability to absorb vitamin D leading to deficiencies. 

List of Conditions That May Be Improved by Optimizing Vitamin D. 
This list is not exhaustive but encompasses researched conditions that may see improvement through the optimization of Vitamin D levels
  • Skin - Eczema, Urticaria, Psoriasis
  • Recurrent Ear Infections
  • Improved Immune Health in General
  • Cardiovascular Disease - Hypertension, Congestive Heart Failure
  • Respiratory Conditions - Asthma, COPD
  • Autoimmune Conditions - Multiple Sclerosis, Rheumatoid Arthritis, Lupus, Hashimoto’s
  • Diabetes
  • IBS/IBD - Crohn’s Disease, Ulcerative Colitis
  • Mental Health - Depression, Anxiety
  • Insomnia 
  • Fibromyalgia - In general there is increased pain sensitivity when vitamin D is low! 
  • Recurrent vaginitis
  • PMS
  • Fertility
  • Kidney Disease
  • Reduced risk of Cancer 

Finding the Sweet Spot - Dosing and Testing 
  • At this time, I find ideal blood levels around 50-75. 
  • Finding the right dosing seems to be very individual. It is best to have a blood test to determine your need. 
  • Blood tests are not perfect, but they are the best tool I know of currently to get an estimation of where you are at. 
  • The blood test needs to be repeated once you have started supplementing to see how that dose is affecting you. I am frequently surprised to see people needing higher or lower dosing. 
  • One size DOES NOT fit all.
  • It is possible to take too much. If you are taking higher dosing (over 5,000 IU daily) you should be retesting at least yearly
  • The research around high dosing 1-2 times a week is not as favorable as taking regular daily dosing. 
  • Vitamin D levels vary during the day. It is best to test at the same time when retesting. 
  • Vitamin D levels go down during illness. 
  • As much as I would like to believe it is true, I do not often see people’s vitamin D levels going up in the summer. I find people still need to supplement year round most of the time. 

Final Thoughts From The Doctor:
My patients consistently report, they have a better mood or better energy when their vitamin D levels are optimized. Sometimes, I feel patients need a loading dose to get their levels up and then need to back off on the dosing. I find my patients rarely have symptoms from having too high of levels. This means retesting is the best way to monitor. I encourage you to get your levels tested and monitor them yearly. 

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2/14/2024

Nurturing Your Inner Ecosystem:A Guide to Supporting the Microbiome

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​Our microbiome lives in us and on us. It is a complex community of bacteria, viruses, yeast, and more. (Yes, even yeast in small amounts can be normal living in us!) The makeup of this community plays a vital role in our overall health and well-being. Just as ecosystems in nature require nurturing to flourish, our inner ecosystem – the microbiome – also needs proper support to maintain balance.


Why Supporting the Microbiome Matters
  • Digestive Health: The gut microbiome aids in breaking down carbohydrates, producing enzymes necessary for digestion, and supporting the absorption of nutrients. A balanced microbiome promotes regular bowel movements and reduces the risk of gastrointestinal complaints.
  • Immune Health: A significant portion of the immune system is situated in the gut. A diverse and well-balanced microbiome helps train the immune system to respond appropriately to potential threats, reducing the risk of autoimmune disorders and allergies.
  • Mood and Mind: The gut-brain connection highlights the microbiome's impact on mental health. Certain gut bacteria produce neurotransmitters like serotonin, often referred to as the "feel-good" hormone. An imbalanced microbiome has been linked to mood disorders and cognitive issues.
  • Weight Management: Surprisingly, the microbiome can influence weight regulation. Studies have shown that certain types of bacteria are associated with obesity and weight loss, suggesting a link between the composition of the microbiome and metabolism.

Nurturing Your Microbiome: Practical Tips
  • Diet Diversity: The current goal is 30 different plant based foods a week. This includes vegetables, fruits, spices, nuts & seeds, and legumes. 
  • Probiotic Foods: Incorporate probiotic-rich foods like yogurt, kefir, sauerkraut, kimchi, and kombucha into your diet. These foods introduce live beneficial bacteria into your gut, promoting a healthy balance. (Note: yogurt and kefir can be problematic with dairy sensitivities.).
  • Prebiotic Foods: Increase prebiotic rich foods like spices, garlic, onions, leeks, asparagus, bananas, oats, lentils, chickpeas, and other legumes, shiitake mushrooms, apples, flaxseeds, and seaweed.
  • Limit Medications: We now know that even non-antibiotic medications can have an impact on your microbiome. While medications can be essential, they can also disrupt the balance of your community. If you are taking antibiotics yearly, this is too much and means there is a more serious underlying problem that needs to be addressed. Other common over-the-counter medications that can impact gut health include NSAIDs (tylenol, ibuprofen, aleve, etc), PPIs (omeprazole, protonix, nexium, etc), H2 blockers (pepcid, zantac, etc), and sleep medications.
  • Reduce Stress: Chronic stress can negatively impact the microbiome. Engage in stress-reduction practices such as meditation, yoga, deep breathing, or spending time in nature.
  • Adequate Sleep: Prioritize quality sleep, as sleep disturbances can affect the composition of the microbiome. Aim for 7-9 hours of uninterrupted sleep per night.
  • Stay Hydrated: Drinking enough water supports digestion and helps maintain a healthy environment for your gut bacteria to thrive. Limit coffee and alcohol - high amounts can both have potential negative impacts.
  • Limit Processed Foods and Sugar: High-sugar and heavily processed foods can negatively affect the balance of the microbiome. Opt for whole, nutrient-dense foods instead. Preservatives are designed to prevent the growth of microorganisms in foods, so it makes sense that they would have a negative impact on our internal ecosystem.
  • Stay Active: Regular physical activity has been linked to a more diverse and healthier microbiome. Aim for at least 150 minutes of moderate exercise per week.
  • Eat Organic: Pesticides can kill good bacteria. Use the environmental working group’s yearly updated dirty dozen and clean 15 to help you prioritize how to spend your money at the store. 

​How do I know how healthy my microbiome is?
If you have ever had a visit at Rooted Family Medicine you have heard Dr. Ariel talk about the happy pooping box! This is a great tool to help decide if your gut is in order. 
The happy pooping box:
  • Bowel movements are daily, 1-3 times a day. Probably not more than that and definitely no less.
  • There are no days without bowel movements.
  • Stools are formed, easy to pass, not urgent,  there is no straining or need to wipe excessively. There is no mucus, blood, or undigested food (except corn :). No vomiting.
  • No symptoms of gas, bloating, bad breath or burping. 
  • No symptoms of acid reflux or excessive post nasal drip. 
  • No increase in fatigue after meals.
Anything outside of these parameters is a flag from the body telling us that there is a problem. It doesn’t tell us what the problem is, only that it is present. Consider finding your own local ND if your microbiome is telling you it’s unhappy. ​

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5/31/2023

Thyroid Testing 101

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Many women come into my office wondering if they have hypothyroidism. Here I have included common symptoms and my favorite lab tests to assess thyroid.

This is a starting guide and with all health problems, individual assessment is important and essential for quality care. 

HYPOTHYROID (most common thyroid problem)
Symptoms include:
  • Constipation
  • Fatigue
  • Difficulty losing weight
  • Dry skin
  • Sleep disruption
  • Hair changes (thinning)
  • Generalized weakness
  • Cold intolerance
  • Slow Heart Rate 
  • Poor concentration.
  • Irregular menstrual cycles - infertility
  • Depression

HYPERTHYROID (less common thyroid problem)
Symptoms include:
  • Heart racing
  • Tremors
  • Weight loss 
  • Diarrhea or just going more frequently
  • Nervousness
  • Heat Intolerance
  • Sweating
  • Exophthalmos (Bulging eye)

​Dr. Ariel's Favorite Testing to Assess Thyroid Function (with Ideal Ranges):
  • TSH - (0.5-2) - The messenger that comes from the brain to the thyroid. This is the most common test that is run. 
  • Free T4 (1-1.5) - Hormone that comes from the thyroid. 
  • Free T3 (3-3.8) - Hormone that comes from the thyroid. 
  • Thyroid Peroxidase Antibody (TPO) (<30) - a marker of autoimmune disease
  • Thyroglobulin Antibody (TG) (<30) - a marker of autoimmune disease
  • Reverse T3 (<13-15) - I don't always run this test but it can give more information if there is difficulties getting the TSH within range. 

What if all your thyroid tests are normal but you still feel like you have hypothyroid symptoms? Then a proper naturopathic assessment is needed of the below areas:
  • Digestive Function
  • Adrenal Health
  • Nutrient Status (including iron, B vitamins, and vitamin D)
  • Chronic Infections

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3/11/2021

Acid Reflux Realities

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What if I told you acid reflux actually can be related to low stomach acid?!

Many of us have been led to believe that acid reflux is a condition of too much stomach acid. I actually treat it regularly as a condition of not enough stomach acid. Let me explain. Generally the stomach desires to be a place of high acidity. It’s meant to be that way! When there is proper acidity levels, the acid works to break down your food, so it can be assimilated in your lower digestive tract.

When there are proper levels of acid in the stomach, the acid comes up and touches the lower esophageal sphincter (the gateway between the esophagus and the stomach). When acid touches the sphincter, it automatically closes. If there is not enough acid in the stomach, the sphincter doesn’t close all the way and this creates many acid reflux symptoms. There is a small subset of folks who do have too much stomach acid, but this is less common. 

While proton pump inhibitors (like Prilosec, Nexium, and Protonix) and acid reducers (like Tums and Rolaids) can help reduce the symptoms of acid reflux, very rarely do they treat the root of the problem. Therefore requiring the patient to need to keep using them to manage the symptoms.
I treat acid reflux successfully in my practice often. Let’s start with the basics. There are certain foods and beverages that can irritate the digestive system. Common trigger foods include: Coffee, Chocolate, Refined Carbohydrates, Tomatoes, Oranges, Pop (soda), Alcohol, and Peppermint. Eating a lot of food before bed can also be problematic. 

I often tell my patients to pay attention to the list above. It does not necessarily mean that you are sensitive to everything or you can never eat it again. Only it is worthwhile to pay attention to how you feel when you ingest these foods/drinks.

It’s also important to be conscious of how you are eating. Eating in a stressed environment (i.e. behind your desk frantically typing emails or while driving) can cause blood to go to your muscles. While, eating in a relaxed environment causes blood to shunt to the abdomen to help with digestion. It is also important to chew your food properly to help break it down.

When working with patients with suspected low stomach acid, I have common treatments that I have found to be helpful. First, I like to calm the inflammation and assist the digestive process. I often do this with some version of digestive enzymes and demulcent herbs. Demulcent herbs have a mucusy like function that coats the esophagus and stomach lining. Next, I like to stimulate acid production. This can be done with using some form of bitters. 

When thinking of bitters, I like to think back to when we started meals with a dark green leafy salad. This bitter salad was often served before the meal to help stimulate your stomach in the production of acid. Bitters can be used in a variety of ways, through bitter foods, drinks, or tinctures. I often like to use a combination of bitter herbs that is made to be more palatable. Some people will use apple cider vinegar or small amounts of lemon or lime juice. Note: some people with excessive yeast issues, can have issues with apple cider vinegar. The taste of the bitterness on the tongue is part of what stimulates the acid production. 

I usually have people do these two treatments regularly with each of their meals. Using this protocol, I have weaned many patients off of proton pump inhibitors and regular use of Tums or Rolaids. The great news is they don’t have to continue this protocol forever. 

Of course this protocol does not work for everyone. Nothing in medicine is that simple! I often say that this protocol works well for about 80% of my patients. The other 20% have a different problem that needs to be addressed first. Variables of this problem could include a hiatal hernia, digestive microbiome imbalances, and a common condition called SIBO. Further testing can help identify the path for the individual. 
​

Please locate a trained naturopathic doctor to guide you through this process, as not everyone is able to do it at the same pace.

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8/7/2020

Is my anxiety really an anemia?

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After six years in practice, I’m still continuously surprised by how many women are anemic. This is important because anemia can cause symptoms of depression and anxiety. There are multiple forms of anemias including iron deficiency anemia and vitamin B12 and Folate deficiency anemia. Women have a higher tendency towards iron deficiency anemia because of blood loss during menstrual periods. “But I’ve been checked”, you might say, “my hemoglobin was normal.” Many conventional care practitioners are only looking at a hemoglobin level to check for an iron deficiency anemia. While this is a valuable test, I find a ferritin to be more indicative of quality-of-life in my patients. I prefer a hemoglobin to be in the range of 13.5 to 14.5 and a ferritin in the range of 50 to 100 in menstruating women. Any ferritin under 30, I consider to be anemic. Anything under 20, I consider an "under the floor" functioning level.

Common signs of iron deficiency anemia  include:
  • Headaches
  • Depression
  • Anxiety
  • Sensitivity to cold / cold hands and feet
  • Desire to chew ice
  • Short attention span
  • Brain Fog
  • Fatigue
  • Heavy periods - (Bonus! - Improving iron status can make periods less heavy! Score!)
  • Dizziness
  • Restless leg syndrome
  • Heart palpitations
  • Shortness of breath
  • Hair loss (Ferritin should be >75 for optimal hair maintenance) 
​
If an iron deficiency is discovered, it’s important to note that the next step is not to just supplement iron. I prefer to ask WHY. Why are you anemic? My starting list to investigate usually includes: heavy menstrual periods, a vegetarian diet or a diet low in high iron foods, celiac disease or gluten sensitivity, digestive issues (constipation, diarrhea, abdominal pain), and/or chronic infections. It is possible to have multiple issues contributing at once. Supplementing iron should always be done with care. It is possible to supplement too much iron. I like to monitor ferritin and other iron markers while treating with iron and getting to the root cause of the issue. Talk to your doctor to see if checking for an anemia could help you. 

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9/18/2015

I Love My ND Video Contest

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In celebration of Naturopathic Medicine Week (October 5-11) we are running a video contest for the patients of naturopathic doctors. You get a chance to make a quick video and let the world know why you love your ND! One submission will be randomly chosen as our winner to receive a complimentary 60 minute craniosacral with the one and only Dr. Ariel.

How to enter:
1.     Create a 30 second video that highlights why you love your ND or how Naturopathic Medicine has helped you. 
2.     Upload your video to YouTube
3.     Email [email protected] with a link to your video
4.     Sit back and wait to hear if you have won! 
5.     Submission deadline is October 1st by 5pm and the winner will be announced via social media on October 2nd.

Your video will likely end up on our social media and website and will eventually make it to the website for the Minnesota Association of Naturopathic Physicians. 

Thank you for doing your part to help raise awareness for this important health care option. 

To get started uploading videos on YouTube from your desktop, follow the steps below:
1.     Sign into YouTube (they now use your google account)
2.    Click the Upload button at the top of the page.
3.    Before you start uploading the video you can chose the video privacy settings, make sure your video is set to “public”.
4.    Select the video you'd like to upload from your computer. 
5.    Click Publish to finish uploading a public video to YouTube. 
6.    Once the upload is completed YouTube will send you an email to notify you that your video is done uploading and processing. Simply forward this to r[email protected]

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2/21/2015

Dr. Ariel's Tips for Beating the Common Cold

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  1. Avoid sugar, dairy, fruit and simple carbohydrates. These all break down to simple sugars and provide food for bacteria, making it harder for you immune system to clean up the bugs. If you are experiencing congestion, you may also want to avoid citrus as it contributes to mucus production. 
  2. Eat vegetable soup. This is the easiest for you body to break down and provides the best nutrients for your immune system.
  3. Try warming socks! See a handout on how to do here. It's best to do this before bed. The alternating hot and cold stimulates your immune system and helps you breathe at night. 
  4. Rest. We often think "I'm not that sick" and we continue on with our normal routine. This prolongs our cold because we don't give our immune system time to respond and clear up bad guys. 
  5. Hydration. Water is the best tool that we have to break up mucus.
  6. Avoid using over the counter treatments to decrease symptoms. While these can reduce your symptoms they will often make the cold last longer. The symptoms you experience are actually your body trying to beat the cold. 
  7. Alternating hot and cold. Hydrotherapy (use of water for treatment) is an excellent way to get our immune system working! Try alternating hot and cold treatments to your throat or sinuses. My favorite method involves two washcloths, a medium sized bowl, water, and ice. Fill your bowl or bucket with ice water and put one of the washcloths in there. Warm the other washcloth under hot water from the sink. Apply the warm washcloth until it cools off then remove it. Apply the cold cloth until it warms up. Do this process 3 times ending with the cold cloth. 
  8. Supplements. Probiotics, vitamin D, and herbal supplements can be very helpful during times of illness. This is where a visit to your naturopathic doctor (ND) can be very helpful as we can guide you through which supplements will be the most helpful for you.
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9/17/2014

Herbal Book Resource List

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As requested from a recent medicinal herb walk, here is a list of some of my favorite herb books and authors. 
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Medicinal Plant Books:
  • Edible & Medicinal Wild Plants of the Midwest by Matthew Alfs - good local info on using herbs as medicine and  food, very well referenced. 
  • Herbal Medicine from the Heart of the Earth by Sharol Tilgner - excellent resource for medicinal aspects of plants and combinations for particular ailments. 
  • The Herbal Medicine Maker's Handbook by James Green - good for how to "make medicine" from tinctures to salves. Not the best for medicinal aspects of plants themselves. 
  • The Book of Herbal Wisdom: Using Plants as Medicine by Matthew Wood - Amazing prospective on herbal medicine from a well known and respected herbalist. Any other book by Matthew Wood would also be good. 
  • Edible and Medicinal Plants of the West by Gregory L. Tilford - Although this book is based out of the West many of the plants are here in the Midwest as well. I started learning herbs with this book and love it for that use. Good pictures and easy quick information. 
  • Botanica Poetica by Sylvia Seroussi Chatroux - Fun poetry book to learn herbs in an artsy sort of way. 
  • Dandelion Hunter by Rebecca Lerner - A novel about living off the land in an urban setting with medicinal tips. Fun read if you are into herbs. I also like her website and blog firstways.com
Other general book recommendations regarding plants and nature:
  • If you are looking to get into more information about edible wild plants check out the author Samuel Thayer
  • Get as many identification books as you can to compare from multiple sources
  • Check out Last Child in the Woods by Richard Louv on how to save our children from nature deficit disorder!

Of course this is just a short list of my favorites and I am always finding more. If you have a favorite list it in the comments below!

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2/11/2014

Sleep like a Baby...

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PictureImage provided by photographer Destiny Skubis
Let's talk sleep hygiene. If you have never heard this term before, let me introduce you. Just as we need proper body hygiene to prevent illness and promote health, we can also look at our sleep habits to make sure they are setting us up for optimal health during the day. During sleep our brains process the events of the day and cement memories as well as clean out thoughts we don't need anymore. Support your sleep and your brain by adopting these habits below.
  • Consider the time you head to bed. Every hour of sleep you get before midnight is worth twice the quality of sleep after midnight. 
  • Turn off all electronics at least 1 hour before bed. This means television, computer, and cellphones. Electronics are very stimulating to the brain and make it difficult to get to sleep.  
  • Sleep in a dark room. Our brains start to produce melatonin, which promotes sleep, when they are exposed to less light. Start by dimming the lights in your room 1 hour before bed then sleep in complete darkness. 
  • Create a nighttime ritual or routine. Our bodies and minds are comforted by patterns. Remind your mind that it is time for bed by starting a bedtime routine. Some ideas include: a warm bath, meditation, progressive muscle relaxation, or light yoga (click here for a 5 minute bedtime routine). Reading can also be good if it is not too stimulating or not on an electronic device. 
  • Mild to moderate exercise during the day. This helps promote restful sleep at night. 
  • Optimal sleep is 7-8 hours a night, more for growing children. Read more about how optimal sleep time and room temperatures can affect weight loss here. 

If you are still having trouble falling asleep and maintaining sleep see your healthcare provider for further support. Naturopathic medicine has supportive therapies that can assist you in your change to healthy sleep patterns. 

This is a short summary for more a very detailed blog with more information check out:
  • Precision Nutrition - Hacking Sleep

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11/11/2013

Recipe: Kale Chips

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Once you try them you'll never go back. Kale chips might just become your new favorite snack. 
Don't worry, you won't have to feel bad about this addicting treat - because it's good for you!
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Kale is high in many great nutrients like vitamins A, C, and K, calcium, and manganese.
 It's anti-inflammatory and anti-carcinogenic! 


Many studies have now shown that food sources of nutrients are better than supplements. Check out the two articles below to read more information about this.

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Recipe: 
Adapted from other recipes and a personal obsession with making Kale Chips

Ingredients:
1 Bunch of Kale
1-2 Tbsp of Olive Oil (depending on amount of kale used)
Salt to taste

1. Preheat the oven to 350 degrees.
2. Rip or cut your kale into bite size pieces. 
3. Toss the kale, olive oil, and salt to taste in a bowel. 
4. Spread the kale out in one layer on a baking sheet. 
5. Bake for 5-8 minutes or until cripsy. 
6. ENJOY THE DELICIOUSNESS

This recipe can also be adapted and made with Brussels sprouts! 

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Resources:
About the wonders of kale:
  • World's Healthiest Foods - A great resource for food/nutrient information


Articles on food as best nutrient sources:
  • Skip the calcium pills, opt for kale and dairy, study
  • Food best source of vitamins, study finds

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