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There are some, studies, in addition to the ones you noted above, which are small, but pretty well done.

Effect of a Low-Fat Vegan Diet on Body Weight, Insulin Sensitivity, Postprandial Metabolism, and Intramyocellular and Hepatocellular Lipid Levels in Overweight Adults
 

Question  What are the effects of a low-fat vegan diet on body weight, insulin resistance, postprandial metabolism, and intramyocellular and hepatocellular lipid levels in overweight adults?

Findings  In this 16-week randomized clinical trial, a low-fat plant-based dietary intervention reduced body weight by reducing energy intake and increasing postprandial metabolism, which was associated with reductions in hepatocellular and intramyocellular fat and increased insulin sensitivity.

Meaning  A low-fat plant-based diet is an effective tool for reducing body weight and increasing insulin sensitivity and postprandial metabolism.

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Ron, maybe that article has been already discussed elsewhere, the groups have not been taken at an isocaloric level, so the lesser amount of energy in the intervention group maybe enough by itself  to explain weightloss and increased insulin sensitivity.

Also, the control group made no change from its former diet, which may have been unhealthy, besides the population was overweight. The dietary intake was self-reported, which allows a potential large error, possibly jeopardizing the conclusions.

Also, the study did not report fasting glucose and HA1C changes. Some people, like myself, have pretty high fasting glucose but low postprandial peaks, whereas others have the opposite. I agree that insuline levels are probably a better parameter for healtspan and longevity but we cannot compare them directly to blood sugar measurements.

 

So, did the lowfat diet increase insulin sensitivity because of it decreased energy intake  hence decreased hepatocellular and IM lipids, or because of the effects of decreased lipids, or both? Would it work in healthy, exercising, food-conscious guys like the members of this forum?

And it would be interesting to conduct a controlled trial on blood sugar and insulin changes in isocaloric, healthy diets, with one control arm, one VLF arm, one high fat-low carb arm .

 

 

 

Quote

The study also has limitations. Self-reports of dietary intake have well-known limitations.44 However, it is reassuring that the reported diet changes were paralleled by changes in weight and plasma lipid levels. Health-conscious participants may not be representative of the general population but may be representative of a clinical population seeking help for weight problems or type 2 diabetes. We followed the participants for 16 weeks and were not able to estimate the effects of the diet over a longer period. In addition, the study design did not allow separation of the specific effects of the low-fat vegan diet from the weight loss it causes.

Conclusions

This randomized clinical trial found that a low-fat plant-based dietary intervention reduces body weight by reducing energy intake and increasing postprandial metabolism, apparently owing to increased insulin sensitivity resulting from reduced hepatocellular and intramyocellular fat. This intervention may be an effective treatment for overweight adults.

 

Edited by mccoy

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On 3/25/2021 at 5:54 PM, mccoy said:

And it would be interesting to conduct a controlled trial on blood sugar and insulin changes in isocaloric, healthy diets, with one control arm, one VLF arm, one high fat-low carb arm .

Mccoy,

Dr. Greger's latest video discusses a study [1] that is close to fitting your description. One of the authors happened to be our good friend Luigi Fontana (the study was done in Italy).

They locked up 50 diabetics in two hotels, randomly assigning 25 in one hotel to a high-carb, low-fat "macrobiotic diet" with a nutrient ratio of 72C/18F/10P or a healthy high(er) fat diet control with a nutrient ratio of 50C/30F/20P. Both diets looked pretty healthy. The macrobiotic diet was vegan and heavy in whole grains and legumes while the control diet had some meat/fish/dairy and got a lot of calories from extra virgin olive oil (since the study was done in Italy, so presumably the EVOO was pretty good quality, for those of you who think that makes a difference). Both diets were pretty high in vegetables, at least relative to what most people eat.

Here is a sample day from the macrobiotic diet:

Screenshot_20210423-134727_Word.jpg 

and here is a sample day from the control diet:

Screenshot_20210423-134800_Word.jpg

After three weeks on each diet, the high-carb macrobiotic group did a lot better in terms of a number of markers of health, including fasting and postparandial blood glucose, HbA1C and insulin resistance as well as LDL and total cholesterol. Who says you need to sacrifice glucose control to get good cholesterol numbers, and visa versa?

Here is the table of results on the different metrics both at baseline and after 21 days on each diet:

20210423_140637.jpg

Of course, the high-carb, low-fat macrobiotic group lost more weight than the higher-fat control group, which could explain some of the difference. But you asked for an isocaloric dietary comparison, so there you have it.

--Dean

---------------

[1]  Nutr Metab (Lond). 2014 Aug 25;11:39. doi: 10.1186/1743-7075-11-39. eCollection 

2014.

The effect of the macrobiotic Ma-Pi 2 diet vs. the recommended diet in the 
management of type 2 diabetes: the randomized controlled MADIAB trial.

Soare A(1), Khazrai YM(1), Del Toro R(1), Roncella E(1), Fontana L(2), Fallucca 
S(1), Angeletti S(3), Formisano V(1), Capata F(1), Ruiz V(4), Porrata C(5), 
Skrami E(6), Gesuita R(6), Manfrini S(1), Fallucca F(7), Pianesi M(8), Pozzilli 
P(1).

Author information:
(1)Department of Endocrinology and Diabetes, University Campus Bio-Medico, Via 
Alvaro del Portillo 21, 00128 Rome, Italy.B

BACKGROUND: Diet is an important component of type 2 diabetes therapy. Low 

adherence to current therapeutic diets points out to the need for alternative 
dietary approaches. This study evaluated the effect of a different dietary 
approach, the macrobiotic Ma-Pi 2 diet, and compared it with standard diets 
recommended for patients with type 2 diabetes.
METHODS: A randomized, controlled, open-label, 21-day trial was undertaken in 
patients with type 2 diabetes
comparing the Ma-Pi 2 diet with standard (control) 
diet recommended by professional societies for treatment of type 2 diabetes. 
Changes in fasting blood glucose (FBG) and post-prandial blood glucose (PPBG) 
were primary outcomes. HbA1c, insulin resistance (IR), lipid panel and 
anthropometrics were secondary outcomes.
RESULTS: After correcting for age, gender, BMI at baseline, and physical 
activity, there was a significantly greater reduction in the primary outcomes 
FBG (95% CI: 1.79; 13.46) and PPBG (95% CI: 5.39; 31.44
) in those patients 
receiving the Ma-Pi 2 diet compared with those receiving the control diet. 
Statistically significantly greater reductions in the secondary outcomes, HbA1c 
(95% CI: 1.28; 5.46), insulin resistance, total cholesterol, LDL cholesterol and 
LDL/HDL ratio, BMI, body weight, waist and hip circumference were also found in 
the Ma-Pi 2 diet group compared with the control diet group
. The latter group 
had a significantly greater reduction of triglycerides compared with the Ma-Pi 2 
diet group.
CONCLUSIONS: Intervention with a short-term Ma-Pi 2 diet resulted in 
significantly greater improvements in metabolic control in patients with type 2 
diabetes compared with intervention with standard diets recommended for these 
patients.
TRIAL REGISTRATION: Current Controlled Trials ISRCTN10467793.

DOI: 10.1186/1743-7075-11-39
PMCID: PMC4190933
PMID: 25302069

 

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Nice find Dean.

I love Luigi's work and appreciated the reference. This particular diet does not narrowly focus on the matter of %fat macros. Other reasonable and valuable conclusions can be made however.

First, as you noted, the differences in weight can account for the results.  The weight loss observed in the macro diet does however dispel the myth that high carbohydrate diets can't lead to high compliance weight loss and improvement in biomarkers in out of control diabetics. It would be easy to stop there but I think it is worth looking at other differences.

The authors indeed compared "macrobiotic Ma-Pi 2 diet" vs. the "recommended diet."  If this was indeed the recommended diet, yes it absolutely stinks. Sure it has whole grains and fruit, etc. but the high meat (veal specifically) content and associated high saturated fat content with the particular meat/cheese selection have well-established relationships (at certain doses) with insulin resistance, elevated LDL, and metabolic dysfunction all variables equal. Even the carbohydrates selected in the control group (notwithstanding that they had less carbohydrate overall) including substantial whole wheat is associated with a high glycemic index (though whole wheat is not quite as bad as refined - exceptions apply such as sourdough), and even worse for the breakfast whole wheat crispbread.  By contrast the macro diet was quite lovely: though it had a little brown rice (high GI but reasonable portions) and most of the carbs came from low GI millet, millet balls, barley, legumes and and assortment of high fiber starchy below ground & "chunky" whole vegetables. Yum.

It is an interesting study and thank you Dean for bringing attention to it. The author title conclusions focusing an macro vs. that version of recommended was appropriate. But to make further inferences regarding what aspects of the differences accounted for the observations requires additional study and indeed is the focus of ongoing investigation.

But reasonable, more narrow conclusion can be made:

1) Macro diet is superior to diet the standard diet for the biomarkers in question &

2) Macro diet (including the associated whole foods based starchy vegetables) implemented as they did is compatible with and may result significant improvement in a population of out-of-control diabetics.

Would you agree?

 

  

Edited by Mechanism

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2 minutes ago, Mechanism said:

Would you agree?

Hey Mechanism. Nice to hear from you! You're not going to come through and delete this post like you have so many of your other ones, are you? I was sad when I saw all the holes in the threads you've contributed to over the years.

As to your question, yes, I think that pretty much sums it up. Certainly the control diet was far from perfect. But as control, higher fat diets go, it was better than most. And the fact that they housed the study participants for the duration of the study, prepared all meals for them, supervised their eating and threw them out of the study if they let more than 5% of the food they were allotted go to waste, makes it one of the most controlled diet comparison studies I've ever seen.

--Dean

 

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Regarding the deletion of my content- My motivation at the time was primarily to prevent potential harm from poor information rendered prior to my getting up-to-speed on the health & CR literature. I really was quite naive and it took years to get reasonably up to speed. I don't remember the details but I think I came across an old post that was off the mark and my instinct was to "do no harm" and it was simply easier at the time to systematically purge my posts to create a clean slate following achieved nutritional competency than to screen all the hundreds of posts individually.

Though the intention behind it was good (I figured my comments were dated and of so-so quality at best up to that point anyway, so what good would even my better comments be in this vibrant community with new updated information coming every day), I should have given the decision more thought than I did at the time.  I had not realized it would have adversely affected the group like it apparently did, but I should have. That was a major oversight and poor judgement on my part. I'm sorry and extend my sincere apology to everyone here who was affected.  If it makes any difference, I'm also happy to put in my 2 cents on a subject previously discussed if it helps.

There is no comparison of course Dean, but I am curious what went in your own semi-departure and then return? I realize removing your personal labs ( which I never shared) is very different. Moreover if frustration over the potential risks of deep CR & overappraisal of its benefits played some role in your leaving (based on your posts), how then did you decide to re-engage? I sense there is more to the story though entirely up to you what to share if that is the case. Was the break from the forum a good transition (you deliberately increased your BMI again about that time if memory serves), and if so, what do you get from the forum these days that brought you back? I find this forum is less about CR these days than our own unique conceptions of optimal health.  Michael's posts are direly missed (though to his credit all his old ones are still online!).

I agree with your 2nd set of comments re: the study. It was an interesting one and I wish there were more metabolic ward controlled feeding studies in persons these days.

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5 minutes ago, Mechanism said:

There is no comparison of course Dean, but I am curious what went in your own semi-departure and then return?

Off topic for this thread, but I'll answer here anyway.

To the best of my recollection I simply got bored and a bit burned out from all the posting sometime around late 2016. Maybe it was Trump's election that discouraged me about the future.

8 minutes ago, Mechanism said:

 (you deliberately increased your BMI again about that time if memory serves), and if so, what do you get from the forum these days that brought you back?

I don't think I increased my BMI much. I've always said I'd like to target 20-21, but other than around the time of my son's illness, I've never made it. I'm still hanging out around 19.

As to what brought me back, I'm not really that much back. I don't post anywhere near as much as I used to - only when I find something particularly interesting. But with a few exceptions, I like engaging with the smart and interesting few folks who still hang out here sometimes, although those numbers are dwindling and some seem to be going off the deep end... 

--Dean

 

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17 hours ago, Dean Pomerleau said:

To the best of my recollection I simply got bored and a bit burned out from all the posting sometime around late 2016. Maybe it was Trump's election that discouraged me about the future.

17 hours ago, Mechanism said:

 (you deliberately increased your BMI again about that time if memory serves), and if so, what do you get from the forum these days that brought you back?

I don't think I increased my BMI much. I've always said I'd like to target 20-21, but other than around the time of my son's illness, I've never made it. I'm still hanging out around 19.

As to what brought me back, I'm not really that much back. I don't post anywhere near as I ag as I used to - only when I find something particularly interesting. But with a few exceptions, I like engaging with the smart and interesting few folks who still hang out here sometimes, although those numbers are dwindling and some seem to be going off the deep end... 

Hi Dean!

As you know, our political views are very different.  But I don't let that put me into depression, when national politics don't go the way I wanted.  My overall view on politics is this:  We live in a democracy.  There are two major parties.  From time to time (frequently), the ruling party will change.  It would not be good if one of the two parties was always in control -- if that were the case, we'd be living under a government that resembles Communist China -- on the way to a loss of our freedoms.

About the List:  I basically agree with you -- the old mailing lists, and these forums, used to concerned primarily with Calorie Restriction -- but they aren't anymore.  It's become a miscellaneous rabble group.

And,  I agree with Mechanism, that I miss seeing more posts from Michael Rae, who is truly possibly the top CR practitioner on the List.

(I'm also disappointed in Khuram's anti-vax stand.)

  --  Saul

 

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48 minutes ago, Saul said:

But I don't let that put me into depression, when national politics don't go the way I wanted.  My overall view on politics is this:  We live in a democracy.  There are two major parties.  From time to time (frequently), the ruling party will change.  It would not be good if one of the two parties was always in control -- if that were the case, we'd be living under a government that resembles Communist China -- on the way to a loss of our freedoms.

I agree completely. I generally prefer a government divided, as the outcomes are often better for all of us. It's why separation of powers is at the foundation of democracy and why I am worried about some of the current political currents.

I also find that that for some on the Left politics is a religion-like defining characteristic, which transcends the usual philosophical underpinnings of political convictions and becomes an issue of morality, with "good" vs. "evil" seeping into the political discourse. It is at the root of "hate crimes" and the increasing acceptance of, and demands for, censorship. Since the 1970s, as abortion and gun rights were politicized, it has attracted single-issue voters to the Right, too.

But, back to nuts.

I have reduced my nut intake somewhat and my fat intake has dropped to about 22-25%. I'll see how it affects my next bloodwork panel. Nowhere near the 10% or so of the traditional Okinawan diet though.

But fat does appear to benefit the absorption of other nutrients. I was reminded of this by a video I saw last night, linked below. I'll probably limit my avocado intake to one a week and stick to a lower amount of nuts daily (I also get fat from flax, daily).
 


 

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Hi Ron!

I eat very few nuts daily -- a few pistachios, walnuts and sunflower seeds, and maybe two raw peanuts before bed.  But I eat half a Hass avocado as part of lunch.  These, and the 3ozs of raw salmon that I eat for dinner, constitute almost all of the lipid sources that I consume daily.

  --  Saul

Edited by Saul
spelling correction

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On 4/23/2021 at 8:14 PM, Dean Pomerleau said:

Of course, the high-carb, low-fat macrobiotic group lost more weight than the higher-fat control group, which could explain some of the difference. But you asked for an isocaloric dietary comparison, so there you have it.

--Dean

Thanks for the reference Dean, some of the results are really impressive and counterintuitive. I was almost convinced to start such a diet, when I looked up at the menu... 

That's a pretty rigid macrobiotic diet, lots of millet and other cereals at all times, relatively few vegetables, a few legumes,  a little sesame, no fruit, little else.  😥😰 

I might be convinced to try a Mcdougall-like diet with fruits, lots of vegetables and cereals, but the MA-PI diet is just terrible!! Hypolipidemic and hypoproteic and absolutely boring. Must try and input that into cronometer to see what comes out. I'm pretty sure I'd lose lots of weight with it, since I would develop food aversion.🤢

An interesting study though, I may develop my custom-tailored low-fat-hi carb regime and try it out.

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I have tried to verify the macrobiotic  high-carbs, VLF diet MAPI2  as outlined in the article quoted by Dean.

Now, there seem to be a few problems. According to cronometer, the diet would amount to about 1070 kcals, not 1900. Besides, there seem to be some  deficiencies in a few amminoacids and in many vitamins and minerals. This is clearly a diet which needs extensive supplementation and may be followed for a limited time.

One possible explanation is that the amounts of cereals reported are dry mass and not cooked. It is not specified though. I'm going to try this second possibility

 

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Now, if I substitute 250 grams of dry millet to 250 grams of cooked millet, I reach 1686 kcals. This is not certain, although, I'm going to assume that it explained some of the missing calories.

There continue to be some deficiencies though, such as lysin and a few vitamins and minerals (notably calcium, tocopherols and vitamin C), besides the obvious B12 deficiency of a vegan diet. Again, that's not a regimen which I believe can be safely carried out for a long time, unless a suitable supplementation is taken. It remains the issue of lysine deficiency.

image.png.6fbd1018eebede55fee409d56d99b75b.png

image.png.ff4e7f183164b4e65c8a5e4117a7c030.png

 

image.png.cf0acff0d65d219338e6c4deb547f4c3.png

image.png.1fe3fe7d37b0db44990a1acfb13d3695.png

 

 

 

Edited by mccoy

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McCoy,

I eat 12% fat, 15% protein and the rest is carbs. All nutrients are well over 100% excluding vitamin D and B12. Choline is a bit over 500mg so it is at around rda. I eat no animal food except for 1 cup of low-fat kefir. The rest is whole plant based. Lentils, peas, vegetables, fruits, oats, quinoi, chia, flax, walnuts, sunflower seeds, almonds, soy milk and natto. The seeds and nuts are pretty minimal. 2 tsp of sunflower, 2 walnut halves, 5 almonds, tsp of ground flax/chia. I eat a little of these high fat foods with each meal to insure absorption of fat soluble nutrients. Research I’ve looked at indicates very little fat is required to insure absorption of nutrients.

Edited by Mike41

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Mike, your diet sounds far more palatable than the macrobiotic diet posted above. I might survive with yours, I sure wouldn't with the macrobiotic one. A neurological issue, would cause me loss of appetite and eventually a quick drop in body weight and malnutrition, as I've experienced in the past.

The point in the article that VLF does not increase glycemia rather lowers it is made, but only by an experimentally very rigid diet, not a practical one.

Also, I wonder if you are experiencing the same almost miraculous effects touted in the article by a less rigorous, more varied VLF diet.

What I wonder about these diets, is how do you dress your vegetables. And what about cereals and legumes, how do you cook them without fats, the only way I can imagine is in their thick soup, made more palatable by vegetable extracts or salt and herbs and spices.

I read some more elaborated low-fat recipes, but I just don't have the time for that. Nor the patience. And, as I've written before, in Italy there are no fat substitutes for cooking.

From what I can remember, in my case decreasing fats has always resulted in the loss of body weight and adipose tissue, sometimes lean tissue as well.

Edited by mccoy

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On 4/26/2021 at 7:54 AM, mccoy said:

I substitute 250 grams of dry millet to 250 grams of cooked millet

Mccoy, what kind of millet do you use? I saw a video by Dr. Gregger and decided to try some organic Kodo millet. I ordered it a month ago, but didn't notice that it's coming over from India, so it's still not here. I was going to try Kodo first, then finger millet.

I dress my legumes with apple cider vinegar and nutritional yeast (and a bit of brewer's yeast).I place them on a bed of greens, with liberal use of spring or regular onions, hot peppers and a helping of Colavita diced or minced plain (no salt added) tomatoes, straight from Italy (in a 380g carton box). Spices, like cumin, nigella, paprika, amla, ashwaganda, turmeric, ginger, also help a lot. I've also started using fresh turmeric root.

Mike, your low-fat/low-protein diet is impressive. I have cut down on fat considerably, but still eat about 15-20g of almonds, 5-7g of cacao nibs, and 10-15g of walnuts, plus my daily Brazilnut (for selenium). With some legumes and about 15g of flax, plus natto or silken tofu, I am down to about 25% fat and 20g of protein. I am just not sure if I need to drive it further down, but will see what my latest blood panel says in a week or two. I add mushrooms virtually daily, too. I 

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16 hours ago, Ron Put said:

Mccoy, what kind of millet do you use? I saw a video by Dr. Gregger and decided to try some organic Kodo millet. I ordered it a month ago, but didn't notice that it's coming over from India, so it's still not here. I was going to try Kodo first, then finger millet.

Ron, actually I don't eat millet, I was just referring to the substitution in the cronometer app of dry millet to cooked millet, to avoid the discrepancy between the declared caloric intake in the article and the calories resulting in the cronometer app. The estimate is still short of almost 200 kcals but it is not clear were they are missing. Is the total caloric intake wrong or is the meal plan published inaccurate?

As a second thought, sometimes I used millet flour together with wheat flour in homemade bread. Good for a change.

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18 hours ago, Sibiriak said:

Uh oh!       😈

Hah! A nut from the Devil himself!

Well, as of today I'll eat one every other day, thank you. Just in case.

But according to Cronometer, my average intake of selenium is just over 95mg per day, so I figure even the nuts fluctuate wildly, I am likely to be safe from the ravages of selenium.

But, my take is that we would be reading about Brazilian nuts turning people bold and making them demented more frequently if there was an even mild association. There is not even a warning on my packet of nuts, and you'd think if they stopped the AZ and J&J vaccines over seven incidents in a million, "the scientists" would have definitely banned the evil Brazil nuts that are part of every trail mix bag sold at the gas station.

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11 hours ago, Ron Put said:

I figure even the nuts fluctuate wildly, I am likely to be safe from the ravages of selenium.

That makes sense.  Personally,  I rarely eat brazil nuts,  and certainly not because of their selenium content, but I recalled that previous discussion.

One of the supplements I take (primarily for glucosinolates) contains 55 mcg of selenium from sprouted garlic. ( I don't necessarily take it every day.)   In any case,  when I was tested for selenium levels a while back,  I was at the  the upper end of the reference range.

Supplement Facts

Serving Size: 2 vegetable capsules

Serving Per Container: 60

Bio-Organic Nutrients

Amount Per Serving

%Daily Value

Selenium (SeMC from Sprouted Garlic)

55 mcg

79%

Synergized Organic Ingredients

Organic Cruciferous Sprout Protectors
(Broad Spectrum of Fully Active Glucosinolates & Myrosinase Enzymes)

Fresh freeze-dried Sprouts: Broccoli*, Upland Cress*, Daikon*, Red Radish*, Cauliflower, Cabbage*, Arugula*

365 mg

Organic Concentrated Herbal Protectors
Turmeric Rhizome Extract (95% curcuminoids), Milk Thistle Extract from Organic Seed (70% silymarin), Schizandra Berry Extract* (2% schisandrins), pomegranate Fruit Extract* (15% punicalagins), Ginger Rhizome Extract* (3.5% gingerols & shogaols)

325 mg

Organic Superfood Protectors
(Broad Spectrum of Full Active Glucosinolates & Myrosinase Enzymes)
Fresh freeze-dried: Watercress Leaf*, Wasabi Rhizome, Cilantro Leaf*; Caper Berries*, Sprouted Garlic (Selenium)

300 mg

Organic Live Juice Protectors
Artichoke Juice*, Dandelion Juice*, Black Radish Juice*

75 mg

* Certified Organic
‡ Daily Value not established

 

 

Edited by Sibiriak

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