Which Foods are Recommended for Pancreatic Adenocarcinoma?

Highlights

No two cancers are the same, nor are they treated the same, and neither should nutrition be the same for everyone. Nutrition includes foods like pulses, vegetables, fruits, nuts, oils, herbs and spices. Also nutrition includes supplements which are high concentrations of foods or high concentrations of individual ingredients found in foods. For cancers like Pancreatic Adenocarcinoma when undergoing chemotherapy or when you determine you have a genetic risk for developing Pancreatic Adenocarcinoma because of CTNNA2 and MUC4 gene mutations, a very important question is “What foods should I avoid and what foods are recommended specifically for me?”. The other related question is “What nutritional supplements should I avoid?”.

There is no one answer to this question for cancers such as Pancreatic Adenocarcinoma which can be found through internet searches. The answer to the question is “It Depends” because the nutrition plan needs to be personalized for you. Nutrition should depend on the cancer indication, genetic information, adult or pediatric, staging, primary or secondary, advanced, metastatic, relapsed or refractory, ongoing treatments if any, nutritional supplements being taken, age and factors like gender, weight, height, lifestyle, allergies and food preferences.

In short – the process to answer questions like “Should I Avoid eating fruit Malus (crab Apple)” or “Include fruit Saskatoon Berry in my diet” or “Should I reduce consumption of vegetable Kale” or “Can I take Skullcap and Myricetin supplements” is not as simple as internet searches. The process is very complex and answers are based on knowhow of genetics, action of treatments, active ingredients in foods and their associated biological action. Finally the answer to the nutrition question needs to be personalized for you.

RECOMMENDATION: PERSONALIZE YOUR FOODS AND SUPPLEMENTS TO PANCREATIC ADENOCARCINOMA, TREATMENTS, GENETIC INFORMATION, AND OTHER CONDITIONS.

The overall objective of personalized nutrition for Pancreatic Adenocarcinoma is to minimize foods and nutritional supplements which have adverse interactions with cancer molecular drivers and ongoing treatments. And identify those foods and supplements which have a beneficial action. Whenever there are changes in treatments or diagnosis – it is important to remember that your foods and supplements need re-evaluation. And the answers to the nutrition question could be different based on the new context.

RECOMMENDATION: UPDATE YOUR NUTRITION FOR PANCREATIC ADENOCARCINOMA, WHEN TREATMENTS, DISEASE STATUS AND OTHER CONDITIONS CHANGE.

About Pancreatic Adenocarcinoma

cBioPortal is one source of collection of cancer patient data from clinical trials across 350 plus cancer indications. The data from each clinical trial includes the clinical trial name and study details like number of patients, ages, gender, ethnicity, treatments, tumor site, genetic aberrations found and analysis of all the data. The cBioPortal for Cancer Genomics was originally developed at Memorial Sloan Kettering Cancer Center (MSK). The public cBioPortal site is hosted by the Center for Molecular Oncology at MSK – https://www.cbioportal.org/about.

Following key highlights are derived from clinical data for Pancreatic Adenocarcinoma from cBioPortal. The patients enrolled in the studies for Pancreatic Adenocarcinoma are in ages between 29 to 90 with an average age of 67. 53.9% of males and 46.1% of females were the distribution of gender in these clinical studies. From a patient sample size of 3721; the top genes with mutations and other abnormalities for Pancreatic Adenocarcinoma include genes CDKN2A, CTNNA2, MUC4, NOTCH1 and RYR2. The occurrence frequency distribution for these genes respectively is 1.1%, 0.5%, 0.5%, 0.5% and 0.4%. These tumor genetic details of Pancreatic Adenocarcinoma are mapped to molecular biochemical pathway drivers of cancer thereby providing definition of characteristic features of Pancreatic Adenocarcinoma.

Pancreatic adenocarcinoma is a type of cancer that affects the pancreas, a gland located in the abdomen, that produces enzymes that aid digestion and hormones that help manage the blood sugar. Pancreatic cancer is seldom detected at early stages when it is most curable because it often does not cause any symptoms until after it has spread to other organs. Signs and symptoms of pancreatic cancer can include abdominal pain that radiates to the back, loss of appetite or unintended weight loss, yellowing of the skin and the whites of the eyes (jaundice), dark colored urine or light-colored stools, itchy skin, blood clot and fatigue. Some of the risk factors of pancreatic cancer include age, smoking, diabetes, family history of pancreatic cancer, obesity, and pancreatitis (chronic inflammation of the pancreas). Staging of this disease is crucial to determine the extent of the cancer and guide treatment. Unfortunately, pancreatic adenocarcinoma often has a poor prognosis, with a low life expectancy for many patients. The presence of liver metastases, or spread of the cancer to the liver, is a particularly concerning feature and can negatively impact a patient’s prognosis. Treatment options for pancreatic adenocarcinoma include surgery, chemotherapy, radiation therapy and enrolling in clinical trials for targeted therapy or immunotherapy options. In addition, supportive care with optimal nutrition (foods and natural supplements) can aid in improving well-being of patients diagnosed with pancreatic adenocarcinoma. (Ref: https://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/diagnosis-treatment/drc-20355427; Vareedayah AA et al, Mo Med, 2018,; https://emedicine.medscape.com/article/280605-overview )

Significance of Nutrition for Pancreatic Adenocarcinoma

All foods and nutritional supplements consist of a collection of one or more active chemical ingredients in different proportions and quantities. The action of some active ingredients in a food can have adverse interactions while other active ingredients in the same food may be supportive from the context of Pancreatic Adenocarcinoma. Hence the same food has good and not-so-good actions and analysis of combined effect will be needed to come up with a personalized nutrition plan.

For example Malus (crab Apple) includes active ingredients Linolenic Acid, Vitamin C, Oleic Acid, Linoleic Acid, 7-4′-dihydroxyflavone and others. And Saskatoon Berry contains active ingredients Quercetin, Delphinidin and others. It is likely that some of these active ingredients of the same food could have opposing effects and hence it is recommended to identify recommended foods based on analysis of all high quantity ingredients contained in foods.

For cancers like Pancreatic Adenocarcinoma, activation or inhibition of selected biochemical pathways like Extracellular Matrix Remodelling, MAPK Signaling, PI3K-AKT-MTOR Signaling, Cell Cycle plays an important role in driving cancer growth. Similarly different treatments work via different molecular actions which should never be canceled out by your foods and supplements. The foods and nutritional supplements contain different active ingredients each of which have a specific molecular action on different biochemical pathways. Hence, eating some foods and nutritional supplements would be recommended with a specific treatment of Pancreatic Adenocarcinoma, while eating some other foods and supplements may not be recommended.

One common mistake when finding foods to eat or not – is to consider only a few active ingredients contained in foods based on internet searches and ignore the rest. Because different active ingredients contained in foods may have opposing effects on relevant biochemical pathways – it is recommended to consider all the high quantity active ingredients that are present in significant and much larger than trace amounts in the food.

RECOMMENDATION: TO FIND RECOMMENDED AND NON-RECOMMENDED FOODS FOR PANCREATIC ADENOCARCINOMA – CONSIDER HIGH QUANTITY ACTIVE INGREDIENTS CONTAINED IN FOODS.

Foods for Pancreatic Adenocarcinoma undergoing chemotherapy treatment

In Pancreatic Adenocarcinoma – the genes CDKN2A, CTNNA2, MUC4, NOTCH1 and RYR2 have high occurrences of genomic abnormalities. Not all of these genes necessarily are relevant for cancer – though they have been reported. Some of these genes directly or indirectly end up manipulating different cancer related biochemical biological pathways. Some of the pathways which are relevant drivers for Pancreatic Adenocarcinoma are Extracellular Matrix Remodelling, MAPK Signaling, PI3K-AKT-MTOR Signaling and others. Paclitaxel is one of the chemotherapies used for cancer treatment. The intent of treatment is to negate or cancel out effects of biochemical pathway drivers Extracellular Matrix Remodelling, MAPK Signaling, PI3K-AKT-MTOR Signaling so as to reduce disease progression and inhibit growth. Those foods whose combined action of active ingredients support treatment action and do not enhance disease drivers are recommended foods and supplements which will be included in personalized nutrition. And similarly – those foods whose combined action of active ingredients is not supportive of treatment action but end up promoting disease drives will not be recommended in your personalized nutrition plan.

RECOMMENDATION: AVOID SUPPLEMENTS AND FOODS WHICH ARE NOT SUPPORTIVE OF CANCER TREATMENT ACTION AND RATHER ENHANCE DISEASE DRIVERS.

Eat more pulses, Common Pea or Pigeon Pea?

Pulses are an important part of many diets. The active ingredients contained in Common Pea are Lupeol, Daidzein, Kaempferol, Linolenic Acid, Beta-sitosterol among others. While the active ingredients contained in Pigeon Pea are Linolenic Acid, Vitamin C, Genistein, Oleic Acid, Vitamin A and others.

Beta-sitosterol can manipulate biochemical pathways Epithelial to Mesenchymal Transition, NFKB Signaling and Apoptosis. Vitamin C has biological action on biochemical pathways Carbohydrate Metabolism, Adherens junction and Cell Cycle.

Vitamin A can manipulate biochemical pathways NFKB Signaling, PI3K-AKT-MTOR Signaling and Focal Adhesion. Oleic Acid has biological action on biochemical pathways Epithelial to Mesenchymal Transition and Extracellular Matrix Remodelling. And so on.

When treating Pancreatic Adenocarcinoma with chemotherapy Paclitaxel – Foods like Common Pea are recommended compared to Pigeon Pea. This is because the active ingredients Vitamin A and Oleic Acid in Pigeon Pea interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Beta-sitosterol and Vitamin C contained in Common Pea support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.

RECOMMENDATION: COMMON PEA IS RECOMMENDED OVER PIGEON PEA FOR PANCREATIC ADENOCARCINOMA ON TREATMENT WITH CHEMOTHERAPY PACLITAXEL FOR SOME CONDITIONS.

Eat more vegetables, Kohlrabi or Kale?

Vegetables are an important part of many diets. The active ingredients contained in Kohlrabi are Kaempferol, Indole-3-carbinol, Linolenic Acid, Brassinin, Beta-sitosterol among others. While the active ingredients contained in Kale are Kaempferol, Indole-3-carbinol, Linolenic Acid, Brassinin, Vitamin C and others.

Brassinin can manipulate biochemical pathways Epithelial to Mesenchymal Transition, NFKB Signaling and Apoptosis. Vitamin C has biological action on biochemical pathways Carbohydrate Metabolism, Adherens junction and Cell Cycle.

Vitamin A can manipulate biochemical pathways NFKB Signaling, PI3K-AKT-MTOR Signaling and Focal Adhesion. Linoleic Acid has biological action on biochemical pathways Epithelial to Mesenchymal Transition, Extracellular Matrix Remodelling and Chemokine Signaling. And so on.

When treating Pancreatic Adenocarcinoma with chemotherapy Paclitaxel – Foods like Kohlrabi are recommended compared to Kale. This is because the active ingredients Vitamin A and Linoleic Acid in Kale interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Brassinin and Vitamin C contained in Kohlrabi support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.

RECOMMENDATION: KOHLRABI IS RECOMMENDED OVER KALE FOR PANCREATIC ADENOCARCINOMA ON TREATMENT WITH CHEMOTHERAPY PACLITAXEL FOR SOME CONDITIONS.

Eat more fruits, Saskatoon Berry or Malus (crab Apple)?

Fruits are an important part of many diets. The active ingredients contained in Saskatoon Berry are Quercetin, Delphinidin among others. While the active ingredients contained in Malus (crab Apple) are Linolenic Acid, Vitamin C, Oleic Acid, Linoleic Acid, 7-4′-dihydroxyflavone and others.

Delphinidin can manipulate biochemical pathways NFKB Signaling, Growth Factor Signaling and MYC Signaling. Quercetin has biological action on biochemical pathways Microtubule Dynamics, TGFB Signaling and WNT Beta Catenin Signaling.

Oleic Acid can manipulate biochemical pathways Epithelial to Mesenchymal Transition and Extracellular Matrix Remodelling. Linoleic Acid has biological action on biochemical pathways Chemokine Signaling, TGFB Signaling and Angiogenesis. And so on.

When treating Pancreatic Adenocarcinoma with chemotherapy Paclitaxel – Foods like Saskatoon Berry are recommended compared to Malus (crab Apple). This is because the active ingredients Oleic Acid and Linoleic Acid in Malus (crab Apple) interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Delphinidin and Quercetin contained in Saskatoon Berry support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.

RECOMMENDATION: SASKATOON BERRY IS RECOMMENDED OVER MALUS (CRAB APPLE) FOR PANCREATIC ADENOCARCINOMA ON TREATMENT WITH CHEMOTHERAPY PACLITAXEL FOR SOME CONDITIONS.

Eat more nuts, Almond or Peanut?

Nuts are an important part of many diets. The active ingredients contained in Almond are Quercetin, Salicylic Acid, Vitamin E, Linolenic Acid, Beta-sitosterol among others. While the active ingredients contained in Peanut are Quercetin, Vitamin E, Ferulic Acid, Linolenic Acid, Beta-sitosterol and others.

Beta-sitosterol can manipulate biochemical pathways Epithelial to Mesenchymal Transition, NFKB Signaling and Apoptosis. Quercetin has biological action on biochemical pathways Microtubule Dynamics, Growth Factor Signaling and TGFB Signaling.

Vitamin A can manipulate biochemical pathways NFKB Signaling, PI3K-AKT-MTOR Signaling and Focal Adhesion. Lecithin has biological action on biochemical pathways Chemokine Signaling, JAK-STAT Signaling and MYC Signaling. And so on.

When treating Pancreatic Adenocarcinoma with chemotherapy Paclitaxel – Foods like Almond are recommended compared to Peanut. This is because the active ingredients Vitamin A and Lecithin in Peanut interferes with treatment action by canceling out the biochemical pathways through which the chemotherapy works. While the active ingredients Beta-sitosterol and Quercetin contained in Almond support the treatment action by enhancing the biochemical pathway effect through which the chemotherapy works.

RECOMMENDATION: ALMOND IS RECOMMENDED OVER PEANUT FOR PANCREATIC ADENOCARCINOMA ON TREATMENT WITH CHEMOTHERAPY PACLITAXEL FOR SOME CONDITIONS.

Foods for Genetic Risk of Pancreatic Adenocarcinoma

One of the ways to assess risk of cancer is by checking for presence of genetic abnormalities in a set of genes. There is prior information on a list of genes whose mutations and other aberrations can play a role in risk to different cancers. CTNNA2 and MUC4 are two genes whose abnormalities are risk factors for Pancreatic Adenocarcinoma. In such a cancer risk situation – while there are typically no treatments which a physician can prescribe – the various biochemical pathways which are potentially molecular drivers of Pancreatic Adenocarcinoma can be used as a guide for coming up with a recommended personalized nutrition plan. For Pancreatic Adenocarcinoma gene CTNNA2 has causative impact on biological pathways like Adherens junction and Hippo Signaling. And MUC4 has a causative impact on biological pathways like Post Translation Modification. Foods and nutritional supplements which have molecular action to cancel out biochemical pathways effects of genes like CTNNA2 and MUC4 should be included in a personalized nutrition plan. And those foods and supplements which promote the effects of genes CTNNA2 and MUC4 should be avoided.

Eat more pulses, Mung Bean or Soy Bean?

The active ingredients contained in Mung Bean are Vitamin C, Oleic Acid, Quercetin, Linolenic Acid, Vitexin among others. While the active ingredients contained in Soy Bean are Lupeol, Daidzein, Beta-sitosterol, Vitamin E, Vitamin C and others.

Vitamin C can manipulate biochemical pathways Apoptosis, Adherens junction and MYC Signaling. Quercetin has biological action on biochemical pathways Small Molecule Transport, P53 Signaling and Cell Cycle Checkpoints.

Aescin can manipulate biochemical pathways Cell Cycle Checkpoints. Lecithin has biological action on biochemical pathways MYC Signaling and PI3K-AKT-MTOR Signaling. And so on.

For genetic risk of Pancreatic Adenocarcinoma due to abnormalities in genes CTNNA2 and MUC4 – Foods like Mung Bean are recommended compared to Soy Bean. This is because the active ingredients Aescin and Lecithin in Soy Bean further promote the effects of genes on the biochemical pathways. While the active ingredients Vitamin C and Quercetin contained in Mung Bean together have a canceling effect of genes on the biochemical pathways.

RECOMMENDATION: MUNG BEAN IS RECOMMENDED OVER SOY BEAN FOR REDUCING THE GENETIC RISK OF PANCREATIC ADENOCARCINOMA DUE TO GENES CTNNA2 AND MUC4

Eat more vegetables, Arugula or Bell Pepper?

The active ingredients contained in Arugula are Esculin, Kaempferol, Vitamin A, Vitamin K, Erysolin among others. While the active ingredients contained in Bell Pepper are Vitamin E, Capsaicin, Vitamin C, Oleic Acid, Linolenic Acid and others.

Kaempferol can manipulate biochemical pathways Cell Cycle Checkpoints and PI3K-AKT-MTOR Signaling. Vitamin K has biological action on biochemical pathways MYC Signaling, Cell Cycle Checkpoints and PI3K-AKT-MTOR Signaling.

Capsaicin can manipulate biochemical pathways Small Molecule Transport. Isorhamnetin has biological action on biochemical pathways Small Molecule Transport. And so on.

For genetic risk of Pancreatic Adenocarcinoma due to abnormalities in genes CTNNA2 and MUC4 – Foods like Arugula are recommended compared to Bell Pepper. This is because the active ingredients Capsaicin and Isorhamnetin in Bell Pepper further promote the effects of genes on the biochemical pathways. While the active ingredients Kaempferol and Vitamin K contained in Arugula together have a canceling effect of genes on the biochemical pathways.

RECOMMENDATION: ARUGULA IS RECOMMENDED OVER BELL PEPPER FOR REDUCING THE GENETIC RISK OF PANCREATIC ADENOCARCINOMA DUE TO GENES CTNNA2 AND MUC4

Eat more fruits, Orange or Lemon?

The active ingredients contained in Orange are D-limonene, Linalool, Hesperidin, Vitamin C, Oleic Acid among others. While the active ingredients contained in Lemon are D-limonene, Hesperidin, Eucalyptol, Vitamin C, Oleic Acid and others.

D-limonene can manipulate biochemical pathways Small Molecule Transport, Apoptosis and MYC Signaling. Vitamin C has biological action on biochemical pathways Adherens junction, P53 Signaling and Cell Cycle Checkpoints.

Myrcene can manipulate biochemical pathways Small Molecule Transport and Extracellular Matrix Remodelling. Syringin has biological action on biochemical pathways PI3K-AKT-MTOR Signaling. And so on.

For genetic risk of Pancreatic Adenocarcinoma due to abnormalities in genes CTNNA2 and MUC4 – Foods like Orange are recommended compared to Lemon. This is because the active ingredients Myrcene and Syringin in Lemon further promote the effects of genes on the biochemical pathways. While the active ingredients D-limonene and Vitamin C contained in Orange together have a canceling effect of genes on the biochemical pathways.

RECOMMENDATION: ORANGE IS RECOMMENDED OVER LEMON FOR REDUCING THE GENETIC RISK OF PANCREATIC ADENOCARCINOMA DUE TO GENES CTNNA2 AND MUC4

Eat more nuts, Pine Nut or Brazil Nut?

The active ingredients contained in Pine Nut are Beta-sitosterol, Vitamin E, Oleic Acid, Linolenic Acid, Linoleic Acid among others. While the active ingredients contained in Brazil Nut are Vitamin E, Oleic Acid, Linolenic Acid, Lecithin, Folic Acid and others.

Beta-sitosterol can manipulate biochemical pathways Apoptosis, Adherens junction and MYC Signaling. Vitamin K has biological action on biochemical pathways Cell Cycle Checkpoints, PI3K-AKT-MTOR Signaling and MYC Signaling.

Lecithin can manipulate biochemical pathways MYC Signaling and PI3K-AKT-MTOR Signaling. Folic Acid has biological action on biochemical pathways Apoptosis, P53 Signaling and Cell Cycle Checkpoints. And so on.

For genetic risk of Pancreatic Adenocarcinoma due to abnormalities in genes CTNNA2 and MUC4 – Foods like Pine Nut are recommended compared to Brazil Nut. This is because the active ingredients Lecithin and Folic Acid in Brazil Nut further promote the effects of genes on the biochemical pathways. While the active ingredients Beta-sitosterol and Vitamin K contained in Pine Nut together have a canceling effect of genes on the biochemical pathways.

RECOMMENDATION: PINE NUT IS RECOMMENDED OVER BRAZIL NUT FOR REDUCING THE GENETIC RISK OF PANCREATIC ADENOCARCINOMA DUE TO GENES CTNNA2 AND MUC4

In Summary

An important thing to remember is that cancer treatments may not be the same for everyone – and neither should your nutrition be. Nutrition which includes food and nutritional supplements is a very effective tool controlled by you.

“What should I eat?” is the most frequently asked question in the context of cancer. The answer calculation is complex and depends upon cancer type, underlying genomics, current treatments, any allergies, lifestyle information, and factors like BMI.

The addon personalized nutrition plan recommends foods and supplements which minimizes adverse nutrition interactions and encourages support to treatments.

You can get started NOW and design a personalized nutrition plan for Pancreatic Adenocarcinoma by answering questions on type of cancer, current treatments, supplements, allergies, age group, gender, and lifestyle information.

What food you eat and which supplements you take is a decision you make. Your decision should include consideration of the cancer gene mutations, which cancer, ongoing treatments and supplements, any allergies, lifestyle information, weight, height and habits.

The nutrition planning for cancer from addon is not based on internet searches. It automates the decision making for you based on molecular science implemented by our scientists and software engineers. Irrespective of whether you care to understand the underlying biochemical molecular pathways or not - for nutrition planning for cancer that understanding is needed.

Get started NOW with your nutrition planning by answering questions on the name of cancer, genetic mutations, ongoing treatments and supplements, any allergies, habits, lifestyle, age group and gender.

References

• Pancan Pcawg 2020
• Pan-cancer analysis of whole genomes.
• β-Sitosterol and Gemcitabine Exhibit Synergistic Anti-pancreatic Cancer Activity by Modulating Apoptosis and Inhibiting Epithelial-Mesenchymal Transition by Deactivating Akt/GSK-3β Signaling.
• Vitamin C enhances epigenetic modifications induced by 5-azacytidine and cell cycle arrest in the hepatocellular carcinoma cell lines HLE and Huh7.
• Adhesion to the extracellular matrix is positively regulated by retinoic acid in HepG2 cells.
• Oleic acid-induced ANGPTL4 enhances head and neck squamous cell carcinoma anoikis resistance and metastasis via up-regulation of fibronectin.
• Identification of new potent phthalazine derivatives with VEGFR-2 and EGFR kinase inhibitory activity.
• Protein kinase and HDAC inhibitors from the endophytic fungus Epicoccum nigrum.
• Linoleic acid enhances angiogenesis through suppression of angiostatin induced by plasminogen activator inhibitor 1.
• Brassinin Represses Invasive Potential of Lung Carcinoma Cells through Deactivation of PI3K/Akt/mTOR Signaling Cascade.
• The recruitment of Raf-1 to membranes is mediated by direct interaction with phosphatidic acid and is independent of association with Ras.
• d -Limonene sensitizes docetaxel-induced cytotoxicity in human prostate cancer cells: Generation of reactive oxygen species and induction of apoptosis.
• Myrcene, an Aromatic Volatile Compound, Ameliorates Human Skin Extrinsic Aging via Regulation of MMPs Production.
• Syringin prevents bone loss in ovariectomized mice via TRAF6 mediated inhibition of NF-κB and stimulation of PI3K/AKT.
• Crystal structure of a human cyclin-dependent kinase 6 complex with a flavonol inhibitor, fisetin.
• Research progress on the anticancer effects of vitamin K2.
• The anthelminthic drug praziquantel is a selective agonist of the sensory transient receptor potential melastatin type 8 channel.
• ROS-mediated activation and mitochondrial translocation of CaMKII contributes to Drp1-dependent mitochondrial fission and apoptosis in triple-negative breast cancer cells by isorhamnetin and chloroquine.
• Effects of folate deficiency on gene expression in the apoptosis and cancer pathways in colon cancer cells.
• HyperFoods: Machine intelligent mapping of cancer-beating molecules in foods.

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