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Nutrition Final.docx

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NUTR 1010
Laura E Forbes

11/28/2012 5:15:00 PM Antioxidants continu ed: If you don’t get enough Vitamin A:  Night blindness  Xerophthalmia – Dry eyes  Blindness  Immune compromises  Vitamin A deficiency kills hundreds of thousands of children in third world countries  Can happen in Canada too Too much ?  Loss of appetite  Blurred vision  Pain, nausea  Liver and other organ damage o Could cause death  Birth defects in pregnant What if you get too much?  Its possible to overdose form food sources alone  UL is 2000 RAE (just over twice the RDA) ** All aminas store Vitamin A in liver, polar bears have the most Vitamin A because of all the sea creatures that they eat. Caner:  A disease where cells multiply out of control  Often forms of tumors o Many tumors are just the beginning (not harmful, because they cant metabolize)  Malignant (cancerous) tumors metastasize or infect other parts of the body In Canada:  Second leading cause of death after  In 2012, 186,400 new cases of cancer and 75,700 deaths are expected  2 out of 5 Canadians will develop cancer during their lifetime  1 out of every 4 Canadians are expected to die from cancer How does cancer happen?  There are 3 steps o Initiation o Promotion o Progression Initiation: Mutation in cells DNAthe reproduces, could be caused by free radical Promotion: Progression: Those at risk of Cancer:  Older adults (most people who get cancer are over 50 years of age  Those with family history (genetic predisposition) Preventing Cancer  The Canadian cancer society estimates that 50% of cancers could be prevented through o Stop smoking o Decreasing sun exposure o Decreasing environmental chemical exposure o Being physically active o Maintaining a healthy weight o A healthy diet Diet and cancer  Maintaining a healthy weight  Eating a healthy diet o Lots of veggies and fruits, fibre, antioxidants and phytochemicals o Low in red meats and processed meats Body weight and cancer  Being overweight increases risk of: o Breast, colon, prostate, endometrial, kidney, gallbladder, liver, pancreas, rectum, esophageal cancers  How does this happen? o Hormonal changes, increased inflammation happen in obesity Cancer and vegetable and fruit intake  Veggies and fruit are high in: o Fibre o Antioxidant vitamins (Vitamin A, Vitamin C) o Phytochemicals  Help fight cancer **Bowels aren’t exposed to potential chemicals because the fibre helps us get rid of it quicker phytochemicals  lycopene – a carotenoid (in tomatoes)  polyphenolic compounds (blueberries, pomegranate, red wine, chocolate, coffee, berries, tea) Polyphenols  Often many different compounds in one food  Isolating the effects of each polyphenol is difficult  Supplementation with 1 polyphenol often doesn’t work  Eat the whole food Red meat  Includes beef, pork, lamb, goat  Why so bad? o Too much heme iron can cause oxidation, free radicals o High temperature cooking can cause cancerous chemical formation **charcoal black marks on bbq’d meats contain carcinogens** Avoiding carcinogens  DON’T fry, BBQ or grill your meats, especiall to a “well done” temp  DO roast, poach, stew, slow cook meats Processed meat  Ham, hotdogs, bacon, deli meats, pepperoni  Why so bad? o Nitrites and nitrates (preservatives) o Combine with stomach acid to create nitrosamines  Good news- vitamin C can prevent the formation Coffee and Tea Canadian population and coffee consumption: Men aged Women Men aged Women 18-30 aged 18- 31-50 aged 31- 30 50 % coffee 40 39 71 64 yesterday % tea 20 30 27 35 yesterday Average 2.3 cups 1.9 cups 2.6 cups 2.3 cups cups coffee Average 2.1 cups 1.8 cups 1.9 cups 2.0 cups cups tea What is Coffee?  A beverage made from the roasted seeds of the coffea plant (coffea Arabica) Three general ways of making coffee:  Drip coffee  French press  Espresso Caffeine in coffee and tea:  A stimulant  The most commonly used drug world wide  90% of North Americans consume it everyday Beverage Amount of caffeine Drip brewed coffee – 1 cup 115–175 mg French press coffee – 1 cup 80–135 mg Espresso – 1 shot 100 mg Black tea – 1 cup 45 mg Green tea – 1 cup 30 mg Colas – 1 cup 35-45 mg Energy drinks - 1 cup 75 mg Chocolate – 40 g 15- 32 g Physical effect of caffeine:  Vary from person to person  Nervousness, irritability, restlessness, insomnia, headaches, and heart palpitations  Caffeine dependency is possible o With drawl symptoms may occur  Build tolerance with repeated use Caffeine and Hypertension:  Caffeine increases blood pressure for three hours  Not in regular coffee users  Drink caffeine regularly or not at all Caffeine and Bone Health:  Caffeine inhibits the absorption of calcium  Those who consume caffeine AND have low calcium intakes are at higher risk of having poor bone health Caffeine During Pregnancy:  Caffeine crosses the placenta, so if you drink caffeine, so does your baby  Some evidence that caffeine increases risk of low birth weight and premature birth  Recommendation during pregnancy same as non-pregnant women Caffeine, mental health, sleep:  Caffeine may increase or decrease anxiety, depression, other mental conditions o Increased incidence of suicide  Caffeine effects sleep o Lack of sleep can lead to obesity, chronic disease, mental health disorders Caffeine Recommendations:  Women of childbearing age < 300mg/day  All other adults <400mg/day Decaffeinated Coffee:  Water extraction (Swiss Process): o Coffee beans are soaked in water which contains coffee flavor compounds. o Caffeine moves by diffusion o The flavor stays in the bean o The water put through a charcoal filter removes the caffeine Oily Substance In coffee:  Kahweol and cafestol – oily compounds  increase blood LDL cholesterol levels  associated with increased risk of hear disease  Mostly found in boiled coffee or French press coffee  Filters keep the kahweol and cafestol out! The Good stuff in coffee:  A study in Finland found that 66% of antioxidants in the diet came from coffee  Antioxidants include polyphenolic compounds- chlorogenic acids, flavonoids, melanoids  Coffee also contains potassium, niacin, and magnesium. Overall health effect of coffee:  Moderate intake of coffee is related to better health!  Decreased risk of: (due to phytochemicals) o Type 2 diabetes o Some cancers o Parkinson’s disease o Liver disease  Some concerns for: (due to caffeine) o sleep, mental health, pregnant women, bone health, children Complicating factors:  People who drink coffee aren’t like people who don’t!  Coffee drinkers may be more likely to : o Smoke o Drink alcohol o Have less healthy lifestyles (diet, exercise) What is tea?  Soaked leaves of the tea plant or camellia sinensis  Black tea- leaves are picked, oxidized (aka fermented) and dried  Green tea- leaves are not oxidized  White tea – leave are not oxidized and they ae dried in the sun  Oolong tea- withered in the sun and oxidized  Rooibos tea – Made from a different plant: red bush plant. Does not contain caffeine.  Herbal tea – Made from infusion of different plants Phytochemicals/ antioxidants in tea  Catechin: o A polyphenol o Antioxidant o Highest content in green and white teas o Black tea still contains a lot Other benefical compound in tea:  L – Theanine – amino acid derivative  Has a calming effect  Helps strengthen the immune system Tannins in Tea:  Can bind minerals in the digestive tract to inhibit absorption o Especially IRON  Too much tea could cause iron deficiency anemia Health effects of tea:  Improved cardiovascular health (>3 cups/day) o decreases atherosclerosis by protecting the health of blood vessels  Green tea may help with weight control o Small increase in energy expenditure (5%) and fat burning  Increase bone mass  Prevents dental cavities – fluoride in tea  Improves immune system and mental acuity Alcohol: ethanol  A toxin – our body has to detoxify  Can be burned for energy (NOT A MACRONUTRIENT) o 7 Kcals/ gram of alcohol  found in: o wine o beer o vodka, scotch, rum, tequila, whisky, etc. Fermentation – Creating alcohol  Yeast or bacteria break down sugar into alcohol How do you make wine?  Grapes are crushed  The pulp is fermented with yeast (1-2 weeks)  Secondary fermentation/ aging – wine is stored in casks (often oak) to slowly ferment and mature (3-6 months)  White wine: o Red or white grapes, but grapes skins removed  Fortified wines o Higher sugar content as juice is concentrated o More sugar + fermentation = more alcohol  Sparkling wine o Fermentation in the bottle means CO2 is captured How do we digest/metabolize alcohol?  Alcohol is absorbed in the small intestine AND in the Stomach  No digestion is required before absorption  Your body metabolizes alcohol in several ways Metabolizing Alcohol: 1. Alcohol dehydrogenase and acetaldehyde dehydrogenase in the liver 80% of alcohol consumed is metabolized this way! ** females have less alcohol dehydrogenase. That’s why they cant metabolize as much alcohol as men*** 2. MEOS (microsomal ethanol oxidizing system)  It takes over when alcohol dehydrogenase is saturated  Especially important for long term, heavy drinkers o Alcohol tolerance of alcoholics  10% of alcohol consumes is metabolized this way 3. 10% of the alcohol consumed is lost in the breath and urine How fast do we metabolize it?  Caries from person to person  One average, 1 standard drink per hour is metabolized  Alcohol waiting to be metabolized is in the blood and raises blood alcohol levels How much alcohol is moderate?  Less than 10 drinks/week with no more than 2 drinks/ day for women  Less than 15 drinks/ week with no more that 3 drinks/day foe men  On Special occasions, no more than 3 drinks for women, not more than 4 drinks for men What is Binge Drinking?  More than 5 drinks in a short time for a man, and more than 4 drink in a short time for woman  Evidence of fatty liver can be seen after only 3 days of binge drinking How much can be dangerous?  Alcohol poisoning o Stupor, unconsciousness, vomiting while semiconscious, seizures, difficulty breathing, coma o Women: as little as 4-6 drinks o Men : as little as 6-8 drinks  Drinking and driving: o 2 drinks can put you over the legal limit (0.08 blood alcohol content)  heath Canada recommends not drinking at all if you plan on driving Alcoholism  5-6 drinks/day for 10 years causes o cirrhosis of the liver  occurs in 20% of ppl with alcoholism o Vitamin and mineral deficiencies  Not just caused by poor dietary intake  B vitamins and antioxidants get depleated  Wernick-korsakoff syndrome: and alcohol induces dementia caused by thiamin deficiency Alcohol during pregnancy  Fetal alcohol spectrum Disorder o A whole range of disorders caused by alcohol intake during pregnancy  Growth deficiency  Learning difficulties  Behavioral problems  Physical deformations o No amount of alcohol is safe during pregnancy Good news about alcohol!  Cardiovascular disease o Moderate drinkers have 20-40% lower risk o Moderate alcohol intake increases HDL levels o Decreases Blood pressure, prevents clots  Lower risk of type 2 diabetes o Alcohol may improve insulin sensitivity Especially Red Wine:  Protect bone o Moderate red wine consumption and bone maintenance in older women o Mental function  Mental function o Reduced risk of Alzheimer’s with red wine consumption Why Red Wine:  Red wine may be most beneficial o Contains many polyphenols including resveratrol (antioxidant)  Role in cancer prevention?  Reducing oxidized LDL Introduction to Bones:  Bones are dynamic, living organs!  Having many important roles in the body  Important to maintain healthy bones Functions of Bones:  Structure and Support: o Structural support for organs and body segments o Protects vital organs o Muscle support for movement  Metabolic Processes: o Storage for minerals o Production of blood cells in bone marrow Bones consist of…..  65% minerals  hardness o Hydroxyapatite  Calcium and phosphorus crystals  35% organic substances  strength and flexabiity o Collagen (a fibrous protein) Nutrients Involved in Bone Health  Major Roles: o Calcium o Vitamin D o Phosphorus  Minor Roles: o Magnesium o Vitamin K o Vitamin A o Protein o Fluoride Bone Development:  Growth: o Determines bone size o Begins in womb o Continues until early adulthood  Modeling: o Determines bone shape o longitudinal growth o continues until early adulthood  Remodeling: o Maintains bone integrity o “recycling” o Bone reabsorption and formation o Adulthood Process of Bone Remodeling:  Bone resorption o Breakdown of bone by osteoclasts  Secrete enzymes & acids to erode bone surface o Minerals released into bloodstream  Can be used for muscle contraction: calcium  Bone Formation: o Formation of bone by osteoblasts o Build collagen matrix Peak Bone Mass:  Highest amount attained during the years of normal bone growth o End of adolescence vs. late 20s  Influenced by: o Genetics o Nutrition o Physical Activity o Disease o Drugs Measuring Bone Status  Dual energy x-ray absorptiometry o Measures bone mineral density (BMD)  Bone mineral content (g)/bone area (cm2) – BMD (g/cm) o Monitor changes in BMD o Determine risk of osteoporosis o BMD value compared  T-score Poor Bone Health:  Osteoporosis:  Most prevalent bone disease in North America  Bone is porous and thinner o Low bone mass & deterioration of bone tissue  Increase bone fragility  Increase fracture risk Risk Factors for Osteoporosis:  Modifiable: o Nutrient deficiencies o Sedentary lifestyle o Smoking o Low body weight o Alcohol abuse o Repeated falls o Hormone deficiencies o Medications  Non-modifiable: o Age o Gender o Ethnicity o Fracture history o Family history Age as a Risk Factor:  Risk increases with older age o BMD decreases naturally with age o Bone remodeling imbalance  Resorption occurs more rapidly than formation o Minerals released from inner bone matrix o Bones become wider and less dense Gender as a Risk Factor  Women higher risk than men o Lower peak bone mass o Longer life expectancy o Hormonal changes  Low estrogen levels cause an increase bone resorption and decrease bone formation  Without estrogen bone remodeling balance is uneven, bone density decreases Calcium is:  A mineral  A MAJOR mineral – we need >100mg per day  The most abundant mineral in the body  It makes up 2% of our body weight Calcium is critical for strong bones  99% calcium stored in bones  critical part of hydroxyapatite crystals  provide strength to the bones Calcium has another role as an electrolyte  1% of calcium is in the blood as an electrolyte o regulate heart beat  Blood clotting  Normal functioning of nervous system  Muscle contraction and relaxation o The body controls blood levels CLOSELY If your not getting enough calcium…  Your body will take what it needs from your bones  Blood ca levels don’t change but bones weaken How much is enough:  The RDA’s (form DRIs) for calcium **Younger ages need more calcium because you are still growing your bones and building strength. Menopause losing estrogen, you also lose bone mass and this is why woman are at higher risk for getting osteoperios, they need more calcium. Sources of calcium:  Milk and milk products  Milk alternatives and fortified foods  Fish eaten with bones  Tofu  Some nuts (almonds) and seeds (sesame)  Dark green veggies (kale, bok choy, broccoli) Getting most out of the calcium in your diet  Spread your calcium throughout the day o Your intestines can only absorb about 1 cup of milk’s worth of calcium at one time  Oxylates (spinach), phytates (whole grains) and tannins (tea) decrease absorption o Oxylates grabs calcium and doesn’t let it get absorbed and gets excreted in feces  Avoid taking zinc, iron, and magnesium supplements wen your eating a source of calcium For vegans and other dairy free folks:  best dairy- free sources o milk alternatives (soy, rice, almond, or coconut milk, yogurt and cheese) o high calcium leafy greens (kale, bok choy) o tofu o almonds and sesame seeds  choose servings of several of these foods daily What if I cant get enough?  Things to consider in selecting supplement o Amount – you cant absorb more than 500mg at a time o Form of the supplement – how absorbable is it?  Most supplements are about 30% absorbed  Calcium citrate malate is slightly better absorbed (35%)  Calcium carbonate is the cheapest (tums) Maxing supplement absorption  Don’t take calcium with multivitamin o Interferes with iron, magnesium and phosphorus absorption  Taking calcium supplement with food o Its absorbed better  Take small amounts throughout the day Too much?  Eating more doesn’t change blood levels of calcium  When you have enough, your body stops absorbing it o The extra comes out in feces  Too much calcium could interfere with absorption of iron and zinc Phosphorus:  Major mineral ( .100mg/day needed)  85% phosphorus is found in bones  part of hydroxyapatite crystals  15% in soft tissue an fluids in the body o cell membranes (in phospholipids) o energy storage and release (ATP, Creatinine) o activates enzymes in metabolic reactions o important for DNA o fluid balance o acid- base balance Phosphorus in the diet  In almost every food we eat  Only a deficiency risk in very low energy and low protein diets  Well absorbed in intestine  Added to processed foods & carbonated beverages  Deficiency rare and usually caused by low dietary intake Foods highest in phosphorus are  High protein foods Too much?  Concern about over consuming processed food and carbonated drinks  Too much can interfere with calcium absorption & excretion… may also affect mineralization  Like calcium, phosphorus intake doesn’t affect blood level – tight regulation Magnesium: Major mineral  50 – 60% of our body’s magnesium is in the bone  influences hydroxyapatite formation  regulates calcium balance  is a cofactor for over 300 enzymes o none of these enzymes would work without it o none of the chemical reactions would happen  These enzymes control o Energy use o Building DNA and proteins o Blood clotting o Muscle contractions Where is it?  Found in most food, so acute deficiencies are rare  Best Source: Whole grains, green leafy veggies, nuts, seeds, and beans Too much or too little:  Too much possible from supplements o Diarrhea, nausea  Acute deficiencies are rare, but low intakes are related to increased risk of: o Osteoporosis o Heart disease o High blood pressure o Type 2 diabetes Vitamin D (aka cholecalciferol or calcitirol)  Fat soluble vitamin – stored in fat tissue  considered a hormone o A chemical messenger in the body  Conditionally essential – we can make it ourselves if we’re exposed to enough sunlight  If not, we have to get it from foods ( absorbed better when eaten with fat What does Vitamin D do for Bone Health?  Important for calcium balance o helps absorb calcium o helps retain calcium (decreases excretion) o helps regulate blood levels of calcium  Important in cell membrane o Makes new cells that are functioning properly  Immune system o Vitamin D may play a role in helping the body fight viruses and infections  Preventing MS Getting enough  Synthesize it from a form of cholesterol in our skin (need UV light from the sun) Cholecalciferol goes to the liver ---- Calcidiol goes to the kidneys People who absorb less  People with darker skin  People who live father from the equator o in Edmonton Alberta, people synthesize NO vitamin D between October and May  up to 97% of Canadians have inadequate vitamin D levels during winter and spring  elderly – older skin has fewer vitamin D making compounds  people wearing sunscreen  people who cover all their skin  people who stay indoors during the middle of the day (between 10 -3) Few foods contain Vitamin D naturally  Oily fish- wild salmon, herring, trout, and mackerel o farmed salmon has about ¼ the vitamin D as wild o canned salmon contains lots of vitamin D  most of our dietary Vitamin D comes from fortified milk and margarine o Yogurt and cheese are NOT fortified How much do we need?  RDAs for vitamin D  10 months to 70 years needs 600IU or 15ug  70yrs+ needs 800IU or 20ug o b/c older ppl lose some cholesterol from skin making it harder for them to make it Wild salmon has  Almost 100iU in a 3oz serving! Supplements  Its recommended that men and women over 50 years of age take one  Other people, in the winter if o If your don’t eat a lot of milk and/ fatty fish  and in summer if: o you’re inside or wear sunscreen  recommended : a supplement containing the RDA (600-800IU) Not enough?  Rickets = soft bones  Rickets was common in children living in cities during the industrial revolution  Pollution blocked the sun = no vitamin D  Rich children were sent to the country to be cured Osteomalacia:  In adults, soft bones due to Vitamin D deficiency is called osteomalacia  Poor mineralization  Bowed legs  Aching joints  Risk of fractures Toxicity:  Not possible from sun exposure o Once you have enough, your body stops making it  Toxicity is possible from supplements, but rare o May cause hypercalcemia (high blood calcium levels) o Calcium deposits on organs  Excess vitamin D is stored in fat tissue Vitamin D and Cancer  One study showed that women taking vitamin D supplements had 60% lower risk of cancer  However: o There is emerging evidence that too much vitamin D may be related to INCREASED risk of some cancers o This is why DRIs for vitamin D have remained moderate Vitamin D and MS  What is MS o An autoimmune disease affecting the neurons (nerve cells) of the brain and spinal cord  Myelin sheath is destroyed o Results in:  muscle weakness, difficulty moving, paralysis, speech problems, swallowing problems, wasting, visual problems, fatigue, pain, cognitive impairment, depression  vitamin D has a role in the immune system o regulates T-cells (a type of white blood cell)  In MS, t-calls attack myelin  MS is very rare near the equator  Taking a daily multivitamin with 10ug (400IU) vitamin D decreses risk of developing MS by 40% Vitamin K (Quinones) and fat soluble  what does vitamin K do for bones? o Is needed to make osteocalin – a protein needed to bauild strong bones  Secreted by osteoblasts in step 1 of bone building  Step 2 is too add minerals  Needed for blood clotting Where do you get it?  Green leafy veggies are your best source Vitamin K and bacteria:  Bacteria in your stomach make vitamin K!!!  Much of our dietary needs are met through bacterial vitamin K Too Much? Too Little?  Too much? o No know toxicity effects  Too little? o Rare, in adults o Newborns without bacteria in their stomach are at risk  they get vitamin K shots at birth o may have a role in osteoporosis prevention Nutrition and Energy Metabolism What B Vitamins have in common  They are water soluble vitamins o Transport dissolved minerals in the blood o Must be eaten regularly, but toxicity is rare  You pee out the extra (like vitamin c!)  ALL involved with energy metabolism o Buring CHO, fat, and/ protein  They act as co-enzymes where do we find them?  Added to white flours, pasta and breakfast cereals  Flour, white flour, enriched flour, or enriched white flour is ENRICHED with: o Thiamine o Riboflavin o Niacin o Folic acid o iron ** folic acid assed to the list in 1998 – 30-70% decrease in neural tube defects *** Where do you find them?  Added to white flours, pasta and breakfast cereals  Found abundantly in meats, meat alternatives, milk, grains, fruit and veggies  Severe deficiencies are Rare  Possible low intakes of o Folate among non- veggie eaters o Vitamin B12 among vegans Thiamin  Needed to burn carbs for energy  Needed for amino acid metabolism  Find it in : whole grains naturally contain it. Thiamin is added to enriched grain products; pork also has thiamin what happens when you don’t get enough?  Beriberi  Became very common in Asia when polished rice was introduced  Muscle wasting and weakness  Nerve damage o Dementia, confusion, memory loss Beriberi in Canada  Still happens – alcoholism  Wernicke-karsakoff syndrome o Caused by a combination of alcohol intake and poor quality diet o Dementia, confusion Niacin  Needed for the metabolism of carbs and fats  Also needed to make DNA and for cell differentiation  Found in: meat fish, poultry, enriched grains, and breakfast cereals Tryptophan and Niacin  Tryptophan is… and amino acid  Our bodies can make niacin out of tryptophan o Beans are low in tryptophan o Most grains have lots of tryptophan but corn is lower o Vegetarian populations that depend on corn as the min grain may have a deficiency Deficiency  Pellagra – rare in 1tworld countries, except in alcoholism  The 4 D’s o Dermatitis, diarrhea, dementia, and death Iodine and metabolism  Thyroid hormones control our metabolism o Thyroxine controls basal metabolic rate o Obesity can be caused by low thyroxine levels Iodine and thyroxine  Iodine is a critical component of thyroxine  low levels of iodine intake cause low levels of thyroxine **thyroid hormones are a bit like a thermostat. They control how much energy you burn** Where do we find iodine?  Sea food o Sea weed, fish, shrimp, etc.  Milk products o Plant food grown in iodine rich soil  North American soil is iodine poor  Iodized Salt o ½ tsp of salt contains all the iodine you need. ** Iodine from milk comes from sanitation products used by the dairy industry*** Iodine deficiency  hypothyroidism (low levels of thyroid hormone – Thyroxine)  weakness, fatigue, sluggishness, weight gain, intolerance of cold  Goiter o Swelling of the thyroid gland  During pregnancy  Cretinism o Stunned growth o Low IQ o Deafness o Muteness Iodine deficiency Around the World  Still the most common cause of brain damage  The good news: o Iodized salt has GREATLY decreased the prevalence of iodine deficiency since 1980’s o # of countries affected cut in half  But 54 countries world wide still have problems with iodine deficiency Iron and blood health What is blood?  Plasma- the fluid (water and electrolytes) o 55% of blood volume  Red blood cells (aka erythrocytes) o 45% of blood volume  white blood cells (part of the immune system) and platelets (for blood clotting) o Less than 1% of blood volume What does blood do?  Transports oxygen & Nutrients  Removes waste products  Important in healing process  Important part of immune system Healthy vs. Unhealthy  Healthy blood o Transports everything efficiently  Unhealthy blood o Doesn’t transport oxygen and/or nutrients well o Usually because of problems with red blood cells Red Blood Cells  Contain Hemoglobin 
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