Tag Archives: Hypertension

Mediterranean Diet vs. Cancer Clinical Trials

Lower incidents of cancer and “arrest progression” of  Breast, Colon, and Prostate, as well as a slowed “Aging” process across all micro organisms, are being attributed to nutrients consumed from the Mediterranean Diet.  Organs effected by Alzheimer, Cardiovascular, Diabetes, Hypertension, and Parkinson Disease once thought to be pre-dispositioned diseases, are now completely avoided due to the higher intake of a plant based-fish/poultry diet that includes a lifestyle change with exercise. In order to understand nutrition related disease we first have to address nutritional intake for the Standard American Diet (S.A.D.) and understand what nutrients are common within the Mediterranean Diet that promote well-being.

Compare and Contrast the Standard American Diet (SAD) to the Mediterranean Diet on the following pie charts:

Standard American Diet: 2,594 cals/day

Caloric Sweeteners, Flour, and Cereal Products make up 41% of the S.A. D., Fruits and Vegetables are only 7% of the S.A.D.

Standard American Diet
Fruit/Vegetable 205 .08%
Fats 340 13%
Dairy 256 10%
Sweeteners 440 0.17%
Pork/Meat/Chxn 298 0.11%
Nuts 175 .07%
Pasta/Bread 619 23%
 Calories/day 2,594

Two critical points that Doctors raise as red flags. 1. Higher amounts of calories are  in the Standard American Diet. 2 Empty calories that promote aging is due to how the body is required to process calories that the body cannot use and have small to no amount of  vitamins, minerals, or antioxidants available.

Chemical Sweeteners and Refined Flour

  1. In contrasting the diets, note that 41% of the Standard American Diet is dedicated to the consumption of chemical sweeteners, refined flour, and cereal products.
  2. The Mediterranean Diet has no chemical sweeteners and only 17% of the dietary intake is in pasta and breads.
Calories Mediterranean Diet
Fruit/Vegetable 400 22%
Olive Oil 360 20%
Dairy 257 15%
Wine/Liquor 150 0.09%
Pork/Fish/Chxn 105 0.06%
Nuts 175 1%
Pasta/Bread 300 17%
 Calories/day 1747

Fats, Oil and Dairy products are almost an even draw in calories.

S.A.D 596 calories or 23% of dietary intake  vs Mediterranean Diet 617 or  35% of dietary intake.

  1. S.A.D. utilizes fats such as Margarine, Canola Oil, Butter, and processed cheese.
  2. Mediterranean Diet utilizes Olive Oil (3 Tbsp/day), daily fresh made or aged cheese.

So far the Standard American Diet in just two arguments has shown that 1,655 calories, or 64% of an average American’s diet is composed of sweeteners, refined flour, and processed saturated animal fat. The Mediterranean Diet demonstrates that 917 calories, or  52% of it’s nutritional intake comes from grains, refined flour, plant based oil, and freshly made or aged saturated animal fat.

S.A.D. Protein intake is 473 calories or 18% vs. Mediterranean Diet 235 calories or 13% of total intake.

  1. S.A.D. is heavily loaded with red meat some chicken / pork and low amounts of fish. It is important to note that red meat has 92 calories per ounce.
  2. Mediterranean Diet loads up on fish, poultry and some pork with red meat entering their dietary intake only once every 7-10 days. White meats and fish range from 32-37 calories per ounce are easy to digest and the amount of available oils high in omega 3 promotes healthy organs.

Protein intake is a critical part of everyone’s diet. Vitamins B12 & B16 are most prominent in meats and provide nutrition for the central nervous system.  However, balance is most important when consuming protein. Omega 3 and Protein are in all the meats, fish, and poultry, however the omega-3 is in higher amounts within certain fish (Anchovies, Sardines, Herring, Mackerel, Salmon) also easier to digest. Red meat can take 48-72 hours to digest, therefore a contributor to the aging process of the body as organs endure a work out to utilize and expel what is not needed. In many cases saturated fat is then deposited into the arteries and begin to engulf the organs.

Benefits of Fruits, Vegetables, Herbs, Spices, and Resveratrol

  1. S.A.D. shows that Americans consume only 205 calories or .08% of fruits and vegetables through out the day. (Eat the skin if not hard or bitter.)
  2. Those who follow the Mediterranean Diet are more likely to consume 400 calories or 22% of fruits and vegetables through out the day. Consuming wholesome nutrients found within natural wrappers provides the human body systems with vitamins and minerals that it needs to function daily.

    Free Radicals expedite the aging process by harming the cell membrane. Anti-oxidants neutralize the free radicals, and therefore protect all cell membranes. Eat a variety of colorful fruits, vegetables, herbs, and spices to keep your body loaded up on anti-oxidants.

Clinical trials are executing nutrition in plant extract form as a way of combatting disease and researching compounds that come from Mediterranean herbs and spices:

  • Basil / Bay Leaves:  Antibacterial, antiviral, and antioxidant properties. New evidence suggests basil can decrease carcinogenesis, and help protect against the proliferation of cervical cancer (HeLa cells).
  • Cardamom: Is loaded with anti oxidants that purge the body from free radicals that help prevent multiple forms of cancer. Found to be anti-proliferatvie, anti-invasive, anti-inflammatory, anti-angiogenic. Colon Cancer
  • Oregano: Has flavonoids and phenolic acids (antimicrobial properties) found to prevent colon cancer and restrict growth of malignant cancer cells
  • Rosemary: Aids in preventing oxidative stress which causes prostate and ovarian cancer

Studies have shown utilizing plant extracts from Mediterranean Spices that are linked to reduced incidents of cancer or arrested progression of cancer are:

  • Cinnamon / Cloves: Increased levels of iron and calcium are components that may be attributes of the anti carcinogenic, pro-apoptotic, anti-proliferative properties. Cervical Cancer, Colon Cancer.
  • Ginger: Has shown that it inhibits cancer cell growth in prostate cancer patients.
  • Sumac: Has both anti-oxidants and anti-microbial properties, preventing the on set of cancer.
  • Turmeric:  Contains anti-oxidant, anti-inflammatory, anti-viral, anti-bacterial, anti-fungal, and anti-carcinogenic activities and thus has a potential against various malignant diseases, diabetes, allergies, arthritis, Alzheimer’s disease, Breast Cancer, Colon Cancer and other chronic illnesses.  Plant based resveratrol is known to slow the aging process and is tested to see which cancers that it can prevent, arrest, and cure.  “Resveratrol (1 mg/kg orally) reduced the number and size of the esophageal tumors in rats treated with a carcinogen; and in several studies, small doses (0.02–8 mg/kg) of resveratrol, given prophylactically, reduced or prevented the development of intestinal and colon tumors in rats given different carcinogens. Similarly, topical application of resveratrol in mice, both before and after the UVB exposure, inhibited the skin damage and decreased skin cancer incidence.”

Add resveratrol to your meals, finding it within a variety of sources: purple grapes, cranberries, blueberries, peanuts, pomegranate and Italian Red Wine.

Making small dietary changes will promote overall health and reduce incidence of nutrition related disease and cancers, therefore leading to days of improved strength, stamina, and endurance.

By: Kimberly Crocker-Scardicchio

References

Hypertension: Best Fall & Winter Foods to Reduce Blood Pressure

Fall & Winter Foods that contribute to overall reduction of blood pressure are in abundance as we move through the cooler moths. Eating seasonally is important for your body’s overall health as the variety of nutrients contribute to the body’s natural cleansing and healing abilities.

Fruits and vegetables that are higher in potassium rid the body of excess sodium, providing balance for the body and reducing overall blood pressure and contribute to weight loss. The following list of nutrition have all been researched and have shown evidence of reducing hypertension. Include them in your daily dietary intake!

Vegetables                                                                                             Fruits  

  • Baked Potato                                                                         Bananas
  • Beans                                                                                      Dried Apricots
  • (brown, kidney, lima, pinto, white)                                  Oranges
  • Lentils                                                                                     Prunes
  • Dark Chocolate (1 square per day)
  • Mushrooms                                                                            Dairy
  • Olives and Olive Oil                                                               1% Milk/Skim
  • Pumpkin                                                                                  Yogurt
  • Soybeans
  • Spinach                                                                                    Fish
  • Sunflower Seeds                                                                     Salmon
  • Winter Squash
  • Yams
  • Zucchini

Herbs and Spices to Reduce Hypertension

The following list of herbs, spices and vegetables have shown to reduce blood pressure. Their protective properties also contribute to overall heart and kidney health.

  • Cinnamon
  • Cardamon
  • Hawthorn (found in supplement form)
  • Garlic
  • Onions

Salt, Sugar, Fat, Alcohol

Know your numbers, improve your health.

How well do you know: Salt, Sugar, Fat and Alcohol?
All are tasty! Consumption of Salt, Sugar & Alcohol should be enjoyed in moderation.  All three can bring satisfaction and too much can have a negative effect on an individual, promoting health problems.

Salt will lead to hypertension. Reduce your risk of high blood pressure, look for salt that is hidden in: can foods, soy sauce, chicken and meats (injected with saline water), salad dressing, cheese, fast foods, and prepared frozen foods.  Daily recommendation of sodium  consumption is no more than 2.3 grams per day (1/2 teaspoon) and 1.5 grams for those over 51 years old.

Sodium levels reflected in a blood draw should be 135-145 mEq/L. Increased levels are linked to dehydration or renal (kidney) disease. Decreased levels are indicative of heart failure or edema. An individual that suffers from hypertension is strongly encouraged to follow the DASH Diet, designed to promote a low sodium diet and promotes overall wellness.

Sugar as we know and enjoy it! What other forms of sugar do you consume?

Sugar comes in many forms. A few common names are: sucrose (white), fructose (fruits and veggies), lactose (milk) and glucose (fuel for  our body’s energy). Studies of how sugar impacts both individuals and society are being conducted. For now, (within the context of healthy eating) studies show that sugar does not raise blood glucose any more quickly than do other starchy carbohydrates such as potatoes, rice, or pasta. Keep in mind, it is ones best interest to consume fruit, vegetable and grain carbohydrates as the element of fiber (both soluble and insoluble) will stabilize blood glucose levels by ridding the body of what is not important.

  • Fasting glucose normal levels 70-99 mg/dl.
  • Pre-diabetes 100-125 mg/dl.
  • Diabetes  >125 mg/dl.
  • Numbers that are over 125 mg/dl will prompt your doctor to ask you to return on a different day to draw blood a second time to better regulate the glucose levels.
  • Talk with your Doctor, Dietitian, or Diabetes Educator about obtaining optimal glucose levels by following  a balanced meal plan
Oil is a healthy fat that keeps the body well lubricated.

Oil is a healthy fat that keeps the body well lubricated.

Fats, when possible, should be consumed in liquid (unsaturated) form at room temperature. Olive Oil is an example of a healthy fat and lubricant for veins, arteries and organs. The presence of fat assists fat soluble vitamins with digestion and are stored in the liver. 3-4 tablespoons a day will keep the body healthy.

The Meditarranean Diet is an easy lifestyle to follow and allows for an individual to enjoy a wide variety of foods.

Reduced amounts of meats should be consumed 3 times a week, 4 ounces/day. Fish is light, easy to digest and contributes to raising healthy (HDL) cholesterol and lowering lousy (LDL) cholesterol. Enjoy fish 4 times a week! Solid fats (saturated) like cheese and butter should be consumed in lesser amounts of 1 ounce a day for cheese and 2 eight ounce glasses of 1% milk of choice (almond, cow or soy).

Ideal Cholesterol & Triglyceride Numbers
HDL cholesterol 40-60 mg/dl.
LDL cholesterol <100-129 mg/dl
Triglycerides <150 mg/dl

Wine in moderation is good for the body.

Wine in moderation is good for the body.

Alcohol
Alcohol can make your blood sugar levels fall too low and put you at risk of hypoglycemia, so people with diabetes are advised to drink alcohol with a meal or snack and not by itself.
Alcoholic beverages and drink mixers contain sugar and carbohydrates, so they must be figured into your overall meal plan. Your body will burn the alcohol as a source of fuel instead of burning fat.
If you use insulin, limit alcohol to two drinks per day.  Consume alcoholic drinks only with a meal or snack, and do not reduce your usual amount of carbohydrate.

Alcoholism is determined through a blood draw. A quick look at potassium levels maybe an indication of kidney or heart problems. Lower levels or potassium  is also a clue to a problem with alcoholism.  Potassium levels should be 3.6-5 mEq/L.

All our favorite vices can be included in our daily diet. Done in moderation, we can benefit from the joy of having them, but excessive consumption can damage our organs. Monitor your blood draw by requesting a copy of your blood results and know your numbers to stay healthy.

Kimberly Crocker-Scardicchio

References
Sugar and Diabetes  http://www.bddiabetes.com/us/main.aspx?cat=1&id=274
Fiber stabilizes blood glucose http://www.ncbi.nlm.nih.gov/pubmed/15173415
Reference Range for Blood Draw http://labtestsonline.org/understanding/features/ref-ranges/

Mediterranean Diet Low Sodium Meal Plan

The Mediterranean Diet is high in fruits, vegetables, and lean meats and seafood. The common thread is an abundance of Vitamin E found in many meals. Lastly, socialize and exercise with family and friends to make this a complete Lifestyle Change!

The following sample daily menu is a plan that incorporates both the Mediterranean and “DASH” diets, with the latter focused on reduced sodium intake.  By structuring meals throughout the week improved health will soon be noticed. One change that is noticeable with listed meals is that the calories are loaded in the morning and afternoon, the calories then taper off in the evening.

A key element to the success of this diet is reduced low salt intake in the food preparation. Fluids are equally important for a healthy lifestyle, add 6-8 glasses of water to your daily routine, choosing to squeeze the contents of 1/2 -1 whole lemon to a single  glass of water each day.

Please contact the listed telephone number if you are interested in more information or would like to establish a consultation. kimberlyscardicchio@yahoo.com

Breakfast

  • 1 slice whole wheat toast (I choose Aunt Millies “5 Grain Bread Light”, 2.5 grams fiber/slice.)
  • 1 tbsp Raspberry Jelly
  • Oatmeal (preferably 1 or 5 minute stove top)
  • 1 orange
  • (1.5  breads, 1 grain, 1 fruit)
  • 2 glasses of water (one glass of water with the juice squeezed from a fresh lemon.)

1 glass of water

10:30 am Snack
Chop and Combine

  • 1 Tbsp unsalted nuts  or sunflower seeds
  • 1 (choose 1) apple, plum, pear, peach
  • 1 four ounce low fat yogurt
  • 1 glass water
  • (1 protein, 1 fruit,  1 dairy)

Lunch

  • 2-3 oz fillet of fish, lean meat or poultry with 1/4 tsp salt or Mrs. Dash salt substitute
  • 1 c. ea. sliced carrots / zucchini (sautee 15 min’s with 1/8 c. olive oil. Add minced garlic, parsley)
  • diced 1 potato, 1 pepper, 1 peeled onion season with rosemary, thyme, 1/4 tsp salt, 1/8 c. oil. (Heat on med. for 20 minutes.)
  • 1 glass of wine
  • 1/2 cup grapes
  • (3 vegetable, 1 fruit, 1 protein,  1 fat)
  • 1 glass of water

2:00 pm   Snack

  • 1 Banana, or 1/4 cup berries, or 7 prunes
  • 1 glass of water
  • (1 fruit)

1 glass of water

Dinner

  • 1 cup lettuce
  • 1/2 cup tomato
  • 1 cup VEGETABLE: avocado, beans, sweet potato, or baked potato
  • 4 ounces of fish or chicken
  • 1 ounce of low fat cheese
  • 1-2 tsp Olive Oil and Vinegar
  • Glass of water with lemon
  • 1 Fruit of choice
  • (3 vegetable, 1 fat, 1 dairy, 1 protein, 1 fruit)

2 glasses of  water before bed

Calculate Cholesterol, Choose TLC Diet to Menu Plan

Being informed and understanding what cholesterol is will provide stronger knowledge of individual “Specimen Information”, which should be requested from your Doctor after having blood drawn. Compare your numbers to the information listed below,  choose your foods wisely to improve your daily nutritional intake, and cleanse your body, optimizing it’s overall function in keeping you healthy.

Cholesterol is a fat,  lipid, or a sterol, from which hormones are made. It is a waxy substance that resembles the very fine scrapings of a whitish-yellow candle. Cholesterol flows through your body via your bloodstream, lipids are oil-based and blood is water-based, they don’t mix. If cholesterol were dumped into your bloodstream, it would congeal into unusable globs.

The fat in these particles are made up of cholesterol, triglycerides and a phospholipid, which helps make the whole particle stick together. Triglycerides are a particular type of fat that have three fatty acids attached to an alcohol called glycerol, composed of 90 percent of the fat in the food you eat. The body needs triglycerides for energy, but as with cholesterol, too much is bad for the arteries and the heart.

  • Total Cholesterol Reference Range: 125-200 mg/dl     
  • HDL Cholesterol Reference Range: 40-60 mg/dl 
  • TriglyceridesReference Range:  <150mg/dl                   
  • Direct LDL Cholesterol Reference Range: 100 – 129 mg/dl

                                                                                                                                                                                                               

Healthy Cholesterol Levels, (HDL) should be greater than 50-60 mg/dl.   HDL is a cholestrol that works within the arteries to reduce accumulation of plaque, that can lead to artherosclerosis, in turn, reducing your risk for heart disease. HDL is monitored to ensure there is enough of it to fight off the plaque build up within the arteries.

 “LDL cholesterol”, explained by Harvard University, “in most people, (60-70 % of cholesterol) is carried in LDL particles, which act as ferries, taking cholesterol to the parts of the body that need it. Unfortunately, if you have too much LDL in the bloodstream, it deposits the cholesterol into the arteries, which can cause blockages and lead to heart attacks. The good news is that the amount of LDL in your blood-stream is related to the amount of saturated fat and cholesterol you eat. So, most people can decrease their LDL if they follow a reduced-fat diet.”

VLDL, stated by the “Clinical Reference Laboratory”, expressed as: “VLDL is a major carrier of triglyceride (60 -70% triglyceride 10-15% cholesterol). Circulating fatty acids are converted by the liver to form triglycerides.” Dr. Ginsberg of Columbia university simplifies the definition, “Very-Low Density Lipids are complexes of lipids and proteins assembled in the liver in response to nutrients and hormones. When VLDL are secreted, they carry almost all of the triglyceride in the blood-stream (they are about 85% triglycerides themselves), transporting triglycerides from the liver. When we are overweight, insulin resistant, or have diabetes, our livers secrete more VLDL with more triglycerides on every VLDL particle”.

People have varying degrees of success in lowering their cholesterol by changing their diets.  Meal Plan changes and Exercise both contribute to  lowering cholesterol and are highly recommended before pharmaceuticals are introduced. High cholesterol due to dietary intake of high saturated  foods (anything with animal fat) could be lowered by 5% to 20% with nutritional changes. The Therapeutic Lifestyle Change (TLC) Diet is recommended by the National Cholesterol Education Program of the U.S. National Institutes of Health. 

Calculating total cholesterol helps to put the pieces of the whole together.   The math equation for calculating total cholesterol is:

Total Cholesterol Formula  (TC) = LDL + HDL + (Triglycerides/5)

  • Sample lipid panel
  • Cholesterol, Total=195
  • HDL Cholesterol=55
  • Triglycerides = 100  (100/5=20)
  • Direct LDL Cholesterol=120

How Total Cholesterol is calculated using the sample numbers listed above.

  • example: (LDL) 120+ (HDL) 55 + 20= 195 (TC) Total Cholesterol

Calculating:  VLDL=Triglycerides/5

  • Triglycerides=100
  • example: 100/5=20 (VLDL)
  • Reference Range for VLDL is 5-40 mg/dl

Calculate Cholesterol Ratio

  • Total Cholesterol (mg/dl) / HDL Cholesterol (mg/dl)
  • Example: Total Cholesterol 200 mg/dl/ 50 mg/dl  HDL Cholesterol = 4.1  According to the American Heart Association is to keep your cholesterol ratio at 5 to 1 or lower.
  • Ideal ratio will be 3.5 to 1. Higher cholesterol ratio indicates a risk of heart disease, a lower ratio indicates a reduced risk of heart disease.

 

Various foods, beverages and spices are known for reducing, or interfering with bad cholesterol (LDL) and carrying it out of the body. Choose a variety of foods from the following lists including them at all your meals.

  •  Fruits and Vegetables (totaling 9 per day)
  • Teas
  • Extra Virgin Olive Oil
  • Cinnamon1-4g (1/3 tsp – 1 1/2 tsp a day)
  • Ginger (250 mcg/day capsule form)
  •  Honey 3 1/2 tablespoons / day

Reduce the saturated fat in your diet 

  1. Eat fish 3-4 times a week and benefit from Omega 3!
  2. Limit the amount of meat and milk products.
  3. Choose low-fat products from various food groups.
  4. Replace butter, a saturated fat with: Extra Virgin Olive, Canola, or Peanut oils.  7% of your daily calories should come from saturated fat (200 mg)   with 25% to 35% of daily calories  from unsaturated fat. 
  5.  Your diet should include calories to maintain your desired weight and avoid gaining weight.

Fluids are equally important to a successful diet.  Add 1-2 glasses of water with 1/2 to 1 whole lemon each day. Drink 1-2 cups of Oolong tea each day. Oolong tea burns over 157% more fat than Green Tea and is a popular tea designed to accelerate weight loss. 

TLC Diet is recommended by Doctors as a path for reducing high cholesterol.  Calories/day  1100 – 1695

Lean meat, poultry, fish, dry legumes Choose 5 ounces (140 g)  per day  

  • Anchovies, Mackeral, Sardines, Salmon,
  • Substitute 1/4 cup tofu, or 1/2 cup dry beans or peas for 1 ounce of meat or fish.
  • 2 tablespoons (1 oz) nuts (Almonds, Walnuts, Hazelnuts, Peanuts Soynuts) or seeds
  • Eggs, 2 yolks per week, 1 whole egg. Egg whites or substitutes are okay to eat.
  • Lean Meat. 3 0z. 165 calories, 0 g carbohydrate, 21 g protein, 9 g fat

Low-fat milk products.  Choose 2 per day     

  • 2 to 3 per day
  • 1 cup nonfat or 1% milk
  • 1 cup nonfat or low-fat yogurt
  • 1 ounce fat-free or low-fat cheese
  • Each serving. 80-110 calories, 12 g carbohydrate, 8 g protein, 0-3 g fat

Fruits.  Choose 4-5 per day the selection is endless!    

  • Apple, Apricots, Berries, Banana, Grapes, Melons, Orange, Pear, Plums, Prunes
  • Each serving.  60 calories, 15 g carbohydrate, 0 g protein, 0 g fat

Various Vegetables!  Choose 5-7 per day          

  • Artichokes, Avocado, Peppers, Zucchini, Cucumbers, Mushrooms,Eggplants, Asparagus, Legumes, Broccoli.
  • 1/2 cup cooked (season with garlic parsley and oil), Grilled, or Raw vegetables
  • Each serving.  25 calories, 5 g carbohydrate, 2 g protein, 0 g fat
    1 cup raw thick green leafy greens

Whole grains for bread, cereals, pasta, rice .  Choose 4-6 servings per day.

  •  Whole Grains, Choose Aunt Millies breads.
  • 1 slice whole grain bread
  • 1/2 wheat or multi-grain bagel, or English muffin
  • 1 ounce cold cereal (Bran)
  • Oatmeal for breakfast. (Quaker Oatmeal steel cut. Avoid 1 minute oatmeal)
  • 1/2 cup cooked whole grain pasta, rice, noodles, or other grains
  • Each serving. 80 calories, 15 g carbohydrate, 3 g protein, 1-3 g fat

Fat and oils.  Choose 2-3 servings per day

  • Each serving.  45 calories, 0 g carbohydrate, 0 g protein, 5 g fat.
    No Trans Fat (hydrogenated oils)
    1 teaspoon monounsaturated oil, such as Canola, Corn, EVOO, or Peanut
    1 tablespoon salad dressing (vinagrette)
    1 tbsp MCT Oil

By:  K. Crocker

Literature Research

  3.  Diet Low Sodium Meal Plan
  5. VLDL http://www.crlcorp.com/testDetails.cfm?facilityID=TLS&testID=510
  6. VLDL Dr. Ginsberg  http://www.medscape.org/viewarticle/569664av
  7. LDL Harvard University  http://www.health.harvard.edu/newsweek/Understanding_Cholesterol.htm
  8. Ginger reduces LDL Cholesterol  http://www.ncbi.nlm.nih.gov/pubmed?term=ginger%20reduces%20ldl
  9. Cinnamon reduces LDL Cholesterol http://www.ncbi.nlm.nih.gov/pubmed/14633804
  10. Honey Reduces Cholesterol http://www.ncbi.nlm.nih.gov/pubmed/18454257
  11. Calculate Cholesterol Ratio  http://www.mayoclinic.com/health/cholesterol-ratio/AN01761