A large body of evidence shows that daily consumption of EVOO confers numerous health benefits, including a significantly reduced risk of cardiovascular disease (CVD).
Factors that contribute to CVD include cholesterol, inflammation, blood vessel function, insulin resistance, and high blood pressure (hypertension). The protective effects of EVOO are attributed to its bioactive components, oleic acid (OA) and more than 30 polyphenols.
In this concise review, we’ll look closely at the mechanisms by which OA works in the body to modify and improve these factors.
What is OA? Oleic acid is a monounsaturated fatty acid (MUFA) that makes up approximately 70 to 80 percent of EVOO by volume. MUFAs and PUFAs (polyunsaturated fatty acids) are the key components of liquid fats, such as vegetable oils and the fats in fish.
Lowers “bad” cholesterol and blood lipid levels: OA lowers LDL or “bad” cholesterol by increasing the amount of LDL that is removed from the blood by the liver and reducing the amount that is produced. In scientific terms, OA increases hepatic LDL receptor activity. Similarly, OA helps lower triglyceride levels by stimulating the liver to increase the breakdown and removal of the proteins that produce triglycerides.
Helps regulate blood pressure: After eating, we experience what is termed the postprandial reflex—a rise in blood triglycerides and increase in blood pressure. When OA enters cell membranes, signals are sent from the intestines to the blood vessels to release vasodilators, which relax the blood vessels, and to block the release of vasoconstrictors, which tighten the blood vessels and raise blood pressure.
Protects the blood vessel lining: Damage to the blood vessel lining (the endothelium) is a major risk factor for CVD. By stimulating the release of vasodilators, OA helps protect the endothelium. OA also blocks signals from inflammatory proteins that are released with the postprandial reflex, reducing oxidative stress (which can lead to cell damage) and helping prevent atherosclerosis (buildup of cholesterol plaques in the arteries).
Increases insulin sensitivity: In a study of patients with obesity, OA was shown to up-regulate—increase the activity of—a gene that increases insulin sensitivity. OA also reduces insulin resistance in vascular smooth muscle cells, which make up the blood vessel walls.
Studies continue to reveal the ways in which OA exerts its multiple health-promoting effects. In 2018, the FDA determined that evidence supported a qualified health claim that the daily consumption of 20g daily of high-OA oil (EVOO or other high-oleic oil) may reduce the risk of coronary heart disease.
Stay tuned for part II, in which we’ll explore how the polyphenols in EVOO exert powerful protective effects against CVD.
References: 1. Lu Y, Zhao J, Xin Q, et al. Food Science and Human Wellness. 2024;13:529-540. 2. Pirahanchi Y, Sinawe H, Dimri M. Biochemistry, LDL Cholesterol (National Library of Medicine, 2023). 3. Zheng C, Khoo C, Furtado J, Ikekawi K, Sacks FM. Am J Clin Nutr. 2008;88(2):279-281. 4. US Food and Drug Administration. Constituent Update, November 19, 2018. https://www.fda.gov/food/cfsan-constituent-updates/fda-completes-review-qualified-health-claim-petition-oleic-acid-and-risk-coronary-heart-disease.
Orange-Raspberry Muffins Recipe, Spotlight on Almond Flour, Juicing Fruit, The Benefits of Limiting Processed and Red Meats, and High Intensity Interval Training (HIIT)
Packaged gluten-free baked goods are often tasteless, not to mention filled with additives and other unhealthy ingredients. In just a few minutes, you can bake your own delicious muffins that are so tasty that they won’t provoke eye rolls from gluten lovers. While gluten should be avoided only by those with a sensitivity or celiac disease, a recent study found that everyone can benefit from eating fewer processed and red meats—the health benefits are astounding. Then read about a newly discovered benefit of high-intensity interval training (HIIT).
The combination of olive oil and almond flour creates a tender crumb that rivals any flour-based batter and a muffin that’s infinitely more nutritious. I like to use “tulip-shaped” cupcake liners because you can fill them right up to the level of your baking tin for very tall muffins. Also, topping the batter with berries after filling the liners helps keep the fruit from falling to the bottom.
Ingredients
3 cups almond flour
1-1/2 teaspoons baking powder
1/2 teaspoon fine sea salt
3/4 cup extra-virgin olive oil
1/2 cup sugar, divided use
Freshly grated zest of 1 large orange
1/2 cup fresh orange juice
6 eggs, separated
1 tablespoon vanilla paste
1 cup raspberries
Directions
Step 1
Preheat your oven to 350°F. Place tulip-shaped cupcake liners in the cups of a 12-muffin tin; set aside.
Step 2
In a large bowl, sift together the almond flour, baking powder, and salt. In a separate bowl, whisk together the olive oil, 1/4 cup sugar, orange zest and juice, egg yolks, and vanilla. Fold in the flour mixture.
Step 3
In a very large bowl or the bowl of a stand mixer, beat the egg whites on a low speed to break them up, about a minute. Once they start to foam, increase the speed to high and add the remaining sugar. Whip until the whites form stiff peaks, then use a large spatula to gently fold them into the almond flour mixture in 3 or 4 batches, rotating your mixing bowl as you move your spatula from the center out to the sides. Don’t overmix to avoid deflating the batter—a few streaks of whites are OK.
Step 4
Use a large ice cream scoop to fill the paper liners up to the level of your baking tin. Top with equal amounts of berries. Bake the muffins for 30 to 40 minutes, until the tip of a sharp knife comes out clean. Serve warm or at room temperature.
Yields 12 muffins
Healthy Ingredient Spotlight
Almond Flour
Almond flour, like other nut flours, is wonderful for baking, whether you’re making muffins, a cake like a dacquoise or torte, cookies, or even pie shells. You can grind your own from fresh almonds or buy it by the bag. Some brands are made of blanched almonds, but those made with the almond skins offer even more nutrients. Like almonds themselves, almond flour is naturally rich in vitamin E and other antioxidants, manganese, and magnesium, with a healthy dose of protein and fiber. To keep it fresh, store it in the fridge or freezer.
Quick Kitchen Nugget
Juicer or Hand Squeezer?
When a recipe calls for any type of citrus juice, fresh-squeezed is a must. The question then becomes whether to use a hand press or an electric citrus juicer. The answer depends on how much juice you’ll be making.
For a few tablespoons up to a cup, a metal hand press (look for one with ergonomic handles) will work well with minimal strain on your hands—it does take effort to squeeze its handles together, and you might need different sizes for juicing limes, lemons, and oranges effectively. For juicing large quantities, it pays to have an electric juicer for ease and speed; this countertop appliance can handle all sizes of citrus and can be stored in a cabinet when not needed. There are also large, commercial-grade manual juicers that sit on a flat surface and that you operate by pushing down on a lever to extract the juice, but these tend to take up a lot of counter space.
For Your Best Health
The Benefits of Limiting Processed and Red Meats
While many studies have identified links between frequent consumption of processed meat and chronic disease, few have evaluated the impact on multiple health outcomes. Some previous research also suggested that unprocessed red meat may contribute to chronic disease risk, but evidence has been limited.
Now, a team from the University of Edinburgh’s Global Academy of Agriculture and Food Systems, together with researchers from the University of North Carolina, Chapel Hill, has used data from a Centers for Disease Control and Prevention national health survey to create a simulated, representative sample of the US adult population—called a microsimulation—in order to estimate how changes in meat consumption affect adults’ risk of diabetes, cardiovascular disease, colorectal cancer, and death. The effects were evaluated in the overall population and separately based on age, sex, household income, and ethnicity.
This microsimulation is the first to estimate the effects of reducing processed meat and unprocessed red meat consumption, from between 5 percent and 100 percent, on multiple health outcomes in the US. They found that cutting processed meat intake by 30 percent (the equivalent of around 10 slices of bacon a week) would prevent more than 350,000 cases of diabetes and lead to 92,500 fewer cardiovascular disease cases and 53,300 fewer colorectal cancer cases over a decade.
The researchers also analyzed the impacts of reducing unprocessed red meat intake alone and cutting consumption of both processed meat and unprocessed red meat. Cutting unprocessed red meat intake alone by 30 percent, which would mean eating around one less quarter-pound beef burger a week, resulted in more than 732,000 fewer diabetes cases, 291,500 fewer cardiovascular disease cases, and 32,200 fewer colorectal cancer cases. Reducing consumption of both by 30 percent resulted in 1,073,400 fewer diabetes cases, 382,400 fewer cardiovascular disease cases, and 84,400 fewer colorectal cancer cases.
The finding that more disease cases were prevented by reducing unprocessed red meat than by reducing processed meat is partly due to the average daily intake of unprocessed red meat being higher than that of processed meat, at 47 grams a day versus 29 grams a day, respectively. As less is known about the effect of eating unprocessed red meat on chronic disease risk, the team said these estimates should be interpreted with caution and that more research is needed.
Lindsay Jaacks, PhD, professor, Personal Chair of Global Health and Nutrition at the University of Edinburgh, and one of the authors of the study, said, “Cutting consumption of meat has been recommended by national and international organizations to reduce greenhouse gas emissions, including by the Climate Change Committee here in the UK and the United Nations Intergovernmental Panel on Climate Change. Our research finds that these changes in diets could also have significant health benefits in the US, and so this is a clear win-win for people and planet.”
The study, “Estimated effects of reductions in processed meat consumption and unprocessed red meat consumption on occurrences of type 2 diabetes, cardiovascular disease, colorectal cancer, and mortality in the USA: a microsimulation study,” was published in TheLancet Planetary Healthand was funded by the Wellcome Trust.
Fitness Flash
An Exercise Brain Boost That Can Last for Years
A longitudinal study led by Emeritus Professor Perry Bartlett, PhD, and Daniel Blackmore, PhD, of the University of Queensland’s Queensland Brain Institute found that high-intensity interval exercise improves brain function in healthy older adults for up to five years. The research was published inAging and Disease.
Dr. Bartlett said it is the first controlled study of its kind to show that exercise can not only delay cognitive decline but also boost cognition in healthy older adults. “Six months of high-intensity interval training (HIIT) is enough to flick the switch,” Dr. Bartlett said. “In earlier preclinical work, we discovered exercise can activate stem cells and increase the production of neurons in the hippocampus, improving cognition. In this study, a large cohort of healthy 65- to 85-year-old volunteers joined a six-month exercise program, did biomarker and cognition testing, and had high-resolution brain scans.”
During the study, the researchers assessed the impact of three exercise intensities: low—predominantly motor function, balance, and stretching; medium—brisk walking on a treadmill; and high—four cycles of running on a treadmill at near maximum exertion. Participants exercised three times a week, for between 36 and 45 minutes per session including warmup and cooldown, and under supervision for 6 months.
Dr. Blackmore said only the high-intensity interval exercise led to cognitive improvement that was retained for up to five years. “On high-resolution MRI scans of that group, we saw structural and connectivity changes in the hippocampus, the area responsible for learning and memory,” he said. “We also found blood biomarkers that changed in correlation to improvements in cognition. Biomarkers can be useful in predicting the effectiveness of the exercise a person is doing.”
Aging is one of the biggest risks for dementia, a condition that affects almost half a million Australians. “If we can change the trajectory of aging and keep people cognitively healthier for longer with a simple intervention like exercise, we can potentially save our community from the enormous personal, economic, and social costs associated with dementia,” Dr. Bartlett said.
With one out of three people aged 85 likely to develop dementia, Dr. Blackmore said, the impact of the research is far-reaching. “Our finding can inform exercise guidelines for older people and further research could assess different types of exercise that could be incorporated. We are now looking at the genetic factors that may regulate a person’s response to exercise to see if we can establish who will and who will not respond to this intervention. The use of biomarkers as a diagnostic tool for exercise also needs further research,” he added.
Since HIIT has benefits for people of any age, from heart health to a metabolism boost, talk to your doctor or personal trainer about adding it to your exercise regimen.
Summer on a Skewer Recipe, Spotlight on Muskmelons, Magnesium for Bone Health, Plus Walking to Alleviate Back Pain
Summer brings an amazing bounty of produce along with often-sweltering temps that make a hot kitchen the last place you want to be. I love these fruit-and-cheese skewers because there’s virtually no prep involved, yet the finished dish is elegant enough for a patio party! Are you a fan of nuts and seeds? These are excellent sources of an often-overlooked mineral that plays a vital role in bone health: magnesium. Read more about it below along with the results of a study on a simple way to help ease back pain.
Want an elegant lunch, first course, or light supper that doesn’t require any complex prep or cooking? Here are twists on two summer salad favorites: feta with watermelon and cantaloupe with prosciutto. When served on skewers, they become the perfect finger food. Make one variety or both, or mix and match the ingredients for a colorful presentation. The sweetness of the melons and the slight saltiness of the cheeses are elevated by a drizzle of olive oil and a splash of balsamic—no need to whisk up a vinaigrette.
Ingredients
For the feta skewers:
8-ounce block feta, preferably from Greece
1/2 ripe watermelon
Mint leaves
6 long bamboo skewers
For the mozzarella skewers:
1 large cantaloupe or honeydew
12 mini mozzarella balls
6 slices of prosciutto, halved and rolled up, or 12 thin slices of your favorite salami
For the feta skewers, cut the feta and the watermelon into similarly sized cubes, 18 of the watermelon and 12 of the feta. Assemble ingredients on each skewer in this order: watermelon, mint, feta; repeat the pattern and then cap each skewer with an extra piece of watermelon.
For the mozzarella skewers, use a melon baller to make 18 melon balls close in size to the mozzarella. Assemble ingredients on each skewer in this order: melon, basil, prosciutto; repeat the pattern and then cap each skewer with an extra piece of melon.
Arrange the skewers on a platter and drizzle liberally with olive oil, splashes of balsamic, and a few twists from your black peppercorn grinder.
Yields 6 servings
Healthy Ingredient Spotlight
Muskmelons
That’s the umbrella term of all sweet melons other than watermelon. While watermelon is alone in its category, there are close to two dozen muskmelon varieties, some smooth skinned and others with a rough pattern often described as a netting. Most people are familiar with cantaloupe and honeydew, but there are many more to explore, each delicious in its own way.
There’s a refreshing sweetness to casaba, crenshaw, and canary melons, with white, orange-pink, and pale green flesh, respectively. Becoming more available at farmers’ markets and Asian specialty stores are the round Persian melon with sweet pink flesh and the Chinese hami melon, which is extra sweet. Experiment with them in any recipe that calls for cantaloupe or honeydew, or just enjoy a thick slice on its own.
Melons have a high water content as well as important vitamins, minerals, and fiber. Muskmelons are typically rich in vitamin C, with cantaloupe topping the nutrient list: a one-cup serving has 95% of the vitamin C you need a day and all the vitamin A. (The rich red color of watermelon comes from lycopene, an important antioxidant, so enjoy it, too!)
Quick Kitchen Nugget
Choosing Melons
Buying a whole melon can seem like playing a mystery game. Its sweetness is set at the time of harvest, and the rind doesn’t even indicate the color of the flesh. But there are some clues to help you pick a ripe, sweet melon. Whether round or oblong, the melon should be symmetrical in shape. It should feel weighty in your hands. Checking out the stem end is also key. Unlike a prime pumpkin, there shouldn’t be any stem still attached, and the indentation it left should be hollow and smooth.
When a melon with netting on the rind is ripe, you should be able to easily smell its sweet aroma. But you won’t pick up any scent from a smooth-skinned melon like honeydew. Instead, look for a rind that’s more of a creamy shade rather than a stark color like green. A good watermelon should have a large, creamy-yellow spot where it sat on the ground, and the overall rind should be matte or dull, not shiny.
In terms of food safety, always rinse melons well before cutting to get rid of potential bacteria; those with netting will benefit from a light scrub with a vegetable brush. Pat the melon dry before prepping.
For Your Best Health
Magnesium: The missing Mineral for Bone Health
We already know the importance of calcium and vitamin D for strong bones, but we don’t often hear about magnesium, another key mineral. Magnesium is found in legumes, nuts, seeds, whole grains, and green leafy vegetables, so it shouldn’t be a challenge for anyone following a Mediterranean-style diet to get enough of this essential nutrient.
Adults need between 310 and 420 mg of magnesium per day, with no more than 350 mg coming from any kind of supplement. That’s because high amounts of supplemental magnesium can cause side effects like stomach cramps and nausea (excessive amounts have even been linked to an irregular heartbeat and heart attack, according to the NIH). But there’s no limit on how much you can get from food. If you love nuts and seeds, you’ll be especially thrilled that the top sources of magnesium include one-ounce servings of pumpkin seeds (156 mg), chia seeds (111 mg), almonds (80 mg), cashews (74 mg), and peanuts (63 mg). Other good foods are half-cup servings of cooked spinach (78 mg), black beans (60 mg), and edamame (50 mg); 2 tablespoons peanut butter (49 mg); and a 3-1/2 ounce baked potato with skin (43 mg).
Fitness Flash
Walking: Help for that Achin’ Back
About 800 million people worldwide have low back pain, a leading cause of disability and diminished quality of life. Repeated episodes of low back pain are common: 7 in 10 people who recover from one episode of low back pain go on to have another within a year.
The current best practice for back pain management and prevention is a combination of exercise and education. However, some forms of exercise don’t work for many people because of reasons like high cost, complexity, and the need for supervision. A clinical trial by Macquarie University Spinal Pain Research Group in Sydney, Australia, looked at whether walking could fit the bill. Their study, “Effectiveness and cost-effectiveness of an individualised, progressive walking and education intervention for the prevention of low back pain recurrence in Australia (WalkBack): A randomised controlled trial” was published in The Lancet.
The trial involved 701 adults who had recently recovered from an episode of low back pain and who were randomly allocated to either an individualized walking program and six physiotherapist-guided education sessions over six months, or to a control group. Researchers followed them for between one and three years, depending on when they joined the study. They found that adults with a history of low back pain who walked regularly went nearly twice as long without a recurrence.
According to the paper’s senior author, Macquarie professor of physiotherapy Mark Hancock, PhD, the findings could have a profound impact on how low back pain is managed. “The intervention group had fewer occurrences of activity-limiting pain compared to the control group, and a longer average period before they had a recurrence, with a median of 208 days compared to 112 days,” Dr. Hancock said. “Walking is a low-cost, widely accessible, and simple exercise that almost anyone can engage in, regardless of geographic location, age, or socioeconomic status.
“We don’t know exactly why walking is so good for preventing back pain, but it is likely to include the combination of the gentle oscillatory movements, loading and strengthening the spinal structures and muscles, relaxation and stress relief, and release of ‘feel-good’ endorphins.
And of course, we also know that walking comes with many other health benefits, including cardiovascular health, bone density, healthy weight, and improved mental health.”
Added lead author Natasha Pocovi, PhD, “It not only improved people’s quality of life but reduced both their need to seek healthcare support and the amount of time taken off work by approximately half. The exercise-based interventions to prevent back pain that have been explored previously are typically group based and need close clinical supervision and expensive equipment, so they are much less accessible to the majority of patients. Our study has shown that this effective and accessible means of exercise has the potential to be successfully implemented at a much larger scale than other forms of exercise.”
To build on these findings, the team next hopes to explore how they can integrate the preventive approach into the routine care of patients who experience recurrent low back pain.
Cold Avocado and Cucumber Soup Recipe and The Mediterranean Diet for Longevity
Members of the Fresh-Pressed Olive Oil Club are well aware of the benefits of extra virgin olive oil as part of the world-famous Mediterranean diet. Dozens of studies have assessed its health effects and its link to longevity, most commonly attributed to its improving heart health. But how the Mediterranean diet works its magic hasn’t been thoroughly understood. Investigators from Brigham and Women’s Hospital in Boston recently published the results of a long-term study that helps unravel this mystery. I’m thrilled to share their findings. And to start, here’s a recipe that highlights the plant-based approach that underscores the Mediterranean way of living.
There’s nothing more refreshing than a chilled soup for lunch or dinner during the dog days of summer, especially when there’s no cooking needed. I like to add a different kind of heat with a fresh hot pepper, but you can omit it if you aren’t a fan!
Ingredients
2 pounds cucumbers, about 2-3 large ones
1 small jalapeño, halved and seeded, optional
2 ripe Hass avocados
2 cups plain nonfat Greek yogurt or skyr
3 large scallions, trimmed
3 garlic cloves, peeled
1 cup packed of fresh parsley, dill, and chives
1/4 cup extra virgin olive oil, plus more for drizzling
Optional garnishes: thin slices of avocado, a dollop of yogurt or skyr, more fresh herbs
Directions
Halve the cucumbers lengthwise and use a large spoon to scoop out and discard most of the seeds; leave on the peel. Cut the cucumbers into chunks for easier puréeing. If using the pepper, halve it, scoop out the seeds and veins, and discard them along with the stem. Scoop all the flesh out of the avocados.
Step 2
Working in batches as needed, add the cucumbers, avocados, pepper if using, yogurt, scallions, garlic, herbs, olive oil, water, and vinegar to your food processor bowl or blender and process until puréed—the mixture should be fairly thick. If it’s too thick, add more water, 2 tablespoons at a time, until it’s pourable. Taste and season with salt and pepper as desired. Chill in the fridge for about an hour.
Step 3
To serve, ladle portions into soup bowls or glasses, garnish as desired, and drizzle with more olive oil.
Yields 8 servings
For Your Best Health
The Mediterranean Diet for Longevity
The study: “Mediterranean Diet Adherence and Risk of All-Cause Mortality in Women,” JAMA Network Open,2024.
The health benefits of a Mediterranean diet, on its own and when compared to other healthy ways of eating, are so strong that US dietary guidelines have repeatedly designated it as the healthiest recommended diet. It’s also gotten the nod from many health organizations around the globe, including the American Heart Association, European Society of Cardiology, and Australian National Heart Foundation. While these benefits aren’t in doubt, how it achieves them hasn’t been completely understood. This new study sought to better explain the various ways in which the body responds to the diet—how exactly closely following it lowers mortality risk. What’s more, the more than 25,000 participants were American women. In general, women aren’t included in the same numbers as men in most studies, and regarding research on the Mediterranean diet in particular, most studies have been done in the countries surrounding the Mediterranean Sea, where the diet is more of a way of life than in the US.
For the study, researchers from Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, followed the women, who were all healthy at the start of the study, for up to 25 years. They found that participants who followed the diet most closely had up to 23% lower risk of all-cause mortality…and found evidence of biological changes to help explain why. They were able to detect and evaluate changes in approximately 40 biomarkers representing various biological pathways and clinical risk factors, both traditional ones and novel ones that hadn’t been used in prior studies. Biomarkers of metabolism and inflammation made the largest contribution, followed by triglyceride-rich lipoproteins, adiposity, and insulin resistance. Smaller contributions were seen from biological pathways relate to branched-chain amino acids, high-density lipoproteins, low-density lipoproteins, glycemic measures, and hypertension.
“For women who want to live longer, our study says watch your diet!,” said senior author Samia Mora, MD, a cardiologist and the director of the Center for Lipid Metabolomics at the Brigham. “The good news is that following a Mediterranean dietary pattern could result in about one quarter reduction in risk of death over more than 25 years with benefit for both cancer and cardiovascular mortality, the top causes of death in women (and men) in the US and globally.”
“Our research provides significant public health insight: Even modest changes in established risk factors for metabolic diseases, particularly those linked to small molecule metabolites, inflammation, triglyceride-rich lipoproteins, obesity, and insulin resistance, can yield substantial long-term benefits from following a Mediterranean diet,” said lead author Shafqat Ahmad, PhD, an associate professor of epidemiology at Uppsala University Sweden and a researcher in the Center for Lipid Metabolomics and the Division of Preventive Medicine at the Brigham. “This finding underscores the potential of encouraging healthier dietary habits to reduce the overall risk of mortality.”
How the Study Was Conducted
At the start of the study, blood samples, biomarker measurements, and dietary information were taken from the participants, who self-reported demographics and filled out a validated food-frequency questionnaire. The data collection period was from April 1993 to January 1996, and data analysis took place from June 2018 to November 2023.
Each participant was given a score for Mediterranean diet adherence, which ranged from 0 to 9. Eating a higher-than-median amount of each of a list of foods—vegetables (excluding potatoes), fruits, nuts, whole grains, legumes, and fish—earned 1 point. So did eating a good ratio of monounsaturated-to-saturated fatty acids such as olive oil compared to butter, a less-than-median amount of red and processed meat, and having an alcohol intake within the range of 5 to 15 grams a day (one 5-ounce glass of wine, a 12-ounce can of regular beer, or 1.5 ounces of liquor). Participants were then categorized into one of three levels: 0-3 or low, 4-5 or intermediate, and 6-9 or high. Women with scores of 6 or greater had a 23% lower relative risk of all-cause mortality than did women who scored 3 or less.
“The health benefits of the Mediterranean diet are recognized by medical professionals, and our study offers insights into why the diet may be so beneficial. Public health policies should promote the healthful dietary attributes of the Mediterranean diet and should discourage unhealthy adaptations,” said Dr. Mora.
