Treat and even prevent diabetes with ginger: Study finds it improves several markers of the disease

Image: Treat and even prevent diabetes with ginger: Study finds it improves several markers of the disease

Are you doing everything you can to avoid diabetes or control it if you already have it? It’s a frightening illness that can severely impact a person’s quality of life and even lead to death, so it’s only natural that people who are concerned about their health take steps to reduce their risk. Perhaps you’re already avoiding sugar, watching your diet, and getting plenty of exercise, but are you eating enough ginger?

A new study has demonstrated just how powerful ginger’s effects are in fighting this all-too-common disease. Seventy patients with type 2 diabetes participated in a double-blinded, placebo-controlled trial to assess how ginger could affect their glycemic status, inflammatory markers of the condition, and their lipid profile. A control group took a 1600mg placebo, while the ginger group took 1600mg of ginger daily. Measurements were taken at the beginning and end of the study to assess their blood lipids, blood sugar levels, tumor necrosis factor alpha, prostaglandin E2, and C-reactive protein.

The researchers found that those who underwent the ginger treatment had significantly lower levels of quite a few parameters. These include the important fasting plasma glucose, insulin, triglycerides, total cholesterol, and inflammation markers C-reactive protein and Prostaglandin E2. They also had lower levels of glycated hemoglobin, or HbA1C, which measures how much sugar is damaging the body’s red blood cells, and a measurement of insulin resistance known as HOMA.

The amount of ginger the patients took equated to 1.6 grams, which is not a very big amount; it’s roughly equivalent to just ¼ of a teaspoon. They took it in capsule form in doses of 800mg twice per day.

A family of diabetes fighters

Ginger comes from the same family of plants as turmeric, which was shown in a recent study published in the journal Diabetes Care to be 100 percent effective in preventing people with prediabetes from developing full-fledged diabetes.

In the placebo-controlled, double-blinded and randomized study, researchers in Thailand divided 240 prediabetic participants into groups, one of which was given 250 mg of curcuminoid daily, while the other served as a control. A variety of parameters were measured at the beginning of the study and every three months up until nine months, and the researchers reported that while 16.4 percent of those in the placebo group went on to develop type 2 diabetes, nobody in the curcumin group developed the illness.

That’s a remarkable accomplishment, and it is excellent news for the two out of five Americans aged 40 to 74 who are estimated to have prediabetes. After all, curcumin is found in turmeric, which is not only easy to find and affordable, but also very safe.

Consuming more ginger and turmeric is easy

It’s easy to incorporate more ginger and turmeric into your diet, and doing so can give you a fighting chance against diabetes in addition to many other health benefits. The two flavors complement one another well and can be used to create stews, curries, chicken dishes and aromatic rices for a one-two punch. The easiest way to consume more ginger and turmeric is by making a simple tea out of them; you can add flavors like cinnamon, lemon or honey if desired.

You can also add them, individually or separately, to smoothies or soups. Ginger has a more noticeable presence, so it won’t work in just any soup, but it does pair nicely with carrots and other vegetables.

Turmeric has a subtler flavor, which means you can add it to eggs, vegetables, smoothies and soups without worrying about affecting the flavor too much. Many people like to consume it with milk. Just remember to consume a small amount of black pepper with the turmeric to help your body absorb it.

Turmeric and ginger capsules are also available, but it’s important to get organic varieties from trusted sources to ensure you are getting a pure product.

No rush to label teens as having PCOS, says expert

Dr Veronique Celine Viardot-Foucault.

Diagnosis of polycystic ovary syndrome (PCOS) is challenging, and there should be no rush to label an adolescent as having the condition before a thorough evaluation of symptoms, according to a leading endocrinologist who was speaking at the RCOG World Congress 2018 in Singapore.

“Common features of PCOS such as hirsutism, acne, and obesity are often present in otherwise ‘normal’ adolescents,” said Dr Veronique Celine Viardot-Foucault from the KK Women’s and Children’s Hospital, Singapore, adding that these features may not necessarily be indicative of PCOS.

Appropriate diagnosis of PCOS in adolescents should involve careful evaluation of symptoms such as menstrual irregularities, hyperandrogenism, and polycystic ovarian morphology, she said. Menstrual irregularities—including secondary amenorrhoea and oligomenorrhoea in girls beyond 2 years after menarche, or primary amenorrhoea in those who have completed puberty—may be indicative of androgen excess. [Horm Res Paediatr 2017;88:371-395]

As symptom such as acne is common in adolescence and usually transient, it may not be indicative of hyperandrogenism, said Viardot-Foucault. Also, isolated cases of acne and/or alopecia should not be considered as diagnostic criteria for PCOS in adolescence, but moderate or severe inflammatory acne that is unresponsive to topical therapy may require investigation of androgen excess. [Horm Res Paediatr 2017;88:371-395]

Another feature commonly seen with PCOS is hirsutism, which can be evaluated using the modified Ferriman–Gallwey (FG) scoring system. “However, the FG scoring system is not applicable to younger, perimenarchal patients [younger than 15 years old],” she advised, pointing out that biochemical evidence of hyperandrogenism is preferred in this group.

As there is no clear cut-off of testosterone levels for adolescents, biochemical hyperandrogenism should be defined based on the methodology used, informed Viardot-Foucault. “Ideally, to establish the existence of androgen excess, assaying for free testosterone levels is the gold standard as it is more sensitive than measuring the total testosterone levels,” she said. “But a downside of this is that it requires equilibrium dialysis techniques which are costly and not widely available.”

However, most commercial laboratories use direct analogue radio-immunoassay, which is notoriously inaccurate for measuring free testosterone, cautioned Viardot-Foucault. “If uncertain regarding the quality of the free testosterone assay, it is preferable to rely on calculated free testosterone, which has a good concordance and correlation with free testosterone levels measured by equilibrium dialysis methods,” she suggested. [J Clin Endocrinol Metab 1999;84:3666-3672]

Also, the value of measuring other androgens besides free testosterone in patients with PCOS is relatively low, although increased levels of dehydroepiandrosterone sulphate (DHEAS) have been observed in 30–35 percent of PCOS patients. [Ann N Y Acad Sci 2006;1092:130-137]

“Transabdominal pelvic ultrasound has a lower diagnostic accuracy,” said Viardot-Foucault. “The presence of polycystic ovarian morphology [on ultrasound] in an adolescent who does not have hyperandrogenism or oligo-anovulation does not indicate a diagnosis of PCOS.”

When menstrual irregularities are concerned, the first-line treatment should be cyclical progestogens when contraception is not required and there are no signs of hyperandrogenism, according to Viardot-Foucault. If there is clinical hyperandrogenism or a need for contraception in those sexually active, third-generation oral contraceptives such as ethinyl estradiol 30 µg can be considered.

“There is room for local treatment of hirsutism such as laser [hair removal, but only for patients beyond] 16 years old and [who are] at least 2 years post-menarche,” she said. “If there are metabolic complications, [patients should be referred] to the endocrinologist.”

Comparing the Accuracy of My Blood Glucose Meters

I was first introduced to the One Touch Verio IQ when I began using an Animas insulin pump in May 2016. The sales rep gave me a rave review of this blood glucose meter, telling me that it was one of the most accurate on the market. This meter had also been recommended for calibrating readings on a Dexcom system, which is often considered the golden child of continuous glucose monitoring in the diabetes community.

At the time, I was quite happy with my FreeStyle Insulinx and had no intention of switching. However, the Verio was quite a good looking meter and certainly more modern than any of the other devices I was using. So, I ended up placing it in my travel case and decided that I would use it as my spare.

As wonderful as the encasing, color screen, and rechargeable batteries were, my biggest deal breaker in using this meter was its accuracy. I have consistently found that the One Touch Verio reads at least 0.5 mmol/L (9 mg/dL), if not 1 mmol/L (18 mg/dL) higher than each of my other blood glucose meters.

There have been times where I’ve felt lows coming on, only to check my blood sugar using the Verio and still see a reading within range. From my personal experience, this is not a meter that I can trust.

To be fair, all blood glucose meters will only be accurate to the nearest 1 mmol/L (18 mg/dL) of a laboratory result. Which explains why two simultaneous blood glucose checks will likely produce two different results.

Most blood glucose meters must have a mean absolute relative difference (MARD) within 15 to 20 percent of laboratory results. This standard deems these devices a reliable indicator of blood glucose levels and safe to dose insulin from.

Which blood glucose meter can I trust? I conducted an experiment of sorts at home comparing all of the blood glucose monitoring devices that I currently use. Pictured from left to right, these include FreeStyle Libre, OneTouch Verio IQ, Accu-Chek Guide, and FreeStyle Insulinx. (Note: The FreeStyle Libre is a flash glucose monitoring system that measures interstitial fluid, and produces a reading each time the reader is waved over the sensor worn on the upper arm.)

Given that any moisture or dirt on my hands can impact glucose readings, I washed and dried my hands thoroughly before lancing my finger and repeated this experiment three times.

  Lowest Reading Highest Reading Variance
Experiment 1 FreeStyle Insulinx (7.0 mmol/L) OneTouch Verio IQ (8.2 mmol/L) 1.2 mmol/L
Experiment 2 FreeStyle Insulinx (7.1 mmol/L) OneTouch Verio IQ (8.4 mmol/L) 1.3 mmol/L
Experiment 3 FreeStyle Insulinx (6.2 mmol/L) OneTouch Verio IQ (7.8 mmol/L) 1.6 mmol/L

The FreeStyle Insulinx produced the lowest blood glucose reading in each of my three checks, while the OneTouch Verio IQ produced the highest. Variances between the lowest and highest reading were fairly consistent, ranging from 1.2-1.6 mmol/L.

  Lowest Reading Highest Reading Variance
FreeStyle Libre 7.3 mmol/L 7.4 mmol/L 0.1 mmol/L
OneTouch Verio IQ 7.8 mmol/L 8.4 mmol/L 0.6 mmol/L
Accu-Chek Guide 7.2 mmol/L 7.6 mmol/L 0.4 mmol/L
FreeStyle Insulinx 6.2 mmol/L 7.1 mmol/L 0.9 mmol/L

When comparing the performance of each meter across my three checks, the Accu-Chek Guide reported the lowest variance among the standard blood glucose meters with 0.4 mmol/L. The FreeStyle Insulinx reported the greatest variance, with a 0.9 mmol/L difference between the lowest and highest reading.

I also decided to repeat my experiment a second time with an elevated post-meal blood sugar, as I had my suspicions that the variances might be greater.

Lowest Reading Highest Reading Variance
Experiment 1 FreeStyle Insulinx (10.3 mmol/L) OneTouch Verio IQ (11.5 mmol/L) 1.2 mmol/L
Experiment 2 FreeStyle Insulinx (10.6 mmol/L) OneTouch Verio IQ (12.7 mmol/L) 2.1 mmol/L
Experiment 3 FreeStyle Insulinx (8.7 mmol/L) OneTouch Verio IQ (12.1 mmol/L) 3.4 mmol/L

Once again the FreeStyle Insulinx produced the lowest blood glucose readings across my three checks, while the One Touch Verio produced the highest. Interestingly variances between the lowest and the highest readings ranged significantly higher than my first experiment, from 1.2 mmol/L to 3.4 mmol/L.

Lowest Reading Highest Reading Variance
FreeStyle Libre 11.1 mmol/L 11.3 mmol/L 0.2 mmol/L
Accu-Chek Guide 10.8 mmol/L 11.1 mmol/L 0.3 mmol/L
OneTouch Verio IQ 11.5 mmol/L 12.7 mmol/L 1.2 mmol/L
FreeStyle Insulinx 8.7 mmol/L 10.6 mmol/L 1.9 mmol/L

The Accu-Chek Guide again reported the lowest variance in each of my three tests, while the FreeStyle Insulinx reported the greatest variance. Interestingly, the OneTouch Verio and FreeStyle Insulinx showed significantly larger variances in this second experiment.

I thought it would also be interesting to compare the accuracy of each brand of test strip with laboratory results. This information can also be found on the information packets inside test strip boxes.

Glucose concentrations of less than 5.5 mmol/L (100 mg/dL):

  Within 0.3 mmol/L (5 mg/dL) Within 0.6 mmol/L (10 mg/dL) Within 0.8 mmol/L (15 mg/dL)
Accu-Chek Guide 94.1% 100% 100%
FreeStyle Lite 70.1% 95.5% 99.5%

Glucose concentrations of less than 4.4 mmol/L (75 mg/dL):

  Within 0.3 mmol/L (5 mg/dL) Within 0.6 mmol/L (10 mg/dL) Within 0.8 mmol/L (15 mg/dL)
OneTouch Verio 88.2% 100% 100%

Glucose concentrations greater than or equal to 5.5 mmol/L (100 mg/dL):

Within 5% Within 10% Within 15%
Accu-Chek Guide 71.5% 97.6% 99.8%
FreeStyle Lite 66.9% 91.1% 98.8%

Glucose concentrations greater than or equal to 4.4 mmol/L (75 mg/dL):

  Within 5% Within 10% Within 15% Within 20%
OneTouch Verio 71.1% 94.8% 90.0% 100%

All glucose meters were accurate within 15 or 20 percent of a laboratory result, likely meeting medical device regulations.

All meters showed greater accuracy among the lower glucose level classifications than higher ones. The Accu-Chek Guide also scored significantly better than the other brands at being within 5 and 10 percent laboratory result.

Interestingly, laboratory testing for the OneTouch Verio strips was classified differently from the FreeStyle Lite and FreeStyle Insulinx. The higher glucose level classification started at 4.4 mmol/L (75 mg/dL), compared to 5.5 mmol/L (100 mg/dL) for the other brands. In the higher glucose level classification, the Verio only reached near perfect accuracy at 20% of a laboratory result, compared to 15% for the other brands.

Feeling overwhelmed with all of this data? I think it is best not to get too caught up in the differences. Most meters are only accurate to the nearest 1 mmol/L (18 mg/dL), and two finger pricks will not guarantee you two identical results.

Stick with one meter that you feel comfortable with and that you feel you can trust. Ensure that your hands are clean and dry before lancing your finger and that you obtain a sufficient sample of blood. Finally, you will obtain more insight into your blood glucose data the more frequently you check your blood sugar. As the old saying goes, test early and test often!

Young Adults With Type 1 Diabetes Show Abnormal Brain Activity

Having diabetes may affect the way our brains work. Research is taking place to find out exactly how this occurs.

In a recent study, researchers describe how tying diabetes to cognitive impairment is tricky because many people with diabetes have other conditions like high blood pressure and obesity, which also affect cognition. That’s why they conducted a study in young adults with and without type 1 diabetes “who were virtually free of such comorbidities,” the study authors wrote in their abstract.

brain activity

Christine Embury is a graduate research assistant at the Center for Magnetoencephalography (MEG) at the University of Nebraska Medical Center. She worked with Dr. Wilson, the study’s lead author and was kind enough to answer some questions.

In layman terms, she explains that “neural processing” is brain activity. “In our work, we relate brain activity in specific brain regions to task-specific cognitive processes, like working memory. Widespread brain networks are involved in this kind of complex processing including regions relating to verbal processing and attention, working together to accomplish task goals,” she writes.

Young, Healthy Type 1 Adults Tested

They matched two groups, one with and one without type 1 diabetes, on major health and demographic factors and had them all do a verbal working memory task during magnetoencephalographic (MEG) brain imaging. For the group with type 1 diabetes, the mean years of diabetes duration were only 12.4.

The researchers hypothesized that those with type 1 diabetes would have “altered neural dynamics in verbal working memory processing and that these differences would directly relate to clinical disease measures,” they wrote.

Higher A1c and Diabetes Duration May Alter Brain Activity

They found that those with type 1 diabetes had much stronger neural responses in the superior parietal cortices during memory encoding and much weaker activity in the parietal-occipital regions during maintenance compared to those without type 1 diabetes.

Diabetes duration and glycemic control were both “significantly correlated with neural responses in various brain regions,”

Embury explained that their findings suggest that “the longer one has the condition, the more the brain has to work to compensate for deficits incurred.” Higher A1c levels were also associated with compensatory brain activity, too.

The harrowing conclusion from the study authors is that even young, healthy adults with type 1 diabetes “already have aberrant neural processing relative to their non-diabetic peers, employing compensatory responses to perform the task, and glucose management and duration may play a central role.”

What would be the findings among type 1s who keep their A1c in non-diabetic range, one might wonder? This study suggests it is likely that elevated blood sugar over time is what changes the brain activity. These effects are possibly compounded over time in those with comorbidities like obesity and high blood pressure.

What is Verbal Working Memory?

According to this study, verbal working memory processing may be affected by type 1 diabetes. Embury shared an example of this and wrote, “Participants had to memorize a grid of letters and were later asked to identify if a probe letter was in the previous set of letters shown.” She said we have to use working memory any time that we’re trying to hold on to or manipulate a piece of information for a short amount of time, like remembering a person’s phone number.

The verbal part of “verbal working memory processing” just has to do with the way that the information is presented, like letters or numbers and “anything that requires language processing as well” Embury explains.

More research will help clarify these findings in the future.

Here’s How Much Caffeine Is in a Cup of Coffee

The answer may change depending on the cup.
coffee with callistephus flowers in a jam jar

Knowing how much caffeine is in a cup of coffee can be really helpful when you’re trying to limit your caffeine intake. While being dependent on the stimulant isn’t exactly life-threatening, it can leave you sleepy, grumpy, and jittery. Some people with certain health conditions may find their doctors even suggesting cutting back. And since drinking coffee can become so habitual, it’s easy to go a little overboard without even noticing it.

To be able to monitor caffeine intake, you first have to get a general idea of much caffeine is in a cup of coffee.

According to the USDA, regular, brewed coffee contains about 95 milligrams of caffeine per 8-ounce cup. “This is based on average values of home-brewed and fast-food coffee,” Beth Witherspoon, M.P.H., R.D.N., registered dietitian consultant for Community Coffee Company, tells SELF.

A 2014 study that analyzed caffeine content from multiple sources, including two USDA databases, found that an 8-ounce cup of regular brewed coffee can range in caffeine content from about 75 to 165 milligrams. Flavored coffees tend to have less caffeine, with about 48 milligrams per 8-ounce cup. (Espresso, which you’re probably not drinking a full 8 ounces of at a time, can have as much as 500 milligrams of caffeine per 8-ounce serving.)

There are a lot of things that can influence exactly how much caffeine is in a cup of coffee.

“Caffeine content varies between types and species of coffee beans, and can depend on where the beans were grown, and how the coffee is roasted and then prepared,” Witherspoon says. “All of these factors contribute to the variation in caffeine content between cups of coffee.”

The Mayo Clinic explains that even the same type of coffee from the same coffee shop can vary in caffeine content from day to day. If the beans were ground differently, or an extra scoop was put into the coffee maker, the caffeine content can fluctuate.

Witherspoon adds that light roast coffee usually has more caffeine in it than dark roast. “When measured by volume, light roast beans are denser, weigh more, and thus contain more caffeine than dark roast beans (which lose more water in roasting and weigh less when measured by volume),” she explains.

While most people don’t need to account for every last bit of caffeine they take in daily, a close estimate can help those who are trying to cut back on the stimulant.

Drinking too much caffeine can cause headaches, restlessness, and anxiety in some people. For others, too much after a certain time in the afternoon can cause insomnia.

For the average healthy adult, experts recommend consuming a maximum of 400 milligrams of caffeine each day. That’s three to five 8-ounce cups, depending on specific caffeine content, Witherspoon says. “Individuals should adjust this moderate amount based on how it makes them feel,” she adds.

For example, if you have a hard time falling asleep at night, try cutting yourself off sometime between noon and 2 P.M. to avoid insomnia later on. Everyone has their own level of tolerance, though, so you may need to do some experimenting to find what works for you.

If you’re pregnant or have a heart condition, talk to your doctor about what caffeine limits are appropriate for you. There’s a lot of conflicting evidence about what’s safe during pregnancy, so until more conclusive evidence is available, experts recommend limiting intake to 200 milligrams per day.

Exercise an Antidote for Aging

If you want to counter the physical costs of getting old, regular exercise might be your best option, researchers report.

The findings “debunk the assumption that aging automatically makes us more frail,” said researcher Janet Lord. She is director of the Institute of Inflammation and Ageing at the University of Birmingham in England.

In the study, the team assessed 84 male and 41 female cyclists, aged 55 to 79. The men had to be able to cycle 62 miles in under 6.5 hours, while the women had to be able to cycle 37 miles in 5.5 hours.

Unlike a “control group” of adults who did not get regular exercise, the cyclists did not have loss of muscle mass or strength, did not have age-related increases in body fat or cholesterol levels, and their immune systems were as robust as much younger people.

Male cyclists also had higher testosterone levels than men in the control group, according to the study authors.

“Our research means we now have strong evidence that encouraging people to commit to regular exercise throughout their lives is a viable solution to the problem that we are living longer but not healthier,” Lord added in a university news release.

The findings were published March 8 in the journal Aging Cell.

Researcher Niharika Arora Duggal, also from the University of Birmingham, said, “We hope these findings prevent the danger that, as a society, we accept that old age and disease are normal bedfellows, and that the third age of man is something to be endured and not enjoyed.”

7 Important Questions to Help You Figure out What You Really Want


“The unexamined life is not worth living.” ~ Socrates

Figure out What You Really Want in Life

There are some questions that you can’t stand to hear, much less answer. I totally get it. In the process of writing this, I re-asked myself these same questions, and I’m not going to lie, they were tough to even ask, let alone answer but by the end of this, you will feel such a strong sense of clarity and relief by having done it.

Here are 7 important questions that are meant to help you figure out what you really want in life.

1. Who am I?

This is by far the most important question you can ever ask yourself and if you walk away with any nugget of knowledge or powerful insight, let it be this: get to know yourself because you can’t go anywhere without knowing where you are right now. This is a question that will help you figure out what you really want.

The person you will spend the most time with in your life is YOU so get to know who that person is. Take every personality test that you can get your hands on and eventually you will start to see patterns and begin to have those “ahh” moments and find yourself saying “so that’s why I do that.”

The better you know yourself, the better capable you are of enhancing your life. If you know that you love to immerse yourself in a certain activity then you will be much better off in picking where you’ll be living the next 5 years than the person who doesn’t. This is only one example of when this comes in handy, there are so many more instances (more than you might think) in which knowing yourself will prove to be useful.

2. Why am I here?

Not only is this is a deep question but it’s also very useful one. Not only will it give you a higher perspective on your life but it will grant you knowledge as to what your purpose is. If there’s one thing everyone is looking for other than happiness, it’s purpose.

People want to feel valued and feel like they were put here on Earth for a reason. They want that reason to wake up in the morning and not walk around aimlessly through life. Simply asking this question will expand your way of thinking because once you ask this thought provoking question, it leads to even deeper questions which will allow you to discover what you really want.

3. What makes me wake up in the morning?

If there’s something that immediately comes to mind right now, then focus on that and keep doing it. Realize that not many people have that something that jolts them up in the morning with excitement and passion. If you can’t think of anything then I encourage to do try two new practice. The first one being gratitude.

Every morning when you wake up, declare a statement of gratitude. There is always something to be grateful for. Always. The second practice is trying new things because in trying new things, you begin to hone in on what it is that you really like to do. You will know because you will feel the difference and other people might just compliment you and tell you how good you are at a certain activity or how your face lights up every time you do it.

4. What do I want from life?

In other words, what do you truly desire? If there is something in your life, that you can’t stop thinking about, then that is as clear an indicator as any, to do it. Not everyone wants the same out of life. Some people just want to live a life of peace and tranquility and others want to live a life full of achievement and mastery. Pick what it is you want and don’t let others influence your decision because that might just be the worst mistake you can make for your own personal growth and happiness.

5. What do I expect from life?

You only get in life, what you expect. Hard to believe, I know. It’s difficult to face this question because in asking this question you must accept the fact that you are in control of your life and that everything in your life right now is a result of your thoughts, words, and actions. Do you expect a life of misery and despair because up to this point, that is all you have experienced? Or do you choose to expect a life of joy, happiness, and fulfillment because it is within your power to create it?

6. What pain do I want to sustain?

This is one question that will be especially helpful for the overachiever because it’s hard to grind away at something you absolutely hate, even though you know you can do it. It’s just not practical. In trying to achieve anything it will require some pain but if it is doing what you love then it’ll be worth every second. If you want to lead a healthy life with a fit and aesthetic physique, then by default you have chosen to sustain the pain of muscle fatigue and muscle soreness but you’ll love it because it’ll be a reminder of your progress in what you love to do most.

7. What am I giving to the world?

It is not enough to have all the riches and achieve the highest feats if, at the end of the day, you feel miserable. Inside all of us is the need to contribute and give to our community. Why do you think some people who are successful financially still lead miserable lives that end in suicide? It’s because they have not reached a level of fulfillment that will make them happy. They have everything they could want on the outside but not enough on the inside- which is the part that matters most. The best way to give to those around you is to give the gift of you– your talents, your joy, and your enthusiasm.

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