Diet and Nutrition

Paul L. Reller L.Ac. / Last Updated: August 03, 2017


Information Resources and Additional Information with Links to Scientific Studies

  1. A 2006 study of the status of instruction of nutritional medicine in U.S. University Medical Schools, by the School of Public Health of the University of North Carolina at Chapel Hill found that the many calls for the need to improve nutritional medicine education in standard medical schools over the last 2 decades has been largely ignored, and that even with a call to institute a change in University Medical School training to include Integrative Medicine, that a broad survey of educators at 126 U.S. University Medical Schools found that most of the nutrition education received by medical students still had to be obtained outside of the curriculum, and that "the amount of nutritional education in medical schools remains inadequate". The average training in nutritional science received by U.S. Medical Doctors was a mere 22.3 hours, and instructors surveyed stated that most of the nutritional science education had to be acquired outside of the courses, which presented an inadequate type of information:
  2. A 2010 followup to the survey of U.S. University Medical Schools concerning the alarming lack of instruction in nutritional medicine, by the School of Public Health at the University of North Carolina at Chapel Hill, found that 4 years after the initial broad survey that "the amount of nutrition education that medical students receive continues to be inadequate", noting the some medical schools offered no instruction in nutritional medicine, and only 25 percent required a course dedicated to nutritional science. Only 27 percent of the 105 schools studied met the minimum 25 hours of instruction required by the National Academy of Sciences, while in the 2006 survey, 38 percent of the medical schools met this minimum criteria. The U.S. Medical Doctors are actually stubbornly refusing to actually integrate their education with even a basic knowledge of nutritional science, much less herbal medicine, physiotherapy and acupuncture. To truly receive advice in the realm of diet and nutrition, patients need to consult professionals with actual education in this realm, namely Licensed Acupuncturists and Naturopathic Doctors:
  3. Even in Europe, experts note the lack of education in nutritional science in standard medical schools. A 2014 broad survey by Maastricht University in The Netherlands, and RWTH Aachen University Medical School, in Germany, found that any reliable data was lacking regarding the level of education in nutritional science even in 2014 in Europe, and this broad study found that even minimal instruction was provided in only 69 percent of European University Medical Schools, and that the average instruction was just 24 hours, comparable to the U.S. survey. The authors noted that scientific advice in diet and nutrition was sorely needed, but that patients are still unsure of whom to trust for sound individualized advice. Medical Doctors are still not a good source for this medical advice:
  4. A 2012 study by the University of Auckland, New Zealand, the University of Murcia, Spain, the Queen's Medical Center University Hospital in Nottingham, United Kingdom, the Westfalische Wilhelms University in Germany, Murdoch Children's Research Institute in Australia, and the Ulm University Institute of Epidemiology and Medical Biometry showed that an increased risk of severe asthma, rhinoconjunctivitis, and eczema was associated with the consumption of fast food twice a week in children and adolescents. The stubborn insistence that modern processed food and a meat and simple carbohydrate diet was not harmful to your health is finally being discounted. This large population study also found that eating fresh fruit 4 times a week reduced risk of severe asthma:
  5. The American Institute for Cancer Research provides conservative advice concerning the proof that a plant-based diet dramatically reduces the risk of cancer and cancer mortality, and is easy to adopt for all humans. This dietary protocol merely limits meat products to a small percentage of food intake, severely limits consumption of fast foods, sugary drinks, alcoholic beverages, and sodium in processed foods, and incorporates most a variety of whole grains, legumes, and fresh fruits and vegetables. The Cancer Institute shows that millions of people would be saved from cancer with the widespread adoption of a plant-based diet:
  6. A 2013 conservative report from the leaders of the Kaiser Permanente Medical Group in California recommends a plant-based diet as standard medical care, and shows that there is unequivocal proof that this simple diet will lower body mass index, A1C, excess cholesterol levels, and high blood pressure, as well as dramatically reduce incidence of cancer and diabetes:
  7. This chart from world life shows that the rate of mortality directly attributed to diabetes across the planet is very high, especially in developing countries where poverty has driven an easy demand for fast food, and the traditional staple diets have changed radically in recent decades. Up to 95 percent of these diabetes cases are type 2 diabetes, or Metabolic Syndrome, which is driven mainly by wrong choices in diet and lifestyle:
  8. A 2013 press release from the New York City health department showed that since 1990, the proportion of all deaths in New York City related to diabetes nearly doubled, and now accounted for nearly 11 percent of all deaths in the city, driven mainly by poor choices in diet:
  9. A 2015 study released by the independent Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE) found that an estimated 184,000 deaths per year can be directly attributed to excess sugary soft drink consumption, mainly from diabetes, and represents about 1.2 percent of all of the deaths from diabetes, cardiovascular disease and cancers:
  10. A conservative report printed by the American Diabetes Association in 2009 shows definitively from another very large cohort study conducted by experts the University of Texas, the University of Minnesota, The Johns Hopkins University and the University of Oslo, that chronic consumption of artificial sweeteners and diet sodas is strongly linked to a high risk for Metabolic Syndrome, Diabetes Type 2 and cardiovascular disease. This supposed public health solution to sugar consumption has actually created the same health problems that it was supposed to prevent. Over and over again, standard medicine has led us down these roads of technological misinformation, with diet and nutrition advice touting industrial foods such as margarine (transfats), avoidance of cholesterol in the diet (proven now to have no effect on cardiovascular health, but that has led to 'low-fat' products that hurt our hormonal and immune health), and advising us that just adopting a polypharmacy solution to these health problems allows us to consume a processed and fast food diet without implications:
  11. A 2010 meta-review of all studies concerning the use of artificial sweeteners and the rise in Metabolic Syndrome and Diabetes Type 2 in youth, by experts at the U.S. National Institutes of Health (NIH) shows clearly that by 2010 there was no longer any doubt that the large consumption of artificial sugars in diet soda and other products is linked to weight gain, obesity, Metabolic Syndrome, and diabetes in the young population. The lack of a direct causal relationship in study shows that we need to take a more holistic view of our health, not continue to pretend that there are only simplistic explanations for environmental causes of disease. That our experts have long touted such solutions to public health problems that have been shown to have worsened the very diseases that they were supposed to prevent should greatly alarm the public, who need to seek better advice from Complementary and Integrative Medicine (CIM/TCM):
  12. A 2007 article in the California Law Review by Andrea Freeman, entitled Fast Food: Oppression through Poor Nutrition, outlined positive actions we could take with government action to reverse the outlandish harm that has been foisted on our poorest communities, with enormous taxpayer subsidies and support for fast food corporations that increased the market in the United States from $6 billion in 1970 to over $110 billion in 2001, and continues to grow, often by the elimination of healthy food sources combined with targeted advertising and the lowering of the household income. While touted by so-called fiscal conservatives as a mere question of "choice", this rise in food oppression is costing the taxpayer an enormous amount of money in healthcare costs and a diminished workforce, the biggest contributors to the federal deficit, as well as the obvious human suffering from the burden of disease and obesity:
  13. A 2010 study at the University of Sherbrooke, Quebec, Canada, reviewed the sparse amount of scientific study of genetically modified food crops and concluded that the low-dose hypothesis of accumulation and biotransformation of xenobiotics associated with genetically modified foods is sound, supporting the statistical association between increases in endometriosis and introduction of genetically modified foods. This complex association involves hormonal disruptors, immune toxicants, pro-oxidants, and epigenetic modulators:
  14. A 2000 study at Texas Tech University in Lubbock, Texas, showed that the herbicide Roundup inhibits steroidogenesis, potentially causing hormonal imbalance, by disrupting a key regulatory protein in the body. The study also cites prior proof that organochlorine and organophosphate insecticides disrupt steroidogenesis:
  15. A 1983 study reported in Acta Pharmacology and Toxicology of Copenhagen, Switzerland, found that glyphosate, the herbicide constituent of Roundup, not only disrupts plant enzymes associated with the production of key amino acids tryptophan, tyrosine and phenylalanine, but also disrupts animal enzymes, potentially causing complex human harm in the long-term. This study showed that glyphosate seems to inhibit monooxygenases, and decreased the level of P-450 and the intestinal activity of hydrocarbon hydroxylase. The P-450 pathway in the liver is used to break down both toxins and pharmaceuticals, potentially contributing to both toxicity and abnormal circulating levels of many pharmaceutical drugs. Another common herbicide type, MCPA, increased the intestinal activity of ethoxycoumarin, O-deethylase and epoxide hyrodlase. :
  16. A 1997 summary of concerns of the herbicide Roundup and the Roundup-resistant crops created by Monsanto shows that there are serious concerns for public health and the environment addressed over 15 years ago and still not thoroughly addressed by safety studies. The U.S. Dept. of Justice has prosecuted 2 of the companies contracted by Monsanto to study the safety of Roundup and Roundup-resistant genetically modified crops for fraud, and the World Health Organization has stated that there is an urgent need for scientific study of these public health threats utilizing a more comprehensive and holistic research model to assess real risks:
  17. A 2011 New York Times article on the bestselling book The China Study reveals how researchers from Cornell University, Oxford University, and the Chinese Academy of Preventive Medicine accumulated 20 years of data that show how high consumption of animal-based foods is associated with more chronic disease, while a predominantly plant-based diet resulted in a healthier life:
  18. A 2013 article in the Scientific American, supported by much research from the famed evolutionary biologist Marlen Zuk, of the University of California Riverside, shows how crazy the ideas of the Paleo Diet are. Abundant research in recent years, with the ability to analyze diet of the Paleolithic period with DNA analysis, as well as tools of food preparation and cooking, show that these early humans were not just hunter gatherers that ate a predominantly meat and berry diet, but rather skilled gatherers of many vegetables, fruits, grains, beans, and legumes, as well as abundant herbs, with skills in food preparation that were intelligent and healthy. A simple look at our teeth and evolved gastrointestinal tract shows that we were never these Paleo caricatures that are now popular. Common sense, as well as science, also shows us that humans throughout time and around the world adapted to their environment as needed in an extremely varied manner, with no worldwide Paleo Diet. We also adapted over time, and with cultures, genetically to our available food supply. The ideas of the Paleo Diet are extremely simpleminded:
  19. A 2009 study of genetic material at sites of both modern humans and Neanderthals in 30,000 BC, or the Middle Paleolithic Period (first age of sophisticated stone tools), reveals that these groups prepared grain flours and cooked vegetables in a sophisticated manner even at this date. Grains and beans could be easily dried and stored, whereas meat had to be eaten quickly, or the decayed meat would cause disease. Humans obviously evolved gastrointestinal systems that were ideal for processing plant foods and staple grains, utilizing the long fermentation process in digestion. Three sites were examined in Italy, Russia and Czechoslovakia:
  20. A thorough investigation of the question of whether humans evolved as Paleo carnivores, omnivores or herbivores is presented by Ashley Capps, a poet from the University of Iowa Writers' Workshop, and a proponent of a vegan diet. Here, we see an analysis of the common argument that humans have canine teeth, supposedly proving that we are predominantly meat eaters, which Ashley shows is not a very thoughtful, and oversimplified, argument. Not only our teeth structure, but our gastrointestinal system, and of course the fact that related ape species eat a diet consisting of about 95 percent plant foods despite having larger canines than us, should show us our real nutrient nature:
  21. A short and concise historical proof of the human development as herbivores, even in the Paleo era, is presented here on the Huffington Post, quoting a few renowned geniuses in the field of human development and history, such as Dr. Richard Leakey, Dr. T. Colin Campbell, and other experts in medical health:
  22. A 2014 study of Egyptian mummies from 5500 to 1500 BCE, conducted in France, at the University of Lyon, used an analysis of molecular isotopes to find that a consistent diet with staple grains and vegetables composing well over half of the diet was found, and surprisingly, even along the Nile, fish made up a small portion of the diet. Pork and fish were considered unclean foods, and red meat and fowl needed to be eaten quickly after butchering, or salted and dried, making meat problematic for large populations. Millet gruel was determined to be popular as a childhood staple, and the C3-derived plant foods made up 90 percent of the non-meat portion of the diet. C-3 plants, or 3-carbon Calvin cycle type of photosynthesis, more adaptable to cooler and moist climates, include the staple foods barley, rice, and wheat, and green leafy vegetables, including root vegetables, with plants using this photosynthesis pathway still making up about 85 percent of the plants in the world. Such study shows that ancient human civilizations stuck to a predominantly plant-based varied diet with a dependency on a variety of cereal grains at the core:
  23. A 2009 New York Times article reveals research that finds a low-acid diet with reduction of meat and simple starches and high consumption of alkaline fresh vegetables to significantly prevent and reverse osteoporosis:
  24. DASH (dietary approaches to stop hypertension, or chronic high blood pressure), a study by the NIH (National Institutes of Health), and endorsed by the American Heart Association, found that a diet with predominantly whole grains and fresh vegetables, 3-6 servings per day of legumes, nuts and seeds, and only 1-2 servings per day of lean meat, fish or poultry, was proven to significantly reduce chronic hypertension:
  25. A 2015 study at the McMaster University School of Medicine, in Ontario, Canada, showed that while excess sodium in the diet, mainly from the enormous amount of processed sodium salt in processed and fast foods, is a significant risk for hypertension and cardiovascular disease, that sodium intake of less than 3 grams per day was just as much of a risk, with mild benefits in reducing blood pressure offset by marked increases and imbalances of neurohormones and other adverse effects. Natural salt, or sea salt, contains up to 60 essential minerals, not just sodium, and a teaspoon or two per day added to a healthy diet will reduce cardiovascular risk, which is the opposite of public health advice for decades. It seems that these industry-generated low-salt guidelines both perpetuated high sodium intake in the population that ate an unhealthy processed diet, and also convinced those who ate a fresh whole food diet to avoid salt and increased their cardiovascular risk as well:
  26. A large 2006 study of dietary fats and oils, conducted by the Women's Health Inititative, found that a low fat diet did not significantly reduce the risks of breast, colorectal and other cancers, or cardiovascular disease for postmenopausal women. The recommendation, supported by new guidelines of the U.S. Dept. of Health and Human Services and the World Health Organization, suggests that healthy fats be consumed at about 20-35 percent of total calories, with saturated fats (mainly meat and dairy) making up less than 10 percent:
  27. A 2013 study at the University of California in San Francisco followed 4577 men with prostate cancer from 1986 to 2010 and found that replacing 10 percent of dietary calories from carbohydrates with healthy vegetable fats, such as olive, nut and see oils, fresh nuts and seeds, avocados, etc. resulted in nearly a 30 percent reduction in death from the prostate cancer. Death from any cause was reduced significantly by increasing plant-based fats in the diet, while even a small replacement of carbohydrate calories with animal fats or transfats resulted in a significantly increased risk of death from all causes. Replacement of just 1 percent of carbohydrate calories with transfats nearly doubled the risk of death from all causes:
  28. A 2012 study by the Harvard School of Public health found that saturated fats, found in meat, when predominant in the diet of aging women, were associated with a 60 percent increase in risk of cognitive decline, while consumption of unsaturated fats (plant-based) was associated with a 44 percent less likelihood of cognitive decline. This comprehensive review of dietary fats and physiology by the Harvard School of Public Health confirms the benefits of a plant-based diet rich in healthy fats, and the negative impact of both low-fat and high saturated fat diets, as well as trans-fats:
  29. A 2005 study at the Hormone Research Laboratory of Milan, Italy found that changing to a plant-based diet over an 18 week period, with a healthy intake of plant-based omega-3 fatty acids, resulted in an increase in omega-3 and a significant balancing of omega-3 to omega-6 fatty acids, with a 6 percent decrease in reactive oxygen metabolites (oxidants) and thus a dramatic drop in oxidative stress. This translates into a very dramatic drop in cardiovascular risk, hormonal health, and neurological protection:
  30. A 2003 meta-review of research of the benefits of a plant-based diet rich in plant-based omega-3 fatty acids (alpha linoleic acid or ALA), conducted by researchers at the Harvard School of Public Health, notes that abundant evidence points to the significant reduction of cardiovascular risk from the benefits of omega-3 fatty acids, unsaturated omega-6 fatty acids, antioxidants, minerals, phytochemicals, fiber, and plant protein derived from a plant-based diet rich in fresh vegetables, true whole grains, beans, legumes, nuts, seeds, nut and seed oils, a variety of fruits :
  31. A 2006 study of Transfats (trans fatty acids) by the Brigham and Women's Hospital, Channing Laboratory, and Harvard Medical School, found that transfats are highly associated with cardiovascular disease, obesity, and diabetes, with pro-inflammatory effects, immune dysfunction, and endothelial dysfunction explaining this connection:
  32. A 2008 study of Transfats (trans fatty acids) by the Brigham and Women's Hospital, and Harvard Medical School, Departments of Nutrition and Epidemiology, found that transfats adversely affect lipid profiles, raising triglycerides and LDL, and lowering HDL, as well as exacerbating obesity and insulin resitance. The documented health risks associated with trans fatty acids (TFA), and the easy ability to substitute healthy fats in food production, call for an immediate elimination of these fats from commercial foods, which the researchers say would surely result in tens of thousands of lives saved yearly from cardiovascular deaths:
  33. A comprehensive analysis of lignans and isoflavones, key plant hormone nutrients, is presented in the book, Phytoestrogens: Occurrence in Foods and Metabolism of Lignans in Man and Pigs, available online:
  34. A large 2015 cohort study led by experts at the School of Public Health of Peking University, in Beijing, China, the Harvard School of Public Health, in Boston, Massachusetts, U.S.A. and the Nuffield Department of Public Health at Oxford Medical School, in the United Kingdom, concluded that there is a strongly reduced risk of disease mortality and specific reductions in disease risk in cancers, cardiovascular disease, and respiratory diseases, from the consumption of food spices, factoring out all other causes of death. This study examined 10 diverse populations in China from 2004 to 2008 and showed an inverse relationship between the amount of food spices consumed and disease prevention, and overall saw as much as a 14 percent overall decreased risk of disease mortality:
  35. A 2016 study at King's College London showed that a diet of fresh vegetables and fruit with such nutrients as Vitamin C could decrease the risk of developing cataracts by 33 percent. The study focused on the Vitamin C family of molecules, but found that a simple practice of taking a multivitamin with Vitamin C in it did not decrease risk of cataracts, and that the array of nutrients in fresh whole fruits and vegetables provided this benefit. Cataracts surgery was the most common surgical operation performed in the United Kingdom:
  36. A detailed 2011 review of the long history of the food spice turmeric, for the book Herbal Medicine: Biomolecular and Clinical Aspects, provides a wealth of actual facts, not 'internet facts', concerning this valuable food spice and herbal medicine that is still used extensively in India and provides much public health benefit in a large variety of ways, with more than 100 valuable active chemicals in the plant, and a complex variety of processing methods still used from traditional science. Turmeric contains curcumin, but also many other equally valuable chemicals, and has been studies and documented for 4000 years in India. Turmeric, or Curcuma longa, is one of just hundreds of species of Curcuma that are used in the diet and herbal medicines, which belong in the genus of the ginger, or Zingerbaceae family. The difference between the dietary use and herbal medicine includes the effective dosage, which of course if very low when using a little of the spice in food, which should be done regularly due to the low dose, and the much higher dosage achieved with herbal extracts, as well as the different and complex array of symbiotic chemicals seen in various herbal medicines:
  37. This same 2011 edition of Herbal Medicine: Biomolecular and Clinical Aspects provides us with a real set of facts concerning the history and chemistry of ginger:
  38. A comprehensive analysis of the physiological significance of glycemic index was performed utilizing the available research in 2009, by the University of Toronto, Ontario, Canada, Department of Nutritional Sciences, and published in the Journal of the American College of Nutrition. Research findings showed that foods with a low glycemic index are associated with improvement in serum lipids, reductions of the key marker for inflammatory disease and cardiovascular risk, C-reactive protein, aid in weight control, improve levels of high density lipoprotein cholesterol (HDL-C), decrease risk of developing diabetes, cardiovascualar disease, and various cancers, including breast, colon, and prostate:
  39. A 2015 retrospective cohort study from Harvard Public Health showed a clear association between sugary drink consumption and early menarche, or onset of first menstruation. High fructose corn syrup is the sugar in almost all of these beverages:
  40. A 2011 study at McMaster University, published in the Journal of the American Medical Association (JAMA), found from a study of 28,800 patients with either heart disease or diabetes, age 55 or older, that intake of sodium of less than 3000 milligrams per day was just as harmful as intake over 7000 milligrams, based on health outcomes and rates of excretion. These experts concluded: "Lower sodium excretion was associated with an increased risk of cardiovascular death and hospitalization for congestive heart failure on multivariate analysis." The study also found that insufficient potassium intake presented an increased risk of stroke as well:
  41. A 2008 study of sodium intake for patients with cardiovascular disease, conducted by the University of Palermo, Italy, followed 1244 patients diagnosed with congestive heart failure that were consecutively admitted to hospitals and randomized to a normal sodium intake and a low-sodium diet. The study showed that those on a reduced sodium diet, following common recommendations, had a much higher rate of readmissions and cardiovascular events than those on a normal sodium diet. Both groups were simply taking a loop diuretic only to help with congestive heart failure. These experts reviewed all literature and concluded that this was the first major study to examine the actual outcomes of a low-sodium versus normal sodium intake with patients diagnosed with congestive heart failure:
  42. A 2003 dissertation submitted to the Swiss Federal Institute of Technology Zurich, provided evidence that poor iron homeostasis significantly decreased the utilization of iodine and that supplementation with iron could dramatically reduced thyroid goiter in children who were receiving standard iodine supplementation in salt:
  43. A 2013 cohort study in Spain of cardiovascular risk reduction from adoption of a Mediterranean diet (predominantly fresh and plant-based) with sufficient fresh nuts and cold-pressed virgin olive oil, showed a significant reduction of cardiovascular risk:
  44. A 2013 cohort study of fresh walnut consumption and reduced risk of Metabolic Syndrome and Diabetes Type 2, at the Harvard School of Public Health in coordination with the Nurses Health Initiative, showed that women who consumed 2 or more servings of fresh walnuts per week had a 15-21 percent lower incidence of these diseases:
  45. A 2010 analysis of economic incentives for Agroforestry in the Lower Mississippi Alluvial Valley to restore soil nutrients and stop the massive depletion of topsoil and growth of the dead zone in the Gulf of Mexico due to nitrate fertilizer runoff reveals that we can create the economic potential that will spur a reversal of this devastating problem created by corporate farming in the last decades:
  46. A 2006 survey of organic farming across the globe, by the Research Institute of Organic Agriculture, found that the U.S. ranks behind Australia, China, and Argentina in the amount of organic farmland, but that the growth of organic farming has been rapid since 2002, and the demand now exceeds the supply by a great extent. We see that in 2002, China had very little certified organic farming, but by 2006 ranked second in the world, due to recognition of this growing demand and importance to world health. Unfortunately, the amount of farmland devoted to organic farming is still less than 1 percent of the total. By 2001, the amount of farmland growing GMO crops greatly outpaced organic farming, with the U.S. having about 70 percent of the total GMO cropland, with an estimated 35.7 million ha (hectares, which are equivalent to 2.5 acres). By 2010, the U.S. and Canada combined were estimated to have planted about 2.6 million ha in organic farmland. By 2010, the greatest growth in organic farming was seen Europe, which was banning GMO crops, but the future of healthy organic food will be dependent on public and consumer demand:
  47. An informative explanation of healthy wheat species by Nourished Kitchen explains that there is now a revival in this amazing staple grain long used to make bread, pasta etc. Contrary to current popular belief, we are not all afflicted with ill health due to wheat gluten / wheat, unlike corn, soy and sugarbeets, is not dominated by Monsanto GMO, and some heirloom species have survived the last 150 years of narrowing the wheat species from hundreds to thousands of local adapted species in the world to just a handful in most industries in the United States. In Europe, Farro, a term for either einkorn, spelt or emmer wheat is still widely used, and grain banks have allowed some growers to bring back popular tasty wheat species from long ago. Gluten is not a specific molecule found in wheat, but a term for any combination of starch, protein and sugar that creates a glue-like paste when milled and processed into flour and then water is added:
  48. Wheat, or Triticum aestivum, is a species of grain used as a staple across the planet since the Paleolithic era, not some new food species that is causing harm, although the intense hydridization and processing of wheat in large industries in the United States did lead to an unfortunate dominance of high-gluten flour with a lot of the nutrients removed in the oily germ and fibrous bran, and with processing to increase easier fluff and white smoothness. Even a lot of commercial "whole grain" wheat products are just this same unhealthy high gluten processed flour with just enough bran added to meet regulations. Don't be fooled. Real whole wheat contains a lot of important nutrients, and here they are:
  49. The 2012 second U.S. CDC survey of blood labs and other testing markers for nutritional deficiencies in the U.S. with data through 2006, provides us finally with some guidelines to judge how deficient our diet and nutritional status is, although these markers do not tell the whole story, but are just some of the information we need to consider: