Pecan and Carrot Top (No Waste) Pesto

If you’re keen to make the move from a more product based lifestyle to a produce based one, there is no time like the present to get your hands dirty.

Gardening is an activity that you can do alone or get the kids involved too. The benefits of growing your own food are enormous, from its taste, right through to its economic and environmental impacts.

The good news is that you don't need a traditional garden space to start gardening. Even if you’re a novice gardener, have managed to annihilate even the hardiest of houseplants or, if you’ve a tendency to neglect windowsill herbs positioned at eye level in the kitchen, I want to arm you with some very important information.

Vegepods are now on the move indoors! Move over paddock to plate, we now have Veges-to-table.

The new Vegepod Kitchen Garden is as cute as a cute-cumber! 

Plus it will do all the hard work for you. From sunshine to good soil that drains well, regular watering, and a little love and kindness. Ok maybe the love and kindness part you might need to help out with ;).

An easy to grow kitchen-garden bursting with flavour is now a lot simpler than you think. Goodbye expensive supermarket herbs that are limp and bedraggled the day after you buy them. The Vegepod Kitchen Garden allows you to enjoy the intense, vibrant colours of home-grown produce, ripened by nothing apart from the air and sun spectrum grow lights, in a beautifully simple growing space that will be a focal point in the kitchen.

Imagine waking up to the unmistakable scents of fresh basil and rosemary that waft up into your nostrils as you put the kettle on each morning.

Kitchen Gardens are a dream come true in the kitchen; there’s hardly a dish that doesn’t benefit from their bounty. With the new Vegepod Kitchen Garden, you can mix and mingle all manner of greens, to enhance your meals and drinks, both culinarily and medicinally.

Vegepod Kitchen Garden gives you the opportunity to grow your food, whenever you want, whatever your climate, irrespective of the space you have, just as nature intended. They come with adjustable light heights, plug, manual switch or timer-controlled app and some effervescent professional grow lights.

I asked Simon Holloway from Vegepod (also my neighbour!) a few questions about the new Vegepod Kitchen Garden and here’s what he had to say;

The kitchen truly is the heart of the home, and the new Vegepod Kitchen Garden ensures the heart of your home will become a supercharged paradise. Why do you think more people are delving into growing their own food and what are the benefits? 

There are quite a few very strong and worthy reasons these days why people are joining our Grow Your Food, each with their own priorities but the benefits are all the ultimately achieved by everyone anyway – better health, better mind, better wallet and better for the planet! Some are growing to combat the cost-of-living pressures, some are all about their health (gut health, physical activity, mind wellbeing), some are all about the flavours and better taste, some are about the convenience of readily available fresh herbs when cooking, some are about reducing waste (both physical wrapping and the carbon footprint of store bought goods) and some are about self-empowerment and education. Whatever the priorities, Vegepod has made it almost failproof and it all combines to a win-win-win-win + a few more wins, anyway! 

Leonardo da Vinci  said “Simplicity is the ultimate sophistication” the design not only has a beautiful simplicity but also for all the kitchen pragmatists out there (guilty as charged ;)) it has a load of practical considerations like signature self-watering reservoirs and full spectrum UV lights that promote ginormous growth rates! Was it a long time in the making and did you encounter any stumbling blocks along the way? 

Yes, it was a really long gestation period for our new baby! Three years in the making from “go to woah” to be exact, from early pencil designs and brainstorming sessions to being produced in our factory. And to be honest, you could also say this has actually been 10 years in the making when you consider that we have always had thoughts on “bringing Vegepod indoors” combined with our studious eyes always checking existing indoor edible technologies and practices. We are so proud of not just our signature quality in growing technology and innovation, but also the aesthetics on this one.  These pieces of ‘growing and lit up art’ have to look damn fine amongst the choosiest of high-end kitchens, designer rooms and other emotionally charged places in the home or workspace. We humbly think we have got the balance right with Kitchen Garden.

The Vegepod Kitchen Garden makes edible gardening even more accessible to all. You guys have a thriving community of Podders around the world that are so loving their Vegepods, myself included. What do you recommend for non-green-thumbs and people who are just starting out and keen to venture into the world of growing their own, from the comfort of their kitchen countertops?  

Just start growing with one thing! Don’t be afraid, just dive in and enjoy the journey. It’s so fun, so meaningful, so fulfilling and so healthy. There is no such thing as a black-thumb or green-thumb - just those who have got stuck in and those who haven’t. Life is too short not to enjoy growing your own food to some degree. Both Vegepod Outdoor and Kitchen Garden do help enormously and make things very easy for whoever, so whether you’re a first timer or an expert, just dig in and get growing. You will not regret it, I promise!

To celebrate the release of the Kitchen Garden, Vegepod have kindly offered a 10% discount to all Supercharged Food readers so you can pre-order now for delivery in December.  Just use the code SUPERCHARGED10 at the checkout here.

For a delicious no waste Pecan and Carrot Top Pesto recipe made with Vegepod Kitchen Garden greens, click here.

Has gut health gut you curious?

Perhaps I can help with that?

Today, we’re going to talk all about postbiotics, but before we get into the nitty gritty, you have to understand the basics of the gut microbiome, so we’ll start there. 

Hold onto your microbes; it’s going to be a bumpy ride!

Why is the Gut Microbiome Important? 

I want you to imagine a new town with various people. While some contribute positively to the environment, others… not so much. The community changes over the years depending on external stressors and travellers, but the population stabilises as a whole. 

When the town’s going well, most people are law-abiding and moral, living harmoniously and doing what they can to support the city. If there are unhelpful people, they tend to be kept in check by everyone else. However, some events may cause these not-so-great people to multiply, leading to a population filled with not-so-good people. 

Now, imagine that town is your gut microbiome. 

In a healthy microbiome, the bulk of microbes are good or neutral, living in harmony to support digestion and nutrient production processes. When disruptive events occur, the not-so-good microbes can multiply and overgrow, which can manifest itself in different ways, such as yeast infections or small intestinal bacterial overgrowth (SIBO).   You can read more about SIBO here.

The good news is that, like our town, it is possible to improve and change the state of the gut. You can improve your gut microbiota and gut health by consuming specific foods, such as probiotics.

What are Probiotics? 

If you’re here, I’m sure you’ve heard of probiotics – the positive live and active cultures that better sleep, improve immune function and promote a thriving digestive system. While the gut naturally produces some strains of probiotics, other essential strains can only be consumed through food or supplementation. Certain foods contain live microbes, such as fermented vegetables, kombucha and kefir. 

What are Prebiotics? 

If probiotics are flowers, prebiotics are the soil and fertiliser. Prebiotics increase the diversity of gut bacteria and promote the growth of probiotics. Prebiotics naturally occur in many plant-based foods, including unripe bananas, asparagus, oats and legumes. 

Need a Prebiotic recipe? my tray bake fits the bill and has all the answers.

Get Your Prebiotics in with My Prebiotic Tray Bake

What are Synbiotics? 

Synbiotics combine the power of probiotics with the potency of prebiotics to positively impact the digestive system in a supercharged, easily absorbable way. Synbiotics are more than just the sum of their parts, as they contain live microorganisms and substrates to create a health benefit for the host. Synbiotics aid metabolic syndrome, reduce parasites and pathogens, manage irritable bowel syndrome, inflammatory bowel disease, diarrhoea, atopic dermatitis and other skin conditions.¹  

You’re probably eating synbiotics already, but you may not be getting enough; this is where Love Your Gut Synbiotic Powder comes into place. Love Your Gut Synbiotic Powder will help you repair, restore, and rebalance your gut health from within. It contains 20 billion bits of love for your bacteria in the shape of a unique synbiotic formulation, with plenty of digestive enzymes and a supercharged blast of antioxidants. 

What are Postbiotics? 

So, what are postbiotics?

Unlike probiotics, postbiotics aren’t live microorganisms. They are the waste left behind after the body has digested both prebiotics and probiotics.² They take the line ‘one man’s trash is another man’s treasure’ to a whole new level. Postbiotics contain peptides that help slow the growth of harmful bacteria and short-chain fatty acids, which allow good bacteria to flourish. In this way, they seem similar to probiotics, but they offer additional perks. 

While postbiotics are an emerging and evolving field, they may have anti-inflammatory, anti-hypertensive, antioxidant and anti-cancer properties.² Some preliminary research shows that postbiotics boost the gut health of premature babies, young children, and critically ill patients by promoting communication between the gut bacteria and immune system.³

You can help promote the growth of postbiotics by focusing on getting enough of the foods that promote a healthy gut bacterium, including prebiotic-rich foods like asparagus, onion, chicory root, dandelion greens and root vegetables. 

To transform your gut into a postbiotic producing machine, be sure to include Love Your Gut Synbiotic Powder. Simply add one teaspoon of the delicious tasting powder to your water to support your gut in its natural production of postbiotics; you can thank me later! 

There's nothing like homemade kombucha on a hot day

And now I'd love to share with you a simple Homemade Kombucha Recipe.

Kombucha has also been linked to a myriad of other benefits such as improved digestion, fighting candida (harmful yeast) overgrowth, mental clarity, and mood stability. It truly is a tonic rather than simply a yummy beverage.

Don’t be afraid of the fermenting process which can seem like a complex lab operation rather than a kitchen recipe. Honestly, you just have to take the plunge and enter into the world of fermentation to realise that with some basic knowledge of the way bacteria feed on a constant supply of sugars, the process of keeping your culture alive and enjoying it’s wonderful and delicious creations is actually a very straightforward, common sense process that will become part of your daily rhythm.

Once you get the hang of making it, you can flavour it up with ginger and turmeric or even berries. Purchase a SCOBY online or, if you’re very lucky, a friend might give you one. You can buy kombucha online or at a health food store, although once you’ve made your first batch, you won’t need to buy it any more.

You’ll also need a breathable cloth such as muslin (I use a nut bag), a rubber band, and one sterilised wide-mouthed, 1 litre (35 fl oz/4 cup) capacity glass jar with a lid (Mason jar).

Homemade Kombucha

Ingredients:

• 1 litre (35 fl oz/4 cups) filtered water
• 2 organic black tea bags
• 55 g (2 oz/ 1/4 cup) organic sugar
• 1 SCOBY (see above)
• 100 ml (3 1/2 fl oz) homemade or store-bought kombucha (see above)

Method:

Put the water in a medium saucepan over medium heat and bring to the boil. Remove from the heat, add the tea bags, and steep for 20 minutes. Remove the tea bags, add the sugar and stir until dissolved. Set aside to cool.

Pour the tea into the sterilised jar, then add the SCOBY and the kombucha. Cover with muslin, secure with a rubber band and write the date on the jar.

Store undisturbed in a cool, dark, dry place for 7 days, then test it to see if it’s ready. It should be fizzy and slightly sour/vinegary. If it’s still sweet, let it ferment for a day or so longer (usually up to 10 days).

Once the kombucha is ready, carefully remove the SCOBY using a clean long-handled spoon and place it on a plate with a little of the liquid to stop it drying out (then use it to make another batch straight away). Pour out 100 ml (3 1/2 fl oz) of the kombucha and keep aside to make another batch, then pour the remaining liquid into a jug through a sieve and then into a clean glass bottle with a lid. Secure the lid tightly and make a note on the bottle of the date. The kombucha will keep in the fridge for 2–4 weeks.

Stay Supercharged! 

References 

¹https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648921/

²https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468815/

³https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801921/

Stress. It's something we all deal with daily. But, whether it's work, family, or finances, stress can take a toll on your mental and physical health if you don't know how to deal with it. While there are many ways to deal with stress, not all of them are natural. This blog post will discuss the top seven most natural ways to deal with stress.

#1 Exercise

Exercise is one of the most natural ways to deal with stress. When you exercise, your body releases endorphins, which have mood-boosting properties. So not only does exercise help to improve your mood, but it also helps to reduce the physical symptoms of stress, such as headaches, body aches, and fatigue. Stress can also lead to stress-eating, which can cause weight gain, but exercise can help combat this, too.

#2 Meditation And Deep Breathing

Meditation and deep breathing are great ways to relax both the mind and the body. When you focus on your breath and let go of any thoughts or worries, it can help to alleviate stress. It's also a practice that can be done anywhere and at any time. There are many apps and YouTube channels that can guide you through meditation and deep breathing exercises. You just need to find the one that works best for you.

#3 Get Enough Sleep

Sleep is another natural way to deal with stress. When you're stressed, your body needs more rest in order to recover. Getting enough sleep helps to reduce the physical and mental effects of stress. It also helps to improve your mood and increase your energy levels. If you aren't getting enough sleep, there are a few things you can try to increase to improve your sleep, such as creating a bedtime routine, taking Delta 9 Gummies, bathing with lavender oils or bath salts, and ensuring your bedroom is a comfortable and peaceful environment. These will help relax your mind and body, leading to a better night's sleep.

#4 Connect With Nature

Connecting with nature is a great way to reduce stress and ground any chaotic thoughts. Going for a walk in a park or hiking in the woods can help clear your mind and give you some much-needed peace and quiet. When you're outside in nature, you're exposed to fresh air and sunlight, both of which have stress-reducing properties. Being in nature can also help to clear your mind and give you a new perspective on any stressors you may be facing.

#5 Spend Time With Loved Ones

You can also significantly reduce stress by spending time with loved ones. When you're around the people you care about, you feel supported and loved. This can help you to feel less stressed and more relaxed. Spending time with loved ones can also help to take your mind off of whatever is causing you stress. Having a solid support system is important for managing stress in a healthy way. A support system can also act as a sounding board, allowing you to process your stress and come up with solutions.

#6 Take A Break From Technology

Taking a break from technology is another great way to reduce stress. When you're constantly connected to your phone, computer, and social media, it can be easy to get overwhelmed by everything that's going on in the world. Taking a break from technology will give you a chance to disconnect from the world and relax in silence. Technology can cause stress and anxiety, so it's important to unplug and give yourself some space from it. This can also help improve your focus and productivity when you do go back to using technology.

#7 Make Self-Care A Priority

Taking care of yourself and making self-care a priority can also aid in reducing stress. This can involve practicing good hygiene, eating a balanced diet, getting enough sleep, finding ways to relax and destress, and setting boundaries in your relationships and responsibilities. Self-care looks different for everyone, but it's important to prioritize your own well-being in order to manage stress. Taking care of yourself is an important aspect of managing stress in a healthy way.

In conclusion, there are many natural ways to deal with stress. These methods can help reduce stress's physical and mental effects while also improving your overall well-being. It's important not to let stress take control of your life and to find healthy coping mechanisms. The seven methods mentioned above are all great options to try in order to alleviate stress. Try incorporating some of these into your life when you're feeling stressed out and see how they help you feel better!

To get the best out of life, sticking to things and being consistent is a good way to create lifelong good habits and results!

If there are some areas in your life you want to change, maybe you’re looking to lose weight or you’re hoping to get a little fitter, then putting in the time and effort can help!. Hard work and consistency can really allow you to flourish in this regard. If you stick to a healthy diet and do a few things well, then you’re likely to get what you want. 

Just sticking to the right habits, however, can be difficult for so many people. If you’re so used to doing other things and you have so many other responsibilities, it can be hard to make this kind of thing work. Fortunately, it’s not as difficult as perhaps you’d think. Here are a few things you can do in order to ensure you get the results you need: 

Create A Meal Plan And Stick To It 

If you have a plan, it makes life so much easier. You’ll be able to stick to a guide that is literally taking you in the right direction. Just guessing what you have to do will ensure you do not get the results you want. If you do get the results, they’ll come at a much slower and more frustrating rate. A meal plan can boost your progress but also make you feel better along the way. 

Learn All There Is To Know About Nutrition 

The more you know about nutrition, the better off you’re going to be when it comes to changing your eating habits. If you know very little, then you’ll be more inclined to recede back to old habits. Finding amazing foods will make you feel more comfortable with exploring what’s actually out there. You’ll be happy to change things up and you’ll always look forward to your next meal – which is important. People who dislike being on certain meal plans will likely never get to where they want to be as they’ll revert back to their old selves. 

Recognize That Weight Loss And Weight Gain Are Down To Calories 

If you’re hoping to lose weight or put it on, you have to make sure that you’re consuming fewer or more calories, respectively. Calories in and out are what make a person lose weight or put it on. There is no secret formula – you just have to make sure you are wise with your energy storage.

Stay Fit And Active Throughout Your Eating Plans

When you sit around and barely do much, it’s so easy to let your diet derail. You feel as though you won’t really get much done so you may as well let yourself go a little, right? Whenever you keep active, you simply feel better. Whether we’re talking about general life or confidence, activity and exercise keep us positive. So, heading to the gym and hitting leg extensions or simply going for a run will make your mind pursue the right diet when you’re finished. You’ll feel as though you need to supplement the workout with the right kinds of foods a lot of the time. 

Don’t Be Too Strict And Regimented Throughout Your Life 

People who adopt a policy that is way too strict can suffer somewhere along the line. They’ll be so frustrated at some points that they’ll abandon what they’re doing and spend a week or two binge-eating the wrong foods. Make sure you have a balanced diet that allows you to give in to some cravings while not straying away from your targets. 

Don’t Let Outside Influences Throw You Off Course 

It’s so easy to let people ruin what you’re trying to do. They might directly convince you that you don’t need to do this kind of thing, or their actions might tempt you away. Make sure you have supportive people around you or people with similar ambitions. 

Think About The Long Term And What You Truly Desire 

If you consider things in the short term, then you’re only going to get the results you want over the course of a few weeks. You will also likely get sick of things early on because you aren’t getting the results as quickly as you’d like. You have to picture things over the course of months. Looking at where you’ll be in a year would make a lot more sense because that’s how you’ll be able to see real problems. Don’t look for quick, short-term, extreme options because they just won’t get you to where you wish to be. 

Using an app like Greatness can significantly enhance your journey towards achieving desired results with your diet and eating habits.The Greatness app serves as a powerful tool to teach how to effortlessly create a balanced meal to stay healthy, helping you stay accountable and make mindful choices. This app offers courses on various lifestyle topics, helping you develop and stick to healthy habits. By incorporating such digital solutions into your routine, you can establish new and sustainable habits that align with your health and wellness goals, ultimately leading to the results you desire.

Hello from the UK, it’s been such a surreal experience being here in Britain at this particular time in history, when sadly Her majesty Queen Elizabeth II passed away peacefully in Balmoral.

Last week I was to be able to join thousands of people visiting the Green Park Floral tribute Garden and Buckingham Palace, to pay my respects to someone who was a huge inspiration.

It was a very emotional day, especially looking through the heartfelt tributes and cards and seeing thousands of Paddington Bears lining the gates of Buckingham palace and the surrounding gardens!

There were even sculptures made from watermelons!

Growing up in the UK was the beginning of my admiration for the queen for so many reasons, including her ability to be a grounding, steadfast influence in times of turmoil as well as her dedication and diligence to serving others.

Some years ago, one of my lovely friend was fortunate enough cook for the Queen and she shared with me a recipe for her favourite Scrambled Eggs.  Ma’am loved to sometimes start the day with a protein packed breakfast and these eggs were tailored to the way that she particularly liked them.

Another thing you may not know about Her Majesty the Queen is that she loved to enjoy homegrown foods and ones produced locally in her area.  She was also a fan of eating with the seasons. That's my kind of lady, she certainly put the Great into Great Britain!

Her special scrambled egg dish involves two unusual ingredients (nutmeg and lemon rind), and they really elevate this breakfast dish.  The eggs need to be (brown not white, as Her Majesty preferred the taste) and they were always cooked low and slow to make them super creamy and not clumpy.

Occasionally they would be served with her favourite kippers, usually in her private dining room in Buckingham Palace with a nice cup of Earl Grey tea and a spot of milk.

Ever since I was given this recipe a few years ago, I’ve been making these eggs on the regular and they are spectacular! I always make them when friends come to stay. For those craving more egg-citement and for those social media enthusiasts who want to share your recipe, explore some cracking egg puns and add it to your social media post.

Please enjoy her favourite scrambled eggs recipe. And thank you, your majesty for your lifelong service. May you rest in eternal peace.

The Queen's Scrambled Eggs

Serves 2

Ingredients

• 3 organic (brown) eggs
• 1 tablespoon milk
• Sea salt, to taste
• 1 tablespoon butter or you can use extra-virgin olive oil
• 1 teaspoon finely grated lemon zest
• Pinch ground nutmeg
• freshly cracked black pepper, to taste
• snipped chives and kippers to serve (optional)

Method

Whisk the eggs and milk in a bowl until well combined. Add salt to taste.

Heat the butter or olive oil in a small frying pan over low–medium heat. Add the eggs and turn the heat down to low, moving them around the pan slowly with a spatula so they don’t stick to the bottom.

Just before they are starting to set, add the lemon zest, nutmeg and extra salt, if desired and stir.

Serve immediately, garnished with pepper and chives, if using.

You know your gut needs a little (okay, fine, a LOT of) love. You've tried countless things to heal it. 

Water fast? Tick! 

Coffee enema? Tick! 

Himalayan salt inhalers? Probably a tick there too!

And let’s be honest, nothing’s really worked so far. 

If you're sick of accepting that your constipation, headaches, bloating, acne and stomach pains are normal and there's 'nothing you can do', I'm here to help. 

I'm going to run you through my step-by-step gut-healing process, so your gut can feel brand-spankin' new. 

How to Heal Your Gut  

1. Prepare 🛁 

Before you even think about shotting back charcoal juice and hitting a hot yoga class to sweat out toxins, you need to prepare the gut by cleansing and toning the environment.  To tend to your gut, or as I call it, your inner garden, you might need to do some weeding. Weeding means getting rid of the negative bacteria and bugs to make room for a healthier environment.

To prepare your gut, weed out negative bacteria by eliminating commonly irritating foods, such as gluten, dairy, caffeine, refined sugar and soy. 

Add in Love Your Gut Powder and capsules to speed up the prep. Love Your Gut Powder and capsules gently cleanse the gut and create an alkaline environment with a pH of 8. 

2. Process 🔥

Once you've prepared the gut adequately and weeded out harmful bacteria, it's time to put a little digestive fire (in Ayurveda, they call this Agni) in your belly! The gut needs to be primed to process and absorb nutrients and hydration, with water or lemon infused water being a good form of hydration. That's the role of Fulvic Humic Concentrate. Among other benefits, Fulvic Humic Concentrate helps the gut process nutrients and strengthens the tight junctions that are weakened in conditions like leaky gut that can take some time to heal.

In the process stage, it's essential to focus on rest and self-care. Stress is one of the most significant contributors to an imbalanced gut, impacting gut motility and negatively influencing the gut microbiota composition (an influencer I don't want to follow). Introduce a form of meditation into your routine, ensure you're getting seven to nine hours of sleep, and swap out your coffee for herbal tea.  

3. Populate 👨‍👨‍👧‍👧

After preparing and processing the gut, it's time to get to work! Populating the digestive system is about healing the intestinal wall lining and making room for more positivity in the gut garden. 

Movement can have a powerful influence on the state of the gut. Studies show that exercise alone can increase beneficial bacteria, reduce inflammation, and speed up your metabolism (you can thank me later).¹ You don't need to lunge it out at the gym to get your movement in if that's not your thing. All exercise is good for the gut, so you may like to try swimming, walking, yoga or even gardening instead. 

Love Your Gut adds vital minerals and nutrients to the gut to help it survive and thrive. To up the ante, include Love Your Gut Synbiotic in your routine. It adds over 20 billion high-quality probiotics in every serve. Twenty billion sounds filling, but it's just the right amount for your gut to thrive. Plus, Love Your Gut Synbiotic supports the digestive system through the bonus of fibre and digestive enzymes, so it’s an all-round gut health cheerleader. 

4. Proliferate ❎

The last but certainly not least P is Proliferate. Now, I struggled to find an appropriate emoji for Populate, so go easy on me. I settled on the ❎ symbol as it symbolises the idea of multiplying. Proliferating is all about multiplying the beneficial bacteria in your gut. To help keep the bacteria love alive, make sure you're getting in enough fibre every day. 

Some fibre-rich foods that your gut love include: 

• Apples
• Artichokes
• Bananas
• Berries
• Brussel sprouts
• Celery  
• Cucumbers
• Dandelion greens
• Garlic
• Kale
• Lentils
• Onion
• Pumpkin
• Seeds 

There's an easier way to populate your gut than what you might think, and no, it doesn't involve matchmaking your gut microbes (although that would be a reality TV show I'd love to watch!). The easiest way to populate the gut is by taking Love Your Gut Synbiotic; it’s full of prebiotics that act as multipliers of probiotics by feeding them and helping them thrive. 

There we have it - my step-by-step process of healing your gut. Do you have any gut-healing tips you want to add to this list? Let me know your top tips in the comments below.

Lee x

References 

¹https://pubmed.ncbi.nlm.nih.gov/31454784/