Urinary Tract Infections: What Women Need to Know

In practice since 2019, Trinity Health IHA Medical Group Obstetrics and Gynecologist, Sara Muszynski, MD, is no stranger to the annoying condition of having a urinary tract infection (UTI). She is happy to share her expertise with the many women who have — and will — get them in their lifetimes. This is what she wants all women to know:

Why Us?

Up to 60 percent of women will experience a UTI in their lifetime, and for some women, it will be multiple times. Unfortunately, women are more prone to UTIs as a function of the female anatomy.

Female gastrointestinal tracts and vaginas are colonized with bacteria — some of which are pathogenic, or capable of causing disease. Because of the short distance from the rectum to the vagina to the urethra, the pathogenic bacteria have easier access to the urethra in women. The bacteria can enter the urethra and travel to the bladder, causing symptoms.

Other causes of UTIs include kidney reflux or bladder reflux, where the kidneys or bladder don’t fully empty. The use of catheters is also a way for UTIs to develop.

Symptoms

Classic symptoms of a UTI include burning when urinating, a sensation of needing to urinate frequently, urgency, or lower abdominal pain. The color of the urine may also be an indicator of a UTI, such as urine that appears a darker amber color or cloudy, but not always.

Prevention and Treatment

Many women first experience a UTI once they become sexually active. Sexual intercourse tends to move around the bacteria in the area of the vagina, rectum, and urethra.

  • A personal hygiene reminder: It is always good practice to wipe from “front to back” when using the restroom.
  • Urinating following sex may decrease the bacteria that gain access to the urethra.
  • Another way to prevent a UTI is to urinate when you need to. Don’t “hold it.”
  • Cranberry supplements are often promoted as a source of prevention. Yet clinical studies have not been able to verify what dosing and frequency of cranberry supplements are needed to determine if this is truly effective.
  • Frequent hydration is also crucial. Drinking pure water is best for flushing fluids.
  • My colleagues and I recommend that women wear cotton underwear. Other materials may lead to excess moisture (an environment in which bacteria thrive).

The treatment for UTIs is a short course of antibiotics.

I tell patients that over-the-counter treatments for UTIs are like a “bladder Tylenol.” They don’t remove the bacteria, but they help with the symptoms of pain and urgency to urinate. The only treatment is truly antibiotics. To target the antibiotic, we need to get a urine sample.

When Symptoms Don’t Necessarily Indicate a UTI

Women should also be aware that the symptom of urgency to urinate does not always indicate a UTI. Caffeine in general, diet sodas, and alcohol are bladder irritants that can cause urgency, but not necessarily a UTI.

Taking any antibiotic for a UTI, upper respiratory infection, or sinusitis can promote a yeast infection in the vagina because it changes the bacteria in the vagina. Most women can differentiate between a yeast infection and a UTI, but sometimes there can be confusion. These points will help you to differentiate:

  • Vaginal itching
  • Vaginal discharge
  • Sensation of burning even when not urinating

Finally, the decrease in estrogen in women going through menopause may lead to a woman having vaginal and urethral burning, which is not related to a UTI.

Parting Thoughts

If you are in your reproductive years, it is easier for physicians to order a lab for a urine sample and to tell from your symptoms if you should begin treatment immediately. You may not need to schedule an appointment; it can be handled on the patient portal.

If you are having recurring UTIs or if you are taking antibiotics and symptoms are not improving, this warrants further evaluation and I would advise coming in for an office visit.

Dr. Muszynski sees patients at Trinity Health IHA Medical Group, Obstetrics & Gynecology – West Arbor. To make an appointment with her, call 734-995-2259 or schedule an appointment online.

From Couch to 5K for Seniors

Spring is here, and good weather is a time to think about recommitting to fitness, especially at community events.

Now would be a good time to start training to participate in a community walk, which is a great way for people to get moving, whether they are new to walking for exercise or trying to get back on the exercise bandwagon.

Getting on the exercise bandwagon, and then staying on it, can be a constant work in progress. That is why when patients mention their difficulties with exercise, we can say with assurance that “The struggle is real!”

There is good news, though. Research shows that for older adults, exercise is better than no exercise. Even one minute of exercise can help improve mobility and physical function. The bottom line is this: It is never too late to start exercising, and you can begin with small steps!

Using a “Couch to 5K” program or another beginner walking program is helpful in providing guidance and takes the guesswork out of “how to go about it.” Try this Walk/Run Plan tailored for beginners to get started.

Tips Before Starting an Exercise Regimen

  • After finding a program to get you started, talk to your doctor or physical therapist about the safety of the program before you begin.
  • Spend time looking for footwear with proper cushioning, comfort, and stability. The fit should be a thumb’s-width of space between the end of your longest toe and the end of your shoe. Your heel shouldn’t slip when you walk or jog, and your foot shouldn’t be spilling over the edges of the shoe. If your shoes are not comfortable when you first try them on, they won’t be comfortable when walking or jogging.
  • If you need to use an assistive device for balance or safety, such as a cane or walker, use it! Your safety is most important, and those devices will help you keep your independence.
  • Slow down the program if you find it is too much for you. It is okay to spend 12 weeks completing a 6-week program.
  • Make a public commit to complete the program. Making yourself accountable to someone, whether on social media or to a fitness buddy, can make it easier to keep going, even when you don’t want to.
  • Consider listening to music, nature sounds, a podcast or audiobook to accompany you while you train.
  • Don’t forget to stretch after warming up and definitely after finishing your workout.

And finally, feel proud of yourself for every minute that you exercise because you are one step closer to better health.

Trinity Health Michigan and Detroit Red Wings Team Up to Give Fan Experience to Oxford High School Student

Trinity Health St. Joseph Mercy Oakland patient Kylie Ossege had the unique opportunity to participate in a fan experience, courtesy of Saint Joseph Mercy Health System and the Detroit Red Wings.  Kylie enjoyed a night out recently at Little Caesars Arena (LCA) with friends and family, where she got to take in a game between her hometown team and the Columbus Blue Jackets.

During the night, Kylie received a Dylan Larkin jersey, gift card and a Red Wings goodie bag.  She had her photo taken near the St. Joe’s Bench, located inside LCA, and rode the team Zamboni.  She even appeared on the LCA jumbotron during the game.

Trinity Health St. Joseph Mercy Oakland patient Kylie Ossege was photographed above on the Little Caesars Area jumbotron

Following what has been a very challenging year for her, the evening’s activities offered Kylie and her family a reprieve and a chance to create shared memories.

Since arriving to Trinity Health St. Joseph Mercy Oakland on Nov. 30, with injuries sustained from the Oxford school shooting, Kylie has made a tremendous recovery.  In the months following her admission to the hospital, Kylie was cared for by many hospital colleagues from across different units and different medical disciplines. 

“We are forever grateful to St. Joseph Mercy Hospital and their incredible staff for their amazing dedication and care for Kylie,” said her mother, Marita Ossege.  “From our friends in the ICU to the rehab team, you all have touched our lives in a manner we will never forget.”

Trinity Health St. Joseph Mercy Oakland is a verified trauma center by the American College of Surgeons, which means it can provide first responders, patients and the community with increased access to highly specialized care during emergency situations.  The verification ensures that patients with severe injuries receive priority access to the full spectrum of resources, including in-house coverage for trauma surgery, anesthesia, critical care and radiology, as well as cardiology, orthopedics, neurosurgery, vascular and thoracic care.

Fabian Fregoli, MD, chief medical officer of Trinity Health St. Joseph Mercy Oakland, met with Kylie and her family several times during her stay in the hospital.

“Witnessing Kylie and her family’s courage has been an inspiration to me and our entire team” said Dr. Fregoli.  “To recall where she was when she arrived through our doors and compare that to how well she is doing now, she’s had a truly remarkable recovery and I couldn’t be happier.  She is thriving and we’re all rooting for her.”

When is it time to see a gynecologist?

Our team of expert OB/GYNs meet the changing needs of women from adolescence to mature adulthood. We provide specialized care, including prevention, diagnosis, and treatment for every woman at every stage of her life.

What services does an OB/GN typically provide?

Our services include:

Routine well woman care
Pelvic Medicine
Abnormal pap smear evaluation and treatment
Hormonal problems, including perimenopause and menopause
Natural Family Planning
Urinary incontinence treatment
Endometriosis diagnosis and treatment
Chronic pelvic pain diagnosis and treatment
Laparoscopic gynecologic surgeries
Infertility evaluation
Diagnosis and treatment of breast conditions and disorders
Correction of bladder and rectal prolapse
Surgical services such as colposcopy, and in-office endometrial ablations
Ovarian cyst management
OB/GYNs also deliver babies and can perform caesarean sections.

At what age should a woman first see an OB/GYN?
We encourage patients to come see us when they are ready and feel comfortable doing so. We serve women from their teens into their 80s and 90s.
At what age should a woman first have a pelvic exam? It is recommended to have a pelvic exam annually beginning at age 21, or sooner if you are sexually active..


At what age should a woman have her first a pap smear?
The newest recommendations is to have a pap smear the age of 21, whether sexually active or not, and every third year following, if the test results are normal.


Can a primary care physician (PCP) do a pelvic exam and pap smear?
PCPs, such as Internal Medicine specialists and Family Practice physicians, often perform these exams and tests.


When should you have your annual exam completed by an OB/GYN rather than a PCP?
Patients can choose who they see for annual exams. Many women who are considering pregnancy in the near future choose to see us. Following a pregnancy, patients will frequently come to us for their yearly exams. We make sure our patients understand that if anything abnormal comes up on routine screening, we will send them back to their PCP for management. If they have co-morbidities, they should make sure to see us and their PCP.

What can a woman expect at her first appointment with an OB/GYN?
Some women are anxious about their first appointment with an OB/GYN, so it is important to know that you do not have to be examined at a first meeting. You may prefer to have a general discussion about the female reproductive system or a consultation about a specific issue. If you are anxious about your first exam, we would encourage you to ask questions about how the exam is performed and why it is necessary. Then schedule an appointment when you are ready to have the exam. For support, some women ask a loved one attend the exam. Other patients prefer to visit alone for a private visit.

Are a pelvic exam and pap smear usually covered by medical insurance? What if during the exam a problem is discovered?
Pap smears are a covered screening by insurance companies. If a problem is discovered, we will make sure we make an appropriate plan of care with you that you are comfortable with. This would also be covered by insurance.

At what age should a woman have her first mammogram?
The answer depends on your risk factors, which include your personal and family health history. We recommend that you have a discussion with provider about risk factors before determining when to schedule a first mammogram. Typically, a woman’s first mammogram is between ages 40 and 50, and then annually or every other year thereafter.


How would a woman know if she is beginning menopause?
Menopause transition is unique for each woman. The average age of menopause is age 51 but women can experience symptoms earlier, such as hot flashes, night sweats, and insomnia. We are here to help women navigate that transition using both medical and natural remedies.

Find an OBGYN today,

Improve Your Sleep in 3 Simple Steps

Getting a good night’s sleep is one of the most important things we can do for our overall health and well-being. Sleep deprivation leaves the brain exhausted, causes sluggishness, low attention span,

decreased sociability, depressed mood, insulin resistance and decreased performance. Chronic sleep deprivation is strongly correlated with behavioral health issues, such as depression, anxiety and substance use, as well as a weakened immune system.

The body profoundly needs sleep, and when a person is not getting enough quality sleep it impacts all systems of the body. A lot of people view sleep as a passive activity, but to set ourselves up for a restorative night of sleep takes preparation. Here are a few simple steps to take during the day to help set the stage for better sleep:

Preparation: Sleep is not passive; it requires a proactive routine.

  • Get regular physical activity in the morning or afternoon: Exercise promotes quality sleep. Exercise in morning makes it easier to fall asleep/wake up. Exercise in evening is ok if done on a regular basis and not immediately before bed.
  • Outdoor light exposure: Early morning light is best way to keep circadian rhythm synchronized.
  • Control caffeine, nicotine, and alcohol consumption: Minimize caffeine later in the day as it can prevent you from falling asleep. Limit alcohol consumption to 2 drinks/day for men and 1 for women and not after 3 hours before bed. Alcohol can cause you to wake up in the night and it causes sleep to be fragmented. Nicotine is a stimulant that is best avoided entirely.
  • No bright/blue light 2 hours before bed: Blue light can decrease melatonin production and increase cortisol. You can purchase special light bulbs or install an app/filter on your phone to reduce blue light exposure. Of note, phones/computers/TV, etc. are stimulating even if they do not emit blue light.

Environment: Craft your surroundings to support optimal sleep.

  • Use the bedroom for sleep and intimacy only: No TV, laptop, tablet, etc. in bedroom. Recommended no pets or children in bed.
  • Turn thermostat down: Ideally between 60-67F. A drop in core body temp is a sleep signal for the body that it is time to sleep
  • Dark room: Try black out curtains or an eye mask. No nightlight, and cover clocks and other things that emit light.
  • Quiet: Try earplugs to help if your sleep is disrupted by external noises/partner snores, etc. White noise can also help to cancel out distracting noises that can disrupt sleep.

Timing: Establish a regular sleep schedule.

  • Establish a sleep-wake routine: Stick to a routine, even on weekends. Any routine that has a bedtime before midnight and allows for 7-8 hours is reasonable.
  • Don’t eat for at least 2 hours before bed: Your body needs time to begin metabolizing and absorbing food.
  • Keep naps to 20-30 minutes in the early to mid-afternoon: Research shows that naps (even 9 minutes long) can be restorative. Short naps prevent person from going into deep sleep, which can extend the duration of the nap, result in the person feeling sluggish, and interfere with nighttime sleep. If you have sleep problems like insomnia, naps can add to the problem especially if taken late in the day. Naps do not make up for chronic sleep loss or poor-quality nighttime sleep.

For more information, check out this Lifestyle Medicine Sleep Fact Sheet.

Ready to take the next step?

Our Lifestyle Medicine team is here to support you on your journey to better health. Connect with one of our Board-Certified Lifestyle Medicine Specialists today.

Lila’s Skin Check with Dr. LaFond

The best time to get a skin check is right now! The sooner skin cancer is identified and treated, the better. Lila Lazarus admits to waiting too long, but finally gets her skin checked with Dr. LaFond, MD Dermatology

Lila Lazarus visits Dr. LaFond

You may not be thinking about it, but right now is the best time to get a skin check. While sun damage may be associated with summer, it’s easier to identify suspicious lesions without the signs of sun exposure. The sooner skin cancer is identified and treated, the better. Also, where you get your checkup can make all the difference. Lila Lazarus admits to waiting far too long to get her skin checked, but finally gets her skin checked with Dr. LaFond, MD Dermatology.

Did you know that 1-5 people will be diagnosed with melanoma in their lifetime?

People at high risk of skin cancer include:

  • Fair skin
  • Red or blonde hair
  • History of severe sunburns
  • Exposure in tanning booths
  • Family history of skin cancer

Check your own skin once a month and be sure to tell your dermatologist if you notice anything has changed.

See some tips below to prevent skin cancer:

  • Wear a daily moisturizer with SPF 15+
  • Wear a hat when outdoors that covers your face an neck
  • Apply sunscreen frequently to exposed skin
  • Limit your time in the sun

You should get you skin checked every year by a dermatologist.

You should get you skin checked every year by a dermatologist.

Looking for a Dermatologist?

A Healthy Breakfast Starts Here

Rainbow Frittata

Diabetic Living Magazine
This delicious frittata is loaded with heart-healthy, omega-3 enriched eggs and a medley of colorful vegetables. Start cooking the vegetables on the stove and finish them up in the oven with the egg mixture. To serve, top with avocado slices, grape tomatoes and a touch of sriracha.
Cook Time 30 mins
Total Time 30 mins
Course Breakfast
Cuisine American
Servings 4
Calories 219 kcal

Ingredients
  

  • 1/4 cup 1/2 inch pieces sweet potato
  • 1/4 cup 1/2 inch pieces yellow sweet pepper
  • 1/4 cup coarsely chopped fresh broccoli
  • 8 omega-3 enriched eggs
  • 1 teaspoon fresh basil snipped
  • 1/2 teaspoon fresh thyme snipped
  • 1/2 teaspoon salt
  • 1/2 teaspoon black pepper
  • 1 avocado halved, seeded, peeled, thinly sliced
  • 5 1/2 cups grape or cherry tomatoes halved
  • Sriracha Sauce optional

Instructions
 

  • Preheat oven to 350 F. Coat an oven-going 10-inch nonstick skillet with cooking spray. Add sweet potato, sweet pepper and broccoli; cook and stir over medium 5 to 7 minutes or until tender.
  • In a medium bowl whisk together eggs, basil, thyme, salt and black pepper. Pour mixture over vegetables in skillet. Cook, without stirring, until mixture begins to set on bottom and around edges. Using a spatula, lift egg mixture so uncooked portion flows underneath.
  • Transfer skillet to oven; cook 5 minutes or until egg mixture is set. Remove from oven. Let stand 2 minutes. Top servings with avocado and tomatoes. Drizzle with sriracha.

Notes

Nutrition Facts

1/4 frittata (3/4 cup)
 
219 calories; protein 13.9g; carbohydrates 7.7g; dietary fiber 3.3g; sugars 2.2g; fat 15g; saturated fat 3.9g; cholesterol 372mg; vitamin a iu 2112.2IU; vitamin c 25mg; folate 90.8mcg; calcium 70.7mg; iron 2.2mg; magnesium 30.2mg; potassium 455.8mg; sodium 226mg.
2 lean protein, 1 1/2 vegetable, 1 fat
Keyword bone health, dairy free, gluten free, healthy aging, healthy immunity, low calorie, low carbohydrate, low sodium, nut free, soy free, vegetarian

Do You Know Your Numbers?

DeAngelo Banks

We know how many gallons it takes to fill our cars…
But when it comes to our bodies, we don’t know our numbers.

Nearly half of the adult American population has high blood pressure and most don’t even know it or the health risks of not knowing.

DeAngelo Banks, 46, admits he didn’t know his numbers. He had no symptoms. He thought he was completely healthy. The truth is, he was walking around with hypertension—a major cause of premature death. That didn’t surprise him as his father had hypertension. But it was worse than that. Only after he finally reached out to a doctor did he find out he was in dire straits. He had no idea. He was caught completely off guard. DeAngelo was at risk for heart attack, stroke, kidney disease and other life-threatening complications. By the time he got to the emergency department at St. Mary Mercy Livonia, he found out he needed immediate surgery to repair his heart. His numbers indicated he didn’t have long to live. During recovery from his life-saving surgery, DeAngelo and the St. Mary Mercy Livonia Cardiac Rehab team worked together to get him feeling healthy again. Today, he’s feeling great and much younger than his actual age.

His message: Talk to your doctor. Find out what your numbers are. Don’t be afraid to ask questions about your health. Even the embarrassing questions.

Looking for a Doctor?

Find a St. Joe’s doctor near you and take control of your health.

St. Joe’s Helps Keep Rod Jenkins Young at Heart

After receiving treatment from Michigan Heart Ann Arbor for his Atrial Fibrillation (AFib), in late 2020, Rod Jenkins is now back to fly fishing, hiking, biking and most importantly, being able to keep up with his two-year-old granddaughter.

“She’s a bundle of energy, but now I can be part of her life and it feels great,” said Rod. “I’m also able to explore new trout streams to try out this spring… For the first time in 15 years, I’m back up to speed and off all medications.”

Rod is certainly not alone in facing the challenges of AFib.

What is AFib?

AFib is the most common type of heart arrhythmia or irregular heartbeat, impacting up to 6.1 million people in the United States. AFib is an electrical problem of the heart that can lead to blood clots, stroke, heart failure and other heart-related complications.

When someone has AFib, the electrical signals in the top chambers of the heart (or atria) have become irregular which can lead to a faster heart rate in the bottom chambers of the heart (or ventricles). When the heart isn’t effectively pumping blood through the body, normal activity can become tiring, make breathing challenging, or potentially cause dizziness.

Risk Factors of AFib

Common risk factors for AFib include high blood pressure, obesity, diabetes, hyperthyroidism, sleep apnea, and heavy alcohol use. People can also develop AFib even if they don’t have any of these risk factors and lead a healthy lifestyle. This is why early treatment is the key to managing AFib. As an active, fitness enthusiast, Rod’s condition was unexpected, but he was fortunate to have a key ally in the team at Michigan Heart. They remained supportive through the years and kept pursuing new treatments that eventually resolved his AFib.

Rod’s path to recovery began in 2006 when he started experiencing classic AFib symptoms including being light-headed, shortness of breath and fatigue. Once diagnosed at Michigan Heart, he first attempted to manage his symptoms with medication and a common treatment that involved cauterizing or scarring the inside of the heart. This procedure sought to stop the electrical pulses that triggered his irregular heartbeat and caused many of the AFib symptoms he was experiencing.

That initial treatment did not deliver the desired result for Rod. He then turned to Jihn Han, MD and Robert Lyons, MD from Michigan Heart, who performed a hybrid convergent ablation procedure, an innovative, minimally invasive treatment that involves cauterizing both the inside and outside surfaces of the heart to halt uneven electrical pulses that were causing Rod’s AFib. Michigan Heart provided an additional tune up procedure to ensure Rod’s heart was performing perfectly.

“Over the past 15 years our ability to help patients with AFib has come a long way,” said Dr. Han. The development of procedures such as hybrid convergent ablation is a game changer.”

While medical progress and innovation continues to move forward, there is still no substitute for paying close attention to what your body is telling you and getting the necessary help as soon as an issue arises.

“The first line of defense against AFib is understanding the symptoms, but there are many people who don’t know the warning signs,” said Dr. Lyons. “That’s why it’s crucial to get regular check-ups to stop AFib before it stops you.”

The benefits of catching AFib early and getting effective treatment are life-changing.

“I’m so happy with the results and my quality of life right now and it’s all because of the Michigan Heart team at St. Joe’s,” said Rod. “I was being held hostage by AFib. I have my life back, which is wonderful!”

What causes AFib?

As people get older, their risk for AFib increases. Some people who lead a healthy lifestyle and don’t have any other medical conditions can still develop AFib. However, AFib has some common causes and risk factors. Such as:

  • High blood pressure
  • Diabetes
  • Coronary artery disease
  • Heart muscle problems
  • Heart valve problems
  • Lung disease
  • Sleep apnea
  • Scarring of the atrium
  • Extreme physical stress
  • Genetics
  • Abnormal mineral levels
  • High thyroid levels/Overactive thyroid
  • Toxins – including alcohol and some drugs

What are the symptoms?

Symptoms tend to occur when the heart rate is too fast. A person may have no symptoms when the heart rate is normal. Although these symptoms may be uncomfortable and cause concern, they are not usually life threatening.

Only 60% of people with AFib have symptoms. The other 40% do not have symptoms.

Common Symptoms:

  • Irregular and fast heartbeats
  • Heart palpitations (a pounding feeling in your chest)
  • Trouble breathing
  • Anxiety
  • Chest pain
  • Dizziness
  • Lightheadedness or almost passing out

*If you think you may be experiencing a heart attack or medical emergency – call 911.

Ready to get back to your rhythm?

Schedule an appointment with one of our heart doctors today.

Creamy Spinach Feta Dip

Rainbow Frittata

Diabetic Living Magazine
This delicious frittata is loaded with heart-healthy, omega-3 enriched eggs and a medley of colorful vegetables. Start cooking the vegetables on the stove and finish them up in the oven with the egg mixture. To serve, top with avocado slices, grape tomatoes and a touch of sriracha.
Cook Time 30 mins
Total Time 30 mins
Course Breakfast
Cuisine American
Servings 4
Calories 219 kcal

Ingredients
  

  • 1/4 cup 1/2 inch pieces sweet potato
  • 1/4 cup 1/2 inch pieces yellow sweet pepper
  • 1/4 cup coarsely chopped fresh broccoli
  • 8 omega-3 enriched eggs
  • 1 teaspoon fresh basil snipped
  • 1/2 teaspoon fresh thyme snipped
  • 1/2 teaspoon salt
  • 1/2 teaspoon black pepper
  • 1 avocado halved, seeded, peeled, thinly sliced
  • 5 1/2 cups grape or cherry tomatoes halved
  • Sriracha Sauce optional

Instructions
 

  • Preheat oven to 350 F. Coat an oven-going 10-inch nonstick skillet with cooking spray. Add sweet potato, sweet pepper and broccoli; cook and stir over medium 5 to 7 minutes or until tender.
  • In a medium bowl whisk together eggs, basil, thyme, salt and black pepper. Pour mixture over vegetables in skillet. Cook, without stirring, until mixture begins to set on bottom and around edges. Using a spatula, lift egg mixture so uncooked portion flows underneath.
  • Transfer skillet to oven; cook 5 minutes or until egg mixture is set. Remove from oven. Let stand 2 minutes. Top servings with avocado and tomatoes. Drizzle with sriracha.

Notes

Nutrition Facts

1/4 frittata (3/4 cup)
 
219 calories; protein 13.9g; carbohydrates 7.7g; dietary fiber 3.3g; sugars 2.2g; fat 15g; saturated fat 3.9g; cholesterol 372mg; vitamin a iu 2112.2IU; vitamin c 25mg; folate 90.8mcg; calcium 70.7mg; iron 2.2mg; magnesium 30.2mg; potassium 455.8mg; sodium 226mg.
2 lean protein, 1 1/2 vegetable, 1 fat
Keyword bone health, dairy free, gluten free, healthy aging, healthy immunity, low calorie, low carbohydrate, low sodium, nut free, soy free, vegetarian

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