Amavithamini Okusiza Ukukhulelwa Nokwandisa Ukuzala Ngokwemvelo

Ngezinye izikhathi abantu bafuna amavithamini okusiza ukukhulelwa ukuze balungise imizimba yabo ithuba lokuphila okusha. Le ndlela ingase ihlanganise ukuhlola amaphilisi okuvundisa angcono kakhulu okukukhulelwa noma nje ukwengeza ukudla okunempilo emkhubeni wansuku zonke. Kodwa kungaba nzima. Abanye bagxila ekudleni okunesisindo esilinganiselayo, kanti abanye babheka amasuphilimenti. Futhi izinto eziningi zithinta ukuzala, kusukela kumahomoni kuya endleleni yokuphila. Izahluko ezilandelayo zichaza ama-nutrient ahlukene, okuhlanganisa namaminerali angaziwa kakhulu, kanye namasu okuthi la makhemikhali angasiza kanjani abantu abafuna ukukhulelwa. Ukwengeza uhlelo lokudla lokuvundisa oluhlelekile fertility diet meal plan kungaqhubeka kusekele impilo yokuzala ngokwenza umzimba wamukele amavithamini nama-nutrient abalulekile adingekayo ekukhulelweni.

Ukuqonda Inani Lama-Nutrient Abalulekile

Ukuzala kubandakanya inqwaba yezinqubo. Ukulawulwa kwamahomoni, ukukhiqizwa kwamandla, nokugcinwa kwamaseli konke kuhlobene namavithamini namaminerali. Abaningi abahlola amasuphilimenti okuvundisa angcono kakhulu bathola ukuthi ukuvala izikhala ekudleni kuyasiza. Abanye babona ukuthuthuka ngokufaka amasuphilimenti okuvundisa abesifazane angcono kakhulu njengengxenye yohlelo olubanzi. Kodwa umuntu ngamunye uhlukile. Ngakho umuntu kumele athole okulingana nezidingo zakhe siqu.

Abanye babheka ama-vitamin okuvundisa angcono kakhulu namasuphilimenti okuvundisa angcono kakhulu uma besola ukuthi ukudla kwabo kuphela kungase kungawenzi umsebenzi. Akukho fomula eyimilingo eyodwa, noma kunjalo. Indlela enesisindo esilinganiselayo isalokhu ibalulekile.

I-Manganese

I-Manganese isiza ukugaywa kokudla okuthile futhi isekele amathambo anempilo. Okunye ucwaningo, yize luncane, luphakamisa ukuthi ingase isize ukuzala. Ucwaningo oludala lwathola ukuthi ukudla okune-manganese ephansi kwakuhlobene nengozi enkulu yokweqa isikhathi sokuvuthwa kwamaqanda [1]. Enye ibheke ukuthi ingawuthinta kanjani umsebenzi wamahomoni ebuchosheni. Okusanhlamvu okungakahluzwa, amantongomane, ukhukhamba, nemifino eluhlaza okotshani kuvame ukunikeza i-manganese. Ukuyithatha njalo, ihlanganiswe nezinye amaminerali, kungasiza ukwenza uhlelo lokuzala luhlale luzinzile.

I-Folic Acid Yokukhulelwa Okunempilo

I-folic acid yokuzala ivame ukushiwo, kodwa kungani ixabiseka kangaka? I-folate (noma i-folic acid) ingeyesigaba se-B9 futhi isebenza njengodaka lokwakha amaseli amasha. Abesifazane abafuna ukukhulelwa bangase baqale ukuyithatha okungenani inyanga ngaphambi kokukhulelwa ngoba iphinde isize ukunciphisa izinkinga ze-neural tube embungwini okhula [2]. Inani elinconyiwe cishe ama-microgram angu-400 nsuku zonke. Le nto ebalulekile ingasiza ngisho nemiphumela emitholampilo yokuzala, ngokusho kwezifundo. Imifino eluhlaza enamagatsha, ubhontshisi, nezinhlamvu inayo i-folate. Ngaphezu kwalokho, izinzuzo ze-folic acid kubantu abangakhulelwe zihlanganisa ukusekela ukukhiqizwa kwamangqamuzana egazi abomvu, ukukhuthaza ukusebenza kobuchopho, nokunciphisa ingozi yesifo senhliziyo.

I-B-Complex namanye ama-vitamin

Umndeni wama-B mkhulu. Uhlanganisa i-B1, B2, B3, B5, B6, B7 (biotin), B9 (folate), ne-B12. Zonke lezi zingaba nendima empilweni yamahomoni noma yokushintshashintsha kwamandla omzimba (metabolism). Abanye abantu abacwaninga ngemithi yokukhulelwa noma ezinye izithako zokondla bathola ukuthi la ma-vitamin ayisisekelo. I-B6 ingasiza ukulungisa imijikelezo yenyanga, kuyilapho i-B12 isiza ekwakhekeni kwamangqamuzana egazi abomvu [3].

I-iodine

I-iodine ivame ukunconywa ekusekeleni ukusebenza kwe-thyroid, okuhlobene ngqo namahomoni okuzala. Abanye abantu abanezinkinga zokungakhulelwa ezingachazwanga babona ukuthuthuka uma beqinisekisa ukuthi bathola i-iodine eyanele [4]. Itholakala enhlanzini yasolwandle, usawoti onothe nge-iodine, noma obisi nemikhiqizo yobisi. Nokho, uma idliwa ngokweqile ingadala inkinga, ngakho noma iyiphi inhlelo yokwengeza kungaba kuphephe kakhulu uma ixoxiswana nodokotela.

Amaminerali Abalulekile Empilweni Yokuzala

Amaminerali ayizakhi eziyisisekelo ezinqubweni ezahlukene zomzimba. Angathinta uhlelo lokuzala lwabesilisa nabesifazane. Abanye basuke basebenzise imithi ukuze baqhamuke namaqanda uma kutholakala ukuphazamiseka ekuqhamukeni kwamaqanda, kodwa ukuthola amaminerali ngokuzinzile nakho kubalulekile kakhulu. Ilungu ngalinye lamaminerali linale ndima ekukhiqizeni amahomoni noma ekugcineni izitho zomzimba zisebenza kahle, ngakho akufanele kukhishwe emazingeni. Abantu abaningi bafuna ama-vitamin ukuze bakhulelwe ngokushesha uma bekholelwa ukuthi izikhala ekondleni zingase zibambezela inqubo yokukhulelwa. Imiphumela ingahluka, kodwa ukuvala lezo zikhala kuvame ukuletha izinzuzo empilweni yokuzala iyonke.

I-zinc

I-zinc iyadingeka eziceleni eziningi zokuzala. Isisiza ngekhwalithi yamaqanda, impilo yesidoda, nokulawulwa kwamahomoni. Ngenxa yokuthi inezakhiwo zokuba yi-antioxidant, ingavikela amaqanda nesidoda ekucindezelekeni okweqile [5]. Ukudla njengenyama yenkomo, inyoni nembaza (oysters) kuyimithombo eyaziwayo. Uma ukudla kungenalo lezi, isithasiselo singase sitshalwe. Abanye bakubiza ngokuthi ingxenye yamavithamini athuthukisa ukuzala ngoba kwaziwa ukuthi athuthukisa eminye imisebenzi yokuzalana.

Iron

I-iron iyadingeka kumaseli abomvu egazi athwala umoya-mpilo emzimbeni wonke. Ukukhathala kuyisimpawu esisodwa sokushoda nge-iron, okungase kuphazamise ikhono lomuntu lokukhulelwa. Abesifazane balahlekelwa i-iron njalo ngenyanga ngesikhathi sokuhlotshana, ngakho ukungayitholi ngokwanele kungaba yingozi [6]. Imithombo enconyiwe: inyama ebomvu, inkukhu, inhlanzi, ubhontshisi, i-spinach, kanye ne-blackstrap molasses. Abanye abantu baphawula i-iron kumaphilisi okuthuthukisa ukuzala noma kumavithamini ajwayelekile okubeletha. Ukwenezela kungase kusekele amandla omzimba jikelele.

Calcium

ICalcium yaziwa kakhulu ngokulolonga amathambo namazinyo, kodwa iphinde ihlobane nomsebenzi wemisipha, kuhlanganise naleyo ehlobene nokuzalana. I-calcium eyanele inganciphisa izinkinga zokuvuthwa kweqanda futhi isize ukugcina amazinga e-estrogen enempilo [7]. Ingatholakala kobisi, e-broccoli noma kuma-almond. Uma ukudla kunganele, isithasiselo singangena esikhundleni. Uma ukhulelwe, ukukhula kwamathambo omntwana kudinga lo mmineral ngobuningi.

Vitamin D

I-vithamini D isiza umzimba ukumunca i-calcium, kodwa yenza nokunye. Kunobufakazi obuxhumanisa i-vitamin D ephansi emadodeni nokwanda kokungazali [8]. Kwabesifazane, ukuswela kungase kuphazamise ikhwalithi yeqanda noma ukukhula kwamaseli. Abantu bangakha i-vithamini D ngokuchayeka elangeni. Ekudleni, itholakala ezinhlanzini ezinamafutha, ama-cereal afakwe izithasiselo, noma obisini oluthile. Abanye bathola isengezo sisiza, ikakhulukazi ezindaweni ezingenalanga elanele. Lokhu kudla okubalulekile kungavela kumaphilisi okuthuthukisa ukuzala kwabesifazane noma emikhiqizweni yamadoda.

Magnesium

IMagnesium isekela amakhulu emisebenzi yomzimba, kuhlanganise nomsebenzi wemisipha nowemizwa. Ibuye ithinte ukugaywa kwama-carbohydrate namaprotheni. Eminye imininingwane ixhumanisa amazinga e-magnesium nemiphumela engcono yokubeletha [9]. Ama-almond, amakheshew, imbewu, nohlaza njenge-spinach imithombo emihle. Ngenxa yokuthi izindlela zokudla zanamuhla zingase zingabi nawo umgogodla owanele we-magnesium, ukusebenzisa isithasiselo kwesinye isikhathi kuyelulekwa. Lo mmineral ungavela emithini yokukhulelwa masinyane noma ube yingxenye yezinhlelo ezibanzi zokuthuthukisa ukuzala.

Ama-antioxidant nokuzinza kwama-hormone

Ama-antioxidant asiza ukunciphisa umonakalo odalwa ama-free radical, ongacekela phansi amaqanda nesidoda noma uphazamise izimpawu zama-hormone. Abantu abaningi bawengeza lapho befuna imithi yokuzala etholakala ngaphandle kukadokotela noma izindlela zemvelo kakhulu. Ukudla i-antioxidant enesisindo esilingene kungadala indawo engcono yokukhulelwa, ukuze amaqanda anempilo nesidoda kuvikelwe ezicindezelweni.

I-vithamini E

I-vithamini E ibibaluleke emlandweni ekusekeleni ukuzalana okuvamile. I-antioxidant engasiza ukugcina umchamo wesibeletho (cervical mucus) unempilo futhi inciphise ezinye izinkinga ezithile [10]. Ukudla okufana nopelepele omkhulu, ama-avocado, imbewu, amantongomane, namanye amafutha kunganikeza i-vitamin E. Uma izinga layo liphansi, isithasiselo sokuzala esiyiqukethe singasiza. Kodwa imvamisa ihlanganiswa namanye amavithamini namaminerali ukuze kukhishwe indlela ebanzi nenewulinganiso.

Vitamin C

IVitamin C ivelele ngoba isiza ukumuncwa kwensimbi. Lokho kubalulekile uma umzali osezama ukukhulelwa elwa nesifo se-anemia. Iphinde ibe i-antioxidant esiza ukuvikela umonakalo kumaseli [11]. Imithombo evamile ifaka amawolintshi, upelepele omkhulu, nama-strawberry. Labo abangadli kakhulu imifino nezithelo bangase bathembele kusithasiselo. Imvamisa ifakwa emaphaketheni abhalwe njengemithi yokuzala noma inhlanganisela ejwayelekile yamavithamini nezakhi.

Ama-amino acid asekelayo ukukhulelwa

Ama-amino acid angamaqoqo enza amaprotheni. Angasiza ngokugeleza kwegazi, ukwakheka kwamahomoni, noma ukubekezelela ukucindezeleka. Abantu abafuna imithi yokugqugquzela amaqanda bangabuye bacabange ukuthi ama-amino acid angaba yingxenye yengqikithi yini. I-L-carnitine ne-L-arginine amabili avame ukuvela ezingxoxweni zokuzala. Eyokuqala ingase inyuse ukuhamba kwesidoda, kanti eyesibili ingakhuthaza ukugeleza kwegazi okuhle esibelethweni [12]. Akukho okuyisimangaliso sodwa, kodwa kungasiza izinqubo zemvelo zomzimba.

Imithi yamatshani nemikhipho esekelwe ezitshalweni

Kukhona okuningi okuvela emithini yesintu noma okusekelwe ezitshalweni emhlabeni wokuzala. Abanye abantu bayazizama kungathi banemithi yokugqugquzela amaqanda noma bengayithathi. Izinto ezifana ne-ashwagandha, i-Maca, noma i-ginseng yizibonelo. Zingasiza ukulinganisela ukucindezeleka noma amandla futhi zingase zithuthukise nesifiso sobulili [13]. Kodwa imiphumela iyahlukahluka. Kunconyiwe ukuthi ubuze uchwepheshe kabili mayelana nokusebenzisana okungenzeka noma imiphumela engemihle.

Biotin

I-Biotin, okuwumuthi obizwa nangokuthi iVitamin H, ivame ukungaxoxwa kakhulu ezimeni zokuzala, kodwa ibalulekile ekushintshaneni kwamandla futhi ingasiza nekhwalithi yamaqanda. Izifundo zibonisa futhi ukuthi ingasiza inani lesidoda samadoda [14]. Imithombo emihle ihlanganisa amaqanda, amantongomane, imbewu, ubhatata, namakhowe. Abanye abantu banokuntuleka kwe-biotin, ngakho umthamo wansuku zonke ungabasiza bagcine ibhalansi yamahomoni.

Choline

I-Choline ingasiza ekuthuthukisweni kombungu, ngakho iyasiza kulabo abafuna ukukhulelwa noma asebekhulelwe. Ixhunywe futhi ekusebenzeni kahle kwama-ovary nasekusekelweni kwamahomoni, okungenzeka kusize abantu abanezinkinga ze-endocrine [15]. Isibindi, amagwalagwala amaqanda aphuzi, nezinhlanzi imithombo emikhulu. Abanye bakhetha ukuthatha i-choline njengesithasiselo esisodwa uma bedla lezo zidlo kakhulu ngezikhathi ezithile. Uma isebenza ngokubambisana nezinye izinto ezondlayo, ingasiza ukudala indawo eqinile yokukhulelwa.

Abanye bakhetha amavithamini ukusiza ukukhulelwa ngoba angasiza ukuzinzisa amahomoni futhi asekele amalungiselelo emvelo omzimba okhulelwe, ikakhulukazi uma ehlanganiswe nokudla okunempilo nemizamo yokushintsha indlela yokuphila.

Izinketho Ezitholakala Ngaphandle Kwephepha Likadokotela Nezithasiselo Zokuzala

Abanye abantu bayathemba ukuthola amaphilisi wamahhala abazokhulisa ukushesha ukukhulelwa, nokho lokho kuvame ukuba nzima kakhulu. Imikhiqizo ethengwa ngaphandle kwephepha likadokotela isengaba usizo uma ithembekile. Imvamisa iqukethe inhlanganisela yamavithamini, amaminerali, kwesinye isikhathi nemithi yesintu. Leyo mikhiqizo ingase ibhalwe njengemithi esiza ukuvuthwa kwamaqanda noma izithasiselo zokwandisa inzalo. Umuntu udinga ukuhlola izithako ukuze abone amandla nokuphepha kwazo. Uma enokungabaza, makabuze umhlinzeki wezempilo oqeqeshiwe.

Kuyenzeka futhi ukuthi umbhangqwana unqume ukwengeza izithasiselo ukuze bakhulelwe uma sebebonile ukuthi banesikhala ezakhamzimbeni. Lezi zixazululo zingagcwalisa okuntulekile ekudleni kwansuku zonke, ikakhulukazi uma izinhlelo ezimatasa zenza ukuhlela ukudla kube nzima. Isithasiselo esikhethiwe kahle singahlanganisa amavithamini, amaminerali, ama-antioxidant, nokunye, okungaholela ekubhekaneni kangcono nezidingo zokuzala.

Izinto Zokuphila Zendlela Yokuphila Ezithuthukisa Amathuba

Izindlela zokuphila zinemthelela omkhulu. Ukubhema, ingcindezi ephezulu, noma ukungaphumuli ngokwanele kungavimba imiphumela, ngisho noma kusetshenziswa izithasiselo ezisiza ukuzala. Ukulawula isisindo nakho kubalulekile. Abantu abanciphe kakhulu noma abakhuluphele ngokweqile bangase babhekane nokuguquguquka kwama-hormone [16]. Khonamanjalo, ukuzivocavoca okulingene kusiza ukugeleza kwegazi, okungase kuthuthukise umphumela wezithasiselo ezisiza ukukhulelwa.

Ukudla okuqukethe imifino nemikhiqizo emisha, amaprotheni anesizotha, kanye nezitshalo eziphelele kungaqinisa umthelela wale mizamo. Abanye bagcizelela ukuphuza amanzi anele. Imisebenzi yomzimba, kuhlanganise nezimpawu zama-hormone, ingaphazamiseka uma kunokushoda kwamanzi emzimbeni. Futhi, ukulinganisela ukusetshenziswa kwekhofi noma utshwala kungaletha ukuthuthuka.

Ukuhlanganisa Ukudla Okunempilo Nokuqondiswa Ngodokotela

Akuzona zonke izinkinga zokungazali ezingaxazululwa ukudla okunempilo kuphela. Uma inkinga iqhubeka, udokotela angahlola ukuthi kukhona yini ukuvinjelwa, inani eliphansi lesidoda, noma ezinye izimo. Anganikeza izindlela ezithuthukile noma axoxe ngemithi yokuzala yabesifazane, uma kudingeka. Ngokunye, abesilisa bangelulekwa ukuba benze ukuhlolwa kwesidoda.

Uma kunesidingo, inhlanganisela yokudla okunempilo, imithi esiza ukuvuthwa kwamaqanda, kanye nokungenelela okukhethekile ingaba yindlela eqinile kakhulu. Lokhu kusebenzisana kuvame ukulethela imiphumela engcono kunesinyathelo esisodwa sodwa. Abanye bathembele kumavithamini okusiza ukuzala ukuze baqinisekise ukuthi bagcina amazinga ezakhi-mzimba elinganiselayo, okungaqinisa amathuba okuthi iqanda lifuthwe noma isidoda sithuthuke kahle.

Okubaluleke kakhulu

Ukudla amavithamini okusiza ukukhulelwa kungaba yisinyathelo esibalulekile ekulungiseleleni umzimba ukukhulelwa ngokuzayo. Izinhlobo ezahlukene zokudla okubalulekile—njenge-folate, insimbi, i-zinc, i-magnesium, i-calcium, i-iodine, namavithamini C, D, no-E—kufaka isandla ekusebenzeni kangcono kohlelo lokuzala. I-Biotin, i-choline, ne-manganese nakho kukhombisa amathuba. Abanye abantu baphinde bahlolisise izinto ezifana namaphilisi okuzala angcono kakhulu okusiza ukukhulelwa noma inhlanganisela ekhethiwe kahle yamaminerali, ama-amino acids, nezifinyezo zezitshalo.

Uhambo lungahlanganisa izinguquko zendlela yokuphila, ukubonana nodokotela, noma ukuzama izithasiselo (supplements) zokwandisa ukuzala, kanye nokulungisa imikhuba yosuku nosuku. Umqondo oyinhloko, nokho, ukwakha indawo esekelayo yamaqanda noma isidoda kanye nohlelo lonke lokuzala. Lezi zinyathelo zingathuthukisa amathuba okukhulelwa, yize iseluleko sezokwelashwa esenziwe umuntu siqu sisalokhu siwumqondo omuhle. Ukugxila emavithamini okusiza ukukhulelwa kuyindlela eqinile yokubeka isisekelo sezinhlelo zokuba nengane kusasa.

Imibuzo evame ukubuzwa

Kuthiwani ngokuthatha amavithamini okwandisa ukuzala uma kuqhathaniswa nemithi?

Zombili zingaba nendima. Kwesinye isikhathi ibhalansi enhle yamakhambi omzimba (nutrients) yanele. Kwezinye izikhathi, umuntu angazama usizo lwezokwelashwa noma imishanguzo yokuvuselela ukukhishwa kwamaqanda (ovulation drugs) ukuze kubhekwe izinselelo ezijulile.

Ingabe ikhona ithuba lokuthola amaphilisi amahhala okukhulelwa masinyane?

Kwezinye izindawo, kungase kube nezinhlelo ezingaphelele noma izaphulelo, kodwa izixazululo zamahhala ngokuphelele azivamile. Ukuqinisekisa njalo kunconywa.

Kutheni ngama-“over the counter” izidakamizwa zokuzala ezisetshenziselwa esikhundleni semithi yangempela?

Angasiza abanye abantu, kodwa ukutholakala kwezifo ezithile kungadinga imithi ebhalwe udokotela noma ukunakekelwa okukhethekile. Ukuhlola nodokotela kuhlakaniphile.

Ingabe kukhona amavithamini okuzala aqinisekisa ngqo ukuthi uzothola ukukhulelwa?

Cha. Ukudla okulinganiselayo kusiza impilo, kodwa akukho nokunye okunye okwenyusa umjovo wokukhulelwa ngokuzenzakalelayo. Kungcono ukugcina okulindelwe kungokoqobo.

Ingabe amavithamini okwandisa ithuba lokukhulelwa angasiza ekubhemeni izisu okuphindaphindiwe?

Angasiza empilweni yonke futhi anciphise abanye obungozi, kodwa ukubhema izisu kaningi kungaba nezimbangela eziningi. Ukuhlolwa kochwepheshe kusamele kube sezingeni elibalulekile.

Izikhombo

1. Office of Dietary Supplements - Manganese.. Available at: https://ods.od.nih.gov/factsheets/Manganese-HealthProfessional/#:~:text=Manganese%20is%20an%20essential%20trace,carboxylase%20%5B1%2C2%5D.
2. Greenberg, J. A., Bell, S. J., Guan, Y., & Yu, Y. H. (2011). Ukwengeza i-Folic Acid nokukhulelwa: okungaphezu kokuvimbela iziphambeko zethumbu lobuchopho (neural tube defects). Reviews in obstetrics & gynecology. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC3218540/
3. Watanabe F. (2007). Imithombo ye-vitamin B12 nokutholakala kwayo emzimbeni (bioavailability). Experimental biology and medicine (Maywood, N.J.). Available at: https://pubmed.ncbi.nlm.nih.gov/17959839/
4. Zimmermann M. B. (2009). Ukushoda kwe-iodine. Endocrine reviews. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/19460960/
5. Fallah, A., Mohammad-Hasani, A., & Colagar, A. H. (2018). I-zinc iyinto ebalulekile ekuzaleni kwabesilisa: Uhlolojikelele lwezindima ze-Zn empilweni yamadoda, ekubunjweni, kwekhwalithi yesidoda, nasekufakelweni. Journal of reproduction & infertility. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/30009140/
6. Milman N. (2011). Insimbi ngesikhathi sokukhulelwa: Singaqinisekisa kanjani isimo se-iron esifanele kumama nasengane?. Annals of nutrition & metabolism. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/22123639/
7. Thys-Jacobs, S., Donovan, D., Papadopoulos, A., Sarrel, P., & Bilezikian, J. P. (1999). I-vitamin D nokungahleleki kwe-calcium ku-polycystic ovarian syndrome. Steroids. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/10433180/
8. Blomberg Jensen M. (2014). I-vitamin D nokuzalana kwabesilisa. Nature reviews. Endocrinology. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/24419359/
9. Makrides, M., Crosby, D. D., Bain, E., & Crowther, C. A. (2014). Ukwengeza i-magnesium ngesikhathi sokukhulelwa. The Cochrane database of systematic reviews. Kutholakala ku: https://pubmed.ncbi.nlm.nih.gov/24696187/
10. Ruder, E. H., Hartman, T. J., & Goldman, M. B. (2009). Umthelela wokucindezeleka okunokuthela (oxidative stress) ekuzaleni kwabesifazane. Current opinion in obstetrics & gynecology. Kutholakala ku: https://pmc.ncbi.nlm.nih.gov/articles/PMC2749720/
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