Tuesday, July 12, 2016
Monday, July 11, 2016
Thursday, July 07, 2016
Dangerous Drug Combo
Thyroid Hormone and Proton Pump Inhibitors
Thyroid supplementation is extremely common. Some frequently used drugs, including proton pump inhibitors (PPIs), can interfere with thyroid hormone absorption, causing patients whose disease was previously well-controlled on a thyroid hormone to develop hypothyroidism.
The interaction between levothyroxine and omeprazole in patients with impaired gastric acid secretion requires an increased dose of oral thyroxine, which suggests that normal acid secretion is necessary for effective oral absorption of thyroxine. Patients with hypothyroidism who are euthyroid and on levothyroxine may need thyroid function testing after initiation of a PPI, especially if symptoms of hypothyroidism emerge. And those with impaired gastric acid secretion may require an increased dose of levothyroxine to keep the thyroid-stimulating hormone level within range.
The product labeling for levothyroxine recommends that it not be administered simultaneously. If concurrent use is necessary, administration of the agents should be separated by 4 hours.
Thyroid supplementation is extremely common. Some frequently used drugs, including proton pump inhibitors (PPIs), can interfere with thyroid hormone absorption, causing patients whose disease was previously well-controlled on a thyroid hormone to develop hypothyroidism.
The interaction between levothyroxine and omeprazole in patients with impaired gastric acid secretion requires an increased dose of oral thyroxine, which suggests that normal acid secretion is necessary for effective oral absorption of thyroxine. Patients with hypothyroidism who are euthyroid and on levothyroxine may need thyroid function testing after initiation of a PPI, especially if symptoms of hypothyroidism emerge. And those with impaired gastric acid secretion may require an increased dose of levothyroxine to keep the thyroid-stimulating hormone level within range.
The product labeling for levothyroxine recommends that it not be administered simultaneously. If concurrent use is necessary, administration of the agents should be separated by 4 hours.
Wednesday, July 06, 2016
Tuesday, July 05, 2016
Friday, July 01, 2016
Thursday, June 30, 2016
Thursday, June 23, 2016
Tuesday, June 21, 2016
Monday, June 20, 2016
Wednesday, June 15, 2016
WHO: coffee not carcinogenic, but protective
It's about time!
http://www.wsj.com/articles/world-health-organization-to-drop-coffees-status-as-possible-carcinogen-1465946753
http://well.blogs.nytimes.com/2016/06/15/coffee-may-protect-against-cancer-w-h-o-concludes/?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health®ion=rank&module=package&version=highlights&contentPlacement=1&pgtype=sectionfront&_r=0
http://www.wsj.com/articles/world-health-organization-to-drop-coffees-status-as-possible-carcinogen-1465946753
http://well.blogs.nytimes.com/2016/06/15/coffee-may-protect-against-cancer-w-h-o-concludes/?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health®ion=rank&module=package&version=highlights&contentPlacement=1&pgtype=sectionfront&_r=0
Thursday, June 09, 2016
Wednesday, June 08, 2016
Monday, June 06, 2016
Diet Inextricably Linked to Rheumatoid Arthritis
Your diet greatly influences your chances of developing rheumatoid arthritis. Two studies presented recently at the American College of Rheumatology annual meeting found those who ate a diet high in red and processed meat, refined grains, fried food, high-fat dairy and sweets were more likely to develop rheumatoid arthritis than those who ate a diet high in fruits, vegetables, legumes, whole grains, poultry and fish.
Surprisingly, the same research team found that even following the Dietary Guidelines for Americans can lower the risk of developing rheumatoid arthritis.
Rheumatoid arthritis, an autoimmune disorder, is characterized by pain, stiffness and swelling in multiple joints. The cause is unknown, and it can lead to joint damage and deformity. More women develop it than men.
Surprisingly, the same research team found that even following the Dietary Guidelines for Americans can lower the risk of developing rheumatoid arthritis.
Rheumatoid arthritis, an autoimmune disorder, is characterized by pain, stiffness and swelling in multiple joints. The cause is unknown, and it can lead to joint damage and deformity. More women develop it than men.
Friday, June 03, 2016
Tuesday, May 31, 2016
Friday, May 27, 2016
Thursday, May 26, 2016
Wednesday, May 25, 2016
FDA rules on evaporated cane juice
We completely agree with this ruling. Sugar is sugar no mater how you spin it label-wise.
FDA: "This guidance is intended to help consumers make informed choices among sweeteners by promoting accurate and consistent labeling. To that end, we are advising the regulated industry of our view that the term “evaporated cane juice” is not the common or usual name of any type of sweetener and that this ingredient should instead be declared on food labels as “sugar,” preceded by one or more truthful, non-misleading descriptors if the manufacturer so chooses (e.g., “cane sugar”)."
http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/ucm181491.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery
FDA: "This guidance is intended to help consumers make informed choices among sweeteners by promoting accurate and consistent labeling. To that end, we are advising the regulated industry of our view that the term “evaporated cane juice” is not the common or usual name of any type of sweetener and that this ingredient should instead be declared on food labels as “sugar,” preceded by one or more truthful, non-misleading descriptors if the manufacturer so chooses (e.g., “cane sugar”)."
http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/ucm181491.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery
Tuesday, May 24, 2016
Thursday, May 19, 2016
Tuesday, May 17, 2016
Monday, May 16, 2016
Thursday, May 12, 2016
Wednesday, May 11, 2016
Wednesday, May 04, 2016
Tuesday, May 03, 2016
Friday, April 29, 2016
Wednesday, April 27, 2016
Monday, April 25, 2016
Thursday, April 21, 2016
Monday, April 18, 2016
Friday, April 15, 2016
Tuesday, April 12, 2016
Friday, April 08, 2016
Thursday, April 07, 2016
Sitting...yikes
Sitting for more than 3 hours per day is responsible for 3.8% of all-cause mortality, according to an analysis of behavioral surveys from 54 countries.
Importantly, reducing sitting time to less than 3 hours daily could increase life expectancy by an average of 0.20 years, as reported in an article published in the March issue of American Journal of Preventive Medicine.
Although previous research has linked excessive sitting time with a number of health concerns, including obesity and metabolic syndrome, and with an increased risk for death from cardiovascular disease and cancer, even among people who exercise regularly, other findings have not supported this conclusion.
Excessive sitting is common in modern culture and is determined by multiple social and environmental factors, all of which are "strongly influenced by the current economic system, including a greater number of labor-saving devices for commuting, at home and work, and urban environment inequalities that force people to travel longer distances and live in areas that lack support for active lifestyles," the authors state. In this regard, "only interventions aimed at tackling the macro determinants of sedentary behavior will be able to achieve the bolder scenarios assumed in the analysis."
Here's a tip: Stand up every 20 minutes!!
Importantly, reducing sitting time to less than 3 hours daily could increase life expectancy by an average of 0.20 years, as reported in an article published in the March issue of American Journal of Preventive Medicine.
Although previous research has linked excessive sitting time with a number of health concerns, including obesity and metabolic syndrome, and with an increased risk for death from cardiovascular disease and cancer, even among people who exercise regularly, other findings have not supported this conclusion.
Excessive sitting is common in modern culture and is determined by multiple social and environmental factors, all of which are "strongly influenced by the current economic system, including a greater number of labor-saving devices for commuting, at home and work, and urban environment inequalities that force people to travel longer distances and live in areas that lack support for active lifestyles," the authors state. In this regard, "only interventions aimed at tackling the macro determinants of sedentary behavior will be able to achieve the bolder scenarios assumed in the analysis."
Here's a tip: Stand up every 20 minutes!!
Thursday, March 31, 2016
Wednesday, March 30, 2016
Tuesday, March 29, 2016
Tuesday, March 22, 2016
Friday, March 18, 2016
General Mills to Voluntarily Label GMOs!!
http://www.usatoday.com/story/money/2016/03/18/general-mills-to-label-gmos-on-products/81981314/
Hopefully, this is just the beginning!
Hopefully, this is just the beginning!
Thursday, March 17, 2016
Tuesday, March 15, 2016
Friday, March 11, 2016
Thursday, March 10, 2016
Wednesday, March 09, 2016
Thirdhand smoke is real
Thirdhand smoke (THS) results when exhaled smoke gets on surfaces -- clothing, hair, homes and cars. THS has been shown, in mice, to damage the liver and lungs, complicate wound-healing and cause hyperactivity. Add to this list now type 2 diabetes, the most common form of the disease.
Research published in PLOS ONE shows, in mice, that THS exposure causes insulin resistance, a precursor to type 2 diabetes.
If confirmed in humans, our study could greatly impact how people view exposure to environmental tobacco toxins. Children and the elderly are especially vulnerable to THS and its impact on health. Because infants frequently crawl on carpets and touch objects exposed to exhaled smoke, they are at high risk for THS exposure. The elderly are at high risk simply because older organs are more susceptible to disease.
THS consists of tobacco smoke toxins that linger on surfaces and in dust after tobacco has been smoked. This includes toxins that become increasingly toxic with age and are re-emitted into the air or react with other chemicals in the environment to produce new pollutants. Some of these pollutants are carcinogenic.
To rid a house of THS, you have to strip the home of everything -- furniture, appliances, paint, clothes, ducts, ventilation -- that could have THS. It would be more effective to simply move. There are cleaners we can use, but that would mean exposure to other strong chemicals.
Little was known about the specific health implications of human exposure to THS until this study.
Research published in PLOS ONE shows, in mice, that THS exposure causes insulin resistance, a precursor to type 2 diabetes.
If confirmed in humans, our study could greatly impact how people view exposure to environmental tobacco toxins. Children and the elderly are especially vulnerable to THS and its impact on health. Because infants frequently crawl on carpets and touch objects exposed to exhaled smoke, they are at high risk for THS exposure. The elderly are at high risk simply because older organs are more susceptible to disease.
THS consists of tobacco smoke toxins that linger on surfaces and in dust after tobacco has been smoked. This includes toxins that become increasingly toxic with age and are re-emitted into the air or react with other chemicals in the environment to produce new pollutants. Some of these pollutants are carcinogenic.
To rid a house of THS, you have to strip the home of everything -- furniture, appliances, paint, clothes, ducts, ventilation -- that could have THS. It would be more effective to simply move. There are cleaners we can use, but that would mean exposure to other strong chemicals.
Little was known about the specific health implications of human exposure to THS until this study.
Spouse Can Harm, Help Health
From the March 2016 issue of American Journal of Epidemiology
Low physical activity levels are a public health concern. Few studies have assessed the concordance of physical activity change among spouses. We studied this concordance during a 6-year period (baseline: 1987–1989; follow-up: 1993–1995) in 3,261 spousal pairs from the US-based Atherosclerosis Risk in Communities (ARIC) Study. Linear regression was used to examine the association between change in individuals' sport/exercise and leisure physical activity indices (ranging from 1 (low) to 5 (high)) and change in his or her spouse's indices. The association between individual and spousal changes in meeting physical activity recommendations was assessed with logistic regression. Individual changes in the sport/exercise and leisure indices were positively associated with spousal changes. For every standard deviation increase in their wives' sport/exercise index, men's exercise index increased by 0.09 (95% confidence interval: 0.05, 0.12) standard deviation; for every standard deviation increase in their wives’ leisure index, men's leisure index increased by 0.08 standard deviation. Results were similar for women. Individuals had higher odds of meeting physical activity recommendations if their spouse met recommendations at both visits or just follow-up. In conclusion, changes in an individual's physical activity are positively associated with changes in his or her spouse's physical activity. Physical activity promotion efforts should consider targeting couples.
Married couples might be an appropriate target for obesity prevention interventions. In the present study, we aimed to evaluate whether an individual's risk of obesity is associated with spousal risk of obesity and whether an individual's change in body mass index (BMI; weight in kilograms divided by height in meters squared) is associated with spousal BMI change. We analyzed data from 3,889 spouse pairs in the Atherosclerosis Risk in Communities Study cohort who were sampled at ages 45–65 years from 1986 to 1989 and followed for up to 25 years. We estimated hazard ratios for incident obesity by whether spouses remained nonobese, became obese, remained obese, or became nonobese. We estimated the association of participants' BMI changes with concurrent spousal BMI changes using linear mixed models. Analyses were stratified by sex. At baseline, 22.6% of men and 24.7% of women were obese. Nonobese participants whose spouses became obese were more likely to become obese themselves (for men, hazard ratio = 1.78, 95% confidence interval: 1.30, 2.43; for women, hazard ratio = 1.89, 95% confidence interval: 1.39, 2.57). With each 1-unit increase in spousal BMI change, women's BMI change increased by 0.15 (95% confidence interval: 0.13, 0.18) and men's BMI change increased by 0.10 (95% confidence interval: 0.09, 0.12). Having a spouse become obese nearly doubles one's risk of becoming obese. Future research should consider exploring the efficacy of obesity prevention interventions in couples.
Low physical activity levels are a public health concern. Few studies have assessed the concordance of physical activity change among spouses. We studied this concordance during a 6-year period (baseline: 1987–1989; follow-up: 1993–1995) in 3,261 spousal pairs from the US-based Atherosclerosis Risk in Communities (ARIC) Study. Linear regression was used to examine the association between change in individuals' sport/exercise and leisure physical activity indices (ranging from 1 (low) to 5 (high)) and change in his or her spouse's indices. The association between individual and spousal changes in meeting physical activity recommendations was assessed with logistic regression. Individual changes in the sport/exercise and leisure indices were positively associated with spousal changes. For every standard deviation increase in their wives' sport/exercise index, men's exercise index increased by 0.09 (95% confidence interval: 0.05, 0.12) standard deviation; for every standard deviation increase in their wives’ leisure index, men's leisure index increased by 0.08 standard deviation. Results were similar for women. Individuals had higher odds of meeting physical activity recommendations if their spouse met recommendations at both visits or just follow-up. In conclusion, changes in an individual's physical activity are positively associated with changes in his or her spouse's physical activity. Physical activity promotion efforts should consider targeting couples.
Married couples might be an appropriate target for obesity prevention interventions. In the present study, we aimed to evaluate whether an individual's risk of obesity is associated with spousal risk of obesity and whether an individual's change in body mass index (BMI; weight in kilograms divided by height in meters squared) is associated with spousal BMI change. We analyzed data from 3,889 spouse pairs in the Atherosclerosis Risk in Communities Study cohort who were sampled at ages 45–65 years from 1986 to 1989 and followed for up to 25 years. We estimated hazard ratios for incident obesity by whether spouses remained nonobese, became obese, remained obese, or became nonobese. We estimated the association of participants' BMI changes with concurrent spousal BMI changes using linear mixed models. Analyses were stratified by sex. At baseline, 22.6% of men and 24.7% of women were obese. Nonobese participants whose spouses became obese were more likely to become obese themselves (for men, hazard ratio = 1.78, 95% confidence interval: 1.30, 2.43; for women, hazard ratio = 1.89, 95% confidence interval: 1.39, 2.57). With each 1-unit increase in spousal BMI change, women's BMI change increased by 0.15 (95% confidence interval: 0.13, 0.18) and men's BMI change increased by 0.10 (95% confidence interval: 0.09, 0.12). Having a spouse become obese nearly doubles one's risk of becoming obese. Future research should consider exploring the efficacy of obesity prevention interventions in couples.
Thursday, March 03, 2016
Metformin's Issues
Metformin-related vitamin B12 deficiency might contribute to clinically significant peripheral neuropathy in diabetes patients, new research suggests from the European Association for the Study of Diabetes Meeting.
"The consequences of vitamin B12 deficiency, like neuropathy or mental changes, may be profound. Even more, they may be difficult to diagnose, because they may be ascribed to old age or diabetes itself and may be or become irreversible. On the other hand, vitamin B12 deficiency is relatively easy to diagnose, and treatment is easy, cheap, and effective," the lead researcher commented.
Corroborating with previous research raises concern that the drug may be contributing to peripheral neuropathy separate from the effect of the diabetes itself.
"The consequences of vitamin B12 deficiency, like neuropathy or mental changes, may be profound. Even more, they may be difficult to diagnose, because they may be ascribed to old age or diabetes itself and may be or become irreversible. On the other hand, vitamin B12 deficiency is relatively easy to diagnose, and treatment is easy, cheap, and effective," the lead researcher commented.
Corroborating with previous research raises concern that the drug may be contributing to peripheral neuropathy separate from the effect of the diabetes itself.
Neurologists Use Mindfulness Protocols
From Practical Neurology 12/2015
Mindfulness training—mindfulness-based cognitive therapy and mindfulness-based stress reduction—is an evidence-based group program for reducing symptoms of anxiety and depression and building long-term capacity for emotion regulation, stress coping and enhancing quality of life.
It combines training of attention to moment-by-moment experience with practising a self-caring attitude and insight into self-defeating patterns of thought and behaviour.
It has been applied effectively in diverse clinical groups, including neurological patients and a variety of physical and mental health conditions.
It may be particularly relevant for people with long-term or deteriorating conditions.
It is best learned in a formal 8-week course. It is worth suggesting self-help and online formats to those who are sufficiently motivated.
Mindfulness training—mindfulness-based cognitive therapy and mindfulness-based stress reduction—is an evidence-based group program for reducing symptoms of anxiety and depression and building long-term capacity for emotion regulation, stress coping and enhancing quality of life.
It combines training of attention to moment-by-moment experience with practising a self-caring attitude and insight into self-defeating patterns of thought and behaviour.
It has been applied effectively in diverse clinical groups, including neurological patients and a variety of physical and mental health conditions.
It may be particularly relevant for people with long-term or deteriorating conditions.
It is best learned in a formal 8-week course. It is worth suggesting self-help and online formats to those who are sufficiently motivated.
Anxiety Takes Its Toll on the Heart
Anxiety has emerged as perhaps the most important risk factor for cardiovascular disease, according to a new study in Current Opinion in Psychiatry. Anxiety increases the risk of major cardiac events in coronary heart disease. There is also a need for elucidating the influence of anxiety in cardiomyopathy and hypertension.
Moreover, the researchers suggest that anxiety is an antecedent risk factor, so it influences the prognosis in patients with cardiovascular disease, and needs to be recognized and managed at every step. Anxiety drives other risk factors, such as depression, smoking, sedentary lifestyle, substance use, and overweight.
Moreover, the researchers suggest that anxiety is an antecedent risk factor, so it influences the prognosis in patients with cardiovascular disease, and needs to be recognized and managed at every step. Anxiety drives other risk factors, such as depression, smoking, sedentary lifestyle, substance use, and overweight.
Thursday, February 25, 2016
DGA Call to Action: Supplemental Nutrients Needed
The 2015/2020 Dietary Guidelines for Americans identified potassium, dietary fiber, choline, magnesium, calcium, and vitamins A, D, E, and C as shortfall nutrients. That is, nutrients that are consumed by many individuals in amounts below the Estimated Average Requirement or Adequate Intake levels. More specifically, the guidelines identified calcium, potassium, dietary fiber, and vitamin D as “nutrients of public health concern because low intakes are associated with health concerns,” and suggested supplementing with vitamin D, “especially when sunshine exposure is limited due to climate or the use of sunscreen.”
While the current formulation of the guidelines is big step up for the official recognition of the importance of dietary supplements, especially those supplying significant levels of essential nutrients. The issue for other important nutrients, specifically the omega-3 fatty acids EPA and DHA is a little less clear cut. The guidelines addressed EPA and DHA specifically in a section discussing targets for the consumption of seafood. Americans in general fall woefully short of what is considered healthful intake levels.
While the current formulation of the guidelines is big step up for the official recognition of the importance of dietary supplements, especially those supplying significant levels of essential nutrients. The issue for other important nutrients, specifically the omega-3 fatty acids EPA and DHA is a little less clear cut. The guidelines addressed EPA and DHA specifically in a section discussing targets for the consumption of seafood. Americans in general fall woefully short of what is considered healthful intake levels.
Monday, February 22, 2016
Friday, February 19, 2016
Tuesday, February 16, 2016
Friday, February 12, 2016
Thursday, February 11, 2016
Monday, February 08, 2016
Friday, February 05, 2016
One horrific, one great decision for kids
Great Decision
Decreasing the amount of caloric beverages consumed and simultaneously increasing water consumption is important to promoting child health and decreasing the prevalence of childhood obesity.
New York public schools installed filtered water jets and found an association in decreased student weight. Reduced milk and chocolate milk purchases purchases were one of the reasons why. The research appeared in last month's JAMA Pediatrics.
Horrific Decision
EFSA, which is the FDA of Europe, approved the artificial sweetener sucralose for infant medical foods, as well as for foods and beverages in children aged one to three.
Decreasing the amount of caloric beverages consumed and simultaneously increasing water consumption is important to promoting child health and decreasing the prevalence of childhood obesity.
New York public schools installed filtered water jets and found an association in decreased student weight. Reduced milk and chocolate milk purchases purchases were one of the reasons why. The research appeared in last month's JAMA Pediatrics.
Horrific Decision
EFSA, which is the FDA of Europe, approved the artificial sweetener sucralose for infant medical foods, as well as for foods and beverages in children aged one to three.
Wednesday, February 03, 2016
Tuesday, February 02, 2016
Friday, January 29, 2016
Thursday, January 28, 2016
Tuesday, January 26, 2016
My Ordeal
I have wanted to share something with you for four months. Unfortunately, for legal reasons, I could not speak about it until now. Many of you know what I am talking about. I appreciate your willingness to indulge me as I feel it critically important to clear my name.
On a mid-September evening after meeting my husband for dinner after work, I was driving home in a violent rainstorm. All of a sudden, I was pulled over by police, arrested, and charged with multiple violations, including a hit and run accident and driving under the influence.
Of course, I was stunned because I did not hit any car and was not inebriated. Regrettably, I was simply at the wrong place at the wrong time.
I have dedicated my life to helping people. I would never jeopardize that ideal through such an act of cowardice.
Many of you read about my situation in the local media or heard it through the grapevine. I am speaking of it now because my reputation as a wife, mother, and health professional was tarnished. I felt embarrassed, humiliated, and every other emotion you can imagine. Publicizing my arrest in the media before innocence or guilt was determined took its toll on me.
I am truly humbled by those of you who reached out to me in support.
I vehemently defended my innocence every step of the way and am elated to say that the truth won out. Every charge against me was dropped, my case was thrown out of court, and any record of the unfortunate incident was totally expunged from public record.
In addition, the judge admonished law enforcement for their poor judgement, lying under oath, and overly aggressive treatment.
I now understand more than most that every day, people end up in the wrong place at the wrong time. Please come away from this knowing that, at least in my case, if you fight for what you believe in, the truth can win out in the end.
Sincerely, Bonnie
On a mid-September evening after meeting my husband for dinner after work, I was driving home in a violent rainstorm. All of a sudden, I was pulled over by police, arrested, and charged with multiple violations, including a hit and run accident and driving under the influence.
Of course, I was stunned because I did not hit any car and was not inebriated. Regrettably, I was simply at the wrong place at the wrong time.
I have dedicated my life to helping people. I would never jeopardize that ideal through such an act of cowardice.
Many of you read about my situation in the local media or heard it through the grapevine. I am speaking of it now because my reputation as a wife, mother, and health professional was tarnished. I felt embarrassed, humiliated, and every other emotion you can imagine. Publicizing my arrest in the media before innocence or guilt was determined took its toll on me.
I am truly humbled by those of you who reached out to me in support.
I vehemently defended my innocence every step of the way and am elated to say that the truth won out. Every charge against me was dropped, my case was thrown out of court, and any record of the unfortunate incident was totally expunged from public record.
In addition, the judge admonished law enforcement for their poor judgement, lying under oath, and overly aggressive treatment.
I now understand more than most that every day, people end up in the wrong place at the wrong time. Please come away from this knowing that, at least in my case, if you fight for what you believe in, the truth can win out in the end.
Sincerely, Bonnie
Monday, January 25, 2016
Friday, January 22, 2016
Tuesday, January 19, 2016
Thursday, January 14, 2016
Navigate the Yogurt Culture War
We are reposting this now that yogurt makers are suing each other left and right over marketing claims. Cornucopia came up with a great piece and yogurt scorecard in late 2014.
http://www.cornucopia.org/Yogurt
http://www.cornucopia.org/Yogurt
Wednesday, January 13, 2016
Monday, January 11, 2016
Thursday, January 07, 2016
EPIC Bars sold to General Mills
How many times has this happened to products we love?
http://newhope360.com/news/meat-snack-maker-epic-acquired-general-mills-will-operate-under-annies-business
http://newhope360.com/news/meat-snack-maker-epic-acquired-general-mills-will-operate-under-annies-business
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