Fed & Fit

Ep. 158: Pre-Conception Best Practices with Liz Wolfe

On today's episode, I'm chatting with Liz Wolfe about Pre-Conception Best Practices.

We're back with our 158th episode of the Fed+Fit Podcast! Remember to check back every Monday for a new episode and be sure to subscribe on iTunes!

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Episode 158 Sponsors

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Episode 158 Links

Episode 158 Transcription

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Cassy Joy: Welcome back to another episode of the Fed and Fit podcast. I am your host, Cassy Joy Garcia. And I am especially excited about today’s episode. I’m chatting with dear friend, Liz Wolfe, about preconception best practices. I’m going to quickly introduce you to her, and then I’ll pass the baton off to Liz. Because she can talk about herself better than I can! {laughs}

Liz Wolfe: {laughs}

Cassy Joy: She is an author, podcaster, parent, and nutritional therapy practitioner who is passionate about real food, safe beauty, and healthy families. She’s the author of the Wallstreet Journal bestseller Eat the Yolks, The Purely Primal Skincare Guide, and she’s currently working, three years in, on a comprehensive program called Baby Making and Beyond. Which will give parents and parents to be everything they need to know how to thrive through fertility, pregnancy, and parenthood. Welcome to the show, Liz!

Liz Wolfe: Thanks for having me! I’m glad we finally got this on the books and it’s working out beautifully so far.

Cassy Joy: It is! I’m so excited. I think I probably started chatting with Liz about wanting to come on the show, and pick her brain on these topics, way before I conceived. {laughs}

Liz Wolfe: {laughs}

Cassy Joy: And now, we’re recording this podcast in advance so I’m not quite sure when it will air. But there’s a really good change we’ve got a little nugget on the ground by the time this is on the airwaves.

Liz Wolfe: Oh my gosh. I can’t wait. I’m sure you can’t wait. Oh, did I tell you I put a little something-something special in the mail for you yesterday?

Cassy Joy: You did?!

Liz Wolfe: I did. I’m so excited for you to get it.

Cassy Joy: Aww, that’s so nice. You're the best.

Liz Wolfe: Well, it’s not really for you. It’s for the baby.

Cassy Joy: It’s for the baby.

Liz Wolfe: Yeah.

Cassy Joy: That’s even better. I’m at that point now; so this is the week before Christmas. And my mom was asking, “What can I get you for Christmas?” I’m like, “Anything for the baby.” {laughs}

Liz Wolfe: Yep. Yep.

Cassy Joy: It’s like, I guess I’m officially a parent!

Liz Wolfe: You are officially a parent. You do not matter anymore. And I mean that in the best way possible! {laughs}

Cassy Joy: {laughs} I love it. I love it. Oh man. Ok. Well I have a whole list of things I’d love to pick your brain on. Liz has always been one of my most trusted resources. She’s a dear friend, and I feel very fortunate that when I encounter a question that I can’t wrap my mind around, I shoot her a message and I ask her. And I’m excited to do that, essentially in a format that allows other people to benefit. She’s put in a tremendous amount of work and research in Baby Making and Beyond. I cannot wait for that to be available and refer folks to it.

Something I always admire about how Liz approaches her work is she really; you do a great job of approaching from all corners of an issue. And then what you present is kind of like; here’s what I’ve found across the literature. And then period. You allow folks to kind of make decisions for themselves. And I’ve always admired that.

Liz Wolfe: Thank you.

Cassy Joy: Yeah. So I feel really great about asking you some of these. Ok, so we’ll jump right in. Today’s episode is all about preconception best practices. When Austin and I were first thinking about starting a family; really I guess that conversation started when we were dating/engaged. You know; we knew one day we wanted to have a family. And we got married when I was 29. And so I wasn’t {laughs} I’m in Texas and I don’t mean to stereotype. I have a lot of friends though that had babies much younger than me. And it was one of those things where it got me thinking; am I behind? {laughs}

Liz Wolfe: {laughs}

Cassy Joy: On preparing my body for these things? So preconception best practices was something that I really started to hone in on and do some research. And you were very helpful. But I would love it if you could kind of kick us off with some of what you think are some of the biggest myths out there when it comes to approach preconception. How to prepare our bodies from a really solid holistic perspective based in good science.

Liz Wolfe: I think; well, let me say. What you said before about how I approach things is also the reason why this project has taken three years to come out.

Cassy Joy: {laughs}

Liz Wolfe: Because; what is more of a hot button issue than pregnancy and parenthood? There’s nothing more emotionally charged than that. and I feel like in the community that we’re in, people tend to come from a certain set of values. And what was important to me was to question everything before I even put anything out there; including even the values that I held dear around food, and pregnancy, and parenthood, and all of that. This whole journey has just kind of rocked my world. It’s been amazing, but it’s also why it’s taken so long.

And I have to say; with this type of thing, it was very important to me to recognize my own shortcomings and basically work with people who are much, much smarter than me. So I’ve been working with some very smart people. Some PhDs, neuroscientists, people who really understand how to mine the literature to really figure out the best; I don’t want to say answers to all of the questions because there’s always context to be considered. But people that can really sit down and say; “This is what I’m finding in the literature. Let’s discuss what this probably means.” And that’s another reason why it’s taken so long. But it’s also why it’s going to be so good when it’s ready to go.

Cassy Joy: It’s going to be so good.

Liz Wolfe: It’s going to be so good. So I will remark on what I think is probably the greatest myth out there when you become ready to have a family. And I think this is something that most people’s practitioners will tell them. Just start taking your prenatal, and there’s nothing else you really need to do. Just, you know, bump uglies and see how it goes.

Cassy Joy: {laughing}

Liz Wolfe: And that; well there’s two myths in there. First of all, I don’t want to freak people out and make people feel like they have to do 10,000 things to get ready to have a baby. But I think the biggest myth is that you don’t really need to think about anything else. And the fact is, I think when you're ready to have a kid, I think that’s when you start accumulating whatever information you can, and doing the best you can to take care of yourself. And to me, that means mitigating your stress, starting to sleep better.

Sure you can take a good prenatal, but probably, most people are best served by taking a prenatal that checks certain boxes. I would not be inclined to recommend somebody just goes down to the corner drug store and grabs something off the shelf there, unless that was the only option. In which case; that’s cool. We can work with that. we’ll do everything that we can to work around that. but if you have the choice, going and getting a prenatal that has methyl folate instead of folic acid. That contains choline, which is really, really important. Sorry, there’s probably going to be dogs barking and kid noises. There’s not a whole lot I can do about it. {laughs}

Cassy Joy: Perfect. I love it.

Liz Wolfe: Just working with what we’ve got here. But a prenatal like the one from Innate Response would be good. There’s a whole food based prenatal from Pure Synergy that is also good. So really kind of choosing based on the ingredients in the prenatal, instead of just grabbing something off the shelf. I think the reality is, once you're ready to have kids, you're going to be bombarded with a ridiculous amount of information. This is probably the least of that information. But it’s definitely worth looking at something that’s a little bit better than something just off the shelf at the corner drug store.

On top of that, I think another myth is that you just kind of do the deed and hope it all goes well. I find that so, so many women don’t know anything about their cycles. And it’s really unfortunate because; I hope to impart some knowledge of what it means to be a woman to my daughter. What her cycles mean from day to day.

And that’s something that so many of us; we’ve been going to the gynecologist since we were at least 18, many of us. And we have no ideal what the luteal phase is. What ovulation means. When the proper time to plan intercourse is. And that’s a really easy topic to grasp. It’s not, but the basics of it, what you need to know when you're trying to get pregnant, is actually pretty simple.

And having that foundation of knowledge enables you to troubleshoot. Which might be kind of a funny way to put it; troubleshoot. I don’t know. Maybe that’s too obscure to be funny.

Cassy Joy: {laughs}

Liz Wolfe: But enables you to troubleshoot when things aren’t happening the way you want it to. I think a lot of folks go directly to, for example, the reproductive endocrinologist, when the problem really is just the timing of intercourse. You don’t know when you're ovulating. You don’t know what your cervical fluid should look like, or the position of your cervix. And all of those things can be figured out at home for basically no money. And really enables you to take control of the process.

Cassy Joy: I love that. and I want to interject really quickly with my own personal experience there. I am a wide-open book with the folks here, Liz. {laughs}

Liz Wolfe: {laughs} Talk about a funny metaphor.

Cassy Joy: {laughing} Oh man. But when Austin and I were; I’ll say open to the idea of having a baby. Our first approach was similar to that. it was just kind of like; I’m really not going to plan. I’m not going to plan things. We’ll just see what happens. And then four or five months go by, and I’m like; I don’t understand what’s going on. Why aren’t we with baby yet? And really what happened, to your point. Even as a nutrition consultant, knowing what I know. And I’ve written documents on studying the female cycles. I was still ovulating 4 days sooner than I thought I was.

Liz Wolfe: Mm-hmm.

Cassy Joy: And it was incredible. As soon as I timed it, through temperature. I also used ovulation sticks. Because I was like; we’re just figuring this out with all of the tools. {laughs} That’s exactly when it happened. It was so interesting. I’m glad I had the experience, because I learned something from it. But it is so valuable knowing more about your cycle going into it.

Liz Wolfe: Yeah.

Cassy Joy: That’s really interesting. Well, wonderful! I’m curious. Prenatal is probably one of the questions that I get the most about, and I’m really glad you tackled that from the get go. I was going to ask you about lifestyle factors, but I’m also going to spring you with some nutrition questions. That’s a question that I think a lot of people rattle around in their minds. What should I be eating if I’m trying to prepare my body for a baby. And then what are some things I should avoid?

Liz Wolfe: So, just a note here. One of the things that I’ve gone back and forth on so many times as I’ve been developing this program with Meg the Midwife, who is a midwife in Canada. Cool thing, by the way, about midwives in Canada, is that they work in home birthing and hospital settings. So she has; she’s run the gamut on birth experiences. Which is amazing. From home birth to surgical. So I would be remiss if I didn’t mention her as my partner in this project.

But one of the things; oh my gosh. I completely forgot the question.

Cassy Joy: {laughs} That’s ok.

Liz Wolfe: Mom brain.

Cassy Joy: {laughing}

Liz Wolfe: Are you kidding me? I just shared a meme from chat books the other day that said; “I don’t want to brag, but I can actually forget what I’m doing while I’m doing it.”

Cassy Joy: {laughing} That’s amazing.

Liz Wolfe: How.

Cassy Joy: Nutritionally.

Liz Wolfe: Nutrition! Yes. Ok. Oh my gosh. So I’ve gone back and forth between whether we can really get everything we need from food, and whether that’s actually a smart approach versus the combination of the prenatal and food. Yadda, yadda, yadda. And where I’ve kind of landed is that it’s probably possible to do everything that you need to do with food.

However. I think that modern life is such that, even if a prenatal is only getting you from like 92% to 99%, I think it’s worth having a prenatal in the rotation.

The challenge for me early on was; well, if I tell people they can take a prenatal, then not that anybody should listen to me. They should listen to their health care practitioner. But if I start talking about prenatals that I like, or the one that I used, people are going to end up accidentally relying too much on that as a source of nutrition and not emphasizing food as much. And I just landed on; give people that information that you just need to be really careful that you're getting nutrition from food as well as your prenatal, and go from there.

So I think if you wanted to plan it really carefully, you could probably do everything you needed to do with food. But I think it’s definitely worth having a prenatal around.

So, food wise. One of the things that we spent a ton of time researching. My partner for researching this is Amanda Torres, who is a scientist. She’s actually the woman behind the Curious Coconut. She’s brilliant. And she worked with me on the vitamin A question. I mean, she has been working with me on it for months and months and months.

And what I wanted to figure out was how we can best recommend women get their vitamin A. Vitamin A being a fat-soluble vitamin. Meaning the body can store it. So how we can help women build up their vitamin A stores preconception to take them in those first weeks of pregnancy. Because I know we hear a lot about folate. But vitamin A is actually unbelievably critical, as well. So it was another one that was really, really important to me to understand and discuss in this program.

What I think a lot of people don’t understand is that beta carotene, which is often stated to be basically equivalent to vitamin A because it is converted into vitamin A in the body. That beta carotene is enough to supply your vitamin A requirements. And that’s really not true. Many people have genetic mutations in metabolism of vitamin A, and yadda, yadda, yadda. Don’t want to scare people into thinking they’re never going to be able to get enough vitamin A.

But the very simple truth is; get lots of beta carotene from your fruits and veggies, and most prenatals have beta carotene. But also be really conscientious about food sources of; I guess I want to call it active vitamin A. Converted vitamin A, that’s actually doing different things in the body. So egg yolks, liver. I know, it’s disgusting. But preconception is a great time to eat your liver and get that vitamin A stored up, because a lot of women can’t stomach it once they’re actually pregnant. So it’s a perfect time.

Let’s see; egg yolks, liver, some cod liver oil here and there I think is great. And also, just checking to be sure that you're hitting the vitamin A targets with actual vitamin A versus beta carotene. Beta carotene is just kind of like icing on the cake. I hope that wasn’t too confusing. I really didn’t have my speech prepared on vitamin A. But I think it’s a really, really important topic. And I think most women are not getting enough.

I don’t want people to run out and start chugging cod liver oil for their vitamin A, but I do think this is one of those nutrients that I would recommend women really know how much they’re getting, what form of it they’re getting, and pay attention to that from preconception all the way through pregnancy.

Cassy Joy: I think this is a great spot to stop and hear from one of our sponsors.

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Cassy Joy: That’s great. That’s really great. Before Austin and I conceived Cricket, I remember one night we had chicken livers for dinner. Really for that specific purpose. And that dinner was; so when I recipe develop, I try to start with the most simple ingredients possible, and then we add complexity as necessary. Right? Just because that’s how I like to cook. And we took those bad boys, marinated them in Frank’s Red Hot, and grilled them. And it was the worst thing I’ve ever eaten. {laughs}

Liz Wolfe: Ugh!

Cassy Joy: I’ve since figured out delicious ways. I have a couple of recipes if you Google Fed and Fit liver, a couple of different options should come up as ways that I was able to get it in. But I remember sitting there at that dinner table. And Austin, he’s not as nutritionally minded, but he respects my profession, of course, and take on those things. Man, he was a trooper. He ate half a pound of chicken livers. {laughs}

Liz Wolfe: Good for him! Well that’s important for men, too. Vitamin A, zinc. It’s important for guys, too.

Cassy Joy: It is, yeah. We go at it together. Anyway. Just wanted to throw that out there; in case your thinking; gosh, but I don’t like it! I don’t like those kinds of foods. Be a little inventive. There’s some good recipes out there. I have one for a meatball; caramelized onions really mask the liver flavor. So that makes a really yummy dish.

Ok. That’s really great information, Liz. I love it. I also remember asking my doctor about; well never mind. I won’t go down those weeds. {laughs}

Liz Wolfe: {laughing}

Cassy Joy: It’s too far. It would be too misleading. It would raise more questions than it would answers.

Liz Wolfe: Well, you know, I should probably say that there’s a true; doctors and practitioners will often say, avoid vitamin A because it can be teratogenic. It can cause birth defects. And we’ve gone through all of the literature surrounding that. I feel like we really have a good grip on what levels are appropriate, what are not.

The fact is that even without genetic mutations; and I should say single nucleotide polymorphisms. Not actual mutations. We’re not talking about aliens or anything like that. but even absent any mutations. Any of the most common ones. Which I actually just found out I have a bunch of them. And I didn’t know that before I got pregnant. We have a healthy, beautiful child. So I’m not saying, you have to do this or you are not going to have a healthy baby. The body has a million ways of compensating even four genetic polymorphisms which is a beautiful thing.

So I’m not trying to scare people. But I think it’s really interesting that even absent any polymorphisms, beta carotene is still generally poorly converted into vitamin A. And there are a lot of different things to kind of control those levers. So I’m not telling people to go out and eat a pound of liver every day. I’m talking about Linus Pauling’s general recommendation on vitamin A in pregnancy, and hitting that target with vitamin A instead of beta carotene. Because there’s still some confusion, even with health care practitioners, about which is which.

The actual recommendations that are accepted by governments and by most gynecologists are referring to actual vitamin A. So you are totally safe to hit those targets with actual vitamin A, without worrying about some of the fearmongering that comes out surrounding vitamin A.

That said, I think it’s important for me to say that I do not agree with the recommendations of several people in the paleo community or the Weston A. Price foundation. We just didn’t find it in the literature. And I feel like there’s just too much at stake to say; yeah, this is appropriate for everybody. The way they do. So I think there’s a lot to consider. And we talk about that more in the program.

Cassy Joy: Awesome. I can’t wait to dig into it. What do you think; you kind of touched on a few of them, already. But what are some big missed opportunities when it comes to preconception practices that you haven’t necessarily touched on yet?

Liz Wolfe: Missed opportunities. So, two things I feel like I would say. I think there are some really, really affordable tests that people can order for themselves that are just kind of good to know. I don’t want people running to get a million tests if they don’t feel like they need to. But the test for vitamin D and the test for red blood cell magnesium; both of those are very affordable. And most states, you can order them through requestatest.com or direct labs.

Getting a picture of what your vitamin D status is, and getting a picture of what your magnesium status is can really give you an indicator of overall health. Because if your body is really stressed, you might not even know it. But I think that your magnesium and your vitamin D levels will kind of reflect that. It’s not the end all, be all. You can also test red blood cell folate. It’s not the most important thing in the world to run out and get these nutritional tests. But they’re so affordable; it’s like, if you're already taking the time to think about it months in advance, then this could be something to put in your tool box.

On top of that, I think what many people don’t know is how long it takes for your body to get to the proper nutritional levels of nutrients like folate. So it takes about 3 months for your cells to become; I don’t know what word I want to use. Saturated. For you to become fully sufficient. So if haven’t been eating liver, and leafy greens, and legumes, you want to give yourself a couple of months of lead time to start eating those really regularly so that you can get the proper levels and sustain them in your body. I think that’s probably one of the bigger missed opportunities.

And I missed that opportunity, too, quite frankly. We thought, when we decided to get pregnant. I was like; yeah, we’ll get pregnant in six months. But then you start thinking about it, you're like; ok, let’s just do it now.

Cassy Joy: {laughs} Yep. I’m ready now, so. What’s the difference?

Liz Wolfe: Yeah. If we’re going to do it, let’s just do it now.

Cassy Joy: Yeah. I get that. Well that leads me into my next question. If somebody is thinking; I’m not ready to have a baby right now. When do I really need to start considering this? When do I really need to start putting in some of these practices, and thinking critically about what I am putting in and on my body.

Liz Wolfe: I think a lot of people go to extremes, and they give it a year, six months. {laughs} And that’s a long time to be stressing out over this stuff. So I think three months is reasonable. And for many reasons. I think three months is enough that you can really get some robust nutrition in for a while. You can get to know your cycles a little bit. If you're tracking your temperature and your cervical fluid, you can probably identify any potential issues. Like, you're not ovulating. Or you don’t have sperm friendly cervical fluid. That type of thing. And then you go for it.

I think psychologically, as well as nutritionally, that’s probably an adequate amount of time to plan for. Six months is pretty ideal, but from my experience, most people really don’t want to; {laughs} and don’t end up waiting that long.

Cassy Joy: {laughs} I love it. Ok, three months. That’s a really good ballpark. And then outside of nutrition, what matters?

Liz Wolfe: Oh golly. Sleep. So I have been spending all this time working on the nutrition portion of Baby Making and Beyond, because I know how controversial some of these nutrients are. And we needed a really robust body of scientific evidence around everything that we were talking about.

Now, that said, I actually think sleep and stress are more important. But it’s also more straightforward. Everybody knows stress isn’t good and sleep is great. So those are the two things; if you can get those in line, you're going to be sitting pretty darn good.

Cassy Joy: Mm-hmm. And it’s reassuring, too. Because it’s relatively low hanging fruit.

Liz Wolfe: Yes. Which is great.

Cassy Joy: It is great. If the biggest ticket item that you can do to really help prepare yourself is relatively as simple as getting more sleep, then that’s a really reassuring thing.

Liz Wolfe: Yeah.

Cassy Joy: And then I would love it if we could talk. I kind of mentioned this to Liz before we started recording. But if somebody is listening and experiencing some sort of difficulties when it comes to conceiving, and that could be an ocean of possibilities, right? But do you have any sort of a compass that you would put in that person’s hand to kind of help navigate maybe a little bit where they’re at, if they’re feeling frustrated depending on where they are in the process.

Liz Wolfe: Yeah. So a lot of people who have been through this already know all of these things. So what I’m going to throw out there is for the people who are just now like; ok, wait this is not working. I thought we’d be pregnant by now. And haven’t really explored all of these other options. Because there are people who have and they’re like; yeah, I’ve done that. Did that. Did that. Did that too.

But if you are kind of unsure of what’s going on, and why you're not getting pregnant as planned, I think the number one thing to do is get yourself a good tracking app and body temperature thermometer so you can get to know your cycles, your body temperature, when you ovulate a little bit closer. And you can track your cervical fluid. The one that I use is called Kindara.

I really like it, because they have a thermometer called Wink that is really, really sensitive, and one of the most accurate thermometers I feel like I’ve ever used, and it syncs automatically to your app. And you can track everything from cervical fluid to custom entries. I mean, when you're trying to get pregnant, every little thing matters. So if you feel a little funny one day, you're going to add that as something in your notes. And maybe you’ll see over a couple of months that you feel kind of funny on the same day. Well, what does that mean?

So I think that’s really important. And that’s when you start to get to know the signs of fertility. It will tell when are probably the best days to have sex. It will give you a picture of when you're ovulating. In general, when your temperature shifts, that’s when you know you have ovulated. Not that you are ovulating, but that you have already ovulated. And a lot of people miss that. and they are having sex too late, and they don’t even know that.

It can also tell you if your luteal phase is a little too short. A lot of folks with really low body temperatures, which is something that I actually have and deal with, may or may not have some subclincally depressed thyroid function and metabolic function. So it can help give you some ideas of what kind of doctor you need to see and what you need to talk about. Whether that’s thyroid function or looking for something like PCOS. So it can really open the gates for a lot of different possibilities to enlighten yourself on what might be going on.

Cassy Joy: Awesome. Very helpful. Ok, well that pretty much sums up a lot of my questions. What else do you think is important for someone to consider in that state of wanting to have a baby, or wanting to prepare their body for baby?

Liz Wolfe: I think the most important thing, and it sounds really hippie. But it’s something that I had to learn after I had a baby, and I wish I had learned it way before that. is to be really, really soft with yourself. Give yourself a lot of grace, and a lot of space. Because the whole journey is difficult at times. For some people. For some people, they make it look really easy. I’m not one of those people, and it’s probably not the person listening to this podcast right now.

Just be open to the good and the bad. And as you pass through it, don’t try to run away from it. I think a lot of the frustrations in these journeys that people deal with is trying to run away from the tough stuff and the bad feelings and the frustration. And really if you can sit with it, it’s a really good exercise for when you are pregnant, and you do have a child, and you just have to be in those difficult moments. Those moments of frustration and things like that. and I know that sounds kind of hokie and probably a little too broad to be applicable. But I hope it makes sense. Especially if you're a perfectionist like me. When things aren’t working the way you want it to, or if things are not working within a very narrow range of what you would consider acceptable and perfect, it gets really, really stressful. But now is the time to lose those walls, you know, that you put around yourself. And just really give yourself a lot of grace.

Cassy Joy: Awesome. That’s beautifully said, Liz. Thank you so much. Where can folks find out more about you and your work?

Liz Wolfe: I’m always at www.RealFoodLiz.com. Well, that’s inaccurate. I don’t update that very frequently.

Cassy Joy: {laughs}

Liz Wolfe: So how about, Instagram. Real Food Liz on Instagram. And where you can sign up to get updates on the Baby Making and Beyond program, just go straight to www.BabyMakingandBeyond.com. we will have a beta release probably early 2018, so get on that list. Because I think we will go ahead and offer the beta release to folks who are signed up for the email list.

Cassy Joy: Whoo! That’s exciting. I can’t wait. Ok, Liz thank you so much for coming on today’s show and sharing all your wonderful thoughts and words of wisdom. I cannot wait for this program to be available. When it is, I’m just going to shout it from all the rooftops.

Liz Wolfe: Thank you, friend.

Cassy Joy: Thank you. As always, you can find links to everything we’re talking about today. I’ll provide links to Liz on Instagram. I’ll provide a link to her mailing list so you can make sure you're plugged in, as well, over on the show notes. And if she said something that you missed, or you're driving and you didn’t have a chance to jot it down, don’t worry. We’ve got a full transcript over at www.fedandfit.com as well. Thanks everybody for joining us. We’ll be back again next week.

   

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