by Zhimeng Qui, Dietetic Intern
What are Omega-3s?
Omega-3 fatty acids are a crucial group of unsaturated fats that are in the poly-unsaturated fatty acid (PUFA) family. Within this group, there are three types of fatty acids: Eicosapentaenoic acid (EPA), Docosahexaenoic acid (DHA), and Alpha-linolenic acid (ALA). ALA, a short-chain omega-3 fatty acid obtained through the diet and is responsible for synthesizing long-chain omega-3 fatty acids, including EPA and DHA [1]. DPA is an intermediate between EPA and DHA [2].
Where do they come from?
EPA and DHA are predominantly obtained from marine organisms and deep-sea fish. These fatty acids are found in cold-water fish such as mackerel, herring, tuna, halibut, salmon and cod [2].
The omega-3 fatty acid that is most commonly found in Western diets is ALA. ALA is present in vegetable oils, nuts, flax seeds and flaxseed oil, leafy vegetables, and some animal fats, particularly those from grass-fed animals.
Did you know most Americans aren’t getting enough omega 3s?
Most Americans do not consume sufficient amounts of omega-3 fatty acids. Based on the World Health Organization’s (WHO) recommendation of a combined intake of EPA and DHA to be between 200 and 500 milligrams, the average American adult consumes only 24-60% of the recommended levels for optimal health.
Studies suggest that human beings evolved on a diet with an omega-6 to omega-3 essential fatty acid (EFA) ratio of approximately 1:1, while the ratio in a current Western diet is typically around 15:1. This high ratio is associated with the development of several chronic diseases, including cardiovascular disease, cancer, and inflammatory diseases, while increased levels of omega-3 PUFA (a low omega-6:omega-3 ratio) have protective effects. Thus, it is essential to increase our daily intake of omega-3s to achieve the appropriate ratio of fatty acids.
Why is it important to consume sufficient omega-3s?
The human body is unable to produce omega-3s on its own. While it can be partially converted from ALA, only a small percentage of ALA can be converted to EPA, DPA or DHA. Therefore, getting EPA and DHA from food is the best practical way to increase the levels of these omega-3 fatty acids in your body. There are also omega-3 supplements on the market if you want to take them, and studies show that any side effects of taking omega-3 supplements are usually mild. Some side effects include an unpleasant taste in your mouth, bad breath, heartburn, nausea, upset stomach, diarrhea and headaches [3]. However, studies have found that supplements may interact with the medications. For example, high doses of omega-3 supplements may cause blood thinning and increase risk for bleeding when taken with warfarin (Coumadin®) or other anticoagulant medications [3]. Supplements may also interfere with other medications or treatments like chemotherapy. Always check with your healthcare team to see if it is safe to add supplements to your diet and focus on food first.
Omega-3s have been shown to have potential health benefits. Below are several study results that demonstrate their effectiveness.
Brain function: The human brain is composed of approximately 60 percent fat, with approximately 20% of its dry weight being made up of PUFA [4]. These fatty acids play a crucial role in determining the performance of the brain throughout all stages of life [5,6].
Among other things, growing evidence suggests that omega-3 PUFAs are effective in preventing age-related loss of gray and white matter volume and therefore may be beneficial in mild cognitive impairment (MCI) or age-related cognitive decline [6].
Heart Disease: According to recent studies, the use of prescription ethyl-EPA, combined with statin therapy, may reduce the risk of cardiovascular disease (CVD) events in patients at risk. However, it remains unclear if oral EPA supplements alone are beneficial for CVD. Moreover, both oral prescription ethyl-EPA and EPA supplements have been shown to reduce the risk of myocardial infarction (MI) in patients with CVD risk.
Inflammation: Accumulating evidence suggests that omega-3 PUFAs, especially EPA and DHA, have anti-inflammatory properties and can potentially improve various inflammatory diseases, including inflammatory bowel disease, rheumatoid arthritis, asthma, cancer, and more.
Recommendation
The WHO recommends 200-500 mg of EPA and DHA combined per day. The American Heart Association suggests consuming 2 servings of fish, especially fatty fish, per week, with a serving size of 3 ounces cooked or roughly ¾ cup of flaked fish [7]. Individuals should not exceed a total intake of 3 grams of DHA or other omega-3 fatty acids per day, with no more than 2 grams of it coming from a dietary supplement, as this can potentially increase the risk of bleeding by slowing down blood clotting [5].
References
[1] Grosso G, Galvano F, Marventano S, Malaguarnera M, Bucolo C, Drago F, Caraci F. Omega-3 fatty acids and depression: scientific evidence and biological mechanisms. Oxidative medicine and cellular longevity. 2014;2014:313570. doi:10.1155/2014/313570
[2] Fu Y, Wang Y, Gao H, Li D, Jiang R, Ge L, Tong C, Xu K. Associations among Dietary Omega-3 Polyunsaturated Fatty Acids, the Gut Microbiota, and Intestinal Immunity. Mediators of inflammation. 2021;2021:8879227. doi:10.1155/2021/8879227
[3] National Institutes of Health. Omega-3 Fatty Acids – Consumer. Updated September 22, 2021. Accessed April 26, 2023. https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/
[4] DiNicolantonio JJ, O’Keefe JH. The Importance of Marine Omega-3s for Brain Development and the Prevention and Treatment of Behavior, Mood, and Other Brain Disorders. Nutrients. 2020;12(8):2333. doi:10.3390/nu12082333
[5] Chang CY, Ke DS, Chen JY. Essential fatty acids and human brain. Acta neurologica Taiwanica. 2009;18(4):231-241.
[6] Cutuli D. Functional and Structural Benefits Induced by Omega-3 Polyunsaturated Fatty Acids During Aging. Current neuropharmacology. 2017;15(4):534-542. doi:10.2174/1570159X14666160614091311
[7] American Heart Association. Fish and Omega-3 Fatty Acids. Updated April 5, 2021. Accessed April 26, 2023. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/fish-and-omega-3-fatty-acids
Susan started Savor Health after losing a close friend to a brain tumor and, through that experience, becoming aware of the significant unmet nutritional needs of people with cancer. Struck by the fact that her friend was told “nutrition doesn’t matter” and “eat whatever you want,” Susan read the evidence-based literature on the subject, interviewed oncologists, oncology nurses and oncology dietitians, as well as patients and caregivers, and found that, in fact, nutrition does matter in oncology. Armed with solid scientific evidence supporting the clinical and quality of life benefits of proper nutrition, Susan left Wall Street and created Savor Health, an AI-based provider of personalized and clinically appropriate nutrition solutions for cancer patients, their caregivers and health enterprises. Susan brings to Savor Health over 25 years of industry experience in healthcare and business as well as expertise in strategy, finance and management.
Marissa Buchan is a registered dietitian, with advanced practice certifications in Oncology Nutrition (CSO) and Clinical Research (CCRP). She received her Bachelor’s degree in Psychology from Duke University, and Master’s of Science degree in Clinical Nutrition from New York University. Marissa worked for 10 years at Memorial Sloan Kettering Cancer Center in both the clinical research and nutrition departments. In addition to counseling patients before, during, and after cancer therapy, she spearheaded nutrition-research efforts for the bone marrow transplant service. She has co-authored over 20 articles and has a particular interest in the role of nutrition on the intestinal microbiota and its impact on patient outcomes. When Marissa’s not wearing her lab coat, she’s in her apron whipping up healthy and delicious recipes that you can find on her blog, Get Off Your Tush and Cook.
Dr. DeFrance has a unique background including clinical interventional cardiologist, chief medical officer, educator, outcomes researcher and entrepreneur. He has expertise in Lifestyle medicine in which he was board certified in 2020 and is highly interested in the prevention and reversal of chronic disease. Dr. DeFrance also has expertise in appropriate utilization of technology in medicine, healthcare economics, value-based metrics, and educational design and delivery. He worked as Chief Medical Officer for HealthHelp, one of the largest specialty benefit managers in the US, and led large teams of healthcare professionals in writing evidence based appropriate care guidelines and rule sets which improve the quality and safety of medicine for over 20 million people in the US while also creating sustained savings in healthcare. He has also designed clinical decision support systems that are currently in use helping to improve patient care.
Alyson is a registered nurse and is certified in oncology nursing (OCN) through the Oncology Nursing Society (ONS). She also has her certification as an ONS Biotherapy and Chemotherapy Provider. Alyson studied nursing at Thomas Jefferson University where she obtained her Bachelor’s of Science in Nursing (BSN). Since starting her nursing career in 2004, Alyson has had a strong dedication and commitment to oncology patients. She has worked inpatient specializing in Bone Marrow and Peripheral Blood Stem Cell Transplantation. Alyson currently works in outpatient oncology at the North Shore-LIJ Monter Cancer Center. Alyson is part of the clinical team at Savor Health where she counsels patients on oncology and oncology nutrition issues and contributes to website and other Savor Health content.
Chelsey is a Registered Dietitian and Board Certified Specialist in Oncology nutrition (CSO). She completed her Dietetic Internship at Northwell Health, received her BS in Dietetics at the University of Wisconsin-Madison, and her MS in Nutrition at Stony Brook University’s School of Medicine. Chelsey works as an outpatient dietitian at Mount Sinai covering all of the downtown cancer services at Mount Sinai Beth Israel and Philips Ambulatory Care Center. Chelsey works with patients and families before, during and after treatment to optimize their nutrition through dietary counseling and support. Chelsey has experience counseling clients with a variety of diagnoses including breast cancer, lung cancer, prostate cancer, head & neck cancer, and more. Chelsey also enjoys sharing nutrition knowledge with her peers by running a monthly Employee Wellness program that showcases healthy topics, recipes and food demos.
Michelle is a Registered Dietitian specializing in oncology. She works as a clinical dietitian at an ambulatory cancer center in New York City and is a consultant for Savor Health. She is passionate about educating oncology patients on the importance of nutrition during their fight against cancer and helping them to optimize their nutrition through all phases of treatment. Michelle received her Bachelor of Science degree in dietetics from the University of Wisconsin-Madison and her Master of Science degree in Clinical Nutrition from New York University.
Denise Sievering is a Registered Dietitian who is board certified in Oncology Nutrition as well as Nutrition Support. A fluent Spanish speaker, Denise joined the Savor Health team to support Spanish speaking cancer patients and to continue to expand the Platform’s nutritional strategies and recommendations in Spanish. Denise holds a Bachelor of Science degree from Rutgers University, and completed her internship at New York Presbyterian Hospital (NYP). Denise started her career as a registered dietitian at NYP-Columbia University Medical Center, primarily covering inpatient Oncology units. Denise also holds a Master of Arts degree in Mental Health Counseling from New York University, and incorporates her advanced training in motivational interviewing and empathic listening in her patient encounters, particularly those whose lives have been forever changed by a cancer diagnosis. A New Jersey native, Denise now resides in sunny San Diego, CA where she works as a part-time outpatient Oncology dietitian at Scripps Health-MD Anderson Cancer Center, and also works as an inpatient dietitian at Kaiser Permanente. In her spare time, Denise can be found at a mom-and-pop taco shop, one of the many local craft breweries, and exploring her new city of San Diego with her husband and her rescue pup, Ripley.
Karen is a Registered Dietitian, Board Certified Specialist in Oncology Nutrition and registered in New York as a Certified Dietitian Nutritionist. Fluent in Spanish, Karen joined the Savor Health team to support Spanish speaking cancer patients and to continue to expand the Platform’s nutritional strategies and recommendations in Spanish. Karen received her Bachelor of Science degree from Ithaca College and her Master of Science degree from Hunter College. She works as an outpatient oncology dietitian in New York. Karen often works with local community centers to host nutrition programs for cancer survivors and their families, leading classes on how to live healthier lifestyles throughout their continuum of care. The American Institute of Cancer Research selected to showcase one of her many programs at their conference in 2019. Karen has written for and lent commentary to various publications and truly enjoys teaching people how to eat better. She loves to cook and strongly feels that healthy food doesn’t have to taste bad.
Allie is a Registered Dietitian and a Certified Specialist in Oncology (CSO). She joins Savor in 2023, bringing years of experience from the John Theurer Cancer Center in New Jersey, where she worked with patients with a variety of cancers. Her goal is to help people feel their best, both mentally and physically, when physical health challenges arise. She believes in the power of nutrition ever since the impact it made on her athletic career as a volleyball player during college. Allie graduated with her Bachelor of Science degree from University of Maryland-Baltimore County and has her Master’s degree in Human Nutrition from the University of Wisconsin Stout. She enjoys travelling, enjoying different cuisines, cooking, and hiking and other outdoor activities with her family and dog.
Julia Penberg is a seasoned healthcare professional with more than 30 years of experience focusing on maximizing operational excellence, leading clinical program development and building strong cross-functional teams. Her previous roles include overseeing the performance of clinical managers and nurse practitioners across multiple markets within United Healthcare-Optum’s Medicare Advantage and dual-eligible special needs populations, payer outreach and program development at Mayo Clinic, ground level specialty hospital development and direct patient care as a family and dermatology nurse practitioner. Julia volunteered as an operating room nurse and nurse practitioner on several mission trips to Romania and was a support group leader for the Kansas City chapter of the International Myeloma Foundation. Her motivation throughout her career has been with wellness promotion, disease risk modification and ensuring the best patient experience across the health continuum. Ms. Penberg received an MBA from the University of Dallas; a MS in Nursing from the University of Kansas and a BS in Nursing from the University of Texas-Austin. She is board certified as a Family Nurse Practitioner.
Rachel is a Registered Dietitian and Board Certified Specialist in Oncology Nutrition (“CSO”). She joined NYP-Columbia as the outpatient oncology dietitian in 2020 after working at Jamaica Hospital Medical Center for two years. Rachel completed her dietetic internship through Keene State College in 2017. She is pursuing an MS in Integrative Nutrition at Stony Brook University and has a BS in Human Nutrition, Foods and Exercise from Virginia Tech. Rachel provides nutrition counseling to all types of oncology patients and helps them understand the mental and physical benefits of nutrition as an ally in their fight against cancer. In her free time she enjoys slow meals with family and friends, Pilates, and tending to her fire escape garden.
Allie Werner is a Registered Dietitian at Fresenius Kidney Care where she provides medical nutrition therapy diet counseling to patients on Dialysis. She received her Bachelor’s Degree in nutrition from Indiana University and completed her Master’s Degree and dietetic internship at Loyola University Chicago. In her free time she enjoys spending time with friends and family, checking out the amazing food scene in downtown Chicago, and exercising on her Peloton bike.
Immersed in the tech world for a decade, I've coded, led teams, and honed my skills in architecture and design. As a tech enthusiast, I've seamlessly woven through full-stack projects, fusing my love for code with the art of leadership.
Mohit is a full-stack developer with expertise in Python and JavaScript, known for his efficient coding and ability to deliver scalable software solutions. His technical contributions are highlighted on GitHub and Stack Overflow, demonstrating his commitment to the tech community and problem-solving skills. With a solid educational foundation and a diverse project portfolio, Mohit excels at navigating complex challenges and is well-equipped to contribute to dynamic software projects.
Rayna McCann is a Registered Dietitian and Board Certified Specialist in Oncology Nutrition. She is a Registered Yoga Teacher and yoga4cancer certified. She received her BS in Nutrition at Penn State University and her MS from Stony Brook University. For work, Rayna wears many hats in the world of nutrition and worked for years in clinical settings focusing on oncology nutrition. She is also an Adjunct Professor and passionate about inspiring the future of dietitians. Throughout her career, she has received awards recognizing her dedication to patient safety and her contributions to improving malnutrition awareness. In 2022, Rayna was proud to accept the ‘Dietitian of the Year’ award through the Long Island Academy of Nutrition and Dietetics. Rayna has co-authored abstracts for poster presentations within the American Institute for Cancer Research conference, as well as, the Nutrition and Dietetics Food and Nutrition Conference Expo and subsequent publication. She has enjoyed authoring articles, including an article for The Cure magazine regarding Multiple Myeloma and nutrition. When Rayna is not participating in nutrition related activities, she is dedicated to dog rescue.
Former Senior Vice-President, head of Strategies and Performance at Nestlé global HQ, Valerio is a leading innovation enabler who offers his expertise to a broad spectrum of start-ups, agencies and consulting companies as they expand their businesses and offerings.
Vera has dedicated her professional life to creating innovative digital solutions at the intersection of science and technology. Her most recent engagement was with Nestlé Research, where Vera established the Digital Nutrition & Health group and led the development of Digital Food Safety department.
Dr. Becker has served in many roles throughout her career as a Transplant Surgeon. She is currently Vice President and Chief Medical Officer at LifeGift, an organ transplant procurement organization. Dr. Becker is a Past President of the Organ Procurement and Transplant Network/United Network for Organ Sharing (“OPTN/UNOS”) Board of Directors and served during tumultuous times. While serving as OPTN President, lung allocation and liver allocations were both amended to decrease geographic disparities. She has most recently served on the UNOS corporate affairs committee as an advisor. Dr. Becker is a former committee member for the National Academy of Science, Engineering and Medicine. She is currently serving on the Kidney Disease Improving Global Outcomes (KDIGO) steering committee as the Co-Chair of a workgroup assessing patient factors contributing to kidney graft loss.
Jon Bond is one of the advertising and marketing industry’s most recognized thought leaders and entrepreneurs. He has developed several significant companies and marketing concepts over his 30-year career. Jon was Co-Founder and CEO of Kirshenbaum Bond and Partners (KBP). KBP was the first to develop the modern multi-disciplinary, integrated agency. He was CEO of Big Fuel (now part of Publicis) and co-founded and sold one of the first online media agencies (iballs) to Microsoft. Currently, Jon is founder and Chief Tomorroist at TOMORRO. Established in 2012, TOMORRO is a value accelerator using marketing, innovation, and strategic business development to help visionary companies achieve their ambitions.
Eliza is passionate about helping people live healthier and more fulfilling lives. She has held leadership, advisory and consulting roles at numerous health-focused companies, including RunKeeper, MyFitnessPal/Under Armour, Foodsmart (formerly Zipongo), January AI (precision health), Allara Health (women’s health) and Everyday Health (and their acquisition of weight-loss app, Lose It!). Eliza is a business operator with a track record of building and inspiring high-performing teams to deliver outstanding results and scale effectively. She has a foundation in finance and consulting and 10+ years of operational leadership at Bay Area startups, including two successful exists (MyFitnessPal, Ooyala). Eliza completed her MBA at Harvard Business School and graduated magna cum laude from Middlebury College with a double major in Art History & Economics. She is a Boston native living in New York with her husband and three children.
Ethan Basch is an oncologist and cancer researcher at the University of North Carolina, where he is Chief of Oncology and Physician-in-Chief of the Cancer Hospital. Dr. Basch has conducted research on patient-centered cancer care models for the past two decades, developing connected health technologies and care delivery strategies to improve quality of care and the patient experience. His research group established that care teams miss more than half of patients’ symptoms during cancer care, and demonstrated that electronic tools not only can close that gap, but can improve cancer outcomes including quality of life, hospitalizations, and overall survival. He has published over 300 scientific papers on these topics, including in JAMA, New England Journal of Medicine, Lancet, Journal of Clinical Oncology, JAMA Oncology, Cancer, etc. He has served on the Board of Scientific Advisors of the National Cancer Institute, the Board of Directors of the American Society of Clinical Oncology (ASCO), the Board of the International Society of Quality of Life Research (ISOQOL), and as an editor for JAMA. He received his MD at Harvard Medical School, residency training at Massachusetts General Hospital, and oncology training at Memorial Sloan Kettering Cancer Center, where he was on faculty until moving to North Carolina in 2012. The mission of his work is to improve the experiences and quality of life of people with cancer.
David Raben, M.D. is currently V.P. and Chief Medical Officer, Bicara Therapeutics. Dr. Raben is also on faculty at the University of Colorado where he is a board-certified Professor of Radiation Oncology and has recently been named a U.S. News Top Doctor. He received a B.A. in Psychology from Duke University in 1985 and completed his M.D. at Wake Forest University/Bowman Grey School of Medicine in 1990. After graduation, he completed residency in Radiation Oncology at the Johns Hopkins Hospital from 1991-1994, serving as a chief resident in 1994. Dr. Raben has developed nationally recognized clinical expertise over the past 20 years in the management of head and neck cancer (HNC), lung cancer and prostate/bladder cancers. Clinically, Dr. Raben has a strong interest in nutritional precision for patients, with an interest in reducing processed foods and sugars in patients with locally advanced cancers, especially ones with high cell turnover. An anti-inflammatory strategy with a Mediterranean dietary approach coupled with reductions in high carbohydrate loading may reduce or slow cancer progression and improve a patient’s intrinsic microbiome to enhance immune response to various therapies including immune enabling drugs like checkpoint inhibitors that have shown dramatic success recently in advanced cancers. From a research perspective, his focus has been on laboratory discoveries and innovative clinical trials in areas such as high risk, heavy smoker HNC patients and has explored approaches that inhibit cancer DNA repair or growth factor signaling. Dr. Raben recently completed the first Phase I clinical trial in the US with and oral DNA repair inhibitor (PARP inhibitor) and radiation for heavy smokers when combined with intensity modulated radiation (IMRT). His efforts currently center around evaluation of TGFb inhibition in HNSCC as well as the use of radiation to stimulate activity of immune enabling drugs. Nationally, Dr. Raben serves on the NRG Oncology head and neck steering committee as well as co-chairing the Developmental Therapeutics Co-Chair at the NRG. He actively serves as an ASCO Ambassador for Multidisciplinary Cancer Management Courses (MCMC) to help educate underserved areas around the world in cancer care. Finally, he serves an ad hoc reviewer for high impact journals such as Journal of Clinical Oncology, Annals of Oncology, JAMA Oncology, Oral Oncology, Head and Neck, Int. Journal of Radiation Oncology Biology Physics, Clinical Cancer Research and Cancer Research. He has authored over 140 publications.
Jason Montrie is an award-winning healthcare technology executive and entrepreneur with over two decades of experience in building, growing, and scaling leading healthcare businesses. With a career that includes working at large health insurance companies like Humana, being Co-founder and CEO of the fastest growing heath insurance company in Illinois, and most recently serving as President of the premier healthcare data analytics platform and supplemental benefits company in the Medicare Advantage sector in Pareto Intelligence and Convey Health Solutions, Jason brings un unmatched set of experience and perspective to Savor which will help drive its growth.
Jonathan M. Kurie, M.D. Professor, Department of Thoracic/Head and Neck Medical Oncology, MD Anderson.
Stephanie is a Registered Dietitian and Board Certified Specialist in Oncology Nutrition (CSO). She completed her dietetic internship at NewYork-Presbyterian in 2016 and has a MS in Clinical Nutrition and BA in Biology from New York University. She has worked at NYP Weill Cornell in NYC as an oncology dietitian since 2017. Stephanie combines her passions for food and science by providing individualized nutrition counseling for patients during their medical, radiation and/or surgical cancer treatment to help them get their best nutrition and maximize their quality of life. When not working, Stephanie enjoys hiking in the Hudson Valley, cooking, and spending time with her rescue dog.
I have been surfing online more than 3 hours today yet I never found any interesting article like yours It is pretty worth enough for me In my opinion if all web owners and bloggers made good content as you did the web will be much more useful than ever before
I do believe all the ideas youve presented for your post They are really convincing and will certainly work Nonetheless the posts are too short for novices May just you please lengthen them a little from subsequent time Thanks for the post
Fantastic read! I was especially impressed by the depth provided on the topic, offering a perspective I hadn’t considered. Your insight adds significant value to the conversation. For future articles, it would be fascinating to explore more to dive deeper into this subject. Could you also clarify more about the topic? It caught my interest, and I’d love to understand more about it. Keep up the excellent work!
Hi there, I thought I saw you visited my website, so I came back to say hello. I suppose I could use some of your ideas as I’m trying to find out how to improve my website.
검증사이트 사용으로 사설 토토& 온라인카지노 먹튀를 예방하세요.
You’ve really outdone yourself with this article. It’s excellent.
I do believe all the ideas youve presented for your post They are really convincing and will certainly work Nonetheless the posts are too short for novices May just you please lengthen them a little from subsequent time Thanks for the post
Fantastic site A lot of helpful info here Im sending it to some buddies ans additionally sharing in delicious And naturally thanks on your sweat
Just wish to say your article is as surprising The clearness in your post is just cool and i could assume youre an expert on this subject Fine with your permission allow me to grab your RSS feed to keep updated with forthcoming post Thanks a million and please keep up the enjoyable work
You’vegotthis
Its like you read my mind You appear to know so much about this like you wrote the book in it or something I think that you can do with a few pics to drive the message home a little bit but other than that this is fantastic blog A great read Ill certainly be back
Love the energy!searc h
Stellar job! Custom Song That Tells Your Story
Business dicker I’m often to blogging and i really appreciate your content. The article has actually peaks my interest. I’m going to bookmark your web site and maintain checking for brand spanking new information.
cbd sleep gummies have been a game-changer fit me! They’re useful, toothsome, and a extensive direction to enjoy the benefits of CBD discreetly. I’ve found that they employees me unwind after a long epoch and to ground my sleep quality. Together with, wily exactly how much CBD I’m getting in each gummy makes it undemanding to manage my dosage. If you’re curious forth taxing CBD, gummies are a capacious starting point. Just be unshakable to choose a well-thought-of sort with high-quality ingredients after the superlative observation!
Mygreat learning I do not even understand how I ended up here, but I assumed this publish used to be great
BaddieHub Great information shared.. really enjoyed reading this post thank you author for sharing this post .. appreciated
allegheny county real estate There is definately a lot to find out about this subject. I like all the points you made
allegheny county real estate I do not even understand how I ended up here, but I assumed this publish used to be great
allegheny county real estate You’re so awesome! I don’t believe I have read a single thing like that before. So great to find someone with some original thoughts on this topic. Really.. thank you for starting this up. This website is something that is needed on the internet, someone with a little originality!
Techarp very informative articles or reviews at this time.
Techarp Hi there to all, for the reason that I am genuinely keen of reading this website’s post to be updated on a regular basis. It carries pleasant stuff.
Профессиональный сервисный центр по ремонту бытовой техники с выездом на дом.
Мы предлагаем: ремонт крупногабаритной техники в москве
Наши мастера оперативно устранят неисправности вашего устройства в сервисе или с выездом на дом!
Family Dollar There is definately a lot to find out about this subject. I like all the points you made
Mating Press For the reason that the admin of this site is working, no uncertainty very quickly it will be renowned, due to its quality contents.
Insanont naturally like your web site however you need to take a look at the spelling on several of your posts. A number of them are rife with spelling problems and I find it very bothersome to tell the truth on the other hand I will surely come again again.
Blue Techker I am truly thankful to the owner of this web site who has shared this fantastic piece of writing at at this place.
I always say, if I don’t be taught five new issues a day, I’m disappointed.
Профессиональный сервисный центр по ремонту Apple iPhone в Москве.
Мы предлагаем: мастер по ремонту iphone
Наши мастера оперативно устранят неисправности вашего устройства в сервисе или с выездом на дом!
Сервисный центр предлагает замена тачскрина samsung galaxy tab t285 поменять разъем зарядки samsung galaxy tab t285
Сервисный центр предлагает ремонт мониторов aorus недорого ремонт мониторов aorus недорого
Сервисный центр предлагает ремонт холодильников mastercook недорого ремонт холодильника mastercook на дому
Сервисный центр предлагает ремонт treelogic brevis 705 в петербурге ремонт treelogic brevis 705
Тут можно преобрести купить огнестойкий сейф огнестойкие сейфы купить
Тут можно сейф для дома купить в москве купить сейф для дома в москве
Тут можно преобрести сейф огнестойкий в москве огнестойкие сейфы цена
Тут можно преобрести сейфы пожаростойкие огнестойкий сейф
стоимость перепланировки стоимость перепланировки .
кожзаменитель купить кожзаменитель купить .
Тут можно преобрести купить сейф оружейный оружейный сейф
want to view instagram want to view instagram .
сервис накрутки подписчиков instagram сервис накрутки подписчиков instagram .
раскрутка сайта в топ москва раскрутка сайта в топ москва .
продвижение сайтов по москве продвижение сайтов по москве .
сео раскрутка сайта в москве http://prodvizhenie-sajtov-v-moskve216.ru/ .
франшиза купить готовый бизнес каталог франшиза купить готовый бизнес каталог .
Тут можно преобрести магазин оружейных сейфов шкаф оружейный
Сервисный центр предлагает срочный ремонт электросамокатов archos ремонт электросамокатов archos на дому
вывод из запоя дешево ростов-на-дону krut.forumno.com/viewtopic.php?id=6023 .
франшизы москва франшизы москва .
популярные франшизы популярные франшизы .
какие есть франшизы какие есть франшизы .
Тут можно преобрести сейф огнеупорный купить сейф противопожарный
вывод из запоя срочно ростов http://www.flanrp.rolevaya.com/viewtopic.php?id=145 .
вывод из запоя в стационаре ростов-на-дону http://www.sergiev.0pk.me/viewtopic.php?id=3456 .
вывод. из. запоя. на. дому. ростов. вывод. из. запоя. на. дому. ростов. .
вывод. из. запоя. на. дому. ростов. http://belbeer.borda.ru/?1-6-0-00000751-000-0-0-1730725764/ .
вывод из запоя на дому ростов на дону https://setter.borda.ru/?1-7-0-00000672-000-0-0-1730725091 .
Здесь можно преобрести сейф цена купить сейфы купить в москве
Тут можно преобрести сейфы огнестойкие сейфы пожаростойкие
вывод из запоя ростов-на-дону angelladydety.getbb.ru/viewtopic.php?f=44&t=42909 .
нарколог вывод из запоя ростов [url=http://motik13.0pk.me/viewtopic.php?id=1994]нарколог вывод из запоя ростов[/url] .
вывод из запоя стационарно ростов [url=http://rubiz.forum.cool/viewtopic.php?id=3745/]http://rubiz.forum.cool/viewtopic.php?id=3745/[/url] .
вывод из запоя на дому в ростове [url=www.mymoscow.forum24.ru/?1-6-0-00022906-000-0-0-1730726155/]www.mymoscow.forum24.ru/?1-6-0-00022906-000-0-0-1730726155/[/url] .
наркология вывод из запоя ростов http://www.vishivayu.ukrbb.net/viewtopic.php?f=12&t=13426 .
онлайн казино [url=https://casino-bonus.by/]онлайн казино[/url] .
вывод из запоя цены ростов на дону [url=https://kvitka.ukrbb.net/viewtopic.php?f=58&t=28011]вывод из запоя цены ростов на дону[/url] .
вывод. из. запоя. ростов. на. дону. [url=https://justforum.bestforums.org/viewtopic.php?f=26&t=4732/]https://justforum.bestforums.org/viewtopic.php?f=26&t=4732/[/url] .
Сервисный центр предлагает замена аккумулятора samsung galaxy tab t585 замена камеры samsung galaxy tab t585
Тут можно преобрести сейф огнестойкий купить купить огнеупорный сейф
Тут можно преобрести сейф противопожарный сейфы огнестойкие
казино беларусь казино беларусь .
вывод из запоя стационарно ростов https://aqvakr.forum24.ru/?1-7-0-00011570-000-0-0-1730648582 .
нарколог на дом вывод из запоя ростов http://www.uaforum.ukrbb.net/viewtopic.php?f=13&t=3233 .
нарколог на дом вывод из запоя ростов https://www.setter.borda.ru/?1-7-0-00000670-000-0-0-1730649025 .
вывод из запоя в ростове на дону http://www.dubna.myqip.ru/?1-5-0-00000280-000-0-0-1730649298 .
Тут можно преобрести купить оружейный сейф доставка оружейный шкаф купить
вывод из запоя срочно ростов вывод из запоя срочно ростов .
вывод из запоя дешево ростов-на-дону http://www.to.iboard.ws/viewtopic.php?id=8058 .
Тут можно преобрести огнестойкий сейф купить огнестойкий сейф
вывод из запоя круглосуточно вывод из запоя круглосуточно .
вывод из запоя дешево ростов на дону [url=https://www.internetmoney.bestbb.ru/viewtopic.php?id=31697]https://www.internetmoney.bestbb.ru/viewtopic.php?id=31697[/url] .
Тут можно преобрести шкафы оружейные и сейфы сейфы для оружия москва
Bonos de bienvenida Jugabet Bonos de bienvenida Jugabet .
вывод из запоя ростов на дону на дому https://tatuheart.ukrbb.net/viewtopic.php?f=8&t=15061/ .
вывод из запоя на дому в ростове http://www.family2.quadrobb.me/viewtopic.php?id=1836#p6861/ .
алкоголизм лечение вывод из запоя ростов http://www.kyevlyn.ukrbb.net/viewtopic.php?f=2&t=13616 .
Тут можно преобрести сейф огнеупорный купить сейф огнестойкий цена
промокод prodamus http://www.prodamus-promokod21.ru .
вывод из запоя срочно ростов [url=https://gov.ukrbb.net/viewtopic.php?f=3&t=6368/]https://gov.ukrbb.net/viewtopic.php?f=3&t=6368/[/url] .
Предлагаем услуги профессиональных инженеров офицальной мастерской.
Еслли вы искали официальный сервисный центр xiaomi, можете посмотреть на сайте: официальный сервисный центр xiaomi
Наши мастера оперативно устранят неисправности вашего устройства в сервисе или с выездом на дом!
вывод. из. запоя. ростов. http://uaforum.ukrbb.net/viewtopic.php?f=13&t=3230/ .
. http://www.output.jsbin.com/selocapoyo/ .
. http://devpost.com/xixemop390?ref_content=user-portfolio&ref_feature=portfolio&ref_medium=global-nav .
вывод из запоя ростов ukroenergo.ukrbb.net/viewtopic.php?f=13&t=21376 .
купить диплом орск [url=https://1oriks-diplom199.ru/]1oriks-diplom199.ru[/url] .
вывод из запоя ростов на дону стационар http://www.avtomobili.creartuforo.com/viewtopic.php?id=730/ .
Тут можно преобрести купить шкаф для ружья шкаф для оружия
нарколог на дом нарколог на дом .
нарколог на дом анонимно http://www.mozaisk.anihub.me/viewtopic.php?id=4368/ .
нарколог на дом цены [url=ideya.forums.party/viewtopic.php?id=655]нарколог на дом цены[/url] .
автоматический карниз для штор [url=https://www.elektrokarniz495.ru]автоматический карниз для штор[/url] .
нарколог на дом цены [url=belbeer.borda.ru/?1-6-0-00000754-000-0-0-1730730058]belbeer.borda.ru/?1-6-0-00000754-000-0-0-1730730058[/url] .
нарколог на дом краснодар [url=http://setter.borda.ru/?1-7-0-00000673-000-0-0-1730729894]http://setter.borda.ru/?1-7-0-00000673-000-0-0-1730729894[/url] .
1с купить официальный сайт цена 1с купить официальный сайт цена .
нарколог на дом ideya.forums.party/viewtopic.php?id=659 .
нарколог на дом vishivayu.ukrbb.net/viewtopic.php?f=12&t=13428 .