Fermented foods: what to eat to cut inflammation | Prof. Tim Spector

27:50And what they showed was that even after a couple of weeks, you saw a really significant drop in inflammation markers in the fermented food group. So not only did their microbiome change more than the high fiber group, but they had this dramatic decrease in inflammation markers. So it really helped the immune system. It changed 17 out of 19 proteins they measured. So across the board, these were having a real effect on the immune system. And that's probably the mechanism by which they are having this health effect. So the Stanford study, for the first time, showed in great detail that fermented foods can have a dramatic impact on the immune system, as well as the gut microbiome.

28:38So to me, that was an eye-opener. And then put all the other studies into context. Those other studies had been the epidemiological ones, very population, big level, showing that people that had regular yogurts, had regular cheese, other fermented foods had lower rates of death, heart disease, better metabolic profiles. And some of these we'd done in our own studies at King's using twins, which I was working on for 25 years. So matching the big studies with these detailed ones, and then all the little studies around the world with meta-analyses that had studied like 10 or 20 people with a few inflammatory markers, all showed the same thing.

29:25So you're putting all this together, makes absolutely clear that these foods, if you have them regularly, small amounts regularly, will have a significant impact on your immune system and your gut microbiome. We should be learning from our ancestors, we should be learning from the latest science. We should all be having at least three portions a day. And that led me to do, with the Zoe members, this citizen science project we call Pragmatic Science. So there's no control group, but we got 9 ,000 volunteers. And if anyone's listening, thank you very much for volunteering. Couldn't have done it without you, who signed up, who weren't taking regular fermented foods and said, we want you guys to volunteer to take three a day and do that for two weeks after a one-week run-in.

30:17On the Zoe app, we asked them to record their mood, their energy, their hunger levels, and any problems like bloating or constipation. They did that every day. A thousand dropped out. Understandable. We weren't paying them like they doing these other studies and they didn't get credits for their university. But these are normal people. These are unlike the studies. They're females, males, people aged over 40, the regular people who take these foods. And of the 5 ,500 who diligently did this right to the end, 100 % completion rate, around 50 % showed improvements in mood, energy, hunger, bloating, and constipation.

31:05So to be clear, Jonathan, of the people that completed the study, that means that for the two-week trial period, they had at least three ferments a day, and they didn't miss a day, and they recorded how they felt. On average, around 50 % of them noticed significant improvements in a number of key symptoms. The first was mood and energy. They were the first things people noticed. Then they had an actual reduction in hunger, although they were eating more. And they also had a reduction in bloating and also in improvement in constipation. So that's pretty remarkable, right? So you're saying that - Just in two weeks.

31:50When I saw those data, that was a real wow factor. And it just showed you that if we can get just the people listening to this podcast spread the word that this is a normal thing to do, eating three ferments a day, we can not only improve our inflammation levels at the sort of local level, but actually this can affect our brain, our mental health in the majority of people taking it in just a few weeks. This can have an incredible public health effect. And I just don't think we've realized up to now the huge potential of these fermented foods. You started by saying that you thought it was really good for our inflammation and reducing it.

32:29And now you're talking about this study that you did with thousands of people through Zoe. And there you're talking about things like mood and energy and hunger and constipation, which seems completely different. Yes. What the Stanford study, going back to that one, showed clearly you get an improvement in immune health. And you also got a shift in your gut microbiome towards a healthier looking microbiome. The two things are linked. And we know that inflammation is key to many features in the body and your gut health as well. So if you reduce inflammation, your gut health will also improve. So that would probably explain improving constipation.

33:11The mental effects of this, the improvement in mood and energy and hunger, are probably through the effects of these microbes on the immune system. We think that they're directly interacting with the immune system, whether they're dead or alive, through most of our immune cells, which are actually lining our gut. And they're sending those signals. We don't know exactly how they do it, but they're sending clear signals to the immune system. So all is well. That gets transferred to the brain through the vagus nerve and other mechanisms, calming the brain down, reducing so-called neuroinflammation.

33:49That helps our mood. That helps our concentration. That helps reduce fatigue. So this immune system linked with the gut microbiome is the key to really how we feel most of the time. And a lot of our problems with modern illness is due to the fact that our levels of inflammation are much too high. So that's amazing. So you're saying that on the one hand, you had this sort of like super detailed study at Stanford where you can measure all of these inflammatory markers. And on the other hand, you had this study that you led with, you know, 9 ,000 people. And you could see this impact on symptoms that are in the brain, like energy and mood and hunger.

34:32but also things like constipation and bloating. And a few of those are directly linked because you would expect the gut health improvements and the inflammation improvements to lead to those benefits. Absolutely, yes. So just to maybe wrap back to the original part of the story, we were describing all of these amazing things in the food after it's fermented. Do scientists understand how this fermented food, like I'm eating this yogurt or this kefir or whatever, actually leads to the benefits you're describing after I put it in my mouth and swallow? Not precisely, no. But the current thinking is that it's a combination of the microbes and their chemicals themselves that are having this effect.

35:20And it is so complicated. You can imagine how difficult it is to sort out in humans. But we think that the likely place that this occurs, when you say swallow a yogurt and you've got some microbes in it, it gets through the stomach, wrapped around in the food, so you've still got billions getting into your gut. When they get to the small intestine, which is the bit above the large intestine, it's not very small, it's actually very large, but there's less of our host microbes to fight it off. So we think it probably has an impact there on the immune cells. And something about the lining of the microbes sends signals to the immune cells because we now know that dead or alive, even dead ones have this ability to tickle the immune cells, a bit like a vaccine.

36:11And so we think a lot of this is due to having Having different types of microbe going through your body, having like a vaccine effect on us will tickle the immune system and that will then drive down inflammation and do the other good things that we think. But there's probably likely to be multiple mechanisms that we still don't understand. So it's a very new science in trying to work it out because really we've only just narrowed down what the areas to look at are. And I think I remember our colleague, Professor Sarah Berry, explaining to me that the food itself is transformed by these microbes.

36:50And she was explaining to me that you start with the fat in the milk. It's not very good for you. And then when you look at the cheese, like the structure is completely different if you look at it sort of under the microscope, as I'd understood. And therefore, it's almost like a different food for the microbes in our gut and for ourselves. And did I understand that right? Yes, there are lots of examples where that is true. that the microbes will break it down into these other more healthy, nutritious benefits for us. In a way, what's happening with the fermented food is it's double fermented. So it's already been transformed before you're eating it.

37:26So the difference between just drinking milk and having some kefir or yogurt is that by the time it reaches you, it's already in a better state than it was before. So Sarah's quite correct. The structure is healthier as well. So in simple terms, does that mean that I'm getting almost like a double benefit, that I'm getting both live bacteria that are going to be doing something healthy for me, and I'm also getting this much healthier food that is feeding me and my gut microbes? Yes, in the sense that that food is going to be easily digested. It's already broken down by the microbes beforehand into smaller pieces.

38:02And those nutrients are going to be much more easily extracted from the food and released into your body and used in multiple ways. So absolutely, yes, that's part of the thinking about why the more fermentation goes on, the more you're breaking the food down. People use the analogy with bread, normal bread. You've got lots of gluten, but if it's fermented sourdough bread, the gluten is in smaller chunks and pieces. So people have less problem being gluten intolerant, and it's easier for you to then absorb that gluten. So that's the work of the microbes doing that even before it gets into your body.

38:42If, like me, you've been blown away by the power of fermented foods for your health, Why not share your excitement and pass this episode on to a friend or a family member? I know they'll thank you for it. Now, one of the biggest questions that we had prior to this episode was around eating fermented foods versus probiotics. So, you know, the pills that we buy that say they have all of these live bacteria in, which, you know, I definitely took in the past, but don't anymore. How do you compare these live fermented foods versus probiotics? Interesting. There's hardly any studies I could find directly comparing them in a trial.

39:22We compared the standard probiotic to our Zoe prebiotic, the daily 30, which is 30 freeze dried plants and fiber. And the probiotic was a lactobacillus reuteri, which has been shown to work in 20 diseases. So we did a direct head-to-head comparison and our prebiotic won easily. had 10 times the effect on the gut microbiome compared to this probiotic. But we didn't test it against a fermented food. It would be interesting to see how they match up. But in general, fermented foods have more species of microbe in them. So in the book, I detail how we looked at 70 different commercial fermented foods.

40:06And the range goes from having one species, like in an Actimel children's yogurt, all children's yogurts are terrible to the top one which had about 80 different microbes in it which was a kimchi and a water kefir and more is better more is better so the more microbes you've got the more diversity of chemicals they can produce the more they can help you and our communities are all very different are unique so if you and i just have one micro probatic it may work on you but not on me but if we're having 80 the chances are that it'll probably work equally well on you and I. So the one reason to have fermented foods around the probiotics is that.

40:46The other is you actually get more quantity of them. I would expect if there was a direct study done, fermented foods would win. It's interesting how understudied this is as you talk about it. Yeah. Well, obviously the companies don't want to do it particularly because they're worried and there's a lot of money in probiotics. They don't want to show that just having a a cheaper food version is going to do much better. And you mentioned earlier this concept of ghost biotics, which I know you've got really excited about because we've actually ended up adding it, haven't we, to the latest version of Daily 30.

41:23How on earth can a dead microbe be doing me any good? Three years ago, I would say there was no point in talking about dead microbes. You know, you should forget pasteurized fermented foods, forget all those heat-treated kombuchas, the stuff in supermarkets, et cetera. But now I've totally changed my mind. Studies are true, they work. And the question is, how do they work? And the best theory we have is this idea of specific proteins on the cell wall of dead microbes interacting with our immune system. And they have special receptors there that are picking it up. So they seem to be working in that way, again, using the immune system.

42:10And it makes sense when you start thinking about vaccines. When you have most vaccines, they're either live or they call them attenuated, but that just means dead. A lot of vaccines you're getting are the dead version of the live one. And it's the same, it's the cell wall, whether it's the virus or the bacteria that is tickling our immune system. so this makes us think that eating fermented foods is a bit like being constantly immunized against our environment and protecting us and and it sort of starts to make sense so all the foods that are out there that are been dismissed in the past i think we have to have another look at and that's exactly why as soon as i made my mind about this we we put some dead kombucha into our daily 30 product for that reason, because it may not be quite as good as the live version, but all the evidence suggests it's beneficial.

43:06So I think a lot of people like me will be surprised because they'd assumed that the reason why you would have a probiotic pill or eat these live fermented microbes is so that then these microbes would live in my gut and hopefully increase the number of good microbes in my gut because they've all listened to you and other experts explaining that you know we need to have more of these good microbes that was a myth that's a myth is it yeah what is happening scientifically until recently that's what we believed and a lot of reasons oh fermented foods can't work because we don't find them staying for very long in our guts and that was a lot of people dismissed their their biological rationale that way and we have to realize that they don't stay in your gut they don't colonize your gut as i said 96 % of the microbes in food are not the same ones as you find in your gut normally.

44:01Just to confirm that, I'm getting this clearly, Tim. You're saying like, if I eat one of these super fermented foods with like 80 microbes and I eat it and then I stop eating it, then a week later, none of those microbes will still be living inside my gut? Yeah. Generally, they don't last. This is what the new science is telling us, that it's really this immune reaction as it's passing through, tickling our immune system, not trying to colonize and take over the rest of our gut. And that's a real big sea change in how we're seeing these fermented foods. That's why I've changed my mind on it. That's why the whole direction this field is going in is very different.

44:42That's why I think we're going to be seeing a lot more of these fermented foods killed or pasteurized back in our normal other products because it's a much safer way to use them. And we start thinking of them as helping our immune systems rather than colonizing our guts. So I'd love to turn to actionable advice now because I'm sure you've convinced a lot of listeners that they need to eat the three portions a day that you've been talking about. So maybe let's start for people who are new to this. and then as far as they're aware, they're not eating any fermented foods a day. Where would you start?

45:21I'd start with breakfast. Always a good place to start because you're at home, you're near your fridge. Start with my classic breakfast. Get some full fat yogurt. When you're starting off, mix it with some milk kefir because some people find when you start milk kefir, it's a bit too sour. But if you mix it with yogurt, that should be fine. You can sweeten it by adding fruits to it, berries, et cetera. That way you've got two ferments, easily done. And that's because the yogurt's one and the kefir's a second. Yeah. And they're separate. They have different microbes in them. They both count, do they?

45:55They both count. So it's a win. You can get two before you leave the house. Before you left the house, you've got two, exactly. Then it's very easy in your lunch. You can either have some cheese, which as long as you get anything that isn't completely plastic, avoid things like children's cheeses or pizza cheeses but even philadelphia cream cheese i did a study we looked at that that's got three microbes in it so you can cream cheeses are actually quite good any other cheddar or basic one or you know raw milk cheese even better that would be your third one but add to it some pickle some basic beetroot kraut or some sauerkraut on it if you're having an evening meal, any form of soup, instead of adding cream to it at the end, you just pour in some more kefir or yogurt.

46:47That's an easy win. Into your salads, you can put, again, these krauts and pickles. I would ask everyone to swap their stock cube for some miso paste. You can buy miso paste. It lasts a long time, which is this fermented soybean paste that gives an umami flavor that's fantastic. I never use stock cubes anymore. And I've just replaced that with a teaspoon of this miso paste, which if you're using in cooking, it would be dead, but it's still, it gives you, let's give it half a point for that one, Jonathan. And then um you just think that when you're having a salad can you put in some fermented vegetables into there and start experimenting you know i don't expect you to eat kimchi straight away because it's quite spicy but start experimenting with small amounts and if you want to start thinking about kimchi get some toast put some cream cheese on it and then mix in the kimchi with the cream cheese.

47:56So actually you're giving a mellower flavor to it and you're getting used to it. I managed to convince Davina McCall to start eating kimchi this way. And now she's an absolute addict. So usually people won't like it the first time. It's a bit like toddlers with some new food. You've got to keep going at it, introducing it, doing it in a mild way, and then start thinking about other drinks you can have. So kombucha, the first ones might be a bit sour, but there's some nice fruit ones to start on and you can wean yourself off the sweetness or the artificial sweeteners. Just get used to those flavors.

48:33Water kefir is another one, tibikos. It's not as common as kombucha, but it has just as many microbes in it and is an easier fruit or flavor for the novice starting off. They're just some of the things that you can do. Zoe Cookbook has got plenty of ways you can incorporate into recipes as well tim you've been pitching this to me for a while and i think i'm like everything you pitched me like i slowly start to try and introduce it and i definitely didn't grow up with eating any of these sorts of fermented foods apart from yogurt and and cheese it's now really easy to buy them and these things honestly i just don't think they were available at all 10 years ago even people who don't like dairy so I often ask this in my talks, I don't have dairy, so I can't have these.

49:21No, there's plenty of vegan kefirs and yogurts. The coconut ones are really good. It's a slow journey. And I think people will pick the foods and tastes that they like. And people have a different spice threshold, certainly, and a different sourness threshold. Some people immediately love it. Some people, it's going to take more time. But I can tell you, you go to Japan or Korea, you don't find people who don't have either miso or kimchi. So in a way, everyone can train their palate. Now, I'd love to wrap up with the idea of fermenting yourself at home, because I know that you've really got into this, haven't you, Tim?

49:57I have, yeah. Well, I had to. I'd write a book on it, so I've got to be an expert. And I think you have brought some examples of what is literally in your fridge today that you've cycled over with. A small sample of what's in my fridge, yeah. Oh, how many have you got in your fridge? Oh, far too many. At least 20 pots, I'd imagine. So now we understand why your wife is very upset about your fridge. So could you maybe take the first one out, explain what it is, and maybe start with what you think would be a good place to start? Well, let's go with the simplest ferment everybody can do because, oh, I can't do this.

50:33Well, even you could do this one, Jonathan. And this is raw, unpasteurized honey, a clear jar, and you put about 10 or 12 cloves of garlic in it exactly like this. And amazingly, after a few days, the microbes in the garlic transform the honey. They start eating the honey, and that produces the perfect environment for these microbes. They soften the garlic. They take away the hard taste of it. And it's a delicious either hors d 'oeuvre or you can blend it up and it's perfect for a salad dressing. Can I have a smell? Well, you've got to try one. Oh. Just try one, Jonathan. Don't be scared. I am a little scared.

51:17I know. It looks like something that has been... Oh, they're quite hard, aren't they? They're quite hard. All right. Just go for it. I'm going to go for it. All right. I'm not sure that I'm going to be invited back in the house later tonight. That's pretty good. nothing like as strong as the garlic is if i'd eaten that raw well that's how microbes transform foods into something completely different and the honey tastes different as well yes they're both different i didn't add anything to that you literally just threw garlic in honey that's it that's that's the recipe even i could do exactly so everyone can ferment if they really want to at home that's really surprising so this is where you're saying these microbes do these amazingly complicated things you just put it in the jar and you left it it's mixed you know the microbes and the garlic sitting there bored doing nothing but you wake them up with surrounding them with honey and they go crazy and they come out and they transform the honey and that in turn transforms the garlic into something a completely different dish and i tell you you blend that up and you have that in your salad dressing it's it's an amazing flavor what's next what's next we've got some sauerkraut.

52:32This basically is nothing more than cabbage chopped up and weighed, and you add 2 % salt. And then you put it in a jar and you leave it for a week. That 2 % salt changes the environment so much that you then get exactly the right microbes leaking out of the cabbage. They eat the sugar that's been leaking out because the salt has released it from the the cabbage and the flavors are amazing and you get all the acidity and it's perfectly safe because they've made it so acid nothing no bugs that you don't want in there will live all right i'm going to try tim's uh sauerkraut smells like sauerkraut and there's two types of obviously the one with vinegar which is the common cheap one which doesn't have anything like the flavor and complexity.

53:27Oh, it's delicious. Yeah, there you go. So I've now had two ferments. But anyone can make. I mean, that's the key. So they're the two ones that are so easy. Chop a cabbage and you've got to be able to weigh it. That's about the two skills you need. This one is slightly more advanced. This is my blob. And if you're not watching this on YouTube, it looks disgusting and tim is now reaching into what looks a bit like i won't get you to tea water and pulling out which something that looks a bit like a bit of a squid or an octopus or something it is what is that it is called a um a jellyfish um in some countries russian jellyfish or japanese jellyfish this is a scoby um which is a kombucha mother okay so this is made by the microbes it's like a shell they produce themselves so there's about 50 different microbes in here living inside that sort of jellyfish thing yeah they live inside there and they they produce it for themselves it's like a little protective shell that they live in so this allows them to live for years i've had this for about 10 years this one it has babies and i give it to special friends i'd note that i've never been a special enough friend to get given your or baby scoby.

54:51But on the other hand, it looks disgusting. It looks disgusting, but when you add it to sugary tea, so make a big pot of sugary tea, you just add that to it, leave it for a week, you will get kombucha and a completely different flavor. And again, once you've got this sorted out, it is actually much easier than it looks. And that goes from sugary tea, and we know anything that's just like full sugar is not healthy for you to kombucha which is a sour complex uh some say it's you know the closest you can get to beer and it's good for me and it's very good for you yes it's lots of studies show it reduces blood pressure helps your blood sugar level all kinds of benefits so again you know having this in the house uh the drinks of kombucha but buy it in the stores first to see if you know what it what it should taste like but you can this is incredibly cheap and easy to make and so that i guess is a brilliant example of like the magic of these bacteria moving something really terrible like water and sugar on one hand into something that suddenly is actually healthy for me and actually produces a bit of alcohol as well um usually below one percent so you can't feel it but it's just giving you an idea of what what these microbes are doing.

56:09There's yeast in there and they make CO2 and alcohol. So it's very complicated. And finally, your advanced lesson, Jonathan. So this is miso. I was going to say something that looks even more disgusting than the kombucha. All right. So I'm looking at it and it's a sort of brown paste. If anyone has had a small child who maybe ate their food and then regurgitated it. I'd say it looks a bit like that, Tim. It's not the most appetizing thing. What have I got in front of me? What you've got is fermented soybeans mixed with koji fungus, okay, and salt. So I've got fungus, fermented soybeans, and salt.

56:53So basically, I boiled up a whole bag of soybeans for four hours, and then I got some koji fungus, which is coated on white rice from the internet, mixed them together, added a whole load of salt and put it in a jar, pressed down, left it for three months. So this is more professional. It's definitely different to the garlic and the honey. It took me a while to pluck up the courage to do this, but I was so into my miso. I was spending a fair bit at the store on miso i thought i can do this myself and actually it's really easy to do if you just know the essentials and you've done a bit of fermenting first so the incredible taste of that compared to just a boiled soybean is amazing so i want you to just dip your little finger in there all right and this is a jar full of fungus but professor and dr tim specter says it's safe and i can try it yes you can all right and this is what you should be using instead of your stock cube.

57:55Smells good actually.

57:59Tastes pretty great. It does. And it just shows you, and if you just had boiled soybeans, they are virtually inedible. And so this just shows you how the microbes and the salt and the fungus in the right conditions just were given time will convert this into an absolutely delicious dish. And it's definitely like a layer that tastes a bit like soy sauce within this. Yeah. Well, it's the same basic principle. So there you have it. That's from the easiest to perhaps one of the more complex ones that you need three or six months to make. But you've now got all the tools you need, Jonathan. So Tim, thank you for sort of the tour de force tour around fermenting.

58:42I suspect there are a lot of people listening to this who are now convinced that they should be trying to get their three ferments a day. I'm going to try and do like a little summary as always. And my biggest takeaway is we should all be having more microbes and fungus in our food, which is basically completely opposite of everything that was brought up, which is there should be no microbes and fungus in my food. And that's because we now know that these really help our immune system. And you talked about the study that you carried out yourself at Zoe with like five and a half thousand people who completed this two week study.

59:19and that sort of in just two weeks, half of them had these improvements in mood and energy and hunger and bloating and constipation, which is pretty extraordinary. And that your understanding of the science is this is really the way that it's both improving the microbiome, our gut health, that's then improving our inflammation and therefore having all these effects on our brain. The other thing that I really take away is that everyone is eating live fermented food except Anglo-Saxons. And we're the ones who got told that all our food should be sterile. We've had fridges for much longer than a lot of other cultures.

59:57And therefore, we just got rid of all of our fermented food. And like many other things with our modern food culture, it's turned out to really be bad for our health. And if we can reverse that and start to reintroduce all of these fermented foods, we're going to be a much better place. And if you've been thinking, well, I'm popping a probiotic every day, so I don't need this, then you're saying, actually, that's wrong. These fermented foods are much more powerful than probiotics. And that's because they have many more live bacteria in them, but also because the food itself is also carrying these healthful properties.

1:00:32And this is why for many foods, when we ferment them, they actually become healthier. And so you were giving this example about things like milk, which you're saying, if you're an adult, it's not particularly healthy, and then you can turn it into something like cheese or yogurt, and suddenly it is. And also, and part of this is because we make it so much more complicated. And you said, I shouldn't be scared of the idea that food has all of these chemicals in there. I think you said like 50 or 100 ,000 chemicals. Actually, if these are natural, the things that are just out there in the foods that we're used to eating, they're sort of what my body and my microbes need.

1:01:06If they're being introduced in ultra processed food, then I'm not so interested. And then I think you wrapped up with talking about how could we actually achieve this? And you said, I can get two thirds of the way at breakfast. So if I was to have a breakfast that combined like a full fat yogurt, I actually tend to have a Greek yogurt because it's really high in protein and with kefir mixed, you've already got two of these three. If you were to add like cheese or sauerkraut or something at lunch, you've already got to three and then think about how you could introduce the miso paste, for example, that you just shared with me, which is delicious.

1:01:43Think about drinks like kombucha or water kefir. These are all commercially available now. This is easy to do. There are many of these things which are not really bitter or really hard or really spicy to get into. And if you do this before you know it, your husband or wife will be cross with you too, because you've got 20 fermenting jars in your fridge and you're experimenting with things that take three months. You got it. Tim, thank you so much. Thank you for continuing to always explore the frontiers of food and science and for coming back and telling us all about it. And I would say that if you really want to get deep into this subject, Tim has written a whole new book about it and you can understand everything you would possibly want to know about fermented food there.

1:02:28Thank you, Jonathan. Thank you, Tim. at zoe we never stop being curious about how people respond to food recently we asked thousands of people about breakfast what they eat and how they feel about it their answers may surprise you over 70 percent told us that their breakfast is balanced yet only six percent get enough fiber if you've been listening to this podcast you know that's not enough to be balanced so it's no wonder that only 16 felt energetic after eating and more than half of these thousands of people were hungry again within three hours. Clearly, breakfast is broken. But what if you could get a breakfast that actually supports your energy and keeps you feeling full?

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1:03:47So it's crucial to start building good habits at the start. Get your breakfast fix and try the new formula at zoe.com slash daily 30. Our scientists recently released the latest version of Daily 30, which now includes even more plants, including raspberries, goji berries, fermented green tea kombucha, kale and marine algae. Go to zoe.com slash daily30 to get started. Try it for a week and see how you feel.