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12 Mistakes to Avoid on a Vegetarian or Vegan Diet

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By Rachael Link, MS, RD

A balanced vegetarian or vegan diet can provide many health benefits.

These diets have been associated with weight loss, better blood sugar control, a decreased risk of heart disease and a lower risk of certain types of cancer (1, 2, 3, 4).


However, it can be challenging to maintain a well-rounded vegetarian diet that provides all the nutrients you need.

This article uncovers some of the most common mistakes people make on a vegan or vegetarian diet, and how to avoid them.

Assuming That Vegan or Vegetarian Products Are Automatically Healthier

Unfortunately, just because a food product is labeled "vegetarian" or "vegan" doesn't necessarily mean it's healthier than the regular alternative.

For example, almond milk is a popular, plant-based milk that's often a staple in vegan diets.

However, while almond milk is low in calories and enriched with several important vitamins and minerals, it is not necessarily healthier than cow's milk.

For example, 1 cup (240 ml) of low-fat cow's milk contains 8 grams of protein, while the same amount of unsweetened almond milk contains only 1 gram (5, 6).

Sweetened almond milk can also be high in added sugar, with 16 grams of sugar in just 1 cup (7).

Other vegetarian products, such as soy-based veggie burgers, nuggets and meat alternatives, are often highly processed, with a long list of artificial ingredients. So they're often no healthier than other non-vegetarian processed foods.

Despite being vegetarian, these products are also often high in calories, yet lacking the protein, fiber and nutrients necessary for a balanced meal.

While these products may ease your transition to a vegan or vegetarian diet, it's best to consume them in moderation with a diet rich in nutritious, whole foods.

Summary: Many foods marketed as vegetarian or vegan are often highly processed, high in added sugar or lacking in nutrients. If you include these products in your diet, eat them only in moderation.

Not Getting Enough Vitamin B12

Vitamin B12 plays several important roles in the body. It's important in the creation of red blood cells and DNA, among other processes (8).

Unfortunately, the main sources of vitamin B12 are animal products, such as meat, poultry, shellfish, eggs and milk products.

For this reason, vegetarians have an increased risk of vitamin B12 deficiency (9).

Vitamin B12 deficiency can cause fatigue, memory problems and numbness. It can also lead to megaloblastic anemia, a condition caused by having a lower-than-normal amount of red blood cells (10).

Unfortunately, a high intake of folate can actually mask vitamin B12 deficiency, hiding symptoms until the damage becomes irreversible (11).

However, there are foods and supplements available that can help vegetarians meet their vitamin B12 needs.

Besides animal products, fortified foods and certain types of edible algae also contain vitamin B12 (12, 13).

Vegetarians should monitor their vitamin B12 intake carefully and consider taking supplements if their needs aren't met through diet alone.

Summary: Vegetarians and vegans are at a greater risk of vitamin B12 deficiency, so make sure you consume fortified foods or B12 supplements.

Replacing Meat With Cheese

One of the easiest ways to make nearly any dish vegetarian is to take out the meat and replace it with cheese. When it comes to flavor, the swap works well for sandwiches, salads, pasta and many other dishes.

However, while cheese does contain a good amount of protein, vitamins and minerals, it doesn't replace the wide assortment of nutrients found in meat.

One ounce (28 grams) of beef, for example, contains four times the amount of iron and double the zinc found in one ounce of cheddar cheese (14, 15).

Cheese also contains less protein and more calories than meat.

In fact, ounce-for-ounce, cheese contains only about 80 percent of the protein found in chicken, but nearly 2.5 times the calories (15, 16).

Instead of simply replacing meat with cheese, you should include a variety of plant foods in your diet to meet your nutrient needs.

Chickpeas, quinoa, tempeh, lentils, beans and nuts are all excellent options to help round out a vegetarian diet.

Summary: Instead of just replacing meat with cheese, make sure to also include a diverse range of plant foods in your diet to provide important nutrients.

Eating Too Few Calories

Many foods and food groups are off-limits for vegans and vegetarians, which can make it challenging for them to meet their calorie needs.

In fact, vegans and vegetarians tend to eat fewer calories than people who eat both meat and plants.

One study compared the nutritional quality of 1,475 people's diets, including vegans, vegetarians, vegetarians who ate fish, people who ate both meat and plants and people who ate meat only once a week.

Vegans had the lowest calorie intake across all the groups, consuming 600 fewer calories than people who ate both meat and plants.

Vegetarians had a slightly higher calorie intake than vegans, but still consumed 263 fewer calories than people who ate both meat and plants (17).

Calories are the main source of energy for the body, and your body needs a certain amount to function. Restricting calories too much can lead to several negative side effects, such as nutrient deficiencies, fatigue and a slower metabolism (18, 19, 20).

Summary: Vegans and vegetarians tend to have a lower calorie intake than people who eat meat and plants. If you're following either of these diets, make sure you're meeting your calorie needs.

Not Drinking Enough Water

Drinking enough water is important for everyone, but may be especially important for those who eat a lot of fiber, including vegetarians and vegans.

Vegetarians tend to have a higher fiber intake, since fiber-rich legumes, vegetables and whole grains are staples in a healthy vegetarian diet.

One study found that people who eat both meat and plants eat about 27 grams of fiber per day, while vegans and vegetarians eat about 41 grams and 34 grams, respectively (17).

Drinking water with fiber is important because it can help fiber move through the digestive tract and prevent issues like gas, bloating and constipation.

Fiber consumption is incredibly important for health, and has been linked to a decreased risk of heart disease, stroke, diabetes and obesity (21).

Current guidelines recommend women consume at least 25 grams of fiber per day, and men consume at least 38 grams (22).

To make sure you're drinking enough water, drink when you feel thirsty, and spread your water intake throughout the day to stay hydrated.

Summary: Vegans and vegetarians usually eat a lot of fiber. Drinking enough water can help prevent digestive problems associated with increased fiber intake, such as gas, bloating and constipation.

Forgetting About Iron

Meat is a good source of many important vitamins and minerals, including iron.

For example, a 3-ounce (85-gram) serving of ground beef supplies 14 percent of the iron you need for the entire day (14).

Also, meat contains heme iron, a type of iron your body can absorb easily.

Plant sources of iron contain non-heme iron, which your body can't absorb as easily. Non-heme iron is present in many types of fruits, vegetables, cereals and beans (23).

Because of this, vegetarians have a greater risk of developing iron-deficiency anemia, a condition in which there are not enough red blood cells in the body. Symptoms include fatigue, shortness of breath and dizziness (24).

However, a well-planned vegetarian diet filled with iron-rich plant foods can meet your daily needs.

If you're a vegetarian or vegan, make sure to consume plenty of good sources of iron, including lentils, beans, fortified cereals, nuts, seeds, oats and leafy greens.

Additionally, pairing iron-rich foods with foods high in vitamin C can enhance the absorption of non-heme iron (25).

Vitamin C is found in most fruits and vegetables, so including a vegetable side dish, salad or piece of fruit with your meals can help increase iron absorption.

Summary: Plant foods contain non-heme iron, which the body can't absorb as well as the heme iron found in meat. Vegetarians should include iron-rich foods in the diet and pair them with vitamin C to increase absorption.

Not Eating Enough Whole Foods

Just because a food product is vegetarian or vegan doesn't mean it's good for you.

There are plenty of processed foods available at the grocery store that are free of meat or animal products. However, they often contribute little to your diet.

Instead of eating these, use your vegetarian diet as an opportunity to reduce your consumption of processed foods and increase your intake of nutrient-dense, whole foods, such as fruits, vegetables and whole grains.

Increasing your intake of these foods will help you get the valuable vitamins, minerals and antioxidants you need to help prevent nutrient deficiencies.

Eating whole foods rather than processed foods may give you other benefits too, such as an increased metabolism.

One study measured the metabolism of 17 participants after they ate a meal made with either processed foods or whole foods.

Both groups felt equally full after the meal, but the group that ate the whole foods burned nearly double the calories after their meal than the group that ate the processed foods (26).

To start including more whole foods in your diet, swap out refined grains for whole grains, and limit the amount of processed and convenience foods you eat.

Additionally, try adding more vegetables and fruits to your meals and snacks throughout the day.

Summary: Vegetarian diets should be rich in whole foods, such as fruits, vegetables and whole grains. They'll help you maximize nutrient intake and promote a balanced diet.

Consuming a Diet Low in Calcium

Calcium is an important mineral your body needs to keep your bones and teeth strong, help your muscles work efficiently and support the function of your nervous system (27).

A calcium deficiency can lead to osteoporosis, a condition that causes weak, porous bones and increases the risk of bone fractures (28).

Though calcium is found in a variety of foods, the most well-known source of calcium is dairy products.

Those who don't consume dairy should monitor their calcium intake and include other high-calcium foods in their diet.

Calcium-rich plant foods include kale, collard greens, broccoli, bok choy, almonds, figs and oranges. Fortified foods can also be a good source of calcium.

You can get all the calcium you need by incorporating a few servings of these foods into your meals and snacks throughout the day.

Summary: Those who don't consume milk or dairy products should consume other calcium-rich foods to meet their calcium needs.

Underestimating the Importance of Meal Planning

Whether you're cooking at home or dining out, eating vegetarian or vegan requires some extra planning.

Meal plans are especially useful if you're currently changing your diet to be vegetarian or vegan.

They can help ease your transition and make it easier to maintain a balanced and nutritious diet.

When you're eating out or traveling, advanced meal planning becomes especially important.

Some restaurants offer limited choices for vegetarians, so looking at the menu in advance can help you make informed decisions and select the most nutritious choices available.

Additionally, make it a habit to find a few vegetarian recipes each week and cook them on your own.

Summary: Planning meals ahead of time and knowing what your options are when dining out can ensure you maintain a diverse and balanced diet.

Not Eating Enough Protein-Rich Foods

Protein is an essential part of the diet. Your body uses it to help build tissue, create enzymes and produce hormones.

Studies show that eating protein can also promote feelings of fullness, increase muscle mass and reduce cravings (29, 30, 31).

Current recommendations suggest adults should eat at least 0.8 grams of protein per day for every 2.2 pounds (1 kg) of body weight (32).

For example, an individual who is 154 lbs (70 kg) would need approximately 56 grams of protein per day.

If you're eating animal-based foods, you'll probably find it easy to fulfill this requirement.

A 3-ounce (85-gram) serving of salmon contains 19 grams of protein, while the same amount of roasted chicken provides 27 grams (33, 16).

On the other hand, if you're following a vegetarian diet, you may need to make a more conscious effort to eat high-protein foods that will help you meet your protein requirements.

There are plenty of plant foods that contain an amount of protein comparable to the amount you'd find in meat. For example, 1 cup (198 grams) of cooked lentils contains 18 grams of protein (34).

Beans, lentils, nuts, nut butters, tofu and tempeh can all up your daily protein intake.

Try to incorporate at least one or two of these foods into each meal to make sure you're getting enough protein.

Summary: Vegetarians should be mindful of protein intake and include one or two servings of high-protein plant foods with each meal.

Not Getting Enough Omega-3 Fatty Acids

Omega-3 fatty acids are an essential part of the diet.

They have been shown to reduce blood triglycerides, alleviate inflammation and protect against dementia (35, 36, 37).

Fatty fish and fish oil are the most common sources of omega-3 fatty acids.

They contain docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), the two forms of omega-3 fatty acids that have been shown to be the most beneficial.

On the other hand, plant foods contain alpha-linolenic acid (ALA), a type of omega-3 fatty acid that your body must convert to DHA and EPA to use (38).

Unfortunately, your body is only able to convert about 5 percent of ALA to EPA and less than 0.5 percent to DHA (39).

To meet your omega-3 needs while following a vegetarian diet, eat a good amount of ALA-rich foods or consider taking a plant-based omega-3 supplement like algal oil.

Foods highest in ALA omega-3 fatty acids include chia seeds, walnuts, hemp seed, flaxseeds, Brussels sprouts and perilla oil.

Including a few servings of these foods in your diet each day can easily help you meet your omega-3 fatty acid needs.

Summary: Plant foods contain ALA, a type of omega-3 fatty acid that your body can only use in small amounts. Vegetarians should consume a good amount of ALA-rich foods, or use a plant-based supplement.

Eating Too Many Refined Carbs

Many vegetarians fall into the trap of replacing meat with refined carbs.

Unfortunately, pasta, bread, bagels, cakes and crackers often end up as main ingredients in a poorly planned vegetarian diet.

During processing, refined grains are stripped of the beneficial fiber that is found in whole grains.

Fiber helps ward off chronic disease, keeps you feeling full and slows the absorption of sugar to maintain steady blood sugar levels (21, 40).

A high intake of refined carbs has been linked to a greater risk of diabetes, as well as an increase in belly fat (41, 42).

To maximize the nutrients in your diet, switch out refined grains like white bread, pasta and white rice for whole grains such as quinoa, oats, brown rice and buckwheat.

Additionally, make sure you're pairing those whole grains with plenty of whole fruits, vegetables and legumes to keep your diet balanced and nutritious.

Summary: Instead of replacing meat with a lot of refined carbs, vegetarians should consume whole grains as part of a healthy diet.

The Bottom Line

A balanced vegan or vegetarian diet can be very healthy and nutritious.

However, these diets can also lead to nutrient deficiencies and potential health problems if they aren't well-planned.

If you're just getting started eating this way, check out this article.

To achieve a healthy vegan or vegetarian diet, simply eat plenty of whole foods and make sure you're regularly consuming a few key nutrients.

Reposted with permission from our media associate Authority Nutrition.

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Guillain-Barre syndrome occurs when the body's own immune system attacks and injures the nerves outside of the spinal cord or brain – the peripheral nervous system. Niq Steele / Getty Images

By Sherry H-Y. Chou, Aarti Sarwal and Neha S. Dangayach

The patient in the case report (let's call him Tom) was 54 and in good health. For two days in May, he felt unwell and was too weak to get out of bed. When his family finally brought him to the hospital, doctors found that he had a fever and signs of a severe infection, or sepsis. He tested positive for SARS-CoV-2, the virus that causes COVID-19 infection. In addition to symptoms of COVID-19, he was also too weak to move his legs.

When a neurologist examined him, Tom was diagnosed with Guillain-Barre Syndrome, an autoimmune disease that causes abnormal sensation and weakness due to delays in sending signals through the nerves. Usually reversible, in severe cases it can cause prolonged paralysis involving breathing muscles, require ventilator support and sometimes leave permanent neurological deficits. Early recognition by expert neurologists is key to proper treatment.

We are neurologists specializing in intensive care and leading studies related to neurological complications from COVID-19. Given the occurrence of Guillain-Barre Syndrome in prior pandemics with other corona viruses like SARS and MERS, we are investigating a possible link between Guillain-Barre Syndrome and COVID-19 and tracking published reports to see if there is any link between Guillain-Barre Syndrome and COVID-19.

Some patients may not seek timely medical care for neurological symptoms like prolonged headache, vision loss and new muscle weakness due to fear of getting exposed to virus in the emergency setting. People need to know that medical facilities have taken full precautions to protect patients. Seeking timely medical evaluation for neurological symptoms can help treat many of these diseases.

What Is Guillain-Barre Syndrome?

Guillain-Barre syndrome occurs when the body's own immune system attacks and injures the nerves outside of the spinal cord or brain – the peripheral nervous system. Most commonly, the injury involves the protective sheath, or myelin, that wraps nerves and is essential to nerve function.

Without the myelin sheath, signals that go through a nerve are slowed or lost, which causes the nerve to malfunction.

To diagnose Guillain-Barre Syndrome, neurologists perform a detailed neurological exam. Due to the nerve injury, patients often may have loss of reflexes on examination. Doctors often need to perform a lumbar puncture, otherwise known as spinal tap, to sample spinal fluid and look for signs of inflammation and abnormal antibodies.

Studies have shown that giving patients an infusion of antibodies derived from donated blood or plasma exchange – a process that cleans patients' blood of harmful antibodies - can speed up recovery. A very small subset of patients may need these therapies long-term.

The majority of Guillain-Barre Syndrome patients improve within a few weeks and eventually can make a full recovery. However, some patients with Guillain-Barre Syndrome have lingering symptoms including weakness and abnormal sensations in arms and/or legs; rarely patients may be bedridden or disabled long-term.

Guillain-Barre Syndrome and Pandemics

As the COVID-19 pandemic sweeps across the globe, many neurologic specialists have been on the lookout for potentially serious nervous system complications such as Guillain-Barre Syndrome.

Though Guillain-Barre Syndrome is rare, it is well known to emerge following bacterial infections, such as Campylobacter jejuni, a common cause of food poisoning, and a multitude of viral infections including the flu virus, Zika virus and other coronaviruses.

Studies showed an increase in Guillain-Barre Syndrome cases following the 2009 H1N1 flu pandemic, suggesting a possible connection. The presumed cause for this link is that the body's own immune response to fight the infection turns on itself and attacks the peripheral nerves. This is called an "autoimmune" condition. When a pandemic affects as many people as our current COVID-19 crisis, even a rare complication can become a significant public health problem. That is especially true for one that causes neurological dysfunction where the recovery takes a long time and may be incomplete.

The first reports of Guillain-Barre Syndrome in COVID-19 pandemic originated from Italy, Spain and China, where the pandemic surged before the U.S. crisis.

Though there is clear clinical suspicion that COVID-19 can lead to Guillain-Barre Syndrome, many important questions remain. What are the chances that someone gets Guillain-Barre Syndrome during or following a COVID-19 infection? Does Guillain-Barre Syndrome happen more often in those who have been infected with COVID-19 compared to other types of infections, such as the flu?

The only way to get answers is through a prospective study where doctors perform systematic surveillance and collect data on a large group of patients. There are ongoing large research consortia hard at work to figure out answers to these questions.

Understanding the Association Between COVID-19 and Guillain-Barre Syndrome

While large research studies are underway, overall it appears that Guillain-Barre Syndrome is a rare but serious phenomenon possibly linked to COVID-19. Given that more than 10.7 million cases have been reported for COVID-19, there have been 10 reported cases of COVID-19 patients with Guillain-Barre Syndrome so far – only two reported cases in the U.S., five in Italy, two cases in Iran and one from Wuhan, China.

It is certainly possible that there are other cases that have not been reported. The Global Consortium Study of Neurological Dysfunctions in COVID-19 is actively underway to find out how often neurological problems like Guillain-Barre Syndrome is seen in hospitalized COVID-19 patients. Also, just because Guillain-Barre Syndrome occurs in a patient diagnosed with COVID-19, that does not imply that it was caused by the virus; this still may be a coincident occurrence. More research is needed to understand how the two events are related.

Due to the pandemic and infection-containment considerations, diagnostic tests, such as a nerve conduction study that used to be routine for patients with suspected Guillain-Barre Syndrome, are more difficult to do. In both U.S. cases, the initial diagnosis and treatment were all based on clinical examination by a neurological experts rather than any tests. Both patients survived but with significant residual weakness at the time these case reports came out, but that is not uncommon for Guillain-Barre Syndrome patients. The road to recovery may sometimes be long, but many patients can make a full recovery with time.

Though the reported cases of Guillain-Barre Syndrome so far all have severe symptoms, this is not uncommon in a pandemic situation where the less sick patients may stay home and not present for medical care for fear of being exposed to the virus. This, plus the limited COVID-19 testing capability across the U.S., may skew our current detection of Guillain-Barre Syndrome cases toward the sicker patients who have to go to a hospital. In general, the majority of Guillain-Barre Syndrome patients do recover, given enough time. We do not yet know whether this is true for COVID-19-related cases at this stage of the pandemic. We and colleagues around the world are working around the clock to find answers to these critical questions.

Sherry H-Y. Chou is an Associate Professor of Critical Care Medicine, Neurology, and Neurosurgery, University of Pittsburgh.

Aarti Sarwal is an Associate Professor, Neurology, Wake Forest University.

Neha S. Dangayach is an Assistant Professor of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai.

Disclosure statement: Sherry H-Y. Chou receives funding from The University of Pittsburgh Clinical Translational Science Institute (CTSI), the National Institute of Health, and the University of Pittsburgh School of Medicine Dean's Faculty Advancement Award. Sherry H-Y. Chou is a member of Board of Directors for the Neurocritical Care Society. Neha S. Dangayach receives funding from the Bee Foundation, the Friedman Brain Institute, the Neurocritical Care Society, InCHIP-UConn Center for mHealth and Social Media Seed Grant. She is faculty for emcrit.org and for AiSinai. Aarti Sarwal does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Reposted with permission from The Conversation.


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By Jake Johnson

Unity Task Forces formed by presumptive Democratic presidential nominee Joe Biden and Sen. Bernie Sanders unveiled sweeping party platform recommendations Wednesday that—while falling short of progressive ambitions in a number of areas, from climate to healthcare—were applauded as important steps toward a bold and just policy agenda that matches the severity of the moment.

"We've moved the needle a lot, especially on environmental justice and upping Biden's ambition," said Sunrise Movement co-founder and executive director Varshini Prakash, a member of the Biden-Sanders Climate Task Force. "But there's still more work to do to push Democrats to act at the scale of the climate crisis."

The climate panel—co-chaired by Rep. Alexandria Ocasio-Cortez (D-N.Y.) and former Secretary of State John Kerry—recommended that the Democratic Party commit to "eliminating carbon pollution from power plants by 2035," massively expanding investments in clean energy sources, and "achieving net-zero greenhouse gas emissions for all new buildings by 2030."

In a series of tweets Wednesday night, Ocasio-Cortez—the lead sponsor of the House Green New Deal resolution—noted that the Climate Task Force "shaved 15 years off Biden's previous target for 100% clean energy."

"Of course, like in any collaborative effort, there are areas of negotiation and compromise," said the New York Democrat. "But I do believe that the Climate Task Force effort meaningfully and substantively improved Biden's positions."

 

The 110 pages of policy recommendations from the six eight-person Unity Task Forces on education, the economy, criminal justice, immigration, climate change, and healthcare are aimed at shaping negotiations over the 2020 Democratic platform at the party's convention next month.

Sanders said that while the "end result isn't what I or my supporters would've written alone, the task forces have created a good policy blueprint that will move this country in a much-needed progressive direction and substantially improve the lives of working families throughout our country."

"I look forward to working with Vice President Biden to help him win this campaign," the Vermont senator added, "and to move this country forward toward economic, racial, social, and environmental justice."

Biden, for his part, applauded the task forces "for helping build a bold, transformative platform for our party and for our country."

"I am deeply grateful to Bernie Sanders for working with us to unite our party and deliver real, lasting change for generations to come," said the former vice president.

On the life-or-death matter of reforming America's dysfunctional private health insurance system—a subject on which Sanders and Biden clashed repeatedly throughout the Democratic primary process—the Unity Task Force affirmed healthcare as "a right" but did not embrace Medicare for All, the signature policy plank of the Vermont senator's presidential bid.

Instead, the panel recommended building on the Affordable Care Act by establishing a public option, investing in community health centers, and lowering prescription drug costs by allowing the federal government to negotiate prices. The task force also endorsed making all Covid-19 testing, treatments, and potential vaccines free and expanding Medicaid for the duration of the pandemic.

"It has always been a crisis that tens of millions of Americans have no or inadequate health insurance—but in a pandemic, it's potentially catastrophic for public health," the task force wrote.

Dr. Abdul El-Sayed, a former Michigan gubernatorial candidate and Sanders-appointed member of the Healthcare Task Force, said that despite major disagreements, the panel "came to recommendations that will yield one of the most progressive Democratic campaign platforms in history—though we have further yet to go."

 

Observers and advocacy groups also applauded the Unity Task Forces for recommending the creation of a postal banking system, endorsing a ban on for-profit charter schools, ending the use of private prisons, and imposing a 100-day moratorium on deportations "while conducting a full-scale study on current practices to develop recommendations for transforming enforcement policies and practices at ICE and CBP."

Marisa Franco, director of immigrant rights group Mijente, said in a statement that "going into these task force negotiations, we knew we were going to have to push Biden past his comfort zone, both to reconcile with past offenses and to carve a new path forward."

"That is exactly what we did, unapologetically," said Franco, a member of the Immigration Task Force. "For years, Mijente, along with the broader immigrant rights movement, has fought to reshape the narrative around immigration towards racial justice and to focus these very demands. We expect Biden and the Democratic Party to implement them in their entirety."

"There is no going back," Franco added. "Not an inch, not a step. We must only move forward from here."

Reposted with permission from Common Dreams.

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