Category Archives: Colon Cancer

Links between Obesity, Diabetes, and Colon Cancer

By Hui Xie-Zukauskas

Links 3 conditions_CPDColorectal cancer remains the 3rd most common cancer and is the 2nd leading cause of cancer-related deaths in the United States.

The causes of colon cancer are multi-factorial. They include cellular, molecular, and genetic factors, as well as dietary and lifestyle factors. Today, I’m going to focus on one significant yet modifiable risk factor, obesity.

We start with a glimpse at the numbers.

The incidence rate of obesity is alarmingly high among U.S. adults based on CDC data. Rates for different age groups include middle-aged (40.2%), older (37.0%), and younger (32.3%). Also, about 17% of children and adolescents (age 2-19) are obese.

More than 29 million adults and children in the U.S. have diabetes. 86 million Americans have pre-diabetes, a condition that can lead to type-2 diabetes. Note that an estimated one in two seniors has pre-diabetes.

Obesity may be a factor in approximately 300,000 deaths each year. Diabetes will cause an estimated 75,578 deaths and colorectal cancer, an expected 49,190 deaths in 2016.

A look beyond the numbers

Obesity is a leading cause of diabetes, a disease for which the body fails to control blood sugar levels. High blood sugar levels are characteristic of both obesity and diabetes. What is less well known is that diabetes and obesity are also linked to an increase in cancer risk.

In fact, obesity is linked to many types of cancer (colon, esophageal, thyroid, breast, prostate, uterine, kidney, pancreas, gallbladder and non-Hodgkins lymphoma) and, needless to say, heart disease, stroke, and other chronic illnesses.

Research shows that obesity and diabetes are associated with an increased risk of developing colon cancer.

Intrinsic links between obesity, diabetes, and colon cancer are vastly complicated. One clear tie is sugar. High levels of blood sugar are a characteristic in both obesity and diabetes. High blood sugar also makes us predisposed to cancer by increasing the activity of a gene involved in cancer progression. Apparently, dietary sugar is a link tying together obesity, diabetes, and colon cancer, and thus excess sugar has an impact on our risk for cancer.

Certainly, other links play a causal role. For instance, chronic inflammation is a central process that likely leads obese individuals to an elevated risk of diabetes and colon cancer, which all three conditions share a common inflammatory loop participated by multiple cell signaling molecules, growth and nuclear factors.

Highlighted Call for Actions

1. Colon Cancer screening

If you or your loved ones turn 50, you all should begin screening for colorectal cancer and then continue getting screened at regular intervals. This is because colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Colorectal polyps can be found by screening and then removed before they develop into cancers. Plus, any developing cancer can be found earlier by screening when treatment works best.

2. Diabetes Control

Early intervention is critical to preventing or delaying the onset of type-2 diabetes. Good news for our nation’s seniors is that Medicare will extend coverage for pre-diabetes care. Check out the National Diabetes Prevention Program, a preventive health initiative via the Center for Medicare & Medicaid Innovation.

3. Healthy Weight Management

Nutrition and balance diet, weight loss, daily physical activity and healthy lifestyle are all beneficial for keeping weight down. Look for further details in CancerPreventionDaily earlier posts.

In brief, obese people are at a higher risk for developing cancer. Also, an obese condition is often resistant to chemotherapy regimens. The bottom line is that obesity prevention is a key life-saving approach.

 

Image source: CancerPreventionDaily

The Best Way to Prevent Colon Cancer: Know Your Risk First

By Hui Xie-Zukauskas

Colon cancer remains the second leading cause of cancer deaths in the United States. Fortunately, it cancer is preventable especially by living a healthy lifestyle.

What can you do to prevent colon cancer?

There could be overwhelmed information and many things you can do for colon cancer prevention. However, one sure-fire step is to know risk factors of colon cancer. For those who are unaware of what risks are, let’s go through it.

1.     Age

Colorectal cancer risk increases after age 50. As you get older, your risk of colorectal cancer gets higher. More than 90% of this disease are diagnosed after age 50.

Colon cancer n polyp_MedincineNet2.     Colon polyps

Polyps are small growth in the colon or rectum. Most of them are not cancerous, but some can become cancer and they are commonly seen in people over age 50.The risk of colorectal cancer increases with the presence of polyps. Some polyps are inherited such as seen in familial adenomatous polyposis (FAP), which can measurably increase colorectal cancer risk.

That is why early detection by colon cancer screening is vitally important. A colonoscopy remains the gold standard for screening, because it provides the best view of your entire colon and cancerous polyp(s) can be removed during the procedure.

3.     Family or personal history of cancer

Having biologically close relatives (parents, brothers, sisters, or children) with colon cancer doubles your risk of colon cancer. Previous personal history of cancer or any inflammatory bowel disease increases your risk of colorectal cancer too.

 4.     Obesity

Obesity has been linked to a higher risk of certain cancers including colorectal cancer.

5.     Physical inactivity

Sedentary behavior or lifestyle has been linked to diabetes, obesity, and cardiovascular disease. It can also increase the risk of several cancers including colorectal cancer. So, you may want to examine your TV viewing time, internet surfing time, recreational and/or occupational sitting time, and might be surprised by your total sitting time!

6.     Imbalanced gut bacteria

Growing evidence has pointed to how bacteria may influence the risk for cancer. Millions of microbes in your gut interact with your immune system, some are beneficial, but some are harmful. Experts believe that when bad bacteria overruns your digestive system, you might suffer from inflammatory bowel diseases, and may also be at a higher risk for colorectal cancer, because bad bacteria generate waste products that harm colon tissues and make them more vulnerable to malignancies.

 7.     Tobacco smoking

Cigarette smoking has been linked to a higher risk for several types of cancer; colon cancer is among them.

8.     Heavy alcohol consumption

Colorectal cancer has been linked to heavy intake of alcohol. The fact is that heavy alcohol users tend to have low levels of folic acid in their bodies. Most studies in humans indicate a clear link between colorectal cancer development and inadequate folate consumption. Furthermore, research has shown that folate deficiency increases DNA damage by decreasing the expression of two genes involved in DNA repair.

9.     Diet low in fiber but high in red meats

Surely, it is not clear how much diet might contribute to an increased risk of colon cancer. However, a diet that is high in red meats (e.g. beef, pork, lamb, or liver) and processed meats (such as hot dogs) can increase colorectal cancer risk. Again, a balanced, fiber-rich diet with a lot of vegetables can protect your colon from cancer.

Furthermore, if you are at age of 50+, you can assess your colorectal cancer risk using this interactive tool provided by NCI.

One more point, please be aware that some of these risks are potentially enhanced in modern society. For examples, TV watching is often associated with drinking sweetened beverages and eating junk foods. Sitting in your car during the long commute frequently comes with stress. Overall, these risk factors have a detrimental impact on colon cancer development.

So, what is the next? Take action, be proactive to optimize your colon health, and stop colon cancer NOW!

Image credits: By http://www.medicinenet.com

How Fiber Protects You Against Colon Cancer: New Evidence

By Hui Xie-Zukauskas

You’ve heard that consuming enough fiber can protect you from colon cancer. Do you know why? Today, I’d like to help you understand why fiber could be your secret weapon to fight colon cancer, based on some new research evidence.

Fiber in ColonThe top secret: It’s in a receptor termed G-protein-coupled receptor 109A (GPR109A), as outlined in this schematic illustration. The question is how it plays a role in colon cancer. In other words, how does this receptor, GPR109A, carry out the mission?

First, GPR109A is a tumor suppressor, which means it protects a cell from its progression to cancer, just as a brake in a car. It is located on the colon epithelial cells, the cells covering the surface of your gastrointestinal tract (and of course, other cavities in the body). Like other receptors, GPR109A needs the binding of a ligand (i.e. a lock and key contact) to form a biochemical complex then subsequently alter the receptor conformation and cellular function.

Next, what is the ligand (the key) for GPR109A (the lock)? In this case, GPR109A recognizes not only nicotinate / niacin but also butyrate, a product from bacteria fermentation of dietary fiber.

Now, let’s focus on butyrate.

When butyrate binds to GPR109A, the activation of this receptor triggers a signaling pathway that can set off –

-    the immune cells in the colon to produce anti-inflammatory molecules.

-    the same immune cells to communicate with T-cells, a group of specialized defenders to fight different germs and infections and to strengthen your immunity.

-    the epithelial cells to produce and release cytokines. Cytokines are proteins that regulate immune system and adaptive immune responses.

Here is good news – these events happen only in the colon! So, if you consume plenty of fiber-rich foods, with the aid of good bacteria in the colon to digest them, you’ll have a sufficient supply of butyrate.

This provides one more reason why fiber-rich foods promote your colon health. Collectively from research findings, plant-based foods’ intake has been inversely associated with the risk of colon cancer. A higher intake of vegetables has also been associated with a lower risk of colon cancer.

Niacin also activates GPR109A, which might explain why other nutrients such as niacin (vitamin B3) from plant-based foods has been linked to a reduced risk of colon cancer. Noticeably, niacin has been used as a cholesterol-lowering drug, but serious side effects may occur at a higher dosage, and a prescription from your doctor is needed.

In brief, butyrate- or niacin-activated GPR109A signaling can suppress chronic inflammation and promote cancer prevention. Ultimately, you need plant-based, fiber-rich foods to defend colon cancer.

 

How to Consume Enough Daily Fiber for Cancer Prevention

By Hui Xie-Zukauskas

Imagine a fiber’s tale. “I am a fiber, and my nickname is “Tough Carb”. Together with my sibling soluble and insoluble kinds, I am largely wrapped up in foods like fruits, vegetables and whole grains. Passing through your body, I bind with fats, help nutrients get better absorbed, move the bulk through the intestines, and promote a faster traffic to eliminate the waste your body doesn’t want. At the end, I still survive – remaining unbroken.”

What a fabulous job done by a “personal healthcare agent”! Well, I have more good news for you – Research indicates that a diet high in fiber can lower colon cancer risk. Specifically, every 10 grams of daily fiber intake reduces the risk of colon cancer by 10%.

Now the questions are how much fiber you need each day and how you can meet your goal to prevent colon cancer? Here I offer 5 meal-strategies that can help you effortlessly incorporate fiber into your daily diet and support the healthier, happier colon.

How much fiber do we need?

It is recommended that we eat 25-35 grams (g) of fiber per day. Sounds impossible or difficult? Don’t worry. A rule of thumb is – consume at least 5 servings of fruits and vegetables and 3 servings of whole grains each day. This is based on the fact that fiber is abundant in whole grains, fruits and vegetables, nuts and legumes.

Fiber-rich breakfast ideasHow do you integrate 25-35 g of fiber into your diet on a daily basis?

Here are 5 meal-strategies to get your 25-35 grams each day with ease:

1. Breakfast: Have oatmeal or high-fiber cereal, fiber-rich breads or English Muffins, and more desirable, add fruits.

Breakfast is the most important meal of a day. However, many people skip it. Think about this. A cup of rolled oats (dry) contains nearly 10 g of fiber, and Quaker Instant Oatmeal (3 g of fiber per pack) is also available in all grocery stores. So, if you have 2 packages of oatmeal (6 g of fiber), a slice of whole wheat bread (5-6 g of fiber per slice; depending on brands), and add some fruits like berries, bananas or raisins to your cereal or oatmeal (extra 1-2 g fiber), you’ve got a nice jumpstart, and it’s not hard. Plus, a bonus gain – fiber can boost your energy for a fantastic day ahead!

Broccoli_10972132. Lunch: Eat plenty of veggies and beans. Use whole wheat or whole grain bread to make your sandwiches. Have an apple as a part of salad or desert. Broccoli, one of anti-cancer foods, holds a good supply of fiber; 4.0 g per ½ cup (raw), 5.0 g in 4 spears (frozen) and 9.3 g per cup (fresh, cooked). Beans and fish (esp. salmon) are also excellent protein sources to replace animal meat.

3. Dinner: Eat whole-wheat pasta, brown rice or potato (with skin), plus a variety of vegetables and olive oil. Add beans to your soup. Do you know cooked black beans contain 19.4 g of fiber per cup? How about whole-wheat pasta with chicken and colorful veggies?

whole-wheat-fig-bar4. Snacks: Take All-bran, Multi-grain crackers or high-fiber bars, fresh or dried fruits, as well as nuts and seeds, when you on the go. Fig is one of the highest fiber sources. Try Nature Bakery’s Whole Wheat Figgy Bars or Whole Wheat Blueberry Figgy Bars, they are individually-wrapped, delicious, and reward you another 2-4 g of fiber (2 g fiber per serving, 2 serving per pack). (But I’m not paid for “Ads”. :) )

5. Drinks: Drink more fruit/Veggie juice (fiber-rich) or soy milk (1-1.5 g of diary fiber in per 8 oz cup). See Martha Stewart’s recipes of making delicious green juice at home, which are affordable too.

Eventually, it’s your choice to include foods you desire. But the key is to eat a lot of fiber-rich foods (i.e. plan-based food).

Some folks consider that healthy foods taste boring, especially those from the grocery stores. I sympathize that, and the fix is – to get fresh fruits and vegetables from your local farmers’ market; those foods are yummy and refreshing!

As a final note, a balanced, fiber-rich diet is not the only tool to prevent colon cancer; exercise should go hand-in-hand with it.

 

Image credit: By aaronsg, quakeroats.com, rachelg, lockstockb, and naturesbakery.com

Red and Processed Meats Increase Colon Cancer Risk

By Hui Xie-Zukauskas

Red meat_bunch-of-steak-801548-mIf you eat a lot of red meat or processed meat, you may decide to think twice before the next time you partake. This is because research has shown that a diet high in red and processed meats is associated with an increased risk of colon cancer. This post offers you a focused and updated outlook on some of the reasons for this association.

So, what are we talking about? Red meats include beef, pork, veal, and lamb. Processed meats include hot dogs, bologna, sausages, salami, ham, bacon, hamburger patties, and tinned meat. Colon cancer has been found to be more common among people who have a high daily intake of these kinds of meats. A high intake is considered a daily consumption of red and processed meats that exceeds 5 ounces (about 140 grams).

Why are red and processed meats linked to colon cancer?

1.  Cancer-promoting compounds in the meat:

The harmful substances in these meats are mainly animal-based proteins and heme. Animal-based protein may amplify the expression and activation of cancer-causing genes. Furthermore, red meat, but not veggies, contains heme iron that causes oxidative stress and facilitates the production of carcinogenic N-nitroso compounds, which have been linked to cancer of various organs including the colon.

2.  Cancer-causing agents generated from cooking the meat:

Cooking meat at high temperatures (> 400oF) or on an open flame produces heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs); both are potent carcinogens. These chemicals have toxic effects on the genes and on the metabolism of the large intestine.

3.  Cancer-causing aspects in digesting the meat:

Undigested proteins in the large intestine can increase bacterial fermentation and produce bacterial metabolites, disrupting a balanced and healthy colon cell lining and causing inflammation. The resulting damage to the large intestine significantly increases colon cancer risk.

There still remains much to be learned about exactly how red and processed meat consumption causes colon cancer, but there is some good news for meat lovers, which is that some meats are not linked to colon cancer. These include poultry meats (e.g., chicken, duck, and turkey) and fish (especially salmon, which may even reduce colon cancer risk). As for red meat, it is suggested that bison could be a healthier alternative to other red meat.

 

Reference: Kim E, Coelho D, Blachier F. Review of the association between meat consumption and risk of colorectal cancer. Nutr Res. 2013;33:983-94.

Image credit: By koosswans

Dos and Don’ts to Control Weight and Defend Colon Cancer

By Hui Xie-Zukauskas

Obesity_DT_1341867955b7W3ZfLet’s face the facts first.

An estimated over 60% of Americans and about 2.3 billion people worldwide are overweight and/or obese.

Growing scientific evidence supports a strong link between obesity and colorectal cancer. Obese individuals (BMI > 30) have a 20-40% greater risk to develop colon cancer than those with normal weight (BMI < 25).

Most people don’t realize that obesity increases the risk of colon cancer, though knowing that obesity causes serious health problems such as heart disease and diabetes.

To defend colon cancer, it’s critical to maintain a healthy weight. The following Dos and Don’ts are your guide for strategic weight management:

Do eat plenty of vegetables, fruits and a balanced diet.
Antioxidants, particularly carotenoids, zeaxanthin, and resveratrol are your best defense against colon cancer and other cancers as well. These cancer-fighting nutrients and vitamins can be obtained from a diet high in vegetables, fruits, and whole wheat, and low in red or processed meats, sugar, and refined grains.

Do intake high-fiber food.

Do drink sufficient water daily.

Do drink tea, e.g. green tea.
Catechins from Green tea can promote weight management through its effects on metabolism and metabolic enzymes. While increasing your metabolism, tea catechins also support fat oxidation to facilitate natural fat-burning process in the body, thereby contributing to its cancer-fighting property. See more Tea and Cancer Prevention.

Do exercises at least 30 min a day, 5 days a week.
Exercising doesn’t mean that you have to work out hard at a gym or run for miles daily. There are many simple ways to get exercises into your day and keep you physically active. Check out these gym alternatives 10 Joyful Moves to Boost Your Physical Activity and Walk to Reduce Colon Cancer Risk.

Don’t eat high-fat, high-sugar, or high-calorie diet.
Research has shown that a high-energy, high-processed meat, high-animal fat diet is associated with colon cancer development.

Don’t consume red meat and processed foods.

Don’t eat a big meal.

Don’t drink sugar-loaded beverages.  

Don’t drink alcohol.
Alcohol is high in calories, when combined with a high-fat diet, it may lead to weight gain. Overweight or obese individuals should watch out.

Don’t be physically inactive.
Physical inactivity has been linked to increased risk of several types of cancer. To keep energy balance, just remember this simple equation:  Calories in = Calories out

Don’t stress out! 
Stress can mess up your diet and daily active routines, making your weight management out of control.

The bottom line is:
Obesity is very preventable with a healthy, balanced diet and regular exercises. And colon cancer is preventable!

Image credit:  By Travelling-light

Walk to Reduce Colon Cancer Risk

By Hui Xie-Zukauskas

Walking_together_767369A Chinese man, slim, in so-so health, used to ride his bicycle to work as millions of Chinese people do. One day his bicycle was stolen. Although he could easily afford to buy a new bike, he chose to start walking to work, reasoning, “walking is good for your health.” He started walking to work every day, about 20-25 min each way. He also walked to the markets for grocery shopping, which added extra miles to his routine. A few decades later, he had succeeded in staying in remarkably good shape. In fact, he eventually outlived many of his friends and colleagues, including those who used to be much stronger and healthier than him. His walking routine lasted about 30 years in all before he passed away at the age of 81. He is my father.

This real-life story illustrates the long-term benefits from a physical activity as simple as walking. Today let’s talk about how walking is associated with reducing colon cancer risk.

One of the risk factors for colon cancer is physical inactivity. The American Cancer Society recommends exercising 30 minutes a day, at least 5 days a week, for cancer prevention. Going from a “couch potato” to instantaneously becoming a “gym rabbit” is unrealistic. A better strategy is to perform smaller, feasible, immediately executable actions. Walking is a great example.

The good news is that Walking at least 30 minutes a day can help lower colon cancer risk.

Human studies from the United States and around the world show that increased physical activity can reduce the risk of developing colon cancer by 30-40%. In one of the studies, women who walked regularly (20-30 minutes per day or 1 to 2 hours each week) had a 31% lower risk of developing colon cancer than those who didn’t walk at all. Women who exercised at moderate or vigorous intensity for more than 4 hours weekly showed a 44% lower risk of colon cancer than those who exercised for less than an hour weekly. The risk reduces greatly if walking is done routinely for at least 10 years. Research has also linked walking to reduced risks of heart disease, diabetes, and other cancers such as breast and prostate cancer.

To help prevent colon cancer, you need to engage in at least moderate physical activity such as walking half an hour a day. All you need are a pair of comfortable shoes and clothes in harmony with the weather, in addition to a positive, can-do attitude. In short, walking:
-          Doesn’t need any special equipment.
-          Doesn’t require any practice.
-          Is the body’s natural form of exercise.
-          Is for people of virtually all ages, and especially practical for middle-aged and older                folks.
-          Can be done anywhere and at any time.
-          Is simple, feasible, and one of the easiest exercises.
-          Is safe (but always be wary of traffic).
-          Is free.

If walking 30 minutes a day seems too much in the beginning, break it down to small steps. For example, two 15-minute or three 10-minute increments can be effective and beneficial. You can walk around the neighborhood, in the park, inside a mall or building, or on a treadmill.

In summary, for cancer prevention, walk regularly, walk intentionally, and walk lively! YOU CAN DO IT!

What are your thoughts or tips on walking for health? Please share.

Image credit: By cornetta

How to Replace SAD with PAD for Cancer Prevention

By Hui Xie-Zukauskas

Do you know an estimated 30%-50% of colorectal cancer cases worldwide may be attributed to diet and nutrition? Do you want to learn how to make your diet more effectively fight colon cancer?

green and red healthy foodIn this post, I’m going to share with you the top ten ways for eating anti-cancer foods that ensure you’ll reduce colon cancer risk.

Today, many Americans stuff themselves with the Standard American Diet (SAD), preferring food rich in red meat, processed or refined food products, high-fat, high-calorie, high-salt, low-fiber foods, less fruits and vegetables. SAD is tightly linked to many chronic illnesses such as coronary heart disease, diabetes, stroke and various cancers including colon cancer.

Here is a solution to this fatal problem: Replace SAD with Potentially/Promising Anti-cancer Diet (PAD). In contrast to SAD, PAD features little or limited red meat and processed or refined products, low-fat, low-calorie, low-salt, high-fiber foods, abundant fruits and vegetables.

Top 10 ways to replace SAD with PAD for preventing cancer

1. Replace red meat with white meat, fish, and beans. 
Red meat contains much more fat than poultry and fish do. Accumulating evidence indicates that a diet high in animal fat is a risk factor for colon cancer and other cancers. As an alternative to meat products, a variety of beans provide not only nutritious dietary proteins but also heart-healthy antioxidants.

Junk food_in Sq.2. Replace processed food products with fresh or frozen fruits/vegetables and plant-based foods.
Processed products are pro-cancer foods, basically packed with bad fats, carcinogenic additives or chemicals, excess salt and sugar… These hidden hazards come in fast food, or in boxed, bagged, canned, and frozen/refrigerated forms. The only merit they have is convenience. Avoid or limit processed foods.

3. Replace high-fat food with smart-fat food. 
Your body needs fat to maintain some tissue functions, provide your energy and deliver fat-soluble vitamins. However, you do need to be fat-smart. Smart fats come from sources such as olive oil, various nuts, avocado, and omega-3 fatty acids (e.g. salmon).

4. Replace high-calorie with low-calorie intake. 
Caloric excess may promote systemic inflammation, which is a risk factor for cancer. Foods with low-calories include some beans, green leafy veggies, broccoli, Brussel sprouts, tofu, whole wheat bread, pasta or spaghetti, and fat-free yogurt.

5. Replace low-fiber food with high-fiber food. 
A waste-loaded or toxic colon may overstrain your immune system. Dietary fiber is a strong helper to clean up your bowels and fight off colon cancer. So, consume various foods high in fibers, on a daily basis, including berries (raspberries, blueberries and strawberries), apples, pears, prunes, nuts, veggies like celery and sweet potatoes, black beans, whole wheat, whole bran, and oatmeal. A bonus benefit is that most high-fiber foods are also low-calorie and low-fat.

6. Replace salt with herbs and spices, lemon juice, or other natural ingredients. 
Balanced natural foods have their flavors. Limiting salt without sacrificing flavor is not as hard as you imagine. For example, my taste is very light, so is my loved ones’; salt is not our friend on the table. With a mix of herbs, green onions, ginger and garlic, sometimes raisins (natural sweet), our food doesn’t taste boring.

7. Replace fast food with abundant fruits and vegetables, and healthy snacks. 
Research shows that eating at fast-food restaurants is associated with higher fat and lower vegetable intakes. To ward off colon cancer, try frozen veggies, and just as fresh ones, as a perfect solution for “fast and convenient food”!

8. Replace refined flour and white rice with whole wheat food and brown rice.

9. Replace sugar-rich soda, coke and soft drinks with tea or fresh fruit/veggie juice.

10. Replace flavored juice with just water. 
Research findings revealed a possible association between sufficient water intake and reduced colon cancer risk. Sure enough, water is vital for health and life, period. Read why.

Well, I can list more, but you get the idea. Overall, practicing these simple, small steps can make a huge difference and lead to great rewards.

Take-home-message:
Colon cancer is primarily a diet-linked disease. Health-damaging food is profitable for food industry, but not productive and beneficial for your life. To prevent colon cancer, change your eating habits now; it’s in your power.

Image credits: ilcodeebee999raatcc36faisal424rippel35l33, and a_kartha