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four food groups
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no-cholesterol
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PCRM 1
vegetarian
foods
Powerful Tools for Health
A vegetarian menu is a powerful and pleasurable way to achieve good health.
The vegetarian eating pattern is based on a wide variety of foods that are
satisfying, delicious, and healthful.
Vegetarians avoid meat, fish, and poultry. Those who include dairy products and
Inside this Kit eggs in their diets are called lacto-ovo vegetarians. Vegans (pure vegetarians) eat no
meat, fish, poultry, eggs, or dairy products. While there is a considerable advantage
the whys and hows to a lacto-ovo vegetarian pattern, vegan diets are the healthiest of all, reducing risk
of a broad range of health concerns.
Vegetarian Foods ................. 2
The Protein Myth ................4 a healthy heart
Calcium in Vegetarians have much lower cholesterol levels than meat-eaters, and heart disease
Plant-Based Diets................. 6 is less common in vegetarians. The reasons are not hard to find. Vegetarian meals
are typically low in saturated fat and usually contain little or no cholesterol. Since
What about Milk? ................ 7 cholesterol is found only in animal products such as meat, dairy, and eggs, vegans
Achieving and consume a cholesterol-free diet.
Maintaining The type of protein in a vegetarian diet may be another important advantage. Many
a Healthy Weight ..............10 studies show that replacing animal protein with plant protein lowers blood cholesterol
levels—even if the amount and type of fat in the diet stays the same. Those studies
Vegetarian Diets show that a low-fat, vegetarian diet has a clear advantage over other diets.
for Pregnancy ..................... 11
Vegetarian Diets lower blood pressure
for Children ......................... 12 An impressive number of studies, dating back to the early 1920s, show that veg-
etarians have lower blood pressure than non-vegetarians. In fact, some studies have
new four food groups shown that adding meat to a vegetarian diet raises blood pressure levels rapidly and
Guidelines .............................. 8 significantly. The effects of a vegetarian diet occur in addition to the benefits of reduc-
ing the sodium content of the diet. When patients with high blood pressure begin a
tips for vegetarian diets vegetarian diet, many are able to eliminate the need for medication.
PCRM 3
The Protein Myth
I
poof!
n the past, some people believed one could never get too
much protein. In the early 1900s, Americans were told to
eat well over 100 grams of protein a day. And as recently
as the 1950s, health-conscious people were encouraged to boost
their protein intake. Today, some diet books encourage high
protein intake for weight loss, although Americans tend to take
in twice the amount of protein they need already. And while in-
dividuals following such a diet have sometimes had short-term
success in losing weight, they are often unaware of the health
risks associated with a high-protein diet. Excess protein has
been linked with osteoporosis, kidney disease, calcium stones
in the urinary tract, and some cancers.
PCRM 5
Calcium in
Plant-Based Diets
M any people avoid milk be-
reducing calcium loss
cause it contains saturated A number of factors affect calcium loss
fat, cholesterol, allergenic from the body:
Calcium in Foods proteins, lactose sugar, and frequent trac- • Diets that are high in protein cause
more calcium to be lost through the
food calcium (mg) es of contamination, or simply because
they don’t feel well after consuming dairy urine. Protein from animal products is
Vegetables products. Milk is also linked to type 1 much more likely to cause calcium loss
Broccoli, 1 cup, boiled . . . . . . . . . . . 62 (juvenile-onset) diabetes and other seri- than protein from plant foods. This may
Brussels sprouts, 1 cup, boiled . . . . . . 56 ous conditions. Happily, there are many be one reason that vegetarians tend to
Butternut squash, 1 cup, baked . . . . . 84 other good sources of calcium. have stronger bones than meat-eaters.
Carrots, 2 medium, raw . . . . . . . . . . 40 Keeping your bones strong depends • Diets high in sodium increase calcium
Cauliflower, 1 cup, boiled . . . . . . . . . 20 more on preventing the loss of calcium losses in the urine.
Collards, 1 cup, boiled . . . . . . . . . . 266 from your body than on boosting your • Caffeine increases the rate at which
Kale, 1 cup, boiled . . . . . . . . . . . . . 94 calcium intake. calcium is lost through urine.
Sweet potato, 1 cup, baked . . . . . . . . 76 Some cultures consume few or no dairy • Smoking increases the loss of calcium
products and typically ingest fewer than from the body.
Legumes 500 milligrams of calcium per day. How- A number of factors increase bone build-
Black turtle beans, 1 cup, boiled . . . . 102 ever, these people generally have low rates ing in the body:
Chickpeas, 1 cup, boiled . . . . . . . . . . 80 of osteoporosis. Many scientists believe • Exercise is one of the most important
Great Northern beans, 1 cup, boiled . 120 that exercise and other factors have more factors in maintaining bone health.
Kidney beans, 1 cup, boiled . . . . . . . . 62 to do with osteoporosis than calcium • Exposure to sunlight allows the body
Lentils, 1 cup, boiled . . . . . . . . . . . . 38 intake does. to make the bone-building hormone vi-
Navy beans, 1 cup, boiled . . . . . . . . 126 tamin D.
Pinto beans, 1 cup, boiled . . . . . . . . . 79 calcium in the body • Eating a plentiful amount of fruits
Soybeans, 1 cup, boiled . . . . . . . . . 175 Almost all of the calcium in the body and vegetables helps to keep calcium in
Soymilk, 1 cup, calcium-fortified . . . . 368 is in the bones. There is a tiny amount in bone.
Tofu, raw, firm, 1⁄2 cup . . . . . . . . . 253 the bloodstream, which is responsible for • Consuming calcium from plant-based
Vegetarian baked beans, 1 cup . . . . . . 86 important functions such as muscle con- sources, especially green vegetables and
White beans, 1 cup, boiled . . . . . . . 161 traction, maintenance of the heartbeat, beans, provides one of the building blocks
and transmission of nerve impulses. for bone building.
Grains We regularly lose calcium from our
Corn tortilla . . . . . . . . . . . . . . . . . 19 bloodstream through urine, sweat, and sources of calcium
Rice milk, 1 cup, enriched . . . . . . . 300* feces. It is renewed with calcium from Exercise and a diet moderate in protein
Wheat bread, 1 slice . . . . . . . . . . . . 26 bone or from the diet. will help to protect your bones. People
Whole wheat flour, 1 cup . . . . . . . . . 41 Bones are constantly broken down and who eat plant-based diets and are active
made anew. Up until the age of 30 or so, probably have lower calcium needs. How-
Fruits we build more bone than we lose. Later, ever, it is still important to eat calcium-
Dried figs, 10 figs . . . . . . . . . . . . . 140 the bones tend to break down more than rich foods every day.
Navel orange, 1 medium . . . . . . . . . . 60 build up. The loss of too much bone cal- The “Calcium in Foods” chart on the
Orange juice, 1 cup calcium-fortified . 300* cium can lead to fragile bones or osteo- left side of this page gives the amount of
Raisins, 2/3 cup . . . . . . . . . . . . . . . 48 porosis. calcium found in some excellent plant
* package information How rapidly calcium is lost depends, in sources. A quick glance shows how easy
part, on the kind and amount of protein it is to meet calcium needs. The sample
Source: U.S. Department of Agriculture,
Agricultural Research Service. 2004. USDA you eat, as well as other diet and lifestyle menus on page 5 each provide approxi-
National Nutrient Database for Standard choices. mately 1,000 milligrams of calcium.
Reference, Release 17. Nutrient Data Laboratory
Web site, http://www.nal.usda.gov/fnic/foodcomp
*Fat content of dairy products Many dishes can be easily made cheese-
free. Ask for guacamole, rice, or extra
based on percentage of calories from fat salsa in your burrito or on your tostada
instead of the cheese. Put more veg-
etables on a dinner salad or add some
Butter: 100% fat beans, nuts, or baked tofu chunks in-
stead of cheese.
Cheddar cheese: 74% fat Most recipes calling for milk can be
made with soymilk instead. If it’s a
soup or other savory dish, be sure to
purchase plain soymilk for cooking.
Whole milk: 49% fat Make creamy dips and desserts using
silken tofu in place of sour cream or
“2%” milk: 35% fat cream cheese.
(It is 2% fat only by weight.) Sprinkle nutritional yeast on popcorn
or pasta for a cheesy flavor instead of
parmesan.
PCRM 7
The New Four Food Groups
Be sure to include a good source of vitamin B12, such as fortified cereals or vitamin supplements.
Fruit Legumes
3 or more servings a day 2 or more servings a day
Fruits are rich in fiber, vitamin C, and beta- Legumes, which is another name for beans,
carotene. Be sure to include at least one serving peas, and lentils, are all good sources of fiber,
each day of fruits that are high in vitamin protein, iron, calcium, zinc, and B vitamins.
C—citrus fruits, melons, and strawberries are This group also includes chickpeas, baked and
all good choices. Choose whole fruit over fruit refried beans, soymilk, tempeh, and texturized
juices, which do not contain very much fiber. vegetable protein.
Serving size: 1 medium piece of fruit • ½ cup Serving size: ½ cup cooked beans • 4 ounces
cooked fruit • 4 ounces juice tofu or tempeh • 8 ounces soymilk
PCRM developed the New Four Food Groups in 1991. This consuming primarily plant-based diets. Weight problems—a
no-cholesterol, low-fat plan supplies all of an average adult’s contributor to a host of health problems—can also be brought
daily nutritional requirements, including substantial amounts under control by following the New Four Food Group recom-
of fiber. mendations.
The major killers of Americans—heart disease, cancer, and Try the New Four Food Groups and discover a healthier way
stroke—have a dramatically lower incidence among people to live!
PCRM 9
Achieving and Maintaining a Healthy Weight
O f the many ways to lose weight, The old myth was that pasta, bread, po- have almost the same number of calo-
one stands out as by far the most tatoes, and rice are fattening. Not true. In ries per gram, foods that are high in pro-
healthful. When you build your fact, carbohydrate-rich foods are perfect tein—particularly animal products—are
meals from a generous array of vegetables, for permanent weight control. Carbohy- also usually high in fat. Even “lean” cuts
fruits, whole grains, and beans—that is, drates contain fewer than half the calories of meat have much more fat than a healthy
healthy vegetarian choices—weight loss is of fat, which means that replacing fatty body needs. And animal products always
remarkably easy. And along with it come foods with complex carbohydrates auto- lack fiber. Fiber helps make foods more
major improvements in cholesterol, blood matically cuts calories. But calories are satisfying without adding many calories,
pressure, blood sugar, and many other only part of the story. and it is only found in foods from plants.
aspects of health. The message is simple: The body treats carbohydrates different- Exercise helps, too. Aerobic exercise
Cut out the foods that are high in fat and ly than fat calories. The difference comes speeds up the breakdown of fat and makes
devoid of fiber, and increase the foods from how the body stores the energy of sure that muscle is not lost. Toning exer-
that are low in fat and full of fiber. This different food types. It is very inefficient cises and weight-lifting help firm muscles
low-fat, vegan diet approach is safe and for the body to store the energy of carbo- and increase muscle mass. The trick is to
easy—once you get the hang of it. hydrates as body fat. When your body tries find activities that you enjoy and that fit
Changing eating habits is the corner- to turn carbohydrate into fat, it wastes 23 your lifestyle. Walking is a good way to
stone of achieving and maintaining a percent of the calories of the carbohydrate. start. You can do it anywhere at just about
healthy weight permanently. There is no But fat is easily converted into body fat. any time.
way to “lose 20 pounds in two short weeks” Only 3 percent of the calories in fat are The best weight control program is
and make it last. Very-low-calorie diets or burned in the process of conversion and a high-complex carbohydrate, low-fat,
low-carbohydrate, high-protein diets may storage. It is the type of food that affects vegetarian diet complemented by regu-
cause major health problems and are very body fat the most. lar exercise. This is the best choice for a
difficult to maintain for the long term. Although protein and carbohydrates healthier, longer, happier life.
See how to change your regular Cereal with milk, orange juice, strawberries
meals into low-fat vegan meals.
Scrambled eggs, home fries,
English muffin, sausage, hot tea
P C R M 11
sample menus
Ages 1 to 4 years Vegetarian Diets
Breakfast: Oatmeal with applesauce,
calcium-fortified orange juice
Lunch: Hummus (see recipe) on crack-
ers, banana, soymilk, carrot sticks
for Children
Dinner: Corn, mashed sweet potatoes,
steamed kale, soymilk Right from the Start
Snacks: Peach, Cheerios, soymilk
Ages 5 to 6 years
Breakfast: Whole grain cereal with
banana and soymilk, orange wedges
Lunch: Missing Egg Sandwich (see
E ating habits are set in early childhood. Vegetar-
ian diets give your child the chance to learn to
enjoy a variety of wonderful, nutritious foods. They
provide excellent nutrition for all stages of childhood,
recipe), apple juice, carrot sticks, oat- from birth through adolescence.
meal cookie
Dinner: Baked beans with soy “hot
infants
The best food for newborns is breast-milk, and
dog” pieces, baked potato, spinach,
the longer your baby is breast-fed, the better. If your
soymilk, fruit salad
baby is not being breast-fed, soy formulas are a good
Snacks: Trail mix, graham crackers, alternative and are widely available. Do not use com-
soymilk mercial soymilk for infants. Babies have special needs
and require a soy formula that is developed especially
Ages 7 to 12 years for those needs.
Infants do not need any nourishment other than
Breakfast: Strawberry-banana smooth- breast milk or soy formula for the first half year of
ie, toast with almond butter, calcium- life, and they should continue to receive breast milk
fortified orange juice or formula at least throughout their first 12 months.
Lunch: Hearty Chili Mac (see recipe), Breast-fed infants also need about two hours a week
green salad, bread of sun exposure to make vitamin D—a great motiva-
Dinner: Steamed broccoli with nutri- tor for Mom to get back into a walking routine. Some
tional yeast, steamed carrots, oven fries, infants, especially those who are dark-skinned or
Berry Cobbler (see recipe), soymilk who live in cloudy climates, may not make adequate
amounts of vitamin D. In these cases, vitamin D
Snacks: Popcorn, figs, soy “ice supplements may be necessary.
cream” Vegetarian women who are breast-feeding should
also be certain to include good sources of vitamin
Ages 13 to 19 years B12 in their diets, as intake can affect levels in breast
milk. Foods fortified with cyanocobalamin, the active
Breakfast: Bagel with apple butter,
banana, calcium-fortified orange juice form of vitamin B12 , can provide adequate amounts
of this nutrient. A multivitamin may also be taken
Lunch: Bean burrito with lettuce, to- as directed by your doctor. Breast milk or infant
mato, and guacamole, rice, baked tor- formula should be used for at least the first year of
tilla chips, and salsa your baby’s life.
Dinner: Braised broccoli, carrots, yel- At about 5 to 6 months of age, or when baby’s
low squash, and mushrooms, spaghetti weight has doubled, other foods can be added to the
with marinara sauce, cucumber salad, diet. Pediatricians often recommend starting with an
soymilk iron-fortified cereal because, at about 4 to 6 months,
Snacks: Hummus (see recipe) and baby infants’ iron stores, which are naturally high at birth,
carrots, fruit smoothie, Luna or Clif begin to decrease. Add one simple new food at a time,
Bar at one- to two-week intervals.
The following guidelines provide a flexible plan for
Whole Grains,
4 servings 6 servings 7 servings 10 servings
Breads, Cereals
Legumes, Nuts, 1/4 to 1/2 cup legumes 1/2 to 1 cup legumes 2 servings legumes 3 servings legumes
Seeds, and 3 servings breastmilk, 3 servings soymilk or other 3 servings soymilk or other 2 to 3 servings soymilk or
Non-Dairy Milks formula, or non-dairy milk non-dairy milk non-dairy milk other non-dairy milk
P C R M 13
Recipes for Health
2 green onions, finely chopped cups of cleaned spinach leaves to the pot
1 tablespoon reduced-fat soy mayonnaise right before serving.
2 tablespoons pickle relish NUTRITION INFORMATION PER SERVING: 78
CALORIES, 4 G PROTEIN, 16 G CARBOHYDRATE, 0
1 teaspoon stone ground mustard G FAT, 150 MG SODIUM, 0 MG CHOLESTEROL
¼ teaspoon cumin
¼ teaspoon turmeric
¼ teaspoon garlic powder or granules
Spinach Salad
8 slices whole wheat bread with Fruit Flavors
Buckwheat Corncakes 4 lettuce leaves Serves 6
Makes 16 3-inch pancakes 4 tomato slices A favorite from PCRM’s cooking classes,
The mellow flavor of buckwheat com- Combine the mashed tofu with green on- this recipe is chock full of cancer-fighting
bines with the cornmeal to make a light, ions, mayonnaise, pickle relish, mustard, phytochemicals.
delicious pancake. Serve these satisfying cumin, turmeric, and garlic powder or 10 ounces chopped spinach, washed
pancakes with fruit preserves, applesauce, granules. Mix thoroughly. Spread on whole
1 cup berries, grapes, or 10
or maple syrup. wheat bread and garnish with lettuce and
strawberries, chopped
tomato slices.
½ cup buckwheat flour 1 10-ounce can mandarin or
NUTRITION INFORMATION PER SANDWICH: 197
½ cup cornmeal CALORIES, 10 G PROTEIN, 29 G CARBOHYDRATE, 4 clementine oranges, or grapefruit
G FAT, 271 MG SODIUM, 0 MG CHOLESTEROL sections, drained and rinsed
½ teaspoon baking powder
¼ teaspoon baking soda ¼ cup sunflower seeds
½ ripe banana Lentil Barley Soup ¼ cup chopped Brazil nuts
1 ½ tablespoons maple syrup Serves 6 to 8 ¼ cup fat-free raspberry vinaigrette
1 tablespoon vinegar Toss ingredients together and serve.
This hearty soup is easy to prepare and
1-1 ¼ cups soy- or rice milk
cooks in a single pot. NUTRITION INFORMATION (1/6 OF RECIPE): 111
Fresh fruit, fruit preserves, CALORIES, 3.9 GM PROTEIN, 10.5 GM CARBOHYDRATE,
7 GM FAT, 60 MG SODIUM, 0 MG CHOLESTEROL
syrup for serving 1 cup lentils, rinsed
½ cup hulled or pearled barley
Stir the buckwheat flour, cornmeal, baking
powder, and baking soda together in a mix-
6 cups water or vegetable stock Hummus
1 onion, chopped Makes about 2 cups
ing bowl. In a separate bowl mash the ba-
nana and mix it with the maple syrup, vin- 2 garlic cloves, minced or crushed
A very versatile food: use hummus as a
egar, and 1 cup of milk. Combine the liquid 2 carrots, sliced
sandwich filling, a dip, or spread on a
and dry ingredients and stir just enough to 2 stalks celery, sliced
tortilla and top with lettuce and salsa
remove any lumps. The batter should be ½ teaspoon oregano and roll up.
pourable; if it seems too thick, add the re- ½ teaspoon ground cumin
maining milk. Preheat a non-stick skillet or ¼ teaspoon black pepper 1 can garbanzo beans, drain and
griddle and mist it lightly with a vegetable ¼ teaspoon red pepper flakes reserve liquid, rinse beans
oil spray. Pour small amounts of the batter ½-1 teaspoon salt 2 tablespoons tahini (sesame butter)
onto the heated surface and cook until ¼ cup lemon juice
Place all ingredients except salt into a large
the tops bubble. Turn with a spatula and 3 scallions, chopped
pot and bring to a simmer. Cover and cook,
cook the second side until golden brown. 1 tablespoon garlic, chopped
stirring occasionally, until the lentils are
(Stir the batter each time before pouring.) (about 3 cloves)
tender, about 1 hour. Add salt to taste.
Serve immediately. 1 teaspoon cumin
Note: For an added nutrient boost add 3 ½ teaspoon black pepper
NUTRITION INFORMATION PER PANCAKE: 43
CALORIES, 1 G PROTEIN, 9 G CARBOHYDRATE, 0.2
G FAT, 32 MG SODIUM, 0 MG CHOLESTEROL Optional: ½ cup roasted red peppers
Put all ingredients in food processor and
Missing Egg Sandwich process until smooth. Add reserved bean
Makes about 4 sandwiches liquid for a smoother consistency. Spread
on whole-wheat pita bread, or serve as a
Delicious, lower fat, and cholesterol-free dip for vegetables.
alternative to traditional egg salad.
NUTRITION INFORMATION PER 2 TABLESPOON SERVING:
44 CALORIES, 2 GM PROTEIN, 6 GM CARBOHYDRATE,
½ pound firm tofu, mashed 1.5 GM FAT, 29 MG SODIUM, 0 MG CHOLESTEROL
Kids of all ages love this simple meal. 5-6 cups fresh or frozen berries
(boysenberries, blackberries,
8 ounces pasta spirals or macaroni raspberries, or a mixture of these)
1 onion, chopped 3 tablespoons wholewheat pastry flour
2-3 cloves of garlic, minced ¼ cup sugar or other sweetener
1 small bell pepper, diced 1 cup wholewheat pastry flour
¾ cup textured vegetable protein 2 tablespoons sugar or other sweetener
1 15-ounce can crushed tomatoes 1 ½ teaspoons baking soda
1 15-ounce can kidney ¼ teaspoon salt
Grilled Polenta with beans, including liquid 2 tablespoons vegetable oil
Portabella Mushrooms 1 15-ounce can corn, including liquid ½ cup non-fat soymilk or rice milk
Serves 4 1 tablespoon chili powder
1 teaspoon cumin Preheat oven to 400°F. Spread the berries
Grilling or oven-roasting vegetables is so in a 9 x 9-inch baking dish and mix them
easy and brings out their best flavors. Cook the pasta in boiling water until it is with 3 tablespoons of flour and ¼ cup of
tender. Drain and rinse it under hot water, sugar. In a separate bowl, mix 1 cup of
½ cup polenta (coarsely then set it aside. Heat ½ cup of water in a flour and 2 tablespoons of sugar with the
ground cornmeal) large pot, then add the chopped onion and baking powder and salt. Add the oil and
1 15-ounce can vegetable broth garlic. Cook until the onion is soft, about mix it with a fork or your fingers until the
or 2 cups vegetable stock 3 minutes. Add the bell pepper, textured mixture resembles coarse corn meal. Add
½ cup water vegetable protein, crushed tomatoes, kid- the soymilk or rice milk and stir to mix.
4 large portabella mushrooms ney beans, corn, spices, and an additional Spread the mixture over the berries (don’t
1 tablespoon olive oil ½ cup water. Stir to mix, then simmer over worry if they’re not completely covered),
2 tablespoons soy sauce medium heat, stirring occasionally, for 20 then bake until golden brown, about 25
2 tablespoons balsamic vinegar minutes. Add the cooked pasta and check minutes.
2 tablespoons red wine or water the seasonings. Add more chili powder if
NUTRITION INFORMATION PER SERVING: 166
CALORIES, 3 G PROTEIN, 32 G CARBOHYDRATE, 3
2 garlic cloves, crushed G FAT, 67 MG SODIUM, 0 MG CHOLESTEROL
1 roasted red pepper, cut into thin
strips for garnish (optional)
Combine the polenta, vegetable broth, and
More Recipes
½ cup of water in a saucepan. Bring to a For more delicious recipes
simmer and cook, stirring frequently, until please visit PCRM’s Web site at
very thick, 15 to 20 minutes. Pour into a 9 www.pcrm.org
P C R M 15
THE VEGETARIAN STARTER KIT is published by the Physicians Committee for Responsible
Medicine, 5100 Wisconsin Ave., N.W., Suite 400, Washington, DC 20016, (202) 686-
2210. PCRM consists of approximately 5,000 physicians and 100,000 lay members. PCRM
promotes nutrition, preventive medicine, ethical research practices, and compassionate
medical policy.
THE VEGETARIAN STARTER KIT is not intended as individual medical advice. Persons with
medical conditions or who are taking medications should discuss any diet and lifestyle
changes with their health professional.
Readers are welcome to reproduce articles from this publication for personal or educational
use without additional permission. Material should not be reproduced for resale without
prior arrangement with PCRM. © PCRM, 2005.
Visit PCRM’s Web site at www.pcrm.org.
Note to the Reader: This booklet does not take the place of individualized medical care or advice. If you are overweight, have any
health problems, or are on medication, you should consult with your doctor before making any changes in your diet or exercise
routines. A diet change can alter your need for medication. For example, individuals with diabetes, high blood pressure, or high
cholesterol levels often need less medication when they improve their diets. With any dietary change, it is important to ensure
complete nutrition. Be sure to include a source of vitamin B12 in your routine, which could include any common multivitamin,
fortified soymilk or cereals, or a vitamin B12 supplement containing five micrograms of B12 or more per day.