The Standard American Diet (SAD) is lacking in many vital nutritional components. Being largely composed of prepackaged, convenience foods with few naturally grown food products; this diet has contributed to an epidemic of not only obesity but also extreme nutritional deficiency. While many commercially available vitamin and mineral supplements exist, they are manufactured in an artificial way that reduces bioavailability and promotes chemical contamination. As Americans are not likely to return to eating home grown food directly from their garden, the solution to the nutritional deficiency of America can be found in Whole Food Supplements which are vitamin, mineral and phytonutrient rich products made from actual food concentrates.
The Problem with the Standard American Diet
In the first part of the 1900’s most Americans ate a healthy, whole food diet because they had no choice. All food was grown either by the family or obtained from immediately local sources. America in the 1900’s was a largely agrarian society with most people living in rural areas and able to grow their own food. During the last century, a massive migration to urban areas has occurred. This has meant that even if one has the desire, most people no longer have the ability to produce self grown food. Either because there is no land or because many do not know how, very few people have a garden and even fewer produce protein in the form of dairy products and animal husbandry.
In spite of this developing migration, during World War II, families were encouraged to have a “victory garden”. This was not to ensure that Americans had a great diet but actually to ensure that American families could feed themselves at all, while allowing most of commercial food production to be sent to the troops overseas. That was the last period in history that America got most of their nutrition from locally grown food.
Beginning around the 1950’s, Americans did begin to recognize the value of vitamins and minerals within their diet. This was discovered because more and more pre-prepared, highly processed food products became available and nutritional deficiencies began to emerge.
After the end of World War II, many families became two-income families. In addition, many more single parents are now raising children by themselves. This means that in most homes, all of the adults present in any one household are likely employed outside of the home full-time leaving little time for food preparation alone much less any time for food production. America has become a convenience food nation consuming much of the diet from unnatural food sources.
Prepackaged and easy to prepare food products are just that, food “products”. Though they may contain carbohydrates, proteins, fats and some “essential” nutrients, they are not real food. The entire food supply chain is rife with contamination and chemical processing and many Americans are unaware of how little nutritional value the food that they consume every day contains. So much publicity and education has focused on the so called food pyramid. The governmental and educational agencies that have devised the perfect American diet have never truly addressed the lack of nutrients, other than the Recommended Daily Allowance (RDA) of basic vitamins and minerals such as Vitamin A, Vitamin D and Calcium.
While these RDA levels of vitamin and mineral consumption may be an absolute bottom line essential to avoid obvious diseases of deficiency such as scurvy or rickets, they are hardly adequate and do not reflect but a small portion of the nutrients contained in whole food, necessary for promotion of health and prevention of disease.
A Crisis in America: Obesity and Other Diseases in the Face of Malnutrition
The main focus of the American diet in recent years has become reducing fat and increasing carbohydrates in the diet. This stream of thought was intended to reduce the growing epidemic of obesity but over the past 20 years, obesity has risen into numbers that appear to be a crisis for Americans. In fact, over the past 20 years the number of adult Americans who are obese has risen by 60% to an unprecedented level of almost 35% of American adults being considered obese. A much worse situation is that a similar number of approximately 32% of American children qualify as overweight or obese. For the first time in American history, the life expectancy of these children may be lower than that of their parents or grandparents.
This has led to an epidemic of heart disease, diabetes and other weight related problems occurring in record numbers not only in adults but seen in children as young as 18 months of age. Additional diseases that may be related to a lack of appropriate nutrients other than simple vitamins in American diets may include a wide variety of conditions ranging from immune disorders implicated in conditions such as Rheumatoid Arthritis, Lupus and Cancer to psychiatric and neurological conditions such as ADHD, Autism and Depression.
Most people believe that obesity occurs simply because people eat too much. While that is true in part, obesity also results from continuously consuming the wrong types of food. In the 1900s when Americans were consuming a largely natural, whole food diet directly from farm to table, obesity was an extremely rare occurrence.
As our diet has changed from an agrarian society’s nutrient rich food supply to the urbanized highly processed, artificial foods, our total food consumption has risen. This is in part because, though the body gets more calories from more food, it is still starved of nutrition causing one to eat even more. In addition, in our sedentary lifestyle our bodies actually need less food than when we lived and worked each day on the farm, yet we still eat more because of lack of proper nutrients, abundance of easily obtained processed food and other psychological conditions such as stress eating. In the end, America has become a nation of people who are obese but still malnourished and disease ridden.
An Attempt to Fix the Problem
The ideal diet truly would be that of returning to whole food “farm to table” eating where families either grow their own food and prepare it within minutes of harvesting or at a minimum obtain locally grown food from the market and prepare it within a day or so of harvesting. In today’s society this is no longer possible. Even when fresh vegetables and fruits are consumed as a large portion of the diet, our nation’s food supply is contaminated by the use of pesticides, herbicides and hormones and much of the nutrient value is lost by transportation of the food crop from thousands of miles away. Food is harvested before it is truly ripe, irradiated, stored cold and transported across states, nations and even oceans before it arrives in our grocery stores as tasteless, substandard, nutrient poor produce.
Many people are attempting to eat only organic, locally grown produce for this reason. While this may be an improvement over the nutritional value of the standard American diet, it is nearly always much more expensive and therefore unaffordable for many and unavailable for others as most markets do not focus on obtaining such products. So this effort, while valiant is still not enough.
The good news about the American nutritional situation is that it is quite easy to fix. Given appropriate nutrition, the human body has an amazing ability to heal itself. Many diseases and conditions caused by overconsumption and malnourishment can be easily corrected by supplementation with whole food nutritional products.
As Americans cannot rely on the food supply to provide adequate nutrition and also cannot count on the source, quality and purity of most commercially available nutritional supplements, the only answer appears to lie in whole food supplementation.
What is a Whole Food Supplement?
Whole food supplements are defined as nutritional supplements derived entirely from food. This is a much more natural and beneficial method of obtaining nutrition from food and herbal supplements alike.
Unfortunately, most commercially available nutritional supplements including vitamins, minerals and herbal products are made completely of single ingredient extracts or worse, artificially synthesized in a lab using chemical processes. While synthesized supplements may in fact provide basic vitamins and minerals known to be vital, artificially prepared products are missing many of the alkaloids, antioxidants and phytochemicals that are thought to play a major role in complete nutrition and disease prevention.
The same is true for herbal supplements and treatments as most commercially available herbal products do provide an extract or synthesized form of the primarily active chemical within the herb, they are still missing many of the synergistic ingredients thought to provide additional benefits of herbal and nutraceutical treatment.
Simply Taking Vitamins isn’t Enough
Vitamins and Minerals are absolutely necessary for life but the RDA is generally both inadequate in its estimate and unattainable through the average American diet.
While many commercially available nutritional supplements are available at every corner, through necessity, the Food and Drug Administration (FDA) does little to regulate the manufacturing of food supplements such as vitamins, minerals and herbal products. The FDA cannot apparently manage even its’ main tasks of regulation of the pharmaceutical industry and assurance of the safety of the American food supply.
In the last several years, many counterfeit pharmaceutical products have been discovered such as flu medication being sold online, manufactured outside of the United States was found to be gelatin capsules filled with sheetrock particles. In addition Americans have seen case after case of E. Coli and Salmonella contamination of both American and foreign farm crops such as lettuce, tomatoes, onions and peppers enter our grocery stores. Some of these products were even the so called “organic” products, purported to be safer than traditional crops.
Why a Whole Food Supplement
As there is inadequate supervision of the pharmaceutical and food production industries, there is even less of the nutritional supplement market. The average vitamin or nutritional supplement is manufactured using chemical synthesis and heat processing which destroys the nutritional value of the product within. In addition, many commercially available products are manufactured with fillers, additives, preservatives and other dubious chemicals. Whole food supplements are not.
Within the last several years, significant shortcomings have come to light in terms of foreign made food and health products. Many products have proven to be contaminated with not only the known chemicals that are present in the American food supply but also with much more dangerous unknown chemicals that should never enter the manufacturing process. The only way to ensure that this does not happen is to purchase high quality products from a company with a well established reputation for maintaining high standards of manufacturing and purity. As whole food supplements are natural products, it would be optimal if the manufacturer employed practices of sustainability and green policy.
The ideal food supplement manufacturer recognizes that vitamins do not exist in isolation. The nutritional value of whole food is due to the interweaving of the entire spectrum of nutrients with vitamins and minerals acting in a synergistic fashion with hundreds of other plant alkaloids, phytochemicals and enzymes. The cofactors and bioflavonoids such as terpenes and isoflavones present in whole foods and whole food supplements are integral in the process to restore biochemical balance to the body.
This is quite easy to identify when examining the label of a nutritional supplement, vitamin or herbal product. Though the FDA doesn’t do an adequate job of monitoring the food supply or pharmaceutical industry, they have established standards of labeling which include appropriate identification of all ingredients contained in a supplement. Close examination of most regular supplements when compared to whole food supplements will show that most products contain synthetic vitamins, chemicals and filler products while whole food supplements contain natural vitamins and minerals obtained from concentrated food sources such as fruits and vegetables.
Supplements manufactured from whole food sources will contain not only the natural form of vitamins and minerals but also all of the important phytochemicals and phytonutrients important to restoration of nutritional health and prevention of disease derived from whole food concentrates.
Choosing a Quality Supplement
Whole food supplements are nutritional products which have been manufactured directly from food. Food grown in natural conditions is concentrated using carefully designed and conducted cold processing techniques. These methods allow the concentration of the entire spectrum of nutritional value without removing the phytochemicals, alkaloids and other valuable natural substances that ensure adequate nutritional support and help to prevent disease.
When choosing a whole food supplement one should ensure that the product is from a manufacturing company known to have a long standing reputation for quality and experience in whole food processing. The products should be constituted entirely of whole food products which have been refined using cold processing without the nutrient reducing effects of extreme heat, pasteurization and irradiation. They should also be free of artificial filler products and preservative chemicals. The manufacturer should have a process of testing for purity and guarantee of quality and ideally should offer a money back guarantee if one is not satisfied with the product. For the American consumer, optimally an American product will be purchased an in an effort to aid the environment, a company with “green” policies should be chosen to promote sustainability of the food supply.
Specific Nutrient Needs
Vitamin A and the carotenoids are highly present in many vibrantly colored fruits and vegetables along with fish and animal livers and are essential for:
o proper functioning of the eye and skin including the gastrointestinal tract
o acts as an antioxidant, protecting against cancer and diseases of aging
o important in support of the immune system for protection against viruses and infections of the organ linings of bladder, kidneys, lungs and mucous membranes
o essential for protein utilization
Vitamin A deficiency causes dry hair, skin, eye disorders, fatigue, reproductive difficulties, frequent colds and infections, and skin disorders.
Traditional vitamin supplements will typically contain synthetic Vitamin A Palmitate and/or beta carotene isolate. Whole Food Supplements will contain Vitamin A1, Vitamin A2, retinal, retinoic acid and a number of more the 500 carotenes all of which are precursors to Vitamin A along with essential fatty acid, natural sugars, minerals and other phytonutrients found only in whole food.
Vitamin B Complex
Vitamin B is actually a number of similarly related compounds found in yellow and green fruits and vegetables particularly leafy green and cruciferous vegetables along with nuts, grains, eggs, dairy products and meats and are known to be essential for:
o maintenance of skin, eyes, hair, liver and mouth
o healthy gastrointestinal tract and brain functioning
o coenzymes involved in energy production
o proper functioning of nervous system particularly in the elderly
Specific Vitamin B Deficiencies:
B-1 Thiamine deficiency – Beriberi, canker sores, mental disorders such as dementia, depression and dizziness, fatigue, indigestion, diarrhea, numbness and muscle atropy
B-2 Riboflavin deficiency -mouth sores, cataracts, dermatitis, hair loss, neurological symptoms on skin, light sensitivity, seizures
B-3 Niacin deficiency – pellagra, bad breath, skin and mouth disorders, memory impairment, confusion, depression, muscle weakness
B-5 Pantothenic Acid deficiency – abdominal pains, skin disorders, hair loss, muscle spasms and poor coordination, immune impairment, low blood pressure
B-6 Pyridoxine deficiency – eye, skin and mouth inflammation, mucous membrane disorders, lack of wound healing
B-12 Cyanocobalamin deficiency – pernicious anemia, unsteady gate, dizziness, drowsiness, depression, hallucination headaches, memory loss, tinnitus, spinal cord degeneration
Folic Acid deficiency – certain types of anemia, fatigue, mental disorders, insomnia, diarrhea, spina bifida in developing infant
Traditional Vitamin B supplements will generally contain only the synthetic form of one or more of the B vitamin group, while whole food supplements will contain all of the Vitamin B family along with the added benefits of phytonutrients such as inositols, PABA, biotin and choline derived from concentration of whole foods.
Vitamin C (Ascorbic Acid) is found in citrus fruits, berries and green vegetables and is essential for:
o tissue growth and repair
o adrenal gland function
o healthy gums
o production of anti stress hormones and interferon
o absorption of iron in the gastrointestinal system
o metabolism of amino acids and vitamins
o activity as an antioxidant and support of the immune system
Vitamin C deficiency causes Scurvy, poor wound healing, gum disease, edema, weakness, frequent infections, fatigue, and joint pains.
Traditional Vitamin C supplements will have only Ascorbic Acid or Ascorbate, while Whole Food Supplement vitamin C will contain phytonutrients such as rutin, bioflavonoids, tyrosinase, ascorbinogen, vitamin C factors such as J, K and P along with mineral co-factors necessary for vitamin C activity all derived appropriately from whole food.
Vitamin D is present largely in dairy food products but also in fish and fish oils, green leafy vegetables, vegetable oils, egg yolks and sweet potatoes and is necessary for:
o bone and teeth growth and development in children
o muscle performance including skeletal and cardiac muscle
o prevention of bone and tooth loss in elderly
o thyroid and immune system functioning
o normal blood clotting
Vitamin D deficiency includes rickets, osteomalacea, loss of appetite, burning of mouth and throat, diarrhea, insomnia, and visual difficulties.
Most commercial Vitamin D products including prescription formulas will contain only Vitamin D2 (ergocalciferol) which is less absorbable and more difficult to use but has a longer shelf life than it’s cousin Vitamin D3 (cholecalciferol) while whole food supplements will contain significant amounts of Vitamin D3 along with many other beneficial phytonutrients in the form of whole food concentrates.
Vitamin E is found in cold pressed vegetable oils, dark green leafy vegetables, beans, nuts and grains and is essential for:
o antioxidant activity important for the prevention of cancer and cardiovascular disease
o circulation and tissue repair
o blood clotting and healing
o skin and hair health
Vitamin E deficiency may result in damage to red blood cells, nerve destruction, infertility, menstrual problems, and neuromuscular disorders.
Traditional vitamin E supplements will generally include only one of the 8 active components of the vitamin E family, alpha-tocopherol. Whole food supplements will contain not only alpha-tocopherol but also the 7 other alpha, beta, gamma and delta forms of both tocopherol and tocotrienol derived from concentrated food.
Calcium is vital for the formation of bones and teeth and the maintenance of gums. It is essential for the functioning of all muscular tissue, particularly the heart and participates in cellular functioning in virtually every area of the body. Calcium is highly present in dairy products, meaty and oily fish and green leafy vegetables.
Calcium deficiency can lead to brittle bones, teeth and nails, skin disorders, cardiac disorders such as high blood pressure and heart palpitations, cognitive impairment, hyperactivity and seizure disorders.
Calcium contained in most traditional supplements will contain only calcium carbonate or calcium citrate with the possible addition of Vitamin D or may contain D1-calcium-phosphate which is completely insoluble and cannot be absorbed. Whole Food Supplement calcium products will contain additional nutrients such as amino acids and vitamin C which are necessary for calcium absorption and utilization.
Iron is essential for the production of hemoglobin which is vital to the supply of oxygen throughout the body. Iron is also important for production of many important enzymes within the body. It can be found in meats, fish, eggs, green leafy vegetables, nuts and grains in large amounts as well as a number of herbs such as alfalfa and milk thistle.
Deficiency of Iron includes symptoms of anemia, weakness and fatigue, hair loss, mouth inflammation, fingernail malformation and mental impairment.
Most commercially available iron supplements will contain iron sulfate or iron gluconate as a singular product or in combination with other vitamins and minerals. Iron is best absorbed in the presence of vitamin C and when consumed as a constituent of a food source. Whole food supplement iron will result in better absorption and less stomach upset as it is derived from whole food.
Magnesium is vital as an enzyme catalyst especially with regard to energy production. It also aids in cellular calcium and potassium uptake which makes it essential for the transmission of muscle and nerve impulses. It can be readily found in many foods especially animal products such as dairy, meat and seafood but also in many fruits and vegetables such as apples, apricots, bananas, whole grains and soy products.
Deficiency of magnesium will cause muscular irritability, mental disorders, chronic fatigue, chronic pain syndromes, depression and pulmonary disorders along with being a factor in hypertension and sudden cardiac death.
Traditionally prepared magnesium supplements will contain only magnesium usually in the form of magnesium chloride or magnesium sulfate while whole food supplements will contain other minerals such as calcium and potassium along with vitamin c and other nutrients from whole food concentrates necessary for the proper absorption and utilization of magnesium.
Zinc is important in the growth and function of reproductive organs and may help regulate oil gland activity and prevent acne. It is essential for protein and collagen synthesis and vital to the functioning of a healthy immune system and has been shown to have potent antiviral activity. It plays a major role in wound healing and the sensation of taste and smell. It is also a constituent of many physiological chemicals such as insulin and various enzymes. Zinc is highly present in eggs, fish, beans, meats, mushrooms and many seed such as pumpkin and sunflower seeds.
Deficiency of zinc may result in a loss of taste and smell and may cause the fingernails to become weak and thin. Other signs may include delayed sexual maturation, growth impairment, disorders of sexual organs of both males and females, fatigue, hair loss, slow wound healing and recurrent infections.
Many commercially available supplements will contain either zinc gluconate as a singular product or in combination with other minerals without regard as to the appropriate ratios for optimal absorption and utilization within the body. As whole food supplements are derived from actual food, the appropriate ratios necessary for maximum benefit are already present established by nature.
Unique Benefits of Whole Food Supplements
According to the U. S. Department of Agriculture (USDA), over 70% of Americans do not consume enough whole food products to provide even the RDA of vitamins. While vitamins are necessary for life, ordinary vitamin supplements will not entirely fill the gap. Unlike most commercial dietary supplements which are stand alone chemicals, whole food supplements contain any number of several thousand known and unknown phytonutrients such as:
o Polyphenols (Flavonoids)
o Lignans (Phytoestrogens)
o Phytates (Inositols)
o Sulfides and Thiols
Research has proven these nutrients to be protective against many diseases. Some types of phytonutrients are known to provide such benefits as enhanced immunity, cancer prevention, detoxification and DNA repair.
The phytonutrient category of carotenoids has been shown to protect against certain types of cancer, optical failure from diseases such as macular degeneration and assist in the prevention of cardiac disease. Carotenoids are partially responsible for the vibrant colors of many fruits and vegetables.
Carotenoids can help prevent vitamin A deficiency by acting as precursors to Vitamin A which assists the body in manufacturing Vitamin A. In addition several carotenoids are known to be anti-oxidants and may protect against diseases of aging and exposure to environmental toxins. Carotenoids may also be a factor in the prevention and treatment of other diseases such as:
o Cancer – including cervical, throat, lung, prostate and skin cancers
o Heart disease – including angina pectoris and congestive heart failure
o Infections – including AIDS, Chlamydia, Candidiasis and pneumonia
o Immune system mediated disorders – including rheumatoid arthritis, and photosensitivity
o Other conditions – such as asthma and osteoarthritis
A balanced formula of carotenoids such as found in whole foods and whole food supplements will be better absorbed than individual supplements as too much of any one carotenoids may inhibit the absorption of others. This is one of the many reasons why whole food supplements are more beneficial than simple vitamin supplementation.
Carotenoids known to be present and beneficial can be found in the following fruits or vegetables:
o alpha carotene – carrots
o beta carotene – green cruciferous vegetables such as broccoli, and Brussels sprouts, yellow/orange vegetables such as sweet potatoes, pumpkin and carrots
o beta cryptoxanthin – orange fruits such as mangos, peaches and apricots
o lutein – leafy green vegetables such as turnip greens, collard greens and spinach
o lycopene – red fruits such as watermelon, guava, tomatoes and red grapefruit
o zeaxanthin – green vegetables such as green beans and broccoli, yellow food such as eggs mangos and citrus fruits
Polyphenols (Flavonoids) are known to be active antioxidants and are thought to be important in preventing diseases caused by oxidative stress such as some cancers and some forms of cardiac disease and some inflammatory processes which cause diseases such as arthritis and other diseases of aging. Some examples of polyphenols found in food products include:
o anthocyanins – red foods such as berries, red cabbage, red grapes
o flavones – celery and parsley
o ellagic acid – berries such as strawberries, blueberries and raspberries
o catechins – tea, wine and chocolate along with other tart foods such as berries and apples
o flavanones – found in citrus fruits
o coumarins – found in grains and grasses such as wheat grass
Phenols encompass a number of anti oxidant nutrients such as Resveratrol and are known to be powerful antioxidants. Phenols have proven to be effective in the prevention of age related disorders and many diseases caused in part by oxidative stress such as arthritis, cardiovascular disease and cancer. Phenols are present in purple fruits such as grapes and blueberries along with wine and tea.
Indoles are known to aid in hormone production and maintenance of balance. Indoles are also thought to provide cellular protection against cancers such as colon cancer and endometrial cancer along with others. They are largely present in cruciferous vegetables such as broccoli, Brussels sprouts and cabbages.
Lignans (Phytoestrogens) have weak estrogen like activity which is important in the prevention and possible treatment of hormone mediated cancers such as breast, testicular and prostate cancer. They also may block inflammatory processes which may aid in the treatment of diseases such as arthritis and platelet aggregation leading to stroke. Lignans highly present in flax seed and soy products but are also found in other grains such as wheat, barley and oats along with beans and vegetables such as garlic and broccoli.
Phytates (Inositols) may help lower blood cholesterol and aid in prevention of mental disorders such as bipolar disorder, obsessive-compulsive disorder and depression. Inositols and Phytates are present in large amounts in grains, nuts and melon family members such as cantaloupe, squash and cucumbers.
Saponins are known to lower cholesterol and may act as an immune booster protecting the body against infections from viruses, bacteria and fungi. They may also provide some protection against heart disease and have proven to be effective in the treatment of cancer. Several anti cancer drugs are based on the saponin molecular structure. Saponins can be found in foods such as asparagus, red onions, alfalfa sprouts, and soybeans.
Sulfides and Thiols are vital to the functioning of the cardiovascular system including the smooth muscles of the arteries and arterioles and the linings of both veins and arteries. Thiols have proven instrumental in the development of plaques contributing to atherosclerosis, arteriosclerosis, myocardial infarction and stroke. Sulfides and thiols are highly present in members of the odiferous Lilly family such as garlic, onion, chives and leeks
Terpenes are thought to protect against cancer and free radical damage which may contribute to diseases of aging such as stroke and alzheimers disease. Terpenes are highly present in foods such as green foods, grain and soy products and also in many herbs such as Gingko biloba.
These phytonutrients are just a few examples of natural molecules known to aid in promotion of health and make the case for the use of Whole Food Supplements. There are thousands more, yet to be identified that are present and beneficial and cannot be synthesized in a lab. Supplementation with isolated vitamins and minerals alone will not solve a nutritional deficiency.
As Americans are unlikely to return to the farm, consumption of a whole food supplement appears to be the only way to actually bridge the nutritional canyon that the American diet has created due to a lifestyle of convenient packaged food that is easy to prepare but sorely deficient in nutritional quality.
Anthony Antolics RN, BSN
* Bachelor of Science Nursing…Excelsior College, Magna Cum Laude
* Bachelor of Arts Psychology Mental Health…Southern Connecticut State University, Summa Cum Laude
* Sigma Theta Tau, The National Honor Society of Nursing
* Psi Chi, The National Honor Society in Psychology
* Zeta Delta Epsilon, Honors Service Society by invitation, Southern Connecticut State University
* Tau Kappa, Excelsior College Nursing Honors Society
At 62 years, with a lifelong interest in nutrition and a consistent practitioner of nutritional supplementation, I suffered a heart attack. After extensive research I realized that my program of supplementation had actually caused further nutritional deficiencies. Many of the supplements I had been taking were synthetic compounds and bio-identical hormones. This lead to comprehensive research in whole food supplementation, where the vitamins, minerals and herbals came from and the methods used to process them.
It became quite evident that the best supplements must be derived from whole foods, organically grown herbals and botanicals and all must be processed using little or no heat to preserve the efficacy of all the various enzymes, flavenoids and phytonutrients only present in raw whole foods. Processed this way, whole food supplements are recognized by the body as nutrition and readily metabolized and utilized to improve health and function, strengthen the immune system and increase one’s sense of well-being.