Preventing Prostate Cancer Through Diet and Lifestyle

Melon Chunks with Crumbled Feta and Fresh Mint (from "Diet Simple Farm to Table Recipes")

Nutrition makes a difference!
by Viggy Parr with contributions by Katherine Tallmadge

When men move to the United States or adopt a more westernized diet, their prostate cancer rates increase dramatically.

Based on international comparisons of prostate cancer rates in different countries and over time, studies where researchers examine the lifestyle and health of a group in one location and compare that to the lifestyle and health of a group in a different location—have shown that Asian men, who have some of the lowest worldwide rates of prostate cancer, increase their risk of that cancer when they adopt a Western (American) diet with more animal foods. A recent study (Ahmedin et al, 2010) found that rates of prostate cancer are rising in countries with formerly low rates, such as Japan and Singapore because of westernization, including a sedentary lifestyle, diets filled with animal fats, and rising rates of obesity. These results prove that there is not necessarily a genetic protection against prostate cancer in Asian men, but rather a strong environmental factor.

I hope that the following lifestyle advice can benefit all men and help them to significantly reduce their risk of prostate cancer and help them to live a long and healthy life! (1) Learn more about PSA testing controversies..

1. Body fat: The American Institute for Cancer Research recommends at least 30 minutes of physical activity each day to reduce body fat and help prevent cancer in general. This recommendation is particularly important for prostate cancer.

“Although most men will develop prostate cancer if they live long enough, the cancer often remains dormant and never impacts their health. Only a small minority of men will develop the aggressive form of prostate cancer that can be fatal,” ccording to Karen Collins, MS, RDN, a registered dietitian and nutrition advisor for the American Institute for Cancer Research (AICR).

Overweight men are more at risk for aggressive prostate cancer than men of normal weight. The reasons behind this are not entirely clear; Collins suggests that the hormone changes involved in weight gain or even obesity-caused chronic low-grade inflammation could be the culprit. Inflammation is associated with many cancers for reasons that are not fully understood. Collins explains that inflammation could set off changes in cell signaling pathways that could lead to changes in cell growth and reproduction and the cell’s ability to self-destruct, ultimately leading to cancer.

  • Bottom line: You don’t have to spend hours at the gym to get the cancer-preventing health benefits of exercise—a simple walk through the neighborhood can do wonders for your health. Exercise can be fun, too—try an active game of golf or badminton with friends, yoga, kayaking, paddle boarding, volleyball, swimming—any activity that gets your heart pumping is perfect!
  • Body fat: 8 Steps to Determine – Are YOU dangerously overweight? Learn more about PSA testing controversies!

2. Lycopene (Red fruits such as tomatoes, watermelon, guava): Many studies have shown that lycopene-rich foods reduce the risk of prostate cancer, but the mechanism behind that reduction was not well understood until now. A recent study found that lycopene has a substantial protective effect against prostate cancer by interfering with the genes that would allow the prostate cancer cells to grow and survive. The American Institute for Cancer Research recommends that men take advantage of lycopene’s cancer-preventing effects and fill their diets with foods such as tomatoes, watermelon and guava.

  • Bottom line: Fill your diet with lycopene-rich foods such as tomatoes, watermelon, and red grapefruit. Remember—the cancer-fighting properties of lycopene in tomatoes are much stronger when the tomatoes are cooked, such as in marinara sauce or tomato soup.
  • Source: Rafi, MM, S Kanakasabai, MD Reyes, and JJ Bright. “Lycopene modulates growth and survival associated genes in prostate cancer.” Journal of Nutritional Biochemistry 2013.

3. Selenium: The AICR recommends incorporating selenium-rich foods into your diet to help decrease your prostate cancer risk. Selenium is essential to proper immune system and thyroid functioning, and it has been shown to be anti-carcinogenic. In addition to its powerful preventive effects, selenium may also slow prostate tumor growth. One of the best sources of selenium is the Brazil nut. Besides being a great selenium reservoir, Brazil nuts are high in protein, fiber, magnesium, and phosphorus, along with vitamin E, vitamin B6, calcium, and iron, just to name a few. These nutrient powerhouses can also help lower cholesterol.

4. Cruciferous vegetables: Consumption of vegetables in the crucifer family, including broccoli, cauliflower, and cabbage has recently been linked to a decrease in prostate cancer risk. Chemicals in vegetables like broccoli can suppress the growth of prostate cancer cells and therefore prevent development of the disease.

  • Source: Watson, GW, LM Beaver, DE Williams, RH Dashwood, and E Ho. “Phytochemicals from Cruciferous Vegetables, Epigenetics, and Prostate Cancer Prevention.” The American Association of Pharmaceutical Scientists Journal: 2013. http://www.ncbi.nlm.nih.gov/pubmed/23800833
  • Bottom line: Even if delicious, nutritious foods like broccoli and cauliflower don’t definitively reduce your risk of prostate cancer, they are still incredibly healthful foods with a huge variety of proven benefits. Toss some broccoli into your salad or replace the mashed potatoes with some smashed cauliflower!

5. Vegetable fats: A long-term study of men with prostate cancer found that men who ate more vegetable fats (think nuts, avocados, and nut oils) had a significantly reduced risk of dying from any cause. Simply swapping ten percent of daily carbohydrates for vegetable fats lowered the men’s risk of death by 26 percent, and swapping vegetable fats for ten percent of daily animal fat reduced the men’s risk of death by a whopping 34 percent.

  • Bottom line: Instead of cooking foods in trans-fatty oils or bacon fat, use olive or peanut oil. Foods such as nuts, avocados, peanut butter, and olives are good sources of vegetable fats, as well.
  • Source: Richman, Erin L., Stacey A. Kenfield, Jorge E. Chavarro, Meir J. Stampfer, Edward L. Giovannucci, Walter C. Willett, and June M. Chan. “Fat Intake After Diagnosis and Risk of Lethal Prostate Cancer and All-Cause Mortality.” JAMA Internal Medicine 2013. http://www.ncbi.nlm.nih.gov/pubmed/23752662

6. Animal fats: Frequent meat-eaters beware: studies have shown that diets high in animal fats can increase your risk for prostate cancer. Studies of the often vegetarian Seventh-Day Adventists show decreased rates of prostate cancer in that population compared to the national average.

  • Source: Le Marchand, Loic, Laurence N. Kolonel, Lynne R. Wilkens, Beth C. Myers, and Tomio Hirohata. “Animal Fat Consumption and Prostate Cancer: A Prospective Study in Hawaii.” Epidemiology 5(3): 1994. http://www.ncbi.nlm.nih.gov/pubmed/8038241
  • Milk: A recent studyfound that whole milk, which is high in animal fat, is associated with more aggressive, fatal prostate cancer. Skim/low-fat milk was associated with less aggressive prostate cancers. Some researchers believe that the calcium in milk may be behind milk’s association with prostate cancer, while others believe that natural growth factors in milk are the true cause. Men are urged to be careful about calcium supplements—as with many types of foods, it’s necessary to find the middle ground between too much and too little calcium. Whereas excessive calcium (1200-1500+ mg/day) is associated with increased prostate cancer risk, adequate calcium consumption in general is pretty clearly associated with lower risk of colon cancer. According to Collins, “You’d hate for men to get the idea that they should totally minimize their calcium intake, since some calcium in moderate amounts doesn’t seem to increase prostate cancer risk.”
    • Source: Song, Y, JE Chavarro, Y Cao, W Qiu, L Mucci, HD Sesso, MJ Stampfer, E Giovannucci, M Pollak, S Liu, and J Ma. “Whole milk intake is associated with prostate cancer-specific mortality among U.S. male physicians.” Journal of Nutrition 143(2): 2013. http://www.ncbi.nlm.nih.gov/pubmed/23256145
    • Bottom line: It’s not a bad idea to reduce your meat intake. If you do eat meat, opt for leaner meats such as chicken and fish instead of fatty beef. It also wouldn’t hurt to cut back on milk or switch to skim milk.

7. Soy: Stanford researcher Dr. David Feldman has found that soy can have protective effects against prostate cancer. Genistein, a soy phytochemical, can boost calcium absorption by protecting a vitamin D-derived chemical, calcitriol, against breakdown. A study involving rats found that when placed on a high-soy diet and given supplements of calcitriol, the rats were much less likely to grow prostate tumors.

8. Fried foods: A new study from the University of Washington has found that regularly eating fried foods such as French fries and fried chicken could increase your prostate cancer risk. The high heats involved in deep-frying create new molecular compounds that may be carcinogenic. You don’t necessarily need to swear off doughnuts and fries forever—the study also found that men who ate fried foods one to three times a month did not have an increased risk for prostate cancer.

  • Bottom line: Try to replace fried foods with fresh foods whenever possible, but if you simply have to have a doughnut or fries, limit yourself to one or two indulgences per month.
  • Source: Stott-Miller, Marni, Marian L. Neuhouser, and Janet L. Stanford. “Consumption of deep-fried foods and risk of prostate cancer.” The Prostate 73(9): 2013. http://www.ncbi.nlm.nih.gov/pubmed/23335051

9. Omega-3 fatty acids: A recent study by Dr. Theodore Brasky and colleagues found that high blood levels of omega-3 fatty acids is associated with an increased risk of prostate cancer. However, the study suffers from several serious methodological flaws. The study did not examine any aspects of diet in the volunteers, nor did they ask if the men were taking fish oil supplements. All assessments of omega-3’s were performed by measuring omega-3 blood levels. Karen Collins of AICR cautions that the real issue is all about balance; the balance of omega-3’s and omega-6’s (another type of essential dietary fat) seems to be very important for inflammation. People who eat little to no fish and fill their diets with processed foods may have inadequate consumption of omega-3’s, whereas someone else could go too far in the other direction and throw off that delicate balance by eating a low fat diet with omega-3 supplements. There is likely a tipping point at which omega-3’s cease being helpful and start to be harmful due to the imbalance that too many omega-3’s can cause, much like calcium and milk. It’s important to recognize that although omega-3’s are important, the rest of the diet and lifestyle must also be taken into account. For example, the Inuits, the native people of Greenland, have a diet rich in fish, giving them plenty of omega-3’s. The Inuits also have incredibly low rates of prostate cancer.

 

Conclusion

By eating in accordance with the most up-to-date scientific evidence, you could help reduce your risk for prostate cancer. Start by filling your diet with lycopene-containing foods like tomatoes, watermelon, and grapefruit, selenium-rich foods like brazil nuts, eggs, and mushrooms, vegetable fats like nuts and avocados, and cruciferous vegetables like broccoli and cauliflower. What you add in is just as important as what you leave out—try to cut back on red meat, whole milk, and fried foods. Top everything off with at least 30 minutes of exercise each day and you’ll be doing both yourself and your family a whole lot of good. Collins points out that “for cancer overall, we are discovering so many protective compounds in food that we should focus on variety rather than a few superstars to eat over and over again.” Take her advice and mix it up once in a while. If you follow all of the tips in this article, you’ll be taking full advantage of the most up-to-date prostate cancer prevention science and improving your overall health along the way!

Sources:

(1) https://onlinecourses.science.psu.edu/stat507/sites/onlinecourses.science.psu.edu.stat507/files/lesson04/Colli_-_International_comparision_of_ris.pdf

Jemal, Ahmedin, Melissa M. Center, Carol DeSantis, and Elizabeth M. Ward. “Global Patterns of Cancer Incidence and Mortality Rates and Trends.” Cancer Epidemiology, Biomarkers & Prevention 2010. http://cebp.aacrjournals.org/content/19/8/1893.long

Learn more about PSA testing controversies!

THIS REPORT WAS WRITTEN BY VIGGY PARR WITH CONTRIBUTIONS BY KATHERINE TALLMADGE

2012/2013 Intern, Viggy Parr and Katherine Tallmadge presenting at the Four Seasons Health Club

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Summer’s Last Sigh… Market Recipe: Greek Salad with Heirloom Tomatoes

Four Seasons Displaying Greek Salad with Heirloom Tomatoes, Tabouleh with Chick Peas, Seasonal Vegetables and a Lemon, Basil Vinaigrette, and Fruit Smoothies, all from "Diet Simple Farm to Table Recipes" and prepared by Four Seasons Hotel Executive Chef Douglas Anderson for my Presentation: 4 Steps to Building Muscular Strength

Don’t say good-by to summer yet. There is still plenty of summer’s most lovely seasonal produce, particulary heirloom tomatoes – my favorite – to entertain with, as evidenced by Four Seasons’ beautifully prepared Greek Salad with Heirloom Tomatoes, and other recipes from Diet Simple Farm to Table Recipes. They were uniquely and beautifully interpreted by the Four Seasons Hotel Executive Chef Douglas Anderson  for my presentation, “Four Steps For Strengthening Muscles – Some Surprising News” exclusively for Four Seasons Health Club members.

Four Seasons Hotel Executive Chef Douglas Anderson

Every vegetable in the recipe – the tomatoes, cucumbers, peppers, sweet onions, and garlic – can be found at the local Farmers Markets at Rose Park on Wednesday or Dupont  Circle on Sunday or any other Fresh Farm Market locations. The possibilities are endless! This is a naturally vegetarian recipe. But for the meat lovers, it’s great with grilled chicken or seafood on the side.

“Katherine’s Market Recipes,” are designed to be delicious, easy, quick, family-friendly, nutritious (heart-healthy & diabetes-friendly), and to highlight produce found at our local Farmers Markets this week. At your Farmers Market, you’ll find produce picked at peak ripeness, which means maximum flavor, texture and nutrition. You’re also helping save the environment when you buy at your Farmers Market. Here’s how…

Greek Salad with Heirloom Tomatoes as interpreted by Four Seasons Hotel Executive Chef Douglas Anderson

Greek Salad with Heirloom Tomatoes
From Diet Simple Farm to Table Recipes: 50 New Reasons to Cook in Season!

8 servings

Ingredients:

Vinaigrette:
2 Tablespoons Freshly Harvested Extra Virgin Olive Oil
2 Tablespoons Freshly Squeezed Lemon Juice (1 Lemon)
1 Tablespoon Chopped Fresh Oregano or Basil (or 1 tsp dried)
1 Clove Garlic, Minced (optional)
Salt and Pepper to Taste (Salt is not necessary with the cheese and olives)

Vegetables:
2 cucumbers, peeled, seeded and sliced into a half-moon shape
1 onion, peeled and chopped coarsely
1 medium yellow, purple or green bell pepper, cored, seeded, chopped into large bite-size pieces
1 cup pitted Kalamata or other Greek Olives
4 Heirloom Tomatoes, quartered, and cut into large, bite-size pieces

4 ounces Feta or Goat Cheese, broken into small bits

Instructions:

Combine the vinaigrette ingredients in a large salad bowl and whisk until blended. Add the cucumbers, onion, pepper, and olives and toss into vinaigrette. Let sit for twenty minutes to marinate. Add the heirloom tomatoes and cheese when ready to serve.

Katherine Tallmadge presenting to Four Seasons Health Club members

Tomatoes are one of the “superfoods.” Men who consumed 10 or more servings of tomato products a week had a 35% decrease in risk of prostate cancer relative to those who consumed 1.5 servings or fewer per week.  This is largely attributed to “lycopene” in the tomatoes, which is also in other red fruits such as watermelon, pink grapefruit and guava.  Men with lycopene levels in the top 20% had a 46% decrease in risk of heart attack compared to those in the bottom 20%.  Lycopene is a potent scavenger of gene-damaging free radicals. But don’t expect to get it from a supplement. You must eat the tomato as you need the whole food to receive the benefits! Here’s an explanation…

Lycopene (Red fruits such as tomatoes, watermelon, guava): Many studies have shown that lycopene-rich foods reduce the risk of prostate cancer, but the mechanism behind that reduction was not well understood until now. A recent study found that lycopene has a substantial protective effect against prostate cancer by interfering with the genes that would allow the prostate cancer cells to grow and survive. The American Institute for Cancer Research recommends that men take advantage of lycopene’s cancer-preventing effects and fill their diets with foods such as tomatoes, watermelon and guava.

  • Bottom line: Fill your diet with lycopene-rich foods such as tomatoes, watermelon, and red grapefruit. Remember—the cancer-fighting properties of lycopene in tomatoes are much stronger when the tomatoes are cooked, such as in marinara sauce or tomato soup.

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Katherine’s Labor Day Recipe: Fresh Summer Salsa with Watermelon

My Aunt Betse has been making fresh salsa since the 1960s when she and her engineer husband lived in South America. So I have been exposed to fresh salsa long before its popularity took off in the United States. In fact, I suppose I could have been a multi-gazillionaire by now  if my college roommate and I decided to go ahead with our idea of packaging and selling my fresh salsa in the early 1980s. Oh well…

Salsa is traditionally made with tomatoes, onions, hot pepper, cilantro, lime juice and salt. But I like to add seasonal fruits and vegetables to keep it interesting. In the spring, I add strawberries, in the summer, it’s watermelon, which is especially sweet this year. You could even add celery, carrots, greens, mangos – really, anything goes. In the winter, use canned Italian plum tomatoes.

Today is the 6th of “Katherine’s Weekly Market Recipes,” all of which are designed to be delicious, easy, quick, family-friendly, nutritious (heart-healthy & diabetes-friendly), and to highlight produce found at our local Farmers Markets this week. At your Farmers Market, you’ll find produce picked at peak ripeness, which means maximum flavor, texture and nutrition. You’re also helping save the environment when you buy at your Farmers Market. Here’s how…

So that your salsa is enjoyed for Labor Day festivities, I recommend you buy the tomatoes, watermelon, onion and peppers at the Glover Park – Burleith Farmers Market on Saturday, Dupont Circle’s Fresh Farm Market on Sunday, and Georgetown’s Rose Park Market on Wednesday.

Salsa with watermelon in a rare Butternut Wood Bowl found at a Pennsylvania Flea Market

Katherine’s Spicy Salsa with Watermelon
excerpted from “Diet Simple: 195 Mental Tricks, Substitutions, Habits & Inspirations” (LifeLine Press, 2011)

I usually use vine-ripe tomatoes for my fresh salsa, excerpted from my book, Diet Simple. But watermelon is a surprising and exotically delicious substitute for all the tomatoes, or just half of them – as in this version. Serve this salsa with grilled salmon, chicken or beef… even tortilla chips… whatever you may traditionally use salsa with. My friend, Marc Marzullo, said this salsa was “refreshing, light, and delicious, and I especially like the vegetables chopped in larger chunks.” Since this salsa is getting eaten up today, I didn’t bother adding the lime juice. If you would like your salsa to last longer in your refrigerator, use vinegar instead of lime juice.

22 servings

Ingredients:

1 lb vine-ripe, fresh tomatoes, coarsely chopped (start with about 1-1/2 lbs)
1 lb chopped watermelon, seeds removed
1 large candy onion, peeled and chopped (about ½ pound)
3 – 4 jalapeno peppers (1 – 2 ounces) – or other hot seasonal peppers, to taste
¼ cup chopped fresh cilantro
½ tsp salt, or to taste
freshly ground pepper, to taste
3 – 4 Tbsp fresh lime juice (1 – 2 limes), optional, or vinegar if you wish for the salsa to last longer in your refrigerator

Add the onion to the tomatoes and watermelon. Finely chop 2 of the jalapeno peppers to start with. Taste. If you desire more heat, add 1 – 2 more jalapenos. Mix in the cilantro. Add the salt and pepper, depending on your taste. Mix in the lime juice, if you wish.

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Katherine’s Weekly Market Recipe: Melon Chunks with Crumbled Feta and Fresh Mint

I’ve been told that this year’s peaches and melons are especially sweet and velvety because of the lack of rain. It concentrates their flavor. Whatever! I recommend you quickly run over and buy some melons at Rose Park’s Farmers Market on Wednesday or Dupont Circle’s Fresh Farm Market on Sunday – before the season is over.

Though, getting the melons home takes a little help from my friends…

Anchor Nursery's Jim Breger places the melons into my "carrier" to take home...

Today is the 4th of  “Katherine’s Weekly Market Recipes,” all of which are designed to be delicious, easy, quick, family-friendly, nutritious (heart-healthy & diabetes-friendly), and to highlight produce found at our local Farmers Markets this week. At your Farmers Market, you’ll find produce picked at peak ripeness, which means maximum flavor, texture and nutrition. You’re also helping save the environment when you buy at your Farmers Market. Here’s how…

It helps to have good friends to share my recipe with, especially when they help with the physical labor…

Robert Arnold Bringing Recipe to Christ Church St. Michaels "Green" Potluck Dinner

 Melon Chunks with Crumbled Feta and Fresh Mint

By Katherine Tallmadge, M.A., R.D.
Author: “Diet Simple: 195 Mental Tricks, Substitutions, Habits & Inspirations” (LifeLine Press, 2011)

This is an unusual combination of flavors and textures, and a delight on the palate. Use any kind of melon that happens to be in season.

Serves 8

2 pounds melon chunks (about 1 small cantaloupe or seedless watermelon)
½ pound Feta Cheese or other similar cheese
8 small mint leaves, Chiffonade (Basil will also work)

Combine ingredients in a large bowl and serve!

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Harvard Study: Fruit Reduces Diabetes Risk

Swedish Strawberries (Photo: Swedish Embassy)

People are always asking me if fruit is too high in sugar to eat, especially if you have diabetes. This fear of fruit, I believe, is leftover from the Atkins craze, making foods like fruits, and even vegetables like carrots, verboten. This is one of the most tragic consequences of this diet fad, because avoiding fruit can actually damage your health.

People who eat fruit have a lower incidence of Type 2 Diabetes, the most common form of the disease, according to a recently published Harvard study. But this study isn’t alone in its conclusions. It corroborates decades of research showing the nutritional value and health benefits of fruits.

Fruit is high in water content and fiber, which help you feel full with fewer calories. Even though it contains simple sugars and carbohydrates, most fruits have a relatively low glycemic index, that is, when you eat it, your blood sugar raises only moderately, especially when compared with refined sugar or flour products.

Fruit is loaded with nutrients scientists believe protect people from major chronic diseases such as heart disease, cancer, type 2 diabetes, and more. The potassium in fruit helps lower blood pressure and actually helps neutralize the blood pressure-raising affects of sodium.

Eating more fruits and vegetables – as high as 5 cups per day or more – is a habit which could help you stabilize and even reverse Type 2 Diabetes. Yes, it is possible!

And, the best part of fruit? It’s delicious! It’s easy to eat, to pack in your lunch box for the office or school, and it’s such a refreshing snack or dessert. What could be better?

The study:

Dietary flavonoid intakes and risk of type 2 diabetes in US men and women

Nicole M Wedick, An Pan, Aedín Cassidy, Eric B Rimm, Laura Sampson, Bernard Rosner, Walter Willett, Frank B Hu, Qi Sun, and Rob M van Dam

From the Departments of Nutrition, Epidemiology, and Biostatistics, Harvard School of Public Health, Boston, MA; Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; the Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich, United Kingdom; and the Departments of Epidemiology and Public Health and Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Supported by NIH grant from the National Heart, Lung, and Blood Institute.

Abstract

Background: Data from mechanistic studies support a beneficial effect of specific flavonoids on insulin sensitivity. However, few studies have evaluated the relation between intakes of different flavonoid subclasses and type 2 diabetes.

Objective: The objective was to evaluate whether dietary intakes of major flavonoid subclasses (ie, flavonols, flavones, flavanones, flavan-3-ols, and anthocyanins) are associated with the risk of type 2 diabetes in US adults.

Design: We followed up a total of 70,359 women in the Nurses’ Health Study, 89,201 women in the NHS II, and 41,334 men in the Health Professionals Follow-Up Study who were free of diabetes, cardiovascular disease, and cancer at baseline.

Results: During 3,645,585 person-years of follow-up, we documented 12,611 incident cases of type 2 diabetes. Higher intakes of anthocyanins were significantly associated with a lower risk of type 2 diabetes after multivariate adjustment for age, BMI, and lifestyle and dietary factors. Consumption of anthocyanin-rich foods, particularly blueberries and apples/pears, was also associated with a lower risk of type 2 diabetes. No significant associations were found for total flavonoid intake or other flavonoid subclasses.

Conclusion: A higher consumption of anthocyanins and anthocyanin-rich fruit was associated with a lower risk of type 2 diabetes.

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