
Summary
Marketers are increasingly recognizing the phenomenon of "bullspend," where ad campaigns generate impressive metrics but fail to translate into actual revenue. This disconnect highlights the importance of focusing on tangible results rather than just reach. LinkedIn is noted for delivering the highest return on ad spend among major networks, prompting calls for businesses to reassess their advertising strategies.
The discussion shifts to health and lifestyle, emphasizing the critical role of gut health in preventing chronic diseases. Fasting is highlighted as a practical method to improve gut microbiota by starving harmful bacteria while promoting beneficial ones. The conversation also touches on the importance of whole foods, fiber, and fermented products in maintaining a healthy microbiome. Additionally, the impact of sleep, stress management, and exercise on gut health is explored, with recommendations for practices like time-restricted feeding and regular physical activity to enhance overall well-being.
The episode concludes with a call to action for listeners to adopt healthier lifestyles, underscoring that many changes can be made easily and immediately to promote longevity and prevent diseases such as obesity and Alzheimer's.
Show Notes
In this video, I share the practical steps to improve gut bacteria, reduce inflammation, and prevent the diseases of modern man. Learn about the importance of fasting, nurturing good gut bacteria, and maintaining homeostasis in your body. These simple yet effective tips have helped countless patients transform their metabolic and heart health and achieve overall wellness. Hope you all enjoy!Uploaded 14-05-23Remember that my videos are not a substitute for individualized medical care by a qualified physician. Always consult your physicians before making any diet, nutrition, medication, or lifestyle changes.Chapters0:00 Introduction1:13 Fasting and Obesity4:46 Fiber6:55 Fermented Foods8:14 Processed Seed Oils10:04 Artificial Sweeteners and Sugar11:25 True Allergy Work Up12:34 Sleep15:04 Stress Management - Meditation and Biophilia17:50 Exercise22:08 Conclusion23:29 OutroFull Microbiome Playlist:https://youtube.com/playlist?list=PLN4uKfvSU2v36e8OoIfbXwVKiFejoRGTqOther videos in this series:How Gut Bacteria Diversity Improves Health - https://www.youtube.com/watch?v=4S7Nh0oHNDwWhere Did Our Gut Bacteria Come From? - https://www.youtube.com/watch?v=Is_x0LGNgC0The Heart Disease Risk You Don’t Know About: The role of LPS - https://youtu.be/-vg5-HzSfmAI have a gut feeling about this... | The Microbiome, Metabolism and Overall Health - https://youtu.be/VVfCLb_n8vAMake sure you subscribe! https://www.youtube.com/channel/UCOtQHehGWtblMp1gZC8Kq3Q?sub_confirmation=1My other videos:Reversing Diabetes - The Roles Medication and Diet Play - https://youtu.be/mWNygxUPNsAVitamin K2: The Surprising Benefits From Your Heart to Your Bones - https://www.youtube.com/watch?v=z3njgh2nFRkExposing the links between Calcium, Vitamin K2, and Plaque Buildup in Blood Vessels - https://www.youtube.com/watch?v=D_UJaEZe9ggBest and Worst Breakfast Foods - https://youtu.be/uAJ6-X3ESS4What Eating Processed Flour and Vegetable Seed Oils Really Does to You - https://youtu.be/gVsxe9v72C0Lunch and Dinner | The Meats and Vegetables you Should be Eating and Avoiding - https://youtu.be/pCQovPrsM2kWhat is a Coronary Calcium Score? - https://youtu.be/NYkW2vxyiocWhat is a CT Angiogram (CTA) of the Heart? - https://youtu.be/uHpN1FQ-HvoWhat is Cardioversion? - https://youtu.be/yb-srtyEOuYWhat is a Leadless Pacemaker? - https://youtu.be/2CYZbeYSvVEWhat is Right Heart Catheterization? - https://youtu.be/2hy05-dM-lMWhat is a Heart Attack? - https://youtu.be/lPzT62_b4KoHeart Attack Treatment - https://youtu.be/N0vFV3wOGPUWhat is a Kraft Test? - https://youtu.be/SxS2AayOHmoWhat is an Echocardiogram? - https://youtu.be/DZ3G8P0L_sMMonitoring Heart Failure with CardioMEMS - https://youtu.be/A35IsJxs6mwIntroduction to Cardiac Catheterizations - https://youtu.be/k4UyUBGnojUWhat is a Loop Recorder? - https://youtu.be/mXHAuV27bs8External Counterpulsation (ECP) for Chest Pain and Coronary Calcium - https://youtu.be/4wd-3WyvlNQWhy your Cardiac Examination is Incomplete - https://youtu.be/Rzb5r8FXpRUReverse High Blood Pressure by Treating its Root Cause - https://youtu.be/yaf1swrS1_cPast lectures:How Fasting and Diet can Prevent Heart Disease - https://www.youtube.com/watch?v=0wXWEdipBEg“Fasting for Survival” - https://youtu.be/watch?v=RuOvn4UqznUAddiction: Why You Can't Fast or Keep a Diet - https://youtu.be/kN83jppeI7Q"The Fat Lies" - https://youtu.be/4Uqj35nHB0g"The Bittersweet Truth" - https://youtu.be/AbR1QwJwwpoSocial Links:https://www.facebook.com/orlandocvihttps://www.instagram.com/pradipjamnadasmd/https://www.facebook.com/pradipjamnadasmd/About Dr. Pradip Jamnadas, MD, MBBS, FACC, FSCAI, FCCP, FACPThe founder and Chief Medical Officer of Cardiovascular Interventions, P.A. in Orlando Florida where, since 1990, he has been repeatedly recognized in local publications as a Top Doctor performing thousands of interventio Learn more about your ad choices. Visit megaphone.fm/adchoices
More from Dr. Pradip Jamnadas, MD
Under the direction of Dr. Jamnadas Cardiovascular Interventions has created the most comprehensive cardiovascular clinic in Central Florida. A wide range of on-site assets including a Cath Lab, CT Scanner, and Blood Lab provide his patients with convenient and holistic cardiac care.Uploaded 16-10-20Subscribe to the Channel!https://www.youtube.com/channel/UCOtQHehGWtblMp1gZC8Kq3Q?sub_confirmation=1Sign up for my Heart Health emailshttps://orlandocvi.com/heart-health-updates-yt/My other Videos:Why your Cardiac Examination is Incomplete - https://youtu.be/Rzb5r8FXpRUWhat is a Coronary Calcium Score? - https://youtu.be/NYkW2vxyiocWhat is a CT Angiogram (CTA) of the Heart? - https://youtu.be/uHpN1FQ-HvoWhat is Cardioversion? - https://youtu.be/yb-srtyEOuYWhat is a Leadless Pacemaker? - https://youtu.be/2CYZbeYSvVEWhat is Right Heart Catheterization? - https://youtu.be/2hy05-dM-lMWhat is a Heart Attack? - https://youtu.be/lPzT62_b4KoHeart Attack Treatment - https://youtu.be/N0vFV3wOGPUWhat is a Kraft Test? - https://youtu.be/SxS2AayOHmoWhat is an Echocardiogram? - https://youtu.be/DZ3G8P0L_sMMonitoring Heart Failure with CardioMEMS - https://youtu.be/A35IsJxs6mwIntroduction to Cardiac Catheterizations - https://youtu.be/k4UyUBGnojUWhat is a Loop Recorder? - https://youtu.be/mXHAuV27bs8External Counterpulsation (ECP) for Chest Pain and Coronary Calcium - https://youtu.be/4wd-3WyvlNQMy Lectures:"The Fat Lies" - https://youtu.be/Yo-IL-LH5FQ"The Bittersweet Truth" - https://youtu.be/6zZBiTfIp4QSocial Links:https://www.facebook.com/orlandocvihttps://www.instagram.com/pradipjamnadasmd/https://www.facebook.com/pradipjamnadasmd/About Dr. Pradip Jamnadas, MD, MBBS, FACC, FSCAI, FCCP, FACPThe founder and Chief Medical Officer of Cardiovascular Interventions, P.A. in Orlando Florida where, since 1990, he has been repeatedly recognized in local publications as a Top Doctor performing thousands of interventional procedures in hospital and out patient settings. As a consultant cardiologist with a large diversified inpatient and outpatient practice he is noted for his passions for teaching and illuminating prevention for cardiovascular disease . He is also a clinical assistant professor of medicine at The Florida State University and University of Central Florida.▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬Music: Encouraging Times by hitapaudiohttps://soundcloud.com/user-478711931Video Link: https://youtu.be/afa89fle5Do▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬Disclaimer: The information provided is for general knowledge and is not a substitute for individual medical advice. All viewers should consult their physician before starting any medical program or treatment. Any action you take upon the information that you find within this content is strictly at your own risk. Neither Dr. Pradip Jamnadas nor Cardiovascular Interventions will be liable for any damages or losses in connection with the content on this YouTube Channel. Learn more about your ad choices. Visit megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices
We have some exciting stuff planned for 2025! In the meantime I wanted to share some of the most impactful clips from my previous videos.In this video, you'll learn surprising facts about your body’s most important nerve, along with practical hacks you can start using immediately. Discover how activating your vagus nerve can reduce stress, improve digestion, and transform your well-being.Remember that my videos are not a substitute for individualized medical care by a qualified physician. Always consult your physicians before making any diet, nutrition, medication, or lifestyle changes.Download the slides from this lecture here: https://orlandocvi.com/Vagus-Nerve-Slides/To learn more about how to book a consultation with me please check out https://aristotleeducation.comAll of my social media and official links: https://linktr.ee/pradipjamnadasmdChapters0:00 Understanding the sympathetic and parasympathetic nervous system10:02 Different techniques to hack the vagus nerveSubscribe to the Channel! https://www.youtube.com/channel/UCOtQHehGWtblMp1gZC8Kq3Q?sub_confirmation=1My other videos:How Breathing Hacks the Vagus Nerve to Lower Blood Pressure & Inflammation - https://youtu.be/flDkL8bukEsWhy ‘Healthy’ People Develop Clogged Arteries & How Fasting Can Help - https://youtu.be/cXOoJKe4rugHow Fasting Naturally Lowers High Blood Pressure - https://youtu.be/ogNBtf3APFMHow the Vagus Nerve Heals Your Gut - https://youtu.be/sGQW8Tx78hMVagus Nerve Hacks - https://youtu.be/irn3cFHmK-YWhy Gut Health Affects Everything - https://youtu.be/Npy0qwgh5RMHow to Fast for Different Goals - https://youtu.be/qIcSIC_IjfMAGEs: The Surprising Link Between our Diet and Aging - https://youtu.be/rGD1BYD6N2YEvolution of Cardiac Diagnostics: A New Era with AI-Powered FFR-CT - https://youtu.be/buzfmeTpyCwReversing Diabetes - The Roles Medication and Diet Play - https://youtu.be/mWNygxUPNsAVitamin K2: The Surprising Benefits From Your Heart to Your Bones - https://www.youtube.com/watch?v=z3njgh2nFRkExposing the links between Calcium, Vitamin K2, and Plaque Buildup in Blood Vessels - https://www.youtube.com/watch?v=D_UJaEZe9ggBest and Worst Breakfast Foods - https://youtu.be/uAJ6-X3ESS4What Eating Processed Flour and Vegetable Seed Oils Really Does to You - https://youtu.be/gVsxe9v72C0Lunch and Dinner | The Meats and Vegetables you Should be Eating and Avoiding - https://youtu.be/pCQovPrsM2kWhat is a Coronary Calcium Score? - https://youtu.be/NYkW2vxyiocWhat is a CT Angiogram (CTA) of the Heart? - https://youtu.be/uHpN1FQ-HvoWhat is Cardioversion? - https://youtu.be/yb-srtyEOuYWhat is a Leadless Pacemaker? - https://youtu.be/2CYZbeYSvVEWhat is Right Heart Catheterization? - https://youtu.be/2hy05-dM-lMWhat is a Heart Attack? - https://youtu.be/lPzT62_b4KoHeart Attack Treatment - https://youtu.be/N0vFV3wOGPUWhat is a Kraft Test? - https://youtu.be/SxS2AayOHmoWhat is an Echocardiogram? - https://youtu.be/DZ3G8P0L_sMMonitoring Heart Failure with CardioMEMS - https://youtu.be/A35IsJxs6mwIntroduction to Cardiac Catheterizations - https://youtu.be/k4UyUBGnojUWhat is a Loop Recorder? - https://youtu.be/mXHAuV27bs8External Counterpulsation (ECP) for Chest Pain and Coronary Calcium - https://youtu.be/4wd-3WyvlNQWhy your Cardiac Examination is Incomplete - https://youtu.be/Rzb5r8FXpRUReverse High Blood Pressure by Treating its Root Cause - https://youtu.be/yaf1swrS1_cPast lectures:How Fasting and Diet can Prevent Heart Disease - https://www.youtube.com/watch?v=0wXWEdipBEg“Fasting for Survival” - https://youtu.be/watch?v=RuOvn4UqznUAddiction: Why You Can't Fast or Keep a Diet - https://youtu.be/kN83jppeI7Q"The Fat Lies" - https://youtu.be/4Uqj35nHB0g"The Bittersweet Truth" - https://youtu.be/AbR1QwJwwpoAbout Dr. Pradip Jamnadas, MD, MBBS, FACC, FSCAI, FCCP, FACPThe founder and Chief Medical Officer of Cardiovascul Learn more about your ad choices. Visit megaphone.fm/adchoices
If you're interested in receiving personalized guidance through our fasting program, or would like to learn more about scheduling a consultation with me, please check out: https://orlandocvi.com/fasting-programUploaded 20-09-26In this clip from my conversation on @ThePrimal.Podcast I explain how I help patients gradually work up to a 36-hour fast. I cover how fasting can lower insulin, help the body access stored fat, and improve metabolic flexibility. The goal is to build up slowly and make fasting a sustainable part of a better overall healthy lifestyle.Watch the full conversation here https://youtu.be/y5WeiL_fsMQMake sure to give it a like and subscribe to @ThePrimal.Podcast's channel!Remember that my videos are not a substitute for individualized medical care by a qualified physician. Always consult your physicians before making any diet, nutrition, medication, or lifestyle changes.I enjoy providing educational videos to all of you, but I want to ensure that you are aware that only the official accounts authorized to promote and share my content are Dr. Pradip Jamnadas, MD, Aristotle Education, LLC, The Galen Foundation, and Cardiovascular Interventions. On YouTube there are only two official channels:@pradipjamnadasmd and @thegalenfoundationThere are numerous accounts, videos, and books circulating that use my image or claim to represent my work. In this age of AI, I encourage you to stay vigilant and take a moment to verify the source before believing or sharing any information not posted or confirmed through my official channels. Please protect yourself from consuming false and untrustworthy medical information.All of my official links can be found here: https://linktr.ee/pradipjamnadasmdMy Cardiology practice offers an online supplement store with nationwide shipping, take a look at what we offer here, https://shop.orlandocvi.com.Don’t forget to subscribe! https://www.youtube.com/channel/UCOtQHehGWtblMp1gZC8Kq3Q?sub_confirmation=1About Dr. Pradip Jamnadas, MD, MBBS, FACC, FSCAI, FCCP, FACPThe founder and Chief Medical Officer of Aristotle Education and has been practicing medicine in Central Florida for over 35 years. He is also the founder and medical director of Cardiovascular Interventions, PA, where since 1990 he has been repeatedly recognized in local publications as a Top Doctor. Throughout his distinguished career, he has performed thousands of interventional procedures in both hospital and outpatient settings. As a consultant cardiologist with a large diversified inpatient and outpatient practice he is noted for his passions for teaching and illuminating prevention for cardiovascular disease. He is also a clinical assistant professor of medicine at The Florida State University and University of Central Florida. Learn more about your ad choices. Visit megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices
Today, we'll explore how lipopolysaccharides (LPS) affect heart health and other inflammatory conditions. Atherosclerosis, obesity, mental health, even autoimmune diseases are all now being linked to lipopolysaccharides in the body. Hope you enjoy!Uploaded 11-03-23Remember that my videos are not a substitute for individualized medical care by a qualified physician. Always consult your physicians before making any diet, nutrition, medication, or lifestyle changes.Chapters0:00 Introduction0:26 The benefits of lifestyle changes2:46 What are Lipopolysaccharides?5:55 Lipopolysaccharides and your Lymphatic System7:25 Lipopolysaccharides and other effects on your body10:19 Lipopolysaccharides and Fat12:18 Connecting LPS to Chronic Diseases and Inflammation15:11 OutroOther videos in this series:I have a gut feeling about this... | The Microbiome, Metabolism and Overall Health - https://youtu.be/VVfCLb_n8vAMore coming soon! Make sure you subscribe! https://www.youtube.com/channel/UCOtQHehGWtblMp1gZC8Kq3Q?sub_confirmation=1My other videos:Reversing Diabetes - The Roles Medication and Diet Play - https://youtu.be/mWNygxUPNsAVitamin K2: The Surprising Benefits From Your Heart to Your Bones - https://www.youtube.com/watch?v=z3njgh2nFRkExposing the links between Calcium, Vitamin K2, and Plaque Buildup in Blood Vessels - https://www.youtube.com/watch?v=D_UJaEZe9ggBest and Worst Breakfast Foods - https://youtu.be/uAJ6-X3ESS4What Eating Processed Flour and Vegetable Seed Oils Really Does to You - https://youtu.be/gVsxe9v72C0Lunch and Dinner | The Meats and Vegetables you Should be Eating and Avoiding - https://youtu.be/pCQovPrsM2kWhat is a Coronary Calcium Score? - https://youtu.be/NYkW2vxyiocWhat is a CT Angiogram (CTA) of the Heart? - https://youtu.be/uHpN1FQ-HvoWhat is Cardioversion? - https://youtu.be/yb-srtyEOuYWhat is a Leadless Pacemaker? - https://youtu.be/2CYZbeYSvVEWhat is Right Heart Catheterization? - https://youtu.be/2hy05-dM-lMWhat is a Heart Attack? - https://youtu.be/lPzT62_b4KoHeart Attack Treatment - https://youtu.be/N0vFV3wOGPUWhat is a Kraft Test? - https://youtu.be/SxS2AayOHmoWhat is an Echocardiogram? - https://youtu.be/DZ3G8P0L_sMMonitoring Heart Failure with CardioMEMS - https://youtu.be/A35IsJxs6mwIntroduction to Cardiac Catheterizations - https://youtu.be/k4UyUBGnojUWhat is a Loop Recorder? - https://youtu.be/mXHAuV27bs8External Counterpulsation (ECP) for Chest Pain and Coronary Calcium - https://youtu.be/4wd-3WyvlNQWhy your Cardiac Examination is Incomplete - https://youtu.be/Rzb5r8FXpRUReverse High Blood Pressure by Treating its Root Cause - https://youtu.be/yaf1swrS1_cPast lectures:How Fasting and Diet can Prevent Heart Disease - https://www.youtube.com/watch?v=0wXWEdipBEg“Fasting for Survival” - https://youtu.be/watch?v=RuOvn4UqznUAddiction: Why You Can't Fast or Keep a Diet - https://youtu.be/kN83jppeI7Q"The Fat Lies" - https://youtu.be/4Uqj35nHB0g"The Bittersweet Truth" - https://youtu.be/AbR1QwJwwpo_________________________________________________________Graphic used in Bacteria AnimationTitle: Gram negative cell wallLink: https://upload.wikimedia.org/wikipedia/commons/8/8b/Gram_negative_cell_wall.svgLicensed under CC Attribution 4.0 - https://creativecommons.org/licenses/by-sa/4.0/This work has been modified.Social Links:https://www.facebook.com/orlandocvihttps://www.instagram.com/pradipjamnadasmd/https://www.facebook.com/pradipjamnadasmd/About Dr. Pradip Jamnadas, MD, MBBS, FACC, FSCAI, FCCP, FACPThe founder and Chief Medical Officer of Cardiovascular Interventions, P.A. in Orlando Florida where, since 1990, he has been repeatedly recognized in local publications as a Top Doctor performing thousands of interventional procedures in hospital and out patient settings. As a consultant cardiologist with a large diversified inpatient and outpatie Learn more about your ad choices. Visit megaphone.fm/adchoices
Many of us don't realize just how much the food we eat affects our gut microbiome. These tiny organisms play a huge role, and without them, we would not be who we are. We'll dive into the symbiotic relationship between our bodies and these gut bacteria, highlighting the importance of nurturing them through our dietary choices. Understanding what these microbes are and how they function can guide us in providing the right nutrients for a healthy and diverse microbiome, which is a key step in optimizing our overall health. This video will showcase practical ways to improve your gut health and, by extension, your overall well-being.Uploaded 11-12-23Chapters0:00 Introduction to the Microbiome1:23 What is Gut Bacteria for?4:21 What creates a healthy microbiome?23:12 Challenges of finding the right food to eat today35:22 The effects of Fermented foods and Alcohol on the Microbiome42:05 Maintaining a Proper Balance of Bacteria47:33 Advanced Glycation End Products55:10 ConclusionsQuestions and Answers1:01:00 Explain soluble and non-soluble fiber? What are the best sources for fiber?1:03:04 What are the best breads to eat?1:05:02 Should gut bacteria be helped with Supplements?1:08:04 How do I ferment my own sauerkraut?1:10:56 What are the best yogurts?1:12:29 What are the most important things in a healthy diet?Make sure you subscribe! https://www.youtube.com/channel/UCOtQHehGWtblMp1gZC8Kq3Q?sub_confirmation=1Full Microbiome Playlist:https://youtube.com/playlist?list=PLN4uKfvSU2v36e8OoIfbXwVKiFejoRGTqMy other videos:Reversing Diabetes - The Roles Medication and Diet Play - https://youtu.be/mWNygxUPNsAVitamin K2: The Surprising Benefits From Your Heart to Your Bones - https://www.youtube.com/watch?v=z3njgh2nFRkExposing the links between Calcium, Vitamin K2, and Plaque Buildup in Blood Vessels - https://www.youtube.com/watch?v=D_UJaEZe9ggBest and Worst Breakfast Foods - https://youtu.be/uAJ6-X3ESS4What Eating Processed Flour and Vegetable Seed Oils Really Does to You - https://youtu.be/gVsxe9v72C0Lunch and Dinner | The Meats and Vegetables you Should be Eating and Avoiding - https://youtu.be/pCQovPrsM2kWhat is a Coronary Calcium Score? - https://youtu.be/NYkW2vxyiocWhat is a CT Angiogram (CTA) of the Heart? - https://youtu.be/uHpN1FQ-HvoWhat is Cardioversion? - https://youtu.be/yb-srtyEOuYWhat is a Leadless Pacemaker? - https://youtu.be/2CYZbeYSvVEWhat is Right Heart Catheterization? - https://youtu.be/2hy05-dM-lMWhat is a Heart Attack? - https://youtu.be/lPzT62_b4KoHeart Attack Treatment - https://youtu.be/N0vFV3wOGPUWhat is a Kraft Test? - https://youtu.be/SxS2AayOHmoWhat is an Echocardiogram? - https://youtu.be/DZ3G8P0L_sMMonitoring Heart Failure with CardioMEMS - https://youtu.be/A35IsJxs6mwIntroduction to Cardiac Catheterizations - https://youtu.be/k4UyUBGnojUWhat is a Loop Recorder? - https://youtu.be/mXHAuV27bs8External Counterpulsation (ECP) for Chest Pain and Coronary Calcium - https://youtu.be/4wd-3WyvlNQWhy your Cardiac Examination is Incomplete - https://youtu.be/Rzb5r8FXpRUReverse High Blood Pressure by Treating its Root Cause - https://youtu.be/yaf1swrS1_cPast lectures:How Fasting and Diet can Prevent Heart Disease - https://www.youtube.com/watch?v=0wXWEdipBEg“Fasting for Survival” - https://youtu.be/watch?v=RuOvn4UqznUAddiction: Why You Can't Fast or Keep a Diet - https://youtu.be/kN83jppeI7Q"The Fat Lies" - https://youtu.be/4Uqj35nHB0g"The Bittersweet Truth" - https://youtu.be/AbR1QwJwwpoSocial Links:https://www.facebook.com/orlandocvihttps://www.instagram.com/pradipjamnadasmd/https://www.facebook.com/pradipjamnadasmd/About Dr. Pradip Jamnadas, MD, MBBS, FACC, FSCAI, FCCP, FACPThe founder and Chief Medical Officer of Cardiovascular Interventions, P.A. in Orlando Florida where, since 1990, he has been repeatedly recognized in local publications as a Top Docto Learn more about your ad choices. Visit megaphone.fm/adchoices