CHILD OBESITY AND THE CONSEQUENCES

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0:47From wherever you are around the world. Around the world. Welcome to the Circle of Insight. A show that explores the many facets of human behavior and the wonders of the human mind. And now, here's your host, Dr. Carlos. Welcome, everyone.

1:23Today, I have a great guest. Her name is Dr. Patricia A. Ronald Reba. She's a childhood obesity specialist and author in Orange County, California. She was the founder and medical director of Dr. Patricia M.D., Dr. Reba Health Club, a community-based organization designed to prevent and treat nutrition-related health problems in children aged 0 to 18 years and their families. By the way, you can see right behind her on her left side, Dr. Patricia's Health Club. This is a fabulous idea that we're going to be talking about in a little bit.

1:54She also has another nonprofit organization, Serving Children's Hope. Serving Kids Hope. Serving Kids Hope. She's going to have to help me out on my own introduction, but that's the way it works. Thank you so much again, everybody, for following us. Make sure if you want to support us to share and subscribe this video. Now, let's welcome to the show, Dr. Reba. Welcome, Dr. Reba. Well, thank you for having me. Thank you for being here. This is a fascinating topic because it's our future. That's why I like it so much, because we're talking about children.

2:26We're talking about obesity, which is a huge problem. And we cover a lot of things on the news. And sometimes I think we cover things that we shouldn't be bothering with when we should be talking about things like this. And the first thing I want to talk to you about, Dr. Reba, there's so much. First one is ACEs, because I know your program, Dr. Patricia's Health Club, helps with that. But what is ACEs, and how does it apply to your program? So ACEs is, it's called, it's, the acronym is from the Adverse Childhood Experiences Study.

2:57And it was done by a doctor actually treating obesity at Kaiser. And he ended up seeing that there was this, people were, you know, he was helping people lose weight. And he had this one patient that gained a lot of weight really quickly. And he's like, what's going on here? And it turned out that this woman had had abuse in her life. And so he really started thinking about the fact that, you know, we've always known kind of obesity isn't about calories in and calories out. What else is taking place? And so he did this research project. I think they looked at over 17,000 people and through Kaiser's health system.

3:31And they basically found that, you know, they looked at adverse childhood experiences. So sexual abuse, neglect, physical abuse, parents incarcerated, divorce, mental illness in the family, and, you know, and other things. And they basically found that if you had four or more of those things, you were like, you were more likely to commit suicide. You were more likely to be depressed. You're more likely to be obese, have heart disease, lung disease, abuse drugs.

4:03You were more likely to, you know, have cancer, all these medical conditions, diabetes, all these things that we're trying to use medicines for, we're trying to fix. And actually, it really, you know, stems from dealing with this trauma over time in our lives. And so I'm really excited when this came out. Dr. Nadine Burke Harris, our Surgeon General in California, made this big pitch in January. She's like, she wants everybody to screen for ACEs. And, but right now it's like, it's a little hard because we were, we want to screen for

4:35this. We want to get people on the right track. But right now there's not quite, we're working on it with some other great people in this county, but there's, there's not quite like a description of exactly what to do and how to do it. The basic guidelines though, are exactly what my team and I do. So yes, you have to get treated for mental health, for your trauma, and that can be through EMDR, CPT. Those are different types of trauma treatment and work with a therapist about that. But the rest of the things that will buffer you from those adverse childhood experiences

5:10affecting your life expectancy, because like I said, 20 years less life expectancy, it's crazy. Um, and that would be working on sleep, uh, having proper nutrition, exercise, mindfulness, um, having a support system. And so those are all things that my team and I've been doing for nearly 20 years. As we've been treating childhood obesity, we've been working with families and using this approach instead of adding more stress to these kids and putting them on a diet, doing portion control and all these things that, that don't work.

5:41We all know they don't work, but this maybe starts to tell us why they don't work, that you have to get that underlying trauma, those underlying barriers, which are inhibiting you from becoming more healthy. And for those people listening to us on the podcast, you can watch a clip of Dr. Patricia's Health Club here on our YouTube channel, the Dr. Carlos show, catch the clip. You can see the video and you'll watch the 30 seconds. So tell us a little bit about the show and, and, and how it can impact these individuals. Well, what we've come to, to understand since this pandemic hit, I was seeing all these

6:13kids, um, just, you know, through telemedicine and they were all extremely traumatized by, um, distance learning, the pandemic, all these things going on, especially my early learners, especially my kids on the spectrum, um, especially my kids that were, had special needs. And so I had one patient, actually, she cut half of her hair. She was so stressed. The mom's like, I thought she was fine with distance learning. Yeah. And she was like, and her mom was like, I thought she was fine. Then one day she's like, I just can't handle this. And she cut one side of her hair.

6:45So I was like, I've got to do something. And so what I've always wanted to do is kind of put together a lifestyle show for, uh, for preschoolers and kindergartners. And so I've worked with some amazing people at PBS SoCal, um, in the community, Lisa O'Brien, who's amazing. And we've put together this show, um, that we're working on the half hour, um, shows now for a pilot that we're going to be airing. And it, and it's already in the digital format. We've already started 30 second clips and it's really just teaching kids how to use the

7:18letters of the alphabet to become more healthy. And, um, it's so much fun. And we've been doing this for classrooms. So like, for example, the letter D, I was doing it for this one classroom and we were like, okay, well you can have, you know, dates, uh, start with the letter D and they're healthy for your body. Or if you're feeling down, you can use the letter D to, um, you know, dig in the dirt, play with your dog, draw a picture of your day. Those are all mindful things that you can do that will help actually decrease stress. Um, there's trusted adults, um, like, um, that start with the letter D like dietitians,

7:49uh, doctors and dentists. And so we used to use these, the letters, the alphabet to kind of inspire. And we teaching kids about fruits and vegetables and mindfulness and curbing screen time and being active and getting out in nature and being more healthy. Um, and so it's been, it's been a labor of love. I will tell you, um, we've come up with these third characters and, um, we're having a wonderful time. So, and that's at drphc.org and the kids, we don't want them playing games so they can go on the, um, they can go click on our books on the website.

8:20They can print them out. They can see our video, but then they can, it's only 30 seconds and we only have A, B, and C so far. We're still working on funding, but we're going to get to Z. I promise. Now folks down below, you can also see those links drpc.org. Drph, drphc.org, drphc.org, drphc.org, drphc.org, drphc.org, folks, you can see it in the description. And you also have a GoFundMe page. I think we're going to put a link down there as well. That would be fantastic. Yes. Because we are, we're really working right now.

8:50We're trying to raise a hundred thousand dollars so we can finish the half hour, um, series, um, which will be about 12 episodes. And then we can definitely get all 26 letters of the alphabet. But some of them will be, you know, within, uh, like X and, and Y will be hard to, you know, we'll, we'll combine those with other ones. So Dr. Reba, um, do you have a name for the GoFundMe page? Is it, um, I, I don't know what off the top of my head. That's okay. If we can get it later, I'll send it. I'll get it for you for sure. The podcast is listed too.

9:22Okay. Okay. That'd be great. So yeah, if you're on the podcast, listening to it, you can go over to the YouTube channel, the Dr. Carlos show, and you can get, catch the link there. Um, for the DrPHC.org, uh, for helping out with the show and getting the rest of those letters filled out for ABC here. By the way, I like dates. So those are always good. I like it. I love to use dates, especially like to replace sugar and rest, like could give food sweetness without adding, um, sugar. They're great. So is it okay with the coconut?

9:53Oh yeah. Coconut is, is great. It's just fantastic. Yes. And actually I will say coconut is my favorite food. Oh, there you go. Yeah. There you go. So let me ask you this. We've talked about, before I should get to that, the show seems to be targeted, what, seven or eight year olds? It's actually two to six year olds. Two to six. Okay. Really? Yeah. And we're hitting all of the, I mean, and the cool thing is that we're, we're really trying to engage the whole family. I've got a friend of mine who, uh, used to be in Sugar Ray. I went to high school with him, Stan Frazier, and he's gotten given us all this great music.

10:27So it's going to have more of that, you know, really kind of cool Jack Johnson, more vibe than, um, the squeaky music that you hear on a lot of the kids shows right now. Um, and we're going to really try to have some adult humor in it, um, get these, you know, and get the kids engaged with these, with these birds, but really, we really want the whole family engaged. And so it won't be, you know, hard to, hard to sit through as an adult or an older kid. Was his name Stan Johnson? Stan Frazier. He's great. I've known him since, since high school.

10:59And he's was, like I said, the, our hot band in high school was the Tories and they, and those guys went on to become Sugar Ray. So, well, it's kind of funny because it's just, I think of Stan Frazier and I'm thinking of Stan, the music man, Daniel Tiger. So it all does come around full circle. What are you seeing right now? Switch topics a little bit. What are you seeing right now with a lot of children? What are some of the issues? I know you mentioned, uh, during this pandemic, a lot of them are obviously stressed out. Uh, we just heard about the fortune of the child cutting her hair.

11:32What are the things that you see? Are they eating more snacks? Are they sitting around and watching more TV? What are they doing right now? Yeah, I think I, you know, I, you know, okay. So there's two ways I'm seeing kids dealing with stress. They're either watching screens or they're eating and neither one of those are helping coping mechanisms. And so when, and so, and actually, so our bodies are designed to experience life through all five senses. We feel safe when we experience life through five senses. So if you're, you know, if you're smelling, if you're hearing, if you're touching, if you're tasting, um, if you're what's my other one hearing, then you're experiencing life the

12:08way it should be. But when you're on a screen all day for school and then you're on video games for entertainment, and then you're on screens to communicate with your friends, actually somewhere in our brain, it makes us feel unsafe. You're only using two senses. And so there's a conflict. And so when kids are going to screens for like so many things in their day, their screen time has gone up exponentially. What we're finding is they're having more trouble sleeping. They don't stay sleeping as well, especially if they're using those screens before bed,

12:39their stress level is going up and so forth. So it's a really important time to get kids off of screens, get them doing things that are mindful, um, playing musical instruments, doing art, doing crafts, looking at nature, you know, doing things in the backyard. It's got to, it's, we, we got to get back to basics, um, with our kids instead of, you know, letting, Oh, you watching TV and so forth. Plus one thing that's added to their screen time is parents are just, they're trying to work from home and do all these things too. And so it's like, they kind of are using that as a babysitter.

13:11And so we, as parents and as, um, caregivers, we really need to start being creative and coming up with ideas to get kids, um, healthy and off of screens and also not using food as a tool for, for stress. So, um, so that's, that's important too.

13:29Great stuff, Dr. Reba. You know what folks, we got the, the name of the GoFundMe page. So if you want to help support it out, you can go to help heal and inspire early learners, help heal and inspire early learners to help out, uh, with this program. It's a great program. We're going to learn a little bit more about it right now. You know, my background's in forensic psych. I do a lot of teaching on criminal psychopathology. And one caveat folks, this is not saying that people who have these issues lead into criminal behavior, delinquency, not at all. But we always looking for contributing factors because there are qualities that we see such

14:02as aggression, impulsivity, things of that nature that can lead to, um, unlawful behavior. So I guess my question to you, Dr. Reba is when you see children doing a lot of these activities on the computer TV, and we're talking a lot of hours, does it contribute to impulsivity? Does it contribute to a problem with delayed gratification or anything of that sort? Um, yes. I mean, I think that all the way around, and I think, and I wouldn't even just limit that to kids. I mean, I think it, it increases your overall stress and that just can't be good.

14:33Um, I find even with myself, when the pandemic started, I was doing telemedicine and I was on the screen, screen, screen, screen, screen. And I would take my dogs for a walk. And I was like, I had to like, I really knew the dog walk was over when my head was finally feeling clear. And it would take a while because you do get in this, um, in this state, that's just, it's not a healthy place to be a couple of things that, you know, just, just for the parents, like some real key things to keep in mind is that hour and a half or two before bedtime, trying to get people off of screens, uh, that being on screens.

15:07And we think about it, the skies are blue during the daytime. Our bodies are designed to see that blue light and think it's daytime. So what happens when you think that, you know, when you, you're about to go to bed and you look at this blue screen, I'm just going to check my emails. I'm just going to check my homework. I'm just going to read a book on a screen. What ends up happening is our brains like, Oh, blue light it's daytime. So it affects our melatonin levels. It affects our sleep. Um, if we have a harder time falling asleep and staying asleep and quality of sleep. So, um, really if, if you can start as a family, this isn't just like tell the kids

15:41to do this, the whole family should be really working on turning off those screens about an hour and a half or two before bedtimes. Um, so, um, and that, you know, reading out of a book, uh, you know, playing a board game together, uh, making a fort, getting ready for your day, organizing your backpack, do whatever, you know, you can do together, spending time with pets. Those are all really mindful things, drawing a picture of your day. Those would be great things for your kids to do before they go to bed and for you to do before you go to bed.

16:11Um, and then the second thing is making sure to turn off screens during meals and snacks. 102 miles ago, the oil light came on 100 miles ago. You'd noticed now it's time to head to take five, this oil change, fall in love with your car, all over again, in just 10 minutes, your dream technician will check your tire pressure, top off fluids, change your oil and verify with Carfax exactly what your car really needs all while keeping you in the driver's seat. Take five, the stay in your car, 10 minute oil change, save up to 30% on your next oil

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17:12change to take five, $15 value, valid participating locations, terms and conditions apply. Because if you're watching, if you're watching, so I know you're eating, you're not listening to your stomach. In fact, I find like, if you remember when we saw go to the movie theater, those people would eat those big old barrels of popcorn to be like emotionally eating through the movie because they're distracted by Hollywood, of course. And so when we are distracted by a screen, we're not going to listen to those subtle cues about being full. And we're not necessarily even eating if we're hungry. We're just emotionally eating through this movie.

17:44And so really trying to disconnect food and screens will go a long way to helping your family and yourself become more healthy. Well, that's great advice. Great stuff. And I know it's so powerful because there's so many people right now on the screens. And like you mentioned earlier, going back to the basics, to me, it's kind of like going back to the old days. You know, we didn't have any of that stuff. We had to play Lincoln Logs and Legos and whatnot.

18:08So I guess for parents, Twister. Yeah, Scrabble. I mean, those are great things to pull out right now. You can talk about times when you were younger. You can share those with your children. You know, these games that flash and have batteries are probably not the best things for your children right now. That's a great, great advice. What are you noticing in regards to food? I know the U.S. is trying as hard as it can at times, trying to fight against obesity,

18:40against children, and trying to help with food. We see France always has some novel ideas. They don't show any more commercials targeting children, and they're not allowed to show that. I think we still show cereals, don't we? Like Cocoa Pops and those things? Or do they definitely get rid of those here? You know, that's a good question. I just don't watch commercials or TV watch anymore. I usually tell kids, though, if a food has a commercial, it's probably not healthy. So that's usually my rule of thumb. I'm like, if a food doesn't have a commercial, it comes from nature.

19:14It has to be raised and loved in the sun. You've never seen a commercial for radishes or onions or apples or, you know. And so those are going to be the more natural, healthy foods. But I think my big thing I'm seeing as a trend in food is just that, you know, foods from nature are just, they're skipped over, you know. So I tell families, I'm like, just start drinking water. Like, water's so good for you, you know. And they even just recently did a study on moodiness, and they found that us women, we tend to even, even more so than men,

19:47we can get more moody if we're dehydrated. So I always have my water next to me. It's like, have your water, drinking it throughout the day. And I tell the kids, I'll show them, I'm like, I'll show this pen, or I have this little yellow duck that I'll show them. I'm like, if your pee is yellow, you're not drinking enough water, you know. So just starting to drink more water instead of all those sugary drinks and caffeinated things that none of us need, that can go a long way. And then just start adding fruits and vegetables to meals and snacks. It's just a basic tip.

20:17But all of a sudden, other things are getting crowded out, you know, because, you know, you're having those fruits and vegetables, and those foods are full of nutrients, they're full of fiber, they make you feel full. You know, you can eat a whole thing of pizza, but nobody's ever coming to me with a stomachache. Like, oh, Dr. Patricia, I ate too many, you know, Brussels sprouts or carrots or apples, those natural foods. As long as the screens are off, you should kind of self-regulate and eat what you need. That's great advice. And I guess another thing we have to be careful with, you know what I always found?

20:48Years ago, I was a trainer, and I always found out people really had a misunderstanding of juices. They think juices were harmless, because if that was a liquid, you can just drink as much as you want. I mean, I had clients that would drink a whole bottle of orange juice every day. I was just like, what? You can't do that. It's like a thousand calories. What about juices and kids? We see a lot of these juices now, not going to name any names, but they'll have certain characters on them, and there's a lot of character stuff going on. Maybe we can talk about that, too. There's a lot of TV shows and cartoons slapped on cereals and gummy bears and whatnot.

21:22But maybe we'll start off with the juices and then those characters. What do you think about that? Yeah, I just don't recommend any juices. There's really, it's just, when you think about it, you know, I get this one grandmother, and she was fighting with me about this. She's just like, but doctor, you don't understand, because I'm like, eat foods for nation. She's like, I picked these from my yard, and I squeezed them myself. I'm like, it's a great arm workout. I like the fact that you're gardening. That's very mindful. But when you eat that fruit whole, you feel full from it. When you squeeze it down, and you're just, you're basically just getting the sugar from the fruit.

21:56And so people are like, oh, but it gives me vitamin C. It gives, it has so many negative effects. In fact, my kids with high triglycerides, and my kids that are going towards diabetes, that's the first thing I do. I'm like, let's just drink more water. Eat your fruits and drink your, and drink water. Now, you could change it up a little bit. You could, you know, add some herbs, or add some whole fruits, you know, into a pitcher of water, or, you know, put a lemon on it, or, you know, we put mint in water sometimes, or, you know, you can do a, you know, whatever.

22:27You can have fun with a whole fruit, you know, getting cucumbers and tangerines, but the juice of the fruit, that's the issue. And so you can get the essence of it, but the juice of it is the issue. So eat fruits and vegetables and drink water. That's my big thing. That's great, great advice. I didn't even think about that. That's right, because it's so heavily concentrated on the sugars. Yes. And that's one of the things, too, I guess I wanted to ask you about, we've got about a few more minutes to go here, but the sugar seems to be a big problem in today's society.

22:57I know some of my other podcasts have talked about the sugar industry and what they've done over the past, but that's something you don't hear about. I hear a lot of complaining about milk or eggs and all this other stuff, but nobody seems to say much about the sugar. I don't know if they just assume everybody knows it's bad or what, but it's pretty bad stuff because it's almost in everything. Yes. No, and that's really what we focus on in my practice. You know, we have, and we don't even just take care of children.

23:28We have so many adults now that are pursuing care from us. We, I think my oldest patient's in their seventies right now. We have patients all different ages. I've got one grandpa that lost 50 pounds going through our program, but basically the big thing to do is, you know, is really stop adding sugar to your foods. Stop buying foods that have sugar in the labels. We want to, you know, an apple naturally has some natural sugars. That's fine, but you don't add, add sugar to things. And, and if you can do that, it does a few things. So number one, we look at the people that have high sugars in their diet from sugary drinks, sugary foods, processed grains.

24:02They're more likely to have problems with their heart. Everybody focuses on, you know, it's the fat, it's the cholesterol. It's not, it's sugar that affects your heart. And so once we pull out those sugars and we start eating more natural foods, you start eating more fruits and vegetables. It changes your taste buds. Like if parents will be all the time, they're like, my kid won't eat vegetables. I'm like, well, he's having like, you know, all these sugary drinks all day long. That's affecting his taste buds. So let's just switch over to water and then just keep, continue to serve those bitter foods like vegetables and natural foods.

24:34And over time they develop a taste for it and it works like a charm, but it's just, and, and you never want to pressure a kid, eat your vegetables, eat your vegetables. That will make them go the opposite way, but serving it, serving it, serving it, and then stop buying the other stuff that goes a long way. That's great. Great advice. And I know I'm going to upset some people with this comment, but before we get to my upsetting comment, folks, go again to GoFundMe and help heal and inspire early learners to help out this great program. Dr. Patricia's Health Club. Also, you can check out her nonprofit, Serving Kids Hope.

25:05Here's the upsetting comment, folks.

25:08Parents need to be good models. So the old days of do what I say, not what I do, doesn't seem to help very well with food. Am I right on that? Oh, yeah. No, it's everything. That's what, you know, you can't sit there and smoke and be like, don't smoke. Like what you do, it speaks volumes to your child. So if you say, I had a bad day, I need a drink. I had a bad day, I'm going to watch TV. I had a bad day, and you scream at somebody at your house. Your kids are going to think that's an appropriate way of dealing with stress. But if you go, I had a bad day, I'm going to take the dogs for a walk.

25:40I had a bad day, I'm going to, you know, I'm going to go garden. I'm going to do some yoga. Then all of a sudden, you're really modeling some important things. And I think that's one thing with children, you know, we talked about the ACEs a little bit in the beginning of this. It's like teaching children and inspiring them to have healthy ways of dealing with stress will help with stress overall. It's going to help with their weight. It's going to help with their sleep. It's going to help with their confidence growing up. And so that's a really good place to start. And so thinking about how you deal with stress, how much sleep you're getting, making sure you're getting enough sleep.

26:15And prioritizing sleep all of a sudden will make those priorities for your children. And it goes just, it really makes all the difference in the world with the families where the parents are engaged. The kids tend to do very well. Great advice. Great advice. And actually, I'm going to reframe it a little bit just in case I did upset some people. But remember, your kids always want to be just like you. They do. Especially when they're younger. So the way Dr. Riva hit the nail on the head when she said how you handle stress, how you get a bad phone call, they're going to react that way.

26:47And it always surprises me, too, Dr. Riva, because sometimes they're like, I don't know where they got this from. When you're five or four years old, they're not hanging around groups of kids out of the streets. You know, they're getting it from you more than likely. So if you're eating sweets all the time, guess what? They want to be just like mom and dad and do the same things. So take it as a compliment just to try to change the behavior a little bit, I guess. Dr. Riva, in our last couple of minutes, what is some of the last-minute advice? It's always the toughest question to answer. But what are some of the things you want to highlight for parents, adults, children, everybody, during this time in COVID and, of course, the Christmas holidays?

27:25Any recommendations you can give them? I do. In fact, I think, you know, there's one thing that we've been doing, and I'll get this to you. But I think, you know, it is the holiday season. And it's really important to do these mindful activities. We're trying to eat healthier and so forth. So, number one, use the colors of the seasons to inspire different fruits and vegetables, like pomegranates and, you know, green peppers and different, you know, look with the kids. Say, let's find some red and green fruits and vegetables. And that might be a fun way of getting them engaged with eating some more healthy foods during this season.

27:58The other thing is, you know, like turning on some Christmas music, just, you know, talking at the table, not bringing food, you know, screens to the table is important. And finally, everyone likes to make cookies during Christmas. And cookies are, it's a mindful thing to do, to cook together, and it can be very peaceful. The problem is that it's, you don't want to eat all the cookies. So, what we've come up with is this, we call it gingerbread Picasso, and it's just white flour, water, and salt. And it's on our website, drpatriciamd.com.

28:30And, and you can make this dough, and my mom used to make it for us, and it'd be in the refrigerator, and we'd get, and we'd wake up in the morning, and we would just get it out, and we'd start rolling it out, and we would, it was all the fun of making cookies. We'd use cookie cutters, Christmas ones, and so forth, and make the, and make these ornaments. You have to make the hole in it beforehand, so use like a straw or whatever, and then you bake them like a cookie, and then you can paint them. And you can hang them on your tree, you can hang them in your house, you can give them as gifts.

29:00And here it's like a way of, number one, using up those processed grains like white flour for crafts and not eating them, not getting sugar in, but, but getting that, that family time together where you can all be doing this together. So, that's my, my recommendation is, is, you know, is to try that recipe, and like I said, use the seasons to inspire different fruits and vegetables, and, you know, and just enjoy each other. Working on being thankful can go a long ways to becoming healthy and bringing down people's stress.

29:30Great stuff. Great advice today, folks. Again, DrPatriciaMD.com. You can also go to the GoFundMe page, help heal and inspire early learners, and check out the nonprofit, Serving Kids Hope. Thank you so much, Dr. Reba, for being here. Oh, it's my pleasure. I'd love to come back. I just, I love your show, and I love everything that you're doing, so thank you for having me. Oh, thank you very much. Thank you, everyone, for listening. Remember to support our channel and support our podcast, share and subscribe. If you're watching this on YouTube, you can check out our podcast on the description below. Thanks, everyone.

30:00One hundred and two miles ago, the oil light came on. One hundred miles ago, you noticed. Now, it's time to head to Take Five. This oil change, fall in love with your car all over again. In just 10 minutes, your dream technician will check your tire pressure, top off fluids, change your oil, and verify with Carfax exactly what your car really needs. All while keeping you in the driver's seat. Take Five, the stay-in-your-car 10-minute oil change. Save up to 30% on your next oil change to Take Five. Fifteen-dollar value, valid to participating locations, terms and conditions apply.

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