I’m honored to be the featured guest on the most recent episode of Dr. Robert Su’s excellent podcast show Carbohydrates Can Kill.  You can visit his site to listen to the episode.

And while you’re there, listen to several more.  Like my buddy Jimmy Moore, Dr. Su interviews top-notch medical and nutrition experts, providing the rest of us with a free, on-going education.  During our list trip to Illinois, we listened to several of his podcasts in the van.  Even our girls were interested.

I was pleased when Dr. Su invited me on his show because he’s one of my medical heroes.  In his book Carbohydrates Can Kill, he recounts how his health began failing him in middle age. As a doctor, he was of course familiar with the standard-issue dietary advice to cut back on fat and eat more whole grains, but became frustrated when following that advice only led to worse health problems. So he set out on a personal research mission and determined it was the excess carbohydrates in his diet causing his problems, not the fat. In the book, he recounts his own journey back to health and explains the science of how and carbohydrate restriction can clear up a number of health issues.  It sure worked for him.

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40 Responses to “‘Carbohydrates Can Kill’ Podcast”
  1. Ben says:

    Hi Tom. I enjoy the blog and Fat Head was great.

    Your post yesterday said that one set of people certainly can’t prove a hypothesis, like low salt intake prevents hypertension. But can’t one group of people disprove a hypothesis? Don’t the Kitavans and other groups that have a high carbohydrate intake disprove the carbohydrate hypothesis? It seems like a lot of similar minded bloggers are moving to a more “macronutrients agnostic” posture. Are you not on board with that?

    I believe carb tolerance is individual and probably has something to do with our ancestry, since people evolved in different parts of the world with different sources of foods. The Kitavans do well on a diet that’s heavy in sweet potatoes, but I’m not sure, say, Inuits would.

    Sweet potatoes are also much lower on the glycemic index than white potatoes. I’ll eat a sweet potato now and then, but white potatoes send my blood sugar skyrocketing. The question I have (which I can’t possibly answer) is whether or not white potatoes would be a problem for me if I hadn’t screwed up my metabolism with sugar and white flour as a kid. It’s possible that a diet high in starches but low in sugar is fine if that’s what you grow up eating. Unfortunately, for those of who became insulin-resistant, even starches are a problem now.

  2. I like Dr. Su’s ideas, but I found it very difficult to read his posts and listen to his podcast–the thick accent and occasionally odd grammar constructions were a bit tough to sort through.

    I actually like his accent.

  3. js290 says:

    I don’t understand the obsession over the so-called “carbohydrate hypothesis.” Why don’t people just go measure themselves with a blood glucose meter? Instead of depending on someone else’s formula, figure out one’s own.

    Good idea. Dr. William Davis suggests we all check our individual glucose reactions to food with a glucose meter. I did, and that’s how I learned that pasta, despite being fairly low on the glycemic index, pushes my glucose way up.

  4. Firebird says:

    My Mom visited Lithuania five years ago (she is Lithuanian…as am I). She said that potatoes were in virtually every meal, but it always contained some sort of meat like sausage, bacon, etc. She said the people were very lean and the fattest person she saw there was herself.

    That’s why I believe it’s sugar that does the worst damage. If not for Captain Crunch and Coca-Cola, I might be able to eat potatoes today, but since the damage was done, they send my blood sugar through the roof.

  5. Zachary says:

    First of all, Dr. Robert Su’s accent is magnificent.

    Second of all, you are incredibly well spoken, your voice is so easy to listen to. I love it when you do these radio broadcasts.

    Keep it up! Thanks!

    Thank you. I enjoy Dr. Su’s accent as well.

  6. Katie in FL says:

    I am hoping you will put up a post soon in regard to former president, Bill Clinton, who has gone vegan apparently. Here is one article that I found in a quick search, but there are many, I am sure:

    http://articles.latimes.com/2011/aug/18/news/la-heb-bill-clinton-vegan-20110818

    I don’t know if I’ll write about him or not. I wasn’t much of a Clinton fan, so I figure the vegans deserve each other.

  7. timmah says:

    I’m going to have to listen to this twice.

    I added Carbohydrates Can Kill to my google reader.

  8. Angelyne says:

    I really enjoyed that interview with Dr. Su. Especially, since I have just re-watched your movie Fathead this evening, with my husband. Re-watching it made me realize, that while still interesting, you (and I as well) had evolved quite a bit since making the movie. Then you mentioned to Dr. Su the things you would have changed, if the movie was made today. This made me think that Fat Head was ripe for a sequel. So I was a bit bummed out when you finished the interview saying that you weren’t really interested in producing another film.

    I understand that making a movie is a huge investment of time and money. I can imagine that you don’t have an ample supply of either. But you really have a unique talent for making the science accessible, while at the same time, keeping it entertaining. You reel your viewers in, keep them watching, but in the end they learned something. You made them think. That’s special. No one else in the community has that talent, expect maybe Denise Minger. And as far as I know she has no experience making movies :)

    I know you said you were planning to write a book. That sounds like an interesting project. But most people who read books are already somewhat interested in the subject. While not exactly preaching to the choir, you are at least preaching to those who showed up for mass. With a movie, you are reaching the rest of the congregation who can’t be bothered. Bit of a bad analogy there. But my point is that a movie can reach people like my husband, who would never have the patience to read a book on a subject he is not interested, not matter the inducement.

    If I didn’t have to pay for it myself, I’d reconsider making another documentary. But after our recent land purchase, it would literally be betting the farm to incur that kind of expense again. However, we plan to produce a companion DVD for the book. Probably not as involved as Fat Head, but something people could sit down with their kids and watch.

  9. Patricia says:

    That was a delightful experience! Dr. Su is a great interviewer, isn’t he? I listened to a couple of his other podcasts and they’re wonderful. I can’t wait to get his book. You are always a delight to listened to and most thoroughly enjoy your posts. Education through entertainment is my favorite. I appreciate the way you focus on educating us about bad science. We all need that in order to become more discerning thinkers.

    I hope you and Dr. Su are right; someday what the USDA says will be of no importance (and they’ll just fade away). Indifference would certainly send a loud message. Thank you again for all you do.

    He’s a good interviewer and a very kind and polite man. It was a pleasure talking with him off the air as well.

  10. KathyJo says:

    I thought of you this week while reading a vegan’s green smoothie site. Out of sheer train-wreck curiosity, I explored her arguments concerning current diet “myths.” First, she argued that people don’t need as much protein as is currently recommended. Then, she argued that we need plenty of healthy carbs from whole grains and veggies or else our muscles would start consuming themselves to fuel our bodies. o.O I don’t think she’d get it, no matter how I explained it.

    I’ve watched FatHead more than five times and made it part of our homeschool high school health class, and I’m adding Science for Smart People, too. :-) We appreciate you hard work. I believe The Guy from CSPI is now a villain in some of the games my children play.

    The Guy From CSPI as a villain — I love it.

  11. JC says:

    I see ol’ Bill C. is getting that “death warmed over” look of so many vegans… As my grandfather would say, “That boy looks like 10 miles of rough road!”

    Put him next to Dr. Neal Barnard and title the picture “Two Walking Cadavers.”

  12. Dragonmamma/Naomi says:

    I’ve never, ever measured my glucose before. Can someone please explain what exactly I need to buy; I’m hopelessly confused about all the products out there. It looks like you buy a meter that comes with lancets and test strips, and then you buy refill lancets and test strips?
    I’m a total wuss about needles; how hard is it to stick yourself?

    That’s right; you can go to a drug store and pick up a glucose meter for not much of an investment, maybe $15 or $20.

  13. timmah says:

    Dragonmamma: my mom is diabetic, she pricked my finger one morning about 12 years ago after I complained that I “could not wake up”. The sting lasts only for a fraction of a second.

    My glucose that morning was 103. I should have had her check it again after drinking that 20oz of mt. dew, but didn’t think to because “nothing was wrong”.

  14. fredt says:

    It is my opinion that a related issue is also involved, that is nutrition displacement. One of the factors that drives appetite is vitamin and mineral deficiencies. Real whole food reduces this problem as it has a higher Nutrient Density, …vitamin and calories to calories ratio. Sugar, grains and manufactured oils have the very lowest ratio, hence there is no reason to eat those beyond to satisfy a emotional/mental/reward need, aka addiction or ignorance. Adequate v&m in real food cultures is what saves the people. Remember Chris Voigt.

    Keep up the fine work.

    Indeed. I believe that’s one of the reasons we tend to spontaneously eat less when we replace junk with real food. Our bodies sense when they’ve been given what they need.

  15. Patricia says:

    In the 90′s referred by a family member to an MD who was a general practioner that I thought, at the time, was a little wierd. Regardless of the illness that brought you to him, he would hand you a glucose meter with instructions to test your blood sugar after everything you ate while keeping a food journal with the correlating glucose readings for 30 days.

    I got to know him pretty well and realized he was brilliant. He believed a glucose meter was one of the best weight loss/health tools to be had. Once his patients understood the relationship between food items, blood sugar, weight gain and how one feels, his patients “got it”. He educated his patients on the pattern of blood sugar, disease, weight gain and the fact that you don’t have to be diabetic to benefit from a glucose meter. He passed away a few years ago . . . at the age of 95. Practiced medicine until a week before he died.

    If only there were more doctors like him.

  16. Dave, RN says:

    You can go to Wal_Mart and get the “ReliOn” brand. What’s good about that one is that the strips are cheap at about $20 per 50. Some meters strips are very expensive. It’s like buying a printer. The printer might be cheap but look out for those supplies…

    “Why don’t people just go measure themselves with a blood glucose meter”?

    While a great idea, keep in mind that you can have good blood glucose numbers and still have a high insulin level. If it’s high, the pancreas is pumping out ever increasing amounts of insulin to drive sugar into the cells. Everyone should get a fasting insulin level done.

    That’s a good point. I’ve read about people with normal blood sugars who, when tested, showed insulin levels that were sky-high.

  17. JuneBug says:

    Dragonmamma, when you look for glucose meters, check out how much the strips cost. It’s the strips that will kill ya. Some of them are as much as $1 per strip or more (yes, that means a box of 25 strips cost $25). Look for the cheapest strips you can get and then buy the meter that goes with it. I get one from WalMart that has strips for only 50 cents each. Most meters support alternate site testing now, so you don’t have to stick your fingers.

  18. Kate M. says:

    @ Naomi,

    I am a needle wuss, and I still manage to check my glucose several times a day. Make sure to stick the fleshy pads of your fingers, not the tips or sides of the fingers. It doesn’t hurt much (way less than a paper cut), barely even bleeds, and whatever pain there is lasts only a fraction of a second. You’ll be fine!

    A new glucometer only comes with about 10 each of test strips and lancets. Although the glucometer is inexpensive, the test strips and lancets can be pricey.

    The best thing to do is see if your MD will prescribe you a glucometer, lancets and test strips. If you have insurance, the supplies will be pretty cheap. Even if you don’t have diabetes, your MD may okay it if you are overweight. You won’t know until you ask.

    If your MD won’t prescribe, or you don’t have insurance, your best bet is to buy a cheap store brand glucometer and testing supplies (i.e., CVS or Walmart). Or, if you have a friend or relative who is diabetic, they probably have an old glucometer around that you can take. Just replace the batteries.

    Good luck :)
    Kate

  19. js290 says:

    @Dave, RN: Thanks for clarifying that. I realize that measuring blood glucose is only a proxy for insulin, which is what we’re ultimately interested in. But, right now, blood glucose is the most cost effective option available to everybody. Fasting insulin and fasting leptin are the top two metabolic tests listed in Dr. Rosedale’s book.

  20. Jimmy Moore says:

    Great job my friend! Once you get that farm rolling, we’ll have to get you back on my podcast again. ;)

    I’d be honored to be on your show any ol’ time.

  21. Robinowitz says:

    Off topic: read this nonsense yet? Veganism for everyone? Good grief! Be sure to read about all the support in the comments. Makes me ashamed of CNN, not that they’d ever made me proud before.

    http://thechart.blogs.cnn.com/2011/08/25/becoming-heart-attack-proof/

    Yeah, same old nonsense.

  22. Greg says:

    You can usually get good deals on strips on eBay (people fill their prescriptions and sell extras, I assume?) or Amazon. I’m using Bayer’s Contour meter and always can find strips for 50 cents or less, and new meters are all over eBay for close to free.

    @Ben – lots of bloggers moving towards Paleo without being concerned with carbohydrate intake doesn’t mean it’s somehow ‘more correct’ than low carb…it’s currently very popular but science and truth aren’t about popularity. And like it’s been said before, some Paleo folks don’t worry about carbohydrates because they just simply aren’t carbohydrate-intolerant and found Paleo as part of a quest for better health, not necessarily weight loss, whereas I would guess almost all low-carbers have issues with overweight and carbohydrate intolerance/cravings.

  23. Keenie Johnston says:

    The question I have (which I can’t possibly answer) is whether or not white potatoes would be a problem for me if I hadn’t screwed up my metabolism with sugar and white flour as a kid.

    When did the government ever say it was OK to eat a lot of sugar? And further more, why was your mom so indoctrinated in government (according to you) guidelines to that point where she thought feeding you a bowl of sugar filled cereal every morning was healthy?

    The government never said smoking was bad for you in the 50′s either, but did you honestly think that there would be no ill health effects from inhaling smoke into your lungs multiple times a day?

    When did I claim the government told my mom to feed me sugar? The government never told us to eat more sugar, but they did tell us to consume 300-350 carbohydrates per day — check any food label — and didn’t distinguish where those carbohydrates should come from until recently. And even now, they’re pushing grains.

    My mom, like most moms back then, was told cereals were good for us by plenty of so-called experts. Lots of sugary cereals came with the American Heart Association seal of approval on the box.

  24. Linda says:

    @Robinowitz

    Yeah, I was going to watch that show because, for the most part, I like CNN, but when I read that Clinton had gone vegan and Ornish was his new health god, I had a feeling the whole show would pretty much revolve around that way of eating, and I’d be subjected to more low fat, eat your grains, blah, blah blah.
    My daughter had a heart attack on 9/11, and now has several stents in her heart, takes all kinds of medication. “The Last Heart Attack” sounded like a good show to watch. Forget it.

  25. Gerry Born says:

    Tom,
    I really enjoyed the podcast. Your movie and the Slow Carb diet have greatly improved my health, running and life . THANKS!

    Thank you for listening.

  26. Dragonmamma/Naomi says:

    Thanks for the advice, everyone. I like that idea of figuring out which supplies are cheapest and THEN picking the meter.

  27. Underground says:

    Seems like a good guy, excellent interview.

    You have our gratitude.

  28. Elenor says:

    If you want to learn everything there is to know about blood testing and diabetes WITHOUT the “standard Pharma” ideas, try here: http://www.phlaunt.com/diabetes/ Jenny gives fantastic info about which glucometer to get (some are amazingly inaccurate, so are just usually inaccurate {eye roll}) and where to test (side of ring or little finger, actually, hurts least!) and so on. Also she provides info about the various diabetes drugs they try to foist off on us — that result in illness and death! Gives you LOTS of info — whether or not you have diabetes! (I’m ‘pre-diabetic’ and am working hard to stay there or I hope to return to non-diabetic!)

  29. GuineaPig says:

    “My mom, like most moms back then, was told cereals were good for us by plenty of so-called experts. Lots of sugary cereals came with the American Heart Association seal of approval on the box.”

    Tom your kids are so lucky that they won’t develop sugar addictions and screw up their insulin sensititvity like most americans have.

    I’m banking on that.

  30. LaurieLM says:

    “Don’t the Kitavans disprove the carbohydrate hypothesis?”. The Kitavans disprove that dietary carbohydrates kill all of them. Karl Popper taught that you have to postulate a reasonable- limited- hypothesis first before trying to set about disproving (falsifying) it. Be careful, if you just monkey around with the words, you can dance around the word “proof” by negating it and calling it disproof and then you’re back to trying to prove something- which can’t be done. There is a slight but important difference between- The Kitavans disprove that dietary carbohydrates kill all of them and -The Kitavans prove that dietary carbohydrates kill none of them (or none of the rest of us for that matter).

    1) All men are mortal.
    2) All men are immortal.

    The only statement that is a reasonable, testable (falsifyable) hypothesis is the second one.
    The Inuit don’t disprove the lipid hypothesis either. They disprove that a high animal fat diet kills all of them- but woop-de-doo. The lipid hypothesis has a lot of holes in it. And the carbohydrate hypothesis has some too. But the ‘carbohydrate hypothesis’ is too large and multi-faceted to
    be summarily disproved by the Kitavans.

  31. Charles-Andre Fortin says:

    Thanks Tom for yet another source of information on good nutrition. carbohydratescankill is really an interesting PodCast.

    By the way, you inspire me to start my own blog where I’m trying to translate in french all the science I found around the net.;) I’m starting with Dr. Diamond speech.

    Thanks again

    That’s a great idea. Fat Head aired on French TV with someone overdubbing my narration and dialog. Sure like to know how I sound in French, but I haven’t been able to get a copy.

  32. gallier2 says:

    http://www.youtube.com/watch?v=DLlHR_AGW64
    http://www.youtube.com/watch?v=LaIAe1gyXAI

    Charles-André pourrais-tu donner l’adresse de ton blog?

    Have to check these later … won’t play on the office PC.

  33. Don in Arkansas says:

    Very informative podcast. I had no problem with Dr. Su’s accent, in fact, it made it more interesting. He is probably more grammatically correct than most Americans. Wish his book were a little more reasonable (cheap).

  34. Zachary says:

    Also, I’ve been checking out Dr. Su’s other podcasts, and they are amazing. The listeners roundtable discussions are absolutely great to listen to. More people should do that imo.

    Also, Tom, I know you’re a busy man, but it’d be awesome if you ever decided to start hosting a radio show of your own. It seems like it’d be right up your ally =D

    I don’t foresee doing that anytime soon, but you never know.

  35. Peggy Holloway says:

    Clinton’s story is beginning sound vaguely familiar – like the story of another former president who was one of the first to be prescribed an ever lower-fat diet for his heart disease, with disastrous results: DDE

  36. Peggy Holloway says:

    When I went for my every 3 years physical this summer, I asked for a fasting insulin level and was told they don’t do those. My retired physician partner concurred that fasting insulin levels can ‘t be routinely measured. How does one go about getting one ordered and why does no one at my medical clinic seem to know about the importance of insulin levels and how to measure them?

    You may have to ask your doctor to order the test. Most only test glucose levels.

    http://labtestsonline.org/understanding/analytes/insulin/tab/test

  37. LaurieLM says:

    AMEN ‘fredt’. ‘Nutrition displacement’- I rarely stop thinking about this concept. I’m constantly trying to understand it better because I think it goes under the radar. Humans CAN tolerate eating sugar and grains, but at what cost and for how long?

    The act of eating cereal and sugar (most of cereal is carbohydrate, but not all of it and not the worst of it- the non-carb portion does most of the damage) displaces heart, brain, body, mind healthy building materials- animal fat cholesterol and protein- from coming in. That’s bad enough, but compounds in grains block the absorption of the paucity of nutrients contained in the grains in the first place- from being absorbed well or at all. So grains replace nutrients in the diet, don’t contain enough nutrients themselves and then they block absorption of the paltry amount of nutrients in them to begin with. I’m also pretty certain grains actively leach nutrients already contained in the body- they help to remove even more!

    If you were to heat your house by throwing into the furnace money, wooden furniture, the walls, what have you, for fuel, you would quickly be cold and desititute.

    If your car isn’t running well, try draining out most of the oil and stop putting gasoline in it when it runs out and see how well that works.

  38. Cameron Baum says:

    I’ve been thinking about all of this carefully, and maybe eating wheat isn’t so bad…

    Let me explain. And remember, I’m formulating a hypothesis; I’m not saying I’m right, or wrong, just thinking out loud possibilities.

    Wheat does huge amounts of mischief to the system… but for up-teen decades, we’ve been going wholesale towards mono-cropping. We’ve gotten our productivity levels up, but at the cost of food stability. All it takes is one disease to come along, and devastate world crops. There are thousands of varieties of foodstuffs an animal stocks, and huge proportions of them are either endangered or extinct.

    What if we should be looking at all the grain varieties, to see if they are better for us? I also believe that the different ethnicities of the world are the formations of sub-species. Certain populations have genetic characteristics that have helped them prevail over certain environmental adversities. No single group is superior, because evolution is the continuation of natural selection over a period of time, and natural selection is what works best in a set place at a set time.

    Thus, we need to look at our local environments, and our own genetic pre-dispositioning, and cultural and familial backgrounds before making sweeping statements about diet and nutritional well-being. For me, something that is a huge problem is wheat. This I have worked out, thanks to Tom and his wonderful campaign against the mainstream stupidity. There seems to be a certain amount I can have before things go Hiroshima at toilet time. But other cereals have yet to be proven to be disastrous on the system. My Oat Test isn’t proving that it is anywhere near as bad as wheat, and is certainly filling. And a little porridge fills me up for hours.

    Potatoes are also a food stuff that has yet to demonstrate disaster when it comes to exit strategy. Yet, Tom has stated repeatedly that potatoes are not the best for him. In Peru and Bolivia, they build entire diets around the potato, but then they have hundreds of varieties to choose from, all with differing nutritional values and tastes.

    I certainly find meat to be okay, and increasing the meat levels, and reducing cereal levels has done wonders for me. But in places like Ethiopia, they grow many varieties of wheat, largely to protect against famine. (The famine of 1984 was largely due to mono-cropping in the country.) Could one of those varieties be better for me to digest?

    Perhaps the answer doesn’t simply lie in reducing wheat, but changing our agricultural practices, so we do all of the farming methods of the past, like planting legumes with wheat, because it puts nitrogen in the soil?

    And certainly reducing the amounts of highly processed foods in our diet. That is a must.

    What do people think of this, or am I barking up the wrong tree?

    Oh, and I’ve listened to the podcast. It was very informative, and enjoyable. I’ve downloaded others, and will listen to them at some point, because I think that it might help with the development of my ideas. Keep up the good work Tom!

    I’m all for changing our agricultural practices, but we’re in a pickle with the wheat situation. The type grown now was the result of both of cross-breeding and gene splicing, with the goal of producing much higher yields. That part of the plan worked, and without the higher yields, we might be looking at mass starvation around the world. The problem is that this mutant wheat was never tested to see if it’s actually fit for human consumption. I don’t believe it is, at least not without negative health consequences for many of the people consuming it. Old-fashioned wheat grown using old-fashioned farming methods may not be an option unless we’re willing to create a food shortage, given today’s worldwide population.

  39. Cameron Baum says:

    Tom, we are already in a massive pickle: crop yields are not increasing fast enough. Puccinia graminis, more commonly known as stem rust, is spreading around the globe at an alarming rate. The current strain started in Uganda, Then spread to Kenya, Ethiopia, Sudan and Yemen. It then jumped the Persian Gulf, and is happily going through the fields of wheat in Iran. Scientists are predicting that it’ll soon hit the breadbaskets of India and Pakistan, then go to China and Russia. And if a spore gets onto a passenger’s shoe, it can then fly to other places in the world.

    If it hits America, you are looking at an estimation of a billion dollar’s worth of wheat at risk. As it stands, the wheat in imminent danger of destruction gives as a primary food source a billion people.

    This is the cost of using just a few varieties as key foodstuffs: utter vulnerability of disease and having to use huge amounts of fertiliser and pesticides to keep it growing in environments it struggles to live in.

    Oh, and I forgot to mention… roughly ninety percent of the world’s wheat supply is defenceless to the current strain of stem rust.

    This danger has already happened in the past. Consider the potato. it was brought to Europe in in the late sixteenth century, and became a reliable back-up to cereals. By the early 1800s, the Irish were almost entirely dependant on it. They had settles upon a variety called the Lumper potato, because of the high yields it produced. The potato famine was the result of them being vulnerable to the blight that struck the land, and we all know what the results of that were. Another good example is the 1984 famine in Eithiopia: the results of monocropping.

    As you are soon to be a farmer, I wholly suggest looking at communicating with Heritage Farm in Decorah, Iowa. It’s home to the Seed Savers Exchange, a project dedicated preserving what is known as heirloom varieties. I’d also loom into rare breeds as well. Did you know that farmers in the Orkneys bred a variety of sheep called the North Ronaldsay sheep, which only eats seaweed? The Shenko is a breed of cattle from Ethiopia. It is a good milk producer that is able to withstand harsh conditions, and has a resistance to sleeping sickness.

    The more you look, the more you realise that we have been going for short term gains in food production, at the expense of durability against crises developing, and environmental impact decimating the genetically weaker, high yield crops we covet.

    Yikes. We could have a helluva mess on our hands if the wheat-dependent populations can’t get enough wheat. My wife has been looking into heirloom seeds. I’ll pass this on to her.

  40. Joe Leonardi says:

    I will be catching up on my listening later this week. I look forward to it. Dr. Su is a great source of information and an excellent host. I was a guest a few episodes back.
    Have a great day,
    Joe

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