by Cat, June 2007; updated May 2019
Healthful meals are comprised of whole foods as much as possible, especially fresh (or home canned/frozen) organic or biodynamic foods grown by someone you know. It means avoiding prepared and processed foods (commercially canned, bottled, frozen), and especially avoiding foods made with highly processed or artificial ingredients. Know your ingredients; know your cook. Refer to my article: Diet for Health, Part 3: Procuring healthful food for more on this.
- Includes: 1. Supplements Recommended by Others; 2. Vitamins A, B-complex, C, D, E, and K; 3. Minerals; 4. Miscellaneous Supplements; 5. Supplements to avoid if you are insulin resistant
- See also: 1. Diet & Health Menu; 2. Choline & Lecithin
Supplements Recommended by Others
I don’t intend to suggest that taking supplements can provide the same health benefits as eating healthful meals. Supplements are intended to support our health when there is a dietary lack, or when a health condition causes the body not to assimilate a particular nutrient properly. They should not be used as drugs to “make something go away,” and they should not be abused. Overuse of supplements, just as overuse of drugs, can lead to other health problems.
The supplements listed below are recommended by others to alleviate Insulin Resistance and the other problems grouped together as Metabolic Syndrome, and that progress to Type-2 Diabetes. I am simply trying to consolidate these recommendations in one place.
NOTE: Consult with your health practitioner before taking any supplements.
Vitamins for IR
Vitamin A or Retinol
Vitamin A (as retinol) is an essential carotenoid. This large family, all of which have yellow, orange or red pigment, also includes (13D):
- Beta-carotene, alpha-carotene, beta-cryptoxanthin and gamma-caroten) have vitamin A activity, which means they can be converted to retinol (true vitamin A);
- Lutein, zeaxanthin, and meso-zeaxanthin are important for vision;
- Astazanthin is present in krill and certain algae. Krill oil is a popular supplement for omega-3 oils.
Dietary sources include organ meats, sardines, mackerel, cod liver oil (6) and krill oil (2D). It is not present in fish oil.
Beta carotene is a plant version of vitamin A, found in yellow and orange fruits and vegetables such as carrots, winter squash, oranges. While beta carotene can be converted to vitamin A in the body, many people with impaired sugar metabolism cannot make this conversion.
Vitamin B1 or Thiamine
Dietary sources include lean meats such as pork & fish; whole grains, especially rye and wheat; peas, beans, lentils. Best if grains and legumes are sprouted first (vitamins are more available). It is also added to fortified breads and cereals (but I consider these “junk foods”).
It is required for carbohydrate metabolism (15).
Vitamin B4: either choline, adenine, or carnitine
B4 is confusing; some call it choline, others call it adenine or carnitine, but these are not the same molecules. Online Holistic Health (19C) states:
“Sometimes referred to as “Vitamin B4”, choline (and also known as adenine or carnitine), is a distant member of the B-complex family and is known as one of the “lipotropic” factors. Lipotropic means that choline possesses properties that prevent the excessive accumulation of fat in the liver. Although not officially deemed a Vitamin per the FDA definition, make no mistake about it, choline is an essential and vital nutrient for our health. … Average dosage for choline is between 300 – 3500 mg, although it has been noted that dosages close to 5000 mg show more pronounced improvements in memory and symptoms of Alzheimer’s.
Considered as a “non-essential” vitamin, choline is the precursor to Acetyl-choline. It is one of the components of lecithin (along with inositol – see Vitamin B8, below). See also my article: Choline & Lecithin.
Professor Steven Zeisel made the connection between choline and the development of accumulated fat in the liver (non-alcoholic fatty liver disease or NAFLD), which is often associated with insulin resistance. He reported “there have been three papers in the Journal of Gastroenterologyreporting that when patients with excessive fat accumulation in their liver were given a choline supplement with the TPN, the fat in the liver disappeared!” (19A) onlineholistichealth.com/choline-too-crucial-to-ignore/
Vitamin B5 or Pantothenic Acid
Dietary sources include nutritional yeast, whole grains, legumes, eggs, fish, dairy products). Best if grains and legumes are sprouted first (vitamins are more available).
- It is critical in the metabolism and synthesis of carbohydrates, proteins and fats, and is required for the formation of coenzyme-A (aka CoA) (6,13A).
Vitamin B6 or pyroxidine
B6 is extremely heat sensitive; dietary sources include raw meats, bananas, nutritional yeast). (1)
B6 is important for cardiovascular health because it decreases the formation of homocysteine. It is a cofactor in the enzymatic synthesis of neurotransmitters (serotonin, dopamine, noradrenaline and adrenaline) (6,3A).
Vitamin B7 or Biotin
Formerly known as Vitamin H; dietary sources include nutritional yeast, whole grains, legumes, eggs, fish, dairy products). Best if grains and legumes are sprouted first (vitamins are more available)
It is important in cell growth, fat metabolism and production of fatty acids, and amino acid metabolism. It plays a role in the Krebs Cycle (the process for releasing energy from food).
In individuals with a healthy gut microbiome, gut bacteria produce all the biotin needed; but supplementation may be required for people with candidiasis and other problems related to gut health. Diabetics and insulin resistant people also tend to be deficient in biotin. (3A,13A)
Vitamin B8, or Inositol
Inositol is naturally present in two forms: myo- and chiro-inositol. While inositol is no longer considered essential, we often do not get enough of it, especially as we age. Along with choline, it is an important part of lecithin; both are important parts of the cell membranes. See my articles on Inositol for more, including Notes on Natural Health & Healing, H – P, Choline & Lecithin, and Inositol, Choline and Lecithin. < need to combine the last two
Myo-inositol (one of the two natural forms of inositol) can have a profound effect on people with insulin resistance and type-2 diabetes, by waking-up the insulin receptors on the cell walls, so that the cells can receive the glucose they need, thus lowering blood sugar. This in turn means that there is less excess sugar to be converted to storage fat; indeed, it may result in weight loss!
Inositol can also have profound effect on people with depression and depressive disorders (19B). Note, the author of the article did not provide a reference for the following quote; see below for more, that include references.
“An Israeli study found that inositol is an effective treatment for depression currently being treated with serotonin-specific reuptake inhibitors (SSRI’s):
“These results suggest that inositol has therapeutic effects in the spectrum of illness responsive to serotonin selective re-uptake inhibitors, including depression, panic and OCD, [but] is not beneficial in schizophrenia, Alzheimer’s ADDH, autism or ECT-induced cognitive impairment.””
Inositol plays a key role in neurotransmission. Studies show that it can increase GABA-A receptor function and enhance serotonin receptor sensitivity, working similarly to anti-anxiety (benzodiazepines) and antidepressant (SSRIs) medications (21A). It can also help with anxiety and OCD behavior (21B,C,D,E,F as cited in reference 20; also 22).
Vitamin B9 or Folate
Folate was formerly known as Vitamin M. Note that folic acid is a synthetic form that is not as active as the natural folate form).
Folate is especially important during pregnancy and infancy, as it is necessary for production and maintenance of new cells, and DNA replication (1,13A).
The active form is methyl-folate, which our bodies are supposed to be able to make from folate; but those who have the common MTHFR Gene Mutation cannot methylate the folate (nor vitamin B12 – see below). Those who have this mutation need to take methyl-folate supplementally; I recommend everyone use this supplement because MTHFR mutation is very common.
Dietary sources include liver; nutritional yeast; whole grains; green leafy vegetables such as spinach, kale, turnip greens; dried beans and peas, sunflower seeds. Also added to fortified breads and cereals). Best if grains and legumes are sprouted first (vitamins are more available).
Vitamin B12 or Cyanocobalamine
Natural form of this important vitamin is found only in animal products. Actually, no plant or animal can synthesize this vitamin, only certain microorganisms such as bacteria. But certain animals tissues harbor the B12-producing bacteria, such as liver, shellfish, eggs, and milk products.
It is recommended that those who have the common MTHFR Gene Mutation need to take methyl-cobalamins supplementally; I recommend everyone use this supplement because MTHFR mutation is very common.
B12 deficiencies are often seen in type-2 diabetics who take the drug metformin (1,13A).
Vitamin C or Ascorbic acid
Excellent dietary sources are most fruits, including acerola cherry, citrus fruits, grapes, strawberries (13B). There are also a few vegetables that provide vitamin C, including red and green bell peppers (technically a fruit), onion and green tea (17). If you buy a supplement, choose one that also contains bioflavonoids (most commonly as citrus-bioflavonoids) to enhance the vitamin activity.
Some practitioners recommend 1000 – 2000 mg vitamin C/day in divided doses; others believe this is way too much.
Structurally related to glucose, vitamin C is a powerful antioxidant, and is involved in the synthesis of collagen, carnitine, and the neurotransmitters (serotonin, dopamine, adrenaline). It is also involved in the metabolism of cholesterol to form bile acids. (1,13A)
Vitamin D or Calciferols
One of the fat-soluble vitamins; it’s most common natural source is sunlight (especially at mid-day) reacting with cholesterol in the skin. The most common natural food source is cod liver oil.
The best supplemental form is D3, the form made in human skin from cholesterol, when exposed to the sun. D2 has known toxic effects, especially from overdose; it is made by some plants and fungii, but is not natural to humans; also, most vitamin D2 as a food additive is synthetic.
Calciferols are necessary for (6,13):
- production of insulin;
- promoting intestinal absorption of calcium and phosphorus from foods, and re-absorption of calcium in the kidneys (to regulate blood levels of these minerals);
- promoting bone formation and mineralization;
- inhibiting parathyroid hormone secretion; and promote immunosupression; and
- phagocytosis and anti-tumor activity.
Vitamin E or Tocopherols and Tocotrienols
Another of the fat-soluble vitamins.
Dietary sources include nuts, seeds, olives, and cold-pressed vegetable oils.
Supplement source: choose one that contains mixed tocopherols and tocotrienols (all active forms of Vitamin E). Do not buy the synthetic vitamin E (d-l-alpha-tocopherol), as it has little bio-activity.
Most practitioners do not recommend more than 400 IU per day, in divided doses. If you consume a lot of bottled vegetable oils in cooking or salad dressings (soy, canola, corn, safflower, etc.), you probably need more vitamin E than if you consumed animal fats, since the vegetable oils are more easily oxidized, and the high pressure and temperature processing destroys the natural vitamin E present in these oils.
[NOTE: some practitioners recommend higher dosage, up to 1200 IU/day in divided doses, but people taking greater than 400 IU/day have higher death rate from all causes. This may be because the research uses the inexpensive synthetic form (d-l-alpha-tocopherol), which is known to have little or no bio-activity, and may account for higher death rate of persons taking high doses (13A).]
I take 600 IU of the tocopherol/tocotrienol complex, of which 200IU is game tocopherol, the most common form.
Vitamin E is a powerful antioxidant that has been much studied in relation to heart health, cancer development, and the formation of cataracts. It may prevent or delay CHD (heart disease) by limiting the oxidation of LDL-cholesterol; and help prevent the formation of blood clots. It protects against the damaging oxidative effects of free radicals.
Vitamin K or Quinones
This is another fat-soluble vitamin complex. There are two natural forms, K1 (phylloquinone) found in plants, and K2 (menaquinone), converted from K1 by gut bacteria in animals. K2 comes in several forms, MK-7 to MK-11. (13C)
The synthetic form (menadione), no longer used to treat vitamin K deficiency because it may be toxic by interfering with the function of glutathione, an important detox agent needed by the liver. (13C)
One of the most common foods containing vitamin K2 is cheese. It is present in most dairy products and also eggs.
A great source for information about foods containing vitamin K is Healthline (18). Note, however, Healthline does not distinguish between K1 and K2 in their lists. But it’s easy to figure out which is which because:
- All plant sources (except fermented plant foods) listed are for vitamin K1;
- Meat, dairy and egg sources are for vitamin K2.
- Fermented plant food sources, e.g. sauerkraut or natto, are also for vitamin K2.
Vitamin K1 is important for the liver where it helps control blood clotting. Vitamin K2 is important for blood vessel walls, heart health, bones, and tissues other than your liver, and helps with insulin sensitivity. Both K1 and K2 are effective against cancer (2E)
The RDA for vitamin K2 is 65 mcg, but Mercola recommends a daily dose of 200 mcg of K2 for everyone except women who are pregnant or nursing. If you take it supplementally, always take it with fat because it is fat-soluble, and won’t be absorbed without the presence of fat (fatty acids, cholesterol, etc.). (2E)
Many manufacturers lie about contents and purity on their labels. Many are contaminated with lead (from processing). Buyer beware!! It is always best to get your vitamins from natural, organic food sources.
The multi I trust is Mercola’s Whole Food Multivitamin plus Minerals (there’s one version for men and another for women).
Minerals for IR
NOTE: To improve the absorption rate of mineral supplements, taking a fulvic/humic acid supplement such as Ancient Earth Minerals or Living Earth Minerals is suggested. Despite only trace amounts of minerals in fulvic/humic acid complexes, those complexes help the absorption of individual minerals, and they also help to detoxify body cells and the digestive tract.
Many heavy minerals can be toxic in non-organic form (that is, in salt form), so are best taken in organic, chelated form – bound to an amino acid, peptide, protein or other natural chelator. A chelator is something that grasps onto the mineral, much like a crab holds onto food with its claw.
It also helps to take essential minerals in whole food form (I take Mercola’s Whole Food Multi supplement).
Take in chelated form, such as GTF Chromium or chromium picolinate, 200 mg chromium, 2-times/day (1). Natural sources are nutritional yeast, meats, molasses, and organ meats such as liver and kidney (6).
Dietary sources include dairy products, canned salmon or sardines, shellfish, nuts and seeds, dark green leafy veggies. Add a little butter or olive oil to your dark green veggies: it helps to assimilate the calcium and other minerals. (3A)
Supplementally, calcium lactate is an easily absorbed form. However, a University of Oregon website (16A) gives a general discussion of which types of calcium are the best to take as supplement; then suggests using your average urine and saliva pH to determine which type is best for you.
For example, regarding kidney stones: “High concentrations of calcium and oxalate in the urine are major risk factors for the formation of calcium oxalate stones in the kidneys. Because dietary calcium intake has been inversely associated with stone occurrence,” if you have kidney stones, increasing calcium may reduce oxalate and thus reduce stone formation. (16A, 16B)
- If you are taking thyroid hormone, calcium will interfere with proper assimilation of the hormone. Therefore take calcium supplements, or foods high in calcium (such as milk, yogurt) at a different time of day than when you take the hormone.
- The RDA as established for calcium by the USDA is 1000 mg/day. I believe this is high. It is based on calcium oxalate which is not easily absorbed (most of that form leaves your body without being utilized). Other forms of calcium indicate 200-300 is a better daily recommendation.
- While dairy is high in calcium, when pasteurized – especially ultra pasteurized – the calcium is bound by the casein that has been denatured by the heat of pasteurization, and is not available for absorption. Raw dairy is an excellent source because the calcium is not so bound is is more readily absorbed.
Dietary sources include legumes, nuts and seeds, whole grains, dried apricots, dark green leafy veggies. It is best to sprout nuts, seeds, dried legumes and whole grains for maximum benefit. Add a little butter or olive oil to your dark green veggies, as it helps to assimilate the magnesium (1).
Good supplemental forms include: magnesium chloride, citrate or maleate, 200 mg, 3 times/day) (1). I take magnesium as an 80% solution of magnesium chloride by prescription. See also Magnesium (About) for more about this important mineral.
See also See Mercola: The Miracle of Magnesium (2G) and Problems Due to Magnesium Deficiency (2H) for more
Vanadium (as vanadyl compounds)
Dietary sources include Organic extra virgin, unfiltered, olive oil (6),, parsley, black pepper, dill, mushrooms and shellfish. Taken as a supplement, this mineral is not for the general population; recommended only for people with blood sugar issues only.
Caution: vanadium can severely lower blood sugar, so watch for signs of low blood sugar (jitteriness and other signs of adrenaline rush, lightheadedness, drowsiness, loss of coordination, etc.). I speak from experience; I had to stop using this supplement because of these symptoms. (1,8,4)
Dietary sources include red meat and shellfish, especially oysters (6). Zinc is (2A):
- Needed for optimal development and functioning of the brain and nervous system;
- Plays a role in protein synthesis and collagen formation;
- Involved in the blood-sugar control mechanism and thus protects against diabetes;
- Needed for a healthy reproductive system;
- A key component in numerous vital enzymes and plays a role in the immune system.
‘* CAUTION: The human body requires a balance of zinc and copper in order for either to be effective. Too much of one causes too little of the other to be absorbed and utilized. Also copper can be toxic if taken in excess. Therefore it is best to consult with a healthcare practitioner to determine whether supplementation of one or both is needed, and to what degree.
Trace minerals are those for which we do not need to take very high daily doses. A common dietary source is unrefined sea salt, such as Celtic or Himalayan sea salt.
Fulvic/humic acid mineral supplements such as Ancient Earth Minerals (see not at top of this section) another great supplemental source. The Fulvic/humic acid helps with absorption of the minerals.
Alpha Lipoic Acid (Lipoic Acid)
Dietary sources include green leafy veggies, nutritional yeast, and organ meats). As a supplement, alpha lipoic acid is synthetic and contains 50% of the bio-active, natural, R-form and 50% of the less active synthetic S-form. Look for a supplement that contains the R-form only; it has a short half-life, so best to take this in divided doses, or look for a sustained release form. (1,14)
For more about the benefits of Lipoic Acid see an excellent article on the Oregon State University/Linus Pauling Institute web site: Lipoic Acid (16C).
I have a food sensitivity to sulfur-containing foods and supplements such as lipoic acid, but NAET treatment has enabled me to take it for limited periods of time. I’ve also found that taking it with homeopathic 30C Sulfur helps with the food sensitivity. 2018 update: I started taking myo-inositol supplement to reverse my insulin resistance; turns out, it helps with many of my food sensitivities as well, including lipoic acid and cysteine.
This is a more stable version of the sulphur-containing, antioxidant amino acid cysteine, precursor to the master antioxidant, glutathione.
- Dietary sources include meat, red peppers, garlic, onions, broccoli, Brussels sprouts, oats, milk, whey protein, and wheat germ (13).
- Supplements: Choose a sustained-release form of this supplement, to extend the effects of its short half-life (14).
Due to a food sensitivity to sulfur, (as of the initial writing of this article in 2007) I can no longer take this supplement, even with the help of homeopathic 30C Sulfur. However, I started taking Mercola’s Whole Food Multi in late 2018; it contains 150 mg L-cysteine (as N-Acetyl Cysteine) in a full daily dose (8 tablets), and I don’t have a sensitivity issue with that multi. I suspect that as for my experience with lipoic acid, taking myo-inositol is helping me to tolerate cysteine.
Coenzyme Q10 (Ubiquinone)
This is an essential nutrient found primarily in organ foods (liver, etc.), red meats, and the germ portion of whole grains. Our bodies can also make this nutrient, but this ability is believed to decrease as we age. CoQ10 is important for moving electrons along the electron transport chain” as its fully oxidized state is reduced in 2 redox steps (3 redox states) to generate energy: from fully oxidized (ubiquinone) to partially oxidized (semiquinone), and then to fully reduced (ubiquinol). (13E)
A typical daily dose is 100–200 milligrams (13E). It is fat-soluble, so the supplement form should be taken with fat or oil for maximum absorption. NOTE: the ubiquinol (reduced form of CoQ10) is also available as a supplement. This is the form your body naturally uses (other than for electron transport), and research shows ubiquinol is superior for your health in a number of ways, primarily due to its superior bioavailability. It is one of the few antioxidants that is fat soluble; it works primarily in the cell membranes. It is also more easily absorbed from the gut (than the oxidized for of Q10) (2F).
It is essential for heart and circulatory health, gum health, and regulating blood sugar levels.
This naturally occurring, fat soluble, form of thiamine (vitamin B1) is an allithiamine. It is present in the onion family, that has been shown to be more bio-available and have more activity than the water soluble thiamine. Research shows this to be a valuable supplement for people with insulin resistance and other blood sugar problems, autism, heavy metal toxicity, and to fight A.G.Es (Advanced Glycation Endproducts), a major cause of aging. (14)
2017 note: I’ve not taken this for several years. I may try it again.
This is a natural steroid hormone made in your adrenal glands (also in the brain, ovaries and testicles). Taking human-identical DHEA may be necessary, as insulin resistant people are often deficient in this hormone. For this reason, it is helpful for type-2 diabetics.
It is tied to longevity, lean muscle mass and a strong body, and is the precursor of the sex hormones. It protects against cognitive decline, depression and mood swings.
You cannot get this from your foods. Consult with a doctor before taking this hormone (1,7). 20 to 50 milligrams of DHEA is the generally recommended daily dosage, but some may need higher doses up to 200 to 500 milligrams daily to help treat certain disorders such as depression or lupus, but this should only be done under medical supervision. (5)
I take this on and off, as prescribed by my naturopath (15 mg/day in troche form, that is dissolved under the tongue). Discomfort in my breasts is a sign I can stop it for awhile; 3-4 months later I start again.
Fiber, especially the soluble fiber in oat (which provides beta-glucans) (3) and flax seeds (which are also high in Omega-3 fats) helps to keep your gut microbiome health, which in turn improves your digestion among many other benefits. Also fresh fruits and veggies, and whole grains.
French pine bark extract
Sold as Pycnogenol® from Natural Health Sciences), an antioxidant, has also been investigated for treatment of diabetes. (11)
Dietary sources include meats such as beef, pork, and chicken. Only the ‘L’ version is the bio-active form of this amino acid. L-Carnitine is important in brain, nerve, liver and heart function at the cellular level, and has antioxidant and neuroprotective properties. It is very important for energy production within the cells. Acetyl-L-Carnitine is a more bioavailable form that can cross the blood-brain barrier. (14)
Omega-3 fats, especially EPA
Primary source is from fish oils (salmon, tuna, sardines, mackerel, herring, halibut, trout) and cod liver oil (which is also an excellent source of natural vitamins A and D). (2A,3A) See my article: Omega-3 Fatty Acids for lots more.
Supplements to avoid if you have insulin resistance or type-2 diabetes
WARNING: If you are insulin resistant, or have been diagnosed with type-II diabetes, consult with your doctor before using supplements of:
- Glucosamine (9, 10, 12). Refer to The Glucosamine Connection section of my IR-Causes article in my old iWeb site, Health-Disease section). From my article:
“Glucosamine decreases insulin sensitivity (increases insulin resistance) by inhibiting the action of protein messengers used to relay the insulin-initiated glucose-uptake signal. This could well be the mechanism cells use to turn off glucose uptake, when the cells have enough sugar. And it explains the observation that glucosamine is 10-times as potent (for causing insulin resistance) as glucose in animals. It also serves as a caution to humans who are insulin resistant, to avoid use of glucosamine, as it can increase fasting blood sugar and worsen glucose tolerance.).” (12)
- CLA (Conjugated Linoleic Acid) This fatty acid is making a lot of news lately, especially with regard to weight loss, and cancer prevention. While CLA consumed in whole foods such as grass-fed dairy and beef is health-promoting, when taken as a supplement, it has been shown to have many detrimental effects:
- may cause weight gain by promoting insulin resistance & raising glucose levels;
- reduces HDL levels (good cholesterol);
- causes stomach upset.
- (16) mercola.com/article/soy/avoid_soy.htm and following pages: Page 2, Page 3
- (18) articles.mercola.com/sites/articles/archive/2007/10/18/dairies-unite-to-set-safety-standards-for-raw-milk-cheese.aspx
- krilloil.mercola.com/krill-oil.html and articles.mercola.com/vitamins-supplements/krill-oil.aspx
- articles.mercola.com/sites/articles/archive/2004/08/07/miracle-magnesium.aspx; This link goes to: articles.mercola.com/vitamins-supplements/magnesium-citrate.aspx (Title has been changed)
- (4) tjclarkinc.com/minerals/vanadium.htm
- (6) westonaprice.org/moderndiseases/diabetes.html
- (7) medscape.com/viewarticle/493389?src=mp
- (8) Vanadyl Sulfate Improves Hepatic and Muscle Insulin Sensitivity in …
- (9) pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/glu_0122.shtml
- (10) hopkinsmedicine.org/press/2002/APRIL/020415.htm
- (11) naturalproductsinsider.com/articles/471/471_4c1functional1.html
- (12) altmedicine.about.com/cs/arthritis/a/Glucosamine.htm
- (14) The Perricone Promise, by Nicholas Perricone, M.D.
- (15) nlm.nih.gov/medlineplus/ency/article/002401.htm
- (17) University of Oregon, Linus Pauling Institute:
- lpi.oregonstate.edu/mic/minerals/calcium (the old, original link uoregon.edu/~sshapiro/Pemphigus/Supplements.html is no longer valid)
- (19) lpi.oregonstate.edu/mic/dietary-factors/lipoic-acid
- Online Holistic Health:
- ncbi abstracts: