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‘Myth of physical activity and obesity’ editorial suspended by journal

Article had attracted strong criticism from experts

Earlier this month we reported on an editorial published in the British Journal of Sports Medicine in which the notion that exercise can help obese people lose weight was described as a “myth”. BikeBiz reports that the piece has since been removed. Anyone attempting to access it is now greeted with the message: “This paper has been temporarily removed following an expression of concern.”

The editorial, which was jointly written by London-based Dr Aseem Malhotra and two other experts – one from South Africa, the other from the United States – argued that “manipulative marketing” by the food industry had undermined government initiatives to combat obesity and that “vested interests” distorted public health messaging relating to diet and exercise.

The authors said that while levels of obesity have soared in the Western world over the past three decades, levels of exercise have remained almost static and they therefore laid the blame for the nation’s weight gain on the type and amount of calories consumed. “Let us bust the myth of physical inactivity and obesity,” they wrote. “You cannot outrun a bad diet.”

Dr Malhotra later told the BBC:

"An obese person does not need to do one iota of exercise to lose weight. They just need to eat less. My biggest concern is that the messaging that is coming to the public suggests you can eat what you like as long as you exercise. That is unscientific and wrong. You cannot outrun a bad diet."

However, Philip Insall, director of health at the sustainable transport charity, Sustrans, said that in the case of the UK at least, levels of physical activity had in fact fallen over the past half century. “From 1961 to 2005, levels of physical activity in the UK dropped by 20 per cent and if current trends continue, will reduce by more than 35 per cent by 2030.”

Professor Mark Baker from the National Institute of Health and Care Excellence (NICE), which sets guidelines for health in England and Wales, was blunt in his response when the editorial was first published. He said that it was "idiotic" to downplay the value of exercise and reiterated NICE’s recommendation that people combine well-balanced diets with physical activity.

Alex has written for more cricket publications than the rest of the road.cc team combined. Despite the apparent evidence of this picture, he doesn't especially like cake.

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AJ101 | 8 years ago
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AJ101 | 8 years ago
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Further to the discussions here today's news brings this

http://www.dailymail.co.uk/health/article-3077507/Everything-think-know-...

The headlines are misleading - it is the Daily Mail after all -
but the content about gut bacteria is interesting. In my experience balanced gut bacteria comes from a natural low sugar diet but that comes across less in the way the article is written.

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urbane | 8 years ago
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The food pyramid is corrupted in most developed countries as are other frauds by the drug/food corporations e.g. the low Cholesterol, low saturated fat, and "energy" drinks/bars BS etc.

Calories are simplistic junk science based on the combustion "Calorimeter" which is nonsense for usable human digestion and metabolic food energy input. Human digestion and metabolism is far more complex; food types, combinations and gut/body flora, can significantly vary peak and total energy input and even how it is used.

Exercise may not be enough if we ate or eat unnatural 'foods', quantities and chemicals which we are not evolved to e.g. over-bred cereals like Wheat, soy, excessive sugars, heat extracted inflammatory vegetable oils, too processed food, food from essential mineral depleted soils, pesticides (mess with DNA, hormones etc.) and antibiotics (unbalance gut/body flora); we must address both the causes and the metabolic debt, this can also require supplements.

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ch | 8 years ago
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Separating "eating" and "exercise" as separate variables is meaningful from an "end effect" point of view - but in fact the are not behaviorally independent. "Eating" well correlates behaviorally speaking to improved exercise and visa vesra. Eat too much and motivation and physical ability drop. Exercise too little and salads are tasteless monstrosities while infinite carbs can be consumed.

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Lizzie87 | 8 years ago
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I agree entirely with Rolfster and MattT53 above. The human body is much more sophisticated simply to subscribe to laws of thermodynamics and calories in/out - we're not machines! We are complex animal beings that need nutrient dense food with building blocks for cell renewal and energy. Modern refined foodstuffs do not provide us with the nutrient density we need, thus throwing the body's hormonal balance out of whack with a host of problems as a result. Animal fat and animal protein are energy dense, but also compatible with our basic nutrient requirements, so by eating them we truly satisfy that need. (Did you also know that it takes quite a lot of energy to break protein and fat down in the first place, unlike sugar and carbs who's simple structure mean almost instant energy and fuel storage of the leftovers).

Those who eat this way and only get less than 20% of their energy intake (from carbohydrates from vegetable sources) will rarely overeat, and thus won't have hormonal issues leading to fatigue, overeating and a host of other problems. With the right nutrition (yes, basic building blocks such as amino acids, vitamins and minerals necessary for health) your body will come out of hibernation, have the means necessary for cell renewal and energy in abundance - that's when you will actually start browsing the internet for a new pair of running shoes and WANT to get out and be active!!

The sceptics out there are bound to disagree. But I ask this of those who do - If you are truly engaged and interested in this discussion, instead of just regurgitating what mainstream 'knowledge' (read money-making leeches and its henchmen) still encourages you to believe, perhaps read some more about 'diets' such as LCHF (Low carb high fat) on www.dietdoctor.com and all its success stories (my father being an excellent example going from 105 kilos to 72 kilos on LCHF and staying lean at the age of 70+). Perhaps if you're intrigued you may even have a weight loss story of your own - why not try it??

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tobyrowsell | 8 years ago
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My personal experience, without the benefit of biochemical study, is that the thermodynamic equation is perfectly reasonable, though calibration will inevitably differ by person due to build / environment etc.

I expend lots of energy on sportives and commuting etc. every year on two wheels from April-mid Oct. I also try to reduce daily calorie intake over this period to 1,500-2,000 (with exceptions...obviously!). Hey presto - I get to a sensible BMI and waist size by mid-late summer.

The UK weather and short daylight hours from mid Oct to March means that the bike doesn't see a whole lot of action for a few winter months (and don't even think about a turbo-trainer which is even worse than a gym).

Calorie intake inevitably increases due to more eating / drinking / social time esp. over Christmas....and guess what - the waist grows and everything in the wardrobe seems a bit more snug!

After 7-8 years of this annual weight/BMI cycle (no pun intended) I've accepted the equation, and notwithstanding a winter move to Tenerife / Cyprus, I guess its here to stay.

What does this mean for me re the BJSM article?
- Exercise in a meaningful sense (3-4 hard pedalling sessions per week) can help reduce weight to some extent.....but combine this with a reduced calorie intake to below the daily "recommended" quota, and you can materially alter your BMI and body shape over 2-3 months.....well, at least until the following winter!

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FluffyKittenofT... | 8 years ago
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Have to say I have a general gripe about how often flawed papers get published (at least in certain fields). Or maybe its more a gripe about how quickly the non-specialist media will leap uncritically on such papers if they happen to fit some prejudice or agenda.

(I mean, it seems like the dodgy stuff is always something to do with one or other of: IQ, brain-scanners, evolutionary-psychology, nutrition, or something that causes or prevents cancer. But maybe there are just as many weak papers in mechanical engineering and pure maths, but nobody outside the field ever notices any of those?)

Flawed studies are out the door and half-way round the world before the truth has remembered where it left its keys, glasses and mobile phone.

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wyadvd | 8 years ago
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Have any commenters here actually read the paper in question and familiarised themselves with the actual science of the aetiology of obesity? Do that. Then comment.

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wyadvd | 8 years ago
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Have any commenters here actually read the paper in question and familiarised themselves with the actual science of the aetiology of obesity? Do that. Then comment.

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wyadvd | 8 years ago
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Have any commenters here actually read the paper in question and familiarised themselves with the actual science of the aetiology of obesity? Do that. Then comment.

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MattT53 | 8 years ago
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Haha, the perception that you can eat as much fat/protein as you like and not get fat is laughable - on a per gram basis you're getting the most energy from fat. And eating carbs is very much sensible (one eminent biochemist I was taught by used to elegantly take apart the counter argument in lectures and warn of the dangers of the atkins diet etc). If you want to understant this stuff buy a biochem textbook, not the latest diet fad guide.

And yeah calories in/out does pretty much work out, even if the various pathways differ somewhat in efficiency

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Rolfster replied to MattT53 | 8 years ago
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MattT53 wrote:

Haha, the perception that you can eat as much fat/protein as you like and not get fat is laughable - on a per gram basis you're getting the most energy from fat. And eating carbs is very much sensible (one eminent biochemist I was taught by used to elegantly take apart the counter argument in lectures and warn of the dangers of the atkins diet etc). If you want to understant this stuff buy a biochem textbook, not the latest diet fad guide

So instead of resorting to the logical fallacy of argument from authority can you actually quote any evidence that supports your position. It's always fascinating to watch people defending the discredited status quo in spite of overwhelming evidence that that the dogma of low fat / high carb diets has utterly failed.

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MattT53 replied to Rolfster | 8 years ago
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What evidence would you like? Any biochemistry textbook/wikipedia will show you how fat/protein is converted to acetlyl coA and subsequently ATP (energy, the same outcome as carbs even if it may take a while longer to achieve). What's failed is peoples inability to restrict calorie intake coupled with reduced energy expenditure. I can cite some papers of the effects of feeding mice very high fat diets (basically how you create a model of heart disease) but they may not be open access. Can you cite anything that shows unlimited fat/protein intake doesn't lead to weight gain and health issues? All in moderation.

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Jimnm replied to Rolfster | 1 year ago
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Well, you can eat drink and be Mary if you're that way inclined, it doesn't matter, just ride your bike often. You're born, you live, you die, you're compost! Don't waste your time worrying about your weight. 

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NOtotheEU replied to Jimnm | 1 year ago
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Jimnm wrote:

Well, you can eat drink and be Mary if you're that way inclined 

Body and gender positive in the same sentence, very progressive!  😁

Or are you implying some sort of food industry global conspiricy using trans fats?  

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Joeinpoole replied to MattT53 | 8 years ago
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MattT53 wrote:

Haha, the perception that you can eat as much fat/protein as you like and not get fat is laughable - on a per gram basis you're getting the most energy from fat. And eating carbs is very much sensible (one eminent biochemist I was taught by used to elegantly take apart the counter argument in lectures and warn of the dangers of the atkins diet etc). If you want to understant this stuff buy a biochem textbook, not the latest diet fad guide.

And yeah calories in/out does pretty much work out, even if the various pathways differ somewhat in efficiency

What utter nonsense. Humans have been around about 2M years. We've only been farming our own food for about 10K years. Before that we were entirely hunter-gathers. We only really became farmers when we'd killed off most of the big animals we liked to eat.

Our diet as hunter-gathers was almost entirely protein and fat with a little bit of vegetation thrown in. We are designed to be fat-burning machines, most definitely *not* carbohydrate-burning machines.

There was precious little carbohydrate available in nature to our fore bearers. Ok, there was fruit but that was seasonal and much smaller and bitter than the modern highly developed fruit in our supermarkets. Then there was tubers like potatoes but again seasonal and much smaller and harder to find than their modern equivalent. Then there was nuts and rice in some parts of the world, again seasonal.

Don't forget we have had relatively recent contact with raw hunter-gatherers in the shape of Native American Indians. Up until about 150 years ago that was how they lived. They mainly eat bison ... and lots of it. They were lean and ripped warriors who were considered to have roughly twice the strength of the American soldiers that they were fighting. I can assure you that they weren't counting calories or stuffing themselves with carbohydrates in order to maintain their physiques.

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poppa | 8 years ago
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Out of interest, what with the whole carbs/no carbs debate, does anyone know if pro athletes in cardio vascular disciplines (e.g. road cycling, runners) adopt a low/no carb diet? Or do they stick to the more traditional varied diet with a more blanaced mix of carbs/protein/fat?

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Must be Mad | 8 years ago
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Well, well, well.
I said the report was badly written and misleading when it first appeared.

Quote:

What the article said was that on its own exercise would not lead to a reduction in obesity in the general population. This to me seems to be perfectly reasonable as most people, even if they do "exercise", burn only a small number of calories (a 1 mile run uses approx 100 calories. They then overcompensate by eating too much.

The flaw with your argument is your assumption that people will get the exercise wrong, but get the diet right. I've seen people count the calories through diet, and then reward themselves with cake at lunch....

The key to fighting obesity is a healthy lifestyle. That means eating sensibly and exercising sensibly. Trying to do one while ignoring the other is just making life hard for yourself.

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FatFreddie | 8 years ago
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I haven't read the article but from talking to people who have (some with very strong opinions) and having read Tim Noakes' (the South African contributor) writing and a lot of other literature on low carb diets and metabolic processes it seems that the basic message is good but has been badly presented.
Talking in general and very simplistic terms, the majority of people who are obese will have chronic blood sugar control problems of one degree or another (sub clinical or pre diabetes to full diabetes). This causes:
- insulin resistance which prevents muscle cells storing glycogen resulting in a lack of stamina because the muscles energy reserves start off half depleted.
- reduced available haemoglobin due to sugar coating the red blood cells and stopping them functioning which results in getting out of breath easily.
- many other factors which act against exercise
Exercise obviously helps, particularly in staving off the onset of these problems but once someone is obese, they need to sort out their diet as a main priority and do as much exercise as they reasonably can, increasing it naturally as they recover. Exercise on it's own will never be enough unless the person has an absolute will of iron.
The problem with this subject is that it's actually quite complicated and there is no simple message - some people are fine on a high carb diet and some struggle and it's down to your genetics and exercise and diet how well you cope. The "healthy diet" as generally described is actually quite unhealthy for some people...

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Joeinpoole | 8 years ago
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What a shame. The report stated the truth and attempted to de-bunk dangerous myths.

This episode reminds me very much of Professor Nutt being sacked as Chairman of the ACMD by the last Labour government in 2009. He had the audacity to point out that many banned substances were considerably less harmful than permitted substances such as alcohol and tobacco. He also published a paper in which the risks associated with horse riding (1 serious adverse event every ~350 exposures) were compared to those of taking ecstasy (1 serious adverse event every ~10,000 exposures). How dare he tell the truth.

Political dogma appears to trump scientific analysis in this country.

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ridders replied to Joeinpoole | 8 years ago
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Prof Nutt Sacked?!

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vonhelmet | 8 years ago
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Calories in/out can't really be a myth, given it's basic thermodynamics. That or all those fat people out there are somehow violating the principle of conservation of energy, in which I am prepared to concede that we have bigger problems to deal with.

The problem is that people underestimate how much fat is in all those blocks of lard they're eating, and overestimate how many calories they're burning walking to their car to drive to the shop to buy more lard.

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Joeinpoole replied to vonhelmet | 8 years ago
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vonhelmet wrote:

Calories in/out can't really be a myth, given it's basic thermodynamics. That or all those fat people out there are somehow violating the principle of conservation of energy, in which I am prepared to concede that we have bigger problems to deal with.

The problem is that people underestimate how much fat is in all those blocks of lard they're eating, and overestimate how many calories they're burning walking to their car to drive to the shop to buy more lard.

Calories are measured by burning the substance under test and measuring how much additional heat is generated. Your body doesn't do that. You can eat as much protein and fat as you like without getting fat. It is over-indulgence of carbohydrates that makes people fat. It is not about 'calories' per se.

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ricardowilson21 replied to vonhelmet | 8 years ago
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Just go buy, and read, Gary Taubes book - "Why we get fat and what to do about it".
It will give you a new outlook on the whole subject.
And read "Fat Chance" whilst youre at it.

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P3t3 replied to ricardowilson21 | 8 years ago
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ricardowilson21 wrote:

Just go buy, and read, Gary Taubes book - "Why we get fat and what to do about it".
It will give you a new outlook on the whole subject.

I've read it. Its compelling, but its also wu wu... its pretty good at convincing lay people. But he fundamentally fails to demonstrate causal links whilst bemoaning the established opinion of an overwhelming majority of medical evidence and opinion for the very same fault. It borders on conspiracy theorist in places.

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ricardowilson21 replied to vonhelmet | 8 years ago
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Just go buy, and read, Gary Taubes book - "Why we get fat and what to do about it".
It will give you a new outlook on the whole subject.
And read "Fat Chance" whilst youre at it.

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Paul_C replied to vonhelmet | 8 years ago
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vonhelmet wrote:

Calories in/out can't really be a myth, given it's basic thermodynamics.

you are NOT a bomb calorimeter, which is how they determine how many calories are in a sample of food...

Different items go down different metabolic pathways... fat is NOT bad, carbs are.

Carbs are not required for life as you can manufacture all the carbs your brain needs from protein.

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fukawitribe replied to Paul_C | 8 years ago
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Paul_C wrote:

Carbs are not required for life as you can manufacture all the carbs your brain needs from protein.

..but quite a few carbs taste really nice. Bummer really.

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sea_biscuit replied to Paul_C | 8 years ago
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Paul_C wrote:
vonhelmet wrote:

Calories in/out can't really be a myth, given it's basic thermodynamics.

you are NOT a bomb calorimeter, which is how they determine how many calories are in a sample of food...

Different items go down different metabolic pathways... fat is NOT bad, carbs are.

Carbs are not required for life as you can manufacture all the carbs your brain needs from protein.

your gastro tract is like a bomb calorimeter though. it will digest everything and absorb it - yeilding the metabolic energy equivalent, as oppose to total energy content. the process is not 100% efficient but pretty good. we have 10-fold more microbes in our gut than in rest of our body helping us to do this - look after them, eat fibre. oh, but thats carb-based or 'non-starch polysaccaride'.

so....simple carbs (sugars) are bad. we have only spent about 0.1% of our existence dealing with them and our bodies struggle to cope. they go down as fat, as does everything if eaten in excess of requirments (like even to many carrots or lettuce)... protein is not ideally used as an energy substrate as its dead useful or 'functional' - enzymes, hair, muscle, cells are all made of protein and its not 'stored' as such to be used as energy...but as any hunger-striker will tell you it is used after about 40 days fasting and you lose all energy and become acidotic...eventually you lose your respiratory muscle tone. your body doesnt really like to use protein (you likely mean the amino acid alanine, as that is the main protein source for gluco-neo-genesis or formation of glucose from non-carb sources).....mainly it uses glycerol from fat breakdown and perhaps ketone bodies.

how not to get overweight: apply above commentators logic and balance intake with output or more appropriately output with intake as expenditure drives/controls/enables better control of sensible intake. its a damn shame that shit-for-you food (err and booze) taste so damn good, gives you a hedonic hit, is socially acceptable, enables social situations to happen, unites families round the table....etc etc.. its the price of progress. its socially acceptable, as you say, to eat yourself to an earlier than wanted death

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andybwhite replied to vonhelmet | 8 years ago
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vonhelmet wrote:

Calories in/out can't really be a myth, given it's basic thermodynamics. That or all those fat people out there are somehow violating the principle of conservation of energy, in which I am prepared to concede that we have bigger problems to deal with.

The problem is that people underestimate how much fat is in all those blocks of lard they're eating, and overestimate how many calories they're burning walking to their car to drive to the shop to buy more lard.

You're right - it ain't as simple as calories in vs calories out and it isn't lard that's the problem its sugar.
The way sugar disrupts the body's metabolism is the key to obesity - dieticians now understand this. Excess insulin production caused by the over consumption of sugar causes calories to be stored as fat within the body. Consuming the same calories as fat does not have the same effect.
The report was correct in what it was trying to say and that was we are not going to bear the obesity epidemic with exercise, we simply have to tackle it by reducing the amount of sugar (and carbs as its the same thing) in our modern diet.

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