How to Prevent Heart Disease – Eat More Cholesterol?

cholesterol and heart disease myth How to Prevent Heart Disease   Eat More Cholesterol?

Note: this article is long and goes into a lot of science. If that isn’t your thing, watch the movie Fat Head for free right now on Hulu. It explains much of this in a very entertaining way!

I’m sure you’ve heard or seen the commercials telling the dangers of high cholesterol levels and the various life saving drugs that lower cholesterol levels. Compelling commercials, but based on bad science! You might be surprised to find out that science actually shows that cholesterol levels have little to no effect on heart disease risk, and if anything, high cholesterol might lower your risk!

Cholesterol is a lipid that is present in the cell membrane of all the body’s cells. It is essential in proper synthesis of hormones, absorption of fat soluble vitamins, and cell regeneration. Sounds important, right?

It certainly is! So important in fact, that the liver is careful to regulate levels and produce 1000 milligrams or more a day. The current dietary recommendation for cholesterol consumption is only 300 mg daily, not even close to what the body needs and produces naturally. Here’s the kicker though, to keep necessary cholesterol and function properly, the liver produces more cholesterol when you don’t eat enough of it, and when you are getting enough from your diet, you liver produces less!

So what is the proper role of Cholesterol in the body, and what should we get from diet and what shouldn’t we?

The Cholesterol- Heart Disease Hypothesis

The typical story on cholesterol and heart disease that you’ve probably heard goes like this:

  1. High Cholesterol in the diet raises blood cholesterol
  2. High Blood cholesterol causes heart disease (this part is referred to as the Lipid Hypothesis)

Seems logical enough, except that when you break it down, the facts don’t make sense. First of all, the Framingham Heart Study, which is the most extensive study on risk factors for cardiovascular disease ever done, found that there is absolutely no correlation between large amounts of cholesterol in the diet and risk of heart disease.

As for the second part, the Lipid Hypothesis, the science here doesn’t make sense either. If blood cholesterol really did cause heart disease, than this would be noticed across the board in different age groups and demographics…. except it doesn’t. In fact, as people age, cholesterol typically decreases some, yet risk of heart disease rises!

Also, women typically suffer 300% fewer heart attacks than men, but higher average cholesterol. Something doesn’t add up! If cholesterol doesn’t cause heart disease, what does? And what effect does cholesterol actually have on the body?

Cholesterol- Different Types and Their Roles

LDL, or Low-Density Lipoproteins typically get the bad rap in the cholesterol world, but LDL serves the important function of transporting cholesterol that the liver produces to the various parts of the body where it can be used. Research is now finding out that there are two types of LDL- Soft big LDL, which are shown to be relatively harmless, and small dense LDL which can be more problematic. The important part to remember here is that while a proper cholesterol balance is necessary, LDL does serve a very necessary purpose! (Interesting note, there has been a correlation shown between consumption of simple carbohydrates and increase in small, dense LDL)

HDL or High-Density Lipoproteins are typically given a halo in the medical world for their role in transporting cholesterol that has been used by the body back to the liver to be excreted as bile. Certainly an important job also, but one that serves its purpose after the LDL has has transported the cholesterol and the body has used it.

Studies are even showing that high cholesterol might not be a problem at all, especially if the two types of proteins are in balance and there are not an abundance of small dense LDL. Some studies even show that higher cholesterol can correlate with a lower risk of heart disease!

In some studies of people around the world, researchers have found that those with the highest blood cholesterol have the lowest risk for heart disease.

Cholesterol is actually a vital nutrient for healthy cell formation and hormone synthesis. It is necessary for production of progesterone, testosterone, DHEA, and other hormones that are vital to proper endocrine function.

What Does Cause Heart Disease?

Heart disease is the number one killer in our country today, which is startling considering that a little over a hundred years ago, it was practically unheard of! In fact, the first heart attack wasn’t even described in scientific literature until 1912, yet heart disease rates have risen steadily since then.

Chapter4 3 300x154 How to Prevent Heart Disease   Eat More Cholesterol?

Source: nhlbi.nih.gov/

Saturated fat has gotten a bad rap for causing heart disease as well (and supposedly also contributes to high cholesterol and thus heart disease) but an analysis of all studies evaluating the connection of saturated fat and heart disease found no correlation. In fact, many studies actually showed a reduced risk of heart disease and mortality with increased saturated fat consumption. Also, saturated fat consumption has dropped as heart disease rate has risen, as has the total amount of calories we are consuming from fat:

Percent+from+macronutrients How to Prevent Heart Disease   Eat More Cholesterol?

Since then, some studies have shown that those with the lowest cholesterol are more likely to die of heart disease (and vice versa).

Cholesterol+vs+Heart+Disease How to Prevent Heart Disease   Eat More Cholesterol?

So then, what actually causes heart disease?

There are still many theories, and most actually come down to nutrition, or lack thereof, rather than genetic factors or cholesterol levels.

For instance, one study in the 1940s and 1950s found a strong correlation between consumption of sugar and increased inflammation throughout the body, including in arterial walls (a major risk factor for cardiovascular episodes). Recent studies are showing that fructose is perhaps more dangerous than regular sugar. Interestingly, consumption of sugar and high fructose corn syrup have risen at rather similar rates as heart disease:

U.S.+Sugar+Trend How to Prevent Heart Disease   Eat More Cholesterol?and:

HFCS++Renal+Disease How to Prevent Heart Disease   Eat More Cholesterol?

Other studies have linked deficiency of vitamins B6 and B12 (found in meat along with saturated fat!) and deficiency of Vitamin C to brittle arterial walls and higher risk of heart disease.

Perhaps the strongest correlation, however, is that between vegetable oils (you know, those “heart healthy” ones like canola, soybean, corn, etc.?) and increased instance of heart disease. There is more an more emerging evidence that supports this claim.

Vegetable oils are high in Omega-6 fatty acids, which have their place in the body, but if eaten out of proportion to Omega-3 acids, can cause some serious problems and inflammation. From this article:

The most important change in the American diet during the years of CHD increase has been the gradual substitution of vegetable fats for those of animal origin. Hydrogenated fats — in the form of margarine and shortening — have replaced butter and lard, while the consumption of vegetable oils has increased more than 10-fold. Since as early as 1956, a number of researchers have found that consumption of trans-fatty acids in hydrogenated oils contributes to heart disease, including most recently Mensink and Katan in the Netherlands, and Walter Willett at Harvard University.

Interestingly enough, the graphs representing consumption of vegetable oils and fats in the last 100 years look strangely similar to the graph showing heart disease rates:

Canola+oil+consumption How to Prevent Heart Disease   Eat More Cholesterol?

Soy+oil+consumption How to Prevent Heart Disease   Eat More Cholesterol?u s corn oil consumption How to Prevent Heart Disease   Eat More Cholesterol?

The imbalance of Omega-6 to Omega-3 fatty acids along with the fact that many vegetable oils are oxidized or hydrogenated, increases inflammation in the body, which can be a factor in increased risk of heart disease. These oils also contain the much feared free-radicals that can weaken and damage arterial walls. From the article above:

Arterial plaque contains cholesterol because the body actually uses cholesterol to repair injuries, tears, and irritations to artery walls. However, like rancid vegetable oils, cholesterol that has been oxidized by high temperatures and exposure to air can itself irritate the arterial walls and initiate pathological buildup. High temperature spray production of powdered milk and eggs, used as additives in many processed foods, began in the early part of the century. Consumption of both hydrogenated fats and products containing oxidized cholesterol increased greatly after the war.

A recent study found that excess consumption of omega-6 fatty acids, the kind found in commercial vegetable oils made from corn, soy, safflower, and canola, increases the amount of oxidized cholesterol in the arterial plaque. Like sugar and white flour, these vegetable oils, produced by high temperature industrial processing, are new to the human diet. It is the polyunsaturated omega-6 fatty acids — not saturated fat — that form the major fat component of arterial plaque, yet for many years the American Heart Association and many establishment nutrition writers advocated consumption of polyunsaturated oils for the heart.

Vegetable oils and hydrogenated fats were introduced in the early 1900’s, (1911 to be exact) and both vegetable oil consumption and heart disease rates have risen since then. It is important to note that these fats simply were not consumed before this time, because they didn’t exist!

Trans fats, which have gotten heat in most circles lately, are present in some forms of these oils/fats, and studies are showing a strong link between trans fat and increased risk of heart disease. These processed vegetable oils were introduced and touted for their potential to reduce the risk of heart disease compared to animal fats, but they haven’t done that. For instance:

  • Rose, et al. (1965): Replacing animal fat with corn oil for two years lowered serum cholesterol by 23 mg/dL but quadrupled cardiac and total mortality.
  • Sydney Diet-Heart Study (1978): Replacing animal fat with vegetable fat for five years lowered cholesterol by five percent but increased total mortality by 50 percent.

While saturated fat gets the bad rap, there is a noticeable lack of studies showing a clear link between saturated fats (from real, unaltered sources) and heart disease or increased mortality. High triglyceride levels, on the other hand, have been linked to increased inflammation and resulting heart disease, as well as increased risk of diabetes and low HDL cholesterol. What causes high triglycerides? Glad you asked- a diet high in sugars and carbohydrates.

Grain consumption (especially wheat) has also risen steadily during this time period, and grains are in an entirely different form than they were a couple hundred years ago. The introduction of the stone mill allowed grains to be ground into much smaller particles that create more of an insulin response in the body and can damage the intestines.

Wheat+Flour+per+Capita How to Prevent Heart Disease   Eat More Cholesterol?

An important note here: since peaking in the 1950’s deaths from heart disease have dropped slightly, which researchers contributed to factors like decrease in smoking and better detection and treatment of factors leading to heart disease.

Though of course, correlation does not prove cause, the graphs above do show a strong resemblance between the rise in heart disease rates and the rise in consumption of products like sugar, vegetable oils, and wheat flour.

What about Statins?

To solve the problem of high cholesterol, which we’ve just found is not necessarily a problem at all, Big Pharma has come to the rescue with statins: drugs that keep the body from producing cholesterol.

The problem is, that since we’ve shown that cholesterol doesn’t necessarily cause heart disease, and that cholesterol is necessary for cell regeneration, hormone synthesis and many other important jobs in the body, decreasing the body’s ability to produce cholesterol might be (and is) the wrong approach!

What about the cells that need regenerating? What about proper hormone balance? What about the body’s ability to absorb fat soluble vitamins? All good questions and all without answers from the manufacturers of these drugs.

To add insult to (lack of ability to repair) injury, statins haven’t actually been shown to reduce risk of cardiovascular problem or mortality at all! (Logical when you realize that cholesterol isn’t the problem). Check out this article for a breakdown of effectiveness of these drugs.

If the body doesn’t have and can’t produce enough cholesterol, it won’t be able to synthesize vital nutrients like Vitamin D, or produce hormones like serotonin, melatonin, progesterone, testosterone, etc., which can leave you depressed, having trouble sleeping, or with reproductive difficulties.

What Does Reduce the Risk of Heart Disease?

A lot of the factors that can help improve heart health and reduce the risk of heart disease fly in the face of conventional wisdom, but you are probably used to that by now!

  1. Eat More Eggs- and cholesterol containing foods. As I mentioned earlier, if the body doesn’t have enough dietary cholesterol, it must manufacture it, and dietary cholesterol has no relation to heart disease. Eggs have a ton of nutrients and help the body synthesize fat soluble vitamins. Enjoy those bacon and eggs!
  2. Reduce Carbohydrate and Grain Consumption- Emerging research is demonstrating the link between inflammation and heart disease. Grains and sugars contribute to inflammation and increase the risk of heart disease. Consuming them, especially in excess, has also been linked to other problems like metabolic syndrome, diabetes, obesity and others.
  3. Avoid Vegetable Oils and Products Containing Them- These oils mess up the balance of protective Omega-3 fatty acids and potentially dangerous Omega-6 fatty acids in the body. They also contribute to inflammation and arterial damage. There is no reason that you need to consume these oils at any point… ever!
  4. Eat Lots of Saturated Fats and Other Healthy Fats- As studies have yet to link saturated fat intake with heart disease, and in fact, many prove the opposite, getting enough saturated fat from sources like animal fats, coconut oil, raw organic dairy, etc is essential to give the body all the building blocks it needs for proper cell and hormone function.
  5. Optimize Vitamin D and Fat Soluble Vitamins- Fat soluble vitamins in proper amounts in the body have a protective effect on tissues and organs (including the heart). If you’ve been on a law-fat diet or used sunscreen all your life, you could be seriously deficient in vitamin D, so consider getting your blood levels tested.
  6. Get Enough Omega-3s- These help balance out the Omega-6 to Omega-3 ratio in the body and prevent inflammation. Omega-3s also can thin the blood and keep it from clotting too regularly, a risk factor in heart disease. Having a proper Omega-3 balance also helps keep triglyceride levels in check.
  7. Exercise- You’ve heard this one before, yet most of us don’t get enough exercise in. Exercise helps strengthen the heart and tone muscles. It increases circulation and reduces stress hormones- all good things to help reduce your risk of heart disease.
  8. Reduce Stress and Get Enough Sleep- High stress levels and lack of sleep can both increase inflammation and stress hormones in the body. Both are also linked to higher levels of many diseases, including heart disease, and increased overall mortality.

Your turn. How much cholesterol are you eating?

Reader Comments

  1. Kathy fletcher says

    My mantra is “Dietary fat does not make you fat!”  People get sick of hearing me say it, but this article says everything I believe. Margarine will kill you, pasta will make you fat, and an avocado everyday will make you healthy, happy, and full!

  2. Susan says

    “FatHead” also has a very interesting blog – recently he posted regarding a link between low-fat, high-carb diets and the development of Alzheimer’s disease, which like heart disease has also increased exponentially since the introductions of processed fats and carbs.

  3. Lever says

    This was really interesting to read. I’ve been really confused about how people are coming to the conclusion that eating high amounts of fat can be good for their heart, but because I consider myself a scientist, I like to look at the evidence of an argument before discounting it. Even if it goes against what I consider very established evidence, its worth looking at and considering if its supported.

    However, your article cherry picks scientific evidence instead of presenting it honestly. It targets readers who are either A) scientifically illiterate (which is not meant as an insult) or B) people who dont actually have access to pubmed or other academic databases, so they cant really check your facts beyond the abstract. Luckily, I do have access.

    Your first claim, that “cholesterol levels may have no effect on heart disease and lower levels may only increase your risk” is based on that one study in the elderly. This is a cohort study, which means it only looks at a fraction of the population from a specific time (thus, results cannot be generalized to the remaining population).

    You say women have 300% less heart attacks then men, but higher cholesterol. No source is given. But i did find that the AHA claims women have higher HDL cholesterol, or what is sometimes referred to as the protective cholesterol that decreases the effect of LDL (the low density kind that increases heart attack risk). There is no evidence i could find that they have higher LDL. Also, your article fails to look at the bigger picture. Such as stress and its effect with cholesterol. You cant look at one variable and make your conclusions on that. Heart disease is brought on by more than just cholesterol, and low stress may mitigate the negative effect of cholesterol.

    You claim that the study you cite decided that higher cholesterol was associated with lower heart disease risk. Again, not the whole picture. Also, another cherry picking example. This is another article dealing exclusively with the elderly (which, again, cannot be generalized passed that cohort). If you read the article, it says that “there is considerable evidence that hypercholeserolemia is associated with coronary heart disease risk in the young and middle aged population, but whether increased cholesterol is associated with higher risk in those over 70 is controversial”. So you stretched another article farther than its reach, yet again.

    This one is my favorite. You claim that “An analysis of all the studies ever done evaluating the connection between saturated fat and heart disease found no correlation”. Not true at all. The meta analysis looked for a very specific number of studies based on 5 criteria. Using a number of terms, including saturated fat and heart disease, they found over 700 total studies. How many did they evaluate? 16 for CHD, 8 for stroke. This research is epidemiological and is based on self-report, not blood samples as it may have been implied by your writing. The article also mentions a few interesting things that are counter to your statement 1.) “There was lower CHD risk when saturated fats were replaced with poly unsaturated fats” 2.) “Benefits of reduced saturated fat intake in regards to CHD may be dependent on increased polyunsaturated fat intake” 3.) “The available data were not adequate for determining whethere there are CHD or stroke associations with saturated fat in specific age or sex subgroups. The results however, were interesting and counter to some data on saturated fat associations with heart disease. But, one study is not science. You need to look at all of the evidence to formulate conclusions. You discount the thousands upon thousands or search results in ISI Web of Science, Ebsco, The Lancet, and PubMed that suggest a strong link between cholesterol, saturated fat intake, and heart disease, as well as the efficacy of Statins and other cholesterol-lowering drugs in mitigating the damage done to people (such as myself) who have extremely high cholesterol levels due to genetic makeup.

    Finally, and i apologize for this rushed and sloppy response to your article, your “what prevents heart disease” portion has no references. None. Although i do agree with many of them, if you dont have evidence for them you should state them as your opinion, not fact. The problem with the saturated fat and heart disease debate is ideology. Many people love to eat fatty unhealthy foods that taste amazing, but may be slowly killing them. Eggs and bacon and red meat are all delicious. Many people profit considerably from the sale of these items as well, and are justified in wanting to keep their jobs and farms and companies. But this is health science, and it is the real world. Every single scientific discovery has a handful, and sometimes even more than a handful, of evidence that is counter to an established fact. Though its always good to question and investigate and learn, its necessary to think critically about these issues.

    • says

      I certainly agree that it is important to consider these things critically and I appreciate your detailed response. I don’t have time to delve into specifics now, though I am working on another post that would explain how the “evidence” supporting the saturated fat/heart disease link is in fact, more flawed… In the meantime though, my opinion is that I’m sticking with red meat, eggs, bacon and lots of coconut oil. :-)

      • Joe says

        Cholesterol is essential to the health of the body. Your body can produce as you said 1,000 mg, and possibly more on it’s own. Dietary cholesterol cannot reach the amount we can produce naturally. We produce a controlled amount through the chains of carbohydrates. The body can produce it from anything really because of it’s importance, but the body uses carbs. Cholesterol essential/carbs essential, and they work together. I’ll stick with that over paleo type diet.

        Contrary to claims of the traditional living Inuit being immune from cardiovascular disease, evidence of severe atherosclerosis has been identified in several frozen mummies of Alaskan Inuit dating back to 400 CE and 1520 CE, both instances predating European contact.7 8 Atherosclerosis has also previously been identified in several artificially prepared mummies of Aleut-Unangan hunter gatherers who lived in the 18th century in the Aleutian Islands in Alaska.9 10 Recently the HORUS study, which examined an additional five recovered mummies of Unangan hunter gatherers who lived in the mid and late 19th century found definite evidence of atherosclerosis in several major arteries in all three who were over the age of 25.11

    • Eliza says

      I appreciate this thoughtful response. However, Katie (Wellness Mama) is not inventing or even cherry-picking these data. It was not as detailed as someone from your background may appreciate, but an easier-to-digest overview of some complicated principles (which I spend most of my time writing/researching) in a format easy enough to share with friends and family.

      You began your post by saying this is contradictory to some long-held views. Indeed many in the medical community still cannot accept the fact that these long-held views still can be traced to the erroneous musings of Ancel Keys.

      A high-fat diet most certainly can be the ticket for protection against CVD, depending on the types of fat. It can be astonishing for people to discover that saturated fats in the diet do not necessarily lead to saturated fats in the body, that the “good” fats long praised by established medical community are actually dangerously inflammatory. Katie pointed to the Rose Corn Oil Trial and the Sydney Diet Heart study. Most doctors have never heard of these – yet they showed significant harm from high omega-6 polyunsaturates.

      The best examples of high-fat diet and beneficial heart outcomes can be found in the Inuit Eskimo (before adopting a more westernized diet) who ate 13000 mg of omega-3 a day and did not experience heart disease (in addition to the 6500 mg of omega-6 plus huge amounts of SFA) and the current intake of the Japanese who enjoy some of the lowest heart disease rates in the world. To you, however, this may seem like more oversimplified cherry-picked data, and I understand your point of view.

      For a more comprehensive peek into this ongoing debate, I invite you to view my article on the topic:

      http://omega3.supplysideinsights.com/reports/2013/02/omega3.aspx

      Enjoy!

  4. Lever says

    Hello Eliza,

    I never said invention of data, but it was most certainly cherry picking. Or, if you prefer this phrase, it was glossing over the details to find something that fit with the idea of this article. I actually think it was very detailed compared to most articles meant for the general public, and well-written as well. But it was defending ideas that are simply not true, based on current evidence. And I agree it is easier to digest. Because most people do not want to be told that their diet may be slowly killing them and are looking for a way to eat poorly, yet still sleep at night knowing (falsely) that they will be okay. This is an example of cognitive dissonance (Im a psychological researcher by trade).

    Your example of what I wrote would be what I would refer to as cherry picking. Yes, there were some findings from an article that I admit were interesting and contrary to general findings. But in the sciences, there is what is called a type 2 error. That is, falsely concluding that a result is significant when it is not. So, in this case, concluding that saturated fat doesn’t increase cholesterol based on just a few articles, while rejecting the 100s of other articles that have concluded the opposite. Since most, depending on the type of study, use a .05 error this means that, statistically speaking, 5 out of every 100 studies published will find a false positive result. So, yes, by definition of the protocols used, there will be examples of this in the literature. Which is why we used replication and rely on dozens upon dozens of articles rather than follow the conclusions based on a handful or less.

    Your right though, fat is not the enemy. Saturated fat is. And saturated fat becomes cholesterol in the body. I’m a little confused by which fats you are referring to as inflammatory, but I will take a look at your article and hopefully have that clarified. Again, the studies referred to are epidemiological and based on self-report. Just like the China Study. But conclusions are made on experimental evidence because it is impossible to control variables and say what is the cause of what in epidemiological studies.

    And although your right that Japanese citizens and Inhuit Eskimos have a much lower incidence of heart disease, both of these populations have a much much higher risk of stroke because of excessive Omega-3s. Although Omega-3 is kind of the darling of health research at the moment (and for good reason), too much of a good thing can be bad. Also, although heart disease risk is much lower in Japan, it is still the 2nd most common cause of death in the country (Perhaps because of increased westernized diets, but that is another discussion). The bottom line is that we should always challenge established scientific findings, as that is how new science is made, but we cannot make conclusions on a handful of evidence saying go left versus a mountain of evidence saying go right. Although I know you and wellnessmama mean well, it would be irresponsible to recommend high saturated fat diets under the premise that they are healthy.

    I appreciate your reply, Eliza!

    • Joe says

      Lever052 – I think you are spot on with your analysis.

      The Inuit example is always used – but Inuit Eskimos have a life expectancy of 43 – the average age for getting heart disease in the West is 63 – they simply might not be living long enough as a group to see any major heart disease trends.

      I also feel that the majority of the studies out there point to saturated fat being a risk factor. This could be for other reasons – and I think oxidized fat and cooking methods have a lot to answer for – but the scientific majority is there none the less.

      One final comment about bacon and eggs. Considering the corruption of the food supply (factory farming etc), the bio-accumulation of organochlorines and the recent research into bacterial exotoxins, as well as nitrosamine content of bacon, the production of carcinogens whilst frying and the low antioxidant content of both of these foods – I think it is pretty irresponsible to promote this as the food people should be eating.

      • Stacey says

        Get nitrate free bacon and free range eggs-these things are okay to consume you just have to know the sources

  5. Donna Tate Ford says

    How do I know if my lotions contain citrus oils? Are there “safe” shops you recommend?
    Feeling overwhelmed.

  6. JC says

    I just realized something people. Trying to figure out nutrition is like trying to figure out politics, religion, or the origin of the universe. It aint gonna happen. Thanks for helping me out people.

    Meanwhile Im going to not try to figure out mother nature anymore and I am going to eat a BALANCED whole foods diet with plenty of saturated fats and some of those evil unsaturated fats. And Im going to eat about equal amounts of protein and carbs too. Even some of the toxic sugar.

    • Heidi says

      If someone waves another study under nose claiming that they have the truth and evidence to support it I think I will eat it, the research that is! Yes keep it simple and enjoy a variety of foods in moderation.

  7. lisa says

    Ok, so I wonder if you have any insight on my current situation. Presently, I’m dealing with a bit of adrenal fatigue, am hypothyroid (FT3, FT4, etc are low & TSH is 7.5), progesterone to estrogen is low and estrogen is high. I just got new tests done and show that I have high cholesterol which I’ve read can correlate with high TSH levels and by balancing that out cholesterol will take care of itself. Interestingly enough though, it’s been since I started eating meat again 3 months ago (I was a vegetarian for about 6 yrs) that my TSH went from about 5.0 to 7.89 and now back down to 7.5 since I started a thyroid support. I’ve been reading a lot about how meat can potentially cause stress to the body and thyroid specifically and that by consuming gelatin that will help balance the amino acids in the body (just started with homemade jello — thanks for the recipe!! — the past few weeks). I wonder if you have any input with regards to my situation.

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