Nutrition & Physical Activity

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Working out at home

Dear Reader,

Creating an at-home exercise program is a great way to get more physically fit, especially if you have limited time and resources. The good news is you can have a well-rounded workout without ever stepping in a gym or using machines! The Centers for Disease Control and Prevention (CDC) recommendations for physical activity are at least 150 minutes of moderate intensity each week, spread out over at least three days. Moderate intensity simply means that you will raise your heart rate and break a sweat. Strengthening activities are also recommended at least twice a week.

One way to incorporate aerobic and strengthening activities in a home-based workout is by alternating between cardio exercises and strength training exercises. For example, do jumping jacks for two minutes then do push-ups for one minute. Follow this up by repeating jumping jacks for two minutes and doing lunges for one minute, etc. In this type of circuit, you integrate aerobic activities with various strengthening activities in an efficient routine. Other examples of at-home aerobic activities include walking/marching/jogging in place and jumping rope. Sit-ups, squats, and leg lifts can be done at home to strengthen muscles.

In addition to working out in your home, it can be easy to get extra exercise while going about your everyday activities. For example, get off the bus or subway a few stops early and walk the rest of the way. Taking the stairs instead of the elevator is always a good option, as well. And, if you have that extra hour, a brisk 30-minute walk or jog outdoors is great aerobic exercise and you will still have 30 minutes to take a shower and get ready for your next activity!

In addition to the information listed above, the USDA MyPlate initiative is a great resource for physical activity information. Also, many Columbia-affiliated students find Alice!’s physical activity initiative, CU Move, to be helpful. The program provides participants with physical activity tips and tools, motivational messages, and event calendars with access to plenty of free and low-cost physical activity options on campus and around NYC.

Break a sweat!

Alice

Bagged tea versus loose leaf: Which is better?

Dear Tiger M,

Thank you for the kind words about Go Ask Alice! The reason it may be hard to find an answer to your question is because there are positives to brewing tea both in and out of the bag. When it comes to green tea, however, generally yes, what you are doing (drinking loose leaf tea and consuming the leaves) is healthier than drinking green tea brewed from tea bags. 

First, some background on green tea: Green is chock full of antioxidants and other nutrients, thanks to chemical compounds found in the leaves called catechins. To maximize your exposure to catechins, and thus extract the greatest health benefits from your cup of tea, the whole buds and young leaves of most loose leaf teas are superior to broken leaf pieces, called fannings and dust, which are found in many bagged varieties.

So why might loose leaf tea leaves be better?

  • Catechins degrade over time. Tea bag tea may have been stored longer than the loose leaf green tea, which means fewer catechins present.
  • Catechins concentrations are higher in the whole leaf than in the pieces and dust (because the greater surface area of the smaller pieces means more surface area is exposed to light and air, which results in faster loss of nutrients). These whole pieces are more likely to be found in loose leaf tea.
  • Tea bags can absorb some catechins. This means you may lose more nutrients in the bag than you do if the leaf is loose.

However, drinking green tea from tea bags can also have its advantages:

  • Green tea in the tea bags is more likely to be dust and fannings and because of this, there is more interaction between the tea and the water (the smaller the tea leaf, the more surface area is exposed to the water, causing more infusion of the tea nutrients).
  • Tea bag material varies with the tea company. Some tea bags are biodegradable and interfere less with tea brewing than others, and may also leach fewer nutrients out of the tea.

Additionally, you mentioned that you chew the leaves, which is very healthy (if you don't mind the strong green tea flavor). This is healthier because it allows you to consume the nutrients that did not dissolve in the water (which are numerous, including minerals and fat soluble vitamins) and even gives you a little extra fiber. But if you are buying the tea bagged, you still may be consuming tea leaves that have lost lots of nutrients due to their small size and potential degradation due to long term storage. However, other factors besides loose tea vs. bagged tea, affect the health benefits of green tea. A few other considerations:

  • Is your green tea organic? Drinking organic green tea ensures fewer chemicals and pesticides will make their way into your hot cup.
  • How fresh is your tea? Catechins are lost the longer the green tea is stored. The fresher the leaf, the more nutrients will be present in the leaf.
  • How are you storing your tea and how was it stored before it found its way to you? Tea should be stored in a sealed container as air tight as possible in a cool, dark place.

The freshness issue, by the way, is not a concern for all teas. In fact, some teas improve with age, much like wine. But green tea's benefits are more likely reaped with a fresher leaf. When checking for tea leaf freshness, keep the following guidelines in mind:

  • Does the tea smell very green or does it smell smoky or even moldy? Generally, fresh green tea smells very green or refreshing, while the older stuff is likely to smell smoky, stale or moldy.
  • Has your tea been stored near light, heat, moisture, or strong odors? Exposures to these things will cause tea leaves to degrade more quickly – so don't store your tea in glass canisters, over your stove, in your refrigerator, or with your spices.
  • Have you checked the leaf color and tea taste? Light green colors suggest higher green tea quality than golden or brown colors. Also, the tea should also taste light, not bitter, when fresh.

So keep brewing and keep chewing! You are getting lots of vitamins and minerals this way, especially if your tea is organic and relatively fresh.

Alice

All about Hoodia

Dear Readers,

Hoodia has been touted as a succulent that has remarkable appetite-suppressing qualities, but thus far, those claims don't hold water. The Hoodia craze has been fueled by the pharmaceutical companies in the United States and South Africa who claim that the San, a tribe in Africa, consume the hoodia to stave off hunger and/or thirst during their long treks through the Kalahari Desert.

Researchers have isolated a set of chemicals, called P57, thought to be the cause of the appetite-suppressing qualitites of hoodia. Researchers injected the P57 into rats. It appeared to suppress the rats' appetites, without causing other effects. A series of follow-up studies have indicated that the chemical acts on the appetite-regulation center of the brain, which is located in the hypothalamus. Few studies on hoodia's effect on humans, however, have been conducted. As a result, many health care providers are hesitant to support the use of hoodia as either effective or safe.

The drug company Pfizer worked for years to develop hoodia as an obesity drug but gave up after they could not create an acceptable synthetic version. What remains unclear is whether or not the supplement could actually help a person shed pounds, whether or not it could do so safely, what the long-term effects of taking it might be, and what dose would be needed for it to work.

Also up for debate is whether or not the San people actually consume the plant as an appetite suppressant. Many contend that the cactus is consumed for its water content. And even if it did work as an appetite suppressant for the San, the conditions of life in the U.S. are remarkably different (i.e., the San are more physically active, people in the U.S. consume a very different diet, and have more access to food than the San).

The final concern with hoodia has to do with the lack of diet industry regulations in the United States. As with many supplements, the amounts of hoodia in each type can vary greatly. Some companies even sell hoodia supplements that contain no hoodia!  Further, no research is available to support what dose of hoodia is needed to produce the desired effects safely.

Due to both the lack of research and regulation on the supplement, it may be best to opt for other options when it comes to weight management until more is known about it. Check out I need an effective, short-term weight loss and toning plan for more well–researched methods of weight loss.

Take care,

Alice

Avocados — which variety is the healthiest?

Dear Reader,

No matter the color, shape, or size, avocados are delicious — and nutritious! There are a wide variety of avocados on the market, each with a unique flavor, texture, and nutritional value. Thanks to alternating shipment seasons, people across the United States have access to avocados all year round. California and Florida produce the vast majority of avocados in the United States.

California avocados largely consist of the Hass variety, which are the most widely available type on the market. They have thick, leathery skin that turns dark green-to-black as the fruit ripens. California ships avocados throughout the United States, even all the way to Florida and other states on the East Coast. These medium-sized fruits weigh approximately 4.8 ounces (136 grams), and contain:  

  • Approximately 227 calories
  • 2.9 grams of saturated fat
  • 13.3 grams of monounsaturated fat
  • 2.5 grams of polyunsaturated fat

Florida avocados are all members of the green-skinned avocado family. These have less fat, but more moisture than the Hass, and thus are not as sweet and nutty tasting. As they ripen, green-skinned avocados retain their light-green skin. Green avocados tend to bruise more easily during shipment because of their thinner skin, restricting shipments from Florida to primarily Eastern U.S. markets. These avocados tend to be larger in size, and typically weigh a hefty 10.7 ounces (304 grams). One green-skinned avocado contains:

  • 6 grams of saturated fat
  • 16.8 grams of monounsaturated fat
  • 5.1 grams of polyunsaturated fat

No matter their hue, eating both black and green avocados provides multiple health benefits, including:

  • Acting as a "nutrient booster" by enabling the body to absorb more fat-soluble nutrients in foods that are eaten with the fruit, such as alpha- and beta-carotene.
  • Providing more than 25 essential nutrients, including fiber, potassium, vitamin E, B-vitamins, and folic acid.
  • Providing consumers with a healthy source of fat. The avocado is virtually the only fruit that has monounsaturated fat (a.k.a. good fat).
  • Providing a good source of fiber.

Adding heart-healthy unsaturated fats to your diet, available in avocados, nuts, and olive oil, may help you make the most of your fruits and veggies and eat a more balanced diet. One delicious way to eat avocados is using avocado spread in place of high-fat spreads, such as butter and mayonnaise. For more information, you can check out Avocados are fatty — are they healthy?.

See you…avocado go now!

Alice

Can't stay healthy for qualifying exams

Dear Dizzy and stressed,

Putting your health first during exam time can be a challenge, but if you want to score well, take care of yourself now! If you are experiencing such extreme dizziness and discomfort it is of utmost importance to seek out medical care immediately. Now, let's tackle some of the related issues you brought forward in your question.

Eating disorders, such as anorexia, can take enormous tolls on your health, including fatigue, dizziness, and/or fainting, irregular heart rhythms, low blood pressure, and dehydration. While you may have found a healthier place regarding anorexia, it is likely that your symptoms are related to your current eating patterns. These symptoms can have major negative effects on your body, and it is recommended that you take action as soon as possible. You may want to call The National Eating Disorders Association eating disorders information and referrals line at 1.800.931.2237. More information can also be found in Eating disorder resources on the web.

In your situation, it may be highly beneficial to learn how to manage stress in a constructive way. Fortunately, there are many things you can do to decrease your stress and up your wellbeing. Some people exercise, meditate, breathe deeply, pursue a hobby, and/or seek support from others. Don't forget about your ZZZ's, too! Chronic sleep deprivation (going for extended periods of time with less sleep than your body needs) can cause a variety of physical and psychological problems. You may want to check out The downsides of sleep deprivation for more on this topic.

Finally, you may want to address your smoking habits and soda intake. Excessive soda consumption (such as consuming at least 2 liters of diet coke per day) can have significant consequences on your health. Soft drinks are acidic, which can wear down tooth enamel and cause tooth decay. Too much caffeine can cause anxiety and sleep loss. For quitting colas, you may want to check out Getting off colas. Cutting out the chain smoking can improve your respiratory and heart health as well. 

It may be a long and arduous road to addressing your health concerns, but it will sure be worth it (for your overall well-being and your academics)!

Alice

For more information or to make an appointment, check out these recommended resources:

Medical Services (Morningside)

Counseling and Psychological Services (Morningside)

Medical Services (CUMC)

Mental Health Service (CUMC)


Weight loss with Alli or hoodia?

Dear Reader,

Trying to find a trusty ally in your quest for a healthy weight can feel like an uphill battle. With so many products claiming to help you shed pounds, it can be good to be a bit cautious when eyeing the options. Some weight loss aids are classified as medications — like Alli — and are closely monitored by the U.S. Food and Drug Administration (FDA). However, other aids like hoodia (made from the roots and stems of an African cactus-like plant) are classified as dietary supplements and are not as closely regulated. More specifically, hoodia is considered an herbal supplement, which is a type of dietary supplement that could contain one herb or a mix of different herbs. Unfortunately, many herbal supplements can have unknown ingredients, interact with other medications, and haven’t always been researched extensively. When considering hoodia or any dietary, herbal, or “natural” supplement, it’s recommended that you chat with a health care provider before diving in.

Hoodia’s claim to fame stems from its history among people living in the Kalahari Desert, who would consume hoodia plants to suppress hunger and thirst during long periods of hunting. However, at least one study has found that hoodia did not actually lead people to eat less or lose weight when compared to people who didn’t consume any hoodia. In fact, the people who consumed it had several not-so-great side effects, including increased heart rate, blood pressure, and feelings of nausea. For more information on the story behind this supplement, check out All about hoodia.

You mention that you’ve already ruled out Alli, but for the curious, here’s the 411: Unlike hoodia, Alli is an over-the-counter (OTC), lower dose form of the prescription drug Orlistat (prescription Orlistat is only for people with a body mass index (BMI) over 30). Because it’s classified as a drug, Alli is under much more stringent safety regulations. Alli works by stopping the enzymes that break down fat. In turn, much of the fat you consume would pass through your body undigested. It is generally seen as safe when taken as directed, but it has been associated with a few rare cases of liver damage. Milder side effects, like gas, abdominal discomfort, urgent bowel movements, anxiety, and headaches, have also been reported. The blocking of fat absorption also affects the body's ability to absorb beta-carotene, and other fat-soluble vitamins, such as A, D, E, and K, so taking a multivitamin may be in order.

Now that you’re armed with info about hoodia and Alli, you might be curious about other weight loss aids. Keeping a skeptical eye when choosing dietary supplements is a smart move as the risks of dietary supplements may outweigh the benefits. For example, a popular dietary supplement called ephedrine (or ma huang) was banned in the United States in 2004 after it was found to lead to heart attacks, stroke, and even death. Some supplements still on the market — like bitter orange — have been found to have similar stimulant effects. As you consider how to rev up your weight loss plan, you might consider some of these pointers:

  • Don’t underestimate the old fashioned diet and exercise plan. It sounds like you’ve had some weight loss success already and are aware of maintaining a balanced diet, but another component to consider is to get that body up and moving.
  • Try browsing the National Institutes of Health Time to Talk tips, which can help you figure out how to talk to your health care provider about using alternative or herbal supplements. It can help you figure out the right questions to ask to make sure an alternative therapy won’t interfere with any of your current medical conditions or medications. While talking with a health care provider is recommended for anyone thinking of adding a supplement or medication, this is especially a wise decision for pregnant or nursing women and children.
  • Keep in mind that advertising can be misleading, especially on the internet. Studies have found that sometimes herbal supplements actually don’t contain the ingredients they claim to or can be contaminated with pesticides or other substances. Sticking with supplements that have been reviewed by safety organizations like the FDA can help you avoid falling into a false advertising trap. You can often spot these products if they include a disclaimer saying that, “These statements have not been evaluated by the U.S. Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.”
  • No matter what medication or supplement you’re taking, it is advised that you follow the recommended dosage and instructions on the label or from your health care provider may help you avoid any serious side effects or reactions.

Best of luck achieving your weight loss goals!

Alice

For more information or to make an appointment, check out these recommended resources:

Medical Services (Morningside)

Student Health Service (CUMC)


I'm worried my boyfriend has bulimia

Dear Reader,

It can be tricky to check in with a loved one about the concern that they may have an eating disorder. You may be afraid that you'll say something that might shut them down or hurt their feelings. You may be afraid that you're mistaken. This worry may be especially great for you since eating disorders are more prevalent in women (though eating disorders are more common among men than many people realize). Don't let these worries stop you from having an honest conversation about what you have observed and what your concerns are.

First, how might you recognize if a loved one has an eating disorder? There are a few different types of eating disorders, but you need not worry about making an "exact diagnosis." The following may be warning signs of bulimia, but a loved one need not exhibit all these signs in order to have it.

  • Frequent complaining or worrying about being overweight.
  • Use of "purging" tactics for weight loss, including excessive exercise, herbal weight loss supplements, weight loss medications, laxatives, or forced vomiting after eating.
  • Not wanting to eat in front of other people.
  • Eating large quantities of food in one sitting.

Warning signs of Anorexia can include:

  • Significant weight loss.
  • Enjoyment of cooking and preparing meals for others without eating much.
  • Significantly distorted body image — sees self as overweight, when he or she is likely significantly underweight.

Some people with eating disorders recognize that they have one, but are afraid to reach out for help. They may be afraid of being judged and/or losing loved ones if they open up about their eating disorder. Others may be in denial about having an eating disorder, while others may have such a low self-esteem that they feel, either consciously or unconsciously, that they do not deserve help. If you are afraid to check in with him about the possibility that he has an eating disorder, it may be helpful to know that eating disorders do not go away on their own and they can have severe health consequences. So the sooner he seeks help, the better his chances of recovery and the less damage that will be done.

But how to bring this up? There are a few good guidelines to cover that will help you convey a nonjudgmental attitude and also help ensure you are respecting your boyfriend's privacy:

  • Make the basis of the conversation about your worry. Try to remain positive while also explaining that you care about him and because of this, you are worried about his health and his emotional state.
  • Avoid comments about his appearance. Some people with eating disorders will not be affected, while others will be extremely affected by hearing your assessment of their weight (e.g. they may be flattered or they may be horrified. Either way, you may inadvertently reinforce their restricted eating or purging).
  • Do not demand that he eat or change his behavior.
  • Avoid placing blame or giving advice.
  • Watch out for accidental "fat phobic" remarks that you might make inadvertently (in other words, avoid making disparaging remarks about weight or overweight people). Avoid making remarks even about your own body weight.

Aside from offering you nonjudgmental support, the most important thing you can do for a person with an eating disorder is to encourage him or her to get treatment. The longer an eating disorder remains undiagnosed and untreated, the harder it is on the body and the more difficult to overcome, so urge your boyfriend to see a therapist or his health care provider right away. If your boyfriend is a Columbia student, he can make an appointment with Counseling and Psychotherapy Services (CPS) or with his primary care provider through Open Communicator.

It may also be worth checking out the following resources:

Recovering from an eating disorder usually takes time. Kudos to you for your patience and your willingness to support someone struggling with an eating disorder. This may at times be difficult for you, too, so make sure you are getting support, as well, whether it be through friends, family, and/or therapy.

Take care,

Alice

Raisin bran confusion — is it a good source of iron?

Dear Reader,

Props to you for wanting to donate blood! Alas, isn't it iron(ic) that one of the foods with higher iron content also may contain an iron absorption inhibitor? It's one thing to worry about getting enough iron through your food sources, but a whole other thing to worry about whether that iron is actually being absorbed. Boosting your hemoglobin by upping your iron intake shouldn't be too tricky, but know that there are a number of possible causes for low hemoglobin — being low on iron is only one cause (more on that later).  

Let's discuss the raisin bran question first. Phytic acid is often found in foods that contain whole grains, including some types of raisin bran. In large enough quantities, phytic acid can inhibit your body's iron absorption. This is annoying since these foods may also be high in iron. In addition to iron absorption inhibitors, there are also substances that aid in iron absorption. The primary is vitamin C, which is often also found in raisin bran. Your best bet is to check food labels so you know when you are consuming foods that contain phytic acid (and also whether it contains a substance such as vitamin C, which will help you absorb iron). If food products contain iron and phytic acid, chances are you'll still likely get at least some iron benefit from them (especially if that food contains vitamin C, too); however, it's wise to have additional sources or iron other than raisin bran. Another iron absorption inhibitor is tannic acid, which is often found in red wine, coffee, some teas, chocolate, and some sodas.

So what does all this mean? Diversified food sources of iron will be your best bet in ensuring that you meet your recommended daily allowance, but there's no harm in making raisin bran one of those sources. Check out the related Q&A's for more information on iron, how much you need, and getting enough of it through your diet.

Now, are you sure low iron is the cause of your low hemoglobin? There are several other possible causes. Cirrhosis (scarring) of the liver is one cause. Some common causes of cirrhosis include alcohol abuse, hepatitis B or C, cystic fibrosis, and some parasites caused by chronic liver damage. These conditions, as well as the cirrhosis itself, would likely be accompanied by additional symptoms, such as fatigue, nausea, weight loss, and/or easy bruising.

Other causes can include certain cancers of the blood (e.g. leukemia, multiple Myeloma) or of the lymphatic system (e.g. Hodgkin's and non-Hodgkin's lymphoma), enlarged spleen (splenomeglamy), or vasculitis (inflammation of blood vessels caused by an autoimmune response of various origins). Though anemia and iron deficiency are common causes of low hemoglobin, it may be worth a trip to your health care provider to rule out these other causes.

Happy hemoglobin boosting!

Alice

Relaxation drinks

Dear A Sip of Calm,

Can we actually find relaxation in a can? Seems like it could be a great idea, unfortunately, at this point in time, it's just too good to be true. Just like herbal supplements, the FDA does not require companies manufacturing the "relaxation beverages" to prove their claims or standardize their ingredients. As such, there is no conclusive scientific evidence that any of these products are safe and effective. What little research has been done has shown that many compounds in these drinks, such as 5-HTP and melatonin, degrade in water. Other ingredients  such as GABA, cannot cross the blood-brain barrier so are completely ineffective. One study even tested five popular brands and found that many of the ingredients listed were barely even present in the drinks themselves!

Two popular ingredients in relaxation beverages that have been studied are valerian and kava and the news is not good. Valerian can cause dependency if taken regularly while kava has been shown to cause liver damage. These types of ingredients can also interact with medications such as Allegra or benzodiazepines (Xanax, Valium, Atvian, etc.) or even with Tylenol and cause serious health problems.

What's your best bet for relaxation? For starters, maintaining a proper diet, exercising, and trying to keep a regular sleep schedule can contribute to feelings of relaxation. You may also want to try meditation and/or yoga.  

In the end, the best way to guarantee a good night's sleep is to take time to unwind in the evening, and leave your bedroom for sleeping only. Enjoy some (decaf) tea, relax, close your eyes, turn off your phone and all other screens, and you'll be off to dream land in no time.

Alice

Conflicting nutrient values charts

Dear Reader,

There is so much nutrition information available from a host of different sources and it’s not hard to see why confusion can arise. You may have access to information published in scientific journals, which are studies that have been critiqued by nutrition experts. At the other end of the spectrum, some sources such as websites and corporate advertisements are created with the intention of boosting sales of the latest diet book or food product. In order to increase the chances of finding valid nutrition information, it's important to identify, use, and refer back to sources you trust. Additionally, when comparing information from multiple sources it is very important to make sure you are comparing exactly the same thing (same serving size, same source, etc).

When gathering information online, it is important to determine who sponsors the site, how often it is updated, the sources for information, and if advertising is involved (or influences content). As an example; Go Ask Alice! is sponsored by Columbia University, content is updated daily (all pages have an update date listed), the sources are described (see below), and the site is advertising free (learn about our no ad policy).

The U.S. Department of Agriculture (USDA) is generally the most reliable source of nutrition and food-related information for the general public in the United States. The dietary guidelines can be found at their MyPlate website where you can also find sample menus and recipes, a food tracker, BMI calculator, as well as several other useful health and food-related tools.

The USDA also has a National Nutrient Database, which is a reliable source for nutrient values for foods. Frequently, this site is accessed by nutrition researchers and developers of nutrient analysis programs. The National Nutrient Database site is user friendly enough that even regular people will be able to do a food search during her/his first visit to the site. Even the National Nutrient Database site, however, can be confusing. For example, it will generate conflicting numbers for nutrients in products such as milk, which comes in a number of varieties. For example, cow's milk provides 8 grams of protein per 8 ounces, evaporated skim milk provides 19 grams, and soy milk, 3 grams. The lesson learned here is to check the details of the food you searched for if the results seem different. For example, a search for milk could yield information on both coconut milk and cow's milk.

The MyPlate SuperTracker and the Nutrient Analysis Tool (NAT) are comprehensive online programs that can be used to analyze not just one food, but an entire day of food intake. They show a comparison of the analysis to your daily nutrient needs. The food lists in these programs come from the USDA National Nutrient Database, and nutrient needs are based on the Recommended Dietary Allowance (RDA).

RDAs are amounts of nutrients that, if consumed on a daily basis, would meet the needs of approximately 97 percent of the population, and are amounts that have been established after years of intensive research studies. The RDA of protein for adult males is 56 grams per day, and for women it is 46 grams per day. This general recommendation is based on 0.8 grams of protein per kilogram of body weight, for individuals in good general health. Protein needs can vary depending on a person's health status and exercise regimen.

For a personalized assessment of your nutrient needs Columbia studnets can make an appointment with a Registered Dietitian. Columbia University students can call x4-2284 or log into Open Communicator to schedule an appointment. Non-students may have access to a nutritionist through her/his primary health care provider or search for a dietitian in your area through the Academy of Nutrition and Dietetics web site. You might also want to check out the resources listed on the Columbia Health Get Balanced nutrition page.

For additional information regarding finding quality health information online, check out Health information on-line: Whom can you trust? Hopefully these new resources will help to clear up your nutrient value confusion, making it easier for you to make healthier eating choices.

Alice

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