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Sally Squires
Washington Post Health and Nutrition Writer
Tuesday, January 29, 2008; 1:00 PM

Confused about nutrition? Wondering how to fit in more physical activity? Welcome to the Lean Plate Club. Ask Sally Squires, nationally syndicated Lean Plate Club columnist for the Washington Post, about eating smart and moving more every Tuesday at 1 p.m. ET. Sally draws upon her master's degree in nutrition from Columbia University to preside over the lively Lean Plate Club web chat. Whether you're trying to reach a healthier weight or simply maintain it, you'll find plenty of tips and strategies.

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Share your own food finds, creative workouts and secrets for healthy, great tasting meals. We'll cheer your successes and help with your setbacks. (None of this, of course, is a substitute for medical advice.) E-mail Sally, author of the newly published Secrets of the Lean Plate Club (St. Martin's Press) at leanplateclub@washpost.com.

Or just sign up for the free Lean Plate Club e-mail newsletter. The Lean Plate Club column appears Tuesdays in the Washington Post Health section and is nationally syndicated by the Washington Post Writers Group. Find other Lean Plate Club members at www.frappr.com/leanplateclub.

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Discussion Transcripts

A transcript follows.

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Sally Squires: Welcome to the Lean Plate Club!

In honor of the new findings that exercise can not only keep your genes young--but may, of course, help you keep fitting into your other jeans, I'm giving away exercise DVD's as prizes this week.

1. Shawn Trautman's Dance Collection Country Western Dance Sampler.

2.Prevention Fitness Systems Shortcuts to Big Weight Loss with Chris Freytag

3. Women's Health Ultimate Fat Burn

4. Prevention Better Bellow Yoga with Desiree Bartlett

5. Eva Barash's Livingroom Yoga.

Here's the deal: tell us how you get revved up from workouts. Share a healthy, great tasting food find. Or just inspire us with your tale of habit change and one of these DVDs could be yours. Winners are announced at the end of the chat and in making this offering, I am not endorsing any exercise regimen. It's simply a way for you to know about the wide range of resources available.

Now on to the chat!

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Pearl River, N.Y.: I am an endocrinologist who read with interest your column on treatment of overweight patients. In particular, I was struck by the comment that physicians tend to make more negative comments about weight than do others with whom the overweight person comes into contact.

This is a terribly difficult situation. Like all doctors, I have a fairly high percentage of overweight and obese patients. Many of them suffer from diabetes or other conditions to which weight is a contributing factor. While I try to be kind but firm in explaining the need to lose weight, at some point, sometimes after years of being "nice," I do have to lay out in fairly graphic terms the medical consequences of failure to lose weight. Then I retire to my inner office an cry, knowing loss of a leg or other medical emergency is a virtual certainty in some of these cases.

My personal view is that weight gain is not so much metabolic but due to lifestyle changes in the past 50 years (I'm 55) that have not only become much more sedentary but also replaced a small McDonald's hamburger with the Double Whopper and 8 oz. bottled cokes with 64 oz. big gulps. By the time people become obese, they are so addicted to sugar, fat and carbs that breaking the habit can be virtually impossible. However, it can and must be done, to prevent physical misery and even early death. I hope overweight patients do not view us as "meanies" but rather ss people who are truly concerned for their welfare.

Sally Squires: Thanks very much for talking about this problem from the doctor's perspective. We've had a lot of interest in how health professionals treat people who are overweight or obese. I'm sure your comments will be of great interest to Lean Plate Club members.

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Springfield, Mass.: Hi Sally -- can you talk a bit about "food addiction" and how someone works to overcome that?

Sally Squires: Food addiction is of growing interest in the nutrition community. Last summer, Yale University convened a conference on the topic, with the goal of pulling together both addition researchers and nutrition researchers, who often don't work that closely together.

Whether food addiction exists is under debate. But there is certainly plenty of anecdotal evidence suggesting that some people FEEL they are addicted to some foods.

The scientific jury is still out for now, but we'll try to post a column momentarily that will give you more information and guidance. Hope that helps.

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Charlotte: I'm in a funk. I know I need to exercise -- I'm definitely over my comfort weight by 15 pounds or so and I'm totally out of shape. However, life has thrown me a ton of problems lately and I'm stressed to the max. I feel like I don't have time to get out and do yet another thing, even though I know it could only help. So -- can you think of any ways to motivate me to get up and out the door to walk or run? I can't afford a gym -- although I wish I could! A personal trainer would get me going I'm sure. But money is tight so free stuff is the way to go for now. HELP! I'm feeling so down already and I don't want to feel worse about my weight. I eat pretty well; lots of veggies and fruit and whole grains. I do enjoy red meat occasionally and probably should eat more fish but otherwise, I think that's not a big problem. I'm more concerned that I'm not moving as much as I should.

And by the way, I've found that frozen fruit is amazing right now! You can buy them in all kinds of mixes, I have a rainbow blend that I got at Costco that includes fruit all colors of the rainbow (strawberries, peaches, white peaches, melon, blueberries, raspberries, cantaloupe, etc). It's not in any sauces or anything-just quick frozen in pieces. Very healthy--and since it's frozen, you can take a small bag or bowl to work and let it sit out in the fridge til lunch or snack. Then you can eat it plain or with some lo-fat yogurt or graham crackers. Really tasty, quick, and healthy. Yum! A great way to get that extra fruit into your diet and stop eating unhealthy vending machine snacks.

Sally Squires: Sorry to hear that life has been dealing you a mixed hand lately. That's not easy. But you really can help improve the cards you have been dealt by getting more active. Exercise is proven to improve mood, energy, sleep, reduce risk of heart disease and type 2 diabetes. Plus just today, we've got a new report from British researchers showing that it can help stave off aging.

But I also know that sedentary living can take on a loggy momentum of its own. So... with limited resources what can you do? Start by heading to your local library. See what exercise DVD's they have to check out. Leslie Sansone's walking tapes are a great place to start (although I sometimes have to turn the volume off since she can be a bit chatty.)

Don't want to do that? Take a tip from fitness guru Jack LaLanne. Walk in front of your television as you watch. I've recently re-discovered the Turner Movie Channel. It's really fun to walk some of those classic flicks. You can also ride a stationary bike if you happen to have one.

Can't afford a gym? Well check out your local YMCA or community rec center. They may offer either free or sliding scale options that will fit your budget.

An exercise buddy could also be just what you need. You make a date to walk and because you're meeting each other, you're more likely to do it.

I'm going to open this to the membership, because I suspect they will have more comments to add. And also, look for some links to other resources that can help you. We also have free exercise demos on our Web site.

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washingtonpost.com: Exercise Could Slow Aging Of Body, Study Suggests (Post, Jan. 29)

Sally Squires: As promised....

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washingtonpost.com: Rx: Get Active (Post, June 26, 2007)

Sally Squires: The American Medical Association and the American College of Sports Medicine have recently advised their members to prescribe activity to all patients.

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washingtonpost.com: A Fitness Icon Keeps His Juices Flowing (Post, June 12, 2007)

Sally Squires: If anyone can help inspire you to move more, it will likely be Jack LaLanne, at 93, he's a glowing example of what being physically fit can help you do. (And yes, he also has good genes on his side!)

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washingtonpost.com: Addicted to Food? Maybe It's All in Your Head (Post, Sept. 4, 2007)

Sally Squires: One last link for food addiction. Also check out Food Addicts in Recovery. We'll post a link in a minute.

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Washington, D.C.: I am giving up meat for Lent, and I am afraid in the end I may eat a lot of pasta. Do you have any resources for recipes to ease someone into a vegetarian diet? I am still going to eat eggs, cheese, etc., just no red meat, poultry, fish or seafood. Thanks!

Sally Squires: It's hard to believe that Ash Wednesday--and the start of Lent for much of the Christian world--is next Wednesday. The Vegetarian Resource Group in Baltimore is a great source of information on eating healthfully the vegetarian way. We'll try to post a link in a minute.

Also: you might check out Dean Ornish's books (yes, another link coming); Vegetarian Times plus a site called Vegetarian in Paradise, (another link coming.)

Diet for Small Planet is a classic that has been updated in recent years. Plus Deborah Madison and Mollie Katzen are long time proponents and cookbook authors of the vegetarian approach.

Hope that helps.

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washingtonpost.com: Vegetarian Times Recipe Finder

Sally Squires: As promised...and this could be chat with the most links ever...Stay tuned for more.

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washingtonpost.com: The Vegetarian Resource Group

Sally Squires: Here you go.

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washingtonpost.com: Dean Ornish's Lifestyle Program webmd.com

Sally Squires: Dean Ornish's site.

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washingtonpost.com: Food Addicts in Recovery Anonymous

Sally Squires: For those seeking help with food addiction. Also, check out Mindless Eating by Brian Wansink, now head of the Department of Agriculture's Center for Nutrition Policy Promotion.

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San Diego: I've become a major fan of the Paisley Farm 4-Bean Salad sold by Costco. The trouble is that it's marinated in sugar. If I drain off the liquid, and then rinse the beans, am I getting rid of enough of the sugar and calories to make it healthier for me?

Sally Squires: I just did a quick search, San Diego, to see if I could nutrition facts on-line for this product. No luck. So here's what you might do. Check the label. See how many grams of sugar are listed. My best is that there won't be many grams. Another way to double-check is to see where added sugar falls on the ingredient label. The lower it is, the less there is. And then by all means, drain away if you want. Odds are you're not eating too much sugar. But draining certainly should help lower what is there.

Hope that helps. Thanks!

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for Charlotte: I just wanted to add one idea -- if life is that complicated right now (and we all know it gets that way sometimes!), don't -add- to it with the weight and exercise stuff.

Start small. For example, pick one thing you're most drawn to -- for me it would be a walk outside on a beautiful day or going x-c skiing that I love. For my mother, it would probably be walking and chatting with a friend or walking around a lively place like a mall because she loves to watch people.

For me, when I'm overwhelmed it helps to take it one day at a time and only look at what I'll get out of that event. Momentum can build from there if you give it time.

Good luck!

Sally Squires: Well said. Also, another free activity is simply to put on music at home and move. Even 10 minutes at a time can make a big difference. And let's face it: we all can squeeze in 10 minutes a couple of times a day.

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Baltimore: I've only had one doctor, my ob-gyn, comment on my weight, which has been an issue for me all my life. He looked me straight in the eye and gently asked, "What do you think about your weight? Do you think it's a healthy weight for you?" I think that was a kind way of saying that I needed to lose weight because it put the ball in my court. And of course, overweight people know they're overweight. And maybe doctors should offer helpful resources on healthy weight, like the Lean Plate Club!

Sally Squires: Hear, hear! (Not surprisingly, :-) I'm all for that! ) Sounds like you ran into a very wise doctor. Thanks Baltimore.

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Re: Walking in front of TV: When you say walk in front of your TV, do you mean march in place or actually walk? I ate a little too much the other night then wanted to watch Harry Potter 5. During most of the movie I was pacing around the room and alternated in little aerobic moves back and forth (e.g. grapevine, squats). Is marching in place just as beneficial?

Sally Squires: You can do either one. The Leslie Sansone tapes--and others by Prevention, for example--will have you march in place, which makes it a little easier to also watch television. Jack LaLanne developed some exercises that you can do on the couch to strengthen your abs if you don't want to walk while watching. There are a million ways to stay active--and enjoy your favorite movie. Thanks for weighing in.

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Advice for Charlotte: There's no easy answer -- you have to just get up and get out and DO IT. I would recommend figuring out what is the best time for you (first thing in the am? after work? after dinner?) and start by getting out and walking. If you have an ipod, use it to listen to music or podcasts to distract you, and walk as fast as you can. Does your workplace have a gym, or discounts on gym membership? That may be a good idea if you think other people working out will prompt you to do more, and also they may have classes you can participate in (and the classes start to feel like a commitment once you become a "regular" -- people want to know why you were not there last week!)

If you do want to lose weight, I would also start tracking what you eat. I too was a healthy eater -- no meat at all, no sweets -- but lost those last 8 lbs by cutting about 200 calories a day from my diet (which was on top of the regular exercise I've been getting for some years now). You are probably right that your diet is fine, but it's worth checking out.

Good luck -- once you start and see results (losing weight, feeling better), you will be hooked!!

Sally Squires: You're absolutely right about activity being the greatest reinforcer there is for more activity. I often think that many of us who are chained to our desks and find ourselves hungry, are often craving activity--not food. But food is easier to get in the office and much more socially acceptable.

What do you think? Thanks for the tips for Charlotte.

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Calgary, Alberta: The best physician I ever had said to me: "You don't just wake up one day and look and feel older than your age because of the extra weight you're carrying around. It's small decisions that you make every day, year after year that make the difference". He then asked me what I thought my biggest barriers were to losing weight. He gave me info on weight watchers and multiple other programs and contact info. He encouraged me to make a commitment and said I could come back for encouragement and help anytime. In contrast, his nurse sighed everytime she had to pull out the bigger BP cuff for me and in her intake session with me she suggested I try exercising (even though I already did one hr cardio 5-7 days per week, she just assumed I was sedentary). The bottom line is don't make assumptions about your patients. Ask them where they are, where they want to be and how you can help. It worked for me.

Sally Squires: Another case of a very smart--and thoughtful--physician. Sounds like that nurse needed a little consciousness raising, however. Congratulations on what you've achieved Calgary!

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Annapolis, Md.: Hey Charlotte -

Exercising is hard to start if you haven't done it for awhile. When I first started, I set aside a time during the day that I watched TV and started walking for 15 minutes and then I slowly increased to 20 minutes and then 30 and I couldn't believe how much better I felt. I had more energy and was really proud of myself. By the way - watch out for the fruit. Eating too much fruit can put weight on you because of the amount of sugar(natural) it has.

Sally Squires: Right on, Annapolis. And your posting reminds me of something that I should have mentioned: The importance of setting a specific goal--and a small reward for achieving it. Most of us forget that last part, but it can really be a powerful reinforcer, even if it's just sipping a special kind of tea, taking a bubble bath, getting a new magazine, or giving yourself permission to daydream.

As for that last fruit comment, I would be remiss if I didn't say that fruit does indeed have sugar, but it's also packed with all kinds of other wonderful ingredients and is rarely if ever the cause of our added pounds. Now, sipping juice endless, may be another story...

Thanks again for chiming in.

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For the vegetarian: Hi, the person going veggie for Lent -- that is pretty much my diet. I eat eggs and dairy, but no meat/poultry/fish/seafood. Some suggestions to make sure you get protein, which I think is the thing you really have to think about and plan for:

(1) Beans. You can cook them many different ways, and I will generally make a pot of beans (1/2-1 lb dried beans) w/various veggies (carrots/onions/celery/squash/whatever is around), and use some of it to puree with veggie stock for soup, or mash up for black bean burgers.

(2) Grilled cheese. Use whole wheat bread, and add apples, pears, tomatoes, onions, or whatever else sounds good to you.

(3) Tofu. I slice extra-firm tofu into slabs (8 slabs from the TJ's block) and saute in a little olive oil, about 6 min per side, then add a little bit of bottled sauce (you can use pretty much anything, including salad dressing). Makes a great substitute for meat in a sandwich -- add some greens and whatever sandwich spread you like. Also good for stir fry, obviously.

(4) Eggs make a great sauce for pasta. Boil some whole wheat pasta, and in a separate pan saute some veggies (any kind, and frozen mixed veggies are fine), then put a couple of poached or fried eggs on top (make sure the yolks are runny) and mix it all up. A little grated cheese on top is nice. Poached eggs are also good on top of beans, and you can put the whole thing on top of a tortilla you've crisped in the oven.

(5) Frozen veggie burgers are good to keep in the freezer for a quick dinner. I like to saute some vegetables to eat with them, but you can just add a salad, too.

Enjoy -- I think it's great that you'll discover a lot of new foods that you can appreciate!

Sally Squires: Yes, and having just returned from the Culinary Institute where we ate a mostly plant-based diet for three days, this approach sure can be tasty and varied, not to mention healthy. Thanks for weighing in.

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Lexington Park, Md.: When changing your lifestyle, because I know weight loss to be a lifestyle change, chicken and fish are usually the choice and baked not fried, but what about pork being the other white meat? What should be the first steps into starting this change? Do you eat chicken/fish daily and get burned out or does this really work in the weight loss arena?

Sally Squires: Other lean meat--including pork or beef and even some cuts of lamb in small amounts--could also be options. Eggs, particularly egg whites which are protein rich and have no cholesterol--are another great choice. Nuts, low-fat and non-fat dairy and especially beans are great high protein options. In fact, most of us get plenty of protein, hey, we really eat plenty of everything. Let's face it: most of us simply eat too much of everything! That's part of the problem.

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Washington, D.C.: I have a big bag of Craisins, which I've run out of ideas what to do with. I have seen recipes for Oatmeal Craisin cookies, but I wanted to make something healthier. Do you have any recipes? Perhaps lemon craisin muffins? Thanks for the advice!

Sally Squires: Those lemon Craisin muffins sounds great, but you can use Craisins for lots of things: put them on top of your cold cereal; add them to your hot cereal; toss them in salads, muffins, bread, pancakes, cookies. You can add them to sauteeed spinach with pine nuts and garlic. They could be part of a wonderful rice pilaf or couscous. Trouble is that Craisins come with a fair amomunt of added sugar. So you may want to try regular raisins or dried cranberries or other dried fruit that aren't as loaded with added sugar.

Everything in moderation...

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Pre-pregnancy nutrition: Hi Sally,

My husband and I have been trying to get pregnant for about 5 months -- no luck yet. I'm about 20 pounds overweight, and I've been wondering if losing the weight would be helpful in conceiving. But should I be concerned about the possibility of being on a diet when I become pregnant (I mean before I realize I'm pregnant)? Once I know I'm pregnant, I'll go off the diet, but eat nutritionally of course! Thanks.

Sally Squires: Yes, weight can certainly impact your ability to conceive. If you haven't yet checked with the obstetrician/gynecologist about not yet conceiving, consider doing that as soon as possible. Your age, weight and medical condition very much can affect conception.

Also, you might check out W. Allan Walker's excellent book on Eating During Pregnancy. And yes, you want to be eating healthfully when you conceive--no fad diets--but you can do that well with good food and still shed a little weight.

Also, you might check out the USDA's Pyrmaid for Expectant Mothers. It will help guide you on how much weight to gain during your pregnancy based on your starting weight. And it also offers help on shedding pounds after delivery.

Find it at the same My Pyramid site listed above. Look for the stork. You can't miss it.

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Florida: Sally, I am six months pregnant with my first child but I've been thinking a lot about my unborn daughter's future eating habits, and reexamining my own as well. I eat pretty healthy, but I am also what a lot of people would call "picky." I don't eat any seafood. I hate broccoli and a lot of other vegetables. The list goes on (just ask my husband). However, I'd like my child to be more adventurous than me, but I also know that I do not intend to start eating seafood, broccoli, etc. I can't stand the smell of seafood and I prefer my husband not to cook it at home. I just worry that my finicky eating habits will rub off on my child and I'm not sure how to encourage her to eat the foods I won't touch without leading by example. Fortunately, this isn't an issue I'll be facing anytime soon, but I was curious to get your opinion.

Sally Squires: First congratulations on your expanding family. This is a very exciting and special time. And you're smart to think about the habits that you are likely to pass down to your baby.

As for not eating seafood during your pregnancy, check with your doctor about making sure that you are getting enough healthy omega-3 fatty acids--the healthy fat found in fish--from other sources. That's really important for brain development for your baby.

If you want your baby to be an adventurous eater, then you need to not reveal any of your food finickiness in front of your child--or at least as little as possible. You've got time to practice, but it's smart to think about it now.

Hope you'll let us know whether you have a boy or girl.

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Washington, DC: How do skinny people resist cravings? How do cravings work? Is it chemical? Why do I have more sugar cravings the more frequently I have dessert, but if I can go without for a few weeks, I don't crave it?

Today I am craving pizza and I really want to order it, but I know I'll eat 4 slices. So I ate a big plate of broccoli and brown rice and a full piece of cheese on the side. But that just didn't do it, so I ended up hitting the chocolate cookies instead. While I do feel better, I still want the pizza. Why is that?

Sally Squires: Well, we know that you're short on calories, so clearly you've got a craving for something salty with fat. (That's basically what pizza is.)

Olives and a few nuts could also fit the bill. But ask yourself, since you are now well nourished, what are you really hungry for? My bet is that it has little to do with food!

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gaining weight: Sally, I am in the strange position of trying to gain weight. A dietitian looked at my food diary and it appears that I am not eating enough calories. I started tracking my food on fitday and found it to be a wonderful way to keep track of what I eat, and the percentages of fat/calories/protein. Since I feel like I eat enough (I am full after my meals), I don't know how to increase my caloric intake. I love nuts so I eat those a lot, but apparently too many of my calories come from nuts, which I know are calorie-dense. What other suggestions would you have? I already eat about 6 meals a day, which add up to about 1800 or 1900 calories/day. Since I am very active, I will need to add a couple hundred calories. I am also considered "underweight" for my size. I don't want to cut back on the activity that I do (training for races, lifting weights, etc.). Thanks!

Sally Squires: Put an extra serving of your favorite food at each one of those six meals (or even at half of them) and you can likely start shifting the balance towards weight gain. You could also throw on an extra tablespoon of olive oil or other healthful--or there will be people on this chat drooling!--A piece of rich, dark chocolate would also be another option for you. Hope you'll let us know how it goes.

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Sally Squires: Thanks to all for a great chat.

Winners today are Charlotte--and the LPC members who offered tips to help boost activity--and San Diego.

Please e-mail me with your name, address and put winner in the subject line.

Until next week, eat smart and move more with the Lean Plate Club!

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Editor's Note: washingtonpost.com moderators retain editorial control over Discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions. washingtonpost.com is not responsible for any content posted by third parties.


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