Psychology Topic 5 Assignment

MAY 2017 PreparedFoods.com 47

NUTRASOLUTIONS

EVERY YEAR, THE American Cancer

Society (ACS) compiles the most recent

data on cancer incidence, mortality,

and survival rates. Sources include the

National Center for Health Statistics;

the Surveillance, Epidemiology, and

End Results Program; the National

Program of Cancer Registries; and

the North American Assn. of Central

Cancer Registries. ACS uses this infor-

mation to project the numbers of new

cancer cases and deaths that will occur

in the US in the current year.

Projections for this year still reflect

the challenges cancers pose to the

health care system. By 2018, we can

expect around 1.7 million new cases of

cancer, with a projected mortality rate

of about 36% (600,920 deaths). The

picture is worse for men than women,

with a projected incidence rate of 20%

higher for men and a cancer death rate

40% higher.

Naturally, consumers want to know

what can be done on an individual ba-

sis to prevent cancer. Are there realistic

lifestyle changes that can mitigate the

odds of contracting cancer? Can dam-

age be minimized and survival chances

increased, if diagnosed? The answer to

both is “Yes.”

Cancer is one of the diseases asso-

ciated with modern diet and lifestyle,

and has been deemed at least partially

preventable. Some modifiable behav-

iors can skew the odds against getting

cancer, and the odds of recovering from

it, in our favor.

Say No To Cancer… with Diet

Mark Anthony, PhD, Contributing Editor

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Cancer, one of the diseases associated with modern diet, is at least partially preventable.

KEYPOINTS 1. Health experts recognize that the connection

between diet and cancer risk is complex, yet indisputable. Developers of better-for-you foods and beverages use that knowledge to create products to help hold back the Big C and keep immunity strong.

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2. Effective ingredients for helping to build up im- munity against cancer overwhelmingly are found in plant-based foods, from fruits and vegetables to botanicals, such as herbs and spices.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Antioxidants are part of a broad class of compounds, with individual groups, such as anthocyanins and flavonoids, bringing their own specific benefits to the fight to stay on top of the health game.

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4. Lipids such as omega fatty acids and fat-sol- uble compounds—tocotrienols, for example— have been the subject of increased study for everything from fighting inflammation to taking out precancerous cells.

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48 PreparedFoods.com MAY 2017

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Topping any list of preventative

strategies is diet. This is because of the

potentially direct impact of individual

nutrients—and because of the indirect

impact on obesity, a definite risk factor

in many cancers.

The big picture of cancer risk

reduction hasn’t changed much in

decades, and the dietary prescription

remains, “increase the proportion of

fruits and vegetables in the diet and

maintain a healthy body weight.”

However, attention increasingly is

turning to more specific ingredients.

The effects of fiber, antioxidants,

meat, and sugar, as well as any nutri-

ent that affects the immune system,

are key. More recently, the gut micro-

biome (the system of healthy bacteria

that populate the digestive system) is

gaining attention for its role in im-

munity and cancer prevention.

Cancer’s Start The nature of cancer itself presents

challenges regarding specific recom-

mendations of its prevention. Cancer is

not a single disease, but an overall term

that describes cells of different origins

that share the general mechanism of

continuous cell division without nor-

mal regulation. That is, cell growth is

out of control, and the cells themselves

are abnormal.

These aberrant cells fail to differen-

tiate normally, to grow up and mature

into well-behaving cells as part of healthy

tissue. Instead, endlessly-dividing cells at

different stages of maturity invade tis-

sues both locally and far from the origin

of formation. That means the strategy

of prevention has multiple and different

potential targets. Thus, prevention may

focus on cell transformation (the con-

version to out-of-control cell division),

proliferation, and invasion.

The development of cancer requires

an accumulation of mutations that be-

gins with the cells of origin and contin-

ues with descendants of those original

cells. These descendants evolve over

time through successive cycles of natural

Chocolate, especially dark chocolate, is rich in flavonols, procyanidins, and other compounds that have been shown to help inhibit growth and proliferation of certain cancers.

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Quick Cancer Stats

Cancer cells are of varied origins. They can arise from different tissues by an accumulation of mutations, or mistakes in the genetic code during cell division that happen over time. (In the average lifespan there are more than 10 trillion cell divisions.) Or, cancer cells can arise due to outside damages to the genetic code. Such insults, as they are called, are caused by the sun; other forms of electromagnetic radiation; and pollutants in the air, water, and food. These, too, take time. The rise in cancers resulting from the nucle- ar explosions in Hiroshima and Nagasaki occurred about five years after the attacks. Similarly, cancers arising from industrial exposure to carcinogens may happen five, 10, or 20 years later.

Cancers grow at an unsteady pace marked by starts and stops as inher- ited changes resulting from successive mutations (some of which provide

advantages over more normal cells). There is a large element of chance in this progression, which explains why there can be spontaneous remissions, and why most people die of causes other than cancer, even though cancer cells are present.

Over the past decade (2004-2013), the overall cancer incidence rate has been stable in women, but declined by approximately 2% annually in men. The cancer death rate (2005-2014) declined by about 1.5% annually in both men and women. However, this reflects a cumulative drop of about 25% from the peak of the 1990s. Also, according to the American Cancer Society, “although the cancer death rate was 15% higher in African Americans than in whites in 2014, increasing access to care as a result of the Patient Protection and Affordable Care Act may expedite the narrowing racial gap; from 2010 to 2015, the proportion of African Americans who were uninsured halved, from 21% to 11%, as it did for Hispanics (31% to 16%).”

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MAY 2017 PreparedFoods.com 49

selection in the local environment, in

much the same way that evolution works

on populations of plants and animals.

At each stage of progression, can-

cer cells are presented with new chal-

lenges. The local environment might

be low in oxygen, scarce in nutrients,

or rife with natural barriers to migra-

tion. When cancer cells divide, they

form clones of the original aberrant

cell. But, with successive mutations

and natural selection, subclones are

formed, resulting in new species that

differ from the original cells.

Feeding Cancer Cancer cells metabolize fuel differently

from normal (referred to as “somatic”)

cells. Normal cells have two ways of uti-

lizing blood glucose as fuel. One mech-

anism requires oxygen, and the other

doesn’t. They are referred to as aerobic

and anaerobic metabolism. The former

produces more energy, while the latter

produces energy at a faster rate.

In normal cells, the by-products of

aerobic metabolism inhibit the anaerobic

pathway from consuming more glucose.

But in cancer cells, this feedback mecha-

nism is held in check; it doesn’t halt the

use of glucose through the anaerobic

pathway, so the cells can still consume

glucose without oxygen at a high rate.

The increased ability to consume

glucose by some cancer cells has led to

a major diagnostic procedure that looks

at the rate of utilization of a glucose de-

rivative. This, coupled with the fact that

some cancers have insulin receptors

that enhance the uptake of glucose, has

led to the simplistic strategy of blaming

cancer on carbohydrate intake.

The rapid and potentially invasive

cell division that characterizes cancer

cells requires more than just a source of

energy. It also requires a source of ni-

trogen for amino acid synthesis. Nitro-

gen is the critical element that separates

proteins from fats and carbohydrates.

For example, the non-essential

amino acid glutamine is important for

tumor growth, where it serves as a ni-

trogen donor. Researchers have made

many recent advances in understand-

ing the metabolism of cancer cells and

have identified several other metabolic

pathways. They are moving beyond the

idea that cancer metabolism amounts

to little more than increased capacity

for glucose and glutamine metabolism

as sources of energy production.

The story of cancer metabolism

turns out to be far more complex, as the

aberrant cells have to cope with insuf-

ficient nutrients resulting from insuf-

ficient circulation. This can require the

cancer cells to rely on a number of met-

abolic fuels, depending upon the local

environment, thwarting the strategy to

selectively starve cancer cells.

Antioxidants and Cancer Because diets associated with low risk of

cancer contain many antioxidants, there

is much interest in the potential for pre-

venting cancer by using isolated forms

of these compounds. Antioxidants are

naturally occurring in foods, especially

plant foods, such as fruits and vegeta-

bles, and have the potential to halt the

damage done by free oxygen radicals.

Free radicals are highly reactive chem-

icals that can harm cells. They are formed

naturally in the body as a byproduct of

metabolism and play an important role

in many normal cellular processes. The

damaging compounds are created when

an atom gains or loses an electron, a

small negatively charged particle found

at distinct distances from the nucleus

or center of the atom. This loss or gain

makes the atom (or molecule consisting

of two or more atoms) highly reactive.

However, at high concentrations

in certain locations, free radicals can

damage the major components of

cells, including DNA, proteins, and cell

membranes. Free radical damage, espe-

cially damage to DNA, has been shown

to play a role in the development and

proliferation of cancer cells.

In response to the production of free

radicals, the body makes its own antiox-

idants. However, the amount the body

produces is not enough to cope with the

additional generation of free radicals

resulting from the disease process itself.

Cruciferous vegetables in the Brassica genus contain a host of phytochemicals that exhibit powerful anti-cancer potential.

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Many nutrients found in foods either

double as antioxidants or participate in

antioxidant activity. These nutrients in-

clude vitamin A and its plant precursor

beta-carotene; vitamins C; and vitamin

E in its tocopherol and especially its to-

cotrienol forms, along with minerals

like selenium and iron that are used to

create antioxidants. Numerous studies

have investigated the anti-cancer po-

tential of isolated antioxidants.

E Research One antioxidant vitamin is showing

impressive promise when it comes to

battling cancer is the tocotrienol form

of vitamin E. A study of cancer pa-

tients published in 2015 in EBioMedi-

cine built on previous studies in which

tocotrienol demonstrated abilities to

prevent the abnormal growth of cells

and the chemical activity of cancer cell

development and growth in preclinical

models of pancreatic cancer.

Results of the study, which was de-

signed to determine the biologically

effective dose of delta-tocotrienol,

as well as its potential effectiveness

against precancerous pancreatic cells,

established that 800mg daily was able

to “induce apoptosis [programmed cell

death] in pre-malignant lesions but

not in adjacent normal tissue,” and

helped confirm findings by the study’s

authors and researchers showing a

“selective killing effect of tocotrienols

against cancer cells over normal cells.”

Observational cases reported in pa-

tients with pancreatic, ovarian, breast,

metastatic colorectal, and other can-

cers have shown good response to to-

cotrienol, especially in patients during

the late-stage phase, affirms Alexander

Schauss, PhD, senior director of re-

search and CEO of AIBMR Life Sci-

ences Inc. He points to a number of

studies scheduled or in progress based

on such observational cases, stressing

that the principal investigators—con-

sidered some of Europe’s most respect-

ed—are different for each study.

“Should the results of these cancer

studies show similar benefits to those

observed in the NCI-funded study of

late-stage pancreatic cancer patients,

one could expect an explosion of inter-

est to incorporate delta-tocotrienol into

a wide range of foods,” Schauss states.

According to Schauss, the annatto seed

of the Brazilian achiote tree (Bixa orellana)

is a premier source of delta-tocotrienol.

This form of vitamin E, he explains, “has

demonstrated the most promising results

to date of any of the four tocotrienols

found in vitamin E, as reported in many

in vitro and in vivo animal studies, and in

several human studies.”

Achiote seed is well-known in the

food industry, since the fruit is the

source of red color owing to its ca-

rotenoid pigments (mainly bixin and

norbixin) found in the seed’s waxy,

reddish coating. The FDA classifies

the colorant derived from this fruit

as “exempt of certification,” meaning

it is considered a natural color, often

shown as “annatto color” or “colored

with annatto” on labels.

“It would be wise for the food industry

to target an interest in delta-tocotrien-

ol, given it has shown the most promise

as a potential potent anti-cancer agent

among any of the tocotrienols of the eight

isomers of vitamin E,” adds Schauss.

On the other hand, Schauss cautions,

“Attention also should be paid by the

food industry to emerging evidence

suggesting that alpha-tocopherol, an

effective antioxidant, might inter-

fere with the anti-cancer benefits of

gamma- and delta-tocotrienol.”

This is worth noting, because

alpha-tocopherol is one of the most

commonly used natural antioxidants in

food processing.

Diets associated with lower cancer risk are also rich in antioxidants, some of the most powerful of which are in dark purple and red fruits.

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“Food formulators should consid-

er focusing on the use of polyphenol

extracts to replace alpha-tocopherol

as an antioxidant should further

studies offer more compelling

evidence of tocopherol inhibiting the

beneficial properties of tocotrienols,”

says Schauss. “Much more is still to

be learned about the tocotrienols and

their benefits, particularly regard-

ing the ‘billion-dollar question’: Can

they prevent common cancers from

developing or progressing?”

Going Green In addition to nutrients, there is a vast

number of antioxidants created by

plants to protect themselves from free

radicals that result from normal pho-

tosynthesis and exposure to ultraviolet

light. Many of these received a great

deal of attention in the past, and many

more are yet to be discovered. Some

that have shown a long history of po-

tential are being investigated more

carefully, with encouraging results.

An excellent example is that of

broccoli and other vegetables in the

Brassica genus, including cabbage,

Brussels sprouts, kale, and mustard

(also called cruciferous vegetables).

In addition to being nutrient-dense

and rich in several carotenoids

(beta-carotene, lutein, zeaxanthin),

they also contain vitamins C, E, and

K; folate; and minerals.

Cruciferous vegetables also contain

phytochemical compounds called glu-

cosinolates. These are converted to sev-

eral other compounds during digestion

including indoles, nitriles, thiocyanates,

and isothiocyanates. All of these com-

pounds have been studied for their

anti-cancer properties, including an

ability to inhibit the development of

cancerous cells of the bladder, breast,

colon, liver, lung, and stomach.

Suggested mechanisms of protec-

tion include protection from DNA

damage; induction of cancer cell death

(rather than endless cell division), and

inhibition of tumor migration into

healthy tissues. A although results of

studies have been mixed, this holds

great promise for humans, because

said mixed results generally range

from inconclusive or statistically insig-

nificant protection to significant pro-

tection via consumption of the com-

pound-containing plant itself.

Researchers at Oregon State Uni-

versity recently published findings of

a more in-depth study of broccoli in

the Journal of Nutritional Biochem-

istry. The researchers focused on the

glucosinolate compound sulforaphane,

previously recognized as contributing

to the prevention of prostate cancer.

The results of the study indicated

that sulforaphane works at the ge-

netic level, influencing a type of RNA

called lncRNA, once believed to have

no function.

The researchers determined that,

instead, lncRNAs could “play a critical

role in triggering cells to become ma-

lignant and spread” and serve a “major

role in cell biology and development,”

controlling which genes are switched

on. It has been suggested that when

such genes are “dysregulated” they can

“contribute to multiple disease pro-

cesses, including cancer.” The scientists

further noted that lncRNAs are “highly

cell- and tissue-specific.”

Emily Ho, PhD, a principal investi-

gator with the Linus Pauling Institute,

suggests that sulforaphane—which

is especially concentrated in brocco-

li—“could open the door to a whole

range of new dietary strategies.” Ho,

who also is the endowed director of

the Moore Family Center for Whole

Grain Foods, Nutrition and Preven-

tive Health at Oregon State University,

adds that “foods or drugs that might

play a role in cancer suppression or

therapeutic control.”

A Rainbow of Protection In the class of colorful plants that can

protect against cancer, purple, red, and

blue fruits and vegetables also have a

long history of study for anti-cancer

properties. These foods include the dark

With a long traditional medicine history coupled with emerging science, certain mushrooms could be the next generation of anti-cancer ingredients.

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and juicy berries rich in the phytochem-

ical groups called flavonoids (including

especially the anthocyanins that give

them their color) and polyphenols.

Polyphenols are a well-studied

group of antioxidants, and many of

these compounds have the potential

to prevent several diseases. Numerous

polyphenols display potent antioxi-

dant properties and may reduce the

oxidative stress associated with some

diseases. Regarding cancer, polyphe-

nols have been shown in laboratory

studies to inhibit carcinogenesis and

induce tumor cell death. Two of the

most interesting polyphenols are cur-

cumin and resveratrol.

Curcumin and resveratrol have been

the subject of thousands of studies in

the past 10 years. Both have been de-

scribed as promising anticancer com-

pounds, but the exact mechanism of

action remains unclear. Curcumin

(diferuloylmethane) is an active ingre-

dient found in the perennial herb Cur-

cuma longa, or turmeric. It is responsi-

ble for the spice’s bright yellow color.

It has long been employed as a tradi-

tional medicine component in China

and India, and is considered both an

anti-inflammatory and an antioxidant.

Resveratrol (trihydroxystilbene) is

synthetized by a variety of plants, in-

cluding peanuts, pistachios, grapes,

blueberries, cranberries, and cocoa. Its

antioxidant effect has been well estab-

lished using several laboratory tech-

niques. As a result, resveratrol has been

closely investigated for its potential as

a preventative, use as a treatment for

several diseases, regulation of the im-

mune system, and cancer prevention.

However, results from clinical studies

in humans remain mixed.

Many foods like nuts, seeds, vegeta-

ble oils, cereals, and legumes are rich

sources of specific phytosterols, such as

the subgroups sitosterol and campes-

terol. Diets rich in phytosterols could

reduce cancer risk by up to 20%.

Some studies suggest that phytos-

terols might inhibit tumor growth and

metastasis without interfering with

normal cell death. Phytosterols could

also enable antitumor responses by

improving immune response.

An increased interest in the me-

dicinal value of mushrooms includes

investigation of the science behind

centuries of anecdotal evidence. Of

value to food product developers, a

number of medicinal mushrooms

also have GRAS status for use in

foods. These include maitake (Grifola

frondosa), popularly called hen of

the woods and considered one of the

best-selling immune-boosting mush-

rooms used by people fighting cancer.

The common and well-employed

shiitake mushroom (Lentinus edo-

des) is being studied for possible can-

cer-fighting attributes, as is the black

fungus mushroom, also called the

wood ear (Auricularia polytricha). The

latter, while more exotic, is commonly

used in Asian recipes. These are just a

few of dozens of mushrooms pulling

double duty as tasty, savory vegetari-

an sources of umami flavoring and as

health-protection agents.

Vitamin D and Cancer Vitamin D describes fat-soluble

pro-hormones (substances that the

body converts into hormones). Its

primary function is to stabilize blood

levels of calcium and phosphorus,

enhancing absorption, and pulling

reserves of these minerals from bones

when necessary.

The effect is to maintain steady

blood levels while strengthening

bones and teeth. Vitamin D is a de-

rivative of cholesterol. It concentrates

in the skin and is activated in a series

of reactions following sun exposure.

Since few foods are naturally rich in

vitamin D (the exception being fatty

fish, dairy, eggs, and certain mush-

rooms), most people get vitamin D

from sunlight exposure and from

D-fortified products like milk, milk

analogs, juices, and cereals.

The link between vitamin D and can-

cer stemmed from early epidemiologic

Meat and Cancer

In October of 2016, 22 scientists from 10 countries met at the International Agency for Research on Cancer (IARC) in Lyon, France, to review more than 800 studies on the link between meat consumption and cancer. These results have been published online in the medical journal The Lancet. The majority position “concluded that there is sufficient evidence in human beings for the carcinogenicity of the consumption of processed meat.”

The strongest link was between processed meats and colon and stomach cancer. In addition, red meat was classed as “probably carcinogenic to humans,” with the link extending to pancreatic and prostate cancer. However, the scientists noted that there was “inadequate evidence in experimental animals” to definitively prove this link. Recommendations are to limit red meat consumption to 500g per week—less than 3oz per day. It should be noted that the findings were strongly contested by not only industry, but also by other nutrition researchers, and further study has been called for.

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NUTRASOLUTIONS

research that showed lower incidence

and death rates for certain cancers

among individuals living in southern

latitudes, where levels of exposure to

sunlight were relatively high, com-

pared with those living in northern

latitudes. Animal and in vitro studies

suggested an association between vi-

tamin D and cancer risk, along with

potential mechanisms.

Vitamin D might slow or prevent

the development of cancer by pro-

moting normal cellular differentia-

tion. It also could decrease cancer cell

growth, stimulate tumor cell death via

apoptosis, or inhibit cancer’s invasive

capability.

Several epidemiologic studies

have investigated the potential link

between higher vitamin D intakes or

higher blood levels of vitamin D and

lower risks of specific cancers. The

results have been inconsistent, pos-

sibly due to the inherent difficulties

in the studies. Some dietary studies

failed to consider vitamin D made

in the skin from sunlight exposure.

For this reason, blood levels of vita-

min D did not necessarily reflect true

vitamin D status.

Some epidemiologic studies have

shown a connection between higher

intake or blood levels of vitamin D

and reduced risk of colorectal cancer.

Also, the Women’s Health Initiative’s

randomized trial found no incidence

of colorectal cancer in healthy wom-

en who took vitamin D and calcium

supplements for an average of seven

years. Research is ongoing, but with

many Americans deficient in this

powerful vitamin, processors still

benefit from finding more ways to in-

clude it in formulations.

A recent review of soy foods sug-

gested a weak but inverse associa-

tion between higher consumption of

dietary isoflavones from soy prod-

ucts, and legumes and endometrial

cancer risk. In other words, more soy

consumption apparently resulted in a

slightly lower risk of this form of can-

cer. However, some research into the

connection between soy intake and

reduced risk of breast cancer yielded

mixed results. Thus, some women at

risk for estrogen-influenced breast

cancer are warned to avoid soy due to

its phytoestrogen content.

On the other hand, other studies

indicate that early and continued

intake of soy can reduce later risk of

breast cancer in some women. The

current recommendation, according

to the nonprofit breast cancer in-

formation group Breastcancer.org,

is “that women who take hormonal

therapy or who have estrogen-recep-

tor-positive breast cancer [should]

avoid soy supplements, because they

contain high concentrations of isofla-

vones. But in general, it’s fine to eat

moderate amounts of soy foods as

part of a balanced diet.”

The Sweet Ending Good news in the area of eating to help

ward off cancer is that compounds in

chocolate appear to be helpful. Cocoa

beans, and the chocolate made from

them (especially dark chocolate) are

rich in flavonols and procyanidins, as

well as other compounds that have

been shown to help inhibit growth

and proliferation of cancers of the

colon, with the latter compound even

showing evidence of an ability to in-

duce programmed cell death in some

cancer cells.

While cocoa butter is a compo-

nent in some skin creams, a 12-week,

parallel, double-blind, randomized

clinical trial published in 2014 in the

Nutrition Journal did demonstrate a

slight increase in protective effect of

dietary cocoa on skin damage from

UV rays. However, the effect was

not deemed statistically significant

enough to warrant recommending

chocolate for skin health.

A recent study on ovarian cancer

that used a procyanidin-rich extract

of natural cocoa powder did confirm

an ability to induce cancer cell death.

Other studies have shown cocoa

compounds to be especially effective

in helping the body excrete harmful

oxygen free-radicals and reduce in-

flammation.

Cancer cells seem to thrive on

extremes—inflammation, pollut-

ants, obesity, and dietary excesses,

including alcohol. While the trans-

lation from promising chemicals in

plants to cancer prevention is not

without difficulties and complica-

tions, plants contain thousands of

chemicals acting synergistically in

ways that cannot be duplicated by

isolated systems.

It is clear is that diet does play a

general role in protection against can-

cer. This confirms that specific foods

and ingredients can be reasonably in-

cluded in food and beverage formula-

tions with an eye toward thwarting or

derailing this killer disease. PF

Mark Anthony, PhD, is an adjunct professor of nutrition science at St. Edwards University, Austin, Texas, and co-director of S/F/B Communications Group. The former lab director of The Institute for Biomedical Research at the University of Texas at Austin is also author of Gut Instinct: Diet’s Missing Link, a book that presents a unique investigation of carbohydrates and the fundamental chemistry of nutrition and metabolics on maintaining health as people age. He can be reached at mjanthony4@gmail.com.

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