Is there a safe amount of sugar?


After last week’s alert about sugar and heart disease, some people – including a representative from the Swedish National Food Agency (issuing official dietary guidelines) – drew a funny conclusion.

They agreed that sugar is hazardous to the heart, but claimed that the study showed that if you kept your sugar intake below about 8 percent of your energy intake, you wouldn’t be at an increased risk.

This is somewhat embarrassing. It turns out that the group that ate the least sugar in the study consumed about that much (7.4%). The most obvious reason for this group being the healthiest, was that no other group ate less sugar!

So now you know. If you eat only 7.4 percent sugar, you’ll not be at an increased risk… compared to others that eat more sugar.

Using the same logic we could do a study of people who smoke 10, 20 or 30 cigarettes daily. If the people smoking 10 cigarettes per day were found to be the healthiest it would “prove” that smoking this amount of cigarettes per day is safe.

Science according to the Swedish National Food Agency.


New Study: Does Sugar Cause Heart Disease?

Doctors Warn: “Sugar is the New Tobacco”

Is Sugar Toxic?

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  1. FrankG
    The logic is barmy but probably makes perfect sense... if you follow the money trail :-P

    I think there are individual thresholds. My own is very low now that I am blessed with Type 2 Diabetes/Metabolic Syndrome but I daresay my 20-something son can tolerate higher amounts, especially if it just on occasion... like Birthdays, Xmas etc...

  2. Joe
    I'm not sure about he logic of the science agency here, but it seems perfectly reasonable to me that sugar as well as other carbs are not harmful in certain doses. This, of course, should be tailored individually, factoring things such as age, weight, prior metabolic damage etc. Sugar is likely benign in reasonable quantities. For instance, it is doubtful that a couple teaspoons of sugar in your coffee is going to have negative health effects for most people. Frequent desserts and regular sugary soft drinks however, will most likely result in negative health outcomes for most people, at least long term.
    Replies: #4, #14
  3. Boundless
    > Using the same logic ...

    This is much like the claims that whole wheat is 5% healthier than refined wheat. What if we turn the wheat consumption dial to 0? Big Grain doesn't want that questions answered.

    But it is likely the case that tolerance to simple saccharides varies by individual and age. Dr. Peter Attia (keto pioneer) has an article on exactly this:

  4. bill
    Joe said:

    "Sugar is likely benign...", based on exactly no evidence.

    Why do people feel the need to defend sugar and/or carbs
    in this discussion site? Would their lives be empty

    Thank you Joe for that useless post.

    Reply: #18
  5. fredt
    OK. I am convinced, the safe amount of sugar is ... none, well at least no processed sugar, or a best, the least you can avoid getting.
    Reply: #7
  6. Diane
    At last there is a use for sugar beyond messing up our bodies with it - sugar powered batteries!

  7. charles grashow
    What about fruit - should there be a daily limit on that?
    Reply: #8
  8. Boundless
    > What about fruit - should there be a daily limit on that?

    Fruits present two issues:
    1. net carbs (primarily sugars)
    2. fructose (which may be free or bound in sucrose)

    That glucose and fructose are fruit-sourced does not mitigate their metabolic hazards to any great degree, and the other benefits of the fruits may not offset them.

    I keep my consumption to below daily and meal net carb targets, and focus on low-sugar and low-fructose fruits. One medium modern bred-for-sweetness apple blows that budget. A handful of blueberries does not.

  9. tess
    I think Bill is being overly harsh. There is history of sugar being used medicinally, and i suspect judicious application MAY well be beneficial. It's using sugar for "entertainment" purposes that really gets to be a problem.

    That said, i'm an abstemious user of sugar. Like alcohol, caffeine and nicotine, the drug-like qualities of sugar need to be carefully self-regulated.

    Reply: #12
  10. Cindy
    I have a somewhat radical belief- that the job of cancer cells is to reduce the amount of excess sugar in the blood. I've worked in cancer research for over a decade and I can usually predict when a cancer drug is working for someone (their blood glucose level goes up) and when it stops working (their blood glucose level goes down).

    It always amazes me that oncologists use PET scans to determine the cancer activity in the body (by determining the amount of glucose uptake in tumors) and then tell their patients to drink carbohydrate laden drinks and eat high carb foods to stay "healthy".

    I believe that no processed sugar is good for you-and that regular intake could be especially bad if it's "feeding" cancer cells.

  11. Rozzy
    What about fatty fruits? Love black olives and creamy avocados are my favorite food ever hope there should not be a limit on them. Coconut meat is also loved in my house.
  12. bill
    tess said:

    "...judicious application [of sugar] MAY well be beneficial."

    Again a sugar apologist with nothing to back the claim.

    Thank you too for a useless post.

  13. tess
    WHAT A BRILLIANT ANALYSIS! however COULD i have doubted you, Bill? your scintillating wit and stunning logic leave me speechless!
    Reply: #16
  14. Charles Grashow
    Pay no attention to Bill - he knows not of what he speaks
  15. Juliet##
    Wow! I really enjoy this blog.
    So, thanks so much for posting all the valuable information for us.
    I found your blog from a reference on another blog…. I think maybe MDA and then Keto Diet references brought me here.
    Anyway -- about sugar -- ok I was aware of the fact that sugar is hidden in many processed and canned foods -- but i never considered the danger of sugar (even fruits and too much protein) driving insulin and ruining success in trying to shed body fat -- i only thought of the calories but not of the impact on the body by elevating insulin, etc.
    But i totally get it now-- from reading a lot of articles on this blog.
    Also -- although i wouldn't have dreamed of intentionally consuming sugar, I never really considered the drawbacks of eating too much fruit or even vegetables or protein. Too much fruit can spike insulin, also -- and in never considered that. Heck, too much anything (except for fat) seems to drive insulin -- so now i get it.
    I wanted to lose a relatively small amount of weight lose for cosmetic reasons so that's why i am interested in a leto diet - but the health benefits of eating this way are motivating, also.
  16. Paul the rat
    Yea, but most of us get what bill means. Simply because we went through the brilliant analysis and stunning logic about - in this instance toxicity of sugar - countless times on the pages of

    and tess listen ALWAYS what pharma-troll Charles Grashow has to say - it is very entertaining

  17. TR
    It's safe if you earned it. After a good glycogen depleting workout (Crossfit/heavy lifting), sugar intake post workout can't be stored as fat and will be immediately used to replenish muscle glycogen stores. It's one of the reasons bodybuilders slam min fructose carbs post workout.
    Reply: #19
  18. Joe
    Bill - Why the hostility?

    To share with you my biases, I wholeheartedly eat a real foods based LCHF diet. I have benefited tremendously from this eating strategy and am convinced that the best science supports carbohydrate restriction as the optimal way to lose weight and enhance health for most people.

    I also have not eaten one gram of added sugar in 14 months (since I started LCHF). I do not share that to brag but to clarify where my convictions are regarding food and nutrition. I hope you can see that I am not a "sugar apologist" as you stated.

    Although you may disagree, I thought my post was relevant to the article because the article is specifically addressing the Sweedish nutrition authorities claim that a limited amount of sugar is probably not harmful. Although I am not sure where they come up with that number, my post seemed to be right on topic from my perspective. I'm sorry that my lack of evidence didn't live up to your expectations.

    I was tempted to post the very same link that Boundless posted since I also enjoy the writing of Peter Attia and find him to be very reasonable in interpreting evidence whereas other people can be extremely dogmatic in their approach to nutrition. Dr. Attia always heavily footnotes his articles so you can read that for more info.

    Lastly, you may want to consider how your characterization of people's posts as "useless" (based off lack of evidence perhaps?) effects other people. It certainly doesn't invite open conversation and could inadvertently cause certain people to reject good nutrition by association. Some people view message boards as an opportunity for conversation rather that an invitation for scholarly debate. Personally, I would like to see people coming to this website be drawn to change their health not just through the information presented on the site but also through the attitudes of those advocating for LCHF.

  19. Sami
    A thought that arises in me is, isn't that a way to neglect using bodily functions, like the functions in your liver, producing glycogen for your requirements (instead of overloading).

    What happens to a muscle if you don't use it?

    Is it really that far fetched to think the same about your organs?

  20. bill
    tess and Joe:

    You are reading hostility into my posts where there
    is none.

    Maybe you could enlighten us with some shred of
    evidence to back the claims you have made.

    Are we to give equal credence to posts of your
    sort and posts with information that can be
    readily researched?

    By the way, I'm bill.

  21. François
    One point that does not seem to have been covered here is the fact that there are general principles and there are individuals, who react somehow differently to various nutrients. I'll paraphrase Peter Attia regarding the ability to intake sugar: about 10% of people are so unable to process sugar that the smallest amount makes them sick (think diabetics and prediabetics, epileptics and Alzheimer's or cancer patients - Cindy, your analysis of cancer treatment is quite right) - 10% seem to be able to tolerate relatively high amounts for prolonged periods of time with no evident ill effect - and there is the rest of us, somewhere in-between. What is the minimal amount of carbs needed in order to survive? None. As long as the body is provided with protein and fat, it can do very well. The Inuit, living on a fat and protein-only diet during winter proved this was indeed healthy).

    Mind you, as soon as the percentage of total daily calories from carbs reaches 40%, the epigenome is switched to inflammation, even if people are unaware of that fact and feel no ill effect.

    Andreas made an important point: in the study, no group had a zero intake of sugar. The people eating the less sugar did the best. Which does not make sugar healthy. You can only conclude that less seems to be best in this observational study.

    For healthy people, the evidence from studies of the epigenome suggest you could have up to 40% of your calories as carbs. This being said, we could enter in the debate of "good carbs" versus "bad carbs" (slow-absorbing carbs in vegetables and in some fruits (not all) versus quick-absorbing carbs in grains, full wheat or not, in sodas and in sweets). This debate cannot apply to sick people: a carb is a carb, period!

    Because of the many phytonutrients available in vegetables, I would recommend up to two large plates of vegetables per day (you still woud be below 60 grams of total carbs and close to nutritional ketosis). I see no use for sugar. And in order to be logical, fruits should be only eaten in a seasonal way.

    I use food as a prescription for my patients. I work in an area of the USA where pre-diabetes and the metabolic syndrome is extremely common because of the ethnic origin of the people. For them, I aim for nutritional ketosis to reverse their diabetes. For people who are healthy, even biochemically, I still suggest a LCHF diet and explain why: to me, it is the best prescription for long-term health. This being said, I feel that some people are simply not ready to make the switch yet. I'd rather preach by example and give them a little breathing space (you can do quite a bit with 60 grams of carbs). In the end, our role is to present the evidence. People can then choose what they want to do.

  22. François
    Further to my comment, I strongly feel that any added sugar is detrimental for anyone's health, based on the evidence available now.
  23. Murray
    Francois, all your points make good sense and are consistent with what I have observed.

    There seems to be a qualitative difference between free-base, acellular sugar and cell-encased sugar, much as there is a qualitative difference between poppy seed dressing and codeine-opium-morphine-heroin. Weston Price's work indicates acellular sugar and starch wreaks havoc on dental health, jaw and nasal development and overall health, which cultures eating cellular sugar and starch did not experience. Our dentist remarked that our son was the only kid he has seen as a patient with perfect occlusion and every other kid in his class by eighth grade was wearing or had worn braces. Something is amiss.

    Apart from careful observation by the likes of Dr. Price, the science is still far too rudimentary to conclude there is a safe dose of acellular sugar. Acellular sugar is immediately bio available to undesirable bacteria in the upper gut. Studies suggest this alone accounts for part of the obesity problem and digestive issues such as acid reflux. Cellular sugar remains unavailable until digestive juices or beneficial bacteria further along have breached fibrous cellular walls. The sugar is released in an environment with beneficial bacteria and enzymatic byproducts of bacterial activity. This apparently buffers the rate of sugar absorption and otherwise transmogrifies the digestive process, so digestion of encased sugar may be as different from acellular sugar as poppy seeds are from morphine. The science is still rudimentary, but experience indicates serious issues.

    Of course, too much cellular sugar in fruit can in principle overwhelm any buffering or other mitigating effect. 50 grams of 50% glycemic acellular sugar would in theory be rate equivalent to 100 grams at 25% glycemic cellular sugar. This arbitrarily assumes linearity, so perhaps after exceeding a threshold of tolerance for cellular sugar the buffer and mitigating effects are overwhelmed. Again, the science is just not there yet. The evidence of epigenetic systemic inflammation above 40% carbs in the diet suggests the body senses when diet exceeds that hypothetical limit of well tolerated cellular sugar and starch.

    Reply: #39
  24. Gray
    I read these posts because I have an interest in nutrition and would love to find out what is not only best for myself but my family also.

    In my studied opinion I think most of you, including the dietdoc are missing something enormous; who can stick to such a diet? Those who write their opinions here obviously think they can, really? How often do you fall off the preverbal wagon? How do you resist everything that a market has to offer?

    I think most of you are bogus, this way of eating is not possible in a society full of terrible cardboard foods.

    Please, everyone, stop lying and tell the truth for a change. You are not sticking to this way of eating all of the time, tell the truth and help those who are struggling.

    Replies: #26, #29, #31, #32, #41
  25. FrankG
    No lies, no deception on my part. Good, wholesome, real whole food, locally sourced from reputable farmers and prepared at home. I can see how some may not have access to these same choices, or that it may require different priorities of one's pocket-book in some areas, I also recognise that when I am away for home for work and have to eat out it is not always the easiest choice, yet it is still very doable BUT given a choice between a varied tasty diet that leaves me satisfied and healthy compared to mass-produced and highly-processed junk... why do you think it would be hard to stick with? :-)

    In terms of "falling off the wagon", ether s room in LCHF for an occasional birthday cake or similar -- although I now find such things way too sweet for my taste. It is what you eat most days that really has the impact... not the occasional "slip up". That said tastes can change over time and now things that I previously might have considered to be a "treat", no longer hold any such desire by me.

    Have you seen Dr Andreas' LCHF for Beginners section..? the choices there not look appetising to you?

    Reply: #27
  26. Gray
    @ Frank. Something is always missing. I can feel it inside of me.
    Replies: #28, #30
  27. FrankG
    Your feelings are your own... please don't project them onto others. I have lived comfortably this way for nearly 6 years now (others here longer) and see no reason why I could not sustain it for the rest of what I hope to be a longer, healthier and richer life than I was facing; had I stuck with the mainstream advice.

    If you need additional help, support or just suggestions about LCHF then please ask away, I can't promise anything but many of the folks here are open to helping others. Just please don't take the tack that people here must be lying.

  28. Paul the rat
    I follow LCHF (sometimes long 'runs' with carbohydrates intake less than 5% or none of total energy) for many years now, without need to, and I quote: "..fall off the preverbal wagon..". I find it very easy to follow (or stick to it, including outings to the restaurants) and very rewarding life-style.
    But obviously I may lie about it - but why?.
  29. Paul the rat
    "@ Frank. Something is always missing. I can feel it inside of me."

    are you a soothsayer Gray ?

  30. Zepp
    Its mostly in your mind!

    Its your way of thinking.. and its formed of our societys comercial interests!

    That you are missing is Dopamine!

    Dopamine is your reward system.. speaking to you.. its about adicction and comfort eating!

    Falling of the wagon is only a problem fort those that have a opinion of whats healty eating!

    Those how not have a clou.. never falls of any wagon becuse they never did climb on to any.. they just let any wagon frome any corporation drive right ower them!

    I do fall of the wagon now and then.. but im not a diabetic as Frank.. he know the consequens of falling of a wagon.. in the long turn!

    Every fall for at diabetic is one step further to be blind and/or amputee!

    What your missing is that there is no need to eat junk food if one isnt very poor!

    And if you have a family.. one often want to give them the moste healty food one can buy!

    And there are no excuse to provide ones family bad food!

  31. bill
    Three years here, no wagon mishaps.

    As Paul said, what would be the motivation
    to lie?

    Have you read "Good Calories, Bad Calories"?
    After reading that book (twice) the decision to
    follow this way of eating was easy.

    I eat almost exclusively fat (egg yolk, coconut oil,
    palm oil, bacon fat, olive oil, palm oil, avocado, nut butters,
    cream) in the morning. Then nothing but a few nuts until
    evening when I eat fat (meat fat, olive oil, butter, fatty fish)
    and (a deck of cards sized) protein with some
    unavailable carbs (salad or other leafy vegetables) for
    dinner, with fat (cream, coconut milk, coconut cream
    fatty cheese) and a few berries and nuts.
    Never hungry never out of energy.

    I drink lots of water and make sure I get lots of

    I never have to stop work to find something to
    eat and all that that entails.

    Why would I 'fail' in this way of eating? What would
    be the point? It's easy, delicious and makes me feel

    Reply: #38
  32. Gray
    How am I projecting my feelings? I am telling you how eating a LCHF makes me feel. Empty and no satiety. I never asked you to answer my post.

    It may be missing dopamine, it may also be my body telling me that eating a LC diet is just nonsense.

    I can understand if you are diabetic, but why would a healthy person do this? I know processed food, added sugar and grains are not good for us as animals, yet there must be a balance to be found for someone who only wants to maintain good health.

    Replies: #35, #36, #37
  33. Di
    Gray - you are projecting your feelings because you are telling everyone who eats LCHF and is content with it that they are bogus and lying!!!!

    I am another person who has been eating this way for 4 years now and I feel so much better eating this way that I will never go back! I look at all the 'fake foods' full of sugar, wheat and chemicals in the supermarkets and I do not think of them as food anymore - they are 'foodlike substances' with no nutritional value which will only impact negatively on my health. Buying these foods only benefits the profits of the fake food industry and the pharmaceutical industry when eating them inevitably makes you ill.

  34. Zepp
    Ofcourse its of importance.. the moste importante to eat a healty diet.. that goes first, before one goes LCHF.. if one need that.. and healty persons seldome need to go ketogenic!

    This site is about how/way to eat LCHF/ketogenic.. and the answers is mostly in that region!

    One can eat a healty diet otherwise too.

    I give you a link that make you see the bigger perspective!

    And then.. way eat junkfood if one isnt poor?

    Or way feed ones family bad food?

    Dopamine is a part of any adiction.. there are no differens whit high bloood sugar and/or blood sugar spikes.. one get ones reward!

  35. bill
    Oh, wait. I lied. No, I just forgot. I put salsa
    on my egg yolks in the morning. There, I feel
    better admitting that.

    "I can understand if you are diabetic, but why would a healthy person do this?"

    Maybe we've seen family and friends get diagnosed
    diabetic and want to avoid the same fate for ourselves.
    Or we want to avoid metabolic syndrome. Or we don't
    get famished in the middle of the day or in the evening.
    So we don't get blood sugar crashes. So our skin
    clears up. So our mood stabilizes. So our blood
    pressure stays low. So our bodies heal from years
    of eating crap. How many more reasons would a
    person need?

    You admit that "...processed food, added sugar and grains are not good for us..."
    and then say there must be balance.

    What would you have me eat to be more 'balanced'?

  36. Paul the rat
    "...but why would a healthy person do this?…"

    allow your brain to run on ketones for a while, than go back to glucose, feel the difference. If, in your case there is no difference, go back to eating bananas.

  37. Charles Grashow

    Have you had a NMR/VAP test done recently? I would be extremely interested in the results.

    Reply: #43
  38. François
    Murrym I could not have said it any better. Thanks for the precisions!
  39. François
    Murray, sorry I have destroyed your name. Big finger slip on a small keyboard.
  40. François
    "I think most of you are bogus, this way of eating is not possible in a society full of terrible cardboard foods." And "Why would a healthy person do this"?
    For one, thanks for calling everyone here bogus.
    No, I am - nor is anyone here - bogus. There is a depth of knowledge about nutrition that comes from practicing it. Everyone here did their homework and decided this was the best way to eat. Since they feel the benefits (more energy, reversal of diabetes or heart disease to name a few) they have continued on.
    Why would a healthy person do this? First, please define healthy. Most physicians do not check HbA1C when the fasting blood sugar is normal but they should especially in African-Americans or Asians, especially women, because of the much higher risk of diabetes on a crappy north-american diet (If there was a platinum medal for crappy diets, the USA would have won it, along with the gold and silver. The bronze would go to the traditional Indian diet). Well tphysicians should check HbA1C in everyone. I have identified a great number of prediabetic patients who thought they were "perfectly healthy" just like you think you are. Maybe you are. I do not know. But did you check if you were metabolically normal?
    Let me return the question: why would anyone continue on a diet most likely to make them sick, then look for something else or take pills?
    For me, LCHF was lifesaving. I had a severe sleep apnea and abdominal obesity and could not tolerate all the mechanical gizmos. And I did not want to have the back of my throat cleaned out (read cut out). The tough part was in the beginning to find recipes I liked. It took me a few months. I now eat zucchini noodles, cauliflower rice and mashed cauliflower, "Mr peanut butter bread" as replacements and I am perfectly happy. With more fat, foods are much more tasty. And satisfying. If you want recipes, go look at He has quite a few excellent ones and hyperlinks to others. Restaurants can be a challenge, but it is possible to eat LCHF even then. just be creative. As for shopping, it is much easier: the real foods are almost always on the periphery of any grocery store. So I shop on the periphery of the grocery store (veggies, fruits, meats, dairy products and I'm out). Fast and easy.
    So you may continue thinking I am bogus if it comforts you in your decision to do nothing. I'll keep on doing LCHF myself and educating my patients and colleagues. One by one. Good luck to you.
  41. robert
    What do you think of this publication? Is the effect they saw real?

    That goes pretty much against Dr. Lustig's view on sugar / fructose. And I'm inclined to follow his train of thought.

    Reply: #45
  42. bill
    I wasn't going to respond because of your nastiness,
    but I'll give you a chance to redeem yourself.

    No NMR or VAP, but on my last blood test my HbA1c
    was 5.3 and my triglycerides were 48.

    Good enough for me.

    Reply: #46
  43. bill
    Oh! And pickles! I eat dill pickles!
  44. Zepp
    Are they idiots?

    Sucrose is glucose and fructose!

    A slip of ones mind, or?

    Its a observation study whit three questionarys and then they have tortured the data again whit sofisticated metods!

    But they seems to have a litle problem interpreting the result?

  45. Charles Grashow
    No NMR or VAP, but on my last blood test my HbA1c
    was 5.3 and my triglycerides were 48.

    Completely useless - at the very least you need to know your LDL-P, small LDL-P
    Even if don't believe they're necessary - then you at least need to know your HDL to get your TG/HDL ratio

    Reply: #47
  46. bill
    Everyone needs to get that?

    What medical utopian society are you living in?

  47. Charles Grashow
    At the very least you need an hsCRP test to check a very important marker of inflammation.

    As to the NMR/VAP test it can ordered without a prescription (in the USA where I live) for a very reasonable cost

    NMR test - $89.00
    VAP - $109.00

    VAP+hsCRP+homocysteine for $199.00

    SO - it's not necessary to live in a utopian society - it's a question of the value you place on your health

    Reply: #49
  48. François
    Charles, it is indeed an excellent idea to know whether there is inflammation in our body. Some people, though, do not have enough money to spare for these tests. I agree that the C reactive protein and homocysteine levels are excellent markers of inflammation and LDL particle size measurement is wonderful when you get it.

    But all this is not really necessary, especially when one is short on money. I recommend HbA1C and a traditional fasting lipid profile with triglycerides, total cholesterol, HDL-C and LDL-C. One has to remember that LDL-C is a calculated value and the higher the triglycerides, the less precise it is. Different formulas are available on the internet to calculate it.

    Let's keep it simple. When HbA1C and triglycerides are elevated, they indicate a high average blood glucose level and thus, a high insulin level, meaning inflammation. LDL-C will be the small dense kind, likely to be associated with cardiovascular syndrome. When HbA1C and triglycerides are low, insulin is also low and inflammation down. LDL-C is most certainly big, fluffy and not dangerous.

    Since triglycerides and HbA1C respond positively to the same dietary changes of LCHF, I feel this is sufficient for most people. The other tests are excellent ones, but in a sense, to me, they are a bit of an overkill.

  49. Simmone
    I agree with Gray when he or she says that most comments on these so called health blogs are 'bogus.' Mass hysteria or wanting to please the hypnotist.

    I find the 'just do it' principle on here rather fascinating when this attitude is still being peddled as the way to lose weight on all the diets most of you seem to despise.

    If this way of eating works for you then all for the good, but don't try and tell everyone just to get on with it, because this way of eating is not possible for all.

    To Dr Andreas, I say shame on you. You are the hypnotist and are selling a diet just as those who came before you have done; Weight Watchers, Slimming World and Cambridge - to name a few.

    This way of eating would only be possible to achieve if you took away the food industry and all the garbage they sell.

    The hostility shown in the comments of your blog Dr Andreas reminds me of fanatical vegans defending a way of life that is unsustainable. You may have to re-think your strategy.

    Replies: #51, #52, #87
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