Ep. 210 - 2024 Fasting Focus! | Time Restricted Eating or Calorie Restriction for Diabetes, HbA1c, Weight Loss & Maintaining Healthy Blood Sugar | Milestone Episodes for Success | Download the Blueprint To Fasting For Fat Loss | Nutrisense CGM

Uncategorized Jan 02, 2024



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In today’s episode, Dr. Scott and Tommy discuss a study on time-restricted eating (TRE) for weight loss in type 2 diabetes. They highlight the study's emphasis on compliance and continuous glucose monitoring, showcasing the significant benefits observed in the TRE group, including notable weight and fat loss, and improved blood sugar control.


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Fasting For Life Ep. 210 Transcript

Hello. I'm Dr. Scott Watier.

And I'm Tommy Welling.

And you're
listening to the Fasting for Life podcast.

This podcast is about using fasting
as a tool to regain

your health, achieve ultimate wellness,
and live the life you truly deserve.

Each episode is a short conversation
on a single topic

with immediate, actionable steps.

We cover everything from fat loss

and health and wellness
to the science of lifestyle design.

We started fasting for life because of how
fasting has transformed our lives

and we hope to share the tools
that we have learned along the way.

Hey run!

Welcome to the Fasting for Life podcast.
My name is Dr.

Scott Water and I am here as always,
and with good friend and colleague Tommy.

Well, and good afternoon to you, sir.

Hey, Scott.

How are you doing? Fantastic, my friend.

Happy New Year to you, sir.

I cannot believe that it is officially

MAN 2023 went by fast.

An incredible year.

Just incredibly grateful for each
and every one of you that's listening in.

If you're new to the podcast,
thank you for giving us a chance.

If you want to learn more about our story
and how fasting transformed our lives

and how and why we come each
and every week with an episode

life application Fasting Application
Research, Head back to episode one.

Give it a listen.

If you're looking for a refresh
and you're a long term listener,

you can always head back to the milestone
episodes right?

So Episode 50 Episode 100 Episode 150.

Last year at this time,
we had a couple of cool episodes

as well about perspective and goal setting
and things like that.

So every year we want to bring you an
intention to end the year with momentum.

So we've done some recent episodes
on the holidays and holiday weekend.

If you missed them and you were just,
you know,

blinders were on, you're like,
I'm just going to get through the season.

Hopefully you had some good moments
and enjoyed time with friends and family

and loved ones,
but it's time to get back on track.

You know, the reality is that happens.

So we want to give you the tools
and equip you to be able to do so.

So head back, listen to those episodes.

But today, Tommy, and for this month,
going through the month of January,

we really want to focus on
some of the foundational science

and some of the foundations
of a fasting lifestyle.

So we're going to be talking about

a study today, which is the effect of time
restricted eating, a.k.a.

fasting on weight
loss in adults with type two diabetes.

Now, some of you don't have type
two diabetes, right?

Well, I get it.

So if it works in type two diabetics,
then it can work to prevent

type two diabetes as well.

And there's lots of cool
things that have happened here

inside of the study, lots of big picture,
big population type applications as well.

So we want to make sure that you

you know, we're talking

about the foundations of fasting
and why we do it ultimately.

You know, for me it was reversing
the undiagnosed pre-diabetes of 30

plus million Americans
diagnosed with diabetes.

But then there's another 80 to 110

estimated a million Americans
that have pre-diabetes that's undiagnosed.

They don't know it.

So we want to empower you to be able to
take something away from today's episode,

start the year off on the right foot
and really gain traction

as we ramp up into 2024
through the month of January time.

So super pumped to be going over
and diving into some of the science

and starting off the season.

And this year with a focus on
something we talk often about,

which is fasting and blood sugar.

and because if we can see what happens

further down the disease process,
then it can give us really,

really good perspective, actionable steps
that we can take now to, like you

said, prevent ever being there or getting
further along in that disease process.

Because really a lot of these things
that we we discuss are giving us insights

from, you know, being further down there
where we don't want to go.

So what we can do is we can actually apply
the results from these studies.

And it's really cool to get a grasp
on what our insulin levels are,

what our blood sugar is actually doing,
and then look at the weight loss

and the fat loss as well and see
how to kind of manage and optimize it.

And every time we we see results
that are potentially applicable

from a study like this and it's cool
because even though you may have

heard similar results in the past,
it can give you just one more thing

to remember a something
to keep this in your fasting lifestyle

like front of mind for the next fasting
or eating decision that you might make,

or the next time
you're taking a look at your bloodwork

or strategizing for some other health
related goal.

So I absolutely love this conversation.

And the reality is the statistics
don't lie, right?

So it's actually in 2019,
it's 37 million Americans, right?

I think I said 30 plus,
but be a little bit more accurate there.

And of those 37 with diabetes, 8
million of those were undiagnosed.

But then when you add in in 2019

So I gave you ranges,

but I want to be a little bit
more specific

because I did have the numbers up
in front of me

that have 18 years of age
and older, had pre-diabetes.

And we're starting to see diabetes in
youth numbers rise exponentially as well.

So as we are spreading
the truth in the word about blood

sugar is not something you have to
you only should worry about

when you are a diabetic
or a diagnosed pre-diabetic.

As you and I were experiencing symptoms
and precursors

and warning signs like check engine light
saying, Hey, you're on the path to this.

Right? Right.

So the fatigue and the cravings
and the insulin resistance and the weight

loss resistance and the eat
less move more calorie tracking macros.

And, you know, I had the trifecta of sleep
and stress added into that as well,

proliferating the cortisol
and insulin response.

Ultimately, I was working harder
and getting less results,

which gets incredibly frustrating.

We're in talk about the compliance

of the study too,
which is one of the cool takeaways.

But the reality is,
is like you're putting this up

or for this time of year, it's, you know,
people have a hyper focus, right?

Maybe not this week because
the holiday hangover is still real.

Not saying the actual physical
hangover of alcohol, but holiday hangover.

Right. It maybe partially,
maybe both. Maybe one or the other.

But the you know, when the holidays
it's a busier time of year.


So for us this year, we're really trying
on focusing on trying to slow down.


And this time of year can also be
you know, you can not be with loved ones.

There can be loss and grief

and stress and additional opportunities
for food in this time of year.

We you know,
we talked about a couple episodes ago

about 50 to 90% of the weight
that people gain during the holidays.

They don't lose the next upcoming


So big picture here, We want to prevent
we want to heal.

We want to reverse.

We want to empower.

We want to get the weight off quickly
so we then can learn how to maintain

those weight loss changes.

There's nothing worse

for me than six months of strictness,
and I get so close to my goal.

And then the life of then or the holiday

or the vacation or the honeymoon
or the cruise or the life stressed

event changing, job moving,
you know, loss, whatever it is.

And then all of a sudden you're like, Man,

I got to work even harder now
to get back there.

We want to

get you off of that dieting mentality
and dieting rollercoaster and transition

you into

an intuitive eating and fasting machine
that knows that you'll never end up

as one of those statistics
that we just shared.

And this study is really cool and app
in applying to some of the bigger groups

in the bigger picture of some of the stuff
that we truly believe

in, some of the reasons why we think
fasting is a superpower, right?

It is a way to accelerate the results
and to regain control

and simplify the process for so many.

Yeah, absolutely.

The subjects actually in
this study were 75 participants with type

two diabetes, with elevated A1, C
average, A1, C was 8.1.

And these participants had stable
weight over the last three months.

But one of the. I love that.

Yeah, yeah, right. Like that.

But it's not that they weren't trying

Also they were trying to lose the weight.

They had been trying, but you know,
it was either going up or staying the same

just a little bit going up or a little bit
going down or mostly staying the same.

So relatively stable
within the last three months, which is,

you know, we're most of us
looking for fasting, have some level of

like weight loss frustration or some sort
of like stagnation in the results.

And so that's that's not surprising and
that makes it very applicable for sure.

And when we also look at this group,
there were some various medications

involved. Like we said there,
there are type two diabetics.

So different medications involved,
which they accounted for,

they adjusted, they had to adjust
some dosages, things like that.

But the cool thing is
this wasn't just a like whitewashed

clean sample
set of like no outside variables

and, you know, just the perfect sample set
that I wouldn't be able to

potentially identify myself with because,
well, they were already at healthy weight

or just a little bit overweight or,
you know, didn't have blood sugar

related issues at all or or whatever,
anything like that.

So, you know, regardless
of where you're coming to fasting from,

you can find some element
of like outside variables

that was also represented
in this study here, which I really like.

the screening criteria was really cool

for this randomized controlled study,
as you were just mentioning.

And the medication,
what was the terminology that they use?

Because when they

they went through and accounted
for that stuff,

this is something that I hadn't seen
in a study up until this point

and it was in effect score.

Yeah, that was interesting
to kind of go down the rabbit hole

and kind of learn a little bit about that
because they do talk about

the medication equation
and how they handled that.

And it was really all about
getting a baseline of stability

before we went into this trial
and when we're looking at the trial,

there were three different groups.

So there was the time restricted
eating group, which is the group

that was told to eat between 12 and 8 p.m.


So your standard,
if you're new to fasting,

your standard Google intermittent fasting,
it's like skip breakfast.

If that breakfast right start at 12,
go to eight, right?


Here's the thing that I like
without calorie counting,

there's a lot of studies that we've looked
at where they all have a very strict

A to be like okay this group
well they want to standardize

and they want it to be equivalent. Right?

So it was cool to see that this speaks
to real life applications of bifurcation

here for me
anyway, is without calorie counting.

So we're talking about simplifying

and they talk about the results here
and we'll get to that in a second.

And then the Calorie restriction group
was a 25% energy restriction daily.

And then the control group,
I was told, don't do anything different.

Just keep doing what you do. Yeah.

Including your choices on your plate,

but also your activity level as well,
which they they did track over time.

So, you know, the control group
basically had, you know,

just a flat neutral caloric
intake for maintenance.

So another cool thing here
was that the actual intermittent fasting

group, the time restricted eating group
on their own,

almost accidentally subconsciously
reduced calories

a little bit
more than the planned 25% group,

which is cool
because they did that without even

worrying about it, tracking it
on their on their phones or in some app.

And so they weren't shooting for that

because they weren't
told that they had to do that.

But on average they ended up doing that.

And we actually went into the research
on that

a little bit in some previous podcast
episodes too, which is it's really cool

because there's multiple studies
to back that up that that just happens,

which is,
which is a nice added benefit of doing it.

It's a little bit more intuitive.
It's simpler.

I don't have to track as much

and the overall caloric deficit
tends to follow in an even better way

than what I'm deliberately
trying to manage that calorie deficit.

Right? Yeah, it was.

I love to see that deficit accounted
for the weight loss.


So, yes, some of the commentary
that they have in the bulk

of the actual research article
where some of the points that you and I

talk often about and when we're looking
at the primary versus secondary metrics,

you know, the body weight was the primary
finding that they were looking at

and they found that the t r e group,
the weight decreased significantly.


But not in the calorie restriction group
relative to the controls.

And that was something that they mentioned
in other similar studies

that they referenced that typically
you'll see that

a similar weight reduction at the four
and six month

mark in a calorie restriction group
that would be more closely

related to the decrease that they saw
on the TR group in this study.

And it had to ultimately,

one of the biggest things
that I really enjoyed about this

study was that they talked
about the compliance component, right?

So there was almost
a 20 point difference in compliance

and they met with dietitians
weekly or biweekly.

So there wasn't like a
just report back to us in six months.


And they wore a CGM for ten day periods

at the different checkpoints that they had
installed during and during the study.

And so the simplicity, the
I don't have to track, I get a little bit

more freedom, which takes the pressure off
and the adherence, the compliance to it.

Because I know like this time of year,

it's like,
All right, I'll get back on my diet

plan, I'll get back on my fasting plan,
I'll go do another 72 hour fast.

All right.

The holidays are over and now it's time
for me to kick back in, right?

Man, I love that this study showed that
it was the actual opposite.

Yeah, because they were finding that
these participants in the time restricted

eating group were actually
they were compliant a little more than six

out of seven days
each week for a six month period. 86%.

Yeah, 86%.

And then whereas on the counting calories
caloric restriction group,

they were only 68% compliance

So I mean it's like, okay,
so between the built in calorie

deficit there that we got with the time
restricted eating group more intuitively

and the far greater adherence
and compliance over the long term

because almost everybody said
that they were still able to maintain

their level of compliance in the TRT group
at six months, which is it

which is an incredible vote for
for long term sustainability of what

they were doing to continue
with that momentum over long term.

Because, you know, these

these folks definitely had more to lose
still at that point.

They were not at their
at their maintenance goals for sure.

And when we look at the percentage
or the weight loss itself,

it was at that five and six month
mark is where the greatest gaps came in.


So the control group
kind of just did their thing.

I've been furloughed, the calorie
restriction group, it was a steady decline

more sharply in the first two months
and kind of leveled out months three,

four or five and six.

But in the TRT group,
it was kind of a decline,

a steady decline, kind of mimic
the serogroup for the first couple of

months leveled out in that third month,
but then had a second wave of decline

that got up next to that 5% range,
which was really cool to see

because again,
we want to talk about beginning

with the end in mind
or that sustainability piece.

because when we're when we're looking

at a lot of these studies that we see,
look at these kind of trends over

six weeks, eight weeks, maybe 12 weeks,
but the rubber really doesn't

start to meet the road, if you will,
until we really start pushing out,

you know, for for long term durations,
because most people

who need to do something
to reverse something or prevent it,

they're going to need to take a little bit
of a longer perspective than that.

So I love any study that's going out
past the three month mark.

So here we are going into the six month
time frame and then seeing a continued

trend right there,
which I think is really good because like

especially after you drop some weight,
you're a smaller version of yourself too.

So now I'm having to adjust
some habits over time

because my plate size needs to be adjusted

My caloric need is a little bit
less than it used to be.

For those pounds that I've lost,
I'm not supporting as much,

you know, extra fat tissue on my body.

So these are important considerations
that do take time to kind of adjust to.

Whereas if, you know, if things happen
too quickly and then I kind of just

like pull the rug out from under me
as far as the methods that I'm using,

then it can be easy to revert back
or see the scale come back.

And I feel like I took a few steps
forward, but then I took multiple steps

backward as well.

Couple of the other secondary statistics
which I found interesting

too, was not just
the primary of the scale,

but that the fat mass decreased in the TRT
group by month six,

but not in the C group
relative to the controls.

So both TRT and SCR
led to reductions in waist circumference,

which is great because we know
that's an indicator of diabetes

and insulin resistance
and metabolic syndrome.

Lean mass and visceral fat didn't really
change that much relative to the controls.

And we'll talk about the food component
here in just a second.

So I'm actually not surprised by that.

When we looked the fact that they were
they were recommended to follow the ADA

guidelines on the food macro composition,
fat, protein and carbohydrates,

but the BMI decreased in the TRT
group as well, but not in the C.R.


So more wins like more rounds
given if you're a boxing fan.


So the TRT group won more rounds
in the many more rounds.

Most of the rounds, all except one
in the secondary statistical analysis

component of the study,
which I thought was really cool. Yeah.

You know,
one thing that that I found interesting

was that they measured something called u
glycemic range.

So actually looking at the time
within a quote unquote normal

glycemic range,
but some studies will use different,

different actual reference ranges
for that.

For this one, it was between 70 and 180
milligrams per deciliter weight stop.

Slow down. Say that again.


So for this study, they were
they were using a U.

Glycemic range
to define the normal range as between

That's a pretty wide range.

Hundred and 80 is normal for diabetics.

But can we please just talk about the fact
that that is not normal physiologically?

Yeah. Yeah.

I don't want to be seeing 180
and to take a look, I would have loved

if this study had tightened up

that range to detect a difference there
within what they considered normal.

That was before the 180.

Like maybe if they had,
if they had looked at a range up to 130.

Yeah. 30. Yeah.

That would have been nice
because we could have zoomed in on some

even a little bit more differentiation
to see if we saw a difference

between these groups right here.
That would have been really cool. Yeah.

And that kind of leads me
to this, the blood sugar

component where we were talking about
the changes in A-1 C and whatnot

is because when we looked at their food
recommendations, you know, 41

to 42% of the dietary

for these folks who have diabetes.

Yeah, we're carbohydrates.

They're calories were
their meals were 40 to 42% carbohydrates.

Did I not say that right? Yes, exactly.

I just wanted to stress
I just want to say it again.


So and 15 of that percent were sugar
and then 40% fat

and only 18% protein,

like, whoa, let's flip that.

Flip it on its head. Right.

So I'm not surprised
that there were some changes,

you know,
not some changes in terms of the agency

between the groups time
restricting, obviously, in this study

and others that they mentioned,
significant weight loss, 68, 68.

Right. Just 68.
You heard of the control group.

But that whole carbohydrate component
and the and we're not anti cart by the way

if you're no no I love a good
now if you're reversing diabetes.

Yes let's cut them out let's prime
it let's get the weight off.


Let's and then we can slowly reintroduce

when your body is more able
to process them more normally.


And maybe for some of your low carb
lifestyle is the way to go.


But that 180 number,
I want to talk about that for a second.

So that's like having the answers
to the SATs.

Like you've got the bubbled in Scantron
because if you're using medications

and you're following the ADA recommended
guide of 42% carbohydrates,

are you really reversing
or preventing disease?

No, you're managing it.

You're managing the numbers.

Right. Well, we're not just a number.

Diabetes starts.

There's new research out
that shows that insulin resistance

will start in the skeletal muscle decades
before it shows up

in the labs, in the liver

and then years before it shows up
in an abnormal, faster blood sugar.

Yeah, right.

So this 180 number,
Yes, that's normal for diabetics.

But if we want to get you to tick down
the scale, take down the BMI chart,

tick down the A1 c know categories,
right from diabetic to pre-diabetic,

get your you glycemic range
the range of the time of normal

or the area under the curve

right for your blood
sugar down reverse the insulin resistance

then I would absolutely love
to see some longer fasting windows

and some different macros
in ADA food recommendations right.

Yeah it's crazy.

Yeah, it is.

You know, the crazy thing was also
that when you look at the table

of some of these numbers,

like when they were,

you know, like you mentioned,
they were wearing a CGM, a continuous

glucose monitor they had these little is
windows is like ten day windows when they

when they were doing that.

So they saw a reduction in the mean
glucose level.

So between the in theory group
and in the caloric restriction group

actually was a little bit better
on some of those readings.

For the caloric restriction group,
I'd like to see

even a little bit more granular data
right on what's the why.

Yeah, yeah. In
how the trends went with that too.

But the thing about that is with the
control group, it was a big increase.

We're talking about -11 to -17
on the experimental groups

and a plus 31 on the control group.

So the control groups,
blood sugar control was not under control.

It weren't nonexistent roles. Yeah.


And so and this was again,

they were basically a maintenance calories
and they weren't really gaining weight.

But at the same time here with without
being cognizant of it and without,

you know, using compartmentalization
of their meal timing or their calories,

their blood sugar control was
getting worse, which is also what we see.

That's where the trends come from
for the pre diabetes and the

being overweight and the obesity trends
that we see all across the world.

They start there.

They they start with a little less blood
sugar control,

which leads to a little bit
higher fasting insulin levels.

That leads to a little bit more stress
on the liver and the rest of the system.

That then starts showing up,
you know, tick by tick on the scale

and then the blood work
and things like that.

That takes years.

But we can glean so much to do
to kind of like accelerate

what we can do to reverse or prevent
like from a study like this.

Again, that's that's just why

we started off the conversation
with those connection points.


So big picture,
what does it look like, right,

when you're looking
at a fasting lifestyle?

there's lots of good and some limitations.

So the study that we just mentioned,

I love that there was a system ization
of obtaining a baseline for folks

leading into this and the fact
that it spans so many different,

you know, little caveats or nuances
to what it what it looks like

for sustainable weight loss
and not just diabetes maintenance,

but for us, what we want is diabetes


So it was interesting when, you know,
some of the limitations to the study,

you know, they did the medication equation
in primary

and secondary outcomes, but they did
rely on self-reported dietary intake.


And here's some some reality
is that since individuals with obesity

tend to under-report energy consumption
by 15 to 20%, it's likely

that the estimates of energy
intake are inaccurate.

So these results are obtained with,

in our recommendation,
poor dietary guidelines.


Using normal ranges
that we would like to see acknowledged.

Tightness tightened up
and the possibility that there was a

and your basic eight hour
you know intermittent fasting 16

eight window right which you can do
a lot more with 24 or 30 or 36 hour fast.

We don't need to go really much longer
than that.

Right. It's a blueprint to fasting.

Yeah, for sure.

I knew, right? Yep.

right. So that's an overall step.

Yeah. 20 page PDFs
got everything in there.

It's got fasting schedules
to push that window and the possibility

that there was a 15 to 20%
underreporting in both groups.


Because they're talking about everybody
in this in this study fell into type

two diabetes and or no
and in the obese BMI category, right?

Yeah. So what did that BMI change?

You mentioned the fat mass change as well,

but the fat mass change in the time
restricted eating group

was actually 30% greater
than in the caloric restriction group,

which means that the additional weight
loss and we talked about how the weight

loss was was higher
in the time restricted eating group,

but was accounted for with greater caloric
restriction that they ended up doing

in a more simple, intuitive way.

But more of their weight loss was fat,
which is absolutely what we want.

Better body composition at the end of it,

even higher metabolic state,
even if the weight loss was the same.

Like they have incredibly
promising results here in a high risk

population that we can apply
to everyday life for anybody.

Absolutely love it.

So great. Incredible study.

Love the big picture application.

What I love to see some of those.

He were able to achieve these results

More fat mass, more weight loss, better
adherence simplicity didn't have to track.

Possibly had an underreporting

with poor dietary recommendations
and crazy normal ranges.


And the results
are still incredible. Right?

So you may be listening
going, well, don't have diabetes.

Well, we don't ever want you to get

because I was an undiagnosed pre-diabetic
with the fasting insulin number

that made me want to go
even just thinking about it.

I had the signs and symptoms I had it.

If you're looking to know the signs

and symptoms of insulin resistance,
we have a PDF, an insulin assessment

on our website,
the fasting, the fasting for life dot com.

You can go there, click resources,
boom, it's there, you can download it.

It's a subjective. It's
just some questions.

It gives you a score, gives you an idea
to start thinking about, well, am I?

And on the back of that has a waist
to height circumference ratio as well,

which is an indicator of insulin
resistance and metabolic syndrome.


So if we want to talk about health

care as being preventative
rather than reactionary,

then we want you all to start this year
by taking an action.

So head to the Shownotes,

click the link,
get the blueprint to fasting for fat loss.

Right? It's 20 pages, it's free.
We'll send it to you and your email.

It has different fasting schedules.

Some of the what in the why

behind fasting,
some of the different variations

of fasting,
some you all just need a refresher.

So we all need to really dive in
and commit some of your brand new

right now, some of you OGs

that are listening to this,
this should be a reaffirmation.

A 2024 should be a continuation of your
fasting journey up until this point.

Tommy I love the fact that fasting
can apply to any walk of life,

any way you decide to eat,
to live, to function.

Fasting is versatile.

You can be a carnivore
or you can just live on air, right?

Can be a vegan,
you can be a pescatarian, you can

it doesn't matter
anything in between, right?

Which I think is, yeah, you could be a
no maybe a no label.

Yeah, just be a lifestyle label.

Right. Fine.

And just don't be a standard
American diet, okay?

Most of the time, at least.

So yeah, what I love about it
is that fasting can be so powerful

for so many of those groups.

And I just love that
this study has so many connection points.

So grab the insulin assessment,
grab the fasting for life blueprint.

It's January 2024.

This year can be absolutely incredible.

Join the Facebook community, go to
the show notes, just click all the links.

Literally just join us.

Didn't get involved yet with us.

Get in the Tree of Trust.

We break the two rules of fasting

We talk about fasting all the time.

Sometimes I joke three and a half million
downloads later, 200

plus episodes later, three plus
almost four plus years in fasting later.

And we still have incredible
conversations, incredible testimonials.

And we want this year to be your year
for you to be that person

that's going to break through,

that's going to get the result,
that's going to reverse the condition,

going to finally make it a lifestyle.

Get off of that dieting crazy roller
coaster once and yeah, wow.

So love it as we launch into 2024.

Happy New Year to you, sir.

Beard's looking good as always, you guys.


We're gonna start doing some video, too,
so you can actually see us

has been requested and we're just,

you know, we're just old dogs
that don't like new tricks.

But we are going to be joining the video
train here coming up real soon as well.

So happy New Year to everybody.

Come join us next week, click
the show notes, go take an action

and get that momentum going for 2024.

Tommy, as always, appreciate
the conversation. Sir Darcy, you like

so you've heard today's episode and
you may be wondering, where do I start?

Head on over to the FaceTime for Life dot
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