New research says "blue zones" can be explained by flawed data

https://www.independent.co.uk/life-style/blue-zones-netflix-ignobel-prize-b2622952.html

by cpncrunch • 2 years ago

245 178 2 years ago

independent.co.uk

closetkantian• 2 years ago

So what are the real Blue Zones if there are any? Where do people actually live the longest in other words?

fnands• 2 years ago

The real Blue Zones are the friends we made along the way.

The problem will always be that you need to find places that keep good records, and have done so for the last century.

What they set out to do was to find correlations between lifestyle and longevity, and what they ended up finding was a great tool for spotting pension fraud.

hieKVj2ECC• 2 years ago

so no correlations between lifestyle and longevity? doubt

giantg218• 2 years ago

The levels of fraud aren't that rampant. Focusing on life expectancy in those regions still seems to have some valid correlation. It was a mistake from the beginning to try to focus on outliers (people living over 100).

mcphage2• 2 years ago

what they ended up finding was a great tool for spotting pension fraud

I mean, that’s not nothing, y’know?

93po• 2 years ago

i mean there are studies that show good socialization leads to longer life expectancy so you're not wrong

dsq2• 2 years ago

I wonder if there was anything historically equivalent to the Antediluvian lifespans described in the Old Testament. If, for example, there was something in the food a few thousand years ago in the area of the Persian/Arabian Gulf, now underwater, that could extend lifespan.

tsimionescu2• 2 years ago

You're wondering if there was any ancient food that allowed people to live to 800 or 900 years old. There wasn't.

quesera• 2 years ago

Possibly a parallel in New Orleans? Anne Rice documents unusual individuals that can live well into the hundreds of years.

nradov7• 2 years ago

In some ancient cultures around that region, stating that someone was hundreds of years old was a sign of respect for their wisdom, authority, and line. The numbers weren't meant to be taken literally.

Terr_• 2 years ago

It's likely the most significant zones simply aren't geographical.

The numbers probably look better in the Affluent Alliance versus the Protectorate of Poverty, for starters.

meindnoch2• 2 years ago

Reminds me of the South Park episode where they discover Magic Johnson's secret for curing his HIV.

gregwebs4• 2 years ago

There’s extensive literature on the lack of modern disease in hunter gatherers. Frontier doctors could get a case report published when they found cancer.

Some lived long but on average their lives were short because they didn’t have antibiotics or emergency medicine and lived in harsh environments that few of us would be able to survive today.

Their wisdom appropriately coupled to a modern less harsh environment might lead to greater longevity. But the harshness is what ensures exercise, movement, unprocessed food, etc.

meindnoch2• 2 years ago

Their "wisdom" of avoiding cancer amounts to dying young. Cancer rates shoot up well beyond 50 years.

tempaway456456• 2 years ago

There’s extensive literature on the lack of modern disease in hunter gatherers.

Well yeah because their life expectancy is about 45 years

giantg218• 2 years ago

You can look to the Amish for some answers. They aren't hunter gatherers but they do live a more primitive lifestyle. Some studies seem to show they have lower rates of cancers. It's not really a secret that if you are active, eat fairly healthy, aeent obese, and don't drink or smoke that you will be significantly healthier than the baseline rates in the US.

LorenPechtel2• 2 years ago

And note that it's not "get cancer" but "find cancer".

In a harsh environment how many die of a tumor that saps their energy before causing any specific effect that causes them to seek out a doctor and presents with something the doctor can find without the million-dollar machinery?

Let's grab our Mr. Fusion and head back a quarter century. My father came to visit. He had definitely declined since the last time we saw him but had no known major health issues. There wasn't anything in particular, yet what my wife saw was enough that she said we wouldn't see him again. Half a year later the big machines found the cancer. Would he have made it that half year in a harsh environment? No.

bluepizza• 2 years ago

Highly developed countries with access to affordable or free healthcare seem to be real blue zones. Especially in highly urban areas. Hong Kong, Singapore, and the big cities of some countries (Tokyo, Sydney) have very high life expectancy numbers.

Seems like getting treatment when you're sick, and having regular check ups to induce lifestyle changes are what makes a place a blue zone.

giantg218• 2 years ago

"having regular check ups to induce lifestyle changes"

More likely that those areas have society level positive lifestyles by default, especially relating to foods (eg Okinawa eating until 80% full, Italy and the mederteranian diet, Loma Linda plant heavy diet, etc).

Plenty of people get at least an annual covered checkup, but that doesn't mean they will make lifestyle changes. Even the ones that try end up like a new years resolution - not being strict about it or giving up after a month or two.

Edit: why disagree?

nradov7• 2 years ago

I think you're confusing correlation with causation. There is no reliable evidence that having regular check ups improves longevity, or even benefits healthy patients at all. And advice given by doctors about lifestyle changes is notoriously ineffective: long-term patient compliance close to zero.

Eumenes• 2 years ago

A marketing term to push TV shows, books, Business Insider articles, clicks/engagement, etc.

fire_lake• 2 years ago

Longevity is a poor metric anyway - we need to emphasize quality * years

melling• 2 years ago

Yes, someone always says this. Health span is the term. Maybe we can all use the term and skip this discussion

https://www.merriam-webster.com/wordplay/what-is-health-span

ImaCake• 2 years ago

Quality of Life Years, QALYs, is a commonly used term in epidemiology/biostatistics.

Mistletoe• 2 years ago

Blue Zones were supposed to be examples of that too.

tsimionescu2• 2 years ago

The two are greatly correlated, so at a population level it's a distinction without a difference. There's no population of people all living to be 100 but spending their 90s on a respirator.

The distinction matters for individual health decisions, and for comparing different interventions, where you can extend someone's life at the cost of their quality of life.

resoluteteeth2• 2 years ago

In theory that is a reasonable distinction (and that type of trade-off can come up in very specific situations like treatment of terminal disease in elderly people) but in terms of lifestyle choices there is currently no known difference between lifestyle choices that increase expected longevity and lifestyle choices that increase expected quality years.

brushfoot6• 2 years ago

This doesn't really address Loma Linda, California, the Adventist blue zone.

The researcher's criticism of Loma Linda isn't that people don't live longer there; it's that Adventist Health purchased Dan Buettner's marketing company Blue Zones LLC in 2020.

Adventists are teetotalers, so he questions why they'd want to be associated with the Blue Zones guideline of drinking "every day at twice the NHS heavy drinking guidelines."

Which is a fair question -- but it doesn't have anything to do with whether Loma Linda is an area with greater longevity.

neaden• 2 years ago

This seems pretty explainable by Seventh Day Adventists' behavioral factors leading to increased life, a group with very little smoking and drinking living longer isn't surprising.

vitorfblima2• 2 years ago

From the paper: For example, the Centres for Disease Control generated an independent estimate of average longevity across the USA: they found that Loma Linda, a Blue Zone supposedly characterised by a ‘remarkable’ average lifespan 10 years above the national average, instead has an unremarkable average lifespan29 (27th-75th percentile; Fig S6).

brushfoot6• 2 years ago

This misses the forest for the trees.

The CDC looked at average life expectancy in Loma Linda across all demographics. Purely geographical and on average.

The blue zones focused on the greater longevity specifically of Adventists in Loma Linda.

It wasn't a question of whether living inside the municipal boundaries of Loma Linda automatically conferred some special health benefits -- clearly it doesn't.

It was, "Why is there an unusually high concentration of outliers living here, and what behaviors cause them to live longer than average?"

happymellon2• 2 years ago

It does if you read it.

Loma Linda residents don't have a notable longer life span than the other residents of California.

brushfoot6• 2 years ago

The idea wasn't that averaging out the lifespan of all Loma Linda residents, regardless of lifestyle, would yield a higher number than everywhere else. It was that there was an unusually high number of outliers living there, and the question was why.

The CDC's average was purely geographic and irrespective of lifestyle, which is different.

FollowingTheDao4• 2 years ago

The whole Blue Zone thing cracks me up. They think everyone will live longer on a plant based diet? Tell that to the Inuit and Sami who have genetically adapted after generations of eating very few, if any, plants.

If they Blue Zones do exists, they exist because people are eating their traditional genetic diet.

And if they eat plants, what plants? Should someone of Irish decent eat wheat even though they are more likely to have Celiac?

I have Sami heritage. I was also a Vegan at one time. A healthy Vegan. The plant based diet was literally killing me with hyperglycemia and immune issues. These people who think there is one true diet are dangerous adn do not know the first thing about nutritional genetics.

InMice2• 2 years ago

For all the nutrition wars raging these days about plant based vs animal etc I really agree with you. Modern transportation of the industrial age shuffled humans around the globe everywhere. Prior to this distinct groups were adapting in distinct biomes for thousands upon thousands of generations. Some were pure carnivore, some were high carb almost all plants, some in between.

FollowingTheDao4• 2 years ago

If you search for a nutritional genomics, I think you’ll be pleasantly surprised. There are plenty of researchers who are trying to do the hard work or telling people how important genetics is to our personalized health. The University of North Carolina at Kannapolis has a very good program.

coffeefirst• 2 years ago

Right, the hype is nuts. My read is regardless of the flaws in demographic data, one observation does seem told hold up: if you go somewhere that's been slower to adapt modernity, and introduce western levels of inactivity and hyperprocessed food, you get all the same maladies.

Which I think is a good sign? It suggests you don't need island magic, you don't need to settle these purist debates or figure out The Answer™. The only thing that matters is addressing the two really bad things that are obviously pathogenic.

And then we can argue about moderate drinking until the end of time.

dennis_jeeves2• 2 years ago

These people who think there is one true diet are dangerous

In my observation (after examining anecdotes, and accounting for flawed anecdotes) everyone without exception does well on an animal based diet. It's when it comes to plants there are enormous variations.

dghughes• 2 years ago

My guess is blue zones are countries that have good social programs and medical systems. Also helpful are regions where the environment isn't going to kill you.

nradov7• 2 years ago

Also helpful are regions where the people aren't going to kill you. Either directly, or by selling you fentanyl.

cs702• 2 years ago

Paper:

https://www.biorxiv.org/content/10.1101/704080v1

Abstract:

The observation of individuals attaining remarkable ages, and their concentration into geographic sub-regions or ‘blue zones’, has generated considerable scientific interest. Proposed drivers of remarkable longevity include high vegetable intake, strong social connections, and genetic markers. Here, we reveal new predictors of remarkable longevity and ‘supercentenarian’ status. In the United States, supercentenarian status is predicted by the absence of vital registration. The state-specific introduction of birth certificates is associated with a 69-82% fall in the number of supercentenarian records. In Italy, which has more uniform vital registration, remarkable longevity is instead predicted by low per capita incomes and a short life expectancy. Finally, the designated ‘blue zones’ of Sardinia, Okinawa, and Ikaria corresponded to regions with low incomes, low literacy, high crime rate and short life expectancy relative to their national average. As such, relative poverty and short lifespan constitute unexpected predictors of centenarian and supercentenarian status, and support a primary role of fraud and error in generating remarkable human age records.

Nice work. It just won a 2024 Ig Nobel Prize. Well-deserved, I'd say:

https://improbable.com/ig/winners/#ig2024

comboy2• 2 years ago

So there's this short little book "Food rules" by Michael Pollan. Not much content but seems like the author went through a lot of research. He comes to conclusion based on this tons of data that all we really know for sure is that people living in these blue regions are living much longer and it seems to be related to what they eat. That it is basically the only solid and stable data point we have. Welp. (I'm overstating it a bit, but not by that much)

mannykannot3• 2 years ago

The one thing that this paper does is demolish the claim that people living in these blue regions are living much longer than average.

twobitshifter4• 2 years ago

Ozempic is showing that life expectancy is mostly avoiding obesity, heart disease, and diabetes, but not a specific magic food. It is just calories, vitamins and minerals.

mfer4• 2 years ago

A while back I dug into the research of this author and I was not impressed. Some examples of things that caught me poor and leading...

* The Blue Zones claim that most places that list many centurions are false due to bad record keeping. Only a few places have good enough records that are trustworthy. In this authors research he called out places that were not blue zones as examples of bad data against Blue Zones.

* In Okinawa the Blue Zones claim that only the oldest generation fits the Blue Zone model. That more recent generations eat poorly and have bad health. That this Blue Zone is going away. This researcher has focused on the more recent food and health of younger generations to discount it being a Blue Zone for that oldest generation.

* In the US he fails to find fault in record keeping (last I dug into it) with the only location that is considered a Blue Zone. Instead he focuses on generalities.

There are more examples like this.

This all seems disingenuous. It's not to agree with Blue Zones but rather to look at his arguments against those put forward for Blue Zones.

I keep thinking of the phrase "Lies, Damn Lines, and Statistics"

minifridge• 2 years ago

It is definitely a bit fishy.

I am sure there are other places with bad record keeping which were not included in the study to deflate the pvalues of book keeping.

gpderetta2• 2 years ago

Yes, I did a bit of investigation and I commented on it the few times this article made the rounds on HN: https://news.ycombinator.com/item?id=20633769

I don't think it is just bad statistics, it is very poor data extractions.

Just an example:

"Like the ‘blue zone’ islands of Sardinia and Ikaria, Okinawa also represents the shortest-lived and second-poorest region of a rich high-welfare state"

Sardinia[1], at 83.8, had in 2018 one of the EU highest life expectancies, certainly higher than the rest of Italy (83.4). Like the rest of Italy it was badly hit by COVID in 2020. Life expectancy at 55 is 30.6 vs 30.1 for the rest of Italy. I don't know how to match it with their Figure 2 that shows the all Sardinian provinces being extreme outliers in negative other than they completely misinterpreted the data. Also the same graph shows 7 blue dots for Sardinian provinces, historically Sardinia had only 4 provinces and has had 8 only for a short period in the mid 2000s.

[edit: The newer version of the paper[2] is different and doesn't have figure 2]

[1] https://ec.europa.eu/eurostat/databrowser/view/demo_r_mlifex... (Sardegna In the table).

[2] https://www.biorxiv.org/content/10.1101/704080v3

srid• 2 years ago

Title says "New research" but this paper was posted 5 years ago, on July 16, 2019.

Here's a tweet from the same year referencing it: https://x.com/Mangan150/status/1159074479194066944

CareerAdvice01• 2 years ago

I come from one of these blue zones on the southern coast of Europe. That low income low literacy people live longer, provided they have good genetics seems plausible to me. These people tend to lead a semi-agrarian life and remain active well into their 80s. Their more educated higher income counterparts will probably have spent their life being sedentary and their retirement in a coffee shop indulging themselves. If food plays a role, it's only insofar as them being less indulgent. Otherwise I believe the obsession on diet is only because it is one factor that is relatively easy for people to change. Genetics plays a huge role, because if your body betrays you early on, you won't be able to remain active and focused on life in your later years. Climate probably also plays a role because again, you need good climate to remain active all year round. So does family. Seeing your family everyday keeps you planted in life. Healthcare might also play a role. Our healthcare is much more caring than the one in the northern European states.

They should make a study focusing on northern European retirees who decide to live here on the coast. We have quite a few of those and I wonder whether they tend to live longer compared to their counterparts back home.

The allegation that its simply fraud is ridiculous. If someone in the village dies, the whole village would know before sunset, and pretty much nobody dies at home anyway. And what about inheritance? Or paying rent? No, that's completely ridiculous. Not to mention that pretty much everyone is highly religious around those parts and not giving your relatives a proper Catholic burial is one of the worst things you could do. Not even a staunch atheist would stoop that low.

fn-mote• 2 years ago

The allegation that [it is] fraud is ridiculous.

No? Even the writeup gives specific examples. Number of pension payouts to Greek 100+ year olds was cut by 72% after an audit.

Even if they had a proper Catholic burial. Never underestimate the power of greed. In a predominantly low-income area great-grandpa's pension might be what is keeping you from losing your home.

lolinder7• 2 years ago

That low income low literacy people live longer, provided they have good genetics seems plausible to me.

That it seems plausible is why the story has circulated for so long, but that doesn't make it true. We do research precisely to check what seems plausible against actual data.

Since you're using a throwaway anyway, can you share which part of the Southern coast of Europe you live in? Maybe together we can find data that would help.

seydor4• 2 years ago

Unfortunately the fraud is real. The fact that blue zones are islands makes it easier to hide the fact from authorities (if it is widespread practice that many people exploit)

red-iron-pine2• 2 years ago

how would islands help? it means they're isolated and static compared to areas with lots of people flowing in and out.

s_dev• 2 years ago

Climate probably also plays a role because again, you need good climate to remain active all year round.

You can be active in any climate. Spain is too hot during the summer so the Spanish aren't active during those hours. If it's too cold you can use a gym or even exercise at home.

and pretty much nobody dies at home anyway.

That's just not true. A lot of people die in their sleep in their beds.

The allegation that its simply fraud is ridiculous.

It's not ridiculous.

Your whole post is just littered with statements that just aren't true.

kelipso2• 2 years ago

You can have a proper burial and just not submit the death certificate to the government.

LorenPechtel2• 2 years ago

The one part of the blue zone theory that does make sense--a lifestyle that involves a lot of physical activity. Which goes along with what we know elsewhere.

Spooky232• 2 years ago

The people in the village know, but the culture is such that they aren’t going to rat out the family for the fraud. The priest has nothing to do with the state bureaucracy.

That happens all over the place. People get busted for collecting grandmas social security checks all of the time in the US. When I was in college in the mid-90s, I rented an apartment from a dude who died in the early 80s.

worstspotgain• 2 years ago

Just chiming in to add one factor that you overlooked: selective caloric restriction.

We know caloric restriction can extend lifespan. It's usually tested as a discrete variable, but its statistical effect in the wild is continuous. It can be unintentional, coincidental, income-related, historical event-related, culturally related, and related to the local economy. Multiple categories can apply at the same time, complicating the analysis.

Add fasting to the mix, and the analysis is even harder. Here's a difficult to refute conjecture: areas that underwent episodes of accidental fasting during world wars may have spikes of ultra-centenarians. The keyword is may, because you have to subtract out the negative correlations that come with the event. For instance, during a famine you may end up eating lifespan-reducing foods.

eadmund3• 2 years ago

drinking 1-2 glasses of wine per day
the astounding thing is that one of the guidelines is that you should drink every day at twice the NHS heavy drinking guidelines. That is a recipe for alcoholism.

Say what? The article implies that 1 glass of wine every day or two (i.e., half of 1–2 per day) is heavy. That seems frankly insane to me.

mike_hearn• 2 years ago

The UK government's guidelines on how much it is safe to drink are based on numbers "plucked out of the air" by a committee that met in 1987. According to The Times newspaper, the limits are not based on any science whatsoever, rather "a feeling that you had to say something" about what would be a safe drinking level. This is all according to Richard Smith, a member of the Royal College of Physicians working party who produced the guidelines. [1]

One might think that having admitted this Smith would be circumspect, apologetic and more careful with his claims about health in future. Of course he did the exact opposite:

However, Mr Smith says this doesn't mean alcohol is not dangerous. He later told The Guardian that this would be a "serious misinterpretation" of his comments. He also argued that the figures were "in the right ball park", and called for heavier taxes to cut consumption

The numbers were based on no evidence but also amazingly in the right ballpark. No contradiction there if you work in public health. Sure enough, ten years later the guidance had become even more extreme [2], with men and women now becoming biologically identical and the government telling citizens that even one drop of alcohol was dangerous:

The report recommend an upper limit of 14 units per week for both adult men and women, and then included the much-derided “no safe limits” observation.

This highly ideological guidance might have been because:

Members of the expert group include prohibitionists and anti-alcohol campaigners

[1] https://www.theregister.com/2007/10/22/drinking_made_it_all_...

[2] https://www.theregister.com/2016/01/22/stats_gurus_open_fire...

Schiendelman4• 2 years ago

Are you saying that defining half of 7-14 (or 3.5.7) drinks per week as heavy seems insane to you?

Current science proposes that even 2 drinks a week significantly increases cancer rate, and is the current suggested limit for health - I suspect it would be lower but for reactions like you're having. It seems likely that double or triple that is indeed unsafe.

Media is very careful not to shame their readers: https://www.cbsnews.com/news/alcohol-cancer-risk-what-to-kno...

alxfoster• 2 years ago

According to the CDC, NIH and other respected credible, mostly objective federal health research groups have all suggested up to 2 drinks per day for men and 1 drink for women is not only safe but also beneficial, citing that moderate drinking "reduced risk of heart attack, atherosclerosis, and certain types of strokes". Obviously this would not be the case for people prone to alcoholism or some other complications or contraindications. Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761695/

https://www.cdc.gov/alcohol/about-alcohol-use/moderate-alcoh...

eadmund3• 2 years ago

Are you saying that defining half of 7-14 (or 3.5.7) drinks per week as heavy seems insane to you?

Yes. I assert that drinking 3½–7 drinks a week sounds moderate. One or two drinks a week is light. Heavy drinking would be something like 24 or more.

I define the heaviness of drinking by intoxication, not cancer risk.

tokai• 2 years ago

Drinking any amount of alcohol everyday is heavy. And frankly alcoholic.

mavhc2• 2 years ago

Alcohol is just as bad for you as smoking according to the data, the only safe amount is 0. Why it's not packaged with giant warning labels is another question entirely

Aerroon• 2 years ago

What always seemed questionable to me about Blue Zones is how they account for unnatural causes of death. A decade ago centenarians would've had to live through two world wars and the devastation and famine they caused. How do you compare a population that went through that to a population that didn't?

seydor4• 2 years ago

Why hasn't the Ignoble Paper been published somewhere? Note that it was first drafted in 2019

stonethrowaway• 2 years ago

Technically speaking (the best kind of speaking) you didn’t need new research to conclude this. All you had to do was ask “is this a pop science book?” and “will I hear about it at my next family gathering from the one person who thinks of themselves as qualified on subject matter but is in fact the furthest from the truth?”

If you answer yes to both, you may safely discard the material as simply a means for the author to advance their career.

Other greatest hits from this genre: Grit, Deep Work, Why We Sleep, Thinking Fast and Slow, How Not to Die.

mywacaday2• 2 years ago

Interview with the author from an Irish national radio station here: https://www.goloudplayer.com/episodes/what-are-blue-zones-an...

Starts at 1:10, also the radio slot is a light hearted one, not serious scientific discussion.

Rocka242• 2 years ago

Absolutely incredible.

I've seen a number of byproducts of the "Blue Zone trend" namely in youtube videos and dinner party conversations from so called health experts. The creator of Blue Zones (Dan Buettner) does seem to profit off of this as well, one quick look at the website shows a Blue Zone cooking course sale and other marketing schemes that could trap the unwary. https://www.bluezones.com/about/history/

I'm not questioning whether or not the intent was malicious but he does stand to gain quite a lot. Happy to see this being exposed. In a semi related sense I highly recommend checking out Bryan Johnson's (founder of Braintree Venmo) Blueprint protocol, I've been following his work for a number of years now and it is scientifically backed although the for profit arm of his initiative just reared its (ugly?) head recently with him selling supplements and dietary goods that are vetted by his agency.

https://protocol.bryanjohnson.com/

jf222• 2 years ago

What's the difference between Johnson and the other 40,000 wellness hackers who make the same claims?

BobbyJo2• 2 years ago

The extreme to which he is taking things and the level of rigor he is (seemingly) applying, are the differences I see. He has a lot more time and resources at his disposal than most wellness hackers.

Rocka242• 2 years ago

The difference that I'm seeing personally and the initial appeal was that he was more open about the science and the results of it. If you go through the site you can see pretty good documentation about different supplements and what their intended purpose was. However, I do think some of the luster of the open-source model he had kind of disappeared when he started selling products which is a double edged sword in the sense that it does somewhat certify the quality of the product but also chips at his ethos.

poulsbohemian• 2 years ago

I live in a community that was part of the Blue Zones project, that has cultural ties to one of the original Blue Zones geographies. While I think there is something to the general idea - eat well, limit stress, have a sense of community, keep moving physically - it was always clear that there was a lot of pseudoscience going on. The videos put out by the project in particular (I think maybe it was a Netflix program for a while?) had a lot of unsubstantiated but authoritative sounding statements. Regardless, I felt like the overall message was positive and got people thinking about how they were living. That said, there was a merchandise angle on it, and thinking back there are ideas we've talked about as a community that Blue Zones could have stewarded - but they would have been outside their established game plan.

Flatcircle• 2 years ago

Been saying this for years. It's so obvious.

throwawaymaths• 2 years ago

Anecdata, but the plural of anecdote is data:

If you go to Hawaii where there are japanese-style graves with YOB and YOD inscribed, the centenarians all seem to have Okinawan names (and there are quite a few).

lucidguppy• 2 years ago

Yay that there's research into adding nuance to results.

Science should sharpen science.

Deep down we know how we should eat and live. Society and the economy, though has different plans.

New research says "blue zones" can be explained by flawed data

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