Cola / Sugary Drinks
Frequent Consumption of Sugar- and Artificially Sweetened Beverages and Natural and Bottled Fruit Juices Is Associated with an Increased Risk of Metabolic Syndrome in a Mediterranean Population at High Cardiovascular Disease Risk
1–3 C´ıntia Ferreira-Peˆgo,4,5 Nancy Babio,4,5 Maira Bes-Rastrollo,5,7,18 Dolores Corella,5,8 Ramon Estruch,5,6,9 Emilio Ros,5,10 Montserrat Fito,´ 5,11 Llu´ıs Serra-Majem,5,6,12 Fernando Aros, ´ 5,6,13 Miguel Fiol,5,14 Jose Manuel Santos-Lozano, ´ 5,15 Carlos Mun˜ oz-Bravo,16 Xavier Pinto,´ 9,17 Miguel Ruiz-Canela,5,7,18 and Jordi Salas-Salvado´ 4–6* on behalf of the PREDIMED Investigators
Background: The relation between the consumption of sweetened beverages and metabolic syndrome (MetS) is controversial. Objective: This analysis evaluated the associations between intakes of sugar-sweetened beverages (SSBs), artificially sweetened beverages, and natural and bottled fruit juices and the incidence of MetS in elderly individuals at high risk of cardiovascular disease (CVD) and without MetS at baseline.
Methods: We prospectively examined 1868 participants free of MetS at baseline from the PREDIMED (PREvencion con ´ DIeta MEDiterranea) study. MetS was defined by using the updated harmonized criteria of the International Diabetes ´ Federation, the American Heart Association, and National Heart, Lung, and Blood Institute. Energy and nutrient intakes were evaluated at baseline and then yearly by using a validated 137-item food-frequency questionnaire. Multivariableadjusted HRs for MetS and its components were estimated from mean intakes during follow-up. We compared the 2 highest consumption categories (1–5 and >5 servings/wk) with the lowest category (<1 serving/wk).
Results: A total of 930 incident cases of MetS were documented during a median follow-up of 3.24 y. When we compared consumption of >5 servings/wk with consumption of <1 serving/wk, multivariable HRs (95% CIs) for MetS incidence were 1.43 (1.00, 2.15), 1.74 (1.26, 2.41), 1.30 (1.00, 1.69), and 1.14 (1.04, 1.65) for SSBs, artificially sweetened beverages, natural fruit juices, and bottled fruit juices, respectively.
Conclusions: The occasional consumption of SSBs and artificially sweetened beverages (1–5 servings/wk) was not associated with the incidence of MetS in middle-aged and elderly individuals at high risk of CVD. The consumption of >5 servings/wk of all of the types of beverages analyzed was associated with an increased risk of MetS and some of its components. However, for SSBs and bottled fruit juices these associations must be interpreted with caution because of the low frequency of consumption in this population.
Source ; The Journal of Nutrition
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Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction
Objectives To examine the prospective associations between consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice with type 2 diabetes before and after adjustment for adiposity, and to estimate the population attributable fraction for type 2 diabetes from consumption of sugar sweetened beverages in the United States and United Kingdom.
Design Systematic review and meta-analysis.
Data sources and eligibility PubMed, Embase, Ovid, and Web of Knowledge for prospective studies of adults without diabetes, published until February 2014. The population attributable fraction was estimated in national surveys in the USA, 2009-10 (n=4729 representing 189.1 million adults without diabetes) and the UK, 2008-12 (n=1932 representing 44.7 million).
Synthesis methods Random effects meta-analysis and survey analysis for population attributable fraction associated with consumption of sugar sweetened beverages.
Results Prespecified information was extracted from 17 cohorts (38 253 cases/10 126 754 person years). Higher consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, by 18% per one serving/day (95% confidence interval 9% to 28%, I2 for heterogeneity=89%) and 13% (6% to 21%, I2=79%) before and after adjustment for adiposity; for artificially sweetened beverages, 25% (18% to 33%, I2=70%) and 8% (2% to 15%, I2=64%); and for fruit juice, 5% (−1% to 11%, I2=58%) and 7% (1% to 14%, I2=51%). Potential sources of heterogeneity or bias were not evident for sugar sweetened beverages. For artificially sweetened beverages, publication bias and residual confounding were indicated. For fruit juice the finding was non-significant in studies ascertaining type 2 diabetes objectively (P for heterogeneity=0.008). Under specified assumptions for population attributable fraction, of 20.9 million events of type 2 diabetes predicted to occur over 10 years in the USA (absolute event rate 11.0%), 1.8 million would be attributable to consumption of sugar sweetened beverages (population attributable fraction 8.7%, 95% confidence interval 3.9% to 12.9%); and of 2.6 million events in the UK (absolute event rate 5.8%), 79 000 would be attributable to consumption of sugar sweetened beverages (population attributable fraction 3.6%, 1.7% to 5.6%).
Conclusions Habitual consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity. Although artificially sweetened beverages and fruit juice also showd positive associations with incidence of type 2 diabetes, the findings were likely to involve bias. None the less, both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar sweetened beverages for the prevention of type 2 diabetes. Under assumption of causality, consumption of sugar sweetened beverages over years may be related to a substantial number of cases of new onset diabetes.
Source : BMJ
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New study links an additive to some soft drinks, laxatives and oil dispersants to obesity
By Brian Bienkowski - Environmental Health News
A chemical used in sodas and some laxatives for years assumed safe by federal health officials might make people more prone to obesity.
The chemical is used as a laxative and in sodas to help ingredients mix properly. It's also a major ingredient in Corexit, the dispersant applied by the millions of gallons in the Gulf of Mexico during the 2010 Deepwater Horizon disaster.
But the chemical, dicotyl sodium sulfoscuccinate, or DOSS, is a likely member of a family of chemicals contributing to obesity, researchers say in a study published today in the Environmental Health Perspectives journal.
That the chemical has been on the market for decades but is only now seen as possibly problematic offers further indictment of an inadequate federal chemical testing regime, critics say. And the new study bolsters evidence that chemicals in the environment play a role in growing obesity rates.
"These chemicals ... change the way you respond to calories," said Bruce Blumberg, a professor and researcher at the University of California who was not involved in the study.
DOSS has been around since the 1950s, used as a direct additive—put in food on purpose —or as an indirect additive in the packaging or processing of food, said Maricel Maffini, an independent consultant and scientist that studies chemical exposure.
A food ingredient database maintained by the Environmental Working Group, a non-profit health and environmental organization, lists DOSS as an ingredient in eight Flavor Air soft drink mixes, a Hawaiian Punch drink mix and Coca Cola’s Fanta.
But it could be in much more, said Maffini, formerly of the Natural Resources Defense Council. Small quantities can fall beneath reporting requirements, she said.
For example, the FDA lists DOSS as used in some breakfast cocoas.
DOSS was declared “generally recognized as safe” in a 1998 petition to the U.S. Food and Drug Administration. The agency had “no questions” for Cytec Industries regarding their conclusion of DOSS’s safety in 1998 for use in carbonated drinks.
Maffini said the “generally recognized as safe” distinction was intended for substances used for decades such as vinegars, oils and salts. “The loophole has been expanded greatly,” she said.
DOSS is also used as a laxative under multiple brand names including Colace and Docusate.
Marianna Naum, a spokesperson for the FDA, said the agency would review the new study but would not comment on the findings and what it means for the future of DOSS until an internal review is complete.
Medical University of South Carolina graduate student and co lead author of the study, Alexis Temkin, said it’s unclear what levels of DOSS are in sodas or breakfast cocoa, but for laxatives a high dose for women would be about 500 milligrams. She and colleagues used doses about 2 to 10 times higher than that. However DOSS “could act completely different in a whole body compared to in a controlled setting in a lab,” she said.
Factors such as diet and lifestyle choices are undeniable but researchers continue to find surprising interactions between obesity and additives ubiquitous in food and consumer products. A study released earlier this year, for instance, linked bisphenol-A (BPA), an additive in plastics, canned food linings and thermal paper receipts, to obesity.
In the current study the researchers stumbled upon their findings almost by accident.
They were looking for non-lethal effects and any endocrine disruption impacts from exposure to the mixture crude oil plus Corexit, Temkin said. “We weren’t really familiar with DOSS before the study … it was sort of a needle in the haystack expedition.”
Oil dispersant concerns
DOSS is an effective oil dispersant because it separates oil and water, making it easier to pick up the oil. It is a major ingredient in Corexit dispersants, which were used in the Gulf of Mexico after the massive BP oil spill in 2010.
An estimated 1.8 million gallons of Corexit were sprayed to break down the oil.
It’s not the first link to health concerns for the dispersants. In April, University of Alabama at Birmingham researchers reported that one Corexit product used, Corexit EC9500A, can damage the cells in people’s lungs or aquatic creatures’ gills.
There was "little potential for worker or public exposure to dispersants due to the extensive controls put in place, including extensive monitoring, by the federal government and BP," said BP spokesman Jason Ryan in an email.
Ryan also pointed out that long-term exposure to DOSS is much more likely to come from consumer products, such as flavored drinks and laxatives.
The U.S. EPA, and the Gulf Coast Ecosystem Restoration Council, comprised of multiple federal and local government agencies that have been working toward Gulf cleanup, all declined to comment on the new study.
Chemicals and obesity
Temkin and colleagues exposed mouse and human cells to different oil dispersant mixtures. DOSS increased genes associated with fat cells and activated receptors that spur the process of non-mature fat cells turning into mature fat cells.
“That a chemical causes more fat cells is concerning,” Blumberg said.
Temkin said it’s too early for the study to inform any kind of policy change for DOSS use, but that an important next step is to find a good way to measure how much of it people are actually exposed to.
“This is a strong study," said Michael Skinner, a professor and researcher at Washington State University who was not involved in the study. That strength comes in part because few studies have drilled down to see what the health effects could be from DOSS, he added.
Most concerning is exposure to such compounds as a fetus or at an early age, Skinner said. It’s not that such compounds simply make you fat, but they may increase your chances, and we can’t ignore that, he said.
“Any disease has two elements—first element is susceptibility to develop disease. That doesn’t mean you’ll get the disease, such as obesity,” Skinner said. “Now the second component is the actual trigger—what promotes the onset of obesity, such as diet and exercise.
“Lifestyle choices later in life are critical elements to promote obesity, but initial susceptibility had nothing to do with that.”
Source : Environmental Health News
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Caramel Color in Soft Drinks and Exposure to 4-Methylimidazole: A Quantitative Risk Assessment
- Tyler J. S. Smith,
- Julia A. Wolfson,
- Ding Jiao,
- Michael J. Crupain,
- Urvashi Rangan,
- Amir Sapkota,
- Sara N. Bleich,
- Keeve E. Nachman
Caramel color is added to many widely-consumed beverages as a colorant. Consumers of these beverages can be exposed to 4-methylimidazole (4-MEI), a potential carcinogen formed during its manufacture. California’s Proposition 65 law requires that beverages containing 4-MEI concentrations corresponding to exposures that pose excess cancer risks > 1 case per 100,000 exposed persons (29 μg 4-MEI/day) carry warning labels. Using ultrahigh-performance liquid chromatography-tandem mass spectrometry, we assessed 4-MEI concentrations in 12 beverages purchased in California and a geographically distant metropolitan area (New York) in which warning labels are not required. In addition, we characterized beverage consumption by age and race/ethnicity (using weighted means calculated from logistic regressions) and assessed 4-MEI exposure and resulting cancer risks and US population cancer burdens attributable to beverage consumption. Data on beverage consumption were obtained from the National Health and Nutrition Examination Survey, dose-response data for 4-MEI were obtained from the California Environmental Protection Agency Office of Environmental Health Hazards Assessment, and data on population characteristics were obtained from the U.S. Census Bureau. Of the 12 beverages, Malta Goya had the highest 4-MEI concentration (915.8 to 963.3μg/L), lifetime average daily dose (LADD - 8.04x10-3 mg/kgBW-day), lifetime excess cancer risk (1.93x10-4) and burden (5,011 cancer cases in the U.S. population over 70 years); Coca-Cola had the lowest value of each (4-MEI: 9.5 to 11.7μg/L; LADD: 1.01x10-4 mg/kgBW-day; risk: 1.92x10-6; and burden: 76 cases). 4-MEI concentrations varied considerably by soda and state/area of purchase, but were generally consistent across lots of the same beverage purchased in the same state/area. Routine consumption of certain beverages can result in 4-MEI exposures > 29 μg/day. State regulatory standards appear to have been effective in reducing exposure to carcinogens in some beverages. Federal regulation of 4-MEI in caramel color may be appropriate.
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Sugar-sweetened beverage consumption and age at menarche in a prospective study of US girls
- J.L Carwile1,
- W.C Willett1,2,3,
- D. Spiegelman1,3,4,
- E. Hertzmark3,4,
- J. Rich-Edwards1,3,5,
- A.L Frazier3,6 and
- K.B Michels1,3,7,*
STUDY QUESTION Is sugar-sweetened beverage (SSB) consumption associated with age at menarche?
SUMMARY ANSWER More frequent SSB consumption was associated with earlier menarche in a population of US girls.
WHAT IS KNOWN ALREADY SSB consumption is associated with metabolic changes that could potentially impact menarcheal timing, but direct associations with age at menarche have yet to be investigated.
STUDY DESIGN, SIZE, DURATION The Growing up Today Study, a prospective cohort study of 16 875 children of Nurses' Health Study II participants residing in all 50 US states. This analysis followed 5583 girls, aged 9–14 years and premenarcheal at baseline, between 1996 and 2001. During 10 555 person-years of follow-up, 94% (n = 5227) of girls reported their age at menarche, and 3% (n = 159) remained premenarcheal in 2001; 4% (n = 197) of eligible girls were censored, primarily for missing age at menarche.
PARTICIPANTS/MATERIALS, SETTING, METHODS Cumulative updated SSB consumption (composed of non-carbonated fruit drinks, sugar-sweetened soda and iced tea) was calculated using annual Youth/Adolescent Food Frequency Questionnaires from 1996 to 1998. Age at menarche was self-reported annually. The association between SSB consumption and age at menarche was assessed using Cox proportional hazards regression.
MAIN RESULTS AND THE ROLE OF CHANCE More frequent SSB consumption predicted earlier menarche. At any given age between 9 and 18.5 years, premenarcheal girls who reported consuming >1.5 servings of SSBs per day were, on average, 24% more likely [95% confidence interval (CI): 13, 36%; P-trend: <0.001] to attain menarche in the next month relative to girls consuming ≤2 servings of SSBs weekly, adjusting for potential confounders including height, but not BMI (considered an intermediate). Correspondingly, girls consuming >1.5 SSBs daily had an estimated 2.7-month earlier menarche (95% CI: −4.1, −1.3 months) relative to those consuming ≤2 SSBs weekly. The frequency of non-carbonated fruit drink (P-trend: 0.03) and sugar-sweetened soda (P-trend: 0.001), but not iced tea (P-trend: 0.49), consumption also predicted earlier menarche. The effect of SSB consumption on age at menarche was observed in every tertile of baseline BMI. Diet soda and fruit juice consumption were not associated with age at menarche.
LIMITATIONS, REASONS FOR CAUTION Although we adjusted for a variety of suspected confounders, residual confounding is possible. We did not measure SSB consumption during early childhood, which may be an important window of exposure.
WIDER IMPLICATIONS OF THE FINDINGS More frequent SSB consumption may predict earlier menarche through mechanisms other than increased BMI. Our findings provide further support for public health efforts to reduce SSB consumption.
Source : Journal Human Reproduction
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Cardio- and cerebrovascular responses to the energy drink Red Bull in young adults: a randomized cross-over study
Erik K. Grasser1 , Gayathri Yepuri1, Abdul G. Dulloo1 and Jean-Pierre Montani1
(1)Laboratory of Integrative Cardiovascular and Metabolic Physiology, Division of Physiology, Department of Medicine, University of Fribourg, Chemin du Musée 5, 1700 Fribourg, Switzerland
Energy drinks are beverages containing vasoactive metabolites, usually a combination of caffeine, taurine, glucuronolactone and sugars. There are concerns about the safety of energy drinks with some countries banning their sales. We determined the acute effects of a popular energy drink, Red Bull, on cardiovascular and hemodynamic variables, cerebrovascular parameters and microvascular endothelial function.
Twenty-five young non-obese and healthy subjects attended two experimental sessions on separate days according to a randomized crossover study design. During each session, primary measurements included beat-to-beat blood pressure measurements, impedance cardiography and transcranial Doppler measurements for at least 20 min baseline and for 2 h following the ingestion of either 355 mL of the energy drink or 355 mL of tap water; the endothelial function test was performed before and two hours after either drink.
Unlike the water control load, Red Bull consumption led to increases in both systolic and diastolic blood pressure (p < 0.005), associated with increased heart rate and cardiac output (p < 0.05), with no significant changes in total peripheral resistance and without diminished endothelial response to acetylcholine; consequently, double product (reflecting myocardial load) was increased (p < 0.005). Red Bull consumption also led to increases in cerebrovascular resistance and breathing frequency (p < 0.005), as well as to decreases in cerebral blood flow velocity (p < 0.005) and end-tidal carbon dioxide (p < 0.005).
Our results show an overall negative hemodynamic profile in response to ingestion of the energy drink Red Bull, in particular an elevated blood pressure and double product and a lower cerebral blood flow velocity.
Source : EU Journal of Nutrition
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Dietary intakes of carbohydrates in relation to prostate cancer risk: a prospective study in the Malmö Diet and Cancer cohort1,2,3
- Isabel Drake,
- Emily Sonestedt,
- Bo Gullberg,
- Göran Ahlgren,
- Anders Bjartell,
- Peter Wallström, and
- Elisabet Wirfält
Background: Dietary carbohydrates have been implicated in relation to prostate cancer.
Objective: Our objective was to examine the associations between dietary intakes of carbohydrates, fiber, and their food sources and risk of prostate cancer, overall and by case severity, in the Malmö Diet and Cancer cohort.
Design: The analysis included 8128 men aged 45–73 y without a history of cancer, cardiovascular disease, or diabetes and who were classified as adequate energy reporters. After a median follow-up time of 15 y, prostate cancer was diagnosed in 817 men. We used Cox proportional hazards regression to model associations between energy-adjusted nutrient and food intakes with risk of incident prostate cancer, with competing risk of death from non–prostate cancer causes taken into account.
Results: After adjustment for age and other known or potential risk factors, we observed no associations between total carbohydrates or dietary fiber and prostate cancer. We observed positive associations between the intake of low-fiber cereals with overall and low-risk prostate cancer and between intakes of cake and biscuits and rice and pasta with low-risk prostate cancer (all P-trend < 0.05). A high intake compared with zero consumption of sugar-sweetened beverages was associated with increased risk of symptomatic prostate cancer (HR: 1.38; 95% CI: 1.04, 1.84).
Conclusions: Results from this large study with high-validity dietary data suggest that a high intake of refined carbohydrates may be associated with increased risk of prostate cancer. However we observed no significant associations with high-risk prostate cancer, and not all foods that are typically high in refined carbohydrates were associated with prostate cancer.
Source : The American Journal of Clinical Nutrition
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Impact of Beverage Content on Health and the Kidneys
Johnson, Richard J. MD; Thomas, Jeffrey MD; Lanaspa, Miguel A. PhD
The last 50 years have witnessed an epidemic rise in obesity, diabetes, high blood pressure, and chronic kidney disease. Some animal research suggests the epidemic may in part be triggered by sugar. Sugar contains glucose and fructose, and studies suggest it is the fructose component that may have a role in chronic disease development. Animal studies indicate that fructose is distinct from other sugars by its ability to cause transient adenosine triphosphate (ATP) depletion in the cell with uric acid generation. The administration of fructose, or the raising of uric acid, can induce kidney disease and accelerate established kidney disease in animals. Therefore, we believe that the greatest risk from sugar is when it is given as a soft drink, as the rapidity of ingestion relates directly to the concentration of fructose that the cells are exposed to and hence govern the degree of ATP depletion and uric acid generation. Restricting sugar-sweetened beverages may be one strategy to combat obesity, diabetes, high blood pressure, and kidney disease, but human intervention studies are needed to support the theory.
Source : Journal Nutrition Today
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Soda and Cell Aging: Associations Between Sugar-Sweetened Beverage Consumption and Leukocyte Telomere Length in Healthy Adults From the National Health and Nutrition Examination Surveys
Cindy W. Leung, ScD, Barbara A. Laraia, PhD, Belinda L. Needham, PhD, David H. Rehkopf, ScD, Nancy E. Adler, PhD, Jue Lin, PhD, Elizabeth H. Blackburn, PhD, and Elissa S. Epel, PhD
Objectives. We tested whether leukocyte telomere length maintenance, which underlies healthy cellular aging, provides a link between sugar-sweetened beverage (SSB) consumption and the risk of cardiometabolic disease.
Methods. We examined cross-sectional associations between the consumption of SSBs, diet soda, and fruit juice and telomere length in a nationally representative sample of healthy adults. The study population included 5309 US adults, aged 20 to 65 years, with no history of diabetes or cardiovascular disease, from the 1999 to 2002 National Health and Nutrition Examination Surveys. Leukocyte telomere length was assayed from DNA specimens. Diet was assessed using 24-hour dietary recalls. Associations were examined using multivariate linear regression for the outcome of log-transformed telomere length.
Results. After adjustment for sociodemographic and health-related characteristics, sugar-sweetened soda consumption was associated with shorter telomeres (b = –0.010; 95% confidence interval [CI] = −0.020, −0.001; P = .04). Consumption of 100% fruit juice was marginally associated with longer telomeres (b = 0.016; 95% CI = −0.000, 0.033; P = .05). No significant associations were observed between consumption of diet sodas or noncarbonated SSBs and telomere length.
Conclusions. Regular consumption of sugar-sweetened sodas might influence metabolic disease development through accelerated cell aging.
Source : American Journal of Public Health
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Drinking sugar-sweetened beverages during adolescence impairs memory, animal study suggests
Research to be presented at the Annual Meeting of the Society for the Study of Ingestive Behavior (SSIB) finds that daily consumption of beverages sweetened with high-fructose corn syrup or sucrose can impair the ability to learn and remember information, particularly when consumption occurs during adolescence. Both adult and adolescent rats were given daily access to sugar-sweetened beverages that mirror sugar concentrations found in common soft drinks. Adult rats that consumed the sugar-sweetened beverages for one month performed normally in tests of cognitive function; however, when consumption occurred during adolescence the rats were impaired in tests of learning and memory capability.
The lead author, Dr. Scott Kanoski from the University of Southern California, says, "It's no secret that refined carbohydrates, particularly when consumed in soft drinks and other beverages, can lead to metabolic disturbances. However, our findings reveal that consuming sugar-sweetened drinks is also interfering with our brain's ability to function normally and remember critical information about our environment, at least when consumed in excess before adulthood."
In addition to causing memory impairment, adolescent sugar-sweetened beverage consumption also produced inflammation in the hippocampus, an area of the brain that controls many learning and memory functions.
"The hippocampus is such a critical brain region for memory function," says Kanoski. "In many ways this region is a canary in the coal mine, as it is particularly sensitive to insult by various environmental factors, including eating foods that are high in saturated fat and processed sugar."
Source : Science Daily
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Caramel color: The health risk that may be in your soda
It’s the most common coloring in foods and drinks—and it can contain a potential carcinogen. Here’s what Consumer Reports found when it tested soft drinks that have caramel color. Published: January 23, 2014 06:00 AM Caramel color, added to many soft drinks and some foods to turn them brown, may sound harmless, even appetizing. But in no way does it resemble real caramel. Some types of this artificial coloring contain a potentially carcinogenic chemical called 4-methylimidazole (4-MeI). Under California’s Proposition 65 law, any food or beverage sold in the state that exposes consumers to more than 29 micrograms of 4-MeI per day is supposed to carry a health-warning label. In recent Consumer Reports’ tests, each of the 12-ounce samples of Pepsi One and Malta Goya had more than 29 micrograms per can or bottle. While we cannot say that this violates California's Prop 65, we believe that these levels are too high, and we have asked the California Attorney General to investigate.
Caramel color is the single most used food coloring in the world, according to a 2013 report from market research firms Mintel and Leatherhead Food Research. “There’s no reason why consumers should be exposed to an avoidable and unnecessary risk that can stem from coloring food brown,” says Urvashi Rangan, Ph.D., toxicologist and executive director of Consumer Reports’ Food Safety & Sustainability Center. “Manufacturers have lower 4-MeI alternatives available to them. Ideally there would be no 4-MeI in food.”
The risks In 2007, a federal government study concluded that 4-MeI caused cancer in mice and the International Agency for Research on Cancer determined the chemical to be “possibly carcinogenic to humans” in 2011. There’s no federal limit for levels of 4-MeI in foods and beverages, but as of January 7, 2012 California requires manufacturers to label a product sold in the state with a cancer warning if it exposes consumers to more than 29 micrograms of 4-MeI per day. In this case, the exposure comes from consumption.
The California Office of Environmental Health Hazard Assessment used 29 micrograms as the cut off point because that’s the level they determined poses a one in 100,000 risk of cancer—that is, no more than one excess cancer case per 100,000 people who are exposed to that amount daily for a lifetime.
Consumer Reports’ experts think even that risk is too high. “It’s possible to get more than 29 micrograms of 4-MeI in one can of some of the drinks we tested. And even if your choice of soft drink contains half that amount, many people have more than one can per day,” says Rangan. “Given that coloring is deliberately added to foods, the amount of 4-MeI in them should pose a negligible risk, which is defined as no more than one excess cancer case in 1 million people.” To meet that risk level, Consumer Reports’ experts say a soft drink would need to contain about 3 micrograms or less per can.
How we tested
Consumer Reports* tested 81 cans and bottles of various popular brands of soft drinks from five manufacturers between April and September 2013. We purchased the products from stores in California and the New York metropolitan region. In December 2013, we bought and tested 29 new samples, again from the same areas, of those brands that had initially tested above 29 micrograms per can or bottle in either location.
What we found
While our study was not large enough to recommend one brand over another, both rounds of testing found that the level of 4-MeI in the samples of Pepsi One and Malta Goya purchased in both locations exceeded 29 micrograms per can or bottle. The products we purchased in California did not have a cancer-risk warning label.
In our initial testing, some of the other brands we bought in California had average levels around or below 29 micrograms per can, but the New York area samples of those same brands tested much higher. In our second test, though, the levels in the New York samples had come down. For example, regular Pepsi from the New York area averaged 174 micrograms in the first test and 32 micrograms in the second. “The fact that we found lower amounts of 4-MeI in our last round of tests suggests that some manufacturers may be taking steps to reduce levels, which would be a step in the right direction,” says Dr. Rangan
On average, three of the brands—Coke, Diet Coke, and Coke Zero—came in under 5 micrograms per can in our tests, a level Consumer Reports’ experts believe is more acceptable. Sprite, a clear soda that was tested as a control, showed no significant levels of 4-MeI.
What manufacturers say
Because California’s regulations took effect two years ago, we contacted PepsiCo and Goya in early January 2014 to ask whether their products sold in California were in compliance with the state’s law. A spokesperson for PepsiCo said in an e-mail, “When the regulatory requirements changed in California, PepsiCo moved immediately to meet the new requirements.” She also said reformulated products containing lower levels of 4-MeI would be available nationwide by February 2014. Goya did not provide a response to our questions.
After we informed PepsiCo of our test results, the company issued a statement that said that Proposition 65 is based on per day exposure and not exposure per can. It also cited government consumption data that shows that the average amount of diet soda consumed by people who drink it is 100 milliliters per day, or less than a third of a 12-ounce can. For that reason, they believe that Pepsi One does not require cancer-risk warning labels—even if the amount of 4-MeI in a single can exceeds 29 micrograms.
Consumer Reports says there is analysis of government data that shows higher levels of daily consumption of soft drinks generally. "No matter how much consumers drink they don't expect their beverages to have a potential carcinogen in them. And we don't think 4-MeI should be in foods at all. Our tests of Coke samples show that it is possible to get to much lower levels," says Rangan.
What Consumer Reports is doing
Based on our results, Consumers Union, the policy and action arm of Consumer Reports, is taking several actions. First, we are alerting the California Attorney General’s office of our test findings regarding Pepsi One and Malta Goya. We are also petitioning the Food and Drug Administration (FDA) to set a federal standard for 4-MeI and in the meantime to require manufacturers to list the type of caramel color they use on their products’ ingredient lists. That’s important because there are four types of caramel coloring. Only the two made with ammonia compounds can contain 4-MeI. However, manufacturers can use the general term “artificial color” interchangeably with “caramel color.” “Europe has labeling requirements and consumers in the United States should have the right to make an informed choice about what they are drinking and eating,” says Dr. Rangan.
In a statement from the agency, the FDA said it does not believe that 4-MeI from caramel color at levels currently in food pose a risk. However, they appreciated Consumer Reports’ tests and are currently doing their own tests of foods, including sodas, for 4-MeI. They are also reviewing new safety data on 4-MeI to determine what, if any, regulatory action needs to be taken.
What you can do
To express your concern about caramel color in food to the FDA, go to Consumers Union’s website NotInMyFood.org.
If you want to limit your exposure to 4-MeI, for now the only option is to consume few if any products that list "caramel color" or "artificial color" on their labels. “Clearly, it’s feasible for manufacturers to reduce levels of 4-MeI in their products right now,” says Dr. Rangan. “But until a federal standard is set or there is more transparency in labeling, you may want to read ingredient lists carefully.”
Source : Consumer Reports
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Soft Drinks and Sugar in the Diet May Have Negative Effects on the Kidneys
Two new studies highlight the potential negative effects that soft drinks and sugar can have on kidney health. Results of these studies will be presented at ASN Kidney Week 2013 November 5¬–10 at the Georgia World Congress Center in Atlanta, GA.
In one study, researchers led by Ryohei Yamamoto, MD, PhD (Osaka Univ Graduate School of Medicine, in Japan) found that consuming at least two soft drinks per day is linked with proteinuria—or increased excretion of protein in the urine, which is a hallmark of kidney dysfunction. Among 3579, 3055, and 1342 university employees with normal kidney function at the start of the study who reported that they drink zero, one, and two or more soft drinks per day, 301 (8.4%), 272 (8.9%) and 144 (10.7%) employees developed proteinuria during a median of 2.9 years of follow-up, respectively.
Another study led by Agustin Gonzalez-Vicente (Case Western Reserve University) and conducted in rats found that moderate fructose intake increases the kidney’s sensitivity to angiotensin II, a protein that regulates salt balance. This leads to increased salt reabsorption by cells in the kidneys, a finding that might help explain why consumption of high-fructose corn syrup as a sweetener may contribute to the epidemic of diabetes, obesity, kidney failure, and hypertension.
Studies: “Soft Drink Intake and Prediction of Proteinuria: A Retrospective Cohort Study.” (Abstract 2458)
Disclosures: Hiromi Rakugi has an ownership interest in and receives research funding from Astellas Pharma Inc., Daiichi Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Eisai Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Mitsubishi Tanabe Pharma Corporation, and Mochida Pharmaceutical Co., Ltd.; and receives research funding and honoraria from MSD K. K., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K.K., Ono Pharmaceutical Co., Ltd., Pfizer Japan Inc., Shionogi & Co., Ltd., and Takeda Pharmaceutical Co., Ltd., (All in Japan).
“Chronic Consumption of Fructose Increases Proximal Tubular Transport by Enhancing the Sensitivity to Angiotensin II.” (Abstract 3955)
Disclosures: Jeffery L. Garvin receives honoraria from APS and NIH.
Source : Newswise
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More Proof Soft Drinks Tied to Diabetes
By Cole Petrochko
One can -- or one more can -- of soda daily significantly increased the risk of diabetes in a European population, researchers found.
Consuming an additional 12 ounces of sugar-sweetened beverages -- a standard size can of soda -- daily was associated with a 22% (95% CI 1.09 to 1.38) increased risk for diabetes, and an extra can of artificially-sweetened beverage put the risk 52% higher (95% CI 1.26 to 1.83), according to Dora Romaguera-Bosch, PhD, MSc, of Imperial College London in England, and colleagues at the InterAct consortium.
However, only the association between sugar-sweetened beverages and diabetes risk remained significant after adjustment for body mass index and energy intake (HR 1.18, 95% CI 1.06 to 1.32), they wrote online in the journal Diabetologia.
Soda and other artificially- and sugar-sweetened beverages may contribute to diabetes due to their effect on body weight and blood glucose, the researchers wrote. A link between sugary drink consumption and diabetes has also been seen in prior research in American populations.
The authors studied associations between consumption of juices, nectars, sugar-sweetened soft drinks, and artificially-sweetened soft drinks with diabetes incidence in a case-cohort study of 15,374 participants from eight European countries, and including 11,684 incident cases of diabetes.
Cohorts from eight countries were involved in the EPIC (European Prospective Investigation into Cancer and Nutrition)-InterAct study. InterAct specifically looked at incidence of diabetes.
Participants answered dietary questionnaires that measured:
- Food intake over the year prior to the survey
- Individual energy intake
- Consumption of juices, nectars, and soft drinks
Covariates included smoking status, alcohol intake, education, physical activity, BMI, and, "in most participating centers," baseline chronic conditions, including hypertension, hyperlipidemia, and cardiovascular disease.
Raw scores were also calculated with adjustment for age, sex, BMI category, and physical activity levels.
Compared with those who consumed lower levels of sugary soft drinks, high-level consumers were more likely to be male, physically active, less educated, smokers, and have a higher waist circumference. Juice and nectar high consumers were mostly younger, female, physically active, former smokers, and better educated than those with lower juice and nectar consumption.
Although soft drink consumption was linked with diabetes incidence, there was no association between diabetes and consumption of juices and nectars. One or more glasses daily of soft drink was associated with a 58% increased risk of diabetes compared with those who consumed the lowest levels of soft drinks (P<0.0001).
When this comparison was adjusted for BMI, this trend remained significant, though the association was not as strong (P=0.0005).
Artificially-sweetened soft drink consumption was associated with diabetes risk prior to adjustment for BMI (P<0.0001), but this association lost significance after adjustment (P=0.24).
Consumption of sugar-sweetened soft drinks remained significantly associated with diabetes both before (P<0.0001) and after (P=0.013) adjustment for BMI.
"The observed association between sugar-sweetened soft drinks and diabetes in the present analysis is of similar magnitude as the association reported in a meta-analysis of eight prospective studies, which was based on 15,043 diabetes cases mostly from the U.S.A.," they concluded.
They also noted that future studies should examine whether BMI acts as a mediator or confounder with the association.
The authors said the study was limited by the clinical definition of type 2 diabetes, lack of follow-up dietary data, a definition of juices and nectars that included those with and without added sugar, and possible measurement errors. The study was also limited by center-specific factors, possible residual confounding, and possible reverse causality.
Source : Science Daily
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Energy Drinks May Put Heart at Risk
Energy drinks may raise blood pressure and interfere with the heart's electrical system, increasing the risk of sudden cardiac death, a meta-analysis found.
In a pooled analysis of 93 people who consumed energy drinks, the QT interval – a segment of the heart's rhythm on an ECG – was significantly prolonged by 10 ms, according to Sachin A. Shah, PharmD, from the University of the Pacific in Stockton, Calif., and colleagues.
In another pooled analysis of 132 people, researchers found a significant increase in systolic blood pressure by 3.5 mmHg that was associated with the consumption of energy drinks, Shah reported at the American Heart Association Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013 meeting in New Orleans.
Diastolic blood pressure and heart rate were not significantly increased but Shah and colleagues said that the QT prolongation and increase in systolic blood pressure were maintained in most subgroup sensitivity analyses.
"Doctors are generally concerned if patients experience an additional 30 ms in their QT interval from baseline," Shah said in a statement.
His co-author Ian Riddock, MD, from David Grant USAF Medical Center in Travis Air Force Base, Calif., added, "QT prolongation is associated with life-threatening arrhythmias. The finding that energy drinks could prolong the QT, in light of the reports of sudden cardiac death, warrants further investigation."
The seven pooled studies included healthy, young participants whose ages ranged from 18 to 45.
A previous review in the journal Pediatrics found that nearly half of the more than 5,000 caffeine overdoses reported in 2007 involved people under age 19. The review noted that up to half of the energy drinks on the market are consumed by adolescents and young adults.
The FDA has initiated several probes into energy drinks after reports of deaths were preliminarily linked to the drinks.
Drinks such as Monster, Red Bull, Rockstar, Full Throttle, and AMP have three times the amount of caffeine as colas. A 16-oz. can of Monster Energy, for example, contains 160 mg of caffeine, which is almost as much as five cans of soda.
Since 2005, the FDA has required drugs to be evaluated in a Thorough QT (TQT) study to determine their effect on the QT interval.
"The threshold level of regulatory concern is around 5 ms," according to the 20-page "Guidance for Industry" on how to conduct "Clinical Evaluation of QT/QTc Interval Prolongation," published by the FDA.
But the FDA can do nothing about the observed 10 ms increase in QT interval found by Shah and colleagues in this meta-analysis.
"Although the U.S. Food and Drug Administration limits caffeine content in soft drinks, which are categorized as food, there is no such regulation of energy drinks, which are classified as dietary supplements," the authors of the review in Pediatrics wrote.
Energy drinks capture 47% of the beverage market share internationally, Shah and colleagues noted. They said a general consensus on how to evaluate the health risks of energy drink consumption does not exist.
They therefore sought to determine the specific effect of energy drinks on "notable electrocardiographic and blood pressure parameters."
Researchers included data from seven previously published observational and interventional studies.
They said that further safety evaluation of energy drink consumption is warranted to guide public health policy.
Source : Medpage Yoday
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Soft drink intake in relation to incident ischemic heart disease, stroke, and stroke subtypes in Japanese men and women: the Japan Public Health Centre–based study cohort I
- Ehab S Eshak,
- Hiroyasu Iso,
- Yoshihiro Kokubo,
- Isao Saito,
- Kazumasa Yamagishi,
- Manami Inoue, and
- Shoichiro Tsugane
Background: Soft drink intake has been associated with obesity and diabetes, but its relation with risk of cardiovascular disease (CVD) is limited.
Objective: We examined the association between soft drink intake and risk of CVD in a Japanese population.
Design: This was a prospective study in 39,786 Japanese men and women aged 40–59 y in which soft drink intake was determined by using a self-administered food-frequency questionnaire. Follow-up was from 1990 to 2008. HRs and 95% CIs of incidence were calculated according to categories of soft drink intake.
Results: During 18 y of follow-up, we ascertained 453 incident cases of ischemic heart disease (IHD) and 1922 cases of stroke, including 859 hemorrhagic and 1047 ischemic strokes. Soft drink intake was positively associated with risk of total stroke and more specifically ischemic stroke for women; the multivariable HR (95% CI) in the highest soft drink intake (almost every day) category compared with the lowest intake (never or rarely) category was 1.21 (0.88, 1.68; P-trend = 0.02) for total stroke and 1.83 (1.22, 2.75; P-trend = 0.001) for ischemic stroke. That association did not change significantly after the exclusion of early incident cases within 3–9 y from baseline. A nonsignificant inverse trend for risks of total and ischemic strokes was shown for men, and it was weakened after the exclusion of early incident cases or after the exclusion of participants with baseline comorbidities. Soft drink intake was not associated with risk of IHD or hemorrhagic stroke for either sex.
Conclusion: Soft drink intake is associated with higher risk of ischemic stroke for women.
Source : The American Journal of Clinical Nutrition
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Coke reveals its secret: It may need to carry a cancer warning
Drinks firm forced to change recipe in California after ingredient classed as health hazard
Nightmares about the backlash they suffered the last time they dared to change the secret recipe for their drink still most likely haunt Coca-Cola executives.
But 27 years after the ill-fated launch of New Coke, the threat of having a cancer warning placed on their famous red bottles is forcing them to revise the closely guarded ingredients again.
With its arch rival Pepsi, Coca-Cola is altering its drink in the US after the state of California declared one of its flavourings a carcinogen – though it will continue to sell the old form of the drink in Britain and the rest of Europe, with no cautionary labelling.
The two drinks have been made to include less of the chemical 4-methylimidazole, a caramel flavouring known as 4-MEI, which the National Institute of Environmental Health Sciences in the US has linked it to cancer in mice and leukaemia in rats. It can be formed during the process of cooking certain ingredients and consequently may be found in minor amounts in many foods. Under Californian law, drinks containing a certain level of carcinogens must have a cancer-warning label on their packaging.
But the two companies – which, combined, make up 90 per cent of the soft-drink market in the US – insist the ingredient is not a health risk.
Coca-Cola said yesterday the cancer warning is: "scientifically unfounded", while also maintaining that the company has been able to make the changes through a "manufacturing process modification" rather than a full change of formula.
"The caramel colour in all of our products has been, is and always will be safe," a spokesperson said.
"The changes will not affect the colour or taste of Coca-Cola. Over the years, we have updated our manufacturing processes from time to time, but never altered our secret formula. Caramel is a perfectly safe ingredient and this has been recognised by all European food-safety authorities.
"The European Food Safety Authority (EFSA) reaffirmed the safety of caramel colouring as recently as March 2011 and stated that the presence of 4-MEI in caramel colouring is not a health concern. In fact, 4-MEI is found in many foods including baked goods, coffee, bread, molasses, soy sauce, gravies and some beers."
The American Beverage Association, the drinks industry's trade body in the US, also said that there is no evidence that the ingredient poses a risk to humans. And the US Food and Drug Administration said someone would have to drink 1,000 cans of Pepsi or Coke per day to ingest the same dosage of the chemical given to the laboratory mice.
The secret recipe: 'Merchandise 7X'
Is a great deal of self-propagated myth surrounding the Coca-Cola recipe and its "Merchandise 7X" combination of flavourings, which is apparently privy to just two executives who are not allowed to fly in the same plane in case the secret goes down with them. Last year an American radio presenter tracked down a 1979 article in an Atlanta newspaper which revealed nutmeg, neroli and even coriander were ingredients.
The original recipe from 1886 has been changed several times. Cocaine was replaced by caffeine in 1904. But the most controversial change was in 1985, when the company introduced New Coke with a sweeter taste. The product bombed, lasting just three months before the original was reinstated.
Source : Daily Telegraph
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Sugary Drinks Tied to More Heart Attacks
Men who frequently drink sodas and other sugar-sweetened beverages may be putting themselves at risk of a heart attack, an observational study showed.
In a study of male healthcare professionals, those who consumed the most sugary drinks -- a median of 6.5 per week -- were 20% more likely to have a myocardial infarction (MI) during follow-up than those who never drank them (RR 1.20, 95% CI 1.09 to 1.33), according to Frank Hu, MD, PhD, of the Harvard School of Public Health in Boston, and colleagues.
A similar relationship was not seen for consumption of artificially sweetened diet beverages, they reported online in Circulation: Journal of the American Heart Association.
"These results, as well as those from other observational studies and trials, support recommendations to reduce the consumption of sugar-sweetened beverages in order to prevent cardiovascular disease," the authors wrote.
Sugar-sweetened beverages have been associated with weight gain and type 2 diabetes, but few studies have examined the relationship between the sugary drinks and coronary heart disease.
Hu and colleagues looked at data from the Health Professionals Follow-Up study, a prospective cohort study of mostly white men who were ages 40 to 75 at baseline in 1986.
The current analysis included 42,883 participants after excluding those with type 2 diabetes, cardiovascular disease, or cancer at baseline.
The men reported their consumption of sugar-sweetened and artificially sweetened beverages at baseline and every four years using a food frequency questionnaire. At baseline, the average intake was 2.5 sugar-sweetened beverages and 3.4 artificially sweetened beverages each week.
Over 22 years of follow-up, there were 3,683 incident coronary heart disease cases, defined as fatal or nonfatal MIs.
The greater risk of having a heart attack in the quartile with the greatest consumption of sugar-sweetened beverages was significant after controlling for numerous potential confounders, including age, smoking, physical activity, alcohol, multivitamins, family history, diet quality, energy intake, body mass index, pre-enrollment weight change, and dieting.
Further adjustment for self-reported high cholesterol, triglycerides, and blood pressure, as well as diagnosed type 2 diabetes, only slightly weakened the association.
"This suggests that sugar-sweetened beverages may impact on coronary heart disease risk above and beyond traditional risk factors," the authors wrote.
When treated as a continuous variable, each additional serving per day of sugar-sweetened beverages was associated with a 19% greater relative risk of coronary heart disease (P<0.01). That is consistent with a previous analysis of women participating in the Nurses' Health Study, which showed that each serving increase was associated with a 15% greater risk.
Hu and colleagues also examined the relationship between consuming sugary drinks and various biomarkers, finding an association between greater consumption and adverse effects on triglycerides, C-reactive protein, interleukin-6, tumor necrosis factors 1 and 2, HDL cholesterol, lipoprotein(a), and leptin (P≤0.02 for all).
Referring to the inflammatory markers, they noted that "inflammation is a key factor in the pathogenesis of cardiovascular disease and cardiometabolic disease, and could represent an additional pathway by which sugar-sweetened beverages influence risk."
The study, according to the authors, was limited by some error in measuring dietary intakes, the uncertain generalizability of the findings beyond the study population, the possibility of unmeasured and residual confounding, and the large number of comparisons that were made.
Source : Medpage Today
via : De Koning L, et al “Sweetened beverage consumption, incident coronary heart disease, and biomarkers of risk in men” Circulation 2012; DOI: 10.1161/CIRCULATIONAHA.111.067017.
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Women who drink four or more cola beverages per week have a higher risk of developing the bone disease osteoporosis, finds a new study, landing another blow on fizzy drinks makers.
Regular cola consumption was linked to lower bone mineral density in all women studied, regardless of other factors such as smoking, alcohol consumption and calcium intake, researchers found.
Low bone mineral density increases the risk of osteoporosis, also known as brittle bone disease.
The news is another hammer blow to soft drinks makers, already struggling against falling fizzy drinks sales as consumers shift to healthier, non-carbonated beverages.
The study, published in the American Journal of Clinical Nutrition, used dietary questionnaires from more than 2,500 people who were part of an osteoporosis study in the US. Their average age was around 60 years.
The results were similar for regular, diet and decaffeinated colas. "The more cola women drank, the lower their bone mineral density was," said Katherine Tucker, the lead researcher and from Tufts University.
Men appeared to be unaffected, despite drinking slightly more cola per week on average.
Suspicions on what may cause cola to damage bone density initially rested on an ingredient called phosphoric acid. Tucker called for more controlled studies on this.
"Physiologically, a diet low in calcium and high in phosphorus may promote bone loss, tipping the balance of bone remodelling toward calcium loss from the bone. Although, some studies have countered that the amount of phosphoric acid in cola is negligible compared to other dietary sources such as chicken or cheese."
Another reason researchers suspected phosphoric acid was because it is not generally present in non-cola beverages. Other fizzy drinks that were not cola-based did not appear to affect bone density, the study found.
Cola drinks Coca-Cola and Pepsi remain two of the biggest-selling soft drink brands in the world. Cola made up more than 70 per cent of fizzy drinks consumed by those taking part in the recent osteoporosis study.
Consumption of carbonated soft drinks, although now stagnating in mature markets, rose by 300 per cent in the US alone between 1960 and 1990.
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