Long-term compliance is low and can be a big issue with a ketogenic diet, but this is the case with any lifestyle change.  Even though the ketogenic diet is significantly superior in the induction of weight loss in otherwise healthy patients with obesity and the induced weight loss is rapid, intense, and sustained until at least 2 year, the understanding of the clinical impacts, safety, tolerability, efficacy, duration of treatment, and prognosis after discontinuation of the diet is challenging and requires further studies to understand the disease-specific mechanisms.
Digestible carbs are also sometimes called “net carbs” but be very careful of this term on labels of low-carb products, processed foods, protein bars and energy/chocolate bars. Manufacturers often use “net carbs” as a way to disguise sugar alcohols that may slow weight loss and impact blood sugar. In fact, try to avoid any processed product that list “net carbs” on a label. Learn more about keto sweeteners
I was wondering if you have created some flour mixes to replace all purpose. Like a keto flour mix of sorts. I am also wondering, if with any other gluten free flour mix, the amounts of binder like xantham gum, guar gum, or gelatin would apply following the same rules of a non-keto flour mix. I found this recipe but haven’t tried it: https://donnareish.com/low-carb-flour-mix/
In Asia, the normal diet includes rice and noodles as the main energy source, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: some patients are vegetarians, will not eat root vegetables or avoid beef. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in America and Europe. However, they appear to be just as effective.[54]

One of the staples of low-carb diets is protein. Lean meats like fish, chicken, beef, and pork are all wonderful protein sources that are sure to satisfy your cravings. Eggs can be incorporated into meals at any time of day and contain six grams of protein, which makes them perfect as a pre-workout snack, too. Vegans can replace meat with plant-derived protein products like tofu and tempeh. When you assemble your meals, keep in mind that protein should take up roughly one-fourth of your plate.
Wow. I am pretty new to the Keto diet and these things are life savers. I strongly crave carbs and these things satisfy my cravings. I used a one dozen muffin pan and shortened the time to 20 minutes and the doughnut-muffins came out perfectly. I swapped almond milk with heavy whipping cream, and I also swapped erythritol with the same amount of stevia. Altogether these came out great, and they are delicious!
We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions have been raised about the possible benefits for other brain disorders such as Parkinson’s, Alzheimer’s, multiple sclerosis, sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.
The American Heart Association recommends eating six to eight servings of grains every day, which is a lot of carbohydrates. But whole grains also contain a lot of fiber, which is the basis for the recommendation. Fiber is bulky and slow to digest, so you feel full longer after a high-fiber meal. Fiber also aids in healthy elimination, which can keep you feeling – and looking – less bloated and sluggish. People who eat a high-fiber diet are at a lower risk for heart disease, strokes and certain types of cancers because fiber helps you avoid the insulin spikes that occur when you eat starchy carbs. Fiber also helps control your cholesterol levels.
I love hearts of palm, I am steering away from pasta and other carbs. Hello? Made for me. Bought two cans. Made one two hours after delivery (with shrimp and a pesto-fredo sauce) and it was awesome. Delish. Fantabulous. I did not plop it into boiling water so I didn't get a chance to try it "softened" more like pasta and I don't really feel the need to. It was it's own experience and one I will keep buying into. Please buy this so they can keep making it, maybe they can try other pasta types as well. I'm partial to pappardelle
A Cochrane systematic review in 2018 found and analysed eleven randomized controlled trials of ketogenic diet in people with epilepsy for whom drugs failed to control their seizures.[2] Six of the trials compared a group assigned to a ketogenic diet with a group not assigned to one. The other trials compared types of diets or ways of introducing them to make them more tolerable.[2] In the largest trial of the ketogenic diet with a non-diet control[16], nearly 38% of the children and young people had half or fewer seizures with the diet compared 6% with the group not assigned to the diet. Two large trials of the Modified Atkins Diet compared to a non-diet control had similar results, with over 50% of children having half or fewer seizures with the diet compared to around 10% in the control group.[2]
I’ve been using Hodgson Mill soy flour for years, and I’m absolutely heart-broken they stopped making it. I wish I knew why! It was low in carbs and the flavor & consistency differences between the Hodgson Mill and regular flour were negligible. I’ve tried Bob’s soy flour, and it’s not even in the same ballpark with a salty, metallic taste. And the consistency is a super fine, chunky powder that clumps.
In essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar, which comes from carbohydrates, as the body’s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (the process is called ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones.
This is so incredibly helpful! My doctor told me I’m at high risk for Diabetes and that he would bring me back in 3 months for repeat labs. He told me to go on a low carb diet and without realizing it, I ended up doing the keto diet. I was determined to lower my carb intake even more and I haven’t had over 20g net carbs since I started. This is a lifesaver. Thank you!
A Cochrane systematic review in 2018 found and analysed eleven randomized controlled trials of ketogenic diet in people with epilepsy for whom drugs failed to control their seizures.[2] Six of the trials compared a group assigned to a ketogenic diet with a group not assigned to one. The other trials compared types of diets or ways of introducing them to make them more tolerable.[2] In the largest trial of the ketogenic diet with a non-diet control[16], nearly 38% of the children and young people had half or fewer seizures with the diet compared 6% with the group not assigned to the diet. Two large trials of the Modified Atkins Diet compared to a non-diet control had similar results, with over 50% of children having half or fewer seizures with the diet compared to around 10% in the control group.[2]
Fat: Most of the calories in a ketogenic diet come from fat, which is used for energy. The exact amount of fat a person needs to eat will depend on carbohydrate and protein intake, how many calories they use during the day, and whether they are losing weight (using their body fat for energy). Depending on these factors, somewhere in the range of 60 to 80 percent of calories will come from fats on a ketogenic diet (even up to 90 percent on, for example, the Ketogenic Diet for Epilepsy). People tend not to overeat on diets this high in fat, so calorie counting is rarely necessary.

Coconut flour is a low carbohydrate alternative to regular flour. A quarter cup serving contains 16 grams of carbohydrates, 10 grams of fiber, 4 grams of fat and 4 grams of protein for a total of 120 calories.  While it’s a bit higher in carbs compared to other low carb substitutes for flour, it makes up for it in texture. Its light appearance and consistency make it more absorbent than any other flours.
The biggest difference is in the fat!! Your fat should be around 70-75% of your daily food intake! When I first heard that, I was like, “Are you kidding, No Way, I will surely gain weight!” I was truly wrong and misguided. I think we’ve all been too accustomed to hearing for years and years that fat makes you fat! That is the farthest thing from the truth. Let’s not blame the butter for what the bread did. Sugar and Carbs are the culprit to gaining weight among other health related issues.
The brain is composed of a network of neurons that transmit signals by propagating nerve impulses. The propagation of this impulse from one neuron to another is typically controlled by neurotransmitters, though there are also electrical pathways between some neurons. Neurotransmitters can inhibit impulse firing (primarily done by γ-aminobutyric acid, or GABA) or they can excite the neuron into firing (primarily done by glutamate). A neuron that releases inhibitory neurotransmitters from its terminals is called an inhibitory neuron, while one that releases excitatory neurotransmitters is an excitatory neuron. When the normal balance between inhibition and excitation is significantly disrupted in all or part of the brain, a seizure can occur. The GABA system is an important target for anticonvulsant drugs, since seizures may be discouraged by increasing GABA synthesis, decreasing its breakdown, or enhancing its effect on neurons.[7]
Normal dietary fat contains mostly long-chain triglycerides (LCTs). Medium-chain triglycerides (MCTs) are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[18] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhea, and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[18]
Almond flour is a gluten-free nut flour that should consist of nothing but ground blanched almonds. This means that you can make your own at home, from scratch, by grinding whole blanched almonds to a fine meal (unless you just want to buy it). Using a coffee or spice grinder usually works best. Be careful not to grind them for too long or the nuts will release their fat and you´ll end up with almond butter, which is a great tasting nut butter but perhaps not what you were going for when making almond flour.
For orecchiette: cut dough into 4 pieces, roll out into even-sized logs and slice off even-sized pieces. This will ensure evenly-sized pasta. Using your thumb, press each piece against your opposite palm, creating an indentation.  Lightly dust with coconut flour as needed. You can either leave them as they are or turn them out (see post for gif images). 
This paleo low carb bread recipe with almond flour came about somewhat by accident during my Sunday meal planning. Lately I’ve been making the flattened version of my 4-ingredient almond flour biscuits to use for sandwiches each week, but since I’ve been wanting to create an almond flour bread recipe, last weekend I decided to attempt that instead.
Just found your website! What an incredible help it is for me. I just converted to a low carb diet a couple of weeks ago, and must admit began struggling with some of the foods we love as a family and didn’t want to give up. Plus the information about almond flour increasing inflammation was eye opening. I have both rheumatoid and osteo – arthrits and recently it has really acted up. Now I know why. I will use coconut four more now! Thank you.

Thanks for providing these recipes. I just made the bread from the recipe and I noticed my batter was more wet than yours in the video and that it was actually to wet to form a domed top. After baking I also found that the loaf did not rise as much as yours. I followed the recipe exactly except possibly the coconut oil which was refrigerated, (not sure why) which made it very hard to try to measure exactly. Could this be why the bread did not turn out properly. It’s still cooling but I assume that it will taste good even though it is only 2″ tall.
Carolyn Ketchum writes All Day I Dream About Food, a food blog that focuses primarily on low carb, gluten free recipes. She has a Masters in Physical Anthropology and Human Evolution from Arizona State University and has an extensive background in higher education administration. She currently lives in the Boston area with her husband and three children. You can check out her experiments with low carb baking at All Day I Dream About Food.
In relation to overall caloric intake, carbohydrates comprise around 55% of the typical American diet, ranging from 200 to 350 g/day. The vast potential of refined carbohydrates to cause harmful effects were relatively neglected until recently. A greater intake of sugar-laden food is associated with a 44% increased prevalence of metabolic syndrome and obesity and a 26% increase in the risk of developing diabetes mellitus. In a 2012 study of all cardiometabolic deaths (heart disease, stroke, and type 2 diabetes) in the United States, an estimated 45.4% were associated with suboptimal intakes of 10 dietary factors. The largest estimated mortality was associated with high sodium intake (9.5%), followed by low intake of nuts and seeds (8.5%), high intake of processed meats (8.2%), low intake of omega-3 fats (7.8%), low intake of vegetables 7.6%), low intake of fruits (7.5%), and high intake of artificially sweetened beverages (7.4%). The lowest estimated mortality was associated with low polyunsaturated fats (2.3%) and unprocessed red meats (0.4%). In addition to this direct harm, excess consumption of low-quality carbohydrates may displace and leave no room in the diet for healthier foods like nuts, unprocessed grains,  fruits, and vegetables.
Regular flour is made from wheat and grains, both of which have high amounts of carbohydrates. To make a similar flour with fewer carbohydrates, different sources — sources considered low-carb — are used. These sources typically include nuts such as almonds and walnuts, seeds such as flax seed, and legumes such as peanuts and soy. Wheat also can be used as low-carb flour, but only if the wheat section containing the protein is used and nothing else.

The day before admission to hospital, the proportion of carbohydrate in the diet may be decreased and the patient begins fasting after his or her evening meal.[19] On admission, only calorie- and caffeine-free fluids[37] are allowed until dinner, which consists of "eggnog"[Note 8] restricted to one-third of the typical calories for a meal. The following breakfast and lunch are similar, and on the second day, the "eggnog" dinner is increased to two-thirds of a typical meal's caloric content. By the third day, dinner contains the full calorie quota and is a standard ketogenic meal (not "eggnog"). After a ketogenic breakfast on the fourth day, the patient is discharged. Where possible, the patient's current medicines are changed to carbohydrate-free formulations.[19]


Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures, and kidney stones.[18] The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone.[38] About one in 20 children on the ketogenic diet develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone.[39] The stones are treatable and do not justify discontinuation of the diet.[39] Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in one-seventh of the incidence of kidney stones.[40] However, this empiric usage has not been tested in a prospective controlled trial.[9] Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:[39]
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]
The ingredients above are usually quite expensive and might take some experimenting to get the hang of using. The low-carb or keto way of eating by no means require baking. If you don’t miss bread you certainly don’t need to replace it with a low-carb version but if you do miss bread or maybe just miss the baking itself the recipes below might be of interest to you.
To help you get acquainted with making keto-friendly baked goods, we decided to put this article together with all the info you’ll need to get started. Below you will find the many low carb flour options you can use on keto, how to utilize them correctly, and some of our favorite low-carb flour recipes. After reading through this guide, you will have the information you need to make the keto-friendly version of the high-carb food that you’ve been craving.

My keto diet recipes are creative, full of flavor, and always low carb. You will find lots lots of keto diet meal prep recipes that allow you to eat low net carb keto meals all week long. All of my keto diet recipes are designed with you guys in mind, in fact, many of them are special requests from you, and that’s the kind of recipes you will find on my site. 

Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[46]
AMAZING! I just made this bread and I can’t believe how perfect it is! My fiance and I are doing low carb. Not quite keto but trying to stay close to that range of carb intake! Honestly I’ve just been saying I’m avoiding bread, potatoes, and pasta. Either way this bread rocks. The only substitutions I made to the recipe was plain seltzer water in place of the still water. Wanted to give the dough some extra lift. I also put some pumpkin and sunflower seeds on top to increase the heartiness. This bread came out rocking our socks off. Can’t wait to make some grilled cheese Sammie’s with it!
3. Dreamfields Low-Carb Pasta: Now this pasta really comes down to the individual. The company says they’ve created this whole-wheat pasta in a way that won’t impact your blood sugar significantly, “Its blend of fiber and plant proteins helps create a pasta that offers many healthy benefits while still having the same great taste of traditional pasta.” You see, the low-carb spaghetti box says there are 41 grams of carbs and 5 grams of fiber, which leaves you with a whopping 36 grams of carbs–not low at all–but again, the company says these carbs shouldn’t impact you like normal carbs. But many people have found they still have to take insulin for all of those 36 grams of carbs, but that the carbs do raise their blood sugar slower than a normal serving of 36 grams of carbs. Others say they don’t see a spike in their blood sugar and the pasta is indeed low-impact. You will have to experiment and decide for yourself!
Hi Jan, Sorry they didn’t work for you. It’s hard to say what happened without being in the kitchen with you. Did you use exactly the same ingredients and amounts? Also, if they were not cooked, then they probably needed to be in the oven for longer. If they were clumpy, it’s also possible that the almond flour wasn’t fine blanched (it needs to be) or the batter wasn’t mixed well enough. Hope this helps.
Before starting, ask yourself what is really realistic for you, Mattinson suggests. Then get your doctor’s okay. You may also work with a local registered dietitian nutritionist to limit potential nutrient deficiencies and talk about vitamin supplementation, as you won’t be eating whole grains, dairy, or fruit, and will eliminate many veggies. “A diet that eliminates entire food groups is a red flag to me. This isn’t something to take lightly or dive into headfirst with no medical supervision,” she says.
But I just made some biscuits from an old cooking book, which had Almonds grounded (so I just used my almond flour) & I switched sugar for some xylitol & then thought I’d use the Coconut flour in place of ordinary Plain Flour! I did it cup for cup, so it was 2/3 cup……remembered about needing more liquid, so I added an egg (receipt already had 150g butter, which I put in 160g) They taste nice, but I think maybe I should have reduced the coconut flour, after reading your points, or added another egg, or more butter, what would you do? They also have an almond on top. thanks, Pam
Shirataki Noodles: There are people who like this pasta, but I don’t know many of them. You probably should try it yourself just in case you’re one of those few who likes them. With essentially zero calories, carbs, fat, or protein (in other words: void of nutrition whatsoever), these “noodles” are made with yam flour (konnyaku) and water. There are a variety of brands and you can find them just about everywhere these days. In your grocery store, you’ll probably find them within the produce section. Even stranger is that they are packaged in a bag full of water. What’s the downside to a pasta that has basically zero carbs? They smell gross. They taste gross. The texture is gross. Ick. You’re encouraged to rinse them thoroughly in an effort to rid them of their funky taste and smell, but I found that no amount of rinsing was good enough. If you’re someone who does like these noodles, please let us know how you managed to make them edible!
Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions.[19] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[18]
Nutritional ketosis has been proposed as a mechanism through which hunger may be suppressed. A recent meta-analysis investigated the impact of diet on appetite and shed some light on this possible phenomenon (11). The meta-analysis included 12 studies which investigated the effect of either a very low energy diet (VLED: defined as <800 calories per day) or ketogenic low-carbohydrate diet (KLCD: defined as CHO consumption of <10% of energy or <50 g/day, but ad libitum consumption of total energy, protein and fat). Interventions ranged from 4 – 12 weeks and weight loss was from 5.0 to 12.5 kg. In all studies nutritional ketosis was confirmed in VLED and KLCD via circulating levels of β-hydroxybutyrate. Interestingly, both groups reported decreases in appetite. The results of this meta-analysis are noteworthy in two regards. The VLED groups were clearly and significantly hypocaloric, suggesting a state in which hunger should be increased, not decreased. Similarly, the KLCD groups experienced simultaneous reductions in weight and appetite, while eating an ad libitum diet. The results of this meta-analysis provide support for the theory that nutritional ketosis may exert an appetite suppressing effect.
During the 1920s and 1930s, when the only anticonvulsant drugs were the sedative bromides (discovered 1857) and phenobarbital (1912), the ketogenic diet was widely used and studied. This changed in 1938 when H. Houston Merritt, Jr. and Tracy Putnam discovered phenytoin (Dilantin), and the focus of research shifted to discovering new drugs. With the introduction of sodium valproate in the 1970s, drugs were available to neurologists that were effective across a broad range of epileptic syndromes and seizure types. The use of the ketogenic diet, by this time restricted to difficult cases such as Lennox–Gastaut syndrome, declined further.[10]
As you will see, simple keto meals begins with the healthy fat consideration first, making sure plenty of low-starch veggies surround the fat along with a moderate protein source. Wild-caught salmon, as a high-fat fish, is a perfect keto choice, and easy keto meals can be a fatty cut of healthy protein like salmon or lamb served with plenty of green veggies.
The popular belief that high-fat diets cause obesity and several other diseases such as coronary heart disease, diabetes, and cancer has not been observed in recent epidemiological studies. Studies carried out in animals that were fed high-fat diets did not show a specific causal relationship between dietary fat and obesity. On the contrary, very-low-carbohydrate and high-fat diets such as the ketogenic diet have shown to beneficial to weight loss.
6. Skinny Pasta: This pasta is made from “konjac” which is a plant “native to Japan and has been used there for hundreds of years,” according to their website. With 9 calories per serving and 3.5 grams of fiber. Unlike the skirataki noodles listed below, it doesn’t come with a funky smell that has to be rinsed out thoroughly, but it does come in a similar pouch with a bit of liquid that you drain, rinse, etc. before preparing. The noodle (which is available in spaghetti, fettucine, lasagna shape, etc.) has a little bit of a rubbery texture but the flavor is basically whatever you put on it, and the carb-count is nearly non-existent.

Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.


1 cup of almond milk (or milk of choice); 1/3 cup quinoa flakes (purchased at http://www.nuts.com); sweetener of choice; pinch of salt; toppings of choice (usually nuts or berries or banana). Heat the milk in medium saucepan. When it comes to a slight boil, drop in the flakes and salt. Remove from heat, stir and let the cereal cook for about 3 mins. Give it a final stir after 3 mins. It will be thicker and creamier and ready to serve.
Toasted coconut flakes make the perfect alternative to corn flakes in cereals like this one, letting you still enjoy the crunch but without the added issues that traditional cereals can cause. Just be careful to watch the flakes as they toast so they don’t burn. Serve this cereal with your favorite milk and a few berries and you have a tasty and filling breakfast cereal to keep you going all morning.
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