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Dietary patterns and health-related quality of life among Iranian adolescents

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Abstract

Purpose

Examining the associations of a-posteriori-defined dietary patterns and health-related quality of life (HRQOL) among Iranian adolescents.

Methods

This cross-sectional study was conducted among 900 apparently healthy students (mean age 15.33 years; 53.0% female) during 2020–21. The validated Persian version of self-report Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales (PedsQL) for healthy adolescents was used in an online survey to assess HRQOL. Total, physical health, psychosocial health, emotional functioning, social functioning, and school functioning PedsQL scores were calculated, and impaired HRQOL was defined as > 1 standard deviation below the total population sample mean PedsQL scores. A validated food frequency questionnaire was used to assess dietary intakes during telephone interviews. Daily intakes of 20 predefined food groups were calculated and submitted to the principal component factor analysis to identify a-posteriori-defined dietary patterns.

Results

Three major dietary patterns labeled as Mediterranean, mixed, and unhealthy were identified, of which only the Mediterranean pattern characterized by high intakes of vegetables, fruits, olives, potatoes, eggs, nuts and legumes, pickles, low-fat dairy, fish, poultry, and vegetable oils was consistently associated with HRQOL. Controlling for covariates in the multivariable-adjusted binary logistic regression analysis, participants in the top tertile of Mediterranean pattern score were less likely to have impaired HRQOL than those in the bottom tertile (total: OR 0.25; physical health: OR 0.35; psychosocial health: OR 0.15; emotional functioning: OR 0.17; social functioning: OR 0.15; and school functioning: OR 0.18; all P < 0.010).

Conclusion

Current findings indicate that an a-posteriori-defined Mediterranean-style dietary pattern is associated with better HRQOL among healthy Iranian adolescents.

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References

  1. U.S. Departement of Health and Human Services, Office of Disease Prevention and Health Promotion. (2010). Healthy People 2020 Foundation Health Measure Report on Health-related Quality of Life and Well-being. Retrieved March 7, 2021, from https://www.healthypeople.gov/2020/about/foundation-health-measures/Health-Related-Quality-of-Life-and-Well-Being

  2. Centers for Disease Control and Prevention. (2018). Health-related Quality of Life (HRQOL). Retrieved March 7, 2021, from https://www.cdc.gov/hrqol/concept.htm

  3. Testa, M. A., & Simonson, D. C. (1996). Assessment of quality-of-life outcomes. New England Journal of Medicine, 334(13), 835–840.

    CAS  Google Scholar 

  4. Meade, T., & Dowswell, E. (2016). Adolescents’ health-related quality of life (HRQoL) changes over time: A three year longitudinal study. Health and Quality of Life Outcomes. https://doi.org/10.1186/s12955-016-0415-9

    Article  PubMed  PubMed Central  Google Scholar 

  5. Wu, X. Y., Zhuang, L. H., Li, W., Guo, H. W., Zhang, J. H., Zhao, Y. K., Hu, J. W., Gao, Q. Q., Luo, S., Ohinmaa, A., & Veugelers, P. J. (2019). The influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents: A systematic review and meta-analysis. Quality of Life Research, 28(8), 1989–2015.

    PubMed  Google Scholar 

  6. Vajdi, M., & Farhangi, M. A. (2020). A systematic review of the association between dietary patterns and health-related quality of life. Health and Quality of Life Outcomes, 18(1), 337. https://doi.org/10.1186/s12955-020-01581-z

    Article  PubMed  PubMed Central  Google Scholar 

  7. Hu, F. B. (2002). Dietary pattern analysis: A new direction in nutritional epidemiology. Current Opinion in Lipidology, 13(1), 3–9.

    CAS  PubMed  Google Scholar 

  8. Tucker, K. L. (2010). Dietary patterns, approaches, and multicultural perspective. Applied Physiology, Nutrition and Metabolism, 35(2), 211–218.

    Google Scholar 

  9. Ocké, M. C. (2013). Evaluation of methodologies for assessing the overall diet: Dietary quality scores and dietary pattern analysis. The Proceedings of the Nutrition Society, 72(2), 191–199.

    PubMed  Google Scholar 

  10. Davison, J., Stewart-Knox, B., Connolly, P., Lloyd, K., Dunne, L., & Bunting, B. (2021). Exploring the association between mental wellbeing, health-related quality of life, family affluence and food choice in adolescents. Appetite, 158, 105020. https://doi.org/10.1016/j.appet.2020.105020

    Article  PubMed  Google Scholar 

  11. Movassagh, E. Z., Baxter-Jones, A. D. G., Kontulainen, S., Whiting, S. J., & Vatanparast, H. (2017). Tracking dietary patterns over 20 years from childhood through adolescence into young adulthood: The Saskatchewan pediatric bone mineral accrual study. Nutrients. https://doi.org/10.3390/nu9090990

    Article  PubMed  PubMed Central  Google Scholar 

  12. Lake, A. A., Mathers, J. C., Rugg-Gunn, A. J., & Adamson, A. J. (2006). Longitudinal change in food habits between adolescence (11–12 years) and adulthood (32–33 years): The ASH30 study. Journal of Public Health, 28(1), 10–16.

    PubMed  Google Scholar 

  13. Danaei, G., Farzadfar, F., Kelishadi, R., Rashidian, A., Rouhani, O. M., Ahmadnia, S., Ahmadvand, A., Arabi, M., Ardalan, A., Arhami, M., Azizi, M. H., Bahadori, M., Baumgartner, J., Beheshtian, A., Djalalinia, S., Doshmangir, L., Haghdoost, A. A., Haghshenas, R., Hosseinpoor, A. R., … Malekzadeh, R. (2019). Iran in transition. Lancet, 393(10184), 1984–2005.

    PubMed  Google Scholar 

  14. Zarei, N., & Ahmadi, A. (2015). Nutrition transition: An intergenerational comparison of dietary habits among women of Shiraz. Iranian Journal of Public Health, 44(2), 269–275.

    PubMed  PubMed Central  Google Scholar 

  15. Amiri, P., Ardekani, E. M., Jalali-Farahani, S., Hosseinpanah, F., Varni, J. W., Ghofranipour, F., Montazeri, A., & Azizi, F. (2010). Reliability and validity of the Iranian version of the Pediatric Quality of Life InventoryTM 4.0 Generic Core Scales in adolescents. Qual Life Res, 19(10), 1501–1508.

    PubMed  Google Scholar 

  16. Varni, J. W., Seid, M., & Kurtin, P. S. (2001). PedsQLTM 4.0: Reliability and validity of the Pediatric Quality of Life InventoryTM Version 4.0 Generic Core Scales in healthy and patient populations. Med Care, 39(8), 800–812.

    CAS  PubMed  Google Scholar 

  17. Varni, J. W. (1998–2021). The PedsQLTM Measurement Model for the Pediatric Quality of Life Inventory TM. Retrieved March 7, 2021, from https://www.pedsql.org/about_pedsql.html

  18. Varni, J. W., Burwinkle, T. M., Seid, M., & Skarr, D. (2003). The PedsQL 4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr, 3(6), 329–341.

    PubMed  Google Scholar 

  19. Esfahani, F. H., Asghari, G., Mirmiran, P., & Azizi, F. (2010). Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. Journal of Epidemiology, 20(2), 150–158.

    PubMed  Google Scholar 

  20. Mirmiran, P., Esfahani, F. H., Mehrabi, Y., Hedayati, M., & Azizi, F. (2010). Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study. Public Health Nutrition, 13(5), 654–662.

    PubMed  Google Scholar 

  21. Asghari, G., Rezazadeh, A., Hosseini-Esfahani, F., Mehrabi, Y., Mirmiran, P., & Azizi, F. (2012). Reliability, comparative validity and stability of dietary patterns derived from an FFQ in the Tehran lipid and glucose study. British Journal of Nutrition, 108(6), 1109–1117.

    CAS  Google Scholar 

  22. Ghaffarpour, M., Houshiar-Rad, A., & Kianfar, H. (1999). The manual for household measures, cooking yields factors, and edible portion of foods. Agriculture Sciences Press.

    Google Scholar 

  23. Azar, M., & Sarkisian, E. (1980). Food composition table of Iran. Shaheed Beheshti University Press.

    Google Scholar 

  24. Boyce, W., Torsheim, T., Currie, C., & Zambon, A. (2006). The family affluence scale as a measure of national wealth: Validation of an adolescent self-report measure. Social Indicators Research, 78(3), 473–487.

    Google Scholar 

  25. de Onis, M., Onyango, A. W., Borghi, E., Siyam, A., Nishida, C., & Siekmann, J. (2007). Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization, 85(9), 660–667.

    PubMed  PubMed Central  Google Scholar 

  26. Kelishadi, R., Rabiee, K., Khosravi, A., Famouri, F., Sadeghi, M., Roohafza, H., & Shirani, S. (2001). Assessment of physical activity in adolescents of Isfahan. J Shahrekord Univ Med Sci, 3(2), 55–66.

    Google Scholar 

  27. Aadahl, M., & Jorgensen, T. (2003). Validation of a new self-report instrument for measuring physical activity. Medicine and Science in Sports and Exercise, 35(7), 1196–1202.

    PubMed  Google Scholar 

  28. Jalilpiran, Y., Dianatinasab, M., Zeighami, S., Bahmanpour, S., Ghiasvand, R., Mohajeri, S. A. R., & Faghih, S. (2018). Western dietary pattern, but not Mediterranean dietary pattern, increases the risk of prostate cancer. Nutrition and Cancer, 70(6), 851–859.

    PubMed  Google Scholar 

  29. Karamati, M., Jessri, M., Shariati-Bafghi, S. E., & Rashidkhani, B. (2012). Dietary patterns in relation to bone mineral density among menopausal Iranian women. Calcified Tissue International, 91(1), 40–49.

    CAS  PubMed  Google Scholar 

  30. Kim, J. O., & Mueller, C. W. (1978). Factor analysis: Statistical methods and practical issues. SAGE Publications, Inc.

    Google Scholar 

  31. MacCallum, R. C., Widaman, K. F., Zhang, S., & Hong, S. (1999). Sample size in factor analysis. Psychological Methods, 4, 84–99.

    Google Scholar 

  32. Garson, G. D. (2019). Multilevel modeling: Applications in STATA®, IBM® SPSS®, SAS®, R, & HLMTM. SAGE Publications.

    Google Scholar 

  33. Costarelli, V., Koretsi, E., & Georgitsogianni, E. (2013). Health-related quality of life of Greek adolescents: The role of the Mediterranean diet. Quality of Life Research, 22(5), 951–956.

    CAS  PubMed  Google Scholar 

  34. Knox, E., & Muros, J. J. (2017). Association of lifestyle behaviours with self-esteem through health-related quality of life in Spanish adolescents. European Journal of Pediatrics, 176(5), 621–628.

    PubMed  PubMed Central  Google Scholar 

  35. Muros, J. J., Salvador Perez, F., Zurita Ortega, F., Gamez Sanchez, V. M., & Knox, E. (2017). The association between healthy lifestyle behaviors and health-related quality of life among adolescents. Journal de Pediatria, 93(4), 406–412.

    Google Scholar 

  36. Zervaki, K., Yiannakouris, N., Sdrali, D., & Costarelli, V. (2017). Diet quality, disordered eating and health-related quality of life in Greek adolescents. Nutr Food Sci, 47(4), 511–521.

    Google Scholar 

  37. Evaristo, O. S., Moreira, C., Lopes, L., Abreu, S., Agostinis-Sobrinho, C., Oliveira-Santos, J., Povoas, S., Oliveira, A., Santos, R., & Mota, J. (2018). Associations between physical fitness and adherence to the Mediterranean diet with health-related quality of life in adolescents: Results from the LabMed physical activity study. European Journal of Public Health, 28(4), 631–635.

    PubMed  Google Scholar 

  38. Zurita Ortega, F., Salvador Pérez, F., Knox, E., Gámiz Sánchez, V. M., Chacón-Cuberos, R., Rodríguez Fernández, S., & Muros, J. J. (2018). Physical activity and health-related quality of life in schoolchildren: Structural equations analysis. An de Psicol, 34(2), 385–390.

    Google Scholar 

  39. Esteban-Gonzalo, L., Turner, A. I., Torres, S. J., Esteban-Cornejo, I., Castro-Pinero, J., Delgado-Alfonso, A., Marcos, A., Gomez-Martinez, S., & Veiga, O. L. (2019). Diet quality and well-being in children and adolescents: The UP&DOWN longitudinal study. British Journal of Nutrition, 121(2), 221–231.

    CAS  Google Scholar 

  40. Ferrer-Cascales, R., Albaladejo-Blazquez, N., Ruiz-Robledillo, N., Clement-Carbonell, V., Sanchez-SanSegundo, M., & Zaragoza-Marti, A. (2019). Higher adherence to the Mediterranean diet is related to more subjective happiness in adolescents: The role of health-related quality of life. Nutrients. https://doi.org/10.3390/nu11030698

    Article  PubMed  PubMed Central  Google Scholar 

  41. Boraita, R. J., Ibort, E. G., Torres, J. M. D., & Alsina, D. A. (2020). Gender differences relating to lifestyle habits and health-related quality of life of adolescents. Child Indicators Research. https://doi.org/10.1007/s12187-020-09728-6

    Article  Google Scholar 

  42. Jimenez Boraita, R., Arriscado Alsina, D., Gargallo Ibort, E., & Dalmau Torres, J. M. (2020). Factors associated with adherence to a Mediterranean diet in adolescents from La Rioja (Spain). British Journal of Nutrition. https://doi.org/10.1017/S0007114520003803

    Article  Google Scholar 

  43. Solera-Sanchez, A., Adelantado-Renau, M., Moliner-Urdiales, D., & Beltran-Valls, M. R. (2020). Health-related quality of life in adolescents: Individual and combined impact of health-related behaviors (DADOS study). Quality of Life Research. https://doi.org/10.1007/s11136-020-02699-9

    Article  PubMed  Google Scholar 

  44. Mayo Clinic Staff. (2017). Mediterranean diet: A heart-healthy eating plan. Retrieved March 7, 2021, from https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801

  45. Davis, C., Bryan, J., Hodgson, J., & Murphy, K. (2015). Definition of the Mediterranean diet; a literature review. Nutrients, 7(11), 9139–9153.

    CAS  PubMed  PubMed Central  Google Scholar 

  46. Bolton, K. A., Jacka, F., Allender, S., Kremer, P., Gibbs, L., Waters, E., & de Silva, A. (2016). The association between self-reported diet quality and health-related quality of life in rural and urban Australian adolescents. Australian Journal of Rural Health, 24(5), 317–325.

    Google Scholar 

  47. Novak, D., Stefan, L., Prosoli, R., Emeljanovas, A., Mieziene, B., Milanovic, I., & Radisavljevic-Janic, S. (2017). Mediterranean diet and its correlates among adolescents in non-mediterranean European countries: A population-based study. Nutrients. https://doi.org/10.3390/nu9020177

    Article  PubMed  PubMed Central  Google Scholar 

  48. Munoz, M. A., Fito, M., Marrugat, J., Covas, M. I., Schroder, H., & Regicor & investigators. (2009). Adherence to the Mediterranean diet is associated with better mental and physical health. Br J Nutr, 101(12), 1821–1827.

    CAS  PubMed  Google Scholar 

  49. Gomez-Pinilla, F. (2008). Brain foods: The effects of nutrients on brain function. Nature Reviews Neuroscience, 9(7), 568–578.

    CAS  PubMed  PubMed Central  Google Scholar 

  50. Casas, R., Sacanella, E., & Estruch, R. (2014). The immune protective effect of the Mediterranean diet against chronic low-grade inflammatory diseases. Endocrine, Metabolic & Immune Disorders: Drug Targets, 14(4), 245–254.

    CAS  Google Scholar 

  51. Del Chierico, F., Vernocchi, P., Dallapiccola, B., & Putignani, L. (2014). Mediterranean diet and health: Food effects on gut microbiota and disease control. International Journal of Molecular Sciences, 15(7), 11678–11699.

    PubMed  PubMed Central  Google Scholar 

  52. Jennings, A., Mulligan, A. A., Khaw, K. T., Luben, R. N., & Welch, A. A. (2020). A Mediterranean diet is positively associated with bone and muscle health in a non-mediterranean region in 25,450 men and women from EPIC-Norfolk. Nutrients. https://doi.org/10.3390/nu12041154

    Article  PubMed  PubMed Central  Google Scholar 

  53. Kjelgaard, H. H., Holstein, B. E., Due, P., Brixval, C. S., & Rasmussen, M. (2017). Adolescent weight status: Associations with structural and functional dimensions of social relations. Journal of Adolescent Health, 60(4), 460–468.

    Google Scholar 

  54. Martinez, M. E., Marshall, J. R., & Sechrest, L. (1998). Invited commentary: Factor analysis and the search for objectivity. American Journal of Epidemiology, 148(1), 17–19.

    CAS  PubMed  Google Scholar 

  55. Ferguson, C. J. (2009). An effect size primer: A guide for clinicians and researchers. Prof Psychol Res Pr, 40(5), 532–538.

    Google Scholar 

  56. Davies, H. T., Crombie, I. K., & Tavakoli, M. (1998). When can odds ratios mislead? BMJ, 316(7136), 989–991.

    CAS  PubMed  PubMed Central  Google Scholar 

  57. Ansari-Moghaddam, A., Rakhshani, F., Shahraki-Sanavi, F., Mohammadi, M., Miri-Bonjar, M., & Bakhshani, N. M. (2016). Prevalence and patterns of tobacco, alcohol, and drug use among Iranian adolescents: A meta-analysis of 58 studies. Children and Youth Services Review, 60, 68–79.

    Google Scholar 

  58. Davis, C. G., Thake, J., & Vilhena, N. (2010). Social desirability biases in self-reported alcohol consumption and harms. Addictive Behaviors, 35(4), 302–311.

    PubMed  Google Scholar 

  59. Messeri, P., Cantrell, J., Mowery, P., Bennett, M., Hair, E., & Vallone, D. (2019). Examining differences in cigarette smoking prevalence among young adults across national surveillance surveys. PLoS ONE, 14(12), e0225312. https://doi.org/10.1371/journal.pone.0225312

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Marques, A., Peralta, M., Santos, T., Martins, J., & Gaspar de Matos, M. (2019). Self-rated health and health-related quality of life are related with adolescents’ healthy lifestyle. Public Health, 170, 89–94.

    CAS  PubMed  Google Scholar 

  61. Dube, S. R., Thompson, W., Homa, D. M., & Zack, M. M. (2013). Smoking and health-related quality of life among US adolescents. Nicotine Tob Res, 15(2), 492���500.

    PubMed  Google Scholar 

  62. Coathup, V., Northstone, K., Gray, R., Wheeler, S., & Smith, L. (2017). Dietary patterns and alcohol consumption during pregnancy: Secondary analysis of avon longitudinal study of parents and children. Alcoholism, Clinical and Experimental Research, 41(6), 1120–1128.

    CAS  PubMed  Google Scholar 

  63. Gutierrez-Pliego, L. E., del Camarillo-Romero, S., Montenegro-Morales, L. P., & de Garduno-Garcia, J. (2016). Dietary patterns associated with body mass index (BMI) and lifestyle in Mexican adolescents. BMC Public Health, 16(1), 850. https://doi.org/10.1186/s12889-016-3527-6

    Article  PubMed  PubMed Central  Google Scholar 

  64. Mehio-Sibai, A., Feinleib, M., Sibai, T. A., & Armenian, H. K. (2005). A positive or a negative confounding variable? A simple teaching aid for clinicians and students. Annals of Epidemiology, 15(6), 421–423.

    PubMed  Google Scholar 

  65. Khaw, K.-T., Day, N., Bingham, S., & Wareham, N. (2004). Observational versus randomised trial evidence. Lancet, 364(9436), 753–754.

    PubMed  Google Scholar 

  66. Morabia, A. (1995). Poppers, Kaposi’s sarcoma, and HIV infection: Empirical example of a strong confounding effect? Preventive Medicine, 24(1), 90–95.

    CAS  PubMed  Google Scholar 

  67. Allison, C., Colby, S., Opoku-Acheampong, A., Kidd, T., Kattelmann, K., Olfert, M. D., & Zhou, W. (2020). Accuracy of self-reported BMI using objective measurement in high school students. J Nutr Sci. https://doi.org/10.1017/jns.2020.28

    Article  PubMed  PubMed Central  Google Scholar 

  68. Bonell, C., Jamal, F., Harden, A., Wells, H., Parry, W., Fletcher, A., Petticrew, M., Thomas, J., Whitehead, M., Campbell, R., Murphy, S., & Moore, L. (2013). Systematic review of the effects of schools and school environment interventions on health: Evidence mapping and synthesis. NIHR Journals Library. https://doi.org/10.3310/phr01010

    Article  Google Scholar 

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Acknowledgements

The present work was funded by the Mashhad University of Medical Sciences, Mashhad, Iran (Grant Number 981143). The funding source had no further role in the study (i.e., in design, data collection, analysis, drafting of the manuscript, or decision to publish).

Funding

The present work was funded by the Mashhad University of Medical Sciences, Mashhad, Iran (Grant Number 981143). The funding source had no further role in the study (i.e., in design, data collection, analysis, drafting of the manuscript, or decision to publish).

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Authors and Affiliations

  1. Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Seyedeh-Elaheh Shariati-Bafghi, Mohammad Safarian, Golnaz Ranjbar & Mohsen Nematy

  2. Department of Community Nutrition, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Bahram Rashidkhani

  3. Department of Psychology, Faculty of Education Sciences & Psychology, Ferdowsi University of Mashhad, Mashhad, Iran

    Javad Salehi Fadardi

  4. Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran

    Javad Edalatian

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Contributions

SESB, BR, JSF, MS, GR, and MN made substantial contributions to the conception and design of the work. SESB and JE made substantial contributions to the acquisition of data. SESB and BR made substantial contributions to the analysis and interpretation of data. SESB, JSF, MS, and JE drafted the work, and BR, GR, and MN revised it critically for important intellectual content. All authors approved the version to be published.

Corresponding authors

Correspondence to Golnaz Ranjbar or Mohsen Nematy.

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Conflict of interest

Seyedeh-Elaheh Shariati-Bafghi, Bahram Rashidkhani, Javad Salehi Fadardi, Mohammad Safarian, Javad Edalatian, Golnaz Ranjbar, and Mohsen Nematy declare that they have no conflicts of interest.

Ethical approval

The Ethics in Research Committee of Mashhad University of Medical Sciences, Mashhad, Iran approved the study protocol (Approval Number IR.MUMS.MEDICAL.REC.1399.155). All procedures performed were in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consents were obtained from parents or legal guardians of all participants prior to their inclusion in the study.

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Shariati-Bafghi, SE., Rashidkhani, B., Salehi Fadardi, J. et al. Dietary patterns and health-related quality of life among Iranian adolescents. Qual Life Res 31, 789–802 (2022). https://doi.org/10.1007/s11136-021-02942-x

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