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February 1, 1995, Vol 273, No. 5 >
ARTICLE | February 1, 1995

Physical Activity and Public Health: Title and subTitle BreakA Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine FREE

Russell R. Pate, PhD; Michael Pratt, MD, MPH; Steven N. Blair, PED; William L. Haskell, PhD; Caroline A. Macera, PhD; Claude Bouchard, PhD; David Buchner, MD, MPH; Walter Ettinger, MD; Gregory W. Heath, DHSc; Abby C. King, PhD; Andrea Kriska, PhD; Arthur S. Leon, MD; Bess H. Marcus, PhD; Jeremy Morris, MD; Ralph S. Paffenbarger, Jr, MD; Kevin Patrick, MD; Michael L. Pollock, PhD; James M. Rippe, MD; James Sallis, PhD; Jack H. Wilmore, PhD
[+] Author Affiliations

This statement and its recommendations are endorsed and supported by the Committee on Exercise and Cardiac Rehabilitation, Council on Clinical Cardiology, American Heart Association.

Reprint requests to Department of Exercise Science, University of South Carolina School of Public Health, Columbia, SC 29208 (Dr Pate).


JAMA. 1995;273(5):402-407. doi:10.1001/jama.1995.03520290054029
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Article
References

Objective.  —To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention.

Participants.  —A planning committee of five scientists was established by the Centers for Disease Control and Prevention and the American College of Sports Medicine to organize a workshop. This committee selected 15 other workshop discussants on the basis of their research expertise in issues related to the health implications of physical activity. Several relevant professional or scientific organizations and federal agencies also were represented.

Evidence.  —The panel of experts reviewed the pertinent physiological, epidemiologic, and clinical evidence, including primary research articles and recent review articles.

Consensus Process.  —Major issues related to physical activity and health were outlined, and selected members of the expert panel drafted sections of the paper from this outline. A draft manuscript was prepared by the planning committee and circulated to the full panel in advance of the 2-day workshop. During the workshop, each section of the manuscript was reviewed by the expert panel. Primary attention was given to achieving group consensus concerning the recommended types and amounts of physical activity. A concise "public health message" was developed to express the recommendations of the panel. During the ensuing months, the consensus statement was further reviewed and revised and was formally endorsed by both the Centers for Disease Control and Prevention and the American College of Sports Medicine.

Conclusion.  —Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week.(JAMA. 1995;273:402-407)

REFERENCES

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Paffenbarger RS, Hyde RT, Wing AL, Hsieh C-C.  Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med . 1986;;314: 605-613.
2 +
Morris JN, Clayton DG, Everitt MG, Semmence AM, Burgess EH.  Exercise in leisure time: coronary attack and death rates. Br Heart J . 1990;;63: 325-334.
3 +
Powell KE, Thompson PD, Caspersen CJ, Ford ES.  Physical activity and the incidence of coronary heart disease. Annu Rev Public Health . 1987;;8: 253-287.
4 +
Hagberg JM.  Exercise, fitness, and hypertension.  In: Bouchard C, Shephard RJ, Stephens T, Sutton JR, McPherson BD, eds. Exercise, Fitness, and Health . Champaign, Ill: Human Kinetics Publishers; 1990;:455-566.
5 +
King AC, Taylor CB, Haskell WL, DeBusk RF.  Influence of regular aerobic exercise on psychological health. Health Psychol . 1989;;8:305-324.
6 +
Dishman RK.  Psychological effects of exercise for disease resistance and health promotion.  In: Watson RR, Eisinher M, eds. Exercise and Disease . Boca Raton, Fla: CRC Press; 1992;:179-207.
7 +
Marcus R, Drinkwater B, Dalsky G, et al.  Osteoporosis and exercise in women. Med Sci Sports Exerc . 1992;;24( (suppl) ):S301-S307.
8 +
Centers for Disease Control and Prevention.  Prevalence of sedentary lifestyle—behavioral risk factor surveillance system, United States, 1991. MMWR Morb Mortal Wkly Rep . 1993;;42:576-579.
9 +
Caspersen CJ, Powell KE, Christenson GM.  Physical activity, exercise, and physical fitness. Public Health Rep . 1985;;100:125-131.
10 +
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11 +
Fisher M, Eckhart C, eds. Guide to Clinical Preventive Services: An Assessment of the Effectiveness of 169 Interventions . Baltimore, Md: Williams & Wilkins; 1989;.
12 +
American College of Sports Medicine.  Position stand on the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Med Sci Sports Exerc . 1990;;22:265-274.
13 +
Fletcher GF, Blair SN, Blumenthal J, et al.  AHA medical/scientific statement on exercise. Circulation . 1992;;86:340-344.
14 +
Bouchard C, Shephard RJ, Stephens T, eds. Physical Activity, Fitness, and Health . Champaign, Ill: Human Kinetics Publishers; 1994;.
15 +
Kohl HW, Blair SN, Paffenbarger RS, Macera CA, Kronenfeld JJ.  A mail survey of physical activity habits as related to measured physical fitness. Am J Epidemiol . 1988;;127:1228-1239.
16 +
Taylor HL, Jacobs DR, Schucker B, Knudsen J, Leon AS, Debacker G.  A questionnaire for the assessment of leisure time physical activities. J Chronic Dis . 1978;;31:741-755.
17 +
Leon AS, Connett J, Jacobs DR Jr, Rauramaa R.  Leisure-time physical activity levels and risk of coronary heart disease and death: the Multiple Risk Factor Intervention trial. JAMA . 1987;;258:2388-2395.
18 +
Morris JN, Kagan A, Pattison DC, Chave SPW, Semmence AM.  Incidence and prediction of ischemic heart disease in London busman. Lancet . 1966;; 2:533-559.
19 +
Blair SN, Goodyear NN, Gibbons LW, Cooper KH.  Physical fitness and incidence of hypertension in healthy normotensive men and women. JAMA . 1984;;252:487-490.
20 +
Paffenbarger RS, Wing AL, Hyde RT, Jung DL.  Physical activity and incidence of hypertension in college alumni. Am J Epidemiol . 1983;;117:245-257.
21 +
American College of Sports Medicine.  Position stand: physical activity, physical fitness, and hypertension. Med Sci Sports Exerc . 1993;;10:i-x.
22 +
Helmrich SP, Ragland DR, Leung RW, Paffenbargerh RS.  Physical activity and reduced occurrence of non-insulin-independent diabetes mellitus. N Engl J Med . 1991;;325:147-152.
23 +
Manson JE, Nathan DM, Krolewski AS, Stampfer MJ, Willett WC, Hennekens CH.  A prospective study of exercise and incidence of diabetes among US male physicians. JAMA . 1992;;268:63-67.
24 +
Manson JE, REStampferal.  Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet . 1991;; 338:774-778.
25 +
Cummings Kelsey JL, Nevitt MD, O'Dowd KJ.  Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev . 1985;;7:178-208.
26 +
Snow-HarterR. xercise, bone mineralsity, and osteoporosis. Exerct Sport Sci Rev . 1991;;19:351-388.
27 +
Lee I, Paffenbarger RS, Hsieh C.  Physical activity and risk of developing colorectalong college alumni. J Natl Cancer Inst . 1991;;83:1324-1329.
28 +
Taylor CB, Sallis JF, Needle R.  The relationship of physical activity and exercise to mental health. Public Health Rep . 1985;;100:195-201.
29 +
Blair SN, Kohl HW, Paffenbarger RS, Clark DG, Cooper KH, Gibbons LW.  Physical fitness and all-cause mortality. JAMA . 1989;;262:2395-2401.
30 +
Paffenbarger RS, Hyde RT, Wing AL, Lee I, Jung DL, Kampert JB.  The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med . 1993;;328:538-545.
31 +
Hahn RA, Teutsch SM, Rothenberg RB, Marks JS.  Excess deaths from nine chronic diseases in the United States. JAMA . 1986;;264:2654-2659.
32 +
McGinnis JM, Foege WH.  Actual causes of death in the United States. JAMA . 1993;;270:2207-2212.
33 +
Haskell WL.  The influence of exercise training on plasma lipids and lipoproteins in health and disease. Acta Med Scand . 1986;;711( (suppl) ):25-37.
34 +
Duncan JJ, Farr JE, Upton SJ, Hagan RD, Oglesby ME, Blair SN.  The effects of aerobic exercise on plasma catecholamines and blood pressure in patients with mild essential hypertension. JAMA . 1985;;254:2609-2613.
35 +
Hagberg JM, Montain SJ, Martin WH, et al.  Effect of exercise training on 60-69 year old persons with essential hypertension. Am J Cardiol . 1989;;64:348-353.
36 +
Tipton CM.  Exercise training and hypertension: an update. Exerc Sports Sci Rev . 1991;;19:447-505.
37 +
Bouchard C, Depres JP, Tremblay A.  Exercise and obesity. Obesity Res . 1993;;1:133-147.
38 +
Pavlou K, Krey S, Steffee WP.  Exercise as an adjunct to weight loss and maintenance in moderately obese subjects. Am J Clin Nutr . 1989;;49: 1115-1123.
39 +
Wood PD, Stefanick ML, Williams PT, Haskell WL.  The effects on plasma lipoproteins of prudent weight-reducing diet, with or without exercise, in overweight men and women. N Engl J Med . 1991;; 325:461-466.
40 +
Ivy JL.  The insulin-like effect of muscle contraction. Exerc Sports Sci Rev . 1987;;15:29-51.
41 +
Koivisto VA, Yki-Jarvinen H, DeFronzo RA.  Physical training and insulin sensitivity. Diabetes Metab Rev . 1986;;1:445-481.
42 +
Dalsky GP, Stoke KS, Ehsani AA, Slatopolsky E, Lee WC, Birge SJ.  Weight-bearing exercise training and lumbar bone mineral content in postmenopausal women. Ann Intern Med . 1988;;108:824-828.
43 +
Nehlsen-Cannarella SL, Niemann DC, Balk-Lamberton AJ, et al.  The effects of moderate exercise training on immune response. Med Sci Sports Exerc . 1991;;23:64-70.
44 +
Nieman DC.  Physical activity, fitness, and infection.  In: Bouchard C, Shephard RJ, Stephens T, eds. Physical Activity, Fitness, and Health . Champaign, Ill: Human Kinetics Publishers; 1994;;796-813.
45 +
King AC, Taylor CB, Haskell WL.  Effects of differing intensities and formats of 12 months of exercise training on psychological outcomes in older adults. Health Psychol . 1993;;12:292-300.
46 +
Hill AB.  The environment and disease: association or causation? Proc R Soc Med . 1965;;58:295-300.
47 +
Centers for Disease Control and Prevention.  Public health focus: physical activity and the prevention of coronary heart disease. MMWR Morb Mortal Wkly Rep . 1993;;42:669-672.
48 +
Rauramaa R, Salonen JT.  Physical acivity, fibrinolysis, and platelet aggregability.  In: Bouchard C, Shephard RJ, Stephens T, eds. Physical Activity, Fitness, and Health . Champaign, Ill: Human Kinetics Publishers; 1994;:471-479.
49 +
Moore S.  Physical activity, fitness, and atherosclerosis.  In: Bouchard C, Shephard RJ, Stephens T, eds. Physical Activity, Fitness, and Health . Champaign, Ill: Human Kinetics Publishers; 1994;: 570-578.
50 +
Stephens T.  Secular trends in adult physical activity. Res Q Exerc Sport . 1987;;58:94-105.
51 +
Caspersen CJ, Christenson GM, Pollard RA.  The status of the 1990 Physical Fitness Objectives— evidence from NHIS 85. Public Health Rep . 1986;; 101:587-592.
52 +
Stephens T, Jacobs DR, White CC.  A descriptive epidemiology of leisure-time physical activity. Public Health Rep . 1985;;100:147-158.
53 +
Caspersen CJ, Pollard RA, Pratt SO.  Scoring physical activity data with special consideration for elderly population.  In: Proceedings of the 21st National Meeting of the Public Health Conference on Records and Statistics: Data for an Aging Population . Washington, DC: Public Health Service; July 13-15, 1987;:30-34. DHHS publication PHS 88-1214.
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Schoenborn CA.  Health habits of US adults, 1985: the 'Alameda 7' revisited. Public Health Rep . 1986;;101:571-580.
55 +
Caspersen CJ, Merritt RK.  Trends in physical activity patterns among older adults: the Behavioral Risk Factor Surveillance System, 1986-1990. Med Sci Sports Exerc . 1992;;24( (suppl) ):S26.
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DiPietro L, Caspersen C.  National estimates of physical activity among white and black Americans. Med Sci Sports Exerc . 1991;;23( (suppl) ):S105.
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Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Paffenbarger RS, Hyde RT, Wing AL, Hsieh C-C.  Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med . 1986;;314: 605-613.
2 +
Morris JN, Clayton DG, Everitt MG, Semmence AM, Burgess EH.  Exercise in leisure time: coronary attack and death rates. Br Heart J . 1990;;63: 325-334.
3 +
Powell KE, Thompson PD, Caspersen CJ, Ford ES.  Physical activity and the incidence of coronary heart disease. Annu Rev Public Health . 1987;;8: 253-287.
4 +
Hagberg JM.  Exercise, fitness, and hypertension.  In: Bouchard C, Shephard RJ, Stephens T, Sutton JR, McPherson BD, eds. Exercise, Fitness, and Health . Champaign, Ill: Human Kinetics Publishers; 1990;:455-566.
5 +
King AC, Taylor CB, Haskell WL, DeBusk RF.  Influence of regular aerobic exercise on psychological health. Health Psychol . 1989;;8:305-324.
6 +
Dishman RK.  Psychological effects of exercise for disease resistance and health promotion.  In: Watson RR, Eisinher M, eds. Exercise and Disease . Boca Raton, Fla: CRC Press; 1992;:179-207.
7 +
Marcus R, Drinkwater B, Dalsky G, et al.  Osteoporosis and exercise in women. Med Sci Sports Exerc . 1992;;24( (suppl) ):S301-S307.
8 +
Centers for Disease Control and Prevention.  Prevalence of sedentary lifestyle—behavioral risk factor surveillance system, United States, 1991. MMWR Morb Mortal Wkly Rep . 1993;;42:576-579.
9 +
Caspersen CJ, Powell KE, Christenson GM.  Physical activity, exercise, and physical fitness. Public Health Rep . 1985;;100:125-131.
10 +
US Dept of Health and Human Services. Healthy People 2000: National Health Promotion and Disease Prevention Objectives . Washington, DC: US Dept of Health and Human Services; 1991;. DHHS publication PHS 91-50212.
11 +
Fisher M, Eckhart C, eds. Guide to Clinical Preventive Services: An Assessment of the Effectiveness of 169 Interventions . Baltimore, Md: Williams & Wilkins; 1989;.
12 +
American College of Sports Medicine.  Position stand on the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Med Sci Sports Exerc . 1990;;22:265-274.
13 +
Fletcher GF, Blair SN, Blumenthal J, et al.  AHA medical/scientific statement on exercise. Circulation . 1992;;86:340-344.
14 +
Bouchard C, Shephard RJ, Stephens T, eds. Physical Activity, Fitness, and Health . Champaign, Ill: Human Kinetics Publishers; 1994;.
15 +
Kohl HW, Blair SN, Paffenbarger RS, Macera CA, Kronenfeld JJ.  A mail survey of physical activity habits as related to measured physical fitness. Am J Epidemiol . 1988;;127:1228-1239.
16 +
Taylor HL, Jacobs DR, Schucker B, Knudsen J, Leon AS, Debacker G.  A questionnaire for the assessment of leisure time physical activities. J Chronic Dis . 1978;;31:741-755.
17 +
Leon AS, Connett J, Jacobs DR Jr, Rauramaa R.  Leisure-time physical activity levels and risk of coronary heart disease and death: the Multiple Risk Factor Intervention trial. JAMA . 1987;;258:2388-2395.
18 +
Morris JN, Kagan A, Pattison DC, Chave SPW, Semmence AM.  Incidence and prediction of ischemic heart disease in London busman. Lancet . 1966;; 2:533-559.
19 +
Blair SN, Goodyear NN, Gibbons LW, Cooper KH.  Physical fitness and incidence of hypertension in healthy normotensive men and women. JAMA . 1984;;252:487-490.
20 +
Paffenbarger RS, Wing AL, Hyde RT, Jung DL.  Physical activity and incidence of hypertension in college alumni. Am J Epidemiol . 1983;;117:245-257.
21 +
American College of Sports Medicine.  Position stand: physical activity, physical fitness, and hypertension. Med Sci Sports Exerc . 1993;;10:i-x.
22 +
Helmrich SP, Ragland DR, Leung RW, Paffenbargerh RS.  Physical activity and reduced occurrence of non-insulin-independent diabetes mellitus. N Engl J Med . 1991;;325:147-152.
23 +
Manson JE, Nathan DM, Krolewski AS, Stampfer MJ, Willett WC, Hennekens CH.  A prospective study of exercise and incidence of diabetes among US male physicians. JAMA . 1992;;268:63-67.
24 +
Manson JE, REStampferal.  Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet . 1991;; 338:774-778.
25 +
Cummings Kelsey JL, Nevitt MD, O'Dowd KJ.  Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev . 1985;;7:178-208.
26 +
Snow-HarterR. xercise, bone mineralsity, and osteoporosis. Exerct Sport Sci Rev . 1991;;19:351-388.
27 +
Lee I, Paffenbarger RS, Hsieh C.  Physical activity and risk of developing colorectalong college alumni. J Natl Cancer Inst . 1991;;83:1324-1329.
28 +
Taylor CB, Sallis JF, Needle R.  The relationship of physical activity and exercise to mental health. Public Health Rep . 1985;;100:195-201.
29 +
Blair SN, Kohl HW, Paffenbarger RS, Clark DG, Cooper KH, Gibbons LW.  Physical fitness and all-cause mortality. JAMA . 1989;;262:2395-2401.
30 +
Paffenbarger RS, Hyde RT, Wing AL, Lee I, Jung DL, Kampert JB.  The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med . 1993;;328:538-545.
31 +
Hahn RA, Teutsch SM, Rothenberg RB, Marks JS.  Excess deaths from nine chronic diseases in the United States. JAMA . 1986;;264:2654-2659.
32 +
McGinnis JM, Foege WH.  Actual causes of death in the United States. JAMA . 1993;;270:2207-2212.
33 +
Haskell WL.  The influence of exercise training on plasma lipids and lipoproteins in health and disease. Acta Med Scand . 1986;;711( (suppl) ):25-37.
34 +
Duncan JJ, Farr JE, Upton SJ, Hagan RD, Oglesby ME, Blair SN.  The effects of aerobic exercise on plasma catecholamines and blood pressure in patients with mild essential hypertension. JAMA . 1985;;254:2609-2613.
35 +
Hagberg JM, Montain SJ, Martin WH, et al.  Effect of exercise training on 60-69 year old persons with essential hypertension. Am J Cardiol . 1989;;64:348-353.
36 +
Tipton CM.  Exercise training and hypertension: an update. Exerc Sports Sci Rev . 1991;;19:447-505.
37 +
Bouchard C, Depres JP, Tremblay A.  Exercise and obesity. Obesity Res . 1993;;1:133-147.
38 +
Pavlou K, Krey S, Steffee WP.  Exercise as an adjunct to weight loss and maintenance in moderately obese subjects. Am J Clin Nutr . 1989;;49: 1115-1123.
39 +
Wood PD, Stefanick ML, Williams PT, Haskell WL.  The effects on plasma lipoproteins of prudent weight-reducing diet, with or without exercise, in overweight men and women. N Engl J Med . 1991;; 325:461-466.
40 +
Ivy JL.  The insulin-like effect of muscle contraction. Exerc Sports Sci Rev . 1987;;15:29-51.
41 +
Koivisto VA, Yki-Jarvinen H, DeFronzo RA.  Physical training and insulin sensitivity. Diabetes Metab Rev . 1986;;1:445-481.
42 +
Dalsky GP, Stoke KS, Ehsani AA, Slatopolsky E, Lee WC, Birge SJ.  Weight-bearing exercise training and lumbar bone mineral content in postmenopausal women. Ann Intern Med . 1988;;108:824-828.
43 +
Nehlsen-Cannarella SL, Niemann DC, Balk-Lamberton AJ, et al.  The effects of moderate exercise training on immune response. Med Sci Sports Exerc . 1991;;23:64-70.
44 +
Nieman DC.  Physical activity, fitness, and infection.  In: Bouchard C, Shephard RJ, Stephens T, eds. Physical Activity, Fitness, and Health . Champaign, Ill: Human Kinetics Publishers; 1994;;796-813.
45 +
King AC, Taylor CB, Haskell WL.  Effects of differing intensities and formats of 12 months of exercise training on psychological outcomes in older adults. Health Psychol . 1993;;12:292-300.
46 +
Hill AB.  The environment and disease: association or causation? Proc R Soc Med . 1965;;58:295-300.
47 +
Centers for Disease Control and Prevention.  Public health focus: physical activity and the prevention of coronary heart disease. MMWR Morb Mortal Wkly Rep . 1993;;42:669-672.
48 +
Rauramaa R, Salonen JT.  Physical acivity, fibrinolysis, and platelet aggregability.  In: Bouchard C, Shephard RJ, Stephens T, eds. Physical Activity, Fitness, and Health . Champaign, Ill: Human Kinetics Publishers; 1994;:471-479.
49 +
Moore S.  Physical activity, fitness, and atherosclerosis.  In: Bouchard C, Shephard RJ, Stephens T, eds. Physical Activity, Fitness, and Health . Champaign, Ill: Human Kinetics Publishers; 1994;: 570-578.
50 +
Stephens T.  Secular trends in adult physical activity. Res Q Exerc Sport . 1987;;58:94-105.
51 +
Caspersen CJ, Christenson GM, Pollard RA.  The status of the 1990 Physical Fitness Objectives— evidence from NHIS 85. Public Health Rep . 1986;; 101:587-592.
52 +
Stephens T, Jacobs DR, White CC.  A descriptive epidemiology of leisure-time physical activity. Public Health Rep . 1985;;100:147-158.
53 +
Caspersen CJ, Pollard RA, Pratt SO.  Scoring physical activity data with special consideration for elderly population.  In: Proceedings of the 21st National Meeting of the Public Health Conference on Records and Statistics: Data for an Aging Population . Washington, DC: Public Health Service; July 13-15, 1987;:30-34. DHHS publication PHS 88-1214.
54 +
Schoenborn CA.  Health habits of US adults, 1985: the 'Alameda 7' revisited. Public Health Rep . 1986;;101:571-580.
55 +
Caspersen CJ, Merritt RK.  Trends in physical activity patterns among older adults: the Behavioral Risk Factor Surveillance System, 1986-1990. Med Sci Sports Exerc . 1992;;24( (suppl) ):S26.
56 +
DiPietro L, Caspersen C.  National estimates of physical activity among white and black Americans. Med Sci Sports Exerc . 1991;;23( (suppl) ):S105.
57 +
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