Gluten: What You Don't Know Might Kill You

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Something you’re eating may be killing you, and you probably don’t even know it!

If you eat cheeseburgers or French fries all the time or drink six sodas a day, you likely know you are shortening your life. But eating a nice dark, crunchy slice of whole wheat bread -- how could that be bad for you?

Well, bread contains gluten, a protein found in wheat, barley, rye, spelt, kamut, and oats. It is hidden in pizza, pasta, bread, wraps, rolls, and most processed foods. Clearly, gluten is a staple of the American diet.

What most people don’t know is that gluten can cause serious health complications for many. You may be at risk even if you don’t have full blown celiac disease.

In today’s blog I want to reveal the truth about gluten, explain the dangers, and provide you with a simple system that will help you determine whether or not gluten is a problem for you.

The Dangers of Gluten

A recent large study in the Journal of the American Medical Association found that people with diagnosed, undiagnosed, and "latent" celiac disease or gluten sensitivity had a higher risk of death, mostly from heart disease and cancers.(i)

This study looked at almost 30,00 patients from 1969 to 2008 and examined deaths in three groups: Those with full-blown celiac disease, those with inflammation of their intestine but not full-blown celiac disease, and those with latent celiac disease or gluten sensitivity (elevated gluten antibodies but negative intestinal biopsy).

The findings were dramatic. There was a 39 percent increased risk of death in those with celiac disease, 72 percent increased risk in those with gut inflammation related to gluten, and 35 percent increased risk in those with gluten sensitivity but no celiac disease.

This is ground-breaking research that proves you don’t have to have full-blown celiac disease with a positive intestinal biopsy (which is what conventional thinking tells us) to have serious health problems and complications -- even death -- from eating gluten.

Yet an estimated 99 percent of people who have a problem with eating gluten don’t even know it. They ascribe their ill health or symptoms to something else -- not gluten sensitivity, which is 100 percent curable.

And here’s some more shocking news ...

Another study comparing the blood of 10,000 people from 50 years ago to 10,000 people today found that the incidences of full-blown celiac disease increased by 400 percent (elevated TTG antibodies) during that time period.(ii) If we saw a 400 percent increase in heart disease or cancer, this would be headline news. But we hear almost nothing about this. I will explain why I think that increase has occurred in a moment. First, let’s explore the economic cost of this hidden epidemic.

Undiagnosed gluten problems cost the American healthcare system oodles of money. Dr. Peter Green, Professor of Clinical Medicine for the College of Physicians and Surgeons at Columbia University studied all 10 million subscribers to CIGNA and found those who were correctly diagnosed with celiac disease used fewer medical services and reduced their healthcare costs by more than 30 perecent.(iii) The problem is that only 1 percent of those with the problem were actually diagnosed. That means 99 percent are walking around suffering without knowing it, costing the healthcare system millions of dollars.

And it’s not just a few who suffer, but millions. Far more people have gluten sensitivity than you think -- especially those who are chronically ill. The most serious form of allergy to gluten, celiac disease, affects 1 in 100 people, or 3 million Americans, most of who don’t know they have it. But milder forms of gluten sensitivity are even more common and may affect up to one-third of the American population.

Why haven’t you heard much about this?

Well, actually you have, but you just don’t realize it. Celiac disease and gluten sensitivity masquerade as dozens and dozens of other diseases with different names.

Gluten Sensitivity: One Cause, Many Diseases

A review paper in The New England Journal of Medicine listed 55 "diseases" that can be caused by eating gluten.(iv) These include osteoporosis, irritable bowel disease, inflammatory bowel disease, anemia, cancer, fatigue, canker sores(v), and rheumatoid arthritis, lupus, multiple sclerosis, and almost all other autoimmune diseases. Gluten is also linked to many psychiatric(vi) and neurological diseases, including anxiety, depression(vii), schizophrenia,(viii) dementia(ix), migraines, epilepsy, and neuropathy (nerve damage).(x) It has also been linked to autism.(xi)

We used to think that gluten problems or celiac disease were confined to children who had diarrhea, weight loss, and failure to thrive. Now we know you can be old, fat, and constipated and still have celiac disease or gluten sensitivity.

Gluten sensitivity is actually an autoimmune disease that creates inflammation throughout the body, with wide-ranging effects across all organ systems including your brain, heart, joints, digestive tract, and more. It can be the single cause behind many different "diseases." To correct these diseases, you need to treat the cause -- which is often gluten sensitivity -- not just the symptoms.

Of course, that doesn’t mean that ALL cases of depression or autoimmune disease or any of these other problems are caused by gluten in everyone -- but it is important to look for it if you have any chronic illness.

By failing to identify gluten sensitivity and celiac disease, we create needless suffering and death for millions of Americans. Health problems caused by gluten sensitivity cannot be treated with better medication. They can only be resolved by eliminating 100 percent of the gluten from your diet.

The question that remains is: Why are we so sensitive to this "staff of life," the staple of our diet?

There are many reasons ...

They include our lack of genetic adaptation to grasses, and particularly gluten, in our diet. Wheat was introduced into Europe during the Middle Ages, and 30 percent of people of European descent carry the gene for celiac disease (HLA DQ2 or HLA DQ8), which increases susceptibility to health problems from eating gluten.

American strains of wheat have a much higher gluten content (which is needed to make light, fluffy Wonder Bread and giant bagels) than those traditionally found in Europe. This super-gluten was recently introduced into our agricultural food supply and now has "infected" nearly all wheat strains in America.

To find out if you are one of the millions of people suffering from an unidentified gluten sensitivity, just follow this simple procedure.

The Elimination/Reintegration Diet

While testing can help identify gluten sensivity, the only way you will know if this is really a problem for you is to eliminate all gluten for a short period of time (2 to 4 weeks) and see how you feel. Get rid of the following foods:

    • Gluten (barley, rye, oats, spelt, kamut, wheat, triticale -- see www.celiac.com for a complete list of foods that contain gluten, as well as often surprising and hidden sources of gluten.)
    • Hidden sources (soup mixes, salad dressings, sauces, as well as lipstick, certain vitamins, medications, stamps and envelopes you have to lick, and even Play-Doh.)

For this test to work you MUST eliminate 100 percent of the gluten from your diet—no exceptions, no hidden gluten, and not a single crumb of bread.

Then eat it again and see what happens. If you feel bad at all, you need to stay off gluten permanently. This will teach you better than any test about the impact gluten has on your body.

But if you are still interested in testing, here are some things to keep in mind.

Testing for Gluten Sensitivity or Celiac Disease

There are gluten allergy/celiac disease tests that are available through Labcorp or Quest Diagnostics. All these tests help identify various forms of allergy or sensitivity to gluten or wheat. They will look for:

    • IgA anti-gliadin antibodies
    • IgG anti-gliadin antibodies
    • IgA anti-endomysial antibodies
    • Tissue transglutaminase antibody (IgA and IgG in questionable cases)
    • Total IgA antibodies
    • HLA DQ2 and DQ8 genotyping for celiac disease (used occasionally to detect genetic suspectibility).
    • Intestinal biopsy (rarely needed if gluten antibodies are positive -- based on my interpretation of the recent study)

When you get these tests, there are a few things to keep in mind.

In light of the new research on the dangers of gluten sensitivity without full blown celiac disease, I consider any elevation of antibodies significant and worthy of a trial of gluten elimination. Many doctors consider elevated anti-gliadin antibodies in the absence of a positive intestinal biopsy showing damage to be "false positives." That means the test looks positive but really isn’t significant.

We can no longer say that. Positive is positive and, as with all illness, there is a continuum of disease, from mild gluten sensitivity to full-blown celiac disease. If your antibodies are elevated, you should go off gluten and test to see if it is leading to your health problems.

So now you see -- that piece of bread may not be so wholesome after all! Follow the advice I’ve shared with you today to find out if gluten may be the hidden cause of your health problems. Simply eliminating this insidious substnace from your diet, may help you achieve lifelong vibrant health.

That’s all for today. Now I’d like to hear from you ...

Are you one of the millions that have been lead to believe gluten is perfectly safe to eat?

How do foods that contain gluten seem to affect you?

What tips can you share with others about eliminating gluten from your diet?

Please let me know your thoughts by posting a comment below.

To your good health,

Mark Hyman, MD

References

(i) Ludvigsson JF, Montgomery SM, Ekbom A, Brandt L, Granath F. Small-intestinal histopathology and mortality risk in celiac disease. JAMA. 2009 Sep 16;302(11):1171-8.

(ii) Rubio-Tapia A, Kyle RA, Kaplan EL, Johnson DR, Page W, Erdtmann F, Brantner TL, Kim WR, Phelps TK, Lahr BD, Zinsmeister AR, Melton LJ 3rd, Murray JA. Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology. 2009 Jul;137(1):88-93

(iii) Green PH, Neugut AI, Naiyer AJ, Edwards ZC, Gabinelle S, Chinburapa V.
Economic benefits of increased diagnosis of celiac disease in a national managed care population in the United States. J Insur Med. 2008;40(3-4):218-28.

(iv) Farrell RJ, Kelly CP. Celiac sprue. N Engl J Med. 2002 Jan 17;346(3):180-8. Review.

(v) Sedghizadeh PP, Shuler CF, Allen CM, Beck FM, Kalmar JR. Celiac disease and recurrent aphthous stomatitis: a report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(4):474-478.

(vi) Margutti P, Delunardo F, Ortona E. Autoantibodies associated with psychiatric disorders. Curr Neurovasc Res. 2006 May;3(2):149-57. Review.

(vii) Ludvigsson JF, Reutfors J, Osby U, Ekbom A, Montgomery SM. Coeliac disease and risk of mood disorders--a general population-based cohort study. J Affect Disord. 2007 Apr;99(1-3):117-26. Epub 2006 Oct 6.

(viii) Ludvigsson JF, Osby U, Ekbom A, Montgomery SM. Coeliac disease and risk of schizophrenia and other psychosis: a general population cohort study.
Scand J Gastroenterol. 2007 Feb;42(2):179-85.

(ix) Hu WT, Murray JA, Greenaway MC, Parisi JE, Josephs KA. Cognitive impairment and celiac disease. Arch Neurol. 2006 Oct;63(10):1440-6.

(x) Bushara KO. Neurologic presentation of celiac disease. Gastroenterology. 2005 Apr;128(4 Suppl 1):S92-7. Review.

(xi) Millward C, Ferriter M, Calver S, Connell-Jones G. Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev. 2004;(2):CD003498. Review.

(xii) Green PH, Jabri B. Coeliac disease. Lancet. 2003 Aug 2;362(9381):383-91. Review.

 

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by zoewhite at 12:41 AM on 01/07/10

Very useful and informative. This HAS really slipped under the radar of the media. 

I wonder what Dr. Hyman thinks of the recent (1/2010) AAP supplement from the Autism committee denying any association of diet and Autism, leaky gut etc.

I suspect that the  studies quoted/reviewed (though I have not reviewed them) were not powered to find the sensitive individuals but the general trend.

I look forward to his comments.

 

by doccrisco at 05:40 AM on 01/07/10

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by jameskall00 at 07:04 AM on 01/07/10

Oats do not themselves contain gluten.  For gluten sensitive persons, oats (as with any other food products) must be processed in facilities that do not produce wheat and or other gluten containing products.  There are several good sources of oats that follow these procedures. 

by mjbogdanov at 07:45 AM on 01/07/10

inmotion

Very true.   My daughter who has celiac could not eat oatmeal, but is now eating the "gluten free" oats, and is fine.  Apparently the oats were contaminated with wheat, which baffled the Doctors, as oats have a different molecule than gluten? so it did not make sense scientifically...

by inmotion at 12:01 PM on 01/07/10

Working with a nutritionist, I discovered I was gluten intolerant.  She instructed me to only eat "steel-cut" oats.  The machinery that is used to process "steel-cut" oats is only used on oats, not wheat. I've eaten "steel-cut" oats for years without a problem!

by earm1511 at 12:55 PM on 01/07/10

So glad you made the clarification.  I know my husband has gluten senisitivity, but he chooses to ignore the link to his ulcerative colitis. (He had IGg testing at one point that showed a high sensitivity to wheat and rye. However his hot-shot gastro pooh-poohed  my gluten question and says gluten intolerance has no link to UC. "you either have celiac disease or you don't. Period")

I've read just about everything I can get my hands on about the gluten thing and current  nutritional evidence is that steel cut or certified gluten free oats are fine. I"m surprised Dr. Hyman is a little behind the times on this.

by kanoshrosieposie at 11:55 AM on 01/11/10

I know a lady who suffered from SEVERE 'eczema' for many, many years. Her face was literally pealing off and it looked as though she had been burned. She looked very bad. It affected most of her face, head and arms. She tried everything she could think of, including going to doctors and nothing worked. Last year she was in Holland, where she originates from, and found a naturopathic doctor who knows about gluten allergies. He did some special blood tests and found she was highly allergic. She stopped eating products with gluten and you should see her now. All her skin problems have cleared up. Wow. It's a miracle.

by surayajan at 09:36 AM on 01/07/10

inmotion

My daughter, who is 23, was diagnosed as "the worst case of celiac, yet the healthiest" the head of pediatric gastrentology has ever seen.  She was 18, and was misdiagnosed as 'lactose intolerant' for 3 years.    She changed her diet, got imediate relief, and its been a continuous journey of learning.  She recently realized she is also intolerant to soy.  Good news is she has a healthy baby boy who is 1 yr old.  She ate and used all organic during pregnancy, and continued during breast feeding.  Unfortunately, probably because of stress and work, her milk dried up at 6 months.  My grandson is extremely healthy, not overweight, walked at 8 months, and did get his first ear infection. That is great, since she and her brother had ear infections every six weeks when they were little.   My point is....I truly believe the organic, gluten free diet is very healthy, and she also took Juice PLUS+ during pregnancy.  This is an extra 17 fruits and vegatables every day in capsule form.    She stopped taking Juice Plus after pregancy for various reasons, and was soooo tired.  She started taking it again, and her energy has returned.    I highly recommend eating organic, more veggies, and eating Juice Plus. Its really not that hard to eat gluten free.  You can't stop and grab something at the fast food window...but thats a blessing in disguise.   Everyone can benefit from better nutrition and Juice Plus.....the proof is in our personal stories and 17 cllinical studies....it mirrors everything Dr. Hyman believes in...better nutrition.  And its easy!    

by inmotion at 11:53 AM on 01/07/10

I read the UltraMind Solution and as a health conscious psychotherapist and hypnotherapist I usually recommend to clients the book, and the website.  In hypnotherapy I give suggestions to become healthier by eating and sleeping in self healing ways.  I know by my experience that there is a great deal of sense in eating healthy.  What sometimes baffles me is why people are programmed to be addicted to certain unhealthy foods, and how addictions of all kinds have been so common in society.  With all the misinformation I just wonder if the insurance reform can use functional medicine when the Medical Associations, Department of Agriculture, Food conglomerates and Media have vested interest in preventing health in people as well as in life in general on the planet. 

by susanrazavitherapist.com at 01:07 PM on 01/07/10

Two years ago, I heard a report about gluten and how many were sensitive.  I had had vague symptoms for years and doctors, homeopaths, naturopaths -- none recommended that I elimnate gluten but the report spurred me to take personal action.  For two weeks I ate NO gluten.  Then I had a piece of bread -- wow!  Did I feel lousy.  I had diarrhea -- my stomach felt bloated and I was craving sweets.  I immediately became very strict in removing all gluten.  It is SO worth it.  I easily lost 30 pounds and I have a ton more energy and I sleep well.  I'm 72.  I believe that I suffered for nearly 20 years before I figured this out.  I do need to be strict and I read all labels.  I hope many, many  people will try this simple solution.  BTW -- my ankles were constantly swollen and my feet hurt and because the gluten affects inflammation that was another way it affected me.  I just love my new slim feet!  aging well coach

by agingwellcoach at 01:32 PM on 01/07/10

Is Ezekiel Bread Gluten Free?

by Ila at 01:36 PM on 01/07/10

The answer is no, it is not.  Food For Life makes the most popular Ezekiel bread on the market, which is carried at Whole Foods and many other chain stores.  Ezkiel bread is a whole sprouted grain bread that has wheat grain and berries in it.

What is a bit confusing is that Food For Life also has a line of Gluten Free Breads (3) and tortillas that are packaged similarly to the Ezikiel bread . . . so you need to be cautious  . . . unless it specifically states Gluten Free, it's not.

 

by karenwinslow1 at 11:07 PM on 01/07/10

I quit eating gluten and in fairly short order life-long (60+ years) conditions had begun reversal.  A bite of holiday stuffing, which should have been a warning (bad feeling in stomach), folowed by a serving, was followed by 24 hours of symptoms.  Corn and quinoa pasta, millet bread, delicious and no symptoms, no problems.  Life is good.

by Jillel at 02:30 PM on 01/07/10

My husband just fowrarded an email to me today which also covered gluten and celiac disease and besides the diet Sherry Brescia also suggested that a great probiotic which she has created and sells does wonders for this problem of gluten and celiac disease.

Kris in Montana

by Drmom9 at 05:02 PM on 01/07/10

My autistic son, now 15 has been recovered using chelation of mercury (lead and arsenic too) and the gluten/casein free diet along with supplements and sensory integration.

My eldest daughter ,30, has recovered about 90% from her chronic fatigue using similar protocols.

One of the many doctors whose lectures I listened to was Natasha Campbell-McBride, a Russian trained Physician from the UK who recovered her own autistic son. She did an MA in molecular nutrition and went on to treat hundreds of spectrum kids.

Her book is "Gut and Psychology Syndrome" (the so-called "GAPS diet"). She explains the theory behind the diet and even includes recipes for healing the gut, getting rid of Candida Albicans etc etc.

 

I HIGHLY recommend her approach. 

 

 

 

 

 

 

mumofautismcfs

by mumofautismcfs at 08:03 PM on 01/07/10

Your article was very informative and confirms many ideas I've had all along about celiac.

My 13 year old daughter has celiac disease and went undiagnosed for the first seven years of her life (over half of her young life!). She had horrible stomach cramps and was constantly constipated.  As a toddler, I remember her walking around every night holding her tummy and crying.  When she went to the bathroom, she was in terrible pain.  At first they thought it was a dairy allergy, because the constipation was not on the list of symptoms initially.  One day our pediatrician called me and said to have her blood tested because they had added constipation to the list of symptoms.  She immediatley tested positive.

I spent the next four weeks in Whole Foods reading labels and substituting items for foods she enjoyed.  I purchased brightly colored cutting boards and utensils that stood out from our usual ones.  I bought her a new toaster, waffle iron and sandwich griller.  I made a cupbord just for her gluten free foods that is far away from any other food cupboards.  We bought a small freezer chest for the basement that can hold frozen items . . . such as her sandwich bread which we get a monthly shipment of from Canada. 

Once everything was set in place, everything just functioned automatically and she improved dramatically.  We have mastered the art of eating out in restaurants all over the world.  I have translated favorite family pasta and cookie recipes into gluten free effortlessly  because I found a wonderful all purpose flour.  It's all in the ingredients as they say!

I really believe that through the years the ultra processing of foods has caused an increase in this disease.  I also believe that the United States has been so slow to diagnose Celiac Disease instead of the many other ailments you mention, because it does not require constant doctor's attention or appointments or pharmacuticals once it is properly diagnosed and treated.  All it requires is good common sense and healthy eating.

by karenwinslow1 at 10:57 PM on 01/07/10

My husband is also gluten intolerant, which we discovered after years of trial and error.  The more I read in my studies in preperation for health counseling, it just made sense.  He is now doing very well and gaining healthy muscle weight.  My question, is that even for someone who loves to cook, it can be challenging to find just the right ingredients for converting recipies to gluten free.  I was wondering which gluten free all purpose flour you have chosen.  I have tried a number of them, but have not come across one that he really loves.

BlessingsSmile

  In the majority of cases, being healthy really comes down to making a choice.....what will you choose? Healthybychoiceonline.com / Holistic Health Counseling

by healthybychoiceonline.com at 12:26 PM on 01/19/10

I've had many food allergies (23) documented by an Immuno Labs Bloodprint test. Wheat was the primary grain I was allergic to. I enjoy eating oats, spelt and barley as alternatives to wheat. I followed the dietary guidelines for a few months, and did a reintroduction of allergens. This was 3 years ago, and I have relapsed to eating many of the foods I was allergic to and have experienced a return of symptoms.

I had the IgA anti-gliadin antibodies and IgG anti-gliadin antibodies tested and they were both negative. I am wondering if those results definitively indicate that I do not have gluten allergy or sensitivity, or if the additional tests Dr. Hyman discussed are also necessary to rule out gluten. My understanding is that the digestive system and immunological response in the body are always changing, so blood tests might provide a snapshot at best.

I plan to try the gluten self test but I am confused about how to tell if I feel bad because I am eating foods I am allergic to whether the gluten itself is bothering me as well.

by Elizabeth G at 01:23 PM on 01/08/10

My husband also is gluten intolerant, but we never would have known it by looking at his test results which came out negative.  Through my studies for holistic health counseling, I recognized that he also had a skin condition that can be indicative of celiac disease which also runs in his family.  I have read over and over that you cannot trust the blood test results.  Apparently "false negatives" are very common.  Dr. Hyman is correct, that elimination is really the only way to know.  The tough thing can be accepting the reality of being gluten intolerant.  Ignoring it, or denying it can be very dangerous to your health.  Be aware also, that spelt is a form of wheat, and though it is lower in gluten, it still has it.  Also, so does barley and oats that are not "gluten free".  You would be better sticking with different forms of brown rice, millet, buckwheat (which is not actually wheat), and my favorite....quinoa.

 BlessingSmile

In the majority of cases, being healthy really comes down to making a choice.....what will you choose? Healthybychoiceonline.com / Holistic Health Counseling

by healthybychoiceonline.com at 12:35 PM on 01/19/10

Does anyone know if Enterolab is a reliable company for Gluten testing..

Thanks 

 

by murphy at 06:54 PM on 01/08/10

In an effort to lose stubborn weight (my heart specialist wanted me to lose 10 -12 kilograms), I tried an eating plan flor about 2 months that cut out bread and other such items - and I stopped being bloated and feeling sick after every meal.  Plus dropping weight (probably because having  retained a great deal of fluid when I was eating gluten products).

Then I re-introduced all these items in moderate amounts as per eating plan and immediately I began to feel ill again. (and gained weight rapidly).  Finally, I went to the doctor to get a test done to see if I was intolerant to gluten.

The test came back as being on the edge (?) and as I discussed this matter with my doctor and  I also mentioned I couldn't drink milk or eat custard (home made) without severe stomach cramps, pains, bloating, diarreha ; he suggested I might stay on a gluten free diet as I was probably mildly intolerant.  And that lactose intolerance went hand in hand with gluten intolerance.

A couple of months later, eating at a restaurant whose staff assured me the batter on the fish was cornstarch only not gluten, I was violently ill all night,violently vomiting and suffering stomach pains, cramps, diarreha and more or less hugging the toilet for six hours. (great when you are a guest in someone's home - luckily they had another toilet).

I have since been very diligent in avoiding gluten and only have a little plain skim milk yoghurt.

So I am very glad to read your very informative article which made me feel I wasn't "carrying on" or feeling a freak and a nuisance when eating at friends' places.

In fact a few months ago, my hubby and I were eating breakfat with a group of friends at a restaurant at the beach, and one friend leaned across to me, patting me on the shoulder, and said quitely seriously,"Don't worry about gluten today. Forget about it and eat what you like and whatever you like.  Just enjoy the food and really enjoy the day and do the gluten thingy again tomorrow."  Flabbergasted, I just stared at her and she assured me I'd have a lovely day without fussing about gluten and such like.  I am still amazed at this comment.  She meant it kindly in the tone and mindset of someone suggesting settling for a beachy outfit rather than a more formal dress.  

Luckily for me, the owner of the restaurant's partner was a cealiac and she had several wonderful dishes for breakfast, brunch and lunch.  

Although many "products" are now on the market, I prefer to make all my gluten free foods myself and avoid all those awful chemicals which seem to creep into these products.

Thank you again Cheers Peggy

 

 

 

 

 

 

by Peggywho at 11:30 PM on 01/08/10

Sometimes I get this feeling , especially around my mestral cycle , like I am craving Gluten. DOes anyone else get this feeling? Is it "normal"? How do I curb it? 

 

Thanks

 

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by rebepa333 at 01:13 PM on 01/10/10

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