The Hidden Biology of Body Fat Distribution: Men vs. Women – Why Shape Matters More Than Size

We often judge health by overall weight or BMI, but the location of your fat is arguably far more critical than the total amount. Body Fat Distribution: Men vs. Women reveals profound biological differences influencing not just appearance, but long-term metabolic health, disease risk, and even how we respond to diet and exercise. Understanding these patterns – the classic “apple” shape more common in men versus the “pear” shape often seen in women – isn’t just about aesthetics; it’s about unlocking the keys to personalized health strategies. Why do men tend to carry weight around their middles, while women often store it in hips and thighs? And what does this mean for your health? This comprehensive guide dives deep into the science, debunks myths, and offers evidence-based insights.

Why Fat Location is the Real Health Indicator (Beyond BMI)

For decades, Body Mass Index (BMI) reigned supreme as the go-to health metric. But its limitations are glaring. BMI doesn’t distinguish between muscle and fat, nor does it reveal where fat is stored. Two individuals with identical BMIs can have drastically different body compositions and health risks based entirely on their body fat distribution.

• The Apple Shape (Android Obesity): Characterized by excess fat accumulation around the abdomen and internal organs (visceral fat). This pattern is more common in men.

• The Pear Shape (Gynoid Obesity): Characterized by excess fat accumulation around the hips, buttocks, and thighs (subcutaneous fat). This pattern is more common in women.

Research consistently shows that the “apple” shape, driven by visceral fat, carries significantly higher risks for cardiovascular disease, type 2 diabetes, certain cancers, and metabolic syndrome, even at lower total body weights. Conversely, the “pear” shape, particularly gluteal-femoral fat, appears to offer some metabolic protection. Understanding the fundamental differences in body fat distribution between men and women is crucial for accurate risk assessment and effective intervention.

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The Stark Biology: How Men and Women Store Fat Differently

The most visible difference in body fat distribution: men vs. women comes down to primary storage depots:

1. Men (Predominantly Android/Visceral Fat):

   • Visceral Adipose Tissue (VAT): Fat stored deep within the abdominal cavity, surrounding internal organs like the liver, intestines, and kidneys. This is metabolically active and dangerous.

   • Upper Body Subcutaneous Fat: Fat stored under the skin in the abdominal area. While still subcutaneous, it often correlates with higher visceral fat in men.

   • Key Driver: Higher testosterone levels, genetic predisposition, and lifestyle factors contribute to central fat storage.

2. Women (Predominantly Gynoid/Subcutaneous Fat):

   • Gluteal-Femoral Adipose Tissue (GFAT): Fat stored subcutaneously in the hips, buttocks, and thighs. This depot is metabolically more benign and may even be protective.

   • Lower Body Subcutaneous Fat: Encompasses GFAT and other lower body subcutaneous stores.

   • Breast Tissue: Primarily composed of specialized adipose tissue.

   • Key Driver: Estrogen is a major regulator, promoting fat storage in the lower body, especially during reproductive years. Genetics also play a significant role.

Crucial Stat: Women generally have about 10% higher total body fat percentage than men at the same BMI level. This difference is biologically programmed and essential for functions like reproduction.

Visceral Fat vs. Subcutaneous Fat: Why the Belly is the Beast

Not all fat is created equal. The health impact hinges dramatically on the type of fat and its location within the body fat distribution: men vs. women spectrum.

• Visceral Fat (The Active Threat – Prominent in Men):

  • Location: Deep inside the abdomen, packed around organs.

  • Metabolism: Highly metabolically active. Releases a constant stream of free fatty acids (FFAs) directly into the portal vein, flooding the liver.

  • Hormone Secretion: Produces inflammatory cytokines (like TNF-alpha, IL-6) and adipokines (like leptin, resistin) that promote insulin resistance, inflammation, and blood clotting.

  • Blood Supply: Richly supplied with blood vessels and nerves, making it highly responsive to stress hormones.

  • Health Risks: Strongly linked to insulin resistance, type 2 diabetes, heart disease, stroke, fatty liver disease, certain cancers (e.g., colon), and Alzheimer’s disease. It’s the primary driver behind the dangers of the “apple” shape.

• Subcutaneous Fat (The Storage Depot – Prominent in Women’s Lower Body):

  • Location: Under the skin, throughout the body (buttocks, thighs, abdomen, arms).

  • Metabolism: Primarily acts as an energy storage reservoir. Releases FFAs more slowly and systemically.

  • Hormone Secretion: Produces beneficial adipokines like adiponectin (which improves insulin sensitivity and fights inflammation), especially from the gluteal-femoral region.

  • Blood Supply: Less dense vascularization compared to visceral fat.

  • Health Risks: Generally considered less harmful than visceral fat. Excess abdominal subcutaneous fat still carries some risk, but gluteal-femoral subcutaneous fat in women is associated with lower cardiometabolic risk and may even be protective. It acts as a “metabolic sink,” safely sequestering excess fatty acids.

Key Insight: The preferential storage of fat in the safer gluteal-femoral depot is a major reason why premenopausal women often have better metabolic health (lower triglycerides, higher HDL cholesterol, better insulin sensitivity) than men at similar BMI levels, despite having more total body fat.

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Hormones: The Master Conductors of Fat Distribution

Sex hormones (estrogen and testosterone) are the primary architects sculpting the distinct patterns of body fat distribution: men vs. women.

• Estrogen (The Female Fat Director):

  • Promotes Fat Storage: Enhances the activity of Lipoprotein Lipase (LPL), the enzyme that pulls triglycerides from the bloodstream into fat cells, particularly in the gluteal-femoral region.

  • Suppresses Fat Breakdown (Lipolysis): Makes fat cells in the hips and thighs less responsive to the fat-mobilizing effects of catecholamines (like adrenaline), making it harder to lose fat from these areas.

  • Protective Effect: Contributes to the favorable metabolic profile associated with lower body fat (higher adiponectin, better insulin sensitivity). The drop in estrogen during menopause explains the shift towards abdominal fat storage and increased metabolic risk in older women.

  • Direct FFA Uptake: Women are more efficient at directly taking up circulating Free Fatty Acids (FFAs) into subcutaneous fat stores, especially peripherally, preventing them from causing damage elsewhere.

• Testosterone (The Male Fat Director):

  • Promotes Central Fat Storage: Favors the development of visceral and upper body subcutaneous fat depots.

  • Stimulates Fat Breakdown (Lipolysis): Increases the sensitivity of abdominal fat cells to catecholamines, leading to higher rates of FFA release, especially from visceral depots (contributing to liver fat accumulation and insulin resistance).

  • Inhibits Lower Body Fat: Discourages fat accumulation in the gluteal-femoral region. Low testosterone in men can paradoxically lead to increased abdominal fat and gynecomastia.

• Cortisol (The Stress Hormone): Chronically elevated cortisol (due to chronic stress) promotes visceral fat accumulation in both sexes, amplifying the risks associated with the “apple” shape.

The Hormonal Shift:

• Puberty: Triggers the development of sex-specific fat patterns.

• Pregnancy: Promotes fat storage (especially gluteal-femoral) for energy reserves.

• Menopause: Declining estrogen leads to a shift from gynoid (pear) to android (apple) distribution, increasing visceral fat and metabolic risk.

• Andropause (Male Menopause): Gradual decline in testosterone can lead to increased abdominal fat and reduced muscle mass.

Metabolism in Action: Storage, Release & Burning

The fundamental metabolic processes of fat cells (adipocytes) also exhibit differences in body fat distribution: men vs. women:

1. Fat Storage (Lipogenesis):

   • Women: More efficient at storing dietary fat, especially after a meal, into subcutaneous adipose tissue, particularly the gluteal-femoral depot. This is driven by higher LPL activity in these regions under estrogen’s influence. They also have a greater capacity for “direct FFA uptake” into subcutaneous stores.

   • Men: Show greater uptake of dietary fat into visceral adipose tissue. Their abdominal subcutaneous fat may also be less efficient at long-term storage compared to women’s lower body fat.

2. Fat Release (Lipolysis):

   • Women: Have higher basal rates of lipolysis (fat release) from abdominal subcutaneous fat compared to men. During exercise or fasting, women show a greater increase in lipolysis from abdominal subcutaneous fat. Gluteal-femoral fat is very resistant to lipolysis. Women release more FFAs overall but handle them better (more oxidation, re-esterification).

   • Men: Show higher rates of lipolysis from visceral fat depots. Abdominal subcutaneous fat lipolysis is significant, but the visceral release is particularly problematic due to its direct route to the liver. Visceral fat is highly sensitive to lipolytic stimuli.

3. Fat Burning (Oxidation):

   • Women: At rest, men and women oxidize similar proportions of fat vs. carbs. However, during moderate-intensity exercise, women rely more on fat as a fuel source than men do, who tend to burn more carbohydrates. This may be an adaptation to preserve glycogen stores. Women also show higher non-oxidative FFA disposal (re-storage).

   • Men: Tend to oxidize more carbohydrates during exercise. Postprandial (after-meal) fat oxidation might be slightly higher in men.

The “Fat Burning” Myth: While women may burn a higher proportion of fat during moderate exercise, men, due to typically higher muscle mass and absolute workload, often burn more total fat calories in the same session. Spot reduction (losing fat from a specific area by exercising it) remains a myth for both sexes.

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Health Risks: Why Your Fat’s Zip Code Matters

The location of your fat profoundly impacts your disease risk profile. Here’s how body fat distribution: men vs. women translates to health outcomes:

• High Risk (Visceral/Abdominal Fat – “Apple Shape” – More Common in Men):

  • Cardiovascular Disease (Heart Attack, Stroke): Strongest association. Visceral fat promotes inflammation, dyslipidemia (high triglycerides, low HDL), high blood pressure, and endothelial dysfunction.

  • Type 2 Diabetes: Visceral fat directly causes insulin resistance in the liver and muscles. High FFA flux impairs insulin signaling. Pro-inflammatory cytokines worsen resistance.

  • Metabolic Syndrome: A cluster of conditions (abdominal obesity, high blood pressure, high blood sugar, unhealthy cholesterol levels) driven by visceral fat and insulin resistance.

  • Non-Alcoholic Fatty Liver Disease (NAFLD): Fat accumulation in the liver, directly fueled by FFAs from visceral fat draining via the portal vein.

  • Certain Cancers: (e.g., colorectal, pancreatic, postmenopausal breast cancer). Chronic inflammation and elevated insulin/IGF-1 levels are likely culprits.

  • Sleep Apnea: Abdominal fat can physically impede breathing.

  • Dementia/Alzheimer’s Disease: Links are emerging via vascular damage and inflammation.

• Lower Risk (Gluteal-Femoral Fat – “Pear Shape” – More Common in Pre-Menopausal Women):

  • Metabolic Protection: Associated with lower triglycerides, higher HDL (“good”) cholesterol, better insulin sensitivity, and lower inflammatory markers compared to abdominal fat storage at the same total fat mass.

  • Cardiovascular Protection: Lower risk of heart disease and stroke compared to those with similar BMI but abdominal obesity.

  • “Safe Sink” Hypothesis: Gluteal-femoral fat may act as a buffer, safely storing excess lipids and fatty acids that would otherwise ectopically deposit in organs like the liver or muscle or contribute to harmful blood lipid levels. It releases beneficial adiponectin.

The Menopause Shift: The loss of estrogen protection and shift towards visceral fat accumulation after menopause significantly increases women’s risk for all the conditions listed under “High Risk,” catching up to and sometimes surpassing men’s risk profiles for heart disease.

Measuring Your Risk: Beyond the Bathroom Scale

Assessing body fat distribution: men vs. women requires simple tools, not just a scale:

1. Waist Circumference:

   • How: Measure at the narrowest point between the bottom of your ribs and the top of your hip bones (usually near the navel). Breathe out normally before measuring.

   • High-Risk Thresholds:

     • Men: ≥ 40 inches (102 cm)

     • Women: ≥ 35 inches (88 cm)

   • Why it matters: Directly correlates with visceral fat levels and metabolic risk.

2. Waist-to-Hip Ratio (WHR):

   • How: Measure waist circumference (as above). Measure hip circumference at the widest part of your buttocks. Divide waist measurement by hip measurement.

   • High-Risk Thresholds:

     • Men: ≥ 0.90

     • Women: ≥ 0.85

   • Why it matters: Captures the classic “apple vs. pear” distinction. A higher ratio indicates more central/abdominal fat relative to hip fat.

3. Waist-to-Height Ratio (WHtR):

   • How: Divide your waist circumference by your height (both in the same units – inches or cm).

   • High-Risk Threshold: Generally considered high risk if ≥ 0.5 for both men and women. (e.g., A 70-inch tall person should aim for a waist < 35 inches).

   • Why it matters: Simple, height-adjusted measure strongly linked to visceral fat and health risks.

4. Body Fat Percentage (BFP) & Visceral Fat Rating (Advanced Tools):

   • Methods: Bioelectrical Impedance Analysis (BIA – scales/handhelds), DEXA scans (gold standard for body composition), CT/MRI scans (gold standard for visceral fat quantification, expensive/clinical).

   • Why it matters: Provides actual fat mass vs. muscle mass. Advanced scans directly measure dangerous visceral fat volume. BIA devices often give an estimated visceral fat rating.

Action Step: Measure your waist circumference today! It’s the single most practical and powerful indicator of risk related to body fat distribution.

Lifecycle Changes: Fat Distribution from Puberty to Golden Years

Body fat distribution: men vs. women isn’t static; it evolves dramatically throughout life, heavily influenced by hormonal shifts:

1. Childhood: Fat distribution is relatively similar between boys and girls. Subcutaneous fat predominates.

2. Puberty:

   • Boys: Testosterone surge drives muscle growth and a shift towards central (abdominal/visceral) fat deposition. Fat mass percentage typically decreases.

   • Girls: Estrogen surge triggers breast development and significant fat accumulation, primarily in the gluteal-femoral region (hips, thighs, buttocks). Fat mass percentage increases.

3. Reproductive Years (Women):

   • Estrogen dominance maintains the gynoid (pear) pattern. Gluteal-femoral fat serves as an energy reserve for potential pregnancy and lactation.

   • Pregnancy promotes further fat storage, especially in the lower body, for fetal development and breastfeeding energy needs.

4. Menopause (Women):

   • The dramatic decline in estrogen is a game-changer. Fat storage shifts from the lower body to the abdomen (visceral and subcutaneous).

   • Muscle mass tends to decrease.

   • This shift significantly increases the risk of metabolic syndrome, heart disease, and type 2 diabetes – risk profiles become more similar to (or even exceed) men of the same age.

5. Andropause (Men – Gradual):

   • Testosterone levels slowly decline with age (starting around 30-40, accelerating after 60).

   • This can lead to increased abdominal (visceral) fat accumulation and reduced muscle mass (sarcopenia).

   • Low testosterone itself is linked to insulin resistance and increased cardiovascular risk.

6. Aging (Both Sexes):

   • Tendency towards increased overall body fat percentage.

   • Loss of muscle mass (sarcopenia) further slows metabolism.

   • Physical activity often decreases.

   • Result: Increased risk of central obesity and its associated diseases in both sexes, though the hormonal drivers differ.

Key Takeaway: Hormonal transitions (puberty, menopause, andropause) are critical windows where understanding body fat distribution: men vs. women is vital for proactive health management.

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Busting Common Myths About Body Fat Distribution

Let’s separate fact from fiction regarding body fat distribution: men vs. women:

• Myth 1: “Spot Reduction” is Possible. You cannot lose fat from a specific area (like belly or thighs) by only exercising that area. Fat loss occurs systemically based on genetics and hormones. Crunches won’t magically melt belly fat; overall calorie deficit combined with strength training and cardio is key.

• Myth 2: Subcutaneous Fat is “Just as Bad” as Visceral Fat. While excess subcutaneous fat isn’t ideal, visceral fat is biologically active and poses a far greater direct threat to metabolic health. Gluteal-femoral subcutaneous fat in women is particularly less harmful.

• Myth 3: Women Can’t Build Muscle Like Men. Women absolutely can and should build muscle! While testosterone levels mean men generally build muscle faster and to a greater absolute size, women experience significant strength and metabolic benefits from resistance training, which is crucial for managing fat distribution, especially after menopause. Discover the differences in RF Microneedling vs Traditional Microneedling for skin benefits related to underlying tissue health.

• Myth 4: All Belly Fat is Visceral Fat. Abdominal fat includes both subcutaneous (under the skin) and visceral (around organs). You can have a “soft” belly (more subcutaneous) or a “hard” belly (more visceral). Waist circumference is a good proxy for total abdominal fat volume.

• Myth 5: Fat Distribution is Purely Genetic and Unchangeable. While genetics play a major role (explaining up to 70% of BMI variation), lifestyle factors like diet, exercise (especially intensity and type), stress management, and sleep significantly influence where your body stores fat, particularly visceral fat accumulation. Hormonal health is also modifiable.

Strategies for Managing a Healthier Fat Distribution

While you can’t completely override your genetic blueprint, you can significantly influence your body fat distribution: men vs. women and reduce dangerous visceral fat:

1. Prioritize Diet Quality & Calorie Balance:

   • Focus on Whole Foods: Vegetables, fruits, lean proteins (fish, poultry, legumes), whole grains, healthy fats (avocado, nuts, seeds, olive oil).

   • Control Portions: Be mindful of calorie intake to achieve a healthy weight or prevent weight gain, which directly impacts visceral fat.

   • Limit: Added sugars, sugary drinks, refined carbohydrates (white bread, pasta, pastries), excessive saturated and trans fats, and ultra-processed foods. These directly promote visceral fat storage and inflammation.

   • Consider Patterns: Mediterranean or DASH diets are consistently linked to healthier body composition and reduced visceral fat.

2. Embrace Regular Exercise (The Non-Negotiable):

   • High-Intensity Interval Training (HIIT): Highly effective for burning visceral fat. Involves short bursts of intense activity followed by rest.

   • Moderate-Intensity Cardio: Brisk walking, jogging, cycling, swimming for sustained periods (150+ minutes/week). Great for overall fat loss and heart health.

   • Strength Training (Resistance Training): CRITICAL. Builds muscle mass, which boosts resting metabolism and improves insulin sensitivity, helping to combat visceral fat. Aim for 2-3 sessions per week, targeting all major muscle groups. This is essential for both men and women, especially as they age.

   • Consistency is Key: Find activities you enjoy and stick with them long-term.

3. Master Stress Management:

   • Chronic stress = high cortisol = increased visceral fat storage.

   • Techniques: Mindfulness meditation, deep breathing exercises (box breathing), yoga, tai chi, spending time in nature, adequate sleep, hobbies, connecting with loved ones. Consider professional help if needed.

4. Prioritize Sleep (7-9 Hours Quality Sleep):

   • Poor sleep disrupts appetite hormones (ghrelin increases hunger, leptin decreases satiety), increases cravings for unhealthy food, raises cortisol, and impairs glucose metabolism – all promoting visceral fat gain.

5. Limit Alcohol:

   • Excessive alcohol contributes significantly to “beer belly” (visceral fat) due to its calorie content, impact on liver metabolism, and effect on hormones and appetite.

6. Consider Hormonal Health (Especially During Transitions):

   • Women (Menopause): Discuss symptoms and risks with your doctor. Hormone Replacement Therapy (HRT) might be appropriate for some women to help manage symptoms and potentially mitigate the shift towards visceral fat, but it’s not without risks and requires individualized assessment.

   • Men (Low Testosterone): If experiencing symptoms (low energy, reduced muscle mass, increased belly fat, low libido), get testosterone levels checked. Treatment may be warranted and can help improve body composition.

   • Both: Manage conditions like PCOS (in women) which involves insulin resistance and can worsen abdominal obesity.

7. Be Patient and Consistent: Changing body composition, especially reducing stubborn visceral fat, takes time and consistent effort. Focus on sustainable lifestyle changes, not quick fixes.

Case Studies: Real-World Impact of Fat Distribution

• Case Study 1 (Male, 48, “Apple Shape”): BMI 28, Waist 42 inches. High triglycerides, low HDL, borderline high blood sugar. Focused intervention: HIIT 3x/week, strength training 2x/week, adopted Mediterranean diet principles, reduced beer intake, improved sleep. After 6 months: Waist 38 inches, triglycerides normalized, HDL improved, blood sugar normalized. Key: Targeted visceral fat reduction through lifestyle overhaul.

• Case Study 2 (Female, 52, Post-Menopausal Shift): Always “pear-shaped,” noticed significant belly fat increase after menopause. Waist increased from 32 to 36 inches. Started strength training 3x/week (previously only cardio), increased protein intake, focused on stress reduction through yoga. After 9 months: Waist back to 33 inches, clothes fit better, energy improved. Key: Counteracted menopausal shift by building muscle and managing stress.

• Case Study 3 (Male, 35, “Skinny Fat”): Normal BMI (23), but waist 37 inches (high for his height – WHtR > 0.53). Sedentary job. DEXA scan revealed high body fat percentage (28%) and significant visceral fat. Intervention: Started consistent strength training 3x/week, added walking daily, reduced processed carbs/sugars. After 4 months: Waist 34 inches, body fat 22%, visceral fat reduced significantly. Key: Highlighted that BMI is insufficient; waist measurement and lifestyle change are crucial even at “normal” weight.

Frequently Asked Questions (FAQs)

1. Q: Can I change my natural body shape (apple/pear)?

   • A: You can’t fundamentally change your genetically determined skeletal structure or primary fat storage tendency. However, you can significantly reduce overall body fat, particularly dangerous visceral fat, and build muscle, which dramatically improves your health profile and body composition within your natural frame. A “pear” can become a leaner pear; an “apple” can reduce their belly fat substantially.

2. Q: Why is it so hard for women to lose thigh/hip fat?

   • A: Gluteal-femoral fat in women is biologically programmed to be more resistant to lipolysis (fat breakdown) due to high estrogen, lower blood flow, and higher alpha-2 adrenergic receptors (which inhibit fat release). It’s designed as a stable energy reserve. Patience, overall fat loss, and strength training to build muscle in those areas (giving a toned appearance) are key.

3. Q: Do men get cellulite?

   • A: Yes, but it’s much less common and usually less severe than in women. The primary reason is the structural difference in connective tissue (septae) under the skin. In women, it forms perpendicularly, allowing fat to bulge through more easily, creating the dimpled appearance. Men’s connective tissue is crisscrossed, providing more support. Differences in fat distribution and skin thickness also play roles.

4. Q: Is liposuction a good solution for belly fat or saddlebags?

   • A: Liposuction primarily removes subcutaneous fat, not visceral fat (the most dangerous kind). While it can contour specific areas, it’s not a weight loss solution or a substitute for lifestyle changes. Removing subcutaneous fat (especially gluteal-femoral in women) without addressing underlying lifestyle factors might even lead to increased visceral fat storage or fat redistribution elsewhere. It’s cosmetic, not therapeutic for metabolic health. Understand the differences in Cavitation vs Endermologie for Cellulite.

5. Q: How quickly does fat distribution change after menopause or starting/stopping hormones?

   • A: The shift in fat distribution during menopause is gradual but noticeable over several years as estrogen declines. Hormonal changes (like starting or stopping HRT, or testosterone therapy in men) can influence fat distribution patterns within weeks to months, but significant body composition changes still require concurrent diet and exercise.

6. Q: Are fat distribution patterns different across ethnicities?

   • A: Yes. For example, South Asians tend to have higher visceral fat at lower BMIs compared to Caucasians. African American women often have higher abdominal subcutaneous fat and may have VAT levels comparable to African American men at higher BMIs. These differences contribute to varying disease risk profiles among ethnic groups. Always use waist circumference as a key indicator regardless of ethnicity.

Conclusion: Embrace Your Biology, Optimize Your Health

Understanding Body Fat Distribution: Men vs. Women is not about judgment, but empowerment. It reveals the profound biological differences that shape our bodies and our health risks. While genetics set the stage, lifestyle is the powerful director. You cannot change your fundamental body type, but you absolutely can reduce dangerous visceral fat, build metabolically active muscle, and improve your overall health profile, regardless of whether you are an “apple” or a “pear.”

Stop obsessing over the number on the scale. Pick up a tape measure. Track your waist circumference. Prioritize strength training alongside cardio. Nourish your body with whole foods. Manage stress and prioritize sleep. Understand and respect your hormonal shifts throughout life.

By focusing on the location and health of your fat, rather than just the total amount, you take a giant leap towards personalized, effective, and sustainable health optimization. Your shape tells a story – understand it, work with your biology, and write a healthier next chapter.

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