Development of metabolic syndrome depends on distribution as well as amount of fat. Excess fat in the abdomen (called apple shape), particularly when it results in a high waist-to-hip ratio (reflecting a relatively low muscle-to-fat mass ratio), increases risk. The syndrome is less common among people who have excess subcutaneous fat around the hips (called pear shape) and a low waist-to-hip ratio (reflecting a higher muscle-to-fat mass ratio).
The Modified Atkins diet and modified ketogenic diet (sometimes called 'modified ketogenic therapy') use a high proportion of fats and a strict control of carbohydrates. These are often considered more flexible than the classical or MCT ketogenic diets, as more protein can be eaten, and approximate portion sizes may be used in place of weighed recipes.
Epilepsy is one of the most common neurological disorders after stroke,[7] and affects around 50 million people worldwide.[8] It is diagnosed in a person having recurrent, unprovoked seizures. These occur when cortical neurons fire excessively, hypersynchronously, or both, leading to temporary disruption of normal brain function. This might affect, for example, the muscles, the senses, consciousness, or a combination. A seizure can be focal (confined to one part of the brain) or generalised (spread widely throughout the brain and leading to a loss of consciousness). Epilepsy can occur for a variety of reasons; some forms have been classified into epileptic syndromes, most of which begin in childhood. Epilepsy is considered refractory (not yielding to treatment) when two or three anticonvulsant drugs have failed to control it. About 60% of patients achieve control of their epilepsy with the first drug they use, whereas around 30% do not achieve control with drugs. When drugs fail, other options include epilepsy surgery, vagus nerve stimulation, and the ketogenic diet.[7]
Patients with poor skin quality (cellulite) are not good candidates for liposuction because they may develop skin irregularities due to under- or over-correction of localized fat deposits. Age is generally not a major consideration when discussing liposuction; however, older patients often have less elasticity in their skin and thus may not achieve the same benefits of liposuction that a younger patient with tighter skin might achieve.
As you get older, your body changes how it gains and loses weight. Both men and women experience a declining metabolic rate, or the number of calories the body needs to function normally. On top of that, women have to deal with menopause. "If women gain weight after menopause, it's more likely to be in their bellies," says Michael Jensen, MD, professor of medicine in the Mayo Clinic's endocrinology division. In menopause, production of the hormones estrogen and progesterone slows down. Meanwhile, testosterone levels also start to drop, but at a slower rate. This shift in hormones causes women to hold onto weight in their bellies. The good news: you can fight this process. Read on.
Tumescence is the state of being ‘swollen and firm’ [Figure 2]. Tumescent liposuction uses large volumes of very dilute, hypotonic solutions of a vasoconstrictor agent that is gently injected into the subcutaneous fat and virtually eliminates surgical blood loss. It also permits the procedure to be done under regional anaesthesia with conscious sedation. Local anaesthesia may be supplemented for areas proximal to the level of the regional anaesthesia.
It is possible to combine the results of several small studies to produce evidence that is stronger than that available from each study alone—a statistical method known as meta-analysis. One of four such analyses, conducted in 2006, looked at 19 studies on a total of 1,084 patients.[23] It concluded that a third achieved an excellent reduction in seizure frequency and half the patients achieved a good reduction.[18]
[Guideline] Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009 Oct 20. 120(16):1640-5. [Medline].
I’m discouraged to see that nowhere in the article nor in the comments is there a mention of a diet’s best fit to genetics. Consider if someone is an APOE E2 carrier and/or has certain polymorphisms of the APO5 gene. These are quite rare in Okinawa but much more prevalent in the USA (12% of the population). According to a number of well-designed studies, these genetic characteristics point to a higher fat, lower carbohydrate diet as beneficial and even a “moderate” carb diet as problematic.
It is to be appreciated and emphasised that the dreaded complications of pulmonary embolism, deep venous thrombosis, penetration injuries, bleeding, pulmonary oedema, hypovolemic shock, fat emboli, drug toxicity and mortality are absent in every large series of large volume liposuction. In all these cases, credit goes to a strict adherence to the 5 pillars of safety (safe surgeon, safe anaesthesiologist, safe facility, safe co-workers and a properly selected patient).
You don’t have to go low-carb to ditch those extra pounds around your waist in a short period of time. In fact, opting for more whole grains might just get you there faster. Researchers at Tufts University have linked eating three or more daily servings of whole grains to as much as a 10 percent reduction in visceral body fat, the kind that ups your risk for chronic diseases, like diabetes, heart disease, and high blood pressure.
Selecting the right food will be easier as you become accustomed to the Keto approach. Instead of lean meats, you’ll focus on skin-on poultry, fattier parts like chicken thighs, rib-eye steaks, grass-fed ground beef, fattier fish like salmon, beef brisket or pork shoulder, and bacon. Leafy greens such as spinach, kale and lettuce, along with broccoli, cauliflower and cucumbers, make healthy vegetable choices (but you’ll avoid starchy root foods like carrots, potatoes, turnips and parsnips). You can work in less-familiar veggies such as kohlrabi or daikon.
Tumescent liposuction (fluid injection) is the most common type of liposuction. It involves injecting a large amount of medicated solution into the areas before the fat is removed. Sometimes, the solution may be up to three times the amount of fat to be removed). The fluid is a mixture of local anesthetic (lidocaine), a drug that contracts the blood vessels (epinephrine), and an intravenous (IV) salt solution. Lidocaine helps numb the area during and after surgery. It may be the only anesthesia needed for the procedure. Epinephrine in the solution helps reduce loss of blood, bruising, and swelling. The IV solution helps remove the fat more easily. It is suctioned out along with the fat. This type of liposuction generally takes longer than other types.
Liposuction, also referred to as Lipoplasty, is a procedure to remove the unwanted fat deposits from certain areas and contour the body. It can be performed on  men and women. Common sites for liposuction include the neck, arms, back, hips, thighs, and buttocks. Liposuction is best suited for patients who maintain a healthy weight and exercise regularly but continue to have certain problem areas.
Metabolic syndrome is increasing in prevalence, paralleling an increasing epidemic of obesity. In the United States, where almost two thirds of the population is overweight or obese, more than one fourth of the population meets diagnostic criteria for metabolic syndrome. [25] In the United States, data from a 1999-2000 survey showed that the age-adjusted prevalence of metabolic syndrome among adults aged 20 years or older had risen from 27% (data from 1988-1994) to 32%. [26]
Physicians of ancient Greece treated diseases, including epilepsy, by altering their patients' diet. An early treatise in the Hippocratic Corpus, On the Sacred Disease, covers the disease; it dates from c. 400 BC. Its author argued against the prevailing view that epilepsy was supernatural in origin and cure, and proposed that dietary therapy had a rational and physical basis.[Note 3] In the same collection, the author of Epidemics describes the case of a man whose epilepsy is cured as quickly as it had appeared, through complete abstinence of food and drink.[Note 4] The royal physician Erasistratus declared, "One inclining to epilepsy should be made to fast without mercy and be put on short rations."[Note 5] Galen believed an "attenuating diet"[Note 6] might afford a cure in mild cases and be helpful in others.[11]

Because the ketogenic diet alters the body's metabolism, it is a first-line therapy in children with certain congenital metabolic diseases such as pyruvate dehydrogenase (E1) deficiency and glucose transporter 1 deficiency syndrome,[35] which prevent the body from using carbohydrates as fuel, leading to a dependency on ketone bodies. The ketogenic diet is beneficial in treating the seizures and some other symptoms in these diseases and is an absolute indication.[36] However, it is absolutely contraindicated in the treatment of other diseases such as pyruvate carboxylase deficiency, porphyria, and other rare genetic disorders of fat metabolism.[9] Persons with a disorder of fatty acid oxidation are unable to metabolise fatty acids, which replace carbohydrates as the major energy source on the diet. On the ketogenic diet, their bodies would consume their own protein stores for fuel, leading to ketoacidosis, and eventually coma and death.[37]
You’ll see many doctors advertising liposuction as part of their practice; however, just because liposuction is readily available does not mean that just anyone can perform it well. You need to vet potential doctors carefully to find a cosmetic surgeon who can perform liposuction safely and achieve the results you desire. Pay attention to 3 key factors when choosing a cosmetic surgeon for your liposuction procedure:
Pushing yourself past the normal “threshold” is a great way to burn belly fat. According to the World Health Organization, the U.S. Dept. of Health and Human Services, and other authorities, adults should undertake almost two and a half hours of moderate-to-vigorous physical activity each week to maintain good health. If you regularly work out, but hardly break a sweat and don’t feel “challenged”, then your body probably won’t respond by gearing up its metabolism and burning those visceral fat cells. However, surprising your body with varied workout styles and intensities, beyond what you normally do, can kick-start your system very quickly.
Pushing yourself past the normal “threshold” is a great way to burn belly fat. According to the World Health Organization, the U.S. Dept. of Health and Human Services, and other authorities, adults should undertake almost two and a half hours of moderate-to-vigorous physical activity each week to maintain good health. If you regularly work out, but hardly break a sweat and don’t feel “challenged”, then your body probably won’t respond by gearing up its metabolism and burning those visceral fat cells. However, surprising your body with varied workout styles and intensities, beyond what you normally do, can kick-start your system very quickly.

What is the keto diet? Rather than relying on counting calories, limiting portion sizes, resorting to extreme exercise or requiring lots of willpower, this low-carb diet takes an entirely different approach to weight loss and health improvements. It works because it changes the very “fuel source” that the body uses to stay energized: namely, from burning glucose (or sugar) to dietary fat, courtesy of keto diet recipes and the keto diet food list items, including high-fat, low-carb foods.
The ketogenic diet reduces seizure frequency by more than 50% in half of the patients who try it and by more than 90% in a third of patients.[18] Three-quarters of children who respond do so within two weeks, though experts recommend a trial of at least three months before assuming it has been ineffective.[9] Children with refractory epilepsy are more likely to benefit from the ketogenic diet than from trying another anticonvulsant drug.[1] Some evidence indicates that adolescents and adults may also benefit from the diet.[9]
In general, a person with metabolic syndrome is twice as likely to develop IHD and five times as likely to develop diabetes as someone without it. The probability of developing metabolic syndrome is also closely linked to a lack of physical activity and the fact of being overweight/obese. Other causes include insulin resistance, ethnicity (often Asian), family history, older age and other factors (Box 23.1). Associated diseases and signs may be raised uric acid levels, hepatic steatosis, haemochromatosis and acanthosis nigricans. Metabolic syndrome may be associated with inflammatory periodontal disease.
In my book "Fat for Fuel," I sought to educate readers about the benefits of using healthy fats as a catalyst to bring about improved mitochondrial function, thus allowing you to achieve better health. In essence, the book answers WHY it is important for you to consume healthy fats. However, you still need to know HOW to prepare the right ketogenic foods in an appetizing way.
The length and comfort level of your recovery from liposuction will depend on several variables, including the number of treatment areas and their size, your general health, and whether your lipo was performed on its own or in combination with other procedures. Be sure to follow all of your surgeon's postoperative directions to ensure a smooth liposuction recovery with the best possible aesthetic results.
It’s scary but true that most of the disorders associated with metabolic syndrome are symptomless. However, one very common visible sign of metabolic syndrome is a large waist circumference: at least 40 inches for men and 35 inches for women. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. (26)
Metabolic syndrome is also sometimes called dysmetabolic syndrome syndrome X, metabolic disease or insulin resistance syndrome. What is metabolic syndrome exactly? It’s actually the term for a cluster of conditions, including abdominal obesity, high triglyceride levels, high fasting blood sugar levels, high blood pressure or low HDL cholesterol. When a person has three or more of these metabolic risk factors occurring together, then he or she is diagnosed as having metabolic syndrome.
Additional research has raised the possibility that metabolic syndrome adversely affects neurocognitive performance. [70] In particular, metabolic syndrome has been blamed for accelerated cognitive aging. [71] Patients with mental illnesses also face increased cardiometabolic risk due at least in part to socioeconomic factors such as greater poverty and poorer access to medical care. [72, 73]
While many of our patients perform SmartLipo in conjunction with the tumescent liposuction that has been Dr. Schlessinger's hallmark treatment for more than 15 years, there are many patients who choose to undergo simple tumescent liposuction. This offers cost savings over the SmartLipo method, but there is also a bit less fat obtained when the SmartLipo isn't performed alongside the tumescent method.
Another possible sign of metabolic syndrome is a high triglyceride level. Triglycerides are a type of fat or lipid found in your blood. When you eat, your body converts any calories it doesn’t need to use right away into triglycerides. A triglyceride level of 150 mg/dL or higher (or being on medicine to treat high triglycerides) is a metabolic risk factor for metabolic syndrome.

The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients.[18] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[48] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.[18]


There is debate regarding whether obesity or insulin resistance is the cause of the metabolic syndrome or if they are consequences of a more far-reaching metabolic derangement. A number of markers of systemic inflammation, including C-reactive protein, are often increased, as are fibrinogen, interleukin 6, tumor necrosis factor-alpha (TNF-α), and others. Some have pointed to a variety of causes, including increased uric acid levels caused by dietary fructose.[18][19][20]
The end result of the “ketone diet” is staying fueled off of circulating high ketones (which are also sometimes called ketone bodies) — which is what’s responsible for altering your metabolism in a way that some people like to say turns you into a “fat-burning machine.” Both in terms of how it feels physically and mentally, along with the impact it has on the body, being in ketosis is very different than a “glycolytic state,” where blood glucose (sugar) serves as the body’s energy source.

Ultrasonic-assisted liposuction is thought to result in greater fat removal with less blood loss, less trauma to the body and a faster recovery. It is also thought to result in greater skin contraction. It has been particularly helpful in the removal of large volumes of fat as well as from fibrous areas where fat traditionally has been difficult to remove such as the love handles, flanks and back.
Yes, they're technically a fruit, but we think olives deserve a shout-out all of their own, since they're also a great source of healthy fats and are one of a few keto-approved packaged foods. Plus, they're a great source of antioxidants, will satisfy your craving for something salty, and are blissfully low-carb. “About a palm's worth only has 3 grams of net carbs,” Sarah Jadin, RD, told Health in a previous interview.
"Dr. Yaker, You performed my full body Liposuction. I'm speechless, but what I can say is, your work is beautiful! I look amazing!! It's rare to find a surgeon that cares, listens, understands, and delivers their word all in one. You felt my urgency for the surgery and got me in as soon as you could after my consult. I use to just feel motivated to make healthy lifestyle changes. I now know I will make healthy lifestyle changes. Thank you for that!"
In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.[55]

Excess abdominal fat leads to excess free fatty acids in the portal vein, increasing fat accumulation in the liver. Fat also accumulates in muscle cells. Insulin resistance develops, with hyperinsulinemia. Glucose metabolism is impaired, and dyslipidemias and hypertension develop. Serum uric acid levels are typically elevated (increasing risk of gout), and a prothrombotic state (with increased levels of fibrinogen and plasminogen activator inhibitor I) and an inflammatory state develop.


Nutrition: What is it and why is it important? Nutrition is the supply of materials that organisms and cells require to live. Humans need seven major types of nutrients to function. A nutritionist studies nutrients, how the body uses them, and the relationship between a person’s diet and their health. Here, learn more about nutrients and what a nutritionist does. Read now

Use fat as a lever.  We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.
Team work, a judicious and an appropriate selection of a surgically and medically fit patient are essential factors resulting in an overall reduction in the duration of the surgery to within three hours [Figure 17]. When a large volume liposuction is planned for an obese patient, it is advisable to stage this procedure in 2 to 3 session. It is preferable to perform liposuction on either front of the torso in supine position or the back in prone position. This avoids the need to change the position, or turning the patient over, half way through the operation, thereby taking additional time. This also reduces the patients' exposure to the rigorous physiological demands of this procedure.
Keeping a toothbrush handy can do more than polish up that smile (and counter the effects of all that belly-slimming garlic); brushing your teeth throughout the day can also help you ditch that belly fat fast. A study conducted a sample of over 14,000 participants found that brushing after every meal was linked to lower weight. That minty toothpaste flavor not only clashes with virtually every food, brushing may also trigger a Pavlovian response that tells your brain the kitchen’s closed.
Physical inactivity is a predictor of CVD events and related mortality. Many components of metabolic syndrome are associated with a sedentary lifestyle, including increased adipose tissue (predominantly central); reduced HDL cholesterol; and a trend toward increased triglycerides, blood pressure, and glucose in the genetically susceptible. Compared with individuals who watched television or videos or used their computers for less than one hour daily, those who carried out these behaviors for greater than four hours daily have a twofold increased risk of metabolic syndrome.[27]
Mediterranean diet: Traditional cuisine of countries bordering the Mediterranean Sea, shown to reduce the risk for heart disease, diabetes, some cancers and dementia. On the menu: Plenty of fruits, vegetables and beans, along with olive oil, nuts, whole grains, seafood; moderate amounts of low-fat yogurt, low-fat cheese and poultry; small amounts of red meat and sweets; and wine, in moderation, with meals.
There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).

Real peanut butter is made with two ingredients: peanuts, and maybe some salt. You already know that peanuts give you belly-slimming monounsaturated fats, tummy-filling fiber, and metabolism-boosting protein. But peanuts have a hidden weapon in their weight-loss utility belt: Genistein, a compound that acts directly on the genes for obesity, helping to turn them down and reduce your body’s ability to store fat. (Beans and lentils have the same magic ingredient, albeit in slightly less delicious form.) But be careful of the brand you buy: if you see ingredients like sugar, palm oil, or anything you can’t pronounce, put it back. They’ll undermine any good the peanuts might do.
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Snack on portion-controlled fruit, seeds and nuts. One study found that snacking on 42g of almonds per day (instead of munching on something high-carb with equal calories) helped to reduce belly fat and improved cholesterol levels. “The high levels of fibre are proven to combat excess calorie consumption later in the day,” says registered dietitian Lucy Jones.
Usually the body uses glucose (a form of sugar) from carbohydrates (found in foods like sugar, bread or pasta) for its energy source. Chemicals called ketones are made when the body uses fat for energy (this is called ‘ketosis’). With the ketogenic diet, the body mostly uses ketones instead of glucose for its energy source. Research has shown that a particular fatty acid, decanoic acid, may be involved in the way the diet works. 

A daily run or Spin class is great for your heart, but cardio workouts alone won't do much for your waist. "You need to do a combination of weights and cardiovascular training," says Sangeeta Kashyap, MD, an endocrinologist at Cleveland Clinic. Strength training increases muscle mass, which sets your body up to burn more fat. "Muscle burns more calories than fat, and therefore you naturally burn more calories throughout the day by having more muscle," says Kate Patton, a registered dietitian at Cleveland Clinic. Patton recommends 250 minutes of moderate-intensity exercise or 125 minutes of high-intensity exercise a week.
.. it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. What is unhealthy about red meat. We should know that acrilamides, pyrroles in burnt meat (and veges) from BBQ and over-heated cooking inflames the colon. According to Clark H R, PhD ND an inflamed part allows easy entry for the cancer nucleus and cancer complex, to start and fuel a malignancy at that location.
Dr. Yaker specializes in liposuction surgery and offers this procedure to Plano area men and women who desire a slimmer appearance. Liposuction (“Lipo”) is a surgery that removes fat from the body. During this procedure, a small puncture is made in the skin and a “cannula” helps to loosen fat cells and suction them out. Common areas for fat removal include the stomach, hips, lower back, thighs, arms, neck and chest. Liposuction is ideal for those who are at a healthy weight and is not an alternative to a weight loss plan, nor is it a surgery to “treat” being overweight. Dr. Yaker offers various techniques including liposuction surgery, ultrasound assisted lipo and laser lipo procedures. Each of these will be discussed during the consultation. 
Because the population of the U.S. is aging, and because metabolic syndrome is more likely the older you are, the American Heart Association (AHA) has estimated that metabolic syndrome soon will become the main risk factor for cardiovascular disease, ahead of cigarette smoking. Experts also think that increasing rates of obesity are related to the increasing rates of metabolic syndrome.
But just because belly fat comes off a bit more easily doesn’t make it less dangerous. In fact, it’s the exact opposite. “Belly fat is unfortunately the most dangerous location to store fat,” says Dr. Cheskin. Because belly fat—also known as visceral fat, or the deep abdominal fat that surrounds your organs—is more temporary, it’s more active in terms of circulating in the bloodstream. That means it’s likely to raise the amount of fat in your blood (known as blood lipid levels) and increase your blood sugar levels, which as a result raises your risk of heart disease and type 2 diabetes.
Belly fat is slightly different than other fat deposits on the body and is often called visceral fat. Visceral fat is considered the most dangerous form of fat in the body because it is in such close proximity to our vital organs. It is actually located beneath the abdominal muscles and the subcutaneous layer of fat, making it difficult to see and even harder to get rid of! These larger fat cells release hormones and chemicals that can be dangerous in many ways, leading to an increased risk of various diseases and metabolic imbalances.
The most common and relatively minor short-term side effects of ketogenic diet include a collection of symptoms like nausea, vomiting, headache, fatigue, dizziness, insomnia, difficulty in exercise tolerance, and constipation, sometimes referred to as keto flu. These symptoms resolve in a few days to few weeks. Ensuring adequate fluid and electrolyte intake can help counter some of these symptoms. Long-term adverse effects include hepatic steatosis, hypoproteinemia, kidney stones, and vitamin and mineral deficiencies.
That sour cherry is pretty sweet when it comes to your health. The results of a study conducted at the University of Michigan found that rats given high-fat foods along with tart cherries ditched nine percent more body fat than those in a control group over just 12 weeks. Cherries are also a good source of antioxidant pigment resveratrol, which has been linked to reductions in belly fat, dementia risk, and lower rates of macular degeneration among the elderly.
While many people think that cardiovascular workouts are the best possible way to burn belly fat, combining your workout styles is actually a better way to quickly lose belly fat. When you do weight training in between cardio exercising, that high-intensity exercise can cause your metabolism to shoot up, burning more fat more quickly. Alternating workout styles and physical demands on your body can keep your metabolism “on its toes”, operating at a high level, even burning fat when you’re not working out!
This is a wealth of information. My husband and I are starting the keto diet tomorrow and I knew nothing about it. When I sat down to look up information about it, I found this. Thank you! This is everything I need to know in one place. We are not as healthy as we’d like to be and I am optimistic this will help us obtain our goals, along with an exercise plan.
Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?
The involvement of the endocannabinoid system in the development of metabolic syndrome is indisputable.[33][34][35] Endocannabinoid overproduction may induce reward system dysfunction[34] and cause executive dysfunctions (e.g., impaired delay discounting), in turn perpetuating unhealthy behaviors.[medical citation needed] The brain is crucial in development of metabolic syndrome, modulating peripheral carbohydrate and lipid metabolism.[33][34]
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