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They also were asked to exercise for at least 150 minutes a week and had access to a nutritionist or other coach

All patients were followed for a full year

Furthermore, adipose insulin resistance facilitates the release of adipokines (such as adiponectin, leptin, and resistin) and cytokines (like TNF-, IL-6 and IL-1) leading to chronic inflammation and hyperglycemia

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When appetite decreases significantly, its easy to unintentionally skip meals or fall short on protein intake