Tag Archives: inflammation

Spice up your life to cool down inflammation

There has been quite a lot of press interest in the adverse effects of certain anti-inflammatory drugs and their potential to trigger a host of unwanted side effects including heart attacks. It’s no secret that most anti-inflammatory medications can play havoc with your stomach and gut but the news that taking these drugs could cause heart complications was quite a shock to those who have come to rely on these drugs to get them through the day. Interestingly, research over the years into the spice turmeric has revealed some encouraging results when used to treat pain and inflammation. Turmeric is composed of a complex mixture of organic compounds the principle one being curcumin. Although easily confused with the spice cumin, curcumin is completely unrelated and a unique compound to the spice turmeric. It belongs to a group of compounds called curcuminoids that are responsible for the typical yellow colour of turmeric. Anyone who has seen natural turumic root in the supermarket may notice a similarity to another culinary spice, ginger root. However, this is no coincidence because turmeric and ginger both belong to the same botanical family; Zingiberaceae. Both of these spices accumulate pharmacologically important compounds within the root tissue. In the case of turmeric the compounds are known as curcuminoids where as in ginger the compounds are called gingerols. The key fact that interests us is the ability of these compound to effectively reduce inflammation and pain while sparing other tissues the hazardous side effects commonly associated with anti-inflammatory medications. This may sound a bit to good to be true but to understand how turmeric, or more specifically the curcumoid known as curcumin, achieves this we will have to discuss the inflammatory process and a bit of biochemistry!

Inflammation – the basics.

When ever we injure ourselves the body has to mend the damage. To do this, chemicals need to be released that enhance blood supply, neutralise any invading bad bacteria and stimulate the local immune reaction. Over this early (acute) phase inflammation is accompanied by pain, swelling and some heat. In the majority of cases this process is self-limiting and once the injury has been mended all the levels settle to normal along with all the related symptoms. However, this is not always the case especially if there is an ongoing irritant present such as arthritis, joint damage or autoimmune disease. In these cases the inflammation becomes chronic and the sufferer experiences daily pain and disability. Anti-inflammatory drugs can offer great relief but often at a price and their safe long term use has become questionable.

Inflammation – the chemistry

The cascade of events that eventually causes inflammation kicks off within cell membranes. A specific fatty acid, known as arachidonic acid (AA), is released from it’s bound state within the cell membrane by an enzyme (phospholipase-A2). Two key players in the inflammation story, COX and LOX, then act upon the now freed AA. The COX enzyme comes in two forms, COX1 and COX 2. When AA interacts with COX1 it produces a mixture of compounds (prostaglandins; PG’s) that protect the stomach and maintain the ability of the blood to clot. When AA interacts with COX2 in produces PG’s that signal pain and enhance inflammation. The LOX enzyme converts AA into another powerful group of inflammatory compounds known as leukortrines. Drugs that block the COX and LOX enzymes are known as anti-inflammatory drugs for this reason; they block the inflammatory cascade. However, by blocking the COX1 enzyme these drugs also block the stomach and gut protective PG’s and cause thinning and blood vessel leaks as they also block the PG’s that maintain blood clotting. As a result, specific drugs were developed that selectively block the COX2 enzyme but leave the COX1 alone. In theory, this sounded great but in reality the drugs did leave the COX1 enzyme alone in the majority of tissues except the COX1 found within the cells that line the blood vessels. These cells are called endothelial cells and the COX1 enzyme within these cells produces a special compound known as prostacyclin, which in turn maintains the smooth flowing of the blood within the blood vessels. By blocking the action of endothelial COX1 and the production of prostacyclin blood becomes stickier and prone to clotting, which explained the increased heart attack risk associated with drugs that have COX2 inhibitor action.

Inflammation – the natural answer

Research into the anti-inflammatory actions of curcumin has revealed that curcumin is a safe and effective inhibitor of COX2 and of the LOX enzyme that is responsible for the generation of the powerful inflammatory actions of leukortrines. What’s more, curcumin has also been shown to block the initial release of AA from the cell membrane. By doing this curcumin may have an effective preventative action as well as a powerful anti-inflammatory effect when used on a regular basis. To date, there have been no indication or suggestion that curcumin inhibits the endothelial COX1.

One factor that goes against curcumin is it’s poor absorption from the digestive tract. To get around this problem manufacturers have produced a highly bio-available extract; Theracurmin. This innovative ingredient uses a microscopic particle (100 times smaller than regular curcumin powder) size to enhance the curcumin absorption from the gut. Studies using Theracurmin have shown that the microscopic curcumin particles are absorbed up to and reach concentrations 300 times higher than regular powders.

How to take curcumin supplements

Theracurmin is simple and easy to use; take 1-2 capsules daily around a meal time. Because of the lack of available information, those who are pregnant or breast feeding or taking warfarin should only use curcumin based products after taking medical advise.

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Krill oil – It’s fish oil… with a difference!

Fish oils are making regular headlines but not many people are aware of the health benefits of krill oil. Krill are small shrimp-like creatures that live in the cold Arctic waters. Its largely thanks to the very high levels of long-chain polyunsaturated fatty acids (LCPFA’s) contained in the krill’s body that they thrive so well in the icy waters of the Arctic. Two fatty acids that belong to the LCPFA group found in especially high concentrations in krill oil are also found in regular fish oils; eicosapentaenoic acid (EPA) and docosahexaenoic acid (DPA). In addition to this, the EPA and DHA found in krill oil are attached to another special compound called phospholipid (PL) These fatty acids protect cell membranes and maximize their flexibility and fluidity and, being attached to PL, are readily taken up by the brain. Unlike fish oils, krill oil also contains a rich source of potent antioxidants. Studies into the use of krill oil in humans have indicated that the oil may have superior properties in reducing the symptoms of premenstrual syndrome and easing the inflammatory aspects of many other conditions.

If you follow the health press or health pages in most news papers I think we all agree that the oils derived from fish offer some great benefits. The fatty compounds are known to deliver a ready supply of health promoting unsaturated fatty acids such as EPA and DHA that are known to protect the heart, brain and ease inflammation. If, however, you are not a big fish eater then a daily fish oil supplement may be a good idea. For some people the problem with fish oil supplements is an unfortunate fishy odour repeating on the breath. The good news is krill oil can deliver all the fatty acids of fish oil but none of the fishy smell. Analysis of the oil derived from krill shows that the potent antioxidant known as astaxanthin predominates. Astaxanthin helps protect against fatty acid oxidation, one of the processes associated with heart disease.

Studies involving krill oil in human health show that in addition to the established heart and brain functions krill oil appears to offer superior help and protection in cases of premenstrual syndrome (PMS). In a 90 day trial involving 70 women, Krill oil (KO) was compared to fish oil (FO) for its ability to ease many of the commonly reported PMS-related symptoms. In the study, 2,000 mg of KO or FO were used for the first 30 days and thereafter (for the remaining 60 days) just to use the oils over the 8 days before and first 2 days of their period. One key finding was that none of the KO users had gut upset where as 64% of the FO users complained of an unpleasant fishy after taste or reflux. Other results indicated that KO & FO eased joint pains and stiffness, breast tenderness, bloating and eased depression and irritability. KO did result in a 50% reduction in overall pain killer use compared to that of a 33% reduction in the FO group. Although 2,000 mg is a large intake of oil it only lasted for one month, after which its use over the menstrual period would appear to be a practical use. Studies have not been performed on a maintenance daily dose of 500 mg which would appear to be a reasonable compromise.

Krill oil has also demonstrated some promise in the ongoing battle against high cholesterol levels. Animal studies have shown that krill oil intake is associated with a reduction in both cholesterol and glucose levels. Investigations into the effects of krill oil on inflammation have shown that after just 7 days of using krill oil supplements key markers for inflammation (C-reactive protein) was reduced by almost 20% and by day 30 of the trial this level had dropped by 30%.

In general, intakes of krill oil can range from 1000-3000mg per day with a maintenance level of intake at the 500mg level. Krill is a safe supplement with no known toxicity. Some people have reported flatulence and diarrhoea but this may simply reflect intake levels and can be managed with simple dose adjustments. Like all oil based supplements those on anticoagulants need to take care when using Krill oil and should seek the advice of their doctor before starting it.

Product link: View Neptune Krill Oil here

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Eat you way back to sport; how diet and nutrition can boost recovery from injury

It’s not easy to get accurate figures when it comes to sporting injuries since so many never get registered at hospitals or become incorporated into nationwide surveys. Most people simply manage their injuries at home and limp along until they get better. Interestingly, back in 2005 Barclays Bank (Barclays Spaces for Sports) commissioned a survey into the rate of sporting injuries in the UK and published some very interesting results; just under 30% of the UK experience a sports related injury every year. That translates to roughly 22 million cases per year, the majority of which are the direct result of over-exertion, lack of preparation and general clumsiness! Most people recover well from injury but some 25% of those injured were forced to quit their sport. By far the most common injuries were sustained in sort tissues such as ligaments and tendons with football injuries leading the pack.

While some 26% choose to leave their injury to nature to heal there are many ways encourage the recovery from injury that could reduce the risk of a problem becoming chronic or forcing early retirement from your chosen sport. All to often little is mentioned about the effects of food, diet and nutrition and its effects on the healing process. Keeping in mind the saying “we are what we eat” it would make sense to look at your when suffering from an injury because your food will, in essence, be the mother-load when it comes to supplying your body with the building blocks for healing and tissue regeneration. It’s amazing that Hippocrates noticed this and famously commented “feed the patient and they’ll get better” over 2000 years ago and its only now that we beginning to re-appreciate the effects of nutrition on healing all over again. In general, the healing time can be viewed as the expected amount of time for wound repair, following an injury or surgery. The disability time refers to the generally expected maximal amount of time within which a person should have regained pre-injury or pre-surgical ability and performance. As a rule of thumb, healing time is always longer than disability time.

From injury to recovery
If someone reaches their expected healing time but continues to complain of pain and disability the condition is said to shift into the chronic phase, a scenario that has many possible implications. To illustrate this with a common example; the healing time for a simple knee ligament injury is in the region of 3 months. Someone complaining of persistent pain and disability after this time is then considered to be suffering from a chronic injury that needs careful investigation in order to discover if there are any maintaining or aggravating issues. Nutritional and dietary factors are now thought to play a key role in healthy resolution of tissue repair following injury and there is special interest in key amino acids, vitamins and zinc. If all the right nutrients are in place injury healing should run like a seamless process and full function should be restored. However, deficiencies and poor diet can cause serious disruption to one or more of the 4 key points of the healing process. If this happens, a weak and ineffective repair will result nudging the problem ever closer to a chronic injury state. Nutritional research has now confirmed that each of the 4 stages (vascular reaction, inflammation, proliferation and remodeling) of the healing process requires specific vitamins, minerals and amino acids for a successful outcome, even from relatively trivial injuries

Healing; a 4-stage process
The initial phase following any sporting injury is characterized by the rapid constriction of blood vessels closely followed by a more prolonged phase of blood vessel dilation as the vessels open up and become leaky. This allows important healing components of the blood to exit the blood vessels and take up residence within the damaged tissue. You tend to notice this phase of the reaction since there will be swelling, heat and pain! Despite this rather unpleasant side effect is vital ti the healing process since it starts to clear away the damaged tissue. Because of the presence of white blood cells any invading bug are confronted and destroyed which prevents opportunistic infections complicating the injury. The second stage of the process is associated with some persistent warmth surrounding the damaged area. Heat is a typical sign of injury and represents the outward effects of inflammatory chemicals and increased blood supply. Its over these phases that the protein-based healing framework is laid down forming a vital scaffolding onto which new tissue will be built as the region is repaired. For this reason, this stage of the healing process is descriptively known as the proliferative phase. In most cases, basic tissue healing is up to 70% complete after four weeks, but the process of remodeling in more extensive injuries can continue for around two years.

Nutrients are the vital basic raw materials for healing
A quick look at the health section of your local supermarket or health store will reval just how many vitamin and mineral supplements there are, each with their own story to tell! When it comes to injury management there are a few that stand head and shoulders above others, these include vitamin C, vitamin A, zinc, L-Arginine and L-Glutamine. Vitamin A is needed for the formation of strong and effective collagen fibres that prevent wounds from breaking down prematurely. This is especially evident in skin injuries. Along with its collagen strengthening function vitamin A is also necessary for an effective immune response that protects against nasty infections that sould seriously delay the healing process. Because of its potential to be toxic, retinol (true vitamin A) is not normally recommended as a supplement. To get round this, it’s non-toxic relative, known as beta carotene, is safe to use by those who have not had a history of smoking related lung cancer. This caveat to beta carotene use follows on from some research findings indicating that it may aggravate this form of lung cancer. In health the body can convert beta carotene into retinol as needed without the worry of toxicity. Foods that are colourful tend to owe their colours to the carotenoid group of compounds of which beta carotene is just one. Select from a variety of foods such as carrots, spinach, kale, apricots, papaya, mango and tomatoes. Vitamin C is another important nutrient needed for the production of strong collage. While scurvy (a gross deficiency state) is unlikely today, an optimal amount of vitamin C is still essential for the healthy resolution of an injury. Vitamin C is also needed for the normal functioning of many immune cells as well as for the strength of blood vessel walls. Collagen, the very glue that holds us together is dependant on adequate vitamin C levels, a lack of vitamin C is commonly associated with fragile and poorly healed injuries. Its interesting that we all tend to associate oranges with vitamin C but its sweet red peppers that actually boast the highest amounts. Other vitamin C foods include cooked broccoli. Contart to popular belief, cooking is known to release more readily available (bioavailable) vitamin C than eating food raw. Also consider eating more ‘greens’, sprouts and tomatoes to boost your vitamin C intake from foods. When we look to the trace element zinc it becomes apparent that a deficiency is known to result in a delayed or poorly healed injury. Zinc is needed to increase scar strength. The need for zinc is thought to be the highest from time of injury especially during the early inflammatory phase. Getting a good boost of zinc from your diet can present vegetarians with a dilemma; the highest amounts are found in oysters (around 77mg per serving), followed by beef, crab, pork and lobster! However baked beans (1.7mg per serving) and cashew nuts (1.6mg per serving) offer fair amounts when eaten on a regular basis. Zinc toxicity can be an issue with higher intakes. Keeping a supplement dose to around 15mg for a few months is a reasonable thing to do over a phase of injury when your zinc needs are higher than normal.

The need for proteins
Protein intake is vital to optimal wound healing, it’s an established fact in all manner of injuries. Out of the many available to the body two key amino acids (Arginine and Glutamine) appear to be essential for soft tissue regeneration and repair. Arginine has a surprising immune function in addition to stimulating the production of complex proteins needed essential for the formation of new body tissue where as glutamine is used by specialist healing cells known as fibroblasts as a primary energy source during the healing process. Fibroblasts are central to the balanced production of fibrous tissue scar tissue. Using supplements of these important amino acids has been shown to enhance repair and healing. Balancing the proteins in your diet is normally the best way to obtain a broad a broad spectrum of well absorbed amino acids with foods such as parsley, raw spinach, fish, meat and beans boasting a high glutamine content with chocolate (yes chocolate!), coconut, dairy products, meat, oats, nuts, raw cereals, peanuts, soybeans and walnuts serving as good sources of arginine. To be on the safe side, those suffering from viral infections or who are pregnant or lactating and those with schizophrenia should avoid taking over 30 mgs of arginine per day while those with liver or kidney diseases, Reye’s syndrome or other disorders resulting in the accumulation of ammonia in the blood need to avoid excessive glutamine intakes.

In managing your sporting injury it is important to remain realistic and understand that healing is a natural process but it can be enhanced with good diet, specific supplements when needed and the careful use of physical therapy and rest.

 

Product link: ST-Repair, nutrients to support tissue healing

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The hidden health benefits of pomegranate.

Few can argue that a good diet goes a long way to maintaining health but as various foods reveal their hidden secrets and we are just discovering the real healing powers of the food we eat. With heart disease forever on the rise in the UK the news that the humble pomegranate could help reduce the risk of heart and circulatory disease was met with great interest by doctors and patients alike. Pomegranates have long been known to deliver a high concentration of antioxidants, more so that green tea and red wine, but not much was known about the real power of the pomegranate on health. In general, antioxidants are good for us. They help to reduce the damaging effects of a stressful life and improve the health of tissues that can become affected by inflammation. In the cardiovascular system its the smooth lining of blood vessels that shows the impact of stress and inflammation with the generation of thickenings known as plaques that can eventually encroach on the hollow blood vessel reducing the flow of blood. As time passes, such a reduced blood flow can seriously influence the organ that relies on it; in the case of the heart this can lead to a heart attack or a stroke if the brain’s circulation is affected. The damaging chemicals generated by bad diet, smoking and stress are known as free radicals. Antioxidants scavenge free radicals and neutralize them before they can  cause trouble. Interestingly, the use of pomegranate to help off set heart disease has been the focus of research first in Haifa, Israel, then followed in 2004 by a UK team from the Hammersmith Hospital in London and reported by the BBC’s on line news service. What drew their interest was the remarkably high concentrations of soluble antioxidants known as polyphenols and anthocyanins of which the phenol compound known as ellagic acid appears to be responsible for the bulk of the fruits health benefits. What became evident from the study that followed people over 3 years was that those who regularly consumed pomegranate juice enjoyed many cardiovascular benefits above and over those of non-pomegranate users. The benefits included a lowering of blood pressure, promotion of a healthier blood fat profile and improvement in the health of the artery wall. Their research was backed up by some impressive results all of which indicated a real benefit to the heart and circulatory system of regular pomegranate consumption.

Hot on the heels of the positive effects of pomegranate on heart health comes work that suggests an equally powerful effect on male prostate health. Preventing disease in the prostate looks to be well suited to nutritional measures. Its been estimated that slowly accumulating levels of inflammation, over some 15 years, lies at the centre of many non-cancerous prostate problems. Pomegranate consumption has been shown to significantly reduce the inflammation that eventually causes trouble in the gland and beneficially influence various blood test results that are used to monitor the health of the prostate gland. It’s interesting that the tradition of breaking a pomegranate open at a wedding as a symbol of fertility still occurs in Greece today reflecting its long association with promoting reproductive health.

If you don’t fancy drinking or eating a daily serving of two of pomegranate then consider the whole fruit dietary supplement by Natures Way. It’s standardised to contain 40% ellagic acid, the key antioxidant in pomegranate, and is supplied in vegetarian capsules. Just two capsules a day is a convenient way to get your pomegranate is your not actually a fan of the fruit!

Further reading

Pomegranate and PSA

University of Maryland pomegranate review

In vitro antiproliferative, apoptotic and antioxidant activities of punicalagin, ellagic acid and a total pomegranate tannin extract are enhanced in combination with other polyphenols as found in pomegranate juice. Journal of Nutritional Biochemistry

Pomegranate and blood pressure study. Atherosclerosis 158 (2001) 195–198

Pomegranate and cardiovascular health. Drugs & Experimental Clinical Research (2002) 49-62

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Sugar, gout and metabolic syndrome

Consumption of sugar sweetened soft drinks and fructose is strongly associated with an increased risk of gout in men. This was the finding of a study published in the British Medical Journal back in 2008. Gout is a joint disease which causes extreme pain and swelling. It is most common in men aged 40 and older. It is caused by excess uric acid in the blood (hyperuricaemia) which leads to uric acid crystals collecting around the joints.

In the United States, levels of gout have doubled over the last few decades, which coincided with a substantial increase in the consumption of soft drinks and fructose (a simple sugar and the only carbohydrate known to increase uric acid levels). Conventional dietary recommendations for gout have focused on the restriction of purines (found in high levels in meat and meat products, especially liver and kidney) and alcohol but with no restriction of sugar sweetened soft drinks.

With this in mind, researchers in the US and Canada examined the relation between intake of sugar sweetened soft drinks and fructose and the risk of gout. They followed over 46,000 men aged 40 years and over with no history of gout. The men completed regular questionnaires on their intake of more than 130 foods and beverages, including sugar sweetened soft drinks and diet soft drinks, over a period of 12 years. Different types of fruits and fruit juices (high in natural fructose) were also assessed.

At the start of the study, and every two years thereafter, information on weight, regular use of medications and medical conditions were also recorded. Gout was diagnosed according to American College of Rheumatology criteria. During 12 years of follow-up, the researchers documented 755 newly diagnosed cases of gout. The risk of gout increased with increasing intake of sugar sweetened soft drinks. The risk was significantly increased with an intake level of 5-6 servings per week and the risk was 85% higher among men who consumed two or more servings of sugar-sweetened soft drinks per day compared to those who consumed less than one serving per month. These associations were independent of other risk factors for gout such as body mass index, age, diuretic use, high blood pressure, alcohol intake, and dietary factors.

Diet soft drinks were not associated with the risk of gout.

Fruit juice and fructose rich fruits (apples and oranges) were associated with a higher risk of gout. However, the authors stress that this finding needs to be balanced against the benefit of fruit and vegetable intake to prevent other chronic disorders like high blood pressure, coronary heart disease, stroke and certain types of cancer.

In conclusion, the 2008 findings provide evidence that consumption of sugar sweetened soft drinks and fructose is strongly associated with an increased risk of gout, say the authors. Furthermore, fructose rich fruits and fruit juices may also increase the risk. In contrast, diet soft drinks were not associated with the risk of gout.

To bring this article more up to date, fructose does now appear to be closely associated with a number of uric acid related disorders that include high blood pressure, fatty liver, generalised inflammation, elevated blood fats (lipids) as well as the growing epidemic of abdominal obesity and type-II diabetes.

Adopting a low glycaemic style diet would appear to be the way forward for many who have become habitual sugar and fructose consumers; not only will it reduce the problems associated with gout this dietary approach will minimise the growing problem of metabolic syndrome.

Further reading

Hypothesis: Could Excessive Fructose Intake and Uric Acid Cause Type 2 Diabetes?

Pre-diabetes; what can be done?

Hi GI foods and heart disease

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Gene’s, the immune system and inflammation; all linked to Parkinson’s disease

A newley discovered genetic link implicates the immune system as a trigger for the development of late-onset Parkinson’s disease. Researchers from Johns Hopkins have confirmed that a gene in the human leukocyte antigen (HLA) region of the human genome was strongly linked with Parkinson’s disease; this region contains a large number of genes related to immune system function. Their results were published in the August issue of the journal Nature Genetics and supports the long held idea that inflammation and autoimmune disease lies at the heart of this problem and helps dispell the old concepts that environmental factors were the exclusive cause.
The research may help explain why, in some patients, the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen appear to be protective against Parkinson’s disease. The new findings and connection between Parkinson’s disease and inflammation, especially in the context of the variable genetic make-ups of individuals, should lead to better, more selective treatment.
From the holistic perspective, this study re-inforces the need to focus on dietary factors that are linked to a reduced level of inflammation in the body and possibly the use of specific supplements with known anti-inflammatory properties.
Click here for access to the full scientific paper.

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Antioxidant supplements & artery health – the latest!

Just published… a key study looking at the effect of antioxidant supplementation with vitamin C, vitamin E, coenzyme Q10 and selenium on arterial health and  inflammation. As the research gathers pace, heart disease and the clogging of the arteries known as atherosclerosis is being view more as an inflammatory disease rather than a passive accumulation of fatty material within the walls of blood vessels.

This latest paper helps support the long held theory that antioxidants can help off set this process and protect the health of the cardiovascular system.

In this study, 70 people with two diagnosed cardiovascular risk factors (see the study for details) were recruited from a hypertension clinic. 35 people were given a 6 month course of capsules containing vitamin C (500 mg) vitamin E (200 iu), co- enzyme Q10 (60 mg) and selenium (100 mcg) while the other 35 were given a placebo. The summary conclusion is displayed below and the results and technicalities can be viewed by following the link at the end of this post.

Conclusions: Antioxidant supplementation significantly increased large and small artery elasticity in patients with multiple cardiovascular risk factors. This beneficial vascular effect was associated with an improvement in glucose and lipid metabolism as well as decrease in blood pressure.

The original paper is free to download from the open access journal by clicking here.

Shargorodsky M, Debbi O, Matas, Z, Zimlichman R. Effect of long term treatment with antioxidants (vitamin C, vitamin E, coenzyme Q10 and selenium) on arterial compliance, humoral factors and inflammatory markers in patients with multiple cardiovascular risk factors. Nutrition & Metabolism 2010, 7:55 doi: 10.1186/1743-7075-7-55

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