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"L-carnitine exerts a nutrigenomic effect via direct modulation of nuclear receptor signaling in adipocytes, hepatocytes and SKMC, demonstrating its nutritional impact." Nutrition Research , January 2021, Jeukendrup, A E et al

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The EHR cohort was younger and had a larger proportion of men than the survey cohort (median age 44 years versus 52 years, and 37% male versus 18%), and both of these factors may contribute to some of the apparent difference in weight loss efficacy between self-report and EHR data