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A 48-week randomized, double-blind, placebo-controlled trial with 48-week follow-up

[DOI] [PMC free article] [PubMed] [Google Scholar] (516).Parks EJ

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Over time, this can lead to: Loss of lean body mass and lower resting metabolic rate Reduced protein intake , making it harder to maintain muscle Micronutrient deficiencies , particularly vitamin D, calcium, magnesium, and B-vitamins Lower energy levels and slower recovery from illness or exercise (Mozaffarian, 2025) Gastrointestinal side effects can make the picture even more complex