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it works upstream, on an enzyme called nicotinamide N-methyltransferase (NNMT) that fat cells over-express when they become metabolically sluggish

Meta-analysis showed that mean weight increased (lean mass), ranging from 1.65 (95 % CI, 1.611.69) to 6.20 (95 % CI, 5.227.18) kg, although it was heterogeneous (I2 = 98 %)

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