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An integral part of the energy starvation hypothesis is mitochondrial dysfunction

Notice the overlap in heart health

Decreased peripheral target tissue responsiveness to insulin action leads to insulin resistance (IR), a complex pathophysiological condition with reduced sensitivity, impaired ability to inhibit glucose production and stimulate peripheral glucose elimination, and often accompanied with hyperinsulinemia to maintain blood sugar stability (1)

Despite substantial preclinical promise, the real-world efficacy of nutraceuticals in human diseases remains contentious due to variability in study design, poorly characterized participant populations, bioavailability challenges, and inconsistent regulatory oversight