Tired of Insomnia? Helpful Herbs and Sleep Hygiene

Ashley Wyckoff, Bachelor of Science

Insomnia affects approximately 24 million people, or 10% of the U.S. adult population.1,2 Symptoms of insomnia go beyond just trouble falling asleep; people who experience sleep disturbances also tend to have low energy, fatigue, difficulty concentrating and emotional changes.

Since sleep disturbance is such a prevailing problem, there are many options on the market for those affected by insomnia. The good news is there are herbs that have been clinically shown to help. Plus, lifestyle habits can play a role. Get some sleep with these lifestyle hacks and clinically studied herbs!

As with many health conditions, it is important to get to the root cause. Stress, improper sleep hygiene and circadian rhythm imbalance can all cause insomnia. Poor mental health can not only cause one to not be able to fall asleep, but also for the little sleep that one gets to not be replenishing.3 One’s “sleep hygiene” comprises the customs and routines a person has that influences their sleep.4 A circadian rhythm is one’s sleep/wake cycle that can be disturbed by travel, daylight savings and change in routine.3

The Best Herbs for Sleep

Honokiol is a polyphenol found in magnolia bark, leaves and seed cones. It has been found to promote the GABAA receptor, allowing the neurotransmitter to better bind to their active sites.5 The GABAA receptor is fast-acting and results in sedation and reduced stress.6,7

Lemon balm is an herb that is part of the mint family.8 It can help support GABA levels by inhibiting the enzyme that normally degrades it.9

Chamomile is a flower commonly used in herbal infusions. It has been shown to have many benefits due to the high amounts of bioactive components, flavonoids and terpenoids in it. One compound in particular, apigenin, works in the central nervous system to reduce stimulation.10

Ashwagandha is an herb that has been used for thousands of years. It is an adaptogen which allows you to adapt better to stress.11

How to Improve Sleep Hygiene and Circadian Rhythm

Avoid stimulants at night: Stimulants such as caffeine, alcohol and even the blue light from electronics can make it more difficult to fall and stay asleep. Alcohol, while it can help some people fall asleep, typically results in waking up in the middle of the night. Electronics’ bright lights can cause your body to not produce the melatonin it should at night.12,13

Sleep environment: Make your sleep environment as relaxing as possible. Make sure your room is dark, quiet and comfortable. Try to avoid watching TV, eating or doing other activities in bed. This helps train your body to correlate being in bed to sleeping.14

Yoga/exercise: Exercising regularly can help improve sleep quality and has been shown to support mood.12,15 Yoga can also be a relaxing activity to do before bed or to help your body wake up in the morning.

Keep a sleep/wake routine: It is important to keep a schedule by going to bed and waking up at consistent times, even on the weekend. This helps keep your circadian rhythms in balance. It can also help to have the same routine every night.12



Insomnia comes with more problems than just feeling tired. Inadequate amounts of sleep can lead to depression, cognitive impairment and other illnesses.3,15 However, that does not mean there is nothing to help. Finding the cause of your sleep disturbance and then implementing better sleep hygiene could help you improve your sleep. Stress-reducing herbs can also help you to relax and have higher quality sleep.

About the Author: Ashley Wyckoff, BS, is a product operation specialist at Life Extension headquarters in South Florida. She holds a Bachelor of Science in Biology from the University of Florida. In her spare time, she enjoys hiking, reading and yoga to keep her mind and body healthy. She believes in equal access to quality healthcare and it is her goal to make it a reality.




References

  1. United States Census Bureau. QuickFacts: United States. Table. https://www.census.gov/quickfacts/fact/table/US/PST045218. Accessed 7/10/2019.
  2. Medscape online. News & Perspectives page. What is the prevalence of insomnia? https://www.medscape.com/answers/1187829-70532/what-is-the-prevalence-of-insomnia. Accessed 7/10/2019.
  3. Mayo Clinic. Insomnia. Symptoms & causes. https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167. Last updated 10/15/2016. Accessed 7/10/2019.
  4. Yang, Chien-Ming et al. “Maladaptive sleep hygiene practices in good sleepers and patients with insomnia.” J Health Psychol. 2010;15(1):147-55.
  5. Alexeev, Mikhail et al. “The natural products magnolol and honokiol are positive allosteric modulators of both synaptic and extra-synaptic GABA(A) receptors.” Neuropharmacology vol. 62,8 (2012): 2507-14. doi:10.1016/j.neuropharm.2012.03.002
  6. Hasler, Gregor et al. “Effect of acute psychological stress on prefrontal GABA concentration determined by proton magnetic resonance spectroscopy.” The American journal of psychiatry vol. 167,10 (2010): 1226-31. doi:10.1176/appi.ajp.2010.09070994
  7. Nutt, D. GABAA Receptors: Subtypes, Regional Distribution, and Function. Journal of Clinical Sleep Medicine. 2006;2(suppl 2): S7-S11.
  8. Najafian, S. Storage conditions affect the essential oil composition of cultivated Balm Mint Herb (Lamiaceae) in Iran. Industrial Crops and Products. 2014;52:575-81.
  9. Weeks, BS. Formulations of dietary supplements and herbal-extracts for relaxation and anxiolytic action: Relarian. Med Sci Monitor. 2009;15(11):Ra256-62.
  10. Srivastava, Janmejai K et al. “Chamomile: A herbal medicine of the past with bright future.” Molecular medicine reports vol. 3,6 (2010): 895-901. doi:10.3892/mmr.2010.377
  11. Kaushik, Mahesh K et al. “Triethylene glycol, an active component of Ashwagandha (Withania somnifera) leaves, is responsible for sleep induction.” PloS one vol. 12,2 e0172508. 16 Feb. 2017, doi:10.1371/journal.pone.0172508
  12. Irish, Leah A et al. “The role of sleep hygiene in promoting public health: A review of empirical evidence.” Sleep medicine reviews vol. 22 (2015): 23-36. doi:10.1016/j.smrv.2014.10.001
  13. National Sleep Foundation. Sleep Problems, Sleep Routine, Sleep Tools & Tips, The Science of Sleep. Why Electronics May Stimulate You Before Bed. https://www.sleepfoundation.org/articles/why-electronics-may-stimulate-you-bed. Copyright 2019. Accessed 7/11/2019.
  14. National Sleep Foundation. Sleep Hygiene. https://www.sleepfoundation.org/articles/sleep-hygiene. Copyright 2019. Accessed 7/11/2019.
  15. Fortier-Brochu, Émilie et al. Insomnia and daytime cognitive performance: a meta-analysis. Sleep Med Rev. 2012;16(1):83-94.

Live Foreverish Podcast: Men’s Health Series with Michael A. Smith, M.D. & Christopher Mohr, Ph.D., R.D.

National Men's Health Month

Did you know that June was National Men’s Health Month? If not, that’s okay. We’ve got you covered with important information on men’s health topics in our new podcast series. While these dedicated health months are helpful to build awareness, men should be focused on their health year-round! The series is available for download, or you can listen now on LiveForeverish.com.

In this special Live Foreverish podcast series, you’ll hear from Christopher Mohr, Ph.D., R.D., a nationally recognized Registered Dietitian and sports nutritionist who has worked with professional athletes, including the Cincinnati Bengals and WWE Wrestlers. Featured in this three-part series:

Episode 1: Maintaining Muscle Mass for Longevity
Exercises for increasing muscle and best times to work out

Episode 2: Nutrition for Men: Protein, Minerals and Supplementation
Healthy fats, fruits & vegetables and protein intake (types and how much for men)

Episode 3: Personalize Your Preventative Health Care Regimen with Lab Testing
Hormone testing: testosterone and estrogen balance and thyroid function

About Live Foreverish: Join Dr. Mike and Dr. Crystal as they sit down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and helpful advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!

Migraines: Relief is Possible with These Healthy Habits

Julia Dosik BS, MPH

If you are one of the over 37 million Americans that suffers from migraines, here’s some help! You may be wondering what you can do to keep these draining headaches at bay. Well, the first place to start is to understand the facts around them.

To learn about auras and the causes & triggers of migraines, check out our Migraine Headaches 101 blog post.

Natural Methods for Prevention and Relief of Migraines

Although relief is found for some migraine sufferers through OTC or prescription medications, consider more natural approaches and lifestyle changes for migraine prevention and relief. While there is unfortunately not a way to do away with migraines forever, there are healthy lifestyle habits that may help extend your time between migraine attacks.

1. Adequate Water Hydration It is extremely important to drink enough water to hydrate your body throughout the day. The most common suggestion is to drink about eight 8-ounce glasses of water per day, which is about 2 liters (or half a gallon) per day. Of course, the amount of water will increase based on daily activity level.

2. Regular Exercise Dr. Andrew D. Hershey, a headache specialist and the chair and director of the Division of Neurology at the Headache Center in Cincinnati, states that exercise helps both the body and the brain. He recommends patients with migraines exercise 4-5 times per week for 45 minutes. 1

3. Healthy Sleep Cycles If you are a migraine sufferer, it’s vital to get adequate sleep every night for prevention. Around 7-8 hours of sleep is the common recommendation, along with going to sleep around the same time each night. Also, avoid playing on your phone and/or computer right before you go to sleep as the blue light emitted from these devices can make it harder for your brain to wind down and fall asleep.

4. Well-Balanced Diet Since prolonged hunger may bring on migraines, it’s important to avoid skipping meals and to focus on a well-balanced diet consisting of fruits, nuts, vegetables, protein and good fats (i.e. avocado, cheese, eggs, extra virgin olive oil, etc.). With that being said, it is also important to avoid the specific foods or food groups that you notice trigger your migraines.

5. Stress-Reduction Techniques Techniques such as meditation, breathing exercises, taking a walk (without your phone) and being mindful of all your surroundings, journaling and anything else that brings you relief from the daily stressors of life can be advantageous for migraine prevention.

Dietary Supplements: CoQ10 and Magnesium

In addition to these lifestyle habits, regular intake of the antioxidant CoQ10 and the mineral magnesium can also contribute to migraine prevention and relief.

Not only is CoQ10 an important nutrient for energy production in the body, human studies also show that it can help make migraines shorter in duration and less severe, all without the side effects seen in prescription medications.2 If you are a premenopausal woman with migraines, there is even better news! A new 2018 study revealed that taking CoQ10 consistently for three months can lead to significantly fewer migraine attacks and when they did occur, they did not last as long and were less severe.3

Magnesium is a vital mineral that plays a role in over 300 biochemical reactions in the body. One of its major roles is relaxing smooth muscles within the blood vessels, which supports healthy blood flow in the body. When it comes to the brain, magnesium is essential in controlling brain electrical activity such as balancing excitatory-to-inhibitory actions of nerve cells as well as helping to boost blood flow. Studies show migraine sufferers are deficient in magnesium.4 For migraine prevention, magnesium oxide is one of the most frequently recommended nutrients by neurologists for their migraine patients. In fact, magnesium’s effectiveness is seen primarily in patients who have or have had aura with their migraines.5

Don’t Give Up, Don’t Give in!

Although migraine headaches come with a host of distressing symptoms, educating yourself on your triggers and avoiding them as best as you can could make a world of difference. Maintain your healthy lifestyle habits, take your nutrients daily (and medication as needed), be gentle with yourself when one does come on and take all the rest that you need! Migraines DO pass. You are NOT alone in what you are experiencing. For even more helpful migraine information, visit the Life Extension Migraine Headache Health Protocol.

About the Author: Julia Dosik, BS, MPH, is a clinical corporate trainer at Life Extension headquarters in South Florida. She holds a Bachelor of Science in biology and psychology as well as a Master of Public Health specializing in health education. Julia utilizes a mix of in-person, virtual and written training to educate employees and consumers on how the human body functions and the importance of supplementing with science-backed ingredients. It is her deepest belief that high-quality dietary supplements are fundamental to an individual’s physical and mental well-being.




References:
  1. https://americanmigrainefoundation.org/resource-library/why-do-i-have-migraine/
  2. Shoeibi A, Olfati N, Soltani Sabi M, et al. Effectiveness of coenzyme Q10 in prophylactic treatment of migraine headache: an open-label, add-on, controlled trial. Acta Neurol Belg. 2017 Mar;117(1):103-9
  3. Dahri M, Tarighat-Esfanjani A, Asghari-Jafarabadi M, et al. Oral coenzyme Q10 supplementation in patients with migraine: Effects on clinical features and inflammatory markers. Nutr Neurosci. 2018Jan 3:1-9.
  4. Mauskop A, Varughese J. Why all migraine patients should be treated with magnesium. J Neural Transm. 2012 May;119(5):575-9.
  5. https://americanmigrainefoundation.org/resource-library/magnesium/


Migraine Headaches 101: Causes and Triggers

Julia Dosik BS, MPH

What is a Migraine?

A migraine is a type of headache characterized by an extreme sensitivity to light, sound and/or smell, painful throbbing on one or both sides of the head, nausea, vomiting, dizziness, lightheadedness, blurry vision and an overall feeling of weakness. Do any of these symptoms sound familiar to you? If so, you could be one of the over 37 million Americans that suffer from migraines.

You may be wondering what you can do to keep these draining headaches at bay. Well, the first place to start is to understand the facts around them. What causes migraines? Is there a genetic component? What are auras? We will answer these questions below!

Migraine Causes

Although science has yet to uncover the cause of migraines, several theories have been developed. One theory is that blood flow in specific brain regions begins to decrease, which may contribute to the onset of pain localized in one area of the head. Another theory is that pain occurs due to waves of activity from excitable brain cells. These waves of activity spark chemicals in the brain to narrow blood vessels. Abnormalities in the communication between brain chemicals and nerve cells may also cause migraine episodes. For women specifically, migraines occur more often than men because of their fluctuating estrogen levels during fertile and post-menopausal years.2 However, that does not mean that men are immune to the attacks of migraines.

Do Genetics Play a Role in Migraine Headaches?

As with many other health conditions, migraines do have a genetic component. In fact, when one or both parents suffer from migraines, their children have a 50-75% chance of getting them, too.3

What are Auras?

Migraines are usually associated with visual, sensory or motor disturbances. In the context of migraines, these symptoms or sensations are known as auras. Common examples of auras include: seeing flashes of bright light, squiggly lines, blind spots in vision, tingling in the face and hands, muscle weakness and speech or language difficulty.4 In fact, some people can detect when they are getting a migraine because the aura usually precedes the pain. On the other hand, there are people that may get the aura, but do not get pain. Either way, getting an aura could actually be beneficial because it gives you time to prepare for what may come. Whether it’s taking medication or quickly getting to a dark, non-stimulating room, acting fast when experiencing an aura could save you from hours of agonizing discomfort.

Migraine Triggers

As you get to know your body more, you may find that certain foods, drinks, environmental conditions and stress can exacerbate existing conditions such as acid reflux, for example. Well, the same goes for migraines. There are certain triggers than can contribute to the onset of migraines in some individuals, especially those experiencing chronic migraines (occurring more than 15 days out of the month). Common migraine triggers are salty and processed foods, not eating and drinking enough water throughout the day, unusually bright lights, strong smells, loud noises, extreme exercise, sleep cycle changes, weather changes and even drinking too much caffeine.

You may be thinking, “but Excedrin has caffeine in it, and I take it for my migraines.” Yes, Excedrin is a popular over-the-counter (OTC) migraine medication and it does contain about 65 mg of caffeine. However, caffeine should be consumed in moderation as too much of it may lead to over overstimulation of nerve cells, which is one of the above theories behind migraine pain. The good news is that relief is possible with healthy habits and supplementation. Tomorrow, we will discuss how to get relief in part 2 of our migraine blog series.

About the Author: Julia Dosik, BS, MPH, is a clinical corporate trainer at Life Extension headquarters in South Florida. She holds a Bachelor of Science in biology and psychology as well as a Master of Public Health specializing in health education. Julia utilizes a mix of in-person, virtual and written training to educate employees and consumers on how the human body functions and the importance of supplementing with science-backed ingredients. It is her deepest belief that high-quality dietary supplements are fundamental to an individual’s physical and mental well-being.





References:
  1. https://americanmigrainefoundation.org/resource-library/facts-about-migraine/
  2. https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/how-a-migraine-happens
  3. https://americanmigrainefoundation.org/resource-library/facts-about-migraine/
  4. https://www.mayoclinic.org/diseases-conditions/migraine-with-aura/symptoms-causes/syc-20352072

Vitamin K2: The Missing Ingredient for Our Bones, Arteries and More

Carol Campi, MA, DC, BSN – Life Extension Wellness Specialist

We all know how important calcium and vitamin D are for our bones. And you probably know that vitamin K is necessary for blood to clot. But did you know that vitamin K has more than one form? The various forms are called vitamers. Vitamin K1 is needed to activate various clotting factors, while both K1 and K2 play a major role in our bone and arterial health.1 Vitamin K is vital for getting calcium into our bones and keeping it out of our arteries and soft tissue.2


What is Vitamin K and Where Do We Get It?

The vitamin K vitamers are fat-soluble molecules consisting of a common ring-like structure with side chains of varying lengths. There are several differences between K1, also known as phylloquinone, and K2, or menaquinone. The K1 side chain is monounsaturated and it is primarily found in the liver, while K2 is polyunsaturated and generally found in bone, cartilage and smooth muscle. K2 is further categorized by the number of carbon groups that make up its side chains, with two common forms being menaquinone 4 (MK-4) and menaquinone 7 (MK-7).

Vitamin K1 is plant-based and can be found in many leafy green vegetables, as well as algae and plant-based oils. Menaquinones are found mostly in fermented foods and in small amounts in animal-based foods. A very high amount of K2 is found in the traditional Japanese food nattō (fermented soybeans). Gut bacteria can convert K1 to K2 in animals, but it is still unclear how much this contributes to K2 formation in humans. How efficiently humans convert K1 to any form of K2 is also under investigation and is likely dependent on one’s genetics, gut health, diet and use of drugs such as Coumadin (warfarin). 3


What is the Function of Vitamin K2?

Vitamin K is required to activate specific vitamin K-dependent proteins. One of these is osteocalcin which, when activated, supports bone synthesis. This process occurs throughout life since bone is constantly being remodeled (i.e., resorbed and regenerated).2 The MK-4 form also has the unique role of regulating the expression of various genes, including those that promote bone growth.4 Together, these actions support bone quality and may impact bone density, lessening the risk of osteoporosis.

Another vitamin K-dependent protein is matrix GLA protein which, when it becomes activated by vitamin K2, inhibits the calcification of soft tissue such as our cartilage, tendons and the smooth muscle that surrounds our blood vessels.3 This is important because when calcium deposits in our arteries, it can lead to arterial stiffness, increased blood pressure and cardiovascular events likes heart attacks and strokes.

Benefits of Vitamin K2 for Bone Health

Numerous studies have shown positive benefits of vitamin K2 for bone health. Several observation studies in Japan, where nattō is a frequent staple, found that postmenopausal women consuming the most nattō had less bone loss over time.5 A three-year randomized controlled trial (RCT) using 180 mcg MK-7 in postmenopausal women found less decline in bone mineral density (BMD) in the lumbar spine and femoral neck; bone strength was also better-maintained and there was less loss of height in the thoracic spine.6 Several studies from Japan using very high doses of MK-4 (45 mg/day—that’s 45,000 mcg!) found a decreased incidence of bone fractures in postmenopausal women with osteoporosis.3 Given that the total recommended daily allowance (RDA) of vitamin K for adult women is only 90 mcg (and 120 mcg for men), this amount is much higher than any suggested nutritional dose coming from conventional sources. It is, however, a pharmacological dose that has been deemed safe, has been repeatedly found to support the bone health of osteoporotic, postmenopausal women, and is commonly prescribed in Japan per standard of care.7

Another study on healthy postmenopausal women given a much lower dose of 1500 mcg of MK-4 versus a placebo also found significant BMD improvement and an increase in activated osteocalcin.8 Thus, it appears that vitamin K2, in both the MK-4 and the MK-7 forms, helps to maintain BMD, support bone health and lessen the risk for fractures.

Benefits of K2 for Cardiovascular Health

The 2004 Rotterdam study on 2,400 healthy men and women over 55 looked at the association of dietary intake of K2 and aortic calcification and heart disease over a seven-year period. Ingesting at least 32 mcg of vitamin K2 was associated with a reduced risk for cardiovascular disease and an approximately 50% reduction in deaths related to arterial calcification.9 The 8-year European Prospective Investigation into Cancer and Nutrition (EPIC) study consisting of 16,000 participants between the ages of 49-70 found that for every 10 mcg increase in K2, mostly in the form of MK-7 and MK-9, there were 9% fewer coronary events.10

A double-blind RCT that gave postmenopausal women 180 mcg of MK-7 or a placebo found that after three years, the women given the MK-7 had less arterial stiffness and more flexible arteries.11 These effects could translate into healthier blood pressure and better delivery of nutrients and oxygen to the tissues and organs. The placebo group from this study was also found to have a higher amount of non-activated matrix GLA protein, which correlates with increased risk for calcium being deposited within the arterial walls.

Other Important Health Benefits from Vitamin K2

  • K2 may reduce the risk of developing kidney stones by its role in activating a urinary GLA protein.12,13
  • K2 has been found to support insulin sensitivity and glycemic control in those at risk of diabetes.14
  • K2, specifically MK-4, is involved in turning on and off certain genes such as those involved in hormone production and bone growth.4
  • K2 is associated with improved outcome in certain cancer cases.15
  • K2 is found in high concentrations in the brain and may play a protective role in neurological health.15

The Relationship Between Calcium, Vitamin D and K2

Optimizing our levels of calcium, vitamin D and vitamin K2 are necessary for optimal health, especially as we age. Our bodies need 1,000-1,200 mg of calcium every day to maintain healthy bone turnover and D3 to support the absorption of that calcium from our intestinal tract into our circulation. But without sufficient vitamin K2 available to activate the vitamin K-dependent proteins such as matrix GLA and osteocalcin, much of that calcium is likely to get deposited inappropriately in our arteries, heart valves, joints and tendons, and not in our bones where it is needed.

A combination of dietary and supplemental sources can be used to get our daily calcium dosage. Ideally the amount of supplemental D3 should be determined by the amount required to maintain a blood level of 50-80 ng/mL—this will vary between people and may be anywhere from 2,000-8,000 IU (50-200 mcg) per day.16 The typical Western diet, heavy on processed foods, provides only very small amounts of K2, and even though K1 is quite abundant in green vegetables if consumed, much of it is not sufficiently converted to K2. Currently, there is no commercially available blood test for assessing K2 levels. Doses of MK-4 as high as 45 mg per day have been found to be safe and are routinely prescribed in Japan for osteoporotic women. However, based on the reviewed studies, a daily intake of 1,500 mcg of MK-4 and 180 mcg of MK-7 is likely more than sufficient.

Safety and Medication Interactions

The only safety concern for vitamin K revolves around its interaction with warfarin—a vitamin K antagonist. Warfarin and its family of anticoagulating drugs work by preventing K1 from activating various clotting proteins. Unfortunately, these drugs also interfere with the activation of matrix GLA and osteocalcin; common side effects of anticoagulants include an increased risk of aortic stenosis due to calcification and osteoporosis.17 Those individuals on warfarin should not alter their vitamin K1 or K2 intake without first consulting with their physicians. For the rest of us, unless you are fans of nattō or goose liver, it’s unlikely that you are getting adequate amounts of K2 from your diet. You may want to consider supplementing with the suggested amounts of MK-4 and MK-7 to help promote healthier bones, arteries and more.

About the author: Carol Campi, MA, DC, BSN has been a Wellness Specialist at Life Extension for the past 6 years and an enthusiast of health optimization and anti-aging science for most of her life. Her academic interests have ranged from research-based psychology to chiropractic to acute-care nursing. It was while working as an acute care nurse that she came to the realization that she could help more people by educating them on ways to prevent illness and optimize their health span. In her role as a Wellness Specialist at Life Extension she suggests and evaluates lab results, helps customers to optimize their diet with appropriate nutraceutical support and integrates conventional with holistic approaches to healthcare.


References:
  1. Circulation. 2017;135(21):2081-2083
  2. J Nutr Metab. 2017;2017:6254836.
  3. Linus Pauling Institute. Vitamin K. Accessed 6/11/19. https://lpi.oregonstate.edu/mic/vitamins/vitamin-K
  4. Thromb Haemost. 2008;100(4):530-47.
  5. J Nutr. 2006;136(5):1323-8.
  6. Osteoporos Int. 2013;24(9):2499-507.
  7. Nutrients. 2014;6(5):1971-80.
  8. J Bone Miner Metab. 2014;32(2):142-50.
  9. J Nutr. 2004;134(11):3100-5.
  10. Nutr Metab Cardiovasc Dis. 2009;19(7):504-10.
  11. Thromb Haemost. 2015;113(5):1135-44.
  12. Chin Med J (Engl). 2003;116(4):569-72.
  13. Nephrol Dial Transplant. 2018;33(3):514-522.
  14. Diabetes Res Clin Pract. 2018;136:39-51.
  15. Int J Mol Sci. 2019;20(4)
  16. Dermatoendocrinol. 2017;9(1):e1300213.
  17. Nutr Clin Pract. 2007;22(5):517-44.

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