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The exclusion criteria were: females who were pregnant or experiencing a menstrual period, type 2 diabetes treated using an insulin regimen, malignancy, hematopathy, active tuberculosis, peptic ulcer with gastric bleeding, binge-eating disorder, psychiatric disease, congestive heart failure, clinically relevant renal or hepatic insufficiency, unstable coronary artery disease, cancer or a history of cancer

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Medical experts first recommend lifestyle changes: increase water and fiber intake and engage in regular physical activity

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