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Lastly, the energy density of weight change is determined by the amount of energy expended through the fat reduction, which provides more energy (9 kcal/g) than glycogen or protein (4 kcal/g), a sustained fat loss is therefore required to sustain metabolic expenditure [21, 22]
It often leads to sarcopenic obesity, where muscle is lost and fat accumulates, which can reduce function and potentially affect long-term outcomes
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