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A meta-analysis of randomized controlled trials (RCTs) including patients with HF found no improvement in hospitalization rates or echocardiographic parameters such as LVEF or LV end-systolic or diastolic volume

[DOI] [PMC free article] [PubMed] [Google Scholar] 53.Willard F.S., Douros J.D., Gabe M.B., Showalter A.D., Wainscott D.B., Suter T.M., Capozzi M.E., van der Velden W.J., Stutsman C., Cardona G.R., et al

Losing muscle not only impacts strength and energy but can also slow metabolism, making long-term weight maintenance more challenging

Microbiome Optimization Strategies Probiotic Supplementation Multi-strain formulas containing Lactobacillus and Bifidobacterium species help restore healthy bacterial ratios and compete with gas-producing bacteria for intestinal resources

The authors suggest that maintaining extremely large weight losses may be harder biologically