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Accessed January 20, 2021

Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC heart failure long-term registry

Increased energy expenditure must complement reduced food intake in order to maintain weight loss since physiological compensatory adaptations protect against major weight decrement: decreased caloric intake leads to increased hunger, lower sensitivity to satiety factors, and a reduced metabolic rate [83, 84]

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The authors cautioned that the study identified associations rather than proof of causation