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In Study 4, patients received an initial 8-week low-calorie diet (total energy intake 1,000 to 1,200 kcal/day) followed by 60 weeks of a reduced-calorie diet (1200 to 1800 kcal/day) and increased physical activity (100 mins/week with gradual increase to 200 mins/week)

LCarnitine helps transport fat into cells where its converted to energy, supporting metabolism and cellular function

The pellet was discarded and the supernatant was re-supplied with methanol to induce further precipitation

15% body weight)