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Dodonova SA, Zhidkova EM, Kryukov AA, Valiev TT, Kirsanov KI, Kulikov EP, Budunova IV, Yakubovskaya MG, Lesovaya EA. Synephrine and Its Derivative Compound A: Common and Specific Biological Effects. Int J Mol Sci 2023; 24:17537. [PMID: 38139366 PMCID: PMC10744207 DOI: 10.3390/ijms242417537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
This review is focused on synephrine, the principal phytochemical found in bitter orange and other medicinal plants and widely used as a dietary supplement for weight loss/body fat reduction. We examine different aspects of synephrine biology, delving into its established and potential molecular targets, as well as its mechanisms of action. We present an overview of the origin, chemical composition, receptors, and pharmacological properties of synephrine, including its anti-inflammatory and anti-cancer activity in various in vitro and animal models. Additionally, we conduct a comparative analysis of the molecular targets and effects of synephrine with those of its metabolite, selective glucocorticoid receptor agonist (SEGRA) Compound A (CpdA), which shares a similar chemical structure with synephrine. SEGRAs, including CpdA, have been extensively studied as glucocorticoid receptor activators that have a better benefit/risk profile than glucocorticoids due to their reduced adverse effects. We discuss the potential of synephrine usage as a template for the synthesis of new generation of non-steroidal SEGRAs. The review also provides insights into the safe pharmacological profile of synephrine.
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Affiliation(s)
- Svetlana A. Dodonova
- Research Institute of Experimental Medicine, Department of Pathophysiology, Kursk State Medical University, 305041 Kursk, Russia; (S.A.D.); (A.A.K.)
| | - Ekaterina M. Zhidkova
- Department of Chemical Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, 115478 Moscow, Russia; (E.M.Z.); (T.T.V.); (K.I.K.); (M.G.Y.)
| | - Alexey A. Kryukov
- Research Institute of Experimental Medicine, Department of Pathophysiology, Kursk State Medical University, 305041 Kursk, Russia; (S.A.D.); (A.A.K.)
| | - Timur T. Valiev
- Department of Chemical Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, 115478 Moscow, Russia; (E.M.Z.); (T.T.V.); (K.I.K.); (M.G.Y.)
| | - Kirill I. Kirsanov
- Department of Chemical Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, 115478 Moscow, Russia; (E.M.Z.); (T.T.V.); (K.I.K.); (M.G.Y.)
- Faculty of Oncology, Ryazan State Medical University Named after Academician I.P. Pavlov, 390026 Ryazan, Russia
| | - Evgeny P. Kulikov
- Laboratory of Single Cell Biology, Russian University of People’s Friendship (RUDN) University, 117198 Moscow, Russia;
| | - Irina V. Budunova
- Department of Dermatology, Northwestern University, Chicago, IL 60611, USA;
| | - Marianna G. Yakubovskaya
- Department of Chemical Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, 115478 Moscow, Russia; (E.M.Z.); (T.T.V.); (K.I.K.); (M.G.Y.)
- Faculty of Oncology, Ryazan State Medical University Named after Academician I.P. Pavlov, 390026 Ryazan, Russia
| | - Ekaterina A. Lesovaya
- Department of Chemical Carcinogenesis, N.N. Blokhin National Medical Research Center of Oncology, 115478 Moscow, Russia; (E.M.Z.); (T.T.V.); (K.I.K.); (M.G.Y.)
- Faculty of Oncology, Ryazan State Medical University Named after Academician I.P. Pavlov, 390026 Ryazan, Russia
- Laboratory of Single Cell Biology, Russian University of People’s Friendship (RUDN) University, 117198 Moscow, Russia;
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Prather JM, Florez CM, Vargas A, Soto B, Harrison A, Willoughby D, Tinsley G, Taylor L. The effects of a thermogenic supplement on metabolic and hemodynamic variables and subjective mood states. J Int Soc Sports Nutr 2023; 20:2185538. [PMID: 36862833 PMCID: PMC9987759 DOI: 10.1080/15502783.2023.2185538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Thermogenic supplements are widely used in the general population to support attempted fat loss; however, the efficacy and safety of these supplements are questioned. PURPOSE To determine whether a thermogenic supplement affects metabolic rate, hemodynamic responses, and mood states. METHODS In a randomized double-blind crossover design, 23 females (22.2 ± 3.5 years; 164.8 ± 6.4 cm; 73.5 ± 6.9 kg) who were moderate caffeine consumers (<150 mg/day) reported to the lab after a 12 h fast for baseline assessments of resting energy expenditure (REE) via indirect calorimetry, heart rate (HR), blood pressure (SBP and DBP), blood variables, and hunger, satiety, and mood states. Thereafter, subjects ingested the assigned treatment (active treatment containing caffeine, micronutrients, and phytochemicals [TR] or placebo [PL]). All variables were reassessed at 30-, 60-, 120-, and 180 min post-ingestion. Subjects repeated the same protocol with ingestion of the opposite treatment on a separate day. All data were analyzed using a 2 × 5 ANOVA with repeated measures and significance was accepted a priori at p < 0.05. RESULTS In the TR group, mean increases in REE of 121 to 166 kcal/d were observed at 30-, 60-, and 180 min post-ingestion (p < 0.01 for all). PL group mean decreases in REE of 72 to 91 kcal/day were observed at 60-, 120-, and 180 min (p < 0.05 for all). Respiratory quotient decreased at 120 and 180 min in both treatments. Slight increases in SBP of 3-4 mmHg were observed at 30, 120, and 180 min (p < 0.05 for all) post-ingestion of TR, while no effects were observed for DBP. Observed increases in SBP were within normal blood pressure ranges. TR decreased subjective fatigue with no other significant changes in mood states. Glycerol was maintained in TR, while there was a decrease at 30, 60, and 180 min (p < 0.05 for all) post-ingestion of PLA. Free fatty acids increased in TR at 60 and 180 min (p < 0.05) post-ingestion as well as a significant difference between treatments at 30 min post-ingestion indicating greater circulating free fatty acids levels in TR vs. PL (p < 0.01). CONCLUSION These findings indicate that ingestion of a specific thermogenic supplement formulation produces a sustained increase in metabolic rate and caloric expenditure and reduces fatigue over 3 h without producing adverse hemodynamic responses.
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Affiliation(s)
- Jessica M Prather
- University of Mary Hardin-Baylor, Human Performance Lab, School of Exercise and Sport Science, Belton, TX, USA
| | - Christine M Florez
- University of Mary Hardin-Baylor, Human Performance Lab, School of Exercise and Sport Science, Belton, TX, USA
| | - Amie Vargas
- University of Mary Hardin-Baylor, Human Performance Lab, School of Exercise and Sport Science, Belton, TX, USA
| | - Bella Soto
- University of Mary Hardin-Baylor, Human Performance Lab, School of Exercise and Sport Science, Belton, TX, USA
| | - Abby Harrison
- University of Mary Hardin-Baylor, Human Performance Lab, School of Exercise and Sport Science, Belton, TX, USA
| | - Darryn Willoughby
- University of Mary Hardin-Baylor, Human Performance Lab, School of Exercise and Sport Science, Belton, TX, USA
| | - Grant Tinsley
- Texas Tech University, Energy Balance & Body Composition Lab; Department of Kinesiology & Sport Management, Lubbock, TX, USA
| | - Lem Taylor
- University of Mary Hardin-Baylor, Human Performance Lab, School of Exercise and Sport Science, Belton, TX, USA
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The Safety and Efficacy of Citrus aurantium (Bitter Orange) Extracts and p-Synephrine: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14194019. [PMID: 36235672 PMCID: PMC9572433 DOI: 10.3390/nu14194019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
Synephrine has been used to promote weight loss; however, its safety and efficacy have not been fully established. The goals of our study were to give an overview of the safety and efficacy of p-synephrine, to systematically evaluate its efficacy regarding weight loss and to assess its safety, focusing on its cardiovascular side effects in a meta-analysis. PubMed, the Cochrane Library, Web of Science and Embase were searched for relevant studies. Only placebo-controlled, human clinical trials with synephrine intervention were included in the meta-analysis. The meta-analysis was reported according to the PRISMA guidelines using the PICOS format and taking into account the CONSORT recommendations. Altogether, 18 articles were included in the meta-analysis. Both systolic and diastolic blood pressure (DBP) increased significantly after prolonged use (6.37 mmHg, 95% CI: 1.02–11.72, p = 0.02 and 4.33 mmHg, 95% CI: 0.48–8.18, p = 0.03, respectively). The weight loss in the synephrine group was non-significant after prolonged treatment, and it did not influence body composition parameters. Based on the analyzed clinical studies, synephrine tends to raise blood pressure and heart rate, and there is no evidence that synephrine can facilitate weight loss. Further studies are needed to confirm evidence of its safety and efficacy.
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Benjamim CJR, Júnior FWDS, Porto AA, Rocha ÉMB, Santana MD, Garner DM, Valenti VE, Bueno Júnior CR. Bitter Orange (Citrus aurantium L.) Intake Before Submaximal Aerobic Exercise Is Safe for Cardiovascular and Autonomic Systems in Healthy Males: A Randomized Trial. Front Nutr 2022; 9:890388. [PMID: 35694173 PMCID: PMC9184817 DOI: 10.3389/fnut.2022.890388] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/26/2022] [Indexed: 12/18/2022] Open
Abstract
Background There are still no studies of the cardiovascular safety of the isolated use of Citrus aurantium in aerobic submaximal exercise. Objective To evaluate the effect of C. aurantium supplementation on the recovery of cardiorespiratory and autonomic parameters following a session of submaximal aerobic exercise. Methods Twelve healthy male adults achieved a crossover, randomized, double-blind, and placebo-controlled trial. C. aurantium (600 mg, p-synephrine at 30% amount [180 mg]) or placebo (600 mg of starch) were ingested 90 min before evaluation in randomized days. We evaluated systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP), heart rate (HR) and, HR variability indexes at Rest and during 60 min of recovery from exercise. Results Citrus aurantium ingestion accelerated the reduction in SBP after exercise, anticipated the return of vagal modulation of the heart after exercise via the HF (ms2), pNN50 (%), and 2 UV% indices. Moreover, rushed the output of sympathetic modulation after exercise via the 0V% index. No unfavorable cardiovascular effects were achieved for HR, DBP, PP, and MAP parameters. Conclusions Citrus aurantium was shown to be safe for the cardiovascular and autonomic systems alongside submaximal aerobic exercise in healthy males.
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Affiliation(s)
- Cicero Jonas R. Benjamim
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- *Correspondence: Cicero Jonas R. Benjamim
| | | | - Andrey Alves Porto
- Autonomic Nervous System Center, São Paulo State University (UNESP), Marilia, São Paulo, Brazil
| | | | - Milana D. Santana
- University Center of the Juazeiro do Norte, Juazeiro do Norte, Brazil
| | - David M. Garner
- Autonomic Nervous System Center, São Paulo State University (UNESP), Marilia, São Paulo, Brazil
- Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Vitor E. Valenti
- Autonomic Nervous System Center, São Paulo State University (UNESP), Marilia, São Paulo, Brazil
| | - Carlos Roberto Bueno Júnior
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- School of Physical Education of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Ruiz-Moreno C, Del Coso J, Giráldez-Costas V, González-García J, Gutiérrez-Hellín J. Effects of p-Synephrine during Exercise: A Brief Narrative Review. Nutrients 2021; 13:nu13010233. [PMID: 33467423 PMCID: PMC7830131 DOI: 10.3390/nu13010233] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/09/2021] [Accepted: 01/13/2021] [Indexed: 11/16/2022] Open
Abstract
The p-synephrine is the principal phytochemical found in bitter orange (Citrus aurantium). This substance is widely included in dietary supplements for weight loss/body fat reduction due to its potential benefits of increasing fat oxidation. For years, p-synephrine-containing dietary supplements have been marketed without proper knowledge of their true effectiveness to enhance fat utilization, especially when combined with exercise. However, the effects of p-synephrine on fat oxidation during exercise have been investigated in the last few years. The aim of the current discussion is to summarize the evidence on the effects of p-synephrine intake on fat oxidation and performance during exercise. Previous investigations have demonstrated that the acute intake of p-synephrine does not modify running sprint performance, jumping capacity, or aerobic capacity. However, the acute intake of p-synephrine, in a dose of 2-3 mg/kg of body mass, has been effective to enhance the rate of fat oxidation during incremental and continuous exercise. This effect has been observed in a range of exercise workloads between 30% and 80% of peak oxygen uptake (VO2peak). The p-synephrine has the ability to increase the maximal rate of fat oxidation during exercise of increasing intensity without affecting the workload at which maximal fat oxidation is obtained (Fatmax). The effect of p-synephrine on fat oxidation is normally accompanied by a concomitant reduction of carbohydrate utilization during exercise, without modifying the energy expended during exercise. The shifting in substrate oxidation is obtained without any effect on heart rate during exercise and the prevalence of adverse effects is negligible. Thus, the acute use of p-synephrine, or p-synephrine-containing products, might offer some benefits for those individuals seeking higher fat utilization during exercise at low to moderate intensities. However, more research is still necessary to determine if the effect of p-synephrine on fat oxidation during exercise is maintained with chronic ingestion, in order to ascertain the utility of this substance in conjunction with exercise programs to produce an effective body fat/weight loss reduction.
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Affiliation(s)
- Carlos Ruiz-Moreno
- Exercise Physiology Laboratory, Camilo José Cela University, 28693 Villanueva de la Cañada, Spain; (C.R.-M.); (V.G.-C.); (J.G.-G.)
| | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University, 28943 Fuenlabrada, Spain
- Correspondence:
| | - Verónica Giráldez-Costas
- Exercise Physiology Laboratory, Camilo José Cela University, 28693 Villanueva de la Cañada, Spain; (C.R.-M.); (V.G.-C.); (J.G.-G.)
| | - Jaime González-García
- Exercise Physiology Laboratory, Camilo José Cela University, 28693 Villanueva de la Cañada, Spain; (C.R.-M.); (V.G.-C.); (J.G.-G.)
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Stohs SJ, Shara M, Ray SD. p-Synephrine, ephedrine, p-octopamine and m-synephrine: Comparative mechanistic, physiological and pharmacological properties. Phytother Res 2020; 34:1838-1846. [PMID: 32101364 PMCID: PMC7496387 DOI: 10.1002/ptr.6649] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 01/23/2023]
Abstract
Confusion and misunderstanding exist regarding the lack of cardiovascular and other adverse health effects of p-synephrine and p-octopamine relative to ephedrine and m-synephrine (phenylephrine) which are known for their effects on the cardiovascular system. These four molecules have some structural similarities. However, the structural and stereochemical differences of p-synephrine and p-octopamine as related to ephedrine and m-synephrine result in markedly different adrenergic receptor binding characteristics as well as other mechanistic differences which are reviewed. p-Synephrine and p-octopamine exhibit little binding to α-1, α-2, β-1 and β-2 adrenergic receptors, nor are they known to exhibit indirect actions leading to an increase in available levels of endogenous norepinephrine and epinephrine at commonly used doses. The relative absence of these mechanistic actions provides an explanation for their lack of production of cardiovascular effects at commonly used oral doses as compared to ephedrine and m-synephrine. As a consequence, the effects of ephedrine and m-synephrine cannot be directly extrapolated to p-synephrine and p-octopamine which exhibit significantly different pharmacokinetic, and physiological/pharmacological properties. These conclusions are supported by human, animal and in vitro studies that are discussed.
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Affiliation(s)
- Sidney J Stohs
- School of Pharmacy and Health Professions, Creighton University Medical Center, Omaha, Nebraska.,Department of Pharmaceutical & Biomedical Sciences, Kitsto Consulting LLC, Frisco, Texas
| | - Mohd Shara
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Stohs SJ, Ray SD. Review of Published Bitter Orange Extract and p-Synephrine Adverse Event Clinical Study Case Reports. J Diet Suppl 2019; 17:355-363. [DOI: 10.1080/19390211.2019.1577936] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Sidney J. Stohs
- Creighton University Medical Center, Omaha, NE, USA Kitsto Consulting LLC, Frisco, TX, USA
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An Overview on Citrus aurantium L.: Its Functions as Food Ingredient and Therapeutic Agent. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:7864269. [PMID: 29854097 PMCID: PMC5954905 DOI: 10.1155/2018/7864269] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/24/2018] [Accepted: 04/01/2018] [Indexed: 01/01/2023]
Abstract
Citrus aurantium L. (Rutaceae), commonly known as bitter orange, possesses multiple therapeutic potentials. These biological credentials include anticancer, antianxiety, antiobesity, antibacterial, antioxidant, pesticidal, and antidiabetic activities. The essential oil of C. aurantium was reported to display marked pharmacological effects and great variation in chemical composition depending on growing locations but mostly contained limonene, linalool, and β-myrcene. Phytochemically, C. aurantium is rich in p-synephrine, an alkaloid, and many health-giving secondary metabolites such as flavonoids. Animal studies have demonstrated a low affinity of p-synephrine for adrenergic receptors and an even lower affinity in human models. The present review focuses on the different biological activities of the C. aurantium in animal and human models in the form of extract and its pure secondary metabolites. Finally, it is concluded that both the extract and isolated compounds have no unwanted effects in human at therapeutic doses and, therefore, can confidently be used in various dietary formulations.
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Bush JA, Ratamess NA, Stohs SJ, Ellis NL, Vought IT, O'Grady EA, Kuper JD, Kang J, Faigenbaum AD. Acute hematological and mood perception effects of bitter orange extract (p-synephrine) consumed alone and in combination with caffeine: A placebo-controlled, double-blind study. Phytother Res 2018; 32:1593-1607. [PMID: 29672965 DOI: 10.1002/ptr.6090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/02/2018] [Accepted: 03/17/2018] [Indexed: 11/09/2022]
Abstract
The purpose of this study was to examine acute hematological and mood perception responses to supplementation with p-synephrine alone and in combination with caffeine during quiet sitting. Sixteen subjects visited the laboratory on 6 occasions and were given (in randomized double-blind manner) 103-mg p-synephrine (S), 233-mg caffeine + 104-mg p-synephrine, 240-mg caffeine, 337-mg caffeine + 46-mg p-synephrine, 325-mg caffeine, or a placebo (PL). The subjects sat quietly for 3 hr while completing mood state questionnaires every 30 min. Venous blood samples were collected at baseline (pre) and 3 hr (post) to determine immune, lipid, and chemistry panels. Compared with PL, no significant supplement differences were observed during the S trial with the exception of differential time effects seen in hematocrit (decrease in PL, no change in S), triglycerides and very low-density lipoproteins (no changes in PL, significant decreases in S), and iron (no change in PL, significant elevation in S). Supplements containing caffeine showed increased feelings of attention, excitement, energy, and vigor. These data indicate that consumption of 103-mg p-synephrine does not negatively impact acute blood parameters, does not augment the effects of caffeine, or produce stimulant-like perceptual mood effects.
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Affiliation(s)
- Jill A Bush
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Nicholas A Ratamess
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Sidney J Stohs
- School of Pharmacy and Health Professions, Creighton University, Omaha, NE, 68178, USA
| | - Nicole L Ellis
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Ira T Vought
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Elizabeth A O'Grady
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Jeremy D Kuper
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Jie Kang
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Avery D Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, 08628, USA
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