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Carolyn Bramante, who works in the weight management clinic at the University of Minnesota says she still uses metformin "quite often" for patients with a host of weight-related issues, including type 2 diabetes, pre-diabetes, and obesity, too

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Dietary nitrates have been shown to reduce oxygen use during physical exercise by affecting the efficiency of mitochondria, the cell organs responsible for producing energy ( Beets and their juice are often used for this purpose because of their high inorganic nitrate content

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Without understanding the nutritional component, it would be easy to assume the issue is poor programming or lack of effort