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There was some evidence of publication bias (Egger test, P = 0.94), but the trim-and-fill method indicated that this publication bias did not impact the estimate
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However, maintaining a calorie-deficient diet is also one of the hardest parts of following a medical weight loss program, as patients are encouraged to continue exercising and will experience increased hunger and cravings
In fact, hyperglycemia itself stimulates tumor growth through distinct mechanisms and often amplifies the growth-promoting action of insulin
