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coolant etc for the car to run as it should - if it lacks one of these elements then everything else starts to suffer

non-supplemented baseline Before: 145 lbs, 28% body fat, active trainer, strong metabolic baseline Protocol: 300 kcal deficit, 1.8g protein/kg, 2g L-carnitine daily, 4 resistance + 3 cardio sessions weekly After: 135 lbs, 22% body fat (10 lbs loss, ~9 lbs fat + 1 lb muscle), visible abdominal and shoulder definition Result: L-carnitine + training allowed aggressive deficit while preserving strength

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Specification and emulation of the reference trial including our expansion studies are stated in the Supplementary Information, following the TrAnsparent ReportinG of observational studies Emulating a Target trial (TARGET) guideline (Supplementary Tables 2729) 42