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Abstract Nuclear factor kappa B (NF-B) plays a central role in the inflammatory process, and activation of Keap1-Nrf2 system counteracts with NF-B by upregulating various genes such as superoxide dismutase (SOD), catalase, and heme oxygenase-1 (HO-1)

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Key components include resistance training and daily moderate aerobic exercise, adequate high-quality protein intake (1.21.6 g/kg adjusted body weight/day) distributed evenly across meals, micronutrient supplementation, and periodic reassessment of lean mass via DXA, BIA or functional outcomes (e.g., handgrip strength and gait speed) to optimize fat loss while minimizing sarcopenia risk (Table 2)

Adenosylcobalamin is particularly advantageous for those with cellular energy deficits or hereditary metabolic conditions