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They work best when paired with: Strength training to preserve lean muscle Higher protein intake Consistent hydration Balanced, realistic meals This is not about extreme restrictions
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Response history matters too
Severe vomiting or inability to pass gas requires urgent medical consultation, as these could signal serious underlying conditions needing immediate intervention
Bland-Altman analysis revealed minimal systematic bias (mean difference=0.032), with 63% of participants having PHCS-2 and PHCS-8 scores within 0.25 points (Figure 1)
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