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K
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w
o
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d
s
:
E
x
p
er
im
en
ta
l
Me
s
o
co
t
in
u
s
(
h
is
to
lo
g
y
)
So
y
p
lu
s
z
in
c
Su
p
p
lem
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t
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W
is
ta
r
r
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t
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s
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c
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a
rticle
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d
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r th
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CC B
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-
SA
li
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n
se
.
C
o
r
r
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s
p
o
nd
ing
A
uth
o
r
:
Yu
n
iast
in
i
Dep
ar
tm
en
t o
f
Nu
r
s
in
g
,
Po
lte
k
k
es Ke
m
en
k
es T
an
ju
n
g
Kar
a
n
g
B
an
d
ar
L
am
p
u
n
g
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L
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p
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I
n
d
o
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esia
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m
ail:
y
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in
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6
5
@
g
m
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c
o
m
1.
I
NT
RO
D
UCT
I
O
N
Stu
n
tin
g
in
ch
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r
en
is
a
s
ig
n
if
ican
t
h
ea
lth
ch
allen
g
e,
p
ar
ti
cu
lar
ly
in
d
ev
elo
p
in
g
co
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n
tr
i
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an
d
is
clo
s
ely
lin
k
ed
to
d
ef
icien
cies
in
ess
en
tial
n
u
tr
ien
ts
,
s
u
ch
as
zin
c
an
d
p
r
o
tein
.
Z
in
c
p
lay
s
a
cr
u
cial
r
o
le
in
v
ar
io
u
s
p
h
y
s
io
lo
g
ical
p
r
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ce
s
s
es
s
u
p
p
o
r
tin
g
g
r
o
wth
an
d
im
m
u
n
e
f
u
n
ctio
n
[
1
]
,
[
2
]
.
Def
ici
en
cy
in
zin
c
af
f
ec
ts
ap
p
r
o
x
im
ately
1
7
%
o
f
th
e
g
l
o
b
al
p
o
p
u
latio
n
,
a
n
d
ch
il
d
r
en
'
s
r
ap
id
g
r
o
wth
d
u
r
i
n
g
ea
r
ly
y
ea
r
s
in
cr
ea
s
es
th
eir
r
is
k
o
f
th
is
d
ef
icien
cy
,
p
o
ten
ti
ally
r
esu
l
tin
g
in
s
tu
n
tin
g
[
3
]
.
R
esear
ch
h
as sh
o
wn
th
at
zin
c
s
u
p
p
lem
en
tatio
n
ca
n
ef
f
ec
tiv
ely
en
h
an
ce
g
r
o
wth
o
u
tco
m
es
in
ch
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r
en
u
n
d
er
f
i
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y
ea
r
s
o
l
d
,
r
ein
f
o
r
cin
g
th
e
n
ee
d
f
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r
s
af
e
a
n
d
ef
f
icien
t
in
ter
v
en
tio
n
s
t
o
c
o
m
b
at
s
tu
n
tin
g
[
4
]
.
Fu
r
th
er
m
o
r
e,
a
d
eq
u
ate
p
r
o
tein
in
t
a
k
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is
ass
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ciate
d
with
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p
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f
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ch
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r
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n
'
s
d
ev
elo
p
m
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n
t
[
1
]
,
[
5
]
.
Mu
lti
-
f
a
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ted
ap
p
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h
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in
c
o
r
p
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atin
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th
ese
n
u
tr
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ar
e
ess
en
tial
to
ad
d
r
ess
s
tu
n
tin
g
an
d
im
p
r
o
v
e
p
u
b
lic
h
ea
l
th
o
u
t
co
m
es
[
4
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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Hea
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Sci
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N:
2252
-
8
8
0
6
E
ffects o
f so
y
p
lu
s
z
in
c
s
u
p
p
leme
n
ta
tio
n
o
n
g
r
o
w
th
a
n
d
kid
n
ey
h
ea
lth
in
w
is
ta
r
r
a
ts
:
…
(
Yu
n
ia
s
tin
i
)
141
Z
in
c
is
an
ess
en
tial
tr
ac
e
elem
en
t
in
v
o
l
v
ed
in
o
v
e
r
1
0
0
e
n
zy
m
atic
p
r
o
ce
s
s
es
v
ital
f
o
r
m
etab
o
lis
m
,
en
d
o
cr
in
e
f
u
n
ctio
n
,
an
d
im
m
u
n
e
in
teg
r
ity
.
R
esear
ch
in
d
icate
s
th
at
zin
c
is
in
teg
r
al
to
th
e
f
u
n
ctio
n
o
f
v
a
r
io
u
s
im
m
u
n
e
ce
lls
,
in
clu
d
in
g
T
ly
m
p
h
o
c
y
tes
an
d
n
eu
tr
o
p
h
ils
,
e
n
h
an
cin
g
b
o
th
i
n
n
ate
an
d
ac
q
u
ir
ed
im
m
u
n
ity
[
6
]
,
[
7
]
.
C
h
ild
r
en
with
lo
wer
zin
c
lev
els
ex
h
ib
it
h
ig
h
er
s
u
s
ce
p
tib
ilit
y
to
in
f
ec
tio
n
s
,
h
ig
h
lig
h
ti
n
g
th
e
n
ec
ess
ity
f
o
r
ad
eq
u
ate
zin
c
n
u
tr
itio
n
to
b
o
ls
ter
im
m
u
n
e
r
esp
o
n
s
es
[
8
]
.
Ultim
ately
,
e
n
s
u
r
in
g
s
u
f
f
icien
t d
ie
tar
y
zin
c
is
cr
itical
f
o
r
p
r
o
m
o
tin
g
g
r
o
wth
an
d
r
e
d
u
cin
g
h
ea
lth
r
is
k
s
in
p
e
d
iatr
ic
p
o
p
u
latio
n
s
,
esp
ec
ially
i
n
lo
w
-
an
d
m
i
d
d
le
-
in
co
m
e
co
u
n
tr
ies wh
er
e
m
aln
u
tr
itio
n
is
p
r
ev
alen
t
[
9
]
,
[
1
0
]
.
W
h
ile
ev
id
en
ce
s
u
p
p
o
r
ts
i
n
d
iv
id
u
al
b
e
n
ef
its
o
f
s
o
y
p
r
o
tein
i
n
p
r
o
m
o
tin
g
g
r
o
wth
an
d
m
itig
atin
g
r
en
al
in
ju
r
y
,
t
h
er
e
r
e
m
ain
s
in
s
u
f
f
ici
en
t
ex
p
lo
r
atio
n
o
f
th
eir
s
y
n
er
g
is
tic
ef
f
ec
ts
.
Fo
r
ex
am
p
le,
s
o
y
p
r
o
tein
h
as
b
ee
n
s
h
o
wn
to
en
h
an
ce
g
r
o
wth
p
er
f
o
r
m
an
ce
in
m
aln
u
tr
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n
co
n
tex
ts
an
d
im
p
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o
v
e
k
i
d
n
ey
h
is
to
lo
g
y
,
as
d
em
o
n
s
tr
ated
i
n
s
tu
d
ies
o
n
v
a
r
io
u
s
an
im
al
m
o
d
els
[
1
1
]
.
Ho
wev
er
,
th
e
in
teg
r
atio
n
o
f
th
ese
two
co
m
p
o
n
e
n
ts
in
s
y
s
tem
atic
s
tu
d
ies f
o
cu
s
in
g
o
n
g
r
o
wth
e
n
h
an
ce
m
e
n
t a
n
d
r
en
a
l h
ea
lth
is
n
o
tab
ly
a
b
s
en
t.
T
h
is
s
tu
d
y
aim
ed
to
ex
p
lo
r
e
an
d
co
m
p
ar
e
th
e
ef
f
ec
ts
o
f
s
o
y
p
lu
s
zin
c
(
SP
Z
)
s
u
p
p
le
m
en
tatio
n
,
co
n
tain
in
g
v
ar
y
in
g
zin
c
co
n
c
en
tr
atio
n
s
,
an
d
f
o
o
d
f
lav
o
r
in
g
s
o
n
th
e
g
r
o
wth
an
d
h
ea
lth
o
f
W
is
tar
r
ats.
B
y
d
iv
id
in
g
t
h
e
ex
p
er
im
en
tal
a
n
im
als
in
to
f
iv
e
tr
ea
tm
e
n
t
g
r
o
u
p
s
,
th
is
s
tu
d
y
was
ab
le
to
o
b
s
er
v
e
th
e
im
p
ac
t
o
f
d
if
f
er
en
t
d
iets
o
n
th
e
k
id
n
e
y
an
d
b
o
d
y
weig
h
ts
o
f
th
e
r
ats.
T
h
e
r
esu
lts
ar
e
ex
p
ec
ted
to
m
ak
e
a
s
ig
n
if
ican
t
co
n
tr
ib
u
tio
n
to
an
im
al
n
u
tr
itio
n
an
d
h
ea
lth
s
tu
d
ies.
2.
M
E
T
H
O
D
2
.
1
.
Study
des
ig
n a
nd
s
a
m
ple
T
h
is
s
tu
d
y
u
s
ed
a
r
an
d
o
m
ize
d
co
n
tr
o
lled
tr
ial
d
esig
n
in
v
o
lv
in
g
20
-
d
ay
-
o
ld
W
is
tar
r
ats.
T
h
e
s
tu
d
y
was
co
n
d
u
cted
i
n
a
b
i
o
lo
g
y
a
n
d
p
h
ar
m
ac
o
l
o
g
y
la
b
o
r
ato
r
y
u
n
d
er
s
tr
ict
eth
ical
o
v
er
s
ig
h
t.
T
h
e
s
am
p
le
u
s
ed
i
n
th
is
s
tu
d
y
co
n
s
is
ted
o
f
2
5
2
0
-
d
a
y
-
o
ld
W
is
tar
wh
ite
r
ats.
No
W
i
s
tar
r
ats
d
ied
d
u
r
in
g
th
e
o
n
e
-
wee
k
ac
clim
atiza
tio
n
p
r
o
ce
s
s
;
th
e
s
am
p
le
was
d
iv
id
ed
in
t
o
f
iv
e
tr
ea
tm
en
t
g
r
o
u
p
s
.
R
an
d
o
m
izatio
n
was
ex
ec
u
te
d
u
s
in
g
a
s
y
s
tem
atic
ap
p
r
o
ac
h
to
en
s
u
r
e
u
n
b
iased
ass
ig
n
m
en
t
to
tr
ea
tm
en
t g
r
o
u
p
s
.
Fo
llo
win
g
an
ac
clim
atiza
tio
n
p
er
io
d
o
f
o
n
e
wee
k
,
ea
ch
r
at
was
ass
ig
n
ed
a
u
n
i
q
u
e
i
d
en
tifi
ca
tio
n
n
u
m
b
er
.
A
r
a
n
d
o
m
n
u
m
b
er
g
en
er
ato
r
was
em
p
lo
y
ed
to
allo
ca
te
r
ats to
o
n
e
o
f
th
e
f
iv
e
tr
ea
tm
en
t
g
r
o
u
p
s
,
en
s
u
r
in
g
th
at
ea
ch
g
r
o
u
p
h
a
d
an
eq
u
al
ch
an
c
e
o
f
b
ein
g
s
elec
ted
.
T
h
is
m
eth
o
d
m
itig
ated
s
elec
tio
n
b
ias
an
d
f
ac
ilit
ated
a
b
alan
ce
d
d
is
tr
ib
u
tio
n
o
f
v
ar
iab
les
th
at
co
u
ld
in
f
l
u
en
ce
th
e
o
u
tco
m
es o
f
th
e
s
tu
d
y
.
2
.
2
.
L
o
ca
t
io
n o
f
re
s
ea
rc
h
T
h
is
r
esear
ch
was
co
n
d
u
cted
in
th
e
An
ato
m
ical
Path
o
lo
g
y
L
ab
o
r
ato
r
y
at
GT
P
Sen
to
s
a,
a
f
ac
ilit
y
eq
u
ip
p
e
d
with
s
tate
-
of
-
th
e
-
a
r
t
b
io
lo
g
ical
an
d
p
h
a
r
m
ac
o
lo
g
ical
r
esear
ch
eq
u
ip
m
en
t.
T
h
e
lab
o
r
ato
r
y
ad
h
e
r
es
to
s
tr
ict
eth
ical
g
u
id
elin
es,
in
li
n
e
with
th
e
p
r
in
cip
les
o
f
th
e
Dec
lar
atio
n
o
f
Helsin
k
i
an
d
r
elev
an
t
n
atio
n
al
r
eg
u
latio
n
s
f
o
r
th
e
h
u
m
an
e
tr
e
atm
en
t o
f
lab
o
r
ato
r
y
an
im
als.
2
.
3
.
G
ro
up
I
n
th
is
s
tu
d
y
,
m
ice
wer
e
d
i
v
id
ed
in
to
f
iv
e
g
r
o
u
p
s
to
ev
alu
ate
th
e
ef
f
ec
ts
o
f
s
u
p
p
le
m
en
tatio
n
an
d
f
o
o
d
f
lav
o
r
in
g
o
n
g
r
o
wth
an
d
h
ea
lth
.
Gr
o
u
p
1
s
er
v
ed
as
th
e
co
n
tr
o
l
g
r
o
u
p
an
d
r
ec
eiv
ed
b
r
ea
s
t
m
ilk
,
s
tan
d
ar
d
f
ee
d
,
an
d
d
r
in
k
in
g
wate
r
with
o
u
t
an
y
ad
d
itio
n
al
s
u
b
s
tan
ce
s
.
Gr
o
u
p
s
2
an
d
3
wer
e
ea
c
h
g
iv
e
n
S
PZ
s
u
p
p
lem
en
tatio
n
with
d
if
f
er
e
n
t
zin
c
co
n
te
n
ts
,
n
am
ely
0
.
0
2
0
m
g
an
d
0
.
0
3
5
m
g
p
er
g
r
am
o
f
b
o
d
y
weig
h
t,
r
e
s
p
ec
tiv
ely
,
to
ass
ess
its
im
p
ac
t
o
n
m
o
u
s
e
d
e
v
elo
p
m
en
t.
Gr
o
u
p
s
4
an
d
5
wer
e
s
u
b
jecte
d
to
th
e
s
am
e
co
n
d
itio
n
s
as
g
r
o
u
p
s
2
an
d
3
,
b
u
t
with
th
e
ad
d
itio
n
o
f
v
an
ill
a
f
lav
o
r
in
g
.
T
h
e
ad
d
itio
n
o
f
f
lav
o
r
in
g
is
ex
p
ec
ted
to
af
f
ec
t
p
alata
b
ilit
y
an
d
f
o
o
d
in
tak
e.
T
h
is
s
tu
d
y
aim
ed
to
e
x
p
lo
r
e
an
d
co
m
p
a
r
e
th
e
ef
f
ec
t
s
o
f
v
ar
io
u
s
tr
ea
tm
en
ts
o
n
m
i
ce
,
with
a
p
ar
ticu
lar
f
o
cu
s
o
n
t
h
e
r
o
le
o
f
zin
c
an
d
f
o
o
d
f
la
v
o
r
in
g
in
d
ietar
y
m
o
d
if
icatio
n
s
.
I
n
th
is
s
tu
d
y
,
th
e
s
elec
tio
n
o
f
zin
c
s
u
p
p
lem
en
tatio
n
d
o
s
es
o
f
0
.
0
2
0
m
g
an
d
0
.
0
3
5
m
g
p
er
g
r
am
o
f
b
o
d
y
weig
h
t
was
p
r
e
d
icted
b
ased
o
n
th
e
cr
u
cial
r
o
le
o
f
zi
n
c
in
p
h
y
s
io
lo
g
ical
p
r
o
ce
s
s
es,
p
ar
ticu
lar
ly
th
o
s
e
r
elate
d
to
g
r
o
wth
a
n
d
im
m
u
n
e
f
u
n
ctio
n
.
C
o
m
p
ar
is
o
n
o
f
t
h
ese
two
d
o
s
es
f
ac
ilit
ated
th
e
ex
am
in
atio
n
o
f
th
e
th
r
esh
o
ld
at
wh
ich
zin
c
ex
h
ib
i
ts
o
p
tim
al
ef
f
icac
y
r
eg
ar
d
in
g
h
ea
lth
an
d
g
r
o
wth
o
u
tco
m
es
i
n
2
0
-
d
a
y
-
o
ld
W
is
tar
r
ats,
th
u
s
co
n
tr
ib
u
tin
g
to
a
b
ett
er
u
n
d
e
r
s
tan
d
in
g
o
f
d
ietar
y
zin
c
r
eq
u
ir
em
e
n
ts
a
t th
is
s
tag
e
o
f
d
ev
elo
p
m
e
n
t.
2
.
4
.
M
et
ho
d o
f
g
iv
ing
s
o
y
pl
us
zinc
(
SP
Z
)
s
up
plem
ent
a
t
io
n
So
y
p
lu
s
zin
c
s
u
p
p
lem
en
tatio
n
was
ad
m
in
is
ter
ed
o
n
ce
d
aily
f
o
r
1
4
d
ay
s
.
Ad
m
in
is
tr
atio
n
was
p
er
f
o
r
m
ed
v
ia
a
tu
b
e
to
en
s
u
r
e
th
at
th
e
co
r
r
ec
t d
o
s
e
was r
ec
e
iv
ed
b
y
th
e
m
ice
.
All p
r
o
ce
d
u
r
es we
r
e
p
er
f
o
r
m
e
d
u
s
in
g
asep
tic
tech
n
iq
u
es
to
p
r
ev
en
t
co
n
tam
in
atio
n
th
at
co
u
l
d
af
f
ec
t
th
e
r
esu
lts
o
f
th
e
s
tu
d
y
.
So
y
a
Plu
s
Z
in
c
is
a
p
r
o
d
u
ct
m
a
d
e
f
r
o
m
n
atu
r
al
in
g
r
ed
ien
ts
,
wh
er
e
s
o
y
b
ea
n
s
ar
e
th
e
m
ain
co
m
p
o
n
en
t
,
wit
h
a
q
u
an
tity
o
f
1
0
0
g
r
am
s
.
So
y
b
ea
n
s
ar
e
a
r
ich
s
o
u
r
ce
o
f
p
r
o
tein
an
d
c
o
n
tain
im
p
o
r
tan
t
am
in
o
ac
i
d
s
s
u
ch
as
le
u
cin
e.
I
n
ad
d
itio
n
,
4
0
g
o
f
g
r
an
u
lated
s
u
g
ar
was
ad
d
ed
to
p
r
o
v
id
e
a
b
ala
n
ce
d
s
wee
t
tast
e,
wh
ile
3
g
o
f
s
alt
w
as
u
s
ed
to
im
p
r
o
v
e
th
e
tast
e
an
d
q
u
ality
o
f
th
e
m
ea
l.
Z
in
c
is
ad
d
ed
ac
c
o
r
d
in
g
t
o
n
ee
d
,
an
d
it
s
u
p
p
o
r
ts
a
h
ea
lth
y
im
m
u
n
e
s
y
s
tem
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
15
,
No
.
1
,
M
ar
ch
20
26
:
1
4
0
-
1
49
142
an
d
m
etab
o
lis
m
.
A
to
tal
o
f
1
0
0
0
m
l
o
f
wate
r
was
r
eq
u
ir
ed
to
d
is
s
o
lv
e
an
d
p
r
o
ce
s
s
th
e
i
n
g
r
ed
ien
ts
in
to
th
e
d
esire
d
f
o
r
m
.
All
o
f
th
ese
i
n
g
r
ed
ien
ts
ar
e
c
o
m
b
in
e
d
in
th
e
SP
Z
m
an
u
f
ac
tu
r
i
n
g
p
r
o
c
ess
,
wh
ich
aim
s
to
p
r
o
d
u
ce
a
h
ig
h
ly
n
u
tr
itio
u
s
p
r
o
d
u
ct.
2
.
5
.
P
r
o
ce
du
re
f
o
r
m
a
k
ing
s
o
y
plu
s
zinc
T
h
e
p
r
o
ce
s
s
o
f
m
ak
in
g
SP
Z
b
eg
in
s
with
t
h
e
p
r
ep
ar
atio
n
o
f
s
o
y
b
ea
n
s
,
wh
ic
h
ar
e
clea
n
ed
o
f
d
ir
t
b
ef
o
r
e
b
ein
g
s
o
ak
e
d
in
clea
n
,
b
o
iled
wate
r
f
o
r
a
p
p
r
o
x
im
atel
y
8
h
,
with
th
e
wate
r
ch
a
n
g
ed
ev
er
y
2
h
to
r
em
o
v
e
an
y
u
n
p
leasan
t o
d
o
r
s
.
Af
ter
s
o
ak
in
g
,
th
e
s
o
y
b
ea
n
s
ar
e
r
em
o
v
ed
f
r
o
m
th
e
s
k
in
b
y
s
q
u
ee
zin
g
.
Nex
t,
th
e
b
len
d
ed
s
o
y
b
ea
n
s
ar
e
m
ix
e
d
with
wate
r
an
d
f
ilter
e
d
u
s
in
g
f
in
e
clo
th
to
o
b
tain
s
o
y
b
ea
n
ex
tr
ac
t.
T
h
e
s
o
y
b
ea
n
ex
tr
ac
t
is
th
en
b
o
iled
at
9
2
°C
,
an
d
p
an
d
an
leav
es,
s
u
g
ar
,
an
d
s
alt
ar
e
ad
d
ed
t
o
en
h
a
n
ce
th
e
f
lav
o
r
.
On
ce
co
o
led
,
zin
c
is
ad
d
ed
to
th
e
s
o
y
b
ea
n
ex
tr
ac
t
to
en
r
ich
its
n
u
tr
ien
t
co
n
ten
t.
Fin
ally
,
th
e
p
r
o
ce
s
s
ed
s
o
y
b
ea
n
ex
tr
ac
t
was
p
ac
k
ag
ed
in
g
lass
b
o
ttles
o
r
p
l
asti
c
b
ag
s
f
o
r
s
u
b
s
eq
u
en
t
ad
m
in
is
tr
atio
n
to
ex
p
er
im
e
n
tal
an
i
m
als.
T
h
is
p
r
o
ce
s
s
co
m
b
in
es tr
ad
itio
n
al
tec
h
n
iq
u
es with
n
u
tr
itio
n
al
m
o
d
if
icatio
n
s
to
p
r
o
d
u
ce
a
n
u
tr
itio
u
s
p
r
o
d
u
ct.
2
.
6
.
K
idn
ey
ex
cisi
o
n pro
ce
d
ure
T
h
e
k
id
n
ey
ex
cisi
o
n
p
r
o
ce
d
u
r
e
was
p
er
f
o
r
m
e
d
f
o
llo
win
g
s
tr
ict
s
tep
s
to
en
s
u
r
e
th
e
s
u
c
ce
s
s
o
f
th
e
o
p
er
atio
n
an
d
th
e
s
af
ety
o
f
th
e
ex
p
e
r
im
en
tal
a
n
im
als.
First,
th
e
m
ice
wer
e
p
o
s
itio
n
ed
d
o
r
s
ally
with
th
eir
leg
s
f
ix
ed
t
o
f
ac
ilit
ate
s
u
r
g
ical
ac
ce
s
s
.
T
h
e
an
im
al'
s
b
o
d
y
s
u
r
f
ac
e
was
th
en
d
is
in
f
ec
ted
with
7
0
%
eth
an
o
l
to
m
in
im
ize
th
e
r
is
k
o
f
c
o
n
tam
in
atio
n
.
An
i
n
cisi
o
n
is
m
ad
e
th
r
o
u
g
h
th
e
a
b
d
o
m
i
n
al
wall
an
d
ab
d
o
m
in
al
m
u
s
cles
to
o
p
e
n
t
h
e
a
b
d
o
m
i
n
al
ca
v
ity
,
allo
win
g
ac
ce
s
s
to
th
e
k
i
d
n
e
y
s
f
o
r
ca
n
n
u
latio
n
.
T
h
e
k
i
d
n
e
y
r
em
o
v
al
p
r
o
ce
s
s
was
p
er
f
o
r
m
e
d
asep
t
ically
b
y
cu
ttin
g
th
e
b
lo
o
d
v
ess
els
co
n
n
ec
tin
g
th
e
k
id
n
e
y
s
.
Af
te
r
th
e
k
id
n
ey
s
we
r
e
r
em
o
v
ed
,
th
e
tis
s
u
e
weig
h
t
w
as
m
ea
s
u
r
ed
b
ef
o
r
e
b
ein
g
s
to
r
ed
in
1
0
%
f
o
r
m
alin
f
o
r
h
is
to
l
o
g
ical
ex
am
i
n
atio
n
.
T
h
e
p
r
o
ce
d
u
r
e
c
o
n
clu
d
ed
wit
h
th
e
lab
elin
g
o
f
th
e
tis
s
u
e
s
to
r
ag
e
co
n
tain
e
r
s
to
f
ac
ilit
ate
f
u
r
th
er
an
aly
s
is
.
T
h
is
p
r
o
ce
s
s
r
eq
u
ir
es sp
ec
ial
ca
r
e
a
n
d
atten
tio
n
t
o
en
s
u
r
e
t
h
e
in
te
g
r
ity
o
f
th
e
g
e
n
er
ated
d
ata
.
2
.
7
.
Da
t
a
a
na
ly
s
is
a
nd
et
hics
T
h
e
ef
f
ec
t
o
f
SPZ
s
u
p
p
lem
en
tatio
n
o
n
r
at
k
id
n
ey
f
u
n
ctio
n
was
m
ea
s
u
r
ed
u
s
in
g
s
tatis
tical
an
aly
s
is
,
in
clu
d
in
g
ANOV
A,
to
d
eter
m
i
n
e
s
ig
n
if
ican
t
d
if
f
e
r
en
ce
s
b
et
wee
n
tr
ea
tm
en
t
g
r
o
u
p
s
.
T
h
e
p
ar
am
eter
s
co
m
p
ar
e
d
b
etwe
en
th
e
g
r
o
u
p
s
in
cl
u
d
ed
k
id
n
ey
weig
h
t,
i
n
itial
an
d
f
in
al
b
o
d
y
weig
h
ts
,
an
d
p
o
te
n
tial
p
er
ce
n
tag
e
ch
a
n
g
e
(
%)
in
b
o
d
y
weig
h
t.
W
e
u
s
ed
ANOV
A
b
ec
au
s
e
th
e
d
ata
we
r
e
n
o
r
m
ally
d
is
tr
ib
u
ted
(
Sh
ap
i
r
o
-
W
ilk
p
>
0
.
0
5
)
.
T
h
is
r
esear
ch
h
as
p
ass
ed
th
e
eth
ical
test
f
r
o
m
th
e
T
an
ju
n
g
Kar
an
g
Min
is
tr
y
o
f
Hea
lth
Po
ly
tech
n
ic,
with
th
e
n
u
m
b
er
4
6
5
/KE
PK
-
T
J
K/V/2
0
2
5
.
An
im
al
welf
ar
e
eth
ics
f
o
cu
s
es
o
n
th
e
p
r
o
tectio
n
a
n
d
g
o
o
d
tr
ea
tm
en
t
o
f
an
im
als in
th
e
co
n
tex
t
o
f
r
esear
ch
an
d
ev
er
y
d
ay
p
r
ac
tice.
R
esear
ch
f
lo
w
as sh
o
wn
in
Fig
u
r
e
1
.
Fig
u
r
e
1
.
R
esear
ch
f
lo
w
3.
RE
SU
L
T
S
T
ab
le
1
s
h
o
ws
th
e
n
u
tr
itio
n
al
co
m
p
o
s
itio
n
o
f
t
h
e
“
SPZ
”
r
ec
ip
e,
p
r
o
d
u
ce
d
f
r
o
m
a
co
m
b
in
atio
n
o
f
s
ev
er
al
in
g
r
e
d
ien
ts
with
a
to
t
al
weig
h
t
o
f
9
4
0
g
.
T
h
e
co
m
p
o
s
itio
n
co
n
s
is
ted
o
f
1
0
0
g
o
f
s
o
y
b
ea
n
s
,
4
0
g
o
f
s
u
g
ar
,
an
d
2
m
g
o
f
zin
c
d
is
s
o
lv
ed
in
8
0
0
g
o
f
wate
r
.
T
h
e
n
u
tr
itio
n
al
co
m
p
o
s
itio
n
a
n
aly
s
is
r
ev
ea
led
th
at
th
e
to
tal
en
er
g
y
p
r
o
d
u
ce
d
f
r
o
m
t
h
ese
in
g
r
ed
ien
ts
was
5
3
8
.
6
k
ca
l
.
So
y
b
ea
n
s
p
r
o
v
id
e
th
e
lar
g
est
co
n
tr
ib
u
tio
n
t
o
th
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
E
ffects o
f so
y
p
lu
s
z
in
c
s
u
p
p
leme
n
ta
tio
n
o
n
g
r
o
w
th
a
n
d
kid
n
ey
h
ea
lth
in
w
is
ta
r
r
a
ts
:
…
(
Yu
n
ia
s
tin
i
)
143
m
ac
r
o
n
u
t
r
ien
ts
,
with
a
to
tal
o
f
4
0
.
4
g
o
f
p
r
o
tein
,
1
6
.
7
g
o
f
f
at,
an
d
6
2
.
5
g
o
f
ca
r
b
o
h
y
d
r
ates
f
o
r
th
e
en
tire
r
ec
ip
e.
Z
in
c
was
s
u
p
p
lied
p
r
i
m
ar
ily
b
y
th
e
ad
d
itio
n
o
f
2
m
g
o
f
zin
c,
with
a
to
tal
zin
c
co
n
ten
t
in
th
e
r
ec
i
p
e
r
ea
ch
in
g
5
.
9
m
g
.
T
h
is
n
u
tr
itio
n
al
co
m
b
in
atio
n
d
e
m
o
n
s
tr
ates
th
e
p
o
te
n
tial
o
f
"
SPZ
"
as
a
s
u
p
p
lem
en
t
t
h
at
ca
n
s
u
p
p
o
r
t
g
r
o
wth
an
d
k
id
n
e
y
h
e
alth
in
W
is
tar
r
ats.
T
h
ese
d
ata
ar
e
im
p
o
r
tan
t
f
o
r
f
u
r
th
er
r
esear
ch
o
n
th
e
ef
f
ec
ts
o
f
zin
c
an
d
s
o
y
p
r
o
tein
s
u
p
p
le
m
en
tatio
n
o
n
an
im
al
n
u
tr
itio
n
.
T
ab
le
2
s
h
o
ws
th
at
k
id
n
ey
weig
h
ts
v
ar
ied
am
o
n
g
th
e
tr
ea
tm
en
t
g
r
o
u
p
s
,
with
th
e
lo
west
v
a
lu
e
b
ein
g
0
.
0
1
7
8
g
an
d
th
e
h
i
g
h
est
b
ein
g
0
.
0
3
0
8
g
.
T
h
e
in
itial
an
d
f
in
al
b
o
d
y
weig
h
ts
s
h
o
wed
v
ar
ia
tio
n
s
,
r
ef
lectin
g
t
h
e
g
r
o
wth
o
f
m
ice
d
u
r
in
g
th
e
e
x
p
er
im
en
t.
T
h
e
a
v
er
ag
e
weig
h
t
s
h
o
wed
a
s
ig
n
if
ican
t
d
if
f
er
e
n
ce
b
etwe
en
g
r
o
u
p
s
,
esp
ec
ially
in
tr
ea
tm
en
t
B
5
,
with
a
p
-
v
alu
e
o
f
0
.
0
3
3
,
i
n
d
icatin
g
th
e
e
f
f
ec
t
o
f
s
u
p
p
lem
en
tatio
n
o
n
k
i
d
n
ey
g
r
o
w
th
an
d
h
ea
lth
.
T
h
e
p
-
v
a
lu
e
in
th
e
last
co
lu
m
n
in
d
icate
s
th
e
s
tatis
tical
s
ig
n
if
ican
ce
o
f
th
e
d
if
f
er
en
ce
b
etwe
en
tr
ea
tm
en
ts
,
wh
er
e
a
p
-
v
alu
e
b
elo
w
0
.
0
5
in
d
icate
s
a
s
ig
n
if
ican
t tr
ea
tm
en
t e
f
f
ec
t.
T
ab
le
1
.
Nu
tr
itio
n
al
co
m
p
o
s
itio
n
o
f
SPZ
p
er
r
ec
ip
e
S
o
y
p
l
u
s
z
in
c
W
e
i
g
h
t
(
g
)
N
u
t
r
i
t
i
o
n
a
l
c
o
m
p
o
s
i
t
i
o
n
o
f
S
P
Z
p
e
r
r
e
c
i
p
e
(
9
4
0
g
)
En
e
r
g
y
(
k
c
a
l
)
P
r
o
t
e
i
n
(
g
)
F
a
t
(
g
)
C
a
r
b
o
h
y
d
r
a
t
e
s
(
g
)
Zi
n
c
(
m
g
)
S
o
y
a
b
e
a
n
1
0
0
3
8
1
4
0
.
4
1
6
.
7
2
4
.
9
3
.
9
S
u
g
a
r
40
1
5
7
.
6
0
0
3
7
.
6
0
Zi
n
c
2
-
-
-
-
2
W
a
t
e
r
8
0
0
-
-
-
-
-
To
t
a
l
9
4
0
5
3
8
.
6
4
0
.
4
1
6
.
7
6
2
.
5
5
.
9
T
ab
l
e
2
.
K
id
n
ey
w
eig
h
t
an
d
i
n
it
ia
l a
n
d
f
in
a
l b
o
d
y
w
eig
h
t
Tr
e
a
t
men
t
K
i
d
n
e
y
w
e
i
g
h
t
(
G
r
)
I
n
i
t
i
a
l
b
o
d
y
w
e
i
g
h
t
(
G
r
)
F
i
n
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l
b
o
d
y
w
e
i
g
h
t
(
G
r
)
A
v
e
r
a
g
e
(
G
r
)
p
-
v
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l
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e
C
o
n
f
i
d
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n
c
e
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n
t
e
r
v
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l
(
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r
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DIS
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ely
[
1
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]
.
T
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t
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p
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[
1
3
]
.
T
h
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en
tial
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u
i
r
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f
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r
t
h
e
r
c
l
a
r
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y
[
1
4
]
.
F
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h
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,
r
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s
e
a
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an
s
tr
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in
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d
to
k
id
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n
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[
1
5
]
,
[
1
6
]
.
R
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to
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d
with
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s
in
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ats
[
1
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]
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Z
in
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s
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ay
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ag
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p
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tially
ca
u
s
ed
b
y
d
ietar
y
d
ef
icien
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o
r
to
x
in
s
[
1
8
]
.
M
o
r
eo
v
e
r
,
zin
c
ca
n
en
h
an
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t
h
e
p
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ec
ts
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f
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h
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iet
ag
ain
s
t
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ep
h
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to
x
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a
g
en
ts
an
d
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th
e
r
f
o
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m
s
o
f
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n
al
s
tr
ess
,
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eb
y
im
p
r
o
v
in
g
o
v
er
all
k
id
n
ey
h
ea
lth
[
1
8
]
.
T
h
e
co
m
b
in
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n
o
f
s
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y
b
ea
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an
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s
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g
ar
in
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s
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d
in
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ain
tai
n
in
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o
v
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all
en
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alan
ce
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s
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t
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m
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ar
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f
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r
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wth
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T
h
e
ca
r
b
o
h
y
d
r
ate
c
o
n
ten
t
(
6
2
.
5
g
f
r
o
m
s
u
g
a
r
)
s
u
g
g
ests
a
q
u
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y
s
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wh
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is
im
p
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tan
t
f
o
r
m
et
ab
o
lic
ac
tiv
ities
in
g
r
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win
g
r
a
ts
,
as
in
d
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d
b
y
s
tu
d
ies s
h
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win
g
ca
r
b
o
h
y
d
r
ate
in
tak
e
is
r
elate
d
to
weig
h
t
g
ain
an
d
e
n
er
g
y
lev
els [
1
9
]
.
Kid
n
ey
h
e
alth
is
a
cr
itical
asp
ec
t
o
f
n
u
tr
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n
al
in
ter
v
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n
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n
s
.
T
h
e
in
g
r
ed
ie
n
ts
in
SP
Z
,
in
clu
d
in
g
s
o
y
an
d
zin
c,
ex
er
t
a
s
y
n
e
r
g
is
tic
ef
f
ec
t
th
at
ca
n
en
h
a
n
ce
r
en
al
h
ea
lth
th
r
o
u
g
h
an
tio
x
i
d
ativ
e
an
d
an
ti
-
in
f
lam
m
ato
r
y
p
r
o
p
er
ties
.
Stu
d
ies
h
av
e
s
h
o
w
n
th
at
an
tio
x
i
d
an
ts
an
d
p
r
o
p
e
r
m
etal
io
n
s
tatu
s
,
lik
e
zin
c
,
c
an
im
p
r
o
v
e
k
id
n
ey
f
u
n
c
t
i
o
n
a
l
i
t
y
b
y
r
e
d
u
c
i
n
g
o
x
i
d
a
t
i
v
e
s
t
r
es
s
a
n
d
p
r
es
e
r
v
i
n
g
r
e
n
a
l
m
o
r
p
h
o
l
o
g
y
u
n
d
e
r
p
a
t
h
o
l
o
g
i
c
a
l
c
o
n
d
i
t
i
o
n
s
[
2
0
]
.
So
y
p
r
o
tein
h
as
b
ee
n
d
em
o
n
s
tr
ated
to
allev
iate
k
id
n
ey
d
am
a
g
e
in
ex
p
er
im
en
tal
m
o
d
els,
en
h
an
cin
g
r
esil
ien
ce
ag
ain
s
t n
ep
h
r
o
to
x
icity
[
2
0
]
.
I
n
th
e
p
r
o
v
id
e
d
d
ata,
th
e
b
o
d
y
weig
h
ts
o
f
W
is
tar
r
ats
u
n
d
er
g
o
in
g
d
if
f
er
e
n
t
tr
ea
tm
en
ts
illu
s
tr
ated
v
ar
iatio
n
s
th
at
co
u
ld
b
e
co
r
r
e
lated
with
th
e
s
u
p
p
lem
en
tatio
n
ty
p
e.
Pre
v
io
u
s
s
tu
d
ies
h
av
e
in
d
icate
d
th
at
zin
c
pl
ay
s
a
cr
u
cial
r
o
le
i
n
g
r
o
wth
an
d
m
etab
o
lic
p
r
o
ce
s
s
es.
Fo
r
in
s
tan
ce
,
zin
c
s
u
p
p
lem
en
tatio
n
h
as
b
ee
n
lin
k
ed
t
o
im
p
r
o
v
em
e
n
ts
in
b
o
d
y
weig
h
t
an
d
o
v
er
all
g
r
o
wth
p
er
f
o
r
m
a
n
ce
in
v
ar
i
o
u
s
an
im
al
m
o
d
els
[
2
1
]
-
[
2
3
]
.
I
n
s
tu
d
ies
with
ad
u
lt
r
o
d
en
ts
,
zin
c
d
ef
ic
ien
cy
r
esu
lt
ed
in
s
ig
n
if
ican
t
r
ed
u
ctio
n
s
in
b
o
d
y
weig
h
t
g
ai
n
,
s
u
g
g
esti
n
g
th
at
ad
eq
u
ate
zin
c
le
v
els
ar
e
im
p
er
ativ
e
f
o
r
s
u
p
p
o
r
tin
g
g
r
o
wt
h
d
u
r
i
n
g
cr
itical
life
s
tag
es
[
2
2
]
,
[
2
4
]
.
T
h
is
is
p
ar
ticu
lar
ly
r
elev
an
t
in
t
h
e
c
o
n
tex
t
o
f
th
e
p
r
esen
t
s
tu
d
y
,
as
t
h
e
in
v
esti
g
ated
tr
ea
t
m
en
ts
(
d
e
n
o
ted
as
B
1
to
B
5
)
r
ev
ea
l
v
ar
y
in
g
im
p
ac
ts
o
n
f
in
al
b
o
d
y
weig
h
ts
,
co
r
r
o
b
o
r
atin
g
th
e
n
o
tio
n
t
h
at
th
e
s
p
ec
if
ic
n
u
tr
itio
n
al
co
m
p
o
s
itio
n
,
in
cl
u
d
in
g
zin
c
,
a
f
f
ec
ts
g
r
o
wth
tr
ajec
to
r
y
in
W
is
tar
r
ats [
2
3
]
,
[
2
5
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
E
ffects o
f so
y
p
lu
s
z
in
c
s
u
p
p
leme
n
ta
tio
n
o
n
g
r
o
w
th
a
n
d
kid
n
ey
h
ea
lth
in
w
is
ta
r
r
a
ts
:
…
(
Yu
n
ia
s
tin
i
)
145
Kid
n
ey
h
ea
lth
is
an
o
th
er
v
ital
co
n
s
id
er
atio
n
in
th
is
s
tu
d
y
.
T
h
e
d
ata
r
ef
lect
ch
an
g
es
n
o
t
o
n
ly
in
b
o
d
y
weig
h
t
b
u
t
also
in
k
id
n
ey
w
eig
h
t,
wh
ich
is
a
k
ey
in
d
icato
r
o
f
r
en
al
h
ea
lth
.
Acc
o
r
d
in
g
to
r
esear
ch
,
zin
c
s
u
p
p
lem
en
tatio
n
h
as
b
ee
n
s
h
o
wn
to
m
itig
ate
r
en
al
d
am
a
g
e
an
d
p
r
eser
v
e
k
id
n
e
y
f
u
n
c
tio
n
in
m
o
d
els
o
f
o
b
esit
y
-
r
elate
d
c
o
m
p
licatio
n
s
[
2
3
]
,
[
2
6
]
.
Mo
r
eo
v
er
,
th
e
p
r
o
t
ec
tiv
e
r
o
le
o
f
s
o
y
p
r
o
tein
ag
ai
n
s
t
r
en
al
o
x
id
ativ
e
s
tr
ess
h
as
b
ee
n
d
o
cu
m
en
ted
,
e
m
p
h
asizin
g
it
s
e
f
f
icac
y
in
i
m
p
r
o
v
in
g
k
i
d
n
ey
p
ar
a
m
eter
s
[
2
7
]
,
[
2
8
]
.
T
h
e
r
esu
lts
f
r
o
m
th
e
v
ar
io
u
s
tr
ea
tm
en
ts
in
th
is
s
tu
d
y
,
d
ep
ictin
g
d
if
f
er
en
t
p
-
v
alu
es
ass
o
ciate
d
with
k
id
n
ey
weig
h
t
ch
an
g
es,
s
u
g
g
est
th
at
ce
r
tain
co
m
b
i
n
atio
n
s
o
f
s
o
y
an
d
zin
c
m
a
y
s
ig
n
if
ican
tly
in
f
l
u
en
ce
r
e
n
al
h
e
alth
,
af
f
ir
m
in
g
th
e
o
b
s
er
v
atio
n
s
f
r
o
m
s
im
ilar
s
tu
d
ies [
2
8
]
,
[
2
9
]
.
A
n
o
tab
le
asp
ec
t
o
f
th
ese
f
in
d
in
g
s
is
th
e
s
tat
is
tical
s
ig
n
if
ican
ce
n
o
ted
in
ce
r
tain
g
r
o
u
p
s
(
e.
g
.
,
B
2
an
d
B
5
)
,
in
d
icatin
g
d
i
f
f
er
en
tial
r
esp
o
n
s
iv
en
ess
to
th
e
s
u
p
p
lem
en
tatio
n
s
tr
ateg
y
em
p
lo
y
ed
[
2
2
]
,
[
2
3
]
.
Stu
d
ies
h
av
e
in
d
icate
d
th
at
th
e
i
n
ter
ac
tio
n
b
etwe
en
d
ietar
y
co
m
p
o
n
en
ts
,
s
u
ch
as
s
o
y
an
d
zin
c,
ca
n
en
h
an
ce
b
io
lo
g
ical
f
u
n
ctio
n
s
,
lead
i
n
g
to
b
etter
h
e
alth
o
u
tco
m
es.
So
m
e
ev
id
en
c
e
s
u
p
p
o
r
ts
th
at
s
o
y
is
o
f
lav
o
n
e
s
m
ay
p
r
o
m
o
te
th
e
s
ec
r
etio
n
o
f
s
atiety
h
o
r
m
o
n
es,
th
u
s
co
n
tr
ib
u
tin
g
to
weig
h
t
m
an
ag
em
en
t,
wh
ich
ca
n
in
d
ir
ec
tly
r
elate
to
k
id
n
ey
h
ea
lth
d
u
e
t
o
im
p
r
o
v
ed
m
etab
o
lic
s
tatu
s
[
2
3
]
,
[
2
7
]
.
Z
in
c
is
a
cr
u
cial
m
icr
o
n
u
tr
ien
t
th
at
in
f
lu
en
ce
s
s
ev
er
al
p
h
y
s
io
lo
g
ical
f
u
n
ctio
n
s
.
Z
in
c
d
ef
ic
ien
cy
ca
n
d
etr
im
en
tally
af
f
ec
t
g
r
o
wth
p
ar
am
eter
s
an
d
k
id
n
ey
h
ea
lth
in
r
o
d
en
t
m
o
d
els.
Fo
r
ex
a
m
p
le,
s
tu
d
ies
h
av
e
d
em
o
n
s
tr
ated
th
at
d
ietar
y
zin
c
r
estrictio
n
ca
n
r
esu
lt
in
r
ed
u
c
ed
b
o
d
y
weig
h
t
an
d
o
v
er
all
h
e
alth
in
W
is
tar
r
ats,
in
d
icatin
g
th
e
m
in
er
al'
s
im
p
o
r
tan
ce
in
p
r
o
m
o
tin
g
n
o
r
m
al
g
r
o
wth
p
atter
n
s
[
2
4
]
.
Z
in
c
is
cr
i
tical
f
o
r
th
e
p
r
o
p
er
f
u
n
ctio
n
in
g
o
f
e
n
zy
m
es
v
ital
f
o
r
m
etab
o
lic
p
r
o
ce
s
s
es,
in
clu
d
in
g
th
o
s
e
r
elate
d
to
k
id
n
e
y
f
u
n
ctio
n
.
R
esear
ch
s
h
o
ws
th
at
zin
c
s
u
p
p
lem
en
ta
tio
n
ca
n
a
m
elio
r
ate
r
e
n
al
in
j
u
r
ies
an
d
b
io
ch
em
ical
i
m
p
air
m
en
ts
in
d
u
ce
d
b
y
v
ar
io
u
s
to
x
i
n
s
[
3
0
]
.
So
y
p
r
o
tein
is
ass
o
ciate
d
with
s
ev
er
al
h
ea
lth
b
en
e
f
its
,
in
clu
d
in
g
en
h
an
ce
d
a
n
tio
x
id
a
n
t
ac
tiv
ity
,
wh
ich
p
lay
s
an
im
p
o
r
ta
n
t
r
o
l
e
in
k
id
n
ey
p
r
o
tectio
n
an
d
i
n
o
v
er
all
m
etab
o
lic
h
ea
lth
.
S
tu
d
ies
in
d
icate
th
at
in
co
r
p
o
r
atin
g
s
o
y
p
r
o
tein
in
t
o
d
iets
ca
n
lead
to
im
p
r
o
v
ed
r
en
al
f
u
n
ctio
n
m
a
r
k
er
s
an
d
weig
h
t
g
ain
in
r
ats
co
m
p
ar
ed
to
o
t
h
er
p
r
o
tein
s
o
u
r
ce
s
[
3
1
]
,
[
3
2
]
.
T
h
e
p
r
o
tect
iv
e
asp
ec
ts
o
f
s
o
y
,
attr
ib
u
ted
to
its
an
tio
x
id
an
t
p
r
o
p
er
ties
,
m
ay
m
itig
ate
o
x
id
ativ
e
s
tr
ess
o
n
r
e
n
al
tis
s
u
es,
th
er
e
b
y
im
p
r
o
v
in
g
k
i
d
n
ey
h
ea
l
th
an
d
m
ain
tain
in
g
f
u
n
ctio
n
ality
[
3
1
]
,
[
3
2
]
.
I
n
th
e
ex
p
er
im
e
n
tal
co
n
te
x
t
p
r
o
v
id
ed
,
th
e
g
r
o
wth
m
etr
ics
o
f
W
is
tar
r
ats
ex
p
o
s
ed
to
SPZ
ex
h
ib
ited
p
o
s
itiv
e
ch
a
n
g
e
s
,
as in
d
icate
d
b
y
th
e
m
ea
n
d
if
f
er
en
ce
s
in
weig
h
t
g
ain
f
r
o
m
d
ay
0
to
d
ay
2
1
.
T
h
i
s
r
an
d
o
m
ize
d
co
n
tr
o
ll
ed
t
r
ia
l
e
m
p
lo
y
ed
a
r
ig
o
r
o
u
s
m
et
h
o
d
o
lo
g
y
to
ev
a
lu
a
te
th
e
ef
f
e
ct
s
o
f
s
o
y
p
lu
s
z
in
c
s
u
p
p
lem
en
t
at
io
n
o
n
g
r
o
w
th
an
d
h
ea
lth
in
2
0
-
d
a
y
-
o
ld
W
i
s
ta
r
r
a
t
s
.
T
h
e
in
n
o
v
at
iv
e
a
s
p
ec
t
o
f
th
i
s
s
t
u
d
y
i
s
th
e
s
t
r
a
teg
ic
u
s
e
o
f
t
wo
d
i
s
t
in
c
t
z
in
c
s
u
p
p
l
e
m
e
n
ta
tio
n
d
o
s
e
s
(
0
.
0
2
0
m
g
an
d
0
.
0
3
5
m
g
p
er
g
r
am
o
f
b
o
d
y
w
ei
g
h
t)
,
wh
i
ch
f
ac
i
li
t
ate
s
an
a
s
s
e
s
s
m
en
t
o
f
th
e
o
p
ti
m
a
l
th
r
e
s
h
o
ld
f
o
r
im
p
r
o
v
ed
p
h
y
s
io
l
o
g
i
ca
l
o
u
tco
m
e
s
.
T
h
e
co
n
t
r
o
l
led
en
v
ir
o
n
m
en
t,
a
lo
n
g
s
id
e
s
tr
i
ct
ad
h
er
en
c
e
to
e
th
ica
l
g
u
id
el
in
e
s
f
r
o
m
th
e
D
ec
lar
at
io
n
o
f
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5.
CO
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SI
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wh
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