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Comprehensive lifestyle modification should include dietary change to lower calorie intake, lifestyle and behavioral training, and increase physical activity

Without adequate L-Carnitine, these fatty acids cannot be oxidized for fuel and are instead stored as body fat

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Gamma-butyrobetaine, an intermediate substance required for L-carnitine biosynthesis, is limited in embryos and young animals due to the low activity of -butyrobetaine hydroxylase [13, 14]