If you’ve been anywhere near instagram over the last year, you’ve probably at some point encountered one of the millions of posts promoting Cleansing Teas. Endorsed by social media icons such as Kylie Jenner and the Kardashian family, Fitness Teas is the latest and most popular iteration of slimming, toning, and detoxifying tea-based health drinks to hit the consumer market.
Touted by fitspo bloggers, social media health experts and celebrities like Amber Rose and Vanessa Hudgens as the next big thing in easy weight loss, cleansing teas promises to flush toxins from the body and promote faster fat metabolism.
Table of Contents
Boasting more than 1.7 million followers on instagram, Fit Tea is undoubtedly the most popular weight loss tea detox available on the market. The success of this simple health tea blend is at least in part due to a pervasive advertising campaign carried out in a guerilla fashion via sponsored instagram posts from social media icons, a practice that has come under fire from the FDA and several nonprofit consumer advocacy groups.
Despite the controversy surrounding the techniques used to advertise weight loss tea, the product itself appears to deliver significant results- if the before and after posts saturating the #TeaTox hashtag are anything to judge from.
Detox Tea, unlike some of the other teatox or health tea products that have been marketed in a similar fashion, appears to contain several ingredients that have been clinically proven to promote faster fat loss.
In this article, we’ll attempt to cut through the hype surrounding fitness teas and assess the composition of this wildly popular weight management detox formula to determine whether it can actually promote faster fat loss.
We’ll be breaking down the ingredients one by one and taking a look at their potential side effects and interactions, as well as exploring whether it’s possible to make your own weight loss tea at home. To begin with, let’s take a look at the promises made about Fit Tea:
What is Teatox Detox Tea & What Does it Do?
Presented as a loose leaf tea blend that contains a range of traditional medicinal tea leaves and herbal extracts, fitness teas promises weight-conscious consumers the ability to promote faster fat loss, boost energy levels, increase immune system function, detox the body, and improve overall bodily health. Based on the claims made on the product website, Fit Tea does two things- burns fat and detoxifies.
Detoxification and detox health products have become incredibly popular in recent years. Google Trends insights demonstrate that global worldwide searches for queries such as “detox” and “teatox” have more than tripled in popularity over the last half-decade, with searches somewhat humorously more common after the excess of the Christmas and New Year’s festive season.
The difficulty in assessing whether Teatox is able to “detox” the body lies in the vague nature of the term- detoxification can refer to any practice that removes any kind of toxin or unhealthy substance from the body.
For the duration of this article, we’ll refer to detoxing as any action that ultimately minimizes the levels of free radicals or otherwise unhealthy elements from the body to promote overall homeostasis, and assess the claims made by Fit Tea on this basis.
The second primary claim made of Fit Tea- that it can promote faster fat loss- is presented on the product website under the description of ingredients. Fit Tea promises to increase fat oxidation, or the breakdown of fat tissue, and boost metabolic rate, or the speed at which the body is able to convert food into energy.
Fit Tea also claims to inhibit the production adenosine triphosphate citrate lyase, which while not outlined on the product website, plays a key role in the creation of new fat tissue.
Is weight loss tea able to actually deliver on these promises, however? The user-reported effects featured on the Fit Tea website definitely believe so, with hundreds of reviews stating that supplementing the diet with Fit Tea has resulted in significant weight loss results of up to 25 pounds, increased energy levels, and even relief from conditions such as chronic fatigue and migraines.
In order to gain an unbiased perspective, however, it’s essential to take a look at the scientific evidence that supports the application of the ingredients in Fit Tea as weight management solutions.
The Detox Tea Formula
The creators of fitness teas are refreshingly upfront about the contents of their products when compared to many of the other “teatox” products available on the market. Consumers are provided with a full breakdown of the constituent ingredients of Fit Tea on the product website, which amounts to a blend of three different tea leaves, two fruit extracts, three medicinal herbs and two natural sweeteners.
The natural formulation of Fit Tea makes it compatible with a wide variety of dietary limitations, and is manufactured in FDA-approved production facilities located in the US that adhere to CGMP practices. The raw ingredients used in the creation of Fit Tea are also GMO-free, which is an added benefit for anybody living a natural or synthetic-free lifestyle.
Let’s take a closer look at the ingredients in fitness teas and assess the scientific evidence supporting them:
Organic Green Tea
Green Tea has been used as a medicinal tea for thousands of years primarily throughout Asia, but has become popular as a health supplement in recent years for its wide range of health-promoting properties. The Fit Tea website claims that the Organic Green Tea in their product is able to increase the metabolic rate of the body by up to 4%, helping the body burn stored fats and reducing the rate at which the body is able to store fat. The primary claim made of this ingredient is that it is able to promote a metabolic state called “thermogenesis”, which causes the body to increase the rate at which the body converts energy into heat.
The concept behind the fat burning properties of green tea is sound- fat loss occurs in the body when caloric intake, or the amount of energy the body can harvest from dietary consumption, is less than the amount the body needs to function. A thermogenic metabolic state increases the amount of energy the body needs to function, thereby lowering the threshold required to induce lipolysis, or the breakdown of fat tissue for energy.
The popularity of green tea and green tea extracts in weight loss supplements has led to a wide body of scientific evidence being published on the matter. Surprisingly, green tea has been demonstrated in multiple clinical trials to offer a significant boost to fat burning rates. A trial conducted in 2014 at the University of Halifax found that supplementing the diet with an extract of green tea was able to induce weight loss of up to 3.5kg in 12 weeks with no other lifestyle changes[1].
Two more clinical studies on the effects of green tea extracts in treating obesity have been performed in the last two years, with both concluding that it is able to induce weight loss[2][3]. It should be noted, however, that while these trials demonstrated that green tea alone is able to deliver enhanced weight loss, the weight loss was not considered to be “statistically significant” or clinically relevant. The threshold for a weight loss supplement to meet these criteria is quite strict, however, with a body fat percentage reduction of 5% to 10% necessary to be deemed statistically significant.
Another meta-study performed in 2009 that was published in the International Journal of Obesity assessed a large number of individual clinical trials on the effects of green tea on weight loss concluded that it has an overall positive effect on weight loss and weight maintenance[4]. Given the evidence available, it’s safe to assume that the Organic Green Tea in Fit Tea does have the ability to induce faster weight loss, but the total effectiveness of the product does not rely on this ingredient alone.
Green tea, however, does have a significant effect on detoxification. Green tea extract has been demonstrated to lower the levels of damaging toxic metal build up in the digestive tract[5] as well as flush built-up toxic chemicals from the body[6]. The most powerful detoxifying properties of green tea, however, are found in the antioxidant benefits of the polyphenolic compounds found in green tea extract.
Antioxidants are frequently used as a generic term to describe the health-boosting and detoxifying effects of health supplements, but are poorly understood. Put simply, antioxidants help to reduce the symptoms of oxidative stress, a condition that occurs when the body is unable to neutralize the harmful effects of free radicals in the body. Free radicals are elements found in pesticides, pollution, tobacco smoke and alcohol that find their way into the body and cause damage. The molecular composition of these free radicals contains an unpaired electron, an uncommon and unbalanced molecular state that causes them to “steal” an electron from other molecules in the body.
Free radicals cause damage by stealing electrons from the tissue of your body, damaging cells and DNA and causing a chain reaction that if not balanced by an equal amount of antioxidants can cause oxidative stress, leading to chronic fatigue, weight gain, anxiety and diabetes. Antioxidants, such as those found in green tea, are able to donate an electron to free radical elements without becoming unstable themselves, and are thus named “antioxidants”.
There is a large body of scientific evidence supporting the use of green tea to prevent oxidative stress, pointing to the high levels of polyphenols in green tea as the antioxidant mechanism[7]. Just some of the health benefits derived from green tea due to these properties include increased immune system function, better skin health[8], reduced risk of cancer[9], and overall better health[10], supporting the claims made of weight loss tea that it can deliver a detoxifying health boost.
Oolong Wu Yi
Oolong is the second tea leaf used in the Fit Tea formula. While Fit Tea doesn’t make any specific claims about the health properties of this tea, it has been associated with a wide range of health benefits including protection from chronic heart disease, improved cardiovascular health, anti-inflammatory properties, and antioxidant benefits similar to green tea. The Fit Tea website does, however, link to a 2001 clinical trial performed by a Japanese University that links Oolong tea to increased fat oxidation and increased metabolic rate.
In the trial, 12 men were given a random assortment of beverages ranging from plain water to a full strength oolong tea brew once daily for three days. At the conclusion of the trial, the three participants that consumed the full strength brew had a fat oxidation rate 12% higher than the other participants. While this is an impressive result, the small sample size of the study is problematic and does not provide statistically significant evidence to support the use of Oolong tea as a fat burner. To determine the efficacy of Oolong as a weight management supplement, it’s necessary to take a closer look at the clinical evidence.
There are a number of trials that have provided evidence supporting the anti-fat properties of Oolong tea in controlled animal trials. A 1999 study examining the effects of Oolong on fat metabolism in mice found that the caffeine content of the tea increased the rate at which fat breakdown occurred[11], while another 2016 trial demonstrated that the polyphenols in Oolong tea are able to induce weight loss in mice[12]. Ultimately, Oolong has essentially the same properties as green tea when used as a fat metabolism booster, but lacks a similarly sized body of scientific evidence.
Oolong tea has been linked to a number of secondary health benefits that can assist with overall wellness, however. A 2003 Japanese clinical trial demonstrated that Oolong tea is able to increase energy metabolism[13], a 2006 trial linked demonstrated Oolong has protective qualities that prevent cancer[14], and another widely-cited trial has linked it to reduced risk of arthritis, improved neurological function, and protection from diabetes[15].
Garcinia Cambogia Extract
Garcinia Cambogia Extract is arguably the most interesting and most effective ingredient in the Fit Tea formula. Derived from the malabar tamarind plant, which grows extensively throughout Southeast Asia, Garcinia Cambogia has a number of properties that make it a highly effective fat burning supplement. Fit Tea doesn’t make any specific claims about the health effects of Garcinia Cambogia apart from linking to a 2001 clinical trial which concluded that it is able to reduce abdominal fat accumulation[16].
Although Fit Tea may be somewhat tight-lipped about the health benefits of Garcinia Cambogia, it’s actually an incredibly effective tool for minimizing weight gain that has led to it being used extensively in thousands of different weight loss supplements over the last few years. Garcinia Cambogia appears to be able to stop the body from actually forming new fat, putting the brakes on the processes that create fat deposits.
This mechanism has significant implications on the rate at which the body is able to burn fat. When the body consumes food, some of the energy derived from that food is converted into fat for later use. Dieters commonly experience plateaus in weight loss that cause them to remain “stuck” on a particular body fat percentage or BMI. Garcinia Cambogia possesses properties that stop the body from creating new fat deposits which, when combined with the metabolic rate-boosting properties of green and oolong tea, create a highly effective and complementary fat-burning system.
When the body creates fat from dietary intake- specifically carbohydrates- a process occurs called lipogenesis. Lipogenesis literally means “the creation of fat”, and requires a key enzyme called citric lyase. Garcinia Cambogia contains high levels of a naturally-occurring organic compound called hydroxycitric acid which inhibits the production of the citric lyase enzyme, effectively halting new fat creation.
There are a number of clinical trials that provide evidence for this mechanism. A 2012 trial provided conclusive evidence of the inhibitory effect of hydroxycitric acid[17], and another comprehensive meta-study that examined 36 different individual studies conducted by the University of Exeter was published in the Journal of Obesity in 2010 that concluded Garcinia Cambogia is a highly effective tool for short-term fat loss[18].
Garcinia Cambogia also offers a number of health-boosting and fat loss-enhancing properties outside of lipogenesis inhibition. A 2013 meta-study concluded that Garcinia Cambogia extract is also able to modulate serotonin levels in the brain, leading to a sensation of increased satiety which gently inhibits appetite[19]. This additional effect helps to prevent one of the most difficult roadblocks experienced by dieters- food cravings.
Overall, Garcinia Cambogia extract both prevents new fat from developing while at the same time minimizing total caloric intake by inhibiting appetite, making it a highly effective fat burning tool.
Pomegranate
Dried pomegranate doesn’t appear to be included in the Fit Tea formula for any specific weight-loss reasons, and the product website makes no claims as such. Fit Tea describes pomegranate as a “super fruit” that contains a vast array of vitamins. While this is true, pomegranate actually has powerful antioxidant properties that support the claims made by Fit Tea about the detoxifying ability of their product.
A 2014 study demonstrated that pomegranate is able to deliver relief from oxidative stress, protect the body from cancer, lower bad cholesterol levels, regulate blood pressure and minimize inflammation[20]. A 2013 trial points to pomegranate as a potent antibacterial and antiviral protective agent[21] and another in the same year demonstrated that pomegranate consumption delivers better cardiovascular health[22]. Pomegranates are also rich in vitamins C, K, and B, as well as minerals such as potassium and folate.
Organic Rooibos
Rooibos is the third tea used in the Fit Tea formula. Sourced from a bush that grows in Southern Africa, Rooibos has a number of health benefits that weight loss tea don’t mention on the product website- in fact, Fit Tea only go so far as to say Rooibos has nothing in it that will be harmful to the body, which is not a particularly compelling reason to include it in a detox tea.
Despite the abrupt description of Rooibos provided by the Fit Tea website, the inclusion of it in the product formula appears to be an informed decision, as it has been demonstrated to function as a powerful antioxidant[23], reduce inflammation[24] and has even been shown in in vitro trials to increase the rate of fat oxidation[25], potentially increasing the rate at which the body can break down fat deposits.
Overall, Rooibos tea is a powerful health-boosting element of the Fit Tea formula, and while the product website could probably benefit from a more detailed explanation of why it’s included, it possesses properties that act in a synergistic fashion with the other ingredients of the formula to multiply the detoxifying power of fitness teas.
Ginger
The makers of Fit Tea claim that the inclusion of ginger in their formula helps to “calm the stomach acid” and tone the muscles of the digestive tract. While this is somewhat of an outlandish claim, it’s backed up by clinical evidence[26], although the health benefits of ginger are far simpler. Ginger has been used as a medicinal herb in cultures around the world for thousands of years to prevent nausea, improve digestive health, and relieve pain.
The ability of ginger to improve digestive function is likely the primary reason for its inclusion in the Fit Tea formula. A poorly-functioning digestive system often causes a slow metabolic rate, which leads to weight gain. Inversely, a healthy digestive function operates in an efficient manner, converting food to energy at a higher rate. There are literally thousands of clinical trials assessing the health benefits of ginger, with the best resource a 2011 biomolecular assessment of over 200 separate clinical studies[27].
Ginger contains an organic compound called gingerol, which was proven in a 2014 clinical trial to decrease body weight and increase insulin sensitivity[28]. Further evidence supporting the use of ginger as a weight control supplement can be found in a 2013 clinical trial performed by the University of Cairo, which determined ginger is able to reduce total body weight while at the same time increasing the levels of “good cholesterol” in the body[29].
Stevia & Honey
Stevia & honey are both added to the Fit Tea formula as natural, sugar-free sweeteners. Honey is likely added to the formula in trace amounts as a mild flavoring, as honey does contain high levels of natural sugar and calories. As Fit Tea is advertised as a 0 calorie product, it can’t logically contain too much honey.
Stevia is a natural sugar-free sweetener that is extracted from the leaves of the Stevia rebaudiana plant. Stevia is included in the Fit Tea formula as a natural, calorie-free sweetener to improve flavor without increasing the caloric content of the product, while avoiding the health risks of sugar. Stevia has become popular in recent years as it is 100-300 times sweeter than sugar[30] with none of the associated negative effects.
Guarana
Guarana is, interestingly, not listed as one of the primary components of detox tea, but is instead listed as a supplementary element in the “other ingredients” section of the formula. It’s safe to assume that as it’s not a primary ingredient it is present in only small amounts in the Fit Tea formula, but deserves a mention as it’s a powerful natural fat-burner and energy-booster.
Guarana has been used in traditional medicine for thousands of years to promote wakefulness, increased energy, boost metabolism and burn fat. Not only does guarana increased mental alertness[31] and improve cognitive function[32], it can also speed up the rate at which the body is able to metabolize fat[33]. The inclusion of guarana in the Fit Tea formula is likely the source of the “energy boost” users experience, but has no significant health concerns.
Cleansing Teas Formula Breakdown: The Results
Now that we’ve taken a look at the ingredients in the Fit Tea formula and the scientific evidence behind them, it’s time to find out whether Cleansing Teas can live up to the hype. Let’s assess the claims made by Fit Tea and see whether Fit Tea can back them up.
Does Weight Loss Tea “Detox” the Body? What Does That Mean?
Fit Tea is most commonly available in 14-day or 28-day detox packages. It’s always somewhat difficult to assess the veracity of any claims made by a product that promises to “detox” the body, as it’s impossible to determine exactly what the detox removes from the body. In the case of Fit Tea, it seems that the detox function of the product targets free radicals, or unbalanced negative elements that cause oxidative stress in the body.
Free radicals are commonly introduced into the body by excessive alcohol consumption or other unhealthy lifestyle habits, so if we interpret the detoxification claims made by Fit Tea as the ability to cleanse the body of toxins caused by unhealthy lifestyle choices, the claims are completely accurate. Almost all of the ingredients in Fit Tea offer relief from oxidative stress by providing the body with large amounts of antioxidants, which have a net positive effect on the health of the body.
Does Teatox Promote Weight Loss?
Given the large body of scientific evidence supporting the fat-burning qualities of green tea, garcinia cambogia extract and oolong tea, it’s safe to say that drinking weight loss tea will definitely boost the rate at which the body is able to burn fat. Although the process of losing weight is often presented as mysterious or complicated, it is, in reality, a simple thermodynamic process. Consuming fewer calories, or energy, than the body needs will cause the body to harvest calories, or energy, from fat deposits, breaking them down.
Fit Tea reduces caloric intake by gently suppressing appetite, then increases the caloric burn rate of the body by inducing thermogenesis, increasing the overall rate at which the body can break down and utilize energy stored as fat. In addition to this mechanism, the garcinia cambogia extract in the formula prevents the formulation of new fat deposits. As with any weight management supplement or product, however, fitness teas will likely deliver best results when used in combination with a healthy diet and regular physical exercise- it’s unlikely you’ll lose any weight just by drinking tea and sitting on the couch.
Does Detox Tea Boost Energy Levels?
The metabolic processes that Fit Tea boosts, by extension, increased the amount of energy available to the body. Increasing the base metabolic rate of the body causes the digestive system to convert food into energy in a more efficient manner, resulting in an overall increase in energy levels. When combined with the stimulatory effects of the caffeine and guarana in the formula, the metabolism-boosting ingredients in Fit Tea are more than capable of increasing energy and eliminating fatigue.
Cleansing Teas & Dietary Restrictions
Fit Tea is compatible with almost every kind of dietary restriction imaginable. Gluten, dairy, and soy free, Fit Tea contains no animal products and is therefore compatible with celiac, vegan and vegetarian lifestyles.
Health & Safety
Detox Tea advise that their product is completely natural and therefore free from any significant health risks, but as with any weight management supplement, it’s best to consult with your doctor or a registered health professional before beginning any supplementation regime, especially when taking prescription medication.
Potential Side Effects
The natural composition of Fit Tea means that it’s unlikely to cause any side effects, but a few of the ingredients have been demonstrated to be somewhat harmful in large amounts. A 2011 clinical study determined that high oolong tea consumption over an extended period of time is a contributing factor to the future risk of diabetes[34], but as Fit Tea is intended to function as a short-term weight loss detox this is a small and unlikely eventuality.
Rooibos tea has also been linked to illness when consumed in excessive amounts. A 2016 clinical study linked Rooibos tea with liver toxicity[35]. Perhaps the only concerning ingredient in the Fit Tea formula is garcinia cambogia, which has been linked to acute liver failure when used as a high-concentration dietary supplement[36][37]. A 2013 study on the interaction between small doses of HCA, the active ingredient in garcinia cambogia extract, and the liver, however, concluded that it does not cause liver inflammation or toxicity[38]
Making Your Own Weight Loss Tea
Cleansing teas may be an effective weight management supplement, but it’s certainly not the cheapest weight loss solution around, with a one-month detox priced at $45.00 USD. Depending on your personal preference, you may find this price to be reasonable, considering that the ingredients in the Fit Tea formula have all been independently tested for purity and carefully balanced by nutritious scientists to deliver the best, most effective combination.
It is possible, however, and potentially cheaper, to formulate your own “DIY” Fit Tea to create a similar solution that delivers the same results at a fraction of the price. Let’s take a look at a potential DIY Fit Tea formula to see if creating your own formulation is cheaper than the real deal.
DIY Weight Loss Tea Recipe
If you’re making your own cleansing teas for the sake of economy, doing away with the accessory ingredients like stevia, guarana and pomegranate is probably one of the most cost-effective moves you can make. Let’s take a look at the core fat-burning ingredients of fit tea and their average prices online. For this guide, we’ll assume that one ounce of tea translates to roughly 17 cups of tea.
- Green Tea: 1 oz av. price $1.85 USD
- Rooibos Tea: 1 oz av. price $1.70 USD
- Oolong TeaL 1 oz av. price $2.00 USD
- Garcinia Cambogia Extract av. price. $10 USD/100 capsules (1 month supply)
The total cost of the above formula is $15.55 USD for roughly 60 servings of DIY Weight Loss Tea- one third of the price of the retail version of Fit Tea. Keep in mind, however, that buying garcinia cambogia extract or any of the tea leaves in bulk economy lots likely provides less-than-ideal quality ingredients, but will function as a rough-and-ready version of Fit Tea if you’re on a budget.
To save money on cleansing tea while still ensuring you’re getting the best ingredients available, it’s probably best to buy a reputable and effective brand of garcinia cambogia extract and source your own tea locally. If you’re looking for convenience, taste and likes on your instagram fitspiration posts, however, Fit Tea is your best bet.
The Verdict
Fitness Tea is backed up by a vast body of scientific evidence that supports the claims made on the product website. The website itself could probably benefit from some more detailed information regarding the ingredients and the specific reasons for their inclusion n the formula, but overall the product is scientifically sound and is definitely able to promote faster fat loss.
While it’s probably more cost-effective to create your own detox tea at home, the official Fit Tea can nudge your body in the right direction and deliver a small competitive edge in the pursuit of weight loss. There is no replacement, however, for a healthy lifestyle that consists of a balanced, nutritional diet and regular physical exercise. Adding fitness teas on top of positive lifestyle choices is probably the best total solution for fast fat loss overall.
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[2] https://www.ncbi.nlm.nih.gov/pubmed/19597519
[3] https://www.ncbi.nlm.nih.gov/pubmed/24558988
[4] http://www.nature.com/ijo/journal/v33/n9/abs/ijo2009135a.html
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4550946/
[6] https://www.ncbi.nlm.nih.gov/pubmed/9194336
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679539/
[8] https://www.ncbi.nlm.nih.gov/pubmed/12871030
[9] https://www.ncbi.nlm.nih.gov/pubmed/10559550
[10] https://www.ncbi.nlm.nih.gov/pubmed/14519827
[11] https://www.ncbi.nlm.nih.gov/pubmed/10094584
[12] https://www.ncbi.nlm.nih.gov/pubmed/25031332
[13] https://www.ncbi.nlm.nih.gov/pubmed/13678386
[14] https://www.ncbi.nlm.nih.gov/pubmed/16425281
[15] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055352/
[16] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4053034/
[17] https://www.ncbi.nlm.nih.gov/pubmed/22530711
[18] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010674/
[19] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748738/
[20] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4007340/
[21] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671682/
[22] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3678830/
[23] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897768/
[24] https://www.ncbi.nlm.nih.gov/pubmed/19419525
[25] https://www.ncbi.nlm.nih.gov/pubmed/25617707
[26] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4313008/
[27] https://www.ncbi.nlm.nih.gov/books/NBK92775/
[28] https://www.ncbi.nlm.nih.gov/pubmed/24615565
[29] https://www.ncbi.nlm.nih.gov/pubmed/23329526
[30] https://www.ncbi.nlm.nih.gov/pubmed/19961353
[31] https://www.ncbi.nlm.nih.gov/pubmed/25880065
[32] https://www.ncbi.nlm.nih.gov/pubmed/16533867
[33] https://www.ncbi.nlm.nih.gov/pubmed/16182414
[34] https://www.ncbi.nlm.nih.gov/pubmed/21244473
[35] https://www.ncbi.nlm.nih.gov/pubmed/27871602
[36] https://www.ncbi.nlm.nih.gov/pubmed/26626648
[37] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952288/
[38] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3848168/
