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and Topping, Annie (2009) Registered nurses' attitudes towards the role of the healthcare assistant
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Because every NNMT reaction consumes SAM and diverts nicotinamide away from NAD+ production, chronically elevated NNMT activity is thought to gradually starve the cell of the exact resources it would need to run its mitochondria efficiently and burn stored fat — a self-reinforcing loop where reduced energy expenditure and continued fat storage feed into each other
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