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Whey Protein
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(ImmunePro Rx
™is unique in that it is not a by-product of cheese manufacture and it does
not undergo the following processing that denatures (damages) the original
milk proteins)
WHEY PROTEIN
REPORT
Current Concepts
on Whey Protein Usage, Prepared for The Cleveland Eye Clinic
by: David Marshall, Jr., O.D., Ph.D., Consult
Contents:
-
Introduction -
A. What
is WHEY?
-
Current Concepts of Whey Usage -
-
Clinical Implications -
1.
Wound Healing
2.
Glutathione
3.
Ocular Ramifications
b.
Macular degeneration
c. Immunity
d. Cancer
e. Diseases of Aging
f. HIV and AIDS
INTRODUCTION
A. What is
WHEY?
NOTE:
ImmunePro Rx™ is not a by-product of cheese manufacturing and therefore it
does not undergo the excessive heating, chemical modification, or pH
adjustment that is outlined below. All of which denatures (damages) the native
protein structure and results in little or no biological activity in the whey
product.
Whey is a
by-product of cheese manufacture resulting from drainage of liquid from
the curd(1). It contains lactose, protein, ash, and lipids. The
protein concentration at this stage of processing is about 67 protein.
Whey proteins can be fractioned and concentrated via a process called
micro-filtration to yield whey protein concentrates (WPC). The protein
concentration can be as high as ~ 95% protein after the removal of the
fats and lactose. WPC's are an excellent source of nutrition and are high
in lactalbumin, minerals, and vitamins. It possesses a number of
functional advantages such as solubility, high water retention, foaming
and gelation(1). As a result of these qualities, whey protein
concentrates (WPC) have been used in a wide range of food products such as
the formulation of dairy foods, egg white replacement, beverages, surimi
and comminuted meat products (1).
In response to
the efficacy of whey consumption, Karen Collins, M.S., R.D., a registered
dietician from the American Institute for Cancer Research, states that
whey is a safe and healthy ingredient in foods since levels of pesticides
and hormones are not concentrated in whey (2).
Whey protein
concentrates are of particular interest to the practitioner due to their
wide-range and near full-blend of essential and non-essential amino acids,
which are commonly referred to as the building blocks of life. Linked
amino acids combine to form proteins. These protein comprise nearly every
tissue and organ in the body, therefore any supplementation of the diet
with proteins may be beneficial to injury repair, metabolism, and general
health.
B. Whey
Manufacturing
The
importance of whey products has gained prominence within the last 5 years.
Asia is the leading exporter of whey produce, exporting an estimated
15,680,683 kg in 1992 and 16,184,519 kg in 1995. This represents~ 60% of
all worldwide exports. The leading importer of whey is North America,
which in 1995 brought in an estimated 26,444.593 kg . This amount
represents a 5 fold increase in imported product over a four year span and
nearly 90% of all worldwide imports of whey(3).
Commonly
whey is prepared from cheese products such as cheddar cheese. In
accordance with the Ohio State University method(11), whey is
prepared from milk using lactic acid culture and rennet as a coagulant. The
milk is HTST (High Temperature Short Time) pasteurized (163° F, 30
seconds) and held overnight at 40°C then warmed to 30° C and
inoculated with 1.5% cheese starter. After incubation for 30 minutes, 38.7
ml rennet extract is diluted with cold water and added to 50 gallons of
milk with stirring. Twenty-five minutes later curd is cut and cooked by
gradual warming to 38-40°. Cover a thirty minute time interval while the
temperature is maintained for 1.5 hours. The whey is then drained through
a stainless steel screen and separated at 55° C.
Whey
Protein is produced by ultrafiltration at 45° C after addition of 20 g
of citric acid with the pH adjusted to 3. After
ultrafiltration to 1/5 the original volume, the retentate is diafiltered
with addition of 20 g citric acid at pH 3. The concentrated
whey is warmed to 40°C and spray dried to, provide whey protein
concentrates. This WPC (protein 79.9% and calcium 0.136%) is then used to
prepare laboratory scale samples and the WPC solutions are freeze
dried(3). Additional micro-filtration techniques may be added to increase
the protein yield to ~95%.
Many whey
products are then put through an ion-exchange process to remove fat and
lactose. In this procedure the cold-filtered protein concentrate is put
through a static electrical charge which separates undesirable fractions
from the WPC. However, there is a price to pay for this process. The
immunoglobulin fraction is greatly reduced(4). The end product
is a whey protein isolate that is relatively fat, lactose, and sugar-free
product possessing a high amino acid (protein) concentration.
In addition
to the before-mentioned procedures, some manufacturers hydrolyze their WPC
to produce di-, tri-, oligo-, and polypeptide (long and short-chain amino
acids). It also provides for a variety of amino acids, with special
emphasis on the branched-chained amino acids (L-leucine, L-isoleucine, and
L-valine), in addition to important amino acids such as L-cystine and
glutamine, all of which are essential for wound healing, immunity, and
cellular nitrogen retention.
note:
Hydrolyzing breaks apart peptide bonds. The ion-exchange and hydrolyzing
process used on whey protein permanently modifies the native structure.
The protein is denatured and the biological activity is ended.
Current
Concepts of Whey Usage
A. Nutritional
Value
The real
nutritional value of WPC's lies in their abundance of amino acids. For
example the typical WPC contains up to 18 amino acids, which nearly
represents the full blend(57).
Alanine,
arginine, and aspartic acid are three common amino acids found in numerous
whey proteins. Alanine aid in the metabolism of glucose, whereas arginine
causes retardation of tumors and assists in the release of growth hormones
and the maintenance of a healthy immune system. It also provides an
environment for an increase in muscle mass and body fat reduction, in
addition to being an essential ingredient of protein synthesis.
Aspartic
acid increases stamina, therefore it is good for fatigue. It also aids in
RNA/DNA synthesis.
Cysteine/cystine
are perhaps two of the more important amino acids found in WPC. They are
helpful in detoxifying toxins and are precursors to the body's most potent
antioxidant, glutathione. They promote the burning of fat and are useful
in the treatment of rheumatoid arthritis and bronchitis. Due to the
possible toxic effects of cysteine at high levels it is not a recommended
supplement.
Glutamic
acid and glutamine are essential to nervous tissue function. Glutamic acid
is a neurotransmitter for retinal neurons and is commonly referred to as
"brain fuel" since the brain converts it to a compound that
regulates brain cell activity. It is also a precursor to glutathione.
Glutamine is important to cellular nitrogen retention and is important in
alcoholism, mental ability, impotence and maintaining a healthy digestive
tract.
Glutathione,
a potent antioxidant, is important for the safe metabolism of the hydrogen
peroxide free radical. It helps protect against radiation and oxidative
damage and is the body's best defense against the formation of cataracts,
age-related macular degeneration (ARMD), cancer, and immunity. This
important protein will be discussed in detail later in text.
The
essential amino acids are well represented in most WPC's. They can't be
manufactured by the body and therefore must be obtained through dietary
consumption. They consist of the branched-chained amino acids, lysine,
phenylalanine, methionine, and tryptophan. The three branched-chained
amino acids are leucine, isoleucine, and valine. They are essential to
tissue growth and repair. They promote the healing of bones, skin, and
muscle, They also regulate blood sugar levels, so they must be taken in a
balance to insure proper regulation.
Phenylalanine
is often used to treat depression. It is a precursor to the
neurotransmitter, norepinephrine and aids in memory. It should be avoided
by phenylketonurics (PKU)
Lysine,
methionine and tryptophan are also found in many WPC's. Lysine is an
essential building block for all protein and helps to maintain proper
nitrogen balance.
The body
uses methionine to derive the brain food, choline. It also aids in
digestion, as well as serving as a fat burner. It can interact with other
substances to detoxify harmful agents, and is essential for the production
of cysteine and taurine.
L-Tryptophan
acts as an sleep aid, as demonstrated by the drowsy feeling we sometimes
experience after Thanksgiving dinner (turkey meat has a relatively high
amount of tryptophan.). It is also necessary for the production of niacin
and is used by the body to make the neurotransmitter, serotonin.
The
rational for using WPC's to attain this dietary level of nutrition is that
25 grams of powder provides approximately 20 grams of amino acids. To
acheive this level of nutrition taking tablets or soft gels would require
taking 48 to 60 units per day, which would be difficult and expensive.
B.
Body-building
A large
number of weightlifters and bodybuilders use WPC's during their training
regimen. They sometimes utilize a three step process which consists of
stacking, "cycling", and "cutting". The initial stage,
stacking involves taking two or more compounds at one time to maximize
results. They may take WPC and or creatine or chromium. This is then
followed by cycling, in which large doses of a supplement is used to
change the level of body fat. Some will use 10 or more one ounce WPC
servings a day. This should be approached with caution since large doses
of protein consumption may present challenges to the liver. The final
stage, cutting, involves maximizing the muscle bundles for visualization.
This is the point in which the bodybuilder aspires to achieve that
"cut up" appearance.
It is
important to consult a physician before attempting any of these extreme
methods.
C. Clinical
Implications
1. Wound
Healing
Austrialian
researchers claim that whey extract could become a standard treatment for
chronic wounds, especially ulcerations from high blood sugar and hypertension.
Initial experiments using a whey extract containing a number of natural
growth factors excelled at spurring cells to grow thus prompting this
essential step in the body's normal repair of injuries(32). The
compound also encouraged rapid wound healing in rats and pigs(32).
Scientists
working on a joint government-industry project at the Cooperative Research
Center for Tissue Growth and Repair in Adelaide, Australia have patented a
process for mitogenic bovine whey extract which is unique as a
naturally-derived cocktail of growth factors in which 1000 L of milk
yields 30 grams of extract. When the extract is mixed with a collagen gel
and applied to wounds it enhanced the healing of surgical incisions.
Clinical
trials are currently underway in the United States at the Veterans
Administration Medical Center in Bay Pines, Florida under the direction of
Martin Robson, M.D.
These
observations have their origin in the fact that whey protein contains high
levels of amino acids which may be important to wound healing. These amino
acid include arginine, glycine, and particularly the branch-chained amino
acids (BCAA) leucine, isoleucine and valine, which are essential to
promote healing of bones, skin, and muscle tissues. Another amio acid,
proline, aids in the production of collagen, heals cartilage and
strengthens joints, tendons and cardiac muscle.
2. Glutathione
In order to
understand the mechanisms beneficial biochemical interactions and possible
whey protein potential health benefits of WPC, a brief biochemical review
of the protein Glutathione is required, since it is this protein more than
any other that has been thought to provide a protective function for a
number of organ systems, including the crystalline lens of the eye, the
retina, prostate gland, and the immune system.
a. Glutathione
Synthesis
For the
body to produce Glutathione (GSH) six building blocks are required:
L-glutamate, L-cysteine, L-glycine, magnesium, potassium, and 5' ATP. Two
enzymes are also required and they are L-gamma-glutamyl-cysteine
synthetase (equation 1) and glutathione synthetase (equation 2) and the
reaction proceeds in the following manner:
Mg 2+
(1) L-glutamate
+ L-cysteine + ATP--------->
L-gamma
-glutamylcysteine + ADP + P
Mg2+
(2)
L-gamma-glutamylcysteine + L-glycine +ATP----------->
K+
L-gamma-glutamylcysteinylglycine
+ADP + P
L-cysteine
is the rate limiting substrate in this reaction12 , while the
rate controlling enzyme for the reaction is L-gamma -glutamylcysteine
synthetase(5) .
b. Scavenger
Pathways
The 2 major
functions of glutathione are to detoxify hydrogen peroxide (H2O2) and
other organoperoxidases (free radicals) and to defend against oxidation
within cells via the Glutathione Redux Cycle, or more commonly referred to
as the Scavenger Pathways(6,7).
Glutathione
plays it's role of "scavenger" through out the body. The role of
scavenger is primarily accomplished through glutathione peroxidase (GSH
px). The peroxidase interacts with the H2O(2) to reduce it to harmless
water, thus limiting it electron stealing capacity. This is illustrated in
the following equation:
(2)
2-glutathione-SH +ROOH ------>
glutathione
disulfide + ROH + H2O
The
disulfide is then reduced with the co-enzyme NADPH in the prescene of the
enzyme Glutathione Reductase to yield the original glutathione compound.
(3) glutathione
reductase +NADPH + H+ ----------->
2-glutathione-SH
+ NADP -
Many
theories of aging and disease are based upon the interaction of the
formation of free-radicals and the subsequent reduction in glutathione
levels which allows for an accumulation of free-radicals to remain within
a cell and organ or organ system. Free-radicals that remain within cells
may cause cell damage, DNA damage and may even cause cell death, cancer
transformation or loss of cell immunity to viral or bacterial infection.
3.
Ocular Ramifications
To fully
appreciate the manner in which supplementation with WPC may be beneficial
to maintenance of ocular tissues, let us look at the processes of
cataractogenesis and oxidative insult to the retina.
a. Cataracts
1. Mechanisms
of cataractogenesis
The exact
mechanism of cataract formation follows a strict ordered sequence.
Initially, in the pre-cataractous state, a cascade of early
cataract-related changes occurs resulting in an oxidative insult to the
cell membrane and to the amino acids methionine and cysteine (17-20). This
can be caused by x-rays, photochemical insult, hyperbaric oxygen levels 18
and other causes. The remaining cascade of events then proceeds in the
following manner: (a) unfolding of protein structures, which exposes the
protein thiols making them available for further oxidation, (b)
di-sulphide linked aggregate formation, and (c) a decrease in enzymatic
activity (glutathione peroxidase) which protects and repairs damage (17,18,20).
It is at this stage that the cataract truly begins to develop accompanied
by a change in the lens Re-dux ratio, decreased ATP levels, and a change
in cation permeability which induces an influx of H2O (water)
within the cell membrane(17-20).
The site of
initial damage according to Spector(18) occurs in the lens
epithelium. The causative agent at this point is thought to be primarily
the hydrogen peroxide radical, which in the absence of glutathione, may
now accumulate unopposed. These free-radicals which are defined as
molecules with an one or more unpaired electrons in their outer orbit,
which attempt to stabilize their charge by stealing an electron from the
outer shell of a stable neighboring molecule setting off a chain-reaction
sequence(6), causes DNA damage to the lens epithelium cells(21).
Examination of lens epithelial cells at the time of cataract surgery
usually reveals an ongoing pattern of programmed cell death (apoptosis)(18)
which may be documented by evaluation of lens chromatin fragmentation(21)
.
In the case
of experimentally UV-induced cataracts, exposure to the UV radiation
generated hydrogen peroxide, superoxide and DNA damage(21,31).
The consequences of this action is to degrade the lens crystallin,
decrease transmembrane voltage, reduce glutathione stores(24),
decrease enzyme activity, and increase in prostaglandin production(25).
It is interesting to note that no significant change in the non-protein
thiols occurred until 85% of the lens epithelium cells were already dead(21).
2.
Cataractogenesis and Glutathione
The major
role of glutathione in the crystalline lens of the eye is to provide lens
clarity via maintenance of the limiting anterior epithelial cell layer and
to correct and/or halt oxidative damage to the lens(5). Arnold
was perhaps the first investigator to discover the presence of glutathione
in the lens, and it is now clearly evident that the highest concentration
of glutathione is found in the lens epithelium(6) , which has a
5X greater concentration than in the second most glutathione rich site,
the lens cortex. The nuclear region of the lens is primarily devoid of
GSH(5,6).
It is well
is established that lenticular glutathione levels decrease with age (5,6,8)
ranging from a concentration of 3.5 umol/g at age 20 and decreasing to 1.8
umol/g at age 65. It is inferred that it is this age related reduction in
GSH which is in part responsible for cataract formation in the elderly. In
fact, Reis was the first to note the lack of GSH in cataractous lenses(5).
In addition, a number of substances which inhibit GSH synthesis, such as
Buthionine Sulfoximine(16) produce cataracts in experimental
conditions. It is interesting to note that glutathione levels are
unchanged in some reversible forms of cataracts, such as those induced
after the administration of diquat(5). Reduced GSH levels is a
precipitating factor age-related cataract formation(7). To
further illustrate this point, researchers at Alcon Laboratories have used
aldose reductase inhibitors to halt the progression of certain cataracts(13).
The importance in this finding is that aldose reductase acts competitively
to reduce levels of GSH and its inhibition allowed GSH levels to remain
high.
As
mentioned previously, glutathione and it's enzyme, glutathione peroxidase
has great importance in regards to the elimination of free-radicals within
the lens. Recent reports indicate that glutathione metabolizes chronic low
levels of free-radical production26 typical of normal
metabolism and the most potent anti-oxidant in the lens system. This point
is illustrated by the inability of other enzymes, such as catalase to
limit lens damage caused by hyperbaric oxygen(27) and H202(28,29).
Glutathione
is essential for the maintenance of tissue ascorbate (Vitamin C) and
alpha-tocopherol (vitamin E) levels (30) according to
Mrtensson. He found that as GSH levels decreased, a corresponding decrease
in ascorbic acid and vitamin E followed, which led to systematic
mitochondrial death, which in turn leads to a cessation of cellular
metabolism(31).
The
regional distribution of glutathione in different cataracts is of
interest. Pau (et al 9) found that in primary nuclear and
supranuclear cataracts, there was only a slight decrease in GSH levels
relative to the subcapsular and (20) nuclear, implying a
different mechanism for various cataract types and possibly a different
mode of non-surgical intervention.
Experimental
data has shown that supplying the lens with additional glutathione,
particularly in the form of the peroxidase increases delays cataract
development and may even prevent cataract development(23). This
may be accomplished my enriching the aqueous with the glutathione
precursor amino acids or glutathione directly(10) . Glutathione
in conjunction with vitamin E added as a supplement to a galactose diet
did halt opacification of cortical cataracts in the animal model15.
Further evidence for GSH infiltration into the lens comes from the
identification of glutathione transporters in the lens epithelium(11).
Taking glutathione orally has not been shown to raise tissue levels of
glutathione. Taking WPC which contains high levels of cystine, the
rate-limiting substitute for the production of glutathione, may be helpful
for the prevention of cataracts.
b. Macular
degeneration
It is
widely accepted that lipid peroxidation plays a major role in retinal
light damage(58). The vertebrae retina is known to contain
relatively high levels of antioxidants and anti-oxidant enzymes(59).
Among these are three members of the glutathione system, glutathione
peroxidase, reductase, and transferase. The others are catalase and
superoxide dismutase (60). When levels of these antioxidants
begin to decrease with increasing age(59, 60) , retinal changes
associated with macular degeneration begin to develop. This is
particularly true for glutathione peroxidase and catalase(59, 60)
.
The method
oxidative damage occurs is due to light or heat damage and then coupled
with the age-related reduction in GSH(px) and catalase allows for the
propagation and accumulation of the free radicals, making the retina
susceptible to further damage(60).
Stone and
Dratz (61) found evidence of glutathione-dependent enzymes in
the outer segments of rats and suggest that since these membranes are rich
in polyunsaturated fatty acids, they are susceptible to free-radical
induced peroxidation. Therefore when RPE disruption occurs with early
ARMD, which limits the amount of phagocytosis occurring, coupled with the
age-related reductions in antioxidant activity, adverse retinal changes
are manifested and may proceed unchallenged.
It may
therefore be possible to replenish or revitalize the antioxidant activity
of the retina by dietary supplementation primarily with a glutathione or
precursor to halt the progressive lipid perioxidation occurring during
ARMD.
c. Immunity
Primarily
the process of enhancing the immune response is accomplished through the
replenishment of glutathione (GSH). It has been theorized that the ability
of lymphocytes (CD4 cells) to correct oxidative damage is determined by
their capacity to regenerate intracellular stores glutathione which allows
them to respond vigorously to a wide variety of antigens(33).
In 1981,
researchers discovered that mice fed a non-denatured whey protein
concentrate exhibited a marked increase in antibody production in response
to T-cell dependent antigens(36). Numerous experiments in
subsequent years have confirmed this early observation (37,38,39,40,41,42,43,44).
Thus, enhanced immunity against colds and hepatitis and most dramatically
pneumococcal infection(42) could be accomplished through
dietary supplementation with whey protein concentrates (WPC's).
An
interesting peripheral observation was that the immunosustaining effect of
the protein mixture found in whey was unrelated to its nutritional
efficiency and as a result of this phenomenon this unique property was
defined as the bioactivity of the product(33).
This
bioactivity occurs through the ability of the protein concentrate to help
replenish glutathione levels via continuous dietary provision of
glutathione precursors, especially cysteine/cystine, during lymphocyte
proliferation, thus supporting an optimal immune response. This process
seems to not only increase intercellular levels of GSH or GSH precursors
at the time of ingestion, but also builds up stores of these substances
within the cells which lasts for a substantial post-ingestion time
interval(33).
The
proposed bioactivity is dependent upon three bioactive proteins contained
in whey, serum albumin, lactoferrin and alpha lactalbumin. These proteins
contain a high number of cysteine/cystine residues, an important GSH
precursor. Serum albumin contains 17 cysteine residues/ 66,000 MW molecule
and 6 glutamylcysteine dipeptides(39). Lactoferrin contains 17
cysteine residues/ 77,000 MW molecule and four gluatmylcysteine
dipeptides, while alpha-lactalbumin contains 4 residues per 14,000 Mw
molecules (39). It is these residues which are primarily
responsible for replenishment of GSH stores.
d. Cancer
Two major
theories of oncology both implicate GSH as a putative protective factor
due to its dual role as a antioxidant and detoxifying agent. Free radical
accumulation is thought to be a major factor in tumor formation (45).
In fact at least twelve carcinogens have been identified that are
detoxified by GSH conjugation. These are: aflaxotoxin B1,
N-acetyl-2-aminofluorene, benzanthracene, benzopyrene, benzidine,
dimethyl-hydrazine, 1-nitropyrine dimethylnitrosamine, ethylmethane
sulfonate, N-methyl-4-aminobenzene, 7-methylbenzanthracene and
3-methyl-cholanthracene (46,47,48).
Further
evidence supporting the anti-tumor forming capacity of whey protein is
illustrated by a University of Wisconsin study in which hormones known as
androgens are responsible for depleting GSH levels in the prostate. This
relatively GSH-free environment is thought to promote prostate
carcino-genesis in men (49). This condition can be reversed in
vitro by increasing colonial levels of GSH via continuous whey protein
supplementation.
e. Diseases of
Aging
As in
carcinogenesis, free-radical accumulation has been implicated in producing
a variety of diseases associated with aging (50).These maladies
result from the toxic accumulation of these materials due to the absence
or reduced levels of GSH. Diseasessuch as Alzheimer's (51),
Parkinson's 52, and arteriosclerosis53 all appear to
be preceded or associated with cellular organ or organ system reductions
in GSH. Therefore much speculation has arisen regarding the potential
benefits supplementation with whey protein may provide in these cases. If
results obtained from other organ system studies are of any indication
results could be promising.
f. HIV and AIDS
The
mechanism by which whey protein concentrate yields an enhanced immune
response has already been discussed. Recently this knowledge has been
applied to the treatment of HIV infected individuals. Staal (et al 34)
reported that HIV-infected individuals have lower GSH concentrations in
their blood lymphocytes, while Herzenberg (et al 35) found that
the more glutathione patients carry in their CD4 helper T-cells, the cells
primarily targeted by the HIV virus, the greater the chance of increased
longevity exists.
More recent
claims have stated that supplementation with whey protein concentrates
(WPC's) may help AIDS patients maintain body weight and in some cases
limit wasting syndrome. In a pilot study WPC's were given to a population
consisting of 14 AIDS infected children (ages 8 months-15 years) in an
attempt to limit determine the efficacy of daily oral dietary ingestion of
whey proteins. They found no toxic side effects and an average weight gain
of 3.2 - 18% from their entrance weight(54).
A. Robert
Neurath M.D. and his colleagues at the Laboratory of Biochemical Urology
at Lindsley F. Kimball Research Institute of the New York Blood Centers
has reported that a modified version of protein extracted from whey
blocked the aids virus from infecting cells in vitro(55). In
their National Institutes of Health sponsored study the scientists
modified beta- lactoglobulin to produce a substance referred to as B69.
They reported that B69 latched onto a protein structure called CD4 on the
surface of cells which kept the aids virus from using this site as an
entryway into the cell.
Newarth
further hypothesized that if additional results with B69 were promising,
the compound may be formulated into a cream or foam that could be
dispensed within condoms to limit the transmission of the virus.
Dr.
Jefferey Laurance, an AIDS researcher at Cornell Medical College, however,
urges caution regarding B69 developments. He states that HIV can infect
some cells , including rectal and vaginal cells, without using the CD4
site as an entryway.
In summary,
animal studies have yielded promising reports regarding prolonged life
spans of infected animals in the laboratory, while theoretical data(56)
and initial clinical observations in humans have produced evidence that
dietary supplementation with WPC's can provide definite benefits to the
HIV infected individual. Further research, however, is warranted in this
area.
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