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The 2019 European guidelines for management of adult obesity in primary care 36 and the South Asian consensus on MNT in diabesity (CoMeND) 1 give importance to a decrease in WC over weight loss alone, as a decrease in WC is associated with a decrease in visceral fat and its associated cardiometabolic risks

2.2.2 Destruction of the ECM in chondrocytes In OA, the excessive production of ROS exerts a dual effect on the ECM, leading to its destruction and inhibiting its synthesis