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Over time, mutated mtDNA molecules can undergo clonal expansion, and once the mutational burden exceeds a critical thresholdtypically 60% and 90% they produce a biochemical defect in OXPHOS, a concept referred to as the mtDNA mutational load (112)

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A randomized, double-blind, placebo-controlled clinical trial with 225 overweight and obese adults found that B420 supplementation over six months was associated with statistically significant changes in body fat mass and waist circumference compared to placebo