Ah, supplements. 👃

Convenient, persuasive, and full of promises. But do they actually help you on your quest to lose fat and build muscle? And even if they do, do you really need to use supplements to reach your goals?

In this article, I’m going to list a long line of what I think are the best supplements folks should be taking to support them in their body recomposition journey.

I’ll also go into more detail on:

• Whether you need supplements at all.
• How most “fat burning” supplements really work.
• The fastest way to lose fat and build muscle.

👇 Jump to the list

What supplements do I need to lose fat and build muscle?

You don’t need any supplements to lose fat and build muscle effectively. And there are certainly no substitutes for training hard, or eating less.

That said, you can certainly make these processes more comfortable, and even a little faster, when you invest in quality supplementation.

Here are 20 of the best supplements for building muscle, losing fat, and staying on top of your game no matter your age. The best ones, the ones I’d recommend you take no matter what, I’ve tagged with a star. Others are more specific, and might help support a particular health concern.

Which supplement is best for cutting fat?

Yep, the best thing you can do to lose fat is to simply eat less. Up to a point, that is. Larger calorie deficits bring cortisol up higher. When cortisol is elevated for long periods of time (say, the 12 weeks you’re dieting), it’ll impact your mood, your testosterone levels, your energy, and your ability to hold onto hard-won muscle.

So no astronomically large energy deficits. But are there any supplements out there that can help you cut fat faster?

Fat burning supplements

“Fat burners” don’t directly “melt” fat.

Instead, fat burning supplements work by stimulating the adrenals. Also, sometimes, by suppressing appetite. Sound familiar? It should. Your morning coffee does the same things.

All fat burning supplements contain a hefty dose of a stimulant (plus a few other ingredients) to boost your energy and mood.

Here’s the problem. When you diet, your cortisol is already elevated by your calorie deficit. When cortisol is elevated, baseline adrenaline is elevated too. Going too hard on the fat burning supplements can push your adrenals too hard and leave you de-sensitized to your own adrenaline. That’s inherently unsustainable.

For you, that means less energy overall, and a reliance on those stimulants to feel like you’ve got any energy at all. 😭

Much safer, and more sustainable, than “fat burner” supplements that rely on stimulating the adrenals, are supplements that support normal, healthy metabolic function while you’re dieting. These are listed below, and can stave off the necessary (but small) adaptations your metabolism makes as it adjusts to your lower calorie intake.

👇 Jump to the list

What's the fastest way to lose fat and gain muscle?

The fastest way to lose fat or build muscle is to pick one of these goals and stick to it. Want to lose fat faster? Increase the size of your energy deficit by eating less. Want to build muscle faster? Eat more and ramp up your workout volume a little to get the greatest growth stimulus possible.

Losing fat

You’ll lose about 2lbs a week in a 1,000kcal per day deficit. If your maintenance calories are 2,700kcal, then you’d need to eat 1,700kcal to lose 2lbs a week. This is fast enough to see significant changes in an acceptable timeframe. If you lose 2lbs every week for 12 weeks, you’ll have lost 24lbs in under three months. You’ll be getting comments left, right, and centre.

Can you drop weight even faster than that? You can, but it’s best reserved for those who are very overweight to start with, or for only the early stages of your diet. If you’re 20% body fat, you could get away with losing 2.5-3.0lbs a week for the first few weeks, as you drop water and muscle glycogen.

Building muscle

Building muscle faster is more tricky. You can’t force it to happen any more quickly by eating more. When you do that, you’ll just get fatter, impair your insulin sensitivity, and have to diet back down again sooner.

Diet down until you’re as lean as you can get without torturing yourself, then get after it with a modest calorie surplus of 500kcal or less until you’re around 20% body fat. Then lean out to around 10% or just below, and go up again.

For many, this will involve bouncing between about 8%-22% body fat, give or take a couple of percentage points either end. Some will feel pretty uncomfortable at 10%, while others might naturally achieve 7% before they start to feel rough.

How can you tell your body fat percentage? Most measurements are inaccurate, so it’s best to search for some visual references online of what 8% body fat looks like. Then diet aggressively until you’re as close to that as you can get.

👇 Jump to the list

Where supplements come in

I know, I know. This is an article about supplements. But I’d be short-changing you if I didn’t emphasize that there are no shortcuts.

Still, supplements can help support the above protocols.

Supplements when dieting

When you’re in a calorie deficit, your diet is guaranteed to become more restricted. As a result, your diet will be less varied and more prone to micronutrient gaps. Over time, this will lead to deficiencies which, if they become severe enough, will begin to manifest with symptoms.

When dieting, then, supplements can help fill those gaps and stave off deficiencies and support normal metabolic function.

Supplements when building muscle

When looking to build muscle, supplements can help boost your strength, aid your digestion, and even keep insulin sensitivity a bit higher. Even as your weight increases. Supplements can support recovery from harder training, and they can support your sleep to ensure you’re recovering optimally from those hard training bouts.

In both scenarios, supplements can help you hit your protein quota for the day, and protect against injury, so you can keep progressing towards your goals.

The best 20 supplements for building muscle and losing fat

Muscle growth

The following supplements can help you build new muscle, and hold onto it while dieting.

1 - Protein powder ⭐

Some people struggle to hit their protein requirements (0.8-1.0g/lb for most people) from whole foods alone, but that’s not a problem. Protein powders help you hit your protein macronutrient requirement.

The most important thing when choosing a protein powder is that you can digest it well. If it bloats you and gives you cramps, bin it.

Otherwise, the source isn’t that important. You can buy whey isolate; whey concentrate; a blend of milk, casein, and whey proteins; or even vegan protein. By far the first, and most important, thing is that you’re getting enough protein.^[1]

However, you will want to pick a powder with a strong amino acid profile. There’s too much to go into on that front here, but try to find a chart of the powder’s amino acid content. Make sure they’re all accounted for whenever possible, and the more leucine it contains, the better. Whey is perhaps the strongest, on this front, but in the protein hierarchy, raw quantity is most important.

2 - Creatine ⭐

Creatine is the most well-researched supplement of all time. Its benefits are many, and its drawbacks few.

Here’s the (very basic version of) how creatine works: it sits in your muscles and pulls water into them, keeping them hydrated. It also facilitates energy production via ATP, the form of energy you use in explosive and power-based activities, like lifting weights.

In other words, supplementing with creatine can help you look fuller, from water retention within your muscles, as well as make you stronger thanks to more available energy and perhaps even better leverage.

Since your muscles grow from mechanical tension, and this tension is experienced in the five or so reps before muscular failure, if you can get one more rep per set from taking creatine, you can eke out that little bit more growth from every workout. That means faster gains. 💪^[2]

3 - Caffeine

Caffeine is adrenergic, stimulating the adrenal glands to release adrenaline. When it comes to building muscle, this is great, because it increases performance. Like creatine, if you’re able to get an extra rep or two, you’ll get a slightly larger growth stimulus and better gains over time.

This aspect isn’t terribly sustainable, though. Over time, you may come to rely on higher and higher doses to keep performance stable.

Unlike other stimulants, though, caffeine doesn’t put you at risk of depleting your dopamine. Instead, caffeine sensitizes you to it. It does this by upregulating certain dopaminergic receptors, making it perhaps the most sustainable of all stimulants.

Metabolic support

These supplements won’t actively help you lose fat, but they’ll make your fat loss journey more sustainable as they fill in some of the most common deficiencies, and support healthy metabolic function.

4 - Iodine

It’s difficult to get enough iodine from food unless you’re using iodized salt. In the UK, though, iodized salt isn’t widely available, and modern attitudes towards salt dissuade many from its use.

Eating a lot of seafood and/or dairy every day will get you to the recommended daily intake, but if you’re vegan, vegetarian, or rarely eat fish, you’re at risk of a deficiency.

Iodine deficiencies can leave your thyroid struggling. When your thyroid gland is underactive, your metabolism slows, eating into your calorie deficit and slowing weight loss.

That said, supplementing with doses of iodine that are too high (>500µg) can actually suppress thyroid activity, too, so look for more moderate doses of around 100µg when supplementing.

5 - Selenium

Like iodine, selenium is also essential to proper thyroid function, albeit for slightly different reasons. It plays a part in the conversion of T4 to T3. When this conversion is impaired, the consequence is the same: impaired thyroid function, a slowed metabolism, and a smaller calorie deficit than you’d manage otherwise. ^[3][4]

An underactive thyroid also leaves you feeling fatigued, cold, and generally a bit crap. Not exactly the kind of get-up-and-go you need to sustain the level of movement required for fat loss.

6 - General multivitamin

General multivitamins aren’t required if you’re eating a varied diet at or above maintenance calories. It’s when you begin to cut back in a fat loss phase, though, that you’re more at risk of developing deficiencies.

If you’re restricting certain food types, or even food groups, entirely, then a general multivitamin and mineral supplement is probably a good idea. You’d still be better off getting your vitamins and minerals from whole food sources wherever possible, but that becomes difficult in the latter stages of a diet.

Digestion

Even if you’re hitting your macronutrient targets and supporting a healthy metabolism, none of that means much if your digestion is taking a hit. Poor digestion can slow down progress, whether you’re aiming to lose weight or gain it.

In the latter phases of a diet, it’s tempting to push fibre content higher and higher to feel more full. If you’re not used to such high fibre intakes, well… gastric distress, anyone? 😷

Similarly, if you’re piling great volumes of food into your gullet to build muscle, your digestive system needs all the help it can get.

For these reasons, supplements that support your digestive system get a well-deserved spot on the list.

7 - Psyllium husk ⭐

Psyllium husk is a wonder fibre. In the gut, it barely ferments, meaning very little gas or bloating. It’ll increase stool size and softness, making it a great regulator of your bowel movements. 👀

Psyllium husk will also lower your total and LDL (bad) cholesterol, while helping to control appetite.^[5]

If you’ve never tried this stuff, try it. I once mentioned it at work and had to suffer newfound status as the stool messiah. Truly life changing.

8 - Probiotics

Probiotics have been considered of great benefit to digestive health for a long time, thanks to their ability to proliferate new, beneficial cultures of bacteria in the gut.

Whether this is true or not, a systemic review and meta-analysis of over 2,000 participants and 23 randomized controlled trials found that probiotic supplements bring about a “moderate and statistically significant reduction” of both systolic and diastolic blood pressure compared with controls.^[6]

Cortisol-fighting

As we’ve mentioned, chronically elevated cortisol can be a problem during fat-loss phases.

Cortisol is released in response to stress, but its primary function in the body is one of energy mobilization. In other words, cortisol grabs stored energy (in the form of fat or glycogen), and turns it into a form the body can use.

Obviously, that’s a good thing when you want to lose fat. And it makes sense why it’d be elevated when you’re not getting enough energy from the food you’re eating (the definition of a calorie deficit).

But when cortisol is elevated all day, every day, for months on end, you’re sure to experience negative side effects. These include insulin resistance and an inefficient immune system.

Whether you want to stave off these side effects, or are nearing the end of your diet and want to give your body a break, supplements that actively lower cortisol can do just that.

9 - Phosphatidylserine

Excellent for the brain, and for many markers of performance, phosphatidylserine is a potent stress-fighting supplement.^[7]

Its effects are impressive, but t’s anything but cheap. Scour reviews online, though, and you’ll also notice a happy side effect: it seems (anecdotally) to reduce belly fat.

For all intents and purposes, though, spot fat reduction shouldn’t be possible. Take it for improved sleep, and reduced stress. If you reduce your belly fat too, good on ya’.

10 - 5-HTP (5-hydroxytryptophan)

5-HTP doesn’t fight cortisol directly, but it’s a precursor to serotonin. I can only describe high serotonin as the “comfort food feeling”. The one you get when you’re full of mashed potatoes. It’s a happy, sleepy, cosy feeling.

If you rarely feel like that, you might not have much serotonin. 5-HTP has been shown to successfully store levels of serotonin in those with depression.^[8] Since it helps you relax and fall asleep, and given how important sleep is for recovery from hard workouts and for optimal rates of fat loss, I’ve included this here.

11 - Ashwaganda

Ashwagandha is an adaptogen, something that makes you more resilient to stress. It reduces cortisol levels, and has also been touted to boost testosterone and overall sexual health.^[9]

12 - Chelated magnesium

Magnesium deficiency is associated with a host of health issues. High blood pressure, atherosclerosis, and insulin resistance included. None of these are good, but especially avoid insulin resistance if you want to maximize nutrient uptake into muscle cells rather than fat cells.

Magnesium is also responsible for far more, though. It aids your digestion, and helps all aspects of sleep and rest. When you sleep better, your body and brain are better equipped to buffer stress.

You can find magnesium from a variety of dietary sources. These tend to be:

• Leafy greens
• Nuts
• Seeds
• Whole grains
• Legumes

Unfortunately, although the above foods are abundant in magnesium, they also tend to contain anti-nutrients. The oxalates and phytates found in these foods bind to the minerals and block their absorption.

For this reason, magnesium supplementation can be helpful.

Many magnesium supplements also suffer from absorption issues. Chelated magnesium is more absorbable. The most common, affordable chelated form of magnesium is magnesium (bis)glycinate. Oxide forms are not chelated and are often poorly absorbed. Not surprisingly, magnesium oxide tends to be found in cheaper supplements.

Longevity, cardiovascular support, and injury prevention

I’ve included a number of supplements for cardiovascular support because, if you’re older and haven’t always followed the best diet, your arteries have had plenty of time to stiffen up and begin building up plaque.

Supplements that can help with general longevity, performance, and injury prevention are also listed here.

While they won’t build muscle for you, they’ll support you in your ability to keep at this for years to come, which is ultimately what’s required if you want to reach your genetic potential.

13 - Fish oil ⭐

The omega-3 fatty acids found in fish are super healthy. While a quality omega 3 supplement can be expensive, it’s still more cost-effective (at least in the UK) to take every day than it would be to buy and eat just two portions of either wild-caught or farm-raised salmon.

There are two forms of omega-3 fatty acids you should know about, EPA and DHA. There is another, plant-based form, called ALA, which is found in flax seeds and hemp, but it’s a poor choice.

ALA needs to be converted into EPA and DHA for you to reap the benefits, but that process is inefficient. Your body successfully converts as little as 5% of the ALA you consume into a usable form.

EPA and DHA have no such issues. If you’re older and haven’t always had the best diet, high doses of fish oil can work wonders for lowering total triglycerides and bad cholesterol.^[10] It’s great for inflammation and cardiovascular health, as well as for the brain.

Fish oil

Cheaper than consuming fish twice a week, fish oil is a great option.

⚠️ Warning - this all comes with one important caveat. Fatty acids are inherently unstable and prone to oxidization (aka, becoming rancid). Rancid fats are terrible for you and will have the opposite effects of what you’re looking for.

To be safe, check for your chosen brand on the IFOS (International Fish Oil Standards) website, which independently tests batches of fish oil for quality. It’s the ‘total oxidation’ number you’ll be interested in. It should be below the quantity specified in the column to the left.

14 - Vitamin D3

Vitamin D3 won’t help you build muscle on its own. But, since those in forever-overcast climates (like the UK) are often deficient in it, a supplement can help.

Symptoms of vitamin D3 deficiency include fatigue, more frequent sickness, and depression. Plus, since vitamin D3 regulates the absorption of calcium, a severe deficiency will cause brittle bones. The last thing you want is to have hundreds of kilograms on your back and hear something snap because you didn’t take your VitD3. 🙄

Obviously, fatigue is something we want to regulate at the best of times, so it’s important to keep your D3 up.

15 - Citrus bergamot

Another cholesterol busting supplement, “multiple clinical trials have provided evidence that different forms of orally administered bergamot can reduce total cholesterol and low-density lipoprotein cholesterol.”^[11]

Other studies’ findings suggest citrus bergamot is also capable of lower triglycerides and increasing HDL (good) cholesterol. The findings in these studies were nothing to sniff at, either. Some reported decreases in LDL (bad) cholesterol of more than 33% after 30 days taking 500mg of citrus bergamot.

16 - Garlic ⭐

Aged garlic extract is extremely powerful at lowering blood pressure, with hypertensives routinely seeing decreases in systolic measurements of as much as 14.5 points after a 12-week treatment period.^[12]

Interestingly, a second study looking at the effects of different-sized doses of garlic found two capsules a day (480mg garlic containing 1.2mg S-allylcysteine) more effective than either one or four capsules a day in lowering systolic blood pressure.^[13]

A lot of garlic supplements out there boast their “high strength”, with a single capsule containing 1,000mg of aged extract or more. Given that ~500mg seems to be the most effective daily dose, I’d suggest sticking with doses of around that size.

Aged garlic extract also seems to improve blood cholesterol levels.^[14]

17 - Nattokinase

There’s not a ton of research on nattokinase, but what we do have is very promising.

Nattokinase is an enzyme found in Nattō (fermented soybeans). It is capable of breaking down fibrin, which is the sticky protein that binds platelets and red blood cells to form blood clots.

It should go without saying, but you do not want blood clots forming in your body. They’re killers. Interestingly, Nattō is naturally high in Vitamin K, making these two a natural pairing.

18 - Vitamin K2

Vitamin K2, also, has been shown to help regulate blood clotting. There is also some evidence that vitamin K can help clear out arterial plaque in those with atherosclerosis.

High doses of vitamin D3 (listed earlier) can lead to arterial calcification. It’s one of the few downsides of supplementing with it. For that reason, it’s common to see vitamin D3 supplements include K2.

19 - Beet juice

Beetroot is super high in nitrates, which your body converts into nitric oxide. Nitric oxide is a powerful vasodilator, meaning it relaxes your blood vessels, allowing a greater volume of blood to flow through them and lowering your blood pressure.

Beet juice also improved physical performance in healthy athletes.^[15] Beet juice improves blood flow, and in the study, athletes required a lower volume of oxygen during rest times after a set of back squats when they’d drunk 140mL of beet juice prior to exercise. After three minutes of rest, those who drank beet juice achieved more reps than the control group.

In other words, beet juice (and other nitric oxide-boosting supplements) can improve workout recovery time, allowing you to eke out more reps and a greater muscle building stimulus.

I’ve included beet juice here, in the longevity section, though, for its potential to reduce blood pressure.^[16]

20 - Type II collagen

There’s some evidence that collagen can support joint health, either in larger doses, by providing the necessary amino acids for repair, or in lower doses by confounding your body’s autoimmunity towards its own joints.

When you’re doing hard work in the gym, especially as you age, it only makes sense to support your joints. To stave off injuries, promote recovery, and ensure you’re able to lift safely and pain-free for a long time.^[17]

What about zinc? What about EAAs?

Sure, there’s plenty more I could have included here, but there’s a lot of information to unpack when it comes to supplements.

I’ve done my best to include everything I think is important, even if you make a reasonable effort to eat a varied, balanced diet.

When you start restricting or eliminating entire food groups, deficiencies become a far bigger possibility.

So, are you deficient?

The truth is, a varied diet based on whole, unprocessed foods will cover 99% of your bases outside what’s listed above. One very modest serving of red meat a day (about 150g of pork or lean beef mince) is enough to give you a huge chunk of your zinc, for example. Cut red meat out of your diet completely, however, and a zinc deficiency becomes likely.

If you cut out dairy completely, you’ll lack calcium. If you cut out red meat, you’ll lack iron (and the aforementioned zinc). If you cut out eggs, you’re cutting out your greatest source of choline.

When you cut entire food groups out of your diet altogether, you run the risk of deficiencies.

Most nuts, grains, seeds, and vegetables are poor sources of minerals because they contain phytates and oxalates - anti-nutrients that block the absorption of these minerals.

Spinach, for example, contains incredibly high amounts of calcium. But you’ll only absorb about 5% of it due to the oxalatic acid. Regular dairy is the best, most bioavailable source of calcium in general. But some vegetables are exceptions to the rule. Bok choi is high in calcium that’s even more bioavailable than that in dairy.

That said, nuts, grains, seeds, and vegetables can be great sources of vitamins. Vitamins are either water-soluble or fat soluble. Fat soluble vitamins are best absorbed (you guessed it) when taken with a bit of fat (one of the reasons pill-form multivitamins aren’t necessarily absorbed very efficiently).

Still, vegetarians, vegans, pescetarians, those with intolerances… any group that’s cutting out food groups will want to examine their diet closely and make mature decisions about what gaps might be there. Eating sustainably, and ethically, is wonderful. But doing so at the expense of your health is harmful, but avoidable.

Final thoughts

We’ve discussed a lot of supplements here, but you definitely don’t need all of them to make great progress. In fact, you can make great progress without any of these supplements. That said, they’ll support you in your pursuit of muscle growth by protecting you from injury, giving you an edge in performance, and making it easy to hit your goals.

References

[1] Hevia-Larraín, Victoria et al. “High-Protein Plant-Based Diet Versus a Protein-Matched Omnivorous Diet to Support Resistance Training Adaptations: A Comparison Between Habitual Vegans and Omnivores.” Sports medicine (Auckland, N.Z.) vol. 51,6 (2021): 1317-1330. PMID: 33599941.

[2] Chilibeck, Philip D et al. “Effect of creatine ingestion after exercise on muscle thickness in males and females.” Medicine and science in sports and exercise vol. 36,10 (2004): 1781-8. PMID: 15595301.

[3] Rayman, Margaret P. “Selenium and human health.” Lancet (London, England) vol. 379,9822 (2012): 1256-68. PMID: 22381456.

[4] Triggiani, Vincenzo et al. “Role of iodine, selenium and other micronutrients in thyroid function and disorders.” Endocrine, metabolic & immune disorders drug targets vol. 9,3 (2009): 277-94. PMID: 19594417.

[5] Jovanovski, Elena et al. “Effect of psyllium (Plantago ovata) fiber on LDL cholesterol and alternative lipid targets, non-HDL cholesterol and apolipoprotein B: a systematic review and meta-analysis of randomized controlled trials.” The American journal of clinical nutrition vol. 108,5 (2018): 922-932. PMID: 30239559.

[6] Qi, Dan et al. “The effect of probiotics supplementation on blood pressure: a systemic review and meta-analysis.” Lipids in health and disease vol. 19,1 79. 25 Apr. 2020. PMCID: PMC7183137.

[7] Baumeister, J et al. “Influence of phosphatidylserine on cognitive performance and cortical activity after induced stress.” Nutritional neuroscience vol. 11,3 (2008): 103-10. PMID: 18616866.

[8] Birdsall, T C. “5-Hydroxytryptophan: a clinically-effective serotonin precursor.” Alternative medicine review : a journal of clinical therapeutic vol. 3,4 (1998): 271-80. PMID: 9727088.

[9] Lopresti, Adrian L et al. “Modulation of the hypothalamic-pituitary-adrenal (HPA) axis by plants and phytonutrients: a systematic review of human trials.” Nutritional neuroscience vol. 25,8 (2022): 1704-1730. PMID: 33650944.

[10] Thusgaard, Marianne et al. “Effect of fish oil (n-3 polyunsaturated fatty acids) on plasma lipids, lipoproteins and inflammatory markers in HIV-infected patients treated with antiretroviral therapy: a randomized, double-blind, placebo-controlled study.” Scandinavian journal of infectious diseases vol. 41,10 (2009): 760-6.. PMID: 19685375.

[11] Nauman, Mirielle C, and Jeremy J Johnson. “Clinical application of bergamot (Citrus bergamia) for reducing high cholesterol and cardiovascular disease markers.” Integrative food, nutrition and metabolism vol. 6,2 (2019): 10.15761/IFNM.1000249. PMCID: PMC6497409.

[12] Ried, Karin et al. “Aged garlic extract lowers blood pressure in patients with treated but uncontrolled hypertension: a randomised controlled trial.” Maturitas vol. 67,2 (2010): 144-50. PMID: 20594781.

[13] Ried, K et al. “Aged garlic extract reduces blood pressure in hypertensives: a dose-response trial.” European journal of clinical nutrition vol. 67,1 (2013): 64-70.. PMCID: PMC3561616.

[14] Steiner, M et al. “A double-blind crossover study in moderately hypercholesterolemic men that compared the effect of aged garlic extract and placebo administration on blood lipids.” The American journal of clinical nutrition vol. 64,6 (1996): 866-70. PMID: 8942410.

[15] Garnacho-Castaño, Manuel Vicente et al. “Circulating nitrate-nitrite reduces oxygen uptake for improving resistance exercise performance after rest time in well-trained CrossFit athletes.” Scientific reports vol. 12,1 9671. 11 Jun. 2022. PMCID: PMC9188609.

[16] Bahadoran, Zahra et al. “The Nitrate-Independent Blood Pressure-Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis.” Advances in nutrition (Bethesda, Md.) vol. 8,6 830-838. 15 Nov. 2017. PMCID: PMC5683004.

[17] Barnett, M L et al. “Treatment of rheumatoid arthritis with oral type II collagen. Results of a multicenter, double-blind, placebo-controlled trial.” Arthritis and rheumatism vol. 41,2 (1998): 290-7.. PMID: 9485087.