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Trial registration Keywords: Metabolic syndrome, Very-low-calorie-diet, L-carnitine, Weight loss Introduction Metabolic syndrome (MetS) is defined as a cluster of cardiovascular risk factors (i.e., abdominal obesity, hyperinsulinaemia, atherogenic dyslipidemia, hypertension, hypercogauability) that increase the risk of developing co-existing coronary heart disease (CHD) and type 2 diabetes [1]