King Oyster Mushroom
2.05 mg/g ergothioneine in king trumpet fruiting bodies (dry weight)
Pleurotus eryngii fruiting bodies were measured at 2.05 mg/g of ergothioneine — the top of the 0.4–2.0 mg/g range reported for mushrooms generally. Ergothioneine is a compound the human body cannot make, and mushrooms are by far the leading dietary source.
Liang et al., Int J Med Mushrooms, 2013
HR 0.79
cardiovascular mortality per 1 SD higher plasma ergothioneine, over a median 21.4 years (Smith et al., Heart, 2020)
Lifespan extended
4–5 mg/kg/day of dietary ergothioneine extended lifespan in male mice (Katsube et al., GeroScience, 2024)
0 trials
randomized trials testing king trumpet, or ergothioneine, against a human longevity endpoint
Liang et al., Int J Med Mushrooms, 2013
A metabolomics study measured 112 plasma metabolites in 3,236 Swedish adults and followed them for a median of 21.4 years. One compound came through every stage of the analysis: ergothioneine, a sulfur-containing amino acid that humans cannot synthesize and that comes overwhelmingly from mushrooms. Higher plasma levels were associated with lower cardiovascular mortality, lower overall mortality, and lower risk of coronary disease. Smith and colleagues published the finding in Heart in 2020.[3]
King trumpet mushroom (Pleurotus eryngii) is one of the most ergothioneine-dense culinary mushrooms measured. Its fruiting bodies have been reported at 2.05 mg/g dry weight,[11] sitting at the top of the 0.4–2.0 mg/g range reported for mushrooms as a category.[12] Beelman and colleagues argued in 2020 that ergothioneine deserves consideration as a "longevity vitamin," on the grounds that mushrooms are by far its leading dietary source and that many people eat very few of them.[1]
That is a genuinely interesting chain of reasoning. It is also a chain with a link that has never been measured. This article follows it end to end and marks where it holds and where it does not. For the full king trumpet overview, see what is king trumpet mushroom: the meaty mushroom with health benefits.
Key Takeaways
- King trumpet (Pleurotus eryngii) fruiting bodies were measured at 2.05 mg/g ergothioneine (dry weight), at the top of the 0.4–2.0 mg/g range reported for mushrooms generally (Liang et al., 2013; Weigand-Heller et al., 2012)
- In the Malmö Diet and Cancer study, each 1 SD increase in plasma ergothioneine was associated with 21% lower cardiovascular mortality (HR 0.79), 14% lower overall mortality (HR 0.86), and 15% lower coronary disease risk (HR 0.85) across a median 21.4 years (Smith et al., Heart, 2020)
- Ergothioneine was the metabolite most strongly connected to a health conscious food pattern in that study — it was not ranked first among 112 metabolites as a mortality predictor, and the association is partly entangled with the rest of a healthy diet
- Ergothioneine from mushrooms is bioavailable in humans, and pure ergothioneine significantly raises plasma and whole blood levels — but no study has measured plasma ergothioneine after eating king trumpet specifically (Weigand-Heller et al., 2012; Cheah et al., 2017)
- Dietary ergothioneine at 4–5 mg/kg/day extended lifespan in male mice and rescued age-related learning and memory decline (Katsube et al., GeroScience, 2024)
- Whole blood ergothioneine declines significantly after age 60, and people with mild cognitive impairment had lower plasma levels than age-matched peers (Cheah et al., 2016)
- Bruce Ames listed ergothioneine among ten putative "longevity vitamins" in 2018 — nutrients whose shortfall causes no acute deficiency syndrome but may accelerate degenerative disease over decades (Ames, 2018)
What Smith 2020 Actually Found
This study is the single most-cited piece of evidence in the ergothioneine longevity conversation, and it is also the most frequently misreported. It is worth being precise about what was measured.
Smith and colleagues used liquid-chromatography mass spectrometry to measure 112 plasma metabolites in 3,236 participants of the population-based Malmö Diet and Cancer study, all free of cardiovascular disease and diabetes at baseline.[3] The starting question was not "which metabolite predicts death." It was narrower: the team had previously identified a health conscious food pattern associated with reduced cardiometabolic risk, and wanted to find the plasma metabolites that mark that pattern.
Of the 112 metabolites, five were associated with the food pattern after Bonferroni correction (p < 0.0004). Four of those five went on to predict at least one clinical endpoint. Ergothioneine was the metabolite most strongly connected to the food pattern, and in Cox models it was associated with lower risk on three endpoints: coronary disease (HR 0.85 per 1 SD, p = 0.01), cardiovascular mortality (HR 0.79, p = 0.002) and overall mortality (HR 0.86, p = 4e-5). Over the median 21.4-year follow-up, 603 participants developed cardiovascular disease, 362 developed diabetes, and 843 died.
What the Study Actually Tested
How Ergothioneine Came Out of a 112-Metabolite Screen
Smith and colleagues did not rank 112 metabolites against death. They screened 112 metabolites against a health conscious food pattern, kept the handful that survived correction, and then tested those against disease and mortality endpoints. Ergothioneine came through every step. The distinction matters for how much weight the finding can carry.
- 112
Plasma metabolites measured
LC-MS panel in 3,236 adults free of CVD and diabetes at baseline (Malmö Diet and Cancer study)
- 5
Associated with the healthy food pattern
Survived Bonferroni correction against the health conscious food pattern at p < 0.0004
- 4
Predicted at least one endpoint
Reached p < 0.05 for coronary disease, diabetes, cardiovascular mortality or overall mortality
- 1
Ergothioneine — strongest link to the food pattern
The metabolite most strongly connected to the HCFP, and associated with all three risk endpoints
HR 0.79
Cardiovascular mortality
p = 0.002 · per 1 SD
HR 0.86
Overall mortality
p = 4e-5 · per 1 SD
HR 0.85
Coronary disease
p = 0.01 · per 1 SD
What this does not say: ergothioneine was not crowned the single best mortality predictor out of 112 candidates — that framing appears in popular coverage but not in the paper. What the paper reports is narrower and, in one way, more awkward: ergothioneine was the metabolite most tightly bound to a healthy eating pattern. Some of the survival signal therefore travels with the rest of that diet, not necessarily with the molecule.
Source: Smith et al., Heart, 2020 [3] — Malmö Diet and Cancer study, n=3,236, median 21.4-year follow-up (603 incident CVD, 362 incident diabetes, 843 deaths). Counts and hazard ratios quoted as published; confidence intervals were not reported in the source abstract and are therefore not shown.
This matters because of a claim that circulates widely in popular coverage: that ergothioneine was "the number one predictor of mortality out of 112 metabolites." That is not what the paper reports. The 112-metabolite panel was screened against a dietary pattern, not ranked head-to-head against death. The distinction changes how much weight the result can bear.
It also surfaces the study's central confound, which the authors do not hide. Ergothioneine earned its place in the analysis precisely because it was the strongest marker of eating well. People with high plasma ergothioneine were, by construction, people whose diets scored well on a health-conscious pattern. Some of the survival advantage almost certainly belongs to the vegetables, the fish and the whole grains rather than to the molecule. The authors' own conclusion is appropriately hedged: higher ergothioneine was an independent marker of lower risk "which potentially can be induced by a specific healthy dietary intake."
What survives all of that is still notable. A 21.4-year follow-up in more than three thousand people, with consistent direction across three separate endpoints, is a durable signal. It is a strong reason to investigate ergothioneine. It is not evidence that supplementing it, or eating more of it, changes anyone's risk.
Why King Trumpet Is a Serious Ergothioneine Source
Ergothioneine is unusual among dietary antioxidants: the human body cannot make it. It has to come from food. The body maintains a dedicated transporter for it — OCTN1, encoded by the SLC22A4 gene — which absorbs it in the small intestine, reabsorbs it in the kidney, and concentrates it in tissues under high oxidative stress.[7]
Fungi are essentially the only meaningful dietary source. Beelman and colleagues describe mushrooms as "by far, the leading dietary source" of ergothioneine, with small amounts elsewhere in the food chain, most likely because soil fungi pass it to plant roots.[1]
Among mushrooms, content varies substantially by species. Liang and colleagues measured king trumpet fruiting bodies at 2.05 mg/g dry weight — and found that submerged "Hi-Ergo" mycelium reached 5.76 mg/g, while solid-state fermented products fell to 0.79–0.80 mg/g.[11] For comparison, Weigand-Heller and colleagues describe mushrooms generally as containing 0.4 to 2.0 mg/g dry weight,[12] which places king trumpet fruiting bodies at the top of the ordinary range.
A caution on rankings, though. Cross-study species comparisons are unreliable, because cultivation conditions, strain, tissue and assay method all move the number. Beelman's review reports gray oyster (Pleurotus ostreatus) at 1310 mg/kg dry weight against white button (Agaricus bisporus) at 630 mg/kg.[1] When Apparoo and colleagues screened 14 mushroom species by HPLC in 2024, shiitake (Lentinula edodes) came out highest in their panel.[8] King trumpet is reliably a strong ergothioneine source; the confident claim that it is the richest does not survive contact with the literature.
The practical point is less about winning a ranking and more about the baseline. Most Western diets contain very few mushrooms of any species, which is the observation underlying Beelman's "longevity vitamin" argument. Moving from almost no mushrooms to regular mushrooms is a far larger change in ergothioneine intake than choosing between two good mushroom species.
Does Eating King Trumpet Actually Raise Your Blood Levels?
Here is the link in the chain that most articles skip, and it deserves a direct answer: no published study has measured plasma ergothioneine in people after they ate king trumpet.
What has been shown is adjacent and genuinely supportive. Weigand-Heller and colleagues ran a randomized crossover dose-response study in ten healthy men, giving 8 g and 16 g of Agaricus bisporus mushroom powder and tracking postprandial red blood cell ergothioneine. Ergothioneine was bioavailable after consuming mushrooms.[12] Separately, Cheah and colleagues gave pure oral ergothioneine to healthy volunteers and found it "avidly absorbed and retained by the body," with significant elevations in plasma and whole blood and less than 4% urinary excretion.[13] Notably, in that same study, changes in oxidative damage and inflammation biomarkers were mostly non-significant — absorption was clear, downstream benefit was not.
There is one randomized controlled trial of king trumpet itself, and it is worth reading carefully because it is often cited for something it did not do. Kleftaki and colleagues randomized 100 metabolically unhealthy patients to three months of conventional nutritional counseling, with the intervention arm also eating a daily baked, UV-B irradiated P. eryngii snack.[4] The snack group saw regulated glucose, reduced body weight, fat mass, waist and hip circumference, significantly increased 25(OH)D2, lower LDL and SGOT, and reduced IL-6 and oxidized LDL.
Those are real, useful findings for king trumpet as a food. But that trial measured biochemical markers, vitamin D status, inflammation and oxidative stress — it did not measure ergothioneine. It cannot be used as evidence that eating king trumpet raises plasma ergothioneine, and citing it that way (as many summaries do) manufactures a link the data does not contain.
Chain of Reasoning
Four Links From King Trumpet to Longevity — and Where They Hold
The case for eating king trumpet for longevity is an argument in four steps. Read end to end it sounds seamless. Audited link by link, one step has only been demonstrated for other mushrooms, one is correlational, and the conclusion has never been tested in people at all.
- 1
King trumpet contains ergothioneine
Directly measuredFruiting bodies measured at 2.05 mg/g dry weight — at the top of the 0.4–2.0 mg/g range reported for mushrooms generally.
Liang 2013 · Weigand-Heller 2012
- 2
Eating king trumpet raises blood ergothioneine
Shown for other sources, not this speciesErgothioneine from mushrooms is bioavailable in humans, and pure ergothioneine significantly raises plasma and whole blood levels. Neither was tested with Pleurotus eryngii — the one P. eryngii trial never measured ergothioneine.
Weigand-Heller 2012 · Cheah 2017 · (not Kleftaki 2022)
- 3
Higher blood ergothioneine tracks lower mortality
Association onlyEach 1 SD higher plasma ergothioneine was associated with 21% lower cardiovascular mortality across a median 21.4 years — observational, and confounded with a broader healthy eating pattern.
Smith 2020
- 4
Therefore eating king trumpet extends human life
Never testedNo trial has raised anyone’s ergothioneine and measured a longevity outcome. The strongest experimental evidence is a mouse study in which 4–5 mg/kg/day extended lifespan.
Nothing in humans · Katsube 2024 (mice)
How to read it: a solid connector means the step was measured directly; a dashed connector means the step is inferred rather than demonstrated. Two dashed connectors in a row is the honest status of this chain. That is not a reason to avoid king trumpet — it is a reason to treat it as a nutritious food with a promising mechanism rather than a proven longevity intervention.
Sources: Liang et al., Int J Med Mushrooms, 2013 [11]; Weigand-Heller et al., Prev Med, 2012 [12]; Cheah et al., Antioxid Redox Signal, 2017 [13]; Smith et al., Heart, 2020 [3]; Katsube et al., GeroScience, 2024 [5]. Kleftaki et al., Antioxidants, 2022 [4] is cited for what it did not measure.
So the honest state of the chain is: king trumpet demonstrably contains a lot of ergothioneine; mushroom-derived ergothioneine is demonstrably absorbed by humans, though shown with a different species; higher plasma ergothioneine tracks lower mortality, though observationally and with dietary confounding; and nobody has closed the loop.
Katsube 2024: The Mouse Longevity Data
The strongest experimental evidence that ergothioneine affects aging comes from a 2024 study by Katsube and colleagues in GeroScience.[5] It is more impressive than the healthspan framing usually given to it.
Katsube's team gave male mice ergothioneine dissolved in drinking water from seven weeks of age until the end of their lives. Ingestion of 4–5 mg/kg/day "remarkably extended the lifespan" of the mice — not merely healthspan, but survival. The longevity effect was corroborated in a second organism: Caenorhabditis elegans showed increased life span and non-frailty span in the presence of ergothioneine.
The functional data is equally specific. At 88 weeks of age, ergothioneine-fed mice showed significantly smaller age-related declines in weight, fat mass, and both average and maximum movement velocity. Ergothioneine suppressed age-related increases in a panel of plasma biomarkers including chemokine ligand 9, creatinine, symmetric and asymmetric dimethylarginine, urea, quinolinic acid and kynurenine. Oral ergothioneine also rescued age-related impairment in learning and memory, apparently associated with preserved hippocampal neurogenesis and reduced TDP-43 protein aggregation.
This is a dietary supplementation experiment in aging mammals measuring the outcomes that matter most to human longevity questions: how long the animals lived, how well they moved, and how well they remembered.
The limits are the usual ones, and they are not trivial. Mice age roughly thirty times faster than humans and differ substantially in metabolism. The study used male mice only, so sex-specific effects are unknown. And a dose of 4–5 mg/kg/day in a mouse does not translate directly to a human dietary intake — nor to any quantity of king trumpet. This is a strong signal that the molecule does something in mammals. It is not a dosing recommendation.
Why Ergothioneine Levels Fall with Age
Ergothioneine is not stable across the human lifespan. Cheah and colleagues examined ergothioneine in an elderly population and found that whole blood levels decline significantly beyond 60 years of age. Within that group, participants with mild cognitive impairment had significantly lower plasma ergothioneine than age-matched subjects without it.[9] The authors suggest that ergothioneine deficiency may be a risk factor predisposing individuals to neurodegenerative disease.
Two mechanisms are plausible contributors: reduced OCTN1 transporter activity with age, lowering absorption efficiency, and a heavier oxidative stress burden consuming ergothioneine faster than diet replaces it. Both point the same direction — dietary intake plausibly matters more with age, not less.
Two cautions belong here. This is cross-sectional and correlational: lower ergothioneine in cognitively impaired people could be a consequence of illness, reduced appetite or dietary change rather than a cause of it. And declining blood levels do not by themselves establish that restoring them helps.
The "Longevity Vitamin" Designation and Its Basis
Bruce Ames proposed the "longevity vitamin" category in 2018 for nutrients required by proteins that protect against long-term damage rather than immediate survival.[2] Under his triage theory, a modest shortfall is rationed toward immediate survival functions, quietly sacrificing long-term protection. Ames reviewed evidence for ten putative longevity vitamins and listed "the fungal antioxidant ergothioneine" first among them. Ergothioneine fits because there is no acute deficiency syndrome — no beriberi equivalent — yet chronic insufficiency may accelerate degenerative processes.
Two reviews have pushed the same argument, and both frame it as an open question rather than a settled conclusion. Paul and colleagues titled their 2022 review "Ergothioneine: A Stress Vitamin with Antiaging, Vascular, and Neuroprotective Roles?" — noting that they had proposed vitamin status back in 2010 and that the designation is "gaining momentum."[6] Tian and colleagues asked in 2023 whether ergothioneine is "an underrecognised dietary micronutrient required for healthy ageing?"[7]
The question marks are load-bearing and are frequently dropped when these titles are quoted. The transporter argument is suggestive — organisms rarely maintain dedicated, selective transporters for compounds with no function — but it is not decisive. Tian's own review notes that genetic knockout of SLC22A4 is "not lethal," though it does increase susceptibility to oxidative stress. Ergothioneine looks important. It has not been shown to be essential in the way that word is normally used in nutrition.
Neuronal Senescence: The Newest Anti-Aging Angle
Cellular senescence — where damaged cells stop dividing but linger, secreting inflammatory signals that age their neighbors — is one of the more compelling frameworks in aging biology. Apparoo and colleagues extended the ergothioneine story into it in 2024.[8]
The study first screened 14 mushroom species by HPLC to identify the highest ergothioneine content. Shiitake (Lentinula edodes), not king trumpet, topped that panel and was the species carried forward into the experiments. The team then tested ethanolic extract of that ergothioneine-rich mushroom, alongside an equimolar concentration of pure ergothioneine, against t-BHP-induced senescence in HT22 cells — a mouse hippocampal neuronal line. They measured radical scavenging by DPPH and ABTS, cell viability by MTT, and senescence-associated markers and ROS staining.
The results support ergothioneine-rich mushroom extract acting against neuronal senescence, offering a mechanism beyond simple radical scavenging. Two caveats are essential: this is in vitro work in an immortalized cell line, which is a long way from a living brain, and the species that produced the effect was shiitake. It is a mechanistic result about ergothioneine-rich mushrooms as a class, not a demonstration about king trumpet.
There is one animal result specific to this species. Liang and colleagues fed P. eryngii basidiocarp powder to C57BL/6J mice in an amyloid-beta-induced Alzheimer's model for six weeks.[10] The mushroom delayed brain atrophy, and low, medium and high doses all significantly reduced escape latency (49–85%) and distance (53–69%) in reference memory tasks, with no adverse effects on body weight, serum biochemistry, or liver and kidney histopathology. The authors attribute the effect to the mushroom's antioxidant profile, which includes ergothioneine alongside adenosine and polyphenols — so this is a whole-food result, not an ergothioneine result.
What the Evidence Supports, and What It Does Not
Supported. King trumpet is a dense dietary source of ergothioneine. Ergothioneine from mushrooms is absorbed by humans through a dedicated transporter. Higher plasma ergothioneine is associated with lower cardiovascular and overall mortality across two decades of follow-up. Blood levels fall after 60. In mice, dietary ergothioneine extends lifespan and preserves memory and mobility. A UV-treated king trumpet snack improved glucose, body composition, vitamin D status and inflammatory markers in a three-month randomized trial.
Not supported. That ergothioneine was the top mortality predictor among 112 metabolites. That the Kleftaki trial showed king trumpet raises plasma ergothioneine. That mushrooms supply a specific percentage — 95% or any other figure — of dietary ergothioneine in the US. That king trumpet is definitively the richest ergothioneine source. That eating king trumpet has been shown to extend human life.
Unknown. Whether eating king trumpet meaningfully raises plasma ergothioneine, and by how much. Whether raising plasma ergothioneine by any means changes disease or mortality risk. What intake, if any, would be needed. How much of the Malmö association is the molecule and how much is the surrounding diet.
None of this is a reason to skip king trumpet. It is a genuinely nutritious, high-protein, high-fiber mushroom with a demonstrated metabolic trial behind it and an unusually well-characterized bioactive compound. It is a reason to eat it as food rather than to treat it as a longevity drug.
This article is educational and is not medical advice. Ergothioneine has no established recommended intake, and no mushroom or supplement is a substitute for medical care. If you are managing cardiovascular disease, diabetes, cognitive symptoms, or are pregnant or taking prescription medication, talk to your doctor before making significant dietary changes or starting supplements.
The Bottom Line
King trumpet mushroom is one of the most ergothioneine-dense culinary mushrooms, with fruiting bodies measured at 2.05 mg/g dry weight (Liang et al., 2013), at the top of the 0.4–2.0 mg/g range reported for mushrooms generally. In the Malmö Diet and Cancer study, each standard-deviation increase in plasma ergothioneine was associated with 21% lower cardiovascular mortality and 14% lower overall mortality across a median 21.4 years — though ergothioneine entered that analysis as the metabolite most strongly tied to a health conscious food pattern, so the signal is entangled with diet quality as a whole (Smith et al., Heart, 2020). Ergothioneine from mushrooms is bioavailable in humans (Weigand-Heller et al., 2012) and pure ergothioneine raises plasma levels (Cheah et al., 2017), but no study has measured plasma ergothioneine after eating king trumpet specifically — the one P. eryngii randomized trial reported metabolic and inflammatory benefits without measuring it (Kleftaki et al., 2022). In mice, 4–5 mg/kg/day extended lifespan and rescued memory decline (Katsube et al., 2024). The chain from king trumpet on the plate to a longer human life is mechanistically coherent and observationally supported, but it has never been closed by a trial.
Frequently Asked Questions
Sources & References
- 1RTHM-01170·Beelman, Robert B et al. (2020). “Is ergothioneine a 'longevity vitamin' limited in the American diet?.” Journal of nutritional science.Study breakdown →PubMed →↩
- 2RTHM-00936·Ames, Bruce N (2018). “Prolonging healthy aging: Longevity vitamins and proteins..” Proceedings of the National Academy of Sciences of the United States of America.Study breakdown →PubMed →↩
- 3RTHM-00655·Smith, Einar et al. (2020). “Ergothioneine is associated with reduced mortality and decreased risk of cardiovascular disease..” Heart (British Cardiac Society).Study breakdown →PubMed →↩
- 4RTHM-00771·Kleftaki, Stamatia-Angeliki et al. (2022). “A Randomized Controlled Trial on Pleurotus eryngii Mushrooms with Antioxidant Compounds and Vitamin D2 in Managing Metabolic Disorders..” Antioxidants (Basel.Study breakdown →PubMed →↩
- 5RTHM-00884·Katsube, Makoto et al. (2024). “Ergothioneine promotes longevity and healthy aging in male mice..” GeroScience.Study breakdown →PubMed →↩
- 6RTHM-01594·Paul, Bindu D (2022). “Ergothioneine: A Stress Vitamin with Antiaging, Vascular, and Neuroprotective Roles?.” Antioxidants & redox signaling.Study breakdown →PubMed →↩
- 7RTHM-01805·Tian, Xiaoying et al. (2023). “Ergothioneine: an underrecognised dietary micronutrient required for healthy ageing?.” The British journal of nutrition.Study breakdown →PubMed →↩
- 8RTHM-01850·Apparoo, Yasaaswini et al. (2024). “Potential role of ergothioneine rich mushroom as anti-aging candidate through elimination of neuronal senescent cells..” Brain research.Study breakdown →PubMed →↩
- 9RTHM-00420·Cheah, Irwin K et al. (2016). “Ergothioneine levels in an elderly population decrease with age and incidence of cognitive decline; a risk factor for neurodegeneration?.” Biochemical and biophysical research communications.Study breakdown →PubMed →↩
- 10RTHM-01237·Liang, Chih-Hung et al. (2020). “Effect of the King Oyster Culinary-Medicinal Mushroom Pleurotus eryngii (Agaricomycetes) Basidiocarps Powder to Ameliorate Memory and Learning Deficit in Ability in Aβ-Induced Alzheimer's Disease C57BL/6J Mice Model..” International journal of medicinal mushrooms.Study breakdown →PubMed →↩
- 11RTHM-00538·Liang, Chih-Hung et al. (2013). “Antioxidant properties of fruiting bodies, mycelia, and fermented products of the culinary-medicinal king oyster mushroom, Pleurotus eryngii (higher Basidiomycetes), with high ergothioneine content..” International journal of medicinal mushrooms.Study breakdown →PubMed →↩
- 12RTHM-00270·Weigand-Heller, AuBrei J et al. (2012). “The bioavailability of ergothioneine from mushrooms (Agaricus bisporus) and the acute effects on antioxidant capacity and biomarkers of inflammation..” Preventive medicine.Study breakdown →PubMed →↩
- 13RTHM-00856·Cheah, Irwin K et al. (2017). “Administration of Pure Ergothioneine to Healthy Human Subjects: Uptake, Metabolism, and Effects on Biomarkers of Oxidative Damage and Inflammation..” Antioxidants & redox signaling.Study breakdown →PubMed →↩