Any relationship between dietary BCAAs and blood levels of BCAAs can therefore be influenced by many factors, including the timing of the blood samples, the BCAA content of the food, endogenous factors such as insulin which regulate BCAA metabolism and degradation, and numerous comorbid conditions (such as obesity, diabetes, renal failure, liver cirrhosis, cancer, sepsis) that influence BCAAs independently of dietary BCAA content [19]. Here, INS is linked to diabetes mellitus.