In articles #2 through #5 of the Leptin Diet Weight Loss Challenge, I describe various additional problems that are common in stubborn weight loss. Each one of these problems stresses out your liver and contributes to the accumulation of fat in your liver. Therefore, improvement in any of these areas--especially to the point of engaging consistent weight loss--helps gradually unclog your liver over time. This is reflected not only by weight loss, but also in trend improvements in your waistline, blood sugar, triglycerides, and LDL cholesterol.

But why does fasting work where regular diets fail? Simply put, during fasting, the body switches from burning sugar to burning fat for energy. Free fatty acids (FFA) are oxidized for energy and FFA synthesis is reduced (body is burning fat and not making it). The decrease in triacylglycerol synthesis results in a decrease in VLDL (Very Low Density Lipoprotein) secretion from the liver which results in lowered LDL.
Indirect calorimetry is a more practical and widely used protocol. There are many different devices (handheld and otherwise), but none of them involve the substantial equipment or time investment that direct calorimetry requires. Indirect calorimetry measures the volume of oxygen that you consume compared to the volume of carbon dioxide that you expire while your body is at rest. Based on the numbers, a formula is used to calculate the number of calories you burn when your body is at rest.
That was the bad news. But the good news is that it’s obviously still possible to lose weight anyway; after all, plenty of people do. Understanding the hormonal adaptations that make weight loss harder can help you make a plan for combating them, and at the very least the knowledge can help you be compassionate to your body: it’s only trying to keep you alive!
Hi Joanna, 1st at all congrats for the blog, it’s awesome! I have a doubt that I can’t find the asnswer of. My cortisol Salvia results show that my cortisol is very high the whole day and my DHEA low. I like to workout (strength training) and I read that working out empty stomach makes the cortisol higher. Instead, having carbs before going to gym helps to control the cortisol when working out. Is that true? If I workout at 6am, would that also work? Thanks in advance 🙁
What I have just read sounds very similar to me. I have been on pain killers for back pain . Also roaccutante for really bad acne for the last ten years . I recently bought a book the fatty liver you can reverse it . I was amazing to read and such an eye opener . I have followed the recommended diet for six days and have lost six pounds all ready . After I have an ultrasound and was diagnosed with fatty liver I knew I had to get pro active. Reading this has given me more drive to stick to the diet .
Need a snack? A handful of almonds, pecans, pistachios, walnuts, or other nuts is a tasty treat. They are high in monounsaturated fat, which lowers LDL "bad" cholesterol but leaves HDL "good" cholesterol alone. Studies show that people who eat about an ounce of nuts a day are less likely to get heart disease. Keep the portion small, so you limit fat and calories. And avoid those covered in sugar, chocolate, or a lot of salt.
The major point the team makes – which they say the public doesn’t really understand – is that exercise in and of itself doesn’t really lead to weight loss. It may lead to a number of excellent health effects, but weight loss – if you’re not also restricting calories – isn’t one of them. “Regular physical activity reduces the risk of developing cardiovascular disease, type 2 diabetes, dementia and some cancers by at least 30%,” they write. “However, physical activity does not promote weight loss.”
Many basic metabolism mysteries remain. It’s not fully known why two people with the same size and body composition have different metabolic rates. They also don’t know why people can have different metabolic responses to weight gain (where some people with obesity develop insulin resistance and diabetes, for example, and others don’t). They don’t know why certain ethnic groups — African Americans, South Asians — have a higher risk of developing metabolic disorders like diabetes, and why people with diabetes have a higher cardiovascular disease risk.
The blood levels of BOHB that can be achieved with the salts or ester formulations are in the 1-3 mM range, similar to what can be achieved with a well-formulated ketogenic diet in insulin sensitive humans, but well below levels achieved after a 4-7 days of total fasting (Owen 1969). In more insulin resistant humans, the ester formulation may deliver higher blood levels than a sustainable diet (as opposed to short term fasting). For example, in the Virta IUH Study of over 200 patients with type 2 diabetes, blood ketone mean levels were 0.6 mM at 10 weeks and 0.4 mM after 1 year.

— CAUTION: If you are pregnant, nursing, taking any medications, or being treated for any medical condition, consult your doctor before use. Discontinue use and consult your doctor if any adverse reactions occur. CAUTION: Do not exceed recommended dose. This product is not intended to be used with a standard diet. For best results, should be taken in conjunction with a healthy ketogenic diet and regular exercise program. Individual results may vary. Pregnant or nursing mothers and individuals with a known medical condition should consult a physician before using this or any dietary supplement. Use only as directed. Some people might experience slight intolerance to the product. Please use caution if you have allergies or sensitivities to any of the listed ingredients. If you are pregnant, nursing, or have a medical condition, please consult with your physician before use. If you have any questions about consuming this dietary supplement, consult with your health care professional before using. If you use prescription drugs or over-the-counter medications, are unaware of your current medical condition or have a pre-existing medical condition(s), consult with your health care professional before using. Discontinue use immediately if you experience any adverse symptoms or reactions while taking this product. Discontinue use 2 weeks prior to surgery. Do not use if your health status is unknown. Do not use if safety seal is damaged or missing. Keep out of reach of children and pets. Store in a cool, dry place, away from heat moisture. For questions please contact Codeage through Buyer-Seller Messaging. CAUTION: Do not exceed recommended dose. Pregnant or nursing mothers, children under 18, and individuals with a known medical condition should consult a physician before using this or any diet supplement. —
If your doctor recommends statins or other cholesterol-lowering medications, but all means take them. “But don’t stop there,” recommends Pritikin cardiolologist Ronald Scheib, MD, FACC. “Give yourself the best chance of living heart-attack-free by adopting a healthy lifestyle like Pritikin. If you can, come to Pritikin for education in everything from fitness to cooking classes. In doing so, you’re not only lowering your cholesterol, you’re helping eliminate virtually all environmental factors that harm your heart.”

Diabetes Forum App Find support, ask questions and share your experiences with 295,123 members of the diabetes community. Recipe App Delicious diabetes recipes, updated every Monday. Filter recipes by carbs, calories and time to cook. Low Carb Program Join 250,000 people on the award-winning education program for people with type 2 diabetes, prediabetes and obesity. Hypo Awareness Program The first comprehensive, free and open to all online step-by-step guide to improving hypo awareness. DiabetesPA Your diabetes personal assistant. Monitor every aspect of your diabetes. Simple, practical, free.
Since having fewer sweets helps you keep off excess pounds, you'll also be more protected against type 2 diabetes. But eating less sugar also lowers your risk of the disease in another way: "A diet with lots of fast-digesting carbohydrates, like sugar, requires the pancreas to release lots of insulin, meal after meal, day after day," explains Dr. Ludwig. "That excessive demand may overtax insulin-producing cells, causing them to malfunction, eventually leading to diabetes."
But not eating many carbs throughout the challenge made me very tired every afternoon. I'm a solid five-days-a-week exerciser-usually a mix of running and bodyweight exercises. I'm not a morning person, so I typically work out when I get home from work. During these 10 days, though, I could barely keep my eyes open long enough to make dinner and shower. My reps took more effort and my runs felt harder than usual. The dietary changes I made for the challenge may have cut my carbohydrate or caloric intake too low, explained Spano. To prevent this, "replace sugar-containing foods with naturally sweet foods and increase total carbohydrates from starches and grains," she suggests.

The liver is the largest solid organ in the body; and is also considered a gland because among its many functions, it makes and secretes bile. The liver is located in the upper right portion of the abdomen protected by the rib cage. It has two main lobes that are made up of tiny lobules. The liver cells have two different sources of blood supply. The hepatic artery supplies oxygen rich blood that is pumped from the heart, while the portal vein supplies nutrients from the intestine and the spleen.
Over the years I’ve learned that depriving yourself of certain foods or food groups is the worst thing you can do to your mind and body. I used to cut out carbs. I couldn’t maintain a healthy weight. I was miserable. Once I started eating everything in moderation, my weight stabilized; I was happier; and I stopped feeling like I was missing out on things.
Urine test for diabetes: What you need to know Urine tests for diabetes check for protein, ketones, and glucose. They are frequently used for diagnosing and monitoring diabetes, and to assess people who are experiencing symptoms, such as fatigue or nausea. Depending on the results, recommendations may be given about medication or lifestyle changes that could help. Read now
SOURCES: National Heart, Lung and Blood Institute: "High Blood Cholesterol: What You Need to Know." National Cholesterol Education Program of the National Heart, Lung and Blood Institute: "Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)." Mayo Clinic: "Dietary fats: Know which types to choose." Antonio Gotto, MD, the Stephen and Suzanne Weiss Dean, Weill Medical College of Cornell University, New York, N.Y. National Heart, Lung and Blood Institute: "Introduction to the TLC Diet." WebMD.com: "Therapeutic Lifestyle Changes (TLC) diet for high cholesterol." Reuters Health: "Moderate Exercise Can Improve Women's Cholesterol." Harvard HealthBeat: "What to Do About High Cholesterol." National Heart, Lung and Blood Institute: "Cholesterol-Lowering Medications and You." American Heart Association: "Side Effects of Cholesterol-Lowering Drugs."
Hello! We have a section on this in our weight loss plateau post—it’s fine to use them, but be careful if you have any digestive issues as a result of them, and make sure they’re not interfering with your weight loss goals. “In addition to potentially contributing too many calories, sources of fat like coconut oil (including concentrated supplements) contain medium chain triglycerides (MCT). These cannot be stored in body fat, meaning that whatever is consumed has to be promptly burned for energy. So you’re adding these sources on top of your dietary fat consumption for satiety, this type of fat takes priority. Often times people fall into the trap of adding supplements of coconut oil or straight up MCT oil and it ends up adding extra calories. Yes, it may raise your ketones a bit, but the overall cost may impact your weight loss.”
Many doctors are highly skeptical that people can significantly lower their cholesterol through dietary changes and heightened exercise. But an increasing number of them are coming around to the view that such lifestyle changes may well have powerful effects, and a recent study of a high-fiber, soy-intensive diet did show impressive results in lowering LDL.
The word metabolism is used these days in so many ways these days.  People complain of a “slow metabolism” or they say something they did “slowed down their metabolism.”  Scientists use the term basal metabolic rate (BMR) – which sounds really complicated but it’s essentially the energy you need to blink and swallow.  Our bodies actually need energy just to be at rest.  In other words, your lungs need energy to be lungs; your kidneys need energy to be kidneys; even your bones need energy to be bones.  If you add all these live tissues up you get metabolism, or BMR. An easy way to picture metabolism is the energy you need to blink and swallow.  After that, as soon as you swing your legs out of bed, or walk up a flight of stairs, you need MORE energy than your BMR.
No-sugar diet plan: What you need to know Eliminating sugar from the diet can help prevent weight gain, diabetes, heart disease, and other problems. Whether cutting sugar out of the diet completely or simply cutting back, we have eight important tips for following a no-sugar diet, and some advice about fruits and other natural foods that contain sugar. Read now
Kicking a sugar habit is challenging—even for the most strong-willed among us. See, research has found that sugar tricks your brain into wanting more and more of it. But there's good news. A little sweetness is OK—emphasis on little. The American Heart Association recommends no more than six teaspoons of added sugar a day for women. Also okay: the sugar found in whole foods like fruits and veggies, says Kimber Stanhope, PhD, a nutritional biologist at the University of California, Davis. "These naturally occurring sugars come packaged with good-for-you vitamins, minerals, fiber, and other nutrients." But if you can dial back your intake of added sugar, she says, you'll start to rack up some amazing health benefits. In fact, the perks of the less-sugar life are so good, we think they'll motivate you to try to cut it (mostly) out.

Have you considered investing in a metabolism test for weight loss or increased exercise performance? Metabolic testing is widely available at health clubs, universities, and some medical clinics, often for a substantial fee. Before you invest, it's important to understand how a metabolism test works and how the data is used to lose weight or improve your level of fitness.


The rest of this article is devoted to strategies that speed up the process of unclogging your liver and improving your metabolism. These strategies are especially relevant to someone who isn't making progress, even when implementing solutions given in earlier articles. These strategies can be employed by anyone to help speed up the process. The basic solutions I gave in previous Leptin Diet Weight Loss Challenge articles, along with consistent exercise, provide the foundation for getting your liver to work better. If you are engaging the weight loss process while employing them, then your liver is improving.
Being overweight tends to increase your chances for high cholesterol and heart disease. This could be because individuals who are overweight often consume foods high in saturated fat and cholesterol, which increase your cholesterol levels. Obesity could also lead to high cholesterol because obese people usually do not get the exercise necessary for a healthy cholesterol level. High cholesterol levels caused by poor diet and exercise can be easily remedied with a more active and healthy lifestyle. Other times, cholesterol does not have anything to do with weight; it can affect those who are a regular weight. In this case, the condition is usually treated with medication.

People claiming huge benefits of these supplements – despite the lack of solid scientific support – may sometimes have a financial reason to believe in the supplements. Some of these products are sold under a multi-level marketing arrangement, where sales people are paid based on commission. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.
At enrolment, BMI had a strong negative correlation with the HRQL physical component score (rs = −0.48, p = 0.004) and was also negatively correlated with four SF-36 health domains, including physical functioning (r = −0.54, p = 0.001), general health (r = −0.40, p = 0.02), social functioning (r = −0.40, p = 0.02), and bodily pain (r = −0.40, p = 0.03). Compared with population norms,23 both the PCS and MCS were significantly decreased (p = 0.0003 and p = 0.0007, respectively) (fig 4A, B) and seven of the eight SF-36 health domains scored significantly lower in patients with chronic liver disease at t = 0. After the initial three month intervention, PCS and MCS significantly increased (p<0.0001 and p = 0.004, respectively) (fig 4A, B) and all but one health domain were comparable with population norms. In patients who maintained weight at t = 15, both PCS and MCS remained significantly higher than enrolment scores (p = 0.005 and p = 0.003, respectively). In contrast, in patients who regained weight, PCS and MCS scores decreased after 15 months and were no different to those at enrolment (p = 0.12 and p = 0.06, respectively) (fig 4A, B). Although mean PCS score was higher at t = 0 in patients who maintained weight, this did not reach statistical significance (p = 0.10). There was no association between fibrosis score and quality of life in patients with chronic liver disease.
That was the bad news. But the good news is that it’s obviously still possible to lose weight anyway; after all, plenty of people do. Understanding the hormonal adaptations that make weight loss harder can help you make a plan for combating them, and at the very least the knowledge can help you be compassionate to your body: it’s only trying to keep you alive!
Statins do not eliminate the above artery killers, but healthy living plans like the Pritikin Program can. When you exercise daily and eat well – an abundance of whole foods like fruits, vegetables, and whole grains, and very little salt, fat, sugar, and refined (“white”) carbohydrates – the following benefits happen, demonstrated in more than 100 peer-reviewed studies on the Pritikin Program:
Ignore color changes that occur after 15 seconds. The color blocks on the chart indicate a negative result or varying degrees of positive – trace, moderate, or large. Dark purple signifies the highest level of ketones (acetoacetate) present in your urine. Studies have suggested that urine testing for ketosis is most reliable when performed in the early morning and late evening after dinner.2,11
Canadian researchers report that dieters with the most organochlorines (pollutants from pesticides, which are stored in fat cells) experience a greater than normal dip in metabolism as they lose weight, perhaps because the toxins interfere with the energy-burning process. Other research hints that pesticides can trigger weight gain. Always choose organic when buying peaches, apples, bell peppers, celery, nectarines, strawberries, cherries, lettuce, imported grapes, and pears; non-organic versions tend to have the highest levels of pesticides. But going organic is just the first step. Here are 23 more ways to eat clean.

"Most people I have worked with don't benefit from VO2 max testing," he says, explaining that the test can be discouraging if a client thinks they are in better shape than they are. "I don't like delivering discouraging news, so I only do VO2 max if either someone is completely lost, very stubborn and apparently unfit (to give them objective data), or very fit and wants to know their numbers."
Unfortunately, your liver is expected to deal with this problem with both hands tied behind its back. For example, the excess leptin production from white adipose tissue causes a depression in its companion hormone, adiponectin. Low adiponectin in turn causes insulin resistance in your liver, which raises your blood sugar and simultaneously converts sugar to fat in your liver. Now your liver cannot process carbohydrates properly, resulting in easy weight gain or weight regain from eating carbohydrates. Having a fatty liver elevates the risk for type 2 diabetes by 500 percent3.
You’re hitting all your macros, working out regularly, and drinking your BHB religiously, but how do you truly know whether you’re in ketosis? Ketone strips are a good way to determine whether your body has transitioned to fat-burning mode. It varies by individual, but in general, it will take 2 to 7 days for your body to achieve ketosis, depending on what you’re eating, your body type, and your activity level.
Reducing the amount of sugar in your diet may make you eat less food overall, promoting weight loss. When you eat simple carbohydrates, such as candy, soda or doughnuts, your pancreas creates insulin, a hormone that processes the food into blood sugar and moves it to your body's cells for energy use. If you eat these foods excessively, your pancreas must produce a large amount of insulin at once, prompting your body to start storing fat. The insulin surge then causes your blood sugar levels to drop quickly, leaving you feeling tired and hungry again.

Blood samples for measurement of liver enzymes, cholesterol, triglycerides, glucose, and insulin were obtained after an overnight fast at months 0, 3, and 15. Routine biochemical tests were performed using a Hitachi 747-100 analyser (Roche, Australia). Circulating insulin was determined using the Tosoh AIA600 analyser two site immunoenzymometric assay (Tosoh Medics, San Francisco, California, USA) with a coefficient of variation of 4–5%. Insulin resistance was determined using the homeostasis model of assessment (HOMA)19 with an upper threshold of 1.64.20
In the Type 2 Diabetes Reversal program, we correct the insulin resistance which is the root cause of type 2 diabetes. Our patients are able to get off the oral diabetes medications and insulin injections. Our patient are able to get their blood sugar level under control, reversing the course the disease and get off their oral diabetes medications and insulin injection.
Until there is more definitive information on the necessary blood levels and the differing proportions of BOHB an AcAc to optimize cellular and organ functions, it will be difficult to specify the dosing and duration of supplemental ketones. However for fuel use, and very likely for exercise performance as well, sustained blood levels of BOHB in the range of 0.5 mM to 1.0 mM are likely to be required. This is achieved physiologically by an estimated ketone production of 50-100 grams per day in a keto-adapted human.
Over several weeks, I did largely phase out the roast chicken on my own. I also cut out shrimp and squid, which are high in dietary cholesterol. The secret was adding multiple terrific dishes to the weekly cycle. There was a Turkish eggplant recipe, and white beans with escarole and tomato. Foods with high soluble fiber content are especially useful in drawing cholesterol from the blood. Oatmeal (the steelcut kind at health-food stores), unrefined (not pearled) barley, recently ground flaxseed, roasted soybeans, cannellini and other beans, eggplant, whole-wheat pasta and Brussels sprouts all helped. So did the cholesterol-lowering butter substitute Benecol (another option is Take Control).
We studied 35 nonsmoking, centrally obese Caucasian men with metabolic syndrome (15). None had diabetes, the apoE2/E2 or E4/E4 genotype, macroproteinuria, creatinemia (>120 μmol/l), hypothyroidism, or abnormal liver enzymes or consumed >30 g alcohol/day. None reported cardiovascular disease or taking agents affecting lipid metabolism. The study was approved by the Royal Perth Hospital Ethics Committee. Seven subjects had participated previously in a pilot study of the effect of weight loss on LDL apoB-100 kinetics (6).

In people with cirrhosis and end-stage liver disease, medications may be required to control the amount of protein absorbed in the diet. The liver affected by cirrhosis may not be able to metabolize the waste products, resulting in elevated blood ammonia levels and hepatic encephalopathy (lethargy, confusion, coma). Low sodium diet and water pills (diuretics) may be required to minimize water retention.
Over the years I’ve learned that depriving yourself of certain foods or food groups is the worst thing you can do to your mind and body. I used to cut out carbs. I couldn’t maintain a healthy weight. I was miserable. Once I started eating everything in moderation, my weight stabilized; I was happier; and I stopped feeling like I was missing out on things.

Blood glucose concentrations are decreased during both exogenous and endogenous ketosis, although by different mechanisms. During endogenous ketosis, dietary carbohydrate deficit is the underlying cause of low blood glucose, along with reduced hepatic gluconeogenesis and increased ketone production (Cahill et al., 1966). With exogenous ketosis, carbohydrate stores are plentiful, yet ketones appear to lower blood glucose through limiting hepatic gluconeogenesis and increasing peripheral glucose uptake (Mikkelsen et al., 2015). One clinical use of the ketogenic diet is to improve blood glucose control, yet the elevated blood FFA may increase the risk of heart failure (Holloway et al., 2009). Thus, the ability of exogenous ketones to lower blood glucose without elevating blood FFA concentrations could deliver the desired effect of the diet, whilst also decreasing a potential risk.
Now that you know how many calories you eat each day, it's time to increase your metabolic rate. You're not going to rev up your metabolism by eating a huge calorie-filled breakfast or snacking more often. You're also not going to fill up on metabolism-boosting foods or sip on energy drinks or special teas. You're going to keep your diet exactly the same and increase metabolism with movement. 
Her clients have had similar success. One woman, for instance, has gone from around 170 pounds to 140 pounds since April without making any initial dietary changes. She’s started to gravitate towards more keto foods over time, but still eats her favorite high-carb treats. As for exercise? Her routine consists of a couple of walks each week, Heverly says.
From 140kg to 93kg , 24 weeks , I am still rehabbing a serious knee injury but I’m motivated and consistent , I’ve been in a real bad place in the last 2 years but this has changed me as a person , if I can do it , you can to ! If you ever need help or a chat message me ! I know how it feels and what it takes ! #fitness#transformation#24weeks#weightloss#motivation
Twenty seven patients had hepatic steatosis in association with chronic hepatitis C and 11 of these patients were included in an earlier report describing the initial response to a three month weight reduction programme.11 Data from these patients were included in this study to monitor longer term outcomes. All patients with chronic HCV were ineligible for, or non-responders to, current antiviral treatment. Sixteen patients with non-HCV obesity related steatosis were included. Ten of these 16 patients had a clinical and histological diagnosis of NAFLD. In another four non-HCV patients, steatosis was present in association with another non-steatogenic primary liver disease (inactive hepatitis B, n = 2; nitrofurantoin induced autoimmune chronic active hepatitis, n = 1; and primary biliary cirrhosis, n = 1). In the remaining two patients, one had been treated for pituitary Cushing’s disease and another had previously received tamoxifen therapy for breast cancer which had been ceased for six months. This patient cohort reflects the increasingly common finding of overweight and steatosis in association with another liver disease. When steatosis was present with hepatocyte ballooning, Mallory’s hyaline or subsinusoidal fibrosis in the acini, patients were subclassified as non-alcoholic steatohepatitis (NASH).17

My metabolic rate was what he’d have predicted for someone my age, height, sex, and weight. In other words, I didn’t have a “slow metabolism.” I had burned the equivalent of 2,330 calories per day in the chamber, including during sleep, and most of those calories (more than 1,400) were from my resting energy expenditure. My biomarkers — my heart rate, cholesterol levels, blood pressure — were all excellent, suggesting no heightened disease risk leftover from my overweight years.
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