Dr. Campos, it is so discouraging to see that you disparage the ketogenic diet based on your assumption that it is very heavy in poor quality processed meats. No diet that relies on processed foods can be viewed as “healthy”. Become better informed by getting up to speed with what Jeff Volek, RD, PhD, calls a “well-formulated ketogenic diet.” Also, learn more about the potential of the diet to slow cancer progression (my specialty). You owe it to your patients who are depending on you for advice. Present them with facts, not opinions.
• High-protein ketogenic diet — This method is a variant of the SKD. In a high-protein diet, you increase the ratio of protein consumption to 10 percent and reduce your healthy fat consumption by 10 percent. In a study involving obese men that tried this method, researchers noted that it helped reduce their hunger and lowered their food intake significantly, resulting in weight loss.11
Advent of the tumescent technique in 1987 has allowed for safe contouring in ambulatory single session liposuction under regional or general anaesthesia. Safety and aesthetic issues define MegaLiposuction to be in Volume in litres of more than 10% of Body weight in Kgs. 870 cases of liposuction were performed between September 2000 and August 2008. In (65%) cases, the total volume of aspirate was greater then 5 liters. (Range: 5 to 25 liters). In 24% cases, the large volume liposuction was combined with a limited or a total block lipectomy. Regional anaesthesia with conscious sedation was preferred except where liposuction was for above the subcostal region (the Upper Trunk, Lateral Chest, Back, Gynaecomastia, Breast, Arms and Face) or when the patient so desired. Tumescent infiltration with Lactated ringer, adrenalin, triamcinalone and hyalase was made in all cases. This approach has clinically shown less tissue edema in the post operative period than when the conventional physiological saline was being used in place of Ringer Lactate. The amount injected varied from 1,000 ml to 12,500 ml depending on the size, site and area. Local anesthetic was included only to the terminal portion of the tumescent mixture while infiltrating the sub-costal regions, or when above costal region was combined with below costal region being anaesthetized with Spinal Anaesthesia. The aspirate was restricted to the unstained white / yellow fat and the amount of fat aspirated did not have any bearing to the amount of solution infiltrated. There was no major complication. Blood transfusion was given only on one occasion when the patient had been on aspirin and had also received Low Molecular weight Heparin intra-operative. The hospital stay ranged from 8 to 24 hours for liposuction as well as for liposuction with a lipectomy. Serous discharge from access sites, sero-sanguinous fluid accumulation requiring drainage were necessitated in less than 10% cases. Minor re-contouring touch ups were requested in 5% cases. Early ambulation was encouraged for mobilization of third space fluid shifts to expedite recovery and to prevent deep vein thrombosis. More than 10% patients were operated on for Liposuction of other areas, after a gap of 7 days to 6 months. Meticulous perioperative monitoring of systemic functions ensures safety in tumescent megaliposuction for the obese and rewarding results can be achieved in a single sitting.

There are theoretically no restrictions on where the ketogenic diet might be used, and it can cost less than modern anticonvulsants. However, fasting and dietary changes are affected by religious and cultural issues. A culture where food is often prepared by grandparents or hired help means more people must be educated about the diet. When families dine together, sharing the same meal, it can be difficult to separate the child's meal. In many countries, food labelling is not mandatory so calculating the proportions of fat, protein and carbohydrate is difficult. In some countries, it may be hard to find sugar-free forms of medicines and supplements, to purchase an accurate electronic scale, or to afford MCT oils.[54]
Metabolic syndrome is a multiplex risk factor that arises from insulin resistance accompanying abnormal adipose deposition and function. [4] It is a risk factor for coronary heart disease, as well as diabetes, fatty liver, and several cancers. The clinical manifestations of this syndrome may include hypertension, hyperglycemia, hypertriglyceridemia, reduced high-density lipoprotein cholesterol (HDL-C), and abdominal obesity. (See Prognosis, Workup, Treatment, and Medication.)
Insulin is a hormone that lets your body use or store sugar as fuel. Ketogenic diets make you burn through this fuel quickly, so you don’t need to store it. This means your body needs -- and makes -- less insulin. Those lower levels may help protect you against some kinds of cancer or even slow the growth of cancer cells. More research is needed on this, though.
Fleury, N., Geldenhuys, S., & Gorman, S. (2016, October 11). Sun exposure and its effects on human health: Mechanisms through which sun exposure could reduce the risk of developing obesity and cardiometabolic dysfunction. International Journal of Environmental Research and Public Health, 13(10), 999. Retrieved from https://www.mdpi.com/1660-4601/13/10/999/htm
On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When insulin levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off. This is great if you’re trying to lose weight, but there are also other less obvious benefits, such as less hunger and a steady supply of energy. This may help keep you alert and focused.
On a metabolic syndrome diet treatment plan, you should avoid fake and processed foods, artificial sweeteners, diet sodas, trans fats, refined carbohydrates and sugar, and alcohol. Foods to eat include fish and omega-3 foods, vegetables, fruits, legumes, and whole grains. In addition, the following supplements are beneficial for metabolic health: ginseng, berberine, bitter melon, holy basil, spirulina and maca root.

Meat products make up a big part of the keto diet, but experts stress the importance of choosing quality. "Since the keto diet is based a lot on animal proteins, it's important to buy organic poultry and grass-fed, organic beef," says Aimee Aristotelous, RD. "Not only do organic selections help with limiting environmental toxins, but grass-fed options of red meats even change the composition of fats." The result, she explains, is that your body is able to better absorb those healthy fats.
• Reducing appetite — Constant hunger can cause you to consume more calories than you can burn, which can eventually lead to weight gain. A ketogenic diet can help you avoid this problem because reducing carbohydrate consumption can reduce hunger symptoms. In one study, participants who were given a low-carbohydrate diet had reduced appetites, helping them lose weight easier.2

The Modified Atkins diet and modified ketogenic diet (sometimes called 'modified ketogenic therapy') use a high proportion of fats and a strict control of carbohydrates. These are often considered more flexible than the classical or MCT ketogenic diets, as more protein can be eaten, and approximate portion sizes may be used in place of weighed recipes.

A: It's generally recommended that only 5 percent of your daily diet is allocated to carbohydrates because if you consume more than that, your body gets thrown off ketosis. However, this is only for SKD, or the standard ketogenic diet. If you're an athlete or a bodybuilder, you can consume more carbs without affecting ketosis by following a targeted ketogenic diet (TKD) or a cyclic ketogenic diet (CKD).
Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >
One of the most common reasons people call our office is to get information about liposuction prices. The average cost of liposuction is a difficult question to answer because there are many factors that can affect the price of liposuction. For example, stomach liposuction cost will be very different then the cost of total body liposuction and traditional liposuction costs will be different then laser liposuction cost. This blog helps to answer some of the questions about liposuction costs for women and men, but really the best way to find out how much liposuction will cost for you would be to come in for a complimentary consultation.
Naturally sweet recipes in Zero Belly Diet were the key to test panelist Isabel Fiolek’s dramatic 13-pound weight loss. “I happen to have a big sugar addiction,” Isabel admits, “But the recipes have been surprisingly satisfying for my sweet tooth.” Isabel also made dramatic health strides: A checkup after her six weeks on Zero Belly Diet revealed she’d dropped her total cholesterol by 25 percent and her blood glucose level by 10 percent.
Spending more time in the kitchen can help you shed belly fat, as long as you’re cooking with the right foods, according to one 2017 study. After analyzing data from more than 11,000 men and women, UK researchers found that people who ate more than five homemade meals per week were 28 percent less likely to have a high body mass index, and 24 percent less likely to carry too much body fat than those whole only downed three meals at home.

• Reducing appetite — Constant hunger can cause you to consume more calories than you can burn, which can eventually lead to weight gain. A ketogenic diet can help you avoid this problem because reducing carbohydrate consumption can reduce hunger symptoms. In one study, participants who were given a low-carbohydrate diet had reduced appetites, helping them lose weight easier.2
The ketogenic diet achieved national media exposure in the US in October 1994, when NBC's Dateline television programme reported the case of Charlie Abrahams, son of Hollywood producer Jim Abrahams. The two-year-old suffered from epilepsy that had remained uncontrolled by mainstream and alternative therapies. Abrahams discovered a reference to the ketogenic diet in an epilepsy guide for parents and brought Charlie to John M. Freeman at Johns Hopkins Hospital, which had continued to offer the therapy. Under the diet, Charlie's epilepsy was rapidly controlled and his developmental progress resumed. This inspired Abrahams to create the Charlie Foundation to promote the diet and fund research.[10] A multicentre prospective study began in 1994, the results were presented to the American Epilepsy Society in 1996 and were published[17] in 1998. There followed an explosion of scientific interest in the diet. In 1997, Abrahams produced a TV movie, ...First Do No Harm, starring Meryl Streep, in which a young boy's intractable epilepsy is successfully treated by the ketogenic diet.[1]
The Johns Hopkins Hospital protocol for initiating the ketogenic diet has been widely adopted.[43] It involves a consultation with the patient and their caregivers and, later, a short hospital admission.[19] Because of the risk of complications during ketogenic diet initiation, most centres begin the diet under close medical supervision in the hospital.[9]
^ Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358–63. doi:10.1542/peds.102.6.1358. PMID 9832569. https://web.archive.org/web/20040629224858/http://www.hopkinsmedicine.org/press/1998/DECEMBER/981207.HTM Lay summary]—JHMI Office of Communications and Public Affairs. Updated 7 December 1998. Cited 6 March 2008.
Small pockets of fat can be removed from the abdomen, hips, thighs, knees, flanks, chest, chin and neck. The best candidates for tumescent liposuction include those patients who maintain a healthy diet and exercise routine, but who still struggle with stubborn fat in common problem areas. Tumescent liposuction is not designed to remove large volumes of fat and should not be used to jumpstart a weight loss regimen. It is also not approved for removing or reducing the appearance of cellulite.
In 1977, Fisher and Fischer reviewed 245 cases with the planotome instrument for treating cellulite in the lateral trochanteric (hip-thigh) areas. There was a 4.9 per cent incidence of seromas, despite incision-wound suction catheters and compression dressings; 2.0 per cent of the cases presented pseudo-cyst formation that required removal of the capsule (cyst) through a wider incision (+ 5.0 mm) and the use of the panotome.[16][17]
A clinical trial at Great Ormond Street Hospital in 2008, and other studies since then, showed that the diet significantly reduced the number of seizures in a proportion of children whose seizures did not respond well to AEDs. After three months, around 4 in 10 (38%) children who started the diet had the number of their seizures reduced by over half, and were able to reduce their medication. Although not all children had better seizure control, some had other benefits such as increased alertness, awareness and responsiveness.
Sure, ketchup is tasty, but it’s also a serious saboteur when it comes your weight loss efforts. Ketchup is loaded with sugar — up to four grams per tablespoon — and bears little nutritional resemblance to the fruit from which it’s derived. Luckily, swapping out your ketchup for salsa can help you shave off that belly fat fast. Fresh tomatoes, like those used in salsa, are loaded with lycopene, which a study conducted at China Medical University in Taiwan links to reductions in both overall fat and waist circumference. If you like your salsa spicy, all the better; the capsaicin in hot peppers, like jalapeños and chipotles, can boost your metabolism, too.
Although it is not essential to suction the sub-dermal layer of fat in large-volume lipoaspiration, the author concurs with the Massive All Layer Liposuction Mall[24] concept as it helps reduce the thickness and consistency of the superficial fat and enhances skin retraction. This however is better indicated in cases where there is only a limited correction for body contouring rather than volume reduction [Figure 9].
Among the most common undesirable outcomes of liposuction are 1) incomplete liposuction with very little evidence that liposuction was actually done, 2) excessive liposuction producing an unnatural or disfigured appearance, 3)irregular and uneven results with unsightly depressions in the skin, and 4) large scars that reveal that the patient has had liposuction. Caveat emptor (Buyer beware).

An easy way to determine if you have too much belly fat is to measure yourself at home. Take a measuring tape and wrap it around your bare stomach, directly above your hip bone. The tape should be snug but not too tight. For women, a measurement of 35 inches or more indicates an unhealthy amount of belly fat. For men, a measurement of 40 inches or more indicates an unhealthy measure.
During this procedure, Dr. Schlessinger will first mark the areas to be suctioned. At that time, you will then be taken to the state-certified ambulatory surgical center and a trained nurse will numb the areas to be treated. This will take about an hour or two, but during this time you will be able to watch TV or listen to music at your leisure. After this time, you will have a short time to relax and let the numbing take effect.
Optimally, the management approach results in weight loss based on a healthy diet and regular physical activity, which includes a combination of aerobic activity and resistance training, reinforced with behavioral therapy. Metformin, an insulin sensitizer, or a thiazolidinedione (eg, rosiglitazone, pioglitazone) may be useful. Weight loss of ≈ 7% may be sufficient to reverse the syndrome, but if not, each feature of the syndrome should be managed to achieve recommended targets; available drug treatment is very effective.
Similarly, several studies have demonstrated that up to half or more of patients undergoing PD have metabolic syndrome, and at least one study has demonstrated a significant increase in the prevalence with initiation of PD therapy. The only study that made a head-to-head comparison concluded that metabolic syndrome was significantly more prevalent in patients undergoing PD compared with in-center HD. These observations have raised concerns that PD therapy itself may contribute to the development of metabolic syndrome. However, the prevalence of metabolic syndrome in patients undergoing in-center HD in the only study with head-to-head comparison was substantially lower than in other studies. Moreover, there are two challenges with the diagnosis of metabolic syndrome in patients undergoing PD. First, the intraperitoneal instillation of dialysate with PD results in an increase in waist circumference, an important component for the diagnosis of metabolic syndrome. Second, there is continuous systemic absorption of glucose from intraperitoneal dialysate, and hence, patients undergoing PD are never in a postabsorptive state. This results in overestimation of fasting glucose and lipid parameters. Finally, the results from studies examining the association of metabolic syndrome with cardiovascular events or all-cause mortality have been inconsistent. This is not surprising because the individual components of metabolic syndrome themselves do not portend a higher risk for death or cardiovascular events in patients with ESRD, including among those undergoing PD.
The biggest shifts in your daily habits will be how you food shop and how you cook, and recipes that are ketogenic need to be followed rather than just low-carb. You will require the healthy fats in order to get into ketosis and have enough energy without the carbs. And you will be considerably more energetic and healthier when cooking your own keto-friendly food rather than buying supposedly keto foods off the shelf.
The World Health Organization (WHO) was the first to publish an internationally accepted definition for metabolic syndrome in 1998, but the criteria that have received the most widespread acceptance and use in the United States are those established in 2002 as guidelines in the third report of the National Cholesterol Education Program expert panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III).
I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.

Team work, a judicious and an appropriate selection of a surgically and medically fit patient are essential factors resulting in an overall reduction in the duration of the surgery to within three hours [Figure 17]. When a large volume liposuction is planned for an obese patient, it is advisable to stage this procedure in 2 to 3 session. It is preferable to perform liposuction on either front of the torso in supine position or the back in prone position. This avoids the need to change the position, or turning the patient over, half way through the operation, thereby taking additional time. This also reduces the patients' exposure to the rigorous physiological demands of this procedure.
The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain function. However, if little carbohydrate remains in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures.[1] Around half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet.[2] Some evidence indicates that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.[1] Potential side effects may include constipation, high cholesterol, growth slowing, acidosis, and kidney stones.[3]

In the first week, many people report headaches, mental fogginess, dizziness, and aggravation. Most of the time, this is the result of your electrolytes being flushed out, as ketosis has a diuretic effect. Make sure you drink plenty of water and keep your sodium intake up.6One of the fathers of keto, Dr. Phinney, shows that electrolyte levels (especially sodium) can become unbalanced with low carb intake.


Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they might make it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.
Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?
A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed, 24% occasionally prescribed the diet as a last resort, 24% had only prescribed the diet in a few rare cases, and 16% had never prescribed the diet. Several possible explanations exist for this gap between evidence and clinical practice.[34] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[31]
If you are considering liposuction, the first step is to become as educated as possible about the procedure. Next, schedule a consultation with a board-certified plastic surgeon with extensive experience performing liposuction. Be sure to choose a surgeon certified by the American Board of Plastic Surgery, as this level of certification ensures that the surgeon has undergone extensive training and is highly esteemed by his or her colleagues.
Some people on a keto or low carb diet choose to count total carbs instead of net carbs. This makes it more difficult to fit in more leafy greens and low carb vegetables (which are filled with fiber), so you should only try that if you don’t get results with a net carb method. And, start with reducing sugar alcohols and low carb treats before deciding to do a “total carbs” method.
Your parents weren’t kidding about how important veggies are for a healthy body. What they probably didn’t tell you, however, was that snacking on veggies is also one of the easiest ways to shed unwanted belly fat, too. According to a study published in the Journal of the Academy of Nutrition and Dietetics, opting for non-starchy veggies, like cauliflower, broccoli, and cucumber, as snacks helped overweight kids shed 17 percent of their visceral fat while improving their insulin sensitivity over a five-year period. Think snacking on veggies will leave you hungry? The 20 Most Filling Fruits and Veggies will have your belly satisfied in no time.
Physical inactivity is a predictor of CVD events and related mortality. Many components of metabolic syndrome are associated with a sedentary lifestyle, including increased adipose tissue (predominantly central); reduced HDL cholesterol; and a trend toward increased triglycerides, blood pressure, and glucose in the genetically susceptible. Compared with individuals who watched television or videos or used their computers for less than one hour daily, those who carried out these behaviors for greater than four hours daily have a twofold increased risk of metabolic syndrome.[27]
Hi Barb, That can definitely be it. Losing when you are close to goal can be more difficult. It could also be that your body’s healthy weight is a little higher than what you’d like – which doesn’t mean you can’t lose, but makes it more difficult. If just eating Keto foods isn’t working, double check the macros for your weight and see if the amount you’re eating needs to be adjusted. You’ll find more help and support in our support group here.

Over the past several years, liposuction has become one of the most sought after procedures for improving the appearance of our bodies. Not only has in office liposuction proved to be a very effective technique for achieving amazing results, it also has a long track record of safety and laser liposuction risks are few.  Due to our busy lifestyles, minimally invasive liposuction has gained increased attention because of the decreased risks and much more rapid recovery.  Today’s best liposuction technique involves the use of tumescent “numbing” fluid.  Once the tissues are numbed, our surgeons will perform the liposuction.  The liposuction procedure can be simply removing the fat with a suction device or it can branch into different techniques including the use of laser liposuction (such as SmartLipo), ultrasound liposuction (such as Vaser Liposuction) or radiofrequency devices (such as the BodyTite system). In each of these branches, the fat is suctioned out after the areas are treated with energy.  At Imagen Body Sculpting & Cosmetic Center, we may also use other devices such as power assisted liposuction (PALS Liposuction or Power Lipo) to achieve even better results.
Short-term results for the LGIT indicate that at one month approximately half of the patients experience a greater than 50% reduction in seizure frequency, with overall figures approaching that of the ketogenic diet. The data (coming from one centre's experience with 76 children up to the year 2009) also indicate fewer side effects than the ketogenic diet and that it is better tolerated, with more palatable meals.[18][50]
Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often, no initial fast is used (fasting increases the risk of acidosis, hypoglycaemia, and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size, but alter the ketogenic ratio from 2:1 to 4:1.[9]
Get enough calcium. Adults typically need around 1,000 milligrams of calcium every day to help maintain muscle and nerve function, and it's necessary for healthy bones and teeth.[21] But calcium may also help prevent the body from storing visceral fat in the abdomen. Though studies have not shown a drastic change in weight due to increased calcium intake, researchers suggest that it may have a small effect in some people. Calcium requires vitamin D to be absorbed into the body; therefore, be sure to get enough vitamin D as well.[22] Sources of calcium include:[23]

In my book "Fat for Fuel," I sought to educate readers about the benefits of using healthy fats as a catalyst to bring about improved mitochondrial function, thus allowing you to achieve better health. In essence, the book answers WHY it is important for you to consume healthy fats. However, you still need to know HOW to prepare the right ketogenic foods in an appetizing way.


Metabolic syndrome promotes coronary heart disease through several mechanisms. It increases the thrombogenicity of circulating blood, in part by raising plasminogen activator type 1 and adipokine levels, and it causes endothelial dysfunction. [14] Metabolic syndrome may also increase cardiovascular risks by increasing arterial stiffness. [15] Additional mechanisms include oxidative stress, [16] which has been associated with numerous components of metabolic syndrome. [17]
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