This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
The patient is prepared circumferentially in the torso and the lower extremity as these can be treated without repeated pepping and repositioning. The patient's skin is painted with 5/10 percent Povidone Iodine solution while he/she stands next to a sterile draped operating table. Upon completion of the skin preparation, the patient lies on the table and is sedated or is given regional or general anaesthesia as required.
While many of our patients perform SmartLipo in conjunction with the tumescent liposuction that has been Dr. Schlessinger's hallmark treatment for more than 15 years, there are many patients who choose to undergo simple tumescent liposuction. This offers cost savings over the SmartLipo method, but there is also a bit less fat obtained when the SmartLipo isn't performed alongside the tumescent method.
Advocates for the diet recommend that it be seriously considered after two medications have failed, as the chance of other drugs succeeding is only 10%.[9][31][32] The diet can be considered earlier for some epilepsy and genetic syndromes where it has shown particular usefulness. These include Dravet syndrome, infantile spasms, myoclonic-astatic epilepsy, and tuberous sclerosis complex.[9][33]
Eat more fruits and vegetables. According to the 2015-2020 Dietary Guidelines, a person on a 2,000-calorie-per-day diet should eat 2.5 cups of vegetables and 2 cups of fruit a day. This amount will vary depending on how many calories you need. Be sure to choose a variety of fruits and vegetables. Different fruits and vegetables have different amounts and types of nutrients.
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.)
Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[46]
Blood transfusion was given only on one occasion when patient had been on aspirin and had also received Low Molecular weight Heparin intra-operative. Liposuction volumes between 5 and 25 liters (mean of 15.5 liters) were aspirated. Weight reduction 6 months post surgery at the patient's follow-up varied from 1 to 25 kg, with an average of 9.5 kg. 4% to 10% of preop body weight[21] Table 1.
There’s a reason everyone harps on about protein: Not only does it help keep you full, but it’s also responsible for repairing the tiny tears caused by strength training in your muscles. This helps them grow bigger and stronger, nudging out body fat in the process. As a general rule of thumb, aim to get at least 70 grams of protein throughout the day, says Dr. Cheskin. (These high-protein foods can help you reach that goal.)
I’m discouraged to see that nowhere in the article nor in the comments is there a mention of a diet’s best fit to genetics. Consider if someone is an APOE E2 carrier and/or has certain polymorphisms of the APO5 gene. These are quite rare in Okinawa but much more prevalent in the USA (12% of the population). According to a number of well-designed studies, these genetic characteristics point to a higher fat, lower carbohydrate diet as beneficial and even a “moderate” carb diet as problematic.

Hi Stacey, I can’t give medical advice and definitely recommend following your doctor’s recommendations. You can ask him/her if low carb would be better suited for you. Also, you may want to double check with him/her if the kidney concern was related to high protein, because that is a common misconception about keto – it is not a high protein diet/lifestyle.


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Hi Stacey, I can’t give medical advice and definitely recommend following your doctor’s recommendations. You can ask him/her if low carb would be better suited for you. Also, you may want to double check with him/her if the kidney concern was related to high protein, because that is a common misconception about keto – it is not a high protein diet/lifestyle.
Avocados are a double-whammy to belly fat. First, they’re packed with heart-healthy monounsaturated fats that dim your hunger switches; a study in Nutrition Journal found that participants who ate half a fresh avocado with lunch reported a 40 percent decreased desire to eat for hours afterwards. Second, healthy fats like the unsaturated fats found in avocados seem to prevent the storage of belly fat.
PAL technique is based on power assisted reciprocating movements of the cannulae. The advantage being, the surgeon is not fatigued with rapid to and fro movements of cannulae and can concentrate on refinement. It also allows the use of finer cannulae and the results are better. Some tough tissues like in Gynecomastia are relatively easily suctioned and Liposuction in female breast, (where UAL may have unproven potential for thermal damage to mammary gland) can also be managed.
When Johns Hopkins researchers compared the effects on the heart of losing weight through a low-carbohydrate diet versus a low-fat diet for six months—each containing the same amount of calories—those on a low-carb diet lost an average of 10 pounds more than those on a low-fat diet—28.9 pounds versus 18.7 pounds. An extra benefit of the low-carb diet is that it produced a higher quality of weight loss, Stewart says. With weight loss, fat is reduced, but there is also often a loss of lean tissue (muscle), which is not desirable. On both diets, there was a loss of about 2 to 3 pounds of good lean tissue along with the fat, which means that the fat loss percentage was much higher on the low-carb diet.
Three awesome essential oils for weight loss are grapefruit, cinnamon and ginger. Grapefruit essential oil actually works with your body in activating enzymes that help your body break down brown body fat. Cinnamon oil has been shown time and time again to help regulate blood glucose levels and something in your body called GTF, glucose tolerance factor. For that reason, cinnamon oil is also fantastic for anybody with diabetes. (19, 20)
Instead of satisfying your sweet tooth with some refined sugar, turn to berries and enjoy a slimmer waistline in no time. Berries are loaded with antioxidants, which can help reduce inflammation throughout the body, and research from the University of Michigan reveals that rats given a cherry-rich diet shaved off a significant proportion of their belly fat when compared to a control group. Berries like strawberries, raspberries, blueberries, and blackberries are also loaded with resveratrol, an antioxidant pigment that has been linked to reductions in belly fat and a reduced risk of dementia, to boot.
Too much fat at the waist . Although obesity in general raises your risk of metabolic syndrome, excess belly fat (being “apple-shaped”) is the riskiest kind of fat, defined as more than 40 inches around the waist for men, or more than 35 inches for women. Ask your doctor about different measurements for your ethnicity, Ndumele says. “Individuals of Asian descent are thought to have an increased risk at a lower threshold of belly fat, for example.”

Since diet sodas contain artificial sweeteners as well as other unhealthy ingredients, you don’t want to touch these lethal soft drinks. Studies show that the consumption of diet soda is associated with significantly greater risks of select incident metabolic syndrome components and type 2 diabetes. According to one 2009 study, daily consumption of diet soda was associated with a 36 percent greater risk of metabolic syndrome and a 67 percent greater risk of having type 2 diabetes! (5)
In part, keto diet weight loss is a real thing because high-fat, low-carb diets can both help diminish hunger and boost weight loss through their hormonal effects. As described above, when we eat very little foods that supply us with carbohydrates, we release less insulin. With lower insulin levels, the body doesn’t store extra energy in the form of fat for later use, and instead is able to reach into existing fat stores for energy.
There is debate regarding whether obesity or insulin resistance is the cause of the metabolic syndrome or if they are consequences of a more far-reaching metabolic derangement. A number of markers of systemic inflammation, including C-reactive protein, are often increased, as are fibrinogen, interleukin 6, tumor necrosis factor-alpha (TNF-α), and others. Some have pointed to a variety of causes, including increased uric acid levels caused by dietary fructose.[18][19][20]
Liposuction has become exceedingly popular due to its remarkable ability to correct a common problem: areas of excess fat that are resistant to diet and exercise. Healthy, fit men and women can reshape and refine their trouble spots and attain the shape they desire through liposuction. In Omaha, many people have entrusted the board-certified plastic surgeons at Aesthetic Surgical Images to sculpt their bodies and enhance their confidence through this procedure.
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The metabolic syndrome is the name of a cluster of risk factors that, when they appear together, dramatically raise your risk of heart disease, heart failure, stroke and diabetes, as well as other non-cardiovascular conditions. Like smoking, it’s one of the strongest predictors of heart disease. “Nearly one in three Americans have metabolic syndrome. Many people don’t recognize that they have the condition and underestimate the risks it presents,” says Chiadi E. Ndumele, M.D., M.H.S. , cardiologist at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease. “Understanding that you have metabolic syndrome in the first place can help motivate you to make the needed changes.” 

Many Plastic surgeons are still apprehensive about the physiology of large-volume liposuction and patients being exposed to prolonged procedures, anaesthesia, fluid shifts, and infusion of high doses of epinephrine and Lignocaine. The super-wet and tumescent techniques used under regional anaesthesia permits local anaesthesia of the skin and subcutaneous tissues by direct infiltration. Large volumes of a lactated Ringer's solution with epinephrine and the limited use of dilute anaesthetic solutions produce tumescence and firmness of targeted areas. Dilution of lignocaine and epinephrine diminishes and delays their peak plasma concentrations reducing potential toxicity.


Target organ damage occurs through multiple mechanisms in metabolic syndrome. The individual diseases leading to metabolic syndrome produce adverse clinical consequences. For example, hypertension in metabolic syndrome causes left ventricular hypertrophy, progressive peripheral arterial disease, and renal dysfunction. [12] However, the cumulative risk for metabolic syndrome appears to cause microvascular dysfunction, which further amplifies insulin resistance and promotes hypertension. [13]
After increasing water intake and replacing electrolytes, it should relieve most all symptoms of Keto Flu. For an average person that is starting a ketogenic diet, eating 20-30g of net carbs a day, the entire adaptation process will take about 4-5 days. My advice is to cut your carbs to fewer than 15g to ensure that you are well on your way into ketosis within one week. If you are experiencing any more keto flu symptoms, double check your electrolyte intake and adjust.
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.
This procedure has become one of the most commonly performed cosmetic procedures. At Aesthetic Surgical Images, you can rest assured that our entire staff of caring professionals will treat you with personalized attention. In your initial consultation, one of our plastic surgeons will discuss your goals, address any concerns and even help you visualize realistic results using a state-of-the-art computer imaging system. Learn more about this procedure by reviewing our list of Frequently Asked Questions.
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]
Liposuction evolved from work in the late 1960s from surgeons in Europe using techniques to cut away fat, which were limited to regions without many blood vessels due to the amount of bleeding the technique caused.[18] In the mid-1970s Arpad and Giorgio Fischer created the technique of using a blunt cannula linked to suction; they used it only to remove fat on the outer thighs.[20] Illouz and Fournier extended the Fischers' work to the whole body, which they were able to use by using different sized cannulae.[18] Illouz later developed the "wet" technique in which the fat tissue was injected with saline and hyaluronidase, which helped dissolve tissue holding the fat, prior to suctioning.[18] Lidocaine was also added as a local anesthetic.[18] Fournier also advocated using compression after the operation, and travelled and lectured to spread the technique.[18] The Europeans had performed the procedures under general anesthesia; in the 1980s American dermatologists pioneered techniques allowing only local anesthetics to be used.[18] Jeffrey Klein published a method that became known as "tumescent" in which a large volume of very dilute lidocaine, along with epinephrine to help control bleeding via vasoconstriction, and sodium bicarbonate as a buffering agent.[18]
Stop treating your kitchen like an all-night diner and you’ll stop seeing those unwanted pounds piling onto your frame, too. The results of a study published in Cell Metabolism found that mice who only had access to food during an eight-hour period stayed slim over the course of the study, while those who ate the same number of calories over a 16-hour period gained significantly more weight, particularly around their middle. When you’re finished with dinner at night, shut the fridge and don’t look back until morning — your belly will thank you. When you do head back to the kitchen in the A.M., make sure the best healthy kitchen staples for cooking are there waiting for you.
• Cyclic ketogenic diet (CKD) — Whereas TKD is focused on fitness enthusiasts, CKD is focused more on athletes and bodybuilders. In CKD, you cycle between a normal ketogenic diet, and a short period of high carb consumption or "re-feeds."8 The idea here is to take advantage of the carbohydrates to replenish the glycogen lost from your muscles during athletic activity or working out.9
Anyone with metabolic syndrome should make every attempt to reduce their body weight to within 20% of their "ideal" body weight (calculated for age and height), and to incorporate aerobic exercise (at least 20 minutes) into their daily lifestyle. With vigorous efforts to reduce weight and increase exercise, metabolic syndrome can be reversed, and the risk for cardiovascular complications can be substantially improved.
• Standard ketogenic diet (SKD) — SKD is the type I typically recommend for most people, because it is very effective. It focuses on high consumption of healthy fats: As I explain in my book, "Fat for Fuel," you should aim for having 70 to 85 percent of your total daily calories to come from healthy fats. For your protein intake, the general rule of thumb is to follow the formula of 1 gram of protein for every kilogram of your lean body mass.
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In a way, moderate-intensity physical activity is that "magic pill" a lot of people are looking for, because the health benefits go beyond keeping your waistline trim: Not only can it reduce your risk of cancer, stroke, diabetes and heart attacks, but studies have shown that physical activity can significantly improve the moods of patients with major depressive disorders.
Ultrasound-assisted liposuction (known as “ultrasonic”) is a technique used on areas where a greater amount of dense fat resides. It’s a dual process using ultrasound and suction. First, ultrasound waves transmit energy through a special device aimed to help loosen and melt the fat. This liquid is then suctioned out using a cannula. UAL liposuction is commonly used on men seeking a higher level of muscular definition.  You may hear this type of liposuction referred to as hi-def liposuction or VASER® Lipo, or simply Vaser hi-def.

Jeffery Klein, now at San Juan Capistrano, California, initially described the tumescent technique for lipo-aspirations in June of 1986 and the first article describing this technique was published in the January of 1987.[11] Ever since, Lipoaspirations and fluid managements have added a greater safety dimension. Ultrasonic liposuction was developed by Italian surgeon, Michael Zocchi[12] in 1996
A small Feb. 20, 2017, study looked at the impact of a six-week ketogenic diet on physical fitness and body composition in 42 healthy adults. The study, published in the journal Nutrition & Metabolism, found a mildly negative impact on physical performance in terms of endurance capacity, peak power and faster exhaustion. Overall, researchers concluded, “Our findings lead us to assume that a [ketogenic diet] does not impact physical fitness in a clinically relevant manner that would impair activities of daily living and aerobic training.” The “significant” weight loss of about 4.4 pounds, on average, did not affect muscle mass or function.
Although you do want to increase your walking over time, this doesn’t necessarily mean that you have to be working your way up to a more intensive form of cardio like swimming or running. “Moving on to new exercises is not something someone should feel they have to do unless their goals change and a new exercise is needed to support those goals,” says Gagliardi. “Walking alone can be progressed by changing the distance, speed, terrain, and by adding intervals.”
A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[20] and followed-up by a report published in 2001.[21] As with most studies of the ketogenic diet, no control group (patients who did not receive the treatment) was used. The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction, and 3% were seizure-free.[Note 7] At 12 months, 55% were still on the diet, 23% had a good response, 20% had an excellent response, and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive, or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three, and four years was 39%, 20%, and 12%, respectively. During this period, the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction, and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free, but had had an excellent response.[21][22]

Keto flu symptoms and side effects can include feeling tired, having difficulty sleeping, digestive issues like constipation, weakness during workouts, being moody, losing libido and having bad breath. Fortunately, these side effects don’t affect everyone and often only last for 1–2 weeks. (And yes, you CAN build muscle on keto.) Overall, symptoms go away as your body adjusts to being in ketosis.


Excess abdominal fat leads to excess free fatty acids in the portal vein, increasing fat accumulation in the liver. Fat also accumulates in muscle cells. Insulin resistance develops, with hyperinsulinemia. Glucose metabolism is impaired, and dyslipidemias and hypertension develop. Serum uric acid levels are typically elevated (increasing risk of gout), and a prothrombotic state (with increased levels of fibrinogen and plasminogen activator inhibitor I) and an inflammatory state develop.
Reduced hunger. Many people experience a marked reduction in hunger on a keto diet. This may be caused by an increased ability of the body to be fueled by its fat stores. Many people feel great when they eat just once or twice a day, and may automatically end up doing a form of intermittent fasting. This saves time and money, while also speeding up weight loss.
Keto is not hard to follow at all. See, this is why I took my diet and nutrition into my own hands. I have PCOS and the ketogenic diet has worked wonders for me. I’m finally pregnant at the age of 32 and after 11 years of marriage because the ketogenic diet made me lose over 100 lbs and brought my insulin resistance under control. I feel better than I’ve ever felt. Sometimes doctors don’t seem to know as much as they should, or as much as they assume they do, and that’s pretty disturbing. Just like they’re still using the old school and very inaccurate BMI charts that are just pure bs. I’ll just take care of myself outside of certain situations involving illness or injury. I’m doing great on my own.

• Standard ketogenic diet (SKD) — SKD is the type I typically recommend for most people, because it is very effective. It focuses on high consumption of healthy fats: As I explain in my book, "Fat for Fuel," you should aim for having 70 to 85 percent of your total daily calories to come from healthy fats. For your protein intake, the general rule of thumb is to follow the formula of 1 gram of protein for every kilogram of your lean body mass.
A recent systemic review and meta-analysis of randomized controlled trials comparing the long-term effects (greater than 1 year) of dietary interventions on weight loss showed no sound evidence for recommending low-fat diets. In fact, low-carbohydrate diets led to significantly greater weight loss compared to low-fat interventions. It was observed that a carbohydrate-restricted diet is better than a low-fat diet for retaining an individual’s BMR. In other words, the quality of calories consumed may affect the number of calories burned. BMR dropped by more than 400 kcal/day on a low-fat diet when compared to a very low-carb diet.
This is a wealth of information. My husband and I are starting the keto diet tomorrow and I knew nothing about it. When I sat down to look up information about it, I found this. Thank you! This is everything I need to know in one place. We are not as healthy as we’d like to be and I am optimistic this will help us obtain our goals, along with an exercise plan.
For weight loss, today's keto diets are the descendants of low-carb diets like the Atkins diet, which peaked in popularity in the early 2000s. Both types of diets reject carbs in favor of meatier meals. There is no single blueprint for the keto diet, but plans usually call for eating fewer than 50 grams of carbohydrates a day. (Wheat bread contains about 16 grams of carbohydrates per ounce, according to the USDA.) Celebrity adherents to the diet include Halle Berry and Kourtney Kardashian.
The ketogenic diet is not a benign, holistic, or natural treatment for epilepsy; as with any serious medical therapy, complications may result.[28] These are generally less severe and less frequent than with anticonvulsant medication or surgery.[28] Common but easily treatable short-term side effects include constipation, low-grade acidosis, and hypoglycaemia if an initial fast is undertaken. Raised levels of lipids in the blood affect up to 60% of children[38] and cholesterol levels may increase by around 30%.[28] This can be treated by changes to the fat content of the diet, such as from saturated fats towards polyunsaturated fats, and if persistent, by lowering the ketogenic ratio.[38] Supplements are necessary to counter the dietary deficiency of many micronutrients.[18]
Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions.[19] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[18]
There are many ways in which epilepsy occurs. Examples of pathological physiology include: unusual excitatory connections within the neuronal network of the brain; abnormal neuron structure leading to altered current flow; decreased inhibitory neurotransmitter synthesis; ineffective receptors for inhibitory neurotransmitters; insufficient breakdown of excitatory neurotransmitters leading to excess; immature synapse development; and impaired function of ionic channels.[7]
The exact mechanisms of the complex pathways of metabolic syndrome are under investigation. The pathophysiology is very complex and has been only partially elucidated. Most patients are older, obese, sedentary, and have a degree of insulin resistance. Stress can also be a contributing factor. The most important risk factors are diet (particularly sugar-sweetened beverage consumption),[6] genetics,[7][8][9][10] aging, sedentary behavior[11] or low physical activity,[12][13] disrupted chronobiology/sleep,[14] mood disorders/psychotropic medication use,[15][16] and excessive alcohol use.[17]
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