When you eat less than 50 grams of carbs a day, your body eventually runs out of fuel (blood sugar) it can use quickly. This typically takes 3 to 4 days. Then you’ll start to break down protein and fat for energy, which can make you lose weight. This is called ketosis. It's important to note that the ketogenic diet is a short term diet that's focussed on weight loss rather than the pursuit of health benefits. 
Metabolic syndrome is a serious health condition that affects about 23 percent of adults and places them at higher risk of cardiovascular disease, diabetes, stroke and diseases related to fatty buildups in artery walls. The underlying causes of metabolic syndrome include overweight and obesity, physical inactivity, genetic factors and getting older.
The popular low-carb diets (such as Atkins or Paleo) modify a true keto diet. But they come with the same risks if you overdo it on fats and proteins and lay off the carbs. So why do people follow the diets? "They're everywhere, and people hear anecdotally that they work," McManus says. Theories about short-term low-carb diet success include lower appetite because fat burns slower than carbs. "But again, we don't know about the long term," she says. "And eating a restrictive diet, no matter what the plan, is difficult to sustain. Once you resume a normal diet, the weight will likely return."
Results can vary. Tumescent liposuction, just the same as regular liposuction, involves suctioning of fat from areas where excess accumulation has occurred. Whether this procedure will have short-term results or long-term results depends entirely on how you diet afterward. Dr. Schlessinger has seen many patients who never again need any help in the areas treated, while others who had poor habits after the surgery needed extra procedures within a year or so. Whatever the case, it is unlikely that the same amount of fat will re-accumulate in the exact same areas.
Say cheese! Adding some extra calcium and vitamin D to your diet could be the key to getting that flat stomach you’ve been dreaming about. Over just 12 months, researchers at the University of Tennessee, Knoxville found that obese female study subjects who upped their calcium intake shed 11 pounds of body fat without other major dietary modifications. To keep your calcium choices healthy, try mixing it up between dairy sources, calcium-rich leafy greens, fatty fish, nuts, and seeds.
PAL uses an up and down, vibrating like motion of the cannula to acquire greater fat removal. When compared to simple suction-assisted liposuction, PAL requires less energy for the surgeon to operate while also resulting in greater fat removal. It is commonly used for difficult, secondary, scarred areas, and when harvesting large volumes of fat for transfers to other areas.[11]
Limit foods high in refined carbohydrates and refined sugar (white bread, white pasta, white rice), and replace them with high fibre ‘complex carbs’ – think: whole grains, brown rice, sweet potato, oats, beans and pulses. Fill your boots with as many vegetables as possible – they’re low calorie, high in micronutrients, and the fibre in them will keep you full.

Vegan ketogenic diet or vegetarian diet: Yes, both are possible. Instead of animal products, plenty of low-carb, nutrient-dense vegan and/or vegetarian foods are included. Nuts, seeds, low-carb fruits and veggies, leafy greens, healthy fats and fermented foods are all excellent choices on a plant-based keto diet. There’s also a similar plan called ketotarian, which combines keto with vegetarian, vegan and/or pescatarian diets for supposedly greater health benefits.
First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (about 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.[48]
The previous definitions of the metabolic syndrome by the International Diabetes Federation[40] and the revised National Cholesterol Education Program are very similar and they identify individuals with a given set of symptoms as having metabolic syndrome. There are two differences, however: the IDF definition states that if body mass index (BMI) is greater than 30 kg/m2, central obesity can be assumed, and waist circumference does not need to be measured. However, this potentially excludes any subject without increased waist circumference if BMI is less than 30. Conversely, the NCEP definition indicates that metabolic syndrome can be diagnosed based on other criteria. Also, the IDF uses geography-specific cut points for waist circumference, while NCEP uses only one set of cut points for waist circumference regardless of geography. These two definitions are much more similar than the original NCEP and WHO definitions.

A sustainable exercise program, for example 30 minutes five days a week is reasonable to start, providing there is no medical contraindication. (If you have any special concerns in this regard, check with your doctor first.) There is a beneficial effect of exercise on blood pressure, cholesterol levels, and insulin sensitivity, regardless of whether weight loss is achieved or not. Thus, exercise in itself is a helpful tool in treating metabolic syndrome.
Doing crunches until the cows come home? Stop it! When you're down to your final inches of belly fat, the dreaded crunch won't be the exercise that finally reveals your six-pack. "You can't spot reduce," Jill says. Instead, she suggests doing functional exercises that use the muscles in your core—abdominals, back, pelvic, obliques—as well as other body parts. "These exercises use more muscles, so there is a higher rate of calorie burn while you are doing them," she says. Planks are her favorite functional exercise—they activate not just your core muscles but also your arm, leg, and butt muscles.
Some people may ask: Why not just have liposuction of the abdomen and remove the large amount of abdominal fat that is a big part of the problem? Data thus far shows no benefit in liposuction on insulin sensitivity, blood pressure, or cholesterol. As the saying goes, "If it's too good to be true, it probably is." Diet and exercise are still the preferred primary treatment of metabolic syndrome.
When you call to schedule your procedure, we will request a deposit of 50% of the total cost of the procedure.  We only schedule one procedure per day, therefore if you cancel less than 2 weeks prior to your procedure 20% of your deposit is non-refundable.  If you cancel or reschedule your procedure less than 48 hours before your surgery, there will be no refund of your deposit.  
This website is provided for information and education purposes only and is not intended to offer specific medical or surgical advice to anyone. No doctor/patient relationship has been established by the use of this site, and no diagnosis or treatment is being provided. The information contained here should be used in consultation with a doctor of your choice. No claim or opinion on these pages is intended to be medical advice or to replace a one-on-one relationship with a qualified health care professional. No guarantees or warranties are made regarding any of the information contained herein.
Early ambulation within 24 hours was encouraged for mobilization of third space fluid shifts to expedite recovery and to prevent deep vein thrombosis. Prolonged sitting is to be avoided for 3 to 4 weeks following abdominal liposuction and pressure garments are to be worn for 3 to 6 months. It is important to support the heavy skin and subcutaneous fat of the obese patient longer than advocated to prevent it from gravitating down and forming folds, because skin retraction takes longer following megaliposuction. Pressure (finger tip) massage or an external ultrasound massage is advised for persistent edema, pain or firm and lumpy areas.
Pomegranate and pomegranate seeds in particular have been shown to help ameliorate metabolic syndrome. Research published in Food & Nutrition concluded that pomegranate “exerts hypoglycaemic effects, including increased insulin sensitivity, inhibition of α-glucosidase, and impact on glucose transporter type 4 function, but is also responsible for a reduction of total cholesterol, and the improvement of blood lipid profiles, as well as anti-inflammatory effects through the modulation of peroxisome proliferator-activated receptor pathways. These effects may also explain how pomegranate-derived compounds function in the amelioration of adverse health effects caused by metabolic syndrome.” (12)
The problem is that if you aren't motivated prior to surgery, you probably won't be after surgery. Dr. Schlessinger recommends to these patients that they go back to diet and exercise and make sure they can lose weight on their own. If they can get within 10 percent of their goal weight and still have areas that need improvement, then tumescent liposuction is an option.
The popular belief that high-fat diets cause obesity and several other diseases such as coronary heart disease, diabetes, and cancer has not been observed in recent epidemiological studies. Studies carried out in animals that were fed high-fat diets did not show a specific causal relationship between dietary fat and obesity. On the contrary, very-low-carbohydrate and high-fat diets such as the ketogenic diet have shown to beneficial to weight loss.

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When the anesthesia wears off, you may have some pain. If the pain is extreme or long-lasting, contact your physician. You will also have some redness and swelling after the surgery. In some cases, the swelling will remain for weeks or even months. Contact your surgeon to find out if your pain, redness and swelling is normal or a sign of a problem.


Polycystic ovary syndrome (PCOS) is the most common endocrine disorder, and it affects women of reproductive age. Symptoms include obesity, hyperinsulinemia and insulin resistance. A pilot study took 11 women through 24 weeks of a low-carbohydrate ketogenic diet (20 grams or less per day). Among the five who completed the study, they lost 12 percent of their weight on average and reduced fasting insulin by 54 percent. Additionally, two women who previously experienced infertility problems became pregnant. (6)
It’s time to get real about the dangers of belly fat, because it’s affecting more of us than ever before. According to the latest government stats, 26 per cent of British adults are classified as obese. That’s just over one in four people, meaning that Britain is on-track to become the fattest country in Europe by 2025. If current trends continue, forecasters have warned that half of us will be obese by 2045.

Most of the bacteria that dwell in your gut are pretty useful. They produce hormones, regulate your immune system, digest food, extract nutrients, control your mood, manage your appetite, and much more besides. That obese people tend to have higher numbers of Firmicutes bacteria is no coincidence – according to research published in the online journal Nature, these bacteria increase the number of calories your body absorbs from food.

Excess fat is removed through tiny openings with a very small stainless steel cannula. The cannula is connected to a powerful suction pump and inserted through these openings. Because the cannulas are so small, there is virtually no discomfort, recovery time is lessened, and a better cosmetic result can be achieved. Additionally, Dr. Schlessinger has the finesse to get out just the right amount of fat so your results look good.
A: The amount of weight you lose is entirely dependent on you. Obviously adding exercise to your regimen will speed up your weight loss. Cutting out things that are common “stall” causes is also a good thing. Artificial sweeteners, dairy, wheat products and by-products (wheat gluten, wheat flours, and anything with an identifiable wheat product in it).
Going into nutritional ketosis by following a ketogenic diet is one of the most radical but highly beneficial lifestyle changes you can make to improve your health. As with most dietary changes, always remember to listen to your body. If you feel any side effects other than the ones listed above, then necessary adjustments to your food intake may be needed.
If antioxidants are the good guys of gut health, trans fats are the supervillains. These sneaky fats actively contribute to your wobbly waist – not just by adding new fat, but by moving fat from other areas of your body to your belly. During a six-year study at Wake Forest University, monkeys that were fed an 8 per cent trans fat diet had 33 per cent more belly fat than monkeys that were fed an 8 per cent monounsaturated fat diet.
Ultrasound-assisted liposuction (UAL). This type of liposuction is sometimes used in conjunction with traditional liposuction. During UAL, the surgeon inserts a metal rod that emits ultrasonic energy under your skin. This ruptures the fat-cell walls and breaks down the fat for easier removal. A new generation of UAL called VASER-assisted liposuction uses a device that may improve skin contouring and reduce the chance of skin injuries.
Localized fat accumulation patterns also vary by race and age. A decrease in the subcutaneous fatty layer and elevations in intra-abdominal fat contents are seen with increasing age. Women have a proportionately higher percentage of body fat than men and have a gynaecoid pattern of fat deposition characterized by increased deposits over the lateral thigh, buttock, hips, and truncal region, while men show an android pattern that centres on the truncal and abdominal regions.
Yes you can lose fat on a low carb because it’s just another low calorie diet. How do I know this? I’ve done low carb, (Atkins, etc) high carb, (Slimming Word) moderate carb etc and log my food and was shocked each time to see they were all low calorie. After the initial week or so the rate of fat loss is same as any other diet. It’s calories in calories out. Simple. It’s what some call indirect deficit diet placing silly restriction, rules can eat must eat etc. and of course you lose weight but nothing to do with low carb. It works because it’s a low calorie diet.
It is very interesting to read about the keto/low card diet.I love to change my lifestyle as I an TYPE 2 Diabetic.I subscribed for a free printable low carb meal .The initial email stated that that I will receive an email for instructions to access the members area .Your free download will be there.However it is very deceiving ,I never got the 2nd email with instructions which is frustrating and not good .Hopefully this is not a way to get us to pay to get the printable version.
Polycystic ovarian syndrome. Thought to be related to insulin resistance, this disorder involves the release of extra male hormones by the ovaries, which can lead to abnormal menstrual bleeding, excessive hair growth, acne, and fertility problems. It is also associated with an increased risk for obesity, hypertension, and — in the long-term — diabetes, heart disease, and cancer.
What is the keto diet? Rather than relying on counting calories, limiting portion sizes, resorting to extreme exercise or requiring lots of willpower, this low-carb diet takes an entirely different approach to weight loss and health improvements. It works because it changes the very “fuel source” that the body uses to stay energized: namely, from burning glucose (or sugar) to dietary fat, courtesy of keto diet recipes and the keto diet food list items, including high-fat, low-carb foods.
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.
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)

The surgeons who perform liposuction must understand the physiology and differences between smaller volume and large volume liposuction. The anaesthesiologist is an integral member of the team and must have a complete understanding of the procedure and be well trained to handle preoperative, peri-operative, or post-operative problems of fluid shits and drug toxicity. The patient's core body temperature must be maintained using heating blanket systems on the table, minimizing body exposure and using warmed wetting solution.
In relation to overall caloric intake, carbohydrates comprise around 55% of the typical American diet, ranging from 200 to 350 g/day. The vast potential of refined carbohydrates to cause harmful effects were relatively neglected until recently. A greater intake of sugar-laden food is associated with a 44% increased prevalence of metabolic syndrome and obesity and a 26% increase in the risk of developing diabetes mellitus. In a 2012 study of all cardiometabolic deaths (heart disease, stroke, and type 2 diabetes) in the United States, an estimated 45.4% were associated with suboptimal intakes of 10 dietary factors. The largest estimated mortality was associated with high sodium intake (9.5%), followed by low intake of nuts and seeds (8.5%), high intake of processed meats (8.2%), low intake of omega-3 fats (7.8%), low intake of vegetables 7.6%), low intake of fruits (7.5%), and high intake of artificially sweetened beverages (7.4%). The lowest estimated mortality was associated with low polyunsaturated fats (2.3%) and unprocessed red meats (0.4%). In addition to this direct harm, excess consumption of low-quality carbohydrates may displace and leave no room in the diet for healthier foods like nuts, unprocessed grains,  fruits, and vegetables.
There is an enhanced fat removal with minimal blood loss, improved skin retraction and safer large-volume procedures with the UAL. Reports of cutaneous burns, [Figure 13] hypo and hyperaesthesia and seroma formation brought considerable debate concerning the long-term effects and clinical use of UAL. Subsequent evidence of large trials with long term follow-ups have led it to be well-established and accepted technique.[26,27] It is especially indicated in areas of dense, fibrotic fat.
Results can vary. Tumescent liposuction, just the same as regular liposuction, involves suctioning of fat from areas where excess accumulation has occurred. Whether this procedure will have short-term results or long-term results depends entirely on how you diet afterward. Dr. Schlessinger has seen many patients who never again need any help in the areas treated, while others who had poor habits after the surgery needed extra procedures within a year or so. Whatever the case, it is unlikely that the same amount of fat will re-accumulate in the exact same areas.
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]
Because some cancer cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer.[59][60] A 2018 review looked at the evidence from preclinical and clinical studies of ketogenic diets in cancer therapy. The clinical studies in humans are typically very small, with some providing weak evidence for anti-tumour effect, particularly for glioblastoma, but in other cancers and studies, no anti-tumour effect was seen. Taken together, results from preclinical studies, albeit sometimes contradictory, tend to support an anti-tumor effect rather than a pro-tumor effect of the KD for most solid cancers.[61]

If you’re new or just still learning the ropes for the keto diet food list, your biggest questions probably revolve around figuring out just what high-fat low-carb foods you can eat on such a low-carb, ketogenic diet. Overall, remember that the bulk of calories on the keto diet are from foods that are high in natural fats along with a moderate amount of foods with protein. Those that are severely restricted are all foods that provide lots of carbs, even kinds that are normally thought of as “healthy,” like whole grains, for example.
Long-term compliance is low and can be a big issue with a ketogenic diet, but this is the case with any lifestyle change.  Even though the ketogenic diet is significantly superior in the induction of weight loss in otherwise healthy patients with obesity and the induced weight loss is rapid, intense, and sustained until at least 2 year, the understanding of the clinical impacts, safety, tolerability, efficacy, duration of treatment, and prognosis after discontinuation of the diet is challenging and requires further studies to understand the disease-specific mechanisms.
Continue to adhere to medical advice for overall health . It’s important to work with your doctor to assess your overall risk of metabolic syndrome and related heart problems, says Ndumele. Get key markers (such as blood pressure, cholesterol, and blood sugar) checked as recommended by your doctor. If you’ve been prescribed medication for high blood pressure, high cholesterol or insulin resistance, be sure to take it as directed.
Ultrasonic techniques are available as an internal, canula based, as well as an external one, with paddle application. The high ultrasonic energy produced by passing electrical energy to a piezoelectric crystal creates micro cavities in a liquid or semi liquid medium during the expansion cycle of the sound wave. This property of microcavitation is used in UAL.

The ketone bodies are possibly anticonvulsant; in animal models, acetoacetate and acetone protect against seizures. The ketogenic diet results in adaptive changes to brain energy metabolism that increase the energy reserves; ketone bodies are a more efficient fuel than glucose, and the number of mitochondria is increased. This may help the neurons to remain stable in the face of increased energy demand during a seizure, and may confer a neuroprotective effect.[56]
My point here is that the warnings about the ketogenic principles are well taken and well documented. My concern is implications that this is a fad. I don’t use the word diet with my patients and I’m concerned that the principles behind the label and the real results that these readers have commented on might get minimized. I have found it best to encourage patients to read authors like: Stephen Phinney, Jeff Volek, Patricia Daly, and Charles Gant and the be partners with their doctors and check blood work as they move along. I am not for or against the article. If ketogenic principles offer people enduring, satisfying, and cohesive change then why not read about its potential and flexilbity?
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.
The modified Atkins diet reduces seizure frequency by more than 50% in 43% of patients who try it and by more than 90% in 27% of patients.[18] Few adverse effects have been reported, though cholesterol is increased and the diet has not been studied long term.[48] Although based on a smaller data set (126 adults and children from 11 studies over five centres), these results from 2009 compare favourably with the traditional ketogenic diet.[18]

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.


Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
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