Spinal anaesthesia is preferred as bulk of fat to be sucked out is situated in lower half of the torso and the duration of surgery is about three hours. It reduces the drugs administered to the patient as general anaesthesia is avoided. A 27 gauge needle avoids the often troublesome post spinal anaesthesia headaches. Fentanyl is additionally added to the high spinal because it has a bupivacaine sparing effect on spinal anaesthesia. This covers the subcostal areas as well and further reduces the need of lignocaine in the infiltrating solution.
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.
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.

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.


People use a ketogenic diet most often to lose weight, but it can help manage certain medical conditions, like epilepsy, too. It also may help people with heart disease, certain brain diseases, and even acne, but there needs to be more research in those areas. Talk with your doctor first to find out if it’s safe for you to try a ketogenic diet, especially if you have type 1 diabetes.
Although you won't be able to completely transform your body or even lose more than a few pounds in a month, you can jump-start your weight-loss journey and be well on your way to achieving your goals. Just be mindful that while you can lose weight in a month, you can't specifically target your belly; there's no such thing as being able to spot-reduce fat (your body decides where the fat comes from - yay, genetics!). We tapped registered dietitian and ACSM-certified personal trainer Jim White, who owns Jim White Fitness and Nutrition Studios and helps clients reach their weight-loss goals, for insight on how to lose belly fat in 30 days.
Drink lots of water. This is especially crucial on a low carb or keto diet. Why? When you eat carbohydrates, your body stores the extra as glycogen in the liver, where they are bound to water molecules. Eating low carb depletes this glycogen, which allows you to burn fat – but it also means you are storing less water, making it easier to get dehydrated. Instead of the traditional recommendation of 8 cups of water per day, aim for 16 cups when following a low carb lifestyle.

Don’t buy your tickets to Bonnaroo just yet; the kind of acid that will help you slim down is the stuff right inside your cabinet. A 12-week study published in Bioscience, Biotechnology, and Biochemistry reveals that obese study subjects who made vinegar part of their diet dropped more belly fat than a control group, and other research suggests that acidic foods, like vinegar, can increase the human carbohydrate metabolism by as much as 40 percent.


Add a cup of low-fat milk, a part-skim mozzarella stick, or a half cup of low-sodium cottage cheese to breakfast, and you may have a belly-busting win. While lots of research links calcium with lower body weights, results from a 2014 study suggest that calcium-containing foods may reduce waist circumference in those genetically predisposed to carrying weight in their midsection.
You’ll see many doctors advertising liposuction as part of their practice; however, just because liposuction is readily available does not mean that just anyone can perform it well. You need to vet potential doctors carefully to find a cosmetic surgeon who can perform liposuction safely and achieve the results you desire. Pay attention to 3 key factors when choosing a cosmetic surgeon for your liposuction procedure:
A: The most common ways to track your carbs is through MyFitnessPal and their mobile app. You cannot track net carbs on the app, although you can track your total carb intake and your total fiber intake. To get your net carbs, just subtract your total fiber intake from your total carb intake. I have written an article on How to Track Carbs on MyFitnessPal.
Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.
The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture, and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more food energy than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein, and carbohydrate is then evenly divided across the meals.[37]
Despite continuous advances in the medical world, obesity continues to remain a major worldwide health hazard with adult mortality as high as 2.8 million per year. The majority of chronic diseases like diabetes, hypertension, and heart disease are largely related to obesity which is usually a product of unhealthy lifestyle and poor dietary habits. Appropriately tailored diet regimens for weight reduction can help manage the obesity epidemic to some extent. One diet regimen that has proven to be very effective for rapid weight loss is a very-low-carbohydrate and high-fat ketogenic diet.[1][2][3]
The fact that the diagnostic criteria for metabolic syndrome vary between ethnic populations is testimony to significant nuances in the manifestation of metabolic syndrome in these groups. The original metabolic syndrome criteria were derived in mostly Caucasian populations, and some have argued for modification of individual criteria for specific ethnic subgroups, as has been done with waist circumference for patients of Asian origin. [39]
High-density lipoprotein (HDL – the "good" cholesterol) ordinarily transports excess cholesterol from the tissues back to the liver. In the liver, the cholesterol is either recycled for future use or excreted into bile. HDL's reverse transport is the only way that cells can get rid of excess cholesterol. It helps protect the arteries and, if there is enough HDL present, it can even reverse the build up of fatty plaques in the arteries. When there are excessive amounts of VLDL and triglyceride present, however, HDL concentrations in the blood decrease.
Mediterranean diet: Traditional cuisine of countries bordering the Mediterranean Sea, shown to reduce the risk for heart disease, diabetes, some cancers and dementia. On the menu: Plenty of fruits, vegetables and beans, along with olive oil, nuts, whole grains, seafood; moderate amounts of low-fat yogurt, low-fat cheese and poultry; small amounts of red meat and sweets; and wine, in moderation, with meals.
Make things yourself. While it’s extremely convenient to buy most things pre-made or pre-cooked, it always adds to the price per pound on items. Try prepping veggies ahead of time instead of buying pre-cut ones. Try making your stew meat from a chuck roast. Or, simply try to make your mayo and salad dressings at home. The simplest of things can work to cut down on your overall grocery shopping.
Some traditional liposuction methods such as suction-assisted liposuction (SAL) have been used for some time, while there are ultrasound-assisted and laser technology methods that are relatively new. It is important to know that while some new liposuction techniques can improve your outcome, choosing a procedure based on “what’s new” is never a medically sound decision. Hearing about a brand name procedure such as Smart Lipo or CoolLipo on television, through an advertisement or online does not necessarily mean it is the best procedure for you. Your board-certified plastic surgeon will determine what is best for you based on his or her experience, your body type and your cosmetic goals.

We strive to achieve your goals by continually investing in the very latest in treatment technology, and progressing our own ability through progressive Liposuction treatments and education, because your results come first. That being said, we also strive to make your aesthetic goals attainable, so you get the very best value, along with your desired Liposuction result.

You don’t have to be the next Usain Bolt in the making to enjoy some serious belly-slimming results from hitting the track from time to time. Even a moderate-rate jog a few times a week can blast through that belly fat; in fact, a study conducted at Duke University Medical Center found that, over the course of an eight-month study, overweight adult study subjects who jogged 12 miles a week lost the most belly fat and burned 67 percent more calories than participants who did an equivalent amount of resistance exercise, or a combination of cardio and resistance work.
Ketone bodies synthesized in the body can be easily utilized for energy production by heart, muscle tissue, and the kidneys. Ketone bodies also can cross the blood-brain barrier to provide an alternative source of energy to the brain. RBCs and the liver do not utilize ketones due to lack of mitochondria and enzyme diaphorase respectively. Ketone body production depends on several factors such as resting basal metabolic rate (BMR), body mass index (BMI), and body fat percentage. Ketone bodies produce more adenosine triphosphate in comparison to glucose, sometimes aptly called a "super fuel." One hundred grams of acetoacetate generates 9400 grams of ATP, and 100 g of beta-hydroxybutyrate yields 10,500 grams of ATP; whereas, 100 grams of glucose produces only 8,700 grams of ATP. This allows the body to maintain efficient fuel production even during a caloric deficit. Ketone bodies also decrease free radical damage and enhance antioxidant capacity.
Weight loss is the primary reason my patients use the ketogenic diet. Previous research shows good evidence of a faster weight loss when patients go on a ketogenic or very low carbohydrate diet compared to participants on a more traditional low-fat diet, or even a Mediterranean diet. However, that difference in weight loss seems to disappear over time.
Here's something else most people probably don't know: Fidgeting is good for you. It's considered a nonexercise physical activity, and it's an important way to burn energy. You get more health benefits if, in addition to exercising, you are a more fidgety, more active person the rest of the day. This means gesturing while you're talking, tapping your foot, just moving around.
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.
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.
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.[10][14]
The ketogenic diet is indicated as an adjunctive (additional) treatment in children and young people with drug-resistant epilepsy.[26][27] It is approved by national clinical guidelines in Scotland,[27] England, and Wales[26] and reimbursed by nearly all US insurance companies.[28] Children with a focal lesion (a single point of brain abnormality causing the epilepsy) who would make suitable candidates for surgery are more likely to become seizure-free with surgery than with the ketogenic diet.[9][29] About a third of epilepsy centres that offer the ketogenic diet also offer a dietary therapy to adults. Some clinicians consider the two less restrictive dietary variants—the low glycaemic index treatment and the modified Atkins diet—to be more appropriate for adolescents and adults.[9] A liquid form of the ketogenic diet is particularly easy to prepare for, and well tolerated by, infants on formula and children who are tube-fed.[5][30]

Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose).[19] Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.[56]
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.
Keto diets are high in healthy fats and protein also tend to be very filling, which can help reduce overeating of empty calories, sweets and junk foods. (4) For most people eating a healthy low-carb diet, it’s easy to consume an appropriate amount of calories, but not too many, since things like sugary drinks, cookies, bread, cereals, ice cream or other desserts and snack bars are off-limits.
Belly fat is slightly different than other fat deposits on the body and is often called visceral fat. Visceral fat is considered the most dangerous form of fat in the body because it is in such close proximity to our vital organs. It is actually located beneath the abdominal muscles and the subcutaneous layer of fat, making it difficult to see and even harder to get rid of! These larger fat cells release hormones and chemicals that can be dangerous in many ways, leading to an increased risk of various diseases and metabolic imbalances.
Recent research indicates prolonged chronic stress can contribute to metabolic syndrome by disrupting the hormonal balance of the hypothalamic-pituitary-adrenal axis (HPA-axis).[23] A dysfunctional HPA-axis causes high cortisol levels to circulate, which results in raising glucose and insulin levels, which in turn cause insulin-mediated effects on adipose tissue, ultimately promoting visceral adiposity, insulin resistance, dyslipidemia and hypertension, with direct effects on the bone, causing "low turnover" osteoporosis.[24] HPA-axis dysfunction may explain the reported risk indication of abdominal obesity to cardiovascular disease (CVD), type 2 diabetes and stroke.[25] Psychosocial stress is also linked to heart disease.[26]
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Basically, carbohydrates are the primary source of energy production in body tissues. When the body is deprived of carbohydrates due to reducing intake to less than 50g per day, insulin secretion is significantly reduced and the body enters a catabolic state. Glycogen stores deplete, forcing the body to go through certain metabolic changes. Two metabolic processes come into action when there is low carbohydrate availability in body tissues: gluconeogenesis and ketogenesis.[4][5]
Liposuction, also referred to as Lipoplasty, is a procedure to remove the unwanted fat deposits from certain areas and contour the body. It can be performed on  men and women. Common sites for liposuction include the neck, arms, back, hips, thighs, and buttocks. Liposuction is best suited for patients who maintain a healthy weight and exercise regularly but continue to have certain problem areas.
Prediabetes: When blood glucose (also called blood sugar) levels are higher than normal and not yet high enough to be diagnosed with diabetes. That’s an A1C of 5.7 percent to 6.4 percent (a way to estimate your 3-month average blood sugar reading), a fasting blood glucose level of 100 to 125 mg/dl, or an OGTT (oral glucose tolerance test) two hour blood glucose of 140 to 199 mg/dl.
Often caused by lymph node removal or damage due to cancer treatment, lymphedema occurs because there’s a blockage in the lymphatic system and results in the swelling in leg or arm. A 2017 study involved patients who suffered from obesity and lymphedema and who embarked on a 18-week ketogenic diet. Weight and limb volume was significantly reduced. (5)

In the post operative period following abdominal liposuction, the patients are advised to avoid prolonged sitting for 3 to 4 weeks to prevent development of skin folds and creases. Pressure garments are to be religiously worn for 3 to 6 months. While, a regular finger tip pressure massage in the indurated areas is fine with small areas of induration, an ultrasound massage works well for lumpy areas and sites with persistent pain or edema.

The metabolic syndrome can be induced by overfeeding with sugar or fructose, particularly concomitantly with high-fat diet.[36] The resulting oversupply of omega-6 fatty acids, particularly arachidonic acid (AA), is an important factor in the pathogenesis of metabolic syndrome.[medical citation needed] Arachidonic acid (with its precursor – linoleic acid) serve as a substrate to the production of inflammatory mediators known as eicosanoids, whereas the arachidonic acid-containing compound diacylglycerol (DAG) is a precursor to the endocannabinoid 2-arachidonoylglycerol (2-AG) while fatty acid amide hydrolase (FAAH) mediates the metabolism of anandamide into arachidonic acid.[37][35] Anandamide can also be produced from N-acylphosphatidylethanolamine via several pathways.[35] Anandamide and 2-AG can also be hydrolized into arachidonic acid, potentially leading to increased eicosanoid synthesis.[35]

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.
High-volume, low-calorie greens will fill you up, without filling you out. Test panelist Kyle Cambridge says regular salads turbocharged his success: “My wife Stacie and I decided to add salad to each meal, and the pounds started melting off.” Kyle lost 25 pounds and four inches in just six weeks on the program. “I even had to buy a new belt!” he said. “But the best was when Stacie came up to me in the kitchen, and gave me a hug. She laughed and smiled and said ‘I can wrap my hands around you again.'”
In the 1960s, medium-chain triglycerides (MCTs) were found to produce more ketone bodies per unit of energy than normal dietary fats (which are mostly long-chain triglycerides).[15] MCTs are more efficiently absorbed and are rapidly transported to the liver via the hepatic portal system rather than the lymphatic system.[16] The severe carbohydrate restrictions of the classic ketogenic diet made it difficult for parents to produce palatable meals that their children would tolerate. In 1971, Peter Huttenlocher devised a ketogenic diet where about 60% of the calories came from the MCT oil, and this allowed more protein and up to three times as much carbohydrate as the classic ketogenic diet. The oil was mixed with at least twice its volume of skimmed milk, chilled, and sipped during the meal or incorporated into food. He tested it on 12 children and adolescents with intractable seizures. Most children improved in both seizure control and alertness, results that were similar to the classic ketogenic diet. Gastrointestinal upset was a problem, which led one patient to abandon the diet, but meals were easier to prepare and better accepted by the children.[15] The MCT diet replaced the classic ketogenic diet in many hospitals, though some devised diets that were a combination of the two.[10]
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"Depending on your approach, [keto diets] can contribute to significant lean body mass loss along with fat loss," said Melinda Manore, a professor of nutrition at Oregon State University. (Typically, dieters want to shed only fat, not lean body mass, which includes muscle.) And as with other fad diets, people typically regain the weight once they go off the diet.
“Starting slow and working your way up is better than overdoing it and giving up,” says Gagliardi. “I like the idea of attaching the new behavior of taking a walk to an existing behavior.” An easy way to approach it: Commit to going for a quick 10-minute walk after dinner, and slowly increase the time as you become more comfortable with daily movement.
There are many different liposuction techniques available to surgeons today. The main difference between each type of liposuction is the technology they use to assist the fat removal process. The manufacturers of each type claim to have unique advantages, and cosmetic surgeons will sometimes prefer a certain technique depending on the nature of the procedure. Just remember that the skill and experience of the cosmetic surgeon performing liposuction will make the biggest difference in your results.
You’ll find lean, satiating protein in every single bite you take on Zero Belly Diet. The muscle-building macronutrient is fundamental to the plan, and eggs happen to be one of the easiest and most versatile delivery systems in the universe. Not only that, they’re also the number-one dietary source of a nutrient called choline. Choline, which is found also in lean meats, seafood and collard greens, attacks the gene mechanism that triggers your body to store fat around your liver. One Zero Belly Diet recipe—a breakfast hash with sweet potatoes and fresh farm eggs—became test panelist Morgan Minor’s go-to breakfast, and after just 3 weeks on the program, the female firefighter lost 11 pounds and 4 inches from her waist! The more eggs you eat, the less egg-shaped you get.

Lazy keto diet: Last but not least, the Lazy keto diet often gets confused with dirty keto … but they’re different, as the “lazy” refers to simply not carefully tracking the fat and protein macros (or calories, for that matter). Meanwhile, the one aspect that remains strict? Not eating over 20 net carb grams per day. Some people find this version less intimidating to start with or end with … but I will caution that your results will be less impressive.
At the core of the classic keto diet is severely restricting intake of all or most foods with sugar and starch (carbohydrates). These foods are broken down into sugar (insulin and glucose) in our blood once we eat them, and if these levels become too high, extra calories are much more easily stored as body fat and results in unwanted weight gain. However, when glucose levels are cut off due to low-carb intake, the body starts to burn fat instead and produces ketones that can be measured in the blood (using urine strips, for example).
In the United States, metabolic syndrome has a high prevalence in African Americans, particularly African American women, and this has been attributed to the higher prevalence of obesity, hypertension, and diabetes in this population. [40] However, the highest age-adjusted prevalence of metabolic syndrome in the United States is found in Mexican Americans, approximately 31.9% of whom had the condition (compared with 27% of the general population) in a 1988-1994 survey. [41]
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