The tumescent technique. This involves even more fluid than is used in the super-wet technique. The surgeon will infuse three to six times as much fluid as the volume of the aspirate (fat, fluid and blood content) to be removed. Proponents say the tumescent technique swells the tissues, which aids in fat removal; but detractors say it interferes with the surgeon's ability to sculpt. Opponents also claim the technique is unsafe because of potential fluid overload and an overdose of anesthetic.
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]

Meat – like grass-fed selections – and fresh veggies are more expensive than most processed or fast foods. What you spend on Keto-friendly foods will vary with your choices of protein source and quality. You can select less-expensive, leaner cuts of meat and fatten them up with some oil. Buying less-exotic, in-season veggies will help keep you within budget.
Liposuction removes fat from your body using suction. In this procedure, small, thin, blunt-tipped tubes (cannula) are inserted through small cuts in the skin. Your plastic surgeon moves these tubes under your skin to target fat deposits and then suction them out. From traditional liposuction procedures to new laser liposuction technologies such as Smart Lipo, there are a variety of techniques that facilitate liposuction:
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]
While several national and international organizations use certain criteria to define metabolic syndrome, others, including the American Diabetes Association (ADA), question the value of the specific diagnosis of metabolic syndrome. They point out that the criteria, taken together, are no more useful at predicting the risk of cardiovascular disease or diabetes than the individual criteria considered separately. The science needs to be clearer, suggests the ADA, before metabolic syndrome be considered a definable syndrome.
They found that any diet resulted in more weight loss than no diet at all after six months. Low-fat and low-carb diets were pretty much indistinguishable, with low-carb dieters losing 19 pounds (8.73 kilograms), on average, and low-fat dieters losing an average of 17.6 pounds (7.99 kg), both compared to non-dieters. At 12 months, the benefits showed signs of leveling off for both types of diets, with both low-fat and low-carb dieters reporting being 16 pounds (7.27 kg) lighter, on average, than non-dieters.
^ Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F (October 2005). "Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement". Circulation. 112 (17): 2735–52. doi:10.1161/CIRCULATIONAHA.105.169404. PMID 16157765.
For many of Dr. Ayoub’s patients in Omaha, liposuction is the first surgical procedure they have ever undergone. So, it’s understandable that they would be nervous about having liposuction performed, despite their desire to lose their stubborn fatty deposits. When you work with us, though, you need not worry. Your safety and comfort are our top priorities, and we will do everything possible to make your liposuction procedure a pleasant experience.

High-protein ketogenic diet (HPKD): This version of the keto diet is often followed by folks who want to preserve their muscle mass like bodybuilders and older people. Rather than protein making up 20 percent of the diet, here it’s 30 percent. Meanwhile, fat goes down to 65 percent of the diet and carbs stay at 5 percent. (Caution: folks with kidney issues shouldn’t up their protein too much.)

Essentially, the keto diet for beginners works by “tricking” the body into acting as if its fasting (while reaping intermittent fasting benefits), through a strict elimination of glucose that is found in carbohydrate foods. Today the standard keto diet goes by several different names, including the “low-carbohydrate” or “very-low-carbohydrate ketogenic diet”(LCKD or VLCKD for short).

Eat a healthy diet. Emphasize plant-based foods, such as fruits, vegetables and whole grains, and choose lean sources of protein and low-fat dairy products. Limit added sugar and saturated fat, which is found in meat and high-fat dairy products, such as cheese and butter. Choose moderate amounts of monounsaturated and polyunsaturated fats — found in fish, nuts and certain vegetable oils — instead.

Most people who have metabolic syndrome already have a closely related condition called insulin resistance, which is when the body stops responding to insulin (a hormone produced in the pancreas). After the food we eat is converted into a type of sugar called glucose, insulin is what enables the glucose to enter the body’s cells and be used as energy. For someone who is insulin resistant, however, the glucose builds up in the blood, setting the stage for damage.
That’s because strength training helps you build muscle, which will replace body fat. In fact, strength training is one of the few activities you can do to spike the amount of calories you burn, even after you’re done with your workout. Bonus: When your metabolic rate becomes faster due to muscle growth, you’ll have a little more wiggle room in your diet if that’s something you struggle with, says Dr. Cheskin.

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).


Various strategies have been proposed to prevent the development of metabolic syndrome. These include increased physical activity (such as walking 30 minutes every day),[48] and a healthy, reduced calorie diet.[49] Many studies support the value of a healthy lifestyle as above. However, one study stated these potentially beneficial measures are effective in only a minority of people, primarily due to a lack of compliance with lifestyle and diet changes.[12] The International Obesity Taskforce states that interventions on a sociopolitical level are required to reduce development of the metabolic syndrome in populations.[50]
Many people struggle with weight loss issues. Losing belly fat in particular is about more than just aesthetics: visceral fat, the kind of fat that tends to settle around the midsection, can cause an increase in your body's production of stress hormones that can affect your body's insulin production. As a result, excess belly fat can lead to serious complications like type 2 diabetes and heart disease.[1] There is no way to target belly fat, but diet and exercise will eventually burn off belly fat. Knowing how to take the first step can help you feel better and get you on the road to a healthier, more active lifestyle.
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.

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.


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.” 
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
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