I have great respect for Harvard Medical School. I notice that they support their readers posting comments and I am most appreciative of the article and all the many thoughtful comments by the readers. The readers seem to have the most expertise here and I hope that the doctor who wrote the article will think long and hard about the comments by readers. After 35 years of clinical practice in mental health, I notice that all issues of emotion involve medical issues, nutrition, and the gut bacteria. I would say that these issues and all of the executive brain functions seem to improve with ketogenic principles. For those that apply it in a flexible and smart manner, it appears to improve every area of their lives. I strongly encourage the author of the article to take one class via The Institute for Functional Medicine. If he is open to more learning he can take more classes and get certified. I’m sure a fine doctor, he will be an even better doctor and personally healthier, if he gets more training. Are we all open to new learning(especially us healthcare providers)?

Thanks for this inputs. 20 years ago I gain 17 pounds a year for 5 years. I was healthy but my dr told me start diet, any diet just come back in a month I want to see you start loosing… I started Atkins and lost 7 pound in a month. She was checking my progress every six months and checking my condition. I lost 64 pounds in 3 years. Now I started eating out of control. I am eating healthy but too much… I gain 40 pound back after 20 years. Now I will start again my Atkins to take off 30 pounds…
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.
Small pockets of fat can be removed from the abdomen, hips, thighs, knees, flanks, chest, chin and neck. The best candidates for tumescent liposuction include those patients who maintain a healthy diet and exercise routine, but who still struggle with stubborn fat in common problem areas. Tumescent liposuction is not designed to remove large volumes of fat and should not be used to jumpstart a weight loss regimen. It is also not approved for removing or reducing the appearance of cellulite.
Eating the same types of food at the exact same time of day can cause your body to fall into an unwanted rhythm. Occasionally, you need to stretch your stomach a bit, so to speak, consuming different foods, nutrients, vitamins, minerals, organic compounds, etc. in order to keep your metabolism flexible and your system dynamic and responsive. That doesn’t mean chowing down on hamburgers as a “cheat day”, but it does mean broadening your culinary horizons!
The oral glucose tolerance test (OGTT), or glucose tolerance test is a blood test used (not routinely however) to diagnose diabetes, and gestational diabetes. Information in regard to reliability of the oral glucose tolerance test is important, as some conditions (common cold), or food (caffeine), or lifestyle habits (smoking) may alter the results of the oral glucose tolerance test.
Conklin's fasting therapy was adopted by neurologists in mainstream practice. In 1916, a Dr McMurray wrote to the New York Medical Journal claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent endocrinologist Henry Rawle Geyelin reported his experiences to the American Medical Association convention. He had seen Conklin's success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite only having studied the patients for a short time. Further studies in the 1920s indicated that seizures generally returned after the fast. Charles P. Howland, the parent of one of Conklin's successful patients and a wealthy New York corporate lawyer, gave his brother John Elias Howland a gift of $5,000 to study "the ketosis of starvation". As professor of paediatrics at Johns Hopkins Hospital, John E. Howland used the money to fund research undertaken by neurologist Stanley Cobb and his assistant William G. Lennox.[10]
A ketogenic diet could be an interesting alternative to treat certain conditions, and may accelerate weight loss. But it is hard to follow and it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. We also do not know much about its long-term effects, probably because it’s so hard to stick with that people can’t eat this way for a long time. It is also important to remember that “yo-yo diets” that lead to rapid weight loss fluctuation are associated with increased mortality. Instead of engaging in the next popular diet that would last only a few weeks to months (for most people that includes a ketogenic diet), try to embrace change that is sustainable over the long term. A balanced, unprocessed diet, rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water seems to have the best evidence for a long, healthier, vibrant life.
Since the healing process is gradual, you should expect to wait at least several months to get an accurate picture of the results of your surgery. The small incisions used for access will fade over a number of months, usually becoming barely visible. For six to nine months, you may experience a fluctuating return of ten to 15 percent swelling with exercise or excessive activity. It is important to see your doctor as scheduled. Follow-up visits will continue for several weeks and then after several months at prescribed intervals.
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.)
It is vitally important that you follow all patient care instructions provided by your surgeon. This will include information about wearing compression garments, taking an antibiotic, if prescribed, and the level of activity that is safe. Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.
Precise and accurate pre operative marking is essential for a good result. With the patient standing, areas to be treated are outlined with a fiber tip permanent marker pen. Areas to be avoided or areas for fat grafting are also separately identified. Port sites per area are defined to allow cross-tunnelling aspiration to minimize surface abnormalities.
"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
The liver uses triglycerides, cholesterol, and protein to make triglyceride-rich very low-density lipoproteins (VLDL). In the blood, an enzyme removes triglycerides from VLDL to first produce intermediate density lipoproteins (IDL) and then low-density lipoproteins (LDL - the "bad" cholesterol). LDL is not all bad; it is an essential part of lipid metabolism and is necessary for the integrity of cell walls and for sex hormone and steroid production. However, in excess, LDL can oxidize and accumulate, eventually leading to fatty deposits in artery walls and to hardening and scarring of the blood vessels (and to cardiovascular disease and blood clots).

Let me explain what I mean by insulin resistance. A healthy digestive system breaks down food into glucose. Next, insulin, a hormone made by the pancreas, helps the glucose enter your cells to be used as fuel. However, if you experience insulin resistance, your cells won’t respond in a typical fashion to insulin, and hence, the glucose cannot enter your cells as easily. This phenomenon results in increased glucose levels in your bloodstream despite your body’s efforts to manage the glucose by producing more and more insulin.
The short circuits in Zero Belly Diet offer a variety exercises that blast your core without relying on traditional sit-ups—easy enough to squeeze in before dinner in the comfort of your living room. Within six weeks of incorporating the mini circuits, test panelist Krista Powell lost 25 pounds—and she was finally able to dress in a way that reflected her true sense of style: “I’d avoided wearing high heels because the extra weight made my knees hurt so bad. I can actually wear my heels with confidence and without pain!”
I am trying to get back into keto. I did it before and I was so happy when I lost 10lbs (I did the keto for a month). I am ready to go back to this lifestyle. All this information is very helpful, I have written it all down so it can be easier for me to remember what is allowed and what is not. Looking forward to get back on this keto journey. Thank you for all the great info.
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.”
A ketogenic diet also has been shown to improve blood sugar control for patients with type 2 diabetes, at least in the short term. There is even more controversy when we consider the effect on cholesterol levels. A few studies show some patients have increase in cholesterol levels in the beginning, only to see cholesterol fall a few months later. However, there is no long-term research analyzing its effects over time on diabetes and high cholesterol.
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.
Bhasin et al, as part of the Framingham Heart Study, found that sex hormone-binding globulin is independently associated with the risk of metabolic syndrome, whereas testosterone is not. Age, body mass index (BMI), and insulin sensitivity independently affect sex hormone-binding globulin and testosterone levels. [48] More recent studies have raised the possibility of an association between testosterone deficiency and metabolic syndrome. [49]
Over the past century, ketogenic diets have also been used as natural remedies to treat and even help reverse neurological disorders and cognitive impairments, including epilepsy, Alzheimer’s symptoms, manic depression and anxiety. Research shows that cutting off glucose levels with a very low-carb diet makes your body produce ketones for fuel. This change can help to reverse neurological disorders and cognitive impairment, including inducing seizure control. The brain is able to use this alternative source of energy instead of the cellular energy pathways that aren’t functioning normally in patients with brain disorders.
Team work, a judicious and an appropriate selection of a surgically and medically fit patient are essential factors resulting in an overall reduction in the duration of the surgery to within three hours [Figure 17]. When a large volume liposuction is planned for an obese patient, it is advisable to stage this procedure in 2 to 3 session. It is preferable to perform liposuction on either front of the torso in supine position or the back in prone position. This avoids the need to change the position, or turning the patient over, half way through the operation, thereby taking additional time. This also reduces the patients' exposure to the rigorous physiological demands of this procedure.
^ Feinman, R. D; Pogozelski, W. K; Astrup, A; Bernstein, R. K; Fine, E. J; Westman, E. C; Accurso, A; Frassetto, L; Gower, B. A; McFarlane, S. I; Nielsen, J. V; Krarup, T; Saslow, L; Roth, K. S; Vernon, M. C; Volek, J. S; Wilshire, G. B; Dahlqvist, A; Sundberg, R; Childers, A; Morrison, K; Manninen, A. H; Dashti, H. M; Wood, R. J; Wortman, J; Worm, N (2015). "Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base". Nutrition. 31 (1): 1–13. doi:10.1016/j.nut.2014.06.011. PMID 25287761.
Doctors disagree on the issues of scarring with not suturing versus resolution of the swelling allowed by leaving the wounds open to drain fluid. Since the incisions are small, and the amount of fluid that must drain out is large, some surgeons opt to leave the incisions open, while others suture them only partially, leaving space for the fluid to drain out.[15]
The involvement of the endocannabinoid system in the development of metabolic syndrome is indisputable.[33][34][35] Endocannabinoid overproduction may induce reward system dysfunction[34] and cause executive dysfunctions (e.g., impaired delay discounting), in turn perpetuating unhealthy behaviors.[medical citation needed] The brain is crucial in development of metabolic syndrome, modulating peripheral carbohydrate and lipid metabolism.[33][34]
These affect your brain and spine, as well as the nerves that link them together. Epilepsy is one, but others may be helped by a ketogenic diet as well, including Alzheimer’s disease, Parkinson’s disease, and sleep disorders. Scientists aren’t sure why, but it may be that the ketones your body makes when it breaks down fat for energy help protect your brain cells from damage.
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.
The low glycaemic index treatment (LGIT)[49] is an attempt to achieve the stable blood glucose levels seen in children on the classic ketogenic diet while using a much less restrictive regimen. The hypothesis is that stable blood glucose may be one of the mechanisms of action involved in the ketogenic diet,[9] which occurs because the absorption of the limited carbohydrates is slowed by the high fat content.[5] Although it is also a high-fat diet (with approximately 60% calories from fat),[5] the LGIT allows more carbohydrate than either the classic ketogenic diet or the modified Atkins diet, approximately 40–60 g per day.[18] However, the types of carbohydrates consumed are restricted to those that have a glycaemic index lower than 50. Like the modified Atkins diet, the LGIT is initiated and maintained at outpatient clinics and does not require precise weighing of food or intensive dietitian support. Both are offered at most centres that run ketogenic diet programmes, and in some centres they are often the primary dietary therapy for adolescents.[9]
• Your body is still growing — In one study, epileptic children experienced a reduction in symptoms and improved cognitive performance when a ketogenic diet was introduced.49 However, this may have a negative effect on the growth of their bodies in the long run, according to a study published in the journal Developmental Medicine & Child Neurology.50

Cyclical ketogenic diet (CKD): If you find it difficult to stick to a very low-carb diet every day, especially for months on end, you might want to consider a carb-cycling diet instead. Carb cycling increases carbohydrate intake (and sometimes calories in general) only at the right time and in the right amounts, usually about 1–2 times per week (such as on weekends).
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A popular keto supplement are exogenous ketones (popularly called “keto diet pills”) that may help you achieve results earlier as well as remain in that state. (Don’t confuse exogenous ketones with raspberry ketones, as the latter don’t raise ketone levels in the body or mimic endogenous ketones, so you wouldn’t use raspberry ketones in your regimen.)
People who have metabolic syndrome typically have apple-shaped bodies, meaning they have larger waists and carry a lot of weight around their abdomens. It's thought that having a pear-shaped body — that is, carrying more of your weight around your hips and having a narrower waist — doesn't increase your risk of diabetes, heart disease and other complications of metabolic syndrome.
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