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)?
While many people turn to artificial sweeteners in a misguided attempt to whittle their waistlines, those fake sugars are likely to have the opposite effect. According to Yale researchers, artificial sweeteners are actually linked with an increased risk of abdominal obesity and weight gain, possibly because they can trigger cravings for the real stuff and spike insulin levels in a similar fashion to real sugar.
Spices are an easy way of adding more flavor, vitamins and antioxidants into your food. Furthermore, they are low in carbohydrates. Make sure that you're using fresh, organic spices for maximum flavor and nutrients. Some spices sold in packets found at the local grocery should not be used, as they often contain fillers that can increase your carbohydrate consumption, thus putting you out of ketosis.26
A systematic review in 2018 looked at 16 studies on the ketogenic diet in adults. It concluded that the treatment was becoming more popular for that group of patients, that the efficacy in adults was similar to children, the side effects relatively mild. However, many patients gave up with the diet, for various reasons, and the quality of evidence was inferior to studies on children. Health issues include high levels of low-density lipoprotein, high total cholesterol, and weight loss.[24]
Aside from the various keto-friendly foods mentioned in this article, you may be wondering if there are other options that may help support your ketogenic diet. If you find that the ketogenic diet is limiting when you start out, don't worry. There's actually a lot you can add to your diet that's "keto" as long as consumption is controlled. Here are some commonly asked questions:

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.
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.

Con: Results can vary depending on how much fluid you drink. By drinking more water, you dilute the concentration of ketones in the urine and thus a lower level of ketones will be detected on the strips. The strips don’t show a precise ketone level. Finally, and most importantly, as you become increasingly keto-adapted and your body reabsorbs ketones from the urine, urine strips may become unreliable, even if you’re in ketosis.
Sure, ketchup is tasty, but it’s also a serious saboteur when it comes your weight loss efforts. Ketchup is loaded with sugar — up to four grams per tablespoon — and bears little nutritional resemblance to the fruit from which it’s derived. Luckily, swapping out your ketchup for salsa can help you shave off that belly fat fast. Fresh tomatoes, like those used in salsa, are loaded with lycopene, which a study conducted at China Medical University in Taiwan links to reductions in both overall fat and waist circumference. If you like your salsa spicy, all the better; the capsaicin in hot peppers, like jalapeños and chipotles, can boost your metabolism, too.

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.

Whatever the source of protein you consume, make sure they are organic grass fed and antibiotic-free, as they are generally healthier and safer for your body. In one study, researchers indicated that grass fed beef (regardless of cuts) contains more omega-3 acid and conjugated linoleic acid compared to grain-fed beef.21 As for non-meat sources of protein, try to look for organic and pesticide-free varieties.
Keto diets, like most low carb diets, work through the elimination of glucose. Because most folks live on a high carb diet, our bodies normally run on glucose (or sugar) for energy. We cannot make glucose and only have about 24 hours’ worth stored in our muscle tissue and liver. Once glucose is no longer available from food sources, we begin to burn stored fat instead, or fat from our food.
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.)
Triglycerides are a common form of fat that we digest. Triglycerides are the main ingredient in animal fats and vegetable oils. Elevated levels of triglycerides are a risk factor for heart disease, heart attack, stroke, fatty liver disease, and pancreatitis. Elevated levels of triglycerides are also associated with diseases like diabetes, kidney disease, and medications (for example, diuretics, birth control pills, and beta blockers). Dietary changes, and medication if necessary can help lower triglyceride blood levels.

Yes, it should if the bump is just swelling from fluid. During the healing process, you may develop an infection. If so, see a doctor immediately. Sometimes you may develop a collection of fluid called a seroma. Seromas typically can grow and are not very hard, but if this doesn't go away, that may be a possibility that needs to be reviewed by your surgeon.
Hi Gigi, Low carb and keto is about the balance of macronutrients eaten (fat, protein and carbs), not specifically meat or lack thereof. Most people on keto do eat meat, though some people do vegetarian keto. Fat is actually necessary for many body processes. There is no issue for the kidneys with a high fat diet, but if you eat too much protein that isn’t great for the kidneys. It’s a common misconception that keto is high protein (it isn’t). Keto is great for diabetics as it naturally helps stabilize insulin. All of this being said, please know I’m not a doctor and you should consult your doctor on any medical questions or before starting any diet. If you have more questions that aren’t medical questions, I recommend our low carb & keto support group here.
A sedentary lifestyle is highly associated with visceral fat, not only because it usually means a lack of physical exercise, but also because it’s associated with lower metabolic levels, higher intake of unhealthy food, and psychological effects such as stress, anxiety, and guilt. This is according to a research paper published in the Obesity journal. By staying active as much as possible (taking the stairs instead of the elevator, standing up while working, or taking a bike to work), you can keep your physical and mental energy high, preventing the development of belly fat.
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.
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.
If you've tried exercise and dieting and still have areas on your body that won't respond, you should consider the newest method of liposuction, SmartLipo, which is performed by Dr. Schlessinger along with tumescent liposuction, which was invented by a dermatologist. Before you select a physician and undergo the procedure, it's important for you to know that all liposuction - even tumescent liposuction - is not alike.

BMI (body mass index), an alternate measure of obesity that is used by many healthcare practitioners; it is calculated by taking: (Weight in pounds X 705) / (height in inches squared); for example: (150 pounds X 705) / (67 inches X 67 inches) = a BMI of 23.5. An adult with a BMI greater than 30 is considered obese. This calculation does not, however, describe where the excess weight is on the body.


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 concept of removing excess fat from localized body sites to achieve similar gains is credited to Charles Dujarrier, who in France,[2–4] attempted to remove subcutaneous fat using a uterine curette on calves and knees of a ballerina in 1921. An inadvertent injury of the femoral artery led to amputation of the dancer's leg. This unfortunate complication arrested further progress in this field and but it was a valiant attempt at the time.[5]

Liposuction, also known as lipoplasty, is a commonly performed cosmetic plastic surgery procedure that can reduce the appearance of unsightly bulges and help you attain a slim, svelte physique. It is frequently performed on the abdomen, back and buttocks, but the technique can also be used on the thighs, knees, calves, upper arms, face, neck and other body areas.
Most plastic surgeons do not offer tumescent liposuction; whereas, most dermatologists do as it was invented by a dermatologist and offers the quickest recovery possible with the least risk. For example, if you are put under general anesthesia and are asleep or have to go to a hospital for your surgery, you are not getting true tumescent liposuction. Additionally, if you have significant bruising or are told you will have prolonged recovery periods that are more than about 24 hours, you aren't getting tumescent liposuction.

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.

The researchers explain that people who cook their own meals may simply have other good-for-you habits, like exercising more. However, they also concluded that home cooks ate more fruits and vegetables (along with a wider variety of foods), have healthier methods of prepping their food, and splurge less on foods high in calories and sugar. No clue where to start? Check out these 25 high-protein chicken recipes for weight loss.
Animal proteins (meat, fish, etc.) have very little, if any, carbs. You can consume them in moderate amounts as needed to control hunger. Overall, choose fattier cuts of meat rather than leaner ones. For example, chicken thighs and legs are preferable to chicken breasts because they contain much more fat. We’ve got quick keto diet chicken recipes to help.
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.

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]


If you are considering liposuction, the first step is to become as educated as possible about the procedure. Next, schedule a consultation with a board-certified plastic surgeon with extensive experience performing liposuction. Be sure to choose a surgeon certified by the American Board of Plastic Surgery, as this level of certification ensures that the surgeon has undergone extensive training and is highly esteemed by his or her colleagues.

Thanks for this article. I just started a Keto diet so found it appropriate to my current lifestyle. Though I don’t believe your bottom line is strong enough since you simply stating that the diet is “hard to follow” and food is “notoriously unhealthy” without evidence going deeper into why those “notoriously unhealthy” foods are worse than keeping carbohydrate-heavy food that are addictive and give the body a quick sugar high for energy. I believe “hard to follow” is your opinion only, since acceptable Keto foods are found at all restaurants easily and also all grocery stores. All the foods you mention: “rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water” are all Keto-friendly. Many people have been on a Keto-diet for years. A healthy lifestyle is a healthy mindset change and making right choices – it’s not going to be easy.


In 2005, the American Heart Association (AHA) in conjunction with the NHLBI also released a scientific statement regarding metabolic syndrome that includes a set of criteria that defines the condition. In order to provide more consistency in both patient care and research, the International Diabetes Federation, NHLBI, AHA, World Heart Federation, and the International Association for the Study of Obesity published a joint statement in 2009 that describes a "harmonized" definition of metabolic syndrome. Waist circumference, with population and country-specific criteria, replaced obesity as a measure of body status.
That’s because women tend to store more temporary fat in their bellies. “The fat stores are gained and lost,” says Lawrence Cheskin, MD, chair of the department of nutrition and food studies at George Mason University and director of the Johns Hopkins Weight Management Center. “By and large, belly fat comes off easier in the sense that it comes off first. That’s where a good amount of the fat is lost from.”
What should I expect during open heart surgery? Open heart surgery is an operation to repair a fault or damage in the heart. It is a major operation during which the surgeon will open the chest to access the heart. This surgery will require a hospital stay of at least one week. Read on to learn more about the procedure, including preparation and recovery. Read now

Almonds, peanuts, walnuts, pistachios — at GH, we're nuts about nuts! People who snack on nuts may have lower abdominal fat than those who munch on carb-based treats, according to a 2015 study in the Journal of the American Heart Association. Nuts are rich in monounsaturated fats, a heart-healthy (and more satisfying) pick than their grain-based counterparts.
The ketogenic diet is a mainstream dietary therapy that was developed to reproduce the success and remove the limitations of the non-mainstream use of fasting to treat epilepsy.[Note 2] Although popular in the 1920s and '30s, it was largely abandoned in favour of new anticonvulsant drugs.[1] Most individuals with epilepsy can successfully control their seizures with medication. However, 20–30% fail to achieve such control despite trying a number of different drugs.[9] For this group, and for children in particular, the diet has once again found a role in epilepsy management.[1][10]

Aside from carb flu, be warned that staying in long-term, continuous ketosis may have drawbacks that may actually undermine your health and longevity. To stay on the safe side, I recommend undergoing a cyclic ketogenic diet. The "metabolic magic" that ketosis brings to the mitochondria actually occurs during the refeeding phase, not during the starvation phase.
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Although the first formal definition of metabolic syndrome entered medical textbooks not so long ago (1998), it is as widespread as pimples and the common cold . According to the American Heart Association, 47 million Americans have it. That's almost a staggering one out of every six people. The syndrome runs in families and is more common among African-Americans, Hispanics, Asians, and Native Americans. The risks of developing metabolic syndrome increases as you age.
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