The original therapeutic diet for paediatric epilepsy provides just enough protein for body growth and repair, and sufficient calories[Note 1] to maintain the correct weight for age and height. The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant medications. This classic ketogenic diet contains a 4:1 ratio by weight of fat to combined protein and carbohydrate. This is achieved by excluding high-carbohydrate foods such as starchy fruits and vegetables, bread, pasta, grains, and sugar, while increasing the consumption of foods high in fat such as nuts, cream, and butter.[1] Most dietary fat is made of molecules called long-chain triglycerides (LCTs). However, medium-chain triglycerides (MCTs)—made from fatty acids with shorter carbon chains than LCTs—are more ketogenic. A variant of the classic diet known as the MCT ketogenic diet uses a form of coconut oil, which is rich in MCTs, to provide around half the calories. As less overall fat is needed in this variant of the diet, a greater proportion of carbohydrate and protein can be consumed, allowing a greater variety of food choices.[4][5]
Keto flu symptoms and side effects can include feeling tired, having difficulty sleeping, digestive issues like constipation, weakness during workouts, being moody, losing libido and having bad breath. Fortunately, these side effects don’t affect everyone and often only last for 1–2 weeks. (And yes, you CAN build muscle on keto.) Overall, symptoms go away as your body adjusts to being in ketosis.
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A diet that’s low in fat and carbohydrates can improve artery function, according to a 2012 study by Johns Hopkins researchers. After six months, those on the low-carb diet had lost more weight, and at a faster pace. But in both groups, when weight was lost—and especially when belly fat shrank—the arteries were able to expand better, allowing blood to travel more freely. The study shows that you don’t have to cut out all dietary fat to shrink belly fat. For heart health, simply losing weight and exercising seems to be key.
Anyone with metabolic syndrome should make every attempt to reduce their body weight to within 20% of their "ideal" body weight (calculated for age and height), and to incorporate aerobic exercise (at least 20 minutes) into their daily lifestyle. With vigorous efforts to reduce weight and increase exercise, metabolic syndrome can be reversed, and the risk for cardiovascular complications can be substantially improved.
Increases in cholesterol levels need discussion too. We do see temporary increases in cholesterol levels often as individuals transition onto a ketogenic diet. However, when you examine lipid particle size (a more important way to look at the cardiovascular risks), the risk pattern doesn’t seem to increase with a ketogenic diet. Harvard Health has written about lipid particle size here before: http://www.health.harvard.edu/womens-health/should-you-seek-advanced-cholesterol-testing-

A related clinical diet for drug-resistant epilepsy is called the medium-chain triglyceride ketogenic diet, in which MCT oil is extensively used because it’s more ketogenic than long-chain triglycerides. (13) Another dietary therapy for epilepsy called Low Glycemic Index Treatment (LGIT) was developed in 2002 as an alternative to the keto diet. LGIT monitors the total amount of carbohydrates consumed daily, and focuses on carbohydrates that have a low glycemic index.) (14)


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.
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.
Eating mindfully. A child who learns to see food as fuel and not emotional compensation can start to make better choices at mealtime — for example, selecting complex carbs instead of simple carbs (whole-grain instead of white bread, brown rice instead of white); getting more fiber with beans, fruits, and vegetables; choosing "healthy" fats like olive oil and nuts; and avoiding too many empty calories from soda and sweets.
Indulging in delicious food is a core principle of Zero Belly Diet. It was the balanced, “zero sacrifice” approach that helped test panelist Jennie Joshi finally lose her pregnancy weight. In just over a month on Zero Belly Diet, Jennie lost 11 pounds, “and the pregnancy pooch is leaving!” she said. “I couldn’t believe I was indulging in dark chocolate—and finally getting results! It’s a lifestyle, not a diet. It’s easy to stick with, and it makes sense.”
Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[46]

Carbohydrate facts: Simple = bad, complex = good? Carbohydrates provide energy for the body, but the health benefits they offer depend on the type of carbs we consume. Complex carbs, found in brown rice, for example, contain more nutrients than simple carbs, such as white rice. Refined carbs, such as sugary drinks, are best avoided, as their nutritional value is low. Read now
[Guideline] Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009 Oct 20. 120(16):1640-5. [Medline].
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.
In 1977, Fisher and Fischer reviewed 245 cases with the planotome instrument for treating cellulite in the lateral trochanteric (hip-thigh) areas. There was a 4.9 per cent incidence of seromas, despite incision-wound suction catheters and compression dressings; 2.0 per cent of the cases presented pseudo-cyst formation that required removal of the capsule (cyst) through a wider incision (+ 5.0 mm) and the use of the panotome.[16][17]

1000 to 1500 ml crystalloids administered pre operatively as a priming solution and another 2000 ml of crystalloids given at the time of SA. Here again, depending on the clinical parameters, the rate of the fluid is adjusted accordingly. Overall, the patient, under Spinal Anaesthesia, will need about 1500 ml of crystalloids and 500 ml of colloid more than required under general anaesthesia.

But just because belly fat comes off a bit more easily doesn’t make it less dangerous. In fact, it’s the exact opposite. “Belly fat is unfortunately the most dangerous location to store fat,” says Dr. Cheskin. Because belly fat—also known as visceral fat, or the deep abdominal fat that surrounds your organs—is more temporary, it’s more active in terms of circulating in the bloodstream. That means it’s likely to raise the amount of fat in your blood (known as blood lipid levels) and increase your blood sugar levels, which as a result raises your risk of heart disease and type 2 diabetes.
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!

There are currently no legal requirements for food manufacturers to label trans fats, according to the British Dietetic Association, so you need to check ingredients lists for hydrogenated fats and hydrogenated vegetable oils. The biggest culprits? Your ‘cheat day’ favourites: cakes, biscuits, ice cream, popcorn, pies, fried food, fast food, takeaways — the list goes on.
Moving more . Even if you’ve never exercised before, you can start now and markedly reduce your risks. Even moderate amounts of activity will make a difference with heart markers. Walking is a good starter plan for many people. “I tell my patients to get an activity tracker,” Ndumele says. “Aim for 5,000 steps a day and work up to at least 10,000 steps a day.” Talk to your doctor to get the go-ahead on the types of workouts you want to try.

Development of metabolic syndrome depends on distribution as well as amount of fat. Excess fat in the abdomen (called apple shape), particularly when it results in a high waist-to-hip ratio (reflecting a relatively low muscle-to-fat mass ratio), increases risk. The syndrome is less common among people who have excess subcutaneous fat around the hips (called pear shape) and a low waist-to-hip ratio (reflecting a higher muscle-to-fat mass ratio).
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.
Glucose. Usually a fasting glucose test is performed but, in some cases, a healthcare practitioner may also order a post prandial glucose (after a meal) or a GTT (glucose tolerance test – several glucose tests that are taken before and at timed intervals after a glucose challenge). The goal of glucose testing is to determine whether a person has diabetes or a decreased ability to process glucose (impaired glucose tolerance), which can eventually result in diabetes.
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.

But just because belly fat comes off a bit more easily doesn’t make it less dangerous. In fact, it’s the exact opposite. “Belly fat is unfortunately the most dangerous location to store fat,” says Dr. Cheskin. Because belly fat—also known as visceral fat, or the deep abdominal fat that surrounds your organs—is more temporary, it’s more active in terms of circulating in the bloodstream. That means it’s likely to raise the amount of fat in your blood (known as blood lipid levels) and increase your blood sugar levels, which as a result raises your risk of heart disease and type 2 diabetes.


Metabolic syndrome is defined as the presence of a cluster of risk factors that are associated with a significantly higher risk for cardiovascular disease in the general population. The definitions for metabolic syndrome from different expert groups are somewhat different but generally include measures of adiposity, dyslipidemia, hypertension, and abnormal fasting blood glucose levels. Insulin resistance is the dominant but not the only condition underlying the pathogenesis of metabolic syndrome. The different components of the metabolic syndrome are independent risk factors for the development and progression of chronic kidney disease (CKD); hence, patients with metabolic syndrome are significantly more likely to have CKD. Conversely, metabolic syndrome is highly prevalent in patients with ESRD, including among those undergoing maintenance dialysis.
In 1977 and 1978, Gerald B. Phillips developed the concept that risk factors for myocardial infarction concur to form a "constellation of abnormalities" (i.e., glucose intolerance, hyperinsulinemia, hypercholesterolemia, hypertriglyceridemia, and hypertension) associated not only with heart disease, but also with aging, obesity and other clinical states. He suggested there must be an underlying linking factor, the identification of which could lead to the prevention of cardiovascular disease; he hypothesized that this factor was sex hormones.[66][67]
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.
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]
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.
Limits of lignocaine dosage have been explored since the development of this technique. Lillis[14] unofficially reported no complications with tumescent lignocaine dosages of greater than 70 mg/kg.[4] Ostad et al,[15] proposed the maximum tumescent safe lignocaine dosage to be 55 mg/kg of body weight. Maximum safe dose of tumescent lignocaine was a major bone of contention in academic discussions. The demonstration that the peak lignocaine concentration in the blood occurs at approximately 12 hours of initiating of the tumescent infiltration as against the 2 hours as was originally conceived was an unprecedented finding. A safe dosage for tumescent lignocaine was shown to be 35 mg/kg to 50 mg/kg by Kleinin.[16] The rate of infusion of the tumescent anaesthesia was shown to be independent of plasma lignocaine levels.
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)
As you get older, your body changes how it gains and loses weight. Both men and women experience a declining metabolic rate, or the number of calories the body needs to function normally. On top of that, women have to deal with menopause. "If women gain weight after menopause, it's more likely to be in their bellies," says Michael Jensen, MD, professor of medicine in the Mayo Clinic's endocrinology division. In menopause, production of the hormones estrogen and progesterone slows down. Meanwhile, testosterone levels also start to drop, but at a slower rate. This shift in hormones causes women to hold onto weight in their bellies. The good news: you can fight this process. Read on.

There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).

Lean protein like fish is a great way to fight fat and boost your metabolism. But the farmed salmon you get at the local market might not be the best bet for your belly. The cold-water fish has a well-deserved reputation for packing plenty of heart-healthy omega 3 fatty acids—1,253 mg of the good stuff, and just 114 mg of inflammatory, belly-busting omega 6s. But the farmed variety—and 90 percent of what we eat today is farmed—has a very different story to tell. It packs a whopping 1,900 mg of unhealthy omega-6s.
Metabolic syndrome is a common condition that goes by many names (dysmetabolic syndrome, syndrome X, insulin resistance syndrome, obesity syndrome, and Reaven syndrome). Most people identified as having this syndrome have been educated about the importance of watching for signs of diabetes, having their blood pressure monitored and lipid levels checked, and exercising – but there has been little to tie all of these factors together except pursuit of a "healthier lifestyle."
Your glycogen stores can still be refilled while on a ketogenic diet. A keto diet is an excellent way to build muscle, but protein intake is crucial here. It’s suggested that if you are looking to gain mass, you should be taking in about 1.0 – 1.2g protein per lean pound of body mass. Putting muscle on may be slower on a ketogenic diet, but that’s because your total body fat is not increasing as much.5Note that in the beginning of a ketogenic diet, both endurance athletes and obese individuals see a physical performance for the first week of transition.
• Standard ketogenic diet (SKD) — SKD is the type I typically recommend for most people, because it is very effective. It focuses on high consumption of healthy fats: As I explain in my book, "Fat for Fuel," you should aim for having 70 to 85 percent of your total daily calories to come from healthy fats. For your protein intake, the general rule of thumb is to follow the formula of 1 gram of protein for every kilogram of your lean body mass.
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.[42]
Pre-tunnelling (Mladick)[25] increases instrument control as, without suction, it creates desired superficial as well as deep planes of fat removal. It prevents an inadvertent removal in the sub-dermal fat layer that can result in contour irregularities. Similarly, cross tunnelling with at least two port sites at right angles are used to treat an area of adiposity. The use of multiple port sites provides for better contouring and feathering of edges.
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.
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]
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.
We are brazilian, living in Brazil. My daughter, Isabel, 21y. o., born in 1996, has syndrome of deficiency of Glut1. She was diagnosed around her first year of life. At that time her baby bottle, her begining diet meal, was 50ml water plus 50ml oil plus vitamin. Since then, which means, for 20 years, she is under this diet. For almost 18 years under 4:1 proportion. At this right moment 3:1. The only problem she had since started the diet were kidney stones in 2002. Nothing else. Grateful to the diet she doesn’t take any kind of medicine to avoid seizures. Her health is perfect, no colesterol at all. We are at your will for any issues related to her health.
^ 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.
Perhaps the best nut to consume if you’re trying to burn belly fat, almonds are full of polyunsaturated and monounsaturated fats, which are the good kind that we want, and which help to eliminate visceral fat through anti-inflammatory and cholesterol-balancing activities. Also, these nuts have high concentrations of fiber and magnesium, which help build muscle and burn fat.
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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