The ketogenic diet is a medical nutrition therapy that involves participants from various disciplines. Team members include a registered paediatric dietitian who coordinates the diet programme; a paediatric neurologist who is experienced in offering the ketogenic diet; and a registered nurse who is familiar with childhood epilepsy. Additional help may come from a medical social worker who works with the family and a pharmacist who can advise on the carbohydrate content of medicines. Lastly, the parents and other caregivers must be educated in many aspects of the diet for it to be safely implemented.[5]
On the other hand, the types of foods you’ll avoid eating on the keto, low-carb food plan are likely the same ones you are, or previously were, accustomed to getting lots of your daily calories from before starting this way of eating. This includes items like fruit, processed foods or drinks high in sugar, those made with any grains or white/wheat flour, conventional dairy products, desserts, and many other high-carb foods (especially those that are sources of “empty calories”).
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.”

Ultrasound-assisted liposuction (UAL): Also known as ultrasonic liposuction, the cannula is energized with ultrasound. This makes the fat melt away on contact. The ultrasound vibrations burst the walls of the fat cells. This emulsifies, or liquified, the fat, making it easier to suction out. This method is suitable for fibrous areas, such as the male breast, back, and in areas where liposuction has been done before.
Leafy greens like collard greens, watercress, kale, and arugula may not be on your everyday list, but they all contain a compound called sulforaphane. This nutrient has been shown to act directly on the genes that determine “adipocyte differentiation”—basically, turning a stem cell into a fat cell. A healthier intake of the compound means a healthier body weight for you. And just a scant teaspoon of vinaigrette will help your body absorb the fat-soluble nutrients.

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.

For weight loss, today's keto diets are the descendants of low-carb diets like the Atkins diet, which peaked in popularity in the early 2000s. Both types of diets reject carbs in favor of meatier meals. There is no single blueprint for the keto diet, but plans usually call for eating fewer than 50 grams of carbohydrates a day. (Wheat bread contains about 16 grams of carbohydrates per ounce, according to the USDA.) Celebrity adherents to the diet include Halle Berry and Kourtney Kardashian.

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.

It starts with limiting carbohydrate intake to just 20–30 net grams per day. “Net carbs” describes the amount of carbs remaining once dietary fiber is taken into account. Because fiber is indigestible once consumed, simply don’t count grams of fiber toward their daily carb allotment. So that means subtracting grams of fiber from total carb games, to give you the total net carbs.
Over 8–10 mmol/l: It’s normally impossible to get to this level just by eating a keto diet. It means that something is wrong. The most common cause by far is type 1 diabetes, with severe lack of insulin. Symptoms include feeling very sick with nausea, vomiting, abdominal pain and confusion. The possible end result, ketoacidosis, may be fatal and requires immediate medical care. Learn more
Care must be exercised in the gluteal crease, lateral gluteal depression, distal posterior thigh, middle medial thigh, and the infero-lateral ilio-tibial band as these areas have an increased susceptibility to superficial contour deformities due to minimal amounts of deep fat and adherence of the more superficial layer to the underlying fascia or the muscle.
But then I got sick and tired of being sick and tired, and since then, I’ve made it my life’s work to learn everything there is to know about how to lose belly fat fast. But nothing in my 20 years of health journalism has prepared me for the groundbreaking research that has emerged in just the last year—new science that shows exactly how we can turn off our fat genes and lose weight almost automatically.
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.

Long-term use of the ketogenic diet in children increases the risk of slowed or stunted growth, bone fractures, and kidney stones.[18] The diet reduces levels of insulin-like growth factor 1, which is important for childhood growth. Like many anticonvulsant drugs, the ketogenic diet has an adverse effect on bone health. Many factors may be involved such as acidosis and suppressed growth hormone.[38] About one in 20 children on the ketogenic diet develop kidney stones (compared with one in several thousand for the general population). A class of anticonvulsants known as carbonic anhydrase inhibitors (topiramate, zonisamide) are known to increase the risk of kidney stones, but the combination of these anticonvulsants and the ketogenic diet does not appear to elevate the risk above that of the diet alone.[39] The stones are treatable and do not justify discontinuation of the diet.[39] Johns Hopkins Hospital now gives oral potassium citrate supplements to all ketogenic diet patients, resulting in one-seventh of the incidence of kidney stones.[40] However, this empiric usage has not been tested in a prospective controlled trial.[9] Kidney stone formation (nephrolithiasis) is associated with the diet for four reasons:[39]

Most condiments below range from 0.5–2 net carb grams per 1–2 tablespoon serving. Check ingredient labels to make sure added sugar is not included, which will increase net carbs. (Stevia and erythritol will become your go-to sweeteners because neither raise your blood sugar — combine for a more natural sweet taste and, remember, a little goes a long way!)

My point here is that the warnings about the ketogenic principles are well taken and well documented. My concern is implications that this is a fad. I don’t use the word diet with my patients and I’m concerned that the principles behind the label and the real results that these readers have commented on might get minimized. I have found it best to encourage patients to read authors like: Stephen Phinney, Jeff Volek, Patricia Daly, and Charles Gant and the be partners with their doctors and check blood work as they move along. I am not for or against the article. If ketogenic principles offer people enduring, satisfying, and cohesive change then why not read about its potential and flexilbity?
It is to be appreciated and emphasised that the dreaded complications of pulmonary embolism, deep venous thrombosis, penetration injuries, bleeding, pulmonary oedema, hypovolemic shock, fat emboli, drug toxicity and mortality are absent in every large series of large volume liposuction. In all these cases, credit goes to a strict adherence to the 5 pillars of safety (safe surgeon, safe anaesthesiologist, safe facility, safe co-workers and a properly selected patient).
^ Jump up to: a b c Vemuri VK, Janero DR, Makriyannis A (March 2008). "Pharmacotherapeutic targeting of the endocannabinoid signaling system: drugs for obesity and the metabolic syndrome". Physiology & Behavior. 93 (4–5): 671–86. doi:10.1016/j.physbeh.2007.11.012. PMC 3681125. PMID 18155257. The etiology of many appetitive disorders is characterized by a pathogenic component of reward-supported craving, be it for substances of abuse (including alcohol and nicotine) or food. Such maladies affect large numbers of people as prevalent socioeconomic and healthcare burdens. Yet in most instances drugs for their safe and effective pharmacotherapeutic management are lacking despite the attendant medical needs, collateral adverse physical and psychological effects, and enormous global market potential. The endocannabinoid signaling system plays a critical role in motivational homeostasis as a conduit for reward stimuli and a positive modulator of brain reward circuits. Endocannabinoid-system hyperactivity through CB1 receptor transmission is considered contributory to a range of appetitive disorders and, hence, is a major focus of contemporary pharmaceutical research.
The media sometimes tells stories of liposuction patients who have endured bad results at the hands of inexperienced surgeons. Today’s liposuction techniques are much safer and more predictable than ever before, but surgeon skill still remains the number one factor when researching this procedure. The goal is to attain a natural and smooth result. An experienced surgeon will be able to provide this outcome.
Because metabolic syndrome and insulin resistance are closely tied, many healthcare providers believe that insulin resistance may be a cause of metabolic syndrome. But they have not found a direct link between the two conditions. Others believe that hormone changes caused by chronic stress lead to abdominal obesity, insulin resistance, and higher blood lipids (triglycerides and cholesterol).
Most condiments below range from 0.5–2 net carb grams per 1–2 tablespoon serving. Check ingredient labels to make sure added sugar is not included, which will increase net carbs. (Stevia and erythritol will become your go-to sweeteners because neither raise your blood sugar — combine for a more natural sweet taste and, remember, a little goes a long way!)

Blood vessels (veh-suls): The system of flexible tubes—arteries, capillaries and veins—that carries blood through the body. Oxygen and nutrients are delivered by arteries to tiny, thin-walled capillaries that feed them to cells and pick up waste material, including carbon dioxide. Capillaries pass the waste to veins, which take the blood back to the heart and lungs, where carbon dioxide is let out through your breath as you exhale.
The contents displayed within this public group(s), such as text, graphics, and other material ("Content") are intended for educational purposes only. The Content is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in a public group(s).
Another win for your morning cup of joe: Caffeinated coffee keeps things moving through the digestive tract. Since staying regular is key to a tighter-looking tummy, drinking about 8 to 16 ounces of java at the same time every day can help you stay on schedule. Remember: Sugary drinks can lead to weight gain, so skip fancy flavorings and synthetic sweeteners containing sugar alcohols, which can cause bloating.
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.
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.

In the mid-1990s, Hollywood producer Jim Abrahams, whose son's severe epilepsy was effectively controlled by the diet, created the Charlie Foundation to promote it. Publicity included an appearance on NBC's Dateline programme and ...First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a multicentre research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.[1]
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.
Stop treating your kitchen like an all-night diner and you’ll stop seeing those unwanted pounds piling onto your frame, too. The results of a study published in Cell Metabolism found that mice who only had access to food during an eight-hour period stayed slim over the course of the study, while those who ate the same number of calories over a 16-hour period gained significantly more weight, particularly around their middle. When you’re finished with dinner at night, shut the fridge and don’t look back until morning — your belly will thank you. When you do head back to the kitchen in the A.M., make sure the best healthy kitchen staples for cooking are there waiting for you.
First, a little background: Eric Westman, MD, director of the Duke Lifestyle Medical Clinic, explained to Health in a previous interview that in order to successfully follow the keto diet, you need to eat moderate amounts of protein, reduce your carb intake, and increase fats. When you reduce your carb consumption, your body turns to stored fat as its new fuel source—a process called ketosis. To stay in ketosis, followers of the keto diet must limit their carbs to 50 grams a day, Dr. Westman says.
Tumescent liposuction is a common approach used by surgeons. It is a suction-assisted (SAL) form of lipo that first injects a liquid agent into the area that is to be treated. The liquid agent includes saline, Lidocaine (a numbing agent) and Epinephrine (a medication that controls bleeding). A cannula is then inserted and passed through the fat deposits, suctioning them out. An attached power-aided motor allows the surgeon to control the speed of the fat removal, which can be as great as a few pounds or as little as several ounces. 
Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.

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A survey in 2005 of 88 paediatric neurologists in the US found that 36% regularly prescribed the diet after three or more drugs had failed, 24% occasionally prescribed the diet as a last resort, 24% had only prescribed the diet in a few rare cases, and 16% had never prescribed the diet. Several possible explanations exist for this gap between evidence and clinical practice.[34] One major factor may be the lack of adequately trained dietitians, who are needed to administer a ketogenic diet programme.[31]

Ultrasound is used as an ablative tool in urology and neuro-surgery. Ultrasonic assisted liposuction (UAL) was developed and introduced in the early 1990s by Zocchi[12] in Italy. His interest in ultrasound was originally for harvesting collagen from aspirated fat. The chance observations that adipose tissues were effectively emulsified while connective tissue structures were preserved in vitro led to the concept of using ultrasound adjunctively in vivo.
There are many ways to do liposuction, for example liposuction can be accomplished painlessly either totally by local anesthesia or with general anesthesia. In the realm of liposuction, maximum speed and maximum volume of aspirate are not criteria for excellence. Ultimately, excellence is measured in terms of patient happiness which is a function of safety, patient comfort, finesse, and quality of results.
That’s because it theoretically causes a mild ketosis (yep, the basis of the keto diet), which is a fat-burning state that should make you feel less hungry. The key in being successful with a low-carb diet (especially if you’re used to a more high-carb lifestyle) is to compensate for those lost carbs with protein-rich foods, says Dr. Cheskin. That way, your volume of food stays the same, but you’re doing it healthfully rather than in a way that exacerbates your weight gain.
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.)
Increasing numbers of people around the world are suffering from chronic diseases such as diabetes and obesity, and the main culprit is usually the food they eat. The standard American diet, for example, consists of excessive amounts of protein, processed grains and carbohydrates — particularly in the form of refined, added sugars — none of which is good for your health.
Dr. Campos, it is so discouraging to see that you disparage the ketogenic diet based on your assumption that it is very heavy in poor quality processed meats. No diet that relies on processed foods can be viewed as “healthy”. Become better informed by getting up to speed with what Jeff Volek, RD, PhD, calls a “well-formulated ketogenic diet.” Also, learn more about the potential of the diet to slow cancer progression (my specialty). You owe it to your patients who are depending on you for advice. Present them with facts, not opinions.
Carbohydrates have been linked to this skin condition, so cutting down on them may help. And the drop in insulin that a ketogenic diet can trigger may also help stop acne breakouts. (Insulin can cause your body to make other hormones that bring on outbreaks.) Still, more research is needed to determine exactly how much effect, if any, the diet actually has on acne. 
In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.[55]
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.

Tumescence is the state of being ‘swollen and firm’ [Figure 2]. Tumescent liposuction uses large volumes of very dilute, hypotonic solutions of a vasoconstrictor agent that is gently injected into the subcutaneous fat and virtually eliminates surgical blood loss. It also permits the procedure to be done under regional anaesthesia with conscious sedation. Local anaesthesia may be supplemented for areas proximal to the level of the regional anaesthesia.

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.)

The amount of fat removed really depends on the size of the patient and their aesthetic goals. From a safety standpoint, the American Society of Plastic Surgeons recommends roughly 10 pounds of fat or less. Otherwise it is considered a high-volume liposuction, which does present an increased set of risks. It’s advised to get down to your ideal weight before undergoing a liposuction procedure.


A well-formulated ketogenic diet, besides limiting carbohydrates, also limits protein intake moderately to less than 1g/lb body weight, unless individuals are performing heavy exercise involving weight training when the protein intake can be increased to 1.5g/lb body weight. This is to prevent the endogenous production of glucose in the body via gluconeogenesis. However, it does not restrict fat or overall daily calories. People on a ketogenic diet initially experience rapid weight loss up to 10 lbs in 2 weeks or less. This diet has a diuretic effect, and some early weight loss is due to water weight loss followed by a fat loss. Interestingly with this diet plan, lean body muscle is largely spared. As a nutritional ketosis state sustains, hunger pangs subside, and an overall reduction in caloric intake helps to further weight loss.

Normal dietary fat contains mostly long-chain triglycerides (LCTs). Medium-chain triglycerides (MCTs) are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[18] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhea, and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[18]
Advent of the tumescent technique in 1987 has allowed for safe contouring in ambulatory single session liposuction under regional or general anaesthesia. Safety and aesthetic issues define MegaLiposuction to be in Volume in litres of more than 10% of Body weight in Kgs. 870 cases of liposuction were performed between September 2000 and August 2008. In (65%) cases, the total volume of aspirate was greater then 5 liters. (Range: 5 to 25 liters). In 24% cases, the large volume liposuction was combined with a limited or a total block lipectomy. Regional anaesthesia with conscious sedation was preferred except where liposuction was for above the subcostal region (the Upper Trunk, Lateral Chest, Back, Gynaecomastia, Breast, Arms and Face) or when the patient so desired. Tumescent infiltration with Lactated ringer, adrenalin, triamcinalone and hyalase was made in all cases. This approach has clinically shown less tissue edema in the post operative period than when the conventional physiological saline was being used in place of Ringer Lactate. The amount injected varied from 1,000 ml to 12,500 ml depending on the size, site and area. Local anesthetic was included only to the terminal portion of the tumescent mixture while infiltrating the sub-costal regions, or when above costal region was combined with below costal region being anaesthetized with Spinal Anaesthesia. The aspirate was restricted to the unstained white / yellow fat and the amount of fat aspirated did not have any bearing to the amount of solution infiltrated. There was no major complication. Blood transfusion was given only on one occasion when the patient had been on aspirin and had also received Low Molecular weight Heparin intra-operative. The hospital stay ranged from 8 to 24 hours for liposuction as well as for liposuction with a lipectomy. Serous discharge from access sites, sero-sanguinous fluid accumulation requiring drainage were necessitated in less than 10% cases. Minor re-contouring touch ups were requested in 5% cases. Early ambulation was encouraged for mobilization of third space fluid shifts to expedite recovery and to prevent deep vein thrombosis. More than 10% patients were operated on for Liposuction of other areas, after a gap of 7 days to 6 months. Meticulous perioperative monitoring of systemic functions ensures safety in tumescent megaliposuction for the obese and rewarding results can be achieved in a single sitting.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the "change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
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