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Male Testosterone Replacement Therapy (TRT) | Laser Center …

Posted: February 10, 2019 at 9:41 pm

Feel Better with TRT and Get Back in the Game!

We hear a lot about the changes caused by menopause in women, but much less about andropause (so called manopause) or low testosterone in men. Young men in their late teens and twenties seem to have boundless energy driven by high testosterone levels, but that doesnt last. Testosterone levels drop about one percent a year after age 30 and many men experience an even steeper decline. This steady drop in testosterone can lead to a need for Testosterone Replacement Therapy (TRT).

Physical signs of declining testosterone (low T) include decreased muscle strength and size, increased fat- especially belly fat, loss of body hair, dry eyes, elevated blood pressure, thinning dry skin, enlarging fatty breasts (gynecomastia), and lack of body odor.

The Adam Questionaire is a sensitive tool for screening for low T. A decrease in sex drive or erectile dysfunction suggest low T. Other symptoms include decreased energy or strength, decreased enjoyment of life, sadness or grumpiness, falling asleep after dinner, or a recent deterioration in work performance.

Fortunately, most men can be restored to hormonal health with proper medical care. The benefits of testosterone replacement therapy (TRT) include increased energy and strength, increased muscle mass, decreased osteoporosis, improved cholesterol profile, lowered blood sugars, improved sexual function, and increased longevity.

Men experiencing the symptoms of low T need a focused medical history, physical exam, and laboratory testing by a physician with specialized training in TRT. Although testosterone may be replaced by transdermal gels or implanted pellets, most patients are best managed by self administered injections of bioidentical testosterone and HCG (human chorionic gonadotropin). Some men may also need estrogen blocking pills.

The good news is that many of these negative symptoms are not really from aging at all, but rather from low testosterone. You can improve your health and recapture the joy and vigor of life.

TRT is safe if appropriately prescribed and monitored. There is no evidence that testosterone causes cancer, however preexisting prostate cancer may grow faster with TRT. It is very important to have a prostate exam and a serum PSA (prostatic specific antigen) level prior to beginning therapy, and to monitor the PSA level regularly.

You may very well start feeling better within days. However, body composition changes will transform over several months as your testosterone (T) level is optimally tuned. Several patients have already reported weight loss and lean muscle gain within the first month. They have have also reported increased erection strength, better sex drive, and an overall uptick in energy.

Male breast enlargement (gynecomastia) is a sign of testosterone/estrogen imbalance. Patients with this problem may need an estrogen blocker in addition to TRT. Therapy does not reverse the enlargement, but often Laser Assisted Liposuction can correct it very nicely.

The Laser Center of Maryland proudly provides Baltimore, Annapolis, Columbia, Severna Park, Glen Burnie and Pasadena, Maryland with comprehensive and advanced laser surgery and cosmetic surgery.

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Male Testosterone Replacement Therapy (TRT) | Laser Center ...

Dieting – Wikipedia

Posted: February 10, 2019 at 9:40 pm

Dieting is the practice of eating food in a regulated and supervised fashion to decrease, maintain, or increase body weight, or to prevent and treat diseases, such as diabetes. A restricted diet is often used by those who are overweight or obese, sometimes in combination with physical exercise, to reduce body weight. Some people follow a diet to gain weight (usually in the form of muscle). Diets can also be used to maintain a stable body weight and improve health.

Diets to promote weight loss can be categorized as: low-fat, low-carbohydrate, low-calorie, very low calorie and more recently flexible dieting.[1] A meta-analysis of six randomized controlled trials found no difference between low-calorie, low-carbohydrate, and low-fat diets, with a 24 kilogram weight loss over 1218 months in all studies.[1] At two years, all calorie-reduced diet types cause equal weight loss irrespective of the macronutrients emphasized.[2] In general, the most effective diet is any which reduces calorie consumption.[3]

A study published in American Psychologist found that short-term dieting involving "severe restriction of calorie intake" does not lead to "sustained improvements in weight and health for the majority of individuals".[4] Other studies have found that the average individual maintains some weight loss after dieting.[5] Weight loss by dieting, while of benefit to those classified as unhealthy, may slightly increase the mortality rate for individuals who are otherwise healthy.[6][7][8]

The first popular diet was "Banting", named after William Banting. In his 1863 pamphlet, Letter on Corpulence, Addressed to the Public, he outlined the details of a particular low-carbohydrate, low-calorie diet that had led to his own dramatic weight loss.[9]

One of the first dietitians was the English doctor George Cheyne. He himself was tremendously overweight and would constantly eat large quantities of rich food and drink. He began a meatless diet, taking only milk and vegetables, and soon regained his health. He began publicly recommending his diet for everyone suffering from obesity. In 1724, he wrote An Essay of Health and Long Life, in which he advises exercise and fresh air and avoiding luxury foods.[10]

The Scottish military surgeon, John Rollo, published Notes of a Diabetic Case in 1797. It described the benefits of a meat diet for those suffering from diabetes, basing this recommendation on Matthew Dobson's discovery of glycosuria in diabetes mellitus.[11] By means of Dobson's testing procedure (for glucose in the urine) Rollo worked out a diet that had success for what is now called type 2 diabetes.[12]

The first popular diet was "Banting", named after the English undertaker William Banting. In 1863, he wrote a booklet called Letter on Corpulence, Addressed to the Public, which contained the particular plan for the diet he had successfully followed. His own diet was four meals per day, consisting of meat, greens, fruits, and dry wine. The emphasis was on avoiding sugar, sweet foods, starch, beer, milk and butter. Bantings pamphlet was popular for years to come, and would be used as a model for modern diets.[13] The pamphlet's popularity was such that the question "Do you bant?" referred to his method, and eventually to dieting in general.[14] His booklet remains in print as of 2007.[9][15][16]

The first weight-loss book to promote calorie counting, and the first weight-loss book to become a bestseller, was the 1918 Diet and Health: With Key to the Calories by American physician and columnist Lulu Hunt Peters.[17]

Low-fat diets involve the reduction of the percentage of fat in one's diet. Calorie consumption is reduced because less fat is consumed. Diets of this type include NCEP Step I and II. A meta-analysis of 16 trials of 212months' duration found that low-fat diets (without intentional restriction of caloric intake) resulted in average weight loss of 3.2kg (7.1lb) over habitual eating.[1]

Low-carbohydrate diets are relatively high in protein and fats. Low-carbohydrate diets are sometimes ketogenic (i.e., they restrict carbohydrate intake sufficiently to cause ketosis).

Low-calorie diets usually produce an energy deficit of 5001,000 calories per day, which can result in a 0.5 to 1 kilogram (1.1 to 2.2 pounds) weight loss per week. One of the most commonly used low-calorie diets is Weight Watchers. The National Institutes of Health reviewed 34 randomized controlled trials to determine the effectiveness of low-calorie diets. They found that these diets lowered total body mass by 8% in the short term, over 312 months.[1] Women doing low-calorie diets should have at least 1,000 calories per day and men should have approximately 1,200 calories per day. These caloric intake values vary depending on additional factors, such as age and weight.[1]

Very low calorie diets provide 200800 calories per day, maintaining protein intake but limiting calories from both fat and carbohydrates. They subject the body to starvation and produce an average loss of 1.52.5kg (3.35.5lb) per week. "2-4-6-8", a popular diet of this variety, follows a four-day cycle in which only 200 calories are consumed the first day, 400 the second day, 600 the third day, 800 the fourth day, and then totally fasting, after which the cycle repeats. These diets are not recommended for general use as they are associated with adverse side effects such as loss of lean muscle mass, increased risks of gout, and electrolyte imbalances. People attempting these diets must be monitored closely by a physician to prevent complications.[1]

Detox diets are promoted with unsubstantiated claims that they can eliminate "toxins" from the human body. Many of these diets use herbs or celery and other juicy low-calorie vegetables.

Religious prescription may be a factor in motivating people to adopt a specific restrictive diet.[18] For example, the Biblical Book of Daniel (1:2-20, and 10:2-3) refers to a 10- or 21-day avoidance of foods (Daniel Fast) declared unclean by God in the laws of Moses.[18][19] In modern versions of the Daniel Fast, food choices may be limited to whole grains, fruits, vegetables, pulses, nuts, seeds and oil. The Daniel Fast resembles the vegan diet in that it excludes foods of animal origin.[19] The passages strongly suggest that the Daniel Fast will promote good health and mental performance.[18]

Fasting is practiced in various religions. Examples include Lent in Christianity; Yom Kippur, Tisha B'av, Fast of Esther, Tzom Gedalia, the Seventeenth of Tamuz, and the Tenth of Tevet in Judaism.[20] Muslims refrain from eating during the hours of daytime for one month, Ramadan, every year.

Details of fasting practices differ. Eastern Orthodox Christians fast during specified fasting seasons of the year, which include not only the better-known Great Lent, but also fasts on every Wednesday and Friday (except on special holidays), together with extended fasting periods before Christmas (the Nativity Fast), after Easter (the Apostles Fast) and in early August (the Dormition Fast). Members of The Church of Jesus Christ of Latter-day Saints (Mormons) generally fast for 24 hours on the first Sunday of each month. Like Muslims, they refrain from all drinking and eating unless they are children or are physically unable to fast. Fasting is also a feature of ascetic traditions in religions such as Hinduism and Buddhism. Mahayana traditions that follow the Brahma's Net Sutra may recommend that the laity fast "during the six days of fasting each month and the three months of fasting each year" [Brahma's Net Sutra, minor precept 30]. Members of the Baha'i Faith observe a Nineteen Day Fast from sunrise to sunset during March each year.

Weight loss diets that manipulate the proportion of macronutrients (low-fat, low-carbohydrate, etc.) have been shown to be no more effective than diets that maintain a typical mix of foods with smaller portions and perhaps some substitutions (e.g. low-fat milk, or less salad dressing).[21] Extreme diets may, in some cases, lead to malnutrition.

The Dietary Guidelines for Americans is a set of recommendations about a healthy diet written for policy makers, nutrition scientists, and dieticians and other clinicians, produced by the US Department of Agriculture, in concert with the US Department of Health and Human Services and quintannually-revised. The current guidelines are written for the period 2015 - 2020 and were used to produce the MyPlate recommendations on a healthy diet for the general public.

One of the most important things to take into consideration when either trying to lose or put on weight is output versus input. It is important to know the amount of energy your body is using every day, so that your intake fits the needs of one's personal weight goal. Someone wanting to lose weight would want a smaller energy intake than what they put out. There is increasing research-based evidence that low-fat vegetarian diets consistently lead to healthy weight loss and management, a decrease in diabetic symptoms[22] as well as improved cardiac health.[23]

When the body is expending more energy than it is consuming (e.g. when exercising), the body's cells rely on internally stored energy sources, such as complex carbohydrates and fats, for energy. The first source to which the body turns is glycogen (by glycogenolysis). Glycogen is a complex carbohydrate, 65% of which is stored in skeletal muscles and the remainder in the liver (totaling about 2,000 kcal in the whole body). It is created from the excess of ingested macronutrients, mainly carbohydrates. When glycogen is nearly depleted, the body begins lipolysis, the mobilization and catabolism of fat stores for energy. In this process, fats, obtained from adipose tissue, or fat cells, are broken down into glycerol and fatty acids, which can be used to generate energy.[24] The primary by-products of metabolism are carbon dioxide and water; carbon dioxide is expelled through the respiratory system.

Some weight loss groups aim to make money, others work as charities. The former include Weight Watchers and Peertrainer. The latter include Overeaters Anonymous and groups run by local organizations.

These organizations' customs and practices differ widely. Some groups are modelled on twelve-step programs, while others are quite informal. Some groups advocate certain prepared foods or special menus, while others train dieters to make healthy choices from restaurant menus and while grocery-shopping and cooking.

A 2008 study published in the American Journal of Preventive Medicine showed that dieters who kept a daily food diary (or diet journal), lost twice as much weight as those who did not keep a food log, suggesting that if you record your eating, you would be more aware of what you eat and, therefore you wouldn't eat as many calories.[25]

A 2009 review found that existing limited evidence suggested that encouraging water consumption and substituting energy-free beverages for energy-containing beverages (i.e., reducing caloric intake) may facilitate weight management. A 2009 article found that drinking 500ml of water prior to meals for a 12-week period resulted in increased long-term weight reduction. (References given in main article.)

Fasting is when there is a long time interval between the meals. In dieting, fasting is not recommended, instead, having small portions of food after small intervals is encouraged. Lengthy fasting can also be dangerous due to the risk of malnutrition and should be carried out only under medical supervision. During prolonged fasting or very low calorie diets the reduction of blood glucose, the preferred energy source of the brain, causes the body to deplete its glycogen stores. Once glycogen is depleted the body begins to fuel the brain using ketones, while also metabolizing body protein (including but not limited to skeletal muscle) to be used to synthesize sugars for use as energy by the rest of the body. Most experts believe that a prolonged fast can lead to muscle wasting, although some dispute this. The use of short-term fasting, or various forms of intermittent fasting have been used as a form of dieting to circumvent this issue.

While there are studies that show the health and medical benefits of weight loss, a study in 2005 of around 3000 Finns over an 18-year period showed that weight loss from dieting can result in increased mortality, while those who maintained their weight fared the best.[6][8][26] Similar conclusion is drawn by other studies,[6][27] and although other studies suggest that intentional weight loss has a small benefit for individuals classified as unhealthy, it is associated with slightly increased mortality for healthy individuals and the slightly overweight but not obese.[7] This may reflect the loss of subcutaneous fat and beneficial mass from organs and muscle in addition to visceral fat when there is a sudden and dramatic weight loss.[8]

Low-carbohydrate and low-fat diets perform similarly in the long term as weight maintenance depends on calorie intake, not macronutrient ration.[28]

"The glycemic index (GI) factor is a ranking of foods based on their overall effect on blood sugar levels. The diet based around this research is called the Low GI diet. Low glycemic index foods, such as lentils, provide a slower, more consistent source of glucose to the bloodstream, thereby stimulating less insulin release than high glycemic index foods, such as white bread."[29][30]

The glycemic load is "the mathematical product of the glycemic index and the carbohydrate amount".[31]

In a randomized controlled trial that compared four diets that varied in carbohydrate amount and glycemic index found complicated results:[32]

Diets 2 and 3 lost the most weight and fat mass; however, low density lipoprotein fell in Diet 2 and rose in Diet 3. Thus the authors concluded that the high-carbohydrate, low-glycemic index diet was the most favorable.

A meta-analysis by the Cochrane Collaboration concluded that low glycemic index or low glycemic load diets led to more weight loss and better lipid profiles. However, the Cochrane Collaboration grouped low glycemic index and low glycemic load diets together and did not try to separate the effects of the load versus the index.[33]

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Dieting - Wikipedia

10 Fast Weight Loss Tips if You Weigh 200 lbs or More …

Posted: February 6, 2019 at 6:41 pm

These fast weight loss tips if you weigh 200 lbs are perfect for you if you feel like youve tried everything under the sun and still cant lose weight. Gut health, exercise, carbohydrate intake, and SO many other factors are likely at play here.

Read below and see if any of the following resonate with you

Do you feel like youve tried every weight loss scheme under the sun?

That no matter what crazy diet you try nothing seems to stick?

You watch helplessly as the scale slowly creeps up higher and higher, while feeling totally out of control and powerless

You know you desperately want to lose weight, be thin and free, but no matter what you do, it just doesnt work.

Thats because weight loss is not a game of numbers. Its emotional.

Its much deeper than data or calories.

If you truly reflect on it long enough, it could likely bring tears to your eyes.

But lets reflect on something else instead

Where you are going.

Take a second, right now, to pause and deeply imagine where you could be 1 year from now with the RIGHT plan in place.

The truth is, youve got so so much left to live for and so much more of life to experience.

If you can lock in, focus, and be present for this article, Alex and I are going to do the absolute best we can to help you slay this weight loss dragon.

Weve now walked hand in hand with thousands of clients through this process of losing weight at 200 pounds or more.

Beautiful women like Shawna, Cory, Alison, and thousands of others have completely touched our lives and even brought us to pools of tears with their stories.

Its now your turn

10 Fast Weight Loss Tips if You Weight 200 Pounds or More

A successful weight loss journey is going to be different for you than some 20-something

Talk about obvious statements right?

And its the capital T Truth.

Were shocked by how many women are put on some fast weight loss protocol designed for a college age girl looking to lose her last 5 pounds

Instead of that, you need a program and lifestyle designed for YOU!

While every weight loss program on the planet earth is telling you to go running, do lots of jumping, and perform crazy intense exercises, were just sitting here shaking our heads.

Exercising at this weight will unnecessarily stress your joints, cause cravings, and is too much of a risk.

Besides, our clients lose the weight without doing ANY of that.

This is because exercise plays such a minusculerole for weight loss

In fact, a recent study done by Current Biology took 322 adults from 5 different countries through a calorie reduction weight loss program. They split the groups between those that did exercise and those that did not.

Shockingly enough,adding in exercise did not play ANY major role over calories burned or weight lost.And for those that saw changes, they were minor at best.

Your focus needs to be on your diet not on some new P90ExtremeJumpingFactor program.

Before some of you freak out We LOVE exercise and believe that it is INCREDIBLY healthy and necessary for long-term health.

Exercise can easily be added in at a later point once healthydieting habits have been established and your hormones are working properly again (see below).

Binge eating and emotional eating are things most of our clients have experienced and suffered greatly from.

In fact, Dr. Michael Mantell from Greatist.com found that there were 5 main negative emotional factors that cause binge and emotional eating:

Tackling these is crucial to fast weight loss success.

You need to tackle the emotional aspect of this with a powerful support group or community of people you can trust.

Do whatever it takes to get with a community that can help. Its that important.

This is a key part of our fast weight loss program, for this very reason. Because IT WORKS.

Next up on our list of fast weight loss tips if you weigh 200 lbs or more is

Listen, we dont hate carbohydrates.

They are fine and dandy.

The problem is that if youre 200 pounds or more, youlikelyhave a lot of insulin resistance (90% of the time).

This makes every carbohydrate you eat wildly ineffective at providing energy you can use and stick to your body like glue.

It also can lead to metabolic resistance, pre-diabetes, or diabetes.

You need to do a carbohydrate DETOX.

Cut out carbohydratesfor a month-long period at a bare minimum.

You can reintroduce them later when the body repairs itself and your hormones level out. The body needs a break from the excessive consumption totruly reset and detox.

Leptin is the hormone designed to send the brain these two important messages:

Many of you will be thinking: Where has this hormone been??!!

The truth is, leptin is getting blocked due to the insulin resistance you have.

This is why when you focus on diet first, exercise will come in later very naturally to your life when your leptin is functioning properly again.

Cutting down on carbohydrates and eating lots of lean protein and veggies will help level your leptin.

Gut inflammation is likely an underlying issue if you weigh 200 lbs or more.

The annoying part of this is that if you have a leaky gut, thebody isnt processing properly the foods you eat (even the good ones!).

The good news? Healing the digestive tract is simple.

First you eliminate foods that hurt your gut health (sugars, flour, processed foods). Then you consume probiotics to replace the heal the gut.

Consumelots of apple cider vinegarand make sure to take agood probiotics supplementto do this!

Walking is surprisingly effective for weight loss.

Some of you may be unable to do a full walk due to knee and hip problems.

Thats okay. Just do what you can with what you have!

Next up on our list of fast weight loss tips if you weigh 200 lbs or more is

Counting calories is great model for bodybuilders looking to get to 5% body fat or overly obsessed personal trainers looking to take mirror photos.

Counting calories is a pretty terrible model if you are over200 poundsand trying to get a weight loss journey started off on the right foot.

This is because of the hormonal damage you likely have.

Insulin resistance, leptin resistance, high cortisol, and MANY others are likely affecting you.

So when you do count calories,the weight wont drop fast enough.Sometimes it wont budge at all.

This is an excruciating feeling when you areeating like a rabbit and not seeing the scale move.

Focus less on calories and more on the QUALITY of what you areeating.

According to the latest science,militant diets win out vs. standard diets.

Those who lose the most weight in the first 2-4 weeks of dieting have thegreatest weight loss resultsin the following year.

Therefore,losing weight fast will better impact you in both the short-term and the long-term. The most effective thing you can do is actually acold turkey approach.

And you need some weight loss wins at your back to keep moving forward!

Get results fast, and use a program that moves quickly.

The more you love yourself, accept yourself, and commit to working on yourself, the better off you will be.

A failure to take care of yourself and your body is a failure to love yourself.

Commit to this journey, accepting where you are, and loving yourself throughout the entire process!

Your health and your happiness are the greatest assets you have.

If this article spoke to you in any way, our 21-Day Fat Loss Challenge is the next thing you need to see.

Yeah, people lose an average of 10-21 pounds in 21 days, and thats cool and all, but heres what were more pumped about: We have helped thousandsof clientsmaking lifelongchanges and habits that STICKfor them.

Testimonials that have literally brought us to tears:

We have over 1,500 challengers in our private support group going through the Challenge together, and every day they aresharingexperiences, results, motivation, recipes, supporting one another.

Remember its not about what happened in the past that matters, its what you aredoing in the NOW.

I know that many of you are ready tomake a big and PERMANENT change in your life, and this is where you should start.

Everything is laid out for you in an easy to understand step-by-step process ANYONE can do.

You will know what to eat, when to eat it, and what to do next every day for your weight loss success.

You can start YOUR 21 Day Fat Loss Challenge byclicking here.

Leave me a comment below if you enjoyed this article on fast weight loss tipsif you weigh 200 lbs or more or if have any questions!

Lauren at Avocadu

Hey there! I'm Lauren McManus, one-half of the Avocadu team! Together, my boyfriend Alex and I run this website! We believe in quality over quantity and that diet determines 85% or more of your health and well-being. In short, we believe in being healthy from the inside out.

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10 Fast Weight Loss Tips if You Weigh 200 lbs or More ...

11 Fruits can you Eat Safely in a Ketogenic Diet – Cool …

Posted: February 2, 2019 at 9:41 am

Lemme start with a disclaimer.

I am no nutritionist. I just love the ketogenic diet. So, whatever I am stating is purely based on the research I have done.

When I started with the keto diet I was surprised that so many fruits are being taken out of the list. I really could not understand, why?

I am a fruit lover and relish just any kind of fruits. So it was hard for me to omit a certain bunch.

I love oranges and watermelons so I know how hard it was for me to give it up.

Fruits are definitely good while you are on a regular diet for the nutritional values.

But many fruits contain fructose in high amount andFructose is a BIG NO for keto.

The high fructose level in fruits gets metabolized in the liver which in turn turns into fat. This fat deposits around the abdomen (which is really hard to get off).

So the fruits which contain a high amount of fructose or sucrose leads to high carb diet and hence omitted from keto list.

So check out the fruits which you can happily gulp down while in a keto.

Blackberries are reasonably low in carbohydrates. It contains only 4.9 grams of carbs per 100 gms.

Not only it is tasty but I like the blackberries more for its medicinal values.

Blackberries lower the blood glucose level and hence leads to a better cholesterol profile. It also provides the antimicrobial and antidiabetic effect.

Blackberries also reduce inflammation. This is where your stomach and waist starts to shrink ( Keto effect ) So,happily include it in a keto diet.

I love this fruit.

Really delicious and full of nutrients. And what I like most about it is, instead of being sweet and juicy, this fruit is quite low in carbs.

The loveliest part of strawberries is that I can make several keto desserts with it. Especially strawberry dipped in chocolate. Just too yummy for a keto diet.

You know, strawberries even protect our health with the bio-active compounds. It also improves our blood sugar levels.

Strawberry contains only 5.7 grams of carb per 100 gm.

Should I start with its carb content? Its only 1.8 grams of carbs for per 100 gm of avocado.

They are just amazing.

It is so delicious and can be combined with any type of keto salads.

It provides with many essential fats that are just perfect for a keto diet.

This fruit also comes with a large number of vitamins and minerals and improves our cardiovascular health.

Have you checked the keto recipes? You will find coconut in ample recipes. Whether its coconut milk or coconut creamed bars. Oh, I just love these bars. In fact, I like almost all the keto desserts.

There are other coconut items too like:

They are very useful in making low carb snacks as they themselves contain only 6.25 carbs per 100 gm.

Coconut contains a fairly large amount of medium chain triglycerides which are used by the body to produce instant energy.

Can you believe it that olives have only 1 gm of carbs for per 100 gm?

Yes, olive is one of the best low carb fruits available.

Not only it contains a high amount of good fat (You know how much fat is necessary for keto diet) but it also reduces the risk of cardiovascular diseases.

I love to put a good amount of olive pieces on my keto pizza.

Oh forgot to add that olives improve our bone health too. Yes, it is a win-win from every angle.

Lemons are just so common to use in any of the dishes. Not only it brings the tangy taste but lemons are loaded with hell amount of benefits too.

100 gms of lemon gives only 6 gm of carbs.

This tasty fruit has the highest amount of antioxidants and serves 5.4 grams of carbs per 100 gm of it.

I love to mix the raspberries with some buttercream. It tastes amazing and serves as a quick keto dessert.

This is a fruit which can be a bit tough to consume raw. It is sour.

So you can half dry it in the sun with sprinkles of salt over it.

But the benefits are innumerable.

Gooseberries are well known for its positive effect on skin and hair.

It also contains anticancer properties.

I can tell you about the endless benefits of this fruit but when it comes to keto then it is carb and sugar content that matters.

Gooseberries serve 5.9 grams of carbs per 100 gm. Quite reasonable.

Tomatoes and fruits? Well yes, it is.

Now tomato is a fruit which you can put in any recipes to bring the tangy taste. So when you are mixing it with other vegetables then our mind holds a perception that tomato is also a vegetable.

Even the tomato sauces are widely used.

Tomatoes also contain micronutrients and vitamins which improve our health condition.

It serves only 2.7 grams of carbs per 100 gm of it.

Starfruit is a delicious tropical fruit which is rich in vitamin C.

I love its crunchy yet juicy pulp.

It also carries a small amount of minerals and electrolytes. And yes starfruit is rich in antioxidants too.

It serves 4.2 of net carbs per 100 g

Lime and lemon are often confused with each other.

The difference between them is that lime has a higher concentration of vitamin C and other antioxidants.

It provides a net carb of 8.2 g per 100 g.

Though the carb content is a bit higher, limes keep your arteries cleaner and thus aids in better blood flow.

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11 Fruits can you Eat Safely in a Ketogenic Diet - Cool ...

Ayurvedic Home Remedies For Weight Loss – Pitta Ayurveda

Posted: January 31, 2019 at 8:41 pm

Among the alternate medicine systems that available, Ayurveda seem to be the one that got fastest growing around the world. Ayurveda medicine is originated from India and is current growing fast in western world. Ayurveda medicine did offers a lot health benefits for people will going through with the treatments like meditation, massage, diet, and herbs remedies. Besides, Ayurveda can assist someone to lose weight as well. The fact is, many people have adopted Ayurvedic practices and managed to lose significant weight, and at the same time also received a restoration of peace and balance of their body and mind.

With the use of Ayurvedic medicines for weight loss, it involves different types of herbs that can help to burn fat of a person and rebuild the natural metabolic process of the body.

1. Gymnema

This is an Ayurvedic type of herbs that is regarded as the destroyer of sugar. Gymnema got its name due to thousand years ago, Ayurvedic practitioners have been discovered that chewing a few of these leaves can effectively reduce the taste of sugar. Nowadays, it is widely used in India as well as many other countries that have Ayurveda medicine practices. Gymnema is mainly being used for suppressing blood sugar levels.

2. Guggul

This herb is a highly effective resin extract which you can get from the tiny, thorny mukul myrrh tree. It is well-known as the Fat Killer. Guggul is a great herb in Ayurveda due to it can remove extra fat from the body, boost cellular flame, support liver function and control cholesterol at healthy level. The herb isnt a nutritive tonic by itself, however, it assists in catalyze tissue regrowth and grows white blood cells. Besides, it can stabilized the conditions of ailments including gout, arthritis, diabetes, nervous disorders, skin disease, and help for weight loss.

3. Ginger (Zingiber Officinale)

Many Ayurveda physicians believe Ginger can help in losing weight without any side effects. This is due to ginger is rich with photochemical that can controls oxidation of fatty acids and regulate metabolism of cholesterol. It suppresses the accumulation of fat and controls the level of cholesterol in the blood.

For those overweight people, they can only reduce their weight if they can treat the root causes for their obesity and weight gain. Here is the Ayurveda way that can help a person to lose weight by follow the diet plan that targeted on the root causes of obesity.

Step 1: Identify Ayurveda body type. Knowing what dosha a person possess either is Vata, Pitta or Kapha. ( You can take this Ayurveda Test to know your dosha type)

Step 2: Arrange a treatment plan according to the Ayurveda body type of the person to get rid of extra fat, toxins and imbalances.

Step 3: Prepare Ayurvedic weight loss diet as well as daily routine for a person to stick to.

Step 4: Improve digestion to lose fat and weight through correct exercises.

Early morningChop a lemon into half, make it a juice, take a teaspoon of honey and mixed in a glass of warm water. Stir it and drink.

Breakfast Taking mung bean sprouts or wheat together with a glass of skimmed milk.

MidmorningCan either take a glass of pineapple, orange, or carrot juice.

Lunch Taking raw vegetables or salad that includes beet, carrot, cabbage, cucumber, and tomatoes. Boiled or steamed the raw vegetables. Eating together with wholegrain bread and a glass of buttermilk. Besides, you can also eat green coriander leaves, roasted cumin seeds, some grated ginger mixed in the milk and a little salt.

Mid-afternoon Dry fruits, coconut water, fresh and organic vegetable soup, lemon tea, ginger tea.

DinnerSteamed vegetables, wholegrain bread, seasonal fruits(except apple and banana).

You can actually find some great herbs when you are looking for herbal remedies for abdominal. There are a lot of herbal treatments happen to be incredibly effective to reduce the fat of your abdominal without side effects. Among the herbs, there are 3 that very commonly being use for such treatment which are lemon balm, alfalfa and calendula.

Panchakarma is the ancient Ayurvedic remedies for detoxification and cleansing. with the complements of Ayurvedas healing therapies to rebuild your mind, soul, and body, it will help you to reduce your weight to your desired level.

You will need a weight loss chart to help you to reduce weight. You will want to keep track of your weight and your progress while you are into a weight loss program. This chart is incredibly useful since it could aid you to trace your weight weekly or monthly. Most of the charts are simple enough to make but if you dont know how to make one, you can download it from here.

Many people are looking for quick fixes of obesity treatment in Ayurveda, and some have went to subscribe for Shathayu program. However, there are quite a few negative feedbacks received from those who went for the treatment packages. If you want to read more on Shathayu Ayurveda weight loss reviews, you may check out this:

Shathayu Ayurveda JP Nagar Bangalore reviews

For people who wish to get pills or supplement products to reduce fat, they must get the right products. For using drying herbs, they need to be done separately. If you want to mix it with other herbs, you will need to do it in the right way. The resulting mixed herbs need to be portioned in equal mix amounts as per the recipe. Most of the Ayurveda herb tablets are produced from powdered ingredients together with the mixture of decoctions, fruit juices, or water.

You may get the Ayurveda weight loss pills here:

With that said, Ayurveda is an excellent solution for people who want to reduce their weight. You are able to do it naturally and benefits for weight loss and gaining healthy body at the same time. Besides, you will find you are becoming very energetic and vitality too. You may absolutely want to try them out and stick to the diet that suggested above.

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Ayurvedic Home Remedies For Weight Loss - Pitta Ayurveda

Foods You Can Safely Eat Past The Due Dates | ActiveBeat

Posted: January 29, 2019 at 6:43 am

By: kgeorge onSunday, January 27th

Weve all done itdrank from a questionable carton of milk, mowed down on the remains of old yogurt, and even dared cook meat that had been in the freezer for a few months (well six to be exact).

Youre not alone and not necessarily wrong to try to salvage food instead of throwing it away when its expired its best before date. We live in a world where there is so much food wasted, and a lot of it is prematurely thrown away! While we tend to exercise the phrase better safe than sorry when it comes to food spoilage, there are some foods that can be eaten past their expiry date. These dates are just given to let consumers know when they are at their peak quality and freshness, and sometimes there is a little bit of leeway between that date and their real expiration. Heres a list of foods that even food experts admit we can consume safely past the expiry date on their packaging

With the amount of chemicals and beverage additives in carbonated drinks, it shouldnt surprise you that they are formulated to last a really, really long time. Just to give you a perspective of the shelf life, food scientists estimate that diet soda is good for up to 4 months past its shelf life expiry date, while soda with regular sugar content can safely be consumed up to 9 months after its listed expiration date.

If you pop open a can of soda thats been sitting around for a while, your own senses and good judgment will serve you well in determining whether or not it is still good. You should pour old pop into a glass and observe its character and consistency before drinking it; if it no longer fizzes up, or if it appears watery and there arent any bubbles, dont consume it. There are some health risks associated with drinking expired soft drinks.

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Foods You Can Safely Eat Past The Due Dates | ActiveBeat

Food and Diet – CNN

Posted: January 29, 2019 at 6:43 am

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Food and Diet - CNN

Why Diets Don’t Work in The Long Term Calories Part VII

Posted: January 29, 2019 at 6:42 am

Click here for Calories Part I, Part II, Part III, Part IV, Part V, and Part VI.

We have explored the bodys adaptation to reducing calories and weight and seen how the body acts more like a thermostat than a scale. The body acts as though it has a Body Set Weight (BSW) and strives vigorously to defend that weight against increase or decrease alike.

But how long do these adaptations last? If we maintain a certain body weight, will our body eventually recognize this as a new BSW? Certainly at first glance, this seems like a reasonable assumption. But is it true?

Reduce Energy Expenditure

Lets look at some recent studies to answer this important question.

Long-term persistence of adaptive thermogenesis in subjects who have maintained a reduced body weight by Dr. Rosenbaum et al.

In this study, 21 subjects were recruited and fed a liquid diet consisting of 45% carbohydrates over one year and the Total Energy Expenditure (TEE) were measured. As expected, during the initial weight loss phase (10% of body weight) TEE was reduced. As weight went down, the body tries to regain the weight by reducing TEE. In essence, the body is defending the BSW and trying to return to the original weight. But how long does this last?

What is interesting is that TEE is reduced over the course of the full year. Even after one year at the new, lower body weight, the TEE was still reduced by an average of almost 500 calories/day. (see figure on right)

In other words, this reduction in TEE starts almost immediately after caloric reduction and persists for a long time at least 1 year and going strong. It does not appear that this BSW has been changed at all. There is no sign that BSW has changed.

The body is still trying to get back to the original BSW. Remember that this weight loss is achieved with no change in the composition of the diet only the amount (a portion control strategy).

Lets put this into dietary terms. We start by eating 2,000 cal/day and burning 2,000 cal/day. We decide to lose some weight and reduce our calories to 1,500 cal/day. Our body almost immediately reduces TEE to 1,500 cal/day.

We lose some weight but then the weight loss stops even though we are still eating less than before. Because TEE has been reduced, we feel cold, tired, hungry and a bit miserable but we decide to stick it out thinking that things must improve. However, even after 1 year, things are exactly the same. We feel lousy and the weight is not coming off despite our best efforts to eat only 1,500 cal/day.

Finally, we think that we should go back to a normal diet 2,000 cal/day. The weight comes rushing back because now we are eating 2,000 calories/day and expending only 1,500. Sound familiar? Thought so Thats because everything Im describing here has been well described over the last 100 years!This actually starts to make a bit of sense. Suppose we are the manager of a power plant. Every day, we receive 2,000 tonnes of coal and we burn 2,000 tonnes of coal. We also maintain a supply of coal just in case we dont have enough (storage shed). Now, all of a sudden, we start getting only 1,500 tonnes of coal.

What do you imagine that we should do? If we keep on burning 2,000 tonnes of coal, we would quickly burn through our stores of coal and then our power plant would be shut down. Massive blackout over the entire city. Anarchy and looting commence.

Our boss would tell us how utterly stupid we are and say something like Your ass is FIRED! The problem, of course, is that he is entirely correct in his assessment.

Because we, as the manager of this power plant, are not that stupid would not do that. As soon as we figured out that we were only getting 1,500 tonnes of coal, we would reduce our power output to 1,500 of coal. In fact, we might use only 1,400 tonnes just in case. A few lights go out, but there is no blackout. Anarchy and looting avoided. Boss says Great job. Youre not as stupid as you look. Raises all around

Now, lets think about our body. We eat 2,000 calories/day and use 2,000 calories/day. We start a diet so now we are eating only 1,500 calories/day. What happens? Well, the body is not that stupid. It does not want to die. Why do we assume the Mother Nature is a complete moron? The very first thing we do is reduce our TEE to 1,500 calories/day and maintain that for as long as it takes.

We know for a fact that this is what happens. It has been proven over and over again. We just keep not believing it and hoping that our caloric reduction strategy somehow, this time, will work. It wont. Face it. We only believe it because the nutritional authorities keep tell us it works. It doesnt.

Mother Nature is not stupid. Thats why conventional calorie reduced diets dont work in the long term.

Continue to Calories part VIIIhere

Begin here with Calories I

Click here to watch the entire lecture: The Aetiology of Obesity 1/6 A New Hope

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Why Diets Don't Work in The Long Term Calories Part VII

A Harvard expert shares his thoughts on testosterone …

Posted: January 29, 2019 at 6:42 am

An interview with Abraham Morgentaler, M.D.

It could be said that testosterone is what makes men, men. It gives them their characteristic deep voices, large muscles, and facial and body hair, distinguishing them from women. It stimulates the growth of the genitals at puberty, plays a role in sperm production, fuels libido, and contributes to normal erections. It also fosters the production of red blood cells, boosts mood, and aids cognition.

Over time, the testicular machinery that makes testosterone gradually becomes less effective, and testosterone levels start to fall, by about 1% a year, beginning in the 40s. As men get into their 50s, 60s, and beyond, they may start to have signs and symptoms of low testosterone such as lower sex drive and sense of vitality, erectile dysfunction, decreased energy, reduced muscle mass and bone density, and anemia. Taken together, these signs and symptoms are often called hypogonadism (hypo meaning low functioning and gonadism referring to the testicles). Researchers estimate that the condition affects anywhere from two to six million men in the United States. Yet it is an underdiagnosed problem, with only about 5% of those affected receiving treatment.

Studies have shown that testosterone-replacement therapy may offer a wide range of benefits for men with hypogonadism, including improved libido, mood, cognition, muscle mass, bone density, and red blood cell production. But little consensus exists on what constitutes low testosterone, when testosterone supplementation makes sense, or what risks patients face. Much of the current debate focuses on the long-held belief that testosterone may stimulate prostate cancer.

Dr. Abraham Morgentaler, an associate professor of surgery at Harvard Medical School and the director of Mens Health Boston, specializes in treating prostate diseases and male sexual and reproductive difficulties. He has developed particular expertise in treating low testosterone levels. In this interview, Dr. Morgentaler shares his views on current controversies, the treatment strategies he uses with his own patients, and why he thinks experts should reconsider the possible link between testosterone-replacement therapy and prostate cancer.

What signs and symptoms of low testosterone prompt the average man to see a doctor?

As a urologist, I tend to see men because they have sexual complaints. The primary hallmark of low testosterone is low sexual desire or libido, but another can be erectile dysfunction, and any man who complains of erectile dysfunction should get his testosterone level checked. Men may experience other symptoms, such as more difficulty achieving an orgasm, less-intense orgasms, a smaller amount of fluid from ejaculation, and a feeling of numbness in the penis when they see or experience something that would normally be arousing.

The more of these symptoms there are, the more likely it is that a man has low testosterone. Many physicians tend to dismiss these soft symptoms as a normal part of aging, but they are often treatable and reversible by normalizing testosterone levels.

Arent those the same symptoms that men have when theyre treated for benign prostatic hyperplasia, or BPH?

Not exactly. There are a number of drugs that may lessen sex drive, including the BPH drugs finasteride (Proscar) and dutasteride (Avodart). Those drugs can also decrease the amount of the ejaculatory fluid, no question. But a reduction in orgasm intensity usually does not go along with treatment for BPH. Erectile dysfunction does not usually go along with it either, though certainly if somebody has less sex drive or less interest, its more of a challenge to get a good erection.

How do you determine whether a man is a candidate for testosterone-replacement therapy?

There are two ways that we determine whether somebody has low testosterone. One is a blood test and the other is by characteristic symptoms and signs, and the correlation between those two methods is far from perfect. Generally men with the lowest testosterone have the most symptoms and men with highest testosterone have the least. But there are some men who have low levels of testosterone in their blood and have no symptoms.

Looking purely at the biochemical numbers, The Endocrine Society* considers low testosterone to be a total testosterone level of less than 300 ng/dl, and I think thats a reasonable guide. But no one quite agrees on a number. Its not like diabetes, where if your fasting glucose is above a certain level, theyll say, Okay, youve got it. With testosterone, that break point is not quite as clear.

Is total testosterone the right thing to be measuring? Or should we be measuring something else?

Well, this is another area of confusion and great debate, but I dont think its as confusing as it appears to be in the literature. When most doctors learned about testosterone in medical school, they learned about total testosterone, or all the testosterone in the body. But about half of the testosterone thats circulating in the bloodstream is not available to the cells. Its tightly bound to a carrier molecule called sex hormonebinding globulin, which we abbreviate as SHBG.

The biologically available part of total testosterone is called free testosterone, and its readily available to the cells. Almost every lab has a blood test to measure free testosterone. Even though its only a small fraction of the total, the free testosterone level is a pretty good indicator of low testosterone. Its not perfect, but the correlation is greater than with total testosterone.

This professional organization recommends testosterone therapy for men who have both

Therapy is not recommended for men who have

Do time of day, diet, or other factors affect testosterone levels?

For years, the recommendation has been to get a testosterone value early in the morning because levels start to drop after 10 or 11 a.m. But the data behind that recommendation were drawn from healthy young men. Two recent studies showed little change in blood testosterone levels in men 40 and older over the course of the day. One reported no change in average testosterone until after 2 p.m. Between 2 and 6 p.m., it went down by 13%, a modest amount, and probably not enough to influence diagnosis. Most guidelines still say its important to do the test in the morning, but for men 40 and above, it probably doesnt matter much, as long as they get their blood drawn before 5 or 6 p.m.

There are some very interesting findings about diet. For example, it appears that individuals who have a diet low in protein have lower testosterone levels than men who consume more protein. But diet hasnt been studied thoroughly enough to make any clear recommendations.

In this article, testosterone-replacement therapy refers to the treatment of hypogonadism with exogenous testosterone testosterone that is manufactured outside the body. Depending on the formulation, treatment can cause skin irritation, breast enlargement and tenderness, sleep apnea, acne, reduced sperm count, increased red blood cell count, and other side effects.

Preliminary research has shown that clomiphene citrate (Clomid), a drug generally prescribed to stimulate ovulation in women struggling with infertility, can foster the production of natural testosterone, termed endogenous testosterone, in men. In a recent prospective study, 36 hypogonadal men took a daily dose of clomiphene citrate for at least three months. Within four to six weeks, all of the men had heightened levels of testosterone; none reported any side effects during the year they were followed.

Because clomiphene citrate is not approved by the FDA for use in men, little information exists about the long-term effects of taking it (including the risk of developing prostate cancer) or whether it is more effective at boosting testosterone than exogenous formulations. But unlike exogenous testosterone, clomiphene citrate preserves and possibly enhances sperm production. That makes drugs like clomiphene citrate one of only a few choices for men with low testosterone who want to father children.

What forms of testosterone-replacement therapy are available?*

The oldest form is an injection, which we still use because its inexpensive and because we reliably get good testosterone levels in nearly everybody. The disadvantage is that a man needs to come in every few weeks to get a shot. A roller-coaster effect can also occur as blood testosterone levels peak and then return to baseline. [See Exogenous vs. endogenous testosterone, above.]

Topical therapies help maintain a more uniform level of blood testosterone. The first form of topical therapy was a patch, but it has a very high rate of skin irritation. In one study, as many as 40% of men who used the patch developed a red area on their skin. That limits its use.

The most commonly used testosterone preparation in the United States and the one I start almost everyone off with is a topical gel. There are two brands: AndroGel and Testim. The gel comes in miniature tubes or in a special dispenser, and you rub it on your shoulders or upper arms once a day. Based on my experience, it tends to be absorbed to good levels in about 80% to 85% of men, but that leaves a substantial number who dont absorb enough for it to have a positive effect. [For specifics on various formulations, see table below.]

Are there any drawbacks to using gels? How long does it take for them to work?

Men who start using the gels have to come back in to have their testosterone levels measured again to make sure theyre absorbing the right amount. Our target is the mid to upper range of normal, which usually means around 500 to 600 ng/dl. The concentration of testosterone in the blood actually goes up quite quickly, within a few doses. I usually measure it after two weeks, though symptoms may not change for a month or two.

What about pills?

There are pills in the United States for testosterone supplementation, but their use is strongly discouraged because they cause significant liver toxicity. A safe oral formulation called testosterone undecanoate is available in Canada and in Europe, but not in the United States. Whats quite exciting is that an injectable version of testosterone undecanoate (Nebido) was submitted to the FDA for approval in August 2007. (Its already approved in many other countries.) It lasts for 12 weeks, so a patient could come in and get a shot about four times a year. [Editors note: In December 2009, the brand name of the drug in the United States was changed to Aveed. As of January 2011, it was still awaiting FDA approval.]

Cherrier MM, Asthana MD, Plymate S, et al. Testosterone Supplementation Improves Spatial and Verbal Memory in Healthy Older Men. Neurology 2001;57:8088. PMID: 11445632.

Isidori AM, Giannetta E, Greco EA, et al. Effects of Testosterone on Body Composition, Bone Metabolism and Serum Lipid Profile in Middle-aged Men: A Meta-analysis. Clinical Endocrinology 2005;63:28093. PMID:16117815.

Liu PY, Swerdloff RS, Veldhuis JD. Clinical Review 171: The Rationale, Efficacy and Safety of Androgen Therapy in Older Men: Future Research and Current Practice Recommendations. Journal of Clinical Endocrinology and Metabolism 2004; 89:478996. PMID: 15472164.

Moffat SD, Zonderman AB, Metter EJ, et al. Longitudinal Assessment of Serum Free Testosterone Concentration Predicts Memory Performance and Cognitive Status in Elderly Men. Journal of Clinical Endocrinology and Metabolism 2002;87:50017. PMID: 12414864.

Wang C, Cunningham G, Dobs A, et al. Long-term Testosterone Gel (AndroGel) Treatment Maintains Beneficial Effects on Sexual Function and Mood, Lean and Fat Mass, and Bone Mineral Density in Hypogonadal Men. Journal of Clinical Endocrinology and Metabolism 2004;89:208598. PMID: 15126525.

Other than improvement in sexual symptoms, what are some of the potential benefits of testosterone-replacement therapy?

Some studies have looked at testosterone therapy and cognition. Although the findings werent definitive, there was some evidence of cognitive improvement. Other studies have shown that it improves mood. Testosterone therapy has also been shown to be effective in the treatment of osteoporosis and in increasing muscle bulk and strength. [See Testosterones impact on brain, bone, and muscle, above.]

What risks do you consider when prescribing testosterone-replacement therapy?

When patients ask about risks, I remind them that they already have testosterone in their system and that the goal of testosterone treatment is to restore its concentration back to what it was 10 or 15 years previously. And the molecule itself that we give is identical to the one that their bodies make naturally, so in theory, everything should be hunky-dory. But in practice, there are always some curveballs.

For example, testosterone can increase the hematocrit, the percentage of red blood cells in the bloodstream. If the hematocrit goes up too high, we worry about the blood becoming too viscous or thick, possibly predisposing someone to stroke or clotting events. Although, frankly, in a review that I wrote in the New England Journal of Medicine* where we reviewed as much of this as we could, we found no cases of stroke or severe clotting related to testosterone therapy. Nevertheless, the risk exists, so we want to be careful about giving testosterone to men who already have a high hematocrit, such as those with chronic obstructive pulmonary disease, or those who have a red-blood-cell disorder.

Although its rare to see swelling caused by fluid retention, physicians need to be careful when prescribing testosterone to men with compromised kidney or liver function, or some degree of congestive heart failure. It can also increase the oiliness of the skin, so that some men get acne or pimples, but thats quite uncommon, as are sleep apnea and gynecomastia (breast enlargement).

What about the risk of developing prostate cancer?

I think that the biggest hurdle for most physicians prescribing testosterone is the fear that theyre going to promote prostate cancer. [See Incongruous findings, below.] Thats because more than six decades ago, it was shown that if you lowered testosterone in men whose prostate cancer had metastasized, their condition improved. (It became a standard therapy that we still use today for men with advanced prostate cancer. We call it androgen deprivation or androgen-suppressive therapy.) The thinking became that if lowering testosterone makes prostate cancer disappear, at least for a while, then raising it must make prostate cancer grow. But even though its been a widely held belief for six decades, no one has found any additional evidence to support the theory.

Havent there been any studies that follow men who go on testosterone-replacement therapy to see what their rate of cancer is compared with that in men who are not on it?

As with a number of treatments or medicines that have been around for a long, long time, it hasnt been scrutinized like a new drug would be. And although theyve been discussed, there arent any large-scale, randomized controlled clinical trials of testosterone-replacement therapy under way. [See A male equivalent to the Womens Health Initiative? below.]

There have been a number of smaller studies on men receiving testosterone-replacement therapy, and if you look at the results cumulatively, the rate of prostate cancer in these men was about 1% per year. If you look at men who show up for prostate cancer screening, same sort of age population, the rate tends to be about the same. You have to be cautious in comparing studies and combining the results, but theres no signal in these results that testosterone-replacement therapy creates an unexpectedly high rate of prostate cancer.

We also have epidemiologic studies, like the Physicians Health Study, the Baltimore Longitudinal Study of Aging, and the Massachusetts Male Aging Study, that include tens of thousands of men who are followed for 5, 10, 15, or even 20 years. At the end of the study period, the researchers see who developed prostate cancer and who didnt. They can then look at blood samples taken at the start of the study to see if, for example, the group that got prostate cancer had a higher level of testosterone over all. About 500,000 men have been entered in some 20 trials of this type around the world. Not one of those studies has shown a definitive correlation between prostate cancer and total testosterone. Three or four have shown weak associations, but none of those have been confirmed in subsequent studies.

Another point Id like to make for people worried about a link between high testosterone and prostate cancer is that it just doesnt make sense. Prostate cancer becomes more prevalent in men as they age, and thats also when their testosterone levels decline. We almost never see it in men in their peak testosterone years, in their 20s for instance. We know from autopsy studies that 8% of men in their 20s already have tiny prostate cancers, so if testosterone really made prostate cancer grow so rapidly we used to talk about it like it was pouring gasoline on a fire we should see some appreciable rate of prostate cancer in men in their 20s. We dont. So, Im no longer worried that giving testosterone to men will make their hidden cancer grow, because Im convinced that it doesnt happen.

Can testosterone worsen BPH?

The evidence shows that testosterone treatment does not change the strength or rate of urine flow, does not change the ability to empty the bladder, and does not change other symptoms such as frequency or urgency of urination, as assessed by the American Urological Association Symptom Score or the International Prostate Symptom Score. Ive had a couple of patients over the years who had some worsening of urinary symptoms with testosterone, but thats rare, even with long-term use.

Studies have come to conflicting conclusions about whether high levels of testosterone increase the risk of developing prostate cancer. A sampling of studies that have helped drive the controversy follows.

Increases in cancer risk

Parsons JK, Carter HB, Platz EA, et al. Serum Testosterone and the Risk of Prostate Cancer: Potential Implications for Testosterone Therapy. Cancer Epidemiology, Biomarkers, and Prevention 2005;14:225760. PMID: 16172240.

Shaneyfelt T, Husein R, Bubley G, et al. Hormonal Predictors of Prostate Cancer: A Meta-Analysis. Journal of Clinical Oncology 2000;18:84753. PMID: 10673527.

No effect or decreases in cancer risk

Eaton NE, Reeves GK, Appleby PB, et al. Endogenous Sex Hormones and Prostate Cancer: A Quantitative Review of Prospective Studies. British Journal of Cancer 1999;80:93034. PMID: 10362098.

Mohr BA, Feldman HA, Kalish LA, et al. Are Serum Hormones Associated with the Risk of Prostate Cancer? Prospective Results from the Massachusetts Male Aging Study. Urology 2001;57:93035. PMID: 11337297.

Morgentaler A. Testosterone and Prostate Cancer: An Historical Perspective on a Modern Myth. European Urology 2006;50:93539. PMID: 16875775.

Mixed findings

Slater S, Oliver RT. Testosterone: Its Role in the Development of Prostate Cancer and Potential Risks from Use as Hormone Replacement Therapy. Drugs and Aging 2000;17:43139. PMID: 11200304.

Whats your strategy for the concomitant administration of erectile dysfunction drugs?

My preference is to start men on testosterone, for a couple of reasons. First, if a man has successful return of his own erections, its like a home run for him. He doesnt have to take a pill in anticipation of having sex. He can have sex whenever he wants. Second, the benefits of testosterone-replacement therapy often go way beyond erectile dysfunction. That may be what brought the patient into the office originally, but then he comes back saying how much better he feels in general, how much more energetic and motivated he is, how his drives on the golf course seem to be going farther, and how his mood is better.

But if somebody fails testosterone therapy, meaning that their erections arent any better, Ive said, Well, lets stop the testosterone and try one of the PDE5, or phosphodiesterase type 5, inhibitors sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). A lot of patients then say, Well, actually, Id like to stay on the testosterone. True, its not helping my erections, but Im more turned on, and Im getting these other benefits. So we often continue the testosterone and add a PDE5 inhibitor.

Theres a significant failure rate of the PDE5 inhibitors for erectile dysfunction, something on the order of 25% to 50%, depending on the underlying condition. It turns out that a third of those men will have adequate erections with testosterone-replacement therapy alone and another third will have adequate erections with the pills and testosterone combined. Theres still a third who dont respond, but normalizing their testosterone level has definitely rescued many men who had failed on PDE5 inhibitors.

In 2002, the federally sponsored Womens Health Initiative (WHI) stopped its hormone replacement therapy (HRT) trial (estrogen plus progestin), which included more than 16,000 women, three years early because those taking the pills had an increased risk of developing breast cancer and blood clots, and an increased risk of suffering a stroke or heart attack than those taking a placebo. The findings ran counter to the long-held belief that HRT could preserve health and trim heart-disease risk in women.

Unlike previous studies of HRT, which had been observational in nature, the WHI was a double-blind, randomized controlled trial. The gold standard of scientific inquiry, these trials can conclusively test theories and assess cause and effect.

To date, no large, double-blind, randomized controlled studies of a link between testosterone treatment and prostate cancer have been completed. In its 2004 report, the Institute of Medicine (IOM) committee studying the need for clinical trials of testosterone-replacement therapy noted that only 31 placebo-controlled studies had been done in older men, with the largest one enrolling just 108 participants. Most of these studies lasted only six months.

The IOM report estimated that a study of whether there is an increased risk of prostate cancer in men on testosterone therapy might require following 5,000 men for three to five years. Before launching such an endeavor, the report recommended more firmly establishing the effectiveness of testosterone-replacement therapy, saying that studies of long-term risks and benefits should be conducted only after short-term efficacy has been proven. That means the male equivalent of the WHI remains far off.

Whats your thinking on performing a prostate biopsy before prescribing testosterone therapy?

I started doing prostate biopsies before putting men on testosterone therapy because the fear had always been that a hidden cancer might grow due to increased testosterone. It was also believed that low testosterone was protective. Well, we found prostate cancer in one of the first men with low testosterone we biopsied, even though his PSA level and digital rectal exam (DRE) were normal. As we did more of these, we found more and more cases, about one out of seven, despite normal DRE and normal PSA. When we had data for 77 men and the cancer rate was about the same, 14%, the Journal of the American Medical Association published our findings. At the time, that rate of prostate cancer in men with normal PSA was several times higher than anything published previously, and it approximated the risk of men who had an elevated PSA or an abnormal DRE. That was in 1996.

In a subsequent study of 345 men with normal PSA and low testosterone, we found the cancer rate was similar: 15%. And we had a large enough group to look at the impact of testosterone on cancer risk. For men whose total testosterone or free testosterone value was in the lowest third, the odds of having a positive biopsy were double the odds in the rest of the men. Thats the first evidence that low testosterone may be an independent predictor for the development of prostate cancer.

That would argue for doing a routine prostate biopsy on anyone considering testosterone-replacement therapy.

Its not universally accepted, but thats what I do. Several recent studies have shown that low testosterone is associated with higher Gleason scores, with advanced-stage prostate cancer, and, even worse, with shorter survival times. [See Low testosterone, PSA, and prostate cancer, below.]

What recommendations do you have for monitoring once testosterone therapy begins?

The general recommendation is that men 50 and older who are candidates for testosterone therapy should have a DRE and a PSA test. If either is abnormal, the man should be evaluated further for prostate cancer, which is what we do with everybody whether they have low testosterone or not. That means a biopsy. But if all of those results are normal, then we can initiate testosterone therapy. The monitoring that needs to happen for men who begin testosterone therapy is really very simple: DRE, PSA, and a blood test for hematocrit or hemoglobin, once or twice in the first year and then yearly after that, which is pretty much what we recommend for most men over age 50 anyway.

Morgentaler A, Rhoden EL. Prevalence of Prostate Cancer Among Hypogonadal Men with Prostate-Specific Antigen Levels of 4.0 ng/dL or less. Urology 2006;68:126367. PMID: 17169647.

Morgentaler A, Bruning CO 3rd, DeWolf WC. Occult Prostate Cancer in Men with Low Serum Testosterone Levels. Journal of the American Medical Association 1996;276:19046. PMID: 8968017.

Massengill JC, Sun L, Moul JW, et al. Pretreatment Total Testosterone Level Predicts Pathological Stage in Patient with Localized Prostate Cancer Treated with Radical Prostatectomy. Journal of Urology 2003;169:16705. PMID: 12686805.

Isom-Batz G, Bianco FJ Jr, Kattan MW, et al. Testosterone as a Predictor of Pathological Stage in Clinically Localized Prostate Cancer. Journal of Urology 2005;173:193537. PMID: 15879785.

What changes do you see taking place on the testosterone front over the next five years?

I think that the importance of testosterone for cardiovascular health is going to be increasingly recognized. In the past, because men die of heart attacks more often than women and men have more testosterone, the fear has been that testosterone causes heart problems. But every single study of whether testosterone is bad for the heart has been negative, and what people havent pointed out in most of those negative studies is that there may be a beneficial effect.

I think well also find out in five years that there very well may be general health benefits of having normal testosterone compared to low testosterone. There are growing data for all-cause mortality that men who have low testosterone die earlier than those who have normal testosterone. A study by the Veterans Administration reported about a year ago showed low testosterone levels were associated with a dramatically increased mortality rate. Its hard to know why that is, but I think well be focused on that in the coming years.

Any closing thoughts?

I think that low testosterone is under-recognized, its effects are greatly underappreciated, and its diagnosis isnt readily understood. This is an area that has tremendous research potential in the coming years.*

Originally published March 2009; last reviewed February 18, 2011.

Originally posted here:
A Harvard expert shares his thoughts on testosterone ...

Weight Loss with VEEP – Visual Eating and Exercise Plan

Posted: January 27, 2019 at 1:43 am

Weight Loss with VEEP - Visual Eating and Exercise Plan

The awakening is underway. Diets are over. Meal plans are obsolete. How food works is the key.

Lookcut is a consumer first resource for the mostcutting edge and truthful information for weigh loss,nutrition and longevity.

Weight loss solves nothing. You won't hear that anywhere else but here. And it's the truth. Losing weight does not stop weight gain. In fact losing weight often creates weight gain later on. There are lots of diets, lots of weight loss plans. None of them address the real problem.

The real problem is real life.

After weight loss real life goes on. Then what? Real life promotes weight gain. Real life is complex. Real life is full of stress. In real life processed food is unavoidable. Real life is filled with events and occasions where you just want to eat and not worry about your weight.

The key is knowledge. If you knew exactly what to eat at any time, or exactly what to eat to make up for overdoing it, you could control your weight.

LookCut is the home of VEEP, The Visual Eating and Exercise Plan. VEEP is not a diet. VEEP is a weight loss learning system. The longer you use VEEP, the more you learn about how to use food in real life, how to make up for overindulging, how to minimize weight gain from alcohol, how to use specific combinations of superfoods for maximum effect, how to use timing of key foods for weight loss any time you wish - in short, real life.

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Weight Loss with VEEP - Visual Eating and Exercise Plan


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