Removing unseemly fat from the body should be strictly carried out under the expert hands of doctors.

WHILE definitely not a replacement for a healthy diet and regular exercise, modern-day liposuction surgery (sometimes referred to as liposculpturing) can safely address those hard-to-lose fatty deposits that simply dont respond to diet and exercise, creating big improvements in body contour and shape.

For some of us, certain areas of the body are immune to the effects of exercise. No matter how many miles we run, sit-ups we do, weights we lift, or laps we swim, the fat remains, unless it is removed with liposuction.

Liposuction is appropriate for large, disproportionate hips, buttocks, thighs, the abdomen and love handles, as well as fat deposits on arms, back, knees, sides, and under the chin.

Very often, many different areas can be treated during a single operation.

Is liposuction safe?

Liposuction is a relatively safe surgery when performed within safety limits. Even large volume liposuctions have been performed safely without complications.

Liposuction should be safely performed in a hospital setting by an experienced plastic surgeon.

Surgery begins with a tiny incision inconspicuously located in a natural skin fold or crease in an area to be treated.

Next, a salt water/anaesthetic solution is injected through a micro-cannula.

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Sucking out fat

Late last year, while on a tour of CaliforniasAo Neuvo State Park, I saw a shark attack victim lying on the beach. She was a Northern elephant seal, and looked quite placid despite the gaping, crescent-shaped hole in her neck. She bore the traumatic hallmark of the great white shark.

Years of watching Discoverys Shark Week taught me that seals and sea lions are the preferred prey of Carcharodon carcharias. Nothing like blubber to fuel the body of a constantly-swimming predator with a physiology that runs hotter than that of the average shark. I remember one researcher likened baby elephant seals, in particular, to hot dogs the bread of the snack corresponds to the fat content of the young pinnipeds, making the weener seals easy-to-catch and energy-rich mouthfuls for the sharks.

When the sensational documentaries werent showing awful re-enactments of great white shark attacks on humans, they brought their cameras in close to seal kills. The programs took a philosophy similar to the fictional marine biologist Matt Hooper in JAWS all great white sharks do is swim and eat. (Yes, yes, and make little baby sharks, but I have yet to see that on basic cable.) If they arent chomping people, then they strip the fat from seals. We think of them in the typological way that we approach many species. Great white sharks eat seals and sea lions. Thats all that there is to it.

But great white sharks dont live on a strict diet of marine mammals. Study sites situated near pinniped colonies, as well as nature films, have restricted our view of what great white sharks feed on. In actuality, great white sharks consume different prey based upon age, size, and location. When they are just pups, for example, the leviathans-to-be seek out a wide variety of smaller fare before graduating to more difficult menu options. And, as a new paper indicates, many sharks retain their cosmopolitan tastes as they age.

In a PLoS One study published this week, University of Wyoming researcher Sora Kim and colleagues used chemical clues in great white shark vertebrae to track feeding preferences among fifteen individuals collected between 1957 and 2000. The logic behind their technique is simple, and has been used on a variety of other creatures living and extinct to outline diet. As an animal feeds, chemical tracers in the form of carbon and nitrogen isotopes become incorporated into their teeth and bones. There is a correspondence between certain carbon isotope ratios and particular food sources. Match the chemical signature in the consumer in with the isotopic profile of whats being consumed, and you can reconstruct an animals diet.

Even better, shark vertebrae contain long-running records of these isotopes. As great white sharks grow, their vertebrae accrete new rings on a yearly schedule. Each ring, therefore, holds a chemical snapshot from a year in the sharks life. By comparing the isotope ratios in different vertebral bands, Kim and collaborators were able to follow how the diets of individual sharks shifted during their lives.

Contrary to assertions that pinnipeds are a great white shark staple, the fish sampled in the study were highly variable. Both age and individual variation were at play in their diets. For example, five sharks in the sample showed the expected shift from a diet of fish and small prey to marine mammals and other more substantial fare at about age four. But this wasnt true of all sharks. Five other sharks in the same sample showed no difference between juvenile and adult diet. These sharks may have scavenged pinniped carcasses or fed on large squid while young, giving them an adult feeding profile at a young age. There are some possible confounding factors with this hypothesis such as young sharks inheriting an adult isotope signal from their mothers but the researchers appear to favor the idea that some sharks were more precocious in their prey choices than others of their kind. Not all great white sharks follow the same life history.

While Kim and colleagues point out that some sharks followed the expected dietary switch, the change was not the dominant signal in their results. Many of the Pacific great white sharks they sampled were generalists who took different prey in varying locations. Some sharks were nearshore marine mammal specialists, but others had more flexible foraging approaches. And even though the isotopic data are not refined enough to tell us exactly what species the sharks were eating, the cataloged chemical traces are enough to detect distinct dietary patterns.

The study raises new questions about great white shark biology. For one thing, why did the sharks have such individualistic diets? Competition may be the key, Kim and co-authors hypothesize. Imagine if all adult great white sharks were seal specialists who congregated at the same beaches. There may not be enough food for all, and swimming in the same waters as bigger, more experienced sharks would be risky for smaller novices who could wind up as meals themselves. By being flexible able to tackle elephant seals as well as squid, tuna, and other food sources great white sharks may lessen competition with their own kind.

As the researchers behind the new study state, further isotopic studies and satellite tracking programs may help marine biologists better understand the ecology of their prodigious fish. For now, though, one thing is clear. The sharks werent all cruising near shore, looking up for seal silhouettes. Great white sharks have much more varied tastes than blood-spattered basic cable shows would have you believe.

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Great White Shark Diet Is More Than Seals

India, Oct. 6 -- Ritu Dalmia, one of India's best known chefs admits that she's the queen of snacking. At midnight. "All through the day I tend to take small bites here and there - I can't avoid it in my job, though I can still control it. But come night, I really snack. I just have to," she says. Dalmia is trying to clamp down on the midnight munchies, but it's hard. Even the dietician's suggestion of going to bed earlier hasn't worked. What has helped, though, is choosing what to snack on. "If earlier it was Camembert with crackers and fig chutney, or worse slivers of fatty ham and sausages, now I dig into sunflower seeds, nuts, or a dip like tzatziki, hummus or baba ghanoush with vegetable sticks. And I am loving it. So is my body," Dalmia says.

The restaurateur clearly is on the right track. The urge to snack strikes us all at some point of our lives (and of most of us, at some point of the day!). But mindless snacking, specially the 11 am, 5 pm and post-midnight tummy rumblings can undo even the strongest of wills and defeat all well meaning diets. Still, snacks aren't the devils they're made out to be. In fact, in-between pockets of nourishment have shown to make you less cranky, keep your weight under control, and provide essential nutrients. So long as you graze on the right stuff.

The local options

"Indians are notorious for their chai nashta and unfortunately almost all Indian snacks are lethal and totally unkind to waistlines," states Dalmia. "Chiwda, laccha, namkeens of all sorts, pakodas, samosas... no one can come close to Indians where snacking is concerned, except for maybe the Spanish." Aditya Bal, a foodie and a popular TV host agrees. "Across India, both in urban and rural areas, all I see people eat is deep-fried food, morning to night, and in between, they nibble on something sweet," he says. He adds that most Indian cultures simply don't have enough healthy alternatives to choose from. They don't, for example, have momos the way the people in the North East do. "I believe that Gujaratis have healthier snacks compared to others. Most of their stuff like dhokla, khandvi, etc is steamed. We can follow their example. But with fast food taking over so completely, coupled with their fabulous marketing, I am sure our next generation is in even deeper trouble compared to us," he explains.

All's not lost. Mumbai chef Vicky Ratnani, the man behind the Mumbai restaurant and lounge Aurus, lists several Indian snacks that won't keep your cardiologist busy. "Everyone can snack healthily, if they so desire,' he says. "Opt for steamed bhutta, which is one of the healthiest foods you can nibble on. I love bhel without sweet chutney, and lots of vegetables and sprouts like black beans, channa and masoor." Bal finds that nothing beats fresh, hot idlis with just a bit of sambar. "Steamed perfection," he says.

The global choices

The good news is: the whole world snacks. "Europeans usually snack as a rule," says Dalmia. "And while the French snack less than other cultures, they have street carts selling flat crusty cakes called galettes, which work as a between-meal snack. In Italy, shops sell pizzas by the slice or small paninis. They munch on olives or cheese with drinks before dinner, which really is snacking, isn't it? You'll also find office goers having an espresso between breakfast and lunch and eating a small piece of something. In Spain, tapas bars serve bite-size foods, and people go to nibble in these snack restaurants all the time. In fact when I was with friends in Barcelona, we were snacking all through the day. It was a way of life for them."

The Japanese, on the other hand, don't snack much. They see meals as almost a ritual. And when they do snack, it is usually on extremely healthy drinks and dairy that has body-boosting ingredients like probiotics. It's something we can learn from them for sure. Or make like the French and savour our snacks slowly to get maximum satisfaction out of them. "From the Spanish we can learn to have small portions," says Ratnani. Or snack smart - like they do in South East Asia. "Take Thailand's famous snack - sticky rice with dried prawns, or even their roadside grills," says Bal, referring to tiny controlled portions through the day. "In Singapore I see people eating round the clock, but everything is so cleverly cooked - steamed vegetables, soupy broths, and poached chicken." For Dalmia, Middle Eastern dips "are the most fabulous things to snack on" - she ensures that there's always some in the fridge to prevent her reaching out for the cheese and marmalade.

Nibbles for thought

Some rules for smart snacking: chuck the guilt: Snacking will not make you fat, but bad eating (whether at a snack or at a meal) will. A 100-to-200-calorie snack two to three hours before a meal can take the edge off your hunger and keep you from overeating. Studies show that people who have an afternoon snack score higher on memory and concentration tests than those who have, perhaps, a diet soda.

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Munch ado about nothing: How to snack right

Moderately obese people who ate the Mediterranean diet lost more weight than groups of people who followed either a low-fat or a low-carbohydrate diet, researchers reported.

The Mediterranean group weighed almost seven pounds less than they weighed six years earlier. In the low-carb group, the total was 3.7 pounds, and the low-fat group was 1.3 pounds. The Mediterranean diet is one based on the eating habits of people who live in that part of the world -- high in produce, and including olive oil and fish.

The researchers, in a letter published Wednesday in the New England Journal of Medicine, collected data from a two-year work-based program called the Dietary Intervention Randomized Controlled Trial. They randomly assigned 322 moderately obese people, most of them men, to the three diet categories. The participants were given education assistance about the diets.

After two years, the average weight loss was 6.4 pounds in the low-fat group, almost 10 pounds in the Mediterranean group and 10.3 in the low-carb group. At that point, 259 people remained in the study.

After six years, 67% had continued with their original diet, 11% had switched to another diet, and 22% were not dieting.

The researchers, led by Dr. Dan Schwartzfuchs of the Nuclear Research Center Negev in Israel, concluded that the workplace intervention had long-lasting, favorable postintervention effects, particularly among participants receiving the Mediterranean and low-carbohydrate diets, despite a partial regain of weight.

mary.macvean@latimes.com

twitter.com/mmacvean

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Mediterranean dieters kept weight off for six years

Women have come a long way in the past century, from winning the right to vote to gaining ground in the workplace. But "having it all" can sometimes feel like "having to take care of it all," which is why busy women often take unhealthy shortcuts that can lead to serious health problems.

The idea that women can have a career and raise two or three children and look fantastic while doing it, and have a clean home to boot, is unrealistic, says Dr. Annie Nedrow, associate director at Duke Integrative Medicine. Many families have moved away from the typical gender roles, so men and women share household responsibilities. But women still shoulder a lot of tasks, and to save time, they take shortcuts that shortchange their health over the long haul.

What begins as cutting a few corners in your 20s, can become a downward spiral that winds up causing health problems down the road when women are in their 30s or 40s, Nedrow says. "It's a snowball effect that I see all of the time."

Here are the top five ways women cut corners and how it affects their health.

1 Not getting enough sleep. The National Sleep Foundation recommends adults sleep, on average, seven to nine hours per night, but 37 percent of adults in the U.S. report regularly sleeping fewer than seven hours a night, and women are more likely to report difficulties during the day from sleep loss. Lack of sleep has been tied to health problems such as increased risk of hypertension, diabetes, obesity, depression, heart attack and stroke, according to a 2009 report by the Centers for Disease Control and Prevention on the effects of sleep loss.

2 Eating junk food. It's easy to fall into the convenience of buying fast food for lunch and dinner or to raid the vending machines at work for a quick snack. Not only are fast foods typically high in calories and low in nutrients, but research is uncovering evidence that junk food is truly addictive and can lead to inflammation in the body that puts people at higher risk for obesity, heart attack, diabetes and cancer.

A study published in June in the Public Library of Science One journal analyzed the inflammatory responses of rodents fed control diets, a lard-based diet or a "junk-food" diet that consisted of things like cookies and chips. "The diet that consisted of human junk food caused the most inflammation and dramatic metabolic changes," says Liza Makowski, assistant professor of nutrition at the UNC Gillings School of Global Public Health and the study's senior researcher. "These animals (on the junk food diet) ate more, gained more weight, and showed more signs of inflammation and more signs of stress in their tissues," Makowski says. In fact, the rats, like people, could not stop eating the junk food.

A 2010 study published in Neuro-science by scientists from The Scripps Research Institute showed for the first time that the same brain chemistry behind drug addiction fuels the compulsion to overeat.

And if that's not enough bad news about junk food, studies also show it can affect your mood. When people regularly eat commercial baked goods like doughnuts or fast foods such as pizza, hamburgers and hot dogs, they are at a greater risk for depression, according to a recent study reported in the journal Public Health Nutrition.

3 Not exercising. The benefits of exercise have been widely acknowledged. Exercise benefits both mind and body and can actually increase productivity by relieving stress and boosting blood flow to the brain. The "2008 Physical Activity Guidelines for Americans" by the U.S. Department of Health and Human Services reports strong evidence that exercise lowers the risk of early death, heart disease, stroke, type 2 diabetes, and colon and breast cancer, along with preventing obesity. Physical activity may also improve sleep and reduce depression. In 2011, less than half of women ages 18 and older met the physical activity guidelines for aerobic exercise.

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Stop shortchanging your health