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When people say, You cant outrun a bad diet, I smile and nod. Its perfectly true, in a holistic sense. Exercise and diet are two different things, with separate effects on your health and performance. You cant automatically compensate for deficiencies in one area by being extra good at the other, any more than donating to charity makes it OK to embezzle at work.

Still, theres a little voice in my head that asks: Well, how far were you planning to run? It may be true that youd have to jog three or four miles to burn the calories in a single McDonalds Happy Meal, but some people run a lot farther than four miles. The question of how many calories a person can burn in a given day is an interesting scientific one, with some researchers arguing that our ability to get food through the digestive tract is actually the fundamental limitation on feats of sustained human endurance.

Thats why a new study in the International Journal of Sports Physiology and Performance, from a team led by Brent Ruby of the University of Montana along with colleagues from the University of Wisconsin, caught my eye. Ruby and his colleagues collected a bunch of data from a competitor in the Mudslinger Oregon 24, a mountain-bike race in Oregon that involves racking up as many 11-mile loops as you can in 24 hours. The most interesting detail: they fed their subject a dose of very expensive doubly labeled watera mix that contains water molecules with either an uncommon isotope of hydrogen or an uncommon isotope of oxygenthat enables them to calculate with very high accuracy how many calories he burned over the course of his 24-hour ordeal.

The subject, a 41-year-old male, managed to complete a very impressive total of 238 miles. The course, for context, includes dominantly soft-dirt, single-track, and loose-gravel fire roads with occasional large rocks that required periodic rider dismount. In the process, he also climbed a total of over 25,000 feet, not too far from Everesting. He started out with an average heart rate of 162 beats per minute for the first three laps, but had dropped to 113 for the last three laps, with an overall average of 134. He wasnt messing around.

His total energy expenditure during the event was 9,775 calories. In round numbers, thats roughly quadruple the typical energy expenditure of an adult male whos living a normal life rather than biking all day and night. Its a lotbut its not unprecedented. Earlier studies have tended to focus on extreme examples like polar explorers and Grand Tour riders. A 2019 study, for example, found that seven riders in the Giro dItalia averaged 7,719 calories per day for 24 straight days.

An earlier paper by Ruby and his colleagues found that Ironman triathletes burned just over 9,000 calories, and that ten Western States 100-mile finishers averaged a total expenditure of 16,310 calories while finishing in 26.8 hours. That works out to a little over 14,000 calories per 24-hour period. Again, thats just an average: some of the subjects were several thousand calories higher. Those who run 100-mile races are not exactly typical shmoes, but Ruby is careful to point out that these werent the people winning the race. The title of that paper is Extreme endurance and the metabolic range of sustained activity is uniquely available for every human not just the elite few.

Of course, you cant go on burning that much fuel indefinitely. Thats the point Herman Pontzer and John Speakman make about the alimentary limit on sustained endurance: you simply cant eat (and digest) that much. In this case, Rubys 24-hour cyclist managed to shovel down 5,616 calories, a little over half of what he burned. Most of that was in the form of carbohydrate, which he managed to consume at a rate of 58 grams per hour. Thats impressively close to the traditional guidance for marathoners of 60 grams per hour (though more recent research has pushed the target up to 90 or even 120 grams per hour). Given how much trouble most people have stomaching that amount of carbohydrate, its hard to imagine the cyclist doubling his intake over an entire day.

One other detail enabled by the doubly labeled water measurement: his total water turnover was 17.2 liters (about 4.5 gallons). He drank 13.3 liters (3.5 gallons), and lost about seven pounds from start to finish. That weight loss came entirely in the first half of the race, which was during the daytime in temperatures that climbed as high as 92 degrees Fahrenheit with 84 percent humidity. During the night, it dropped to 37 degrees with 17 percent humidity, so its not surprising his fluid loss stabilized.

We dont get any information about how the cyclist made his fuel and hydration decisions, but its interesting how closely his rate of fluid consumption (the darker line in the graph below) matches the air temperature (the lighter line) over the course of the race. Its what youd expect to see if someone was drinking according to thirst:

When it was hot, he drank a lot; when it was cool and he was presumably sweating less, he drank less. Given that some of the seven pounds he lost would be the result of burning fuel stores rather than losing fluids, its likely that he got his hydration pretty close to perfect.

Ruby is probably most famousor infamousfor a study he ran back in 2015 that compared McDonalds fast food with products from Gatorade, Cliff, Power Bar, and other sports nutrition companies. They all worked equally well for restocking glycogen after a 90-minute bike ride and fueling a subsequent 20K time trial. Calories, in this view, are calories (or at least carbs are carbs). As I said at the top, I dont think thats true in the long term: theres more to health than burning as many calories as you consume. Still, its not a bad place to startand Rubys data offers a reminder that, with sufficient fitness and motivation, were capable of burning a staggering number of calories.

For more Sweat Science, join me on Twitter and Facebook, sign up for the email newsletter, and check out my book Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance.

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The Physiology of a 24-Hour Mountain-Bike Race - Outside

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Is it possible to lose weight while eating a diet consisting solely of fast food from McDonalds? According to Tennessee grandfather Kevin Maginnisaka @bigmaccoaching on TikTokyou can.

Maginnis, 56, began documenting his McDonalds-only diet on the social media platform in February. His goal: to eat McDonalds morning, noon, and night for 100 straight days, to show himself and his followers that its not as much what youre eating, its the quantity that [youre] eating.

His plan was widely received on TikTok before the platform banned his account. Maginnis first video garnered more than 2.2 million viewsbut that doesnt mean this diet trend comes free from controversy. Though Maginnis has lost weight so far on his unconventional plandown 21 pounds since his last weigh inmany experts are concerned not only for his health but also potentially the health of people who are inspired by him.

Heres what you need to know about Maginnis McDonalds-only diet, why it might be leading to some weight loss, and why the results may not necessarily be healthy or sustainable.

The McDonalds-only diet is not an official eating planit was not created by registered dietitians and there are no clinical trials available to evaluate its safety or effectiveness.

The diet was created by Maginnis himself, on February 21, according to his TikTok videos. The diet only has a few simple rules:

An exercise recommendation is not included on this plan, and Maginnis claims he only gets in around 2,000 steps daily.

Desiring to reach a healthy weight, Maginnis said he tapped into his past experiences being an ex-wrestler and boxer. Since calorie restriction helped him lose pounds and inches in the past, he decided to try limiting portion sizes at his beloved fast food joint and only eat when he is hungry.

According to his most recent TikTok update, Maginnis has been on his diet for 21 days and hes lost 21 pounds.

The reason for that, largely, is calorie restriction. The reason [Maginnis] is losing weight on this diet is because he is consuming fewer calories than he is burning each day, Lainey Younkin, MS, RD, LDN, weight loss dietitian atLainey Younkin Nutrition, told Health.

Maginnis weight loss isnt necessarily surprising to experts. Idrees Mughal, MBBS, a Britain-based physician with an additional masters in nutritional research, said that when the goal is purely weight loss, how much you eat is more important than what you eat.

What hes eating may also be contributing to the weight loss. He is consuming protein at each meal, which suppresses appetite and keeps you full longer, Younkin said. This could be leading to less snacking than he was doing before and a calorie deficit at the end of the day.

But whether his weight loss will be sustainable and able to be maintained is yet to be determined. The true test wont actually be whether or not he can lose the weightmany different calorie deficit diets lead to weight lossits whether or not he will keep it off, registered dietitian Sarah Anzlovar, MS, RDN, LDN, owner ofSarah Gold Nutrition, LLC, told Health.

According to Anzlovar, most people regain weight lost within six months to one year because bodies increase the drive to eat and metabolism often slows down with weight loss. Once someone like Maginnis stops his weight loss experiment, he will need to maintain a significant calorie deficit in order to maintain the weight loss, Anzlovar said.

Mughal agreed that while it is true that in the short term, simply reducing the amount you are eating can offer some health benefits, it likely wont be a sustainable strategy. Both quality and quantity of food impact weight loss for long-term success, he said.

In addition to his 21-pound weight loss, Maginnis McDonalds-only diet has also resulted in a reduction in many of his heart-health markers, including his triglycerides, LDL cholesterol, and total cholesterol, he said in his TikTok videos.

In the short term, heart health can improve among people with obesity who lose a significant amount of weight. The weight loss will override the unhealthy dietary pattern, Dr. Mughal said.

But unhealthy eating patterns will catch up with people who dont prioritize diet quality. Eventually, it will negate the beneficial effects of the weight loss, Dr. Mughal said, adding that as ones health journey continues, diet quality needs to become the focus without actively restricting calories to keep hunger cues and the risk of binge eating in check.

Weight loss and heart health markers aside, McDonalds food is not nutritionally up to par to support overall health.

McDonalds meals significantly lack fruits and vegetables, which contribute important minerals, antioxidants, and fiber to your diet, Anzlovar said. This could not only significantly affect digestive health, but it could also lead to vitamin and mineral deficiencies unless a multivitamin is included.

In fact, research has confirmed that these patterns among fast food eaters lead to poorer diet quality; higher intakes of total and saturated fats, sugar, and sodium; and lower intakes of fiber, dairy, fruit, vegetables, and micronutrients.

Underconsumption of nutrient-dense foods like produce, whole grains, nuts, and seeds is linked to an increased risk of many chronic diseases, including type 2 diabetes and coronary heart disease.

And while Maginnis may be getting a good amount of protein in his diet, the protein provided by many fast food establishments is often ultra-processed, which means its loaded with sodium, Younkin said, adding that ultra-processed foods have also been linked to high blood pressure, heart disease, and certain cancers.

[But] since this is a short-term experiment, its hard to know exactly how much it will affect long-term health, Anzlovar said.

Though Maginnis has seen some short-term success on his McDonalds-only diet, experts certainly arent recommending others to follow in his footsteps.

For the most part, Americans are urged to follow the MyPlate method, which was developed to help people incorporate the recommendations established by the Dietary Guidelines for Americans. The method includes making half of your food volume fruits and vegetables at meals; with lean proteins, dairy, and quality carbohydrates making up the remainder of the plate.

McDonalds foodor fast food in generaldoesnt neatly fit into those guidelines. [I cannot] think of a single combination of a McDonalds meal that would fit these goals, registered dietitian and author Lauren Harris-Pincus, MS, RDN, told Health. Especially since they no longer offer salads or grilled chicken on the menu.

Its also important to remember that weight loss alone doesnt necessarily improve health markers over the long term.

Research has shown that even with maintained weight loss, poor health habits, including diet quality can negatively affect metabolic markers such as cholesterol and blood sugar, Anzlovar said. On the flip side, incorporating healthy habits like eating fruits and vegetables and other health-promoting foods along with exercising can improve long term health.

So while jumping on this TikTok trend may sound appealing, there are some long-term risks associated with eliminating entire food groups, especially if this diet is adopted for an extended period of time.

Because of this, trying any diet should be discussed with your healthcare provider beforehandespecially if its one that involves hitting the drive-through window multiple times a day, as it will not be an ideal match for most people who want to achieve long-lasting health benefits.

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Can You Really Lose Weight on a McDonald's-Only Diet? It's More ... - Health.com

TULSA, Okla. Americans are piling on the pounds. According to the Centers for Disease Control and Prevention, the prevalence of obesity in the United States had reached 41.9% by 2020. Health professionals agree it is a complex problem. While behavioral changes are first on their list of recommendations, three new medications are offering help and hope to patients.

"This is me being vulnerable!" Ali Herman stated in a recent Tiktok video from her account @lifeon120. "I'm scared of needles and I'm about to inject myself."

The first step in Ali Herman's weight loss journey was a tough one that she shared on social media. She showed her first injection of the new weight loss drug, Mounjaro.

"I was like, it's gonna hurt. It's gonna hurt it's gonna hurt," Ali Herman said. "and I completely psyched myself out."

Only Ali found that first injection did not hurt, after all. She insists she did not even feel it. Ali, who lives in Beggs, turned to

"I fought weight all my life. I fought obesity all of my life," said Matt Lee, APRN, CNP.

As one who has battled to keep weight off, Lee has tried the medications. So has his wife, Abbi, who has lost more than 80 pounds. His patients, who range in age up to their 70's have lost up to 100 pounds. Ali lost 43 after four months on the program.

Across the nation, patients are asking for obesity drug Wegovy and type 2 diabetes drug Ozempic - which share the same active ingredient: Semaglutide. Ozempic was approved for the treatment of type 2 diabetes back in 2017. Then, a higher dose of semaglutide was approved for weight loss treatment. Pharmacists say the medication helps the body regulate blood sugar, makes you feel less hungry and fill up faster while eating. The most recent drug, approved in 2022, is Mounjaro. Tirzepatide was first developed as a new diabetes drug. However, after clinical trials found patients lost up to 22-percent of their body weight, more than triple the benefit of older drugs for obesity, it is now under fast-track consideration by the FDA for weight loss treatment.

At his Sapulpa health and wellness clinic, Lee says the phones ring constantly with people calling for information on the options for weight loss. Patients must have a BMI of 27 and not have certain medical issues such as pancreatitis.

However, Lee insists his patients must make changes for long term success.

"Because it's not a magic drug. I know there's a lot of people making it out to be that but we still want people to exercise, we still want people to improve their diet overall. Drink their water like they should," Lee stated.

In Tulsa, Dr. Micah Derby, who specializes in internal medicine at OSU Medicine, also prescribes the newer weight loss medications to some of his obese patients.

"We first talk about lifestyle modification, always and forever," said Micah Derby, D.O., internal medicine physician at OSU Medicine in Tulsa. "Like, 'Hey, are you are you exercising? Are you doing, you know, portion control? What are you doing to obtain your weight loss without medicinal help.'"

He also warned some patients can develop side effects ranging from headaches to nausea and gastrointestinal issues such as diahhrea. Dr. Derby also said it is not recommended for patients with a history of pancreatitis, slow gut syndrome or medullary thyroid carcinoma.

"These medications kind of help you forget to eat and drink," Dr. Derby said. "Forget to drink water, your blood pressure is going to get down and you're going to get a little dizzy. So, all kinds of different types of side effects but mostly it's mostly what we say gastrointestinal."

While drug manufacturers say these new medicines promise fewer side effects than their predecessors, Dr. Derby says every medication needs to be carefully considered. He encourages patients to discuss options at length with their physician and decide if one of the new medications is the best way to move forward. He has seen that the medications can help patients leap the weight loss hurdle they struggled with before.

For patients who reach their goal weight, there are options. Doctors say there is data showing patients can stay on the medication for an extended duration of time with close monitoring of health and dosage. However, those who come off the medication will have to stay vigilant to avoid weight gain.

"If they have not taught themselves good eating habits during the time that they're using it, of course, nature is going to do what nature does. You're still eating your pizza, your cheeseburgers, your weight is going to come back on," Dr. Derby added.

As for the cost, there is a wide range depending on whether it is prescribed by a physician or private clinic, if the patient has insurance, and if the health insurance company covers the medication. With complete health coverage, some patients pay as little as $25 a month for treatment. There may be coupons available online to patients who qualify for the drug manufacturer's discounts. Those without coverage may face expenses up to $1,000 per month. At Divine Health, monthly treatment is approximately $300 per month.

Matt Lee believes the health improvements his patients are seeing will improve their long term health. "We're preventing the high blood pressure, we're preventing the diabetes, we're preventing the high cholesterol," Lee said. "And hopefully we are preventing some of the cancers that are related to it as well."

Ali Herman found losing weight helped bring two key of her health conditions, Hashimoto's and Polycystic Ovarian Syndrome (PCOS), under control. The weight loss has also greatly improved her outlook.

"Mind over body you can do this," Herman said. "You are strong, you are brave, you are confident and it's kind of given me the tools to do that. I think that's where my new goal is gonna lie not in the numbers but in the mindset of it all."

Ali clearly looks different from her TikTok feed on her first day of treatment and yet what remains the same is her ultimate goal for losing weight. She is hoping her new regimen of no sugar, a healthy diet and plenty of water - along with the medication - will help bring about the pregnancy she has been hoping for with her husband.

Stay in touch with us anytime, anywhere --

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New weight loss medications offer help and hope in obesity fight - 2 News Oklahoma KJRH Tulsa

Metabolic and bariatric surgery (MBS)can safely lead to sustained weight loss in Prader-Willi syndrome (PWS) patients, a meta-analysis shows.

It may indeed be time to take a new look at MBS for patients with PWS, the researchers wrote.

The study, Metabolic and bariatric surgery for obesity in Prader Willi syndrome: systematic review and meta-analysis, was published in the journal Surgery for Obesity and Related Diseases.

PWS is the most common genetic cause of life-threatening obesity. Together with developmental delays and behavioral difficulties, patients with PWS develop an insatiable appetite and food-seeking behaviors.

Treatment with a lab-made form of growth hormone (GH), which is deficient in PWS, has been shown to improve body composition and cognitive function in these patients. In addition, patients usually undergo dietary restriction and standard weight-loss programs. These strategies remain ineffective in many cases.

MBS has shown efficacy as a treatment for severe obesity. However, its effects in PWS remain poorly characterized.

To shed light on this, a team led by researchers at Drexel University College of Medicine in Philadelphia, Pennsylvania, conducted a meta-analysis of published studies reporting the use of the three most common MBS techniques for PWS patients: laparoscopic sleeve gastrectomy (LSG); gastric bypass (GB); and biliopancreatic diversion (BPD), with or without duodenal switch (DS).

LSG is a minimally-invasive surgery that cuts part of the stomach to reduce its size. The remaining part is closed into a tube shape resembling a sleeve. In GB, a small pouch is created from the stomach and connected directly to the small intestine. This is intended to feel full with less food.

In BPD without DS, a stomach pouch is connected further along the small intestine, whereas in BPD with DS a portion of the stomach is removed, but the part that connects to the duodenum (first part of the small intestine) is maintained and connected to a lower segment of the intestine. The duodenum is connected to the lower part of the small intestine. Overall, in BPD, food bypasses much of the small intestine, which results in fewer calories absorbed and weight loss.

The researchers analyzed published studies up to July 2022 that reported results on MBS outcomes in PWS. From 256 screened publications, 22 were included in the meta-analysis. Eligibility criteria included haing PWS diagnosis, body mass index (BMI, a measure of body fat) of 35 kg/m2 or greater (indicative of class 2 obesity), and a minimum follow-up of 12 months post-MBS.

In total, from an initial 104 PWS patients who underwent MBS, 67 patients (64%) met the criteria.

Patients (56% males) were placed in three groups, according to the type of intervention; 26 had a LGS (mean age 12.8 years), 28 patients had a BPD (21.4 years), and 10 had GB (18.4 years). BMI before the surgical intervention (baseline) was similar between the three surgery groups.

At one year of follow-up, PWS patients in the LSG group lost a mean of 14.9 kg per square meter (kg/m2) in BMI, those in the GB group a mean of 11.4 kg/m2, and a mean of 15.5 kg/m2 in the BPD group.

The reduction in BMI was still significant three years after surgery in the LSG group, with a mean reduction of 15.2 kg/m2 since baseline.

Those in the GB group also showed a sustained reduction in BMI mean of 12.1 kg/m2 at up to two years of follow-up. The BPD-DS group had the most patients followed more than five years. In this case,the mean reduction in BMI was 10.7 kg/m2 at a seven-year follow-up.

While long-term follow-up data was not available for all patients, statistical analysis showed that the BPD-DS group had the largest weight loss in the long term, with a mean reduction in BMI of 10.9 kg/m2 at 10-years of follow-up.

In contrast, the LSG group presented a slight weight gain after seven years (gain of 0.3 kg/m2, two patients) and after 10 years (0.8 kg/m2 in BMI, also two patients).

No deaths were reported in any of the surgery groups within one year of follow-up. In the BPD group, there were three revision cases, conducted between the second and fourth year after surgery. One case was related to excessive weight loss and two to severe obesity recurrence.

No surgical complications were reported for LSG and GB procedures.While nutritional complications were seldom reported, there was one case of iron deficiency in the LSG group and one in the BPD group. Two cases of osteoporosis (weak and brittle bones) were reported in the BPD-DS group.

Overall, the current data on MBS in patients with PWS show that procedures performed today such as the LSG, GB, and BPD with or without DS can safely provide rapid weight loss and alter the natural progression of weight gain seen in these patients, the study concluded.

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PWS study examines lasting effects of metabolic, bariatric surgery - Prader-Willi Syndrome News

Taking the right steps and maintaining a healthy diet can help boost weight loss

There are strategies to help you reduce weight safely if your doctor advises it, even though weight loss is not always the solution to health issues. For the best long-term weight management, a consistent weight loss of 1 to 2 pounds per week is advised.

Nonetheless, many weight-loss diets leave you feeling hungry or unsatisfied or they eliminate important food groups and are not sustainable. Besides working out and staying in a calorie-deficit, you can follow these tips to boost your weight loss.

The idea that missing meals causes weight loss is a prevalent one. Although you are technically eating less calories at the time, skipping a meal usually results in excessive hunger and unpredictable eating patterns that are bad for your metabolism.

Due to their high caloric content, nuts often get a poor rap, but evidence suggests that substituting pistachios for carb-based snacks helps hasten weight reduction. Because they include amino acids that aid in frying abdominal fat, almonds are also advantageous if consumed before exercise.

Lack of sleep causes your satisfaction hormone, leptin, to drop and your hunger hormone, ghrelin, to rise, which can lead to weight gain. We have stronger cravings for salty and sweet foods when we are sleep deprived.

Meals high in fibre can help you feel satisfied, which is ideal for weight loss. Only foods made from plants contain fibre, including fruit and vegetables, oats, wholegrain bread, brown rice, pasta, beans, peas, and lentils.

Choosing healthier selections might be made easier if you know how to read food labels. To determine how a specific food fits into your daily calorie allocation on the weight loss plan, use the calorie counts.

Whether you're making a meal or just a snack, utilising smaller plates and bowls is a simple method to control your portion size and prevent overeating. You shouldn't feel bad if you fill up smaller dishes with fibre, protein, etc.

All the macronutrients are present in a perfectly balanced meal, which also meets the body's daily requirements. According to a study, when you eat the nutrients your body requires, your fullness level rises and you stop craving unnecessary foods.

In the long run, the limitation does not aid in weight loss. There are fad diets that are neither sustainable nor a long-term solution, including the no-carb, detox, apple cider vinegar, and maple syrup diets. In order to burn off the extra calories, eat whatever you want in moderation and exercise at least three days per week.

Incorporating healthy fats in your diet can aid in weight loss and help you control sugar cravings. Nuts are a fantastic source of healthy fats and are abundant in minerals. In order to avoid eating chocolate or brownies, try to munch on almonds as a snack.

It takes your brain 20 minutes to process this before it tells you to immediately quit eating. But, if you eat more quickly, your brain may become disoriented and you may miss the cues of fullness, leading to overeating.

Incorporate these tips to your routine for faster weight loss and better overall health.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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Obesity: 10 Easy Tips That Will Help Boost Your Weight Loss Journey - NDTV

Health

Concerns grow after 67 cases of botulism poisoning in past three weeks linked to clinics in Istanbul and zmir

Desperate patients are seeking risky weight-loss treatments in Turkey because of unacceptable NHS waiting times, a surgeon has said.

Ahmed Ahmed, a consultant bariatric surgeon at Imperial College healthcare trust and the treasurer of the British Obesity and Metabolic Surgery Society, said there had been a notable increase in patients presenting with complications after undergoing surgery abroad.

Theres certainly an increase in people going abroad for surgery and having bariatric surgery in Turkey, he said. Since Covid and the ever-increasing waiting lists on the NHS, people are being forced to go abroad to seek treatment. People should not have to go abroad.

Concerns have been raised after European health officials advised EU citizens against travelling to Turkey for weight-loss Botox injections after 67 cases of botulism poisoning in the past three weeks linked to private clinics in Istanbul and zmir.

The European Centre for Disease Prevention and Control alert said some patients had been admitted to intensive care. None of the cases highlighted were in the UK, and the UK government watchdog, the Medicines and Healthcare products Regulatory Agency (MHRA), had not received any reports of botulism linked to weight-loss treatments.

Gastric botulinum toxin injections, commonly known as gastric Botox injections, are advertised as a way to relax the stomach muscles, with the aim of reducing appetite and aiding weight loss. The treatment is offered as a cheap, less invasive alternative to gastric surgery, but Ahmed says it is unlikely to be effective.

There is no evidence whatsoever that gastric Botox injections work at all, he said, adding that gastric Botox was not offered on the NHS for this reason. Anybody who practises evidence-based medicine would not be doing this.

Ahmed said he was aware of patients who had sought surgery abroad and subsequently needed NHS treatment because of serious complications.

I work at St Marys hospital in Paddington, west London, and Ive had people coming straight on the Heathrow Express to my A&E department after surgery in Turkey, he said.

Ive seen people are being told they were having one operation but when weve investigated theyve had another procedure. Ive seen internal leaks or narrowing, joins not being done properly.

Im not saying that all Turkish bariatric surgery is bad, but I can tell you that Ive seen a higher than expected rate of complications from people who have flown abroad to get it.

According to the Foreign Office, at least 22 British citizens have died during medical tourism trips to Turkey, with several publicised cases involving bariatric surgery.

Dawn Knight, a patient safety campaigner and trustee of the Joint Council for Cosmetic Practitioners, said some clinics were engaged in aggressive marketing in the UK, offering treatments ranging from hair restoration to dental operations, gastric sleeves and liposuction.

These clinics are preying on the very vulnerable by offering a fast-track route. But the risks are exponentially higher than being under a GP on home soil, she said. There are huge risks with flying after a procedure like bariatric surgery but some clinics are suggesting you come out, have the surgery and fly home in a couple of days.

Marc Pacifico, the president of the British Association of Aesthetic Plastic Surgeons (BAAPS), said: With any drug or injectable product, it is crucial that the provenance, safety record and ingredients have been checked and regulated. The risks of being injected with an unknown product could cause serious medical harm and have both short- and long-term consequences.

BAAPS would strongly urge anyone considering undergoing injectable treatment to ensure they see a reputable clinician who uses products that are both CE marked, MHRA approved and, if a prescribed medicine, available on the British National Formulary.

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Brain functional and structural magnetic resonance imaging of ... - Nature.com

High levels of caffeine in the blood can keep a check on body fat, thereby reducing the drinkers risk of developing Type 2 diabetes, found a study by European researchers using genetic data of 10,000 people. The study is significant because instead of focusing on the consumption of caffeinated drinks, it focusses on how the compound is broken down by the body. The researchers found that those with low caffeine metabolism had higher levels of the compound in the blood as it took longer for them to process it and had consequently lower body mass index (BMI). Dr Ambrish Mithal, Chairman of Endocrinology and Diabetes at Max Healthcare, feels the study opens up a new avenue for research but warns that it is not evidence for one to increase their coffee or tea consumption.

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What is the link between caffeine and diabetes?Caffeine consumption has always been linked to weight loss. That is the reason you see all sorts of weight loss pills and fads containing caffeine. What this study has done, however, is take the link a step further to say higher blood caffeine content reduces the risk of Type 2 diabetes.

The researchers have used genetic markers of caffeine metabolism and have used a method called Mandelion randomisation. This is one step ahead of observational studies that tracked coffee consumption and diabetes risk to establish a link between the two but is one step behind a randomised control trial that can prove that one causes the other.

The finding that caffeine metabolism is linked to lower body mass index is not surprising. And, since obesity is one of the major risk factors for Type 2 diabetes, having a lower BMI would of course reduce the risk for it. But what researchers have found is that only 50 per cent of this risk reduction is because of the lower BMI. What causes the other 50 per cent reduction in risk we dont know. And, that is where more studies are needed.

Does caffeine really lead to weight loss?

Caffeine increases the energy expenditure of the body and thereby promotes weight loss. What we know so far is that consuming 100 mg of caffeine a day can increase the energy expenditure of a person by 100 calories a day. This is actually quite high a person uses up only about 200 calories even when they do a rigorous workout.

Does this mean that increasing coffee consumption can prevent diabetes?

Absolutely not. First, the study is talking about caffeine metabolism and not the amount consumed. Second, going overboard with caffeinated drinks can lead to a host of other problems. It can increase a persons heart rate, lead to anxiety and restlessness, cause tremors of the hand, insomnia and headaches. Besides, drinking it with sugar can do more harm than good.

How much coffee or tea is too much?

So, a big cup of black coffee contains about 100 mg of caffeine. And tea contains about one-third to half that quantity, depending on the kind of tea being consumed. An average Indian adult can have about 300 mg of caffeine a day. So, that would mean around three cups of coffee. But this does not mean people should increase their intake if they drink less. Also, if people already suffer from anxiety or are prone to increased heart rate, they should restrict their consumption to about 200 mg of caffeine a day. Instead of focusing on drinking more coffee and tea, working on lifestyle changes would be better to control weight and keep diabetes at bay.

What are the changes that people should focus on?

As I said earlier, obesity is one of the major risk factors for Type 2 diabetes. So if people keep their weight in check, they reduce their risk of the disease significantly. Maintaining body weight is a combination of diet and exercise. Along with regular exercise, you must cut down on refined carbohydrates, increase fibre and protein intake and keep the total calories under control.

Why Dr Mithal?

Dr Mithal is Chairman of Endocrinology and Diabetes at Max Healthcare. He has won numerous awards, including the highest award for physicians, Dr BC Roy award. He has also received the third highest civilian award, Padma Bhushan, for his contribution to the field of endocrinology. He was appointed as one of the domain experts in the governments National Health Authority, the body implementing Ayushman Bharat insurance scheme.

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First published on: 17-03-2023 at 17:31 IST

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Does caffeine affect blood sugar? A doctor unpacks a new study on the effects of caffeine levels on body fat, long term risks of diabetes - The Indian...

Columbus [Ohio], March 9 (ANI): According to new research, being able to walk to a nearby food retail shop may be a key determinant in long-term weight loss following bariatric surgery.Nevertheless, researchers discovered that merely residing near a food shop isn't a surefire route to long-term weight loss, especially if the market serves largely processed convenience foods.

The findings were published in Surgery for Obesity and Related Diseases and Obesity Surgery.

A closer look at store products affected whether that proximity was beneficial, showing that living within a five-minute walk of a store with a low-quality selection of foods was actually linked to less weight loss at the two-year post-operative point.

The research team examined neighborhood characteristics and other social determinants of health that may help or hinder continued weight loss in the two years after bariatric surgery.

The analysis included select data from the electronic health records of all patients who received bariatric surgery at The Ohio State University Wexner Medical Center from 2015 to 2019 in Franklin County, Ohio. Data included race, insurance type, procedure and percentage of total weight loss from two to 24 months after surgery.

Researchers combined health records with census and county data, which enabled the team to count not just the number of food stores, parks/recreational areas and fitness facilities in the county, but precisely where they were relative to patients' home addresses.

Bariatric surgery reduces the size of the stomach and leads to rapid weight loss, which requires patients to initially eat a soft diet in small quantities and gradually transition back to a more varied diet, being coached for six months by a dietitian and nurse practitioner.

Previous research has shown that living in healthier areas has helped people manage their weight, but very few studies had looked at the social determinants of health that affect patients who have had a significant surgery to achieve their weight loss, she said.

The patient sample consisted of 772 patients who had undergone one of two types of stomach-reduction surgery. Of those, 60% were white and 82% were women.

The initial study found that while Black surgery patients had higher levels of poverty and unemployment than white patients, consistent with previous studies, those variables did not negatively affect weight loss outcomes. Nor did living near open spaces or fitness and recreation facilities.

Access to a higher number of food stores within a 10-minute walk was linked to a greater percentage of weight loss among all patients. But there was some nuance: Black patients with access to a higher number of food stores within a 10-minute walk experienced greater weight loss over two years. For white patients, the best distance for sustained weight-loss was a five-minute walk from stores.

For all patients, living within a five- or 10-minute walk from moderate- or high-diversity stores had no effect on weight loss, but having one low-diversity store within a five-minute walk or up to two low-diversity stores 10 minutes away was linked to less sustained weight loss.

The researchers noted that living near these stores was not an indicator that patients actually shopped at the markets closest to their homes - but the nature of the most available food stores could be an indicator of larger economic forces at play.

"The real goal is to figure out how to make linkages from the clinic to the community and the community to the clinic," Pratt said, suggesting Ohio State could partner with stores to upgrade their food selection and with fitness facilities to provide patient discounts.

"This is really a starting point to figuring out how we can aid patients in Franklin County and, eventually, beyond, to make sure post-operative weight loss is equitable, and the resources are equitable, for all patients following surgery."

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Long-term weight loss could be linked to how far you live from a food store - Business Insider India

Your weight loss journey was a success but what do you do to make sure you dont gain weight again? Heres how to maintain weight loss.

Congratulations on achieving your weight loss goal! But what now? The real struggle begins. You need to make sure you dont gain it all back by staying consistent to the habits that helped you lose weight. Some people say that they find it more difficult to maintain their weight as opposed to losing it in the first place. So, here we some essential tips to help you maintain your weight loss.

Maintaining weight loss requires commitment, dedication and a positive mindset. By setting realistic goals, tracking your progress, making healthy choices, staying active, getting enough sleep, staying hydrated, and staying positive, you can achieve long-term weight loss success. Remember to be patient, stay focused, and celebrate your successes along the way.

You must have made a routine of exercising to have lost weight. Ensure that you continue with it. Regular physical activity is essential for maintaining weight loss. Aim for at least 30 minutes of exercise such as walking, jogging, or cycling every day. Incorporate strength training exercises to build muscle and increase metabolism.

Avoid opting for crazy crash diets that will make you starve as those are very hard to follow for a longer time period. Instead, focus on eating small portions and make healthy food choices. Include whole foods that are high in nutrients and low in calories. Incorporate fruits, vegetables, lean proteins, and whole grains into your diet. Avoid processed foods and sugary drinks as much as possible.

Maintaining weight loss requires a positive mindset. Celebrate your successes and dont dwell on setbacks. Having minor setbacks is normal but dont let them affect you mentally and try to jump back to your routine as quickly as possible. Remember that weight loss is a journey, and it may take time to achieve your goals. Stay motivated and keep moving forward.

Tracking your progress is essential for maintaining weight loss. Keep a food journal to track your daily food intake and exercise routines. This will help you stay accountable and make adjustments when necessary. You can also track your weight and body measurements to monitor your progress. This will give you a sense of achievement and motivate you to follow your health routine.

One of the most important things to keep in mind when maintaining weight loss is to set realistic goals. It is easy to get caught up in the excitement of losing weight and set unattainable goals that may be difficult to maintain in the long term. Instead, set realistic goals that are achievable and sustainable. This will help you to stay motivated and focused in maintaining your weight loss.

In general, try to pick healthy habits like getting a good amount of sleep. 6-8 hours of sleep is a must to avoid stress which can eventually lead to weight gain. Also, try to stay hydrated and drink at least 8 glasses of water per day. These might seem like insignificant points but they are in fact most essential when it comes to maintaining your weight.

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6 healthy habits to maintain your weight loss success - Health shots

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