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Most people who are getting married hope that the wedding ceremony they are planning will be their first and last one. That is why they try to make sure that everything is perfect and can become really picky and even rude.

It is understandable that they want to be in control and guests even accept some weird rules they make, but this woman who was asked to be her cousins maid of honor thinks that telling her to lose weight is going too far. Her story went viral on Twitter and sparked quite a debate, as anything to do with wedding rules does.

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Twitter user Ife Nkili has a small Twitter account followed by nearly 2.5k people but that didnt stop one of her posts from going viral, which means it resonated with a lot of people. It now has over 200k likes and 4.5k people joined the conversation in the thread.

In that thread, Ife Nkili shared that her close cousin who she almost considers her sibling just confirmed that she is no longer wanted as the maid of honor unless she loses weight. So the woman decided not to attend the wedding altogether.

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Her family wasnt happy about it, but she feels she is just giving back what she received. The family thinks Ife Nkili should still come, but the woman feels that the bride thinks she doesnt look good enough, so why ruin the wedding photos with her presence?

Thankfully, these are just some sarcastic thoughts and not how Ife Nkili actually feels. In the thread, she mentions she has strong self-will and doesnt hate her body, although she does stress over food and if shes gaining weight.

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It seems that her bigger weight is due to genes and she has been bullied for it her whole life by the people who should have been the closest to her. Also, the woman points out that going to the gym is quite expensive and shuts down the comments telling her to try and lose weight by saying that if someone paid for it, she would go.

But the point is not whether she can afford it or not. It is about respecting a family member and a human being and not telling them what to do with their body.

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However, people in the comments had different views. Most of them agreed that it was really rude of the cousin to ask such a thing. If she wants to lose weight, she should do it for herself and not for a cousin or anybody else.

Others felt that it was her cousins wedding so it was her decision what she wanted. There were also people who had the impression that Ife Nkili felt entitled to be her cousins maid of honor and that she wouldnt agree to be just a guest if she didnt have an important role in the wedding.

Some Twitter users saw those comments and actually didnt believe that at all, because if they were called fat, they would pass on the wedding too.

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Being the maid of honor is, as the title says it, an honor. It is a special person the bride trusts the most as she is the one who plans the bridal shower and the bachelorette party, she is the one that the bride turns to for advice on her wedding dress and she holds the brides bouquet on the big day.

Maybe these responsibilities dont seem like a big deal, but they symbolize the close relationship between two women. Ife Nkili really felt that she is close to her cousin, but turns out, she couldnt accept her the way she was and was deprived of the role because her cousin didnt want to change.

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Suzanne Degges-White, PhD, professor and chair of the Counseling and Higher Education department at Northern Illinois University that we, as humans, already very often think that we are never enough and strive for change, most often when comparing ourselves with others.

She writes in an article, Some of us are born to be tall and slender; others are destined to be average and plump or any of a million other variations of the human body in all of its glory. And divergence and variety are okay. And enough. Do not allow others to generate self-doubt you, alone, are the expert on you.

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It must be even more devastating when someone you love points out those insecurities and confirms your inner thoughts and that it is actually such a big deal that you will miss their wedding when you try so hard to convince that people telling you similar words to Suzanne Degges-Whites are right.

But according to A Conscious Rethink, its not worth changing yourself because you want to please someone else: in the long run, changing or trying to change who you are will spell nothing but trouble if the change isnt authentic and natural.

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Even though most reactions people had were supporting Ife Nkili, some thought she was making a big deal out of what could have been handled in a more simple way. We would love to hear your thoughts on Ife Nkilis situation and what you would have done in her shoes, so leave it in the comments!

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Bridezilla Demands Her Cousin Lose Weight To Be Her Maid Of Honor, The Cousin Calls Her Out Online - Bored Panda

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Theres no shame in getting surgical help when it comes to weight loss. Many stars have turned to getting gastric bypass surgery and other procedures to help them lose weight and keep it off in the long term.

One celebrity who kept her procedure private isKelly Osbourne. She didnt reveal that she had a gastric sleeve procedure until announcing in August 2020 that shed lost 85 pounds. She later declared on the Hollywood Raw podcast, I had surgery. I dont give a fkwhat anyone has to say.

I did the gastric sleeve. All it does is change the shape of your stomach. I got that almost two years ago, she explained, adding that she still had to do plenty of work to keep the pounds off. The kind of surgery I had if you dont work out and you dont eat right, you gain weight. All it does is move you in the right direction, she said. So, anyone whos thinking of doing something like this, really think about that.

I had to do a year of stand-alone therapy to prepare myself for the surgery before I even had it, she continued. What people dont realize is, it cuts out this hormone that if you have addiction issues, it stops your craving and it makes you not emotionally eat, which is a huge problem for me All it is, is a push in the right direction. It doesnt solve all your problems. Its not a quick fix.

Actress and comedian Rosie ODonnell underwent vertical gastric sleeve surgery in 2013, a year after she suffered a heart attack. Within two years, she went from a high of 240 to 176 pounds. Rosie explained to People in 2015 how like Kelly, the procedure also curbed her appetite and food cravings.

For me, its been two years. It used to be on Halloween, the week before, I would start sweating until Christmas, because I had huge problems not going and stealing their (her kids) candy, Rosie shared,adding, I couldnt help myself.

But after the gastric sleeve surgery, things changed. This year, the whole trick-or-treat, I had one lollipop, she continued. I dont feel that same pull for it. They told me the part of the stomach they remove have hunger hormones in it, called ghrelins. And that changes the way you think and feel about food. I feel so much freer now in terms of needing to move and play with my kids.

Scroll down for more celebrities who have undergone weight loss surgery.

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Celebrities Who Have Undergone Weight Loss Surgery: Gastric Bypasses, Liposuction and More - Life&Style Weekly

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Apart from reminding you of the fun-filled childhood days, there are several health benefits of skipping rope. It can be an intense workout to build your stamina and muscle strength and a great way to burn fat. Jumping rope can burn a lot of calories in a short period of time. For best results, try to incorporate skipping rope twice a day for short intervals or once everyday with some proper dedicated time. If you are a beginner, you can count how many skips you can do in a go and slowly work on improving your count and thereby lose weight faster.

In terms of calories, someone who weighs 91 kgs and jumps rope at a fast pace for 20 minutes can burn around 362 calories. If someone goes at a slower pace, they can burn approximately 241 calories in the same relatively short period. So get ready with your skipping rope and shoes, find some space and try these interesting styles of skipping rope exercises which are great to burn fat fast.

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Weight Loss: Try these various skipping rope exercises to burn fat fast - Times of India

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Many people assume that to lose belly fat you need to do specific exercises that will target that part of your body. However, eating a healthy, balanced diet is one of the most important factors in visceral fat loss.

When it comes to foods for a healthier diet, yogurt is a great choice for an easy breakfast or quick snack. And yogurt types that are low in added sugar, low in fat, and high in protein can make for helpful additions to a weight-loss-friendly way of eating. Adding protein to your diet has been shown toreduce levels of belly fat.

Continue reading for some inspiration on yummy yogurt combinations that can help with belly fat loss, and for more healthy eating tips make sure to check out 9 Fruits You Need to Add to Your Smoothie for Weight Loss. Read on, and for more on how to eat healthy, don't miss Eating Habits to Lose Abdominal Fat As You Age, Say Dietitians.

This yogurt parfait can help you with your belly fat because it can act as a healthier dessert alternative with less sugar. The recipe calls for a low-fat Greek yogurt because it's usually high in protein and lower in sugar, but you can use any type of yogurt you'd like.

Get our recipe for Yogurt Parfait.

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Greek yogurt is a great choice for keeping your sugar content low and your protein levels higher. This recipe is a sweeter yogurt because of the ginger syrup, so if you're trying to limit your added sugar you can also forgo this addition.

Get our recipe for Greek Yogurt with Fruit.

This homemade yogurt recipe is made with a crockpot. Not only is it healthy and great for your belly fat loss goals because of its low sugar content, but it's cheaper than buying store-bought yogurt, too!6254a4d1642c605c54bf1cab17d50f1e

Get our recipe for Pumpkin Yogurt.

RELATED:The 15 Best Low-Sugar Yogurts, Approved by Dietitians

This recipe is delicious and easy to make. With bananas, granola, and peanut butter, this yogurt combination will leave you feeling full so that you won't be tempted to snack on as many unhealthy, sugary foods.

Get the recipe from Chelsea's Messy Apron.

You can get your chocolate fix with this yogurt combination while avoiding a ton of added sugar or other tricky ingredients. You'll also get a boost of protein, which is helpful for belly fat loss.

Get the recipe from Chelsea's Messy Apron.

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5 Best Yogurt Combinations for Belly Fat Loss Eat This Not That - Eat This, Not That

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Trimming down in the midsectionaka the "pot belly" areais a common fitness goal many people share, and for good reason. Having extra belly fat can be hazardous to your health, making you more likely to develop heart disease, liver issues, and diabetes. In order to lose a pot belly, living a healthy lifestyle is key, including eating a healthy diet and getting in regular exercise.

When it comes to choosing the right exercises, you should focus on a blend of strength training and cardio workouts, with a major emphasis on the strength portion. Strength training builds muscle, elevates your metabolism, and burns more calories than cardio. I recommend most people strength train at least three times per week and perform aerobic activity in between.

If you're already lifting weights and doing cardio, yet still struggle to shrink belly fat, then there may be a couple of exercise habits you're missing. Here are three foolproof habits you need to incorporate in order to help lose a pot belly fast. Check them out below, and next, don't miss The 6 Best Exercises for Strong and Toned Arms in 2022, Trainer Says.

There's no better time than the present to start tracking your training progress.Record how much weight you're lifting and how many reps you're performing in your exercises. The next time you do the same workout, try to go heavier or perform more reps. This will force you to burn more calories, build more muscle, and lose fat in a speedy fashion.

Related: Get Rid of a Pot Belly in Your 50s With This 10-Minute Workout, Trainer Says

In order to maximize your muscle gain and fat loss, you want to force your body to work harder in all rep ranges. Many of us get stuck in a certain rep range zone for a good chunk of exercises, so it's a smart idea to cycle in a couple of moves where you're going heavier but performing lower reps (5 to 6), or doing higher rep work to increase the amount of time under tension (12+).

Walking is such an underrated habit for those looking to melt belly fat. Even though you may be getting in your workout for the day, if you're sitting for multiple hours afterward, you're unfortunately still considered sedentary. That's why aiming to get 10,000 steps per day is promoted so heavily across favorite fitness apps and platforms. Walking will increase your daily activity and your non-exercise activity thermogenesis (NEAT), which accounts for a huge portion of your calorie burn.6254a4d1642c605c54bf1cab17d50f1e

For more inspiration on shrinking belly fat, check out The #1 Bodyweight Workout To Shrink Your Waistline After 40 and Shrink Belly Fat Faster With This 10-Minute Ab Routine, Trainer Says.

Tim Liu, C.S.C.S.

See the article here:
Lose a Pot Belly Fast With These 3 Foolproof Habits, Trainer Says Eat This Not That - Eat This, Not That

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1. Wang, F. et al. Effects of Vegetarian Diets on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of the American Heart Association, 2015.

Details: This meta-analysis included 832 participants. It looked at 11 studies of vegetarian diets, seven of which were vegan. Each of the studies on vegan diets had a control group. The studies lasted from 3 weeks to 18 months.

The researchers evaluated changes in:

Results: Vegetarian diets lowered all cholesterol levels more than the control diets, but they didnt affect blood triglyceride levels. The findings didnt refer specifically to vegan diets.

Vegetarian diets effectively lowered blood levels of total, LDL (bad), HDL (good), and non-HDL cholesterol more than the control diets. Its unclear whether a vegan diet has a similar impact.

2. Macknin, M. et al. Plant-Based, No Added Fat or American Heart Association Diets: Impact on Cardiovascular Risk in Obese Children with Hypercholesterolemia and Their Parents.The Journal of Pediatrics, 2015.

Details: This study involved 30 children with obesity and high cholesterol levels and their parents. Each pair followed either a vegan diet or an American Heart Association (AHA) diet for 4 weeks.

Both groups attended weekly classes and cooking lessons specific to their diet.

Results: Total calorie intake fell significantly in both diet groups.

Children and parents who followed the vegan diet consumed less protein, cholesterol, saturated fat, vitamin D, and vitamin B12. They also consumed more carbs and fiber than those in the AHA group.

Children following the vegan diet lost 6.7 pounds (3.1 kg), on average, during the study period. This was 197% more than the weight lost by those in the AHA group.

At the end of the study, children following the vegan diet had a significantly lower body mass index (BMI) than those following the AHA diet.

Parents in the vegan groups had an average of 0.16% lower HbA1c level, a measure of blood sugar management. They also had lower total and LDL (bad) cholesterol levels than those on the AHA diet.

Both diets lowered heart disease risk in children and adults. However, the vegan diet had a greater impact on the childrens weight and the parents cholesterol and blood sugar levels.

3. Mishra, S. et al. A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: The GEICO study.European Journal of Clinical Nutrition, 2013.

Details: Researchers recruited 291 participants from 10 GEICO corporate offices. Each office was paired with another, and employees from each paired site followed either a low fat vegan diet or a control diet for 18 weeks.

Participants in the vegan group received weekly support group classes led by a dietitian. They took a daily vitamin B12 supplement and were encouraged to favor low glycemic index foods.

Participants in the control group made no dietary changes and didnt attend weekly support group sessions.

Results: The vegan group consumed more fiber and less total fat, saturated fat, and cholesterol than the control group.

Participants who followed the vegan diet for 18 weeks lost an average of 9.5 pounds (4.3 kg), compared with 0.2 pounds (0.1 kg) in the control group.

Total and LDL (bad) cholesterol levels dropped by 8 mg/dL in the vegan group, compared to almost no change in the control groups.

HDL (good) cholesterol and triglyceride levels both increased more in the vegan groups than in the control group.

HbA1c levels dropped by 0.7% in the vegan group, compared to 0.1% in the control group.

Participants in the vegan groups lost more weight. They also improved their blood cholesterol and blood sugar levels compared to those following a control diet.

4. Barnard, N. D. et al. The effects of a low-fat, plant-based dietary intervention on body weight, metabolism, and insulin sensitivity.The American Journal of Medicine, 2005.

Details: This study involved 64 females who had overweight and had not yet reached menopause. They followed either a low fat vegan or a low fat control diet based on the National Cholesterol Education Program (NCEP) guidelines for 14 weeks.

There were no calorie restrictions, and both groups were encouraged to eat until they were full. Participants prepared their own meals and attended weekly nutritional support session throughout the study.

Results: Although there was no calorie restriction, both groups consumed around 350 fewer calories per day. The vegan group consumed less dietary protein, fat, and cholesterol and more fiber than the NCEP diet group.

Participants in the vegan group lost an average of 12.8 pounds (5.8 kg), compared to 8.4 pounds (3.8 kg) in those following the NCEP diet. Changes in BMI and waist circumference were also greater in the vegan groups.

Blood sugar levels, fasting insulin, and insulin sensitivity improved significantly for all.

Both diets improved markers of blood sugar management. However, the low fat vegan diet helped participants lose more weight than the low fat NCEP diet.

5. Turner-McGrievy, G. M. et al. A Two-Year Randomized Weight Loss Trial Comparing a Vegan Diet to a More Moderate Low-Fat Diet.Obesity, 2007.

Details: Having completed the above study, the researchers continued to assess 62 of the same participants for 2 years. In this phase, 34 participants had follow-up support for 1 year, but the others received no support.

There were no calorie restriction goals, and both groups continued to eat until they were full.

Results: Those in the vegan group lost an average of 10.8 pounds (4.9 kg) after 1 year, compared to 4 pounds (1.8 kg) in the NCEP group.

Over the next year, both groups regained some weight. After 2 years, the weight loss was 6.8 pounds (3.1 kg) in the vegan group and 1.8 pounds (0.8 kg) in the NCEP group.

Regardless of the diet assignment, the women who received group support sessions lost more weight than those who didnt receive them.

Females on a low fat vegan diet lost more weight after 1 and 2 years, compared to those following another low fat diet. Also, those who received group support lost more weight and regained less.

6. Barnard, N.D. et al. A Low-Fat Vegan Diet Improves Glycemic Control and Cardiovascular Risk Factors in a Randomized Clinical Trial in Individuals With Type 2 Diabetes.Diabetes Care, 2006.

Details: Researchers recruited 99 participants with type 2 diabetes and pair-matched them based on their HbA1c levels.

The scientists then randomly assigned each pair to follow either a low fat vegan diet or a diet based on the 2003 American Diabetes Association (ADA) guidelines for 22 weeks.

There were no restrictions on portion sizes, calorie intake, and carbs on the vegan diet. Those on the ADA diet were asked to reduce their calorie intake by 5001,000 calories per day.

Everyone received a vitamin B12 supplement. Alcohol was limited to one serving per day for women and two servings per day for men.

All participants also had an initial one-on-one session with a registered dietitian and attended weekly nutrition group meetings throughout the study.

Results: Both groups consumed approximately 400 fewer calories per day, although only the ADA group had instructions to do so.

All participants reduced their intake of protein and fat, but those in the vegan group consumed 152% more carbs than the ADA group.

Participants following the vegan diet doubled their fiber intake, whereas the amount of fiber consumed by those in the ADA group remained the same.

After 22 weeks, the vegan group lost an average of 12.8 pounds (5.8 kg). This was 134% more weight than the average weight lost in the ADA group.

Total cholesterol, LDL (bad), and HDL (good) cholesterol levels all fell in both groups.

However, in the vegan group, HbA1c levels fell by 0.96 points. This was 71% more than the ADA participants levels.

The graph below shows the HbA1c changes in the vegan diet groups (blue) and ADA diet groups (red).

Both diets helped participants lose weight and improve their blood sugar and cholesterol levels. However, those on the vegan diet experienced greater reductions in weight loss and blood sugar than those following the ADA diet.

7. Barnard, N.D. et al. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial.American Journal of Clinical Nutrition, 2009.

Details: Researchers followed participants from the previous study for an additional 52 weeks.

Results: By the end of the 74-week study period, the 17 participants in the vegan group had reduced their diabetes medication dosages, compared with 10 people in the ADA group. HbA1c levels fell to a greater extent in the vegan group.

Participants in the vegan group also lost 3 pounds (1.4 kg) more weight than those on the ADA diet, but the difference wasnt statistically significant.

In addition, LDL (bad) and total cholesterol levels fell by 10.113.6 mg/dL more in the vegan groups than in the ADA group.

Both diets improved blood sugar and cholesterol levels in people with type 2 diabetes, but the impact was greater with the vegan diet. Both diets contributed to weight loss. The differences between the diets werent significant.

8. Nicholson, A. S. et al. Toward Improved Management of NIDDM: A Randomized, Controlled, Pilot Intervention Using a Low-Fat, Vegetarian Diet.Preventive Medicine, 1999.

Details: Eleven people with type 2 diabetes followed either a low fat vegan diet or a conventional low fat diet for 12 weeks.

All participants were offered prepared lunches and dinners according to their diet specifications. Participants could also opt to prepare their own meals if they preferred, but most used the catered meal option.

The vegan diet contained less fat, and participants consumed around 150 fewer calories per meal than those on the conventional diet.

All participants attended an initial half-day orientation session, as well as support group sessions every other week throughout the study.

Results: In the vegan group, fasting blood sugar levels fell by 28%, compared with a 12% decrease in those following the conventional low fat diet.

People on the vegan diet also lost an average of 15.8 pounds (7.2 kg) over 12 weeks. Those on the conventional diet lost an average of 8.4 pounds (3.8 kg).

There were no differences in total and LDL (bad) cholesterol levels, but HDL (good) cholesterol levels fell in the vegan group.

A low fat vegan diet may help reduce fasting blood sugar levels and help people lose more weight than a conventional low fat diet.

9. Turner-McGrievy, G. M. et al. Low glycemic index vegan or low-calorie weight loss diets for women with polycystic ovary syndrome: a randomized controlled feasibility study.Nutrition Research, 2014.

Details: Eighteen females with overweight or obesity and polycystic ovarian syndrome (PCOS) followed either a low fat vegan diet or a low calorie diet for 6 months. There was also an option to join a Facebook support group.

Results: Those in the vegan group lost a total of 1.8% of their body weight over the first 3 months, while those in the low-calorie group didnt lose weight. However, there were no significant differences after 6 months.

In addition, participants with a higher engagement in a Facebook support group lost more weight than those who didnt engage.

People who followed the vegan diet consumed an average of 265 fewer calories than those on the low-calorie diet, despite having no calorie restriction.

Participants in the vegan group also consumed less protein, less fat, and more carbs than those following the low calorie diet.

No differences were observed in pregnancy or PCOS-related symptoms between the two groups.

A vegan diet may help reduce calorie intake, even without a calorie restriction goal. It may also help females with PCOS lose weight.

10. Turner-McGrievy, G. M. et al. Comparative effectiveness of plant-based diets for weight loss: A randomized controlled trial of five different diets.Nutrition, 2015.

Details: Fifty adults with overweight followed one of five low fat, low glycemic index diets for 6 months. The diets were either vegan, vegetarian, pesco-vegetarian, semi-vegetarian, or omnivorous.

A registered dietitian advised participants about their diet and encouraged them to limit processed and fast food.

All participants, except those in the omnivorous diet group, attended weekly group meetings. The omnivore group attended monthly sessions and received the same diet information through weekly emails instead.

All participants consumed a daily vitamin B12 supplement and had access to private Facebook support groups.

Results: Participants in the vegan group lost an average of 7.5% of their body weight, which was the most of all groups. In comparison, those in the omnivore group lost only 3.1%.

Compared with the omnivore group, the vegan group consumed more carbs, fewer calories, and less fat, despite not having any calorie or fat restriction goals.

Protein intakes were not significantly different between groups.

Vegan diets may be more effective for losing weight than a vegetarian, pesco-vegetarian, semi-vegetarian, or omnivorous diet.

11. Lee, Y-M. et al. Effects of a Brown Rice Based Vegan Diet and Conventional Diabetic Diet on Glycemic Control of Patients with Type 2 Diabetes: A 12-Week Randomized Clinical Trial.PLoS ONE, 2016.

Details: In this study, 106 people with type 2 diabetes followed either a vegan diet or a conventional diet recommended by the Korean Diabetes Association (KDA) for 12 weeks.

There was no restriction on calorie intake for either group.

Results: Participants in the vegan group consumed an average of 60 fewer calories per day, compared with the conventional diet group.

HbA1c levels decreased in both groups. However, those in the vegan group reduced their levels by 0.30.6% more than the conventional diet group.

Interestingly, BMI and waist circumference decreased only in the vegan group.

There were no significant changes in blood pressure or blood cholesterol levels between groups.

Both diets helped with blood sugar management, but the vegan diet had more impact than the conventional diet. A vegan diet was also more effective at reducing BMI and waist circumference.

12. Belinova, L. et al. Differential Acute Postprandial Effects of Processed Meat and Isocaloric Vegan Meals on the Gastrointestinal Hormone Response in Subjects Suffering from Type 2 Diabetes and Healthy Controls: A Randomized Crossover Study.PLoS ONE, 2014.

Details: Fifty people with type 2 diabetes and 50 without diabetes consumed either a protein and saturated fat-rich pork burger or a carb-rich vegan couscous burger.

Researchers measured blood concentrations of sugar, insulin, triglycerides, free fatty acids, gastric appetite hormones, and oxidative stress markers before the meal and up to 180 minutes after the meal.

Results: Both meals produced similar blood sugar responses in both groups over the 180-minute study period.

Insulin levels stayed high for longer after the meat meal than the vegan meal, regardless of diabetes status.

Triglyceride levels rose, and free fatty acids fell more after the meat meal. This happened in both groups, but the difference was greater in those with diabetes.

The meat meal produced a greater decrease in the hunger hormone ghrelin than the vegan meal, but only in healthy participants. In those with diabetes, ghrelin levels were similar after both types of meals.

In those with diabetes, markers of cell-damaging oxidative stress rose more after the meat meal than after the vegan meal.

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16 Studies on Vegan Diets Do They Really Work?

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Indian J Med Res. 2018 Nov; 148(5): 642647.

1Department of Nutrition & Dietetics, Mumbai Diet & Health Centre, Mumbai, India

2Department of Diabetology, Dr Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, Chennai, India

1Department of Nutrition & Dietetics, Mumbai Diet & Health Centre, Mumbai, India

2Department of Diabetology, Dr Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, Chennai, India

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Obesity has now become a huge public health issue not only in the developed world but also in developing countries. In view of the health hazards associated with obesity and more importantly for cosmetic reasons, many people, particularly the youth, have started resorting to extreme weight-loss diets to achieve a rapid reduction in weight. These extreme diets are either very low in carbohydrate or very low in fat. Such extreme diets not only make the diet unbalanced but also have safety issues. Moreover, these are not sustainable in the long run. The weight that is lost is regained within a short period of time when people go off these extreme diets. This explains why the popularity of most extreme diets peaks as well as wanes rapidly. Instead of resorting to such extreme diets, correction of obesity is best achieved with balanced, healthy, nutritious diets which are low in calories, combined with adequate physical activity (exercise). Motivational counselling can also help people to initiate weight loss and sustain this weight loss over longer periods of time.

Keywords: Diabetes, low-carbohydrate diets, low-fat diets, obesity, very-low-calorie diets, weight-loss diets

The incidence and prevalence of obesity is rapidly rising. This is attributed to several factors including globalization, urbanization and rapid changes in lifestyle, leading to unhealthy diets and sedentary behaviours. The obesity epidemic is no longer confined to the developed world but is now rampant in developing countries as well. Obesity leads to type 2 diabetes, hypertension, cardiovascular disease, non-alcoholic fatty liver disease, cholelithiasis, osteoarthritis, sleep apnoea and even some forms of cancer1.

The above health issues as well as cosmetic reasons have led to the need for weight loss in society today. Undoubtedly, dietary management plays a major role in the management of obesity, and in this context, numerous dietary fads have become popular1,2. Unfortunately, these are also controversial. Most diets recommend restriction of calories and portion sizes, leading to slow weight loss1. Many diets, however, promote rapid weight loss, and in this article, we will refer to them as extreme diets. Some diet plans recommend extreme restriction of the carbohydrate intake without any fat restriction, while others are the reverse and place great emphasis on restriction of fat3. This review will focus on the pros and cons of some extreme diets that are widely used today and then discuss the more conventional diet plans for weight loss.

The extreme diets can be classified into low-carbohydrate (high-fat) diets, low-fat (high-carbohydrate) diets, very-low-calorie diets (VLCDs), and other diet modalities used for weight loss1.

Low-carbohydrate diets have received much attention in recent times. Examples of these diets are Atkins's diet and Protein Power Lifeplan4. These diets are low in carbohydrate (<100 g/day) and mostly fat based (>60%).

The proponents of the low-carbohydrate/high-fat diets give greater importance to restriction of carbohydrates than to fats. It is well known that high-carbohydrate meals lead to increased blood glucose, insulin and triglyceride levels and decreased high density lipoprotein cholesterol (HDL-C)5. High insulin levels inhibit the serotonin release in the brain, leading to decreased satiety. Marked restriction of carbohydrate promotes ketosis which indicates fat mobilization. The main benefit of these diets is that it results in lower blood glucose and insulin levels and appetite suppression. This promotes weight loss and decrease in body fat loss and thus to better control of type 2 diabetes, heart disease and hypertension1.

In reality, weight loss is due to caloric restriction of approximately 500-1000 kcal. When unlimited intake of proteins and fats was permitted, the fat intake actually decreased and the protein intake increased only slightly6. Thus, the caloric reduction was mainly due to reduction in carbohydrate.

In the early phases of ketogenic diet, weight loss is mostly due to water loss, whereas there is no difference in protein and fat loss comparing ketogenic and non-ketogenic diets7,8,9,10. Low-carbohydrate ketogenic diets have little metabolic advantages for weight reduction, and it is mostly the negative energy balance which drives weight loss1.

These include decreased blood glucose, insulin and lipid levels. The Prospective Urban and Rural Epidemiological Study (PURE) study10, a large prospective cohort study of 135,335 individuals, found that high-carbohydrate intake (>60% calories) led to increased total and non-cardiovascular disease mortality. Conversely, high-fat intake was associated with reduced total mortality and non-cardiovascular disease mortality. The PURE study10 thus does not support marked reduction of fat intake and clearly points to the dangers of consuming very-high-carbohydrate diets.

It has been shown that a high-meat diet which is also low in fruits and vegetables leads to bone loss11. Very high protein intake leads to calciuria and affects bones, unless buffered by adequate fruits and vegetable intake. The ketogenic diet may also increase blood uric acid concentrations12,13,14,15,16.

As low-carbohydrate diets have less fruits, vegetables and dietary fibre, this could increase the risk of cancer in the long run17,18,19,20. Seidelmann et al21 recently showed that very-low-carbohydrate diets (<30%) markedly increases the mortality. Their data also suggest that the source of the protein and fat substituted for carbohydrates in the diet is also important and the animal protein is more harmful. Low-carbohydrate/high-fat diets may also promote inflammatory pathways and oxidative stress21.

Historically and culturally, Indian diets are predominantly high carbohydrate based, as shown by Chennai Urban Rural Epidemiology Study (CURES)5 in south India and the Study To Assess the dietaRy CarboHydrate content of Indian type-2 diabetes population (STARCH) study22 across the country. Hence, adhering to low-carbohydrate/high-fat diet for prolonged periods of time is difficult. High-protein/high-fat diets usually comprise non-vegetarian items. It is difficult to plan vegetarian high-fat/high-protein-low-carbohydrate diets, because the vegetable proteins are also usually a rich source of carbohydrate.

Low-fat diets are defined as diets with 11-19 per cent fat, whereas very-low-fat diets have <10 per cent fat. Low-fat diets are also usually by default high-carbohydrate diets (e.g., the Dean Ornish and the Pritikin diets)1,23. The emphasis is more on consuming complex carbohydrates and high fibre. Low-fat diets are made up of vegetables, fruits, whole grains and beans, egg white, non-fat dairy, soya and white flour. The Dean Ornish diet is basically a vegetarian diet1,23. The Pritikin diet includes limited quantities of low-fat animal protein1,23.

Low-fat diets lower total cholesterol, specifically low-density lipoprotein (LDL) cholesterol level, in the short term. However, these effects are not seen over a long period of time24. Moreover, triglycerides levels increase in response to these diets, but the amount of carbohydrate consumption may play a role in this. Diets containing up to 70 per cent carbohydrates do not lead to hypertriglyceridaemia, provided sufficient fibre is included although the HDL cholesterol levels may decrease25. The blood pressure may decrease, leading to reduction in antihypertensive medications26. These diets also usually decrease blood glucose and insulin levels27,28,29,30.

As some amount of fat is needed for palatability of diets, very-low-fat diets are usually less palatable. Long-term compliance can thus be a problem with these diets.

VLCDs provide <800 kcals/day. These diets lead to rapid weight loss. Lean body mass is preserved by providing adequate dietary protein in the form of milk, soy or egg-based powder which is mixed with water and consumed as a liquid31,32. Such diets provide 80 g carbohydrate and 15 g fat/day. Recommended daily allowance (RDA) of essential vitamins and minerals is also ensured. The source of protein may be from lean meat, fish and poultry33,34. These diets must be supplemented with a multivitamin and 2-3 g/day potassium and adequate fluid intake31.

A study35 has shown that VLCDs not only have beneficial effect on weight but also lead to remission of type 2 diabetes. The authors found that about 40 per cent of study participants achieved remission, i.e., fasting plasma glucose of <7 mmol/l (126 mg/dl), and this lasted for several months. Along with weight loss, normalization of liver fat content was also seen. Interestingly, the dropout rate was low. Thus, a short-term VLCD intervention is successful in inducing the weight loss and achieving favourable metabolic profile including reversal of type 2 diabetes mellitus35. However, whether this will sustain in the long term needs more studies.

VLCDs are associated with cholelithiasis, ketosis and increase in serum uric acid concentrations36. Long term safety data of these diets needs to be established. Also, whether these diets cause any micronutrient deficiency also needs to be established.

Meal replacers are often used in weight-loss programme, but their use is usually over a short period of time37. Most individuals tend to severely underestimate their calorie intake when consuming a diet of conventional foods38 because of difficulty in estimating portion sizes and calorie content and in dietary recalls. Meal replacements seem to obviate these difficulties33. Portion-controlled servings of conventional foods also facilitate weight loss39,40,41.

These are fibre-based drinks/foods which increase satiety, thereby leading to weight loss. These supplements have other benefits also, e.g., reduction in serum lipids, blood pressure and uric acid levels42,43,44.

It is believed that rather than short-term use of extreme diets which are not sustainable, a more balanced approach in dietary management of obesity is far better.

These diets tend to contain equal quantities of fats and carbohydrates (~30-40%) and the rest from protein but with the reduction in total calories. The Dietary Approaches to Stop Hypertension (DASH) diet, diets based on the use of food pyramid and the National Cholesterol Education Program (NCEP)Step I and Step II diet are based on this45.

The principle of these diets is that weight loss occurs if a negative energy balance is maintained, and these diets provide a deficit of 500-1000 kcals/day. The goal is to provide a range of food choices and to allow nutritional adequacy and compliance, while slowly but steadily promoting weight loss.

These diets reduce LDL cholesterol, triglycerides (TG) and improve TG/HDL ratio20. Serum insulin levels are also reduced in participants on balanced weight-loss diets. Individuals taking such diets do not complain of hunger; rather, they feel there is too much food. Scientists have found that individuals consuming these diets have positive changes in their dietary behaviours and a better physical wellness. This, however, was not correlated with the weight loss46.

While the PURE study10 pointed to the dangers of very high carbohydrates (>60%), Seidelmann et al21 showed the dangers of very-low-carbohydrate diets (<30%). Thus, based on the Indian dietary patterns, a reduced calorie, moderate carbohydrate (~50%) and moderate fat (~30%) diet with healthy monounsaturated fats and adequate protein (~21%) along with plenty of green leafy vegetables is the best alternative.

Those trying to lose weight are willing to try any extreme diets. Unfortunately, none of these seem to work in the long run. This is shown by the rapid rise and fall of such extreme diets in the society. One of the reasons why people give up these diets is the sheer boredom of following an artificial type of diet or their craving to get back to their normal diet habits.

Weight management consists of two different phases: achieving the weight loss and maintaining the weight loss. The strategies that work for initiating weight loss may not be effective for keeping the weight off and vice versa. Hence, when choosing a weight-loss diet, no diet can be suitable for everyone. Thus, it is clear that weight-loss diets should be individualized. If one has to sustain the weight loss, a negative energy balance has to be maintained. There is enough evidence that increasing physical activity is equally important for achieving and maintaining weight loss and this is not discussed in this article. For weight-loss programmes to be effective, dietary therapy must be combined with adequate physical activity. Furthermore, counselling is equally important, as constraint motivation by a dietician or counsellor can play a significant role to ensure that people do not give up easily on their weight-loss programme. India is facing a serious epidemic of obesity. This must be tackled using a slow and steady but sustained diet and exercise programme, rather than following a crash diet programme as the latter rarely succeeds in the long term.

Financial support & sponsorship: None.

Conflicts of Interest: None.

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Pros & cons of some popular extreme weight-loss diets - PMC

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The quality of vegetarian diets to meet nutritional needs and support peak performance among athletes continues to be questioned. Appropriately planned vegetarian diets can provide sufficient energy and an appropriate range of carbohydrate, fat and protein intakes to support performance and health. The acceptable macronutrient distribution ranges for carbohydrate, fat and protein of 45-65%, 20-35% and 10-35%, respectively, are appropriate for vegetarian and non-vegetarian athletes alike, especially those who perform endurance events. Vegetarian athletes can meet their protein needs from predominantly or exclusively plant-based sources when a variety of these foods are consumed daily and energy intake is adequate. Muscle creatine stores are lower in vegetarians than non-vegetarians. Creatine supplementation provides ergogenic responses in both vegetarian and non-vegetarian athletes, with limited data supporting greater ergogenic effects on lean body mass accretion and work performance for vegetarians. The potential adverse effect of a vegetarian diet on iron status is based on the bioavailability of iron from plant foods rather than the amount of total iron present in the diet. Vegetarian and non-vegetarian athletes alike must consume sufficient iron to prevent deficiency, which will adversely affect performance. Other nutrients of concern for vegetarian athletes include zinc, vitamin B12 (cyanocobalamin), vitamin D (cholecalciferol) and calcium. The main sources of these nutrients are animal products; however, they can be found in many food sources suitable for vegetarians, including fortified soy milk and whole grain cereals. Vegetarians have higher antioxidant status for vitamin C (ascorbic acid), vitamin E (tocopherol), and beta-carotene than omnivores, which might help reduce exercise-induced oxidative stress. Research is needed comparing antioxidant defences in vegetarian and non-vegetarian athletes.

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Vegetarian diets : nutritional considerations for athletes

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The research teams goal was to learn whether that one simple question could be used as a screening tool for nutrition studies, rather than the more detailed questionnaires that are generally used.

We felt it was important to study whether adults can accurately assess the quality of their diet because a simple self-assessment tool may be useful when designing nutrition interventions, said Thomson.

Of course, such a tool would only be useful if perceptions are accurate, she added.

To conduct their study, they used data from the National Health and Nutrition Examination Survey (NHANES).

NHANES is a nationally-representative survey of American adults which is done every two years.

People who take part in the survey must complete 24-hour dietary recall questionnaires, as well as rating the overall quality of their diet. They are asked to rate it as either poor, fair, good, very good, or excellent.

The information provided was used by Thomson and her colleagues to rank the quality of peoples diets.

What the researchers found after examining the data was that the scores calculated by the researchers based on peoples reported food intake was significantly different from how people rated their dietary quality themselves.

In fact, out of 9,700 people, about 85 percent of them (about 8,000 people) got it wrong. Further, out of those people who inaccurately assessed how good their diet was, nearly 99 percent of them felt their diet was better than it really was.

The people who did the best at rating the quality of their diet were those who rated it as poor.

These people were correct 97 percent of the time.

On the other hand, only 1-18 percent of people in the four other categories were on the mark in how they perceived their nutritional intake.

Based on our findings, we recommend that efforts continue to educate adults in the United States about components of a healthful diet, said Thomson. We also feel that work is needed to understand what adults consider when thinking about the healthfulness of their diet.

To help clarify what comprises a healthy diet, Healthline spoke with Catherine McManus, PhD, RDN, LD, assistant professor at Case Western Reserve University School of Medicine.

She said its really about what you do the majority of the time.

The field of nutrition really focuses in on ones overall dietary pattern, said McManus, because it is ok to eat out at restaurants, enjoy a slice of cake, or have some potato chips occasionally, just as long as these food items fit into an overall healthy dietary pattern.

She advises that you can determine if your overall dietary pattern is healthy by following certain recommendations, including:

Nutrient density refers to the ratio of nutrients, like vitamins and minerals, to how many calories are in a food.

If you eat a lot of foods that are not nutrient dense (e.g., desserts, pretzels, potato chips, fried foods), youll need to overconsume on calories to reach your daily nutrient requirements, McManus explained.

McManus said that a portion is the amount you choose to eat at one time.

Basically, all foods/beverages can fit into a healthy dietary pattern, but for foods that are less nutrient dense (e.g., desserts, sugar sweetened beverages, many snack foods), we want to limit the frequency theyre consumed, and the portion being consumed, because they provide calories, but are very limited in essential nutrients, like vitamins and minerals, she said.

Fruits, vegetables and whole-grains are nutrient-dense and are filled with essential nutrients, like dietary fiber, folate, zinc and vitamins A, C and E, said McManus.

McManus pointed out that most people in the United States do not get enough fiber.

She said you should shoot for at least 14 grams for every 1,000 calories you eat.

This will help your digestion, heart health, blood sugar control, and weight.

These are examples of two foods that have a very low nutrient density, meaning they provide calories with little to no nutritional value, said McManus.

They have been linked with increased risk for chronic conditions such as:

McManus further noted that, while fruit does contain sugar, it is natural sugar rather than the added sugars that are found in processed foods.

Therefore, eating fruits shouldnt be viewed with the same level of concern as processed foods containing added sugars.

While sodium serves many important functions in the body, like fluid balance and muscle and nerve function, Americans tend to eat too much of it, said McManus.

This can increase risk for high blood pressure, heart disease, and stroke.

She said the Dietary Guidelines for Americans recommends keeping your intake to under 2,300 mg per day.

While its important to consume all fats in moderation because they are calorically dense, said McManus, it is especially important to limit those that have additional established negative health implications, such as trans fats.

Trans fats, which are formed when liquid oils are turned into solid fats, can raise your bad low-density lipoprotein (LDL) cholesterol, as well as lowering your good high-density lipoprotein (HDL) cholesterol, she explained.

This can increase your chances of developing cardiovascular disease and stroke.

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Majority of Americans Think Their Diet Is Healthier Than it Is, Study Finds - Healthline

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Sarah Jackson used to suffer with severe back pain that left her unable to barely walk. Now, after she's an advanced ballroom and Latin dancer, having lost a whopping six and a half stone and shrinking down to a size 10.

The 50-year-old tipped the scales at 16st 7lb, with doctors suggesting hey weight might be aggravating her scoliosis condition that was causing her discomfort.

"I could barely stand up and was willing to try anything, said Sarah.

"My husband Ian and our daughter both told me I was perfect and didnt need to lose weight, but I was desperate to be able to move without pain.

"My wider family had become worried about the amount of weight Id put on and I started to realise it wasnt doing me any good."

READ MORE:Diet: Expert warns against common mistake

Sarah admitted she'd "tried everything" but losing weight was a last resort.

A comfort eater with an addiction to chocolate, she was sceptical when she joined WW, explaining: "I didnt think WW would work at first, but I lost a stone in a month and was suddenly able to walk for a good hour without my back hurting.

"Id been on so many diets and my weight had yo yod. Previously, I lost weight because I was going for fertility treatment, but once that was over, I put it all back on."

She continued: "At WW, my coach Tracey Taylor made me see that it wasnt a diet, it was a lifestyle change and it would only work if I was 100 percent committed to the plan.

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"Im lucky, because my husband Ian is a chef and he cooked all our meals from scratch and made sure that I was eating the correct portions."

Now, Sarah decides against her sweet treats, having curbed the craving for her beloved chocolate.

"My weakness is chocolate," she admitted.

"I used to eat a bar on the way back from the supermarket to our house. Now, I have a banana instead.

"I can have chocolate on the WW programme, but I tend to avoid it because I am not the sort of person who can eat one square, I want to eat the whole bar."

While Sarah's diet was under control, she swore against exercise because she "hated the idea".

So instead, she and her husband tried out Latin dancing, and to their surprise they both loved it.

She said: "When I joined WW, I told my coach that I would never exercise. I hated the idea.

"I had always wanted to dance and dont really see it as exercise, because I enjoy it so much. So does Ian. We are always down at the dance centre.

"I am obsessed with it and I love wearing nice dresses to dance in too I used to hate having my photo taken, because I would always be in baggy clothes or pyjama bottoms at home.

"Now, I have a wardrobe full of lovely frocks and I am first in front of the camera. My family always loved me for who I was, but are delighted by the new me. I am too - I am so much happier."

She added: "I have changed my attitude to exercise too. Ive even started running and was shocked when I ran 5K on my first ever jog."

Sarah reached her goal of 10st and becoming a size 10, but she still continues to attend WW workshops.

She still has a sweet tooth and will occasionally treat herself to a small slice of cake and enjoys an Indian takeaway once a month: "I also get Ian to make me WW fakeaways, which taste just as good as the real thing," she said.

"WW is part of my life now and it always will be. The programme really works and the community is really special.

"Before, I would rarely go out. I wanted to hide. Now, I love dressing up and socialising. Its hard to comprehend how much I have changed.

"It took a long time for me to recognise the person staring back at me in the mirror after Id reached my goal weight."

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Slimmer who 'hated' workouts drops 6.5st with a new hobby - 'I would never exercise!' - Express

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