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If you want to gain a good picture of a man's overall health, measure his testosterone levels. Testosterone isn't just important for libido, strength, and energy it also plays a role in bone health, cardiovascular health, and the immune system. And increasingly, research suggests the hormone is a reliable indicator for disease and longevity.

Researchers have found that men with low testosterone are more likely to suffer from a number of ailments, from heart attacks to diabetes and they may not live as long.

Theres a clear association between testosterone and mortality, says Hugh Jones, an endocrinologist for the Barnsley Hospital NHS Foundation Trust and a professor at the University of Sheffield in England.

So what does this mean for the roughly quarter of men over 40 who have low testosterone? And is it possible to ward off some of the negative health effects associated with low T?

In 2022, scientists at Baylor University and the University of Texas at San Antonio took a deep dive into the relationship between testosterone and early death. Pulling up records for 10,225 patients who had participated in the National Health and Nutrition Examination survey between 1999 and 2004, the researchers found that the lower a mans testosterone levels, the more likely he was to die of disease before 2019. That likelihood was especially high for heart disease, but lower testosterone was also associated with a higher chance of dying from respiratory disease and Alzheimers.

Previous research supports these findings. A 2021 study published in the journal European Urology Open Science found that among 1,792 men who filled out a national survey between 1999 and 2014, those with low testosterone were more than twice as likely to be dead by 2015 compared to men with higher testosterone levels. They were also more likely to have BMIs in the obese category, diabetes, high blood pressure, and risk factors for heart disease.

So do these studies mean that low testosterone causes disease and early death?

Yes and no, Jones says. In his own research, hes found that low testosterone does seem to worsen mens health. In one study, Jones and his colleagues looked at almost 1,000 men with coronary artery disease, in which arteries that supply blood to the heart become dangerously narrow. They compared this population to men who did not have heart disease and found that the men with coronary artery disease had lower overall testosterone.

Additionally, low testosterone was one of the most reliable predictors of death in both groups, surpassed only by weakening of the heart muscle tissue. Men with low T were more than twice as likely to die due to a cardiovascular problem compared to men with normal testosterone levels.

These same scientists then followed 500 patients with diabetes over a period of six years. They found that by the end of the study, 17.2% of patients with low testosterone levels had died, compared to 9% of patients with testosterone in the normal range.

In a different study, Hugh and his colleagues were able to partially reverse the relationship between low T and higher mortality risk from diabetes in a subset of men who received testosterone replacement therapy. In that population, 8.6% of patients died by the end of the study compared to 19.2% who did not receive treatment.

It may be that low testosterone does put you in a position where you have health consequences, Jones says. However, the relationship is likely more complicated than that, he adds. In many cases, disease can actually be what causes low T, which could drive the link between low T and death in many cases.

Disease likely lowers testosterone as the body diverts resources away from the reproductive system towards keeping the body healthy. In addition, major causes of death, such as heart disease and diabetes, are often associated with higher body weight, which may exert its own dampening effect on testosterone because fat cells convert testosterone into estrogen. That can create a negative feedback loop, Jones says: If you have a disease, it may lower your testosterone, which may make that disease worse.

So why does low testosterone worsen disease? The answer to this question is murky, but scientists have a few ideas.

One of them has to do with inflammation, the bodys response to acute illness or injury, in which the immune system releases chemicals and blood cells to fight foreign invaders and heal itself. In the short term, inflammation is a good thing, but chronic inflammation puts stress on the body, making it more susceptible to conditions like heart disease and diabetes.

Testosterone is what scientists call an immune modulator, Jones says after inflammation is no longer needed, it reduces the number of inflammatory proteins called cytokines in the body. So low T could mean the body is worse at tamping down inflammation.

Another possible explanation: In animal studies, testosterone seems to impact the way the body stores fat, Jones says. Rodents with normal testosterone tend to store fat under the skin, whereas those with lower testosterone tend to store more fat around their organs and within the walls of their arteries. In humans, fat stored in these areas is a major predictor of deadly conditions like heart disease.

If you do have low testosterone or suspect that to be the case, you dont need to panic, says Michael Muehlenbein, Ph.D., a biological anthropologist studying evolutionary endocrinology at Baylor University.

Low testosterone may be a predictor of mortality in some cases, he says, but the relationship is not necessarily causal.

Besides, what constitutes low testosterone is a controversial question, and many men who have testosterone levels below the normal range remain healthy.

Still, its a good idea to get your levels checked out if youre experiencing symptoms such as erectile dysfunction, reduced libido, or fatigue. And if you do have low low testosterone, it may be worth talking to your doctors if it could be the result of another condition. That may then inform whether you should start testosterone replacement therapy.

The trick will be determining if low T is a cause of a disease which would then potentially warrant hormone adjustment or is a consequence of having the disease, Muehlenbein says.

Link:
Low Testosterone May Lead To Early Death. Here's What That Means For You - Fatherly

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Search results

The search strategy identified 214 studies and 6 additional papers were identified through other sources for a total of 220 studies. After removing the duplicates, 184 studies were screened of which 152 were excluded based on title and abstract. Full text of the 32 selected studies was obtained. 14 studies were excluded: 4 studies were conducted on animal models, 10 didnt evaluate TT and LH levels. The PRISMA flow diagram is presented in Fig.1. Complessively, 18 records fulfilled the inclusion criteria and were included in the final analysis14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31.

PRISMA flow diagram. TT: Testosterone; LH: Luteinizing Hormone.

Eighteen studies met the inclusion criteria and were included in this analysis, overall 1,575 male patients with Covid-19 infection and 886 male controls. According to the severity of the disease, 823 patients were classified as presenting moderate disease and 500 as having severe disease. Patients enrollment ranged between 2020 and 2022. 15 studies14,17,18,19,20,21,22,24,25,26,27,28,29,30,31 exhibited a prospective cohort design and 3 studies reported a retrospective cohort design15,16,23. The studies included were conducted in Turkey14,17,21,22,25,29 Italy15,16,26,27,28 China24,30,31 USA18, Greece20, Russia19, Austria23. Among the studies included, 11 were controlled16,17,19,20,21,24,25,28,29,30. Collected data included testosterone levels 14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31, LH levels14,17,19,22,23,24,28,29,30, IL-6 levels15,23,26,27,28,30,31, lymphocytes count14,15,16,23,24,26,27,28,30,31, D-dimer levels14,15,16,20,24,26,27,31. The characteristics of the 18 studies included are presented in Table1.

Out of n=1814,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31 studies encompassed in the systematic review, n=1016,17,19,21,22,24,25,28,29,30 were further meta-analytically compared with regards to mean TT levels variations between Covid-19 and control populations. Of note, at this preliminary assessment, there was considerable heterogeneity across each single study with I2 98.45%, Q (9): 580.22, p<0.00. Publication bias was initially assessed by Galbright and Funnel plot (Suppl. Fig. 1). Inspection of both plots suggested that there was no small-study effect with the smaller studies tending to have higher SMD variability, suggesting absence of publication bias (Egger test, p=0.96). Additionally, the Trim and Fill method suggested that no studies would have needed to be included to remove residual asymmetry from the funnel plot. The main contribution to study heterogeneity was indeed identified by sub-group analysis summarized in Suppl. Fig. 2. Interestingly, year of publication which in this case is directly associated with the progression of the Covid-19 pandemic exhibited a significant ascending influence on SMD observed, while no further study design nor cumulative sample size of patients accrued was associated with the observed heterogeneity. The effect of publication year was further highlighted at cumulative meta-analysis sorted by year, where increasing variations in SMD of TT levels across the studies were observed (Suppl. Fig. 2). However, as per sensitivity analysis, the leave-one-out analysis suggested acceptable variation along the cumulative SMD observed when clustering the data by publication year. According to predefined random-effects model, we found a significant reduction in the SMD of testosterone levels in Covid-19 patients compared to controls (3.25, 95%CI 5.93, 0.57, p=0.00, I2=98.45%). The difference was even higher when examining men with severe Covid-19 (5.04, 95%CI 8.82, 1.26, p=0.00, I2=96.60%) (Fig.2).

Forest plot for Standardized Mean Difference (SMD) across studies presenting serum Total Testosterone (TT) in Covid-19 male patients vs. male control (A), clinically severe Covid-19 patients vs. control (B), clinically severe Covid-19 vs. clinically moderate Covid-19 patients (C) and, Covid-19 related deaths vs. Covid-19 survivor patients (D).

Additionally, within the Covid-19 population, we assessed patients stratified by severity of clinical manifestations. As further evidence, compared with patients exhibiting moderate Covid-19 symptoms, patients with more severe sequelae exhibited lower levels of testosterone showing a slight yet significant absolute higher SMD (3.53nmol/L, 95%CI 5.11, 1.95, p=0.00, I2=88.19%).

This was corroborated across the n=314,15,18 experiences which reported outcomes stratified according Covid-19 survivors and non-survivors, confirming a similar overall decrease in SMD serum TT levels (3.04, 95%CI 4.05, 2.04, p=0.42, I2=0.00%) (Fig.2).

Finally, in order to explore the remaining heterogeneity observed, we investigated the role of patient available comorbidities or inflammatory/haemato-chemical variables retrieved to the SMD estimates by meta-regression analysis. As expected, there was a direct correlation between increasing BMI of the Covid-19 population and the SMD observed across the studies (Coeff. 2.48, SE: 1.15; p=0.033; Suppl. Fig. 3). Moreover, the sole haemato-chemical confounder significantly associated with TT variation was the absolute lymphocyte count depicting an inverse trajectory with the SMD observed across the studies (Coeff. 7.37, SE: 2.19; p=0.001; Suppl. Fig. 3).

Regarding LH levels, only n=717,19,22,24,28,29,30 studies reported the needed information to further compare the overall populations and the sub-groups assessing the outcomes according to the severity of Covid-19 clinical manifestations. A considerable heterogeneity was documented also in this setting with I2 95.60%, Q(6): 136.32, p<0.02. Additionally, the inspection of both Galbright and Funnel plots suggested that there was a significant small-study effect with the smaller studies tending to have higher SMD variability, suggesting the existence of higher risk of bias among the publications assessed (Egger test, p=0.035). However, the Trim and Fill method suggested that only n=1 study would have needed to be included to remove residual asymmetry from the Funnel plot (Suppl. Fig. 4). This preliminary finding was further confirmed at sub-group analysis where the size of the sample analysed was significantly associated with greater variability in the pooled SMD yet not being influenced by the publication year like previously observed (Suppl. Fig.4).

In contrast to TT levels, the effect on cumulative LH variations was non-significant nor clinically relevant between Covid-19 cases and matched controls (SMD: 0.69, 95%CI 0.56, 1.94, p=0.00, I2=95.60%) ranging along the null-effect line from 3.55, 95%CI 2.64, 4.46, to 2.53, 95%CI 4.73, 0.33 in the study of Cinislioglu et al.17 and Xu et al.30 respectively. This was also true when comparing controls with the n=317,28,30 studies with more severe Covid-19 population (SMD: 0.41, 95%CI 2.37, 3.19, p=0.00, I2=95.54%) (Fig.3).

Forest plot for Standardized Mean Difference (SMD) across studies presenting serum Luteinizing Hormone (LH) levels in the Covid-19 patients vs. control (A), clinically severe Covid-19 patients vs. control (B), and clinically severe Covid-19 vs. clinically moderate Covid-19 patients (C).

Furthermore, at sensitivity analysis through leave-one-out assessment there was no single study effect size which would have significantly impaired the observed pooled results if omitted from the analysis (Suppl. Fig. 5).

At meta-regression on quantitative variables available, the relative percentage of Covid-19 patients with active smoking status was the sole factor influencing the pooled SMD estimate for serum LH levels (Coeff. 0.08, SE: 0.01; p=0.001; Suppl. Fig. 6).

Finally, when sub-analyzing within the Covid-19 severity of clinical manifestations, there was no significant or clinically relevant SMD across the n=5 studies included14,17,26,28,30 0.28 (95%CI 1.55, 1.00, p=0.00, I2=88.52%).

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Systematic review and meta-analysis of serum total testosterone and luteinizing hormone variations across ... - Nature.com

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American tenor Holden Madagame is set to make history this week when he takes the stage as the first ever transgender person to sing Mime in a production of Siegfried. Here he looks back at the effect transitioning while pursuing a career in music had on his voice and explores his new position as a trans role model in opera

The way that testosterone works is unique as far as hormones go. Many effects of testosterone are not reversible, the change in vocal range being one of them. I started taking testosterone in 2014, about a year after arriving in Germany. I had completed my Bachelor of Music at the University of Michigan and my intention had been to get my Master of Music, then pursue a career in opera but deciding to take testosterone changed this.

When I started to take testosterone, there were no role models I could look to to guide me on my journey. In the last decade there have been more trans people in opera who take hormones and a few studies on the subject, but there are still relatively few singers who take testosterone because of the unpredictable and irreversible effects on the voice. For this reason, I took a long time deciding whether taking testosterone was viable for me.

The process of an adult AFAB (assigned female at birth) voice taking testosterone is relatively similar to an AMAB (assigned male at birth) person whose voice breaks when they are a teenager. The difference being that an adult AFAB persons vocal cords are less flexible and more solidified in their development than an AMAB persons cords. This is not surprising considering a younger body can regenerate in ways that older bodies cannot. Practically speaking, this means that an AFAB voice on testosterone undergoes a similar period of change, except the larynx is not growing in size as the vocal cords are thickening. For me, this caused a large amount of hoarseness and a significant decrease in my vocal stamina for about a year, but these effects decreased over time.

My way of dealing with these changes was and continues to be relatively simple: patience. Although I would sing occasionally, I knew from my own kinaesthetic awareness of my voice that there were diminishing returns. The neuroticism that could have built up because of this was not worth it to my mental health nor to my overall artistic and creative health so I decided instead to be patient and sing music I enjoyed to get through this exciting and terrifying period of my life. Artistic longevity cannot be maintained unless we as singers take care of our mental health as well as our enthusiasm for making art.

Steve Gregson

Another crucial element which helped me remain patient during this transition was the unique thing that I have been able to give to the world: my existence as a trans opera singer on testosterone makes it possible for other trans singers looking into hormone therapy to see themselves existing and thriving in an industry that is well-known for being normative and unwelcoming.

So how can we create a more welcoming environment for trans performers? Fortunately, the answer is simple. Unfortunately, it requires fundamental changes in how we teach, cast, produce and compose opera. As with any accessibility issue, creating a place for marginalised groups creates better conditions for everyone, with some fundamental aspects being fair wages, fair conditions and transparency. Without these, we create classist, sexist, racist, homophobic, and transphobic conditions without even meaning to.

A seemingly daunting, but easily broken-down idea to consider is less restrictive adherence to gender stereotypes. Adherence to these embodied genders in singers makes it difficult for those who divert slightly from the gender assigned at Fach to succeed in the opera industry. This is not only true for trans people (who of course are most affected by this), but for cisgender people too. There are countless rules for every Fach, for example the well-known rule of the trade that a soprano cannot wear trousers to an audition they should appear as feminine as possible an atrocious anachronism that the industry continues to perpetuate.

The reality of changing these expectations is quite easy for any person in a position of teaching, casting, directing, producing, etc. but we as singers do not have the power to do this without jeopardising our careers. Often singers who do not adhere to industry standards end up sticking to new or popular music because it is more accepting and open about gender.

My recent work with Regents Opera on their production of Rheingold and upcoming production of Siegfried stands as proof that anyone can make efforts to change industry standards. As an artist I am able to be my authentic self in rehearsals, I am paid fairly with clear rehearsal times and adequate breaks, the company is transparent about any given situation and the company has cast singers outside the status quo or the expected choice. My work with Regents Opera has over time allowed me to grow as an artist and feel accepted in the work that I do and, as far as Im aware, I will on 4 February, with the opening night of Regents Opera's Siegfried at London's Freemasons Hall become the first transgender person ever to sing Mime in a production of Siegfried. I am so proud of myself and of Regents Opera for this history-making first.

See the rest here:
Holden Madagame on testosterone, transitioning and the art of patience - Classical-music.uk

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SALT LAKE CITY, Feb. 2, 2024 /PRNewswire/ -- Lipocine Inc.(NASDAQ: LPCN), a biopharmaceutical company focused on treating Central Nervous System (CNS) disorders, today announced that commercialization of TLANDO in the U.S. has been transitioned to its licensee Verity Pharmaceuticals, effective February 1, 2024, enabling the continuity of patient access to TLANDO. TLANDO is the first and only oral testosterone replacement therapy (TRT) option approved by the US Food and Drug Administration (FDA) that does not require dose titration.

In January 2024, Lipocine and Gordon Silver Limited entered into an exclusive license agreement under which Verity Pharma will market TLANDO inthe United States and, if approved, in Canada. Under the terms of the license agreement, Lipocine has received the second tranche of the $11 million license fee, $5 million. In addition, per the license agreement, Gordon Silver Limited is to make license fee payments of $2.5 million and $1 million no later than January 1, 2025, and January 1, 2026, respectively.

About TLANDO

TLANDO is approved by the FDA as a testosterone replacement therapy ("TRT") in adult males indicated for conditions associated with a deficiency or absence of endogenous testosterone: primary hypogonadism (congenital or acquired) and hypogonadotropic hypogonadism (congenital or acquired). TLANDO was developed using Lipocine's proprietary Lip'ral drug delivery technology platform.

For full prescribing information, please visitwww.TLANDO.com.

IMPORTANT SAFETY INFORMATION

TLANDO (testosterone undecanoate) capsules, for oral use, CIII

Initial U.S. Approval: 1953

IMPORTANT SAFETY INFORMATION

WARNING: BLOOD PRESSURE INCREASES (See Boxed Warning on Product Label for more information)

TLANDO can cause blood pressure (BP) increases that can increase the risk of major adverse cardiovascular events (MACE), including non-fatal myocardial infarction, non-fatal stroke and cardiovascular death with greater risk in patients with established cardiovascular disease or risk factors for cardiovascular disease.

Before initiating TLANDO, consider the patient's baseline cardiovascular risk and ensure blood pressure is adequately controlled.

Three weeks after initiating therapy monitor for and treat new-onset hypertension or exacerbations of pre-existing hypertension.

Re-evaluate whether the benefits of TLANDO outweigh its risks in patients who develop cardiovascular risk factors or cardiovascular disease on treatment. Due to this risk, use TLANDO only for the treatment of men with hypogonadal conditions associated with structural or genetic etiologies.

TLANDO INDICATIONS AND USAGE

TLANDO (testosterone undecanoate) is indicated for testosterone replacement therapy in adult males for conditions associated with a deficiency or absence of endogenous testosterone.

Primary hypogonadism (congenital or acquired)

Hypogonadotropic hypogonadism (congenital or acquired)

LIMITATIONS OF USE

Safety and efficacy of TLANDO in males less than 18 years old have not been established.

CONTRAINDICATIONS

TLANDO is contraindicated in:

Patients with carcinoma of the breast or known or suspected carcinoma of the prostate.

Women who are pregnant. Testosterone can cause virilization of the female fetus when administered to a pregnant woman.

Known hypersensitivity to testosterone undecanoate or any of TLANDO's ingredients.

Men with hypogonadal conditions, such as "age-related hypogonadism", that are not associated with structural or genetic etiologies. The efficacy of TLANDO has not been established for these conditions, and TLANDO can increase BP that can increase the risk of MACE.

WARNINGS AND PRECAUTIONS

Increase in Blood Pressure: In Study 18-001, TLANDO increased systolic BP after 4 months of treatment by an average of 4.3 mmHg based on ambulatory blood pressure monitoring (ABPM) and 4.8 mmHg from baseline based on blood pressure cuff measurements [see Adverse Reactions (6.1)].

These BP increases can increase the risk of major adverse cardiovascular events (MACE), with greater risk in patients with established cardiovascular disease or risk factors for cardiovascular disease.

In some patients, the increase in BP with TLANDO may be too small to detect but can still increase the risk for MACE.

Before initiating TLANDO, consider the patient's baseline cardiovascular risk and ensure blood pressure is adequately controlled. Check BP approximately 3 weeks after initiating TLANDO and periodically thereafter. Treat new-onset hypertension or exacerbations of pre-existing hypertension. Re-evaluate whether the benefits of continued treatment with TLANDO outweigh its risks in patients who develop cardiovascular risk factors or cardiovascular disease.

Polycythemia: Increases in hematocrit levels, reflective of increases in red blood cell mass, may require discontinuation of TLANDO. Check hematocrit prior to initiating TLANDO. Evaluate hematocrit approximately every 3 months during the first year of treatment, and then every 6 months thereafter while the patient is taking TLANDO. If hematocrit becomes elevated, stop TLANDO until hematocrit decreases to an acceptable concentration. If TLANDO is restarted and again causes hematocrit to become elevated, stop TLANDO permanently. An increase in red blood cell mass may increase the risk of thromboembolic events.

Cardiovascular Risk: Long term clinical safety trials have not been conducted to assess the cardiovascular outcomes of testosterone replacement therapy in men. To date, epidemiologic studies and randomized controlled trials have been inconclusive for determining the risk of major adverse cardiovascular events (MACE), such as non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death, with the use of testosterone compared to non-use. Some studies, but not all, have reported an increased risk of MACE in association with use of testosterone replacement therapy in men.

TLANDO can cause BP increases that can increase the risk of MACE. Patients should be informed of this possible risk when deciding whether to use or to continue to use TLANDO.

Worsening of Benign Prostatic Hyperplasia (BPH) and Potential Risk of Prostate Cancer: Patients with BPH treated with androgens are at an increased risk for worsening of signs and symptoms of BPH. Monitor patients with BPH for worsening signs and symptoms. Patients treated with androgens may be at increased risk for prostate cancer. Evaluate patients for prostate cancer, including measurement of prostate specific antigen (PSA), prior to initiating and during treatment with androgens.

Venous Thromboembolism: There have been post marketing reports of venous thromboembolic events, including deep vein thrombosis (DVT) and pulmonary embolism (PE), in patients using testosterone replacement products such as TLANDO. Evaluate patients who report symptoms of pain, edema, warmth, and erythema in the lower extremity for DVT and those who present with acute shortness of breath for PE. If a venous thromboembolic event is suspected, discontinue TLANDO and initiate appropriate workup and management.

Abuse of Testosterone and Monitoring of Serum Testosterone Concentrations: Testosterone has been subject to abuse, typically at doses higher than recommended for the approved indication and in combination with other anabolic androgenic steroids. Anabolic androgenic steroid abuse can lead to serious cardiovascular and psychiatric adverse reactions.

If testosterone abuse is suspected, check serum testosterone concentrations to ensure they are within therapeutic range. However, testosterone levels may be in the normal or subnormal range in men abusing synthetic testosterone derivatives. Counsel patients concerning the serious adverse reactions associated with abuse of testosterone and anabolic androgenic steroids. Conversely, consider the possibility of testosterone and anabolic androgenic steroid abuse in suspected patients who present with serious cardiovascular or psychiatric adverse events.

Not for Use in Women: Due to lack of controlled studies in women and the potential for virilizing effects, TLANDO is not indicated for use in women. Potential for Adverse Effects on Spermatogenesis: With large doses of exogenous androgens, including TLANDO, spermatogenesis may be suppressed through feedback inhibition of pituitary follicle-stimulating hormone (FSH) possibly leading to adverse effects on semen parameters including sperm count. Patients should be informed of this possible risk when deciding whether to use or to continue to use TLANDO.

Hepatic Adverse Effects: Prolonged use of high doses of orally active 17-alpha-alkyl androgens (e.g., methyltestosterone) has been associated with serious hepatic adverse effects (peliosis hepatis, hepatic neoplasms, cholestatic hepatitis, and jaundice). Peliosis hepatis can be a life-threatening or fatal complication. Long-term therapy with intramuscular testosterone enanthate has produced multiple hepatic adenomas. TLANDO is not a 17 alpha-alkyl androgen and is not known to produce hepatic adverse effects associated with 17-alpha-alkyl androgens.

Nonetheless, patients should be instructed to report any signs or symptoms of hepatic dysfunction (e.g., jaundice). If these occur, promptly discontinue TLANDO while the cause is evaluated.

Edema: Androgens, including TLANDO, may promote retention of sodium and water. Edema, with or without congestive heart failure, may be a serious complication in patients with preexisting cardiac, renal, or hepatic disease [see Adverse Reactions (6.1)]. In addition to discontinuation of the drug, appropriate work up and management of edema may be required.

Sleep Apnea: The treatment of hypogonadal men with testosterone products may potentiate sleep apnea in some patients, especially those with risk factors such as obesity or chronic lung diseases.

Gynecomastia: Gynecomastia may develop and persist in patients being treated for hypogonadism.

Lipid Changes: Changes in serum lipid profile may require dose adjustment of lipid lowering drugs or discontinuation of testosterone therapy. Monitor the lipid profile periodically after starting testosterone therapy.

Hypercalcemia: Androgens, including TLANDO, should be used with caution in cancer patients at risk of hypercalcemia (and associated hypercalciuria). Monitor serum calcium concentrations periodically in these patients.

Decreased Thyroxine-binding Globulin: Androgens, including TLANDO, may decrease concentrations of thyroxin-binding globulins, resulting in decreased total T4 serum concentrations and increased resin uptake of triiodothyronine (T3) and thyroxine (T4). Free thyroid hormone concentrations remain unchanged, however, and there is no clinical evidence of thyroid dysfunction.

Increases in Prolactin: Increases in serum prolactin have been reported in patients treated with TLANDO in clinical trials. Evaluate serum prolactin levels prior to initiating treatment with TLANDO. Re-evaluate serum prolactin levels 3 to 4 months after starting treatment. If serum prolactin remains elevated, discontinue TLANDO.

ADVERSE REACTIONS

The safety of TLANDO was evaluated in 2 clinical studies in a total of 233 men.

Study 18-001: 138 hypogonadal males were treated with TLANDO 225 mg twice daily with morning and evening meals for approximately 4 months.

Study 16-002: 95 hypogonadal males were treated with TLANDO 225 mg twice daily with morning and evening meals for approximately 24 days.

The most commonly reported adverse reactions ( 2%) were: increased blood prolactin, hypertension, increased hematocrit, upper respiratory tract infection, weight increased, headache, and musculoskeletal pain.

DRUG INTERACTIONS

Insulin: Changes in insulin sensitivity or glycemic control may occur in patients treated with androgens. In diabetic patients, the metabolic effects of androgens may decrease blood glucose and, therefore, insulin requirements.

Oral Anticoagulants: Changes in anticoagulant activity may be seen with androgens. Frequent monitoring of INR and prothrombin time may be necessary in patients taking anticoagulants, especially at the initiation and termination of androgen therapy.

Corticosteroids: The concurrent use of testosterone with corticosteroids may result in increased fluid retention and should be monitored cautiously, particularly in patients with cardiac, renal or hepatic disease.

Drugs that May Also Increase Blood Pressure: Some prescription drugs and nonprescription analgesic and cold medications can increase blood pressure. Concomitant administration of these medications with TLANDO may lead to additional increases in blood pressure.

USE IN SPECIFIC POPULATIONS

Pregnancy: TLANDO is contraindicated in pregnant women and not indicated for use in females. Testosterone is teratogenic and may cause fetal harm when administered to a pregnant woman based on data from animal studies (see Data) and its mechanism of action. Exposure of a female fetus to androgens may result in varying degrees of virilization. In animal developmental studies, exposure to testosterone in utero resulted in hormonal and behavioral changes in offspring and structural impairments of reproductive tissues in female and male offspring. These studies did not meet current standards for nonclinical development toxicity studies. Lactation: TLANDO is not indicated for use in females.

Females and Males of Reproductive Potential: During treatment with large doses of exogenous androgens, including TLANDO, spermatogenesis may be suppressed through feedback inhibition of the hypothalamic-pituitary-testicular axis. Reduced fertility is observed in some men taking testosterone replacement therapy. The impact on fertility may be irreversible. Testicular atrophy, subfertility, and infertility have also been reported in men who abuse anabolic androgenic steroids.

Pediatric Use: The safety and effectiveness of TLANDO in pediatric patients less than 18 years old have not been established. Improper use may result in acceleration of bone age and premature closure of epiphyses.

Geriatric Use: There have not been sufficient numbers of geriatric patients in controlled clinical studies with TLANDO to determine whether efficacy or safety in those over 65 years of age differs from younger subjects. Of the 95 patients enrolled in Study 16-002, the 24-day major safety and effectiveness study utilizing TLANDO, 16 (16.8%) were over 65 years of age. Additionally, there is insufficient long-term safety data in geriatric patients utilizing TLANDO to assess the potentially increased risk of cardiovascular disease and prostate cancer.

Geriatric patients treated with androgens may also be at risk for worsening of signs and symptoms of BPH and hypertension.

DRUG ABUSE AND DEPENDENCE

TLANDO contains testosterone undecanoate, a Schedule III controlled substance.

Abuse and misuse of testosterone are seen in male and female adults and adolescents. Testosterone, often in combination with other anabolic androgenic steroids may be abused by athletes and bodybuilders.

Serious adverse reactions have been reported in individuals who abuse anabolic androgenic steroids and include cardiac arrest, myocardial infarction, hypertrophic cardiomyopathy, congestive heart failure, cerebrovascular accident, hepatotoxicity, and serious psychiatric manifestations, including major depression, mania, paranoia, psychosis, delusions, hallucinations, hostility and aggression.

The following adverse reactions have also been reported in men: transient ischemic attacks, convulsions, hypomania, irritability, dyslipidemias, testicular atrophy, subfertility, and infertility.

The following additional adverse reactions have been reported in women: hirsutism, virilization, deepening of voice, clitoral enlargement, breast atrophy, male-pattern baldness, and menstrual irregularities.

The following adverse reactions have been reported in male and female adolescents: premature closure of bony epiphyses with termination of growth, and precocious puberty.

Withdrawal symptoms can be experienced upon abrupt discontinuation in patients with addiction. Withdrawal symptoms include depressed mood, major depression, fatigue, craving, restlessness, irritability, anorexia, insomnia, decreased libido, and hypogonadotropic hypogonadism. Drug dependence in individuals using approved doses for approved indications has not been documented.

For more information, call 1-844-996-7833.

Please see full Prescribing Information, including Boxed Warning and Medication Guide.

About TLANDO XR

TLANDO XR (also known as LPCN 1111) is a next-generation, novel ester prodrug of testosterone comprised of testosterone tridecanoate (TT) which uses Lipocine's proprietary delivery technology to enhance solubility and improve systemic absorption. Lipocine has successfully completed a Phase2bdose finding study in hypogonadal men. Results suggested that the primary objectives were met, including identifying the dose expected to be tested in a planned Phase 3 study that would be required for FDA approval.

About Verity Pharma

Verity Pharma is a specialty pharmaceutical company focused on delivering meaningful solutions to healthcare professionals and their patients.

Verity Pharma works with best-in-class global pharmaceutical manufacturing partners to ensure that product quality and availability is a constant deliverable. The company is also committed to supporting programs, initiatives, and organizations that help improve health, expand research opportunities and promote education within the healthcare community. Learn more atwww.veritypharma.com.

About Lipocine

Lipocine is a biopharmaceutical company leveraging its proprietary technology platform to augment therapeutics through effective oral delivery to develop differentiated products for CNS disorders. Lipocine has drug candidates in development as well as drug candidates for which we are exploring partnering. Our drug candidates represent enablement of differentiated, patient friendly oral delivery options for favorable benefit to risk profile which target large addressable markets with significant unmet medical needs.

Lipocine's clinical development candidates include: LPCN 1154, oral brexanolone, for the potential treatment of postpartum depression, LPCN 2101 for the potential treatment of epilepsy and LPCN 1148, a novel androgen receptor agonist prodrug for oral administration targeted for the management of symptoms associated with liver cirrhosis. Lipocine is exploring partnering opportunities for LPCN 1107, our candidate for prevention of preterm birth, LPCN1154, for rapid relief of postpartum depression, LPCN 1148, for the management of decompensated cirrhosis, and LPCN 1144, our candidate for treatment of non-cirrhotic NASH. TLANDO, a novel oral prodrug of testosterone containing testosterone undecanoate developed by Lipocine, is approved by the FDA for conditions associated with a deficiency of endogenous testosterone, also known as hypogonadism, in adult males. For more information, pleasevisitwww.lipocine.com.

Forward-Looking Statements

This release contains "forward-looking statements" that are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995 and include statements that are not historical facts regarding Verity Pharma's development and commercialization of TLANDO and TLANDO XR, the amount of the license fee, milestone payments, and royalty payments we will ultimately receive, Verity Pharma's ability to grow the TLANDO franchise, our product development efforts, the application of our proprietary platform in developing new treatments for CNS disorders, our product candidates and related clinical trials, our development of and filing of a NDA with the FDA for LPCN 1148, and the potential uses and benefits of our product candidates. Investors are cautioned that all such forward-looking statements involve risks and uncertainties, including, without limitation, the risks that we may not be successful in developing product candidates to treat CNS disorders, we may not have sufficient capital to complete the development processes for our product candidates, we may not be able to enter into partnerships or other strategic relationships to monetize our non-core assets, the FDA will not approve any of our products, risks related to our products, expected product benefits not being realized, clinical and regulatory expectations and plans not being realized, new regulatory developments and requirements, risks related to the FDA approval process including the receipt of regulatory approvals and our ability to utilize a streamlined approval pathway for LPCN 1154, the results and timing of clinical trials, patient acceptance of Lipocine's products, the manufacturing and commercialization of Lipocine's products, and other risks detailed in Lipocine's filings with the SEC, including, without limitation, its Form 10-K and other reports on Forms 8-K and 10-Q, all of which can be obtained on the SEC website atwww.sec.gov. Lipocine assumes no obligation to update or revise publicly any forward-looking statements contained in this release, except as required by law.

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SOURCE Lipocine Inc.

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Lipocine Announces Continued Commercialization of TLANDO through Verity Pharmaceuticals - BioSpace

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Cycling is well known for its health benefits. It can boost mental health and increase the performance of the cardiovascular system. It is also seen as a great method for losing weight but how true is that and whats the right way to go about it? In this video, Ollie helps us understand it.

The relationship between cyclists and weight has forever been complicated. It is simple physics that if you lose some excess weight and retain your power, you will ride faster especially as the road points upwards. It is also no secret that the overwhelming majority of riders could drop a kilo or two without experiencing any issues, however, how this is done is where the problems really come into play.

Disordered eating is an affliction that is not reserved for professional riders looking to squeeze out every performance gain they can on the hunt for the lightest possible physique. Any performance-based rider who keeps an eye on the scales can find themselves at risk of developing an unhealthy relationship with food.

This statement sounds like complete rubbish on the face of it. We have long been told that exercise is one of the key components of weight loss and that without a fair amount of physical activity, it would be a hard ask to shed some pounds.

A recent study looked at something called the constrained energy model that was devised by a scientist called Ponser. The research looked at the behaviour around exercise and found that people who participated in physical activities, such as long bike rides, would conserve energy elsewhere in the day. This is something we can all relate to after getting in from a long tough ride. The sofa is all too inviting and more often than not, where we find ourselves for the rest of the day.

The saying goes, You cant out-exercise a bad diet and that is exactly what Ollie focuses on here. The solution for losing weight is not to ride your bike for more hours per week, instead, it is to be aware of how you are fueling your body.

The number one thing to avoid if you are looking to lose weight and keep it off is any fad diet. It is possible to find some level of success with these diets however it is typically short-lived, difficult to maintain and will ultimately end in a blowout. More often than not that results in weight gain rather than weight loss.

Wherever you turn online youll likely be bombarded with influencers promoting their diet surrounded by bold claims that make it sound like exactly what you have been looking for. If you dig a little deeper most of these diets are based on zero scientific research.

Fad diets tend to draw you in by offering fast results or making it sound incredibly easy by allowing you to eat your favourite foods. The harsh reality is that there are no shortcuts to sustainable and manageable weight loss. To go about things properly the process should be slow with small changes made over a larger period.

Consuming fruits and vegetables is a great way of eating plenty of food to feel full, without cramming the calories in. When compared to processed foods, fruits and vegetables contain far fewer calories per gram consumed as well as providing vital micronutrients for good gut health along with a generous helping of fibre.

It comes as quite a shock to find out that around 75% of the world's food comes from just 12 plants and five animals. This lack of diversity in our diets is far from beneficial for our health as it can leave massive gaps in the vitamins, minerals and nutrients that we need. As a rough guideline aim to consume 30 different plants a week. This can come from fruits, vegetables, nuts, seeds, beans and spices.

At the other end of the spectrum, we have ultra-processed foods. These are often nutritionally lacking but calorically dense. These foods are also far more easily absorbed into the body meaning that they can cause far greater spikes in blood sugar levels, contribute to weight gain and reduce the diversity of your microbiome. As the name suggests these foods have a combination of hard-to-pronounce chemicals in the absence of fibre, further reducing the benefit of consuming these foods.

It might not come as a great surprise to find out that the more research that is carried out on the chemicals used in ultra-processed foods the more it appears that these could harm health.

But how exactly can you spot an ultra-processed food? There are plenty of foods out there that have some level of processing so how can we identify the ones that are ultra processed? The easiest way is to use a method devised by Brazilian scientist Carlos Montero which is to ask yourself the following questions. Does it come in plastic packaging? Does it contain one or more ingredients that you wouldnt typically expect to find in the kitchen?

With this in mind, it becomes a rather shocking statistic that for Brits and Americans more than half of our calories come in the form of ultra-processed foods. When you realise that things such as breakfast cereals, premade sandwiches, bread and yoghurts all fall under the umbrella of ultra-processed it becomes clear just how much of an issue it really is.

On long endurance rides having a source of fuel that is calorie-dense and quickly absorbed by the body can be a benefit. Fuelling purely on natural foods such as fruits and nuts is great however these can take a long time to get absorbed into the body and can offer a slow and steady release of energy.

Sometimes this is not what is needed and being able to get valuable glycogen to your muscles as fast as possible is required. This is where specific ultra-processed nutritional products come in and serve a valid purpose.

This is another counterintuitive step. We are often told the best way to lose weight is to count your calories so you can form a slight calorie deficit to allow body fat to be used to fill in the gap. We have to eat a bit of humble pie here and admit that some of our advice in the past has been to count calories; however, fresh research has shown that this is simply not an effective way to go about sustainable weight loss.

Although this is a method we are all familiar with, it might surprise you to find out that there have been zero long-term studies that have shown that calorie restriction has led to weight loss beyond the initial few weeks. From a simple thermodynamics approach, the logic behind calorie restriction checks out, the issue is the human body is not a machine. When the amount of calories coming in is reduced the body simply adapts to this by altering your metabolic rate. This means that if you restrict calories, your body will adjust the rate at which it burns the food to match.

The issue with calorie counting is that it massively simplifies what is actually a very complex process. Calorie counting is incredibly hard to do with any level of accuracy as foods can differ in their caloric content with the regulations only stipulating that labels have to be correct +/- 20%.

Firstly the unit of a calorie is as far removed from how we use them in our bodies as it is possible to be. One calorie is a measure of the amount of energy it takes to warm 1cm^3 of water by one degree Celsius. Then there is how food caloric values are calculated which has remained largely unchanged since the 1800s which involves incinerating the food to see how much energy is released.

The issue with this is humans are not incinerators and although we refer to the energy of food being burnt off we dont actually have a furnace inside us. This means that the calorie data we see is heavily caveated all the way from the unit through to what the caloric value of food actually means for us.

One of the easiest ways for weight loss to become unsustainable is to make it too rigid and difficult to follow. Trying to stick to whole foods religiously or exclude food groups can make it incredibly difficult to follow and can have you fighting an eternal battle for cravings and tastes that you enjoy.

Instead, everything should be in moderation and being aware of what you eat and having some broad guidelines to follow on what you are looking to consume is the best way to take a holistic and sustainable approach.

Consistency is the biggest component of weight loss so having a treat once in a while will not throw everything out of the window. Equally, stress has been associated with weight gain so adding stress in the form of a restrictive diet could have counterproductive results.

Blood sugar spikes are when easily absorbed foods are consumed rapidly causing the level of sugar in the blood to increase very quickly. They are attributed to numerous negative health outcomes when spikes are commonly repeated day after day.

Something that a lot of us can all benefit from is spending a little bit longer chewing our food. Not only does it allow us to enjoy the taste and texture of the food more but it also slows down the rate at which the components of the food are absorbed, including sugars.

As cyclists, we typically consume more carbohydrates than the general population which can lead to blood sugar spikes. The best time to consume a lot of these carbohydrates is whilst we are exercising as our body is in a different metabolic state that is more adept at processing and using carbohydrates than when sedentary.

Sleep is one of the other vital components attributed to weight loss, with poor sleep linked to health issues such as type two diabetes and heart disease. It goes one step further than this with studies showing that people who consistently get insufficient sleep are at greater risk of obesity and weight gain.

The hormones present in your body after a poor night's sleep can leave you feeling hungrier and have you reaching for sweet foods more so than if you had a restorative sleep. So putting in the effort to establish an evening and morning routine that facilitates adequate sleep can seriously help your weight loss ambitions.

Do you have any experience with weight loss, we would love to hear your thoughts and stories in the comments section below. For even more fitness features like this one head over to the fitness section of the website.

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The truth behind cycling and the science of weight loss - Global Cycling Network

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A medical scare allowedKelly Clarksonto catch her breath andreexamine her diet andwellness.

Weeks after speaking publicly about her recent weight loss,theKelly Clarkson Show host has revealedthat part of herroad towards better healthwas due to a diagnosis with pre-diabetes.

After guest Kevin James told her on the Jan. 29 episode of hershow that she looked "great," the41-year-old responded, "Oh, thank you. Well, I was told I was pre-diabetic."

Clarkson recalled her reaction to the news."I wasn't shocked," she said. "I was a tiny bit overweight, so, yeah. But I wasn't shocked by it. But they did, they were like, 'You're pre-diabetic, you're right on the borderline.' I was like, 'But I'm not there yet.'"

The "Because of You" singer said two years later, she decided to "do something" about it.

Earlier this month, Clarkson confirmed she had lost some weight and spoke aboutwhat she did to shed the pounds.

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Kelly Clarkson Shares How Pre-Diabetic Diagnosis Led Her to Lose Weight - E! Online - E! NEWS

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What do Squid Game and a healthy food you should be eating more of have in common? They both originated in South Korea. Korean pop culture has seen a surge in popularity in the United States in recent years, and along with it has come a voracious appetite for the Korean veggie dish, kimchi.

In 2023 alone, more than 10,000 tons of kimchi were imported to the US,according toVOA. Kimchi is a dish made by salting vegetables, often cabbage, and adding spices like garlic, ginger, and Korean red pepper along with fish sauce. The mixture is then left to ferment for several days before appearing on the table as a side or a condiment.

If you havent tried kimchi, a new epidemiology study published in the peer-reviewedBritish Medical Journal might be your wake-up call to give it a taste. The study set out to see if the consumption of different types of kimchi could have an effect on weight.

The study narrowed in on over 100,000 Koreans aged 40 to 69 years, with an average age of about 52, who were enrolled in a long-term study that tracked their diet and health metrics in an attempt to identify risks for common diseases. For this study, participants were categorized by how many servings of different types of kimchi they consumed per day and then analyzed for their likelihood of being obese or gaining weight as they aged.

Overall, consuming moderate amounts of kimchi was associated with weight loss, but the effect of kimchi and the type consumed varied between men and women. In men, consuming one to three servings of any type of kimchi was associated with a healthier weight. Men who ate the most kimchi made with cabbage had a 10% lower risk of becoming obese or developing abdominal obesity. Consuming kimchi made with radish lowered the risk of obesity for men by about 10%, and for women by about 8%.

50 Ways to Lose Weight Without a Lick of Exercise

The sweet spot for kimchi consumption appeared to be between one and three servings per day. Eating more than five kimchi servings per day was associated with an increase in weight. That may be because kimchi is often consumed with other foods, such as rice, too much of which could lead to a consumption of excess calories, the researchers theorized. They also noted that kimchi is relatively high in sodium, which could lead to greater detriments to health. As kimchi is one of the major sources of sodium intake, a moderate amount of kimchi should be recommended for the health benefits of its other components, they concluded.

Regarding the reasons that kimchi contributes to weight loss and stability, several studies have pointed to the beneficial bacteria that thrive when kimchi ferments. The condiment has also been shown to improve fasting blood glucose, which can contribute to weight loss. In addition, the spices traditionally used to make kimchigarlic, ginger, and red pepperhave been shown to have beneficial effects on weight in some studies.

If you want to try kimchi, you could always make your own. For the less adventurous, most supermarkets now carry at least one variety. You can use it as a topping for rice, mix it into a sauce, spice up a soup, mix it into scrambled eggs, or eat it for a snack. Just be sure to consider it as you monitor your sodium intake for the day.

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Study: Eating More of This Tangy Condiment Could Help You Lose Weight - The Healthy

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Answer:

As a beginner, you can try five below steps to lose weight:

Step 1: Eat in order

Drink a small glass of water before your meal to completely eliminate hunger. Start your meal with a bowl of vegetable soup to partly fill up your stomach. Consume protein dishes afterwards, and then conclude your meal with a smaller portion of carbohydrates.

This eating order helps you to better control your calorie intake.

Step 2: Increase your vegetables and protein intake for each meal

Eating too few vegetables and protein food sources may lead to an imbalanced meal. Consuming these nutrition groups also keeps you full for a longer time, which can prevent quick hunger and cravings, some of the things that make it hard to lose weight.

A standard main meal should keep you full for four to six hours. To achieve this, people weighing between 50 and 70 kg should consume at least 20 to 25 grams of protein and two servings of vegetables per meal. This is equivalent to a bowl of steamed greens or two hand-size plates of salads.

You should always have a plate of vegetables and a bowl of soup on the table, along with readily available sources of protein like eggs, seaweed, lean chicken floss, or mushroom floss to increase your protein intake in each meal.

A woman in sportswear holding an apple and a tape measure. Illustration photo by Freepik

Step 3: Replace refined with whole grains carbohydrates, chew thoroughly, and extend your mealtime to at least 25 minutes

Starch is one of the essential macronutrients that need to be consumed daily, accounting for 30% to 60% of vital energy. Therefore, replacing refined starches (those without bran or husk) with whole grains (those with bran and husk) is a top priority in the journey towards a healthy diet. The simplest way is to substitute white rice with brown rice, or other options like quinoa, oats, barley, or incorporate various legumes while cooking for diversity and to avoid monotony.

Chewing your food thoroughly and extending your mealtime to at least 25 minutes is essential. Chewing thoroughly helps reduce mindless eating and drinking, while also helping you stay full longer. 25 minutes is the time it takes for your brain to receive signals of fullness from your stomach, so maintaining a meal lasting for this period helps you feel satisfied for a longer period.

Step 4: Exercise before consuming less healthy dishes

If you plan to eat dishes that are high in oil or fried, it is a good idea to engage in at least 30 minutes of exercise before your meal. Oils are high in fat content (9 kcal/g of fat), making it easy for the body to store excess energy and not create the calorie deficit needed for weight loss.

In general, if you exercise regularly for at least 30 minutes every day, you can enjoy foods with higher fat content. Otherwise, it is better to stick to steamed or boiled dishes.

Step 5: Use healthier seasonings in your meals

You should limit the use of industrial seasonings as well as highly processed ingredients like bouillon cubes, MSG, refined salt, and refined sugar. Instead, it is more beneficial to use natural flavorings like dried shrimp, bone broth, boiled meat broth, turnips, carrots, seaweed, and healthy seasonings such as herbs and vegetable sauces.

This may be challenging because your taste buds have become accustomed to industrial seasonings, but it is crucial for gut health and overall well-being.

Dr. Phan Thai Tan

Fitness center HomeFits nutrition coach

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Five weight loss steps for beginners - VnExpress International

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For the 55 years I have been a Registered Dietitian, there have been a series of newest and best diets for weight loss, better health, or solving a variety of problems that no one else has been able to solve.

In each of these cases, I have watched them come and go as people realized, for many reasons, they were not a solution.

Remember that if any of these diets worked, we wouldnt need a new one.

An assortment of cut-up oranges and whole strawberries.

The best eating plan for you is the one you can follow over time and feel satisfied with. Any dietary pattern that asks you to eliminate entire categories of food that you normally eat is very unlikely to work. As Ive written before in this column, we all have our favorite comfort foods and discomfort foods. Trying to eliminate these favorites often does not work over time. We eat what we like and like what we eat.

If you have tried eliminating desserts, dairy, gluten, or carbohydrates, you have probably found that you eventually return to eating these favorite foods.

A popular diet is the keto or ketogenic diet.

This is not a new idea. It was developed in the 1920s to treat intractable seizures in children. It worked pretty well but wasnt sustainable. The children on this diet lost weight, which sparked the idea that this might work for other people to lose weight.

Half of an avocado surrounded by granola.

Ketogenic is a term for a low-carbohydrate diet. Carbohydrates are used first for energy and then protein and fat. The body doesnt store much carbohydrates; small amounts are stored in the liver and muscles. When you dont eat foods with carbohydrates, the stores are depleted quickly. You then begin to burn protein and fat for energy, which produces a waste product called ketones, so you are in a state of ketosis. Note that under normal conditions, this is an abnormal state for the body. The human body is designed to burn carbohydrates first for fuel.

People will tell you that you dont feel hungry since ketones depress the appetite, and foods high in protein and fat fill you up quickly. This is often true, but they dont tell you that you might have constipation, bloating, gas, bad breath, and fatigue, at least for the first few days. You will probably lose much weight in the first couple of weeks, sometimes as much as 8-10 pounds. This is mostly water loss and not body fat because each gram of carbohydrate is stored with 2-3 grams of water.

A plate with eggs, avocado, mushroom, and bacon strips.

Most keto diets tell you to eat less than 30 grams of carbohydrates daily, depending on your calorie needs. This means you must completely eliminate foods high in sugar, such as soda, fruit juice, and all sweets; all grains or starches, such as bread, rice, pasta, and cereal; all fruit except small portions of berries like strawberries; beans or legumes such as kidney beans, lentils, and chickpeas; all starchy vegetables such as potatoes, sweet potatoes, carrots, parsnips, and onions; condiments or sauces such as barbecue sauce, honey mustard, teriyaki sauce, and ketchup; most dairy products except high-fat cheeses; all alcoholic beverages including beer and wine and any processed food that contains ANY sugar including maple syrup and honey. Does this sound like something you want to do??

Lets put 30 grams of carbohydrate in context. One medium piece of fresh fruit has 15-40 grams of carbs; one slice of bread (of any type) has 15-20 grams; one small potato has 15 grams; cup of pasta or rice has 20 grams; 1 cup of milk has 12 grams, and one cup of tossed salad has 3-5 grams, depending on whats in it.

A well-balanced breakfast with different protein, fats, and drinks.

You cant cheat on a keto diet because the body will immediately store any carbohydrate you eat, and you will regain at least some of your lost weight quite quickly. You would then have to start all over again.

What do you eat on a keto diet? The diet is typically rich in foods like butter, cheese, eggs, meat, nuts, oils, seafood, avocado and very low-carbohydrate vegetables.

A keto diet is unsafe if you have a chronic health problem such as diabetes, cancer, kidney problems, cardiovascular disease, or an eating disorder, if you are pregnant or nursing or if you are under age 12.

If you are considering trying this approach, talk with your healthcare provider to be sure it will be safe for you. A Registered Dietitian is your best adviser on your diet and nutritional health.

Ellen Glovsky is a Key Biscayne resident, published author and Registered Dietitian and Nutrition Coach. Her work focuses on helping people explore and enhance their relationship with food, using a Health At Every Size approach. She is also involved in the island community with her work on KBCFs Womens Giving Circle.

To learn more, visit Ellen online atnutrition-coach.com.

For Ellen Glovksy's last #tasteofkb piece,clickhere.

For the Islander's last #tasteofkb feature,clickhere.

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Dietician: The Keto Diet is not a safe and effective way for people to lose weight - Islander News.com

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Can Thinking Harder Help You Lose Weight?

Recent research suggests that engaging in mentally challenging tasks might cause a slight increase in calorie expenditure. It seems that the brains rigorous exercise can contribute to burning calories. However, its crucial to note that the impact on weight loss isnt significant enough to replace traditional methods. Rigorous physical exercise and a balanced diet continue to be the most effective strategies for weight loss.

A study reveals that individuals who show more compassion for themselves when encountering a setback are more successful in maintaining self-control over their eating and exercise behaviors. The data collected from 140 participants attempting to lose weight through a lifestyle modification program shows promising results. Researchers believe that effective interventions could be developed to teach and practice self-care in moments of disappointment, thereby improving weight loss outcomes. To read more about this study, click here.

Another essential aspect of weight management is a good nights sleep. There is a strong link between sleep, metabolism, and weight gain. Lack of sufficient sleep can disrupt hormonal balance, affect energy levels, alter physical activity, and disturb eating patterns. Adequate and quality sleep plays a crucial role in supporting weight loss efforts and maintaining overall health. To read more about how sleep deprivation can affect your weight loss goals, click here.

The human body, through evolution, is programmed to retain fat. This is because fat plays a crucial role in providing energy and supporting reproduction. Hence, losing weight can be challenging, as the body naturally resists this process. It is reported that more than 80% of people who lose a substantial amount of weight regain it within five years. Therefore, it is essential to recognize that small fluctuations in weight are normal and that blaming oneself for finding it difficult to lose weight is unhelpful. Exercise and dieting are both important for weight loss, with exercise helping to prevent gaining or regaining weight. To read more about these facts, click here.

Insulin resistance, a condition where cells in the body do not properly respond to insulin, is often linked with weight loss. However, it is emphasized that weight loss is not the only solution to insulin resistance. A weight-inclusive approach to health is suggested, which includes mindful movements, a non-diet approach to eating, and stress management. Scientific studies back up these recommendations. To read more about insulin resistance and its relation to weight loss, click here.

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The Mind-Body Connection in Weight Loss: Thinking Harder, Self-Compassion, Sleep, Evolution, and More - Medriva

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