• This research aimed to estimate the association of sitting time with abdominal obesity and the role of Janus kinase 2 (JAK2) methylation in the association among rural adults. (nature.com)
  • Prevalence of obesity and severe obesity among adults: United States, 2017-2018. (msdmanuals.com)
  • To evaluate the prevalence of general and abdominal obesity and the concomitant presence of both outcomes and their determinants among adults living in a rural area. (scielosp.org)
  • Cardiovascular diseases in adults are associated with cardio-metabolic factors including hypertension, dyslipidaemia, abdominal obesity and abnormal glucose regulation- the combination of which is known as metabolic syndrome (MetS) [ 2 ]. (biomedcentral.com)
  • We sought to determine whether adding caloric restriction for weight loss would lead to greater improvements in vascular health compared to aerobic exercise alone in older adults with obesity," Brinkley explained. (franciscanhealth.org)
  • In a randomized, controlled trial with 160 sedentary, obese adults aged 65 to 79, participants were assigned to one of three intervention groups for 20 weeks. (franciscanhealth.org)
  • The finding that higher-intensity calorie restriction may not be necessary or advised has important implications for weight loss recommendations to improve cardiovascular disease risk in older adults with obesity," she said. (franciscanhealth.org)
  • In adults, obesity is often defined as having a BMI of 30 or more , according to the Centers for Disease Control and Prevention (CDC). (born-wild.com)
  • Despite this activity play a potential y major role in physical activity for overweight or issue, some have operationalized contributing to the obesity epidemic obese adults to improve their health, the definition of weight maintenance that currently affects both developed and 200-300 minutes per week for as a change of 5 lb ( 2.3 kg) [4] and developing countries. (who.int)
  • Typically thought to affect aging adults, abdominal obesity is increasingly impacting younger individuals, with 24 percent of men and 41 percent of women in their 20s having excess belly fat. (poliquinperformance.com)
  • From the abstract: ' In our study, all of the 203 young adults with abdominal obesity had some rare variant in the genes associated with obesity. (cdc.gov)
  • 220 adults without obesity were randomized to 25% CR or ad libitum control diet for 2?yr (ref. 10). (cdc.gov)
  • The severity of having one or more aggregated cardiovascular risk factors for metabolic syndrome is known as the metabolic syndrome severity (MetSS), and can be measured with the metabolic syndrome severity score (MetSSS). (biomedcentral.com)
  • Metabolic syndrome is a clustering of at least three of the following five medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum high-density lipoprotein (HDL). (wikipedia.org)
  • The key sign of metabolic syndrome is central obesity, also known as visceral, male-pattern or apple-shaped adiposity. (wikipedia.org)
  • There is debate regarding whether obesity or insulin resistance is the cause of the metabolic syndrome or if they are consequences of a more far-reaching metabolic derangement. (wikipedia.org)
  • Physical inactivity is considered a case of public health, and other behavioral and metabolic risk factors, according to WHO (2011), such as smoking, increased blood pressure, increased blood glucose, hypercholesterolemia, overweight and obesity. (scirp.org)
  • It is known that metabolic diseases are strongly associated with lifestyle, especially with the nutritional habits and physical activity practice. (scirp.org)
  • Because abdominal obesity is predisposed to various metabolic disorders, it is of major importance to assess and track the changes with time of this specific fat mass. (biomedcentral.com)
  • Ageing, characterized by an increase of lipid consumption and sedentary lifestyle is known to be linked with metabolic pathologies. (biomedcentral.com)
  • Studies on the accumulation of abdominal fat mass in animals could help to better understand the mechanisms of metabolic syndrome development but the techniques of investigation are lacking. (biomedcentral.com)
  • Ultimately, obesity results from a long-standing imbalance between energy intake and energy expenditure, including energy utilization for basic metabolic processes and energy expenditure from physical activity. (msdmanuals.com)
  • Obesity and metabolic syndrome (O&MS) due to the worldwide obesity epidemic affects children at all stages of chronic kidney disease (CKD) including dialysis and after kidney transplantation. (springer.com)
  • In this CPR, we discuss the management of obesity and metabolic syndrome (O&MS) in children and adolescents with CKD stages 2-5 and on dialysis, as well as after kidney transplantation, focusing on non-pharmacological treatment (diet, physical activity and behavior modification). (springer.com)
  • Metabolic Syndrome (MS) and obesity, mainly visceral obesity, are associated with increased mortality due to Coronary Artery Disease (CAD). (biomedcentral.com)
  • We performed crude and adjusted Poisson regression analyses for each obesity outcome and multinomial logistic regression for metabolic risk. (scielosp.org)
  • While carbohydrates are typically an important part of a balanced diet, lower-carb diets have been shown to increase insulin sensitivity and reduce insulin levels in people living with obesity, diabetes, metabolic syndrome, and PCOS. (healthline.com)
  • One small study from 2012 analyzed different weight loss methods in 157 people living with metabolic syndrome, which is a group of conditions that include a larger waist circumference and high blood sugar ( 19 ). (healthline.com)
  • 31 The presence of abdominal obesity is more highly correlated with the metabolic risk factors than is an elevated BMI. (slideplayer.com)
  • The new IDF consensus definition of the metabolic syndrome stipulates the following as a pre-requisite for a diagnosis of metabolic syndrome: ≥ 80 cm for European women ≥ 94 cm for European men Waist circumference is calculated by comfortably measuring the waist halfway between the bottom of the rib cage and the top of the pelvis. (slideplayer.com)
  • The study shows, contrary to common belief, that Type 2 diabetes and metabolic syndrome can be reversed solely through lifestyle changes," according to lead researcher Christian Roberts of University of California, Los Angeles. (elispot.biz)
  • Fifteen of the men had metabolic syndrome, a condition that is characterized by excessive abdominal fat, insulin resistance, and blood fat disorders such as high levels of triglycerides (fat in the blood) or low levels of HDL (high density lipoprotein, or "good" cholesterol). (elispot.biz)
  • Scientists also need to determine whether long-term lifestyle change can prevent or reverse end-organ damage noted in those with metabolic syndrome or Type 2 diabetes, Roberts said. (elispot.biz)
  • From the abstract: ' In this Review, we discuss advances in the genetics of obesity from the past decade-with emphasis on developments from the past 5 years-with a focus on metabolic consequences, and their potential implications for precision management of the disease. (cdc.gov)
  • The most important risk factors are diet (particularly sugar-sweetened beverage consumption), genetics, aging, sedentary behavior or low physical activity, disrupted chronobiology/sleep, mood disorders/psychotropic medication use, and excessive alcohol use. (wikipedia.org)
  • Thus, practitioners are urged to discuss and intervene by proposing nutritional, lifestyle, and behavior modifications for children in whom an upward trend in BMI is noted. (txpeds.org)
  • Changes in hormones and an increase in sedentary behavior are the main causes of fat gain with aging. (poliquinperformance.com)
  • To formulate clinical practice guidelines for the assessment, treatment, and prevention of pediatric obesity. (medscape.com)
  • Pediatric obesity remains an ongoing serious international health concern affecting ~17% of US children and adolescents, threatening their adult health and longevity. (medscape.com)
  • Pediatric obesity has its basis in genetic susceptibilities influenced by a permissive environment starting in utero and extending through childhood and adolescence. (medscape.com)
  • The psychological toll of pediatric obesity on the individual and family necessitates screening for mental health issues and counseling as indicated. (medscape.com)
  • The prevention of pediatric obesity by promoting healthful diet, activity, and environment should be a primary goal, as achieving effective, long-lasting results with lifestyle modification once obesity occurs is difficult. (medscape.com)
  • Although some behavioral and pharmacotherapy studies report modest success, additional research into accessible and effective methods for preventing and treating pediatric obesity is needed. (medscape.com)
  • Despite a significant increase in research on pediatric obesity since the initial publication of these guidelines 8 years ago, further study is needed of the genetic and biological factors that increase the risk of weight gain and influence the response to therapeutic interventions. (medscape.com)
  • From the paper: 'a recent study indicates that salivary epigenetics, an easy measure to obtain in field or clinic, can be used to further explore the questions of pediatric obesity and related outcomes. (cdc.gov)
  • Waist circumference measures the accumulation of fat around the abdominal area (central adiposity). (medicscientist.com)
  • Central obesity is a key feature of the syndrome, as both a sign and a cause, in that the increasing adiposity often reflected in high waist circumference may both result from and contribute to insulin resistance. (wikipedia.org)
  • In addition, the body adiposity index (BAI), abdominal volume index (AVI), body shape index (ABSI), or conicity index (CI) could have a predictive ability for evaluating HTN [ 16 - 19 ], while the ponderal index (PI) could do the same for preHTN [ 20 ]. (hindawi.com)
  • The aim of this study was to compare the prevalence of overweight/obesity among Cypriot adolescents between cohorts from 2003 and 2010 and to determine whether body mass index (BMI) was associated with psychological traits linked to eating disorders. (who.int)
  • The Centers for Disease Control and Prevention (CDC) defines obesity as having a BMI of 30 or higher. (findmydirectdoctor.com)
  • Obesity is defined by the Centers for Disease Control and Prevention as a circumference greater than 40 inches for men or 35 inches for women. (findmydirectdoctor.com)
  • The specific objectives were to review the current evidence supporting management of ten major modifiable risk factors for prevention of stroke: hypertension, current smoking, diabetes, obesity, poor diet, physical inactivity, atrial fibrillation, excessive alcohol consumption, abnormal lipid profile and psychosocial stress/ depression. (cdc.gov)
  • As many developing countries, including Malaysia, have disproportionately high rates of breast cancer morbidity and mortality, a comprehensive assessment of lifestyle behaviors after breast cancer is essential as these behaviors may potentially affect prognosis, cancer recurrence, long-term survival and risk of other chronic diseases such as cardiovascular, hypertension and diabetes [ 11 ]. (biomedcentral.com)
  • Anthropometric measures were done on a representative sample of students aged 10-18 years and the Eating Disorder Inventory-3rd version (EDI-3) and 26-item Eating Attitudes Test (EAT-26) scales were completed by 13-18-year-olds. (who.int)
  • Particularly, according to sex and age range, the predictive emergent anthropometric indices in men were the body shape index (ABSI) and waist to height cubic (W/Ht 3 ) (AUC = 0.777 and 0.771, respectively), whereas in women, the predictors were CI and ABSI (AUC = 0.737 and 0.729, respectively). (hindawi.com)
  • We aimed to examine the association of alcohol consumption with fat deposition and anthropometric measures. (go.jp)
  • Thyroid hormones Treatment According to dictionary definition The basic modality of management of obesity lies in lifestyle modifications. (medicscientist.com)
  • 2. Increase in physical activity and exercise on a regular basis are important in the prevention and management of obesity. (medicscientist.com)
  • Lifestyle changes, including diet and physical activity, can be used alone or in combination with medications, psychotherapy, or surgery for the management of obesity. (adam.com)
  • HPA-axis dysfunction may explain the reported risk indication of abdominal obesity to cardiovascular disease (CVD), type 2 diabetes and stroke. (wikipedia.org)
  • Genetics, genomics, and diet interactions in obesity in the Latin American environment. (cdc.gov)
  • Other factors that increase the risk of obesity include:a) Family history: Risk of obesity is higher if one or both the parents are obese.b) Childhood Obesity: Being obese during childhood increases the risk of being obese as an adult.c) Genes: Some gene mutations or genetic disorders may cause obesity. (medicscientist.com)
  • World Health Organisation (WHO) has recognized the adverse role of prolonged exposure to digital media (DM) in childhood obesity and recommends that children and adolescents should limit recreational screen-time [ 6 ]. (biomedcentral.com)
  • Intervention and prevention of childhood obesity should begin as early in life as possible. (txpeds.org)
  • Early intervention is critical for the prevention of childhood obesity. (txpeds.org)
  • Obese children are at risk for developing numerous obesity-related conditions and medical problems during childhood ( Table 3 ). (txpeds.org)
  • Additionally, childhood obesity may be an independent risk factor for adult morbidity and mortality, regardless of the persistence of childhood obesity ( 2 ). (txpeds.org)
  • Background Recent studies have associated several microRNAs (miRNAs) with childhood obesity and energy homeostasis, suggesting that an individual miRNA profile could be used as an early predictor to estimate the response to weight loss interventions in the design of precision nutrition. (unav.edu)
  • Conclusions Bioinformatic analysis evidenced that miR-221-3p participates in several obesity-related pathways, and more interestingly, this miRNA targets several candidate genes to childhood obesity according to DisGeNet database. (unav.edu)
  • What is childhood obesity? (born-wild.com)
  • These findings also add further evidence to a critical window, that of early life, at which to intervene to prevent childhood and adolescent obesity. (cdc.gov)
  • Childhood obesity is a challenging clinical condition. (cdc.gov)
  • Leptin was once hailed as a treatment for most cases of childhood obesity but quickly lost favor when resistance to leptin was noted. (cdc.gov)
  • Activity-Inactivity Patterns, Screen Time, and Physical Activity: The Association with Overweight, Central Obesity and Muscle Strength in Polish Teenagers. (nature.com)
  • The findings from NHS cohorts have greatly contributed to our understanding of the etiology of obesity, as well as its consequences. (aphapublications.org)
  • Prader-Willi syndrome is a genetic disorder characterized by excessive hunger that leads to obesityd) Drugs such as sleeping pills and antipsychotic drugse) Abnormal sleep pattern Investigations According to dictionary definition Diagnosis of obesity is done on the basis of one s BMI. (medicscientist.com)
  • Weight gain rather than weight loss often occurs after breast cancer diagnosis despite breast cancer survivors frequently reported making healthful lifestyle changes. (biomedcentral.com)
  • This study describes the prevalence and magnitude of changes in weight before and after breast cancer diagnosis and examines lifestyle behaviors of breast cancer survivors with stable weight, weight gain or weight loss. (biomedcentral.com)
  • Current weight and height were measured while weight at cancer diagnosis and 1 year before diagnosis were self-reported. (biomedcentral.com)
  • Information on magnitude of weight change after breast cancer diagnosis and lifestyle behaviors of breast cancer survivors with varying degrees of weight change could facilitate the development and targeting of effective intervention strategies to achieve healthy weight and optimal health for better survival. (biomedcentral.com)
  • In a clinical setting BMI is a useful tool in assessing children's weight status, but additional clinical information is useful in making the diagnosis of obesity. (txpeds.org)
  • In developing countries, the rapid related risk behaviours and risk factors of progress of modernization is associated with children living in different provinces in a cluster of NCD and unhealthy lifestyles, order to design and implement necessary in- including smoking, physical inactivity and terventions in the next phases of the study. (who.int)
  • Unhealthy eating, low levels of physical activity and sedentary behaviours (SB), the latter characterized by activities that require low energy expenditure performed in reclining or lying position such as sitting in front of screens, substantially contribute to the development of MetS [ 5 ]. (biomedcentral.com)
  • Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. (nature.com)
  • The cohorts have elucidated the role of dietary and lifestyle factors in obesity, especially sugar-sweetened beverages, poor diet quality, physical inactivity, prolonged screen time, short sleep duration or shift work, and built environment characteristics. (aphapublications.org)
  • Causes of obesity are probably multifactorial and include genetic predisposition. (msdmanuals.com)
  • Obesity can happen for a number of reasons, including diet, a sedentary lifestyle, genetic factors, a health condition, or the use of certain medications. (gleneaglesglobalhospitallakdikapul.com)
  • Genome-wide association and gene-lifestyle interaction studies have shown that genetic factors predispose individuals to obesity but that such susceptibility can be attenuated by healthy lifestyle choices. (aphapublications.org)
  • Among key findings are the effects of excess weight, even in normal BMI ranges, on the risk of chronic disease morbidity and mortality, the importance of limiting weight gain, and dietary, lifestyle, and genetic determinants of obesity, as well as gene-environment interactions. (aphapublications.org)
  • Beyond genetic screening-functionality-based precision medicine in monogenic obesity. (cdc.gov)
  • Some tests may also be ordered to check for underlying conditions or complications associated with obesity. (findmydirectdoctor.com)
  • What are the complications of obesity? (findmydirectdoctor.com)
  • Complications include cardiovascular disorders (particularly in people with excess abdominal fat). (msdmanuals.com)
  • In the US, obesity and its complications cause as many as 300,000 premature deaths each year, making it second only to cigarette smoking as a preventable cause of death. (msdmanuals.com)
  • The importance of clinically identifying children with severe obesity is increasing, as these children are at particularly high risk for medical and probably psychological complications and may need to be specifically targeted for treatment. (txpeds.org)
  • screening for comorbidities of obesity should be applied in a hierarchal, logical manner for early identification before more serious complications result. (medscape.com)
  • It measures waist to hip ratio. (medicscientist.com)
  • For per 1 h increment in sitting time, the odd ratio ( OR ) and 95% confidence interval ( CI ) of abdominal obesity was 1.153 (1.095, 1.214) after controlling potential risk factors. (nature.com)
  • Traditional markers such as waist to height ratio (WHtR) have shown higher sensitivity than the body mass index (BMI) and waist circumference (WC) in the evaluation of the CVR [ 12 ]. (hindawi.com)
  • 0.001), and also with waist circumferences and waist-to-hip ratio ( P for trend = 0.042 and 0.007, respectively). (go.jp)
  • The primary outcome measure is the incremental cost-effectiveness ratio. (biomedcentral.com)
  • Longer sitting time was positively correlated with abdominal obesity in the rural population, and methylation level of JAK2 may be an underlying mediation of the effect. (nature.com)
  • Definition According to dictionary definition Obesity is the presence of excess fat in the body. (medicscientist.com)
  • 5. Surgery is done for obesity only when the person is not able to lose weight by dietary changes, exercise, or medicines.a) Liposuction involves reducing the excess fat from the body.b) Bariatric surgery reduces the size of the stomach so that you eat less. (medicscientist.com)
  • Obesity is excess body weight, defined as a body mass index (BMI) of ≥ 30 kg/m 2 . (msdmanuals.com)
  • Consuming fewer calories has consistently been shown to increase insulin sensitivity and decrease insulin levels in people living with excess weight and obesity, regardless of the type of diet they consume ( 17 , 18 , 19 , 20 ). (healthline.com)
  • Excess belly fat-also known as abdominal obesity-is a rapidly growing problem in the Western world with rates increasing from 46 to 55 percent over the first decade of the 21st century. (poliquinperformance.com)
  • From 2015 to 2016, 18.5% (or about 13.7 million) of U.S. youth between 2 and 19 years old were considered to have clinical obesity. (born-wild.com)
  • Cinnamon supplementation positively affects obesity: A systematic review and dose-response meta-analysis of randomized controlled trials, Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition, US National Library of Medicine, National Institutes of Health. (gewoon-merel.nl)
  • This research has contributed to evolving clinical and public health guidelines on the importance of limiting weight gain through healthy dietary and lifestyle behaviors. (aphapublications.org)
  • The NHS cohorts have contributed to our understanding of the risk factors for and consequences of obesity and made a lasting impact on clinical and public health guidelines on obesity prevention. (aphapublications.org)
  • The use of targeted sequencing and clinical criteria makes it possible to identify carriers of rare clinically significant variants in a wide range of obesity-associated genes and to investigate their influence on phenotypic manifestations of abdominal obesity. (cdc.gov)
  • A high consumption of high calorie and low-density food and a reduction of physical activity (PA) has led to an increase of MetS in Western countries but also in developing countries which have changed to a Western lifestyle [ 12 ]. (biomedcentral.com)
  • Considered as by-products of the processes of accelerated urbanization and globalization, the consumption of high energy density foods, sedentary lifestyle, and obesity showed an increase in their prevalences in the last decades in middle- and low-income countries 2 2. (scielosp.org)
  • These associations remained significant after further adjustment for BMI, whereas alcohol consumption had no significant association with abdominal SAT area. (go.jp)
  • In 2005, the Spanish Ministry for Health and Consumption designed the Strategy for Nutrition, Physical Activity and Prevention of Obesity (NAOS) with the aim of promoting a healthy lifestyle among the general population. (biomedcentral.com)
  • Are Physical Activity and Sedentary Screen Time Levels Associated With Food Consumption in European Adolescents? (who.int)
  • The main issue for clinicians or researchers is to use techniques for assessing abdominal fat deposition and its accumulation or changes over time, without sacrificing of experimental subjects. (biomedcentral.com)
  • As aforementioned, the accumulation of intra-abdominal fat can be measured by direct weighing of fat after dissection. (biomedcentral.com)
  • Belly fat-also known as visceral fat-is stored below the abdominal muscles and surrounds the internal organs of the body, including the liver, pancreas, and heart. (poliquinperformance.com)
  • Obesity in Adolescents Obesity is now twice as common among adolescents than it was 30 years ago and is one of the most common reasons for visits to adolescent clinics. (msdmanuals.com)
  • Most genes causing monogenic obesity are implicated in the central energy regulatory circuits of the leptin-melanocortin pathway. (cdc.gov)
  • As part of a physical examination, a health care professional will usually ask about the person's medical history, family history, diet, and physical activity to diagnose obesity. (findmydirectdoctor.com)
  • For a doctor to diagnose obesity in a child over 2 years old or a teen , their BMI has to be at or above the 95th percentile . (born-wild.com)
  • Rarely, obesity results from abnormal levels of peptides that regulate food intake (eg, leptin) or abnormalities in their receptors (eg, melanocortin-4 receptor). (msdmanuals.com)
  • The prevalence of obesity in American children and adolescents has risen dramatically over the past two decades and continues to increase. (adam.com)
  • Adolescents undergoing lifestyle therapy, medication regimens, or bariatric surgery for obesity will need cohesive planning to help them effectively transition to adult care, with continued necessary monitoring, support, and intervention. (medscape.com)
  • Weight-loss surgery (bariatric surgery) is the only option today that effectively treats morbid obesity in people for whom more conservative measures such as diet, exercise and medication have failed. (gleneaglesglobalhospitallakdikapul.com)
  • Increasing evidence demonstrates the effectiveness of bariatric surgery in the most seriously affected mature teenagers who have failed lifestyle modification, but the use of surgery requires experienced teams with resources for long-term follow-up. (medscape.com)
  • The BMI and waist circumference, however, do not directly measure body fat or consider factors such as age, sex, ethnicity, or muscle mass. (findmydirectdoctor.com)
  • Waist circumference measurements are just what they sound like: You measure your waist with a tape measure and monitor changes, using reference cut off point to assess for abdominal obesity based on sex and ethnicity. (poliquinperformance.com)
  • Obesity and maladaptive eating attitudes are common in Cypriot adolescents. (who.int)
  • Les adolescents de 13 à 18 ans ont rempli la troisième version de l'échelle Eating Disorder Inventory-3 et ont passé le test en 26 items Eating Attitudes Test. (who.int)
  • Obesity and neurological disorders: Dietary perspective of a global menace. (nature.com)
  • Sedentary lifestyle: Lack of physical activity3. (medicscientist.com)
  • 3. Weight management programs that include lifestyle changes in the diet and physical activity may also help in losing weight. (medicscientist.com)
  • The availability and accessibility of high-calorie foods, large portion sizes, lack of physical activity, and sedentary lifestyles can influence a person's eating and exercise habits. (findmydirectdoctor.com)
  • Physical activity and exercise is undisputedly the most comprehensive therapeutic agent for an overaged and fundamentally sedentary society. (frontiersin.org)
  • However, many other factors appear to increase a person's predisposition to obesity, including endocrine disruptors (eg, bisphenol A [BPA]), gut microbiome, sleep/wake cycles, and environmental factors. (msdmanuals.com)
  • Endocrine etiologies for obesity are rare and usually are accompanied by attenuated growth patterns. (medscape.com)
  • The researchers found that consuming ACV significantly decreased fasting blood sugar and HbA1C (a measure of blood sugar over time). (healthline.com)
  • None of the aortic stiffness measures changed significantly in either of the two other groups. (franciscanhealth.org)
  • This is the first study to assess the effects of aerobic exercise training with and without reducing calories on aortic stiffness, which was measured via cardiovascular magnetic resonance imaging [CMR] to obtain detailed images of the aorta," said study author Tina Brinkley, an associate professor of gerontology and geriatric medicine at the Sticht Center for Healthy Aging and Alzheimer's Prevention at Wake Forest School of Medicine in Winston-Salem, N.C. (franciscanhealth.org)
  • Both of the calorie-restricted groups showed bigger changes in BMI, total fat mass, percent body fat, abdominal fat and waist circumference than the exercise-only group. (franciscanhealth.org)
  • Taking in more calories than you burn in daily activity and exercise - on a long-term basis - can lead to obesity. (born-wild.com)
  • Usually, obesity results from a combination of inherited factors, combined with the environment and personal diet and exercise choices. (gleneaglesglobalhospitallakdikapul.com)