In what is perhaps the biggest buzzkill of all time, sex doesn’t quite count as cardio or burn a significant amount of calories: Women burn about 3.6 per minute. “It’s still a good idea,” Dr. Seltzer says, citing the activity’s other benefits, like increasing the output of the neurotransmitters serotonin and dopamine, which naturally reduce food cravings.
When it comes to condiments, mustard is about as healthy and low cal as it gets, and the pungent yellow stuff that contains about 5 calories per teaspoon has also been found to stimulate weight loss. Scientists at England’s Oxford Polytechnic Institute found that eating just one teaspoon of mustard can boost the metabolism by up to 25 percent for several hours after it’s been consumed. Researchers attribute this to capsaicin and allyl isothiocyanates, phytochemicals that give the mustard its characteristic flavor. So instead of reaching for the sickeningly sweet ketchup, make sure you have mustard on hand at your next BBQ.
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Caffeine itself may play a synergistic role in increasing metabolic rate. A meta-analysis of 15 studies showed that shows that green tea catechins given with caffeine was able to decrease body weight compared to catechins given alone. I will note that green tea does in fact contain some caffeine, whereas green tea extracts are may or may not contain it. Some studies sugges that regular and high caffeine usage may blunt the benefits of the GTE. In one study, using more than 300 mg/day of caffeine daily negated much of the benefits (a cup of brewed green tea only has 30 mg caffeine). Caucasian population typically drink more coffee and perhaps higher doses of catechins are necessary for benefits. 

Ancient traditional Chinese medicine believes tea to have weight loss effects, and these beliefs are increasing found since the 1990s in westernized world as natural herbs that may increase energy expenditure. The stimulatory effects of the catechin-caffeine combination is greater than caffeine alone. Fat oxidation (the burning of fat for energy) increases with the catechin+caffeine but not so much with the caffeine alone group, except perhaps at very high doses.
Also some research shows that the human body is primed to consume most of its calories during daylight hours. But the lifestyle is problematic for many: Because family meals and dinners with friends often are scheduled for after sunset, “people who try to stop eating after 7pm can’t do it every day for the rest of their lives,” says Dr. Seltzer, who supports an alternative strategy: Eating a hearty meal at your regular dinnertime.
Like a marathoner stretching before the big run, eating half a grapefruit before a meal can enhance your body’s fat-burning performance. A study published in the journal Metabolism found that this “warm-up” tactic can help whittle your middle—by up to an inch—in just six weeks! The scientists attribute the powerful effects to the grapefruits’ fat-zapping phytochemicals. The fruit can interact negatively with certain medications, so as long as you get the green-light from your M.D, plan to have half of a grapefruit before your morning meal and add a few segments your starter salads to reap the benefits.
However, this approach must be discussed and accompanied by a professional medical team and there are currently a series of medically supervised weight loss programs. Behavioral alterations combining a healthy diet and exercise are crucial for accomplishing weight loss, but there are also other methods, including pre-packaged meal replacement plans, pharmacotherapy and surgical weight loss.
“Sweet potatoes are a great source of dietary fiber, which helps to reduce blood sugar and insulin spikes, ultimately reducing belly fat,” explains Shana Maleeff a dietitian and fitness professional in New York City. Maleeff suggests substituting a sweet potato for potato salad, potato chips, or mashed potatoes at BBQs to save hundreds of calories. (We also love this recipe for mashed roasted sweet potatoes).
Want to lose weight? Grab a bottle of V8! According to a study published in Nutrition Journal, tomato juice consumption can aid weight loss because it increases resting energy expenditure (REE)—the amount of energy expended by a person at rest. After eight weeks of drinking unsalted tomato juice twice daily, the 95 women in the study (who were each exhibiting some menopausal symptoms) increased their REE by an average of over 100 calories per day.
How many calories should I eat a day? A calorie is an amount of energy that a particular food provides. Consuming more calories than needed will result in weight gain, consuming too few will result in weight loss. How many calories a person should eat each day depends on a variety of factors, such as age, size, sex, activity levels, and general health. Read now
A significant reduction in body fat (fat mass (FM), Body fat percentage, Arm fat percentage, feet FM, feet fat percentage) was observed in the slow WL group compared to the rapid WL group. In addition, a significant reduction in lean mass (lean body mass (LBM), fat free mass (FFM), Trunk lean) and total body water and RMR was seen in the rapid WL group compared to the slow WL group.
Yogurt is protein-packed and full of probiotics, which are good for gut health and may help your weight-loss efforts. Your gut health can impact your weight, and eating more fiber and probiotics helps keep your gut bacteria happy, which can be good for your metabolism (read more about your gut-weight connection). Go Greek for more protein; plus, research from Appetite found that consumption of Greek yogurt was associated with reduced appetite and increased satiety. Just keep an eye on added sugars in flavored yogurts, which only add calories. Instead, use fresh fruit to sweeten plain yogurt.
Nighttime snacking, for most of us, is a habit that can undermine weight loss success. That's because the calories we eat after dinner tend to be empty ones, from chips, cookies, etc. Brushing your teeth after supper will help you make dinner the last meal of the day. If you need a little something at night, try to satisfy the urge with few calories -- have a stick of gum, one piece of hard candy, or a cup of hot tea).
There’s a large spectrum of where people can fall on a vegetarian diet: For example, vegans consume no animal products, whereas ovo-lacto vegetarians eat both dairy and eggs. The eating style may help with weight loss, suggests a review published in August 2017 in Nutrients, but some vegans and vegetarians may become deficient in specific nutrients, such as calcium, iron, zinc, and vitamin B12, according to an article published in December 2017 in Nutrition, Metabolism and Cardiovascular Diseases. (23, 24)

Ghrelin is often referred to as the ‘hunger hormone’. If ghrelin is high, then you are hungrier. Anecdotal studies and personal experience have hinted at the appetite suppressing effect of green tea but this provides some rational basis for explaining how high dose catechin suppresses hunger. Adiponectin was also increased significantly, which is good although the exact significance is unknown. It has known anti-atherogenic and anti-diabetic properties, but this effect is not consistently seen in the literature.


In previous studies, elevated ratio of myostatin-to-follistatin, as an indicator of skeletal muscle catabolism, was reported to be greater in rapid WL compared to slow WL (25). The results were consistent with other studies in this field (26). In a study by Martin et al., the impact of these 2 protocols had been compared on the indices of anthropometric and lipid profiles. Their study was conducted in the form of a pilot study on obese postmenopausal females. The results of their study showed that slow WL caused more fat mass reduction and less FFM loss. However, in their study, no differences in lipid profile were observed between slow WL and rapid WL (18).
Craving something sweet? Instead of fattening cookies or cake, reach for fresh figs. Thanks to their dense consistency and high amount of filling fiber, they can slow the release of sugar into your blood. Pair with ricotta cheese, melons, and prosciutto to make a satisfying fruit salad, or use as a topping on whole-wheat pizza with crumbled feta and walnuts.

Loads of research demonstrates people who log everything they eat — especially those who log while they're eating — are more likely to lose weight and keep it off for the long-haul. Start tracking on an app like MyFitnessPal when the pounds start sneaking up on you. It'll help you stay accountable for what you've eaten. Plus, you can easily identify some other areas of your daily eats that could use a little improvement when it's written out in front of you. 

The fad military diet consists of low-calorie, odd food pairings such as bun-less hot dogs with banana, carrots, and broccoli. “Any diet like the military diet that severely limits the amount of calories you consume or eliminates one or more entire food groups puts any individual at risk for nutrient deficiencies,” says Kyle. “This can be more harmful than holding onto those 10 extra lbs you’re trying to lose.” (32)
There’s a large spectrum of where people can fall on a vegetarian diet: For example, vegans consume no animal products, whereas ovo-lacto vegetarians eat both dairy and eggs. The eating style may help with weight loss, suggests a review published in August 2017 in Nutrients, but some vegans and vegetarians may become deficient in specific nutrients, such as calcium, iron, zinc, and vitamin B12, according to an article published in December 2017 in Nutrition, Metabolism and Cardiovascular Diseases. (23, 24)
Coconut oil is having a moment right now: it can be used as a butter or olive oil substitute in everything from baked goods to salad dressing, and can even be used as an alternative to milk in lattes (yes, really). Sass is a fan of the heart-healthy oil whipped into smoothies, and you can also use it to sauté veggies, sear fish, or as an olive oil replacement in soups and stews. (It's also a must-add to your beauty routine, and makes a wonderful natural moisturizer for skin and hair.)
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Based on studies such as these, the optimal supplement would provide high doses of catechins with a smaller dose of caffeine (ie. not decaffeinated). This would have all the benefits of hunger suppression, increased energy expenditure, and fat oxidation. The dose would require 10 cups of green tea per day, but by using a cold brew technique, we can get this down to 3 cups per day in a easy to use formulation.

“Use a VersaClimber or take a VersaClimber class. These machines are still not that common, but in my opinion they are far more effective for weight loss than other forms of cardio. They require you to use a large portion of your muscles and it’s functionally better for you than other forms of cardio like spinning. Everyone is talking about Rise Nation in LA at the moment as they are the first dedicated VersaClimbing studio. There’s no harder cardio workout I have tried. To lose fat you have to put in the work. — Dan Roberts, celebrity trainer and creator of Methodology X
Like a marathoner stretching before the big run, eating half a grapefruit before a meal can enhance your body’s fat-burning performance. A study published in the journal Metabolism found that this “warm-up” tactic can help whittle your middle—by up to an inch—in just six weeks! The scientists attribute the powerful effects to the grapefruits’ fat-zapping phytochemicals. The fruit can interact negatively with certain medications, so as long as you get the green-light from your M.D, plan to have half of a grapefruit before your morning meal and add a few segments your starter salads to reap the benefits.
Water is your body's preferred form of fluid. It is thirst-quenching and naturally delicious without one single calorie. You need some 6-8 glasses of water or fluids each day. Recent studies suggest that we should let thirst determine how much we drink each day. Foods that are high in water (soups, Jell-O, produce) also count toward our fluid requirements. Many dieters find drinking water helps keep them from overeating.

"Kibbeh" describes dishes made with bulgur, onions and spices. That mixture is combined with everything from tomatoes to goat. It's layered and baked, shaped into balls or footballs, stuffed, deep-fried or eaten raw. This vegetarian kibbeh recipe is made with pumpkin and stuffed with seasoned greens. Sorrel adds a lemony flavor, but you can use chard or kale and add 1 tablespoon of lemon juice to the filling. Use fine bulgur or the texture of the dough will be gritty.


Steady-state cardio (referred to as simply “cardio” on the weight loss plan below) means you’ll be exercising (e.g. power walking, jogging, running, cycling) at about the same level of intensity for the duration of the workout. Steady-state cardio workouts tend to be longer. Cardiovascular interval training (IT) and high intensity interval training (HIIT), on the other hand, are a shorter workout, but alternate between higher levels of intensity and recovery intervals.  Interval training is a proven technique to massively boost metabolism and torch body fat. HIIT (short bursts of all out exercise e.g. sprinting) is a more intense form of interval training, so beginners should start with regular interval training.
You may say you want to lose weight to feel good about yourself. “Why?” Noom asks again. “It’s like peeling back the layers of an onion,” Noom explains, “And yes, tears might be involved too!” By the time our tester answered the third “Why?” she had indeed gone deep — even in the guise of a 40-year-old mom. The ultimate Why she came up with: “To enjoy life and bring joy to others.”
Another condiment worth utilizing in place of sugary dressings and marinades is apple cider vinegar. According to a study published in Bioscience, Biotechnology, & Biochemistry, consuming apple cider vinegar each day can lead to weight loss, reduced belly fat, waist circumference, and lower blood triglycerides. More specifically, the study of obese Japanese participants found that those who consumed 1 tablespoon of ACV over a three month period lost 2.6 pounds, and those who consumed 2 tablespoons lost 3.7 pounds in the same time frame. Go ahead and toss a tablespoon or two of this calorie, fat, and sugar-free stuff in your next salad dressing, sauce, or smoothie.

This weight loss workout plan consists of both cardiovascular exercise and resistance training. The name of the game is to blitz fat, which means to burn as many calories as you can. Cardiovascular exercise burns a lot of calories, as such this weight loss workout plan is centred around cardio. And to really blitz the fat, you’ll be doing two types of cardio, steady-steate cardio and interval training.
However, this approach has had limited long-term success. First of all, few people can continue for weeks, let alone months and years, using will power to limit calorie intake when they are hungry much of the time. Indeed, it is clear this strategy usually fails because while more Americans are going on diet and exercise programs, there has been a steady rise in the average American’s body mass index (BMI). Today, roughly two-thirds of adults are overweight or obese, childhood obesity has more than doubled in the past 30 years, and adolescent obesity has tripled.
Who is this class for: The example learner for this course is interested in improving their diet and is open to adopting new behaviors around cooking, grocery shopping, eating, and exercise. The learner should be over the age of 18 and should be in good health without any chronic diseases (such as diabetes, heart disease, high blood pressure, cancer, or food allergies.) Prior knowledge of nutrition principles for a healthy diet would be useful to the learner but is not required. Learners are required to seek approval from their primary care physician before starting the course. 

Add a cup of low-fat milk, a part-skim mozzarella stick, or a half cup of low-sodium cottage cheese to breakfast, and you may have a belly-busting win. While lots of research links calcium with lower body weights, results from a 2014 study suggest that calcium-containing foods may reduce waist circumference in those genetically predisposed to carrying weight in their midsection.

However, it seems that the effects of metabolic and anthropometric from slow WL are different from rapid WL. In a pilot study, the difference between these 2 diets on anthropometric status was reported (18). Also, Yudai et al. showed that body weight and total intra-abdominal fat mass in the rapid and slow WLs decreased to the same extent, yet muscle atrophy was significantly higher with rapid than slow WL (19). The review of studies showed that metabolic differences of these 2 types of diets are still unclear.
7. Egert S, Baxheinrich A, Lee-Barkey YH, Tschoepe D, Wahrburg U, Stratmann B. Effects of an energy-restricted diet rich in plant-derived alpha-linolenic acid on systemic inflammation and endothelial function in overweight-to-obese patients with metabolic syndrome traits. Br J Nutr. 2014;112(8):1315–22. doi: 10.1017/S0007114514002001. [PubMed] [Cross Ref]
Real talk: It could take weeks or months to see the metabolic effects of exercise on the scale, and even then, building muscle, which is denser than body fat, could lead to weight gain. “Do what you like because it’s good for you,” Dr. Seltzer says, noting the way exercise is awesome for your heart, mental health, and more—and that not all measure of progress can be seen on the scale.
A study in the journal Metabolism found that eating half a grapefruit before meals may help reduce visceral fat and lower cholesterol levels. Participants in the 6-week study who ate a Rio Red grapefruit fifteen minutes before each meal saw their waists shrink by up to an inch, and LDL levels drop by 18 points. Though researchers don’t exactly know what makes grapefruit so good at burning fat, they attribute the effects to a combination of phytochemicals and vitamin C found in the tart treat.
Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I.-M., … Swain, D. P. (2011, July). Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Medicine & Science in Sports & Exercise, 43(7), 1334–1359. Retrieved from http://journals.lww.com/acsm-msse/Fulltext/2011/07000/Quantity_and_Quality_of_Exercise_for_Developing.26.aspx
Losing weight through exercising and eating a healthy diet may be effective. A balanced and low-calorie diet up your chances of getting a slimmer waist considerably. These foods either help boost metabolism or help ease the process of digestion; both of which are key to healthy weight loss. But to make your weight loss journey more effective, it is important to include natural stimulators that can speed up weight loss. One of the most efficient weight loss stimulators is green tea.
Morbid obesity is associated with a series of diseases, or comorbidities, including coronary heart disease (CHD), high blood pressure, stroke, type 2 diabetes, abnormal blood fats, metabolic syndrome, cancer, osteoarthritis, sleep apnea, obesity hypoventilation syndrome (OHS), reproductive problems, and gallstones. In order to reduce the risk of developing or aggravating one of these conditions and improving the patients’ quality of life, rapid weight loss may be medically advised.

To prep his patients for success, Dr. Seltzer tells them to plan around a large evening meal by eating a lighter breakfast and lunch—NBD since most people who eat a meal before bed tend to wake up feeling relatively full, he says. Research suggests balanced bedtime meals may also promote steady next-day blood sugar levels, which also helps with appetite regulation.

Although they're best known for containing potassium, bananas are also a great source of resistant starch, a type of starch that's important for weight loss. Your body digests resistant starch slowly—helping you feel full for longer—while simultaneously encouraging your liver to switch to fat-burning mode. And no need to wait for them to become completely ripe; bananas actually contain more of this calorie-torching ingredient when they're still a little green.
Losing weight through exercising and eating a healthy diet may be effective. A balanced and low-calorie diet up your chances of getting a slimmer waist considerably. These foods either help boost metabolism or help ease the process of digestion; both of which are key to healthy weight loss. But to make your weight loss journey more effective, it is important to include natural stimulators that can speed up weight loss. One of the most efficient weight loss stimulators is green tea.
Published in The Lancet, this study tested current guidelines, which recommend losing weight at a slow initial rate to promote larger long-term weight reduction. A total of 200 obese adults participated in the study with the goal of losing at least 12.5% of their body weight during the study period. Half of participants were randomly assigned to a modest nine-month diet that reduced calorie-intake by 500 calories a day. The other half of participants were assigned to a fast-track weight loss program, reducing calorie-intake to 450-800 calories a day for three months. After following their assigned diets, participants were then placed on a weight maintenance program for three years.
Sure, you certainly need to drink plenty of water to help expedite the process of ridding your body of excess sodium, you can (and should!) also consume high-water content foods. Reach for cucumbers, tomatoes, watermelon, asparagus, grapes, celery, artichokes, pineapple, and cranberries — all of which contain diuretic properties that will also help you stay full due to their higher fiber content.
Already nearly calorie free, matcha is a great addition to a weight loss program by tackling the problem from both sides. It boosts metabolism and burns fat. One recent study even suggested that matcha may help burn calories by four times. At the same time, matcha does not put any stress on the body. It doesn’t raise blood pressure or heart rate, making it a safe alternative to questionable quick fixes or pharmaceuticals ridden with side effects.
“Stepping on the scale frequently makes you aware of small changes and helps you quickly react to those changes. The National Weight Control Registry, a large group of people who have successfully lost at least 30 pounds and kept it off for 5 years, found that successful ‘losers’ weigh themselves often and make adjustments accordingly. When you begin to understand that sodium, carb intake, hormones and alcohol intake can impact weight and that it isn’t possible to gain 2 pounds of fat overnight, you will begin to better understand your body. The key is to pay attention to overall trends; don’t obsess over day-to-day numbers! — Jennifer McDaniel, MS, RDN, CSSD, LD, food and nutrition expert
The Google team looked at all their search data for 2016 to see what emerged as the top diet trends, and this buzzy acronym diet secured the top spot. Unlike most diets, it swaps counting calories for focusing on insulin levels — a measurement of your blood sugar that nutritionists love to zoom in on when evaluating a food's health merits — to ensure steady, lasting weight loss.
The active compounds in green tea aids in the process of breaking down fat in the fat cells, thereby moving them into the bloodstream. Hence, we can conclude that green tea contains bioactive substances like caffeine and EGCG, which have powerful health impacts. They mobilise the movement of fat content into the fat cells thus making it easier for them to produce energy, and releasing it throughout the body to be used by other cells.
Why you're gaining back the weight section is both complimentary and contradictory to the last section of common mistakes. In common mistakes the author tells you not to check the scale so often, in why you're gaining it back, it's because you're not checking the scale enough. Then it repeats the issues with crash diets (this is why they don't work, I agree with this completely). There is a brief paragraph on emotional eating, and I really wish this was talked about even more, but it's not.
This is the type of tea that's often served in Chinese restaurants and used to make iced tea. It’s fermented -- a process that allows it to change chemically and often increases its caffeine content. The tea has a strong, rich flavor. Whether it helps with weight loss isn't certain. But research done on rats suggests substances called polyphenols in black tea might help block fat from being absorbed in the intestines.

Good news for java lovers: The caffeine in coffee could speed up your metabolism and help your body burn slightly more calories (about 26 per cup). A study in Physiology & Behavior found that the average metabolic rate of people who drank caffeinated coffee was 16% higher than those who drank only decaf. Just be mindful of how much cream and sugar you add to your cup, which could offset any health benefits the beverage provides.
Weight Watchers, which not only champions a sustainable diet but has sustained itself for over fifty years, is a favorite amongst nutritionists. Its practical, flexible philosophy of saving and splurging SmartPoints boils down to balancing out food choices. You can get tips, tools, and motivation by attending the traditional weekly meetings, or get the same resources through its user-friendly app. Either way, research proves that Weight Watchers’ social element supports weight loss. At about $4 a week, OnlinePlus costs about half as much as Meetings+OnlinePlus, which runs around $8 (your fees vary depending on the length of your commitment).
I’ve always been very slim, come from a lean family, I turned 30 a few months ago, and I noticed a couple months ago that my belly had cellulite when pressed. I obviously freaked out, since I weight 90lbs and I’m 1,70m. I recall a few years ago when I wanted to tone up my belly I will just have to do a few abs exercises and I will have my abs showing.
This summer favorite doesn’t have to wreck your waistline! “Using lean ground beef (95 percent lean vs. 80 percent) for your hamburgers will save you 170 calories and 19 grams of fat for a 6-ounce burger,” says Maleeff. Ditch the bun, swap ketchup for tomatoes, and wrap it up in lettuce for a burger that’s full of flavor, not empty calories. Try it here with this low-carb, bunless bite-size burger recipe.
Lipton green tea is simple, pure, light, and delicious. It is made from the finest leaves in the world. There are many variants of Lipton green tea, such as 100% natural green tea (basic green tea), cranberry pomegranate, lemon ginseng, mint, decaffeinated honey lemon, passionfruit, and jasmine. Recently, Lipton has come out with flavored tea bags such as Lemon Zest, Mint Burst, Honey Lemon, and Tulsi Natural. These are available in packs of 100, 25, and 10 tea bags.

Because the diet isn’t as restrictive as a traditional vegan or vegetarian diet, it may be simpler to stick with — hence its No. 2 ranking in U.S. News & World Report’s Easiest Diets to Follow category. Because you’ll be eating meat some of the time, you may also be at a lower risk of the aforementioned nutrient deficiencies that vegetarians and vegans may face.
It seems counterintuitive to drink lots of water when you’re looking to lose weight fast—especially water weight—but staying hydrated is one of the most important steps you can take to lose weight. People often mistake thirst for hunger, so staying hydrated allows you to be more in touch with the times when you are actually hungry, rather than just thirsty. Plus, a lot of good things happen to your body when you drink enough fluids.
Trying to lose weight is a lot like cleaning out the basement: It’s overwhelming and near impossible to know where to start—even when you don’t have a ton of weight to lose. But getting the body you’ve always wanted doesn’t have to be a source of stress. If the scale won’t budge and you’re looking to shed the last 10 pounds, there are plenty of ways to reach your goal. To help you get there, we spoke with a handful of celebs that have successfully slimmed down (and kept it off) and dozens of the fitness and diet industries top experts.

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Many diet plans cut out entire food groups, which can create nutrient deficiencies as well as health problems. For instance, if the diet is very low in carbohydrates and you have type 1 diabetes or type 2 diabetes, it’s probably not a good fit. And if it’s too restrictive and you’re pregnant or breastfeeding, then it’s not a good idea, either. Keep in mind that pregnancy is not a time for weight loss. Speak with your doctor before making any changes to your diet if you are pregnant or breast-feeding.
Sleeping for more than five hours a night might seem like a luxury for some, but it can have a serious impact on your overall health. Not getting the recommended 7-8 hours of shut-eye a night puts you at risk for fatigue the next day, which means you’re more likely to crave and snack on high-calorie comfort food. Try to go to bed sooner so you can get a little more sleep, which will help you eat less. And to blast fat even faster, don’t miss these essential 55 Ways to Boost Your Metabolism.
“Preliminary evidence suggests that if someone is already eating a low-fat, portion-controlled diet and then they get three servings of nonfat milk a day, they lose more weight than someone who eats the same number of calories but doesn’t have the milk,” Somer says. The theory is that calcium may inhibit the storage of fat, and it seems that the weight loss comes largely from the midsection.
Stavrou, S., Nicolaides, N. C., Papageorgiou, I., Papadopoulou, P., Terzioglou, E., Chrousos, G. P., … Charmandari, E. (2016, July 31). The effectiveness of a stress-management intervention program in the management of overweight and obesity in childhood and adolescence. Journal of Molecular Biochemistry, 5(2), 63–70. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996635/
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