I must remember to measure myself to see if I’ve lost any inches – perhaps I’ll start with centimetres as that might be more realistic and have a better feel good factor! The desire to shed pounds is different for everyone. It’s a case of finding and attaining a happy medium and feeling good about yourself. Too thin isn’t always good but neither is obesity.

Why do people get different results with this diet plan? Medical conditions can play a big role in weight gain or loss. It is important to understand any medical conditions you may have before going on a diet. Many different issues can lead to abnormal weight gain, including thyroid issues. If this is a concern for you, read this article on hypothyroidism and its effect on weight. Mental health issues can also lead to weight gain or loss. If you struggle with anxiety, you may experience abnormal weight gain. Make sure to ask your doctor for advice about how to manage the anxiety without over-eating.


I’ve been doing carb free for the last two weeks with one cheat meal per week. I did this same “diet” in high school and lost 48 pounds in 2 months (all while attending keg parties on the weekend, those were the days!) I’m not suceeding (thus far) as much as I had back then, despite being more regimented. Could this be because it’s a decade and a child later? I’ve heard your metabolism can change after childbirth. After reading through your postings I think some of my issue might be the amount of fruit I’m eating.. i:e Bananas in the morning and an afternoon snack of apples and peanut butter. Maybe I’m snacking too much on cheese? Oh I’m just so frustrated. I’m hoping after this week, now that I’m over being sick and can integrate cardio that the fat burn will pick up, but for now I’m super discouraged.
No-sugar diet plan: What you need to know Eliminating sugar from the diet can help prevent weight gain, diabetes, heart disease, and other problems. Whether cutting sugar out of the diet completely or simply cutting back, we have eight important tips for following a no-sugar diet, and some advice about fruits and other natural foods that contain sugar. Read now
hi aagnya.. i thought to reply you. sorry if u feel this wrong actually i have the same problem.. when i got upset or iritated i loose my control. i had not yet follow this diet but i keep following different diets..so yes to control cravings is really difficult. i can only suggest yes you can have a diet holiday but just once in a week but can cover it with little extra workout next day if u do any(as i do same). and u can keep the diet so flexible that there will be no requirement to break it. like some intresting ideas.. bye tk cr

Women who ate low-fat dairy products, such as non-fat yogurt and low-fat cheese three to four times a day lost 70 percent more fat than low-dairy dieters, according to a study published in the journal Obesity Research. "Calcium serves as a switch that tells your body to burn excess fat faster," explains study author Michael Zemel, M.D., director of the Nutrition Institute at the University of Tennessee in Knoxville. Sorry, but you won't reap the same benefits from calcium-fortified O.J. Research shows that you get the best results from dairy products themselves, not fortified foods. Aim for 1,200 mg, which includes about three servings of dairy a day.

Hi Adam. Your story is amazing & Ive been searching for a way to lose weight & look slim. I’m not obese or anything but I am overweight for my height. I’m 5’2″ & I way 137. I really want to be 125 or 120. Hopefully by the summer. But I’m also 16 & built. I’m active in sports & go to the gym regularly but my diet isn’t very healthy but I don’t know with my age if I should cut back on the foods you have suggested. What should I do?
Why is the keto diet good for you? A keto diet is one that prioritizes fats and proteins over carbohydrates. It can help reduce body weight, acne, and the risk of cancer. Find out about the mechanisms through which it achieves these benefits and the research that supports it. This MNT Knowledge Center article also discusses the risks of the diet. Read now
Onion Roti…yuck! I’m a non vegetarian and had requested them to have a lot of non vegetarian food along with vegetarian. Luckily I was never told to have all that..I could have roasted chicken, missi roti(which I like). I mean the diet was pretty much like what you have written. I guess it depends from person to person….And i had consti****** as I didn’t have chapattis with bran for about 3 months when I wasn’t at home, my diet was devoid of any junk food whatsoever just had plain wheat flour chapattis with veggies…not having it for once a while won’t affect. Again I guess it might vary from person to person and it did affect me 🙁
Hi I’m 22 an just moved to Canada from USA an have lots of immigration and legal things I’m paying for I married a Canadian woman that’s why I moved to Canada but I need help and we are on a right budget livin on one income us paying for Immigrations but within 6 months I can barely fit my jeans anymore and I got stretch marks which I never had in my life in cant afford a gym membership and I can’t work legally yet and still won’t be for a while I’m 6ft 3 Caucasion and pushin 250 lbs I feel drained and restless all the time and we live In a apartment so it’s hard to do anything with out neighbours complaining about noise even normal walking I was only 210 lbs when I moved here 6 months ago do you have any help ful advice

“Stop focusing on calories and start focusing on the quality of the foods you eat. High-quality diet options are natural, whole, minimally processed foods, like vegetables, fruits, nuts or seeds that offer a lot more nutritional value in the form of vitamins, minerals, healthy fats and fiber. These foods help tame hunger naturally and nourish our cells at the deepest level so that we aren’t left with constant cravings. — Michelle Loy, MPH, MS, CSSD, Registered Dietitian Nutritionist and owner of Go Wellness in Orange County, California


Green tea isn't known only for its cancer-fighting benefits: It may help boost your metabolism, too. People who took green-tea extract three times a day saw their metabolic rate increase by about 4 percent, according to a study published in the American Journal of Clinical Nutrition. (Translation: You could burn an extra 60 calories a day, which equals about six pounds a year!) It may be because green tea contains catechins, which increase levels of the metabolism-speeding brain chemical norepinephrine, says Joy Bauer, a New York City nutritionist and author of Cooking with Joy.
Hi – well after one week I can say I lost 1 kilo – great! … BUT put it back on! Ha! With visitors in town and the spine of a lettuce that’s what can happen. Hey ho and here we go again. Cianna – your achievement is wonderful. If you can keep doing what you’re doing you’re more than likely to adopt a new lifestyle and keep your pounds off. It is wise to adopt a change in lifestyle that can be sustained. Not sure how long Adam would advocate eating black beans!
Virtual gastric band uses hypnosis to make the brain think the stomach is smaller than it really is and hence lower the amount of food ingested. This brings as a consequence weight reduction. This method is complemented with psychological treatment for anxiety management and with hypnopedia. Research has been conducted into the use of hypnosis as a weight management alternative.[17][18][19][20] In 1996 a study found that cognitive-behavioral therapy (CBT) was more effective for weight reduction if reinforced with hypnosis.[18] Acceptance and Commitment Therapy ACT, a mindfulness approach to weight loss, has also in the last few years been demonstrating its usefulness.[21]

And finally, do you feel like you’re at peace with yourself? Comfortable in your own body? In your life? Or are you constantly battling yourself (or others), never feeling whole or balanced? Do you feel like you’re in touch with your heart—your authentic self? I know it might sound crazy to say that your diet is behind that, too, but it is. When you begin to eat whole grains and abstain from craz-ymaking foods like white sugar, you will see how amazing and joyous and peaceful life really is.
In the first chapter the author doesn't take long to start body shaming people. In the section of how obesity is measured the author tells you that if you have unequal distribution of fats, if you have a protruding tummy or bulging thighs it can make you look unattractive. Gee, thanks for the judgement there. Let's keep it to the facts and not the attractiveness opinions of others. Really, another person's opinion of how attractive I am based on my body shape is not a good measurement of obesity.

While 1,200 may be the right number for some, it can be super restrictive for others, says Jaclyn London, MS, RD, CDN, Nutrition Director at the Good Housekeeping Institute. Try basing your meals and snacks off this plan and double up on veggies at any opportunity — more fruit at snack time works too! You can also add an extra ounce or two of protein at all meals if you find yourself feeling hungry. The combo of fiber from produce and lean protein makes this an adaptable strategy that’ll help you lose weight safely — one meal (and snack) at a time!
There are four phases to the plan, and the first one is severely restricted in carbohydrates. The induction phase lasts two weeks, and the claim is you can lose up to 15 pounds in this time. During this time you consume no more than 20 grams of carbohydrates per day. For example, one slice of bread has 15 grams of carbohydrates, one serving of fruit has 15 grams of carbohydrates, one serving of dairy has 12 grams of carbohydrates, and one serving of vegetables can have between 5 and 15 grams of carbohydrates. It's clear that 20 grams is extremely limited, potentially unhealthy, and would be very difficult to follow for the long-term.

Well, the Atkins diet plan was developed by Dr Robert Atkins way back in 1972. Atkins was a scientist, who was also overweight, and he devised his diet to help himself lose weight, and consequently help millions of other people worldwide to do the same by following the plan and using the food list – a low carb food list and high protein diet plan that guarantees results.
Hi! I have a few queries though i have started with the morning methi water.pepper and almonds. I go for a zumba class frm 7-8 every mon,wed and fri. i work so rush to office by 830. How do i sustain on a toast alone ? U sweat so much that u end up having a headache if u dont eat a proper bfast. Secondly any snacks permitted? dry fruits? Thnx,Sangeeta
I’ve learned a ton about health and fitness – specifically weight loss and motivation – over the past several months. So much so that I’ve recently become a personal trainer so that I could help others reach their health and fitness goals as well. I’m super excited about this new found passion and can’t wait to start helping more people. If you have any questions about this program or any other exercise program please don’t hesitate to ask – I’m here to help.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Also, she promotes heavily processed items like fake butter and mayonnaise, even (although she doesn't overly encourage it) phony hot dogs. She never mentions coconut oil, which surprises me because it's so hyped as a health food, as necessary fats and good for you. It can be used in place of butter or oils (she promotes saffron oil a lot, which I don't know much about).
I am 25 year old nd my height is about 5 feet.I hv so much fat on my belly.my weight is a 78kg.I wnt to loose my fat from body specially from my belly plz advice me natural process for it….I hv sooo many stretchmarks on my belly and west.I am very tensed due to it…plz suggest me any medicine and oil or cream to reduce it fast….i hv no more time bcz my marraige plan is exceeded…..plz help me i m soooo worried.
As chronic obstructive pulmonary disease (COPD) advances, about 35% of patients experience severe weight loss called pulmonary cachexia, including diminished muscle mass.[32] Around 25% experience moderate to severe weight loss, and most others have some weight loss.[32] Greater weight loss is associated with poorer prognosis.[32] Theories about contributing factors include appetite loss related to reduced activity, additional energy required for breathing, and the difficulty of eating with dyspnea (labored breathing).[32]
I’ll try to get back on track again this week and see if I can get rid of that 1 kilo again and aim to keep it off and then try for another. So long as I continue to incorporate exercise in my week 3-4 times I feel good; even though new muscle does weigh (in a gym I vary routines based on alternating a run, rowing, cycling, using kettle bells and incorporating yoga moves to warm up and cool down). That phrase ‘keep fit and healthy’ is something to live by. Incorporating exercise in our lives is key to weight control.
Weight training is the ultimate way to burn calories fast. "A pound of muscle burns up to nine times the calories of a pound of fat," explains Richard Cotton, M.A., chief exercise physiologist for myexerciseplan.com. Weight training increases your resting metabolic rate, which is the number of calories you burn while sitting on your butt. What's more, it gives your metabolism an added boost after you exercise, staying in overdrive for up to two hours after the last bench press, according to a study published in Medicine & Science in Sports & Exercise. Strapped for time? Try these quick moves: squats, bench step-ups, lunges, push-ups, pull-ups and planks. In a pinch, just do single sets of 10 for each exercise — you'll get optimal results for the time invested.

The two diet options that are currently available are the Flex Plan and the Core Plan. The Flex Plan is an updated version of the POINTS Food System in which the goal is to stay within your recommended amount of points each day. The POINTS value for foods is calculated based on the food's calories, fat, and fiber. Along with your weekly POINTS target you are also given a "Weekly Allowance" to use for indulging or special occasions.

Im 14 years old, only 5 foot, and put on 7 pound, yet i still stayed the same height. Therefore, i got fatter, cause i didnt grow at all. I read most. Of your helpful advice/tips, and i got it & i think it’ll be a tad bit difficult, but i culd be committed if i really set my mind to it. I just need your help/motivation. I need you to REALLY help me. Give me like a daily routine. Sorry if thats too much to ask. ;p but yeah, PLEASE TEXT ME ASAP
Johansson, K., Sundström, J., Marcus, C., Hemmingsson, E., & Neovius, M. (2014). Risk of symptomatic gallstones and cholecystectomy after a very-low-calorie diet or low-calorie diet in a commercial weight loss program: 1-year matched cohort study. International Journal of Obesity, 38(2), 279–284. Retrieved from https://www.nature.com/articles/ijo201383.pdf
“Nuts are a superior weight loss food in my book. They offer plenty of protein, healthy fat, and fiber that can really take the edge off hunger at any meal or snack. Nuts are also so versatile and convenient. They can be mixed into oatmeal or yogurt at breakfast, paired with fruit as a snack, or tossed into a hearty salad for a little satisfying crunch at lunch. — Michelle Loy, MPH, MS, CSSD, Registered Dietitian Nutritionist and owner of Go Wellness in Orange County, California
What may come as some consolation is that even the fittest among us know the struggle is real: “Many know me from social media as the jump rope queen and fitness trainer who is always smiling while coming up with difficult and creative workouts. What they may not know is that like everyone else, I too struggle with finding ways to keep my motivation up when it comes to diet and exercise,” says Janine Delaney, psychologist and fitness expert whose social media platform has amassed almost 2 million followers. “As a full-time psychologist, wellness influencer and mom of two teenage girls I have an awful lot going on. Sometimes it would be easier to head for the couch with a bag of chips than plan a healthy meal and fit in a workout. Still, I make it happen.”
1:30 pm – A small plate of salad before starting the meal. The fibers in the salad fills u up which in turn prevents false hunger that makes u overeat.1 bran chappati (mix wheat flour and wheat bran in equal proportions.) with 1 bowl ( normal sized katori ) of dal. Generally at my place dal is cooked at night so I used to store the dal made at night for the other days lunch, u can do the same.
Carb crazy? Consider this: Refined carbohydrates, such as bread, potatoes and rice, create a surge in insulin that in turn drives down your resting metabolic rate, explains Aronne. "It's important to keep carbohydrates in your diet, but really focus on fruits, vegetables and whole grains, which have less of an effect on insulin levels," he explains. And when buying whole-grain breads and cereals, make sure the first ingredient listed is whole wheat, whole oat or cracked wheat.
While it likely took more than a week to gain unwanted fat, most people wish they could lose it quicker than it came on. “When it comes to losing weight, simply cutting back on your portion sizes could be the most underrated way to drop pounds. However, if you’re already eating less (and exercising more) and are still stuck, there are little tricks of the trade that can help jumpstart your efforts,” Ansel says.
The Zone diet is a high-protein, low-carbohydrate, fat-controlled eating plan. It is not as restrictive as other high-protein diets and it allows for a broad range of foods to be consumed. A small amount of protein is combined with twice the amount of "favorable" carbohydrates, including fruits and vegetables. If choosing "less desirable" carbohydrates, the portion size is smaller. Sears' Zone diet is based on the theory that the human body is genetically programmed to reach peak efficiency when all meals, including snacks, consist of a set caloric ratio of carbohydrates, proteins, and fats. The diet recommends an intake of 40% of calories from carbohydrates, 30% from protein, and 30% from fats (40-30-30). When this ratio is achieved, the body is working within the "zone." The body will have maximum energy and weight loss.
Hi! I am 18 years old. My weight is 50 kilos. I really want to lose weight. I have a very nig tummy. But I don’t know hot to start this dieg since I’m really a rice eater. Rice is our main dish. I tried not eating rice before but I felt like I’m going to faint. I don’t have energy and I’m always hungry. I think my body is really used to have rice. Is it still possible to lose weight if there’s rice on my meal? Please help me. Hope to hear from you soon. Cheers!
Hi, I am in a female my early 20’s and put on 14 pounds from june last year. I am on a diet similar to this its called the Candida diet, (no bread, no pasta, no potatoes, no milk product, no sugar) I have been on it almost a week I don’t see much of a difference in my weight. My calorie intake is different every day sometimes as low as 700 calories a day (hard to find high calorie foods that are acceptable on the diet, beans are not allowed) I have been eating avocados and nuts to compensate. I do minimal exercise usually a 40 minute walk a day. When you said your metabolism will slow when given less calories, it that the reason I’m not loosing weight?
The Atkins diet web site states the current plan "is about eating delicious and healthy foods, which makes it so much better than any of those fad diets out there. You eat a variety of your favorite foods -- lean protein, leafy greens, vegetables, nuts, fruits, whole grains. Plus, you get delicious Atkins bars and shakes from day one and every step of the way."
A new German study found that when you drink 17 ounces of water (about two glasses) within a certain time frame, your metabolic rate shoots up by about 30 percent. Using these results, they estimate that by increasing your current water intake by 1.5 liters a day, a person would burn an extra 17,400 calories a year, resulting in about a five-pound weight loss.
Our publisher, Thieme, has made a large investment in the book, fittingly as it is the flagship of their new “Edition Health Science” line of books for medical and health care professionals. Among their efforts was a re-design of the PHD apple. Forgoing the yin yang design that was inspired in part by Shou-Ching’s Chinese heritage, they came up with a clever design:

At the end of the day, successfully achieving a health goal — whether it be to lose weight, tone up or feel more energized — all comes down to identifying a goal that is meaningful to you as an individual, says Delaney. "It's different for everybody. It's about creating goals based on what is important to you and really understanding yourself so that you can continue to work towards them.”
Hello. I really liked this diet sheet, and I really want to follow this, but I have a question. As you’ve written that salads are required to be taken before the food intake. I want to know whether there is any special restriction on the salad to take? Is there any thing I need to take, or shun from my diet? What is the ideal salad? Please help me.
Instead of doing a detox or cleanse in the hopes of resetting your GI system (and speeding up weight loss), boost your gut health naturally with fiber-filled foods. “Fiber is a carbohydrate found in fruits, vegetables and whole grains, but unlike other forms of carbohydrates, it is harder to digest. As it passes through your digestive system, it stimulates the receptors that tell your brain you’re full. People who consume more fiber tend to have healthier body weights,” says Gueron. If you’re looking for more specific fiber-filled foods to reboot your gut, eat the three P’s: prunes, pulses, and pears. Prunes help maintain good digestive health and can positively affect the bacteria living in the gut. Pulses, which include lentils, beans, and peas, improve gut health by strengthening the gut barrier. And pears contain prebiotic fiber, which help promote intestinal health by providing food for beneficial probiotic bacteria.
Thanks, I know the amount of food I was consuming was low working to increase (did I mention I’m Vegetarian) options are limited. Yes I am on the candida diet for a purpose, because of the access of yeast in my body, but I have been told it helps to lower weight. I wasn’t talking about weighting myself every day (saving that for every 2 weeks) I was just talking about a difference in my body. After I’m finished this candida diet I plan on continuing on a weight loss diet similar to what you are on, yet side I don’t eat meat I find it hard to get foods high in calories that are healthy, any suggestions. Thanks for your time.
It brought in some discipline in my life but there is a word of caution …..I was also told to have Chapattis mixed with Wheat Bran and it just became a way of life…..my body got habitual of getting so much of fiber that when I stopped mixing it in my chapatti for a few months as I wasn’t home and didn’t have the luxury of having food according to my whims and fancies I had consti******
Half an hour of aerobic exercise daily. If u want to join a gym good enough. But if due to any reason maybe time or money constraint u can’t join a gym. All you need is a comfortable pair of shoes to do some aerobics, a skipping rope to do at least 500 skips (5 sets of 100 skips and increasing it as you go). 1.5 -2 kgs dumbbells for toning your upper body. Just these basic things and you are set.
Thank you for offering a simple diet plan and sharing your results. I have been on a personal journey to lose weight and have been unsuccessful for many years. I am making a 2 week commitment to stick to the diet plan you have outlined. My biggest problem is night time eating and very low self-esteem. I am looking forward to starting this. Any suggestions for me? Thanks!

So how does the diet work? High trans fat diets cause obesity and other health issues (2). Fat deposits under your skin make you grow in size and weight. To lose weight you need to cut back on fatty, high-calorie foods. Some so-called health experts recommend cutting down on all types of carbohydrates, which I believe is the big mistake. Not all carbohydrates are bad and this diet plan has plenty of carbs. When you cut down fats with carbs, you restrict yourself from almost al satisfying foods, which leads to starving, feeling stressed all the time, and not being able to carry out daily life activities. So to lose weight, you just need to limit your calorie intake or adopt a calorie-deficit diet.
Over the summer I weighed in at 123 at 5’6, now I think I’ve gained about 10 or so pounds. I’m trying everything to get the weight off but I to give into my cravings when they appear, and my husband certainly doesn’t make it easy when I get home from work and he’s prepared dinner as he gets home before me (full of guy foods and carbs) We also have a 1yr old so between work and being a new mom I give in once in awhile especially if my son decides to share his sandwiches with me. I do pilates for about 30min 5days a week and love to walk because I found that helped to drop my baby weight last yr but it’s too cold for that now. What would you suggest?
Face it, if you want to lose weight over the long haul, your best bet is to make sustainable, long-term lifestyle changes like the nine simple ones this woman made to shed 45 pounds and keep them off. But sometimes life comes at you fast and you need a fast solution. One smart lifestyle change is to eat plenty of veggies—especially for someone looking to lose weight. Vegetables are nutrient-packed and provide plenty of filling fiber with hardly any calories. Plus, non-starchy veggies have a high water content, so they hydrate you while filling you up—the perfect combination for weight loss.
Spice up your favorite foods with a few dashes of hot cayenne pepper sauce. Cayenne pepper contains capsaicin, an appetite suppressant; a study in American Journal of Clinical Nutrition found that people who ate capsaicin consumed 200 fewer calories at the next meal. Not only will this help you cut back on calories and boost weight loss, but researchers have also found that capsaicin can help you lose belly fat and lose weight fast.
Studies show that eating breakfast plays a part in successful weight loss — almost 80 percent of people who successfully keep weight off chow down on this meal, according to a study published in Obesity Research. "Your metabolism slows as you sleep, and the process of digesting food revs it up again," explains Heller. Aim for a 300- to 400-calorie breakfast, such as a high-fiber cereal (another metabolism booster) with skim milk and fruit.

“I tell all of my celebrity and professional-athlete clients to get between 6 and 8 hours of sleep per night. Everyone is overly focused on food, water and exercise, all of which are extremely imperative to weight loss and optimal health. However, without proper sleep, all of these the other factors are null and void. When you don’t get enough sleep, levels of the hormone leptin drop, which increases appetite. This surge in appetite makes comfort food more appealing, which can derail weight loss efforts.” — Jay Cardiello, celebrity fitness and nutrition expert


Fathi, Y., Faghih, S., Zibaeenezhad, M. J., & Tabatabaei, S. H. (2016, February). Kefir drink leads to a similar weight loss, compared with milk, in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women: A randomized controlled trial. European Journal of Nutrition, 55(1), 295–304. Retrieved from https://link.springer.com/article/10.1007/s00394-015-0846-9
1 Pelsser, Lidy M., Klaas Frankena, Jan Toorman, Huub F. Savelkoul, Anthony E. Dubois, Rob Rodrigues Pereira, Ton A. Haagen, Nanda N. Rommelse, and Jan K. Buitelaar. “Effects of a Restricted Elimination Diet on the Behaviour of Children with Attention-deficit Hyperactivity Disorder (INCA Study): A Randomised Controlled Trial.” The Lancet, vol. 377, no. 9764, 2011, pp. 494-503.
The Zone diet is a high-protein, low-carbohydrate, fat-controlled eating plan. It is not as restrictive as other high-protein diets and it allows for a broad range of foods to be consumed. A small amount of protein is combined with twice the amount of "favorable" carbohydrates, including fruits and vegetables. If choosing "less desirable" carbohydrates, the portion size is smaller. Sears' Zone diet is based on the theory that the human body is genetically programmed to reach peak efficiency when all meals, including snacks, consist of a set caloric ratio of carbohydrates, proteins, and fats. The diet recommends an intake of 40% of calories from carbohydrates, 30% from protein, and 30% from fats (40-30-30). When this ratio is achieved, the body is working within the "zone." The body will have maximum energy and weight loss.
As chronic obstructive pulmonary disease (COPD) advances, about 35% of patients experience severe weight loss called pulmonary cachexia, including diminished muscle mass.[32] Around 25% experience moderate to severe weight loss, and most others have some weight loss.[32] Greater weight loss is associated with poorer prognosis.[32] Theories about contributing factors include appetite loss related to reduced activity, additional energy required for breathing, and the difficulty of eating with dyspnea (labored breathing).[32]
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