Wiro Sableng #167 : Fitnah Berdarah Di Tanah Agam

Wiro Sableng #167 : Fitnah Berdarah Di Tanah Agam Cerita Motivasi dan Inspirasi Nomor 1WIRO SABLENG

Pendekar Kapak Maut Naga Geni 212

Karya: Bastian Tito

Episode : KUPU-KUPU GIOK NGARAI SIANOK

UNTUK beberapa lama nenek berjuluk Si Kamba Mancuang Tangan Manjulai masih memegangi kain putih yang muncul secara tidak terduga dalam keadaan tergulung pada sebatang potongan bambu dan menancap di tanah, sementara beberapa tokoh silat yaitu Ki Bonang Talang Ijo, Perwira Muda Teng Sien, Pandeka Bumi Langit Dari Sumanik dan Tuanku Laras Muko Balang yang ada di situ memperhatikan. Di atas kain putih terdapat tulisan yang memberi tahu bahwa orang yang membunuh Duo Hantu Gunung Sago Si Kalam Langit adalah Wiro, yang disebut sebagai pemuda Jawa berambut panjang, berjuluk Pendekar 212 Wiro Sableng.
Setelah ditanggalkan dari batang bambu si nenek akhirnya serahkan kain putih pada Ki Bonang Talang Ijo, tokoh silat dari tanah Jawa yang bertindak selaku pimpinan pencarian kupu-kupu batu giok yang lenyap secara gaib dari tempat asalnya di Kotaraja Kerajaan Tiongkok.

"Ki Bonang, baca tulisan ini. Aku ingin tahu bagaimana pendapatmu."

Kakek bermuka hijau ambil kain putih yang diserahkan dan segera membaca apa yang tertulis di atas kain itu. Selesai membaca dia berp
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What Is “Abnormal” Body Fat?

What Is “Abnormal” Body Fat?


What Is “Abnormal” Body Fat?

Posted: 28 Sep 2016 05:00 AM PDT

sharma-obesity-fatty-liver-diseaseThe WHO defines obesity as the accumulation of excess or abnormal body fat that impairs health.

While many folks have no problem seeing how “excess” body fat can often lead to health problems, they may wonder what exactly is meant by “abnormal” body fat and are perhaps unsure as to why this would be included in the definition of obesity.

This is where we need to take a moment to remind ourselves that fat tissue is actually a vital organ, without which, we would experiences all kinds of health problems. Not only, is our ability to store excess calories vital to prepare for the next major illness or famine, it is also a vital organ for reproduction (women stop having periods when their fat stores get too low).

That said, the safest place to store all those excess calories is in your fat tissue, especially the fat tissue directly underneath your skin. This is where the excess calories cause the least trouble, not affecting the functioning of other organs or clogging up your blood stream, and where they can sit for decades, until they are perhaps one-day called upon in a time of need.

It is also “normal” to have a small amount of fat in other depots such as around the gastrointestinal tract, the heart, or the kidneys – here the fat serves both a mechanical and immunological function – again, the fat here generally does not cause any health problems (indeed, lack of fat in these locations may).

All of this is not very interesting from a medical or health perspective, as this kind of fat generally does not cause any real health problems, unless, it perhaps expands to a size that causes mechanical issues simply due to its sheer mass.

In contrast, the term “abnormal” refers to fat accumulation in parts of the body where you would not normally find fat in a “healthy” person. This, is commonly referred to as “ectopic” fat and refers to fat accumulation within organs like the liver, pancreas, heart, skeletal muscle or other organs, where you would rather not have any fat.

These “abnormal” fat accumulations can substantially disrupt organ function, leading to all kinds of metabolic problems.

Interestingly enough, there is not a very strong relationship between the total amount of body fat and the location of that body fat.

The extreme example of this is seen in patients with lipodystrophy, who, being unable to store excess calories in “normal” subcutaneous fat depots, deposit their fat in the liver and other organs, thus presenting with all of the problems generally associated with obesity.

Exactly why some people are more prone to “ectopic” fat deposition that others, who can apparently tuck away all their extra calories underneath their skin with little, if any, impact on their health, remains largely unknown, except that genetics appears to play a very substantial role.

But, whatever the reason, the bottom line remains that even very little extra body fat, if stored in the wrong location, can cause all of the metabolic problems generally associated with obesity.

In contrast, even large amounts of body fat, if safely sequestered away in subcutaneous depots may have little (if any) impact on health.

This is why the WHO included both the presence of “excess” as well “abnormal” body fat in their definition of obesity.

Again, none of this can be measured by stepping on a scale or looking at a BMI chart.

If your excess or abnormal body fat affects your health – you have obesity – if it doesn’t, you don’t.

@DrSharma
Edmonton, AB

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Dance it’s my Life

Dance it’s my Life Cerita Motivasi dan Inspirasi Nomor 1

Jauh hari ketika saya pertama kali menari di atas panggung saat kelas 2 SD lagu Buaya Darat Maia Estianti. Ajang antar RT yang diadakan saat Tujuh belasan, saat itu saya bersama teman-teman seRT saya menari dengan begitu lincah, ke kanan, ke kiri dan mellenggok lenggok. Saya tidak mengerti saat itu mengapa ibu saya semangat sekali saat saya akan tampil, bahkan untuk kostum dan lainnya ibuku menjahitnya langsung tanpa membeli. Setiap tahunnya terus seperti itu, hingga tahun terakhir sekitar tahun 2008 saat saya kelas 6 SD.

Kecintaan saya dengan tari semakin besar, sepertinya memang begitu. Yang mulanya saya hanya bisa menari Modern saja kini sudah merambah ke mana-mana. Ya, ColourGuard. Saya mulai menyukai tarian sambil membawa bendera yang biasa berada di Marching Band. Saya memulainya sekitar kelas 2 SMP hingga sekarang. Alhamdulilah saya bisa mengikuti Lomba tingkat Nasional dan di anugrahi Juara 1 se-Indonesia yang di adakan di Bogor. Kecintaan saya semakin besar sehingga bisa di percaya menjadi Asisten Pelatih di salah satu Unit besar
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There Is No “Healthy” Obesity

There Is No “Healthy” Obesity


There Is No “Healthy” Obesity

Posted: 27 Sep 2016 05:00 AM PDT

sharma-obesity-bmi-ripRegular readers may recall past posts on the issue of “healthy” obesity – i.e. the research on people, who despite meeting the (rather arbitrary) BMI criteria of obesity, appear perfectly healthy.

Now, following on my previous posts on using the actual WHO definition of obesity, as the presence of abnormal or excess body fat that impairs health, I believe it is time to fully abandon the term “healthy obesity”.

After all, if we apply the WHO of obesity, you don’t have obesity till your body fat actually impairs your healthy – if it doesn’t, the medical term “obesity” does not apply to you – no matter what your BMI!

In fact, I may even have to go back and drop Stage 0 from the Edmonton Obesity Staging System.

I would give you that having Stage 0 (absence of any medical, mental or functional issues related to your body fat), no longer justifies the use of the term “obesity” in the first place.

What does this mean for the entire field of obesity?

Well, for one, all textbooks and guidelines are plain wrong, as they continue to rely on BMI as a “defining” criterium (rather than just a screening tool).

In fact, almost the entire literature on obesity may need to be taken with a spoon of salt, given that virtually all of the research on “obesity” defines this condition based on BMI and includes both “healthy” and “unhealthy” people above this arbitrary size-cutoff.

I also suggest that all the folks working on the topic of “healthy obesity” begin using the term “healthy adiposity” instead.

Think of the many implications of this precise use of the medical term “obesity” for policies, guidelines, regulators, and in fact anyone who writes about this issue.

Is all of that going to change overnight?

Or even in a decade?

Who knows?

But if we are serious about calling obesity a “chronic disease” (as done by the American and Canadian Medical Associations), let us make sure we do not apply this medical label for all “fat” people.

Let us reserve this medical term for individuals who actually have demonstrable health consequences from their body fat.

Not only would a substantial number of people with BMI’s over 30 no longer be considered to have obesity.

Perhaps, even more importantly, a very substantial number of people whose (ectopic?) body fat is affecting their health, will find themselves now diagnosed with “obesity”, even if their BMI falls well below 30.

Let’s stop using a measure of size as a measure of health.

@DrSharma
Edmonton, AB

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Non-Smokers Die of Lung Cancer and Teetotalers Die of Liver Cirrhosis

Non-Smokers Die of Lung Cancer and Teetotalers Die of Liver Cirrhosis


Non-Smokers Die of Lung Cancer and Teetotalers Die of Liver Cirrhosis

Posted: 26 Sep 2016 05:00 AM PDT

cause-effectIn all of my interactions with people who believe that the obesity epidemic is vastly overblown and that the links between excess body fat are imagined, I often hear the argument that obesity cannot “cause” [chose your health problem here] because “normal-weight” people can have [same health problem] too!

This is a rather naive argument, pretty much along the lines of, “Tobacco cannot cause lung cancer because non-smokers can get lung cancer too, or alcohol cannot cause liver cirrhosis because teetotalers get cirrhosis too”.

Or, “Drunk driving cannot cause road accidents, because non-drunk drivers get into accidents too”.

Or, “Flu vaccines don’t work, because vaccinated people get the flu too”.

I could go on….

What is missing in this perspective, is a very basic understanding of multiple cause and effect, as well as a fundamental understandings of probability and risk.

Firstly, almost all medical conditions can have more than one cause. Thus, although most lung cancer is by far attributable to smoking, it is also seen with exposure to asbestos, other environmental toxins, and of course sporadic mutagenesis.

Similarly, there are a multitude of reasons why someone may get liver cirrhosis, but, at least in Western societies, alcohol consumption is by far the number one cause of this problem.

And yes, some vaccinated people do catch the flu, but most vaccinated people don’t and when they do, it turns out to be less severe than it would have been without the vaccine.

So, just because “normal-weight” people can also have hypertension, diabetes, fatty liver disease, sleep apnea, osteoarthritis, gastroesophageal reflux, urinary incontinence, plantar fasciitis, and a host of other conditions, does not “prove” that excess weight does not also “cause” all of these conditions.

Yes, skinny people can have sleep apnea too but the overwhelmingly vast majority of sleep apnea is seen in people with excess weight – the same goes for virtually every obesity related health problem.

The other argument I often hear is that obesity cannot be the cause of [chose your health problem here] because not all people with obesity have [same health problem].

This argument is likewise stupid!

The fact that not every smoker dies of lung cancer, in no way “proves” that smoking does not cause cancer.

The fact that not everyone who regularly drinks a lot of alcohol gets a cirrhotic liver, does not disprove the link between alcohol and cirrhosis.

This is where we need to understand the basic concept of risk and probability.

When a certain factor (e.g. excess body fat) increases the risk of a certain condition, it does not mean that everyone exposed to that factor ends up with the condition. It just means that the risk for that condition is vastly higher.

Now let’s add a further level of complexity to the concept of risk, because, as we know, body fat is not body fat is not body fat is not body fat!

Whether or not my body fat actually causes any health problem, depends on a wide range of factors ranging from my underlying genetic predisposition (e.g. for diabetes, hypertension, etc.), my fat location (subcutaneous vs. ectopic), the cellular structure of my fat (hypertrophic vs. hyperplastic), fat-tissue inflammation, and probably countless other factors.

Add to this, that risk for obesity related conditions can be substantially modified by other factors including physical fitness, healthy diets, positive body image, good mental health – it is easy to understand why defining “sick” and “healthy” simply based on a measurement (direct or indirect) of body fat makes no sense.

Thus, we need to ensure that the medical term “obesity” is not used to label everyone above a certain (arbitrary) BMI cutoff.

Rather, we should reserve the medical term “obesity” only for the condition where excess or abnormal body fat directly impairs the health of a given individual (the actual WHO definition of obesity!).

Someone with the exact same amount of body fat (or even more), who does not experience any health impairment should not be referred to as having “obesity” – that person is just “fat” (a word that really needs to be destigmatised!).

Personally, I couldn’t care less about how “fat” anyone is. Only when “fat” becomes “obesity” does it become a medical issue.

@DrSharma
Edmonton, AB

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