Bookmark Website  | Free Registration  | The Team
The Lounge  | Champions  | The Wire |  Schedule |  Audio  |  Arcade  |  The Top Ten  |  Historical  |  Email  |  Video

Dietary Recommendations After Gastric Bypass Surgery


When obesity gets out of hand, unresponsive to dietary, lifestyle and medical interventions, drastic measures are needed to cut down calorie intake. Morbid obesity with a BMI (body mass index, a measure of malnutrition) above 40 kg/m2 is an indication for surgical procedures such as gastric bypass surgery. Gastric bypass is now a well-trodden path to lower BMI's and achieve healthier lives in 18 months or so. First used in the 1950's, only the last two decades have seen safe and successful gastric bypass surgery with any consistency. Half a century of meticulous observations and patient follow-up has led to the formulation of strict guidelines to ensure desired results.

Gastric bypass is a series of steps initiated starting with the decision to undergo the procedure. Identifying existing nutritional deficiencies is the first step towards surgery. Vitamin and mineral deficiency often occur in obesity, and need to be addressed before the procedure. The surgery itself has two goals; to reduce the volume of the stomach and shorten the food transit time in the intestine. After surgery the stomach cannot receive large meals or participate in digestion. This by itself limits food intake. Food also bypasses a large part of the intestine and has little time to interact with liver and pancreatic enzymes. As a result, nutrition absorbed from diet drops drastically. In most types of gastric bypass surgeries done today only 50 cm of the intestine is allowed to function in normal fashion. Compare this to food absorption taking over 7 feet of small and large intestine before surgery.

With such a radical reduction in the capacity to assimilate food, the postoperative period can be rather tricky. Only clear fluids are advised for the first two days while waiting for gut to recover. The gut is then re-trained for about two months before it can go back to a normal diet. During the recovery period the limitations imposed by the gastric bypass procedure should be kept in mind. After surgery the stomach has become much smaller and can only hold approximately eight ounces at a time. The stomach has also lost its ability to pulverize food to initiate digestion. Consequently the appropriate diet for postoperative recovery would be a liquid to soft solid diet that can be taken six to eight times a day in small quantities. Nutrient fluids are preferable since they can provide hydration and energy at the same time. Non-nutrient fluids are best avoided or at least restricted to in-between meals.

The type of nutrient chosen also deserves due consideration. The chosen macronutrient should not affect the stomach emptying time while providing enough energy to recover from the surgery. In this regard carbohydrates and fats are at either end of a spectrum and neither is suitable. Carbohydrates pass through very quickly and produce very uncomfortable symptoms like vomiting, bloating, diarrhea and sweating. Fat slows the gut considerably, and it is oftentimes ruled out because of its direct link to obesity. Research suggests that the macronutrients of choice after gastric bypass surgery are proteins. Proteins do not change gastric transit time significantly. A high-protein diet can also provide enough amino acids for repair and growth after a major surgical procedure like gastric bypass.

Apart from these advantages, a high-protein diet has a special role in the treatment of obesity. Gastric bypass restricts excessive calorie intake to prevent weight gain. However, accumulated adipose tissue also needs to be expended to achieve the desired weight loss. The basal metabolic rate (energy expenditure) should be increased simultaneously to burn stored fat and reduce BMI. This can be achieved by a high-protein diet since proteins in diet increase the basal metabolic rate by stimulating protein synthesis. Observations made during the postoperative period also confirm this proposition. Unless a high-protein diet is provided, weight loss often ceases despite controlled consumption.

Currently, a protein intake of up to 90 grams per day is recommended in the post-operative period. Given the trauma and the limitations the gut is subjected to during the procedure, such a high protein intake can be difficult to maintain. The gut is hardly ready and often fails to assimilate proteins and energy from traditional foods and diets. Therefore, a sugar-free fluid protein concentrate with a high bioavailability, adequate essential amino acids, vitamins and minerals is the most appropriate diet in the post-operative period. Digestion is further facilitated if the protein concentrate is already pre-digested, or hydrolyzed. Such a nutrient fluid can simultaneously supply concentrated energy and hydration even when taken in small quantities.

After recovery and return to a normal diet divided over 3 to 4 meals per day, a high-protein concentrate is still a relevant supplement between or during meals. The protein supplement continues to provide thermogenic action necessary to lose weight essential to sustain weight loss. It also compensates for any amino acid deficiency in the diet and maintains nutrition on bad days not uncommon in the months and years after a major surgery.

ABOUT PROTICA

Founded in 2001, Protica, Inc. is a nutritional research firm with offices in Lafayette Hill and Conshohocken, Pennsylvania. Protica manufactures capsulized foods, including Profect, a compact, hypoallergenic, ready-to-drink protein beverage containing zero carbohydrates and zero fat. Information on Protica is available at http://www.protica.com

You can also learn about Profect at http://www.profect.com

REFERENCES

1. Kellum JM, DeMaria EJ, Sugarman HJ. The surgical treatment of morbid obesity. Curr Prob Surg. 1998;35:791-858.

2. MacLean LD, Rhode BM, Nohr CW. Late outcome of isolated gastric bypass. Ann of Surg. 2000. 231:524-528.

3. Nutritional Implications of Bariatric Surgery: Perspectives of Practitioners Audiotape/Handout packages available post-conference.

4. Weight management-Position of ADA. J Am Diet Assoc. 2002;102:1145-1155

5. Faintuch J, Matsuda M, Cruz ME, et al. Severe protein-calorie malnutrition after bariatric procedures. Obes Surg 2004; 14:175-181.

6. Alvarez-Leite J.I. Nutrient deficiencies secondary to bariatric surgery. Curr Opin Clin Nutr Metab Care 7:569-575.

Copyright Protica Research - http://www.protica.com


MORE RESOURCES:

Weight loss on antipsychotics is possible: study
Reuters
The intervention resulted in a relatively modest weight loss, and did not depend on the type of medication, said Dr. Daniel J. Mueller, who has done research on ways to improve psychiatric drug treatment at the Center for Addiction and Mental Health in ...

and more »


CNN

From 'sumo wrestler' to distance runner
CNN
For others trying to lose weight, Kirimoto says don't forget to enjoy the journey you're on. "Make (exercise) an exciting adventure," he said. "Everyone is different. Consistency is the key to both weight loss and fitness. You may not see results ...

and more »


Doc Offers Glimpse Into Arena Pharma Weight-Loss Combination Therapy
TheStreet.com
BOSTON ( TheStreet) -- The Areniacs -- my term of endearment for the retail-investor supporters of Arena Pharmaceuticals (ARNA) -- have been burning up the Internet message boards for the past few days with talk of weight-loss results from a ...



CNN

Rosie O'Donnell, Whoopi Goldberg swap weight-loss stories
CNN
(CNN) -- "The View" returned to TV on Monday with a new set, two new faces and a pair of returning hosts who've spent their time away focusing on their health. During the season premiere, the revamped "View" cast, which now includes Rosie Perez and ...
Rosie O'Donnell on her 53-pound weight loss: It's filled with 'emotional ...New York Daily News
Rosie O'Donnell says weight loss came with 'emotional turbulence'Los Angeles Times
Rosie O'Donnell shows off massive weight loss on TV returnSFGate (blog)
People Magazine
all 374 news articles »


UAB study examines skipping breakfast, weight loss
WKRC TV Cincinnati
Emily Dhurandhar, the study's lead author, said, “Now that we know the general recommendation of 'eat breakfast every day' has no differential impact on weight loss, we can move forward with studying other techniques for improved effectiveness. We ...



Middlefield men make big gains on 'Extreme Weight Loss' show
News-Herald.com
Submitted Jayce Hein, a native of Middlefield and graduate of Cardinal High School, recently was featured on the ABC-TV series "Extreme Makeover: Weight Loss Edition." A loss of 188 pounds resulted in multiple benefits for Hein, including significantly ...



Weight Lifting Can Boost Your Weight Loss Efforts
The Epoch Times
As noted in a Nerd Fitness blog discussing the merits of weight lifting, while your overall weight loss in terms of pounds may appear slower, you will tend to lose inches faster. This is in part because, unlike traditional cardio, strength training ...

and more »


Powdered weight loss drug leads to charges against Montgomery woman
Aurora Beacon News
A Montgomery woman was charged with trying to pass off a weight loss drug as cocaine after she was stopped during a drug operation by Aurora police on Thursday. According to an Aurora Police Department incident report, officers were conducting a drug ...



Detroit Free Press

FDA approves a third new weight-loss pill
Detroit Free Press
For the third time in about two years, the Food and Drug Administration has approved a new weight-loss pill. Contrave got FDA approval Wednesday. The medication is made by Orexigen Therapeutics Inc., San Diego, and will be marketed by Takeda ...
Novel weight-loss drug is approved to treat obesityEconomic Times
FDA gave green light to weight loss pill Contrave. What you need to knowTech Times
FDA Approves New Weight-Loss PillNews Channel Daily
Huffington Post -Pharmacy Practice News
all 12 news articles »


Reno Gazette Journal

Diet and exercise work hand-in-hand for weight loss
Reno Gazette Journal
"While diet and exercise both play an important role in weight loss, what we consume definitely holds the upper hand in terms of making or breaking your success," said Elise Mische, RD, LD, nutrition and weight-loss specialist at Saint Mary's Fitness ...


Google News


Advertisement



Section Site Map - Submit News - Feedback - Comments - Advertise with Us

Copyright 2006 Luminati Inc. All rights reserved.