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.profect.com
Lincoln Stretch rentals Alsip ..Sometimes, just the thought of starting on a diet and... Read More
The words I read made me furious. There it was,... Read More
NLP Setting an Anchor Process to Get Back Motivation for... Read More
Recently, I won a family cruise on the Regis and... Read More
The following are diet tips that can help you shape... Read More
You are ready to shed those energy draining, body crippling,... Read More
The 3 day diet mixes certain types of foods that... Read More
Liposuction works best with people who are a normal weight... Read More
What a great world we live in. You want something,... Read More
Include in your diet things that contain more water like... Read More
People usually quit weightloss and exercise programs for one of... Read More
When we hear all the success stories of the gastric... Read More
We have such good weight loss intentions. We emotionally beat... Read More
Patrick Henry once said, "I have but one lamp by... Read More
The percentage of Americans who are overweight and obese is... Read More
More than 70% of US adults are overweight and that... Read More
It has been 15 years since I was diagnosed with... Read More
Negative thoughts, symbolic protection, being who we really are ........ Read More
It is a fact that about 70% Americans are overweight.... Read More
The human body is designed to run best on a... Read More
America loves fast food. Last year, consumers spent billions of... Read More
Ready for a hardcore diet to get lean in a... Read More
Atkins Nutritionals filed for bankruptcy at the beginning of August... Read More
America is a nation of self-disclosers, amiably acceptant of our... Read More
Whew! So how did you do on that last lesson?... Read More
Western Springs shuttle limo ..With all of the conflicting studies and fuzzy interpretation of... Read More
Are you considering a low carb diet? If so you... Read More
You know what is so amazing? We get to keep... Read More
At its most basic, dieting is about burning more calories... Read More
Debunking The Ab MythAb training has been done to death... Read More
Which diet is the best? ALL of them and NONE... Read More
Going away for your holidays will also bring with it... Read More
Many individuals these days, male or female, young or old,... Read More
What a great world we live in. You want something,... Read More
Lose The Weight For Good With The Seven Phases of... Read More
There has been a recent surge in the experts weighing... Read More
Why was the FDA trying to hide the facts about... Read More
Do you have a big event coming up? Perhaps you... Read More
If you want any weight loss program to work you... Read More
It's been called the world's oldest medicine, the miracle fat... Read More
Are you ashamed of your weight? Do you have a... Read More
What do you think of the hundreds of weight loss... Read More
As of the writing of this article, May 16, 2005,... Read More
Many people limit themselves to one soda a day especially... Read More
Have you noticed since your WLS and return to regular... Read More
Lets face it, most of us live pretty busy lives... Read More
Developed by Dr. Arthur Agatston, The South Beach Diet touts... Read More
Have you ever worried about something so much it paralyzed... Read More
It happens every morning when you mosey out of bed,... Read More
Reducing childhood obesity in the U.S. needs to be a... Read More
Weight Loss |