Vitamins! Why are they so important after wls...

Vitamins and minerals are essential to our lives and they help us to have a healthier body, now that you have gone through a WLS they are more important so you can continue to be healthy and stay that way...

But why are they important?

Let’s put it this way, your body needs the right amount of the right vitamins and minerals to work at its full potential not just to keep you healthy, and also it can relate to a better weight loss.

Vitamins do regulate core processes such as:

• ·         Appetite and hunger

• ·         Brain activity

• ·         Nutrient absorption

• ·         Metabolic rate

• ·         Fat and sugar metabolism

• ·         Thyroid and adrenal function

• ·         Energy Storage

Food is the best way to get the vitamins and minerals that your body needs, but sometimes we aren’t able to get the amount that we need from our everyday diet, that’s where the supplement comes in...

Here comes the best part after what you as a WLS patientneed to know...! After a bariatric surgery your body is more vulnerable to vitamin deficiencies (depending on the procedure), that’s because the procedures normally reduces the body’s ability to absorb vitamins (malabsorptive procedures), another one is that it doesn’t allow your body to hold as much food from which to draw vitamins (restrictive procedures) or it can go both ways.

In addition, as many as 80% of bariatric surgery patients don’t get enough vitamins before surgery, so the right bariatric diet and bariatric vitamins are that much more important following surgery.

Primarily Malabsorptive:

• ·         Duodenal Switch

• ·         Laparoscopic Gastric Bypass Surgery

• ·        Mini GastricBypass Surgery

Primarily Restrictive:

• ·         Adjustable Gastric Banding (Lap Band Surgery)

• ·         Gastric Sleeve Surgery

• ·         Vertical Banded Gastroplasty

Making sure your body has the right amount of each vitamin will keep you healthy, help you lose weight and help your body keep the weight off!

Now let’s talk about gastric sleeve and which vitamins I have to be aware of as we all know a GS is a restrictive surgery so there is possibility on deficiency on some vitamins such as:

• ·         Thiamin (Vitamin B1)

• ·         Folate

• ·         Vitamin A

...So just be aware and try to find more resources of food to get the amount that is needed.

What happens when you don’t take the vitamins that you need?

Not having regular checkups (blood test) or ignoring the doctors or nutritionist guidelines can have severe problems on a long run. Some of these problems can be caused:

• ·         Calcium deficiencies (Can lead to osteoporosis)

• ·         Iron deficiencies ( Can cause anemia (when your body does not have enough red blood cells to carry oxygen throughout the body), increased feelings of fatigue and hair loss)

• ·         Folate (Folic Acid) deficiency (Can also lead to anemia)

• ·         Protein Deficiency (protein is one of the most important components of your body as it makes up most of your major organs. Not getting enough can lead to a myriad of problems, including muscle deterioration, organ failure, gallstones and even death)

• ·         Thiamin (Vitamin B1) deficiency (affects the heart, digestive system and nervous system. If not caught and treated quickly, learning and memory could be permanently affected. Ultimately, coma and death could be the result)

• ·         Vitamin A deficiency (Can lead to night blindness and increases the risk of disease and death from severe infections. During pregnancy after weight loss surgery, it increases the risk of night blindness and child mortality)

• ·         Vitamin B12 (can cause fatigue and tingling in the hands and can eventually lead to anemia and neurological disorders)

• ·         Vitamin D deficiency (can lead to liver and kidney disorders and bone softening diseases)

• ·         Vitamin E deficiency (causes neurological problems, anemia and can cause wounds to heal more slowly0

• ·         Vitamin K deficiency (increases the risk of osteoporosis and heart disease and can cause you to bruise more easily)

• ·         Zinc deficiency (will give you brittle nails and can lead to hair loss)

The only way to be aware if you have a deficiency in any vitamin is through a blood test. Symptoms that start to appear are often confused with other bariatric surgery side effects and aren’t often diagnosed by a physical exam.

In short, take bariatric vitamins very seriously. If you’re not prepared stick to a strict regimen forever, don’t move forward with surgery.

www.longtermvsg.com

How do I start a healthy post bariatric diet?

The change Starts Here and I can help you get there, with Determination and Will Power que can make it happen, but before you enroll in this life changing adventure these are the things that you have to know and have to do to make it happen...

Three basic goals you have to follow:

1. GET EVERYTHING READY – Food shop weekly. Think about what you will eat during the week, buying the foods from all food groups to build your menu. Each food group contributes different nutrients that are needed for good health.
2. PREPARE FOR MEALS – Think ahead each week to what meals you will be preparing for breakfast, lunch, and dinner and do some preparation ahead of time.
3. SCHEDULE YOUR MEALS – Eat meals close to the same time every day. When you follow an eating schedule you are less likely to eat the food you should avoid. You will burn more calories and your metabolism will work more efficiently.

Very important aspects to take in consideration:

•        Eat protein foods first

•        Eat within one hour of waking up

•        Schedule small meals approximately every 3–4 hours

•        Chew foods well and eat slowly (at least 30 minutes)

•        Don’t drink with meals

•        DO NOT drink carbonated beverages such as soda

•        DO NOT smoke

•        Eat until satisfied or have met meal size

•       Sip fluids slowly

•       Continue taking your vitamin and mineral supplements daily

DO NOT DRINK YOUR CALORIES!!

Liquids will pass through the reduced stomach pouch quickly and you will not feel full.  This is a great way to gain all your weight back, we share you some liquids/drinks you should avoid:

• High calorie drinks                                  • Special coffee drinks

• Beverages made with sugar                     • Soda

• Alcohol                                                   • Juice (no more than ½ cup daily)

• Milkshakes

PAY ATTENTION TO PORTION SIZES!!

1. Keep portion sizes small

1. See handout on food groups

To ensure long range success at losing and maintaining your weight loss follow the recommended servings as a guide... Keep in mind that you will stop eating when your hunger is gone or when you feel comfortable.

• Continue to use a scale and measuring cups consistently to keep yourself in check.

• Continue to eat small pieces of food and chew your food thoroughly and eat slowly.

EAT ON A SCHEDULE!!

You will increase your chance of success if you follow an eating routine of planning meals at the same time frame daily. Keep yourself in check once in a while by writing a food journal.

AVOID HIGH FAT FOODS:

• Fast food                                     • Junk food (chips etc.…)

• Dining out often                           • Donuts, cakes, cookies, pastries, chocolate

• Fried foods                                   • High fat meats like bacon and sausage

• Creams & Gravies                          • High fat casseroles

• Foods made with cream or gravy    • High fat convenient foods (frozen pizza, boxed meals)

• High fat dairy (cheese, ice cream)

CONSUMING HIGH-FAT FOOD ON A REGULAR BASIS COULD CONTRIBUTE TO WEIGHT REGAIN!!

 •The food you eat should be as healthy as possible. Your small stomach pouch can only hold about a 1 cup – 1 ¼ cup of food.  Therefore your goal is to attain the highest quality nutrient intake with a minimal volume of food.

•Your meal plan needs to be high in protein, vitamins and other important nutrients to be successful at attaining a healthy lifestyle. 

•To increase satiety, try to plan meals and snacks by combining carbohydrate foods with protein, fiber and a small amount of fat. 

•A well planned meal should satisfy feelings of hunger for three to four hours and provide the energy you need as you progress through the day.  Sources of carbohydrates and fiber include whole grains, fruits and vegetables.  Protein sources are lean meats, meat substitutes and low fat dairy.

POTENTIAL PROBLEM FOODS:

Some foods have difficulty passing through the opening of the stoma and may cause blockage.  These include foods such as:

•red meat (beef and pork)                                  •nuts

•shrimp                                                              •coconut

•untoasted or doughy bread                                •popcorn

•pasta                                                                 •greasy food or fried food

•rice                                                                    •seeds and skins of fruits and vegetables

•peanut butter                                                    •membrane of citrus fruits

•dried fruit                                                         

•fibrous vegetables like corn, asparagus and celery*

*Fibrous food should be avoided as they have the potential to block the stomach...  If you would like to eat asparagus or other fibrous foods once in a while, then you must be sure to cook them well, cut them into very small pieces first and then chew thoroughly.

www.longtermwls.com

Nutrition - Pregnancy after weight loss surgery…

Will my baby be able to get enough nutrients?

Pregnancy after gastric bypass can be safe and healthy if managed well by you and your health care provider. In fact, research suggests that pregnancy after weight-loss surgery might be safer for both mother and baby than pregnancy complicated by obesity.

Although more research is needed, studies suggest that weight-loss surgery might protect obese women and their babies from obesity-related problems during pregnancy. Examples include gestational diabetes, and preeclampsia — high blood pressure and signs of damage to another organ system, often the kidneys, after 20 weeks of pregnancy.

If you have had weight-loss surgery and are considering pregnancy, consult your health care provider for preconception planning. You might also consult a registered dietitian along with your gastric bypass surgeon for advice on nutrition and weight gain during pregnancy.

Experts typically recommend postponing pregnancy until your weight stabilizes — typically at least 12 to 18 months after surgery. Some experts recommend waiting longer. Rapid or persistent weight loss might deprive a growing baby of important nutrients, leading to low birth weight. To monitor your baby's growth, your health care provider might recommend a fetal ultrasound during the third trimester....

What you really need to know about protein... Life after weight loss surgery

When you step into a health food store or a vitamin shop, there is often an abundance of protein supplements to choose from and sales people claiming they are “nutritionists” trying to sell you the best liquid or powder protein products on the market....

Why is protein important?

Proteins are a part of every cell, tissue and organ in our bodies. These body proteins are constantly being broken down and replaced. The body does not store protein for later use, therefore consuming adequate high quality protein is necessary, otherwise the body will inevitably suffer. When protein intake is not adequate, the body will break down lean body mass to compensate for poor oral intake. Loss of lean body mass is inevitable for WLS patients or individuals following a very low calorie diet. To minimize that loss, sufficient high-quality protein must be consumed.

When should liquid or powder protein supplements be used?

Most WLS patients rely strictly on liquids during the early post-operative phase, and the majority of their calories consumed during that time are often from protein supplements. Liquid or powder protein supplements may also be used post-operatively when patients are unable to consume adequate protein from food alone. This may be due to volume restrictions or food intolerances to protein rich foods.

Is there a risk of developing protein deficiency?

WLS patients, who have undergone the BPD/DS, are often at a higher risk of developing protein malnutrition. However, all WLS patients, despite the procedure, who do not comply with the recommended dietary guidelines, are at risk.

What is the best quality liquid or powder protein supplement?

Commercial protein supplements are available in many flavors, textures, tastes, mix-ability and price; however, the product’s amino acid composition is of the most importance when choosing protein supplements. Amino acids are the building blocks of protein. There are nine indispensable (essential) amino acids (IAA) and 11 dispensable (nonessential) amino acids (DAA). The IAA must come from dietary intake because the body is incapable of producing these compounds.

Also, it is important when choosing protein supplements that they have a score of 100 on the protein digestibility corrected amino acid score (PDCAAS). This is a system that was developed as a method to evaluate protein quality. PDCAAS scores of as close to 100 as possible are desired to indicate that it contains the appropriate amount of IAA that the body needs.

Protein supplements that are made from whey, casein, soy and egg whites have a PDCAA score of 100. It is important to recognize that many of these protein sources are sold as either concentrates or isolates.

Isolates

In general, isolates tend to have a higher concentration of protein than concentrate forms. For whey protein isolates, the filtration process removes a lot of the lactose, minerals and fat in the product; therefore, these products have very little or no lactose and often provide more protein in smaller volumes. These products may be beneficial to those patients who have lactose intolerance. Also, isolates tend to have a better mix ability and cleaner taste, therefore compliance is often better with these products.

Concentrates

Whey protein concentrates have a lower concentration of protein and higher concentration of lactose. Although the protein is of good quality, the percentage of protein will vary. Consumers can always view the nutrition label as well for accurate quantities of protein.

Many surgical weight-loss programs recommend between 60-80 grams of protein per day for the vertical sleeve gastrectomy (VSG) and the Roux-en-Y gastric bypass (RYGB). The biliopancreatic diversion with duodenal switch (BPD/DS) requires approximately 90 grams of protein per-day to accommodate for the malabsorption associated with this procedure.

Protein supplements and meal replacement shakes – they are different

It is important to also recognize that there is a difference between protein supplements and meal replacement shakes (i.e. Unjury® vs. SlimFast®). Many meal replacement supplements often have a blend of soy, casein or whey protein to enhance the texture or taste of the product. Meal replacement shakes also have higher amounts of vitamin and minerals and varying amounts of carbohydrates and fiber.

One thing to consider is that meal replacement shakes are often designed to supplement a diet that includes animal and plant sources of protein. These should not be used as the sole source of protein or calories in the diet for an extended period of time.

What protein supplements should be avoided?

Collagen-based protein supplements are not a good source of high-quality protein and should not be used as the sole source of protein intake in WLS patients. Collagen-based protein supplements do not contain all of the indispensable amino acids that the body needs. When consuming collagen-based products as your sole source of protein, the loss of lean body mass can occur despite meeting your daily protein goals.

Do WLS patients need liquid or powder protein supplements for life?

As you begin to consume more food after surgery, the need for protein supplementation often declines or ceases. Relying solely on protein supplements to meet your protein needs is not recommended after the early post-operative liquid stage. Foods of high biological value are encouraged (meat, poultry, fish, eggs, milk, etc.). WLS patients who cannot meet their protein needs from food alone may benefit from supplementation of high quality protein.

What are the dangers of excessive protein intake?

If you are not well hydrated, excessive protein intake may contribute to dehydration. It is also important to remember that additional protein intake, above the recommended amount, may inhibit the consumption of other important nutrients.

Another reason why eating protein is good for you… It Prevents Emotional Eating!!

By having your Daily Protein intakes it helps you to be satisfied and stay satisfied for longer periods of time...

Control Dumping syndrome with food!

What is dumping syndrome? Is a condition or problem commonly developed on people who have gone through bariatric surgery, its basically when the solid part of a meal gets “dumped” directly from the stomach in to the small intestine without being properly digested, causing discomfort and malnutrition to the patient.

Dumping syndrome signs! Most of this symptoms are experienced from 10 to 30 minutes after eating…

·         Fatigue or Weakness

·         Flushing or Sweating

·         Abdominal cramping or pain.

·         Shakiness, Dizziness, Fainting, or passing out.

·         Loss of concentration or mental confusion

·         Rapid Heartbeat

·         A feeling of fullness even after eating just a small amount.

How to reduce dumping syndrome?

Reduce dairy products and alcohol, avoid eating solids and drinking liquids during the same meal. In fact, don't drink 30 minutes before and 30 minutes after meals…

Avoid eating sugar and other sweets such candy, sweet drinks, cakes, cookies, pastries, sweetened breads…

Recommended type of food:

·         Use Fiber Supplements! Such as psyllium (Metamucil or Konsyl), methylcellulose (Citrucel), or guar gum (Benefiber).

·         Use sugar replacements, such as Splenda, Equal, or Sweet’N Low.

·         Go for complex carbohydrates, such as vegetables and whole-wheat bread, instead of simple carbohydrates, such as sweet rolls and ice-cream.

·         To prevent dehydration, drink more than 4 cups of water or other sugar-free, decaffeinated, noncarbonated beverages throughout the day.

Other tips to treat Dumping Syndrome after bariatric surgery…

·         Eat five or six small meals or snacks a day. 
·         Keep portions small, such as 1 ounce of meat or 1/4 cup of vegetables.  
·         Cut food into very small pieces. 
·         Chew well before swallowing.  
·         Combine proteins or fats along with fruits or starches. (For example, combine fruit with cottage cheese.)  
·         Stop eating when you first begin to feel full.  
·         Drink liquids 30 to 45 minutes after meals.  
·         Reclining after eating may help prevent light-headedness.

www.longtermvsg.com

10 General advises to have a good and healthy life changing meal plan!

1.-Plan your meals!

Once you get any bariatric procedure you cannot wait 3 hours before you eat to start thinking on what you are going to cook, this can cause a poor choice on what you are preparing o it doesn’t let you choose food with good nutrients

2.-Join support groups!

It is really important that you surround yourself with people that have gone under the same procedure, that way you can share experiences, share meals, exercises and keep on helping you stay on track.

One of the perks of going under surgery with Long Term WLS / VSG is that we have that support group you need, that we will help you make that positive change in your life and it also has a Nutritionist that you can find Monday through Friday in the mornings.

https://web.facebook.com/groups/758719204236937/

3.-Put yourself real goals!

Remember to achieve your goals and don’t have to feel like you are doing too much you have to be patient and take things one step at a time.

You can start by suppressing bad eating habits and start adding the new and healthy eating habits to your new lifestyle.

4.-Establish short time goals!

Starts by Meals have what you are going to be eating and how you are going to prepare it. Then with exercises and try to do this every two weeks, it’s better to establish weekly goals that you can keep track on than monthly goals.

5.-Avoid Snacks!

This is really important you have to teach your stomach to have 5 full meals a day, no snacks!!

That way you can have a better digestion and make sure that you are eating healthy.

6.-Do your groceries right!

Make sure that you buy more vegetables, fruits, high protein food and food that helps your digestion.

7.-Serve your meal in small plates!

When you do this you’ll feel like you are eating a whole meal and also you’ll start training your mind to eat small portions of food.

8.-Start knowing when it’s hunger and when its anxiety!

Sometimes we eat depending on how we feel or what we feel, it’s really important to eat only when we are really hungry and going to eat full meal or also when you are scheduled for your meal.

9.-Watch less TV!

Try switching your habits go out more, take long walks, do outdoor activities, this will help you to improve your lifestyle, also when watching TV normally you see a lot of fast food advertisements and believe this only pushes your cravings for junk food, that’s why I recommend being more active.

10.-Exercise more often!

Instead of being bored or watching long hours of TV do more workout activities, this will ensure a better calorie burn and a better digestion.

Remember that a healthy lifestyle is not easy to achieve, but it’s not impossible.

Always have a Healthy mind in a Healthy body…