It’s important to understand Vitamin D metabolism and deficiency potential following weight loss surgery Vitamins after DS need to be followed via laboratory blood studies. There are basic vitamin needs but individual needs should be based on medical history, genetics, alimentary limb length, common channel length and other surgical and physiologic determinations. Vitamins after DS are a life long commitment as well as protein needs and hydration. Duodenal Switch is a malabsorptive procedure which requires at least yearly laboratory blood studies, daily vitamins/minerals, daily high protein and daily hydration intake. There is not an all in one vitamin that is adequate for a DS patient or tailored to your individual needs. (example: you may need more Vitamin D and less Vitamin A if you are taking a all-in-one vitamin you can’t get more of one and less of another vitamin)
DS patients are recommended to take Dry forms (water miscible form) of Vitamin A, D3, E, K due to the fat malabsorption after DS. Dry formulations by Biotech are processed so they can be absorbed by a water soluble method after the DS procedure. Vitamin D seems to be the vitamin that can become deficient the easiest, followed by Vitamin A. Take these vitamins away from dietary fat.
In some cases, patients may need injectable Vitamin A or D to improve vitamin levels.
Many DS surgeon’s do not recommend Children’s vitamins or chewable vitamins unless there is a specific reason or need for them.
DS Surgeon Blog on Vitamin D:
Webinar on Vitamin D metabolism:
Medications that effect Bone health:
This does not constitute medical advice, diagnosis or prescribing. It is simply a compiled list of gathered information. If you are in doubt or have questions please contact your medical healthcare professional.
Not all proteins are created equally. The protein that we digest serves as the source of the essential amino acids, (the building blocks which make up a protein). The essential amino acids can not be made in out body. Protein sources can be animal or plant based. We’ve written a in-depth explanation of protein sources in this previous blog: Protein Optimization
The proteins can also be decided into two categories:
1-High quality or Complete proteins
Complete proteins contain all the indispensable amino acids that we need. Animal based proteins for the most part are complete proteins. These include cheese, mean, fish, mild, yogurt, egg and poetry.
2-Low quality or Incomplete proteins
Incomplete protein are mostly plant based proteins. In most cases, the incomplete proteins either lack or have insufficient about of the one or a number of amino acids to be able to satisfy our nutritional requirements.
This is why we general recommend animal based proteins.
Following weight loss surgery there are some guidelines that can be helpful in our previous blog: Importance of Protein.
Join our 2018 Back on Track challenge and let’s get back on track for 2018! The holidays were wonderful but if you find yourself with a few extra souvenirs don’t feel alone. The average American gains between 1-8 pounds during the holiday season and I am no exception. Let’s get back on track 2018 together.
Time to clear out the kitchen! Disposing of temptations and high trigger foods is the first step to getting back on track. Throw it all away and don’t allow them back in. If foods are difficult to acquired then they are less likely to be consumed.
Stock up on high protein and whole, unprocessed foods that are low carbohydrate and nutrient dense. When quality foods are easily available we are more likely to stay on track with the types of foods we should be eating. Simple sugars/carbohydrates are the biggest culprit of holiday weight gain. We need to go back to the basics of hydration, high protein, low carbohydrate/sugar, vitamin/mineral supplements and exercise. Simple sugars and carbohydrates are easy for our bodies to use and absorb. Cutting them out can jump start your weight loss. Each individual needs to identify the daily carbohydrate intake that works for them. Some people stay under 50 grams of carbohydrates daily and some can tolerate more daily grams. You may also need to look at your protein and fat intake. All excess nutrients absorbed have the potential to turn into fat mass and inhibit weight loss. Metabolism video.
Hydration is an important ways to start getting back on track. Water is essential to life functions. The brain is 85% water, blood is 80% and muscle is about 70% water. Hydration aids in digestion, eliminating waste, byproducts and toxins. It also can decrease the feeling of hunger. Lack of hydration can increase fatigue which can lead to craving high carbohydrate foods to increase energy.
Protein’s importance in almost every bodily function and muscle mass can not be ignored. High quality complete Protein sustains muscle mass during weight loss, aids immunity, antioxidant function, and enhances leptin and insulin function. Filling up on protein first will help with carbohydrate carvings and give a sustained satisfied feeling. A prior blog post gives additional information on the importance of protein and the effects of protein malnutrition. WLS makes daily protein intake important but especially after Duodenal Switch, protein is a necessity of daily life.
Vitamins, minerals and supplements will ensure the body has the nutrients it needs to function adequately and can keep cravings at bay. Deficiencies in vitamins and minerals can cause cravings for foods. Vitamin and minerals are essential to muscle function, red blood cell production, bone health, and numerous other physiologic functions. We may all slack off on our supplements occasionally but now is the time to get back into the habit of daily vitamins and mineral supplements. A daily vitamin, mineral, and supplement routine is a lifetime commitment after Duodenal Switch or any WLS. Here is a list of commonly used supplements. If you haven’t kept up with your minimum yearly laboratory studies, now is the time to be seen and have your labs done.
Exercise can increase weight loss, overall well being, mental well being, mood, alertness, improve digestion, improve sleep, and increases energy levels. Exercise does not have to be a daunting task. Simply adding 15-30 minutes of activity can give added benefits. Yoga, walking, dancing, lifting weights, hiking, and sports activities can be included or added to more traditional forms of exercise. There are many free online videos for all types of exercise available. This year we are teamed up with The Kinesis Centre to offer a 4 week training program that can be accessed from anywhere. A 4 week training program will be included in our 2018 Back On Track Grand prize.
Finding a new hobby can keep both your hands and mind busy, curbing the unconscious eating of foods that are high in sugar and carbohydrates. Adult coloring books, drawing, painting, knitting, crocheting, sewing, dance lessons, gardening, learning to play an instrument and many others are great ways to use your time and expand your quality of life and brain function. New hobbies can also help establish new coping skills. Our previous post on Coping Skills After Bariatric Surgery can be found here. There are a whole host of online videos for “how to” on new hobbies.
Teaming up with others can also help increase weight loss and compliance. Support from friends, family and other groups will assist you. There is a whole gamut of support group online and in person. If you have fallen out of the habit of attending our support group or webinars get back to them. You can find our schedule and announcements regarding webinars here. Our Central Valley Bariatric Facebook page also gives daily inspirational messages, protein recipes and articles and any new information or research available. There is also our Duodenal Switch Facebook Group. Anything that increases accountability is a benefit and motivates us to stay on track.
Experiment with new recipes and flavors that are bariatric friendly and within your dietary needs. There are so many options for quick and easy meals that are whole foods, high protein, and low carbohydrate. We have several recipes on our page for all stages following weight loss surgery and Duodenal Switch. However, there are endless option on the internet in Paleo, low carb, and high protein type recipes.
In the spirit of new starts and getting back on track 2018, we are having a giveaway with the basics to get back into the swing of things. This year we are looking for before and after weight loss surgical journeys for our Grand Prize. Share your weight loss journey! Don’t be shy, your journey can inspire others and/or motivate yourself. To enter the Back on Track 2018 Giveaway, please submit your weight loss surgical journey with before and after pictures to firstname.lastname@example.org or you can also post your before and after pictures on our Facebook page. You will also need to sign a release for the use of your story on our website. We will draw 2 names from those that enter by announcing it on our FaceBook page or by e-mail on February 14, 2018. You must submit your mailing information to email@example.com in order to claim the prize. You must be a verifiable patient of Dr. Ara Keshishian.
We are also doing 3 prizes of a 4 week training with the Kinesis Centre if you share an achievement picture on our FaceBook page . This achievement picture can be a milestone in your journey, something you’ve haven’t done before, a non-scale victory, a goal that you reached, anything that you are proud of achieving. Let’s do this 2018 Back on Track challenge!
Please remember that medications, health status, age, bowel motility, genetics, and diet all play a role in weight and weight maintenance. Please have a physician review your health history and medications.
*NOTE: Giveaway items may or may not be identical to the pictured items.
We are not affiliated with any of the products nor do we endorse any one type of product. There is no cash value to the prizes.
I’ve had some questions regarding how Reconstructive Surgery can affect weight loss and metabolism after Duodenal Switch, Vertical Sleeve Gastrectomy, weight loss surgery and even in people who have not had weight loss surgery. There are several components that can effect a change in metabolism following Reconstructive Surgery that relates to physiological, functional, social and emotional mechanisms. These possible effects can vary person to person based on body type, age, weight, motivation, etc.
Fat mass resection and liposuction
Liposuction or the removal of fat mass by panniculectomy or abdominoplasty can have effects on lipid profile, leptin, waist hip ratio and glucose metabolism for 3-12 months depending on the individual and their health status. This have been researched and documented in both normal and higher BMI individuals. There is also an improvement noted in post bariatric surgical patients having breast reduction and abdominal plastic surgery. Of course, these effects can be controversial, conflicting and further research is needed.
Decrease in inflammatory markers
There is some evidence that the excision or liposuction of fat mass an decrease inflammatory markers and insulin resistance. This can affect C-reactive protein, TNF and cytokines levels. Little is known about the actual mechanism of this effect but the potential for this physiological change is present.
Increase metabolic need for healing
The metabolic needs following plastic surgery are much greater due to the nutrient needs required for healing. Depending on the extent of skin and tissues excised, the nutrient requirements can be considerably higher. This increase in nutrient need can increase metabolic rate, meaning you need more energy for healing. This significant stress also increases the complication associated with reconstructive surgery after weight loss surgical procedures.
Many people are more motivated following plastic surgery because of the dramatic change in body appearance and ability. The increase in motivation can be either diet or physically related. Some people are more motivated to watch what they are eating and increase physical activity to increase the effect of plastic surgery. Obviously, this is an extremely individual experience and can happen in varying degrees
Possible increased restriction
In the case of abdominoplasty, there can be an increase in restriction due to tightening of the skin, muscle and inflammation of the abdominal wall. Thereby, helping to have a fuller feeling sooner when eating. This can also at times result the chance of the complication of reflux and/or stress urinary incontinence if the abdominal muscle tightening is excessive or there is weight regain later on after the abdominoplasty.
Increase mobility and functional status
Excess skin can impair mobility and physical activity for some. The removal of the excess skin can promote mobility, ease of movement, improve gait and posture, and can improve or relieve pain. Skin infections, rashes and irritation are often symptoms of excess skin especially in the abdominal or pelvic area. This is a functional improvement, and depending on the extent of the pannus, can be quite freeing.
Improved self confidence, anxiety, mood, and body image are important motivators and incentives to post bariatric and plastic surgery patients. These improvements can have an effect on social and relationship aspects. However, it’s important to note that patients undergoing cosmetic surgery should have realistic expectations. Cosmetic, plastic or reconstructive surgery is not a panacea and does not in itself solve body image, personal or psychological issues. In addition, a post Bariatric patient may need additional time to recognize their physical and psychological changes following plastic or reconstructive surgery.
There may be metabolic, physiologic, physical and psychological improvements following Reconstructive surgery either after weight loss surgery or in non weight loss patients. These changes will vary based on the individual, age, dedication, health status, adherence to instructions, past medical and psychological history. However, appropriate education, screening and realistic goals and outcomes need to be emphasized prior to undergoing any type of plastic or reconstructive surgery.