Protein intake requirements change over time following weight loss surgery. This is based on the requirements imposed on our body by a number of variables. These include, activity level, muscle mass, over all health condition to name a few.

A very young muscular athletic male with a BMI or 30 will require much higher protein intake (and absorption) that an inactive older Female with the same BMI. The same young athletic male will require much higher protein intake is he is recovering from a surgery than his baseline.

As we have stated in the past, the protein intake, should be adequate and not excessive. High level of protein intake that are not accounted  for based on muscle mass and activity level, will eventually result in weight gain. The best measure of protein intake in a stable weight patient over 3-4 years post op  is their albumin and protein level. Following your yearly laboratory values at a minimum is an important part of weight loss surgery follow up care.

You also need to adjust protein intake when necessary. Protein needs increase depending on physical needs, infection, healing, pregnancy, surgery, age, injury, etc. Plastic surgery requires higher protein needs for appropriate healing.

Information on protein sources and quality here.

The basic formula for protein intake is 1gm/kg of ideal body weight. The calculator below will provide a guide for the protein into based on your stable weight in lbs.

Treatment options should be approached is a global and systemic fashion. It is critical that the nutritional status is at its best possible and optimized for important healthy bone vitamins and minerals. Low protein needs to be corrected. Special attention should be given to nutrients, minerals and vitamins. These include Protein, Calcium, Magnesium, Vitamin D, and Vitamin K1/K2to name a few.

Healthy bones require ongoing and routine force in the form of exercise to remain health. Just as exercise improves muscle strength, it also improves bone health. Exercise is also critical in improving bone structure and density. Ideally, exercise should be weight bearing and resistance.  Examples include: hiking, walking, jogging, climbing stairs, playing tennis, and dancing. Resistance type exercise is weight lifting and resistance bands.  These exercise work by creating a pull or force on the bone either by gravity, movement or weight.  Always check with your physician before beginning an exercise routine, start slowly and building up to longer periods of time.  The ideal goal would be at least 30 minutes a day, every day, if you are able.

We frequently see patients immediately started on osteoporosis medications without checking or improving some of the nutritional markers noted above or without looking at exercise history. In some case, the medication recommended are contraindicated due to nutritional status.

The medications can be grouped in to those  that help with new bone formation (Anabolic agents) or those that help by suppressing the bone breakdown phase (Antiresorptive agents).

National Osteoporosis Foundation has an exhaustive list (below) of medications for treatment of Osteoporosis.

The table below outlines the side effects and mechanism of the actions of the common medications used for treatment of  osteoporosis which was published by the University Health News Publication on August of 2014.

With all this information, the few points to remember is that the most important factors in healthy bone structure are the nutritional status Protein, Calcium, Magnesium, Vitamin D, and Vitamin K1 levels.

This is an animation of normal bone Metabolism. It shows how bone structures is taken down and rebuilt continuously. This allows for a healthy bone maintainence as we age. The key is the balance of breakdown (osteoclast) and the build up (osteoblast) activity is regulated. Osteoporosis develops when there is more breakdown that build up.

With permission of Dr. Susan Ott of University of Washington.

Additional information available on her site.

Past blogs on Bone Health.

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.

There is also much discussion on whey protein. There is a brief and good explanation on this subject here.

Recipes for protein shakes.

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 contact@dssurgery.com 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 contact@dssurgery.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.

The importance of daily protein intake can not be over emphasized. The malabsorptive component of Duodenal Switch makes daily protein intake a lifetime necessity.  The amount of protein intake is dependent on individual needs and laboratory study results (which are also a necessity for life) however,  the minimum daily intake should be around 100+- gms per day.  Also hydration is of the utmost importance throughout the weight loss surgical journey. A minimum of 64 ounces daily for adequate hydration.  High hydration,  high protein, vitamins and minerals supplements, and low carb for life.  Fat will come with eating protein and is tolerate on an individuals basis based on age, common channel, alimentary channel, gut microbiome health, bowel motility, medications, etc.

Protein needs increase depending on physical needs, infection, healing, pregnancy, surgery, age, injury, etc. Plastic surgery requires higher protein needs for appropriate healing.

Whey isolate, low carb protein powders are the protein supplements of choice.

During the immediate post surgical period a good protein intake goal is:

1. 30 gms daily by 30 days post surgery
2. 60 gms daily by 60 days post surgery
3. 90 gms daily by 90 days post surgery, etc.

After healing, protein from real unprocessed food sources, such as meats, eggs, cheeses, dairy, seafood, nuts, any animal product is best.  Shakes are to fill in if you are unable to eat real food products.  Some people become lactose intolerant and may need to avoid items with lactose or take Lactaid.

Sites with information on protein:

https://www.dsfacts.com/protein.php

Dr. Keshishian’s blog on protein: https://www.dssurgery.com/blog/protein

Other protein powder recommendations:

Isopure Zero Carb Unflavored or flavored Whey Isolate: https://www.amazon.com/Natures-Best-Perfect-Isopure-Vanilla/dp/B000E95HP0

Unjury many flavors and chicken soup. https://www.unjury.com

Jay Robb Whey Isolate: https://www.jayrobb.com/protein/whey-protein-unflavored-80-oz.asp

Optinumu Nutriton Whey Isolate: https://www.amazon.com/Optimum-Nutrition-Standard-Extreme-Chocolate/dp/B002DYIZHG/ref=sr_1_1?ie=UTF8&qid=1423600951&sr=8-1&keywords=on+protein+isolate+2+lb

List of Ready to Drink Protein Products:

Isopure clear protein drink comes in several flavors:

Vitamin Shoppe’s Isotech protein drink comes in several flavors

Lift protein drink (Atkin’s) https://www.amazon.com/s/?ie=UTF8&keywords=lift+protein+drink&tag=googhydr-20&index=aps&hvadid=89316918974&hvpos=1t2&hvnetw=g&hvrand=3955536375689546811&hvpone=&hvptwo=&hvqmt=e&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9031137&hvtargid=kwd-152082169968&ref=pd_sl_94bo1om6xz_e

Premier protein is a combination protein and contains lactose which some people do not tolerate. https://www.premierprotein.com

Smaller bottles of Isopure clear whey isolate drink: https://www.amazon.com/Isopure-Protein-Alpine-6-Count-Bottles/dp/B001M0NJOQ

Cystosport clear whey isolate drink: https://www.cytosport.com/products/whey-isolate/?tab=flavors

This does not constitute medical advice, diagnosis or prescribing.  It is simply a compiled list of gathered information and not meant to be all inclusive.  If you are in doubt or have questions please contact our office for further assistance. 

Fat and Protein after weight loss surgery…. This is a subject that seems to come up all the time.

What I recommend is “…Water, protein, vitamins, supplements and every thing else….”

Dehydration can cause a lot of problems, stay hydrated.

Weight Loss Surgery (WLS) is a surgically imposed catabolic state (surgical induced starvation).  The weight is lost by not allowing enough caloric intake/absorption and forcing the body rely on stored sources of energy, mostly fat mass.  The rationale for the high protein intake is to minimize net muscle mass loss during the catabolic state.   Low carbs and low fat further push the body into catabolizing the fat mass, and reducing the net loss of protein content. As the fat mass is broken down it will release hormones and other byproducts that the body will eliminate. Hydration is crucial to every bodily function and even more so in the weight loss phase to allow for elimination of some of these byproducts.

The mechanism by which Duodenal Switch works during the weight loss phase is by limiting the caloric intake.  Long term  Duodenal Switch keeps the weight off due to the malabsorptive component as the caloric intake increases. Protein intake, Vitamin/Mineral supplementation and diligence in surveillance of vitamin/mineral levels is imperative and a life long commitment after WLS.

There are a number of different types of  Fatty Acids.  Our bodies naturally produce, from other components,  all but 2 essential fatty acids: Omega 3 and Omega 6.  Most fatty acids require bile salts to be absorbed within the small intestines.  Those are the fatty acids that are absorbed to a lesser degree after Duodenal Switch.  Medium chained fatty acids do not require bile salts and can be absorbed into the blood stream from the small intestines. Medium chained fatty acids are used for energy as they are processed in the liver. Medium chained fatty acids are actually given to patients with Short Bowel Syndrome to decrease fatty stool and increase their body weight.  This is also a possible reason some fats cause DS patients more loose stools and others do not (medium chained fatty acids). Adding fats is a purely individualized process.  Each person has a different length of small bowel, alimentary limb, common channel, percentage of excess weight to lose and metabolism. Patient’s tolerance for fat in regards to vitamin/mineral levels, stool consistency and frequency is completely individualized.

Fats and Fatty acids can be divided according to their structure in groups:

A) Saturated  Fat (animal fats, butter, lard- solid in room temperature)

B) Unsaturated Fat (liquid in room temperature)

The main focus in the weight loss phase should be hydration, hydration, hydration, protein, low carb, low fat and vitamin/mineral supplementation (page 22).  Rest is key in the early post op phase but gradually adding exercise is also important in ensuring the body does not breakdown muscle mass.  Adequate intake of protein and use of muscles diminishes the bodies natural response of breaking down muscle mass in a low caloric intake state.

Post Surgical Needs for the first 90 days in order of importance:
This is to allow healing to take place before adding additional stress on the body and surgical sites.
Minimum of 64 ounces of fluids daily
Minimum 80-100 grams of protein daily (protein requirements are based on ideal body weight)
30 gms by 30 days post-op
60 gms by 60 days post-op
90 gms by 90 days post-op
Vitamin/Mineral Supplements
Low carb
Low fat
Rest (early Post-op)
Exercise

Proteins are important, not only for structure (muscle) but for functions. We know that proteins and amino acids are involved in all aspects of our body’s function. This is even more critical during the rapid weight loss phase. Protein needs may increase and change based on health status, pregnancy, surgeries, healing, etc.

When it comes to fat, I do not recommend patients consuming excessive amounts of fat- At the same time I do not recommend patients go on a low fat diet.  There is this misconception that since DS is causing fat and fat soluble vitamin malabsorption, then taking more fat (in excessive amounts) can solve the problem of vitamin deficiency. How about the possibility that some patients are causing their own vitamin deficiency by taking large volumes of fat which may results in more frequent bowel movements and decreased vitamin absorption.

It is not to be forgotten that each patient will respond differently with dietary changes after duodenal switch. Some patients may tolerate more and some less fat in their diet.  After the initial 90 day post op phase I recommend that patients go slowly in adding new food items by giving it several days before adding another food item. i.e.; add carrots for 3-5 days to see how your body handles it before attempting to add another new item.  The above is not the entire weight loss process or education and is only a small portion of the education needed before undergoing any WLS procedure. These recommendation are my recommendations for my patients with the Hess technique for Duodenal Switch.

This is not a substitution for formal medical advise that should be given to any patient by their bariatric surgeon and and OB/GYN familiar and experienced in the care of female patients with history of weight loss surgery.  This is information that we provide our patients when we are notified of their pregnancy.

We recommend and instruct to take all precautions to avoid getting pregnant within the first 18 to 24 months following  weight loss surgery. There is a significant amount of information about preferable birth controls, those to avoid, and additional pertinent information on our website.

Women who become pregnant after Weight Loss Surgery (WLS) should receive specific attention from their obstetrician because of the high risk nature of their pregnancy. Please make sure that you share this information with your OB/GYN.  Many patients have become pregnant and delivered health babies after Duodenal switch (DS) without difficulty, but you do need to be watched more closely. The scientific study favor patients getting pregnant after DS when their weight loss , and nutritional markers have stabilized (18 months or longer) and not before.  You also need to make sure you are taking all necessary vitamins, minerals and protein.

The first trimester is a very important time in the development of the fetus. Most organs and structures of the fetus are formed in the first trimester and therefore it is imperative that you pay close attention to your nutrition and your nutritional supplements.

You should continue to take your general multivitamins, other vitamins, minerals and  your calcium as you were taking prior to getting pregnant. In addition, you should also take what will be prescribed by your OB/GYN. Do not substitute your prenatal vitamin and any other supplements that you are prescribed by your OB/GYN with what you were prescribed by our office. Each patient’s situation is individualized and additional changes or supplementations may be needed based on the advice of your surgeon and OB/GYN. Multiple fetus pregnancies require additional vitamin, mineral and protein needs.

 A good prenatal vitamin should contain these:

Vitamin C – is essential for tissue repair, wound and bone healing and increases the body’s resistance to infection. For mother and baby this vitamin is essential daily as it is the agent that holds newly formed cells together. Helps baby to grow and builds strong bones and teeth. It is also instrumental in the body’s ability to absorb iron.

Vitamin D – promotes general growth. It maintains proper levels of calcium and phosphorus thus helping to build baby’s bones and teeth.

B Vitamins (thiamine, vitamin B6, riboflavin) – Thiamine converts carbohydrates into energy for mother and baby and is essential for baby’s brain development. It also aids in normal functioning of the nervous system and heart. If deficient during pregnancy, a baby is at risk for beriberi, a serious heart ailment. Vitamin B6 is also vital to develop your baby’s brain and nervous system. Riboflavin helps the body to produce energy. It promotes growth, good vision and healthy skin for mom and is important for the development of the baby’s bone, muscle and nervous system.

Folic Acid – is one of the B Vitamins that is needed to produce red blood cells. It helps synthesize DNA, is conducive to normal brain functions and is a critical part of spinal fluid, thus making it one of the few nutrients known to prevent neural tube defects such as spina bifida.

Calcium – your developing baby needs this mineral to grow strong bones and teeth, healthy nerves and muscles and to develop normal heart rhythm and blood clotting.

Potassium – is a mineral that helps maintain fluid balance in the body. This mineral helps regulate blood pressure, nerve impulses and muscle contractions.

Vitamin A – is important for cell growth, healthy skin and mucous membranes, and resistance to infections. It benefits red blood cell production in both mother and baby. This vitamin is essential for postpartum tissue repair.

Copper – a trace mineral found in all plant and animal tissues; it’s essential for forming red blood cells-a key process during pregnancy, when your blood supply doubles. Copper also aids tissue growth, glucose metabolism, and growth of healthy hair. It also helps form a baby’s heart, skeletal and nervous systems, arteries, and blood vessels.

Pantothenic Acid – is a trace mineral that regulates the body’s adrenal activity, antibody production, and the growth and metabolism of protein and fats. If you are deficient in this vitamin during pregnancy your baby’s growth may be slowed. This trace mineral is required for many essential functions, including growth, appetite regulation, digestion, wound healing, and the maintenance of collagen and elastin which may explain why some doctors think it may also help prevent stretch marks, one of the banes of pregnancy.

Iron – makes red blood cells, supplies oxygen to cells for energy and growth and builds bones and teeth. In pregnancy this mineral is so crucial because the body must produce extra blood to support the growing baby. During pregnancy you will need double the recommended daily allowance of iron to insure your health and that of your baby’s.

More often than not, many expectant mothers find taking a prenatal vitamin increases nausea in early pregnancy and sometimes beyond. If this happens, ask your doctor or midwife to change your formula or it may help to change how and when you take your vitamin. It is sometimes helpful to take your prenatal vitamins before you go to bed at night. If swallowing a large pill is difficult, cut it in half. In any event just like your mother said all those years, don’t forget to take your vitamin.

The following are important vitamin and nutritional components throughout the pregnancy but in particular the first trimester.

• Folic Acid: one of the B vitamins has been found to prevent neural tube defects (NTD). Increased intake of folic acid reduces the risk of NTDs such as anencephaly and spina bifida (open spine) by as much as 50 to 70% if women take enough before conception and in the early months of pregnancy. Take your general multivitamin and prenatal vitamin every day.

• Vitamin A: important to prevent blindness in the fetus. Vitamin A levels should be drawn and monitored prior to becoming pregnant and during the pregnancy to ensure adequate intake. You may need to take additional Vitamin A in a Dry water-soluble form such as Biotech Vitamin A 25. Please contact your surgeons office if your Vitamin A levels are below normal, or have not been drawn recently.

• Vitamin D: important for bone growth and formation. Vitamin D levels should be drawn prior to becoming pregnant and during the pregnancy to ensure adequate intake. Dry water-soluble form of Vitamin D3 such as Biotech D3 50. There is some research that adequate Vitamin D levels help protect against pre-term labor and an increase in preeclampsia risk.

• Protein: necessary in all structural formation of the fetus and the mother needs to increase protein intake by a minimum of 30 grams daily. Protein is need in nearly all fetal tissue formation.

The second and third trimesters are important in the growth, development and formation of bone structure and the overall growth of the fetus. It is important at this point to continue taking a minimum of 1500 mg Calcium (or what was prescribed by your surgeon), increased protein intake, your multivitamin, prenatal vitamin and any other supplements prescribed by your OB/GYN or surgeon. You may also need to increase your calorie intake with nutritious foods included in a healthy, well balance diet.

If you have any questions please contact your surgeon or the OBGYN. Your surgeon should also be willing to discuss any concerns that you or your OB/GYN may have with them.

Here is an discussion about the outcome of pregnancy after weight loss surgery.

In general we also advice against certain types of birth control because of the associated weight gain reported by the manufacturers. This is a decision that needs to be  made after considering all potential side effects including the potential weight related issues. Ease of use should not be the only variable.

As indicated at the beginning of this blog, the information provided here is not a substitute for your nutritional evaluation by your bariatric surgeon or an experienced OB/GYN.

The 2014-2015 holiday season was 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 together.

Time to clear out the kitchen!  Disposing of temptations and high trigger foods is the first step to getting back on track.  If the food isn’t easily acquired then it is 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 and cutting them back can jump start your weight loss.

Hydration is one of the important ways to start.  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. Resent research has found that fat mass lost breaks down to water and carbon dioxide.

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 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 can 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.

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, 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.

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. The Central Valley Bariatric Facebook page also gives daily inspirational messages, protein recipes and articles and any new information available. Anything that increases accountability is a benefit and motivates us to stay on track.

In the spirit of new starts and getting back on track, we are having a giveaway with the basics to get back into the swing of things. Please comment with whether you are pre or post operative on the blog or Facebook page to be entered into the giveaway.  We will draw 2 names from those that enter by commenting in either place (blog or Facebook) on January 21, 2015. 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.