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Nutrition
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Contents:
Vitamin and
Mineral Supplements: You Must Be Accountable for
This Aspect of Your Health
by Debbie Daley RD LD/N
Help! I Can't Lose More
Weight by Abbe Breiter, M.S., RD LD/N
Planning - Are You or
Aren't You? by Debbie Daley RD LD/N
How Do I
Know if I am getting Enough Protein?
by Abbe Breiter, M.S., RD LD/N
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You Must Be Accountable for This
Aspect of Your Health.
By
Debbie Daley RD LD/N
Are
you taking your vitamin and mineral supplements
every day? You are the only one who can honestly
answer this question and over time, your body
will show it. This must become a part of your
life that is not skipped or followed carelessly.
A patient who has had restrictive/malabsorptive
surgery is at nutritional risk for vitamin and
mineral deficiencies particularly thiamin,
vitamin B-12, folate, calcium and iron.
Preoperative nutrition education places emphasis
on understanding your new anatomy, and the
importance of appropriate food intake and
vitamin/mineral supplementation. Guidelines are
provided for the type, amounts and timing of
your vitamin and mineral regimen which are
needed to decrease the risk of deficiencies and
maximize health.
At U.S. Bariatric Fort Lauderdale, a research
study was conducted with post-surgical gastric
bypass patients to determine the influence of
age on vitamin/mineral status. The study was of
particular interest because aging is often
associated with reduced vitamin and mineral
absorption. Therefore, the hypothesis was that
older bariatric patients may be at a higher risk
for deficiencies.
Each patient self reported their vitamin and
mineral compliance and had laboratory tests
performed to assess their nutritional status.
The results showed the opposite of what was
hypothesized, that younger bariatric patients
have more vitamin and mineral deficiencies than
do older patients. The study further showed that
the vitamin and mineral deficiencies of the
younger patients were directly the result of
their noncompliance in taking vitamin/mineral
supplements. Nearly all the older (ages 51 to 75
years) bariatric patients were taking
vitamin/mineral supplements daily, as compared
to only 23% of younger patients (ages 18
to 30 years). The conclusion of the study was
that age is NOT a significant determinant of
post-surgical vitamin and mineral deficiencies
with gastric bypass surgery but instead vitamin
and mineral compliance was more of a
determinant. Does this suggest older is
wiser????
Food intake should focus on the importance of
maximizing
nutrition with minimal volume. Consuming
adequate protein, dairy foods and a variety of
fruits and vegetables, nuts, whole grains and
healthful fats is important to provide your body
with vitamins, minerals, phytonutrients and
antioxidants. Bariatric surgery patients that
have malabsorptive procedures are unable to meet
nutritional needs from food alone. If you skip
your vitamin and mineral supplements, you are
putting yourself at risk for osteoporosis,
anemia, and serious permanent neurological
damage. Remember you will always be at
nutritional risk even when you have reached your
goal weight. Vitamin and mineral supplementation
is key to optimal health for life and it is your
responsibility to remember to take them daily.
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By
Abbe M. Breiter M.S., RD LD/N
How do I know exactly what I am eating? Can
you remember from day to day, especially
with our busy lives? Maintaining a nutrition
journal or food diary offers you a picture
of your meal plan, a record of your intake,
and a reminder of accountability. The simple
act of writing down what you eat and drink
may open your eyes as to why you are not
reaching your goal and motivate you to reach
the level of success you desire.
You have to know what you are eating and
drinking before you can make any changes to
your plan. A simple daily check-off list
will also help you stay focused. Include
items such as amount of fruits, vegetables,
servings of dairy foods, and grams of
protein eaten today, as well as the fluid
intake for the day. These are simple
reminders of the proper foods that you
should be consuming. Don’t forget to add
vitamins and minerals to that daily list.
Setting goals will also help keep you
accountable to yourself. You must writethese
goals down and assign specific time frames
to achieve these goals. Some may be short
term (in the next thirty days), some may be
longer term (in the next three months), and
others should be long range (in the next
year). If you do not write down your goals,
they will simply remain a dream.
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Planning
- Are You or Aren't You?
By
Debbie Daley RD LD/N
Do you want to know the secret to successful
weight loss and a lifetime of weight
maintenance? The answer is to preplan your
food intake and daily exercise. Planning
helps you to be aware of your patterns.
Without planning, you may be prone to
skipping meals or snacking on whatever you
find. For people that do not plan, exercise
becomes something that is put off until the
end of the day and often by that time, the
person is too tired or finds another excuse
to skip it. Be honest with yourself and ask
the following questions
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Am I weighing my portions? If not, take
out your food scale. Most patients
preoperatively will underestimate their
food intake. After surgery, we find that
most patients’ portion sizes become
distorted and they think they are
consuming more than they are. Refer to
the protein article in this month’s
Silhouette for the dangers of not
consuming adequate protein. It is
equally important to consume appropriate
servings of fruits, vegetables, and
depending on your postoperative Stage,
whole grains, beans and nuts. These
carbohydrates are necessary to provide
your body with vitamins, minerals,
antioxidants, phytonutrients and fiber:
the correct fuel to supply the body
during appropriate strength training
exercises. To ensure adequate intake of
proteins and nutrient rich
carbohydrates, it is essential that you
weigh your food to determine your
portions.
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Am I meeting my protein needs? If not,
what are some options that will work?
One option might be melting cheese onto
the food to add some extra protein
without increasing the volume of food.
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Am I consuming fruits and vegetables in
the correct serving sizes with my meals?
Try using snack-size resealable bags and
making measured portions ahead of time
so you can easily grab a portion without
having to take out the food scale.
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Am I consuming two servings of milk or
yogurt each day? If no, why not? If you
are lactose intolerant, try two servings
of yogurt or Lactaid milk. You might
also try combining lactase enzymes with
your dairy products.
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Am I consuming adequate liquids each
day? If not, be sure you always have a
filled water bottle with you so you can
have a drink 60 minutes after your meal.
If it is handy, you increase your chance
of consuming it by 100%!
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Am I taking my vitamin and mineral
supplements? Remember that these are not
optional and are necessary for your
health.
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Are you following the exercise protocol?
Exercise and proper nutrition go
together for successful weight loss and
weight maintenance. Refer to the new
exercise manual and think of realistic
ways to incorporate exercise into your
life.
We suggest that you keep a journal to raise
your level of awareness and help you to
track your progress as well as identify any
problems. Planning should become a lifestyle
habit. It takes time to learn new behaviors
and unlearn the old ones – give it at least
a couple of weeks, instead of a couple of
days. If you are having any difficulties,
please contact the office so we can help
guide you toward a healthier you.
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By
Abbe M. Breiter M.S., RD LD/N
Adequate protein is an essential part of
the nutrition plan following gastric
bypass surgery. Without proper protein
intake, the body will break down its own
lean tissue to supply its cells and
tissues with the amino acids it needs to
function at an optimal level. The result
is a loss of lean body tissue or muscle
weakness, hair and skin changes, and
lower metabolic rate which in turn may
lead to weight loss plateaus and/or
weight gain. Each person’s needs, based
on body size and weight, are greater
during the rapid weight loss phase when
the Body Mass Indicator (BMI) is greater
than 30, but drop off when the BMI
reaches 30 or below.
Where does protein come from? Protein
can come from food sources such as soy
and beans, and dairy products such as
milk and yogurt. Remember that one ounce
of high quality protein contains, on
average, seven grams of protein as a
nutrient. Simply add up the number of
ounces of protein food that you consume
in one day and then multiply by seven,
this will give you the grams of protein
obtained from food. The next step is to
add the protein from the milk and yogurt
to get the total grams of protein
consumed. If this number is less than
your personal protein prescription, it
is NECESSARY to include a protein
supplement in the diet either from a
shake or powder. Once you have achieved
the proper intake from food, milk and
yogurt the protein supplement can be
discontinued.
Are you getting in enough protein? If
you are unsure of what your needs are,
please contact the office or attend a
nutrition class.
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