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Enzymes and Your Health, Nutritional Dietary Supplement By: Loring A. Windblad: This compilation of information is Copyright 2005 by http://www.organicgreens.us and Loring Windblad. The references ... avoid the use of enzyme products because their mode of action can be complex, and requires specific scientific knowledg... How I Lost 51 Pounds In 4 Months Using The Simplest Diet Plan In The World By: Adam Minsky: Like many people I've been on dozens of diet plans over the years ranging from Atkins to South Beach to Weightwatcher... excess weight quickly though - and works like nothing I've ever tried before.One year on and I'm still at my target wei... Dietary Supplement By: Rolf Rasmusson: Dietary Supplement – why so important?Dietary supplement is a term that is familiar to almost everyone now. The exampl... separate vitamins or minerals, or some kind of mix of vitamins and minerals.Dietary Supplement – what is it?Dietary sup... Atkins Diet - Learn More By: Martin Smith: The Atkins diet can be boring because of the limited choice and some believe it can be dangerous. Get a physical to ... promises you can lose weight without exercise. Exercise helps the body to better utilize the foods you consume. Not ... Dietary and Nutritional Supplements: Know More About Supplements By: Ashley Green: At times, due to your busy and fast life, we tend to miss out on the essential nutrients such as protien, vit... tasty chewable multivitamin and mineral supplements along with protein and vitamin drinks and shakes. You ha... Dietary Recommendations After Gastric Bypass Surgery Protica Nutritional ResearchWhen 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. 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. About The Author Copyright - Protica Research - www.protica.com 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 Copyright - Protica Research - http://www.protica.com Check below for additional Bypass Diet Gastric supplement Links and Information Lighten Up America -- Radio about Gastric Bypass and Obesity Surgery Everything You Must Know About Obesity Surgery from an actual patient; Dan Schulz: gastric bypass surgery; roux en y gastric bypass; after gastric bypass; gastric bypass diet; gastric bypass surgeons; gastric bypass support ; laproscopic gastric ... Diet Formula One Supplement ... 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