I Don't Believe the Simple Carbs Theory

jmm1265
on 11/19/17 8:59 pm

At this point, I have come to believe the simple carbs zero absorption theory is not true. It may be true that less is mal absorbed but the mandates we are supposed to follow is that simple carbs are immediately absorbed in your mouth and stomach before they can get malabsorbed. I don't buy this since one of the most common problems we face is eating too fast.

Before WLS I was a very fast eater and unfortunately that has not changed much post WLS. I eat way too many simple carbs, but they go down fast. There is no way they are absorbed in my mouth and probably no where near fully absorbed in my stomach. I would equate it to drinking liquids while eating which causes everything to pass through too quickly. The carbs moving fast (or anything else) can get absorbed early in the process. It would have to primarily happen in the intestines which causes me to think the real result of simple carbs is bloating and gas, but not 100% absorption.

What do you think?

PeteA
on 11/20/17 6:03 am - Parma, OH
DS on 04/15/13

Whose mandates are you following? No offense but that sounds very strange. I've never heard anyone say that carb absorption can happen in the mouth and stomach. Digestion processes begin in those areas but not carb absorption.

Where have you seen that one of our most common problems is eating too fast. To me the only issue that causes is you fill up before you realize it and maybe put some overall extra strain on your VSG.

The absorption does happen below the stomach in the intestines where some things are more malbasorbed than others.

For a DS'r liquid intake doesn't make any difference in absorption. The liquid passes through the stomach quicker but the bits and pieces still get ground down. It sounds like you are thinking of a gastice bypass pouch.

???

 HW  552    CW  229  SW 464 4/15/13 - Lap DS by Dr. Philip  Schauer - Cleveland Clinic.

    

    

jmm1265
on 11/20/17 3:01 pm

Your response is making rethink this. The information I was given came from a DS nutritionist, but over time I've come to realize that don't seem to provide very accurate info.

I guess that's why I stopped going to nutritionists very early on in the process.

Valerie G.
on 11/20/17 7:34 am - Northwest Mountains, GA

What do I think?

I think I look forward to your support or discarding of this theory in five years.

These foods "start" absorbing earlier, but are not completely absorbed in the mouth or stomach, so you are partially correct. The point is 100% or not, it is still considerably more than complex carbs.

Valerie
11 years post op DS 
There is room on this earth for all of God's creatures..next to the mashed potatoes

PattyL
on 11/20/17 11:09 am

Some people are bulletproof post DS. Others are not. The biggest bulletproof group is in my opinion, men. They lose better, faster, and more than women just like they do on any regular diet ever invented. Some are bulletproof forever and others lose their super powers as time goes on.

Looks to me like you are subscribing to some misinformation here. You have a stomach with a pyloric sphincter, not a pouch. Drinking while eating has no effect other than making you full faster. Your transit time is faster than a person who never had surgery but that also changes over time for most people.

Everyone's body loves sugar because it's the easiest/fastest/most efficient food for your body to use. And the easiest to convert to fat. So high sugar/carb intake is the easiest way for anyone to gain weight. I can tell you for sure the easiest way for me to lose is to eliminate all the carbs from my diet. The easiest way to gain is to let them back in. And that's at 15 years postop. And eating sugar faster has sure never worked for me!

Donna L.
on 11/21/17 8:37 pm, edited 11/21/17 12:45 pm - Chicago, IL
VSG on 06/22/15

I can post things in more detail later since I'm at work and have to be brief.

It's biologically impossible to absorb most nutrients in your mouth and stomach...usually. Not always, but usually. Now, digestion occurs in the mouth and stomach, but digestion is not the same as absorption.

Digestion breaks down our food into raw materials that are basic parts, and absorption is how we access the raw materials. We then use these to build our body structurally, and fuel it with energy.

A good example: all carbohydrate is broken down into a monosaccharide, such as glucose, eventually, because that is all we can absorb - this happens whether it's popcorn, cereal, a cracker, or a candy. A muffin and a taco shell and a jolly rancher all will be glucose in the blood. The difference is how they need to be broken down, and how much time they require.

More complex carbohydrates require more digestion, i.e. they must be in the small intestines for longer to be broken down or we cannot absorb them. Time in the small intestine 1) increases food contact with enzymes which break it up and 2) increases the time the food contacts the intestinal wall, and is thus absorbed.

This is why the DS has good complex carb malabsorption relative to other surgeries - the transit time is reduced, and enzymes have less time to break down the carbohydrate into monosaccharides (glucose and galactose), and the detrius is excreted undigested. It's more appropriate to say there's "maldigestion" in addition to "malabsorption" in some ways, however, I digress.

This is also why you, without a doubt, still absorb simple carbohydrates.

Why? Well, only the small intestines, and parts of the colon, can absorb nutrients, and many are site-specific, such as iron, protein, fat, etc. Carbohydrate, however, is absorbed through the entire length of the small intestines called passive diffusion. We cannot even digest many kinds of carbohydrates, such as fiber or cellulose, as we have digestive systems more similar to carnivores versus herbivores, and it's actually the bacteria in our gut that breaks some of them down - not our digestive organs. We can't even digest stuff like cellulose at all. We digest protein and fat far more easily. Carbohydrate requires several enzymes and a lot of digestive time. This makes sense as we can actually make our own glucose from protein in the liver. We cannot make protein and fat, and without these, DS or not, we will die.

At any rate: back to simple carbs!

You have an enzyme called salivary amylase which immediately begins the process of breaking down carbohydrate when you chew. So, even before the carb**** your intestines, they are already partially broken down. Simple carbs are even more so. The faster they can be turned into monosaccharides like glucose, the faster you will absorb them. That is why most people even with intestinal bypasses (DS, RNY, Crohns, bowel resections non-WLS, etc) still absorb them.

This "early" digestion means that simple carbs especially are ready to be absorbed. And, if you ingest monosaccharides, they will basically be rapidly absorbed on contact with the small intestines.

That's why diabetics use glucose tablets to fix blood sugar - it acts almost immediately without digestion.

I follow a ketogenic diet post-op. I also have a diagnosis of binge eating disorder. Feel free to ask me about either!

It is not that we have so little time but that we lose so much...the life we receive is not short but we make it so; we are not ill provided but use what we have wastefully. -- Seneca, On the Shortness of Life

Donna L.
on 11/21/17 8:45 pm - Chicago, IL
VSG on 06/22/15

Woops, forgot to add that some things can be absorbed, either in buccal or sublingual locations, if saliva can completely break it down. So, can several sugars, FWIW. See this study for more information.

I follow a ketogenic diet post-op. I also have a diagnosis of binge eating disorder. Feel free to ask me about either!

It is not that we have so little time but that we lose so much...the life we receive is not short but we make it so; we are not ill provided but use what we have wastefully. -- Seneca, On the Shortness of Life

jmm1265
on 11/21/17 11:33 pm

Another question then, what about the zero calorie sugars like equal?

Donna L.
on 11/22/17 8:35 am - Chicago, IL
VSG on 06/22/15

Equal is not a sugar. It breaks down into aspartic acid, phenylalanine, and....methanol (?) I think.

Much recent research shows that nonnutritive sweeteners, i.e. artificial sweeteners, often are correlated with weight gain. They can mess up our satiety too, because they are sweet without calories.

Fat and protein actually trigger the highest satiety signals in the gut. Carbohydrates, particularly very processed or very sweet ones, trigger a release of insulin which stimulates hunger and prepares the body to store any energy surplus we eat. It's thought that sugar free stuff possibly interferes with this.

Being full is actually both chemical and physical. We have physical restriction, but what types of food we eat also affects fullness in the brain.

I follow a ketogenic diet post-op. I also have a diagnosis of binge eating disorder. Feel free to ask me about either!

It is not that we have so little time but that we lose so much...the life we receive is not short but we make it so; we are not ill provided but use what we have wastefully. -- Seneca, On the Shortness of Life

jmm1265
on 11/21/17 11:30 pm

Wow, you're hired as my new nutritionist. Thanks for the clarification.

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