Don't forget your carbs

I have been having a hard time keeping muscle since my surgery.  When I use it I lose it.  Turns out I am not getting enough carbs in to help repair my muscle.  I had been worrying so much about my protien intake that I wasn't getting in the simple sugars.  NUT advised that I drink a cup of milk before and after any workout and replace my last meal of the day (1/2 sandwich with 3oz meat) with a bowl of Kashi cerial and milk.  Hopefully this will work for me.

 You could also try protein bars and get your protein and your carbs in one sitting.

How much protein are you trying to get in? I've talked about this same issue with vitalady and she suggested at least 3 protein shakes a day, one before a heavy work out, and one after. She also told me that men post op lose muscle very quickly...."almost overnight" was her exact words. When I went in for my neck surgery and then plastics, she told me to go on at least 3 to 6 protein shakes a day to prevent as much muscle loss as possible. This is in addition to food...as a DSer I eat quite a bit....so I was getting this protein in ON TOP of the protein I was eating.

I remember cardsfan told me a long time ago that he didn't see any results from his work outs until he started getting in 150 + grams of protein plus a day. I'm sorry to disagree with your nut...but massive amounts of sugar isn't going to help you build muscle, you might want to carb load a few days a week, but in general you need protein to build muscle, carbs to stop you from losing weight.

Scott

Scott you should have figured out by now that post WLS is all about ballance, not carb or protien loading.  I wasn't asking for input I was offering some advice to newbies - that it is a struggle no matter how far post opp we are.  I am getting 150+ grams of protien per day without powder.  Some of us just cant choke it down no matter how bad we want too.

I know you didn't have DS surgery, but OH fitness whiz Jeremy Gentles presented a study during his speech last year at the Texas OH event (and it was available on OH's website somewhere as well, back then) done by Drs. Rabkin, a pair of major DS surgeons in the S.F. area.

  The study tracked DS patients for two years out past their surgeries, dividing them up into an equal # of two groups, one that exercised regularly since their surgery and others that did not exercise regularly.  It turned out that the post-ops that exercised, for the most part, did not build any appreciable muscle mass, or at least more so, than the post-ops that didn't.  This was apparently due to the fact that throughout the honeymoon period the body is in a major cal-deficit mode (hence the weight loss) and therefore it is very difficult for the body to appreciably increase its mass during that time.    

   Although the surgery involved in the study was DS, I think the conclusion was that the same can be reached as to any WLSer who is losing a major amount of weight rapidly.  Gentles emphasized to us, though, that this result doesn't mean that WLSers should give up on the idea of exercise during their honeymoon period, as it is still important for maintaining weight loss, lean body tissue, and for the usual cardiovascular beneits of same.  

 

I think you be wrong about not being able to gain muscle mass during the WLS honeymoon period (~1 year), Counselor. Here's a direct quote from Jeremy he made on the exercise board last month. 

"Gaining Muscle - If you are new to exercise such as weight or resistance training, you do not actually gain muscle tissue size in the first 2-3 weeks. When going from an untrained state (so being sedentary or very little experience with weight training), it generally takes 8-12 weeks to experience musclar hypertrophy or growth.

After WLS and/or while on a very low calorie diet, where caloric intake is significantly restricted, it is nearly impossible to actually gain muscle size regardless of the type of exercise you are performing or the grams of protein you are consuming. Caloric restriction causes you to breakdown and mobilize stored fat and stored protein (muscle) to meet your energy needs. Sure, it should be a goal to minimize the loss of muscle tissue but you are not going to retain all of you muscle tissue while calorically restricted. This is another reason that gains in muscle size are not really an option right now. As you caloric intake rises the further post-op you become, the more muscle building potential you will have." 

The last statement is the key but the question remains when does this happen? It certainly is before the 2 years you state in the study.....and it is most likely prior to end of a "one year WLS honeymoon". Based upon the results of some of the lifters here in the locker room, I would surmise that significant muscle mass can begin to be added at around 6 months post-WLS.

Like I asked before, show me the study you refer to if you wouldn't mind.

Boner

 

Well, when it comes to choosing between the results of a scientific WLS study by docs and a general statement by a guy in a "brightly-colored" sombrero, Boneman, I think I'll go with the former ..   &:-D)  

  Not sure how the other members you mention were able to build appreciable muscle mass during that period (hopefully it was 100% "natural") ..  Maybe it DOES make a difference whether their surgery is DS or not, although the biological principals involved would seem to indicate not ..  
   
    btw, is there any way to do a "topic search" on the OH website?   I might be able to still find his article / the study that way, if it is still stored somewhere on it .    I also might be able to get another copy of it at our N. Tex. DS group meeting this Saturday (our leader is a Rabkins patient and gave us a copy of the study at our meeting back when it came out) 

TacoBoy provided the testimony in both cases, Counselor. Are you saying he perjured himself when he spoke to your support group then told a different story on the exercise forum?

I be thinkin' you may have misunderstood what he said initially since what he said on the exercise forum makes perfect sense to me. Try to get a copy of the study from Rabkins since the search function on OH sucks big time.  

Boner

Hello,

Yeah this is a bit late but better late than never....

The issue of losing, gaining and/or preserving lean tissue after WLS or during periods of significant caloric restriction can get a little complicated. There are a variety of factors that influence muscle tissue gains and losses:

- calories in and out
- composition of meals
- meal timing
- hormone profile
- testosterone : cortisol ratio
- the type of activity performed (example: cardiovascular or endurance activites actually turn on pathways that may prevent increases in muscle size)

A couple of things about my previous post:

The post you are referring to in the fitness forum was in direct response to a member who was talking about gaining muscle in the first 2-3 weeks of an exercise program. The statement I made about not gaining muscle tissue size for 8-12 weeks after initiating a weight training program was was aimed at giving her reasons why she had not gained muscle 2-3 after starting a program. This is much different than suggesting that someone who is significantly calorically restricted will gain muscle tissue size in 8-12 weeks. Again, this was simply provided as a reason why she would not see gains in muscle size after 2-3 weeks. That post is here:

http://www.obesityhelp.com/forums/fitness/action,replies/board_id,5104/cat_id,4704/topic_id,3735524/a,messageboard/

The last statement, as you pointed out, is really the key for gaining muscle tissue. At 6 months post op however, many individuals are still consuming far too few calories to gain significant amounts of muscle tissue. With this said, here are several points to consider:

- At 6 months post op we are not talking 200-300 calories of restriction. At that point, most individuals are still losing significant amounts of weight and consuming about 1000 cal/day, give or take a couple of hundred calories. Of course this will be different for each individual, but it is pretty safe to say that if you are losing weight and eating only eating about 1000 cal/day, gaining muscle tissue is going to be difficult. As weight loss slows, you close in on your goal weight, and caloric intake nears what you are expending throughout the day, the potential to gain muscle tissue rises. At 12 months post op the potential to gain muscle tissue should be picking up some steam.

- Body composition changes will obviously still occur. Your percent body fat will decrease and your percent lean body tissue will increase. This does not mean your are gaining muscle tissue, it just means you are losing far more fat than muscle.

- You can gain strength even while losing muscle tissue size; this is especially true for those going from sedentray to active lifestyles or for those who are active but have not strength trainined previously. There are a number of reasons for this and we can go into more detail later if you would like.

- There are some who have great genetics and while most are losing muscle tissue they are able to maintain or gain; this is of course is not the norm.

- Individuals participating is significant amounts of endurance activities not only push themselves further into caloric deficit but also activate pathways that limit lean tissue gains. Now, this is not necessarily a bad thing but if we are considering only gains in muscle tissue size, this certainly can be an issue.

- As many of the other guys have already pointed out, lack of carbohydrate is an issue. While most people focus on protein after a training session, more carbohydrate than protein is actually needed to recover and drive anabolic processes. This of course does not mean that protein is not needed for recover but there IS NO DOUBT that more carbohydrate is needed than protein.

- Be careful with the research available. There are several studies showing the preservation of lean tissue with resistance training during caloric restriction.  Again this might be possible if we are talking restriction of 500 calories or less, but this does not represent the post WLS situation very well until further out. Also, while there is not much research looking at the exercise response of post-ops, individuals who are on a clinically guided very low calorie diet offer a pretty nice example of what happens after WLS.

Let me know if you have any other questions.

-Jeremy

Jeremy,

I read the Counselor's post (along with your supposed endorsement) to downplay the importance of exercise post WLS. This is totally irresponsible and I'm pretty sure you don't believe this.

The point is not really about gaining big-time muscle mass in year one post-WLS, it's about getting healthy by losing fat and by gaining overall strength through both cardio and strength training. Agree?

Regarding building muscle mass, I believe you said, "As your caloric intake rises the further post-op you become, the more muscle building potential you will have." 

If it is indeed true, which I believe to be the case, when does muscle building capacity for WLSers happen? It certainly is prior to "up to 2 years post-WLS" which was what you supposedly said according to the Counselor.

I believe it's incorrect to think someone can't gain some muscle mass as early as 6 months post-WLS. How much? It depends. On what? On how much strength work you do and how much protein you can keep down your frickin' gullet. 

Boner