No.  Take your multivitamin with food.  Take your calcium at another time - between meals? Calcium and iron should not be taken together. regards, Danielle Halewijn RD eNutritioncare.com

That's a funny one.   I had that one pulled on me at my optometrist - y'know carotenoids - carrots, good for the eyes. I played along with it.  They came back at me as low normal. Not to boast, but I definitely get my vegetable intake each day.  When this happened, I was about 4 months post-partum and still taking prenatal vitamins and extra B&C.  I explained this to them and they had no answer as to why my levels came back low.  Maybe I don't eat enough red & orange veggies, since that's where many of the carotenoids are concentrated... The supplement people gotta make money too - but I agree with Sara, It's a crock. On the bright side, use this as an opportunity to look at your diet a little closer.  Are you consuming 5-6 fruit & veg servings each day?  Keep in mind a serving of vegetable is 1 cup raw or 1/2 cup cooked.  If you don't think you are getting in the right amount, maybe take an additional water soluble vitamin supplement in addition to your multi (if post-op).  BTW water soluble vitamins are Bs & C. At 3 months post-op, you may not be up to the recommended amount of veggie intake - and you also just went throught a pretty major life change and procedure. My advice, skip this purchase. regards, Danielle Halewijn RD eNutritioncare.com

I know, it's not comfortable. Partly, there's not much to poop. Second, it takes your colon a little while to wake up from the anaesthesia that is floating around in you.  Plus, if you are taking any pain meds that can slow things down even more. My suggestion is call your doc tomorrow and ask if you ahould take something. There are a lot of people who take docusate sodium (Colace) or milk of magnesia regularly to keep things moving.  You may also want to ask about these. regards, Danielle Halewijn RD eNutritioncare.com

Yikes!  I almost hate to be the one to jump in here. Let me first preface my discussion by saying that as soon as I think I know all of the protein supplements out there - 25 more will hit the market!  It is an unbelieveably huge segment of the supplement world! Ok - I came prepared to discuss the PDCAA score. Proteins are not all created equal.  Our bodies are able to manufacture proteins by joining together amino acids.  There are some amino acids which our bodies can make, these are called 'dispensible' (or formerly non-essential) amino acids.  There are other amino acids which our bodies cannot make and we must obtain from our food (or another outside source), these amino acids are called 'indispensible' (or formerly essential) amino acids.  There is one more category of amino acids, and those are 'conditionally indispensible' - these become "essential" during certain disease states or physiological stress. (we will ignore these today) One of the ways we judge the quality of a protein is on the amino acid profile - if a food or protein source has all of the indispensible amino acids (IAAs) then it is considered a high quality (or high biologic value) protein.  So, proteins are judged by the completeness of their amino acid profile.  Protein from animal sources such as meat or milk are generally complete.  Proteins from collagen (the connective tissue of animals) is naturally low in all 9 IAAs. In former times, we compared proteins to a known reference protein (egg whites) to judge its profile.  Then someone got smart & said "hey, why aren't we looking at the absorbability of these proteins?"  So the scientists did.  Then in 1991 the Food & Agriculture Organization / World Health Organization proposed a superior method of assessing protein quality referred to as the Protein Digestibility Corrected Amino Acid Score (or PDCAAS) .  This score was adopted by the Institute of Medicine and tells you how well a particular protein will provide the IAAs required by humans. What makes the PDCAAS different is that it uses the most limited indespensible amino acid in the protein and uses that to reference the protein source.  In other words, you use the lowest score to calculate the value of the whole thing.  This is appropriate and a good way of judging the value of the supplement.  The fact is, if all of your protein is coming from a single, incomplete amino acid supplement, then your metabolism will be slowed until that indispensible amino acid is available.  It's like building a fence and you run out of nails - you may have plenty of wood, but you can't continue building until you get more nails. So if I'm going to cut to the chase... Most products with a Milk, Casein, Whey, Egg White, and Soy source will score 100% on the PDCAAS.  Most collagen-based supplements will score anywhere from 0 to 50%.  If your PDCAAS equals 50, then you would need to take 2 times the amount of that supplement to equal the effectiveness of a protein that scores 100.   Professionally, I recommend whey proteins as they are readily available and economical and good, complete sources of protein. PDCAAS 100 I also recognize that some people can't tolerate the usual protein supplements or they like the form of the other products (liquid vs. powder). In the world of food eating - we often eat incomplete AA foods.  The classic example is rice & beans.  Rice is lacking in one amino acid, beans are lacking in a different amino acid - if you eat the two together, you get a complete protein.  Research has also shown that these foods don't have to be eaten together, just the missing amino acid has to be made up for within about a day to maintain the rate of protein metabolisn. Back to WLS.  In my professional opinion, in the early days post-op it is very important that you get your protein in.  Some of that may be an incomplete protein.  One should also try to use complete proteins at another time in the day.  By the time you are eating food, you are making up for some of the incomplete supplements by taking in dairy foods, or fish, or another protein (like Wendy's chili - acoording to many of you...).  These foods will provide the limited amino acids and the deficiency in your supplement won't be so important.  Most important is still getting the protein in - however you can.  Sometimes this is very challenging. So my bottom line: Especially in the immediate post op period, a high quality protein from a milk, meat, egg, or soy source is important.  Once you are eating "real" food, the source of the protein supplement is not as critical.  Overall, using a complete protein is recommended . So what about those two products I would still need to read the labels and calculate the PDCAAS.  I will take the Unjury person's word for it that these products score low. So does that matter? Depends on where you are in the post-op world. Looks like there are people out there who do fine using these supplements (per the previous post) Hope this gets you all thinking! Danielle Halewijn RD eNutritioncare.com

Thanks Kim - I'm still a rookie at doing re-posts! -Danielle

You should be eating 3-4 meals per day, never more than 5 hours apart. Do not snack Eat your protein first Right now your calorie level is not as important as getting your daily protein, getting your liquids, and taking your supplements.  Your body is making huge adjustments.  Be patient and celebrate the pounds that have already left! Include activity into your daily life - it is key for long term success! regards, Danielle Halewijn RD eNutritioncare.com

Generally you want 1 ml of water for each calorie you take in.  If you are eating 1000 calories a day, 1 liter works. In a healthy, normal person the recommendation is usually 30 ml/kg of body weight (now that might be too much!) Drink your 1.5L.  Drink more if it's hot or you're exercising a lot. I think you are doing fine! Danielle Halewijn RD eNutritioncare.com

Great question! The information I am sharing comes from a conference I attended last year.  The speaker was  Robert Martindale PhD, MD , Professor of Surgery, Oregon Health & Science Univ. (Some of you may have been his patient - he was previously in Georgia) Normal daily needs are 1000-1200 mg/day. In RNY recs are 1500-2000 mg/day - this assumes a 30-40% malabsorption -Calcium carbonate are not as well absorbed due to decreased acid in stomach and decreased dissolution (breaking apart) in the stomach. -Calcium Citrate with vitamin D is preferred as it is better absorbed - calcium citrate should be taken between meals -Neither calcium should be taken with iron as it decreases iron absorption Then, a study was done looking at the various factors affecting calcium absorption.  It included such variables as vitamin D levels, estrogen therapy, timing of intake, gastric acidity, age, gender, drug standards of dissolution and disintegration, and bioavailability. The results: The lab data slightly favors calcium citrate Cost data favors calcium carbonate clinical result: There was an insignificant level of data to justify one over the other. There are more and more studies out there all the time. Do your research! regards, Danielle Halewijn RD eNutritioncare.com

OK - you're stuck on liquids and not a very happy camper. You will be able to eat a sonic burger, but not right now! It is the displeasure with chew,chew,chewing food that gets many people post-op to just give up on food.  You get a totally different experience with your food when you have to spend so much time chewing it!  It's not uncommon for people to just grind up their food so they can get the chewing part out ot the way. I could say - so what do you like? But, I'm not going to.   I think you needed to vent, you are frustrated, this whole thing isn't what you expected it to be... Your life has now changed. You are in a great place on OH getting the support you need. Good Luck! Danielle Halewijn RD eNutritioncare.com

Thank you so much for sharing that! You made my day! -Danielle

I can offer a little insight into the protein/calcium issue.  Protein acts as a transporter of many nutrients in your body, it's like the bus that travels all through your system.  Calcium rides the albumin bus through your body - it is transported by protein.  Clinically, before we determine if a patient is calcium deficient , we first have to correct for a low albumin level. You are also correct that your body adapts to the malabsorption.  For all of the areas that were bypassed, your body will create new areas to absorb nutrients  This "adaptation" process starts in the first few months and can take many years to complete.  The research for this is well documented in patients that have had their intestines partially removed either due to disease or trauma.  The research for WLS is getting better as we have more years of the high numbers of procedures performed each year.  Alot ot the scary info coming out now is in regard to deficiencies caused by people not continuing their supplements.  My mantra to all post-ops - take your vitamins! Thanks for appreciating what we're trying to do here.  It's nice to know we are making a positive impact.

regards,

Danielle Halewijn RD / eNutritioncare.com

I wanted to let you know - I have been actively researching this question. The answer I come up with is that this whole 25-30 g protein per serving is a myth.  There is no data I can find to support this claim.  In the research, I find nothing.  To the contrary,  I find info supporting my original idea - protein metabolism is a dynamic process and is not limited by volume as suggested.  Protein synthesis in your body IS limited by the quality of protein you consume. The additional idea that only body builders need more protein - well don't you think a protein starved RNY patient has needs at least equal, if not in excess of that bodybuilder? Protein & the kidneys - the protein load only affects the kidneys if you have kidney disease.  For regular folks, get your fluids and you will be fine! If someone disagrees - please take me to school!  But don't come back at me unless you have reliable, peer-reviewed data!  Heresay and 'someone said' doesn't cut it! My advice - get your protein in and ignore the people who think they know how much protein you can absorb!  You are fine! Danielle Halewijn RD eNutritioncare.com

There are other websites that can help with analysis based on ingredients. Carbs are carbs - and with cooking, some starches get closer to sugars.  It is hard to give you a specific answer without knowing what foods you are talking about. In your immediate post-op period, you probably won't be eating your favorite recipes.  You  may also develop some un-expected intolerances.  Take it one step at a time. Danielle Halewijn RD eNutritioncare.com