saturday accountability

Amy, this is only my opinion but I would like to see you nix the carbs for 6 months and focus on vitamins, protein, fruits and vegetables.  3 protein whey shakes a day.  See my profile to see what my doc had me eat.  I kn ow docs are different, but, I'm looking at what you are eating if you just had surgery 9/10/08 and I'm saying " Where is the protein, where is the water? what are all these carbs doing here??" The first 6 months are your optimal weight loss window.  

Anyway, better stop ranting till I know all the facts....glad you are here!!  Glad you are working so hard to lose weight, proud of you! 

"Nixing the carbs" is a bit of an overstatement. You absolutely need carbohydrates to burn as energy-- just try to choose carbs that are whole grains and fruits and vegetables.

As far as shakes go-- there's no conclusive evidence that shakes are better for you in any way-- especially as you are further post op and your intestinal villi become more efficient and your malabsoroption slows to nil.

I rarely have shakes, ****asionally toss powder into ice cream or yogurt if I am running exceptionally low) but still get in 110-120 g protein per day on 1100 calories or under-- it's possible inside of a balanced diet without using lots of supplementation when you get further out.

 Better to let others share their experiences.  Here is a portion of a post  on protein group at yahoo.com. Vicki wrote this...kudos to her for the research. Make your own conclusions and decisions.  I only share my opinions.  


"Do your research/searches on short bowel syndrome, or short gut syndrome.
This is basically what we asked to be given, when you look at it . . . a
shortened gut with less absorption capability. I'll attach a document that
I have (it won't come through on the list; just go to Jennifer privately).
Also, there is a great gastroenterology medical textbook online at
http://gastroresource.com/GITextbook/en/chapter7/7-9.htm . That URL
specifically points to the chapter on malassimilation syndromes, but take a
look at other sections, like the one on protein digestion and absorption,
etc. There used to be a much simplified explanation on a site called
e-gastroenterology.com or something like that, but that site went down a
couple of years ago, darn it. I guess someone didn't want to keep paying
the fee for the site address or something . . .

But here are the main points I've learned by researching how "normie"
digestion and absorption work, stuff about short bowel syndrome, and
studying my own surgical reports so that I know specifically what was done
to me:

1. The vast majority of the acid pumps in the stomach are in the lower 2/3
of the stomach. An RnY pouch is made from the upper 1/3; so most of the
acid pumps that provide the acid to break down food protein into the branch
chain amino acids so they can be absorbed are bypassed, and those digestive
juices do not come into contact with the food until they reach the common
channel, and it's unknown how much "good" they can do down there.

2. In order for protein to be broken down into the BCAA's so they can be
absorbed, what you ingest has to be churned around in the stomach and squish
and mashed up and turned into chyme; and since the vast majority of our
stomach is bypassed, not nearly so much "churning" happens, so much more of
what we eat as food enters the small intestine unbroken down, undigested.

3. The sites in the small intestine which are best suited for absorbing
BCAA's from protein are in the duodenum and the first part of the jejunum.
In all RnY's that I know about, ALL of the duodenum is bypassed, and all
except the very shortest of bypasses, most of the jejunum is bypassed. So,
now you have only partially-digested protein hitting sites of the intestines
which are not best suited for absorbing fully-digested protein.

4. Pre-digested protein shake**** your stomach already broken down in to
the BCAA's that are most easily absorbed by your gut. Not so much need for
our limited digestive capabilities of the small RnY pouch, and much more
likelihood that, somewhere along the way, your intestines will be able to
absorb it.

5. When your digestive system has to "work hard" at getting the nutrition
that it needs, then it adapts; the intestines grow longer, grow thicker, and
grow more villi in order to increase absorption of nutrients (and,
consequently, absorption of calories). This is what you learn by studying
short bowel syndrome. The way that you cause SBS to perpetuate and not
"heal" on patients whom do NOT WANT SBS is to feed them pre-digested protein
and other nutrients, so that their digestive systems don't have to work as
hard to absorb the nutrients. The way you "heal" and "fix" SBS is to make
your body work for its nutrition by eating whole protein foods. Do you
really want your body "fixing" the surgery that you paid good money (and
probably hard recovery time) to get??

I hope this information helps. Plus, study what the folks who are long-term
"winners" with their surgeries are doing; they are the ones who tend to
supplement very well according to regularly-done full sets of labs, and they
track those labs themselves, not just depend on the doctor saying they're
"fine". My original surgeon said no protein drinks, get all your nutrition
from 3 meals a day of 70% protein and 30% vegetables, and one multi-vitamin
and one iron pill a day. When I had my revision, my roux limb (the only
component of my original surgery for which I had both before and after
measurements) had grown from the 30 inches my first surgeon made it to 50
inches at the time of my surgery 5 years later. That was all the "proof" I
needed . . . that and the 70 pounds I regained following the "get all your
protein from food" diet. Of course, not everyone is the same . . . but
study it for yourself. Please. Don't just blindly follow the advice of
dietitions, who are trained on "normie" nutrition and don't fully understand
the medical aspects of things, like malabsorption and hypertrophy."

Thanks for the response. I'm going to research this more fully to make sure I am not doing anything untoward or dangerous.

I'm thinking that with good labs, supplementation after workouts and while healing, and daily intake of 100-120g of food based protein is serving me well right now, but I might be wrong about that. I'll check into it.

Hey Shari,

Thanks for pointing this out, it's good information.  I don't know if you saw what I wrote on the DS board a month or so ago, but if you didn't, here's a link...

My results of going back to having protein shakes.

On the advice of Vitalady, (Michelle) I started back on protein shakes again in June.  I was hesitant at first but cannot BELIEVE how much better I feel now.  I'm not an RNYer and some of the above info doesn't specifically pertain to me, but a lot of it does.  I don't need any scientific proof that I need protein shakes in my life again, I now know how INCREDIBLE I feel and how much stronger I am because of protein shakes.  If you don't have a chance to read the above thread, I basically was getting every bit of 100-150 g of protein a day from other protein sources, was convinced I didn't NEED protein shakes.  My labs were even great on my protein.  But I was getting weary, groggy, tired, weak, and achey.  I had grown accustomed to feeling that way.  Then I started the shakes, and I started doing 2 a day but quickly went to 3-4 because of the effects...and OMG!  I have energy, my mood is stabilized, my muscle tone is gorgeous, my skin is bouncing back, and no more aches and pains.  Science or not, I'll be doing protein for the rest of my life. I AM A BELIEVER!!!!

Just wanted to let you know my personal experience!!!

Lori

Um, Tami, let me see how to say this nicely.  Nope, sorry, can't do it.

This is completely crap "science" and completely confabulates the concepts of malabsorption, malnutrition and adaptation.

First of all, WHY THE HELL WOULD YOU WANT TO EXTEND THE PROTEIN MALABSORPTIVE PROPERTIES OF THE MALABSORPTIVE PROCEDURES???  That's just ridiculous.  What you WANT is to improve the adaptation of the gut remaining in the alimentary tract to absorb protein.  There is no purpose to protein malabsorption in our surgeries -- it is an unfortunate side effect of the deliberate maldigestion and malabsorption of fat and complex carbs. 

If anything, you want to IMPROVE the absorption of protein/amino acids so that you don't need to supplement AS much.  Do you (or whomever you are getting this misinformation from) even UNDERSTAND this?  You want selective fat malabsorption and some carbohydrate malabsorption, and as LITTLE AS POSSIBLE protein malabsorption.  For cryin' out loud, girl -- this is stupid!

Second, if what you are saying made any sense, then according to your "theory," in order to EXTEND the malabsorption of fats and carbohydrates, we should be supplementing our early post-op diets with highly absorbable sugar and free fatty acids.  Um -- NO!!   Do you see the problem??

I don't know how you (or whomever you are chosing to believe) came up with this whacky theory, but it is nonsense.

By the way, it also sounds like this is yet another reason the DS is superior to the RNY -- we have fully functional stomachs that have the digestive functions, as well as the lower part of the stomach and it's secretory functions still present in the alimentary tract, plus a portion of the duodenum for absorption.

I for one have NEVER had a protein shake in over 5 years, and all my protein levels are fine.  Plus, over the last year, I lost 13 lbs of fat mass and GAINED 6.5 lbs of muscle mass.  So empirically, it's working for me.

Diana
Ph.D. Biological Chemistry, UCLA Medical School

 great info. Thanks!!

 So glad to have you here Amy!  Let me know how I can encourage you on in your journey....you are really doing a great job!!  Kudos to you!!

Ok, here it is....

Breakfast:
Special K protein cereal
6 oz calorie coutdown milk
banana

Snack:
100 calorie pack of pretzels

Lunch:
1 slice of Roast Pork w/ BBQ sauce
Grilled chicken breast
Small red potato

Snack:
WW Yogart


Dinner:
Smart One's frozen dinner

Snack:
String cheese
12 oz Chocolate calorie countdown milk

 not bad special kay, but where is your protein drink??????