When obesity gets out of hand, unresponsive to dietary, lifestyle and medical interventions, drastic measures are needed to reduce calorie intake. Morbid obesity which has a BMI (body mass index, a measure of malnutrition) higher than 40 kg/m2 is a sign for surgical procedures such as gastric bypass surgery. Gastric bypass, first used in the 1950's to lessen BMI's and achieve healthier lives in 18 months or so, has only, within the last two decades become a consistently safe and successful surgery. Strict guidelines to ensure patient safety and desired results have required 50 years of meticulous observations and patient follow-up. The decision to proceed with gastric bypass surgery initiates a series of steps. Identifying existing nutritional deficiencies is the first step towards surgery. Vitamin and mineral deficiencies typically occur in obesity, and must be addressed before the procedure. There are 2 goals to gastric bypass surgery; to limit the quantity of food that the stomach can hold also to decrease the time it takes the food to move through the intestine. After surgery the stomach cannot receive large meals or engage in digestion. Alone, this can be an element in reducing the consumptionof food. Food additionally 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. Nowadays following most gastric bypass surgeries only 50 cm of the intestine is permitted to perform normally. This is compared to more than 7 feet of intestine which is normally used for food absorption.
With such a radical reduction in the capacity to assimilate food, the postoperative period will be rather tricky. Only clear fluids are suggested for the 1st two days while awaiting the gut to recover. Before one can return to an ordinary eating plan they must wait for roughly 2 months in which the gut is retrained on how to do its task. It really is significant to bear in mind the restrictions that are imposed by the gastric bypass procedure during the recovery phase. After surgery the stomach has become much smaller and will only hold approximately eight ounces (or less) at a time. The stomach has also lost its ability to pulverize food to initiate digestion. Consequently the acceptable diet for postoperative recovery will be a liquid to soft solid diet that can be taken six to eight times every day in little quantities. Nutrient fluids are preferable since they can provide hydration and energy at the same time. Therefore, non-nutrient fluids needs to be avoided or at the least limited to in-between meals.
The style of nutrient chosen additionally deserves due consideration The chosen macronutrient shouldn't affect the stomach's emptying time whilst providing a sufficient amount of energy to recover from the surgical procedure. Neither carbohydrates or fats are suitable in this regard. Carbohydrates pass through very quickly and produce terribly uncomfortable symptoms like vomiting, bloating, diarrhea and sweating. Fat slows the gut significantly, and it is oftentimes ruled out as a result of of its direct link to obesity. For post operative patients, proteins have become the macronutrient of choice by means of extensive study. They have little or no impact on gastric transit time. Post gastric bypass surgical procedure a high protein eating routine provides sufficient amino acids for repair and growth to occur.
Apart from these benefits, a high-protein diet has a special role inside the treatment of obesity. Gastric bypass is needed to prevent people from eating excessive amounts of calories with the intention of stoping any more fat gain. In order to attain the necessary fat loss goals the accumulated adipose tissue must be expended in your body. Simultaneously, to burn stored fat and reduce BMI, the basal metabolic rate (energy expenditure) must be amplified. This will be achieved by a high-protein diet since proteins in diet increase the basal metabolic rate by stimulating protein synthesis. This can be confirmed by observations that were taken through the postoperative stage of existing patients. In spite of controlled ingestion fat loss frequently ceases with the absence of a high-protein diet.
Presently, a protein consumption of approximately ninety grams per day is recommended within the post-operative period. Working with a high protein consumption could possibly be challenging to maintain, considering the shock along with the constraints of the gut throughout the surgical procedure. The gut is hardly prepared and usually fails to assimilate proteins and energy from traditional foods and diets. Therefore throughout the post operative phase having a sugar-free fluid protein concentrate that has a high bioavailability, plenty of required amino acids, vitamins and minerals is the most appropriate. Digestion is further facilitated if the protein concentrate is already pre-digested, or hydrolyzed. Such a nutrient fluid can simultaneously provide concentrated energy and hydration even when taken in small quantities.
After recovery and return to a traditional diet divided over three to four meals every day, a high-protein concentrate remains a relevant supplement between or during meals. This is because the thermogenic action that's needed to drop some weight and required to sustain weight loss continues to be supplied by the protein supplement. The protein supplement makes up for just about any deficiency of amino acids in the eating routine on bad days as well.
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.
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About Protica Research
Founded in 2001, Protica Research (Protica, Inc.) is a nutritional research firm specializing in the development of capsulized foods (dense nutrition in compact liquid and food forms). Protica manufactures Profect (www.profect.com), IsoMetric, Pediagro, Fruitasia and more than 100 other brands in its GMP-certified, 250,000 square foot facility. One area of specialty is the manufacturing of Medicare-approved, whey protein liquid for bariatric surgery patients.
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