Bariatric Advantage Blog/RSS Feed
Frequently asked questions, product information, and up-to-date news releated to bariatric (weight loss surgery) nutrition ...
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Tuesday, July, 13th at 1:09 PM
Dieting Puts Vitamins and Minerals at Risk
Dieting Puts Vitamins and Minerals at RiskThe results of the "A to Z" study from Stanford University, confirm that most popular weight loss diets put vitamins and minerals at risk. This trial look at people in four diet groups: - Atkins Diet (73 patients) - high protein, low carb
- Zone Diet (73 patients) - low glycemic
- LEARN - a low calorie diet
- Ornish Plan - a vegetarian, very low fat diet
Researchers found that at 8 weeks, all dieters were wating about the same amount of calories, and each diet had unique nutrient deficiencies as follows: - Atkins - thiamine, folic acid, vitamin C, iron, and magnesium
- LEARN - vitamin E, thiamine, and magnesium
- Ornish - E and B-12 and zinc
By contrast, those on the Zone plan had a decrease in risk for deficiency of A, E, K, and C. Referencehttp://www.ajcn.org/cgi/content/abstract/ajcn.2010.29468v1 Am J Clin Nutr 2010 Jun 23. [Epub ahead of print]
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
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Friday, July, 9th at 2:33 PM
Gastric Bypass, Vitamin D and PTH
Gastric Bypass, Vitamin D and PTH
A study conducted at Beaumont Hospital in Royal Oak, MI raises new questions about the relationship between vitamin D status and PTH in post-operative gastric bypass (RNY) patients.
Clinicians followed 123 patients checking baseline labs before surgery and comparing to one year post-operative data. They found that 86% of patients met the criteria for vitamin D deficiency prior to RNY. One year after surgery, mean vitamin D had increased (average supplemental level was 1200-2000 IU/day D3) 29 +/- 13 ng/mL. Despite that increase, and supplementation, 70% of patients remained deficient in D at 12 months. Also at 12 months, PTH was elevated in 33% of patients. Clinicians reported that "there was no correlation between vitamin D deficiency and levels of serum PTH at one year after" gastric bypass surgery.
Reference:
Signori C, Zalesin KC, Franklin B, Miller WL, McCullough PA. Effect of Gastric Bypass on Vitamin D and Secondary Hyperparathyroidism. Obes Surg Jul 2010.
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
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Friday, July, 9th at 1:40 PM
Vitamin D Deficiency After Biliopancreatic Diversion (BPD)
Vitamin D Deficiency After Biliopancreatic Diversion (BPD)
Vitamin D deficiency is common in morbid obesity as well as after bariatric surgery. Research is clear that this deficiency is a risk with bariatric surgery, but it is not entirely clear whether any given bariatric surgical procedure actually worsens deficiency - in fact evidence exists for weight loss improving vitamin D status.
Biliopancreatic Diversion (BPD) is a malabsorptive bariatric surgical procedure that has as a side effect a known impact on absorption of fats and fat-soluble vitamins. A new study, examined vitamin D levels in 219 BPD patients at an average time of three years post-operatively, and found that in patients with BPD, vitamin D levels decrease over time.
It is also worth noting that all patients in this study were asked to take 50,000 IU of vitamin D3 per day after surgery. While the authors admit that compliance was not evaluated, 72.3% of patients studied had vitamin D insufficiency, and 46.8% had a deficiency. This would either imply high rates of non-compliance or would suggest that for some percentage of BPD patients this level and/or method of prevention is not adequate.
Reference:
Khandavala BN, Hilbma PP, Fang X. Prevalence and Persistence of Vitamin D Deficiency in Piliopancreatic Diversion: A Retrospective Study. Obes Surg Jul 2010.
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
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Monday, May, 24th at 11:27 AM
Proton Pump Inhibitors (PPIs) and Fracture Risk
Proton Pump Inhibitors (PPIs) Increase Fracture Risk
Proton pump inhibitors (PPIs) are the most potent acid-blocking medications in use. They are known to inhibit calcium absorption, and also to increase fracture risk. A recent prospective, observational cohort study examined the fracture risk in long-term users of these medications (3 years or more).
Data came from over 130,000 women followed for an average of 7.8 years. While PPI use did not seem to significantly change bone mass density or increase specific risk for hip fracture, researchers did find increased risk for clinical spine fractures, wrist or forearm fractures, and overall total fractures.
It is not uncommon for bariatric surgery patients to take PPIs long-term after surgery. Surgery itself already increases the risk for fracture, calcium malabsorption, and bone loss. Thus clinicians would do well to be aware that PPI use might further contribute to this risk, and consider PPI use as one possible modifiable risk factor.
Reference
Arch Intern Med. 2010;170:747-748, 765-771.
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
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Friday, May, 7th at 2:57 PM
Vitamin D May Be Better Absorbed With More Food
Vitamin D May Be Better Absorbed With More Food
People often want to know if vitamins should be taken with or without food. New research indicates that for Vitamin D, administration with the largest meal of the day may substantially increase the absorption of Vitamin D supplements.
In a small study of 17 patients who had not been responding to vitamin D treatment, researchers at the Cleveland Clinic found that when instructed to take their Vitamin D with the largest meal of the day, vitamin D absorption was greatly improved and that over a 2-3 month period levels were raised on average by 50% from baseline.
Reference:
Mulligan, G. Journal of Bone and Mineral Research, April 2010;
vol 25: pp 928-930.
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
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Friday, May, 7th at 10:19 AM
Omega 3 For Bones?
Omega 3 For Bones?
While there are many nutrients - calcium, vitamin D, vitamin K - that we know are important for bone health, there are still things that we are learning about the impact of other nutrients. A new study indicates that fish oils like DHA may also be important for healthy bone.
The study, conducted in rats, found that animals supplemented with DHA had healthier bone marrow and increased bone density.
It is not known if these findings would extend to humans, although a recent study commissioned by NASA found that astronauts supplemented with the Omega-3 EPA had less bone loss in space compared to unsupplemented astronauts.
References:
Yong Li,
Mark F. Seifert,
Sun-Young Lim,
Norman Salem
and Bruce A. Watkins
Bone mineral content is positively correlated to n-3 fatty
acids in the femur of growing rats. British Journal of Nutrition,
Published online by Cambridge University Press 27
Apr 2010
doi:10.1017/S0007114510001133
Journal of Bone and Mineral Research
Published online ahead of print, doi: 10.1359/JBMR091041
“Capacity of Omega-3 Fatty Acids or Eicosapentaenoic Acid to
Counteract Weightlessness-Induced Bone Loss by Inhibiting NF-ÎşB
Activation: From Cells to Bed Rest to Astronauts”
Authors: S.R.
Zwart, D. Pierson, S. Mehta, S. Gonda, S.M. Smith
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
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Thursday, May, 6th at 3:23 PM
Increased Serum Markers for Bone Loss After Gastric Bypass
Increased Serum Markers for Bone Loss After Gastric Bypass
It is fairly well-understood that bone loss is a risk after gastric bypass surgery. Not all the factors contributing to this are understood. A new study published in January 2010 in the Journal of Clinical Endocrinology and Metabolism suggests a relationship to decreased leptin levels.
The study, which followed 10 men and 10 women found that at 6 and 18 months post op RNY serum osteocalcin, bone alkaline phosphatase and N-telopeptide (NTX) levels, and vitamin D levels were all increased and leptin levels were reduced. After regression analysis, the increase in markers of bone turnover, specifically NTX, were found to be predicted by reduced leptin.
While many factors related to bone loss are thought to be related to nutritional factors such as calcium and vitamin D, it is important to remember that there are other mechanisms including hormone changes, medication use, and central mechanisms of bone loss (such as changes in leptin and ghrelin levels). All of these factors are important to account for when managing risk for bone loss.
Reference:
http://jcem.endojournals.org/cgi/content/abstract/95/1/159
The Journal of Clinical Endocrinology & Metabolism
Vol. 95, No. 1 159-166
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
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Thursday, May, 6th at 1:23 PM
Abnormal GI Flora May Be Linked To Obesity
Abnormal GI Flora May Be Linked To Obesity
Researchers from Cedars Sinai Hospital in Los Angeles, California, presented data at Digestive Disease Week (May 2010) showing that GI flora may be different in those with a higher BMI. They found specifically that individuals with higher BMIs have more methane-producing bacteria. The lead researcher in this study has proposed that higher methane levels in the gut may slow digestive motility and allow for absorption of more calories from a meal.
Reference:
LA Times, May 6, 2010
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
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Thursday, May, 6th at 1:13 PM
Two New Studies on Gastric Balloons
Two New Studies on Gastric Balloons
Two new studies presented at Digestive Disease Week in May 2010 have found that intragastric balloons might offer a save, less-invasive weight loss procedure for some people.
In the first study, researchers used a saline-filled balloon. They followed 81 patients, and found an average 20 pound weight loss in 5-7 months. This study included 14 patients who were overweight (BMI of 27.6 and 30) but not obese - and thus would not be candidates for bariatric surgery.
The second study used an air-filled gastric balloon. 19 patients were followed for 6 months and lost an average of 29 pounds.
Various forms of gastric balloons have been around since the 1980s, but none are currently approved as weight loss devices in the United States. Several clinical trials are currently looking at these devices to learn more about their safety and efficacy.
Reference:
WebMD News, May 6 2010
http://www.webmd.com/diet/weight-loss-surgery/news/20100506/gastric-balloons-may-aid-weight-loss
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
Have a question for Dr. Jacques?
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These statements have not been evaluated by the Food and Drug Administration.
These products are not intended to diagnose, treat, cure, or prevent any disease.
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