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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Friday, October, 23rd at 1:58 PM
Iron, B12 and Folate after Sleeve Gastrectomy
A new study has shown that there is a risk of B12 and folate deficiency, and a lesser risk of iron deficiency one year after vertical sleeve gastrectomy. 151 patients who underwent the vertical sleeve gastrectomy procedure in Saudia Arabia, had their labs followed for one year. The incidence of B12 deficiency increased from 8.1% pre-operatively to 26.2% post-operatively. Folate deficiency developed in 9.8% of patients and iron deficiency developed in 4.9% of patients. These findings suggest that vertical sleeve gastrectomy patients are at nutritional risk based on their procedure and should be monitored for deficiency after surgery.
Hakaem HA, O’Regan PJ, Salem AM, Bamehriz FY, Eldali AM. Impact of Laparoscopic Sleeve Gastrectomy on Iron Indices: 1 Year Follow-Up. Obes Surg. 2009 Jul 15.
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
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Tuesday, September, 29th at 10:53 AM
Why do the new meal replacements have more sodium and potassium?
When we reformulated our meal replacements we went to a higher-grade whey protein isolate. Because highly purified isolates are bitter, sodium and potassium are added to neutralize the taste (by adjusting the pH). This is actually a benefit in longer-term use for weight loss, where there can be issues with electrolyte balance. For short-term use, it really should not matter.
The Daily Value (%DV) for sodium is 2400mg – even at 5 serving/day someone will only be at 1500mg with this product. A low sodium diet is generally defined as one not going over 2000mg/day – which is still higher than the amount in 5 servings. Just for a point of reference, 3 ounces of tuna, 2 medium apples, or 2 cups of milk would give about the same amount of sodium as are found in one serving of the High Protein Meal Replacement. Those who have been advised to restrict sodium or potassium or both, such as individuals on medications for high blood pressure or those on dialysis, should discuss the use of this product with their health professional.
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
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Wednesday, August, 26th at 8:57 AM
Why are Vitamins A, E and D measured in IU rather than grams, mg, or mcg?
Some vitamins – specifically A, E and D – are expressed as a unit of biological activity (IU, International Units), rather than as weight such as grams, milligrams or micrograms. Occasionally, it is helpful to know the weight of a nutrient expressed this way.
Here are some of the common conversions:
Vitamin A
1 IU = 0.3 mcg all-trans retinal = 0.3 mcg retinol = 0.344 mcg retinyl acetate = 0.55 mcg retinyl palmitate = 3.6 mcg Beta-Carotene
1 mcg Retinol = 3.34 IU of vitamin A activity
1 mg of all-trans Beta-Carotene = 1667 IU of Vitamin A activity
1 mcg Beta-Carotene = 1.67 IU of Vitamin A activity
1 mcg dietary Beta-Carotene = 0.167 mcg retinal
Retinol Equivalents (RE) = the Vitamin A activity in foods
1 RE = 1 mcg all-trans retinal = 1 mcg retinal = 3.33 IU Retinol
1 RE = 6 mcg all-trans Beta-Carotene = 6 mcg Beta-Carotene
1 RE = 12 mcg other provitamin A carotenoids
Vitamin E
1 IU = 0.67 mg of d-alpha-tocopherol or 0.45 dl-alpha-tocopherol
1 mg = 1.49 IU d-alpha-tocopherol (natural vitamin E; RRR-alpha-tocopherol)
1 mg = 1.10 dl-alpha-tocopherol (synthetic vitamin E; all-rac-alpha-tocopherol)
Vitamin D
1 IU = 0.025 mcg of cholecalciferol (Vitamin D3)
1 mcg Vitamin D (cholecalciferol) = 40 IU
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
Have a question for Dr. Jacques!?
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Wednesday, August, 26th at 8:45 AM
New research Supports Calcium Citrate Over Carbonate After RNY Gastric Bypass.
New research conducted at the University of Texas Southwestern Medical Center supports the use of calcium citrate over calcium carbonate after gastric bypass surgery. Calcium absorption is impaired after gastric bypass surgery as there is significantly less stomach acid as well as malabsorption from bypassing the duodenum. This study was a double-blind crossover study to compare the absorption of calcium citrate to calcium carbonate after gastric bypass. This is important as bone loss is a serious risk after surgery. Patients are asked to take large amounts of supplemental calcium after surgery, and these are the commonly supplemented forms. This study showed not only better absorption of calcium as calcium citrate, but also a greater decline in serum PTH levels in response to calcium citrate.
Source:
Tondapu P, Provost D, Adams-Huet B, Sims T, Chang C, Sakhaee K. Comparison of the Absorption of Calcium Carbonate and Calcium Citrate after Roux-en-Y Gastric Bypass. Obes Surg. 2009 Sep;19(9):1256-61. Epub 2009 May 13. Click Here to view the source article.
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
Have a question for Dr. Jacques!?
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Wednesday, August, 26th at 8:32 AM
Are water miscible vitamins still fat-soluble?
A water miscible fat-soluble vitamin is one that has been prepared so it can mix or dissolve in water. This may assist with absorption in someone who has fat malabsorption. In the body, the vitamin itself does not become a water-soluble vitamin like vitamin C and the B-vitamins. A, D, E and K remain fat-soluble vitamins in the body.
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
Have a question for Dr. Jacques!?
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Thursday, August, 13th at 11:03 AM
What is the difference between Omega-3, Omega-6, and Omega-9?
There many kinds of fatty acids found in the human diet. The two essential fatty acids are the omega 3 and omega 6 groups.
The important omega 3s include α-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), all of which are polyunsaturated. Dietary sources include flax, hemp, walnuts, and fatty fish. Most research indicates that our modern diets do not contain sufficient omega 3 fatty acids for good health, and for this reason it can be health-supportive to supplement them from a source like fish oil.
Omega 6 fatty acids that are important include linoleic acid (LA) and arachadonic acid (AA). Dietary sources include almost all animal products, and common sources like palm and soybean oils. Most research indicates that the modern American diet is abundant in these fats, and that relative to our omega 3 fatty acids, we have a very high % of omega 6 in what we eat. Excess omega 6 fats interfere with the health benefits of omega 3 fats; in part because they compete for the same rate-limiting enzymes. Most people, therefore do not need to supplement these fatty acids.
Omega 9 fatty acids are non-essential fatty acids that primarily come from sources such as nuts, avocados, olive oil and animal fats. They are fairly plentiful in the American diet and as they are non-essential, they are usually not supplemented.
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
Have a question for Dr. Jacques!?
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Wednesday, August, 12th at 11:31 AM
Do my vitamins need to be taken with or without food?
Many of the common nutrients found in a multivitamin are better absorbed when taken with some food.
Calcium can usually be taken on an empty stomach if desired. Your dietitian will likely give you guidance on the best way to take your vitamins each day.
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
Have a question for Dr. Jacques!?
Submit it here.
Wednesday, August, 12th at 11:28 AM
Sublingual B12: How long do I have to let the tablet sit under my tongue?
You should keep the B12 in your mouth until it completely dissolves.
If it is hard to keep it under your tongue, place it between your cheek and gum on the side of your mouth. You can also crack the tablet in half with your teeth to help it dissolve a bit more quickly.
Chewing and swallowing the tablet is not advised.
Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage
Have a question for Dr. Jacques!?
Submit it here.
Wednesday, August, 12th at 11:25 AM
What is the difference between Calcium Citrate and Calcium Carbonate?
Calcium citrate and calcium carbonate are different chemical compounds with different properties.
Calcium citrate has been shown to be better absorbed by close to 30% when there is low stomach acid such as after a gastric bypass, or in those taking medication that reduces stomach acid.
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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