Bariatric Advantage - Blog/RSS Feed - Frequently asked questions, product information, and up-to-date news releated to bariatric (weight loss surgery) nutrition

Bariatric Advantage Blog/RSS Feed
Frequently asked questions, product information, and up-to-date news releated to bariatric (weight loss surgery) nutrition ...

Tuesday, February, 9th at 2:52 PM

Adjustable gastric banding better than diet for obese teens.

An Australian study published in JAMA on February 9, 2010 looked at the outcomes of gastric banding versus diet therapy in obese teens (ages 14-18). In the study 25 teens were given a gastric band and the other 25 were placed in a lifestyle intervention group. 84% in the gastric banding group lost more than 50% of excess weight compared to 12% in the lifestyle group. The gastric banding group also showed significant improvements in obesity-related health conditions such as hypertension and metabolic syndrome.

Reference:
O'Brien P, et al "Laparoscopic adjustable gastric banding in severely obese adolescents: a randomized trial" JAMA 2010; 303: 519-26.

The full text of this study is available here:
http://jama.ama-assn.org/cgi/content/full/303/6/519

Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage

Have a question for Dr. Jacques? Submit it here.

Tuesday, February, 9th at 10:44 AM

2 Case reports of birth defect associated with deficiency in bariatric surgery patients

The January 2010 issue of SOARD reports on 2 cases of birth defect that appear to have resulted from severe maternal vitamin deficiency after malabsorptive bariatric surgery. The first case was of a baby born at 33 weeks to a 27 year old mother 16 months post-op from a biliopancreatic diversion (BPD). The mother was deficient in vitamin A, D, K, protein, selenium and zinc. The infant was delivered prematurely with multiple defects including bone malformation, cleft palate, facial hypoplasia, and respiratory insufficiency. The baby died at 3 months of age. The second case was of a full-term infant born to a 26 year old mother 11 months post-op from a roux-en-y gastric bypass. The infant was born with multiple defects of bone and cartilage as well as hearing loss which were attributed primarily to maternal vitamin K deficiency. While most of the recent reports of pregnancy after weight loss surgery have been positive in terms of both fetal and maternal health, these cases should remind us that nutritional deficiency in pregnancy can lead to grave results. Both of these patients had been counseled about waiting 18 months to 2 years before becoming pregnant, one even having signed a consent form prior to bariatric surgery. Because of the significant impact that massive weight loss can have on fertility, it is likely that more young, obese women will opt for bariatric surgery to not only improve their overall health, but also to assist with pregnancy. Clinicians and patients alike need to be made aware of the problems that can arise when women who are not adequately nourished become pregnant.

Reference: Kang L , Marty D, Pauli RM, Mendelsohn NJ, Prachand V, Waggoner D. Chondrodysplasia punctata associated with malabsorption from bariatric procedures. Surg Obes Relat Dis. 2010 Jan-Feb;6(1):99-101. Epub 2009 May 23.

Abstract: Click Here

Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage

Have a question for Dr. Jacques? Submit it here.

Tuesday, February, 9th at 10:40 AM

A Case of B1 Deficiency in a RNY Patient After Plastic Surgery

The January 2010 issue of Surgery for Obesity and Related Diseases (SOARD) reports on a case of acute thiamine (B1) deficiency after plastic surgery in a patient with a history of gastric bypass. The patient underwent multiple, successful procedures including panniculectomy, face lift and brachioplasty (arm lift), however she developed symptoms of neurological deficit during recovery. For several days her medical team pursued a cause for the symptoms without success. On day 3, empiric therapy with intravenous thiamine was tried, providing for significant symptomatic improvement within hours. Over the next 48 hours, with continued â€œaggressive thiamine therapyâ€ the patient made a full recovery.

Cosmetic surgery, which often involves large incisions, can be taxing on the nutritional stores of the body. Many nutrients are required for wound healing â€“ such as protein, zinc and vitamin C â€“ however many more are conditionally essential meaning that a patient might have normal/borderline levels that are simply inadequate to meet the demands of surgery. While thiamine is not often thought of as a wound healing nutrient, the body stores very little and deficiency can be induced by administration of glucose. Doctors in this case suspect that deficiency may have been brought about by a combination of marginal levels in the patient coupled with the administration of a glucose-containing IV over the many hours of a lengthy set of procedures.

Reference: Sebastian JL, Michaels JM, Tang LW, Rubin JP. Thiamine deficiency in a gastric bypass patient leading to acute neurologic compromise after plastic surgery. Surg Obes Relat Dis. 2010 Jan-Feb;6(1):105-6. Epub 2009 May 18.

Abstract: Click Here

Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage

Have a question for Dr. Jacques? Submit it here.

Thursday, February, 4th at 2:14 PM

Study Looks at Issues of Compliance

A new study released online January 27, 2010 demonstrates that compliance with nutrition is a challenge for many bariatric surgery patients. The study, titled Nutritional and Pharmacologic Challenges in the Bariatric Surgery Patient, looked at bariatric patients admitted to a single hospital years after their bariatric procedures (admissions for other causes). Researchers evaluated what they were doing for supplementation at the time of admission and compared this to current ASMBS guidelines (available here: http://www.asmbs.org/Newsite07/resources/asmbs_items.htm). Most of the patients were 3-7 years post-op, 87% were roux-en-Y gastric bypass. On admission only 33% were taking a multivitamin and only 5% were taking B12 . Problems were also noted with iron, calcium, folic acid and vitamin D supplementation. In addition, researchers found numerous medication errors, the primary problem being the use of slow releasing medication forms in patients with malabsorptive procedures. Overall, this study points to the continued need for both bariatric surgery patients and healthcare professionals to be better educated on appropriate nutrition and medication protocols.

Reference:
Lizer MH, Papageorgeon H, Glembot TM. Nutritional and Pharmacologic Challenges in the Bariatric Surgery Patient.
Obes Surg. 2010 Jan 27. [Epub ahead of print]

Link to abstract: Click Here

Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage

Have a question for Dr. Jacques? Submit it here.

Thursday, January, 28th at 9:48 AM

What are the ingredients in ProJoe?

What are the ingredients in ProJoe?

Mocha: INGREDIENTS: Brewed Arabica coffee (coffee and water), EasyGest protein blend (milk protein concentrate and whole grain brown rice protein), carageenan, dipotassium phosphate, natural and artificial flavors, calcium hydroxide, caffeine, Ace-K, sucralose, niacin, pantothenic acid, cyanocobalamin, pyridoxine HCL.

Chai: INGREDIENTS: Brewed tea (tea and water), EasyGest protein blend (milk protein concentrate and whole grain brown rice protein), carageenan, natural flavors, dipotassium phosphate, calcium hydroxide, caffeine, Ace-K, sucralose, niacin, pantothenic acid, cyanocobalamin, pyroxide HCL.

Nillaccino: INGREDIENTS: Brewed Arabica coffee (coffee and water), EasyGest protein blend (milk protein concentrate and whole grain brown rice protein), carageenan, dipotassium phosphate, natural and artificial flavors, calcium hydroxide, caffeine, Ace-K, sucralose, niacin, pantothenic acid, cyanocobalamin, pyroxide HCL.

Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage

Have a question for Dr. Jacques? Submit it here.

Monday, January, 25th at 3:32 PM

I have had past reactions to Niacin, can I still take your vitamins?

I have had past reactions to Niacin, can I still take your vitamins?
The most common type of reaction to niacin is called a "niacin flush", which is not caused by all forms of niacin. Crystalline niacin (the acid form) is found in some vitamin formulas and prescription drugs and is used to lower cholesterol. In some people it causes a very uncomfortable reaction called a niacin flush. This is not usually harmful, but it can be scary and very uncomfortable. People who have had niacin flushing may think they have an allergy.

The kind of niacin most commonly found in multivitamins is the amide form, also called niacin, but technically it is niacinamide (or nicotinamide). The amide form does not lower cholesterol and cannot cause flushing. This is the only form Bariatric Advantage uses in any of our products.

Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage

Have a question for Dr. Jacques? Submit it here.

Monday, January, 25th at 2:31 PM

Study Shows More Benefits of Preoperative Weight Loss

Study Shows More Benefits of Preoperative Weight Loss
A study published in the December 2009 in the Archives of Surgery shows that the weight loss prior to gastric bypass surgery is significantly associated with a reduction in post-operative complications.

The study, conducted at the Geisinger Medical Center in Danville, Pennsylvania, examined the detailed records from 881 patients who had bariatric surgery at the facility between 2002 and 2006. All patients in the study had either open or laparoscopic gastric bypass surgery and all participated in a 6-month standardized pre-operative program. As part of this program, patients are advised (but not required) to lose 10% of their excess body weight (EBW). Of the 881 patients included in the study, some gained weight and some lost weight. The authors of the study categorized patients by the amount of weight gained or lost in the preoperative period and compared this to postoperative complications in the same groups.

A loss of 6-10% EBW was associated with the lowest incidence of 30-day postoperative complications for both open and laparoscopic procedures. Those losing greater than 10% EBW also had significantly lower complication rates as compared to those who gained weight or only lost 0-5% excess weight.

This data supports prior data from the Geisinger Center which showed that patients with 10% (or higher) preoperative EWL had shorter postoperative hospital stays, indicating that the likely reason is the reduced rate of complications found in the current analysis.

While the authors stop short of suggesting that all patients undergoing bariatric surgery should be required to undergo preoperative weight loss, the do call for prospective, controlled trials to support their findings.

Reference: Arch Surg. 2009;144:1150-1155, 1155-1156.

Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage

Have a question for Dr. Jacques? Submit it here.

Monday, January, 25th at 2:26 PM

New study - Benefits of calcium and vitamin D for fracture prevention

New study shows benefits of calcium and vitamin D for fracture prevention
A new review the looked at data from 70,000 adults in the US and Europe has found that the combination of calcium and vitamin D lowers fracture risk. The findings that pooled results from several studies found that an average of 1000mg calcium and 800 IU reduced overall fracture risk by 8 per cent, and hip fractures specifically by 16 per cent. Vitamin D alone did not show protective effects for fracture.

Reference: Abrahamsen B, et al "Patient level pooled analysis of 68,500 patients from seven major vitamin D fracture trials in U.S. and Europe" BMJ 2010; DOI: 10.1136/bmj.b5463. <http://www.bmj.com/cgi/doi/10.1136/bmj.b5463>

Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage

Have a question for Dr. Jacques? Submit it here.

Tuesday, January, 12th at 12:26 PM

Study Shows More Benefits of Preoperative Weight Loss

Study Shows More Benefits of Preoperative Weight Loss
A study published in the December 2009 in the Archives of Surgery shows that weight loss prior to gastric bypass surgery is significantly associated with a reduction in post-operative complications.

The study, conducted at the Geisinger Medical Center in Danville, Pennsylvania, examined the detailed records from 881 patients who had bariatric surgery at the facility between 2002 and 2006. All patients in the study had either open or laparoscopic gastric bypass surgery and all participated in a 6-month standardized pre-operative program. As part of this program, patients are advised (but not required) to lose 10% of their excess body weight (EBW). Of the 881 patients included in the study, some gained weight and some lost weight. The authors of the study categorized patients by the amount of weight gained or lost in the preoperative period and compared this to postoperative complications in the same groups.

A loss of 6-10% EBW was associated with the lowest incidence of 30-day postoperative complications for both open and laparoscopic procedures. Those losing greater than 10% EBW also had significantly lower complication rates as compared to those who gained weight or only lost 0-5% excess weight.

This data supports prior data from the Geisinger Center which showed that patients with 10% (or higher) preoperative EWL had shorter postoperative hospital stays, indicating that the likely reason is the reduced rate of complications found in the current analysis.

While the authors stop short of suggesting that all patients undergoing bariatric surgery should be required to undergo preoperative weight loss, the do call for prospective, controlled trials to support their findings.

Reference: Arch Surg. 2009;144:1150-1155, 1155-1156.

Reviewed and Prepared by:
Jacqueline Jacques, ND
Chief of Scientific Affairs
Bariatric Advantage

Have a question for Dr. Jacques? Submit it here.

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.