Vitamin D and Bariatric Surgery

Increasingly, bariatric surgery is used for those with morbid obesity as a pivotal approach to achieve weight loss. Various types of weight loss surgeries have become popular as a way to help people who are severely obese to permanently reduce their weight and improve their health and quality of life.

A gastric bypass solves the problem of absorbing too many calories, but you also experience decreased absorption of nutrients. Vitamin D deficiency is common in obese individuals, and vitamin D malabsorption is common following some weight-loss surgeries. Because of this, your health care provider will check your vitamin D levels beforevitamin_d (2) your surgery and may advise you to supplement before and afterward.

Authors of a 2006 study in the “Annals of Surgery” said that vitamin D deficiency is common following gastric bypass and it progresses over time. Gastric bypass quite literally bypasses the primary site in your digestive tract where most of the absorption of some important nutrients takes place.

Vitamin D is necessary for the absorption and transportation of calcium from the gut to the bloodstream. You have a backup system of sorts that can help load calcium without vitamin D, but it’s much less efficient, absorbing only about 20 percent of what you consume. The “Annals of Surgery” authors said that vitamin D deficiency over time leads to a bone-mineral density problem, known as osteopenia, but can also progress to osteoporosis, or brittle and fragile bones — and ultimately to osteomalacia, or bone softening.

Guidelines issued by the American Society for Metabolic & Bariatric Surgery state that “supplementation with calcium and vitamin D during all weight loss modalities is critical to preventing bone resorption.” Therefore, lifelong screening and aggressive treatment is in order to tend to bone health needs following gastric bypass.

Bariatric surgery can be effectively used to achieve sustainable weight-loss in morbidly obese patients, but it can simultaneously bring forth important functional consequences of nutrient deficiencies and drug absorption that clinician’s must be aware of.

If you are considering bariatric surgery, schedule a consultation with Dr. Heidi Ryan. She and her expert team know how to make sure all of your nutritional needs are met while still helping you lose the weight you need to lose in order to be healthy.

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Lower Your BP By Increasing Your Intake of These Healthy Items

A host of studies on foods and hypertension suggest it may be easier than once thought to reduce high blood pressure. One safe, effective way to decrease blood pressure is to eat foods that work naturally to dilate blood vessels so the heart doesn’t have to work so hard.

  • Blueberries
    • One serving/week can cut risk of high blood pressure.
    • They contain natural compounds called anthocyanins that protect against hypertension, according to a recent British and American study published in the American Journal of Clinical Nutrition.
  • Cereal
    • Harvard University researchers found that having a bowl of whole-grain, high-fiber cereal can reduce the chance of developing high blood pressure.
  •  Potatoes
    • Potatoes are high in potassium and magnesium, two important minerals that can help fight high blood pressure.
    • Research shows that if Americans boosted their potassium intake, adult cases of high blood pressure could fall by more than 10 percent.
  • Beet juice
    • Drinking a glass of beet juice can lower blood pressure within just a few hours, according to a Queen Mary University of London study published in the American Heart Association journal Hypertension.
    • The nitrate in the juice has the same effect as taking a nitrate tablet, the researchers found.lower bp with food image
  • Low-fat dairy products
    • Eating low-fat dairy products can reduce a woman’s risk of developing hypertension according to a 2008 study of nearly 30,000 women with an average age of 54. The women who ate the most low-fat dairy products were 11 percent less likely to develop high blood pressure.
  • Dark chocolate
    • Eating a one-ounce square of dark chocolate daily can help lower blood pressure, especially in people who already have hypertension, according to Harvard researchers who analyzed 24 chocolate studies.
    • Dark chocolate is high in flavonoids, natural compounds that cause dilation of the blood vessels.
    • Look for chocolates that say they contain 50 to 70 percent cacao.

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If you’ve been diagnosed with high blood pressure and are obese, contact Dr. Shawn Tsuda to find out how he can help.

You’ll Need More than Willpower to Change (But it is a Great Start!)

Many people believe they could improve their lives if only they had more of that mysterious thing called willpower. With more self-control we would all eat right, exercise regularly, avoid drugs and alcohol, save for retirement, stop procrastinating, and achieve all sorts of noble goals, right?

Many people will say that lack of willpower is their most significant barrier to change. However, although many of us blame faulty willpower for imperfect choices, it’s clear we still have hope. Is willpower something that can be learned?

Recent research suggests that willpower can in fact be strengthened with practice. Scientists have made some compelling discoveries about the ways that willpower works.

Lack of willpower isn’t the only reason you might fail to reach your goals. Consider this:

  • One must establish the motivation for change and set a clear goal.
  • Monitor one’s behavior toward that goal.
  • Use willpower. Whether your goal is to lose weight, kick a smoking habit, study more, or spend less time on Facebook, willpower is a critical step to achieving that outcome.

At its essence, willpower is the ability to resist short-term temptations in order to meet long-term goals, but the old saying, “the spirit is willing, but the flesh is weak” is quite apt, especially when it comes to changing one’s lifestyle and losing weight.

We have many common names for willpower: determination, drive, resolve, self-discipline, self-control. But psychologists characterize willpower, or self-control, in more specific ways. According to most psychological scientists, willpower can be defined as:

  • The ability to delay gratification, resisting short-term temptations in order to meet long-term goals.
  • The capacity to override an unwanted thought, feeling, or impulse.
  • The ability to employ a “cool” cognitive system of behavior rather than a “hot” emotional system.
  • Conscious, effortful regulation of the self by the self.
  • A limited resource capable of being depleted.

Do you have the motivation to lose weight? Perhaps you have health problems due to obesity, but you can’t lose the weight you need to lose in order to improve your situation. Contact Dr. Heidi Ryan. She and her expert team can help you find the proper treatment for your unique case.

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Criteria for Bariatric Surgery: Do you Qualify?

Gastric bypass and other weight-loss surgeries are major, life-changing procedures. While weight-loss surgery can help reduce your risk of weight-related health problems — such as type 2 diabetes, high blood pressure, and sleep apnea — it can also pose major risks and complications. You may need to meet certain medical guidelines to qualify for weight-loss surgery. In most cases, there will be an extensive screening process to see if you qualify.

In general, gastric bypass and other weight-loss surgery could be an option for you if:

  • Efforts to lose weight with diet and exercise have been unsuccessful.
  • Your body mass index (BMI) is 40 or higher (extreme obesity).
  • Your BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure, or severe sleep apnea.

Even if you meet these general guidelines, you still may need to meet certain other medical guidelines to qualify for weight-loss surgery. A team of health professionals — usually including a doctor, dietitian, psychologist, and surgeon — evaluate whether gastric bypass or one of the other forms of weight-loss surgery is appropriate for you. This evaluation generally determines if the health benefits of the surgery outweigh the potentially serious risks. The evaluation also determines if you’re psychologically and medically ready to undergo the procedure.

When conducting an evaluation for gastric bypass surgery, the health team considers:

  • nutrition and weight history
  • medical condition
  • psychological status
  • motivation
  • age

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If you’re approved for gastric bypass surgery, your health care team gives you instructions about how to prepare in the months or weeks before the surgery. These instructions may include restrictions on eating and drinking, undergoing lifestyle counseling to help you cope with big changes in diet and exercise, quitting smoking, and starting a supervised physical activity or exercise program. In some cases, you may be required to lose weight before having gastric bypass surgery.

Gastric bypass surgery isn’t a miracle procedure — and it isn’t for everyone. Having gastric bypass or other weight-loss surgery doesn’t guarantee that you’ll lose all your excess weight or that you’ll keep it off over the long term; nor is it a way to avoid making changes in your diet and exercise habits.

If you are considering bariatric surgery, contact Dr. Shawn Tsuda. He and his team of experts can help you determine if it’s the right choice for you.

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Don’t Let Hiccups put a Hiccup in Your Post-Bariatric Surgery Life

Hiccups are repetitive, uncontrollable contractions of the diaphragm. They can occur at any age. They can even occur while a fetus is still in the mother’s womb. Everyone can have hiccups, but after having weight-loss surgery, it’s not unusual for hiccups to occur more often.

Hiccups can occur for many different reasons, but they often come and go randomly.hiccups image

The most common causes of short-term hiccups include:

  • overeating
  • eating spicy food
  • consuming alcohol
  • drinking carbonated beverages, such as sodas
  • consuming very hot or very cold foods
  • a sudden change in air temperature
  • excitement or emotional stress
  • aerophagia (swallowing too much air)

But the main reasons many weight-loss surgery patients get hiccups are:

  • eating too quickly
  • overeating

Typically, a short-term case of hiccups will take care of itself. However, the discomfort may make waiting out hiccups unbearable if they last longer than a few minutes.There are many so-called remedies for hiccups such as eating sugar, putting your fingers in your ears, holding your breath, sticking out your tongue, having someone surprise you, scare you, or tickle you. However, there is no guarantee that any of these things help get rid of the hiccups. A better plan would be to try to avoid getting hiccups in the first place.

For bariatric patients it helps to:

  • Eat slowly.
    • Eating and drinking slowly helps avoid gulping air—resulting in the amount of air that is trapped inside the digestive tract.
    • Not drinking from a straw can also help reduce the amount of air in the tummy. Ingesting a lot of air can irritate the vagus nerve.
  • Avoid overeating.
    • Experts suggest that hiccups could be a sign of overworking our digestive system.
    • Reducing the amount of food you eat, even by a bite or two could make a big difference.
    • Adjust portion sizes until finding just the right amount for your pouch size.

Most hiccups are not an emergency. However a prolonged episode can be uncomfortable and disruptive to daily life. Contact your physician if you have hiccups that last longer than two days. Your doctor can determine the severity of your hiccups in relation to your overall health and other conditions.

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Keeping a Diet Diary: Writing it Down Helps!

Several studies have shown that people who keep food journals are more likely to lose weight and keep it off, but how can the simple act of writing down what you eat and drink help in your efforts to lose weight? And for the purpose of this blog, specifically, how can it help someone after bariatric surgery?

Consider this:

  • Keeping a food journal instantly increases your awareness of what, how much, and why you are eating.
  • Food diaries help you identify areas where you can make changes.
    • You don’t realize how many calories you are getting from caloric beverages and snacks.
  • Food diaries can unveil patterns of overeating.
    • They can identify triggers to avoid, such as not eating enough throughout the day and then overeating at night, or overeating when drinking alcohol.
  • For some people, the very fact that they have to record every bite helps deter overeating
    • People often reconsider eating something because of not wanting to write it down.
  • Keeping a diet and activity journal can be a learning tool to help you monitor food intake, activity levels, and feelings connected to eating.
    • Write in your journal each day and note what you have eaten, how you feel after eating, and your physical activity for that day.
    • After surgery you can add any side effects you experience, the supplements you take, and anything else that you find is helping you succeed.

A journal can help you stay in control of what you choose to eat by holding you accountable. In addition, if after weeks of consecutive weight loss you suddenly notice that the scale is moving up, you can review your journal and find out what you are doing differently. Maybe, you have fallen off track and don’t realize it. Reviewing what worked when you were successfully losing can show you what has changed and how to get back on the path that leads to you meeting your weight-loss and health goals.

If you are considering bariatric surgery, contact Dr. Shawn Tsuda for a consultation. He and his expert team will work to find the best treatments for your unique case.

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No Pressure! But these Good Habits can Help you Control Hypertension

Lifestyle plays an important role in treating high blood pressure. If you successfully control your blood pressure with a healthy lifestyle, you might avoid, delay, or reduce the need for medication. The following can substantially affect your condition:

  • Lose extra pounds and watch your waistline. Losing just 10 pounds can help reduce your blood pressure. Also, carrying too much weight around your waist can put you at greater risk of high blood pressure.
    • Men are at risk if their waist measurement is greater than 40 inches.
    • Women are at risk if their waist measurement is greater than 35 inches.
  • Exercise regularly. If you have slightly high blood pressure, exercise can help you avoid developing full-blown hypertension. If you already have hypertension, regular physical activity can bring your blood pressure down to safer levels.
  • Eat a healthy diet. Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products and skimps on saturated fat and cholesterol can lower your blood pressure.
  • Reduce sodium in your diet. Even a small reduction in the sodium in your diet can reduce blood pressure.
  • Limit the amount of alcohol you drink. Alcohol can be both good and bad for your health. In small amounts, it can potentially lower your blood pressure. The protective effect is lost if you drink too much. Generally:
    • more than one drink a day for women and for men older than age 65
    • more than two a day for men age 65 and younger.
    • One drink equals:
       12 ounces of beer
       five ounces of wine or
       1.5 ounces of 80-proof liquor.
  • Quit smoking. Each cigarette you smoke increases your blood pressure for many minutes after you finish.
  • Reduce stress. Chronic stress is an important contributor to high blood pressure.

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If you’ve been diagnosed with high blood pressure, schedule an appointment with Dr. Tsuda to discuss weight-loss options and other treatments.