Help Your Heart With Bariatric Procedures

Nearly 70% of American adults are either overweight or obese. Being obese puts you at a higher risk for health problems such as heart disease, stroke, high blood pressure, diabetes and more.

Obesity statistics

  • Almost 13 million (16.9%) of U.S. children ages 2 to 19 are obese.
  • Nearly one in three (31.8%) U.S. children (23.9 million) ages 2 to 19 are overweight or obese.
  • More than one-third (about 35%) of U.S. adults are obese (more than 78 million adults).

Weight-loss surgery, also known as bariatric surgery, aims to help severely obese people lose weight by shrinking the amount of food that their digestive systems can handle. Bariatric/weight-loss surgeries can provide long-term success for many who have been unable to lose weight through traditional diet and exercise. It’s not a quick-fix answer to all obesity problems, though. The successful bariatric patient has to be committed to long-term diet and lifestyle changes.

Among the many medical issues that are being seen to be helped by these procedures, the decrease in risk of heart problems cannot be overlooked. Studies have found that seven Risk factor.years after they underwent weight-loss surgery, patients as a whole fared better on several measurements of their risk of cardiac problems, and many returned to normal levels. The findings don’t prove that weight-loss surgery reduces the risk of events such as heart attack and stroke, although other research has suggested it does. Still, the findings suggest that bariatric procedures provided plenty of cardiac benefit to the patients.

Several studies suggest that the procedures can reduce the risk of death from heart attack. Obese people who had certain bariatric procedures were less likely than similar people to die from a cardiovascular problem (such as a heart attack) or suffer a first-time heart attack or stroke.

The research is important because it tracks the effects of weight-loss surgery over several years. The procedures may help patients reduce risk through weight loss and an accompanying change in the body’s metabolism and the related workings of the heart.

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If you’re in the Las Vegas area and are considering bariatric surgery, schedule an appointment with Dr. Heidi Ryan. She and her team of experts can help you find the right treatment for your unique situation and health needs.


The Bariatric Food Pyramid – A Visual Tool for Long-Term Success

Bariatric surgery encompasses several surgical techniques classified as restrictive or malabsorptive, based on the main mechanism of weight loss. Clinical studies and meta-analyses show that bariatric surgery decreases morbidity and mortality when compared with nonsurgical treatments. A successful long-term outcome of bariatric surgery is dependent on the patient’s commitment to a lifetime of dietary and lifestyle changes. The surgery is considered a tool that is most successful when combined with a change in diet and exercise routines. The changes caused by surgical intervention require stringent adherence to diet guidelines to obtain adequate nutrition. While your surgeon will equip you with diets and programs necessary for your post surgical needs, a long term nutritional plan for lifelong maintenance is vital.

Based on the current knowledge of dietary strategies and behaviors associated with beneficial long-term nutritional outcomes in post-bariatric surgery patients, researchers have developed a “bariatric food pyramid”, that can be used as a teaching tool and reminder to patients.


Image from Obesity Surgery Violeta Moize

For those of you who have undergone bariatric surgery, you know your daily food consumption differs from others; meeting your nutritional requirements requires a change in thinking to avoid any nutritional deficiencies.

A few quick tips from the bariatric food pyramid are as follows:

Everyday Items

  • Calcium & Vitamin D
  • Iron
  • Multi Vitamin and Multi Mineral
  • Vitamin B 12
  • Fluids – preferably water
  • Exercise


  • High protein
  • low fat
  • 4-6 servings a day – see pyramid for portion guidelines

High Fiber, Low Calorie

  • Vegetables
  • low sugar fruits
  • high sugar fruits
  • Vegetable oils
  • 2-3 servings a day – see pyramid for portion guidelines

 Whole Grains & Cereals

  • Cereals
  • Legumes
  • Tubers
  • 2 servings a day – see pyramid for portion guidelines

Pyramid Tip (Basically foods to avoid)

  • high saturated and trans fat foods
  • high sugar foods
  • carbonated and/or alcoholic beverages

Given the nature of the operation and the physiological demands of this very special patient population, it is not surprising that there is a strong focus on high-quality protein, balanced with nutrient-dense complex carbohydrates and healthy sources of essential fatty acids. Hopefully this tool will help both therapists and patients better understand nutrition recommendations for a healthy long-term post-op diet.

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If you are in the Las Vegas area and considering bariatric surgery, schedule an appointment with Dr. Shawn Tsuda. He and his team of experts with help you find the right treatment for your unique situation.

Battling Diabetes with Bariatric Surgery

The twin epidemics of obesity and type 2 diabetes continue to rise, especially in the United States. Lifestyle intervention programs with diet therapy, behavior modification, exercise programs, and pharmacotherapy are widely used in various combinations to treat obesity. Unfortunately, with extremely rare exceptions, clinically significant weight loss is generally very modest and transient, particularly in patients with severe obesity. The failure rate for those programs is around 95% at 1 year. Many are turning to bariatric surgery as a way to increase their life spans.

Did you know?

  • Someone in the world dies from complications associated with diabetes every 10 seconds.
  • Diabetes is one of the top ten leading causes of U.S. deaths.
  • One out of ten health care dollars is attributed to diabetes.Complications of Obesity
  • Diabetics have health expenditures that are 2.3 times higher than non-diabetics.
  • Approximately 90 percent of type 2 diabetes mellitus (T2DM), the most common form of diabetes, is attributable to excessive body fat.
  • If current trends continue, T2DM or pre diabetic conditions will strike as many as half of adult Americans by the end of the decade. (according to the United HealthGroup Inc., the largest U.S. health insurer by sales).
  • The prevalence of diabetes is 8.9 percent for the U.S. population but more than 25 percent among individuals with morbid obesity.
  • Metabolic and bariatric surgery is the most effective treatment for T2DM among individuals who are affected by obesity and may result in remission or improvement in nearly all cases.

Many years ago, the resolution of type 2 diabetes was observed as an additional outcome of surgical treatment of morbid obesity. Moreover, it has been shown unequivocally that diabetes-related morbidity and mortality have declined significantly postoperatively, and this improvement in diabetes control is long lasting. Studies have shown that return to euglycemia and normal insulin levels occurs within days after surgery, long before any significant weight loss takes place. This fact suggests that weight loss alone is not a sufficient explanation for this improvement.

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If you are in the Las Vegas area and are struggling to control obesity and type 2 diabetes, schedule an appointment with Dr. Heidi Ryan to see how she can help.

Obesity and Vitamin D Deficiency

Think of malnutrition, and obesity probably isn’t the first health problem that springs to mind. But even though obesity obviously represents over nutrition in the caloric sense, people with obesity can still be malnourished when it comes to micronutrients.

Vitamin D Dollarphotoclub_89106377 (2).jpgAccording to studies, the prevalence of Vitamin D deficiency is 35% higher in people with obesity than in people at a normal weight. This is dangerous, because Vitamin D deficiency is a risk factor for heart disease, bone loss, impaired glucose metabolism, metabolic syndrome, and diabetes, and all other kinds of chronic health problems associated with obesity. It’s also possible that Vitamin D deficiency contributes to accumulating body fat, making obesity/deficiency a vicious cycle.

Researchers have considered various reasons why obese people might be Vitamin D-deficient:

  • Less sun exposure — Most people get the majority of their Vitamin D from sunlight on their skin. Obese people may be less likely to be outside with exposed skin like at the pool in a bathing suit, reducing Vitamin D absorption. However, even if you control for time spent outside, people with obesity are still more commonly Vitamin D deficient than other people.
  • Body fat “stealing” Vitamin D — Through a complicated chemical process, it’s possible that excess body fat requires a lot of extra Vitamin D, which diminishes the amount available for other processes.

But that doesn’t answer the million-dollar question: in people who already have obesity, will Vitamin D supplements produce or assist in weight loss?

  • One study tested it out, and concluded that there was “no significant influence of vitamin D supplementation on weight, fat mass, or waist circumference in type 2 diabetic, obese, vitamin D deficient participants of Arab ethnicity after one year.”
  • One study found that in otherwise-healthy overweight and obese women, Vitamin D supplements reduced body fat mass, but not body weight.
  • In another study, a Vitamin D supplement helped improve blood sugar control, but didn’t produce any weight loss.

The bottom line is that Vitamin D is very unlikely to be a weight loss wonder drug. It may improve your health, but it probably won’t make you thin.

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If you are in the Las Vegas area and are considering bariatric surgery, schedule a consultation with Dr. Shawn Tsuda. He and his team of experts can help you find the right treatment for your unique situation.

Let’s Start from the Beginning on Endoscopy Procedures

An endoscopy is a procedure in which your doctor uses specialized instruments to view and operate on the internal organs and vessels of your body. It allows surgeons to view problems within your body without making large incisions.

A surgeon inserts an endoscope through an opening in the body such as the mouth or makes a small incision. An endoscope is a flexible tube with an attached camera that allows your doctor to see. Your doctor can use tools on the endoscope to operate or remove tissue for biopsy.

Endoscopy is normally part of a routine, comprehensive evaluation of your digestive system. A doctor might suggest this minimally invasive, virtually painless procedure for a variety of reasons:Endoscopy background concept glowing

  • To check symptoms you have described that are most likely digestion-related
  • To help your doctor evaluate the severity of a digestive condition
  • To check the status of an existing digestive disorder
  • To target a specific location to remove some cells for laboratory examination, a procedure known as a “biopsy”
  • To screen for cancer in patients who may be at high risk
  • To perform a specific therapy, such as removing polyps or a foreign body, or to stop bleeding

With this procedure, you can be assured of the accuracy of the diagnosis. An endoscopy—upper or lower—is more accurate than an X-ray for detecting inflammation, ulcers, or small tumors of the esophagus, stomach, duodenum, or lower GI tract. Endoscopy is also excellent for finding the causes of gastrointestinal bleeding. If you have had major surgery, it can be used to evaluate the inside of your esophagus or stomach to search for signs of bleeding.

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If you are in the Las Vegas area and are looking for an experienced surgeon to perform an endoscopy, schedule a consultation with Dr. Heidi Ryan. She can help find the right procedure for you.

Acid Reflux Pain and Suffering Can Be Alleviated

Heartburn is a very common symptom created by acid reflux, a condition where some of the stomach contents, including stomach acid, are forced back up into the esophagus, creating a burning pain in the lower chest. Persistent acid reflux that happens more than twice a week results in the diagnosis of gastroesophageal reflux disease (GERD). According to estimates from the American College of Gastroenterology, at least 15 million Americans experience heartburn – the symptom of acid reflux – every day.

Most people are occasionally affected by heartburn, which is rarely a significant cause for concern. Recurrent acid reflux, however, resulting in the diagnosis of GERD can have serious consequences for health.

GERD is seen in people of all ages, and the cause is often attributable to a lifestyle factor, but it can also be due to unavoidable factors such as anatomical abnormalities affecting the valve at the top of the stomach. Changes to lifestyle or behavior can prevent or improve heartburn symptoms.

The American Gastroenterological Association offers the following list of things to try to see if symptoms resolve:

  • Avoid food, drinks, and medicines that you find to be associated with heartburn irritation
  • Eat smaller meals
  • Do not lie down for two to three hours after a meal
  • Lose weight if overweight or obese
  • Avoid increased pressure on your abdomen, such as from tight belts or doing sit-ups
  • Stop smoking

It is important to address persistent problems with gastroesophageal reflux disease as long-term untreated acid reflux can lead to serious complications including an increased risk of cancer.

  • The following foods aggravate acid reflux, and should be avoided:
    • fatty or fried foods
    • peppermint and spearmint
    • whole milk
    • oils
    • chocolate
    • creamed foods or soups
    • most fast foods
    • citrus fruits and juices (grapefruit, orange, pineapple, tomato)
    • coffee (regular and decaffeinated)
    • caffeinated soft drinks
    • tea
    • other caffeinated beverages
    • Spicy or acidic foods may not be tolerated by some individuals

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If you suffer from GERD, schedule an appointment with Dr. Shawn Tsuda. He can help you find the right treatment for your unique case.

acid reflux


Weight Loss Basics – Build the Foundation of a Healthy Lifestyle with These Strategies

While there are plenty of ways to lose weight, some don’t seem to be able to lose enough or maintain weight loss over the long term. Different strategies work for different people, but however you choose to try to lose weight, knowing the basics of a healthy weight is a healthy apple, measuring tape and dumbbells isolatedgood place to start. If you want to maintain a healthy weight for the rest of your life, it’s all about energy balance.

Here are three basic steps for success:

  • Make smart choices from every food group
    • Your body needs the right fuel for your hectic, stress-filled schedule.
    • The best way to get what you need is to enjoy a wide variety of nutrient-rich foods that are packed with energy, protein, vitamins and minerals from all the food groups.
      • Fruits and vegetables
      • Whole grains
      • Low-fat dairy products
      • Lean proteins
  • Get the most nutrition from your diet
    • The biggest nutrition challenge for most Americans is posed by high-fat, high-sugar foods and drinks, such as snack foods, candies and sugary drinks.
    • Eating smarter does not mean you have to immediately go sugar-free and fat-free. You can make a big difference in your calorie intake by just eating and drinking smaller portions and by making empty calorie choices less often.
    • The key is to moderate, not eliminate. Watching portion sizes is an easy way to cut back without cutting out.
  • Balance food and physical activity
    • What you eat is just one part of the energy balance equation. The other is your physical activity.
    • Most of us take in more calories than we spend on our daily activities.
    • The minimum for good health is 30 minutes of moderate to vigorous activity each day. To reach a healthy weight, you may need to be physically active longer (60 minutes a day) or participate in more intense activities.

Obviously obesity and weight issues can be more complicated than just following this advice, and if losing weight was as simple as putting these basics to work, we wouldn’t have the obesity problems we have. Emotions, physical problems, and other limitations can all contribute to weight gain and/or the ability to lose excess pounds. However, knowing these basics is a good way to get you on your way to a healthier, longer life.

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If you are considering bariatric surgery in the Las Vegas area, schedule a consultation with Dr. Heidi Ryan. She and her team of experts can help you find the right treatment for your unique case.