The Role of Genes in Obesity

Genes influence every aspect of human development, physiology, and adaptation, and research shows that genetics also play a role in obesity. However, we still know relatively little when it comes to which specific genes contribute to obesity. Nor do we know the importance of the complex interplay between our genetic makeup and our life experiences.

Obesity Word DNA Strand Medical Research Fat HereditaryWhat we do know is that genes do not always predict one’s future health. Genes and behavior probably are both needed for a person to be overweight. In some cases, various genes may increase one’s susceptibility for obesity and require outside factors such as plentiful food supply or not enough physical activity.

It’s well established that overweight and the different forms of obesity are conditions tending to center within a family. A person with a family history has a two to eight times higher risk than a person with no family history of obesity, and even higher risk is observed in cases of severe obesity.

The most common forms of obesity are probably the result of variations within a large number of genes. Sequence variations within a pool of 56 different genes have been reported as being related to obesity; however, only ten of those genes showed positive results in at least five different studies.

Any attempt to explain the obesity epidemic has to consider both genetics and how (the environment) one lives as well. One explanation that is often cited is that the same genes that helped our ancestors survive occasional famines are now being challenged by environments in which food is plentiful year-round.

As of now, genetic tests are not useful for directing personal diet or physical activity regimens. Studies on genetic variation affecting response to changes in diet and physical activity are still at an early stage. It stands to reason that doing a better job of explaining obesity in terms of genes and environmental factors could help encourage people who are trying to achieve and maintain a healthy weight.

Obesity is a serious public health problem because it is associated with some of the leading causes of death in the U.S. and worldwide, including diabetes, heart disease, stroke, and some types of cancer, but unfortunately, families can’t change their genes. They can, however, change the family environment to encourage healthier eating habits and more physical activity. Those changes can improve the health of family members and the family health history of the next generation.

If you live in the Las Vegas area and are interested in weight-loss surgery, schedule a consultation at VIP Surg.

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Tips for Finding the Right Surgeon for You

Almost any surgery can cause serious complications, so you always want to be in good surgical hands. With so many doctors, how do you know which is the right surgeon for you?

One indicator to note is how often surgeons perform a procedure. That can be vital for operations that are relatively new, such as gastric bypass surgery for treating obesity. While many surgeons have started performing the operation, not all are qualified. A September 2009 study found that the risk of serious complications from the most common form of gastric bypass surgery fell by 10 percent for every additional 10 cases per year the surgeon had performed.

However, quantity isn’t the only or even most important measure of quality. A May 2009 study of 81,289 adults who had heart bypass surgery, for example, found that success depended more on how well surgeons and hospitals adhered to various markers of surgical excellence—such as using the appropriate technique during the operation and prescribing the right medications before and afterward—than the number of procedures performed.

Don’t be afraid to question your doctor. Ask your prospective surgeon these questions before going under the knife:

  • Is surgery really necessary? The best way to avoid surgical errors is to avoid surgery entirely, so ask about the effectiveness and safety of alternatives. Compare those with the risks of surgery and the chance that it will help you.
  • Is your board certification up to date? Look for a surgeon who has undergone the necessary training, even after being in clinical practice, to maintain board certification in his or her specialty.
  • What’s your experience? Ask how many operations the surgeon has performed in the past year and how that compares with his or her peers. You don’t have to find the busiest, most experienced surgeon in North America, but it’s important to avoid the doctor who does very few of the procedures, especially in a place that does very few.
  • What are your success, failure, and complication rates? Not all will be able or willing to tell you, but the good ones should be.
  • What’s the hospital’s infection rate? Seventeen states now make that information public, and many hospitals report their rates voluntarily.

doctor-650534_960_720Just remember to worry less about bedside manner and more about the final outcome. If you have to choose between a nice surgeon and a highly skilled surgeon, the skilled surgeon is the better bet.

If you live in the Las Vegas area and are looking for a surgeon who is both compassionate and highly skilled, Dr. Tsuda at VIP Surg is everything you’re searching for. Whether you have general surgery needs or are interested in bariatric surgery, he and his team of experts have the experience and skill for you to have an excellent outcome.

Tips for Enjoying a Healthy Thanksgiving

Let’s be candid, shall we? During any holiday—especially Thanksgiving—people have a lot of food put in front of them. Many times, it is way too much food for even the best of metabolisms to handle without putting on a few pounds. Wouldn’t it be amazing if you could still enjoy the holidays and yet never gain an ounce?

During Thanksgiving, it’s easy to go overboard with the calories and consumption. Temptations of gooey pecan pie and dense sweet potatoes topped with crackly marshmallows make it seem impossible to be disciplined.

However, eating healthfully on Thanksgiving doesn’t mean you have to forgo all your favorite foods. If you’ve got your eating under control for the majority of the time, go ahead and have a piece of pie — just don’t lose control entirely.

Keep your willpower and your wits about you by using these tips:

  1. Stick to healthy portions.

Just one plate of Thanksgiving food is all you get. Fill up half your plate with vegetables,fruit, and a whole wheat roll, a quarter of it with mashed potatoes or sweet potatoes, and a quarter of it with turkey or ham. The more colorful your plate, the better – so get lots of leafy greens, carrots, bell peppers, and beets in your veggie selection. If you fill up on those lower caloric density and higher nutrition things, you’re going to feel full, but not bloated and tired, because it’s a lighter far.

It’s a holiday, so indulge a bit if your diet allows it. If you’re going to eat dessert, make sure you allot for the calories elsewhere – don’t go back for that second helping of marshmallow sweet potatoes, and instead opt for the cranberry salad.

  1. Eat before you indulge.

Don’t starve yourself during the early part of Thanksgiving Day, with the idea that you’re just “saving room” for all the food, or that this will make it okay for you to overeat later.

If you’re going to a Thanksgiving lunch, be sure you eat breakfast before. If you’re going to a dinner, be sure you eat lunch or have a snack in the afternoon. You should have your normal meals because whenever we get over-hungry, we tend to overeat.

  1. Substitute healthy ingredients for unhealthy ones.

There are plenty of ways to make Thanksgiving fare healthier. For mashed potatoes, consider mixing in chicken broth, herbs, or roasted garlic to perk up the flavor instead of adding in butter. For green bean casserole, swap out fried onions with toasted almonds for a less-oily alternative, and instead of having cranberry sauce, opt instead to make a cranberry salad. For dips, use Greek yogurt instead of sour cream — the consistency is similar, but yogurt has less fat and more protein.

  1. Drink lots of water and take a walk after eating.

Many times, when people think they are hungry, they are really just thirsty. By drinking lots of water throughout the day, you’ll lower the risk of overeating. Keep in mind that alcohol not only has lots of calories, but it’s effects can also lower your willpower for keeping to your healthy lifestyle.

It’s also a good idea to take a walk after eating to get your metabolism going instead of laying on the couch. Ultimately, you’ll sleep much better that night if you do a little exercise after eating rather that falling into a food coma.

All of us at VIP Surg wish you and yours a happy, healthy, and safe Thanksgiving! We are here to help with your bariatric and general surgery needs.

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Bariatric Surgery: Impacting High Blood Pressure Through More Than Weight Loss

According to the Centers for Disease Control, about one in three U.S. adults has high blood pressure (hypertension). Risks include family history, advancing age, poor diet, consuming excessive amounts of alcohol, and being overweight or obese.

Lifestyle changes are a big part of controlling high blood pressure. The main tenets include:

  • Following a healthy diet, which may include reducing salt. The DASH (Dietary Approaches to Stop Hypertension) diet is often recommended. In addition to lowering salt intake, DASH is replete with fruits, vegetables, and low-fat or nonfat dairy. The diet emphasizes whole grains and is rich in potassium, magnesium, calcium and fiber.
  • Exercising regularly.
  • Maintaining a healthy weight.
  • Keeping stress levels at bay. (Stress can cause us to engage in unhealthy blood pressure-raising behaviors.)
  • Drinking only moderate amounts of alcohol.
  • Taking your medications as prescribed.

There are many types of prescription medications that can help control blood pressure and reduce the risk of heart attack or stroke. These medications may need to be taken for life to maintain their effect.

New research is showing, however, that bariatric surgery can allow obese people taking a lot of antihypertensive medications to cut way back on them. Study subjects’ blood pressure was maintained in the normal range with only one agent or even without drugs.

Within a year, those in a recent trial who had bariatric surgery were more than six times as likely to have cut back on their number of blood pressure (BP) medications by hypertension-867855__340about a third. Half of the surgical patients didn’t need any antihypertensive meds to maintain their BP at healthy levels. On the other hand, all of the “standard-care” patients in the study needed antihypertensive medications to keep BP that low, and half of them needed at least three different ones.

Interestingly, most patients in the gastric-bypass group achieved the primary end point in the first month of the postop period. That seems to indicate that something more is happening beyond just weight loss.

That something is likely to be related, at least in part, to the metabolic changes in the surgery group compared with the control group, which included significant improvements in fasting plasma glucose, HbA1c, LDL cholesterol, triglycerides, and high-sensitivity C-reactive protein in addition to the lowering of blood pressure.

If you live in the Las Vegas area and are wondering if bariatric surgery might be right for you, schedule an appointment at VIP Surg. Dr. Tsuda and his team can help find the right treatment for your unique situation.

 

DASH Your High Blood Pressure Away

DASH stands for Dietary Approaches to Stop Hypertension. The DASH diet is a lifelong approach to healthy eating that’s designed to help treat or prevent high blood pressure (hypertension). The DASH diet encourages you to reduce the sodium in your diet and eat a variety of foods rich in nutrients that help lower blood pressure, such as potassium, calcium, and magnesium.

Because the DASH diet is a healthy way of eating, it offers health benefits besides just asparagus-2169305_960_720lowering blood pressure. The DASH diet is also in line with dietary recommendations to prevent osteoporosis, cancer, heart disease, stroke, and diabetes.

The DASH diet emphasizes vegetables, fruits, and low-fat dairy foods — and moderate amounts of whole grains, fish, poultry, and nuts.

Here’s a look at the recommended servings from each food group for the 2,000-calorie-a-day DASH diet:

  • Grains: 6 to 8 servings a day — Grains include bread, cereal, rice and pasta. Examples of one serving of grains include 1 slice whole-wheat bread, 1-ounce dry cereal, or 1/2 cup cooked cereal, rice or pasta.
  • Vegetables: 4 to 5 servings a day — Vegetables are full of fiber, vitamins, and such minerals as potassium and magnesium. Examples of one serving include 1 cup raw leafy green vegetables or 1/2 cup cut-up raw or cooked vegetables.
  • Fruits: 4 to 5 servings a day — Like vegetables, fruits are packed with fiber, potassium and magnesium and are typically low in fat.
  • Dairy: 2 to 3 servings a day — Milk, yogurt, cheese and other dairy products are major sources of calcium, vitamin D and protein. But the key is to make sure that you choose dairy products that are low fat or fat-free because otherwise they can be a major source of fat — and most of it is saturated. Examples of one serving include 1 cup skim or 1 percent milk, 1 cup low fat yogurt, or 1 1/2 ounces part-skim cheese.
  • Lean meat, poultry and fish: 6 servings or fewer a day — Meat can be a rich source of protein, B vitamins, iron and zinc. Choose lean varieties and aim for no more than 6 ounces a day.
  • Nuts, seeds and legumes: 4 to 5 servings a week — Almonds, sunflower seeds, kidney beans, peas, lentils and other foods in this family are good sources of magnesium, potassium and protein. They’re also full of fiber and phytochemicals, which are plant compounds that may protect against some cancers and cardiovascular disease. Serving sizes are small and are intended to be consumed only a few times a week because these foods are high in calories. Examples of one serving include 1/3 cup nuts, 2 tablespoons seeds, or 1/2 cup cooked beans or peas.
  • Fats and oils: 2 to 3 servings a day — Fat helps your body absorb essential vitamins and helps your body’s immune system. But too much fat increases your risk of heart disease, diabetes and obesity. Examples of one serving include 1 teaspoon soft margarine, 1 tablespoon mayonnaise or 2 tablespoons salad dressing.
  • Sweets: 5 servings or fewer a week — You don’t have to banish sweets entirely while following the DASH diet — just go easy on them. Examples of one serving include 1 tablespoon sugar, jelly or jam, 1/2 cup sorbet, or 1 cup lemonade.

While the DASH diet is not a weight-loss program, you may indeed lose unwanted pounds because it can help guide you toward healthier food choices.

Remember, healthy eating isn’t an all-or-nothing proposition. What’s most important is that, on average, you eat healthier foods with plenty of variety — both to keep your diet nutritious and to avoid boredom or extremes. With the DASH diet, you can have both.

If you live in the Las Vegas area and are dealing with health issues that come with obesity, contact VIP Surg. Dr. Tsuda and his team can help you find the treatment that works best for you. Call 702-487-6000 today for an appointment.

 

Gallbladder Disease and Gallstones

Some people think of their gallbladder as being “expendable”. Not that anybody wants any of their organs to be removed, but since many people live a seemingly normal life after getting their gallbladder removed, many people don’t think their gallbladder plays an important role in their overall health. After all, how important can your gallbladder be if you can do just fine after it’s surgically removed? The gallbladder actually plays a very important role in your body. It is an essential part of the digestive system.

Your gallbladder is most likely to give you trouble if something blocks the flow of bile through the bile ducts. That is usually a gallstone. Gallstones form when substances in bile harden. Rarely, you can also get cancer in your gallbladder. Many gallbladder problems get better with removal of the gallbladder. Fortunately, you can live without a gallbladder. Bile has other ways of reaching your small intestine.

In the United States, about a million new cases of gallstone disease are diagnosed each year, and some 800,000 operations are performed to treat gallstones, making it the most common gastrointestinal disorder requiring hospitalization.

Gallstone disease is the most common disorder affecting the body’s biliary system, the network of organs and ducts that create, transport, store, and release bile. Bile contains cholesterol, water, proteins, bilirubin (a breakdown product from blood cells), bile salts (the chemicals necessary to digest fat), and small amounts of copper or other materials. If the chemical balance of bile contains too much of any of these components, particularly of cholesterol, crystals form and can harden into stones.

In terms of size, gallstones can be as small as a grain of sand or as large as a golf ball. A person can form one large stone in his or her gallbladder, or hundreds! About 10 percent of the population has gallstones, but the vast majority experiences no symptoms and need no treatment. However, in 1 percent to 2 percent of these people, gallstones can cause problems by lodging in bile ducts, stopping the flow of bile or digestive enzymes, and leading to severe abdominal pain, vomiting, inflammation, and even life-threatening infection.

Gallstone attack has some classic symptoms: The most agonizing pain is experienced in the upper right part of the abdomen under the ribs. Usually it appears suddenly, sometimes an hour or two after eating a fatty meal. The pain may get worse quickly, and then last for several hours. Many times, the pain may radiate to the back between the shoulder blades or under the right shoulder. Inhaling deeply, or moving, often makes the pain worse. The primary therapy for gallstones that are causing pain, inflammation, or infection is removal of the gallbladder.

A number of factors put people at higher risk of gallstones:

  • Gender: Women between the ages of 20 and 60 are 3 times more likely to develop gallstones than are men in the same age group. By age 60, 20 percent of American women have gallstones.
  • Age: The incidence of gallstone disease increases with age.Tsuda 11-18
  • Genetics: Family history and ethnicity are critical risk factors in development of gallstones, though no gene responsible for gallstone formation has yet been discovered. African-Americans seem to have lower rates of gallstone disease than American Indians, whites, or Hispanics.
  • Obesity: Obesity is a significant risk factor, particularly for women. Obesity also slows down the emptying of the gallbladder.
  • Location of body fat: Belly fat, that spare tire around the middle, dramatically increases the chance of developing stones.
  • Diabetes: People with diabetes often have high levels of triglycerides in their blood, and these fatty acids tend to increase the risk of gallstones.

Even if you’re not at risk for gallstones, it is wise to maintain a healthy body weight, by among other things, sticking to a diet that is low in fat and cholesterol and high in fiber.

If you are in the Las Vegas area and suffering with gallstones or gallbladder disease, schedule a consultation at VIP Surg.

Metabolic Syndrome: The New Silent Killer

For decades, American waistlines have been expanding, and there is increasing cause for alarm. Experts are saying metabolic syndrome is the new “silent killer,” like hypertension in the 1970s. As it turns out, the “love handle” can be fatal.

What is Metabolic Syndrome?

Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke. The term “metabolic” refers to the biochemical processes involved in the body’s normal functioning. Metabolic syndrome is a cluster of metabolic disorders. When a patient presents with these conditions together, the chances for future cardiovascular disease is greater than any one factor presenting alone.

What are Metabolic Risk Factors?

Risk factors are traits, conditions, or habits that increase one’s chance of developing a disease. The five conditions described below are metabolic risk factors. You can have any one of these risk factors by itself, but they tend to occur together. You must have at least three metabolic risk factors to be diagnosed with metabolic syndrome.

  • A large waistline. This also is called abdominal obesity or “having an apple shape.” Screen Shot 2017-10-24 at 11.41.55 AMExcess fat in the stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips.
  • A high triglyceride level (or you’re on medicine to treat high triglycerides).
  • A low HDL cholesterol level (or you’re on medicine to treat low HDL cholesterol).
  • High blood pressure (or you’re on medicine to treat high blood pressure).
  • High fasting blood sugar (or you’re on medicine to treat high blood sugar).

Your risk for heart disease, diabetes, and stroke increases with the number of metabolic risk factors you have. The risk of having metabolic syndrome is closely linked to overweight and obesity and a lack of physical activity.

Insulin resistance also may increase your risk for metabolic syndrome. Genetics (ethnicity and family history) and older age are other factors that may play a role in causing metabolic syndrome.

Can Metabolic Syndrome be Treated?

Metabolic syndrome is becoming more common due to a rise in obesity rates among adults, but it is possible to prevent or delay metabolic syndrome, mainly with lifestyle changes. A healthy lifestyle is a lifelong commitment. Successfully controlling metabolic syndrome requires long-term effort and teamwork with your health care providers.

When changes in lifestyle alone do not control the conditions related to metabolic syndrome, your health practitioner may prescribe medications to control blood pressure, cholesterol, and other symptoms. Carefully following your practitioner’s instructions can help prevent many of the long-term effects of metabolic syndrome. Every step counts, and your hard work and attention to these areas will make a difference in your health.

If you live in the Las Vegas area and are looking for answers to obesity and metabolic syndrome problems, schedule a consultation with VIP Surg. Dr. Tsuda and Dr. Ryan and their team of experts can help find the right treatment for you.