LAPSF

Dr. Cirangle to perform the first live sleeve gastrectomy and Twitter feed this Saturday!

Seeking to educate the public about obesity and what happens in the operating room during  weight loss surgery, Dr. Paul T. Cirangle will be broadcasting a live laparoscopic sleeve gastrectomy with a simultaneous Twittercast.  The first-ever event of its kind is the brainchild of Dr. Cirangle, who aims to educate prospective patients and healthcare professionals by giving an inside view into the gastric sleeve.

Weight loss surgery has been a hot topic in the news lately, especially with ABC’s 20/20 and HBO chronicling the skyrocketing rates of obesity and diabetes.  According to Dr. Cirangle, “LapSF patients have an impressive cure rate for diabetes following the vertical sleeve gastrectomy. More than  92% percent of my patients are cured of diabetes and the excess weight loss results- more than 83%-are much higher than the national average. Since more than two thirds of Americans are suffering from obesity, learning more about weight loss surgery will either benefit the average person or a loved one.”

Viewers will have a bird’s-eye view into the operating room, as well as observing the procedure from the same vantage point as the surgeon.  Inside the abdominal cavity, tiny cameras are attached to a laparoscope that illuminates the operative field for the surgeon. These magnified images are transmitted to a large screen above the patient, maximizing the surgeon’s field of vision. This behind-the-scenes production will allow viewers to experience the surgery as if they were in the room themselves.

The first-ever social media event of its kind is scheduled for Saturday, May 19, 2012 at 8:00am PST. Dr. Cirangle will be answering questions and comments in real time during the event. Both the live surgery and Twitter feed can be viewed side-by-side on the LapSF live surgery page. Follow the Twittercast @lapsfdrcirangle and #livevsg. Please be sure to share this with your friends!

Learn to Love Water

For those of you who dread drinking water and hate it having no taste, this article is for you. After weight loss surgery, it is not easy giving up not only all carbonated beverages, but all sweetened drinks, yet there is still a way to give your water flavor without the calories!

You can make flavored water in many different ways, but our favorites are those with citrus, certain veggies, and herbs to give flavor without the added sugar. Drink from a sport water bottle to prevent you from eating or swallowing the flavorings whole. Also, it will prevent taking large gulps and allow you to sip.

Flavored Water Recipes

Citrus Water = ice water + a sliced lemon + a sliced lime

Antioxidant Water = ice water + 1/4 sliced orange + the seeds of a pomegranate (~1-2 tbsp)

Hint of Mint Water = ice water + three to four mint sprigs

Day at the Spa Water = ice water + cucumber slices + lemon slices

Faux-Mojito Mint Water= ice water + three to four mint sprigs + sliced lime

Fight Sugar Cravings with Tea!

Some of you may be thinking; how can I fight a post weight loss surgery sugar craving with tea? Add sugar? No way! It’s all in the tea bag.

We have discovered a great brand of tea that produces many different flavors that will kick that nasty sugar craving to the curb and  help you increase your fluid intake.

Republic of Tea have a great line of specialty teas (caffeinated and decaffeinated) that come in flavors such as Coconut Cocoa Cuppa Tea, Banana Cocoa Cuppa Tea, and for those who like something fruity they have flavors such as Strawberry or Blackberry Sage. The teas are less than 5 calories per tea bag, but they still satisfy a sweet tooth. If you love chocolate, we recommend the Coconut Cocoa. It is divine!

These teas are great by themselves and have no need for sugar. Be sure to let the tea bag steep for a couple minutes prior to drinking.

Remember that caffeinated teas are okay if you are already drinking the recommended amount of fluid. Be sure to not only have fluids from caffeinated beverages to prevent dehydration.

Even Modest-Intensity Exercise Works!

Not having time or the ability to endure long hours at the gym appears to no longer be an excuse for improving health, specifically blood pressure.  A recent clinical trial of 404 women ages 45 to 75 who were overweight or obese, sedentary and had higher-than-normal blood pressure, found that walking on a treadmill or pedaling an exercise bike – curbed exercise blood pressure. 

The term exercise blood pressure is in reference to the normal blood pressure rise with activity, however steep increases have been linked to increased risk of heart disease – independent of a person’s usual blood pressure at rest. 

The subjects who were broken into four groups: three that exercised at different levels for six months and one that stuck with their usual lifestyle.  The first exercise group followed general adult physical activity recommendations: about 2.5 hours of moderate activity per week.  The second group got only about half that amount of exercise, roughly the equivalent of 15 minutes, 5 days per week – and the third exercise group worked harder getting almost 4 hours of moderate exercise per week.

After six months, all the exercise groups showed improvements in their exercise blood pressure.  What was most interesting however was the modest difference between the hardest working group and the one who did roughly 15 minutes of activity, 5 days per week.  In the most-active group, systolic blood pressure (“top” number) dropped by an average of about 14 points, while the least active group still saw a close 11 point reduction in their systolic blood pressure.  Researchers do note that the exercise did not change the women’s blood pressure at rest; however since high blood pressure my put a strain on the heart, lowering it might do the heart good, even without effects on resting blood pressure. 

The bottom line is that it doesn’t take much to move from a sedentary couch potato status to a moderately active to a moderately active individual rewarded with potential health benefits. 

Source: http://journals.lww.com/menopausejournal/Abstract/publishahead/The_effect_of_different_doses_of_aerobic_exercise.98891.aspx

Portions, Portions, Portions!

After weight loss surgery it is important to follow post-operative diet recommendations, including appropriate portion sizes.  Check out these containers to help keep your portions in check.

OXO Tot Baby Block Freezer Storage Containers, 2 or 4 ounce, $9.99

http://www.amazon.com/Blocks-Freezer-Storage-Containers-2-Ounce/dp/B004QZBEFK/ref=sr_1_1?ie=UTF8&qid=1326140546&sr=8-1

Baby Sprouts 1oz Cube Silicone Freezer Tray, $8.99

http://www.amazon.com/green-sprouts-Silicone-Freezer-Green/dp/B002F9MUM0/ref=sr_1_8?s=baby-products&ie=UTF8&qid=1326140909&sr=1-8

Rubbermaid 7J55 Easy Find Lid Square 1/2-Cup Food Storage Container, 2 pack, $5.99

http://www.amazon.com/gp/product/B0012DMSTK/ref=pd_lpo_k2_dp_sr_3?pf_rd_p=486539851&pf_rd_s=lpo-top-stripe-1&pf_rd_t=201&pf_rd_i=B000BO9K92&pf_rd_m=ATVPDKIKX0DER&pf_rd_r=0ZNFPHED6TT9WPZT95R3

Weight Loss Surgery Web Resources

This is a great way to track your weight loss surgery results

Track Intake & Physical Activity

            www.myfitnesspal.com

            www.myfooddiary.com

            www.mynetdiary.com

            www.livestrong.com/thedailyplate

Apps to Track Intake and Physical Activity

            Carb Master

            Fatsecret.com

            Lose It!

Spark People

Recipes & Healthy Cooking

            www.eatingwell.com

            www.cookinglight.com

            http://blog.foodnetwork.com/healthyeats/

            www.nutritiondata.com

 List compiled by Alisha Gillespie MS RD

Diabetes Risk in Obese Children Linked to Low Vitamin D

According to a recent study, childhood obesity has been linked to lower levels of Vitamin D in comparison to non-obese children.  The low levels of Vitamin D in obese children also appear to be associated with insulin resistance, a risk factor for type 2 diabetes.

The childhood obesity study of 411 obese children and 87 children who were not overweight asked children about their daily consumption of soda, juice, milk, fruits and vegetables, and if they routinely skipped breakfast.  The children’s vitamin D levels, blood sugar, serum insulin, body mass index and blood pressure was also collected.

Lead author Dr. Micah Olson, of the University of Texas Southwestern Medical Center in Dallas notes that, “although [this] study cannot prove causation, it does suggest that low vitamin D levels may play a role in the development of type 2 diabetes.”

Prior studies have linked low vitamin D levels with cardiovascular disease and type 2 diabetes.  However, it would be interesting to see future childhood obesity research looking at making sure obese children get adequate vitamin D and if it could help with insulin resistance. 

13 Strategies for Slowing Down when Eating

1. Sit down for all meals and snacks.
2. Keep serving bowels/platters off the kitchen table.
3. Put utensil (fork/spoon) down between bites.
4. Use small plates ( no more than 10 inches in diameter) and  small/baby utensils to take small bites.
5.  Cut dense foods into small pieces: fingernail or nickel sized.
6. Count chews: aim for 25 chews per bite of a dense food item.
7.  “Half plate strategy”:  1. Divide food on plate into two halves 2. Notice the time 3. Eat the first half of the food 4. After the first half of food is consumed notice the time again 5. Wait until 15 minutes has elapsed before beginning to eat the 2^nd half
8. Use non-dominant hand to eat.
9. Use chopsticks to eat (for those experienced with chopsticks)
10. Strive to be the last one at the table to finish eating.
11. Avoid eating while driving.
12. Control the eating environment: remove distractions, such as TV, play mellow music, dim lights, or light candles.
13. Remember to truly taste the food and enjoy its flavor.

Weight Loss Surgery Linked With Lower Heart Attacks

The Journal of the American Medical Association has published a study that has found obese people who had weightloss surgery were less likely to later suffer a heart attack or stroke, or to die from one, compared to people who did not have surgery.  The Swedish study researchers contend that, “compared with usual care, bariatric surgery was associated with a reduced number of cardiovascular deaths and lower incidence of cardiovascular events in obese adults.”

The study looked at more than 4,000 obese people treated at 500 surgery departments and health care centers in Sweden, following patients on average for more than a decade, to see how many suffered a heart attack or stroke.  In total, 199 of the patients who had weight loss surgery had their first heart attack or stroke, and 28 died as a result.  By comparison, 234 people who decided against surgery suffered a heart attack or stroke, 49 died. 

While the study does not prove that weight loss-surgery cuts the risk of heart disease, it does show that after surgery, patients were 30 percent less likely to have a first-time heart attack or stroke than non-surgery patients, and half as likely to die from one.  Weight-loss surgery of course has other benefits, such as reduction in diabetes, hypertension, sleep apnea, etc – all of which could ease heart risks.  There are many considerations when deciding to have surgery and it is a personal decision, as surgery is only a tool to fight obesity rather than a cure, and requires lifestyle modifications for the best results. 

Source: Huffington Post

Bad Breath By Alisha Gillespie MS RD

Bad breath may be one of the less threatening concerns after weight loss surgery, but it can be an uncomfortable one for you and your loved ones, co-workers and all the other people around you.  The often sweet-metallic breath odor can be the result of dehydration, food not emptying from the pouch well, or the weight loss itself. 

Like many other common problems after weight loss surgery, your bad breath may be prevented by making sure you are getting adequate liquids.  The recommendation after weight loss surgery is to drink a minimum of 64 ounces of liquid daily but note that some recommendations are in excess of 10-12 cups daily.  Hydration is important regardless of whether or not you are experiencing bad breath, but even more important if you are.

There is also the possibility that bad breath is the result of the food you are eating not emptying out of the small stomach pouch quickly enough therefore resulting in a build-up of stomach acids in the pouch causing the undesirable odor. In this case, check with your doctor to see if an over-the-counter antacid may help.

Another explanation for bad breath after weight loss surgery is as you lose weight your body breaks down the stored fat, by-products called ketones form that when exhaled can cause what is known as ketotic breath.  Some compare the breath odor to that of the smell of Juicy Fruit gum.  Try increasing your protein intake to help reduce the effects of ketotic breath without sabotaging your weight loss plan. 

Tips to Fight Bad Breath after Weight Loss Surgery:

• Drink 64 ounces of water or more
• Brush and floss after every meal – liquid or solid.  Remember your tongue – bacteria and food particles can build up on any surface in your mouth
• Chew sugar-free gum – it can stimulate the production of odor-fighting saliva
• Try cinnamon-flavored gums – some research hints that an ingredient in cinnamon gym may further decrease the amount of bacteria in your mouth.
• Visit a dentist to rule out gum disease or tooth decay