LAPSF

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

Words to Know When Eating Out

Words to Look for When Ordering:

• Au jus (cooked in its own juice)
• Baked
• Braised
• Broiled
• Marinara
• Primavera (vegetables)
• Poached
• Roasted
• Steamed
• Stir-fried (ask for light oil)
• Vinaigrette

Words to Avoid When Ordering:

• Alfredo
• Au gratin
• Cheese sauce
• Bearnaise
• Breaded
• Beurre blanc
• Buttered
• Creamed
• Crisp
• Double crust
• En croute
• Fried: deep or pan
• Pastry
• Prime

Head Hunger Versus Physical Hunger

The mechanisms of weight loss surgery can be multi-dimensional – not only do they limit the amount of food that can be eaten but they also bring about temporary hormonal changes that stave off physical hunger.  In turn, patients often have to relearn how to decipher the difference between head hunger – driven by the habit of emotional eating – and the physical need for fuel in the form of food. 

            Head hunger is often related to emotional, stressful or habitual eating – a non-hungry eating.  It is that little voice inside your head that nags at you – not a physical sensation.  That voices that says – “Just one bite won’t make a difference…you have been so good…. you deserve it…so what just walk 5 minutes extra to make up for it.” 

            Physical hunger on the other hand is more of a sensation  – an empty sensation, it gnaws at your stomach, can even be a bit painful, nauseating, or make you feel jittery or nervous.  The physical hunger is a physical sensation that may be felt at the sternum or breastbone located directly in the center of the chest. 

            Many weight loss surgery patients have to re-learn what it really feels like to be physically hungry especially if they have previous eaten whatever and whenever, simply because it looked good or felt good.  It’s hard to know the difference between the little, but often demanding voice up in our heads.  There can be an adjustment period but with time and focus it is possible to drown out that little voice in your head and learn to listen to your body, or more importantly your stomach for it’s true physical hunger ques. 

Family Members of Weight Loss Surgery Patients Also Benefit

Most everyone has heard about the Atkins diet and the Weight Watchers diet but the newest diet out there appears to be the weight-loss-surgery-patient-in-your-living-room diet.  Have you heard of it? 

A study from Stanford researchers recently published in the Archives of Surgery found that obese family members of patients who underwent Roux-en-Y gastric bypass surgery also lost weight – an average of eight pounds in one year – simply by hanging out with the patients.  These family members accompanied their weight loss surgery family member to all of their pre- and post-operative clinic visits, hearing all of the dietary and lifestyle counseling that is recommended.  The counseling sessions included an emphasize on high-protein, high-fiber, low-fat and low-sugar diets and small meals.   They also included goal setting for daily exercise, sleep, and less screen (TV) time. 

The study found that “family members were able to lose weight comparable to being part of a medically controlled diet,” according to the study author.  The adult family members made significant changes to eating habits and reported less emotional and uncontrolled eating and both the adult and child family members made substantial increases in their activity levels.  It is safe to say that weight loss surgery is not only a tool for healthy lifestyle changes for patients but also for their families. 

High Fiber Vegetables , Flaxseed and Chia Seeds for Constipation

            To understand constipation, it helps to understand how the colon a.k.a. large intestine works. As food moves through the colon, the colon absorbs water from the food while it forms waste products, or stool.  If all works out as intended the muscles of the colon contract to push the stool toward the rectum by which time the stool is solid because most of the water has been absorbed.  Unfortunately, if the colon absorbs too much water or if the colon’s muscle contractions are slow or sluggish, causing the stool to move through the colon too slowly constipation can occur. 

            Common causes of constipation are:

·        Not enough fiber in the diet

·        Medications (pain)

·        Dehydration

·        Lack of physical activity

·        Changes in life or routine

Constipation occurring in the weeks following weight loss surgery is often related to pain medication and the lack of fiber during the liquid protein phase of the diet. * However even once the diet advances many weight loss surgery patients struggle with which foods can help increase their daily fiber intake.  Protein is still priority but here are some high-fiber foods you might consider adding to your diet:

Artichokes

Zucchini

Cabbage

Brussels Sprouts

Spinach

Flax and Chia Seeds

* Read here (http://lapsf.com/blog/?p=155) about what to do about constipation in the first few weeks after surgery.

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Chia: An Underappreciated Source of Fiber AND Omega-3 Fatty Acids

The word Chia often invokes images of clay pots and sprouting green “haired” pets, however this underappreciated edible seed is actually packed with vital nutrients that have been consumed for centuries in countries like Mexico, Guatemala, and India.  According to Aztec folklore, chia seeds were known as “running food”, sustaining Aztec warriors for days on conquests.  They also used chia medicinally to treat skin conditions and joint pain. 

Today, the tiny chia seeds are marketed as an ancient wonder food with claims of treating wrinkles and dry skin, bone support and joint health, improvement of mood, boost cognition and memory, improvement of glycemic control, and support weight loss.  While the human studies examining the health benefits of chia are few and don’t prove in support of these claims so far, there are plenty of science based reasons to add chia to your diet.

Chia seeds are packed with alpha-linolenic acid (ALA), the plant source of omega-3 fatty acids.  Just two teaspoons of dried chia seeds provide 1.7 g of ALA (meeting the daily recommended intake (DRI) for adults), 3.6 g fiber, 60 mg of calcium, 15 mg potassium and 89 mg phosphorus — and only 23 calories. 

Chia seeds may be consumed intact, and are commonly soaked in water, to form a gel which can be mixed into beverages, added to prepared dishes or substituted for oil or egg in baked items. 

Thanksgiving Eats-WLS style

Just had weight loss surgery and wondering how to navigate the holiday eating maze, here are some suggestions on what to select for your Thanksgiving meal at any stage after weight loss surgery.  Remember that your portions are very small for the first several weeks after surgery and you may only tolerate a few tiny spoonfuls per meal. It important to stop eating when you BEGIN to feel fool. Enjoy your holiday with your friends, family and loved ones!

 Creamy Pumpkin Mouse

½ c pumpkin puree

1 box Sugar-Free Fat-Free Instant Vanilla Jell-O Pudding

½ c skim milk

¼ c Sugar-Free Cool Whip

1 ½ c water

1 tsp cinnamon

2 scoops Unflavored UNJURY Protein Powder

Mix water, skim milk, and 2 scoops of UNJURY together until smooth.  Add Instant Jell-O Pudding powder and cinnamon to liquid mixture.  Fold in pumpkin puree and sugar-free cool whip.  Divide into 4 small containers – ½ servings – refrigerate until ready to serve.  

Per ½ cup serving: 82 calories, 1 g fat, 7 g carbohydrate, 12 g protein

Pumpkin Spice Latte

1 scoop Nectar Vanilla Bean protein powder

1 tbsp pumpkin puree (NOT PIE FILLING)

¼ tsp apple pie spice (cinnamon, nutmeg, allspice)

½ c skim milk

½ c water

1 tsp Instant Coffee

Heat water (below 130°F) and mix in instant coffee.  Combine prepared coffee, milk, pumpkin, vanilla protein powder, apple pie spice in blender and blend until combined.  Re-heat in microwave until warm or serve over ice. 

Makes 1 serving: 140 calories, 0 g fat, 7 g carbohydrate, 27 g protein

By Alisha Gillespie MS RD

Nutrition to Help Keep your Joints Happy

            Unhappy joints inflamed with arthritis are the one of the causes of reduced physical activity and the main cause of disability in more than 46 million adults over the age of 55, according to the Arthritis Foundation.  The causes of arthritis can involve factors from obesity, diabetes, abnormal development during development, autoimmune diseases attacking the joints, and simply aging however there are far fewer lines of defense for lessening the effects of the painful condition. 

            Currently the first line of defense for arthritis is medication but research is emerging linking the effects of diet on joint health.  These diet and lifestyle changes may help soothe arthritis symptoms:

-          Fruit and veggeis.  The “anti-inflammatory” properties of plant foods can ease the pain and swelling of osteoarthritis (OA).  Cruciferous vegetables like broccoli, cauliflower, and kale, along with alliums such as garlic, onions, and leeks appear to be the most helpful.

-          Ginger. Ginger has been a topical remedy for alleviating arthritis symptoms for thousands of years in China and now including ginger in the diet has proven helpful for managing OA in some studies. 

-          Green tea. Potent plant compounds in green tea leaves have an anti-inflammatory and antioxidant effect that may help reduce oxidative damage in joints.

-          Mediterranean diet.

-          Omega-3 fats. Fish oils, more importantly the omega-3 fatty acids EPA and DHA have shown an anti-inflammatory effect on joints, according to dozens of clinical trials.

-          Food allergies.  Work with your healthcare provider to monitor any symptoms that may be related to your diet. 

-          Move more. Nothing helps keep your joints healthy and happy like physical activity.  Get at least 150 minutes of walking, running, biking, dancing, and strength training each week. 

Source: “Healthy Nutrition for Flexible Joints” Environmental Nutrition Newsletter, July 2011 Volume 34 Number 7.