ArturoRodriguez, MD
md@thebariatric.comhttp://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
viernes, 30 de diciembre de 2011
miércoles, 21 de diciembre de 2011
All calories are not created equal
A widely accepted concept in mainstream nutrition is that weight loss or weight gain is strictly a matter of "calories in versus calories out”. If you "burn" more calories than you take in, you will lose weight regardless of the calorie source and if you eat more calories than you burn off each day, you will gain weight, regardless of the calorie source. In other words, “a calorie is a calorie” whether it comes from protein, fat or carbohydrates.
But in actual fact and practice, are all calories created equal? Well, let’s examine the question from the standpoint of science and from the practical viewpoint of empirical observation.
Common sense observation tells us that all calories are not created equal – or if in scientific jargon they are, then all foods are not created equal. Quite simply, if two groups of people maintain a daily intake of 2000 calories and group A derives the calories from toast, coffee with cream and sugar, hamburger and fries, pizza, ice cream and sugared soft drinks and group B obtains the calories from egg whites, oatmeal, chicken, fish, green vegetables, sweet potatoes, brown rice, and sugar free beverages, it doesn’t take a degree in rocket science (notice we didn’t say ‘nutrition’ as that can sometimes be a mixed bag) to figure out that group B will look better, feel better and perform better than group A.
Given the foregoing example, how is it that any number of registered dieticians, physicians and others in the medical community still hold to the all calories are equal mantra? Could it be that mainstream nutrition hasn’t caught up with modern science? Let’s look at what science says.
In scientific terms, a calorie (kilocalorie or kcal), is the amount of energy required to raise 1 gram of water 1 degree Celsius. According to that definition, bio-chemically speaking, calories from fat, protein or carbohydrates might all be considered equal. But when the physiological and psychological effect of calories from different foods are taking into consideration, the answer changes.
Protein, fats and carbohydrates have primary and secondary nutrient-specific purposes within the body. For example, proteins are used for cellular growth and repair, synthesis of hormones and enzymes, and as a secondary source of energy (proteins can be converted to a form of glucose via gluconeogenesis) while carbohydrates are the body’s primary source of energy. A growing body of research shows that fats, carbohydrates and proteins not only serve different purposes within the body but have different effects on the metabolism via numerous pathways such as their effects on hormones (e.g., insulin, leptin, glucagon, etc), hunger and appetite, heat production, and uncoupling proteins (UCPs) and via the other mechanisms such as thermic effect of food (the heat liberated from a particular food not only of its energy content but also of its tendency to produce heat).
The ‘a calorie is a calorie is a calorie’ school of thought also ignores the ever mounting volume of studies that provide data to indicate that diets with identical calorie intakes but different macro nutrient ratios have different effects on body composition, physical performance, cholesterol levels, oxidative stress, and a host of other physiological factors. Here's some information derived from such studies that show how different foods affect the calories in - calories out equation and the number you see on the scale.
"Let's take a pure food example," says Anne-Marie Nocton, MS, MPH, RD. "If someone were to eat all of her daily caloric requirement as fried onion rings, would the body respond the same way as if all of the calories came from raw spinach? No, because caloric absorption is affected by the composition of the food itself and by the amount of energy it takes the body to process that food. In this example, the body doesn't need to expend many calories to digest and store fat (in the onion rings) because the digestion and storage process isn't very complex. But the spinach contains fiber, and the structure of a fibrous food means that some of the calories will be 'lost' because the body cannot break it all down."
Dr. Rick Mattes, PhD, MPH, RD, professor of foods and nutrition at Purdue University, has similar views. He notes that the simple act of eating raises your metabolism, and eating certain foods raises metabolism even more. “The energy the body uses in the digestion process is called the thermic effect of food (TEF),” he explains. "Protein has a higher TEF relative to carbohydrate and fat.” (Editors note: the thermic effect of protein is about twice that of carbohydrate or fat).
Speaking at an American Dietetic Association conference in Anaheim, California, Dr. Mattes, explained that other factors, such as the form of a specific food, also play roles when you compare calories from different foods. Taking the perspective that calories are equal as chemically processed in the body, Mattes looks at the foods rather than just the calories. When comparing and counting calories, the delivery system matters. For example, are the calories in solid or liquid form? Researchers comparing fruit juice and fruit found that the fruit showed a blunting effect on hunger while juice resulted in only a small decline.
Matte also noted that solid foods have greater compensatory responses than fluids. "Fluids add to the diet rather than replacing other foods,” he says. “This is called a weak compensatory response. And soda isn't the only problem drink - it's fluid calories in general, whether from juice or even milk. In other words, be careful of liquid calories, which may add to your total calorie intake rather than substituting for other foods.
Mattes stated that high-protein food has the highest satiety rating, therefore eating a high-protein diet could theoretically help you feel fuller and stay satisfied longer. While high-protein foods are valuable for their fullness factor, foods such as nuts that are rich in fat and protein have also garnered attention. Many studies have shown that nuts, though high in calories, have high dietary compensation and may even increase metabolism. Mattes illustrated one study that found subjects' resting energy expenditure was 11% higher after nut consumption.
Along these same lines, researchers at the City of Hope Medical Center in Duarte, California studied two groups of overweight people, both on medically supervised low-calorie liquid diets. One group added 3 ounces of almonds to their daily diet, while the other group added the same amount of calories from complex carbs like popcorn and Triscuit crackers. Both groups ate the same number of calories daily, about 1,000. During the 24-week study, the almond-eating group lost more weight even though they ate the same number of calories as the carb group. Same calories, different results.
Dr. David Ludwig, from Children’s Hospital Boston is another authority who debunks the ‘all calories are created equal’ theory. “The idea that ‘a calorie is a calorie is a calorie’ doesn’t really explain why conventional weight-loss diets usually don’t work for more than a few months,” says Dr. Ludwig. “Almost anyone can lose weight in the short-term but very few keep it off in the long-term. That’s given rise to the notion that the body has a ‘setpoint’ and that when you diet, internal mechanisms work to restore your weight to that setpoint.” Low-carb diets,” he continues, “may work better with these internal biological responses to create the greatest likelihood of long-term weight loss.”
“Our data suggest that the type of calories consumed - independent of the amount -can alter metabolic rate,” says Dr. Ludwig.
Finally, we like to reference the work of Richard Feinman, PhD, Professor of Biochemistry at the State University of New York Downstate Medical Center. In an article published in Nutrition Journal 2004, 3:9 with his colleague, Eugene Fine, MD, Dr. Feinman puts the all calories are equal issue to rest by addressing the first and second laws of thermodynamics. “The first law of thermodynamics is the one that's easy to understand, it's the conservation of energy," says Dr. Feinman. "There's a fixed amount of energy in the world, and in the context of nutrition it means that any energy that you take in in the form of food must either show up as work that you do, or heat that you generate, or the chemical transformation that you carry on in your body, making new protein, and so on; and the rest will be leftover as fat. So that's always true. The second law of thermodynamics, however, is a much more difficult law to understand, and it's a dissipation law. It's a law of efficiency. It says that not all processes are equally efficient."
Dr. Feinman, says getting the body's fuel – glucose - from protein is less efficient than getting it from carbs, which means low carb diets make the body use more energy. "Your brain and some cells in your body have to have glucose, and there are several ways they can get that glucose," he explains. "You take in sugar or starches, that's a direct supply of glucose. You can make that glucose from protein. If you do that, that's a very inefficient process, you're going to use energy to turn protein into glucose, and in the end you're going to have to get that energy from burning something, usually fat." Essentially, then, the more inefficient the diet is at turning calories into glucose, the more effective it should be for weight loss.
Now to the topic at hand. Dr. Feinman also states that not all calories are created equal. "For many years nutritionists have been saying, 'a calorie is a calorie,' " Feinman said. "That is, weight gained or lost only depends on the calories in the diet, regardless of the macronutrient composition, that is, protein, carbohydrate, fat. We knew this was not true, so we set out to show that this was not true. I think the bottom line is once you have the idea that all calories are the same, you're not going to try to find the best diet. And I think it's very important to try to find out what's going to be most effective. We don't know that yet, but unless we work at it, we won't find it."
According to Dr. Feinman, A calorie is a calorie" violates the second law of thermodynamics. And we don’t want to do that, do we?
Arley Vest
But in actual fact and practice, are all calories created equal? Well, let’s examine the question from the standpoint of science and from the practical viewpoint of empirical observation.
Common sense observation tells us that all calories are not created equal – or if in scientific jargon they are, then all foods are not created equal. Quite simply, if two groups of people maintain a daily intake of 2000 calories and group A derives the calories from toast, coffee with cream and sugar, hamburger and fries, pizza, ice cream and sugared soft drinks and group B obtains the calories from egg whites, oatmeal, chicken, fish, green vegetables, sweet potatoes, brown rice, and sugar free beverages, it doesn’t take a degree in rocket science (notice we didn’t say ‘nutrition’ as that can sometimes be a mixed bag) to figure out that group B will look better, feel better and perform better than group A.
Given the foregoing example, how is it that any number of registered dieticians, physicians and others in the medical community still hold to the all calories are equal mantra? Could it be that mainstream nutrition hasn’t caught up with modern science? Let’s look at what science says.
In scientific terms, a calorie (kilocalorie or kcal), is the amount of energy required to raise 1 gram of water 1 degree Celsius. According to that definition, bio-chemically speaking, calories from fat, protein or carbohydrates might all be considered equal. But when the physiological and psychological effect of calories from different foods are taking into consideration, the answer changes.
Protein, fats and carbohydrates have primary and secondary nutrient-specific purposes within the body. For example, proteins are used for cellular growth and repair, synthesis of hormones and enzymes, and as a secondary source of energy (proteins can be converted to a form of glucose via gluconeogenesis) while carbohydrates are the body’s primary source of energy. A growing body of research shows that fats, carbohydrates and proteins not only serve different purposes within the body but have different effects on the metabolism via numerous pathways such as their effects on hormones (e.g., insulin, leptin, glucagon, etc), hunger and appetite, heat production, and uncoupling proteins (UCPs) and via the other mechanisms such as thermic effect of food (the heat liberated from a particular food not only of its energy content but also of its tendency to produce heat).
The ‘a calorie is a calorie is a calorie’ school of thought also ignores the ever mounting volume of studies that provide data to indicate that diets with identical calorie intakes but different macro nutrient ratios have different effects on body composition, physical performance, cholesterol levels, oxidative stress, and a host of other physiological factors. Here's some information derived from such studies that show how different foods affect the calories in - calories out equation and the number you see on the scale.
"Let's take a pure food example," says Anne-Marie Nocton, MS, MPH, RD. "If someone were to eat all of her daily caloric requirement as fried onion rings, would the body respond the same way as if all of the calories came from raw spinach? No, because caloric absorption is affected by the composition of the food itself and by the amount of energy it takes the body to process that food. In this example, the body doesn't need to expend many calories to digest and store fat (in the onion rings) because the digestion and storage process isn't very complex. But the spinach contains fiber, and the structure of a fibrous food means that some of the calories will be 'lost' because the body cannot break it all down."
Dr. Rick Mattes, PhD, MPH, RD, professor of foods and nutrition at Purdue University, has similar views. He notes that the simple act of eating raises your metabolism, and eating certain foods raises metabolism even more. “The energy the body uses in the digestion process is called the thermic effect of food (TEF),” he explains. "Protein has a higher TEF relative to carbohydrate and fat.” (Editors note: the thermic effect of protein is about twice that of carbohydrate or fat).
Speaking at an American Dietetic Association conference in Anaheim, California, Dr. Mattes, explained that other factors, such as the form of a specific food, also play roles when you compare calories from different foods. Taking the perspective that calories are equal as chemically processed in the body, Mattes looks at the foods rather than just the calories. When comparing and counting calories, the delivery system matters. For example, are the calories in solid or liquid form? Researchers comparing fruit juice and fruit found that the fruit showed a blunting effect on hunger while juice resulted in only a small decline.
Matte also noted that solid foods have greater compensatory responses than fluids. "Fluids add to the diet rather than replacing other foods,” he says. “This is called a weak compensatory response. And soda isn't the only problem drink - it's fluid calories in general, whether from juice or even milk. In other words, be careful of liquid calories, which may add to your total calorie intake rather than substituting for other foods.
Mattes stated that high-protein food has the highest satiety rating, therefore eating a high-protein diet could theoretically help you feel fuller and stay satisfied longer. While high-protein foods are valuable for their fullness factor, foods such as nuts that are rich in fat and protein have also garnered attention. Many studies have shown that nuts, though high in calories, have high dietary compensation and may even increase metabolism. Mattes illustrated one study that found subjects' resting energy expenditure was 11% higher after nut consumption.
Along these same lines, researchers at the City of Hope Medical Center in Duarte, California studied two groups of overweight people, both on medically supervised low-calorie liquid diets. One group added 3 ounces of almonds to their daily diet, while the other group added the same amount of calories from complex carbs like popcorn and Triscuit crackers. Both groups ate the same number of calories daily, about 1,000. During the 24-week study, the almond-eating group lost more weight even though they ate the same number of calories as the carb group. Same calories, different results.
Dr. David Ludwig, from Children’s Hospital Boston is another authority who debunks the ‘all calories are created equal’ theory. “The idea that ‘a calorie is a calorie is a calorie’ doesn’t really explain why conventional weight-loss diets usually don’t work for more than a few months,” says Dr. Ludwig. “Almost anyone can lose weight in the short-term but very few keep it off in the long-term. That’s given rise to the notion that the body has a ‘setpoint’ and that when you diet, internal mechanisms work to restore your weight to that setpoint.” Low-carb diets,” he continues, “may work better with these internal biological responses to create the greatest likelihood of long-term weight loss.”
“Our data suggest that the type of calories consumed - independent of the amount -can alter metabolic rate,” says Dr. Ludwig.
Finally, we like to reference the work of Richard Feinman, PhD, Professor of Biochemistry at the State University of New York Downstate Medical Center. In an article published in Nutrition Journal 2004, 3:9 with his colleague, Eugene Fine, MD, Dr. Feinman puts the all calories are equal issue to rest by addressing the first and second laws of thermodynamics. “The first law of thermodynamics is the one that's easy to understand, it's the conservation of energy," says Dr. Feinman. "There's a fixed amount of energy in the world, and in the context of nutrition it means that any energy that you take in in the form of food must either show up as work that you do, or heat that you generate, or the chemical transformation that you carry on in your body, making new protein, and so on; and the rest will be leftover as fat. So that's always true. The second law of thermodynamics, however, is a much more difficult law to understand, and it's a dissipation law. It's a law of efficiency. It says that not all processes are equally efficient."
Dr. Feinman, says getting the body's fuel – glucose - from protein is less efficient than getting it from carbs, which means low carb diets make the body use more energy. "Your brain and some cells in your body have to have glucose, and there are several ways they can get that glucose," he explains. "You take in sugar or starches, that's a direct supply of glucose. You can make that glucose from protein. If you do that, that's a very inefficient process, you're going to use energy to turn protein into glucose, and in the end you're going to have to get that energy from burning something, usually fat." Essentially, then, the more inefficient the diet is at turning calories into glucose, the more effective it should be for weight loss.
Now to the topic at hand. Dr. Feinman also states that not all calories are created equal. "For many years nutritionists have been saying, 'a calorie is a calorie,' " Feinman said. "That is, weight gained or lost only depends on the calories in the diet, regardless of the macronutrient composition, that is, protein, carbohydrate, fat. We knew this was not true, so we set out to show that this was not true. I think the bottom line is once you have the idea that all calories are the same, you're not going to try to find the best diet. And I think it's very important to try to find out what's going to be most effective. We don't know that yet, but unless we work at it, we won't find it."
According to Dr. Feinman, A calorie is a calorie" violates the second law of thermodynamics. And we don’t want to do that, do we?
Arley Vest
ArturoRodriguez, MD
md@thebariatric.comhttp://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
domingo, 11 de diciembre de 2011
Obesity
ArturoRodriguez, MD
md@thebariatric.comhttp://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
viernes, 9 de diciembre de 2011
New study tips the scale in favor of weight loss for obese pregnant women
Though some women may use pregnancy as an excuse to indulge a little, some health experts caution that obese pregnant women should be more mindful of their eating habits and perhaps actually strive to lose some extra pounds.
The new study, published by Australian resesearchers in the journal Obstetrics and Gynecology, examined the results of four clinical trials that included 537 obese pregnant women. The study participants were randomly assigned to either a control group or a dietary intervention group that received counseling on healthful eating and calorie tracking. Women in the intervention group gained, on average, 14 fewer pounds than those in the control group. Importantly, limiting their weight gain did not cause harm to these women or to their babies.
Currently, the Institute of Medicine recommends that obese women gain no more than 11 to 20 pounds during pregnancy, which is significantly less than the 25- to 35-pound gain recommended for normal-weight women. However, the latest research now suggests that obese women should strive to maintain their weight, or even shed some pounds, since modest weight loss is not associated with any adverse health effects in the mother or the baby.
The new study, published by Australian resesearchers in the journal Obstetrics and Gynecology, examined the results of four clinical trials that included 537 obese pregnant women. The study participants were randomly assigned to either a control group or a dietary intervention group that received counseling on healthful eating and calorie tracking. Women in the intervention group gained, on average, 14 fewer pounds than those in the control group. Importantly, limiting their weight gain did not cause harm to these women or to their babies.
Currently, the Institute of Medicine recommends that obese women gain no more than 11 to 20 pounds during pregnancy, which is significantly less than the 25- to 35-pound gain recommended for normal-weight women. However, the latest research now suggests that obese women should strive to maintain their weight, or even shed some pounds, since modest weight loss is not associated with any adverse health effects in the mother or the baby.
http://www.acsh.org
ArturoRodriguez, MD
md@thebariatric.comhttp://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
miércoles, 7 de diciembre de 2011
10 Ways to Succeed with the Lap Band
Here are some helpful tips to help you succeed with the Lap-Band on a long-term basis.
Before you have the Gastric Lap Band:
1. Search for the Right Doctor for You
Many companies or groups claim to be the Best Experts in Lap Band surgery. However, it is important to check the qualifications and experience of your surgeon before making your decision. Find out whether the doctor is a member of any medical organizations and whether they have any experience in bariatric surgery. Make sure to research the company and the Doctor´s credentials, and look into the facilities and medical team. You can also check with the companies that manufacture the lap band products, like Allergan or Johnson & Johnson, to find more recommendations. It is very important to be in the right hands when you have surgery. The experience of your surgeon can make a big difference in your weight loss outcome. Surgery can be life-changing – Don´t play with your health. Look for the right doctor, and not just the cheapest deal.
2. Double-check the Doctor´s Coordinators
Some coordinators will say anything to convince you that their team and services are the best. The personality of the coordinators or the medical team can tell you a lot about the kind of work they do. When talking on the phone, check for signs of aggressiveness, or whether they speak poorly of other bariatric teams or surgeons. If they tell you that they know “everything” about Lap Bands or bariatric surgery, this is probably not true. Take your time to analyze their ethics and professionalism, and keep your ears and eyes open. Be cautious of coordinators that seem too pushy or don´t respect your requests. These coordinators are not looking out for your best interests – they are just looking for your money. Instead, look for coordinators that demonstrate clear communication and professionalism, honesty, friendliness and a helpful and caring attitude.
3. Avoid companies that are just “moving patients through the border”
Some “coordinators” may contact you to promote weight loss surgery without an actual connection to a qualified bariatric surgeon. They may not even work for the Doctor that they are promoting, and are just looking to make money. They do not have your best interests in mind – you are a merchandize for them. They might make promises that they can´t follow through with, and may get any Doctor for your surgery as long as they get paid for arranging things for you. When researching into the company, find out as much as you can about all the details, including any hidden costs or fees. Be sure that you feel confidant and comfortable with the people that you are working with before you make your final decision.
4. Communicate with other Banded Patients
Often, the best source of information is someone that has already gone through the experience before. You can find out answers by asking other people that have had the lap band procedure. Search for online forums, chat rooms, or message boards. Some questions you might ask could be:
What kind of surgical weight loss procedure did they receive?
Was the surgery what they expected?
How did the Doctor and his medical team treat them?
Did they have any complications after surgery?
How long did the surgery process take?
How have they adjusted to life with the lap band?
Did they see the results that they were expecting or hoping for?
How soon did they see results?
Would they recommend their doctor to someone else looking for the same surgery?
After you have the Gastric Lap Band Procedure:
5. Begin the Journey: Develop Good Habits
After Lap Band surgery, you will need to make some changes to your diet and activity. Small actions can results in big changes and lead to successful weight loss with your new lap band. Make sure that you learn about what foods to eat and what foods to avoid after your surgery, and determine if you can make these changes. You will also see better results if you include physical activity in your daily routine. If you are always used to driving in the car or riding the bus, try going for a short walk or getting off the bus earlier. If you do walk, try walking faster. Park your car farther away from where you are going so you can get some extra steps into your day. Use any excuse to move your body, like taking the dogs out or doing some gardening. Do anything that will help you to develop new, healthy habits.
6. Your Lap Band Expectations
Imagine yourself at the end of the “Lap Band Road” and keep Focused on that image. The vast majority of banded patients expect the band to work alone by itself, without changing any of their old habits. But the truth is that you do need to put a lot of energy into yourself and encourage yourself to improve your eating habits and activities in order to each your weight loss goals. The Lap Band is a tool to help you, but it won’t do the job alone. For the best results, you need to be committed to positive change.
7. Find the optimum Lap Band Fill
My advice is to reach a “fill point” where you can keep enjoying the foods you like, while still being able to lose or maintain your weight. Too much tightness or restriction will have you at the border line for being de-banded, and stomach erosion can happen frequently in patients with large fills. Do not compete with the Lap Band by trying to force food to pass through the band. If you feel excessive restriction, visit your doctor to have your band adjusted.
8. Maintain Good Communication with your Doctor
This is the most important of the 10 “keys for success.” Make sure you can reach your Doctor whenever you need him or her. The Bariatric Surgeons and Doctors are different than General Surgeons in the follow-up care.
Don’t hesitate to call your Doctor if you have any of the following symptoms: Heartburn, pain at the port area or in the abdomen, frequent vomiting, difficulty swallowing or reflux.
9. Have a Barium Swallow or an Endoscopy atleast once a year
This can help to indicate the condition of your stomach, esophagus, and the lap band system, including the positioning of the band and port. This may also help to detect any problems earlier, which can allow for more time to solve the problem.
10. Have your Fills done under Fluoroscopy as often as possible
Office fills do not detect early, easily-correctable problems until it may be too late. Slippage and erosion are more frequently seen in patients that have never had follow-ups under fluoroscopy. Check with your Doctor to find out their process for lap band fills – if they only do office fills, ask your Doctor to recommend someone that can provide fills under fluoroscopy for you.
Before you have the Gastric Lap Band:
1. Search for the Right Doctor for You
Many companies or groups claim to be the Best Experts in Lap Band surgery. However, it is important to check the qualifications and experience of your surgeon before making your decision. Find out whether the doctor is a member of any medical organizations and whether they have any experience in bariatric surgery. Make sure to research the company and the Doctor´s credentials, and look into the facilities and medical team. You can also check with the companies that manufacture the lap band products, like Allergan or Johnson & Johnson, to find more recommendations. It is very important to be in the right hands when you have surgery. The experience of your surgeon can make a big difference in your weight loss outcome. Surgery can be life-changing – Don´t play with your health. Look for the right doctor, and not just the cheapest deal.
2. Double-check the Doctor´s Coordinators
Some coordinators will say anything to convince you that their team and services are the best. The personality of the coordinators or the medical team can tell you a lot about the kind of work they do. When talking on the phone, check for signs of aggressiveness, or whether they speak poorly of other bariatric teams or surgeons. If they tell you that they know “everything” about Lap Bands or bariatric surgery, this is probably not true. Take your time to analyze their ethics and professionalism, and keep your ears and eyes open. Be cautious of coordinators that seem too pushy or don´t respect your requests. These coordinators are not looking out for your best interests – they are just looking for your money. Instead, look for coordinators that demonstrate clear communication and professionalism, honesty, friendliness and a helpful and caring attitude.
3. Avoid companies that are just “moving patients through the border”
Some “coordinators” may contact you to promote weight loss surgery without an actual connection to a qualified bariatric surgeon. They may not even work for the Doctor that they are promoting, and are just looking to make money. They do not have your best interests in mind – you are a merchandize for them. They might make promises that they can´t follow through with, and may get any Doctor for your surgery as long as they get paid for arranging things for you. When researching into the company, find out as much as you can about all the details, including any hidden costs or fees. Be sure that you feel confidant and comfortable with the people that you are working with before you make your final decision.
4. Communicate with other Banded Patients
Often, the best source of information is someone that has already gone through the experience before. You can find out answers by asking other people that have had the lap band procedure. Search for online forums, chat rooms, or message boards. Some questions you might ask could be:
What kind of surgical weight loss procedure did they receive?
Was the surgery what they expected?
How did the Doctor and his medical team treat them?
Did they have any complications after surgery?
How long did the surgery process take?
How have they adjusted to life with the lap band?
Did they see the results that they were expecting or hoping for?
How soon did they see results?
Would they recommend their doctor to someone else looking for the same surgery?
After you have the Gastric Lap Band Procedure:
5. Begin the Journey: Develop Good Habits
After Lap Band surgery, you will need to make some changes to your diet and activity. Small actions can results in big changes and lead to successful weight loss with your new lap band. Make sure that you learn about what foods to eat and what foods to avoid after your surgery, and determine if you can make these changes. You will also see better results if you include physical activity in your daily routine. If you are always used to driving in the car or riding the bus, try going for a short walk or getting off the bus earlier. If you do walk, try walking faster. Park your car farther away from where you are going so you can get some extra steps into your day. Use any excuse to move your body, like taking the dogs out or doing some gardening. Do anything that will help you to develop new, healthy habits.
6. Your Lap Band Expectations
Imagine yourself at the end of the “Lap Band Road” and keep Focused on that image. The vast majority of banded patients expect the band to work alone by itself, without changing any of their old habits. But the truth is that you do need to put a lot of energy into yourself and encourage yourself to improve your eating habits and activities in order to each your weight loss goals. The Lap Band is a tool to help you, but it won’t do the job alone. For the best results, you need to be committed to positive change.
7. Find the optimum Lap Band Fill
My advice is to reach a “fill point” where you can keep enjoying the foods you like, while still being able to lose or maintain your weight. Too much tightness or restriction will have you at the border line for being de-banded, and stomach erosion can happen frequently in patients with large fills. Do not compete with the Lap Band by trying to force food to pass through the band. If you feel excessive restriction, visit your doctor to have your band adjusted.
8. Maintain Good Communication with your Doctor
This is the most important of the 10 “keys for success.” Make sure you can reach your Doctor whenever you need him or her. The Bariatric Surgeons and Doctors are different than General Surgeons in the follow-up care.
Don’t hesitate to call your Doctor if you have any of the following symptoms: Heartburn, pain at the port area or in the abdomen, frequent vomiting, difficulty swallowing or reflux.
9. Have a Barium Swallow or an Endoscopy atleast once a year
This can help to indicate the condition of your stomach, esophagus, and the lap band system, including the positioning of the band and port. This may also help to detect any problems earlier, which can allow for more time to solve the problem.
10. Have your Fills done under Fluoroscopy as often as possible
Office fills do not detect early, easily-correctable problems until it may be too late. Slippage and erosion are more frequently seen in patients that have never had follow-ups under fluoroscopy. Check with your Doctor to find out their process for lap band fills – if they only do office fills, ask your Doctor to recommend someone that can provide fills under fluoroscopy for you.
ArturoRodriguez, MD
md@thebariatric.comhttp://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
martes, 6 de diciembre de 2011
Colon cancer prognosis worse for the obese, type 2 diabetics
Two new studies that looked at the impact that body-mass index (BMI) and a diagnosis of type 2 diabetes had on survival rates after a colon cancer diagnosis found that both factors influence whether or not someone survives colorectal cancer. In addition, both studies found that deaths from any cause, including heart disease, were also increased in those who were obese or had type 2 diabetes.
Results of the studies were published online in the Journal of Clinical Oncology.
"The message here is to avoid obesity and type 2 diabetes because they have negative health outcomes. We don't know for sure that losing weight or increasing physical activity will help, but we know they're good for trying to avoid other diseases, like cardiovascular disease, that can come up down the road," said Dr. Jeffrey Meyerhardt, author of an accompanying editorial in the same journal, and an associate professor of medicine at the Dana-Farber Cancer Institute and Harvard Medical School in Boston.
There are more than 1 million people who've survived a colon cancer diagnosis living in the United States, and mortality from colorectal cancer has gone down over the past two decades, according to background information in the studies.
And, while previous research has linked a higher BMI and type 2 diabetes to the development of colorectal cancer in the first place, it hasn't been clear how these factors influence the course of colorectal cancer once someone has been diagnosed.
The first study included 2,303 people involved in an ongoing study that began in 1992. Between that time and 2007, the study participants had been diagnosed with colorectal cancer. Follow-up continued through December 2008.
During the study, 851 people with colorectal cancer died. Of those, 380 died as a result of colorectal cancer, while 153 died of heart disease, according to the study. The remaining 318 people died of other causes.
The risk of all-cause mortality was 30 percent higher for people who were considered obese at the start of the study vs. those of a normal weight. The risk of dying from colorectal cancer was 35 percent higher, and the risk of dying from heart disease was 68 percent higher.
Meyerhardt explained that the researchers tried to adjust the data for important factors, such as physical activity, red meat intake (a known risk factor for colorectal cancer), family history and blood pressure levels. Even after adjusting the data, obesity increased the risk of dying.
"In and of itself, obesity does seem to have some effect," Meyerhardt said.
In the second study, researchers recruited 2,278 people who'd been diagnosed with non-metastatic colon or rectal cancer between 1992 and 2007. In this group, there were 842 deaths. Of those, 377 were from colorectal cancer and 152 were from heart disease, according to the study.
People with type 2 diabetes had a 53 percent higher risk of dying from any cause and a 29 percent higher risk of dying from colorectal cancer compared to people without type 2 diabetes. The risk of dying from heart disease was 2.16 times higher in people with type 2 diabetes and nearly four times higher in people with type 2 diabetes who used insulin, compared with people without type 2 diabetes, the study found.
"Insulin use in type 2 diabetes usually indicates longer-standing diabetes, which is usually associated with worse outcomes," Meyerhardt noted.
Obesity, elevated body-mass index and diabetes are associated with worse disease states across the board," said Dr. David Bernstein, chief of gastroenterology at North Shore University Hospital in Manhasset, N.Y. "But, we don't know if you lose weight if that risk will go down. I don't counsel patients who've been diagnosed with colorectal cancer to lose weight, because weight loss tends to be a worry in people undergoing cancer treatment anyway. I do counsel my patients that haven't been diagnosed with cancer to lose weight. The medical community needs to spend more time counseling prevention."
Meyerhardt added that it's also not clear from these studies whether or not obese people or those with type 2 diabetes would benefit from changes in the treatment they receive for colorectal cancer.
http://yourlife.usatoday.com
Results of the studies were published online in the Journal of Clinical Oncology.
"The message here is to avoid obesity and type 2 diabetes because they have negative health outcomes. We don't know for sure that losing weight or increasing physical activity will help, but we know they're good for trying to avoid other diseases, like cardiovascular disease, that can come up down the road," said Dr. Jeffrey Meyerhardt, author of an accompanying editorial in the same journal, and an associate professor of medicine at the Dana-Farber Cancer Institute and Harvard Medical School in Boston.
There are more than 1 million people who've survived a colon cancer diagnosis living in the United States, and mortality from colorectal cancer has gone down over the past two decades, according to background information in the studies.
And, while previous research has linked a higher BMI and type 2 diabetes to the development of colorectal cancer in the first place, it hasn't been clear how these factors influence the course of colorectal cancer once someone has been diagnosed.
The first study included 2,303 people involved in an ongoing study that began in 1992. Between that time and 2007, the study participants had been diagnosed with colorectal cancer. Follow-up continued through December 2008.
During the study, 851 people with colorectal cancer died. Of those, 380 died as a result of colorectal cancer, while 153 died of heart disease, according to the study. The remaining 318 people died of other causes.
The risk of all-cause mortality was 30 percent higher for people who were considered obese at the start of the study vs. those of a normal weight. The risk of dying from colorectal cancer was 35 percent higher, and the risk of dying from heart disease was 68 percent higher.
Meyerhardt explained that the researchers tried to adjust the data for important factors, such as physical activity, red meat intake (a known risk factor for colorectal cancer), family history and blood pressure levels. Even after adjusting the data, obesity increased the risk of dying.
"In and of itself, obesity does seem to have some effect," Meyerhardt said.
In the second study, researchers recruited 2,278 people who'd been diagnosed with non-metastatic colon or rectal cancer between 1992 and 2007. In this group, there were 842 deaths. Of those, 377 were from colorectal cancer and 152 were from heart disease, according to the study.
People with type 2 diabetes had a 53 percent higher risk of dying from any cause and a 29 percent higher risk of dying from colorectal cancer compared to people without type 2 diabetes. The risk of dying from heart disease was 2.16 times higher in people with type 2 diabetes and nearly four times higher in people with type 2 diabetes who used insulin, compared with people without type 2 diabetes, the study found.
"Insulin use in type 2 diabetes usually indicates longer-standing diabetes, which is usually associated with worse outcomes," Meyerhardt noted.
Obesity, elevated body-mass index and diabetes are associated with worse disease states across the board," said Dr. David Bernstein, chief of gastroenterology at North Shore University Hospital in Manhasset, N.Y. "But, we don't know if you lose weight if that risk will go down. I don't counsel patients who've been diagnosed with colorectal cancer to lose weight, because weight loss tends to be a worry in people undergoing cancer treatment anyway. I do counsel my patients that haven't been diagnosed with cancer to lose weight. The medical community needs to spend more time counseling prevention."
Meyerhardt added that it's also not clear from these studies whether or not obese people or those with type 2 diabetes would benefit from changes in the treatment they receive for colorectal cancer.
http://yourlife.usatoday.com
ArturoRodriguez, MD
md@thebariatric.comhttp://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
viernes, 2 de diciembre de 2011
Obesity in America
ArturoRodriguez, MD
md@thebariatric.comhttp://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
lunes, 28 de noviembre de 2011
Benefits of bariatric surgery
ArturoRodriguez, MD
md@thebariatric.comhttp://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
viernes, 25 de noviembre de 2011
Eating breakfast may beat teen obesity
Eating breakfast every day may be the first step in fighting teen obesity.
A new study shows teenagers who eat breakfast regularly eat a healthier diet and are more physically active throughout their adolescence than those who skip breakfast. Years later, they also gained less weight and had a lower body mass index (BMI), a measure of weight in relation to height used to measure obesity.
"Although adolescents may think that skipping breakfast seems like a good way to save on calories, findings suggest the opposite. Eating a healthy breakfast may help adolescents avoid overeating later in the day and disrupt unhealthy eating patterns, such as not eating early in the day and eating a lot late in the evening," says researcher Dianne Neumark-Sztainer, PhD, of the University of Minnesota, in a news release.
Researchers say rates of teen obesity have nearly tripled over the last two decades. Meanwhile, an estimated 12%-34% of children and adolescents regularly skip breakfast, and that percentage increases with age.
Despite those statistics, the role of breakfast in preventing teen obesity hasn't been thoroughly studied. But these results suggest that eating breakfast regularly may be an important tool in fighting teen obesity and promoting a healthier diet.
Breakfast Fights Fat
In the study, published in Pediatrics, researchers analyzed the dietary and weight patterns of a group of 2,216 adolescents over a five-year period (1998-1999 to 2003-2004) from public schools in Minneapolis-St. Paul, Minn.
The researchers write that teens who ate breakfast regularly had a lower percentage of total calories from saturated fat and ate more fiber and carbohydrates than those who skipped breakfast. In addition, regular breakfast eaters seemed more physically active than breakfast skippers.
Over time, researchers found teens who regularly ate breakfast tended to gain less weight and had a lower body mass index than breakfast skippers.
Meanwhile, a related study released in the Archives of Pediatrics and Adolescent Medicine has found another way to help lower BMI among children. Researchers found that reducing television and computer time by 50% in children aged 4-7 led to less sedentary behavior and a lower BMI compared with children with unrestricted TV and computer time after two years.
Although both studies are preliminary, researchers say the results suggest that encouraging children and teens to eat breakfast and cut back on TV time are important ways to combat teen obesity.
webmd.com
A new study shows teenagers who eat breakfast regularly eat a healthier diet and are more physically active throughout their adolescence than those who skip breakfast. Years later, they also gained less weight and had a lower body mass index (BMI), a measure of weight in relation to height used to measure obesity.
"Although adolescents may think that skipping breakfast seems like a good way to save on calories, findings suggest the opposite. Eating a healthy breakfast may help adolescents avoid overeating later in the day and disrupt unhealthy eating patterns, such as not eating early in the day and eating a lot late in the evening," says researcher Dianne Neumark-Sztainer, PhD, of the University of Minnesota, in a news release.
Researchers say rates of teen obesity have nearly tripled over the last two decades. Meanwhile, an estimated 12%-34% of children and adolescents regularly skip breakfast, and that percentage increases with age.
Despite those statistics, the role of breakfast in preventing teen obesity hasn't been thoroughly studied. But these results suggest that eating breakfast regularly may be an important tool in fighting teen obesity and promoting a healthier diet.
Breakfast Fights Fat
In the study, published in Pediatrics, researchers analyzed the dietary and weight patterns of a group of 2,216 adolescents over a five-year period (1998-1999 to 2003-2004) from public schools in Minneapolis-St. Paul, Minn.
The researchers write that teens who ate breakfast regularly had a lower percentage of total calories from saturated fat and ate more fiber and carbohydrates than those who skipped breakfast. In addition, regular breakfast eaters seemed more physically active than breakfast skippers.
Over time, researchers found teens who regularly ate breakfast tended to gain less weight and had a lower body mass index than breakfast skippers.
Meanwhile, a related study released in the Archives of Pediatrics and Adolescent Medicine has found another way to help lower BMI among children. Researchers found that reducing television and computer time by 50% in children aged 4-7 led to less sedentary behavior and a lower BMI compared with children with unrestricted TV and computer time after two years.
Although both studies are preliminary, researchers say the results suggest that encouraging children and teens to eat breakfast and cut back on TV time are important ways to combat teen obesity.
webmd.com
ArturoRodriguez, MD
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
sábado, 19 de noviembre de 2011
Congress declares pizza a vegetable for school lunches
Yes, Congress has affirmed that pizza is, indeed, a vegetable. And, in a related story, they’ve declared Chris Christie Mr. Olympia.
Actually, the truth is that Congress had ALREADY said pizza was a vegetable, or rather, that the tomato paste used on the pizza is a vegetable. You see, when you and I order pizza, it has tomato SAUCE on it. But school lunches have tomato PASTE.
Are you familiar with tomato paste? It’s that gelatinous stuff that comes in tiny cans. Let me read to you from my label of Cento Tomato Paste: a two tablespoon serving (that’s what is on each slice of pizza in school lunches) has 10 percent of your daily recommended requirement of Vitamins A and C; it also has 5 grams of sugar. The ingredients don’t list any added sugars, so I’m assuming that those are sugars naturally found in tomatoes. Tomatoes are a fruit, so truthfully, there are no vegetables in tomato paste.
The USDA is attempting to change the rules about school lunches. They want less tomato paste, which would eliminate pizza, and they want a limit on starchy vegetables: corn, peas and potatoes. That means no French fries. Congress is blocking all these recommendations to keep the lunches as they are.
Their reasoning seems to be that making lunches healthier is too expensive, and the reason they think that is because the potato lobby, the processed foods lobby, and a variety of other Big Fat Butt lobbies told them so.
Look, it’s hard to get kids to eat right. My kids agree with Congress that pizza is a vegetable. In fact, my kids think Lucky Charms Cereal is a vegetable. I can’t get my kids to eat salad, so why do I think the school cafeteria can?
Congress has a tough job – they have to feed a bunch of kids healthy meals every day on a tight budget.
Hey, that’s what I do! And yes, it’s expensive. My food bill is $200 a week for four of us, and that’s with careful planning and plenty of cooking from scratch every night.
The only thing I’ve learned about kids and food is this. Don’t give them bad choices. If they can choose between sliced cucumber and French fries, what do you think they’re going to pick? What would you pick?
To me, lunch is the easiest to regulate. I pack it in their lunchbox, and that’s all they have to eat all day. There is no other food in their elementary schools, even if there was, they would need money to buy it. I don’t give them money. I give them water or a fortified juice, a sandwich on whole wheat bread, some type of fruit, and a small dessert. No chips, no fries. They only have 20 minutes to eat it anyway, because their day is so packed. They eat it all.
Congress is such a bunch of bozos. If they want to improve their image, they should allow the healthier guidelines to pass. Stand up to the food lobbyists! Make speeches about how you are striking a blow against big business and for our most vulnerable children. Get misty about how obesity is robbing our children of their futures. Be seen in public peeling and eating an orange.
Then, when the potato and tomato paste industries start to go under, just vote them a bailout.
Actually, the truth is that Congress had ALREADY said pizza was a vegetable, or rather, that the tomato paste used on the pizza is a vegetable. You see, when you and I order pizza, it has tomato SAUCE on it. But school lunches have tomato PASTE.
Are you familiar with tomato paste? It’s that gelatinous stuff that comes in tiny cans. Let me read to you from my label of Cento Tomato Paste: a two tablespoon serving (that’s what is on each slice of pizza in school lunches) has 10 percent of your daily recommended requirement of Vitamins A and C; it also has 5 grams of sugar. The ingredients don’t list any added sugars, so I’m assuming that those are sugars naturally found in tomatoes. Tomatoes are a fruit, so truthfully, there are no vegetables in tomato paste.
The USDA is attempting to change the rules about school lunches. They want less tomato paste, which would eliminate pizza, and they want a limit on starchy vegetables: corn, peas and potatoes. That means no French fries. Congress is blocking all these recommendations to keep the lunches as they are.
Their reasoning seems to be that making lunches healthier is too expensive, and the reason they think that is because the potato lobby, the processed foods lobby, and a variety of other Big Fat Butt lobbies told them so.
Look, it’s hard to get kids to eat right. My kids agree with Congress that pizza is a vegetable. In fact, my kids think Lucky Charms Cereal is a vegetable. I can’t get my kids to eat salad, so why do I think the school cafeteria can?
Congress has a tough job – they have to feed a bunch of kids healthy meals every day on a tight budget.
Hey, that’s what I do! And yes, it’s expensive. My food bill is $200 a week for four of us, and that’s with careful planning and plenty of cooking from scratch every night.
The only thing I’ve learned about kids and food is this. Don’t give them bad choices. If they can choose between sliced cucumber and French fries, what do you think they’re going to pick? What would you pick?
To me, lunch is the easiest to regulate. I pack it in their lunchbox, and that’s all they have to eat all day. There is no other food in their elementary schools, even if there was, they would need money to buy it. I don’t give them money. I give them water or a fortified juice, a sandwich on whole wheat bread, some type of fruit, and a small dessert. No chips, no fries. They only have 20 minutes to eat it anyway, because their day is so packed. They eat it all.
Congress is such a bunch of bozos. If they want to improve their image, they should allow the healthier guidelines to pass. Stand up to the food lobbyists! Make speeches about how you are striking a blow against big business and for our most vulnerable children. Get misty about how obesity is robbing our children of their futures. Be seen in public peeling and eating an orange.
Then, when the potato and tomato paste industries start to go under, just vote them a bailout.
Fuente: http://www.newjerseynewsroom.com
ArturoRodriguez, MD
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
viernes, 11 de noviembre de 2011
Smile!!
ArturoRodriguez, MD
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
viernes, 28 de octubre de 2011
Zumba brings the dance party into the health club
"Zumba has experienced a rapid surge in popularity in the past year, but we'll see if it's a trend or just a fad," says lead author Walter Thompson , a professor of exercise science at Georgia State University.
The survey, conducted since 2007, is designed to identify trends in areas ranging from career opportunities to groups of people being targeted to specific workouts and to help the fitness industry make business decisions for the future. ACSM surveyed more than 2,600 fitness professionals to compile the top 20 fitness trends for 2012. A total of 37 potential trends were given as choices.
Top 10 fitness trends:
1. Educated and experienced
2. Strength training
3. Fitness programs for older adults
4. Exercise and weight loss
5. Children and obesity
6. Personal training
7. Core training
8. Group personal training
9. Zumba and other dance workouts
10. Functional fitness (for older adults)
Source: American College of Sports Medicine / usatoday.com
ArturoRodriguez, MD
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
sábado, 22 de octubre de 2011
How weight loss may ease an embarrassing problem
Losing weight reduces the risk factors for many diseases, especially cardiovascular disease and type 2 diabetes. Shedding just 10 pounds, for example, can lower blood pressure. Weight loss also lowers blood sugar and improves cholesterol levels.
Now, it looks like a new benefit can be added to the list. Losing weight can reduce urinary incontinence in women who are overweight or obese. In a randomized trial funded by the National Institutes of Health, moderate weight loss in a group of heavy women who undertook a six-month diet and exercise program cut the frequency of urinary incontinence episodes by nearly a half.
Urinary incontinence affects more than 13 million women in the United States. It not only causes inconvenience and emotional stress, it also raises the risk of falls, fractures, and nursing home admissions. Obesity has long been associated with urinary leakage in women, but until now, there’s been little research to confirm that losing weight would help reverse the problem — or to suggest how much weight loss would be needed.
The PRIDE study
Investigators with the Program to Reduce Incontinence by Diet and Exercise (PRIDE) at the University of California at San Francisco worked with 338 overweight or obese women (average age 53) who leaked urine at least 10 times per week. Participants were randomly assigned to either an intensive program of diet, exercise, and behavioral modification or to a control group that was instructed in the benefits of weight loss, exercise, and healthy eating but received no training to help them modify their habits.
At the start of the study, subjects were given self-help bladder-control booklets and completed seven-day voiding diaries in which they identified incontinence episodes as stress incontinence (urine leakage with coughing, sneezing, straining, or exercise), urge incontinence (urine leakage after feeling a sudden need to urinate), or other.
The weight-loss group met weekly for six months in one-hour sessions led by experts in exercise, nutrition, and behavior change. They were given a low-calorie (1,200–1,500 calories per day), low-fat diet and told to gradually increase moderate-intensity physical activity up to at least 200 minutes per week. The control group participants met four times in one-hour group sessions.
Research results
After six months, women in the first group had lost an average of 17 pounds and had 47% fewer urinary incontinence episodes; the control group participants lost an average of 3 pounds and reported 28% fewer episodes. A higher proportion of the women in the weight loss group (41%) than in the control group (22%) experienced a 70% or greater drop in the frequency of incontinence episodes. Perhaps not surprisingly, weight-loss participants reported feeling happier about the change in their incontinence, compared with the control group.
The PRIDE investigators acknowledge that their findings may not apply to all women. They selected participants partly because they lacked certain medical conditions and were willing to stick with the behavioral program. Also, it was impossible to “blind” the experiment so that neither participants nor researchers would know which group was receiving the treatment. Nonetheless, the study strongly suggests that weight loss reduces incontinence episodes, possibly by reducing pressure on the bladder and pelvic floor. Understanding this may help women concerned about urinary leakage during exercise to stick with their workouts, knowing that doing so could improve urinary incontinence down the road.
Now, it looks like a new benefit can be added to the list. Losing weight can reduce urinary incontinence in women who are overweight or obese. In a randomized trial funded by the National Institutes of Health, moderate weight loss in a group of heavy women who undertook a six-month diet and exercise program cut the frequency of urinary incontinence episodes by nearly a half.
Urinary incontinence affects more than 13 million women in the United States. It not only causes inconvenience and emotional stress, it also raises the risk of falls, fractures, and nursing home admissions. Obesity has long been associated with urinary leakage in women, but until now, there’s been little research to confirm that losing weight would help reverse the problem — or to suggest how much weight loss would be needed.
The PRIDE study
Investigators with the Program to Reduce Incontinence by Diet and Exercise (PRIDE) at the University of California at San Francisco worked with 338 overweight or obese women (average age 53) who leaked urine at least 10 times per week. Participants were randomly assigned to either an intensive program of diet, exercise, and behavioral modification or to a control group that was instructed in the benefits of weight loss, exercise, and healthy eating but received no training to help them modify their habits.
At the start of the study, subjects were given self-help bladder-control booklets and completed seven-day voiding diaries in which they identified incontinence episodes as stress incontinence (urine leakage with coughing, sneezing, straining, or exercise), urge incontinence (urine leakage after feeling a sudden need to urinate), or other.
The weight-loss group met weekly for six months in one-hour sessions led by experts in exercise, nutrition, and behavior change. They were given a low-calorie (1,200–1,500 calories per day), low-fat diet and told to gradually increase moderate-intensity physical activity up to at least 200 minutes per week. The control group participants met four times in one-hour group sessions.
Research results
After six months, women in the first group had lost an average of 17 pounds and had 47% fewer urinary incontinence episodes; the control group participants lost an average of 3 pounds and reported 28% fewer episodes. A higher proportion of the women in the weight loss group (41%) than in the control group (22%) experienced a 70% or greater drop in the frequency of incontinence episodes. Perhaps not surprisingly, weight-loss participants reported feeling happier about the change in their incontinence, compared with the control group.
The PRIDE investigators acknowledge that their findings may not apply to all women. They selected participants partly because they lacked certain medical conditions and were willing to stick with the behavioral program. Also, it was impossible to “blind” the experiment so that neither participants nor researchers would know which group was receiving the treatment. Nonetheless, the study strongly suggests that weight loss reduces incontinence episodes, possibly by reducing pressure on the bladder and pelvic floor. Understanding this may help women concerned about urinary leakage during exercise to stick with their workouts, knowing that doing so could improve urinary incontinence down the road.
Article taken from www.health.harvard.edu
ArturoRodriguez, MD
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
ArturoRodriguez, MD
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
jueves, 13 de octubre de 2011
Move your body
ArturoRodriguez, MD
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177
miércoles, 12 de octubre de 2011
Diet before lapband
Why a low Carbs Pre Lap-band Diet is Helpful?
I am used to performing surgery on patients that have not done any pre-operatory diet mainly because many of them can’t follow any kind of diet and by asking for one just increases their stress before surgery.
Long term carbohydrates and fat diets will turn to storage and infiltration of fat into the hepatic cells. Under this condition, the liver total mass will be progressively enlarged to what’s called pre-cirrhotic stage. By this, fat infiltration of the liver and on patients, the liver will remain enlarged during the lapband Surgery, the Gastric sleeve or the Gastric bypass and the working surgical area turns into a tiny space, reduced for errors in placing the instruments in the right position.
Because there is less room to work with also makes it very difficult to see and recognize the structures, to have enough space to do the right sutures and perform a safely procedure unless the surgeon has enough experience to handle these kinds of situations and has the right bariatric instruments to work with.
We don’t know for sure how much the total liver mass will be reduced by one or two weeks with pre op-diet. My personal belief is that will not shrink too much to make a difference and that the surgeon should be able to adapt to all situations.
ArturoRodriguez, MD
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177.
I am used to performing surgery on patients that have not done any pre-operatory diet mainly because many of them can’t follow any kind of diet and by asking for one just increases their stress before surgery.
Long term carbohydrates and fat diets will turn to storage and infiltration of fat into the hepatic cells. Under this condition, the liver total mass will be progressively enlarged to what’s called pre-cirrhotic stage. By this, fat infiltration of the liver and on patients, the liver will remain enlarged during the lapband Surgery, the Gastric sleeve or the Gastric bypass and the working surgical area turns into a tiny space, reduced for errors in placing the instruments in the right position.
Because there is less room to work with also makes it very difficult to see and recognize the structures, to have enough space to do the right sutures and perform a safely procedure unless the surgeon has enough experience to handle these kinds of situations and has the right bariatric instruments to work with.
We don’t know for sure how much the total liver mass will be reduced by one or two weeks with pre op-diet. My personal belief is that will not shrink too much to make a difference and that the surgeon should be able to adapt to all situations.
ArturoRodriguez, MD
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177.
martes, 11 de octubre de 2011
Getting to know you…
Learn More About your Bariatric Surgeon
Dr. Arturo Rodríguez is a highly skilled, compassionate surgeon with more than 13 years of surgical experience. He is a member of the American Society for Metabolic and Bariatric Surgery and Johnson & Johnson Proctor. He has performed more than 6,500 weight loss surgeries for patients from Mexico and the United States.
Dr. Arturo Rodríguez understands the life-changing effect that Bariatric Surgery can have on an individual, and he is committed to providing long-term support for his patients as they embark on their journey to healthier and happier lives. Dr. Rodríguez specializes in minimally invasive laparoscopic Gastric Banding Surgery-Lap Band, Gastric Sleeve and Gastric Bypass which greatly reduces scarring and postoperative recovery time. He is highly skilled in placing and monitoring both the Lap Band and the Realize band, and he personally consults with each one of his patients to determine which procedure best suits their needs. His extensive experience and education also allows him to help patients who suffer from complications of morbid obesity.
Dr. Rodríguez and his professional medical team are dedicated to providing expert care and compassionate support from the first consultation through years of follow-up. Patients also receive long-term support through follow-up consultations, interaction with Dr. Rodríguez in the online forum and patient reunions held in Monterrey.
To schedule an in-person or online consultation with Dr. Rodríguez and learn more about your weight loss options, you can contact him at:
ArturoRodriguez, MD
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177.
Dr. Arturo Rodríguez is a highly skilled, compassionate surgeon with more than 13 years of surgical experience. He is a member of the American Society for Metabolic and Bariatric Surgery and Johnson & Johnson Proctor. He has performed more than 6,500 weight loss surgeries for patients from Mexico and the United States.
Dr. Arturo Rodríguez understands the life-changing effect that Bariatric Surgery can have on an individual, and he is committed to providing long-term support for his patients as they embark on their journey to healthier and happier lives. Dr. Rodríguez specializes in minimally invasive laparoscopic Gastric Banding Surgery-Lap Band, Gastric Sleeve and Gastric Bypass which greatly reduces scarring and postoperative recovery time. He is highly skilled in placing and monitoring both the Lap Band and the Realize band, and he personally consults with each one of his patients to determine which procedure best suits their needs. His extensive experience and education also allows him to help patients who suffer from complications of morbid obesity.
Dr. Rodríguez and his professional medical team are dedicated to providing expert care and compassionate support from the first consultation through years of follow-up. Patients also receive long-term support through follow-up consultations, interaction with Dr. Rodríguez in the online forum and patient reunions held in Monterrey.
To schedule an in-person or online consultation with Dr. Rodríguez and learn more about your weight loss options, you can contact him at:
ArturoRodriguez, MD
md@thebariatric.com
http://www.thebariatric.com
http://www.bandstersforum.com
Phone: 011-52-81-8378-3177.
sábado, 8 de octubre de 2011
Have Lapband surgery for Less in Mexico
 |
| Christus Hospital |
Mexico has become the best location to obtain surgical operations for less money, especially in the areas of weight loss and plastic surgery. You can have lap band surgery for less in Mexico, yet still enjoy the same level of professionalism, technology, after-surgery care, and state-of-the-art medical facilities.
The Mexicans have developed numerous reputable medical schools in recent years, such as the University of Monterrey, and some of the best Mexican hospitals are located nearby with exceptionally skilled physicians and surgeons. Many American medical students have also obtained their education from this University. In addition to gastric bypass or gastric sleeve surgeries, one of the most common and widely available surgeries in Mexico is the Lapband procedure.
Lapband surgery is also known as gastric band surgery. It is minimally invasive, especially when compared to other types of obesity control methods. The surgery is much safer as well. When comparing the price of this surgery between the United States and Mexico, patients can receive the exact same Lap band procedure in Mexico for up to 70% less than in the states. Despite the lower price, patients are advised to avoid the cheapest clinics.
Blindly placing trust in the least expensive location is not the best idea. Patients should expect to pay somewhere between $7,000 and $12,000 for the lap band or gastric bypass procedure. Avoid going to clinics that quote an extremely low Lapband price. Often, the reason for the deeply discounted price is due to a lack of business, poor reputations, a lack of proper facilities, or a lack of qualified personnel.
Choosing where you will obtain your lap band surgery is a very important decision. Certainly, you can have lapband surgery for less in Mexico, yet you must still make an informed, educated choice between hospitals, clinics and doctors. It is always the best choice to choose full-fledged hospitals for any surgical procedure in Mexico, primarily because they have all the necessary medical equipment and emergency surgical backup if any complications should arise. Good hospitals, such as Christus Health, will have major facilities such as blood banks, XRAY, MRI, and ICU centers. Some of these same hospitals will also have boarding facilities in which patients can stay along with a friend or relative. Finally, large hospitals will also have staff who speak English fluently, which is an important factor when considering a surgical procedure in another country. You need to be able to communicate your desires, your feelings, your pain, and your concerns to your physician or surgeon.
The Mexicans have developed numerous reputable medical schools in recent years, such as the University of Monterrey, and some of the best Mexican hospitals are located nearby with exceptionally skilled physicians and surgeons. Many American medical students have also obtained their education from this University. In addition to gastric bypass or gastric sleeve surgeries, one of the most common and widely available surgeries in Mexico is the Lapband procedure.
Lapband surgery is also known as gastric band surgery. It is minimally invasive, especially when compared to other types of obesity control methods. The surgery is much safer as well. When comparing the price of this surgery between the United States and Mexico, patients can receive the exact same Lap band procedure in Mexico for up to 70% less than in the states. Despite the lower price, patients are advised to avoid the cheapest clinics.
Blindly placing trust in the least expensive location is not the best idea. Patients should expect to pay somewhere between $7,000 and $12,000 for the lap band or gastric bypass procedure. Avoid going to clinics that quote an extremely low Lapband price. Often, the reason for the deeply discounted price is due to a lack of business, poor reputations, a lack of proper facilities, or a lack of qualified personnel.
Choosing where you will obtain your lap band surgery is a very important decision. Certainly, you can have lapband surgery for less in Mexico, yet you must still make an informed, educated choice between hospitals, clinics and doctors. It is always the best choice to choose full-fledged hospitals for any surgical procedure in Mexico, primarily because they have all the necessary medical equipment and emergency surgical backup if any complications should arise. Good hospitals, such as Christus Health, will have major facilities such as blood banks, XRAY, MRI, and ICU centers. Some of these same hospitals will also have boarding facilities in which patients can stay along with a friend or relative. Finally, large hospitals will also have staff who speak English fluently, which is an important factor when considering a surgical procedure in another country. You need to be able to communicate your desires, your feelings, your pain, and your concerns to your physician or surgeon.
lunes, 26 de septiembre de 2011
Lapband surgery in Mexico…The obvious choice
With health care costs skyrocketing in the United States, more and more medical procedures are being performed abroad. Mexico is quickly becoming a very popular country for medical procedures especially for those people who do not have insurance.
Lap Band Surgery is a surgical procedure which helps extremely overweight people return to a more healthy weight. The Lap Band is a silicone ring which is placed between the new upper pouch and the lower part of the stomach. The surgery is performed under general anesthesia and takes approximately 25 minutes. The Band is adjustable, reversible and requires no stapling, cutting or rerouting of the intestinal tract. The recovery time is usually 3-7 days and patients are given an extensive post op instruction manual which includes pain management, surgical site care and customized diet instructions. The Lap Band Surgery is also the only adjustable, reversible, surgical weight loss procedure that is approved by the FDA.
Lap Band Surgery is a surgical procedure which helps extremely overweight people return to a more healthy weight. The Lap Band is a silicone ring which is placed between the new upper pouch and the lower part of the stomach. The surgery is performed under general anesthesia and takes approximately 25 minutes. The Band is adjustable, reversible and requires no stapling, cutting or rerouting of the intestinal tract. The recovery time is usually 3-7 days and patients are given an extensive post op instruction manual which includes pain management, surgical site care and customized diet instructions. The Lap Band Surgery is also the only adjustable, reversible, surgical weight loss procedure that is approved by the FDA.
domingo, 25 de septiembre de 2011
Life after gastric bypass surgery
There are a number of important things to consider for patients after they have had Gastric Bypass Surgery. Take some time to read through the information and get informed if you are considering this procedure.
Diet
After having a gastric bypass, the modifications made to your gastrointestinal tract will require permanent changes in your eating habits that must be adhered to for successful weight loss. Without these necessary changes, such as decreasing or limiting your intake of high-fat, high-sugar foods, you may stop losing weight or even begin to gain weight again. Limiting high intakes of sugary foods is especially important to decrease the chance of Dumping Syndrome, where these foods move too quickly through the digestive tract into the intestine and can cause cramping, pain and discomfort, among other related symptoms.
Diet
After having a gastric bypass, the modifications made to your gastrointestinal tract will require permanent changes in your eating habits that must be adhered to for successful weight loss. Without these necessary changes, such as decreasing or limiting your intake of high-fat, high-sugar foods, you may stop losing weight or even begin to gain weight again. Limiting high intakes of sugary foods is especially important to decrease the chance of Dumping Syndrome, where these foods move too quickly through the digestive tract into the intestine and can cause cramping, pain and discomfort, among other related symptoms.
sábado, 24 de septiembre de 2011
Here is my Lapband Story…
I was overweight most of my life. I had tried every diet out there only to gain all the weight back. I was depressed and frustrated. I had heard so many Weight Loss Surgery success stories and realized that Lapband surgery was my only option for permanent Weight Loss. While researching my options I ran across Dr. Arturo Rodriguez’s website and decided to call. I was skeptical about traveling outside the U.S. but after a lot of research I was certain that Dr. Arturo Rodriguez was the right doctor for me.
viernes, 23 de septiembre de 2011
Lapband in children
 |
| Emrah Mevsimier |
Children as young as 14 are having invasive weight-loss surgery on the NHS at up to £14,000 a time.
Official figures reveal a sharp rise in the number of obese teenagers having gastric bypasses, stomach stapling or gastric banding.
In one case, the parents of a 14-year-old were told the Health Service would not pay for a weight-loss course but would instead cover a more costly gastric band.
Emrah Mevsimier had a gastric band fitted aged 13, becoming the youngest person in Britain to have one. He was one of four members of his family to have the operation. His mother died aged 40, a year after having a gastric band fitted.
http://thebariatric.com/
jueves, 22 de septiembre de 2011
Gastric band weight loss ops on the rise for under-25s
The number of under-25s being given weight-loss surgery on the NHS in England has quadrupled over the last three years, according to figures seen by Newsbeat.
That includes people being fitted with a gastric band, having their stomach stapled, or having a gastric bypass.
Between 2006 and 2007, 55 people under the age of 25 had one of these operations, but between 2009 and 2010 the number had risen to 210.
That included 34 teenagers, some as young as 15.
Doctors and eating-disorder groups say they are worried about the rise, claiming the NHS in many cases is not giving young people the support they need before and after the surgery.
That includes people being fitted with a gastric band, having their stomach stapled, or having a gastric bypass.
Between 2006 and 2007, 55 people under the age of 25 had one of these operations, but between 2009 and 2010 the number had risen to 210.
That included 34 teenagers, some as young as 15.
Doctors and eating-disorder groups say they are worried about the rise, claiming the NHS in many cases is not giving young people the support they need before and after the surgery.
martes, 20 de septiembre de 2011
De-Banding the LapBand Can be Complicated
Today I want to share some concepts that frequently are misunderstood by Doctors starting a bariatric program, and by Banded Patients. There are several reasons for De-Banding a Lap-Band patient. Today I would like to focus on EROSION. The incidence of Stomach Erosion ranges from 2 to 15% of the patients who underwent a Lap Band Procedure . The occurence of erosion depends on the Surgeons learning curve, and various patient actions such as the consumption of alcohol, spicy or hot food, frequent vomiting or the use of some medications like Aspirin.
lunes, 19 de septiembre de 2011
Losing Weight During The Holidays
Holidays are a time to enjoy family and friends, and get-togethers almost always center around good food and conversation. Everyone brings delicious foods and desserts to numerous parties and gatherings, and life can get very busy and hectic, leaving little time for your regular exercise routine. For someone who is trying to lose weight, the temptations can be overwhelming.
Diet and exercise are the most important methods of losing weight. However, this may not always be possible or practical during holiday times. Either someone is staying at a hotel, where exercise options are limited, or they might be staying with friends or family where it is hard to get away. As well, it almost seems rude to refuse any food offered at these special occasions. However, the holidays is a time to focus on positive thinking. Focus on ways to eat healthy and maintain your weight. For example, if you stay in a hotel, why not take the stairs to your room instead of the elevator, or check out the swimming pool? If you are staying with friends or relatives, start a game of soccer with the family or take a walk around town. When the food is on the table, choose your favorite vegetables and fruits first – and enjoy sharing a colorful, healthy meal. If the cake is calling your name, chose a smaller piece.
Diet and exercise are the most important methods of losing weight. However, this may not always be possible or practical during holiday times. Either someone is staying at a hotel, where exercise options are limited, or they might be staying with friends or family where it is hard to get away. As well, it almost seems rude to refuse any food offered at these special occasions. However, the holidays is a time to focus on positive thinking. Focus on ways to eat healthy and maintain your weight. For example, if you stay in a hotel, why not take the stairs to your room instead of the elevator, or check out the swimming pool? If you are staying with friends or relatives, start a game of soccer with the family or take a walk around town. When the food is on the table, choose your favorite vegetables and fruits first – and enjoy sharing a colorful, healthy meal. If the cake is calling your name, chose a smaller piece.
sábado, 17 de septiembre de 2011
Lap Band, Gastric Sleeve or Gastric Bypass? That is the Question!
The Bariatric surgical field has experienced extraordinary changes over the past 55 years.
With the initial empiric use of Intestinal Bypass surgery in 1954 by Kremen, Linner and Nelson at the University of Minnesota, severe obesity was identified as a disease that could be successfully treated.
Today, the acceptance of Bariatric Surgery is a proven surgical discipline. It hasn’t always been that way, and has gone through a long bumpy road in a very hostile environment. It has gone from acid critics and nonbelievers to a great demand of this kind of surgery all over the world.
The increase of obesity over the past 50 years has doubled or tripled in some countries.
One third of the population in the United States is obese (23 million) and patients seeking surgical treatment are becoming heavier each year.
With the initial empiric use of Intestinal Bypass surgery in 1954 by Kremen, Linner and Nelson at the University of Minnesota, severe obesity was identified as a disease that could be successfully treated.
Today, the acceptance of Bariatric Surgery is a proven surgical discipline. It hasn’t always been that way, and has gone through a long bumpy road in a very hostile environment. It has gone from acid critics and nonbelievers to a great demand of this kind of surgery all over the world.
The increase of obesity over the past 50 years has doubled or tripled in some countries.
One third of the population in the United States is obese (23 million) and patients seeking surgical treatment are becoming heavier each year.
viernes, 16 de septiembre de 2011
Lap Band Erosion
There are many terms that have become familiar to the lap band population because they are commonly used among doctors and patients. One popular term is “Lap Band” which stands for Laparoscopic Gastric Banding. The term “Lap Band Erosion” also became very popular among the banded patients as lap band message boards increased in popularity. The patients that already had the Lap Band were concerned as“erosion” was often connected to topics such as de-banding or surgical removal of the band. However, the term actually means that the stomach has developed a penetrating ulcer and has eroded (worn away) towards the balloon of the band.
How does Stomach Erosion happen in Lap Band Patients?
Intragastric band erosions have been reported at rates that vary from 3 to 10% depending on the operatory technique or surgeon´s experience, the device used and the patient’s eating behavior. There are several different and controversial theories for the cause of erosion:
jueves, 15 de septiembre de 2011
Lapband surgery Hospital in Monterrey
http://www.thebariatric.com Our New Hospital in Monterrey, Mexico for having Lapband, Gastric Sleeve and Gastric Bypass done by Arturo Rodriguez, MD
miércoles, 14 de septiembre de 2011
My Life with the Lapband
Boy how time flies!
As I approach my 5th year Bandiversary, I started thinking how the Lapband has changed my life or how I had to change my life to live with the Lapband.
First off, I thank God every day for showing me there was an option and giving me the opportunity to have the Lapband procedure.
Like most in my situation, I tried every diet that always ended in failure. I almost got to the point where I wouldn’t want to diet because I KNEW I would gain the weight back and probably gain more. It was a horrible vicious cycle that I lived in for years.
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