BMI » low carb

MAKING THE MOST OUT OF LIFE AFTER BARIATRIC SURGERY

ramana — Sun, 08 May 2011 13:26:34 +0000

Those who undergo or contemplate bariatric surgery do so essentially as a second chance at life. I mean that the severely obese man or woman feels that he (or she) has lost out in life on multiple fronts. Here are a few examples:
Loss of body contour/beauty: you can’t forget how you were once before the fat started piling on.
Poor self image: you hate the thing you see in the mirror.
Poor quality of life: you can’t dance, surf, skip, run or walk without some kind of pain or discomfort. Going up one floor makes you breathless. You avoid holidays where you would need to walk, especially on hilly terrain.
Sexual issues: whether it is inability or unwillingness of one’s partner, sex life may take a back seat or even come unseated!
Health loss: you suddenly have been diagnosed to be having diabetes or heart disease (or anything else) and, suddenly, life sucks!
Social alienation: Even though there have never been as many obese people in the planet as the present, the morbidly obese individual catches everyone’s eye the wrong way. People make jokes, there is job discrimination, and even marriages get burnt!
The need for bariatric surgery serves as the wake-up call. What many people don’t realise is that bariatric surgery should not (and is not) a short cut. You cannot eat all you want and stay slim after the surgery. Therefore, if you look at the long term figures of weight loss after bariatric surgery, it may be as low as 40 to 50 percent, though the initial weight loss achieved may be 75%.
Obviously, we know weight regain is an issue for patients, and has to be addressed properly.
Even better is if you can program your life to prevent weight regain.
An unnamed BMI patient (we take our patients’ privacy seriously) writes to me:

Seems like such a long time ago that I was through surgery. I am still learning what I can and cannot do regarding food. I have a different attitude towards food now, which I never would have believed possible. I find the Paleo Diet hard to follow but have taken some of it on board and restrict foods, such as bread and potatoes to a bare minimum (a couple of slices of bread per week) and I haven’t eaten rice since surgery. I eat an egg for breakfast and sometimes mushrooms. The days of a full Ulster fry-up are long since gone, and dinner is served on a small side plate. I see the portions people eat and shudder. I have seen me ask for a children’s portion and still not finish it. I still have some milk in coffee and I eat natural yoghurt, which is not permitted but in general, my eating habits have really improved. Fresh fruit and veg, and some fish or chicken. I can only digest minced red meat and even then, only in small quantities, but nothing can equal how I feel.

(Eat This!)

(And This!)

As I keep saying, eat natural foods and avoid man-made food products.

(Stay strong when life tempts you!)

She reflects the pursuit of that kind of eating style (like primitive or Paleo man) that I teach. In addition, she has taken up kettlebell training and getting active in general. What does a lifestyle like this (without chips, pizza, cakes and bread on a daily basis) feel to the mind?

I can’t really explain the change which has occurred inside. I have my positive attitude back and feel I can tackle the challenges with more confidence than I have had in ages. The fact I am free of all medication is also a tremendous bonus.

And the bonuses keep coming to keep you motivated.

I saw my cousin today and she couldn’t believe how well I looked since the last time she saw me. I didn’t tell about the surgery, reasoning it was my business and she didn’t need to know. She congratulated me but then admonished me not to put it back on again. I assured her that wasn’t going to happen and left it at that.
I’m enjoying being normal and, for the time being, I am happy about that. I remember you saying that was a very low priority but for the moment, I am content. I now weigh what I did in 1995 and most people have never seen me this size so it comes as a bit of surprise.

Thank you, my dear (you know who you are): these words have inspirational content that mere doctors can only hope to provide!

All photos are original property of BMI.

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LOW CARB DIET BETTER FOR DIABETES!

ramana — Tue, 01 Sep 2009 00:30:21 +0000

According to a study published in the Annals of Internal Medicine (September 1 edition), a Mediterranean diet low in carbs scored far better in diabetics than a low fat diet as recommended by the American Heart Association.

Article source here.

A summary in Medpage Today says that “Among diabetics who followed a Mediterranean-style diet, only 44% required antihyperglycemic drug therapy, compared with 70% of patients who followed a standard low-fat diet (95% CI -31.1% to -20.1%, P<0.001)”.

“Compared with a low-fat diet, a low-carbohydrate, a Mediterranean-style diet led to more favorable changes in glycemic control and coronary risk factors and delayed the need for antihyperglycemic drug therapy in overweight patients with newly diagnosed type 2 diabetes,” Dario Giugliano, MD, PhD, of the Second University of Naples, and colleagues wrote.

Full Medpage Today article may be read here.

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DIABETES AND RICE EATING

ramana — Thu, 20 Aug 2009 16:00:18 +0000

According to this news report, a study published in the British Journal of Nutrition found that people eating a large amount of polished, white rice had a higher prevalence of diabetes mellitus. Conversely, dairy consumption was inversely proportional to diabetes prevalence.

The study was based in Chennai at the famous ‘Dr. Mohan’s Diabetes Speciality Center’.

While we could not access the original article for you, we found another one (from Kolkata) that discusses in details about the various Indian diets and the disease distribution related thereto.

Paradoxically, while the study clearly identifies the role played by vegetable oils (with high amounts of omega-6 fatty acids) and carbohydrates in the incidence of heart disease, it espouses the same high carbohydrate diet as per the American Dietetic Association.

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DOES A LOW CARB LIFESTYLE WORK?

ramana — Sun, 09 Aug 2009 14:25:17 +0000

The Atkins Diet is one of several types of low carb/slow carb/no carb diet that have strong advocates and critics. Often the discussions in internet fora are heated and sink to name-calling and abuse, including colorful descriptions of what someone’s head would be good for.

According to the low carb advocates, if you consume less than 50 grams of carbohydrates a day, the insulin response is very low, and this confers a metabolic advantage to the person keen of fat loss. What advantage? In the absence of high insulin levels/spikes, the body burns fat and uses it as the preferred energy source. Insulin, you might know, normally causes storage of ingested calories (carbs/fats) in belly fat depots. It is no coincidence that in the metabolic syndrome, a condition associated with diabetes and a pot belly, the insulin levels of the patient are very high. In fact, the metabolic syndrome is synonymous with insulin resistance- a condition where higher than normal levels of insulin are required to control blood glucose levels.

So, to come back to the point, low carb advocates claim that when you cut out the grains and sugars, you don’t need to bother about calories. You will lose fat anyways.

High carb advocates include formidable groups and associations, including the nutritional bodies that recommend policy to governments. They are the kingpins of the current nutritional recommendations of the food pyramid where around 60% of your food is supposed to come from carbs. The high carb advocates state that the low carb lifestyle causes cancers, kidney damage and make you weak. Most of such allegations are, however, baseless.

Low carb lifestyles are safe and do work. However, the adherence to any particular lifestyle needs motivation. People who fantasize about having a thick layer of jam layered on white bread are not likely to stick to a low carb lifestyle for long!

Whichever way one looks at it, if the goal is fat loss, the easiest way to do it is to cut out carbohydrates, which takes away a large source of calories. What is more, a diet high on protein and fat is at once more fulfilling and satiating. It helps to curb cravings and create a sharp mind, rather than one befuddled by the glucose fall after a post-meal insulin surge.

A low carb lifestyle also helps if you have the metabolic syndrome or diabetes. There are many patients of ours who are doing well merely by sticking to a low carb diet.

The most important aspect of this diet (for the patient) is understanding it, accepting it as a choice for health and satisfaction, rather than a lifestyle of deprivation.

So, to come to the point, does a low carb diet work for fat loss? It definitely does, but whether it does so by restricting calories alone (on account of it being more satiating an filling) or by having a metabolic advantage is still not unquestionably clear.

The current evidence definitely shows that a caloric deficit is needed for fat loss, and also shows that low carb diets achieve it, but not necessarily better than any other diet.

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WHITE POISON

ramana — Wed, 05 Aug 2009 16:32:05 +0000

Okay, as doctors we are used to saying things you don’t want to here. So let me tell you something that will hurt many of you in a most sensitive place. And that is:

Sugar is white poison. Delicious. Makes life seem worth living. Addictive. So many more things. But the bottomline is that sugar is poison.

Here is a fabulous talk on the subject and on the subject of saturated fats, heart disease and cholesterol. Trust me, this is like nothing you would have imagined about the entire subject!

Take your time, but don’t miss a word of this fascinating story on sugar.

Dr. Lustig: Sugar– The Bitter Truth

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