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Hi everyone! I have been noticing a lot of differences b/w surgical

clinics with protein requirements. In my position, I actually do

weight loss surgery counseling for clients that work with many

different clinics. There seems to be quite a few surgeons that dont'

worry about protein intake for several weeks after surgery, while

others emphasize 50-60 grams as soon as possible after starting the

full liquid diet.

Does anyone have any information on when it is essential that they

have reached their protein goals? I know there are a variety of ways

clinics figure out the patient's goals, I guess I am hoping to get

some feedback from all of you on when to make sure they are ACTUALLY

consuming the goal. In other words, when does protein malnutrition

become a concern, is there a timeline? I have been stressing it hard

at the two week follow-up appointment, i.e. doing a diet recall and

finding strategies to get more protein in, but some of my coworkers

believe it is impossible to achieve goal at this point and just

emphasize working towards goal until their food intake at meals is up

to 1/2 cup.

Any feedback/thoughts on this matter would be appreciated!

Angie Humble, RD,LD

HealthPartners, Health Behavior Group

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Hello,

I am glad you have brought this question up, because I have always wondered too what others are doing. Our program uses the range of 1.0-1.5g/kg of ideal body weight. Our program does AGB and RYGB.

It will be interesting to see what others recommend.

Tammy Hutchisen, RD, CDN, CPT

Mid-land Bariatrics

From: offsightach@... <offsightach@...>Subject: Re: Protein Requirements Date: Friday, April 24, 2009, 2:45 PM

I always calculate the patients protein needs based on their ABW and then reecess each time they come in for a fill so to adjust protein needs as weight drops. This is a more accurate way to keep up with the body's protein needs during periods of excessive weight loss so as to preserve lean body tissue. Deane Peck MS,RD,LDN Sent from my BlackBerry Smartphone provided by Alltel

From: "gracielynn17" Date: Thu, 23 Apr 2009 17:05:46 -0000<BariatricNutritionD ietitians>Subject: [bariatricNutrition Dietitians] Protein Requirements

I currently have a patient who is 7 mo p/o lap band and weighes >400 lbs. The bariatric nutrition care manual states patients should consume 60-80 grams of protein/day but I was wondering if I should calculate her protein needs based on g/kg of ABW; which would be ~100 g/day. Please advise. -Thank You

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I work with Lap-band patients and I always use ideal body weight for protein needs. Greig RDBeloit Memorial HospitalBeloit WISent from my BlackBerry® wireless device from U.S. CellularFrom: Tammy Hutchisen Date: Sat, 25 Apr 2009 04:48:46 -0700 (PDT)< >Subject: Re: Protein Requirements Hello, I am glad you have brought this question up, because I have always wondered too what others are doing. Our program uses the range of 1.0-1.5g/kg of ideal body weight. Our program does AGB and RYGB. It will be interesting to see what others recommend. Tammy Hutchisen, RD, CDN, CPTMid-land BariatricsFrom: offsightach <offsightach >Subject: Re: Protein Requirements Date: Friday, April 24, 2009, 2:45 PMI always calculate the patients protein needs based on their ABW and then reecess each time they come in for a fill so to adjust protein needs as weight drops. This is a more accurate way to keep up with the body's protein needs during periods of excessive weight loss so as to preserve lean body tissue. Deane Peck MS,RD,LDN Sent from my BlackBerry Smartphone provided by AlltelFrom: "gracielynn17" Date: Thu, 23 Apr 2009 17:05:46 -0000<BariatricNutritionD ietitians>Subject: [bariatricNutrition Dietitians] Protein RequirementsI currently have a patient who is 7 mo p/o lap band and weighes >400 lbs. The bariatric nutrition care manual states patients should consume 60-80 grams of protein/day but I was wondering if I should calculate her protein needs based on g/kg of ABW; which would be ~100 g/day. Please advise. -Thank You

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Hi,We also use 1.0-1.5 grams/kg of IBW for our AGB pts. , RD,LDBariatric SolutionsMurray, KYFrom: Tammy Hutchisen <t_hutchisen@...> Sent: Saturday, April 25, 2009 6:48:46 AMSubject: Re:

Protein Requirements

Hello,

I am glad you have brought this question up, because I have always wondered too what others are doing. Our program uses the range of 1.0-1.5g/kg of ideal body weight. Our program does AGB and RYGB.

It will be interesting to see what others recommend.

Tammy Hutchisen, RD, CDN, CPT

Mid-land Bariatrics

From: offsightach <offsightach>Subject: Re: [bariatricNutritionD ietitians] Protein RequirementsBariatricNutritionD ietitiansDate: Friday, April 24, 2009, 2:45 PM

I always calculate the patients protein needs based on their ABW and then reecess each time they come in for a fill so to adjust protein needs as weight drops. This is a more accurate way to keep up with the body's protein needs during periods of excessive weight loss so as to preserve lean body tissue. Deane Peck MS,RD,LDN Sent from my BlackBerry Smartphone provided by Alltel

From: "gracielynn17" Date: Thu, 23 Apr 2009 17:05:46 -0000<BariatricNutritionD ietitians>Subject: [bariatricNutrition Dietitians] Protein Requirements

I currently have a patient who is 7 mo p/o lap band and weighes >400 lbs. The bariatric nutrition care manual states patients should consume 60-80 grams of protein/day but I was wondering if I should calculate her protein needs based on g/kg of ABW; which would be ~100 g/day. Please advise. -Thank You

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Hello,

Would you start with 1.5 g/kg immediately after surgery and continue until the solid phase of diet; then decrease to 1.3 g/kg? Would you utilize 1.0 g/kg when the maintenance phase of diet has been met?

Do you know of any research articles to support using 1.0-1.5 g/kg? It makes sense but just wondering since the ADA Bariatric pocket guide utilized 60-80 grams.

-I really appreciate all your comments-Grace

Grace L. RDWork: (804) 287-7079Mobile: (740) 707-5997

From: offsightach <offsightach>Subject: Re: [bariatricNutritionD ietitians] Protein RequirementsBariatricNutritionD ietitiansDate: Friday, April 24, 2009, 2:45 PM

I always calculate the patients protein needs based on their ABW and then reecess each time they come in for a fill so to adjust protein needs as weight drops. This is a more accurate way to keep up with the body's protein needs during periods of excessive weight loss so as to preserve lean body tissue. Deane Peck MS,RD,LDN Sent from my BlackBerry Smartphone provided by Alltel

From: "gracielynn17" Date: Thu, 23 Apr 2009 17:05:46 -0000<BariatricNutritionD ietitians>Subject: [bariatricNutrition Dietitians] Protein Requirements

I currently have a patient who is 7 mo p/o lap band and weighes >400 lbs. The bariatric nutrition care manual states patients should consume 60-80 grams of protein/day but I was wondering if I should calculate her protein needs based on g/kg of ABW; which would be ~100 g/day. Please advise. -Thank You

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Can anyone using the 1.0 - 1.5 grams/kg of IBW provide a source for that

recommendation.

It is a little confusing because one person is using ABW and some are suggesting

IBW. Whereas the ADA pocketguide gives a general recommendation of 60-80 grams a

day.

If you can provide a resource for your guidelines/calculations that would be

much appreciated.

Jenna Cooke, RD

Outpatient Dietitian

St. 's Hospital

Richmond, VA

>

> From: offsightach <offsightach>

> Subject: Re: [bariatricNutritionD ietitians] Protein Requirements

> BariatricNutritionD ietitians

> Date: Friday, April 24, 2009, 2:45 PM

>

>

>

>

> I always calculate the patients protein needs based on their ABW and then

reecess each time they come in for a fill so to adjust protein needs as weight

drops. This is a more accurate way to keep up with the body's protein needs

during periods of excessive weight loss so as to preserve lean body tissue.

Deane Peck MS,RD,LDN

> Sent from my BlackBerry Smartphone provided by Alltel

>

>

> From: " gracielynn17 "

> Date: Thu, 23 Apr 2009 17:05:46 -0000

> <BariatricNutritionD ietitians>

> Subject: [bariatricNutrition Dietitians] Protein Requirements

>

>

>

> I currently have a patient who is 7 mo p/o lap band and weighes >400 lbs. The

bariatric nutrition care manual states patients should consume 60-80 grams of

protein/day but I was wondering if I should calculate her protein needs based on

g/kg of ABW; which would be ~100 g/day. Please advise. -Thank You

>

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