Protein deficiency studies??

[Guest guest]

I know that it is holier than the Holy Grail that WLS patients must take

protein supplements. I personally do not take any protein supplements,

yet have had average range protein results in my lab tests for the last

two and a half years. The surgical practice that did my surgery,

http://www.sabariatric.com recommends iron, calcium, B-12 and folic acid

supplements, but does not recommend protein supplements. They do not

say not to take them, but they do not recommend them either. It is

probably old age setting in, but, with the possible exception of for

BPD/DS patients, I do not remember reading any medical journal articles

that document protein deficiency as an unavoidable result of WLS without

supplementation. I know there is a protein guru that says we will all

turn to mush without 90-180 grams of daily protein supplementation, but

I never see any studies cited to the effect. Since this same guru used

to erroneously proclaim that if someone drank 12 oz of soda, they had to

drink 12 oz of water just to overcome the dehydration effect of the 12

oz of soda, and then another 64 oz of water to meet daily water needs.

I know the latter proclamation to be untrue because I went 25 years

drinking only soda and a little wine. Being that I drank less than 64

oz of water a year during that time, if soda had the dehydration effect

that the guru proclaimed it did, I surely would have died many times

over of dehydration. Even now as a two and a half year RNY post op I

rarely drink water. I have a glass of milk with my cereal and then

30-50 oz of diet soda a day. I suffer no signs of dehydration or

stoma/gastric pouch expansion. I would also note that sabariatric.com

has diet soda listed as an acceptable post op beverage. See

http://sabariatric.com/diet_table.htm Because of this, I retain a

high level of skepticism for undocumented dietary claims made by that

source. Can some one please refer me to some peer reviewed medical

journal studies that document the need for protein supplementation?

Ray Hooks

For WLS nutrition info, visit

http://www.bariatricsupplementsystem.com

[Guest guest]

If you're going to bash , you can at least be truthful about what

she says. never said that soda causes dehydration, but rather that

CAFFEINATED drinks - soda or coffee or tea etc. - do. There are studies

that prove it either way and it's already been discussed here recently, so

don't bother spending time cutting & pasting anything. Personally, if I

drink caffeine, I get dehydrated, so is right as far as I'm

concerned. As for the protein issue, I'm sure there are some who can get

away with no protein supplementation. There are others who will crash

quickly without it. The majority will fall somewhere in the middle and

crash slowly, after many years. Ask B, she's still working on turning

her labs around. I've never seen say that everyone needs 90-180

grams though, so that's another error on your part. I've seen her recommend

60 grams to the majority of proximals, 90 if they have more bypassed, and

150-180 if they're distal like her. But I've also seen her say many times

that everyone should watch their own labs and adjust their supplements

accordingly because we're all different, rather than just give out blanket

" one size fits all " advice. But your telling people that there's no need

for protein supplementation is extremely irresponsible because the majority

of us WILL need them at some point, especially those of us with a distal

bypass. That's my OPINION, based on my experience. I know that I don't

need to defend here, most everyone knows that she's one of the most

honest, generous, caring people around. And she's far above publicly

bashing another vendor - or employee of a vendor.

By the way, a guru is defined as " a person with knowledge or expertise "

(look, I can cut & paste too!). Since has lived as a post-op for

over 8 years, as opposed to your and my 2 years, and has worked with and

spoken to thousands of other post-ops - proximal to distal and new post-ops

to 10+ years out, as well as surgeons, I tend to think that she has quite a

bit of knowledge and expertise. Many of 's " sources " are people like

all of us who have had the surgery. She's also spent her time in the

library gathering info the " old fashioned " way, but as we all know, most of

the information that you can get about nutrition is not written for us. We

need to go on the experience of people who are farther out than we are.

------------------------------------------------

Terry Mayers

5DollarHosting.comR

http://www.5dollarhosting.com

(877)-838-HOST /

.... because it shouldn't cost a fortune to make a fortune! R

Protein deficiency studies??

I know that it is holier than the Holy Grail that WLS patients must take

protein supplements. I personally do not take any protein supplements,

yet have had average range protein results in my lab tests for the last

two and a half years. The surgical practice that did my surgery,

http://www.sabariatric.com recommends iron, calcium, B-12 and folic acid

supplements, but does not recommend protein supplements. They do not

say not to take them, but they do not recommend them either. It is

probably old age setting in, but, with the possible exception of for

BPD/DS patients, I do not remember reading any medical journal articles

that document protein deficiency as an unavoidable result of WLS without

supplementation. I know there is a protein guru that says we will all

turn to mush without 90-180 grams of daily protein supplementation, but

I never see any studies cited to the effect. Since this same guru used

to erroneously proclaim that if someone drank 12 oz of soda, they had to

drink 12 oz of water just to overcome the dehydration effect of the 12

oz of soda, and then another 64 oz of water to meet daily water needs.

I know the latter proclamation to be untrue because I went 25 years

drinking only soda and a little wine. Being that I drank less than 64

oz of water a year during that time, if soda had the dehydration effect

that the guru proclaimed it did, I surely would have died many times

over of dehydration. Even now as a two and a half year RNY post op I

rarely drink water. I have a glass of milk with my cereal and then

30-50 oz of diet soda a day. I suffer no signs of dehydration or

stoma/gastric pouch expansion. I would also note that sabariatric.com

has diet soda listed as an acceptable post op beverage. See

http://sabariatric.com/diet_table.htm Because of this, I retain a

high level of skepticism for undocumented dietary claims made by that

source. Can some one please refer me to some peer reviewed medical

journal studies that document the need for protein supplementation?

Ray Hooks

For WLS nutrition info, visit

http://www.bariatricsupplementsystem.com

Homepage: http://groups.yahoo.com/group/Graduate-OSSG

Unsubscribe: mailto:Graduate-OSSG-unsubscribe

[Guest guest]

In a message dated 11/23/2002 10:15:08 AM Pacific Standard Time,

rhooks@... writes:

> Can some one please refer me to some peer reviewed medical

> journal studies that document the need for protein

Ray, At this time, I cannot find the documentation on the internet, as I'm

too tired to do so, however, I am living proof that my body cannot absorb

protein from food. Otherwise, I wouldn't have been near death from lack of

protein. Yep, I had a distal gastric bypass, and it isn't because of the so

called " guru " that you are slamming that states we need protein

supplementation, but it's OUR SURGEONS who have told us this, and believe me,

THEY ARE CORRECT. At least for my body and for a lot of other posties. I am

not the one to take the risk again. Certainly, it appears that you have

taken it as a " free-ride " rather than a tool. I just hope you don't end up

sorry.

B

7 yrs out

[Guest guest]

In a message dated 11/23/02 12:15:20 PM Central Standard Time,

rhooks@... writes:

I know that it is holier than the Holy Grail that WLS patients must take

protein supplements. I personally do not take any protein supplements,

yet have had average range protein results in my lab tests for the last

two and a half years. The surgical practice that did my surgery,

http://www.sabariatric.com recommends iron, calcium, B-12 and folic acid

supplements, but does not recommend protein supplements. They do not

say not to take them, but they do not recommend them either. It is

probably old age setting in, but, with the possible exception of for

BPD/DS patients, I do not remember reading any medical journal articles

that document protein deficiency as an unavoidable result of WLS without

supplementation. I know there is a protein guru that says we will all

turn to mush without 90-180 grams of daily protein supplementation, but

I never see any studies cited to the effect. Since this same guru used

to erroneously proclaim that if someone drank 12 oz of soda, they had to

drink 12 oz of water just to overcome the dehydration effect of the 12

oz of soda, and then another 64 oz of water to meet daily water needs.

I know the latter proclamation to be untrue because I went 25 years

drinking only soda and a little wine. Being that I drank less than 64

oz of water a year during that time, if soda had the dehydration effect

that the guru proclaimed it did, I surely would have died many times

over of dehydration. Even now as a two and a half year RNY post op I

rarely drink water. I have a glass of milk with my cereal and then

30-50 oz of diet soda a day. I suffer no signs of dehydration or

stoma/gastric pouch expansion. I would also note that sabariatric.com

has diet soda listed as an acceptable post op beverage. See

http://sabariatric.com/diet_table.htm Because of this, I retain a

high level of skepticism for undocumented dietary claims made by that

source. Can some one please refer me to some peer reviewed medical

journal studies that document the need for protein supplementation?

--------------------------------

I am curious as to why these issues are being brought up at this time on this

venue. Please explain your motives, Ray. Has someone RECENTLY expressed a

concern over them here? If so, I don't remember seeing the post, and would

appreciate your copying it into the list. Both issues have been debated here

before, but what's the reason for resurrecting them now?

The jealousy and insecurity that oozes from this message is sickening and

totally out of line. You continue to attack people, well--perhaps one person

in particular--over and over again. Why? I do not ever see this person

responding in kind to your diatribes.

I must point out, that once again, you are relying on " normie " experiential

evidence to prove a thesis as true for the WLS population. What you did for

25 years before you had your WLS is beside the point. None of us on this list

is interested in what works or has worked for the non-WLS people of the

world. We are not THEM, as I have emphasized before. Furthermore, I believe

you are mistaken in the assumption that the only reason to drink WATER is to

prevent dehydration. There are several other reasons, not the least of which

is to protect the liver and kidneys from overload in processing the high

amounts of protein we are recommended to consume. I believe even YOU adhere

to the concept of " protein first. " Drinking extra water when one consumes

diet soda or coffee is to neutralize the effects of caffeine, and even if

decaffeinated, reduce the possibility of oxalates contributing to the

formation of kidney stones. Now, granted not every person is prone to forming

stones. But how does one know for sure if they're prone or not? Some of us

(many, maybe most of us) would prefer to take the simple preventive measure

of drinking that extra water. As far as professional documentation goes,

would you accept the opinion of a urologist? If so, go ask one.

You posted at one time ONE article that pooh-poohed the need for a certain

amount of water per day, and that even suggested that too much water could be

bad for a person. (Too much of ANYthing can be bad for a person; even too

much Ray). Need I cite all the voluminous studies that contradict that one

author's opinion? The number opposing his view is legion--and I think you

KNOW it. Or do you consider them erroneous as well bcuz they agree with what

" the guru " says?

As for the surgical practice that did your surgery not recommending protein

supplementation, what in the world does that prove? My docs don't recommend

or not recommend it either. Oh, I take that back. They used to say nothing on

the matter, back when I had my bypass. Now they do recommend it. I think you

are as aware as anyone else on this list that there is no concensus among

bariatric surgeons on many things. And I think you also know there are a lot

of docs out there who just plain don't know WHAT they're doing when it comes

to post-op nutrition and they either NEGLECT to make needed recommendations

or they even make WRONG recommendations. My doc STILL does not test for

ferritin. He only started testing for B12 about 6 mos ago. And he STILL tells

all his patients it's fine to get their calcium from Tums or Viactiv. Just go

over in your mind how many posters to this list have been told the same thing

by THEIR docs. And there is a difference in recommendations depending on the

type of surgery one has, and also how proximal or distal a procedure.

For the protein documentation you requested, I offer the following:

First, copied directly from the instructions to patients from a prominent

bariatric surgeon on the west coast:

" Protein Supplements: Please be sure that this amount includes no more than

250 calories, that there are no sugar and no milk products in the product,

and that it has full-chain (essential) Amino Acids. Amino Acids are building

blocks for all proteins. Of the amino acids you need, 11 can be made by your

body if you do not get enough in your diet; the remaining 9 - the essential

amino acids - must come from protein supplement. Amino acids that are needed

by and can be made by your body are: alanine, arginine, asparagines,

asparatice acid, cysteine, glutamic acid, glutamine, glycine, proline, serine

and tyrosine. Essential amino acids: HISTIDINE, ISOLEUCINE, LEUCINE, LYSINE,

METHIONINE, PHENYLALANINE, THREONINE, TRYPTOPHAN VALINE. "

---------------------------I would take this to indicate that the doctor has

some concern that his patients are not going to be getting some of the amino

acids it needs unless they use protein supplements.

Second, from www.wheyoflife.org (or ):

" Whey protein appears to enhance iron absorption, moderates oxidative

damage, improves mood levels, increases serotonin levels, helps offset

fatigue, improves immune function and may reduce LDL cholesterol. Soy protein

also does the latter. "

---------------------------Self-explanatory, I believe.

Third, from Sally Myers, RD and regular contributor on nutritional issues to

the WLS-related newsletter " Beyond Change " :

" How to determine grams of protein you need daily when not yet at ideal

weight: Subtract 120 from your current weight. Multiply that answer by .25

and add it to 120. Base your protein needs on that number. Extra protein is

not needed for fat mass. "

-----------------------------Using this formula, I calculated my daily

protein need to be 146g. (Now y'all can do the math backward and fig out how

much I weigh--still too much ). Are you going to tell me I can get that

much protein from FOOD alone? How would I be able to lose any weight? And it

would be bad for my kidneys and liver to have to process all that.

Four, from Pages 18 & 19 of " Body Rx, " Dr. Connelly's 6-Pack

Prescription "

" Why do MASS protein? To escape fat-storage mode, you have to eat more

protein.

If you want to shut down your metabolism and stay in fat-storage mode

permanently, stay on the standard diet prescription the high-carb,

low-protein, low-calorie, low-fat diet. Protein is the key metabolic

currency of the body. Your body was designed to run on it. Protein molecules

drive all the chemical reactions involved in the breakdown and absorption of

food, including carbohydrates and fat. In other words, protein drives

virtually all aspects of metabolism. Many studies, including some of my own,

show that simply adding protein to your diet turns on your

fat-burning/muscle-building switch, even if you make no other lifestyle

changes. When I gave one group of body builders extra protein along with

their normal diet, they gained two times as much muscle mass as a second

group of bodybuilders doing exactly the same workout and eating the same diet

but without the extra protein. When you're stuck in fat-storage mode, you

need a powerful protein boost to jump-start your metabolism back into

fat-burning mode. In most cases, you cannot easily get enough protein from

food alone to do the job. To fill the protein gap, in addition to increasing

protein consumption through food, I recommend a daily high-potency protein

powder. It is a simple, safe, efficient way to repair your metabolism and

build a lean, shapely body. "

-----------------------------and he's talking about NORMIES here saying they

can't get enough protein in without protein powder. And see, some of us don't

use protein shakes just bcuz we fear protein deficiency. Just as with the

water, there's more than just one reason.

(About the author: Dr. Connelly has devoted his life to the science of

nutrition and fitness, and is considered around the world as a leading expert

in the field of human nutrition and metabolism. A summa cum laude graduate in

neuro-physiology from Boston University, Dr. Connelly has distinguished his

career in anesthesiology, internal medicine, intensive care and

cardiovascular medicine. During his internship and residency at Harvard

Medical School's prestigious Massachusetts General Hospital, Dr. Connelly

began working with critically ill intensive care patients. In order to help

his patients maintain their health, he began researching and formulating

products to help prevent the loss of muscle mass. What he learned about the

effects of nutrients and exercise on human metabolism, body composition,

disease prevention and immune system function, however, would soon have more

far reaching impact. While continuing his research as a Senior Fellow in

intensive care medicine at Stanford University, Dr. Connelly created a high

quality protein formulation, which he trademarked (xxxxxxxxx) and which is

the key ingredient in a standard nutritional protocol in Harvard Medical

Schools Brigham and Women's Burn Care Trauma Unit and Braintree

Rehabilitation Hospital.)

I could cite more. But what's the point of beating a dead horse?

Carol A

[Guest guest]

In a message dated 11/24/2002 4:53:45 AM Eastern Standard Time,

tuesdynite@... writes:

> I could cite more. But what's the point of beating a dead horse?

>

I guess the thought is that sometimes they are only playing dead and enough

beating will revive them. Fay

[Guest guest]

I wrote:

> I know that it is holier than the Holy Grail that WLS patients must take

> protein supplements. I personally do not take any protein supplements,

> yet have had average range protein results in my lab tests for the last

> two and a half years. The surgical practice that did my surgery,

> http://www.sabariatric.com recommends iron, calcium, B-12 and folic acid

> supplements, but does not recommend protein supplements. They do not

> say not to take them, but they do not recommend them either. It is

> probably old age setting in, but, with the possible exception of for

> BPD/DS patients, I do not remember reading any medical journal articles

> that document protein deficiency as an unavoidable result of WLS without

> supplementation.

To which Carole A asked:

>

> I am curious as to why these issues are being brought up at this time on this

> venue. Please explain your motives, Ray. Has someone RECENTLY expressed a

> concern over them here?

I raised the issue because I recently finished reading a pamphlet I

picked up at the ASBS convention in Las Vegas. The title of the

pamphlet is Nutritional Supplementation for the Gastric Bypass Patient,

A Technical Review by Marcia Zimmerman, C.N. This is the most

exhaustive and thorough review I have ever read on the nutritional

consequences of the gastric bypass operation. It is 36 pages long. It

discusses and reviews each and every vitamin and mineral in terms of

physiological functions, co-factors, effects of deficiency,

bioavailability, absorption, excretion, special needs, medications that

interfere with the absorption and utilization, and referenced daily

intakes. I just got my letters from my PCP and surgeon that all my lab

tests were in the normal range. The thought crossed my mind that I

don't take protein supplements, yet my protein results are within the

normal range. I decided to go back to that article to see if it offered

an explanation. On rereading it, I noticed that it did not include a

discussion of long term protein deficiency being caused by the gastric

bypass operation. On further reflection, I recalled that the surgical

practice that performed my gastric bypass does not recommend protein

supplementation. I then realized that I could not recall reading a

medical journal article that documented long term protein deficiency as

being a result of the gastric bypass.

There is nothing sinister here. All these events came together to

arouse my curiosity as to whether there have been any actual studies

that show protein deficiency is a long term gastric bypass side affect

that must be supplemented. The references you gave shed no light on the

issue. I still ask, can some one direct me to a study that documents

that without supplementation, protein deficiency is an unavoidable or

even highly likely side effect of the gastric bypass operation. There

may well be many such studies out there. I would just like to be able

to read at least one of them.

Ray Hooks

For WLS nutrition info, visit

http://www.bariatricsupplementsystem.com

[Guest guest]

In a message dated 11/24/2002 6:24:54 PM Eastern Standard Time,

rhooks@... writes:

> On rereading it, I noticed that it did not include a

> discussion of long term protein deficiency being caused by

> the gastric

> bypass operation.

How many years back did they study their patients? If they would have studied

ME, at nearly 7 yrs out, they would have been able to identify the need for

protein from supplementation, and also that I cannot absorb my protein from

foods. Yep, it took a while, cuz I did some shakes here and there, and of

course, it's only been 3 years 10 months since I was revised for staple line

disruption, so I guess you could say I crashed about a year out after I was

revised due to SLD, cuz after the revision, my " tool " was working as it should,

thus, the malabsorption.

B

Distal RNY 12/27/95

Revision for SLD 3/25/99

TT 12/28/99

275/155

[Guest guest]

In a message dated 11/24/02 5:25:21 PM Central Standard Time,

rhooks@... writes:

<< All these events came together to

arouse my curiosity as to whether there have been any actual studies

that show protein deficiency is a long term gastric bypass side affect

that must be supplemented. >>

------------------------------

1. I believe it possible to request your curiosity be satisfied, WITHOUT the

gratuitous bashing of other people on the list.

2. I will not respond further than this bcuz the list co-moderator has asked

that the subject be dropped.