I have never been a huge fan of bariatric surgery, but apparently studies have proven that many people are able to avoid or significantly improve their diabetes with this surgery. Bariatric surgery includes several methods for helping an individual (generally with a BMI of 40 or above) lose weight by eating less food. This includes reducing the size of the stomach with an implanted medical device (called gastric banding) or through removal of a portion of the stomach (biliopancreatic diversion) or by resecting and re-routing the small intestines to a small stomach pouch which is commonly called gastric bypass surgery. If you have a BMI of 40 or above and are considering some sort of bariatric surgery, the article below will definitely give you hope.

by David Juan, MD http://www.doctorshealthpress.com/

There is some seriously positive news afoot in regards to bariatric surgery. A new study shows that it reduces the long-term risk of diabetes by over 80% among people with obesity. Here we look at the study, and follow up with considerations about your nutrient levels if you decide to pursue this surgery.

Published in the New England Journal of Medicine, this study was based in Sweden. Researchers found that bariatric surgery is far more effective than traditional care and lifestyle changes in preventing diabetes among obese individuals.

The treatment group included 1,658 subjects who had undergone bariatric surgery, compared to a control group of 1,771 equally obese people who had received traditional care. Over 15 years of follow-up, 110 people in the surgery group developed diabetes, compared to nearly 400 in the control group. There was no difference between men and women. This equates to a more than 80% risk reduction, which is very high, and sure to put wind in the sails of those who support bariatric surgery.

You should know, though, of nutritional concerns following this surgery. The most common nutritional deficiencies are for vitamin B12, iron, and folate in two specific surgeries: “Biliopancreatic Diversion” (BPD) and “Short Limb Roux-en-y Gastric Bypass” (RYGB).

These deficiencies may develop slowly, and aren’t diagnosed until many years after surgery. For this reason, it’s a good idea to take supplements right after surgery. Also, have your doctor measure nutrient levels at each annual physical. RYGB leads to a common drop in iron, particularly among middle-aged women. Research shows that almost half of all RYGB patients wind up with iron deficiency within four years.

Vitamin B12 can be even worse after RYGB, with up to seven out of every 10 patients becoming deficient. People who can tolerate meat are less likely to suffer this deficiency, as well as folate and iron deficiencies, compared to those who cannot tolerate meat. Still, taking B12 supplements can correct this deficiency in the vast majority of patients.

Another two important nutrients to keep your eye on are calcium and vitamin D. Deficiencies in these nutrients are more common in obese people due to lack of exercise and high body fat. Pay close attention to them whether you opt for surgery or not.

The article below is another (what I would call) “balanced” look at high-fructose corn syrup. Seems it is not so much the actual corn derived product, but the increase in visceral fat that causes cardiovascular problems. It’s a short read, but well worth it and identifies C-reactive protein, something you should have your doctor measure and explain to you. Enjoy, Ed

By NICHOLAS BAKALAR http://www.nytimes.com/pages/health/research/index.html

The health effects of fructose consumption, largely from high-fructose corn syrup, have been the subject of considerable controversy among scientists and consumers alike. Now a study in the February issue of The Journal of Nutrition reports that fructose consumption may increase cardiovascular risk factors because it increases visceral fat, the kind that accumulates around internal organs.

Researchers examined 559 14- to 18-year-olds in Georgia, recording body mass index, exercise habits and fat mass. They also asked what the students had consumed in the past 24 hours and measured their body fat.

After controlling for other factors, the researchers found that higher fructose consumption was associated with increased systolic blood pressure, C-reactive protein (a sign of systemic inflammation) and visceral fat, and reduced HDL (good) cholesterol — all known risks for cardiovascular disease and Type 2 diabetes.

But when they controlled for visceral fat, the effect of fructose alone was weakened. It was apparently not fructose itself, but its tendency to increase visceral fat that led to a rise in risk factors.

“To just say ‘fructose is bad’ is incorrect,” said Norman K. Pollock, the lead author and an assistant professor of pediatrics at Georgia Health Sciences University. “But when calorie intake from fructose is greater than 16 percent of total intake, we’re seeing these risk factors appear.”

It’s not surprising that people who don’t read food labels have a higher BMI than those who do. What is surprising is that we all don’t scrupulously examine food labels before we buy the “rare” food item that come in a box, bag or can. The reason I say rare, is if we are serious about our health, most of the foods we eat are single ingredient and fresh and don’t come in a package. The first thing I check for is High Fructose Corn Syrup. If it has that form of sugar I put it right back on the shelf. Check out some of the junk in package food items and you may come to realize that what’s in the box isn’t really food. Yikes! Enjoy, Ed

by David Juan, MD http://www.doctorshealthpress.com/

A key piece of dietary health advice is to read the labels on food that you purchase. That way you understand its nutritional pluses, and minuses. A new study found that women who read food labels weigh nearly four kilograms (kg) less than those who don’t.

The health breakthrough suggests that being cognizant of what’s in your food is a preventative step against obesity. The study found that consumers who read labels have a body mass index that is 1.49 points lower than those who shop without considering labels. This equals nearly a four- kg reduction in an adult woman who weighs on average 74 kg and is on average 1.62 cm tall.

The information comes from the U.S. Centers for Disease Control and Prevention, gleaned from 25,000 observations on questionnaires. First they looked at the profile of people who read nutritional labels, and then they looked at their weight.

There were significant differences among the grocery shoppers. Here are a few points that come out of the study:
– Smokers pay far less attention to food labels. This may likely be because they know their lifestyle is not so healthy, so they are less concerned about the nutritional content of food.

– People who lived in cities took nutritional information into account the most.
– The more educated a woman, the more likely it was for her to read food labels.
– For men, 58% habitually or always read the information contained within nutritional labels.
– For women, that figure is much higher, at 74%.

The associated impact on weight and body mass index was higher among women. This is important information to have, because, if you read food labels closely, you can help manage your own weight better. Look closely at the calorie count, the amount of sugar, number of carbohydrates, and the percentage of total fat that is saturated. These are mostly negative things. Then look at the nutritional boost you get out of a food. If it’s swayed too much to the negative, then reconsider whether you need that product.

Reading labels will help you decide sometimes which brand to go with regarding the same food. Make sure you look at the top of the food label to see if it is measuring the entire product, or half of it, or two servings, or what-have- you.
Any good diet is complemented by a quick scan of food labels.

I rarely venture into fast food establishments anymore, the only exception being Subway when I’m on a road trip. Don’t miss the essence of this article though. It’s really not about fast food; it’s about eating food fast. Many of us have such hectic lives that we eat on the go even at home. In our house, we have preserved the evening family meal where we all sit down together in an attempt to eat a leisurely meal. For good health and wellness, we need to slow down, not only during the weekends and vacation, but during meal times as well. Slowing down to enjoy our mealtimes is not only part of the weight loss lifestyle, it’s a healthy habit. Have a great weekend, Ed

(for more on this see “Take Rest” http://youcantoutsourceweightloss.com/blog/2012/09/take-rest/)

by Victor Marchione, MD http://www.doctorshealthpress.com/

Here is a story that is more of general interest than anything else. It might give you a little insight into the games your brain plays with your stomach. Researchers have found that if fast food joints alter their environment a little, their patrons might be a little healthier.

Needless to say, the best health advice is to limit your intake of fast food. But, of course, these foods are so common in America — perhaps we could make some changes that will make us healthier? On one hand, a restaurant’s atmosphere can trigger overeating if it stimulates patrons to eat faster. On the other hand, its ambiance may get you to linger longer…perhaps over a dessert you hadn’t planned on.

Lighting and noise seem to influence food consumption, because they affect how long people eat for. Fast food restaurants are not designed to relax a diner. Instead, bright lights, loud noises, and colorful surroundings merge for a hectic atmosphere. But what if they changed that? Would it affect our eating habits?

A new study did a makeover of one-half of a fast food restaurant in Illinois. They pumped soft jazz music and fitted the room with soft lighting — making it seem more like fine dining. People ate in either the normal part or the new “fine dining” part of the restaurant.

The results showed that people in the fine dining half ate for longer — but they consumed less food overall. They were also no more likely to order extra food. Interestingly, they also actually rated the food more enjoyable. In this case, altering the atmosphere altered food consumption and even food satisfaction.

The study shows that if fast food restaurants want consumers to enjoy their food more, they should tone down the lights and music and create a more relaxing atmosphere. Diners who don’t want to overeat can slow down their meals and relax, so they’ll better recognize when they feel full. Distractions in the environment make us more likely to mindlessly eat. It’s time to slow down.

And, by the way, this trick might work just fine at home as well.