Might be eating wrong

I had my surgery in March 2013 a DS with BPD. Been sticking to how my nut said to eat. At least 60 grams Protein, less than 60 grams of carbs and only 20 grams of fat. After reading other postings I'm questioning if I'm even eating right. I have lost 140 pounds eating this way but wondering now if I'm not eating right. I've tried to find other eating plans for the DS on the internet but haven't had any luck. Any suggestions or information would be great. Am I doing something wrong? Sorry if this question has been asked hundreds of times before. This is my first posting.

Go to "The World According to Egg face."   She's a gal that had an RNY but she features a healthy eating blog for WLS patients. She always has such yummy, nutritious recipes and you can read her entire blog including her story. I've been reading her on and off since I had my sleeve.

It looks like you are on a low fat diet, which is kind of unnecessary.  You are absorbing only 20% of the all the fat you eat to begin with, so you are better off eating fat out of all the options available to you.  So eat protein first, then eat fat.  A lot of fat.

Because you absorb so little fat, you really need to eat 5 times the average amount of fat to get a healthy amount into your body.  Not absorbing fat, or being deficient in fat, isn't healthy either.  You should bump up that 20% by a lot more.  I would double it, then let your bowels adjust.  Then add more if you can.

Your protein might be low - I'm at 150 lbs and my protein number is 58-60.  Multiply that by 1.4 because I am absorbing only 60% of all protein I eat, and I get 84 grams.  And that is just a daily minimum for a sedentary, older person.  I try to get in 100 grams every day.  I would google this calculation and run your numbers to make sure you are getting enough protein. 

I don't know that there is a definite right or wrong but I can tell you that my dietitian has come to realize that DSrs need more fat and protein than other WLSs. She has me sticking to 120 grams of protein every day and not even preaching about low fat anything. She says we need the protein and fats to help our bodies absorb and distribute the nutrients we take in from our vitamins. Low protein will hinder distribution of nutrients worse than anything and we can go into protein malnutrition easily since we malabsorb about 50% of the protein we eat. She has no problem with me getting 120 grams of good bioavailable protein via protein shakes and protein coffee, and just not counting dense protein food. She supports low carb within reason; leafy greens, blueberries and strawberries are fine. 

--gina

How have your labs been?  Do you have hard copies so YOU can actually look at the numbers?  I would think you need more protein and more fat.  How is your skin?  Bowels?  What vites are you taking?  Some people need more fat than others, but you need to consider that our bodies require a certain amount of fat to function.  If we only absorb 20% of what we eat, your body is barely getting any at all.

VERY few dieticians truly understand the needs of the DS, nutritionally, so I'm glad you found us.  We only absorb about half of the protein we consume, so the rule of thumb is 100g minimum.  Some people take more than that.  I also agree that fat is also way too low.  I cannot imagine a high protein diet that's low in fat!  The carbs are at a good level.  Many (like me) only count protein grams and fluids.  I'm mindful of simple carbs, but not sweating the complex carbs like veggies.

Nutritionists simply can't wrap their heads around the idea that people with the DS do not need to eat low fat. We absorb only 20% of the fat we consume. Fat won't hurt you (though if you eat really a lot, you may have diarrhea from it). And while 60 gm protein daily may be enough with other bariatric surgeries, it is probably insufficient for us. Being able to consume fat also means you can eat any cut of meat for your protein, not just lean meat and chicken breast, and use cooking methods that include fat as well. It's very liberating. Your nutritionist will never understand this.

Of course your labs are very important, and it's best for you to know and track your labs to see if there are any trends. When you call your doctor's office, you will just be told "everything is normal" even is something is at the low end of normal and going down each time it's checked. So get your results and use them to guide you. If your protein is at the low end of normal, or going in the wrong direction, you need to eat more protein. Same idea with other labs.

Larra

Sarah I know how you feel, just did a post a couple of days asking just about the same thing. I have started to add more fat to my diet and so far so good. The people here have lived it and succeeded with weight loss, so I decided to go with there advice. Good Luck to you.