dumb NUT!

I had my NUT phone consult that is required by my surgeon, Dr. Smith. I have to use his NUT that is 8hrs from my house. I plan to use a NUT in my town and wanted to find some resources to show them on malabsorption.

Dr. Smith's NUT told me i should be on a low calorie, low carb, low fat diet after surgery. When i asked her why low fat she said DSer malabsorb 40% of fat. I know thats not true and think she was talking to me about RNY even tho i told her several times i was having the DS and she confirmed it when she first called. Anyways, i went looking for factual resources and ive not come up with much. There is a study on DSfacts but its confusing and i dont actually see where it says DSer malabsorb 80% of fat.

The NUT also recommended 1 flintstone complete chewable DAILY, 1 BA ADEK daily and 1(600mg) chewable calcium 3 times a day. When i told her i would be taking Vitaladys schedule she asked me why i would want to take so many vitamins. SERIOUSLY!

I knew from others on here that the NUT would have very little of value to say but i would like input from a NUT that really KNOWS what the DS does. So any help anyone could give me on actual studies i would greatly appreciate it!

jen

There are scarcely any NUTs who "get" the DS. The one on Facebook absolutely does NOT and you need to avoid her like the plague. She is a menace.

Most of what you need, you'll get right here if you dig through a few pages of old posts.

Try summarizing for yourself what you want to know and then try the disgusting search function....Or someone has instructions on how to use Google advanced search to limit your search to this forum.

See what you find, and then post questions as you learn more. That will be very helpful.

There is some information on DSFacts about nutrition, and a little bit on www.dssurgery.com .

Yeah, i heard about the NUT on FB and will def stay away from her:)

I did several searches on both OH and google and while i find a lot of people quoting stuff im not seeing any links to the studies, etc. so i figured i would ask.

Thanks for your input!

I'm shuffling through the stuff I have saved on this computer and have a couple of journal articles about protein malnutrition and some other nutritional complications. They don't really tell you what to do to not get that way, though.

These articles include: (try looking them up online, or perhaps someone has links to openly accessible PDF's; mine came through my school access so my links wouldn't work for you)

Protein malnutrition after bariatric surgery. Obesity Surgery, 15, 2005, pp. 145-154.

Managing the obese patient after bariatric surgery: A case report of severe malnutrition and review of the literature. Journal of Parenteral and Enteral Nutrition, 24, 2, 2000, pp. 126-131.

Severe protein-calorie malnutrition after bariatric procedures. Obesity Surgery, 14, 2004, pp. 175-181.

I have other information hanging around on other devices, but am currently separated from some of them since they're at home :-).

Thanks EN for the info. i will google it so i can read the study's:)

http://www.dsfacts.com/Fat-Malabsorption.html

They measured fat in and fat out.  The measured fat out divided by total fat eaten.  This amount equaled ~81%. 

If fat is in the poop, it's not in your body.

yes that was the study i was talking about in my original post but as a lay person it make no sense. There is nothing on the page that explains how to read the chart and nothing in the conclusion that specifically says DSers malabsorb 81% of fat....its only in the title.

I know most NUTs group DSers with RNY and i would like to avoid that and hopefully train a NUT on the DS so i want solid info to back me:)

Thanks Kayla for your help!

Oh sure, I can help you read the chart.  Once you figure out how to read these things, you forget that it's kinda hard.  I think this is further complicated by the fact that this is not the full paper.  I could have sworn I'd read the whole thing at one point, posted by EN maybe?  Maybe Diana Cox?  I tried searching for it, but I couldn't find it.  Generally a chart is posted with some sort of key describing everything.  I actually don't know what all their symbols mean...I know there is a longer version of this study somewhere! lol

Anyways:

There are 3 columns.  After the description...first column is DSers, second is RNYers, third is a control (obese people with BMI over 40). 
Calories calculated is, I assume, how much a qualified person calculated their calorie intakes to be.  The number before the +/- is the average...the number after should be the standard deviation.  Think of the number after the +/- as a way to tell how varied the responses were...it's generally better if that number is smaller...when it is larger, there is more of a chance that the results are in error.

Calories reported is probably how many calories the study participants SAID they ate.  This shows you how little people know about how much and what they eat.  See how all the numbers are lower (focus on the number before the +/- symbol)?

Basal calories should be how many calories were determined that each participant needs each day, not including calories expended during activity.  A longer study should tell you how this was calculated, whether from a formula or doing a metabolism study. 

% body fat...self-explanatory.  Meals/day...also self-explanatory (see how DSers eat a lot?  lol)  Stools/day...also self-explanatory...DSers poop the most too. 

Protein/day calculated and reported...same as the calorie thing.  Ditto for fat calculated and reported.  See how the average DSer is eating over 168g fat/day? 

Fecal fat = how many grams of fat in the poop.  Use your imagination as far as how this was determined.  Mmm...pretty.  :)

Stool weight = how much the fat weighed.  See how DSers have A LOT of poop?

%fecal fat is how much of the total poop is fat.

Triene/tetraene ratio:  I don't exactly know what this is off the top of my head, but gauging from the study...it is some way to determine whether a person has fatty acid deficiency.

One thing to keep in mind is that this study is actually pretty small.  Each category of participants only had about 8 patients in them.

I really wish I could find that original thread that someone posted.  Unless I'm going crazy, I could have sworn it posted a long study and then broke it down bit by bit to explain it.

Thanks Kayla! I did know how to read most of it and it actually came to me last nite while i was half sleeping (thats when i do all of my best thinking!) to compare fat grams eaten to fat grams in the stool. Thats where you see that 81% of the fat comes out in the stool. DUH!

I really appreciate you taking the time to explain everything.

I really did look for the complete study but like you could not come across it:(

THANKS!

 

That came from Diana, I think, definitely not from me.