Clarification of malabsorption for ds

 

Carbs we absorb 100 %

Protein and Vit we malabsorption

Most of the vereran DSers from here believe, and the traditional figure used on this board over the years has been, that complex carbs are absorbed at 60%, mabalsorbed by 40%, and that simple carbs are all absorbed.  That is mainly based on their own experiences and watching others -- there aren't any scientific studies to give a figure on this for carbs (or protein).  (There was only one small study, by Gagner, and it only addressed fat.  That one study is where the 80% figure for fat malabsorption originates.)  Having said what I did, the average complex carb absorption is probably higher now than a few years ago, because more DS surgeons are giving different limb lengths these days, and not causing as much malabsorption as used to be the case for the DS.  Also, the longer out one is from having had the DS, the more one is likely to absorb.

Wow thank you so much this is the best answer I have read

My dietitian estimates we malabsorb 50% of the protein we eat from food. She doesn't have an estimate for whey protein isolate but she believes we absorb a little more.
Vitamins seem to be all over the place with DS folks--you just have to go by your labs. Vitalady's recommendations work for me for the most part, then I adjust and tweak up or down when my labs come in. For example, I've taken as much as 100,000IUs of dry D3 to bring my D up, alternated 100,000IUs on Mon, Wed & Fri with 50,000 the rest of the days, 70,000 every day, and now I only need 50,000IUs every day.

--gina

So it is more complicated then I thought as it appears to based on the person.
Thank you!!!

 Another malabsorption question?
If the villa grows for about 2 years after surgery then stops. the bodies way of trying to absorb more,
Then what would be the   cause after more time that the body can absorb more calories or
is it possible its actually hormones changing, age, a slower metabolism, and  more carbs.
causing inslin levels to rise causing more fat to be stored?
What ya fokes think?

Great question, I'm looking forward to hearing from the Vets.

Your body being the **** hot self regulating machine that it is does grow more villi in the bowel after a few years (not sure if two is the actual ball park here but my guess is that it varies from person to person).  Now be aware none of this is an exact science as each person has different limb lengths and metabolic set points so I'm gonna generalise my arse off here.

You can gain, stall or lose weight due to metabolic issues.  A sluggish thyroid or various endocrine issues will slow even a bullet train metabolism and allow regain and conversely an over active thyroid can make you lose like a bugger.  Metabolic wise this is the nuclear reactor.

Right here comes the cut and paste cause I'm too freaking lazy to type out a screed on why our metabolism slows as we age so I've cheated because dinner is in 15mins!!

Changes Occurring with Age
A decline in our physical abilities starts around age 30, continues throughout our life, and reaches a plateau between ages 60 and 70. After the plateau, a slower decline follows. The rate of decline varies with our individual level of fitness as well as our lifestyle. The speed at which our nerves conduct impulses declines approximately 15%, resulting in decreased reaction time and slowness in performing tasks. Maximum breathing capacity decreases approximately 40% during this period. Individuals with chronic lung disease, such as emphysema, suffer a more significant decline. Cardiovascular function declines approximately one half of one percent each year starting around age 30. It is no coincidence that many world-class and endurance athletes begin gradually leaving their sport after this age. There is a 40% to 50% reduction in muscle mass during this period with a similar decline in bone mass. There is a simultaneous increase in body fat in both men and women. The metabolic rate also declines with age. This decline is mostly affected by muscle mass. Regular exercise helps to preserve muscle mass, particularly muscle loading exercises such as weight training, walking, and physically challenging occupations.

HI me again!

Ok so with the DS we've got a higher metabolic set point. By rights we should not have a raise in our insulin production.  We should have cheated that bit by our re-routing (please chime in here anyone if you disagree) . If we've been smart and actually started weight baring exercise and calcium supplementation then we have a very very good chance of avoiding the bone density loss and subsequent muscle loss.  We then have avoided  being a sedentary ******* If we slow down the DS slows down is my rationale.

But CARBS! Ok there you really have it nailed down. Behaviour is the underlying issue.  Sure we grow more villi but really we'd need a football field of villi to over power the malabsorbtion of our DS totally.  We only need several donuts and a few chocolate bars a day however to totally undo that.

Some of the Vets have had significant weight regain i.e. about 30% others have not regained at all, others have had a %10-15% bounce back and down.  It is not precise but it is a very long way from morbid obesity.

DINNER!

 

this is wonderful.  Thank you so much for taking the time

The explanation that I got from my surgeon  is that because so much more of our small intestine is "bypassed"  with the DS, villi regrowth cannot overcome the malabsoption, unlike RNY's whose surgeries rely more on restriction than malabsoption.

As for more calorie absoption, from my classes it seems that it becomes less, because as we age, our appetites decrease.  I know that to be true, because as I'm approaching "double nickels", I find that I literallly have to *force* myself to eat more.  My appetite has decreased a great deal from when I had my duodenal switch at 52.  I don't think it's an effect of the surgery, it's just aging.

That's why many restaurants have senior menus with smaller portions.  As we age, we simply eat less, and store more which can be due to homonal changes and a slower metabolism.

Whether we eat more carbs or not is something that we can control, so adjusting carb intake will reduce calorie absorption.

Personally, I eat more protein, anyway.  Carbs are what I eat if I have room left, or I incorporate carbs, for instance, bananas, as a snack.