I wanted to pass this most valuable information along to you all . This is the very imformation that OH provides to their support group leaders for training . So this is really good stuff !!  I would read it closely .. Ask questions if there is something you do not understand. Science is changing all the time . Protein has to be one of our key choices in our food selections . Hope this helps you along your journey. And as always, check with your nut or doc if you are unsure of what your diet should consist of . For me , my Surgeon, Dr. Hutcher says this information below is right on the money . So I trust it ... and have been using this scale for 4 years . So glad I took the time to really understand how it all works . I consider my surgery as still unkown as to what the future holds as far as absorbtion , so I make the best of all I put into my body. I hope you will too !! Nat BIOAVAILABILITY OF PROTEIN TYPES

 

 

The higher on the list, the better.

The numbers are the BV.  (Biologic value).

This is only how easily the (normal) body can absorb them, not the protein grams in each one.  The last few need to be blended to make a complete protein.

And remember….gastric bypass patients don’t absorb nutrients from food protein very well.  

The Biological Value, or BV, of a protein is an indicator of the quality of the protein. It is a measure of a protein's ability to be used by the body (or its bioavailability). It is a percentage (though the scale is skewed resulting in some BV's of greater than 100) of the absorbed protein that your body actually uses. Biological Values are indicators of which proteins are best at aiding nitrogen retention in muscles to help them maintain or grow.   Many of the whey protein powder manufacturers claim that their products have BV values well above regular whey protein by various techniques such as ion-exchange processing, hydrolization, and adding other ingredients such as specific amounts of limiting essential amino acids.   Hydrolyzation is a process breaking large peptides into smaller ones. It is sometimes referred to as "pre-digested".   Regular undigested whey will be broken down into di- and tri-peptides via enzymes in the gut (which gastric bypass patients no longer have).  This process takes a while, even in the non-gastric bypass person. Hydrolyzation is useful when protein delivery is needed very quickly so the body doesn't have to require the time and enzymes doing it. The benefit is of having a quickly absorbed protein to ensure muscle tissue is flooded with nutrients in a timely manner.

 

Protein Source   BV   Whey Protein Isolate Blends Whey Concentrate (Lactalbumin) Whole Egg Cow's Milk Egg White (Albumin) Fish Beef Chicken Casein (a protein from milk) Rice Soy Wheat Beans Peanuts   100-159 104 100 91 88 83 80 79 77 74 59 54 49 43

So, because we(gastric bypass patients) don't have a stomach and the stomach acids, etc, anymore, we don't process the undigested proteins properly and malabsorb most of them.  The same is for the normal food we eat.  We don't absorb most of it.  We, therefore, need the more highly absorbed, pre-digested protein supplements.....whey which is pre-digested (aka hydrolized)...in order to get the proper nutrients our bodies need and are no longer able to get from food. So, whereas whole egg, cow's milk, egg white are near the top of the list of bioavailability for "normal" people, they are not pre-digested (hydrolized), so for us, they are not as high on the list as pre-digested whey protein.  Our bioavailability list would be quite different from the "normal" person's list.  So, make sure your protein powder or drink states that it is pre-digested or hydrolized.  And the best kind of protein would be a whey blend protein. Second best would be a 100% whey protein.  Isolates, though good for a quick acting pick-me-up, are not sufficient alone for the gastric bypass patients on-going maintenance requirements.

 

 

Great read, but as always, people really need to follow their doc's instructions.  Many surgeons do not want their patients using protein supplements at all.  They want them to eat their proteins, and this could give them the impression that they (new patients) are doing it all wrong and that their docs are wrong for telling them not to use protein supplements. I, for one, use a protein supplement, but there are many who do not and are doing great and have great labs. Just my 2 cents......

I'm so glad Dr C agrees with using the supplements.  They are so easy and ensure adequate protein.  I LOVES my animal flesh, but that one shake and one protein bar a day really put me up there without a care!

I am glad that I was instructed to use suppliments. I am in a group of those that are considered the test subjects for all WLS . I for one do not want to take any chances. My labs are fanstastic . Have been for 4 years . I truly do not understand a WLS surgeon that does not instruct to suppliment . There is no way in one day that I can get in 60 grams of protein via meat or fish .  If one is able to get in their protein via food , great ... I wish them all the best . I only know what my surgeon says , and what the ASBS writes in their studies as well as the NIH NDIK STUDIES .  They are looking at now the long term effects of suppliments.  I take no chances !  Nat

I completely agree.  I have been on the upside of the protein scale since day one.  During the first 4 months, many people lose muscle along with fat..  It's a natural process with the surgery and something that they watch.  but,  not me.  In fact, my nut. came to me specifically to see what I was doing because this was something that they did not see.  I think it had something to do with the protein supplements. In fact, have never lost muscle.  However, there is the flip side to the protein agrument.  Too much protein causes an acidic environment in the body which can increase chances of disease, kidney problems, etc.  I think that it is for this reason (one of several) that many docs opt out of the supplement route. Additionally, let's be honest, there are many patients who do not even get in the required 60 grams of protein.  My doc told me that they ask for the 60 grams because it's the absolute min. and they STILL run into problems because people have many excuses for not doing the 60 grams (don't like protein supplements, etc.).  It puts the docs in a bad position because what are they to do?  Harp on a person to force them to use protein supplements?  That's a great boost to the self esteem. Now, in the beginning, I could not eat 60 grams of protein.  I can now, but opt for 140 - 150 grams - BUT...that includes 2 protein shakes a day, packing 50 grams of protein (before soy milk).  So, without the supplements, I would seriously be pushing it.  Plus....I need the calories.  I have a hard enough time not getting in enough calories to fuel my workouts.  and, that's how I've looked at the supplements lately. So, all in all...it's not totally the WLS surgeon, but also the patient. Now...how did you get in the test group?

Thank you for this. My surgeon does allow us protien supplements.  I am not sure how it is handled after full liquids.  I do know they have us (women) supplementing 50 grams a day.  I go in Friday, so I will get more instruction for the mushie stage.  But I am sure they want us to get protien frist from food, but to still supplement.  This is great information, thank you!

Follow your doctor's instructions to a "T".  Many of us have our opinions, but at the end of the day, you have to listen to your doctor and make your own judgement. He may have a reason why he wants you (or does not want you) to use supplements.  And that's between you and your doctor.   Be an informed consumer.  Do your research and make your own decisions. But...in the opinion of many of us here...supplements are a must for success.