Protein- how much are you supposed to get?
Most surgeons' programs list their protein requirements in the 60-80g per day range; some will push men a little higher, into the 90-100g range.
Government recommendation is for 60g per day minimum for healthy adults. As with most of the other government guidelines, this is the minimum required to avoid deficiency disease, but not necessarily optimum health.
Many nutritionists use your ideal body weight in kilos, which is mostly based upon height and sex, and factor in unusual activity levels, age range, athletic goals and injury/healing. The excess weight that we are/were carrying makes no difference as that's mostly fat that doesn't need to be fed.
I don't know what model your nut is using, but one common guideline for ideal weight is for women to be 100lb for the first 5.0 feet height, and 5lb for ea*****h above that. Men are 106lb for the first 5.0 feet and 6lb for ea*****h above that. Convert to kilos by dividing by 2.2. Average adults need 0.8g protein per kilo of ideal weight, infants 2g, adolescents 1g, atheletes 1.2-1.8 depending upon strength and endurance requirements, and an important one for us - injury repair can be 1.5-2.0g, or more in some cases of burns or other thermal injuries.
So, by this method, your "ideal weight" at 5'7" is 135lb and your protein requirement for a "typical" adult would be around 49g, which is on the low side of these various models. However, you are healing from a major injury like surgery, you can double that figure to around 100g. My figures for a 5'10" man would be 166lb, 60g avg need and 120 or so for healing mode. I think that most docs realize that there is no way most of us could ever get in enough protein to meet these healing guidelines with our restricted intake, and given the weight loss goals and timescale, wouldn't want us to be consuming that much for a month or two of healing (however long that takes,) and then try to pull our consumption back to a lower weight loss mode. So they compromise and follow their best judgement based upon their experience and others'.
Another method I have seen takes your lean body mass or muscle mass (including organs and other lean tissues) and assumes that this mass needs to be replaced every six months. That leads to a daily protein requirement which is somewhat higher, and also accounts for the higher lean mass that we typically have when overweight/obese to support and move our much higher body weight, though both methods account for the higher lean mass of athletes, though in different ways.
The other consideration in all of this is that we don't really fit into any of the normally convenient categories (what eles is new?) Can we really be considered to be "healthy adults"? Certainly not athletic (except for a few rare cases, I suppose) though we are healing from significant injury (our surgery). It seems that any of common models that are used have to be altered or tailored for our specific cir****tances, which is what our docs and nuts do in coming up with their own guidelines for us. There may be varying degrees of science, experience and guesswork, uh, professional judgement, involved, but it does seem that there is a pretty good consensus within the bariatric community on this - a much closer consensus than we see on their diet programs (pre-op diet or none, lengthy liquid post op diet or straight to mush and soft proteins, intensely low carb or balanced hi protein.....)
My own doc's plan follows the fairly common 60-70g guideline, which I had little problem meeting - enough that they were adding veg to my diet at the 10 day mark. Most docs like to see progression to getting as much protein, etc. from real food as possible, with the effective timeline of that varying depending upon how quickly they move their patients from liquids to solids, and how quickly the individual can tolerate that progression.
Most of my protein is real food at this point, and has been for quite a while, though I do use the powders and bars selectively - if I am going to have some pudding as a snack, it will be protein loaded so that they aren't "empty" calories, though about half of the added protein comes from using some greek yogurt in the mix instead of some of the milk, so that adds to the "real food" character of it. I do use the protein shakes, but it's more for workout recovery with its rapidly absorbed protein than it is for meeting the daily protein goal; protein bars are mostly for when convenience is needed - if I'm on the road, or really need something when I'm at the gym or at the movies (which means I might have one, maybe two, in a week.)
If you find out what formula/model your nut is using for your protein requirement, please post it - I can add it to my collection!
Government recommendation is for 60g per day minimum for healthy adults. As with most of the other government guidelines, this is the minimum required to avoid deficiency disease, but not necessarily optimum health.
Many nutritionists use your ideal body weight in kilos, which is mostly based upon height and sex, and factor in unusual activity levels, age range, athletic goals and injury/healing. The excess weight that we are/were carrying makes no difference as that's mostly fat that doesn't need to be fed.
I don't know what model your nut is using, but one common guideline for ideal weight is for women to be 100lb for the first 5.0 feet height, and 5lb for ea*****h above that. Men are 106lb for the first 5.0 feet and 6lb for ea*****h above that. Convert to kilos by dividing by 2.2. Average adults need 0.8g protein per kilo of ideal weight, infants 2g, adolescents 1g, atheletes 1.2-1.8 depending upon strength and endurance requirements, and an important one for us - injury repair can be 1.5-2.0g, or more in some cases of burns or other thermal injuries.
So, by this method, your "ideal weight" at 5'7" is 135lb and your protein requirement for a "typical" adult would be around 49g, which is on the low side of these various models. However, you are healing from a major injury like surgery, you can double that figure to around 100g. My figures for a 5'10" man would be 166lb, 60g avg need and 120 or so for healing mode. I think that most docs realize that there is no way most of us could ever get in enough protein to meet these healing guidelines with our restricted intake, and given the weight loss goals and timescale, wouldn't want us to be consuming that much for a month or two of healing (however long that takes,) and then try to pull our consumption back to a lower weight loss mode. So they compromise and follow their best judgement based upon their experience and others'.
Another method I have seen takes your lean body mass or muscle mass (including organs and other lean tissues) and assumes that this mass needs to be replaced every six months. That leads to a daily protein requirement which is somewhat higher, and also accounts for the higher lean mass that we typically have when overweight/obese to support and move our much higher body weight, though both methods account for the higher lean mass of athletes, though in different ways.
The other consideration in all of this is that we don't really fit into any of the normally convenient categories (what eles is new?) Can we really be considered to be "healthy adults"? Certainly not athletic (except for a few rare cases, I suppose) though we are healing from significant injury (our surgery). It seems that any of common models that are used have to be altered or tailored for our specific cir****tances, which is what our docs and nuts do in coming up with their own guidelines for us. There may be varying degrees of science, experience and guesswork, uh, professional judgement, involved, but it does seem that there is a pretty good consensus within the bariatric community on this - a much closer consensus than we see on their diet programs (pre-op diet or none, lengthy liquid post op diet or straight to mush and soft proteins, intensely low carb or balanced hi protein.....)
My own doc's plan follows the fairly common 60-70g guideline, which I had little problem meeting - enough that they were adding veg to my diet at the 10 day mark. Most docs like to see progression to getting as much protein, etc. from real food as possible, with the effective timeline of that varying depending upon how quickly they move their patients from liquids to solids, and how quickly the individual can tolerate that progression.
Most of my protein is real food at this point, and has been for quite a while, though I do use the powders and bars selectively - if I am going to have some pudding as a snack, it will be protein loaded so that they aren't "empty" calories, though about half of the added protein comes from using some greek yogurt in the mix instead of some of the milk, so that adds to the "real food" character of it. I do use the protein shakes, but it's more for workout recovery with its rapidly absorbed protein than it is for meeting the daily protein goal; protein bars are mostly for when convenience is needed - if I'm on the road, or really need something when I'm at the gym or at the movies (which means I might have one, maybe two, in a week.)
If you find out what formula/model your nut is using for your protein requirement, please post it - I can add it to my collection!
1st support group/seminar - 8/03 (has it been that long?)
Wife's DS - 5/05 w Dr. Robert Rabkin VSG on 5/9/11 by Dr. John Rabkin
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