Question:
I need some advice on Protein.
I need some personal opinions in regards to this question. I've heard from some people that you should try to get your protein from shakes and other supplements only, ....while others say that you should be trying to get it from solid food as much as possible. I've always thought that you should be trying to get it from FOOD!?!?!? I'm not talking about early on post-op, I'm talking about later on. I'm beginning to get confused on what to do. I'm still pre-op right now, but trying to get my facts straight. Thanks in advance for all your responces. :) — [Anonymous] (posted on December 13, 2001)
December 13, 2001
thanks for asking this question. i too am still a little confused over the
protein issue. i would prefer getting my protein from solids as i am
strictly a water drinker. just the thought of swallowing something thick
& not so great tasting kinda makes me gag. i would even puree what ever
i have to in order to get my protein from food & not supplements.
— sheryl titone
December 13, 2001
As a relativly new post op I do not consider myself an expert but it seems
to me that our goal should be to eat as healthy a diet as possible and to
live as normal a life as we can with out newly outfitted stomachs. As a
new post op there is no way I could eat enough food to give me 60 grams of
protein. So at 7 weeks I am taking in 55 grams through procomplex drink.
(2 6 ounce servings sipped slowly) During the day I eat hi protein foods
such as cottage cheese, string cheese and tuna. I eat very few
carbohydrates as the ones I can eat at this time have very little
nutritional value. I don't worry too much about fats as I don't add any to
my food and with limiting carbs a lot of what would be in baked goods is
not eaten. Because I live alone I imagine I will continue to eat a protein
drink for breakfast most day. I think I will always have a high protein
lunch and add veggies and fruits in the next couple of weeks to round out
the diet. I don't know what others have in mind for their long term eating
plan. I think once I loose the weight I will not worry about having a bite
of the special holiday or celebration foods but will have control over
them. Good luck to you, I hope you get some good responses to this
question.
— [Anonymous]
December 13, 2001
I have ben getting all my protein from food since about month four post op.
I am now 6&1/2 months post op and have no trouble doing that, but early
on I definately needed to supplement.I make sure that everything I eat has
some protein in it, but I have heard that too much protein is not good for
you in the long run, so I usually get in around 60-75 grams a day. I do
have some carbs, but mostly from fruits and veggies and a few crackers or
Kashi GoLean cereal, which is also high in protein. Anyay, I think it is a
personal preference, and I would rather eat real food than drink those
shakes. I always keep some handy in case my schedule doesn't allow me to
eat all the protein I need, but I haven't had to drink any supplements at
all in a while now. I guess getting it all from food is working, I am down
96 pounds and am 15 pounds from my goal. Best of luck to you!
— Vicki K.
December 13, 2001
If you go to your local library and pull a physiology book, you will be
able to answer your own questions without opinions. When you look at how
your RNY is constructed, you will see that it locks away the lower part of
your stomach, which is where digestion occurs. Digestion meaning the
chemical breaking down of food into absorbable molecules. Absorption of 8
elements takes place (primarily) in the jejunum, which will be bypassed.
So, even though you can one day eat quite a bit of food (not too soon, I
hope!), that won't really change your ability to digest & absorb it.
The length of bypass only determines how much you need to supplement not
IF. I know many surgeons have opinions about this. I asked some if I am
paying them $30K to disable my disgestive system AND it still functions
normally, shouldn't I get my money back? So, in the end, you will have
your surgeon's opinion, our opinions and your own research. Your health and
your long term wt loss are the risk you take in deciding how to proceed.
— vitalady
December 13, 2001
Like Michelle says below, I got a book on nutrition and physiology and
learned that in order to truly digest protein, I needed to begin the
process with hydrochloric acid that is present in the bottom of my stomach.
Since I no longer use that part of my stomach, I am starting OUT with
minimal digestion of FOOD protein. I also learned that this acid breaks
the protein down into amino acids in the stomach and the first part of the
intestine. Since I no longer use the first part of that small intestine, I
know that I am at a disadvantage for digesting food protein. Now, at the
intersection of the Y in the roux n Y, the food protein that I've eaten
gets some of the hydrochloric acid and can begin to break down some. But
the fact that most of the absorption takes place in the part of the
intestine that is bypassed, makes this absorption useless. Yes, part of
the protein is broken down and absorbed once it gets to the Y intersection,
but I don't know how much. So that is why I supplement with the shakes and
Cher-amino. The shakes are pre-digested (meaning they are already broken
down into amino acids and the part about needing the hydrochloric acid
isn't necessary). So they can begin to be absorbed as soon as they hit my
intestine. I know that I have a better chance at absorption with this type
of protein. These books will also tell you that a normal person needs .8
grams of protein per 2.2 pounds of body weight. That means for me at 240,
I need 87 grams of protein per day. Because the RNY surgery is designed to
MALABSORB, I do 90 to 120 grams of protein daily to ensure that I at least
get the minimum 87 grams that I need. Once you are post op, it is
important to have your doctor check your protein levels (it is called
Pre-Albumin). Get a copy of this test each time it is given and see the
results for yourself. Normal range (meaning you're getting enough protein)
is between 20 and 40 on this test. So keep track -- if you're under 20,
then you need more, if you're over 40, then you need less. I still eat
protein in the food form, but don't count it towards my daily grams. Good
luck and God Bless!
— Kimberly L.
December 13, 2001
Oh yeah, I forgot to mention. Prior to doing my own reading on the
digestive system, I thought I was doing well to get in the minimum 60 grams
of protein daily recommended on this site. (I had 5 feet bypassed). My
last visit to the doc showed that my pre-albumin level was at 17 (so below
the normal range of 20-40). That was about 2 weeks ago and I have since
figured out how much I personally need daily and adjusted it for the
absorption factor. That is why I do 90-120 grams daily. I will go back
for another check after the first of the year.
— Kimberly L.
December 13, 2001
Michelle: Hi! :) I agree your explanation is accurate -- for the RNY. I
just wanted to comment that the DS surgery involves a partial gastrectomy
of the stomach -- about 2/3 of it IS permanantly removed, but it is the
fundus (or storage) area. The stomach basically functions as pre-op,
retaining it's 'original' shape and function. Therefore, digestion DOES
occur (the lower part, the antreum, remains intact as well as the pyloric
valve, which shuts the stomach off and signals digestion to occur,
releasing the chyme when finished). Also, about 5 cm of duodenum (where
calcium/iron and other minerals are mainly absorbed) is retained so some
absorption occurs in this area before the intestines are 'diverted' and
then absorption occurs in the 100 cm or so of 'common channel' before the
large intestines. Protein is absorbed throughout the entire intestines ---
So, the more you have the better off you are in terms of absorption. We
DSers have that 5 cm of duodenum and then the 50-100 cm of common channel
at the end, so we highly malapsorb protein (I would assume that distal RNY
folk do as well -- but proximal RNY post-ops do not face as much protein
malapsorption). The DS post-op is highly encouraged to get most of their
protein from food sources (and the requirements are generally higher than a
proximal RNY -- about 80-100+ gms/day but may be similar to a distal RNY).
We eat steak, chicken, seafood, etc. --- There really are no 'restrictions'
for fried foods, etc. -- but we also should stay away from sugar as much as
possible because these are TOTALLY absorbed (whereas fats mainly are not -
hence the allowance of fried foods, etc.). It really is individual because
some people have bad reactions (gas, diahhrea) to fatty foods and/or other
types of foods (developing lactose intolerance, etc.) but there is no
general prohibition against any type of foods other than pure sugars. :)
I personally have NOT experienced adverse reactions to fried or fatty
things but I know others who do. I mainly got protein through dairy (and
protein shakes/bars) in my first three weeks post-op. Now, I mainly get it
through foods (meats, dairy, nuts - nothing better than some fresh cheese
and almonds for a snack! :)). EVery now and then I just go through a
period where I don't feel like eating much and I add a protein shake or bar
to my diet but it certainly is NOT a daily experience. So, the RNY may be
different in terms of how things are processed, etc. but the post-op DSer
does digest foods as a pre-op. All the best, (lap ds with gallbladder
removal, January 25, 2001, preop: 307 lbs/bmi 45 now: 198 lbs/bmi 28,
size sweet 16 but squeezin' into a 14! LOL),
— Teresa N.
December 14, 2001
Well my answer isn't as "scientific" as some but I do know this.
Once you are over the liquids portion of your healing process and are able
to eat solid foods that's what you should stick to. Keep in mind that soft
or liquid foods digest more quickly and make it easier for you to eat more
or become hungry more often. Solid proteins stay in your system longer and
give you that full feeling longer. Maybe this isn't true for everyone but
this works for me and is what my surgeon recommends as well.....
— kristen H.
December 14, 2001
I've been feeling like a failure for two reasons. One, I can't stand any of
the protein drinks and Two I can't afford them. Having said that I did have
my blood tested for the protein level. My doctor (not surgeon) took one
look at the protein level (8.1 I think) and told me to COME OFF OF THE
PROTEIN DRINKS NOW! Hey! I'm not on any!!! I'm getting it from food, and I
don't even eat alot yet. So that goes to show you that you don't always
need the drinks. I'm sure some people do, and all of us are at different
stages and have different needs. But here I've been beating myself up
thinking I'm a failure and yet I'm "evidently" doing something
right as my protein levels are high (or very high) without those expensive
and vile protein drinks. :) YES!
— Danmark
Click Here to Return