VOLUME 15 December 2014 NUMBER 12 Editorial Notice This newsletter is published monthly for Dr. Parham Mora 645 McQueen Smith Road. Suite 205 Prattville, Alabama 36066 Editorial Staff: Melissa Grant Items for the newsletter must be submitted by the 1st of the month for consideration for publication in the upcoming issue! submit items to: [email protected] If you no longer wish to receive Bariatric Bariatric Coordinator. Bulletin, contact: [email protected] Bariatric Bulletin, Bariatric Patients Should Take Supplements For Eye Protection Obese patients who have undergone bariatric surgery to shed weight should take the supplements prescribed to them to protect their eyes. Taking in too little Vitamin A, in particular, could in some cases actually cause night blindness, dry eyes, corneal ulcers, and in extreme cases total blindness. This advice comes from Rui Azevedo Guerreiro and Rui Ribeiro of the Centro Hospitalar de Lisboa Central in Portugal, who reviewed what little research there currently is on the occurrence of eye conditions following bariatric surgery. The review is published in Springer's journal Obesity Surgery. Three different types of bariatric surgery are performed to help with weight loss in obese patients: restrictive (such as adjustable gastric banding and gastric sleeve), malabsorptive, and mixed procedures (including Roux-en-Y gastric bypass and biliopancreatic diversion) that combine the first two types of surgeries. One of the drawbacks of these operations is that patients can develop nutrient deficiencies. This happens, for example, when patients vomit more often, eat less or develop food intolerances. People who have had restrictive bariatric surgery, for instance, often follow an unbalanced diet which subsequently influences their intake of the correct combination of vitamins and micronutrients. Moreover, malabsorptive and mixed bariatric surgeries decrease the surface area of the small intestine that plays an important role in the uptake of nutrients. As a result, too little vitamins and micronutrients may be absorbed properly by the body. Nutrient deficiencies caused by bariatric surgeries can, in the mid to long term, cause eye-related complications that can affect almost every component of the optic system. It can lead to conditions such as night blindness, ulcers, scarring and changes to the cornea, involuntary eye movement (called nystagmus), paralysis of the eye muscles (ophthalmoplegia) or dry eyes. It is the lower intake of especially vitamins A, E, and B1 (thiamine) and copper that worry Azevedo Guerreiro and Ribeiro, as these help with the normal functioning of the eye and optic system. Vitamin A deficiency, in particular, is linked to eye-related complications developing after bariatric surgery. However, the results of the handful of studies done on the subject is inconsistent. In general, Vitamin A deficiency and eye-related complications seem to be more prevalent after malabsorptive bariatric surgery. "There is a risk that bariatric surgery patients, who do not take the vitamin and mineral supplements prescribed to them, could develop eye-related complications because of nutrient deficiencies," emphasizes Azevedo Guerreiro. "Such complications after bariatric surgery are not frequent, but if undetected, they can have devastating consequences for the patients." "The real prevalence of these complications is unknown but the rarity of clinical reports that link nutrient deficiency with eye-related complications could also mean that no one is looking for such problems," adds Ribeiro. http://www.surgicalproductsmag.com/news/2014/12/bariatric-patients-should-take-supplements-eye- protection?et_cid=4296116&et_rid=650448428&location=top Study: Bariatric Surgery May Alter Taste Buds Stomach-shrinking bariatric surgery may also foster changes in a person's taste buds, which could help them lose weight and keep it off, according to a new study. Researchers at Stanford University School of Medicine in California found that patients who reported a decrease in taste intensity after bariatric surgery had lost more of their excess weight after three months than those whose sense of taste became more intense. The results were reported Nov. 4 during Obesity Week 2014, hosted in Boston by the American Society for Metabolic & Bariatric Surgery and The Obesity Society (TOS). The researchers said they did the study after noticing that many of their patients reported changes in their perception of taste after bariatric surgery, including both increased sensitivity to tastes and new aversions to foods. The study included 55 obese patients undergoing bariatric surgery and a comparison group of 33 healthy non-obese people who didn't have surgery. At the start, all participants took a taste test using flavor-saturated paper strips to gauge their ability to identify sweet, sour, bitter, salty and pleasant savory (umami) tastes. The bariatric surgery patients were retested at three, six and 12 months after surgery. Even before surgery, the tests showed the obese patients were "uniformly less taste sensitive than normal weight patients,” said Dr. John M. Morton, chief of bariatric and minimally invasive surgery at Stanford, who worked on the study. "Obese patients may seek to derive satisfaction through volume rather than taste appreciation.” The majority (87%) of patients reported a change in taste perception after bariatric surgery, with 42% saying they ate less because food didn’t taste as good. “After surgery, patients did note less preference for salty foods,” Morton said. Those who said their taste intensity decreased after surgery lost 20% more weight over three months, than those whose taste intensified. “The study provides excellent new insight on taste change after bariatric surgery,” Dr. Jaime Ponce, medical director of bariatric surgery at the Hamilton Medical Center in Dalton, Georgia, and past-president of the ASMBS, noted in a conference statement. “More research is needed to see how we can adjust for taste perception to increase weight loss,” he added. Morton told Reuters Health, "Future strategies may include teaching patients taste appreciation to derive satisfaction with less food volume." http://www.surgicalproductsmag.com/news/2014/11/study-bariatric-surgery-may-alter-taste-buds Get Killer Abs Everybody wants defined abs. Good thing there are so many different abdominal exercises to choose from — you'll never get bored as you work your way toward washboard abs! Here are three versions of the plank, a move that works the lower back, chest, and shoulders in addition to the rectus abdominis. Basic Plank (beginner) Start in a push-up position, but keep your hands directly under your shoulders instead of outside your chest. Legs are extended straight behind you, with feet together. You are balancing on your palms and the balls of your feet. Hold this position for as long as you can, working your way up to 1 minute. It's a lot harder than it sounds! Plank Twists (intermediate) Start in plank position. Maintaining this position, exhale and rotate your torso by bringing your right knee in toward your left armpit. Return to the starting position, then repeat, bringing the left knee toward the right armpit. Plank twists work not only the rectus abdominis but also the internal obliques. Extended Plank (advanced) Start in a basic plank position, but instead of placing your hands under your shoulders, bring your hands together and place them on the floor in front of you (about 3 inches in front of your head). This variation places much greater emphasis and concentration on the rectus abdominis because you're not able to use your arms as pillars to support your body weight. http://www.jillianmichaels.com/fit/lose-weight/washboard-abs?xid=nl_LosingItWithJillianMichaels_20141211 "Your life becomes the thing you have decided it shall be." – Raymond Charles Barker About Raymond Charles Barker Raymond Charles Barker was an influential American minister and author in the mid-twentieth century. He wrote such books as The Power of Decision and Treat Yourself to Life, on ways to change subconscious patterns. He became president of the International New Thought Alliance in 1943, a group practicing the religious philosophy developed in the late 1800's by Phineas Quimby, with early proponents including Ralph Waldo Emerson. Unity Church and Divine Science are among its later offshoots. He founded the First Church of Religious Science in Manhattan in 1946 and served as its minister until 1979. He died in 1988 at the age of 77. Crock-Roasted Chicken with Rotisserie Rub From Prevention Guide Slow Cooker Recipe Book 1 whole chicken (3 1/2 – 4 pounds) 1 Tb. Paprika 1 ½ tsp onion powder 1 Tb. garlic powder, or 3 cloves garlic, pressed 1 tsp salt ½ tsp ground black pepper Rinse chicken and pat dry, removing any visible fat . Discard giblets and neck. Coat 4-quart (or larger) slow cooker with cooking spray. Combine spices in a bowl and stir in warm water by the teaspoon-full until a thick past forms. coat the chicken inside and out with the seasoned paste before placing in cooker, breast-side up. Cover. Cook on low 6-7 hours or on high 3 ½ - 4 ½ hours, or until thermometer inserted in thickest part of thigh registers 180 degrees. Remove chicken from cooker. When cool enough to handle, remove skin and serve. Nutrition: 4 Servings Cal: 230; Pro: 41; Carb: 2; Fib: 1; Fat: 6 http://georgetowncommunityhospital.com/sites/www_georgetowncommunityhospital_com/Uploads/Crock_Pot_Recipes.pdf Roasted Brussels Sprouts Recipe with Balsamic, Parmesan, and Pine Nuts (Makes 3-4 servings) Ingredients: 1 lb. brussels sprouts, trimmed and quartered 2 T olive oil 1 T balsamic vinegar 2 T Parmesan cheese (preferably fresh grated; use more or less to taste) 1 T pine nuts (preferably toasted, could substitute other nuts of your choice) Instructions: Preheat oven to 450F/230C. (You can also roast the brussels sprouts at a lower temperature for a longer time if you need to cook other things in the same oven.) Trim brussels sprouts, remove any discolored leaves, and cut into quarters (or halves if they are small.) Whisk together the olive oil and balsamic vinegar.