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Friday, October 31, 2014

Pumpkin Lasagna? You Bet! Happy Halloween Supper

Recipe compliments of Libby's 100% Pure Pumpkin - All Natural, No preservatives. "Perfect as the base ingredient in sweet or savory recipes, each can of LIBBY’S 100% Pure Pumpkin is all-natural and contains no preservatives. Our Dickinson variety of pumpkin goes from seed to can right here in the USA."

Pumpkin is a valuable source of Vitamin A, and also provides Vitamin C, Calcium, and Iron as well as 1 gram vegetable protein per serving. Canned pumpkin enhances unexpected meals such as spaghetti sauce, soups, stews, and even vegetable casseroles. This is one of my favorite recips from Very Best Baking - Pumpkin. Be sure to link over there to find terrific recipes the whole family will enjoy.

Pumpkin Lasagna with Mushrooms & Spinach

    Nonstick cooking spray
    1 tablespoon olive oil
    8 ounces sliced fresh mushrooms
    1 small onion
    2 cups fresh baby spinach, washed and dried
    1/2 teaspoon salt
    1 cup LIBBY'S® 100% Pure Pumpkin
    2/3 cup (5 fl.-oz. can) NESTLÉ® CARNATION® Evaporated Lowfat 2% Milk
    1 teaspoon dried rubbed sage
    1/4 teaspoon ground black pepper
    Pinch of ground nutmeg
    6 no-cook lasagna noodles
    1 cup part-skim ricotta cheese
    1 cup (4 oz.) shredded part-skim mozzarella cheese
    3/4 cup (3 oz.) shredded or grated Parmesan Cheese

PREHEAT oven to 375° F. Spray 8-inch-square baking dish with nonstick cooking spray. HEAT oil in large, nonstick skillet over medium-high heat. Add mushrooms and onions; cook, stirring occasionally, for 5 to 6 minutes or until tender. Add spinach and 1/4 teaspoon salt; stir until spinach is wilted. Remove from heat.

COMBINE pumpkin, evaporated milk, sage, pepper, remaining 1/4 teaspoon salt and nutmeg in medium bowl. Spread 1/4 cup pumpkin sauce onto bottom of dish. Top with 2 noodles, overlapping slightly. Spread 1/2 cup pumpkin sauce to edges of noodles. Top with half of mushroom-spinach mixture, 1/2 cup ricotta cheese, 1/2 cup mozzarella cheese and 1/4 cup Parmesan cheese. Repeat layers. Top with remaining 2 noodles and sauce. Cover with foil or lid.

BAKE for 40 minutes. Uncover; sprinkle with remaining Parmesan cheese. Bake uncovered for an additional 5 to 10 minutes or until cheese is melted and light golden brown. Let stand for 10 minutes before serving.

Find more recipes at Very Best Baking - Pumpkin and don't forget to make a batch of our highly popular 5 Day Pouch Test Soup: Low Carb Pumpkin Sausage Soup

Thursday, October 30, 2014

5 Day Pouch Test: Slider Food and Rule Breaking

Introducing Two for Thursday, a new weekly blog feature answering two top trending questions about the 5 Day Pouch Test. I hope you enjoy this new feature and it serves you well in your healthy weight management with surgery. Do you have a question? Post it to the comments or email me at - put "Two for Thursday" in the subject line please!  Here we go:
In my 10 years of working with thousands of WLS post-ops not one person has ever said to me, "I truly regret that I followed the rules and missed so many nibbles and bites of treats not allowed on my plan."  ~Kaye Bailey

#1 - Question: What makes a slider food?

Earlier this week I received this question from one of our many LivingAfterWLS Neighbors:
"My question: is Greek yogurt a slider food?  I add a teaspoon of protein powder and one of fiber to the 5.3 ounce cup to give it added oomph. Please let me know as it is one of my nutrition mainstays."

Answer:  Great question! You hit the key factor that prevents yogurt (or any semi-soft protein like cottage cheese, hearty vegetable and protein soups, or even high protein oatmeal) from becoming a slider food: Controlled Portion!  When following the 5DPT guidelines and WLS Four Rules you would eat your measured portion after 30 minutes abstaining from consuming liquids, enjoy your serving, and then allow 30 minutes for your body to absorb and digest the nutrients before sipping your water or tea again. Your additions of protein powder and fiber and stellar - this is a very healthy and smart "nutrition mainstay" and I'm so happy you are doing well with it!  Always remember a good test of slider food is first the nutritional value, degree to which the food is processed and lastly portion size. People who stand at the fridge eating out of a tub of yogurt then washing it down with a beverage are not benefiting nutritionally, which turns a smart food choice into a slider food.

The salad shown here uses cottage cheese as an ingredient in a crab salad, thus controlling the portion size and changing the texture of the salad to be more dense so it feels less like a slider food. 

Three questions to ask to determine if a soft food, such a yogurt, is a slider food:
1. What nutritional value does this food provide? (Protein grams should exceed carbohydrate grams, the ingredients should be recognizable, and nutrients should include vitamins, minerals, and fiber.)

2. Is this food highly processed and will I need a beverage to wash it down?  (Avoid artificial ingredients, refined sweeteners, refined grains, unknown ingredients that you wouldn't use in home cooking, imitation foods, and the obvious junk or fast food.

3. Is this food portion controlled and consumed while following the liquid restrictions. (Use measuring utensils, appropriately sized dinner plates/bowls, and/or portion controlled single-serve items such as string cheese or yogurt. Avoid "free pouring" or "guesstimating."

Link to Infographic

# 2 - When is it okay to start bending the rules?

(Caution: Stern Talk Ahead)

Answer: It is always too soon to bend the food rules after WLS. This question is coming up more often in WLS groups than I have seen in a very long time. It concerns me a great deal, particularly when people as few as two weeks out from weight loss surgery are asking about cheating or confessing to eating off-plan. And more alarming, group members are being supportive with advice like, "It's okay, just be careful. Don't go overboard." Bending the rules that soon after surgery will only cause regret, self-loathing, and quite frankly may interfere with the body's healing process following the trauma of surgery. The excuses are common, "Just needed something to chew." "The chips were calling my name." "I was at a social function and didn't want to offend my hostess." "I didn't think about it before I ate it."  I understand these explanations because I've used them as well.

Anyone who goes into weight loss surgery has been thinking about it pretty much non-stop for months -- if not years -- before going under the knife. We all prepared by evolving a good understanding of the dietary and lifestyle Four Rules. We crossed our heart and promised to follow the rules and make this surgery --our last resort-- work for us. Do you remember that phase in your WLS experience? So why-oh-why would one break the rules and eat something like chips that is so obviously inappropriate before the surgical incisions are even healed? And if one so easily disregards the rules that soon after surgery what is going to happen a year down the road when surgery is a vague memory and the temptations found in returning to the same environment where we became obese are ever present?

To new patients I strongly suggest holding out as long as you possibly can before breaking a rule and re-introducing non-nutritional food to your diet - this is the very food that contributed to obesity in the first place. Follow to the letter the instructions provided by your surgeon. We all promised to follow the rules. Honor that covenant with yourself, your doctor, your deity. Take the promise seriously.

This surgery is a really big deal.

We know what chips taste like.
We know what Halloween candy tastes like.

Is it really that tough to forgo eating inappropriate food and trust our taste memories while acknowledging that our objective is to enjoy food that supports our weight management goals? In place of that food hunger (sometimes called Head Hunger) we can successfully cultivate a hunger and appetite for all the joy that comes with good health, weight loss, and the pursuit of the dreams we had when we opted for surgical intervention.  The cliche "nothing tastes as good as skinny feels" is a great truth, although I prefer to say, "nothing tastes as good as healthy feels."

Many people have made the mistake of bending the rules and derailing the miracle they hoped to find with surgery.  We know that bending the rules leads to a departure from our goals and ultimately disappointment. We know this without having to personally test the theory.

Seriously! Avoid bending the rules for as long as you can. In my 10 years of working with thousands of WLS post-ops not one person has ever said to me, "I truly regret that I followed the rules and missed so many nibbles and bites of treats not supported by my plan." Not one person. Yet, I've listened through the tears to countless people tell me "I just wish I'd never taken that first bite of chocolate (sip of Diet Coke, handful of potato chips, scoop of ice cream, etc). It was the first bite that did me in."

Get more empowering straight talk from our LivingAfterWLS Publications:
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Jack-O-Lantern: Your New Exercise Buddy

Learn the role of exercise during the 5 Day Pouch Test:
The 5 Day Pouch Test: Express Study Guide

We know that Daily Exercise is Rule #4 of Weight Loss Surgery. But daily exercise can become monotonous. The folks at HuffPost Healthy Living have a fun workout perfect for Halloween. A full body workout with your good buddy Jack-O-Lantern. You can see the whole thing online and get moving today. Here's more from the article:
"Here are just a few ways to use your pumpkin to get a full-body workout. Costume changes not required." HuffPost Healthy Living

Halloween means candy and costumes, but it also brings an abundance of pumpkins to seemingly every grocery store and front stoop. Sure, you can cook them and carve them, but why not use them to switch up your workout, too?

As long as you pick a pumpkin that's not too heavy (and not too light!), that gourd can give you just as good of a workout as any old medicine ball, kettlebell or set of dumbbells.

Check out the article here, on HuffPost Healthy Living, complete with cute and short Vine videos of each exercise. 

  • Exercises: 

  • Pumpkin Lunge with a Twist
    Standing Pumpkin Chop
    Single-Leg Pumpkin Deadlift
    Sumo Squat with Overhead Pumpkin Press
    The Offset Pumpkin Pushup
    The Kettlepumpkin Swing
    V-Sit Pumpkin Twist
What are you waiting for?  Have a spooktacular workout!

Wednesday, October 29, 2014

Avocados: That good creamy fruit supports your health! Eat-Up!

The Avocado Advantage

A creamy fruit enhances vegetable nutrition

Slices of fresh avocado with salsa or in a salad add a creamy decadence and rich flavor. They also add fat, a fact that has frightened away many weight-conscious eaters. Now researchers say that avocado’s fat is advantageous, increasing the body’s absorption of antioxidant carotenoids.

Many fruits and vegetables, including carrots, spinach and tomatoes, are packed with carotenoids, such as beta carotene, lycopene and lutein. These nutrients have been linked to risk reduction of various diseases, including cancer and cardiovascular disease. But recent studies have shown that unless vegetables are consumed along with fat—with salad dressing, for example—the body can barely absorb the carotenoids and get them into the bloodstream where they work their magic.

Food scientist Steven Schwartz at Ohio State University and his team wanted to see if avocado, a great source of heart-healthy monounsaturated fat, could match the antioxidant-boosting properties of salad dressing. They gave 11 volunteers salsa or salad with or without avocado, and then tested their blood periodically for 9 1/2 hours. They found that when volunteers ate avocado, concentrations of lycopene, beta carotene and alpha carotene in their blood ranged from 2 to 15 times higher than when the dishes were eaten without avocado. They also found that the fat in the fruit was indeed behind the increased absorption.

“The responses were really dramatic. We found that half of an avocado fruit (about 2 1/2 ounces) with a typical salad is sufficient” to increase carotenoid absorption, says Schwartz. There are also added benefits to consuming avocados—dietary fiber and other nutrients like folate and vitamin K.

Bottom Line: All fat enhances absorption of carotenoids, but monounsaturated-fat-and-nutrient-filled avocados provide an extra health kick.

Shrimp & Avocado Canapes

Precooked shrimp make this pretty appetizer a snap to prepare.

16 whole-wheat crackers
 1 avocado, cut into 16 slices
16 cooked shrimp
Lime wedges

1. Top each cracker with 1 slice avocado, 1 shrimp and a squeeze of lime juice.

Per Serving: cal. (kcal) 61, Fat, total (g) 3, chol. (mg) 8, sat. fat (g) 1, carb. (g) 7, Monosaturated fat (g) 2, fiber (g) 2, pro. (g) 2, sodium (mg) 61, Potassium (mg) 95, Percent Daily Values are based on a 2,000 calorie diet

Weekly Digest: More important that counting calories

The LivingAfterWLS Weekly Digest has been sent to subscriber emails and is also available for viewing live in our archive: Weekly Digest October 29, 2014

More than calories or grams:

Nutrient Intake Most Important After WLS

Quite honestly, with WLS we not only want to lose weight, we want to feel fabulous and full of life when the pounds are gone.

Thank you for joining me in this week's LivingAfterWLS Digest, I know your time is valuable and appreciate you spending some of it with me. Today I address our nutritional needs following weight loss surgery. So often, due to our epic dieting history, we focus on counting calories or fat grams or most recently protein grams as measure of food intake. While these measures are important to our success with WLS, they are not the only things with which we must be concerned. We need to pay close attention to our nutritional intake: vitamins, minerals, phytochemicals, fiber, flavonoids, and all those things that keep the body running. In order to achieve and maintain this euphoria of living we must feed our bodies well.
There is a goodly amount of new information coming out about nutrients and how our body absorbs them. One of the key findings in the last 10 years is that we need healthy monounsaturated fat in our diet because it delivers nutrients throughout the body. Nutritionists are now encouraging us to avoid fat-free products in favor of healthy oils including olive oil, canola oil, and the omega 3 fatty acid found in cold water fish. Today we look at why these healthy fats make a difference in our health and weight management, and how to effectively and appropriately include them in our post WLS diet. Fish and Healthy Fats.

Another commonly known factor in our battle against obesity is self-perception: how we view our body. Take a look at this revealing feature about the role of body image in our weight management: Your Body Perception Matters.   And finally, wrap things up with a terrific easy and affordable weeknight recipe: Crispy Cajun Tilapia and Slaw. So good!
I hope you find this digest useful in your ongoing efforts for improved health with weight loss surgery. You have the power and knowledge to make this your healthiest season ever! Let's do it together!

Check out the Digest in our Archive: October 29, 2014

Be sure to subscribe by clicking the Join our Mailing List image and link:

News: A Simple Blood Drop Test for B12 Deficiency

A new test for Vitamin B12 Deficiency may soon be beneficial to weight loss surgery patients who are at risk of vitamin b deficiency due to compromised nutrient absorption and low dietary intake. A study out of the University of British Columbia identifies Vitamin B deficiency with a simple blood drop test. In a report released today researchers indicate large portions of the population may benefit from this simple test. Below we share the article as published in Medical News Today.

Refresher: The B vitamins are eight water-soluble vitamins that play important roles in cell metabolism. B vitamins are found in all whole, unprocessed foods. B vitamins play a key role in supporting and increasing the rate of metabolism; maintaining healthy skin and muscle tone; enhancing the immune and nervous system; promote cell growth and division; including that of the red blood cells that help prevent anemia; and may reduce the risk of pancreatic cancer.

Read a previously published LivingAfterWLS article detailing each B Vitamin:
LivingAfterWLS Blog: Vitamin B Refresher Course

The B vitamins are: B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6, B7 (biotin), B12, and Folic acid. These vitamins help the process your body uses to get or make energy from the food you eat. They also help form red blood cells. You can get B vitamins from proteins such as fish, poultry, meat, eggs, and dairy products. Leafy green vegetables, beans, and peas also have B vitamins. Many cereals and some breads have added B vitamins. Not getting enough of certain B vitamins can cause diseases. A lack of B12 or B6 can cause anemia. B Vitamins: Wikipedia

Simple new test developed to detect vitamin B12 deficiency

University of British Columbia. "Simple new test developed to detect vitamin B12 deficiency." Medical News Today. MediLexicon, Intl., 29 Oct. 2014. Web.

Nature's Way Vitamin B-100 Complex, 100 Capsules

Researchers at the University of British Columbia have developed a novel method to test for vitamin B12 deficiency that is sensitive enough to work on anyone, including newborn babies and large swaths of the general population.

Vitamin B12 deficiency can be tested with a single drop of blood collected from a finger prick, then blotted and dried overnight on a card consisting of filter paper. The UBC study made dried blood spot card analysis sensitive enough to measure the amount of methylmalonic acid (MMA), an indicator of a person's B12 level.

"This minimally invasive approach helps us measure deficiency in an easier and more convenient way, especially in large samples of people," says study author Yvonne Lamers, a professor in the Faculty of Land and Food Systems and Canada Research Chair in Human Nutrition and Vitamin Metabolism. "Our method is the first to make dried blood spot analysis sensitive enough to test healthy people for B12 deficiency."

The method simplifies blood sample collection for researchers in rural or remote areas where sophisticated lab equipment is unavailable. It's currently being used in a research project in rural Indonesia.

Value Priced eBook: The 5 Day Pouch Test Express Study Guide Just $3.95

The method could also have a significant clinical application. It has the potential to be added to the BC Newborn Screening Program. The program tests for treatable disorders in all infants born in the province. B12 deficiency, if not detected and treated early, can cause delayed brain development, slow learning and digestion problems in babies.

"We are interested in Dr. Lamers' method, which may be sensitive enough to detect and confirm B12 deficiency using the blood spot cards currently collected on B.C. newborns," says Hilary Vallance, director of the BC Newborn Screening Program.

About vitamin B12

Found in meat and dairy products, vitamin B12 is an essential nutrient and is vital for a healthy nervous system. Roughly five per cent of Canadian adults are B12 deficient and 20 per cent show marginal sufficiency, according to Statistics Canada. In developing countries, deficiency is as high as 50 or 80 per cent of the population. Treatment for vitamin B12 deficiency includes injections, supplements, or dietary change.

Get the details: B Vitamin Refresher Course

University of British Columbia. "Simple new test developed to detect vitamin B12 deficiency." Medical News Today. MediLexicon, Intl., 29 Oct. 2014. Web.  29 Oct. 2014.

Saturday, October 25, 2014

WLS High Protein Recipes with Fruits & Veggies

On Friday's LivingAfterWLS Blog we discussed the importance of vegetables in the weight loss surgery diet, as these complex carbohydrates provide nutrients and minerals in support of the high protein weight loss and weight maintenance diet. Including veggies and fruit as part of a diet that involves low-volume capacity (tiny stomach don't ya know?) is challenging. I've pulled some of our top recipes from this blog for you to use in meal planning and as examples to spark ideas for including fruit and veggies on your plate. Take a look at some of these favorites!
"So our task, once we have adjusted to the high protein diet, is to include plant carbohydrates as ingredients in our meal preparations; snacks when appropriate, and side dishes when possible." ~ Kaye Bailey

Holiday Side Dishes:  Check out our Cooking with Kaye newsletter from last November for these terrific Vegetable Side Dishes.  Link to our Archive: Cooking with Kaye

Chicken with Apple Stuffing
Take you boneless skinless chicken breast up a notch with moist and healthy fillings tucked inside the breasts to improve flavor and texture while adding variety to our menus. Give these recipes a try and enjoy your lean clean protein in a whole new way.

Egg-Broccoli Custard Bake
This is intended to be a side-dish for most people. But in our WLS world I think it is a perfect main dish. Protein, dairy and veggies. Not to mention delicious flavor. We added salt and pepper at the table, and my husband gave a few shakes of Tabasco sauce. Delicious recipe - and easy!

Warm Soup: Perfect for Autumn Supper
When post-WLS patients discover soup it often becomes their go-to comfort food. Soup is a very effective tool for calming carb cravings and satisfying our emotional need for comfort with food.

Low-Carb Pumpkin & Sausage Soup
A delicious autumnal soup. Use a butternut squash puree if you prefer. You probably want to hide the leftovers of this soup if you are including it in your pouch test - or your spouse and kids will gobble it up when you are not looking.  (Page 126 of the 5DPT Owner's Manual or online here: 5DPT Recipes).

Chile-Rubbed Grilled Scallop Salad
This recipe, which can be cooked on the outdoor grill, really turns up the heat and the flavor. If you prefer use large shrimp in place of the scallops. Or better ySeared Sea Scallops over Wilted Spinach et, cook both scallops and shrimp for a seafood extravaganza. We found the scallops were just as good the second day, served at room temperature atop the salad.

Baked Tangerine Salmon & Asparagus
Can you think of a better or more delicious spring weeknight meal than Baked Salmon and Asparagus? The health benefits of salmon are well-known: health-wise antioxidants and omega 3 fatty acids delivered in a succulent meaty high protein serving. Salmon is available year round fresh or frozen, sold whole or cut into steaks or fillets. Salmon is also available flash frozen: look for packages with each portion individually wrapped making it easy to thaw and prepare the precise number of servings. On the side serve asparagus, rich in folate, vitamin C, and dietary fiber. Garnish the plate with a delicious slice or two of tangerine. If you find asparagus difficult-to-digest use a potato peeler to remove the tough stringy outer layer and cook only the tender inside of the stalk.
Check out my popular cookbook for more suggestions: Cooking with Kaye on Amazon in hard-cover or eBook for your convenience!!

LivingAfterWLS on Amazon

Friday, October 24, 2014

WLS, Fruits, and Vegetables: Our Healthy Balanced Diet

The 5 Day Pouch Test: Express Study Guide

"Your good health lies at the end of a rainbow of fruits and vegetables. There is an abundant array of colors, shapes, sizes and textures in the fruit and vegetable world. Crunchy apples and celery, creamy bananas and butternut squash, crispy jicama and radishes—an endless variety of produce is out there!" American Heart Association.

After WLS we follow a high protein diet, often forsaking fruits and vegetables for no more reason than practicality - there isn't room in the reduced stomach pouch for fruits and vegetables after we eat our protein course.  In so doing we lose the minerals, phytonutrients, and vitamins plants provide.

So our task, once we have adjusted to the high protein diet, is to include plant carbohydrates as ingredients in our meal preparations; snacks when appropriate, and side dishes when possible.

The American Heart Association, a long time proponent of the well-balanced diet, provides this infographic to guide us in purchasing seasonal fruits and vegetables to benefit our overall health and wellness. (Click the image to get the infographic in printable format directly from AHA).  The following is an article from AHA with more valuable information to include vitamins from fruit and vegetables in our diet:

For a change-up on your egg salad that includes heart healthy vegetables pop over to Bariatric Foodie and try this contest winner: Margaret's Avocado Egg Salad.  It will change your life!


The Natural Beauty of Fruits and Vegetables
Article copyright © 2014 American Heart Association

Your good health lies at the end of a rainbow of fruits and vegetables. There is an abundant array of colors, shapes, sizes and textures in the fruit and vegetable world. Crunchy apples and celery, creamy bananas and butternut squash, crispy jicama and radishes—an endless variety of produce is out there!

And they're so good for us! Fruits and vegetables are high in vitamins, minerals and fiber and low in fat and calories. Eating a variety of fruits and vegetables may help you control your weight and your blood pressure. The American Heart Association recommends eating eight or more fruit and vegetable servings every day. An average adult consuming 2,000 calories daily should aim for 4.5 cups (9 servings) of fruits and vegetables a day.

Choosing Fruit and Vegetables
When shopping for fresh fruits and vegetables, let your senses be your guide. Select those that look fresh and appealing. Leafy greens should be vibrant, with no hints of yellowing or wilting. Root vegetables like carrots, turnips and beets should be hard.

Ripe fruit ought to be plump and wrinkle free. As a general rule, naturally hard fruits and vegetables will keep longer than naturally soft ones.

Use your nose to tell if a pineapple is ripe-there should be a strong sweet smell at its base. A ripe cantaloupe or honeydew will also have a sweet smell at its base and will be slightly soft. Citrus fruits should feel heavy.

Fruits and vegetables that are deeply colored throughout - such as spinach, carrots, peaches and berries - tend to be higher in vitamins and minerals than paler ones, such as potatoes and corn.

Optimize taste and nutrition by buying fresh fruits and vegetables when they're in season. The price will be the lowest then, too. But remember, you can enjoy the taste and nutrition of fruit and veggies any time of year-canned, frozen, dried - it all counts!

Choose canned fruits packed in water, not sugary syrup, and look for canned vegetables without salt. Frozen fruits and veggies should be without added sauces and sweeteners.

Article copyright © 2014 American Heart Association. This recipe is brought to you by the American Heart Association's Simple Cooking with Heart © Program. For more articles and simple, quick and affordable recipes, visit

Thursday, October 23, 2014

Bloglovin: A Great Way to Follow Us!

Are you looking for a way to follow the LivingAfterWLS and catch-up on all the great posts in a quick and efficient manner? Check out our feed on Bloglovin' - the best syndicated blog feed app out there. Here's our page: LivingAfterWLS on Bloglovin

You can view us in your browser or download an app for your computer or device. This is how I keep track of the blogs I follow - cannot live without it! Below is the view of latest LivingAfterWLS Blog posts: 

 Why you don't want to miss a day of the LivingAfterWLS Blog:

On Tuesday we featured a 3-part series about the health benefits of including omega-3 fish in the diet after WLS. For people concerned about nutrient absorption (such as gastric bypass patients) this is must-read information. Take a look:

Consumption of fatty fish may improve patient response to Depression Meds
"It may be quite some time before a definitive study such as this is made of weight loss surgery patients. In the meantime we can actively increase our intake of omega-3 fatty acids by increasing our fish intake. At present the American Heart Association provides approved guidelines and suggestions for including fish in a healthy diet. See this article:  FAQ's: Fish and the Heart Healthy Diet. And check out this recipe: Mediterranean Sea Bass.
This terrific series not only broke the news on this new research, it gave you good 411-Information on how much fish to include in your regular diet and how to do it, with a terrific recipe: Mediterranean Seas Bass.

That's why you need to subscribe and that's what you can expect. The LivingAfterWLS blog is now 10-years old, one of the oldest and most consistent WLS blogs in the Blogsphere. And we intend to keep on providing great information you can use to support your healthiest life after WLS.

While you are checking out Bloglovin on the LivingAfterWLS Blog page click the tab to the right of latest posts that says "Similar Blogs."  Here's what you'll get:

Two of the best known WLS blogs, Eggface and Bariatric Foodie are at the top of the list. Subscribe to them as well and enjoy all your quality WLS reading in one daily feed that you can access by email or by app.  There's a reason they call it Bloglovin!

(This is my own enthusiasm and not a compensated post. I am just thrilled to share this tool with you and hope you find it as useful as I do! Thanks for reading along the last 10 years! Kaye).

One more time: the link to LivingAfterWLS Blog on Blog Lovin'!

Just for fun you can catch my off-the-job blog, Crafting with KeepHer and Kaye at this Bloglovin page: KeepHer & Kaye.

Are you on Bloglovin? Post your Bloglovin address to the comments so KeepHer and I and our terrific LivingAfterWLS readers can join you!  I'd love to see what is happening in your world, WLS related or other! As we always say, we are all in this together!

Tuesday, October 21, 2014

Depression Meds & Fish: Potential to Improve Patient Response

The 5 Day Pouch Test: Express Study Guide

Weight loss surgery patients must always be concerned about dietary nutrition and how our surgically altered digestive systems are responding to and absorbing nutrients, vitamins and minerals, and medications. A new study, though not specific to WLS patients, finds in general people who take antidepressants (SSRI) and regularly include fatty fish in their diet have a better response to the medication than those who eat little or no fish. The findings were shared in a news release October 20, 2014 by European College of Neuropsychopharmacology. The following is an abstract of the study prepared by David McNamee and published on Medical News Today

Could eating more fish make antidepressants work better?

The participants who ate the least fish tended to have the weakest response to antidepressants, whereas patients who had the most fish in their diet had the strongest response.

New research finds that increasing fatty fish intake may be one way to improve the response rate among depressed patients who do not find antidepressants beneficial.

Up to half of patients with depression do not respond to selective serotonin reuptake inhibitor (SSRI) antidepressants.

Previous studies have suggested there may be an underlying genetic reason why up to 42% of cases do not respond to antidepressants. And in 2013, the journal Biological Psychiatry published an online risk calculator that estimated the likelihood of antidepressant response, based on the findings of a large antidepressant trial.

The researchers behind the new study were investigating factors that influence antidepressant non-response when they hit upon an association between improved effectiveness and fish intake. Lead researcher Roel Mocking explains the team's findings:
"We were looking for biological alterations that could explain depression and antidepressant non-response, so we combined two apparently unrelated measures: metabolism of fatty acids and stress hormone regulation. Interestingly, we saw that depressed patients had an altered metabolism of fatty acids, and that this changed metabolism was regulated in a different way by stress hormones."
The patients with depression were then administered a 20 mg dose of an SSRI every day for 6 weeks. Patients who did not respond to the SSRIs were provided with a gradually increased dose of up to 50 mg per day. Non-responding patients tended to have 'abnormal fatty acid metabolism'

Taking measurements of fatty acid and cortisol levels throughout the trial, the researchers found that the depressed patients who did not respond to the antidepressants tended to have abnormal fatty acid metabolism.

American Heart Association Fish Intake FAQ's

Because fatty fish is rich in fatty acids, such as omega-3 DHA, the researchers examined the fish intake in the diet of the participants. They found that the participants who ate the least fish tended to have the weakest response to antidepressants, whereas patients who had the most fish in their diet had the strongest response.

The team reports that participants who ate fatty fish at least once a week had a 75% chance of responding to antidepressants, while participants who never ate fatty fish had only a 23% chance of responding to them. "This means that the alterations in fatty acid metabolism (and their relationship with stress hormone regulation) were associated with future antidepressant response," says Mocking.

McNamee, David. "Could eating more fish make antidepressants work better?." Medical News Today. MediLexicon, Intl., 20 Oct. 2014. Web. 21 Oct. 2014.

It may be quite some time before a definitive study such as this is made of weight loss surgery patients. In the meantime we can actively increase our intake of omega-3 fatty acids by increasing our fish intake. At present the American Heart Association provides approved guidelines and suggestions for including fish in a healthy diet. See this article:  FAQ's: Fish and the Heart Healthy Diet. And check out this recipe: Mediterranean Sea Bass.

FAQ's: Fish and the Heart Healthy Diet

The 5 Day Pouch Test: Express Study Guide

The American Heart Association is a terrific source of dietary information for improved heart health. While keeping in mind the traditionally prescribed high protein diet for weight loss surgery patients we most certainly can benefit from the generalized information from the AHA. Here I've pulled some questions and answers regarding fish intake in the heart healthy diet:
"Enjoy fish baked or grilled, not fried.  Choose low-sodium, low-fat seasonings such as spices, herbs, lemon juice and other flavorings in cooking and at the table." AHA

How often should I eat fish?
The American Heart Association recommends that consumers without documented coronary heart disease (CHD) eat a variety of fish, preferably oily fish (salmon, tuna, mackerel, herring and trout), at least twice a week.

Remember: Two Fish Meals a Week
When we talk about the advantages of eating fish, we’re talking about over the long term – which comes from eating it twice a week," said Alice Lichtenstein, D.Sc., former chair of the American Heart Association's Nutrition Committee. Remember the adage that an apple a day keeps the doctor away? “Eat fish twice a week” isn’t quite as catchy, but Dr. Lichtenstein believes it could have the same effect.“This is not new advice,” she adds. “The problem is people don’t seem to embrace it.” American Heart Association

Try This Recipe: Mediterranean Sea Bass

Are there differences in omega-3 fatty acid content between wild fish and farm-raised fish?
Some farmed fish can have higher levels of omega-3 fatty acid than wild fish, and vice versa.  The omega-3 fatty acid content of wild fish can vary by the temperature of their environment (i.e., higher during the summer than winter), while the omega-3 fatty acid content of farmed fish can vary based on what they are fed.

The American Heart Association recommends eating fish at least twice a week, especially species high in omega-3 fatty acid such as salmon, mackerel, herring and trout, regardless of whether they are wild or farmed.
If I eat fish at least twice a week, should I worry about contamination?
For middle-aged men and for post-menopausal women, the benefits of eating fish a few times per week far outweigh the potential risks.

As fish consumption increases, the number of fatal cardiovascular events decreases and the cardiovascular benefit increases.
Research has shown that omega-3 fatty acids may help decrease the risk of arrhythmias (irregular heartbeats) and may help slow the growth rate of artery-clogging plaque.  Scientific evidence shows that eating fish is associated with reduced cardiovascular risks and increased health.  Based on these benefits, and the fact that most people do not eat recommended amounts of fish, it seems reasonable to recommend that people eat more fish.

Pregnancy: For women who are or may become pregnant, nursing mothers and young children, the benefits of eating fish twice per week are also greater than the potential risks.  However, four specific fish species (shark, swordfish, king mackerel and tilefish) should be avoided to minimize exposure to mercury.  In addition, albacore tuna can be eaten but should be limited to six ounces (one average meal) per week.

The potential risks from other contaminants (such as PCBs or dioxins, which are also found in trace amounts in many foods) are exceedingly small relative to the benefits of eating fish, so you don’t need to be concerned about eating fish because of this potential issue.  (If you eat a lot of sports-caught freshwater fish from local waters, check your local advisories.)  Consumers should remove the skin and surface fat before cooking to reduce the risk of eating contaminants.

Should I take fish oil supplements?
Fish intake has been associated with a lower risk of heart disease.  The American Heart Association recommends that consumers without documented coronary heart disease (CHD) eat a variety of fish, preferably oily fish (salmon, tuna, mackerel, herring and trout), at least twice a week.  Consuming fish oil supplements should only be considered by people with heart disease or high levels of triglycerides who consult with their physicians.

People with documented CHD are advised to consume about 1 gram per day of the fish oils EPA and DHA (eicosapentaenoic and docosahexaenoic acids), preferably from oily fish, although EPA+DHA supplements could be considered in consultation with their physicians.

People who have elevated triglycerides may need two to four grams of EPA and DHA per day provided as capsules under a physician’s care.  Very high intake (greater than three grams of EPA+DHA per day) could theoretically cause excessive bleeding in some people.

For more healthy heart and lifestyle information visit AHA: Getting Healthy

Recipe: Mediterranean Sea Bass

The 5 Day Pouch Test: Express Study Guide

"By all accounts fish is good for us. In fact, the American Heart Association tells us to eat fish twice a week, particularly cold water fatty fish."  (See this post for FAQ's about fish and Omega-3 consumption by the AHA).

Weight loss surgery patients are instructed to eat a diet of rich lean protein cooked without frying or breading. Grilled fish fits that order with ease! And by all accounts fish is good for us. In fact, the American Heart Association tells us to eat fish twice a week, particularly cold water fatty fish. Fatty fish including mackerel, lake trout, herring, sardines, albacore tuna, salmon, and some shellfish are high in two kinds of omega-3 fatty acids. Omega-3 fatty acids are believed to help lower triglycerides and may also fight cancer and reduce inflammation. Additionally fish is rich in B vitamins including B12, Niacin, and B6. It is readily available fresh at the meat counter or flash-frozen in the freezer section of most major supermarkets.

Fish cooks quickly and should be tended closely to avoid overcooking. Fish is done when it turns opaque in the thickest portion and flakes into sections. Scallops, a shellfish, are done when they are opaque and another shellfish, shrimp, are done when they turn pink. When cooking over the direct heat of the grill turn steaks, whole fish, shrimp and scallops halfway through grilling time. Avoid moving the fish protein too much on the grill because it tends to break-up. Thin fillets generally do not need to be turned. Some frequent fish grillers find baskets made specifically to hold fish on the grill are useful.

Try this simple flavorful recipe for grilled fish and I think you will be hooked!

Mediterranean Sea Bass

This Provence-style recipe infuses the clean flavor of olive oil with fresh herbs and garlic for a light and flavorful lean protein main dish. Keep it simple and enjoy. (Suitable fish substitutes: red snapper, striped bass, halibut.)

For the paste:
3 tablespoons extra-virgin olive oil
1 tablespoon finely chopped fresh basil
1 tablespoon finely chopped fresh thyme
2 teaspoons dried lavender
1 teaspoon minced garlic
1/2 teaspoon kosher salt
1/4 teaspoon freshly ground black pepper

4 skinless Chilean sea bass fillets, about 6 ounces each and 1 inch thick
Lemon or lime wedges (optional)

To make the paste: In a small bowl whisk together the paste ingredients. Spread the paste evenly on both sides of the fish fillets. Grill over Direct High heat until the flesh is opaque throughout and starting to flake, 5 to 7 minutes, turning once halfway through grilling time. Serve warm and garnish with lemon wedges, if desired.

Kaye Bailey (c) - All Rights Reserved
Article Source:  Make Grilled Fish a Healthy Part of Your Weight Loss Surgery Diet

Monday, October 20, 2014

Weight Regain: A fact, not a moral failure

The 5 Day Pouch Test: Express Study Guide

"A person is not good if they lose weight and bad if they gain weight. Gained weight is a symptom of the metabolic disorder called obesity. When weight is lost and managed the disease is in remission; when weight gain occurs the disease is in relapse." Kaye Bailey
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Lately the bulk of the email I have received is about weight regain: from people who have put on weight after losing it with surgery and people who are afraid they will gain weight after working so hard to lose it. As I think about it I have never met a WLS patient who is not concerned about the weight coming back. When you think about it, it makes sense. By the time we are morbidly obese we have probably lost and gained the same pounds many times over. We live in a world where being overweight and staying overweight is easy -- Losing weight is the opposite. Losing weight and keeping it off is akin to swimming upstream in a swift current.

There are a few things I hope you will remember about weight regain which may help you face it rationally with kind and gentle compassion:

Weight regain is not a moral issue. A person is not good if they lose weight and bad if they gain weight. Gained weight is a symptom of the metabolic disorder called obesity. When weight is lost and managed the disease is in remission; when weight gain occurs the disease is in relapse. Managing the disease is our responsibility and we are served well when seeking the support of others including our bariatric team, friends, family and WLS community. (Read: Four Truths About Weight Gain After WLS)

Knowledge is power. Not long ago I heard a bariatric surgeon say that patients regain weight because they were not fully educated before surgery. The fact is, life after surgery is quite overwhelming. I'm positive I retained only scant bits of information taught during my pre-op and early post-op recovery. What I know now is the pursuit of new information day in and day out is mandatory if I'm going to stay focused and enthused about weight management. The best place to learn about life after WLS is from other patients who are doing their best -- just like you -- to make this weight management experience healthy and effective.

It is never too late. If we have allowed our health problem to become a moral problem it is easy to suffer feelings of hopelessness. But it is never too late to make little changes which bring about a big difference in our life. Each new day, each new meal, each new step we take is an opportunity to nurture our body and being. It is never too late.

Last week's LivingAfterWLS Digest offered several resources addressing the topic of weight regain after surgery. Take a moment to find something meaningful to you, and pass the word on to a friend who may be feeling down and discouraged. Remember, we are all in this together!

And while you're in the retrospective mode please consider taking a moment to complete our LivingAfterWLS Personal Self-Assessment. This is a proven tool to help you stay on track with weight loss surgery. 

Express Study: Don't Leave Your 5DPT to Chance!

The 5 Day Pouch Test: Express Study Guide

Free Kindle Reader App for all computers and devices makes this $3.95 Guide a top bargain. Get the 5DPT plan and take it anywhere.
Are you starting the 5 Day Pouch Test today with only a little knowledge of the plan? Don't just wing it! Get our low-cost Express Study Guide eBook on Kindle and do the plan the right way! Get the best results possible for your effort. Learn more:

5 Day Pouch Test Owner’s Express Study Guide eBook, available exclusively through Amazon Kindle. This quick study provides the basics of the 5 Day Pouch Test plan to get you back on track with your weight loss or weight maintenance goals with weight loss surgery. What’s in it: The Express Study Guide includes the plan summary broken down by day; 32 Frequently Asked Questions and Answers about the plan; and 10 sample recipes to get you started.

Who it’s for: The 5 Day Pouch Test Express Study Guide is for those who want to learn a little more about the plan without investing in the manual; for people anxious to do the 5DPT and want a quick overview; for those who know the plan and have used it successfully who want a quick reference at their fingertips; and for people who want to succeed long term with their weight loss surgery tool.

The 5 Day Pouch Test: Express Study Guide

Thursday, October 16, 2014

Trick or Treat, Sugar is Sweet, But what about my WLS?

FAQ's on Sugar

by Kaye Bailey
There is so much confusing and conflicting data available about the health benefits or damages of sugar. Let's take a look at some of the most commonly asked questions about sugar and try to answer them reasonably without the hype or fear mongering that is commonly associated with foods of questionable nutritional value. Taking the best information we have available and using our personal experience I believe we can make the best food decisions for ourselves -- and save the drama for another topic.

Is Sugar Addictive?

Sugar taps into a powerful human preference for sweet taste, says Marcia Pelchat, PhD, a scientist at the Monell Chemical Senses Center, a basic research institute in Philadelphia.  "We're born to like sugar," she says. Scientists aren't sure if people can become physically dependent on sugar, although some animal studies suggest that such a thing is possible, she says. "There are the same kinds of changes in brain dopamine, in these animals given intermittent access to sugar, as in drug addicts."

Are some type of sugar better than others?

Celebrities and high-profile chefs have touted the benefits of replacing refined white sugar with purportedly more natural, healthier sugars, such as honey, maple syrup, or molasses. But, according to Rachel K. Johnson, RD, MPH, PhD, a professor of nutrition at the University of Vermont and a spokeswoman for the American Heart Association (AHA) there's no truth to these common misconceptions,  "In terms of something being inherently better about those sweeteners as opposed to table sugar or sucrose -- no." The bottom line: All are simple sugars. "A calorie of sugar is a calorie of sugar, so whether you're getting it from white sugar or some other type of sweetener, you're still adding empty calories to your diet," Johnson says. 

However, there may be one redeeming quality, she says. "Some of those sweeteners -- like maple syrup, molasses, honey -- may have a stronger taste, so you might be able to get the sweetness that you want with less of it, using less calories."

Does sugar cause weight gain?

Several current studies suggest a relationship between sugar intake and weight gain. What the studies do not determine is if the sugar causes the weight gain or the extra calories sugary foods provide that cause the weight gain. Seems like a moot point to me. As people with obesity - in whatever stage we are in - we know what foods we ate that contributed to our personal weight gain. For me sweets and pasta were dietary staples at the height of my morbid obesity. What was on your menu when your disease was at its worst? I suspect we all blame our "sweet tooth" for a certain amount of weight gain. Studies on infants confirm that it is human nature to prefer sweets over foods like vegetables which are an acquired taste. According to registered dietician, Kathleen M. Zelman, "We love sweets because they not only taste good, but make us feel good. Consuming simple carbohydrates (like sweets) boosts the brain chemical serotonin, which can help improve mood. Stress reduces serotonin levels, which may help explain why some people reach for sweets when they're feeling stressed."

Simple Ways to Cut Sugar Calories

According to Zelman, the bottom line is that if you want to control calories, you should limit added sugars of all kinds, including high-fructose corn syrup. She suggests five simple ways to cut back on sugar calories:

  •     Drink fewer sweetened soft drinks.
  •     Satisfy your sweet tooth with naturally sweet fruits, fresh or canned in fruit juice.
  •     Buy only 100% fruit juice that is not sweetened.
  •     Instead of sweetened beverages, enjoy sparkling water with lime and/or a splash of fruit juice.
  •     Choose unsweetened, whole-grain cereals and cereal bar
WLS Patients: Sugar and Dumping Syndrome 

Artificial Sweeteners: What you need to know today!

The 5 Day Pouch Test: Express Study Guide

With Halloween just around the corner and the feasting holidays coming right behind now is a good time to look at sugar, artificial sweeteners and the role they play in our weight loss surgery diets. I am always nervous about the "sugar" issue because if there is one thing health conscious people have strong opinions about it is sweet foods and how they get to be sweet. There is so much information (and mis-information) about sweets in the American diet that we can find "studies" or "proof" to support just about any position we want to take. Today let's look at what the American Diabetes Association says about artificial sweeteners:

Artificial Sweeteners
Artificial SweetenersPublished with permission from American Diabetes Association
Are you struggling to control your sweet tooth?

When you have diabetes, including sweets in your diet requires careful planning. However, it can be hard to just save sweets for special occasions.

Curb Your Cravings
Foods and drinks that use artificial sweeteners are another option that may help curb your cravings for something sweet.

Sometimes artificial sweeteners are also called low-calorie sweeteners, sugar substitutes, or non-nutritive sweeteners. They can be used to sweeten food and drinks for less calories and carbohydrate when they replace sugar.

However, many foods containing artificial sweeteners still have calories and carbs, so be sure to check the nutrition facts label.

Their sweetening power is at least 100 times more intense than regular sugar, so only a small amount is needed when you use these sugar substitutes.

Also, with the exception of aspartame, all of the sweeteners listed below cannot be broken down by the body. They pass through our systems without being digested so they provide no extra calories.

FDA Approved
There are five artificial sweeteners that have been tested and approved by the U.S. Food and Drug Administration (FDA):
  • acesulfame potassium (Brand Names: Sunett, Sweet One)
  • aspartame (Brand Names: Nutrasweet, Equal)
  • saccharin (Brand Names: Sweet 'N Low, Sweet Twin, Sugar Twin:
  • sucralose (Brand Name: Splenda)
  • neotame (Brand Names: Best of All, A Sweet Leaf, Sun Crystals, Steviva, Truvia, PureVia)

These sweeteners are used by food companies to make diet drinks, baked goods, frozen desserts, candy, light yogurt, and chewing gum. You can buy them to use as table top sweeteners. Add them to coffee, tea, or sprinkle them on top of fruit. Some are also available in "granular" versions which can be used in cooking and baking.

What's The Deal With Stevia?
Stevia (sometimes called Rebaudioside A or rebiana) is now generally recognized as safe (GRAS) by the FDA as a food additive and table top sweetener. When something is generally recognized as safe by the FDA, it means that experts have agreed that it is safe for use by the public in appropriate amounts.

Stevia is several hundred times sweeter than sugar. It comes from the sweetest part of the stevia plant and is an ingredient in many foods that you can buy at the store.
Sugar Substitutes in the Store.

Wednesday, October 15, 2014

Are you due for a Post-WLS Check-up? Use this tool!

The 5 Day Pouch Test: Express Study Guide

The LivingAfterWLS Self-Assessment is a proven tool to enhance and motivate your ongoing efforts with WLS.
The LivingAfterWLS “Quarterly Personal Self-Assessment” tool is a worksheet of questions we can ask ourselves in a sincere effort to assess our present state and make an action plan for the next three months. This worksheet should be used as a private tool with the intent to keep your eye on the goal. It is a contract with yourself; a contract of honor and self-respect because you deserve to treat yourself well and engage in appropriate long-term behaviors in pursuit of your healthiest life. Please accept this invitation to join me in the Quarterly Personal Self-Assessment. Take some quiet time to evaluate where you are and where you are going. Put your WLS goal back in sight. Pre-ops, Newbies and Old-timers can all use this tool. You can do this.

First Step in Self-Compassion: The Self-Assessment Worksheet

Download Free LivingAfterWLS Self-Assessment

In our LivingAfterWLS Weekly Digest delivered yesterday to your email Inbox and available HERE in our archives we encouraged our community members to take some time to exercise self-compassion as a positive step toward improving our health and weight loss surgery experience. As part of your self-compassion we invited you to download and complete our LivingAfterWLS Self-Assessment worksheet. Stats from the  newsletter show that many of you clicked the link to the download worksheet! This is exciting because we know that the LivingAfterWLS Self-Assessment is a proven tool to enhance and motivate your ongoing efforts with WLS. It has been part of the LivingAfterWLS curriculum for over eight years and still one of our most requested documents.

Use this tool to recall your original goals, find out where you are today, and map a plan for the future. Do this every three months, make a date with yourself to pause and reflect. When you know where you come from and where you are, then defining where you want to go is invigorating.

You can find this worksheet and more free downloads on our website:
LivingAfterWLS Downloads  and also on our Project 2014 webpage.

Tuesday, October 14, 2014

The Carb Monster has a hold of me - HELP!

The 5 Day Pouch Test: Express Study Guide

Why can't I just quit carbs cold turkey?

And why does the 5DPT help me quit carbs?

This article excerpted with permission from the 5 Day Pouch Test Bulletin January 2014.

Have you ever had a particularly bad snacking day only to find yourself the next morning promising to give-up snacky-carbs for good, cold turkey, right now. And by noon that will-power is forgotten as you reach for the snack of choice. And then the self-blame begins: "Why am so weak? Why am I a failure? Why don't I have will-power?"  I've lived this scenario more times than I care to admit and I know I'm not alone.

But it turns out we aren't just a bunch of weak-bellied carb-addicts. There is a biological reason that motivates the reach for the snack: our body has become accustomed to digesting and using processed carbs as it's primary source of fuel. Withdrawing them cold turkey puts the metabolic process in panic and serotonin levels drop. "You may be powerless to resist baked goods, pasta, and their carb cousins," according to Wurtman and Marquis in "The Serotonin Power Diet. "The reason for this specific, very tough-to-ignore craving for carbohydrates is that your brain is forcing you to yearn for them so that it can produce serotonin."

With the 5 Day Pouch Test we methodically transition from fatty non-nutritional processed carbs to healthy complex carbohydrates found in grains, vegetables, and fruits. The body still produces serotonin from these carbs while benefiting from the healthy nutrients and fiber missing from processed carbs. While some cravings for carbs are experienced the biological trauma is not as severe as when processed carbs are withdrawn cold turkey without providing a similar replacement fuel.

Below, from the 5 Day Pouch Test Owner's Manual page 49:

Carbohydrate withdrawal:
When any heavily consumed food is withdrawn from the diet the body is likely to experience symptoms of withdrawal that may include headache, dizziness, cramping, and nausea. This is not unique to our WLS body; this is a simple fact of biology.  On the 5DPT when processed carbs are withdrawn many people report symptoms of "carbohydrate withdrawal." Do not suffer through this.  If you notice symptoms of carbohydrate withdrawal eat a small piece of melon, some berries, an apple or an orange. Any low-glycemic fruit or vegetable will reduce the symptoms of carbohydrate withdrawal.

You may also try a serving of Emergen-C® energy booster fizzy drink mix, which is known to reduce the symptoms and discomfort of carbohydrate withdrawal. In addition, Emergen-C® provides B vitamins for energy and C vitamins for immunity along with many other vitamins and minerals. You can count a serving of Emergen-C® as part of your daily intake of water. Do not be put off by the 5 or 6 grams carbohydrate per serving: these are beneficial nutrient dense big-bang-for-your-buck carbs. Enjoy!
For nausea, try sipping freshly brewed warm green tea or ginger herbal tea. You can add fresh ginger juice to further ease the symptoms of stomach distress and nausea. If you made the Fennel & Celery Soup (page 36) for a grumpy pouch and have some left then enjoy a 1-cup serving of this soup. It is a known remedy to digestive discomfort and distress resulting from dietary change.

Helpful Article:
Nearly a quarter-million people in the United States will undergo weight loss surgery this year to arrest their morbid obesity and lose weight. In spite of the drastic nature of gastric surgeries not all patients will reach a healthy weight and some may eventually regain weight they lost initially with surgery. Link to Article


You deserve to be your very best:
Obesity be damned for getting in the way!
This article excerpted with permission from the 5 Day Pouch Test Bulletin January 2014.