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Tips to reduce and maintain healthy weight Do not skip meals Eat balanced diet. Include cereals , pulses, green leafy vegetables, other vegetables, moderate vegetable oil(un saturated), fruits, restricted sugar, skimmed milk and its products daily in proper quantities to meet the requirements of carbohydrates, protein, fat, vitamins, minerals and fibre by the body. Calorie reduction is the most important requirement for weight loss. Cut down of 100 calories per day leads to 4.5kg weight reduction per year.The total calories from food should be 25-30% from fat in the form of unsaturated fat, 15% from protein and 50-60% from carbohydrates in the form of complex carbohydrates like wholegrains, vegetables and fruits.Reduction of 500calories from Basal energy expenditure helps to reduce 9 kg weight per year. Go for whole cereals and pulses like wheat, ragi, jowar, millets rather than refined ones like maida and its products like bread, biscuits, refined noodles, pastries etc Don’t be over restrictive like avoiding one or two meals and replacing it with fruits or juices. Regular physical exercise(brisk walking for 45 minutes for 5 to 7 days a week) Physical activity contributes to weight loss, decreases abdominal fat, increases cardio respiratory fitness. Exercises like aerobic exercise, swimming, bicycling, jogging, dancing leads to these benefits. Brisk walking is one of the easiest ways applicable to almost all age groups. Weight lifting can also be helpful to loose weight. You should be more active everyday by doing routine work like climbing up stairs rather than taking elevator or walking somewhere rather than driving , engage yourself in gardening, household work rather than using electronic gadgets and this can help you to burn calories without much difficulty. Watch your food portion size Inclusion of liberal amount of fresh vegetables and fruits reduces hunger pans, maintains your blood sugar and prevent constipation because of its fibre content and it is abundant in phytochemicals , antioxidants which prevent against cancer Try to include fruits with skin because deskinning removes fibre. No fat or low fat dairy and its products can be used. Drink liberal amounts of water frequently like one glass of water once in two hours intervals. Get rid of deep fried items and calorie dense foods. Avoid fatty items like mutton, beef, pork, crab, prawns. Include fish or fish oil , soya and its products weekly twice because of its omega3fatty acid content. Eggwhite can be taken daily. Healios Obesity and Diabetes Center Nutritive sweeteners: White and brown table sugars, molasses, honey, syrups are nutritive sweeteners.In addition sugar alcohols derived from fruits (or) commercially made are also nutritive sweeteners.The most common sugar alcohols include sorbitol, mannitol, xylitol and maltitol.All nutritive Sweeteners provide calories to the body and may affect your blood glucose. Non nutritive sweeteners are the true artificial sweeteners. They do not provide calories and will not influence blood glucose. These include Saccharin, Neotame, Aspartame, Sucralose, Stevia Acesulfame Potassium(Ace-k)
3“H”s to Delay and Prevent Diabetic Retinopathy Patients with diabetes are high risk of micro and macrovascular complications.Diabetic retinopathy is one of the microvascular complications of diabetes which can lead to blindness. Many diabetics are unaware of the 3 “H”s which are very important in the prognosis of patients with diabetes in terms of their risk of developing or progression of diabetic retinopathy. 3 H's are hyperglycemia, hypertension and hyperlipidemia. Hemoglobin A1c indicates average blood sugar levels for 3 months. We come across many patients who have never heard of it. Diabetes Control and Complications Trial study was conducted for 10 years from 1983 to 1993 in patients with type 1 diabetes.There were 1400 patients in this study. This study compared intensive control versus what was considered conventional therapy for diabetes at that time.They then looked at the decrease in the hemoglobin A1c levels in both the groups and its effects on systemic complications. Those who had intensive control had hemoglobin A1c's of about 7 and those who had conventional management had hemoglobin A1c’s about 9.It was observed that patients who had intensive control of there diabetes had a 76% reduction of the onset of diabetic retinopathy over 10 years. Hypertension is an independent risk factor for the progression of diabetic retinopathy.It is observed from studies that a 10 mmHg decrease in the systolic blood pressure and 5mmHg decrease diastolic blood pressure , there was 34% reduction in the progression of diabetic retinopathy just by getting the blood pressure under tighter control. The third important H is hyperlipidemia (hypercholesterolemia).Patients who have high cholesterol are more likely to get retinal exudates and in turn are more likely to lose vision. Exudates increase the chance of vision loss in patients who have hypercholesterolemia versus in those who do not. It is now proved beyond doubt that Bariatric and Metabolic Surgeries like Laparoscopic Roux-en-Y Gastric bypass helps in the remission of diabetes, hypertension and hypercholesterolemia.It thus halts the progression or reverses many micro and macrovascular complications of diabetes like diabetic retinopathy.
Post Bariatric surgery TIP 11 Why am I not enjoying Spices in my Food After weight loss surgery, there are some important lifestyle changes that you are recommended to do for the surgery to be a success. Diet is one of the major changes that you do. Questions about how much and what to eat are on top of your mind then. Spices are an integral part of Indian cooking. Be it pepper or garam masala, you would like to know if you can eat them. Although spices are not heavy in fat or sugar, it is observed that many people are not able to enjoy their spicy food the same way as before the obesity surgery/ bariatric surgery. Spices are considered an irritant, and after weight loss surgery, your stomach becomes a lot more sensitive than before the surgery. After surgery, during the time of healing, exposure to spices like pepper, chilli powder, paparika can cause a lot of indigestion and pressure on the stomach. This can cause a lot of discomfort during the healing process. So when your surgeon advices you the avoid spices, it is advantageous to follow. Although the reaction to spices varies from person to person, the conclusion observed is, that in the long run, love for spicy food is not worth the suffering it gives you. Still if your craving for spicy food persists consult your nutritionist to find out ways to use stomach friendly ingredients that enhances flavor without the spiciness.
Fecal Transplant can Improve Insulin Sensitivity in Type 2 Diabetes Crosstalk between organs is important for controlling energy balance, glucose metabolism and immunity.Obesity and type 2 diabetes, are characterized by a loss of or excessive inter-organ communication that contributes to the development of disease. Recently, several mechanisms linking the gut microbiota with the development of obesity and associated disorders (e.g. insulin resistance, type 2 diabetes, hepatic steatosis) have been identified. Among these, the concept of metabolic endotoxaemia (increase in plasma lipopolysaccharide levels) is believed as atriggering factor leading to the development of metabolic inflammation and insulin resistance. Researchers have reported transient improvement in insulin sensitivity among patients with Type 2 Diabetes and Obesity by Fecal microbiota transplant (FMT) from a lean donor. They were able to predict the response of fecal microbiota transplant based on a baseline fecal sample.This baseline fecal sample examination gives an idea about who will respond to lean-donor FMT and who will not. Dr. Nieuwdorp and colleagues showed in an earlier pilot study that lean-donor FMT into obese males with metabolic syndrome was associated with improved glucose metabolism and alterations in intestinal microbiota composition. This time, they investigated the short- and long-term effect of lean-donor FMT on gut microbiota composition and its relationship with insulin resistance in a larger group of 38 obese men with metabolic syndrome. From baseline to 6 weeks after lean-donor FMT, peripheral insulin sensitivity had improved from 25.8 to 28.8 micromoles/kg/min. Hemoglobin A1c also decreased slightly in the lean-donor FMT group, but other metabolic parameters were not affected. By 18 weeks, neither single nor repeated lean-donor FMT had significantly affected hepatic or peripheral insulin sensitivity. Lean-donor FMT was associated with significant increases in fecal acetate levels, which are inversely related to insulin resistance in humans. Obese diabetic patients who responded by showing increased insulin sensitivity had lower initial fecal microbiota diversity, along with higher abundance of Subdoligranulumvariabile and Dorealongicatena - and lower abundance of Eubacteriumventriosum and Ruminococcus torques in baseline fecal samples, compared with nonresponders. The most important implication from the study is that human insulin sensitivity can be affected through the gut microbiome and it is possible that lifestyle modification in addition to FMT could sustain the microbiome acquired from lean donors for longer and actually lead to clinically significant changes in diabetes measures. But, patients may misinterpret these results and think that the study shows that an FMT can help with their diabetes. In fact, that study shows that performing FMT on patients with diabetes had limited and transient benefits and hence not worth the risks. The only proved option available for the resolution of Type 2 diabetes Mellitus associated with Obesity is Bariatric and Metabolic surgery. It has been proved without doubt that the effects of this miracle surgery is long lasting.
CARDIOLOGY ASSESSMENT: An accurate assessment of your health is needed before surgery. The best way to avoid complications is to understand their potential in the first place. It is important to know because surgery increases cardiac stress, your heart will be thoroughly evaluated with: ECG: as apart of routine pre-operative investigation it is necessary for all cardio and non-cardiopathic patients. 2D Echo: Morbidly obese patients are at risk of cardiovascular events and their optimal assessment before surgery is necessary. A transthoracic echocardiography was routinely performed in non-cardiopathic patients to rule out cardiovascular risk Two-Dimensional Echocardiogram (2D Echo) is a test in which ultrasound is used to picture out the heart. It is capable of displaying a cross sectional “slice” of the beating heart, including the chambers, valves and the major blood vessels that exit from the left and right part of the heart. TMT(STRESS TEST): The TMT involves exercising on a treadmill while you are closely monitored. The test is used to: Determine your likelihood of having coronary artery disease Identify abnormal heart rhythms Evaluate the effectiveness of your cardiac treatment plan Help you develop a safe exercise program
Abdominoplasty is a commonly performed body-contouring procedure to improve the shape and tone of your abdomen. This operation is often referred to as a ‘tummy tuck’. The operation is suitable for people with loose abdominal skin following pregnancy or significant weight loss, or if you have fatty bulges in the lower tummy that you just can’t get rid of with exercise. An abdominoplasty removes any excess skin and fat as well as improving the abdominal contour by tightening the muscle layer. Liposuction is often performed at the same time to optimise the result. The surgery results in a firmer abdomen with a more flattering contour. It is not a weight loss surgery (Bariatric Surgery). PRE OPERATIVE ASSESSMENT It is important for you to tell your surgeon the specific areas that concern you. These may include loose skin, stretch marks, fatty bulges, loose abdominal wall muscle tone and also other medical problems which can affect wound healing, such as smoking and diabetes, as well as risk factors for deep venous thrombosis (DVT or leg vein clots). People contemplating future pregnancies or significant weight loss are best to defer surgery. The expected scars, as well as the other risks of the operation will be explained. THE SURGERY Abdominoplasty is performed under a general anaesthesia. The surgical scar is at the lower most part of the abdomen thus hiding the scar. There are many variations on the procedure ranging from a mini-abdominoplasty with laparoscopic abdominal wall tightening to a full abdominoplasty involving removal of excess skin and fat, tightening of the abdominal wall muscles and repositioning of the umbilicus (belly button). AFTER THE SURGERY After the operation your abdomen or stomach will feel very tight and you may have a slightly flexed posture for a couple of weeks. This means you will be slightly bent over, not able to stand up completely straight. Most patients stay in Hospital for 2-4 days. Recovery times vary with most people being able to return to work in two to four weeks, with no sport or heavy lifting for 6-8 weeks.
ABOUT PILATES Untitled-31 Pilates is a rigorous form of exercise which emphasizes core strength and improvement in posture. During the Bariatric surgery journey, it is important to take up a form of exercise that you feel committed and passionate about. When you’ve lost sufficient weight after bariatric surgery, more intense exercise such as Pilates will be easier for you to try. Pilates is an excellent form of physical fitness to help keep you in shape for long term weight loss surgery results. Benefits of Pilates post Bariatric surgery include: Strengthen your back and abdominal muscles Improve your alignment and posture Develop muscle balance to help prevent injuries Increase your flexibility Improve your circulation Develop a long, lean and strong body Enjoy more energy ITS NOT JUST A EXERCISE PROGRAM, ITS AN EDUCATION. We just don’t exercise you, we educate you about your own body. Many conditions are managed by educating the patient about posture or ways to reduce strain on the body. Particularly relevant with work related problems. Our physiotherapists are experts in prescribing the right exercises to resolve various problems. eg : low back pain, early arthritis, etc DO NOT PUNISH YOURSELF AT GYM Most of the people fight their bodies at gym after weight loss surgery or any other surgery, but gym is not the right place for you. You need an medical expert to guide.
Post Bariatric Surgery TIP 3 Know why protein rich food is important after undergoing a Bariatric Surgery. Body needs protein to build and maintain tissue and muscles. It promotes metabolic activity which in turn burns fat. It is also needed to heal wounds. Eating protein-rich foods first at every meal promotes healing from your surgery and to help you maintain lean muscle as you lose weight. So it is advised to intake protein rich food after Bariatric surgery. Ideally it is best if cooked using low-fat cooking methods. Choose lean protein like skinless chicken. Recommended protein intake is 60-65 gms of protein each day. But sometimes, it is difficult to get that amount through diet only. It can be compensated by protein drinks. But keep in mind, the extent of food your pouch can handle.
Bariatric surgery reduces the risk for Microvascular complications, and its even more effective in people with PreDiabetes. After 15 years of follow-up, bariatric surgery was associated with reduced reporting of microvascular complications in people suffering from diabetes, prediabetes, and normal glycemia prior to surgery. It was found to be most effective in the prediabetes group "I think the most important finding is that prediabetes is a condition that should be treated more aggressively than what we do today to prevent microvascular complications and that metabolic / bariatric surgery is an effective treatment in this group of patients, " said lead author Lena MS Carlsson, MD, PhD, professor of clinical metabolic research at Sahlgrenska Academy, University of Gothenburg, Sweden.