SATURDAY PATIENT SUPPORT GROUP

By admin on March 26, 2009 at 9:25 am

A Message from Sandy Fitch ( one of our patients):

Hey folks-
Please come to the Monthly Support Group
Coffee at Bayleys Rest:
28 MARCH 2009 at 9 AM-
109 W Harwood Rd, Hurst, Texas 76054- 817-268-5779.

Please come to share, get encouragement and plain ole Fun
and visitin’. Bring your old pictures to share.
If you know of someone who does not belong to a group and needs support –bring um on, this group is for everyone, no matter what kind of surgery you have had or where or when you had your surgery.

Posted in Support Groups, Uncategorized

Observations of a Weight Loss Physician Assistant and Dietitian

By admin on March 23, 2009 at 2:12 pm

I have been fortunate to assist Dr. Kim for the past 8 months and I have been doing lap band fills for a little over a year now. I have also been a nutritionist for the past 9 years. I have noticed some things that I want to share.

1. A really tight band does not equal greater weight loss, it usually means more problems.
2. If you can’t eat solid, hard to digest foods, your band is too tight.
3. If you think how tight the band is, or the “restriction” it gives you will help you make healthy food choices, think again.
4. Soups and salads use to be diet foods, but are not band friendly.
5. Eat meat or other protein, dairy, veggies, fruits and then grains and in that order to plan your meals.
6. Chips, cookies, high calorie liquids and other fun foods always go down.
7. There are four parts to successful “banded” weight loss: 25% exercise, 25% nutrition, 25% behavior medication and 25% proper band tightness. Three of those, or 75%, is all about you and 25% is the band. In other words believe more in yourself, than you believe in the band.
8. The band was invented to reduce appetite and restrict portion sizes of healthful foods. Changing your eating habits and fitness is still your responsibility.
9. Being “banded”, having a bypass or gastric sleeve are all equally effective, with different rates of weight loss. Each of the surgeries depends on you to make them work.
10. That little voice inside your head telling you that you can’t, needs to be strangled.
11. Always fidget and dance, or whatever keeps you moving.
12. Exercise might not be fun or a part of your lifestyle, but…………….
13. If you restrict your calories, your body will lower your metabolism, your only defense is exercise.
14. Losing weight by yourself is like to building your own rocket to fly to the moon, you need more help than you are willing to admit. Make sure you have a support group.
15. Patience is the missing ingredient in any weight loss program. Progressive slow weight loss is how the band works best.
16. Mr. Spock on Star Trek was thin because he had no emotions
17. As you get smaller, you need fewer calories and will depend more on exercise to maintain your weight, which means you still have to figure out how to enjoy number 12 and 13.
18. Appetite and hunger are difficult to understand, have you figured out the difference?
19. Exercise is……ok I’ll stop already, refer to 12, 13 and 17
20. Last, but not least, tell yourself that you are confident, effective and motivated thousands of times per day, because the average number of times a day a person alludes to pending weight loss failure is often much greater.

David Kellenberger, MPAS, RD, PA-C

Metabolic and Bariatric Surgery
Nutrition and Dietetics

Posted in Ask the dietitian

Sample Meal Plans

By admin on March 13, 2009 at 2:13 pm

Menu Planning with Exchange Lists

Well balanced meal planning is often a difficult task. As you may know, most Americans do not eat at least 5 servings of fruits and veggies each day. We often think of fried foods, burgers and fries, lasagna, spaghetti and meatballs, sandwiches and other staple American foods as “the only things I know to eat”. The meal plans below point out a way to plan meals based on the “Exchange Lists for Weight Management” produced by the American Diabetes Association and American Dietetic Association.

People often want to be told what to eat, but inevitable go back to eating what they are familiar with, tastes good and is convenient. So instead of giving you a fish, I will attempt to teach you how to fish, by sharing with you a basic method for determining what is in the foods you eat. It always helps to use foods labels or count Weight Watcher® points, but you can also use exchange list too. Exchange lists are helpful because you can exchange any food within a category for another and it will have the same nutrient composition. For example, a small apple will have the same calories, protein, and fat as let’s say 17 grapes, 4 fresh apricots or a small banana. So here is the formula and some sample menus. For a full reference please visit: http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/fd_exch.htm

Exchange List based on the American Dietetic and Diabetes Associations

Starch = 80 calories, 3g protein, 1 gram fat, 15grams carbs, look for starches
with more than 3-5g of fiber per serving
½ cup of cooked cereal, grain, or starchy veggie such as corn and peas
1/3 cup of cooked rice or pasta
1 ounce of bread or 1 slice
1 ounce of snack foods (may also be fatty)

Fruit = 60 calories, fiber and protein varies
1 small fruit
½ cup canned or fresh fruit unsweetened
¼ cup of dried fruit

1 Cup Fat free/low fat milk = 90 calories, 8grams protein, 0-3grams fat, 12grams carbs
1 Cup Reduced fat 2% milk = 120 calories, 8grams protein, 5grams fat and 12 grams carbs
1 Cup Whole milk = 150 calories, 8grams protein, 8grams of fat and 12 grams of carbs

Nonstarchy veggies = 25 calories, 2grams of protein and 5 carbs
½ cup cooked
1 cup raw

1 ounce Very Lean Meat = 35 calories, 7grams protein and 0-1gram of fat
1 ounce Lean Meat = 55 calories, 7grams protein and 3grams of fat
1 ounce Medium Fat Meat = 75 calories, 7grams protein and 5 grams of fat
1 ounce High Fat Meat = 100 calories, 7grams protein and 8grams fat

Fats = 45 calories and 5grams of fat
1 teaspoon of regular margarine or veggie oil
1 tablespoon of regular salad dressing

Sample Meal Plans

Now that you have the exchange list in mind, you can substitute any foods you like in the menus below. If you don’t want an egg, then eat an ounce of turkey breast slices. The calories really never change as long as you exchange foods within the same category.

800 Calories:
Starch 2 (160) Dairy 3 (240) Protein 5 (175) Veggie 3 (75) Fruit 2 (120) Fat 2 (90)
About 55-65 grams of protein
Breakfast: 1 protein 1 egg
1 dairy ½ cup cottage cheese
1 fat 1 tsp of margarine

Lunch: 2 protein 2 ounce of turkey lunch meat
1 dairy 1 yogurt
1 veggie 1 cup raw, ½ cup cooked carrots
1 fruit 4 apricots
1 starch 1 ounce of whole grain crackers

Dinner: 2 protein 2 ounces of fish
1 dairy 1 ounce reduced fat cheese
2 veggie 1 cup sautéed zucchini
1 fruit 1 small apple
1 starch 1 small baked sweet potato
1 fat 1 tsp of margarine

1200-1400 Calories:
Starch 4 (320) Dairy 3 (240) Protein 6 (210) Veggie 3 (75) Fruit 3 (180) Fat 3 (135)
For 1400 calories add an additional Starch and milk or add fruit and more protein, whatever you want as long as it is about 200 calories more.
About 65-75 grams of protein

Breakfast: 1 protein 1 ounce of sausage with <5g of fat per serving
1 dairy 1 ounce of reduced fat cheese
1 starch 1 slice extra crisp whole wheat toast
1 fat 1 tsp of margarine

Lunch: 2 protein/2 starch 1 cup of chili with beans and very lean hamburger or turkey
1 dairy/1 fat 1 ounce of regular cheese
1 starch 6 saltine-type crackers
1 veggie ½ cup green beans made with chicken broth and bacon flavoring
1 fruit 17 small (3oz) grapes

Snack: 1 dairy 1 cup fat free or 1% milk

Dinner: 3 protein 3 ounces of lean pork or chicken
2 veggie 1 cup of cooked broccoli
1 fruit 1 small apple
2 starch ½ cup of corn and ½ cup of green peas
1 fat 1 tsp of margarine

Let’s see what happens if we use the exchange lists to calculate someone’s meals has eaten on a typical day. This menu may be similar to a day you have eaten. The plan represents a breakfast many feel is healthy, a typical lunch at a pizza joint and a country style dinner with friends and family.
Calories/Protein/Fat
Breakfast: 1 cup oatmeal with 2% milk and 2 tables spoons of brown sugar 300/8/5
1 cup of orange juice 120/0/0
4 slices of bacon 180/8/20

Snack: 1 pack of pretzels (1.5 ounces) 80/2/1

Lunch: Individual pan pizza any brand 700/20/25
1 small salad with lettuce, tomato and dressing 135/0/15
20 ounce cola 200/0/0

Dinner 1 fried chicken breast and 1 leg 625/42/45
1 cup of macaroni and cheese 270/14/12
¼ cup of coleslaw 50/1/1
½ cup of fried okra 160/0/15
20 ounces of sweet ice tea 160/0/0

The grand total is 2,980 calories, 95 grams of protein and 139 grams of fat. That leaves about 300-330 grams of carbs too. The average person will not eat this all the time, but frequently. This diet truly represents the “Western Diet” that we have all come to know all too well. It is the diet of cancer promotion, high blood pressure, diabetes, metabolic syndrome, obesity and numerous other conditions.

Posted in Ask the dietitian, Recipes, Uncategorized