Re: hypoglycemia & subsequent wt gain in bariatric pt.

[Guest guest]

,

I have had two patients with similar stories and both were experiencing

rebound hypoglycemia after ingesting CHO. Both were told to carry candy by

other Drs. to correct the hypoglycemia, which of course, resulted in another

attack.The weight gain may be secondary to intake of CHO which is also

causing the low blood sugars. Question her about the relationship if any and

get her off the sweets. Must use non-CHO for snacks.

hypoglycemia & subsequent wt gain in

bariatric pt.

> Hi all,

>

> I am posting a question from a Wt Mgmt DPG member until she gets

> access on this website. Any thoughts on her question...

>

> Shirley Kindrick <kindrick-1@...> wrote:

> I have a patient who presented to me with unstable blood glucose

> levels. She is more than 4 years post-surgery. She had lost

> approximately 260# as of the first of this year, but she has been

> experiencing blood glucose levels dropping well below 40 almost

> daily. Prior to experiencing the low blood glucose levels, she

> exercised 6 days/wk with a trainer. When this problem began last

> fall, her weight was between 150 and 160#. It is now 180#. At the

> time of her surgery, her diagnoses were gout, hypothyroidism, venous

> insufficiency, high cholesterol, depression and sleep apnea. Since

> her bypass, she has had 2 major plastic surgeries to remove excess

> skin - panniculectomy, legs, arms, buttocks and breasts. She takes a

> prenatal vitamin and 1000 mg calcium. She had a work up with an

> endocrinologist who suggested she needed to eat more, but eating more

> has not helped much and has led to weight gain. She, of course, is

> beginning to panic over the weight

>

> Has anyone seen a similar situation? If so, what has helped? Any

> suggestions?

>

>

> Shirley Kindrick, PhD, RD, LD

> Comprehensive Weight Management

> Center for Wellness & Prevention

> The Ohio State University Medical Center

>

>

>

>

>

>

[Guest guest]

,

3 of the symptoms you reported in this patient are strongly associated with

PCOS. If that is what she has, it is likely that restrictive diets will

only exacerbate the problem. If this person who is working with this client

wants, I would be happy to give her more information privately re: how to

assess, manage food, etc, without clogging up this listserve.

Monika M. Woolsey, MS, RD

http://www.afterthediet.com

[Guest guest]

,

It's somewhat complicated, and it is related to balance between fatty

acids. It's related to a recent post I did here on fatty acid

deficiency, which you may also want to dig up.

The most important thing seems to be to get the fatty acids balanced

so that there is a PUFA/omega 3 ratio as low as possible. Current

recommendations are to have a minimum intake of DHA and EPA of 220 mg

each (though I usually find I have to double that), and a PUFA/omega

3 ratio of 1-2 to 1. What is the hardest part for people to be able

to wrap their brains around is the fact that what is important is the

RATIO between these two, not total amounts. An individual who

consumes more PUFA has to drastically increase their omega 3 intake

in order to keep the ratio productive and nervous system-protective.

The rationale for this is that many of the functions that start

to " malfunction " so to speak are dopamine-related. DHA in particular

has been shown to increase the density of dopamine receptors and

improve those functions dependent on good dopamine metabolism.

Also, a fatty acid deficient diet in rats has been shown to atrophy

neurons in the hypothalamus, the hippocampus, and regions of the

cortex. That means any hormone-related functions will suffer in the

face of DHA deficiency, as will memory, mood, circadian rhythm, etc.

You are still on my list as a current subscriber to my newsletter

(publication of which was temporarily suspended but which is

resuming). The next two issues will discuss DHA and EPA in detail,

and will compare seafood choices as well as available supplements.

If all goes well you should be getting this by the end of August. I

started out devoting a 16 page volume to the topic and expanded it to

two issues because it got so complicated. And it took a lot of work

on my part to understand it myself. No wonder the public can't make

choices that help them to heal, it's not easy to wade through.

So hopefully, in a nutshell, what I would recommend is balancing

fatty acids. I have seen rapid and profound changes in women with

PCOS who are willing to change their diet to balance their fatty

acids. I am sold on the concept. Please note however, one reason I

am often reluctant to share this, is because I am so new at this I

have not collected enough data to be able to officially report it.

It's not the next magic bullet, and the concept needs to be used in a

way that does not create even worse imbalance. Women with PCOS are

already bombarded with enough bad nutrition information and I don't

want to make it worse. On behalf of these women, please use this

information without overgeneralizing.

Have a good weekend,

Monika

[Guest guest]

Monika:

My 30 y.o. daughter has recently been officially diagnosed with PCOS. I have thought she had it for a number of years. I would be most interested in recieving your news letter and any information or direction on the subject.

Thank you very much.

Beverly Millison MS RD/LD CDE

Re: hypoglycemia & subsequent wt gain in bariatric pt.

,It's somewhat complicated, and it is related to balance between fatty acids. It's related to a recent post I did here on fatty acid deficiency, which you may also want to dig up.The most important thing seems to be to get the fatty acids balanced so that there is a PUFA/omega 3 ratio as low as possible. Current recommendations are to have a minimum intake of DHA and EPA of 220 mg each (though I usually find I have to double that), and a PUFA/omega 3 ratio of 1-2 to 1. What is the hardest part for people to be able to wrap their brains around is the fact that what is important is the RATIO between these two, not total amounts. An individual who consumes more PUFA has to drastically increase their omega 3 intake in order to keep the ratio productive and nervous system-protective.The rationale for this is that many of the functions that start to "malfunction" so to speak are dopamine-related. DHA in particular has been shown to increase the density of dopamine receptors and improve those functions dependent on good dopamine metabolism. Also, a fatty acid deficient diet in rats has been shown to atrophy neurons in the hypothalamus, the hippocampus, and regions of the cortex. That means any hormone-related functions will suffer in the face of DHA deficiency, as will memory, mood, circadian rhythm, etc.You are still on my list as a current subscriber to my newsletter (publication of which was temporarily suspended but which is resuming). The next two issues will discuss DHA and EPA in detail, and will compare seafood choices as well as available supplements. If all goes well you should be getting this by the end of August. I started out devoting a 16 page volume to the topic and expanded it to two issues because it got so complicated. And it took a lot of work on my part to understand it myself. No wonder the public can't make choices that help them to heal, it's not easy to wade through.So hopefully, in a nutshell, what I would recommend is balancing fatty acids. I have seen rapid and profound changes in women with PCOS who are willing to change their diet to balance their fatty acids. I am sold on the concept. Please note however, one reason I am often reluctant to share this, is because I am so new at this I have not collected enough data to be able to officially report it. It's not the next magic bullet, and the concept needs to be used in a way that does not create even worse imbalance. Women with PCOS are already bombarded with enough bad nutrition information and I don't want to make it worse. On behalf of these women, please use this information without overgeneralizing.Have a good weekend,Monika

[Guest guest]

Monika,

This is very enlightening & I have a keen interest in DHA & efa, but

from another perspective entirely. I would definitley appreciate more

info. & what mailing list or letter are you referring to? Would you

be interested in sharing this info. in a future Wt Mgmt DPG

newsletter?

> Monika:

>

> My 30 y.o. daughter has recently been officially diagnosed with

PCOS. I have thought she had it for a number of years. I would be

most interested in recieving your news letter and any information or

direction on the subject.

>

> Thank you very much.

>

> Beverly Millison MS RD/LD CDE

> Re: hypoglycemia &

subsequent wt gain in bariatric pt.

>

>

> ,

>

> It's somewhat complicated, and it is related to balance between

fatty

> acids. It's related to a recent post I did here on fatty acid

> deficiency, which you may also want to dig up.

>

> The most important thing seems to be to get the fatty acids

balanced

> so that there is a PUFA/omega 3 ratio as low as possible.

Current

> recommendations are to have a minimum intake of DHA and EPA of

220 mg

> each (though I usually find I have to double that), and a

PUFA/omega

> 3 ratio of 1-2 to 1. What is the hardest part for people to be

able

> to wrap their brains around is the fact that what is important is

the

> RATIO between these two, not total amounts. An individual who

> consumes more PUFA has to drastically increase their omega 3

intake

> in order to keep the ratio productive and nervous system-

protective.

>

> The rationale for this is that many of the functions that start

> to " malfunction " so to speak are dopamine-related. DHA in

particular

> has been shown to increase the density of dopamine receptors and

> improve those functions dependent on good dopamine metabolism.

>

> Also, a fatty acid deficient diet in rats has been shown to

atrophy

> neurons in the hypothalamus, the hippocampus, and regions of the

> cortex. That means any hormone-related functions will suffer in

the

> face of DHA deficiency, as will memory, mood, circadian rhythm,

etc.

>

> You are still on my list as a current subscriber to my newsletter

> (publication of which was temporarily suspended but which is

> resuming). The next two issues will discuss DHA and EPA in

detail,

> and will compare seafood choices as well as available

supplements.

> If all goes well you should be getting this by the end of

August. I

> started out devoting a 16 page volume to the topic and expanded

it to

> two issues because it got so complicated. And it took a lot of

work

> on my part to understand it myself. No wonder the public can't

make

> choices that help them to heal, it's not easy to wade through.

>

> So hopefully, in a nutshell, what I would recommend is balancing

> fatty acids. I have seen rapid and profound changes in women

with

> PCOS who are willing to change their diet to balance their fatty

> acids. I am sold on the concept. Please note however, one

reason I

> am often reluctant to share this, is because I am so new at this

I

> have not collected enough data to be able to officially report

it.

> It's not the next magic bullet, and the concept needs to be used

in a

> way that does not create even worse imbalance. Women with PCOS

are

> already bombarded with enough bad nutrition information and I

don't

> want to make it worse. On behalf of these women, please use this

> information without overgeneralizing.

>

> Have a good weekend,

>

> Monika

>

>

>