Tuesday, May 25, 2010

Nutrition Concerns with Gastric Bypass

Today I ran into a lady who had gastric bypass 6 years ago (that part I didn’t know). She’s 50 years old, has osteoporosis in one hip, osteopenia in her back and other hip, she’s anemic and deficient in vitamin D. So I asked her if, after her gastric bypass, her physicians told her about the potential for nutrient deficiencies and emphasized the importance of frequent follow-ups to examine her iron, B12 and vitamin D status as well as her bone density. While I’m used to other people letting me know their doctors don’t give them very in depth follow-up instructions, I figured surgery patients would be more closely monitored. But, I was wrong.

If you have had a gastric bypass, be certain to take your health into your own hands and schedule check-ups. Your body will have a tougher time absorbing iron, calcium, vitamin D and vitamin B12. Nutrient deficiencies are common in gastric bypass because the “bypass” part creates a bypass of part of the small intestine so you don’t absorb as many calories (nor will you absorb certain nutrients from food). Because a lack of B-12 and iron can both cause anemia, leaving you feeling fatigued and crummy and deficiencies in D and calcium can lead to brittle bones, it’s vital to monitor your status frequently, even if you are taking supplements per your physician’s orders.

The more extensive your surgery, the more likely you are to have nutrient deficiencies. Though the weight may come off immediately, you’ll need to resume the eating plan and supplements your physician gave you, for a lifetime. For some, gastric bypass is an absolute lifesaver but, you still need to pay close attention to your overall health even after the weight comes off.

Thursday, May 20, 2010

Feeling Tired? What Lab Tests do You Need?

If you are tired all the time, it's important to see your physician to rule out common causes of fatigue. Three of the top causes are iron deficiency anemia, hypothyroidism and mono. I know what you are thinking here, there's no way you have mono, that's for college kids. However, mono is actually very contagious. You don't need to swap spit with someone to get it. You can also catch it from someone sneezing or coughing near you, eating or drinking after someone and possibly just being in close contact with someone. And if you are at the doctor already, drawing a little more blood and getting a mono spot test is worth it!
Click here to find out what labs you need to test for iron deficiency and for more information about hypothyroidism, click here.

So what do you do if all three of these tests come up negative (meaning you have none of these conditions)? Now you look for other causes such as stress, depression, sleep apnea, a hectic busy schedule, lack of sleep (or lack of good quality sleep) and what you are eating (or not eating). Sometimes, figuring out what may be wrong is best done by process of elimination. You eliminate the potential obvious issues and then look for other possibilities causing the problem.

Monday, May 17, 2010

Got Sleep Apnea?



Is it me or is everyone on a cpap machine? I can't even count the number of people who have told me they have sleep apnea and wake up (insert astounding number here) of times per night from sleep apnea. So what is the real deal on sleep anpea?

If you have sleep apnea, you have several episodes though the night where you temporarily stop breathing. Each time you stop, you wake up and disrupt your sleep pattern. What are the signs and symptoms of sleep apnea? Constant fatigue during the day, regardless of how much you sleep and snoring. In addition, those who are overweight or obese are more likely to suffer from sleep apnea.

Why does sleep apnea need to be treated? Well for one thing, if you don't treat it you are likely to suffer from fatigue and you may increase your risk of stroke and heart attack as well.

Friday, May 14, 2010

Celebrating Women's Health Week

In honor of Women's Health Week, NIH Office of Women's Health recommends several important steps you can take to improve or maintain good health. All of these steps (listed below) are ones you've seen before. In fact, you've likely seen them many times. Therefore, it isn't the "what" but "how" you get these things accomplished with a busy, hectic schedule that can leave people stumped pondering their schedules over an ice cream sundae.

So first up to bad is physical activity. If you can't seem to meet the physical activity requirements, at the very minimum, strap on a pedometer or accelerometer and get 10,000 steps a day. Park further away, walk to your coworkers office instead of emailing, take a trip to a Super Target, and find other ways to add steps in. Also, start with small steps - do 15 minutes of activity a few days a week and work your way up. You'll soon find you have the time, you just needed to get better organized, make those phone calls while you walk or hop on a stationary bike if you want to watch the full hour of Dancing With the Stars.

Secondly, eat a healthy diet. Your diet does not have to be perfect, trust me, no one's is. However, it should be produce-packed, include low fat or fat free dairy, lean meats & poultry, fatty fish, nuts and seeds. If you are missing out on any of the major groups (meat for instance), take a look at the nutrients you may be falling short on as well.

As far as the last three on this list, they are no brainers. However, many people put other things first in life prior to going to their regular checkup (trust me, you can miss work for this), finding ways to manage stress and getting plenty of rest. As I always say, either pay now or pay more later. Think of it like interest on a car. If you pay for that car up front, you'll pay thousands less then if you pay 3 or 5% or more in interest. In a similar manner, if you take some time now, follow these steps below and take care of yourself, you'll pay a lot less later (both in terms of healthcare costs, lost time from work and lost time from life). For more about Women's Health Week and women's health in general, click here.

- Get at least 2 hours and 30 minutes of moderate physical activity, 1 hour and 15 minutes of vigorous physical activity, or a combination of both each week
- Eating a nutritious diet
- Visit a health care professional to receive regular checkups and preventive screenings
- Avoid risky behaviors, such as smoking and not wearing a seatbelt
- Pay attention to mental health, including getting enough sleep and managing stress

Wednesday, May 12, 2010

Dr Oz. on Exhaustion

Exhausted? Pale, dizzy and cold? Check out Dr. Oz's top tips on anemia support, anemia research and anemia treatments by clicking here.

Even better though, I love this clip from Dr. Oz's show that shows : click here to view the video.

Sunday, May 9, 2010

Why Overwhelmed Women Need to Take Care of Themselves First

In honor of Mother's Day and just in time for Women's Health Week, I decided it's time to unveil the best thing women can do for themselves and their family: take some time to get healthy and stay healthy. It's common knowledge that women are the traditional "caretakers" and therefore, they take care of everyone else first. Then when things start going wrong and their body gives them warning signs, they get a wake-up call. Yet, it often falls on deaf ears. After spending decades putting everyone else (including volunteer work, colleagues, the random "friend" on facebook who asked for advice) first, it's a matter of retraining their thought patterns and practicing this new, yet uncomfortable, behavior.

You see, I've met many women who take on more than their fare share of tasks at home. And then among couples, if I ask the man something his response is often “I don’t know go ask {insert wife’s name here}” Clearly, the wife has taken on all of the holiday duties, scheduling appointments, waking up in the middle of the night taking care of the kids and other tasks that take mental and physical energy.

Not only does this take a toll on their energy levels, but, it takes a toll on their overall health because many of my female clients wait a long time before going to the doctor in fear that they are “complaining.” Aside from the burdens they often take on, women are also more likely to suffer from a variety of diseases and conditions including depression, autoimmune diseases, iron deficiency anemia (making them incredibly fatigued), endocrine and metabolic disorders including PCOS and thyroid problems such as Grave’s Disease and heart disease.

If you are an overwhelmed woman, my best piece of advice is to take some time for yourself without distractions. No cell phone, ipod, TV or conversations. Instead, take a walk, sit outside in a hammock and just think about what you need to take care of you. If it helps, journal about what you need to feel less burdened and live a healthy, joyous life. If you feel like your life has skidded off track, check out this article from Martha Beck (one of my favorite writers) titled: Wait! Stop! It’s All Too Much! Because, after all, as a well known public speaker once said: the best gift you can give this world is a healthy you.

Wednesday, May 5, 2010

Top Vegetarian Sources of Iron

The best sources of iron are from meat, poultry and fish – all of which contain heme iron. Heme iron is absorbed better than the type of iron found in plants – non-heme iron. For vegetarians of course, this is a moot point since animal foods aren’t an option. Therefore, you’ll need to be extra aware of your iron intake.

The top vegetarian sources of iron include:
- Fortified cereals (look for 100% DV for iron)
- Instant oatmeal
- Lentils
- Lima, navy, lima, black, pinto
- Molasses
- Spinach
- Black-eyed peas

Be sure to include several of these foods in your diet and consume them with vitamin C to enhance the absorption of non-heme iron. Also, take your calcium supplements and antacids separately since they can inhibit the absorption of non-heme iron. Though the absorption of heme sources of iron are not affected by what is eaten concurrently, the absorption of non-heme sources is affected by what you concurrently.

Monday, May 3, 2010

Breaking Research: Iron Absorption during Pregnancy

You're pregnant and hate your multivitamin (as if morning sickness wasn't enough and then you add constipation and vitamin burps on top of that) yet you want to do what's best for your developing baby. And, prenatal multivitamins serve a purpose - they provide more nutrients that regular multivitamins so both you and your little fetus stay healthy.

From B vitamins to the mineral iron, your need for certain vitamins and minerals increases during pregnancy. And, an abstract published this past week in the FASEB journal (Federation for the American Societies of Experimental Biology) outlines how important it is to pick the right form of iron. This study compared heme iron to non-heme iron. In food, heme iron is found in animal foods whereas non-heme iron is only found in plant-based foods. The majority of the iron in our diet is nonheme iron.

In this 2-day iron absorption study, 20 pregnant women (ages 16-32) and 12 non-pregnant women (ages 18-27) were randomly assigned to receive heme iron (in the form of a meal) or a non-heme supplement (ferrous sulfate). The results were astounding, heme iron absorption was significantly higher, by about 50%, in both the pregnant and non-pregnant women.

If you eat little red meat (the best dietary source of heme iron), it's a good idea to request that your prenatal contains heme iron as opposed to non-heme (the majority of iron supplements contain non-heme iron). Your iron requirements are much higher during pregnancy therefore putting you at greater risk for anemia. And, iron deficiency anemia isn't something to take lightly. During pregnancy, anemia can increase your risk of preterm delivery and low birth weight. In addition, it can leave you feeling absolutely exhausted.

The FASEB abstract can be found by clicking here.