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Created with Fabric.js 1.4.5 BARIATRIC SURGERY and THE LINK BETWEENDIETARY FAT, WEIGHT LOSS and GALLSTONES References:1. Stokes CS, Gluud LL, Casper M, Lammert F. Ursodeoxycholic acid and diets higher in fat prevent gallbladder stones during weight loss: a meta-analysis of randomized controlled trials. Clin Gastroenterol Hepatol. 2014;12(7):1090-1100.e2; quiz e61. doi:10.1016/j.cgh.2013.11.031.2. Gletsu-Miller N, Wright BN. Mineral Malnutrition Following Bariatric Surgery. Adv Nutr An Int Rev J. 2013;4(5):506-517. doi:10.3945/an.113.004341.3. Mateljan G. The World's Healthiest Foods. Seattle, WA: The George Mateljan Foundation; 2007.4. Heart-Healthy Cooking: Oils 101. Health Hub from Cleveland Clinic website. Published October 1, 2014. Accessed March 3, 2015.5. The Lowdown on Cooking With Oils. Cenegenics Carolinas Medical Institute website. Published June 8, 2012. Accessed March 3, 2015. A recent study published in the journal of Clinical Gastroenterology and Hepatology showed that high-fat weight loss diets resulted in just as much weight loss as low-fat weight loss diets (1). Andhigher dietary fat intake during periods of rapid weight loss reduced the risk of gallstone formation. These findings have the potential to shape how the medicalcommunity views safe and healthy weight loss, especially in the context of bariatric surgery. Post-operative protocols usually call for an extremely low-fat diet, and many post-surgical patients develop nutritional deficiencies as a result (2). In addition to sometimes severe deficiencies, many patients develop gallstones as a result of rapid weight loss and drastically reduced fat intake. Observational studies report that approximately 36% of patients who undergo gastric bypass develop gallstoneswithin 6 months of surgery, when the majority of weightloss occurs (1). Because gallbladder removal in conjunction with bariatric surgery can be costly, and because unnecessary removal of accessory organs involved in digestion can contribute to health problems later, non-surgical approaches to gallstone prevention are preferred. 36% CHEWING THE FAT: QUALITY and TYPE MATTERS Nutritional deficiencies are relatively common after bariatric surgery, with a prevalence of upwards of 82% being reported (2). Many of thesedeficiencies could be prevented with increased levels of dietary fat, particularly the fat soluble vitamins (A, D, E, and K). As their namesuggests, these vitamins cannot be absorbed by the body withoutthe presence of dietary fat. That isn't to say that all post-surgical patients should eat high-fat diets.Everyone's body is different, and what works for some doesn't necessarily work for others. However, because fat is the backbone of every cell in the human body, appropriate amounts of high-quality healthy fats in the diet are a must. So what amount of fat is appropriate, which fats are healthy, and how dowe distinguish between high-quality and low-quality sources? Appropriate amounts will vary from person to person. Generally, higher-quality oils and fats are the least processed. Fats from animal sources tend to have higher concentrations of important nutrients like calcium and vitamin D -- both of which are commonly deficient in bariatric patients. However, animal fats might cause digestive upset for some. A good alternative oil for digestive health is coconut oil. Mostof this medium-chain fatty acid is absorbed directly into thelining of the small intestine, so the body doesn't have to work to break it down (3). 82% GALLBLADDER HEALTH: SURGERY MAY NOT BE THE ANSWER THRIVE NUTRITION march 2015 newsletter "GOOD" FAT v. "BAD" FAT Some fats and oils are always considered "bad" forhealth, especially those that contain trans fatty acids. But often, the difference between a "good" fat and a "bad" fat isn't the fat itself but how the fat (or oil) is used. When it comes to cooking, different oils have different purposes, which means that an oil may be"good" if used properly but not as good if used improperly (3).Take for example flaxseed oil. This oil is good for use in non-cooking applications like salad dressings anddips. However, the oil isn't meant to be heated. Its fat structure is far too delicate to stand up to heat, which makes the oil prone to oxidation. Oxidation reactionscan produce free radicals, which can damage or killcells. The rationale behind this also holds true for many oils, including extra virgin olive oil. Contrary to popularbelief, extra virgin olive oil shouldn't be usedin high-heat cooking applications because it's fairlydelicate. As a general rule, oils that have lower smoke points are more delicate and susceptible to damage.
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