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Wednesday, June 6, 2012

June Meeting 2012

Last night, at the support group meeting, Carrie and I shared information about a few interesting things in regards to hunger.  We started off the meeting by talking to a newbie who has no hunger (it's such a wonderful thing when it's turned off for so many of us at the beginning) and then we made a list of all the foods that people crave.

We went through the list and noticed something, by and large, practically all the cravings from nachos to pizza, from chips to cookies (and even vodka and beer) all revolved around carbs.  The only exception I believe was coffee.  By and large, we crave carbs.  There is a reason why.  We knew carbs would be a high part of the cravings.

When we have sugar, our body gets a "high", it's like a high to our brain.  When we are tired or very hungry, our bodies CRAVE sugar.  Sugar is a form of "instant" energy and our bodies know that. When we are physically hungry, it is often because our blood sugar is low.  When we ingest the sugar, the sugars make us spike up in blood sugar and often come crashing down to the point that they go even lower - hence we are hungrier even MORE than before.  So what does our body crave?

Yep you named it - more sugar.

Now sugar can be in it's simplest form - like glucose - the candy, cookies, chips - again, instant energy.  But it can also be carbs.  Carbs that are ingested are either turned into sugar and sent to the body or stored.  The more that we eat, the more carbs the body doesn't need for energy, therefore, it's sent to the cells for storage.  Therefore, our fat stores, get...well...fatter.  The sugar is sent to the cells for storage and the cell gets bigger.

So we went over a few simple things we can do:

1) Make sure that when you get sugar (whatever form but especially simple carbs, simple sugars) that you pair the sugar with a protein.  It will helps slow down the digestive process and will help to stabilize blood sugar.  Protein has very little effect on blood sugar alone. 

2)  Eat protein at EVERY meal and snack as much as you can. Our bariatric centre says this all the time: balance, balance - 3 food groups at meals, and 2 food groups at snacks. Remember the best calculation: a diet consisting of 40% (or more) protein, 30% (or less) carbs, and 30% (or less) fat.  The more protein, the better the loss.

3) Look for whole grain carbs - especially with the kernels intact.  Complex carbohydrates are good.  Look for lots of fibre.  Some products we highlighted were:  La Tortilla Factory tortillas (Schwabs, Remark), Joseph's Flax Pitas (Remark). That have very little carbs especially when you figure out the fibre.  We also showed a product called "Shiritaki Noodles" (Metro) which are a soy alternative to regular pasta (rinse well) and Carbmaster Yogurt from Kroger (very little carbs, lots of protein).

4) Shop from the outside of the supermarket as much as possible.  The stuff on the insides is all highly processed and will spike blood sugars.  Look at the glycemic index of foods.  It gives you an idea of some foods that will spike blood sugar (high glycemic) or lower/regulate blood sugar (low glycemic foods).  The worst offenders are usually: white breads, rice, white pasta...etc.  The body processes starch almost as fast as it processes glucose (sugar from say, candy).  If you cook pasta, cook it "al dente" - the mushier it is, the more it will spike your sugars.  The more ripe the fruit as well.  Fresh fruit is better than juice or dried fruit (which has sugar added to it generally) because it has fibre.  Fibre slows down digestion.

5) Want to lose faster or are you losing slower?  Watch the carbs. (I wish I would have known this during my surgery as I'm sure this is one reason I lost slowly).  The more carbs in your diet, the more your body doesn't need them, therefore they are stored.

6) Watch drinks. Many drinks may have virtually any calories...but may be full of carbs.  Again, carbs are broken down to sugars if not needed by the body. Find a protein shake that is water based and low carb (2 grams of sugar or other) and that's even better.

7)  Add acid foods - lemon, lime, vinegar, pickles, mustard - all slow down the blood sugar response.

8) Say yes to fibre and favour the good fats.

Here's the interesting about WLS and hunger:  Initially when you have your surgery (Think a few weeks out), your ghrelin hormone (hunger) is greatly reduced in your body so most people experience very little physical hunger.   This changes especially at 6 months out or more and here's why:   A study from 2011 discovered that the physical reaction (spike in blood sugars as our body pumps out insulin to deal with the sugar in our body) changes from surgery to the 6th month after WLS.

At 6 months out (or so), the physical blood sugar reaction is 3X stronger or more powerful at 6 months out for those who have had the vertical sleeve.  That means that your body pumps out more insulin, and your blood sugar spikes and comes back down.  When it comes down, you may be hungrier than before.  Sugar has a very strong effect.  More sugar = more what do you take in? More sugar...and so the ugly, vicious cycle continues.

If you had an RNY, the response in sugar is 20X greater at 6 months out.

Have hunger? Hungry an hour or so after eating?  Find the hunger increasing?  Time to work on stablizing your blood sugar as possible.  Stable blood sugar is the key to getting the hunger monster under control.  

By the way, the Bariatric Centre has seen a lot of people struggling at the 6 month mark with hunger, cravings, emotional eating and the like.  They have moved their 9 month social work group class up to the 6 month mark.  Hunger *is* going to be back.  While you don't have it, use that super power to say NO to the stuff you just don't need.  It's a wonderful time when you don't have the all consuming hunger and although it's hard to eat initially and can be a challenge early out, the new relationship you have with food when you aren't as hungry, is really a wonderful thing.  When hunger comes back, so many of us struggle.  That's when you may need the support group even more.

As well, so many of us have to start watching out for signs of reactive hypoglycemia.  So many of us after RNY get it around the first year mark or so.   Read about Reactive Hypoglycemia here.

Please don't hesitate to email Carrie or I should you need information on products, information or if you have a question.


1 comment:

  1. I had a lot of concerns with the foamies post surgery - eating anything that had more than 2g sugar or not chewing enough - the only way to get over it was to throw it up. As a result, I was very careful with my diet. I stuck to (and still 'mostly' stick to) the 40/30/30. In fact it's probably more like 50/20/30. And my weight loss was fast. Also, even to this day (3+ years out) hunger is not a real concern. I only get hunger when I am having my hypoglycemic reaction. And since I am in a hurry to get that under control, I am still very careful about what I put in my mouth. I think if we don't try to change the rules 2, 3 or more years out, we can continue to be successful. I'm not saying I haven't gained back any weight. I've gained approx 10 lbs. And I have to admit, my concerns with foamies in the beginning and my concerns with reactive hypoglycemia now are like forced behaviour modification. Left to my own devices, I'm not certain I would have done so well. Thanks for all the info