Bariatric Surgery is so far the best solution to the problem of obesity and diabetes, and greatly influences the improvement of non contagious diseases related to nutrition.
Therefore it is necessary that the doctor, the health team and the patient be aware of the importance of nutrition, not only before the surgery and immediately after it, but for the rest of the patient’s life.
Es fundamental cumplir diariamente con las necesidades de proteína, carbohidratos y grasas en la alimentación del paciente, la cual debe seleccionarse en la forma más tolerable y absorbible, con el objeto de prevenir deficiencias nutricionales importantes que muchas veces se atribuyen equivocadamente al déficit de otros nutrientes. Es decir la alimentación debe cumplir con las leyes de alimentación.
It is essential to meet the daily needs of protein, carbohydrates and fats in the patient’s diet, it must also be highly tolerable and absorbable in order to avoid important nutritional deficiencies often mistakenly attributed to the shortage of other nutrients. In other words the diet must conform to the rules of healthy nutrition, which indicate the diet must be:
– Sufficient
– Complete
– Balanced
– Varied
– Safe
The multidisciplinary management of the Bariatric Surgery patient is essential, a professional in clinical nutrition is a crucial part of this team and has the important task of evaluating the nutritional status of the patient, determining pre-existing nutritional deficiencies, developing appropriate and corrective nutritional interventions and creating a pre and post operative plan that will contribute to the patient’s success.
En el manejo nutricional preoperatorio, tiene como fin primordial la reducción del hígado graso, como también la grasa abdominal, con el objetivo de disminuir posiblemente, tanto el tiempo operatorio como las complicaciones quirúrgicas y lograr una pérdida de mayor peso preoperatorio, para lograrlo y según el centro de excelencia se indican diferentes tipos de dietas manteniendo un balance, equilibrio y necesidad para cada individuo, así como las vitaminas y minerales en las cantidades diarias requeridas.
Preoperative nutritional management has the primary purpose of reducing fatty liver, as well as abdominal fat, with the hope of possibly decreasing both surgical complications and duration of the procedure and to achieve higher preoperative weight loss. In order to achieve this and according to the Center of Excellence, different diets are prescribed, all of which are designed according to the patient’s needs. Adequate vitamin and mineral supplementation is also taken into account.
At LIMARP, our multidisciplinary team carefully detects the patient who requires additional observation and nutritional monitoring before surgery, specifically those with a BMI that indicates high risk. These patients follow a plan prior to surgery that will allow them to lose between 20 to 30 kilos depending on each particular case. The process may last anywhere from 3 to 6 months and includes psychological support.
PILLARS OF NUTRITIONAL TREATMENT
Diet should be calculated and designed for the individual. First the basal metabolic rate (BMR) and daily energy expenditure are calculated. A negative energy balance of 500 kcal per day must be achieved to obtain a 0.4 kg (1 lb) weight loss per week.
Energy percentage distribution (EPD):
Protein: 12-20%
Fat: 25-30%;
Carbohydrates: 55-60% (with a predominance of the complex).
Per day: Breakfast 20%; snack 15%; lunch 30%; snack 10% and dinner 25%.
Eating behavior includes portion control, acquiring the habit of chewing food slowly and thoroughly, separating food and drink and avoiding foods that are poorly tolerated. The supplement requirements vary and usually involve multivitamins and minerals. Frequent monitoring of the nutritional status of all patients is carefully done to help prevent any serious clinical deficiencies.
Nutritional education is of the essence for the success of the Bariatric patient, and it includes:
– Education on the basics of quality nutrition in order to modify eating habits.
– How to identify the different food groups.
– Portion size.
– Food variety.
The treatment of obesity calls for the identification of patients at high risk, the implementation of measures to make long-term lifestyle changes, and the avoidance of fads or trends from the commercial diet industry. Nutritional management is a fundamental part of successful Bariatric Surgery; it is essential in preventing complications in the short and long-term.
The American Society for Metabolic and Bariatric Surgery agrees in certain assessments, general care, food and drinks that the patient must follow or avoid. A healthy lifestyle is necessary for the long-term success of Bariatric Surgery, as well as for a better nutritional status and overall health.
Our team is at your service and we can help. For a free evaluation call LIMARP International Center of Excellence for Obesity at (664) 686-2542 or fill out a contact form at www.limarp.com
