Bariatric Surgery Better Than Medication for Diabetes

A new study says people with type-2 diabetes may have more success in managing their diabetes with bariatric surgery rather than traditional medical therapies.

The study, published this week in the New England Journal of Medicine compared the standard treatment of medication, diet and exercise to weight-loss surgery, also known as bariatric surgery, for the treatment of type-2 diabetes.

“Research has already shown that gastric bypass surgery improves or resolves type-2 diabetes in days or weeks following surgery,” says Noel Williams, MD, director of the Penn Metabolic and Bariatric Surgery Program. “This new study shows that in addition to gastric bypass, sleeve gastrectomy has the same positive impact on type-2 diabetes and is more effective than medical management alone.”

During a sleeve gastrectomy, a sleeve-shaped tube is created from a small portion of the stomach and the majority of the stomach is removed. Food passes through the new stomach tube directly into the intestines. Nutrients and calories are absorbed from food normally, but patients feel full sooner and longer.

“It is important that patients choose an experienced physician to perform their weight-loss surgery,” says Dr. Williams. “The Penn Metabolic and Bariatric Surgery program performs more than 500 procedures every year and more sleeve gastrectomies than any program in the Philadelphia region.”

Type-2 diabetes is a chronic disease in which the body cannot or does not produce enough insulin to manage blood sugar levels. Type-2 diabetes is often associated with obesity, though people of average weight may also develop the disease.

“Research is proving that weight-loss surgery reduces the co-morbidities associated with obesity,” says Dr. Williams. “Following surgery some patients quickly see their blood sugar level return to normal and they are able to stop taking insulin and other medications.”

The study also found bariatric surgery helped people lower their blood pressure and cholesterol.

Read more about the study here.

Learn more about weight-loss surgery at Penn, and how it may help you control your diabetes by attending a free informational session about weight-loss surgery. 

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Crispy, Crave-worthy and Low-Calorie: Kale Chips Recipe

You know those days when carrots or low-fat yogurt just won’t cut it and you need a snack with a satisfying crunch? Fear not, there’s no need to resort to potato chips. Instead, try this recipe for kale chips. They’re low-calorie, filled with powerful antioxidants, a good source of calcium, fiber and vitamins A and C and they’re oven-baked, not fried. Sound too good to be true? Give them a try and you’ll be raving, too.

Ingredients:

• One bunch of kale, any type, rinsed and dried
• 2 to 3 tsp olive oil
• Salt or soy sauce, to taste
• Seasonings of choice - try chili flakes, paprika, garlic powder or Parmesan cheese*

Directions:

1. Preheat oven to 375 degrees.
2. Remove the kale leaves from the tough end and inner stems. Cut longer leaves in half or bite-size pieces. 
3. Place kale pieces in large bowl and toss in about 1 teaspoon of olive oil. The kale leaves only need to be lightly coated with oil. Too much oil makes the chips limp and greasy. If more oil is needed, add about 1 teaspoon at a time. Sprinkle in salt or soy sauce and seasonings of choice.
4. Put the kale pieces in a single layer in a baking sheet lined with parchment paper for easier cleaning. 
5. Bake for 12-15 minutes or until crisp.  Toss halfway through for more even baking. Watch carefully as they can burn easily.

Nutrition Information: Amount per serving

• Calories: 47
• Total Fat: 1.5 g
• Total Carbohydrate: 6 g
• Protein: 2 g
• Fiber: 2 g

This recipe yields 10 servings (5 large chips).

*Adding Parmesan cheese increases calorie and fat content.

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Put Down that Remote: Increase Physical Activity without Turning off the TV

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, discusses a recent study that shows the health benefits of physical activity during television viewing. 

Have you been trying to figure out how to incorporate more exercise into your lifestyle?  A recent study published in the American College of Sports Medicine’s Medicine & Science in Sports and Exercise journal shows that you don’t even have to turn off the television to fit in a daily workout.

Researchers found that stepping in place and walking on a treadmill during television commercials significantly increase physical activity and can actually constitute a workout. They studied a group of 23 men and women, ages 18 to 65 and representing a variety of weights, and measured their calorie expenditure at rest and at different levels of activity while watching television.

Their findings show that stepping in place during the commercials of one hour of television burns an average of 146 calories per hour and results in average of 2,111 steps. Walking on a treadmill at three miles per hour for the same time period burns an average of 304 calories per hour. Both represent significant increases in physical activity when compared to remaining sedentary, which produces minimal, if any, calorie expenditure. 

So, the next time you sit down to watch your favorite television program, try moving your feet during the commercial breaks! It is an easy opportunity to burn calories and become a healthier you without missing a single minute or episode of the television shows you love.

- Cara Stewart

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Struggling to Lose Weight? SuperTracker to the Rescue!

Karen Buzby RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, introduces a new online weight management tool to help people achieve and maintain their weight loss goals.
You have probably heard before that weight loss is a matter of eating less and exercising more. Easier said than done – right? Anyone who has attempted to diet knows that translating healthy lifestyle advice to practical changes isn’t always so simple or straightforward.

SuperTracker is a new online tool that can help you plan, calculate and record caloric intake and physical activity, making weight loss easier than ever before. As part of the U.S. Department of Agriculture’s MyPlate program, SuperTracker is user friendly, interactive and contains a wealth of information to help you make smart choices about food and exercise. And it’s free.

Key features of SuperTracker include:

Daily calorie limit - Calculated based on height, weight and personal weight loss goals.

Food tracker - Record food items and portion size from an extensive database in an electronic food diary to review eating patterns and calorie balances each day.

Food group targets and graphs – Provides recommendations about number of servings from each food group based on a person’s daily caloric allowance. It also graphs food choices to show how dietary choices measure up to goals.

Personalized nutrient report – Customized reports of individuals’ average carbohydrate, protein, fat, vitamin and mineral intake. Helps identify which foods to eat more of and which to cut back on.

Physical activity tracker – Compares weekly physical activity totals to pre-set targets for moderate-intense and muscle-strengthening exercise.

Virtual healthy lifestyle coach – Advice, inspiration and support from a virtual coach helps people stay motivated and reach their weight loss goals.

Don’t wait another day. Start tracking your diet and activity goals with the SuperTracker today! 

- Karen Buzby, RD, LDN

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Shape Up Your Plate in Honor of National Nutrition Month

Karen Buzby, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, discusses a new government-sponsored program to encourage better food choices and provide tips for eating healthy.
March is National Nutrition Month and the Academy of Nutrition and Dietetics is providing you the information you need to achieve a healthier lifestyle. But even after you make the commitment to eating healthy, figuring out how to achieve that on a meal-to-meal basis can be tough and confusing. The U.S. Department of Agriculture has developed a program to help.

MyPlate is an online resource that provides dietary advice based on the 2010 Dietary Guidelines for Americans. Unlike other diet guides, MyPlate uses an actual place setting to visually illustrate a healthy meal made up of all the major food groups. That means no more confusion about how to translate dietary advice to an actual meal and no more guessing about portion size.

Follow these tips to get your plate in shape*:

Balance calories
If you’re unsure how many calories you need to manage your weight, there’s no need to guess! Go to www.ChooseMyPlate.gov to find out your daily caloric needs. MyPlate provides the recommended number of daily servings from each food group to help you make smart and healthy dietary choices.

Enjoy your food, but eat less
Take your time to eat and pay attention to feelings of fullness.

Avoid oversized portions
Use smaller plates to encourage smaller portions. When eating out, opt to share a meal or take home part of the serving.

Fill up on nutrient-rich foods
Make vegetables, fruit, whole grains and low-fat dairy products staples in your diet. They’re high in nutrients and vitamins and low in fat, making them ideal food choices for good health. In fact, experts recommend covering half your plate with fruits and vegetables and ensuring that half your grains are whole grains.

Always choose low- or non-fat milk
By choosing fat-free or 1 percent low-fat milk, you cut calories and fat without losing the flavor or important nutrients like calcium and vitamin D.

Curtail your sweet tooth
There’s no doubt that sweet foods and beverages are both tasty and addicting, but they’re also high in fat, sugar and salt. Eat them only occasionally and in small quantities to satisfy your sweet tooth without compromising your healthy diet. One easy way to do this is by replacing sugar beverages with water and unsweetened drinks. 

Pay attention to sodium
You might be surprised by the sodium content in everyday foods. Before making a food selection, read the nutrition facts label and stick to foods that are low in sodium to help promote cardiovascular health.

For more information, visit the MyPlate website. 

- Karen Buzby, RD, LDN

*USDA, Center for Nutrition Policy and Promotion, DG Tip Sheet No. 1, June 2011.

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