New Year, New You Patient Open House

It is a new year and Penn Medicine is hosting a special open house for patients who are interested in living a healthier life in 2011.

From 10 am until noon on Saturday, January 22, Penn Medicine will host a health and wellness open house at the Ruth and Raymond Center for Advanced Medicine. Physicians, nurses, therapists, dietitians, and staff members from Penn Medicine will answer questions and provide information about diabetes management, weight loss/bariatric surgery, nutrition, exercise and smoking cessation. This event will be especially informative for patients who are considering weight loss/bariatric surgery.

The event is free, but registration is required. Please call 800-789-PENN (7366) for more information or to register.

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FDA recommends Extending Weight-Loss Surgery Eligibility

A recent front-page article in the Philadelphia Inquirer highlighted an FDA advisory panel recommendation to allow doctors to use the adjustable gastric band – a less invasive form of weight-loss surgery – in patients with milder obesity.

Under the new guidelines, people with a body mass index (BMI) of 30 to 35 and weight-related medical complications of obesity would qualify. Currently the device is only approved for people with BMIs of 40 and higher, or 35 to 40 with other medical complications.

The article includes comments from Penn Metabolic and Bariatric Surgery Program faculty Noel Williams, MD, FRCSI, David Sarwer, PhD, and Thomas Wadden, PhD.

Read the Full Article
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Dear Diary: Today I ate…

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains the benefits of keeping a food diary.

Keeping a food diary is an important first step when losing weight. Awareness and accountability are critical components of healthful eating and weight loss. Keeping a food diary raises your awareness of your diet, gives you control of your eating habits and helps you lose weight.

When starting a food diary, it is important to find a format that works well for you. Some options include a notebook, smart phone application or website, such as Lose It!, MyFitnessPal or SparkPeople. Many cell phone applications and websites have a database of nutrition values to help you accurately record and track your intake.

Tracking what you eat works best if you record your food and beverage intake as you go. Write down what, when, where and the quantity that you eat. Make sure to include all snacks and beverages even if you grab just one cracker on your way out the door.

Preparing food at home also gives you better control and knowledge of what you are eating. The more accurate your food diary, the better it can guide you to make healthy dietary choices and ultimately achieve successful weight loss.

Finally, be sure to review your journal weekly to assess if changes are needed.

Sample entry:

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Healthy, Tasty Snack Recipe

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, provides an easy recipe for a healthy snack.

Dry-roasted chickpeas make a tasty and nutritious snack! You can have them as a crunchy pick-me-up or as a salad topping. They are low fat, low calorie and a good source of protein, fiber and folate. The recipe below makes four servings. Each serving has 100 calories, four grams of protein and five grams of fiber.

Ingredients:

• One can of chickpeas or garbanzo beans
• Spice blend of choice: garlic powder, chili powder, cumin, black pepper, rosemary, and so on
• Cooking spray

Directions:

1. Position oven rack in the top third of the oven.
2. Preheat the oven to 450 degrees Fahrenheit.
3. Pour the chickpeas into a colander, rinse and thoroughly pat dry.
4. Coat a large baking sheet with cooking spray and spread the chickpeas on the sheet.
5. Sprinkle the chickpeas with the spice blend of your choice.
6. Bake for 30 to 40 minutes until the chickpeas are browned and crunchy, stirring every 10 minutes to prevent burning.
7. Allow to cool on a baking sheet. Store in an air-tight container for up to two days.

Enjoy!

- Cara Stewart, RD, LDN

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Finding the right protein supplement to meet your nutritional needs

Karen Buzby, RD, LDN, member of the Penn Metabolic & Bariatric Surgery team, explains how to find the right protein supplement.

Protein is an essential dietary nutrient. It builds tissue and regulates various bodily processes necessary for good health. After weight-loss surgery, all patients follow a liquid diet for two weeks. It is important to include adequate protein intake in the post-surgical diet to facilitate recovery. That is why patients are encouraged to find a preferred protein drink before surgery to ensure optimal nutrition and safe weight loss in the recovery stage.

You can find protein supplements at local supermarkets, pharmacies or specialty nutrition stores. There are a variety of choices and these tips can help you find your favorite, nutritious protein supplement:

• Read the ingredients. Complete protein products containing whey, casein or soy provide more benefit than products that are mixed with less nutritious ingredients, such as collagen.


• Determine if you prefer a powder or liquid protein supplement. There are pros and cons to each type of supplement. Powder products are mixed with eight ounces of water, low-fat milk or another low-calorie liquid to produce a beverage with the recommended concentration of protein. Liquid products come premixed and some have screw tops for easy storage after opening.


• Sample a small quantity of the protein supplement. Purchase a single-serving to taste test before committing to a full container or case of the product.


• Make sure the products are low in fat and sugar. The concentration of protein, fat and carbohydrates varies from product to product. It is important to select a product that is low in fat, calories and carbohydrates. Make sure the product contains 15 grams or less of sugar per serving. Keep in mind that a typical protein drink contains 150 to 200 calories per 8 ounce serving.


• Check the expiration date. Like all food, protein drinks have a limited shelf life. Do not use products that have expired.

Please refer to the “Step-by-Step Diet Guidelines following Weight Loss Surgery” in your diet instruction booklet for a detailed list of recommended protein supplements.

- Karen Buzby, RD, LDN

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Healthy Recipes for the Holiday Season

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, provides tips for making holiday recipes healthy.

Holiday recipes are time tested and family approved, but they also frequently contain many calories and unhealthy ingredients. With just a few minor changes, you can transform most of your family’s beloved holiday dishes and desserts into healthier and more nutritious alternatives.

Try these tips to make your family’s favorite foods healthy without losing the taste they love:

• Use two egg whites instead of one whole egg.
• Use evaporated skim milk or buttermilk instead of heavy cream.
• Thicken gravy, soup or sauce with pureed vegetables, mashed potatoes or cornstarch and cold water.
• Replace half the oil in a recipe with an equal amount of applesauce.
• Replace refined grains with whole grains, such as whole wheat bread, brown rice, bulgur, barley or quinoa.
• Use leaner cuts of meat including skinless poultry, ground turkey breast, pork loin, beef round or flank steak.
• Replace some of the meat in a recipe with beans, tofu or soy-based proteins.
• Use creative toppings for casseroles, such as almonds instead of fried onions.

- Cara Stewart, RD, LDN

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Hydrate for a Quicker Recovery

Karen Buzby, RD, LDN, a member of the Penn Metabolic & Bariatric Surgery team, provides tips for staying hydrated after bariatric surgery.

After weight loss surgery, staying hydrated is critical to recovery. Drinking enough fluid helps patients recover from surgery safely and as quickly as possible. So, pour a four-ounce glass of any low calorie beverage or protein drink, get comfortable and sip, sip, sip.

Most patients have to re-learn how to drink following weight-loss surgery. It is best to start slowly and gradually increase fluid consumption to the goal of 48 to 64 ounces daily.

Here are some tips to help reach the liquid consumption goal:

• Calculate how much to drink every hour to reach your goal. Watch the clock, drink at the pre-set time and record your intake. It may be helpful to set a timer as an hourly reminder to drink.
• Carry a water bottle around the house or on walks outside.
• Measure fluid intake instead of estimating.
• Drink from a six- or seven-ounce container instead of the one-ounce medicine cups from the hospital.
• Find your preferred low-calorie or protein drink. It does not matter if it is hot, cold or room temperature. Also, remember to factor melted ice into beverage totals. One standard-sized ice cube equals one ounce of fluid.

Please refer to the “Step-by-Step Diet Guidelines following Weight Loss Surgery” for more information.

- Karen Buzby, RD, LDN

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