Better than Weight Loss Surgery?

There's an encouraging article today in the Los Angeles Times about scientists working on a procedure that would be much safer than weight loss surgery. It involves disrupting the vagus nerve. The vagus nerve tells us when we're hungry, it's the communication path between the stomach and the brain. See the full article here. Here's an excerpt;

WEIGHT loss surgery works, but is so invasive and has such unpleasant long-term side effects that it's recommended for only a fraction of the obese population, and even many in that group are reluctant to undergo the surgery. In hunting for a simpler and safer alternative, researchers have zeroed in on a nerve that carries much of the communication between brain and gut.

Disrupting this communication, they believe, could lead to safe, effective and sustained weight loss -- mainly by cutting off signals from the gut that tell the brain it's time to eat....

Two different methods of disrupting the vagus nerve are now in clinical trials. One method, vagotomy, simply cuts the nerve and permanently disables it. The other, vagal nerve blocking, uses an electric current to periodically confuse the nerve and prevent it from transmitting signals. Preliminary results suggest that both methods help to safely reduce excess body weight by about 20% on average within six months of therapy.

photo by Marcusrg

LivingAfterWLS Food Editor Reaches Goal Weight!

Barbara (left) and Lynn (right) at the LivingAfterWLS Directors' Meeting:Our good Neighbor and LivingAfterWLS Food Editor Celadon (Barbara Gibbons) has reached her weight loss goal!!! And she is just too darn sweet and modest to post about it. Registered member read about it in her blog: About Goal and Maintenance.I consider Barbara my dear friend and power player in the LivingAfterWLS community.

High Protein Diet After Surgical Weight Loss

Gastric Bypass Patients Succeed Eating High Protein DietBy Kaye Bailey(At left: Hoisin-Glazed Chicken Breasts) The first rule for successful weight loss and weight maintenance after Weight Loss Surgery (WLS) is Protein First – that means eating protein for three daily meals, and protein must be 50 percent of food intake. Some bariatric centers advise as much as 70 grams of protein a day. The

What to do if Your Study Contradicts Conventional Wisdom

I just read a recent paper from the British Journal of Sports Medicine, "Daily Energy Expenditure and Cardiovascular Disease Risk in Masai, Ruran and Urban Bantu Tanzanians". The study caught my eye because I think we have a lot to learn from healthy traditionally-living populations worldwide.

The Masai have a very unique diet consisting almost exclusively of whole cow's milk, cow's blood and meat. As you might imagine, they eat a lot of fat, a lot of saturated fat and a modest amount of carbohydrate (from lactose). They also have low total cholesterol, low blood pressure, and virtually no overweight. They have been a thorn in the side of the lipid hypothesis for a long time.

The Bantu are an agricultural population that traditionally eat a diet low in fat and high in carbohydrate. Their staples are root vegetables, corn, beans, fish and wild game. The paper also describes a group of urban Bantu, which eats a diet intermediate in fat and carbohydrate. Incidentally, the investigators describe it as a "high-fat diet", despite the fact that the percentage fat is about the same as what Americans and Europeans eat, shamelessly exposing their bias.

The investigators recorded the three groups' diets, activity levels, physical characteristics and various markers of cardiovascular disease risk. Here's what they found: only 3% of Masai were obese, compared to 12% of rural Bantu and 34% of urban Bantu (they'd fit right in here!). The Masai, despite smoking like chimneys, had generally lower CVD risk factors than the other two populations, with the urban Bantu being significantly worse off than the rural Bantu.

Overall, the Masai came out looking really good, with the rural Bantu not too far behind. The urban Bantu look almost as bad as Americans. How do we make sense of these two conflicting facts? 1) The urban Bantu eat an amount of fat and saturated fat that's right in the middle of what the Masai and the rural Bantu eat, yet they seem the most likely to keel over spontaneously. 2) Saturated fat KILLS!! Answer: keep digging until you find something else to blame your results on.

They certainly did find something, and it's the reason the study was published in the British Journal of Sports Medicine rather than the American Journal of Clinical Nutrition. The Masai exercise more than either of the other two groups. I don't have too much trouble believing that. However, the authors used a dirty trick to augment their result: they normalized calorie expenditure to body weight. They present their data as kcal/kg/day. In other words, the fatter you are, the lower your apparent energy expenditure! It makes no sense to me. But it does inflate the apparent exercise of the Masai, simply because of the fact that they're thinner than the other two groups.

Due to this unscrupulous number massaging, here's what they got (data re-plotted by me):


I'm going to try to un-massage the data. Here's what it looks like when I factor bodyweight out of the equation. Calories expended (above resting metabolic rate) is on the Y-axis. The bars look a bit closer together...



Here's what it looks like when you add back resting metabolic rate. I assumed 1500 kcal/day. This graph is an approximation of their total energy expenditure per day:



Hmm, the differences keep getting smaller, don't they? I'm not challenging the fact that the Masai exercise more than the other two groups, but I do have a problem with this kind of manipulation of the data in misleading ways.

Their conclusion is that exercise is protecting the Masai from the deadly saturated fats in their diet. A more parsimonious explanation is that saturated fat per se doesn't cause heart disease. It's also more consistent with other healthy cultures that ate high-fat diets like the Inuit, certain Australian aboriginal groups, and some American Indian groups. It's also consistent with the avalanche of recent trials of low-carbohydrate diets, in which people consistently see improvements in weight, blood pressure, and CVD markers, among other things. Not that I have much faith in blood lipid markers of CVD.

My conclusion, from this study and others, is that macronutrients don't determine how healthy a diet is. The specific foods that compose the diet do. The rural Masai are healthy on a high-fat diet, the rural Bantu are fairly healthy on a low-fat, high carbohydrate diet. Only the urban Bantu show a pattern really consistent with the "disease of civilization", despite a daily energy expenditure very similar to the rural Bantu. They're unhealthy because they eat too much processed food: processed vegetable oil, processed grain products, refined sugar.

Thanks to kevinzim for the CC photo

LivingAfterWLS Cookbook

ON SALE NOW!!$18.00 + $3.95 Shipping & Handling300 Recipes - 175 Pages - Spiral BoundFor WLS Patients - By WLS PatientsLearn More & Order OnlineReceive Your Free Gift

"Normal" Recipes in the Kitchen

The LivingAfterWLS "Normal" eating is a diet of clean, lean protein; nutrient rich vegetable and fruit carbohydrates; healthy fats; limited grains, processed carbohydrates and sweets. It is easy to get into a rut of safe or predictable food. The danger with a food rut is boredom which may lead to eating that falls out of the "normal" diet. At LivingAfterWLS we have recently remodeled our online

Chicken & Artichoke Casserole

Catsroomie, one of the excellent weight loss surgery cooks in the Neighborhood recently posted this recipe for Chicken & Artichoke Casserole:Just came across this recipe on Allrecipes.com and it sounds delicious. Haven't tried it yet, but I plan to this weekend.Artichoke ChickenINGREDIENTS1 (15 ounce) can artichoke hearts, well drained and chopped (marinated preferred)3/4 cup grated Parmesan