Carbs?

[SteveT74 360]

3 hours ago, ms.sss said:

Like others have stated above, everyone will have a different recipe for what works for them. What works for one, may not work for the other. With that said, I watch/track calories and carbs (and Protein, fibre, fat).

These were two goals my nutritionist set for me, which I consider my primary daily goals (I don't always meet them, but I do the majority of the time):

• 70g Protein
• minimum 2.5L Water, the more the better.

The next two I set for myself:

• Net carbs under 20g.
• Fat, I put a limit of 20-30g (but this is the most flexible macro I watch/track). I have noticed that if I take in more fat over consecutive days, my bathroom regularity improves.

I end up averaging about 500 cals a day*.

* I know this sounds like a small amount of cals, but I don't feel deprived nor starving...primarily due to the restriction of my sleeve (sometimes I think my surgeon may not have meant to make it this size, but whatevs, I'll take it). I am physically satisfied with the amounts I eat at meals. My nutritionist last month said she would like to see me take in more calories, but not to force it, if I can't. I'm sure I could choose more fatty, high-carb foods to do this, but honestly, I don't want to. In any case, both she and my surgeon were satisfied with my progress.

P.S. I am also only 5'1".

If you're only eating 6 or 700 calories a day and almost all of that is coming from protein, it sounds like you're not eating enough calories to support a healthy nutritional balance. You're also eating so much protein that you're excluding important micronutrients. I am a big believer in going ultra-low carb (love Keto), but to cut out carbs AND fat is definitely going catch up with you. You can live without carbs (except for Fiber, which we really need a lot of), but fats and protein are both essential. Protein is very important--particularly in the month or two after surgery when you're recovering since amino acids are required for tissue growth, neurological repair and growth, Hair growth etc. However, you can't really live long term on protein alone.

First off, your body will convert protein to glycogen to compensate for the reduction in available glucose that you might ordinarily get from carbs. Protein molecules can be converted to glucose by your liver in a process called glyconeogenesis. It's an inefficient way to create glucose--which is a good thing in most instances since it means that your body consumes about three time the amount of energy to create glucose from protein than it does from carbohydrates. However, this process also creates a lot of unpleasant by-products and waste that needs to be processed by your liver and kidneys. If this is your primary/only source of energy for a long enough period of time, your going to risk liver and kindney damage and possibly failure. This is one of the things your Surgeon is checking for when they do your blood work every three months (it shows up in your creatine, thiamine and protein level reports). This will tell him or her if you're eating to little or too much protein.

Second, you need to have fats in your diet. I am not talking about cheese burgers and bacon. We can all live without that crap. However, healthy fats are very important for neurological function, heart health, liver function and hormone production etc. You need to also be eating the right kinds of fats from things like avocado, fatty fish oil (wild caught sockeye salmon), extra virgin olive oil, ghee etc, nuts (pecans, macadamia, brazil nuts--all great). These are all great sources of omega-6 fatty acids, which are also very important for your immune function and will help you suppress free radicals and mutations that can cause cancer and other health issues.

Third, even though I am a Keto evangalist, you do need to some carbs in your diet. Those carbs need to come mostly in the form of fiber along with some nutrient rich foods that will help improve your micronutrient profile. Sure, we can take supplements but most of those pills only mimic the Vitamins we would otherwise get through a healthy diet. There not one in the same. That said, 20 net grams of carbs is more than enough to live on---but your total carbs (including fiber and sugar alcohols does not require any limitation). Depending your choices though, you can certainly have more than 20 net grams of carbs and still be very healthy and lose lots of weight. You just have to monitor your calories a little more carefully.

Finally, even with your tiny tummy, you can easily get your calorie (nutrient) consumption up to 1000 to 1200 a day if you add in fats. A small handful of brazil nuts, macadamia nuts, pumpkin seeds or pecans will get you plenty of healthy fat, protein and fiber to fuel you through the day. Sure, these are calorie dense foods, but if you can't eat food in quantity, you should still try to get your calorie consumption up near 1000k a day. It's not going to really change your rate of weight loss significantly (it might slow things a tiny bit), but it will help you prevent regain to get yourself to a point where you can eat a sustainable amount of calories daily. You don't want your body to adapt to 600 calories a day and base your new set point on maintenance at that level. That's not a recipe for long term success.

[sillykitty 10,776]

@SteveT74 I think you are making a lot of assumptions here, based on your own experience. There are a lot of different paths to success after WLS.

@ms.sss is under care by both her surgeon and a nutritionist, and they are both satisfied

And as anecdotal evidence, I was very low cal during my weight loss, many days very similar to what @ms.sss describes. I did not wreck my metabolism. I got under goal weight without intending to. I am now averaging over 1500 cals a day, and still struggling to not continue to lose. (Btw 1500 cals avg is basically eating all day, since I have a lot of restriction) Now will I be a "long term success"? I hope so, but I can't know for certain, just as you can't.

We are all so different. I would never assume that someone on a different, but medically supervised plan, is going to be unsuccessful.

[SteveT74 360]

11 minutes ago, sillykitty said:

@SteveT74 I think you are making a lot of assumptions here, based on your own experience. There are a lot of different paths to success after WLS.

@ms.sss is under care by both her surgeon and a nutritionist, and they are both satisfied

And as anecdotal evidence, I was very low cal during my weight loss, many days very similar to what @ms.sss describes. I did not wreck my metabolism. I got under goal weight without intending to. I am now averaging over 1500 cals a day, and still struggling to not continue to lose. (Btw 1500 cals avg is basically eating all day, since I have a lot of restriction) Now will I be a "long term success"? I hope so, but I can't know for certain, just as you can't.

We are all so different. I would never assume that someone on a different, but medically supervised plan, is going to be unsuccessful.

I am not sure what you mean about assumptions. While there may be many ways to WL and more than one healthy dietary approach (points I fully agree with), you're making assumptions when you say her nutritionist is satisfied. That's not what I am reading. She says her nutritionist wants her to get her calories up, but not push herself since we know how that can go.

Moreover, I am not making far out assumption about OP's diet. She gives us the ino. OP said she's eating 5-600 calories and she's set goals of 70g Protein, 20-30 grams fat and 20 grams of net carbs. It doesn't sound like she's consistently hitting those goals if she's still under 600 calories, but I am going to assume she is for purposes of this response that she is hitting hose goals. If she hits those goals, she's eating 280 calories from protein per day, 80 calories from carbs and a max of 270 calories from fat--which adds up to 680 calories a day (although she says she's eating less than that), Based on this information, her macros are 41% protein, 39.5% fat (best case scenario) and 11.7% carbs. If she's at or under 600 calories a day, she's not actually hitting these goals and if her emphasis is on protein-- the balance is going to be heavier on protein and even lighter on carbs and fat. With such low calorie consumption, her present diet is likely not providing her with sufficient micronutrients in the long term. So, I am suggesting that if she is so restricted (bless her for that) it's hard to eat more calories in bulk that she is presently consuming, she can get her calories up by consuming foods that have healthy dense fats--like a handful or two of nuts a day that are high in healthy fats and protein. You don't need to eat a lot of nuts to get a lot of quality calories. This will get her where her nutritionist wants and will be manageable with a tight stomach. It will also help her in the long run potentially avoid some of the nutritional pitfalls that could happen (like Hair loss and other more significant issues).

I respect you a lot SillyKitty and love your posts, but don't think your reprimand--soft as it may have been--was warranted.

her nutritionist would like to see her get the calorie consumption up. Moreover, the info I was providing isn't based on assumption, it's based on science. OP can continue to stick to this type of diet and be ok in the short term, but it's not ideal. If she's meeting her protein numbers (which I assume she is--so, yeah, that's one assumption), she's consuming at least 300 calories in protein. If she is specifically trying to go low carb and low fat on 600 calories a day, you're I would reasonably assume her actual protein intake is more than needed to meet her surgeon's minimum. At this calorie consumption rate, you're looking at macros that 70% plus in protein. If that's the case, she doesn't need to necessarily cut down on her protein, but those macros should be balanced out a bit or there will be nutritional deficiencies. I am sure that's what her nutritionist is concerned about in the long term. Short term (say over a 5 or 6 month period), this might be ok. However, since she had surgery on

[FluffyChix 17,415]

32 minutes ago, SteveT74 said:

I am not sure what you mean about assumptions. While there may be many ways to WL and more than one healthy dietary approach (points I fully agree with), you're making assumptions when you say her nutritionist is satisfied. That's not what I am reading. She says her nutritionist wants her to get her calories up, but not push herself since we know how that can go.

Moreover, I am not making far out assumption about OP's diet. She gives us the ino. OP said she's eating 5-600 calories and she's set goals of 70g Protein, 20-30 grams fat and 20 grams of net carbs. It doesn't sound like she's consistently hitting those goals if she's still under 600 calories, but I am going to assume she is for purposes of this response that she is hitting hose goals. If she hits those goals, she's eating 280 calories from Protein per day, 80 calories from carbs and a max of 270 calories from fat--which adds up to 680 calories a day (although she says she's eating less than that), Based on this information, her macros are 41% protein, 39.5% fat (best case scenario) and 11.7% carbs. If she's at or under 600 calories a day, she's not actually hitting these goals and if her emphasis is on protein-- the balance is going to be heavier on protein and even lighter on carbs and fat. With such low calorie consumption, her present diet is likely not providing her with sufficient micronutrients in the long term. So, I am suggesting that if she is so restricted (bless her for that) it's hard to eat more calories in bulk that she is presently consuming, she can get her calories up by consuming foods that have healthy dense fats--like a handful or two of nuts a day that are high in healthy fats and protein. You don't need to eat a lot of nuts to get a lot of quality calories. This will get her where her nutritionist wants and will be manageable with a tight stomach. It will also help her in the long run potentially avoid some of the nutritional pitfalls that could happen (like Hair loss and other more significant issues).

I respect you a lot SillyKitty and love your posts, but don't think your reprimand--soft as it may have been--was warranted.

her nutritionist would like to see her get the calorie consumption up. Moreover, the info I was providing isn't based on assumption, it's based on science. OP can continue to stick to this type of diet and be ok in the short term, but it's not ideal. If she's meeting her protein numbers (which I assume she is--so, yeah, that's one assumption), she's consuming at least 300 calories in protein. If she is specifically trying to go low carb and low fat on 600 calories a day, you're I would reasonably assume her actual protein intake is more than needed to meet her surgeon's minimum. At this calorie consumption rate, you're looking at macros that 70% plus in protein. If that's the case, she doesn't need to necessarily cut down on her protein, but those macros should be balanced out a bit or there will be nutritional deficiencies. I am sure that's what her nutritionist is concerned about in the long term. Short term (say over a 5 or 6 month period), this might be ok. However, since she had surgery on

Steve with all due respect I’m going to agree with @sillykitty . What you describe isn’t my experience. I was in ketosis (had access to massive energy stores for fuel) long before I began my 2 week liquid pre-op diet whose main purpose is to empty the liver of fat and sugar and get you into ketosis.

Because i was MO, I had all the fat and endless energy to make up any lack of exogenous dietary fat. (Remember rabbit starvation is only a thing if you are super skinny—it doesn’t apply to the obese population.)

Due to ketosis, my insulin was low so I could access those energy stores any time! I had no need to add more fat to that which existed in my food choices (the fat in my meats, seafood, poultry,eggs,cheese, avocados, nuts/seeds.

in fact, I challenge anyone to a menu dual! That’s how confident I am that I’ve been maxing the nutrition in my diet !

Wait for it...

average cals for WEIGHTLOSS mode in the past 13 months have been 600-850 most of the time. I routinely eat about 30g total carbs, about 20 or less net carbs, 60-74g lean dense protein, and about 30-40g of fat per day.

I do take my supps faithfully. I feel good. I’m losing regularly. And satisfied. I’m on my way to goal #3.

my labs look good, my docs are very pleased, and my RD doesn’t want me to lose any more.

since being online I’ve seen countless people knuckle down with super low cal, low carb and moderate fat (low fat by your standards, but it is still about 45-50% fat by cals consumed.). They make lower than goal extremely quickly. And none that I know are stuck with maintenance calories at the 600-800 range. I personally maintain at somewhere between850-1100 cals but my metabolism was already broken pre-surgery. I don’t know what maintenance will look like for me. But most long term vets I know (3-15 years) eat well beyond 850 cals per day—most of them are either full blown low carb or carb cycle, or are athletic beasts and are metabolically flexible now.

No way can I lose at the needed rate during my honeymoon period at 800+ cals per day__low carb or otherwise. I just can’t. But I eat plenty and am satisfied.

Just my 2 cents.

[ms.sss 15,651]

Wow, being discussed so thoroughly seems oddly unsettling (?)

@SteveT74, thanks for taking the time to write all this, I can tell you have put a lot of thought and research into your posts. As someone who to tends to lose hours reading about subjects that interest me as well as take pride in composing a well thought out essay/email/argument/post-it note, I can appreciate your efforts.

To be clear, both my nutritionist and surgeon (and while i'm at it my PCP) are satisfied with my progress so far (despite my NUT preferring that I up my calories). I'm sure they think I could be doing even better, like more calories, more exercise, more sleep, less salt, less special-occasion alcohol, less Perrier (my nemesis!) etc, but for now they are cool with what I'm doing. Come three months from now, they may advise me differently, and thats cool too...I could very well be in a different position to better address that, then.

Edited March 29, 2019 by ms.sss

[sillykitty 10,776]

21 hours ago, SteveT74 said:

I am not sure what you mean about assumptions. While there may be many ways to WL and more than one healthy dietary approach (points I fully agree with), you're making assumptions when you say her nutritionist is satisfied. That's not what I am reading. She says her nutritionist wants her to get her calories up, but not push herself since we know how that can go.

Moreover, I am not making far out assumption about OP's diet. She gives us the ino. OP said she's eating 5-600 calories and she's set goals of 70g Protein, 20-30 grams fat and 20 grams of net carbs. It doesn't sound like she's consistently hitting those goals if she's still under 600 calories, but I am going to assume she is for purposes of this response that she is hitting hose goals. If she hits those goals, she's eating 280 calories from Protein per day, 80 calories from carbs and a max of 270 calories from fat--which adds up to 680 calories a day (although she says she's eating less than that), Based on this information, her macros are 41% protein, 39.5% fat (best case scenario) and 11.7% carbs. If she's at or under 600 calories a day, she's not actually hitting these goals and if her emphasis is on protein-- the balance is going to be heavier on protein and even lighter on carbs and fat. With such low calorie consumption, her present diet is likely not providing her with sufficient micronutrients in the long term. So, I am suggesting that if she is so restricted (bless her for that) it's hard to eat more calories in bulk that she is presently consuming, she can get her calories up by consuming foods that have healthy dense fats--like a handful or two of nuts a day that are high in healthy fats and protein. You don't need to eat a lot of nuts to get a lot of quality calories. This will get her where her nutritionist wants and will be manageable with a tight stomach. It will also help her in the long run potentially avoid some of the nutritional pitfalls that could happen (like Hair loss and other more significant issues).

I respect you a lot SillyKitty and love your posts, but don't think your reprimand--soft as it may have been--was warranted.

her nutritionist would like to see her get the calorie consumption up. Moreover, the info I was providing isn't based on assumption, it's based on science. OP can continue to stick to this type of diet and be ok in the short term, but it's not ideal. If she's meeting her protein numbers (which I assume she is--so, yeah, that's one assumption), she's consuming at least 300 calories in protein. If she is specifically trying to go low carb and low fat on 600 calories a day, you're I would reasonably assume her actual protein intake is more than needed to meet her surgeon's minimum. At this calorie consumption rate, you're looking at macros that 70% plus in protein. If that's the case, she doesn't need to necessarily cut down on her protein, but those macros should be balanced out a bit or there will be nutritional deficiencies. I am sure that's what her nutritionist is concerned about in the long term. Short term (say over a 5 or 6 month period), this might be ok. However, since she had surgery on

@SteveT74 I do also appreciate your well thought out responses and your passion.

The bolded part of your response is the crux of what I disagree with. The science of diet, weight loss, metabolism is not at all cut and dry. For every study that says one thing, you will find a study that contradicts it.

I stick by my assertion that you have made a lot of assumptions, or maybe a better term is have opinions, and are treating them as facts.

"you're excluding important micronutrients .. we can take supplements but most of those pillsonly mimic the Vitamins"

"your going to risk liver and kindney damage and possibly failure"

"It will also help her in the long run potentially avoid some of the nutritional pitfalls that could happen (like Hair loss and other more significant issues)."

"you need to have fats in your diet"

" you should still try to get your calorie consumption up near 1000k a day. It's not going to really change your rate of weight loss significantly (it might slow things a tiny bit), but it will help you prevent regain to get yourself to a point where you can eat a sustainable amount of calories daily. You don't want your body to adapt to 600 calories a day and base your new set point on maintenance at that level. That's not a recipe for long term success."

[GradyCat 3,695]

I'm 4 months post-op and just browsed through MyFitnessPal entries and it looks like I average 35-40 carbs per day