MiladyB

Nutrition and Vitamin Comparisons

72 posts in this topic

I received this chart from my surgeon's nutritionist today. (I LOVE my nutritionist!!) As a support group leader I get members who have had different types of weight loss surgery. I wanted to know the difference between the nutrition and vitamin recommendations for the varies types of weight loss surgeries. She sent me this chart and I thought all of you might find it as helpful as I did.

NUTRITIONAL COMPARISONS.doc

cinwa likes this

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That's an excellent chart Beth. Pity we don't all have a nutritionalist with that knowledge.

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That's an excellent chart Beth. Pity we don't all have a nutritionalist with that knowledge.

Yep, she certainly has a heart for her job. She isn't a wls patient but she struggled with being morbidly obese for years. She's been able to maintain a 80 pound weight loss for years. I told her once how much people on here appreciate her knowledge and all the information she gives. She teared up. :) So yeah, I think I've got a prize in her.

pmcq11 likes this

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Beth, I love your dietician!

I have a question, though. Under vitamins, it doesn't list B12. Do they not recommend that?

Kelly

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Thanks for the chart. It was helpful.

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Beth, I love your dietician!

I have a question, though. Under vitamins, it doesn't list B12. Do they not recommend that?

Kelly

Kelly, they don't include B12 because they have their patients take the Celebrate vitamins. Celebrate has the highest amount of B12 in their multi than any other bariatric vitamin. The practice has found that the amounts in the vitamins are enough to maintain a normal level of B12 the majority of the time. So no additional B12 is needed unless labs indicate the need. I was doing an additional B12 sublingual for several months. My B12 came back really high. I stopped taking the additional B12 and just stayed with the Celebrate multi-vitamin. It seems to be enough for me because my B12 levels are high normal at this time. I get it checked every 6 months to keep an eye on it.

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Huh. I thought we couldn't asborb it from a vitamin that we swallow, because we now lack the intrinsic factor that you need to absorb it? I take ENS, and two of those has the same amount of B12 as the chewable multis, plus I use the B12 patch, and mine's still kinda low. Wonder why?

Kelly

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Huh. I thought we couldn't asborb it from a vitamin that we swallow, because we now lack the intrinsic factor that you need to absorb it? I take ENS, and two of those has the same amount of B12 as the chewable multis, plus I use the B12 patch, and mine's still kinda low. Wonder why?

Kelly

Kelly, from the information that I have read we can absorb B12 in an oral formulation as long as we are taking an adequate amount.

You can refer to this article from Webscape:

http://www.medscape.com/viewarticle/545489_5

Vitamin B12 absorption is dependent on the presence of intrinsic factor, which is produced in the parietal cells of the stomach. In addition, hydrochloric acid is necessary to cleave vitamin B12 from protein in the stomach. These variations can lead to deficiencies in patients after gastric bypass surgery.[21] Monthly B12 injections are effective in this population; however, appropriate supplementation can also be achieved by using the oral formulation (1000

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Celebrate has the highest amount of B12 in their multi than any other bariatric vitamin.

This is incorrect. Bariatric Fusion vitamins have 600mcg of B12. Compared to the 350mcg of Celebrate. Aditionally, Fusion vitamins also have calcium citrate and iron in its vitamins. Celebrate does not. You need additonal supplements for calcium and iron. Fusion is also 25 bucks a month and you take 4 vitamins a day. It is by far the most complete vitamin for WLS patients. It is 25 bucks a month. Celebrate are 15 bucks if you buy 90 days, but you still need to add the iron, the calcium and you are getting a lesser quanitity of b12, which all people WLS or not, have a very difficult time absorbing

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Bariatric Fusion says on the label you only need to take four a day, but the ASMBS says we need 200% of the RDA of most vitamins and minerals after RNY, and four Bariatric Fusion doesn't give you that. It gives you 200% of some stuff, but four only gives you 100% of many things, including vitamin E, riboflavin, niacin, B6, and pantothenic acid. You would need to take eight a day in order to get the 200% we need.

They do contain some calcium citrate, but they contain some calcium carbonate. And they don't tell you how of of each they contain, only that it's 300 mg total per tablet. So if you took four a day, that would be 1200 mg. Only there is no way to know how much of it is citrate and how much is carbonate. And we need 1500 - 2000 mg calcium per day. So you would need to take some additional calcium citrate, but there's no way to figure out just how much.

Kelly

ardita likes this

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Oh! And even though Bariatric Fusion contain plenty of iron, you won't absorb it because they contain so much calcium. The calcium interferes with the absorption of iron. So you would probably need to take additional iron anyway.

Kelly

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Added to which, calcium and iron should never be taken together.

There may be some financial saving using Bariatric Fusion but bottom line, what price do you put on your future health.

SlimSmitty likes this

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lol Kelly - you beat me to it.

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lol Kelly - you beat me to it.

LOL.

Kelly

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Added to which, calcium and iron should never be taken together.

There may be some financial saving using Bariatric Fusion but bottom line, what price do you put on your future health.

I don't think you would really save anything. I mean, if you want to meet the ASMBS guidelines, you'd have to take eight a day, which would be about $50 a month. Then you'd have to add on calcium citrate. You'd be taking a ton of pills a day and it wouldn't save you money.

Kelly

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the ASMBS says we need 200% of the RDA of most vitamins and minerals after RNY

Kelly

I have been to their site several times and I see mention to the fact that a multivitamin must be taken, I can not locate any information to support how much or what percentages. Could you you link it cause I have to be an idiot to not find it.

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I have been to their site several times and I see mention to the fact that a multivitamin must be taken, I can not locate any information to support how much or what percentages. Could you you link it cause I have to be an idiot to not find it.

Sure. Here's the link to their guidelines. I think it's on page 7. And I believe it says something like 200% of the RDA of at least 2/3 of all nutrients. To be honest, that 2/3 part confuses me a little. Does it mean as long as it has 200% of at least 2/3 of stuff, it's OK? No matter which ones it is? Because it seems like we should need a certain amount of vitamin A and certain amount of vitamin D and you get the picture. How would it be OK if we have enough of 2/3 of things but not enough of the other 1/3? So I just look for 200% of most stuff.

http://www.asbs.org/Newsite07/resources/bgs_final.pdf

Kelly

ardita likes this

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thanks alot

I found the info on the calcium and iron not being taken together but not on the RDA of 200%.

TBH, I am fine with the calcium and iron together in one pill because, it is the iron that I wont fully absorb and since I am not a pre menapausal woman, my iron requirement is not nearly as high. Plus the weekend at wal mart, I found a bottle of iron of 250 pills for 5 bucks. this works out to 2 pennies a day or 60cents a month for additional iron. This is why the Fusion, coupled with an extra iron pill seemed like a good plan, until you tossed in the 200% RDA monkeywrench :) :)

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It's at the very top of page 7. Under multivitamin-multimineral supplement, it says "A high-potency multivitamin containing 100% of daily value for 2/3 of nutrients" and then over to the side, under the column for RNY, it says "200% of daily value."

There is still the calcium issue with Bariatric Fusion, too. Not enough calcium, and some of it's calcium carbonate, and you don't know how much. So there is no way to really figure out how much more calcium citrate you would need to take. You just know you'd need to take some.

I think the idea of getting all your vitamins in just four tablets a day is very attractive. Unfortuntely, it doesn't seem to work out very well in practice.

Kelly

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Kelly, I just wanted to get back to you about the B-12 in the Celebrate multi-vitamin. I sent Vic an email and asked him about the absorption, since we no longer have the intrinsic factor. Here is what he explained.

Beth

Sorry for the delay in getting back to you. From a formulation standpoint and from research, our products contain sufficient levels to ensure that MOST patients will not require additional B12 outside of our multivitamin. There is a common misconception about the absorption of B12. Sublingual or injection are probably the easiest forms for the body to absorb but the body will absorb B12 via passive absorption if taken orally. It is at a rate of 1-2% which is why we need to put so much in to be absorbed. 350 mcg equates to 3.5 to 7 mcg of absorption while the body needs 2 mcg daily to function and this does not take into account what is stored.

The thing to keep in mind is that everyone is different and there are a-lot of factors that play into how a person will react. You may be a person that falls into the B12 minority and if that is the case, then you should probably look at supplementing with additional B12. Working with your RD is the best bet and keeping a close watch on your labs which I know that you do.

I don't think that I am telling you anything that you don't already know but I hope that this helps.

Thanks.

Vic

Edited by MiladyB

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Thanks, Beth. Maybe I just don't absorb it well. Because I used the chewable vitamins from Celebrate for a number of months, along with the B 12 patch, and now I use ENS which I think has the same amount of B 12 as the chewables, and still use the patch, and mine is still low. I actually started using the patch twice a week instead of just once a week, and I'm gonna get it checked again next month, and if it's still low I guess I'm gonna start doing shots.

Kelly

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just to update myself - I have recieved my 90 day supply of Celebrate Chewables on Saturday. And I have a bottle of calcium citrate and a bottle of iron as well.

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just to update myself - I have recieved my 90 day supply of Celebrate Chewables on Saturday. And I have a bottle of calcium citrate and a bottle of iron as well.

Sounds like you are set. :) You may just want to check what form the iron is in. If it is Ferrous Sulfate you may find it pretty hard on your digestive system. The most absorbable forms are Carbonyl, Ferrous Fumerate and Ferrous Gluconate. The Carbonyl or Ferrous Fumerate are the best absorbed forms.

With the Calcium double check the labels to make sure you are getting in 1500mg of Elemental Calcium. Here is a thread to help you understand how to read the Calcium labels. http://www.thinnertimesforum.com/post-op-gastric-bypass/26018-you-sure-youre-getting-all-calcium-you-think-you.html

ardita likes this

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Toomany...I had to copy your info...

Aug. 27, 2009 - Joined this forum!!:D

9/2 - Added sig flair

9/2 - informational seminar

9/10 - initial consult and weight of 365

9/14 - Family Dr. appt

9/15 - Dr. requires bloodwork today

9/16 - support group mtg

9/17 - Psych Eval

9/21 - Nutitionist

9/22 - Cardiologist

9/28 - Echo and Stress test

10/8 - APPROVED!!

I can't believe people go through this process so fast! How can anyone learn a new lifestyle that quickly? Do most doctors just expect people to learn it as they go along after surgery? This is my timeline...

2/09-consultation w/ Bariatric TEAM including surgeon, physicians assistant, nutritionists, and nurses.

2/09-first nutritionist appointment

2/09 through 8/09-pretesting (leg ultrasounds, ekg, pulmonary testing, colonoscopy, upper endoscopy, etc.) to make sure I'm of sound health enough to go through surgery

3/09-nutritionist, new patient orientation

4,5,6,7,8,9/09-nutritionist (ongoing)

10/09-surgery

I had to lose ten percent of my weight in order to get the recommendation from the nutritionists for surgery...none of this two weeks ahead of time stuff I've seen other people do. I'm just in complete awe that doctors would make people go into something so serious so quickly without preparing them, and making them prove they're worthy first. I guess maybe I'm a lil jealous too, lol.

But...since my surgeon and nutritionists aren't up on the latest vitamin trends for bariatric patients (we ARE in Maine after all...the slowest state in the nation) I've been told to take Flintstones twice a day. Since being on here, and having the VP of Celebrate speak about his vitamins, and who he's had developing them, I've learned better. Since I have this big bottle of Flintstones, does everyone think it'd be ok to take four a day to make up the difference until they're gone and I can get some Celebrates? It's going to be a struggle for me to afford Celebrate, but I have to do what I have to do.

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Amy, I personally wouldn't do the Flintstones, even at four a day. Four a day would give you 200% of most thing, but it still only gives you 104% of biotin and they have NO selenium. The vitamin A in them is also not absorbed well, so I don't know if you'd actually end up getting enough of that with four Flintstones or not. I mean, it wouldn't kill you to use up the rest of them, but I couldn't recommend it, either.

If affording vitamins is going to be rough for you, I can tell you that Bariatric Advantage has a program that gives free vitamins to people in need. You could contact them and ask about it. I don't know the details about it. I do know you have to have your doctor fill out some form.

Kelly

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