IS PROTEIN SUPPLEMENT REQUIRED AFTER OBESITY AND METABOLIC SURGERY?
Proteins are the basic building blocks of our body. In addition to being the building blocks, many biological functions are carried out through proteins. At the same time, proteins can be used as an energy source in case of hunger.
Obesity and metabolic surgery operations (bariatric surgeries) are mainly divided into two groups. Volume-restricting and absorption-impairing surgeries. Both types of surgery put the body in a controlled state of starvation. The aim in the post-operative period is to prevent the use of proteins as an energy source by providing adequate protein and energy intake to the body. The target is the loss of adipose tissue while preserving muscle tissue.
The loss of muscle tissue reduces the body’s basal calorie needs. Patients lose weight fast, but; There may be an increase in weight regain rates.
According to the American Metabolic and Bariatric Surgery guide and the Turkish Endocrinology and Metabolism Society’s Bariatric Surgery Guide; It is recommended to take 60-120 g of protein per day for patients who have undergone bariatric surgery.
In surgeries where the stomach volume is reduced or malabsorption; Adequate protein intake may not be achieved due to complications such as inadequate nutrient intake, malabsorption or vomiting/food intolerance.
Studies have shown that the targeted protein amount cannot be reached in the first months (especially liquid and puree periods). It was observed that only two-thirds of the patients’ targeted protein amount could be tolerated (approximately 30-50g). For this reason, it has been determined that PROTEIN SUPPORT MUST BE USED AT THE FIRST MONTH after the surgery.
There are some products produced specifically for postbariatric patients. Sufficient protein supplementation is often possible with these products.
In addition, it is possible to make protein supplements with some recipes that can be made at home.
Whey (whey proteins) is the protein with the highest nutritional value among other nutritional proteins (egg, soy, etc.). The availability of whey in the body is approximately 15% more than the availability of egg protein. It is supportive to prevent sarcopenia (muscle loss, decrease in muscle strength and function).
Obese individuals can consume whey. It has an effect that keeps you full and accelerates fat burning. It is also good for stomach problems and relieves bloating.
Thanks to the vitamins and minerals in its content, it is among the nutrients that balance the sugar rate in the blood if consumed regularly.
To make whey, cheese must first be made. In order to obtain cheese, it is necessary to cut and strain the milk with an acidic substance such as lemon or vinegar. After curdling and straining the milk, the cheese remaining at the top and the slightly sour-smelling yellowish water at the bottom is whey.
If the whey is to be consumed in a short time, it is placed in a glass jar and stored in the refrigerator. It is very important to keep your mouth closed while storing this water.
If you want to store it for more than 5 days, you have to put it in the freezer.
How can you evaluate whey at home?
- You can use it as a thickener in soups.
- You can create a protein-rich diet thanks to the whey you will use in recipes such as pancakes or omelets.
- You can use it in meat marination sauces.
- Whey, consumed with fruit, can be consumed as a natural protein drink.
- Soup recipe with whey
Materials
- 4 cups of whey
- Salt
- 1 egg
- Juice of half a lemon
- 3 tablespoons of yogurt
All the ingredients are taken into the soup pot. It is whipped using a whisk and made smooth. It should be stirred continuously until it boils. After 10 minutes, the stove is turned off. If it has a thick consistency, hot water can be added. If it has a light consistency, up to half a glass of water can be added.
RED CREPE
- 2 Tablespoons Oatmeal Flour
- 1 cup unflavored whey protein
- 1 whole egg
- 1 egg white
- 1 red bell pepper
- Salt
All the ingredients are taken into a bowl and mixed until smooth. The pan is greased with a small amount of olive oil and left on high heat until the pan is heated. When the pan is heated, it is reduced to medium heat. Some mixture is added to the pan and spread to cover the pan. After both sides are cooked, it is taken to the plate. Cook in the same way until the mixture is finished.
After preparing the pancakes, you can fill them with chicken, vegetables and cheese to increase their nutritional value.
- TOMATO SAUCE
- 1 Kg Tomato
- 4 cloves of garlic
- ¼ Chopped Onion
- ¼ Cup of Whey
- Fresh Basil
- Salt, Black Pepper
All ingredients except whey are mixed with a blender until smooth. Cook on medium heat for 5-10 minutes until boiling. Once removed from the heat, slowly add the whey while stirring. It can be used as a sauce for Meat/Chicken Dishes and instead of tomato paste for vegetable dishes.
One of the mistakes that patients often make is to use products known as ‘athlete products’ for protein supplements. Sports products and postbariatric protein supplements differ from each other in content. ATHLETE PRODUCTS ARE NOT RECOMMENDED FOR POSTBARIATRIC PATIENTS!
| POSTBARIATRIC PROTEIN SUPPLEMENT | ATHLETE PRODUCTS |
| low carb | Various carbohydrate content |
| High fiber content | Various fiber content |
| Essential amino acid content regulated | Variable |
| added vitamins | No vitamin content |
| Does not contain sugar | Contains sugar |
| lactose free | Usually contains lactose |
Things to consider in the products used while making protein supplements
- It should be 100% digestible, rich in essential amino acids (histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine).
- It should contain whey, soy and egg protein as a protein source.
- If there is lactose intolerance, isolated whey protein should be preferred.
- It should contain 14-25 g of protein.
- It should be between 150-250 calories.
- It should contain less than 5g of sugar and less than 5g of fat. (Dumping Syndrome can be seen if the sugar content is high)
- It should contain fiber, do not contain lactose and gluten (for the absence of gas, bloating, diarrhea problems)
Daily protein intake should not exceed 2.1 g per kg. Protein supplementation should be done under the supervision of postbariatric dietitians. The content, duration of use, and consumption of protein supplements are regulated by postbariatric dietitians.
In case of insufficient protein intake;
- Weight loss comes from muscle tissue, not from adipose tissue.
- The immune system is weakened.
- Wound healing is delayed.
- Hair loss, sagging, skin problems occur.
- Intense fatigue is felt.
DYT. TUĞBA GÜNAL
KAYNAKLAR:
- Luca Busetto ,Dror Dicker, Carmil Azran ,Rachel L. Batterham , f Nathalie Farpour-Lambert, Martin Fried, Jøran Hjelmesæth ,Johann Kinzl, Deborah R. Leitner,Janine M. Makaronidis , Karin Schindler l Hermann Toplak,Volkan Yumuk, Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management ;2017
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