Tag Archives: lifestyle management

Joint Pain, Weight Loss and Orthopedic Surgery

Posted on by
Reply

Orthopedic surgeons, rheumatologists and physicians specializing in rehabilitation medicine know that the knee joint has to support the force of three to six times one’s weight.  The impact of extra weight is also multiplied on other joints, including those of the back, hips and ankles.  The results of this increased wear and tear are impressive; for example, men who are just 40 pounds over their ideal body weight have a five-fold increase in osteoarthritis (1).  This close link between obesity and osteoarthritis is well documented (2).  Of course, the incidence of severe osteoarthritis in people that are one hundred or more pounds overweight is exponentially higher, and the age of onset is much earlier.  As always in medicine, unless patients and their doctors attack the root cause of their disease, in this case arthritis, medications and other therapy will only temporarily alleviate the pain and allow for permanent injury to the bone and cartilage.

For patients who do not yet require surgery to replace damaged joints, substantial weight loss has been shown to alleviate the debilitating symptoms of osteoarthritis.  Schauer, et al, documented that seventy percent of patients that were taking medications for joint pain had no pain and were off all arthritis medications after weight loss surgery (3). Another published study documented that 58 percent of patients undergoing weight loss surgery complained of chronic low back pain, but this number decreased to only 20 percent after surgery (4).

Unfortunately, not everyone will have resolution of his or her knee pain after weight loss since joint cartilage lost after years of obesity will never regenerate.  This damage may result in the need for surgery to repair or replace the damaged joint.  Of course, recovery from joint replacement is more difficult in obese patients and many orthopedic surgeons will not perform joint replacement surgery in severely obese patients because of the significantly higher risk of complications.  A patient who is unable to undergo joint replacement due to excess weight is a prime example of a person who needs surgical weight loss.

To evaluate the impact of surgical weight loss on patients requiring joint replacement therapy, the Mayo Clinic followed 20 patients who had hip and knee replacements after weight loss from gastric bypass.   This recent study found a significant improvement in physical rehabilitation after joint replacement in patients who had previous weight loss due to gastric bypass.   In fact, not only did the recovery from joint replacement improve, the re-operation rate due to complications after surgery was dramatically lower (5).

Everyone is aware that osteoarthritis will often improve with good weight control.  For those people who are severely obese and are suffering from chronic joint pain, surgery for permanent weight control may be the best option to help your physician or surgeon improve your treatment results.

1- Annals of Rheumatic Disease; Felson, 1996,  2- Amer. Jour. of Public Health; Sahyoun, 1999, 3- Schauer 20004, 4- Melissas, 2004, 5- Parvizi, 2000

Article courtesy of Ramsey Dallal, MD

Share


Heart Failure Risk Increasing

Posted on by
Reply

Four Pounds Can Make a Difference

The numbers are startling.

Nearly four out of 10 Americans will be obese within five years if people keep packing on pounds at the current rate.

Currently, about 31%, or about 59 million people, are obese, which is defined as roughly 30 or more pounds over a healthy weight. Almost 65% are either obese or overweight, according to government statistics.

The average American has gained eight pounds in the past 10 years, in spite of research proving that people could live longer and healthier at an ideal body weight.  And, half this “average American” weight gain, or a mere four pounds, could be enough to significantly increase the risk of heart failure.

Cardiologists will be first to acknowledge that obesity increases the risk of death from heart disease. Doctors have long known that obesity contributes to heart failure — specifically an enlargement and thickening of the left ventricle, the heart’s main pumping chamber. But we were never sure how much of the added risk stems from obesity, or its impact on blood pressure and other risk factors.

Now, a new study shows that being slightly overweight — as little as a few pounds over — can increase that risk. It’s the first major study to probe the progressive relationship between weight gain and heart failure.

In the New England Journal of Medicine1, a study involving nearly 6,000 people followed for over 14 years by the Boston University School of Medicine, demonstrated that being even moderately overweight is a causative factor of congestive heart failure in women.  In other words, many cases of heart failure can be attributed to obesity alone.

People in this study were not extremely obese. Even a little excess weight, the study found, can raise the risk of congestive heart failure.

In fact, “after adjustment for established risk factors, the risk of heart failure is increased by 5% for men and 7% for women for each increase of 1 in Body Mass Index (BMI),” says the journal report.

Because patients who qualify for bariatric surgery have a BMI that is at least 15 points above a “healthy weight,” their risk for heart failure is increased by at least 100%.

We are very good at treating all consequences of obesity — high blood pressure, high cholesterol, diabetes. But, when it comes to treating obesity itself, we often throw up our hands.  That just doesn’t make sense.

Minimally invasive weight-loss surgery has proven to be successful with thousands of obese patients. At The N.E.W Program, when we get patient’s weight down, we discover their diabetes improves, their cholesterol is lower, their blood pressure looks better.

Heart failure is yet another bad medical condition to have. And, for people with severe obesity or worse, we know that bariatric surgery is certainly a successful method to eliminate this grim prognosis.

Article by Dr. B. Quebbemann.

(Brian Quebbemann, MD, FACS is the Surgical Director of The N.E.W. Program, Inc.)


Share


Tofu & Broccoli Stir-Fry

Posted on by
Reply

This is a tasty vegetarian meal that even meat-eaters will love. Tofu is a versatile protein that takes on the flavors of the foods it’s cooked with. Like all soy foods, tofu is very heart-healthy, in part because it is often used as a replacement for meats that may be high in saturated fat or cholesterol. Broccoli is a member of the cruciferous family of vegetables, which are known for their role in cancer prevention. It is also very high in insoluble fiber, which helps to keep the colon healthy. The protein and fiber make this dish very filling on its own, but you may also choose to add a whole grain, such as quinoa or brown rice.

4 servings, 1 1/4 cups each

Active Time: 30 minutes

Total Time: 30 minutes

Ingredients

  • 1/2 cup vegetable broth or reduced-sodium chicken broth
  • 1/4 cup dry sherry (see Note) or rice wine
  • 3 tablespoons reduced-sodium soy sauce
  • 3 tablespoons cornstarch, divided
  • 2 tablespoons plus 1 teaspoon sugar
  • 1/4 teaspoon crushed red pepper, or more to taste
  • 1 14-ounce package extra-firm water-packed tofu, drained
  • 1/4 teaspoon salt
  • 2 tablespoons canola oil, divided
  • 1 tablespoon minced garlic
  • 1 tablespoon minced fresh ginger
  • 6 cups broccoli florets
  • 3 tablespoons water

Preparation

  1. Combine broth, sherry (or rice wine), soy sauce, 1 tablespoon cornstarch, sugar and crushed red pepper in a small bowl. Set aside.
  2. Cut tofu into 3/4-inch cubes and pat dry, then sprinkle with salt. Place the remaining 2 tablespoons cornstarch in a large bowl. Add the tofu; toss gently to coat. Heat 1 tablespoon oil in a large nonstick skillet or wok over medium-high heat. Add the tofu; cook, undisturbed, until browned, about 3 minutes. Gently turn and cook, stirring occasionally, until browned all over, 2 to 3 minutes more. Transfer to a plate.
  3. Reduce heat to medium. Add the remaining 1 tablespoon oil, garlic and ginger; cook until fragrant, about 30 seconds. Add broccoli and water; cover and cook, stirring once or twice, until tender-crisp, 2 to 4 minutes. Stir the reserved broth mixture and add to the pan. Cook until the sauce has thickened, 1 to 2 minutes. Return the tofu to the pan; toss to combine with the broccoli and sauce.

Nutrition
Per serving: 258 calories; 13 g fat (1 g sat, 9 g mono); 0 mg cholesterol; 23 g carbohydrates; 7 g added sugars; 14 g protein; 4 g fiber; 544 mg sodium; 539 mg potassium.

Recipe courtesy of eatingwell.com.


Share


Join Us!

Posted on by
Reply

Join us this Tuesday, Sept. 21, for a one-of-a-kind special event guaranteed to make you feel beautiful inside and out!  Hairstylist Matt Viers will share tips for updating your hairdo for your healthy lifestyle. Karla Campbell, Registered Dietitian, will teach you how the foods you eat can give you stronger hair and nails.  See you then!

Call Julian Reyes at 949.428.4118 to register.  Hurry, seating is limited!


Share


The Final Touch

Posted on by
Reply

Skin reduction surgery helps weight-loss patients achieve their ultimate goals.

Each year, well over 100,000 people undergo bariatric surgery in the United States in the battle against an obesity epidemic that affects nearly nine million Americans.  In their first year after weight-loss surgery, those who comply with their physician’s diet and exercise advice typically lose a significant amount of weight.

While this weight reduction is a great victory for their physical and psychological health, many of these people are dismayed by the large amount of excess skin that remains on their arms, abdomen, waist, thighs, breasts and other areas.

Fortunately, plastic surgery offers an excellent solution to alleviate this problem.  However, for a variety of reasons, post-bariatric surgery patients present special challenges for additional surgery and should, therefore, seek out a plastic surgeon who understands their special needs and has experience in this rapidly developing sub-specialty.

Safety First

Safety is the most critical consideration for all surgery patients, but even more so for those who have had bariatric surgery.  Because of the nature of stomach-reduction procedures, these patients often have altered hemodynamics (blood flow throught the body) and may have ionic imbalances, which can lead to such conditions as iron deficiency anemia and deficiency of vitamin B12 and/or folate.  Therefore, thorough blood work to detect these and other possible complications is an absolute necessity prior to skin reduction surgery.

In addition, these considerations also place a limit on the length of time this patient should be in surgery.  Because of this and the often great amount of skin to be removed, patients are normally counseled to expect a series of surgeries to accomplish all of the skin reduction they desire.

Special Considerations

A plastic surgeon who is skilled in skin reduction for post-bariatric patients will know how to modify common plastic surgery techniques to accommodate the especially large amount of skin to be managed.  For instance, the tummy tuck incision is started lower and modified to eliminate skin folds.  Other incision changes are used to make adjacent body features look attractive and natural.

Surgeons familiar with the special needs of post-bariatric patients are careful to minimize the risk of pressure sores by padding key areas of the body during surgery.  These patients are also at risk for hypothermia, so they are provided a warm room and intravenous fluids to keep their internal body temperature at an appropriate level.

Both during and after surgery, there is special attention given to minimizing the risk of blood clot formation.  Surgeons give patients IV medication and place special compression garments on them while operating.  As soon as possible after surgery, patients are encouraged to walk in order to deter the development of clots that can move through the body and damage vital organs or even threaten a heart attach or stroke.

Also following surgery, skin reduction patients are closely monitored to avoid variety of complications from diabetes, sleep apnea, a body mass index (BMI) greater that 35 and other conditions they may have developed while they were obese.

Overall, post-bariatric patients are to be commended for their diligence and perseverance in losing their excess weight.  Skin reduction surgery goes the extra step beyond that achievement to finally give them the desired result of all their efforts.

Article by Arian Mowlavi, MD


Share


“Because You Can”

Posted on by
Reply

Thursday, September 23

“Because You Can”

A few of our successful patients will be talking about their weight loss experience and how their careers and lifestyles have greatly affected their everyday life. Come Join Us!

Please Contact Julian Reyes – 949.428.4118 to Sign Up

*Seating Limited*



Share


“Shape Your Body”

Posted on by
Reply

Wednesday, September 22
“Shape Your Body”

Have you lost a considerable amount of excess weight and are looking for tips and treatments on how to tighten your skin? Board Certified Plastic Surgeon, Dr. Richard Lee, will be hosting a “Free body Contouring Seminar” focusing on tummy tucks. Come Join Us!

Please Contact Julian Reyes – 949.428.4118 to Sign Up

*Seating Limited*


Share


“Let Your Hair Down”

Posted on by
Reply

Tuesday, September 21
“Let Your Hair Down”

Hairstylist Matt Viers will be giving tips and techniques on how to improve YOUR look! Karla Campbell, RD will suggest   vitamins and supplements that can strengthen your hair and nails! Come Join Us!

Please Contact Julian Reyes – 949.428.4118 to Sign Up

*Seating Limited*



Share


Protein and Muscular Fitness

Posted on by
Reply

Exercise trainers often recommend amino acid supplements to their clients stating that they increase their energy, increase stamina, and build muscle mass or burn calories.  The truth is that you can get more amino acids (an important component of dietary protein) if you simply spend your money on protein rich foods like fish, meat and dairy products.  In theory, if you want to gain 1 pound of muscle per week, you will need 14 extra grams of protein per day, the amount of protein contained in 2 ounces of red meat.  The fact is, there is no scientific evidence that individual amino acids have any bodybuilding effect. When it comes to developing well-toned muscles, exercise, and natural whole-food nutrition is all that’s required.  The N.E.W. Program, Inc. emphasizes this healthy balance for our clients.

The N.E.W. Program teaches clients how to obtain a more active lifestyle by practicing a few simple lifestyle pattern guidelines.  These lifestyle patterns are the topic discussed in our unique Lifestyle Management Program, now offered ON-LINE through the website www.thenewprogram.com.  Join us for a these insightful and power-packed workshops and learn how to implement the simple patterns you need to control your weight forever.

Share/Bookmark


Amino Acids: Food versus Pill

Posted on by
Reply

Bodybuilders often spend a lot of money on amino acid supplements and they encourage their clients to buy these supplements stating that they increase their energy, stamina and muscle mass.  The truth is that you can get more amino acids (proteins) if you spend your money on wholesome foods.

According to the advertisements in muscle building magazines, protein powders and amino acids are essential for optimal muscle development.   Unfortunately these misleading articles have led to the general population spending billions of dollars every year on these types of products. We are often led to believe that just because it is legal and they sell a lot of it then it must be good for you….kind of like cigarettes?!  To date there is no scientific evidence that individual amino acids have any bodybuilding effect. The body needs all the essential amino acids to make new muscles.  Real food provides the proper balance of all the amino acid’s, costs less, and does not overburden the kidneys.

Often athletes want to bulk up and they take protein pills and powders and are amazed that in 6 weeks they have such improved muscle mass and tone. They attribute it to the protein pill rather then the fact that they have a strenuous work out routine every day and have greatly improved their eating habits.   Wholesome meals and consistent training make more of a difference then the protein supplement.

Exercise not excessive protein is the key to developing bigger muscles.  In theory, if you want to gain 1 pound of muscle per week, you need 14 extra grams of protein per day, the amount in 2 ounces of meat.

The chart below compares two popular amino acids in the natural food versus the supplement.

Amount                                                arginine(mg)                  leucine(mg)
Food

2 egg whites                                          380                               600
1C skim milk                                         350                               950
4oz chicken breast                                 2100                             2650
6oz tuna                                                2700                             3700

Supplement

1 serving Twin Labs amino fuel              85                                 320
1 serving Ultimate Nutrition                    350                               1260
1 serving Nature’s Best                         440                               1300

The actual cost comparison reveals that supplements cost anywhere from 2-4x what the whole food cost for the equivalent amount of protein.