FAAAAAHTS or Gastrointestinal colonization with methanogens increases difficulty of losing weight after bariatric surgery

Gastrointestinal colonization with methanogens increases difficulty of losing weight after bariatric surgery.

This is totally my gut.

 

I feel like we knew this - have you lived with a gastric bypass or duodenal switch patient for a period of time?  I'm just saying, those of us with altered bariatric intestines  LIVE with "MARSH ASS."   Welcome to the world of pre-biotics, probiotics, fart-smell-better products and I kid you not, LINED UNDERWEAR.  

 

Hey, I never said I was a professional.  Read the studies.

 

What is a methanogen?  Wisegeek says --

"Methanogens are a type of microorganism that produces methane as a byproduct of metabolismin conditions of very low oxygen. They are often present in bogs, swamps, and other wetlands, where the methane they produce is known as "marsh gas." Methanogens also exist in the guts of some animals, including cows and humans, where they contribute to the methane content of flatulence. Though they were once classified as Archaebacteria, methanogens are now classified as Archaea, distinct from Bacteria.

Some types of methanogen, including those of the Methanopyrus genus, are extremophiles, organisms that thrive in conditions most living things could not survive in, such as hot springs, hydrothermal vents, hot desert soil, and deep subterranean environments. Others, such as those of the Methanocaldococcus genus, are mesophiles, meaning they thrive best in moderate temperatures.  Methanobrevibacter smithii is the prominent methanogen in the human gut, where it helps digest polysaccharides, or complex sugars."

Gut bacteria may decrease weight loss from bariatric surgery March 6, 2015

 

Source: Cedars-Sinai Medical Center

The benefits of weight loss surgery, along with a treatment plan that includes exercise and dietary changes, are well documented. In addition to a significant decrease in body mass, many patients find their risk factors for heart disease are drastically lowered and blood sugar regulation is improved for those with Type 2 diabetes.

Some patients, however, do not experience the optimal weight loss from bariatric surgery. The presence of a specific methane gas-producing organism in the gastrointestinal tract may account for a decrease in optimal weight loss, according to new research by Ruchi Mathur, MD, director of the Diabetes Outpatient Treatment and Education Center at Cedars-Sinai.

"We looked at 156 obese adults who either had Roux-en-Y bypass surgery or received a gastric sleeve. Four months after surgery we gave them a breath test, which provides a way of measuring gases produced by microbes in the gut," said Mathur. "We found that those whose breath test revealed higher concentrations of both methane and hydrogen were the ones who had the lowest percentage of weight loss and lowest reduction in BMI (body mass index) when compared to others in the study."

The methane-producing microorganism methanobrevibacter smithii is the biggest maker of methane in the gut, says Mathur, and may be the culprit thwarting significant weight loss in bariatric patient. Mathur and her colleagues are conducting further studies to explore the role this organism plays in human metabolism.

While that research continues, bariatric patients may still have options to improve weight loss after surgery.

"Identifying individuals with this pattern of intestinal gas production may allow for interventions through diet. In the future there may be therapeutic drugs that can improve a patient's post-surgical course and help them achieve optimal weight loss," said Mathur.

The study, "Intestinal Methane Production is Associated with Decreased Weight Loss Following Bariatric Surgery" was done in collaboration with the Mayo Clinic. The paper is being presented by Mathur Thursday, March 5, at the 97th annual meeting of the Endocrine Society in San Diego.

 

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Diabetes Remission Post Bariatric Surgery - or - Diabetes Comes Back For Some After WLS.

Diabetes Remission Post Bariatric Surgery

Medscape -  

Researchers in Pennsylvania have developed a tool comprising 4 preoperative clinical variables that surgeons and patients can use to predict the likelihood of type 2 diabetes remission after Roux-en-Y gastric bypass surgery.

Christopher D. Still, DO, director of Geisinger Obesity Institute, Danville, Pennsylvania, and colleagues developed their algorithm, known as the DiaRem score, on the basis of a retrospective cohort study of 690 patients who underwent gastric bypass surgery. They verified the results in 2 additional cohorts; their findings were published online September 13 in the Lancet Diabetes and Endocrinology.

DiaRem scores range from 0 to 22, with low scores consistently predicting higher remission rates and high scores predicting lower remission rates.

"Bariatric surgery is a very effective tool not so much for weight loss but curing or resolving comorbid medical problems," Dr. Still told Medscape Medical News in a telephone interview. "The surgery is the best we have for long-term success, but it's not without potential risks and costs."

RNY patients after gastric bypass surgery have lower brain-hedonic responses to food than after gastric banding

RNY patients lose more than gastric band patients, and this study hypothesizes that RNY patients "think" differently about food.

As a ten-year RNY patient - I scream - AYE!  FOR THE LOVE OF DOG DO NOT FEED ME ICE CREAM!

It's called DUMPING SYNDROME, our brains learn to connect certain foods to the reactions they might or will cause, which is a learned behavior, and our brains react, which can be SEEN on an MRI machine.  Twitch.  Twitch.  (And, no, many people never ever learn.)

Amazing.

Study -

• http://gut.bmj.com/content/early/2013/08/20/gutjnl-2013-305008.full

Objectives Roux-en-Y gastric bypass (RYGB) has greater efficacy for weight loss in obese patients than gastric banding (BAND) surgery. We hypothesise that this may result from different effects on food hedonics via physiological changes secondary to distinct gut anatomy manipulations.

Design We used functional MRI, eating behaviour and hormonal phenotyping to compare body mass index (BMI)-matched unoperated controls and patients after RYGB and BAND surgery for obesity.

Results Obese patients after RYGB had lower brain-hedonic responses to food than patients after BAND surgery. RYGB patients had lower activation than BAND patients in brain reward systems, particularly to high-calorie foods, including the orbitofrontal cortex, amygdala, caudate nucleus, nucleus accumbens and hippocampus. This was associated with lower palatability and appeal of high-calorie foods and healthier eating behaviour, including less fat intake, in RYGB compared with BAND patients and/or BMI-matched unoperated controls. These differences were not explicable by differences in hunger or psychological traits between the surgical groups, but anorexigenic plasma gut hormones (GLP-1 and PYY), plasma bile acids and symptoms of dumping syndrome were increased in RYGB patients.

Conclusions The identification of these differences in food hedonic responses as a result of altered gut anatomy/physiology provides a novel explanation for the more favourable long-term weight loss seen after RYGB than after BAND surgery, highlighting the importance of the gut–brain axis in the control of reward-based eating behaviour.

Understanding and Managing Food #Addiction (and SUGAR!) Livestream Video Via Obesity Action Coalition (OAC)

• Absolutely worth the watch if you like good brain food.

• Dr. Nicole Avena is a research neuroscientist and expert in the fields of nutrition, diet and addiction. She received a Ph.D. in Neuroscience and Psychology from Princeton University, followed by a postdoctoral fellowship in molecular biology at The Rockefeller University in New York City. She has published over 50 scholarly journal articles, as well as several book chapters and a book, on topics related to food, addiction, obesity and eating disorders. She also edited the book, Animal Models of Eating Disorders (2012) and has a popular book of food and addiction coming out in 2014 (Ten Speed Press). Her research achievements have been honored by awards from several groups including the New York Academy of Sciences, the American Psychological Association, the National Institute on Drug Abuse, and her research has been funded by the National Institutes of Health (NIH) and National Eating Disorders Association. She also maintains a blog, Food Junkie, with Psychology Today.

• http://www.facebook.com/DrNicoleAvena

Sugary drinks linked to 180,000 deaths worldwide - Sugar is a toxin?

Well, yeah?  Listen to the entire video before judging please.  

"What if you're NOT an athlete?" <-- like most of us?  Sugar is NOT okay, builds up, and causing obesity.

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So maybe being pear-shaped is not such a good thing?

We have heard for years that being pear-shaped was preferable to other body-shapes, that carrying excess body-fat in the hips, thighs, legs and rear was 'healthier' than the belly.  That 'pears' were a preferable body-shape to have than 'apples.'  This is not necessarily so.

Chicago Tribune - via Journal of Clinical Endocrinology

If you're pear-shaped and smug, a new study's findings may take you down a peg: For those at slightly increased risk of developing diabetes, fat stored in the buttocks pumps out abnormal levels of two proteins associated with inflammation and insulin resistance. (And that's not good.)

The new research casts some doubt on an emerging conventional wisdom: that when it comes to cardiovascular and diabetes risk, those of us who carry some excess fat in our hips, thighs and bottoms ("pear-shaped" people) are in far better shape than those who carry most of their excess weight around the middle ("apples").

The new study was posted online this week in the Journal of Clinical Endocrinology and Metabolism, and it focuses on a number of proteins, with names such as chemerin, resistin, visfatin and omentin-1, that could one day be used to distinguish between obese people headed for medical trouble and those whose obesity is less immediately dangerous.

The subjects in the study were all people with "nascent" metabolic syndrome — meaning patients who already have at least three risk factors for developing diabetes (large waist circumference, high blood pressure, high triglcerides, low HDL, or "good" cholesterol, and high fasting blood sugar) but no cardiovascular disease or diabetes complications yet.

The researchers found these subjects' "gluteal adipose tissue" — fat in and around the buttocks — pumped out unusually high levels of chemerin, a protein that has been linked to high blood pressure, elevated levels of C-reactive protein, triglycerides and insulin resistance, and low levels of good cholesterol. The blood and subcutaneous fat drawn from gluteal tissue also contained unusually low levels of omentin-1, a protein that, when low, is linked to high triglycerides, high circulating glucose levels and low levels of good cholesterol.

"Fat in the abdomen has long been considered the most detrimental to health, and gluteal fat was thought to protect against diabetes, heart disease and metabolic syndrome," said Ishwarlal Jialal, a professor of pathology and laboratory medicine and of internal medicine at UC Davis and lead author of the study. "But our research helps to dispel the myth that gluteal fat is innocent," he added.

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Weight Loss Surgery Doesn't Cure Diabetes, forever - Sorry.

"I had weight loss surgery and beat diabetes, FOREVER!"  Not so much.

Don't buy that tee shirt just yet.

NYT -

Many people whose diabetes at first went away were likely to have it return. While weight regain is a common problem among those who undergo bariatric surgery, regaining lost weight did not appear to be the cause of diabetes relapse. Instead, the study found that people whose diabetes was most severe or in its later stages when they had surgery were more likely to have a relapse, regardless of whether they regained weight.

“Some people are under the impression that you have surgery and you’re cured,” said Dr. Vivian Fonseca, the president for medicine and science for the American Diabetes Association, who was not involved in the study. “There have been a lot of claims about how wonderful surgery is for diabetes, and I think this offers a more realistic picture.”

The findings suggest that weight loss surgery may be most effective for treating diabetes in those whose disease is not very advanced. “What we’re learning is that not all diabetic patients do as well as others,” said Dr. David E. Arterburn, the lead author of the study and an associate investigator at the Group Health Research Institute in Seattle. “Those who are early in diabetes seem to do the best, which makes a case for potentially earlier intervention.”

Study - http://www.ncbi.nlm.nih.gov/pubmed/23161525

Obes Surg. 2012 Nov 18. [Epub ahead of print]

A Multisite Study of Long-term Remission and Relapse of Type 2 Diabetes Mellitus Following Gastric Bypass.

Source

Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA, [email protected].

Abstract

BACKGROUND:

Gastric bypass has profound effects on glycemic control in adults with type 2 diabetes mellitus. The goal of this study was to examine the long-term rates and clinical predictors of diabetes remission and relapse among patients undergoing gastric bypass.

METHODS:

We conducted a retrospective cohort study of adults with uncontrolled or medication-controlled type 2 diabetes who underwent gastric bypass from 1995 to 2008 in three integrated health care delivery systems in the USA. Remission and relapse events were defined by diabetes medication use and clinical laboratory measures of glycemic control. We identified 4,434 adults with uncontrolled or medication-controlled type 2 diabetes who had gastric bypass.

RESULTS:

Overall, 68.2 % (95 % confidence interval [CI], 66 and 70 %) experienced an initial complete diabetes remission within 5 years after surgery. Among these, 35.1 % (95 % CI, 32 and 38 %) redeveloped diabetes within 5 years. The median duration of remission was 8.3 years. Significant predictors of complete remission and relapse were poor preoperative glycemic control, insulin use, and longer diabetes duration. Weight trajectories after surgery were significantly different for never remitters, relapsers, and durable remitters (p = 0.03).

CONCLUSIONS:

Gastric bypass surgery is associated with durable remission of type 2 diabetes in many but not all severely obese diabetic adults, and about one third experience a relapse within 5 years of initial remission. More research is needed to understand the mechanisms of diabetes relapse, the optimal timing of surgery in effecting a durable remission, and the relationship between remission duration and incident microvascular and macrovascular events.

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Chemicals in nail polish, hairspray linked to diabetes in women?

Chemicals commonly found in beauty products such as nail polishes, hair sprays and perfumes may increase risk of diabetes for some women, new research suggests.

Oh.

Is Sugar Toxic?

I don't know HOW I missed this episode of 60 Minutes.

And here I go, down the rabbit hole of carbohydrate paranoia once again and feel tempted to throw away EVERYTHING in my kitchen and snort Splenda again. Watch with me?  Hold me?

Dr. Sanjay Gupta reports on new research showing that beyond weight gain, sugar can take a serious toll on your health, worsening conditions ranging from heart disease to cancer.

Is sugar toxic?