Weight Loss Surgery
I am a bariatric surgeon and I struggle with finding the right advice for my patients. Personally, I have immersed myself into health, wellness, and longevity but struggle to relay that information to patients that have a significant amount of weight to lose. Most conversations that I hear in the health and wellness podcasting realm always focus on the gastric bypass. However, there are a lot of sleeve gastrectomies and duodenal switches that maintain the integrity of the stomach and its functionality (unlike the gastric bypass). To the question - I perform surgeries that limit calorie intake. Our average patient gets 1200-1400 kcals a day. In the ongoing discussion of calories versus hormones as what controls our weight, I significantly lean towards hormones and inflammation. We have a good portion of our patients who continue to struggle with their weight even at this kcal consumption. What is your opinion/guidance to someone that maintains a consistent suppressed kcal consumption but still struggles with weight loss?
Children's protein and other nutrition needs
After listening to your conversation with Don Layman about protein, in which Don told listeners not to worry about my children's protein intake because they are so efficient at using it, I, of course, began to worry about it. What struck me was how different children's needs are from those of adults. Peter mentioned his young son probably doesn't need more than 40g of protein per day. But what is a good target for protein consumption for kids? What is the minimum amount of protein my child needs to be healthy? Are there other key nutrition needs that should be on my radar? Will a "balanced, whole food diet" generally tick the boxes? How harmful is sugar for my kids, compared to me? Should I be concerned that my daughter is 80th percentile for weight and only 20th percentile for height? Should I simply not worry about any of this until my pediatrician raises an issue? Now that I think about it, an entire episode on children's health and wellness--focused on (1) minimum targets for nutrients, movement, and sleep; (2) areas where children's needs diverge from those of adults, and (3) areas where the status quo approach or "common knowledge" is wrong--would be awesome. I'm a mother of three - ages 6, 4, and 2. Thanks!
Effect of Caloric Restriction on BMR
1) If you have substantial body fat (e.g., 20-30% as a 30 yr old male) and are maintaining a 25% reduction in calories, will your metabolism actually "slow down". If so, what does that time window look like, i.e. how long can you stay at a reduction until your body starts trying to conserve energy? 2) Is there an actual benchmark for percentage reduction in caloric intake whereby your body does not go into "conservation mode". 3) How does BMR / metabolic rate impact or play into the Fat Flux model, and at what point does manipulating your metabolic rate (through increased muscle mass, or decreased calories to the point of "conservation mode") impact that model.