Healthy Memphis

Saint Francis - Memphis Center for Surgical Weight Loss made regional news Friday when a medical team used a recently-approved adjustable band to treat three patients by dramatically reducing the size of their stomachs.

All were at least 100 pounds heavier than their recommended weight. All underwent the procedure hoping that the band, sold as the Realize Adjustable Gastric Band, will help them lose weight. The band, which won federal approval in September, joins similar devices already on the market.

“Gastric bypass is still the gold-standard. But a lot of people are still scared of gastric bypass because they are scared of changing their anatomy and rerouting their intestines,” said Dr. Virginia Weaver, the center’s medical director. Surgeons commonly use staples to create a dramatically smaller stomach pouch and then link it to a surgically shortened section of the digestive system.

For those willing to accept more gradual weight loss, Weaver said research suggests adjustable bands are as effective for weight loss and in curing type-two diabetes. The bands go around the stomach. The resulting stomach can hold just a half-cup of food or liquid.

Patients who opt for bypass surgery typically lose 60 to 80 percent of excess body weight within 18 months, Weaver said. In comparison, patients who choose the band take two to three years to lose 55 to 60 percent of excess weight. After five years, the weight loss is comparable, Weaver said.

Complication rates for both procedures are low and death rates even lower.

Weaver predicted interest in the adjustable band will grow following a recent study that showed it helped people lose enough weight to send their type-two diabetes into remission.

Have you had surgery to help you lose weight?

One of my sisters-in-law took the plunge and late last year underwent gastric bypass surgery. She's already dropped nearly 40 pounds, but it hasn't been easy. The surgery itself wasn't difficult. But she said it's been unexpectedly tough to join everyone at the dinner table and be able to eat just a bite or two.

If you took the plunge, let us know about your experience with the surgery. If you are considering it, how will you decide?

It is Girl Scout cookie time, which is an annual excuse to eat for a good cause. Faced with eager young entrepreneurs hovering near card tables stacked with boxes of Thin Mints, Samoas and Peanut Butter Patties, even a super model would be hard pressed not to stock up.

So when Kimberly Kilpatrick offered to help me sort through this year's offerings from a nutrition standpoint, I accepted. Kilpatrick is a clinical dietitian at Baptist Memorial Hospital - DeSoto.

"It is important to look at the calories, fat and carbs. All of those are equally important," she began.

Her short list of healthier options included Cinna-Spins and Do-si-dos.

At 100 calories per serving and 2 grams of fat, Cinna-Spins are as close to diet food as Girl Scout cookie get. Even better, a serving equals 15 cookies and includes just 1 gram of artery-clogging saturated fat.

A single serving of Do-si-dos includes just two cookies, 110 calories and 5 grams of fat, including less than 2 grams of saturated fat. It is a crisp sandwich cookie with an ingredients list that includes peanut butter and oatmeal.

If diabetes is a problem, Kilpatrick suggested the sugar-free chocolate chip cookie. Three cookies pack 160 calories and 9 fat grams, including 3 grams of saturated fat. But it delivers zero grams of sugar and 7 grams of sugar alcohol. "Just because it says sugar-free or low-fat, it doesn't mean you can have all you want," she warned.

While Kilpatrick declined to label any of the cookies as a bad choice, food nutrition labels don't lie.

A single Lemon Chalet Creme cookie has 80 calories and three grams of fat, including 1 of saturated fat.

Samoas, which I could consume by the box, run 150 calories for a two-cookie serving. Not horrible, until I read they have 8 grams of fat, 5 of it saturated. Thin Mints, a perennial favorite, run 150 calories for four cookies. They have 7 grams of fat, almost two-thirds of it saturated.

High calorie or low, Kilpatrick said it all really comes down to portion control. "With all the cookies, watch how much you are eating," she said. That means limit the cookies to once or twice a week.

When selecting Girl Scout cookies and other treats, how often do you consult nutrition labels and how important is the information in making your selection? Let us hear from you.

Just don't let yourself slip into sweats, pour a glass of milk and eat a sleeve or two of cookies.

Here is help for anyone still looking for help fulfilling New Year's resolutions to get fit and eat healthier.

The American Heart Association's free online My Start! program offers exercise tips, nutritional advice and other information plus a weekly summary of how your energy in (food) compares with your energy out (exercise).

To check it out, log on to My Start.

There is more evidence linking a brisk, daily walk with a trimmer waist and a lower risk of diabetes, heart disease or stroke.

It comes from Duke University Medical Center where investigators charted exercise's impact on 171 middle-aged, overweight men and women.

None exercised before joining the federally-funded study. Forty-one percent of the volunteers also suffered from metabolic syndrome, an umbrella term that includes high blood pressure, high blood sugar, poor cholesterol levels and a large waist. The syndrome is associated with an increased risk of developing heart disease, stroke and diabetes.

After eight months of exercise, the percentage of volunteers with metabolic syndrome fell to 27 percent. Their waistlines also shrank.

Volunteers who walked just 30 minutes a day, six days a week enjoyed the benefit. "That's about 11 miles per week. And our study shows that you'll benefit even if you don't make any dietary changes," noted Dr. Johanna Johnson, the study's lead author and a clinical researcher at Duke.

The work appears in the Dec. 17 issue of the American Journal of Cardiology.

The diabetes drug Avandia was back in the news this past week and Mid-South physicians are still answering questions from confused and worried patients.

The issue for patients, physicians and federal regulators is whether the drug, which is prescribed to lower blood sugar, increases a patient’s heart attack risk. “It is not a straight-forward situation,” said Dr. Jay Cohen, a Memphis diabetes specialist.

A study published in the New England Journal of Medicine last month linked Avandia to a 43 percent increased risk of heart attack or heart-related deaths. It prompted the FDA to issue a safety alert warning that Avandia might leave patients at significantly increased risk for heart attack or heart-related deaths.

But investigators reached that conclusion by pooling the results of 42 smaller studies that were designed to answer different questions, weren’t long-term and included relatively few patients, noted Dr. Abbas Kitabchi, another Memphis specialist. “It is difficult to know what to make of the results,” he said. “We are telling patients we aren’t going to take them off” the drug based on the New England Journal study.

Heart failure is a different story, added Dr. Kashif Latif. He is also a Memphis diabetes specialist. “There were always reservations about using these medicines for patients with heart failure,” he said.

On Wednesday, the federal Food and Drug Administration announced it asked manufacturers of both Avandia and Actos, a related drug, to strengthen their warnings about heart failure. The FDA wants both to carry more prominent black-box warnings.

For now, Latif said he believes few physicians are switching patients from Avandia based on the possible heart attack risk highlighted in the New England Journal study. But he and other doctors said if patients are worried, they will prescribe a different medication.

Cohen added, “The biggest risk to patients is having blood sugars that are out of control. It is important for patients to talk to their physician.”

A definitive answer about Avandia and heart attack risks is expected in 2009. That’s when results are due from research currently underway.

Did you know that if your waist (measured at your belly button) is 35 inches or more if you are a woman or 40 inches or more if you are a man,  puts you at greater risk for health problems such as diabetes, high blood pressure, and heart disease?  If your waist is large that means that you carry a lot of fat in your middle, right where most of your organs are.  It is actually better to carry extra pounds on your thighs, rear, and lower legs since these areas are further away from your internal organs.  Get out your measuring tapes!!

Diabetes prevention dominates this week's Health & Fitness section.

One story highlights new research underway at the University of Tennessee Health Science Center. Dr. Samuel Dagogo-Jack's directing that effort, which hopes to uncover links between someone's race and their diabetes risk.

Another story spotlights a Baptist Rehabilition - Germantown program targeting African - American adults whose elevated blood sugar means they are pre-diabetic. The free program of exercise, nutritional advice and support is designed to help them make the lifestyle changes proven to reduce their odds of developing the disease.
Read the rest of this entry »

Do you have questions about diabetes? Wondering about treatment? Want to know more?

Dr. James Bailey, the University of Tennessee Health Science Center's chief of general internal medicine and a member of the board of directors for the Healthy Memphis Common Table, has agreed to conduct a discussion on diabetes with our readers this week.

Add your question. Or just post a comment about your experiences with diabetes, treatment or efforts to manage the disease. Your story might be helpful to other readers.

Information presented here is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.