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Drinking by meals ? Solid Versus Liquid -- Satiety Study in Well-Adjusted Lap-Band Patients



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This is a report of a research effort of Prof. John Dixon and team in Australia on satiety, solid vs. liquid meals… and, whether it makes a difference to drink with meals, yes or no. The conclusion is short and simple:

Conclusion: Solid meals are more satisfying in both LAGB and non-LAGB individuals. However, a solid meal with accompanying Water did not alter meal satiety.

Do you agree or disagree with these findings ?

Some may say this is a “small” study with only 22 patients in the two comparative groups. I disagree. The power of the study is actually rather high due to the manner in which the research was conducted; inclusion and exclusion criteria considerations, etc. The control group was very well matched and the intervention (meals) yielded strongly statistically significant differences. The lack of any real differences in the individuals who were allowed to drink with the test meal vs those who were not is real. It didn’t make any difference if they drank with their meals or not with regards to how satisfied they were after the meals.

Solid Versus LiquidSatiety Study in Well-Adjusted Lap-Band Patients

Abstract

Background Patients following laparoscopic adjustable gas- tric banding (LAGB) are generally advised to avoid liquid calories, opt for solids and refrain from drinking with meals as this is believed to prolong satiety. The role of food consistency and satiety following LAGB is largely uninvestigated. The purpose of the study was to: (1) deter- mine if food consistency impacts on post meal satiety in participants with well-adjusted LAGB and (2) compare the level of satiety achieved after consuming a solid versus a liquid meal between groups.

Methods

Twenty intervention (well-adjusted LAGB) and 20 control participants were recruited. All participants con- sumed three iso-caloric breakfasts that were randomised for nine mornings. Participants were asked to rate their satiety on visual analogue scales (VAS) at set times after the test meal. Areas under the curve (AUC) VAS scores were compared within and between groups.

Results

Solids (bars) with or without water provided greater satiety than the liquids (shakes) for both groups. Drinking water with the bar did influence satiety in the intervention group. For the intervention group (LAGB), AUC VAS values for the bar with water were 77.4 ± 11.2* and 72.4 ± 16.7* for the controls.

Conclusion

Solid meals are more satisfying in both LAGB and non-LAGB individuals. However, a solid meal with accompanying water did not alter meal satiety.

Jones Dixon_Solid vs Liquid LAGB Satiety_Obes Surg_2013.pdf

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I really think that depends on the amount of Water you take in with your meal. I may sip a little on occassion, but I do not drink two glasses as I use to with a meal.

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Funny, but I did a test in my home. I got a large styrofoam cup (12 ounces) from Walmart and cut a quarter size diameter hole in the bottom of this cup. I then fill it with my Protein shake to a 4 ounce mark marked on cup and what seem seconds the cup emptied. Next I tried oatmeal with some milk it lasted some seconds before it emptied. Then i mixed a cup of skim milk (0%) into the oatmeal and it lasted only a few seconds more. Then on the third test of oatmeal using same as second test, I chased the solution with 6 ounces of Water. I was truly amazed that pouring Water alone on top of the oatmeal diluted it enough to quickly drian out the of the cup. So, my conclusion was liquids should not be taken with food because the feeling Full (filled) goes away quickly.

I do know that we are not created equal and that bands can be different during surgery installation and that our stomachs are all shape differently where the band is stitched. This only shows a restriction of a quarter coin diameter and if the restriction is as small as a nickel diameter a longer Full is available.

This experiement was done by me at home out of curiosity because I actually didn't believe liquids could dilute the food that quickly. I tried these test around Jan 2013.

Best wishes and Keep the Faith

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"Despite the common use of LAGB, the mechanism that generates early satiation, prolonged satiety and sustained weight loss is poorly understood, but insight is emerging. It has been demonstrated that the passage of food through the banded area and gastric emptying is not substantially delayed and cannot account for the prolonged satiety"

"Care must be taken to ensure that patients understand that a drink with their meal is not going to reduce their satiety; however, the difference between this and maladaptive eating behaviours such as drinking large volumes of Fluid in order to ‘flush’ moist foods through the band must be emphasized. This study used a solid and dense Meal Replacement with 250 ml of Water only. This could be applied to a solid Breakfast meal and a cup of black tea for example."

These are the two most important points that I gleaned from the study:

1. We really don't understand why the band works.

2. Acceptable drinking habits are easily confused with unacceptable drinking habits.

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I am in the habit of not drinking with meals because it was what I was taught from the very beginning, however I would be inclined to agree with the study by way of common sense.

A lot has changed in their understanding of the band. One of the more recent realizations is that food passes through the band in less than a minute when eaten, it doesn't sit on the band collecting in the pouch unless you're eating too fast or too tight so it's not emptying correctly. Being as it doesn't sit above the band, that would mean there's nothing to "wash through" as previously thought and the reason they taught us not to drink with meals. So, it makes sense that the study would find no difference in satiety between those who drank with meals and those who didn't.

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I am one of those banded people where I have been told its fine to drink with meals, not the gulping type of drinking but the sipping kind when needed and of course you need to be sure the food has passed through the band before drinking liquid.

I drink whilst eating if I need to and at twenty minutes or less these days I get the satiety feeling and I stop, I'm down nearly 100 pounds in ten months and in all that time the liquid has not washed food right through the pouch because the food does not sit in your pouch longer than a minute.

Also it did not affect my satiety at all. My satiety limit hit me at twenty mins with or without drinking, this I have also tested.

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I find this amazing timing. I was just having this conversation with my wife last night. I have a very hard time waiting an hour after my meal to drink something. I try not to drink while I am eating. But once I am done I want something to drink. My wife said it was one of the worst things I could do. I never felt it was detrimental in any way. I now try to hold of about ten minutes or so, but than go for my crystal light.

I also found the posts interesting because I didn't realize food was passing through my band as fast as it apparently is. I thought that was the whole point of this. Fill the pouch, feel full, pouch empties into stomach, feel full longer.

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I too was told not to drink with my meals but found that if I didn't, my food wasn't passing through within the alotted minute and therefore when I chewed for a minute or longer as instructed, my food was feeling stuck. So I chose to start sipping Water and found that worked. Sometimes some meats like chicken depending on how it's cooked or beef meat, I may have to take larger amounts of water to help flush it down. I have not noticed that I'm fuller with or without drinking water with my meals.

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Since being diagnosed with a GI motility disorder in January, I've been eating very differently than I was taught with the band.

Little or no Fiber (veggies and fruits are out, rice, potatoes, Pasta are in)

Avoid red meat

Eat half as much at each meal, but eat more often

Drink Water with meals to speed gastric emptying

I'm still supposed to chew 15-25 times per bite and take tiny bites.

I'm still not hungry up to 5 hours after eating, with an empty band.

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Funny' date=' but I did a test in my home. I got a large styrofoam cup (12 ounces) from Walmart and cut a quarter size diameter hole in the bottom of this cup. I then fill it with my Protein shake to a 4 ounce mark marked on cup and what seem seconds the cup emptied. Next I tried oatmeal with some milk it lasted some seconds before it emptied. Then i mixed a cup of skim milk (0%) into the oatmeal and it lasted only a few seconds more. Then on the third test of oatmeal using same as second test, I chased the solution with 6 ounces of Water. I was truly amazed that pouring Water alone on top of the oatmeal diluted it enough to quickly drian out the of the cup. So, my conclusion was liquids should not be taken with food because the feeling Full (filled) goes away quickly.

I do know that we are not created equal and that bands can be different during surgery installation and that our stomachs are all shape differently where the band is stitched. This only shows a restriction of a quarter coin diameter and if the restriction is as small as a nickel diameter a longer Full is available.

This experiement was done by me at home out of curiosity because I actually didn't believe liquids could dilute the food that quickly. I tried these test around Jan 2013.

Best wishes and Keep the Faith[/quote']

Rojasanoll-nice job...

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