Dr. Jossart, there's a pretty strong current of belief around here that after lap sleeve, it's "impossible" to absorb more than 20g of Protein at a time. This is often used to say that high-Protein shakes, for instance -- say 50g or 60g of protein -- are a waste of money.

Many people claim that their doctors and nutritionists gave them this fact. Also, I DO find some reference to protein malabsorption on the net -- for instance, a consent form I found referenced it. However, I searched the medical databases and couldn't find ANY reference to lap sleeve significantly altering protein metabolism (intake, yes, but not basic metabolism).

From what I understand, one of the primary "selling points" of the lap sleeve is that it is not malabsorptive. I guess if the smaller, scarred stomach is unable to produce sufficient gastric acids or pepsin or whatever, protein metabolism might be challenging, but that seems a stretch (and I believe it would be noted in literature). I'm starting to think that the "20 grams of protein in a sitting" meme is an urban legend.

One possibility is that since the lap sleeve used to be just part of the lap sleeve plus DS procedure, which unless I'm mistaken IS malabsorptive, there may be old data floating around masquerading as current truth.

I'd appreciate it if you could shed any light on this, because a lot of people are giving a lot of other people a lot of potentially incorrect advice :lol0:

I see you posted this back in April and did not get it answered. I am also wondering why we need so much Protein if malabsorption is not a problem. I did read a study showing that sleeve patients were more likely to be Iron B12 and folate deficient. However the general population is at risk for B12 deficiency according to some studies.

I really wish the docor would give a plausible reason why we need so much protein

QUOTE=ouroborous;42308]Dr. Jossart, there's a pretty strong current of belief around here that after lap sleeve, it's "impossible" to absorb more than 20g of protein at a time. This is often used to say that high-protein shakes, for instance -- say 50g or 60g of protein -- are a waste of money.

Many people claim that their doctors and nutritionists gave them this fact. Also, I DO find some reference to protein malabsorption on the net -- for instance, a consent form I found referenced it. However, I searched the medical databases and couldn't find ANY reference to lap sleeve significantly altering protein metabolism (intake, yes, but not basic metabolism).

From what I understand, one of the primary "selling points" of the lap sleeve is that it is not malabsorptive. I guess if the smaller, scarred stomach is unable to produce sufficient gastric acids or pepsin or whatever, protein metabolism might be challenging, but that seems a stretch (and I believe it would be noted in literature). I'm starting to think that the "20 grams of protein in a sitting" meme is an urban legend.

One possibility is that since the lap sleeve used to be just part of the lap sleeve plus DS procedure, which unless I'm mistaken IS malabsorptive, there may be old data floating around masquerading as current truth.

I'd appreciate it if you could shed any light on this, because a lot of people are giving a lot of other people a lot of potentially incorrect advice

The sleeve has no malabsorption or intestinal bypass. Some protein drinks may cause diarrhea and thus lead to slight malabsorption. Protein drinks are usually only necessary in the early weeks after surgery and not in the long term with this operation. It is best to advance to more regular food items so that you have a sense of fullness. Liquids(i.e. protein drinks) tend to empty fast and do not give a good sense of fullness. There is no data on how much protein a sleeve patient can absorb at once but most sleeve patients in the early months after surgery can consume about 600 calories per day and 60-70 grams of protein. Those who do, essentially never develop protein deficiency like a DS patient might. The only time you would see nutritional problems in a sleeve patient is if they are vomiting.

Thank you but I am still wondering why we need 70 g of protein a day when there is no mal-absorption. The average adult female only needs 45-50 g of protein a day

Excellent question. The baseline recommendation of 50 grams of protein per day is for someone who is at a stable weight. For those who have undergone weight loss surgery and are in a state of starvation, protein intake should be increased to offset the protein breakdown(muscle mass) that occurs with starvation. That is why the general recommendation is about 70 grams of protein. A larger, more muscular man may need even more(90 grams).

Thank you very much. That is the information I have been looking for.

(Delayed response) This is useful information, particularly the higher numbers. I think it's very interesting that many doctors and nutritionists seem to take a "one size fits all" approach to nutrition. My suspicion is that my Protein needs are in the higher range, and I may need to drink one or more protein shakes a day to meet my needs.

AFAIK, there isn't any real test for protein deficiency, right?

Ouroborous,

if you get kwashiorkor, you've got a deficiency. Sorry, couldn't help the smart-ass comment. :-)