Gastric bypass and exercise

Question
Hi. I had Rny August 2007. I started at 341. The scale showed 158 this morning. My goal is 135-140. My question is caloric intake and exercise. I've become 'addicted' to working out. I usually spend about 60-90 minutes a day at cardio with weight training three days a week. I've been doing research on nutrition for higher level of exercise and am finding it too general and not specific for my malabsorption needs. I currently use Fitday and have it set for 30% protein, 35 carb (complex) and 35 fat with caloric limit at 1300-1500. I also try to drink 60 ounces of water daily. Do I need to increase or decrease one or more of the macronutrients? I don't want to sabotage my success, but want the benefits of healthy active exercise. Do you know of any resources that explain HOW nutrition or food comsumption and exercise work with the bariatric patient? Thanks very much!
Lori P.

Answer
Hi Lori,

Sorry for the delay in replying to this.

There is not a perfect answer to your question.  We do believe that in those who are exercising rigorously, there may be some conditionally higher needs for certain nutrients - however, no one knows exactly how much would be right.

What you can do, however, is play within the safe range.  Setting aside nutrients for which you may take higher than normal levels because of your surgery, here is what I might recommend.  For all nutrients, there is the RDA or RDI - this is the basic amount people need to not have a deficiency.  There is also something called the UL - tolerable upper limit of safety - which is the average amount of a nutrient most people can take without developing a toxicity.  Here is a good table showing you the ranges for most common nutrients: http://gnc.webmd.com/rda-dv-ul-upper-limit?page=2

So what you might do is try adjusting your intake within this range and seeing how you feel.  Now, because you have an RNY, some of your nutrient intakes (for things like iron or vitamin D) may be above the UL - and this is fine so long as they are monitored.  

Protein is the other nutrient that often needs to adjust up with exercise.  Most RNY patients are taking 60-70 grams/day. The range you can use is 1 to 1.5 grams of protein per kilo of lean body mass (or ideal weight).  Remember to convert pounds to kilos when you do this.

I hope some of this is helpful.

Please let me know if you need more information.

In Health,

Dr. Jacques  

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