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denzel

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denzel last won the day on August 10

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About denzel

  • Rank
    Sleeved 02.02.15
  • Birthday 05/22/1963

Profile Information

  • Gender
    Female
  • Location
    Perth
  • Interests
    travel, exploring, flora, fauna, naturalist (not to be confused in anyway with naturist!),land care, outdoors, health, medical, reading, animals - pets, specifically greyhounds, parrots and cockatoos, positive reinforcement training, former scuba diver and belly dancer, socialising
  • Band/Sleeve Status
    Post-Op
  • Weight Loss Status
    100% (Goal Weight!)

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12,716 profile views
  1. denzel

    Double digits!

    @Queenies that is magnificent news! Congratulations and very well done!
  2. denzel

    Non Scale Victories (NSVs)

    @Millymollymandy that is absolutely fantastic news!! I am so happy for you!
  3. denzel

    Accountability

    up 270 gm this week for me to 51.25 kg, BMI 21.75
  4. denzel

    Weigh In Wednesday

    up 270 gm this week for me to 51.25 kg, BMI 21.75
  5. denzel

    Weigh In Wednesday

    Absolutely fantastic @Boganlicious! Congratulations and very well done!
  6. denzel

    Goal Weight

    Re measurement of obesity accuracy. Waist-to-height ratio Calculating a patient’s waist-to-height ratio is the most accurate and efficient way of identifying whether or not they are at risk of obesity, a new study shows. The research, published in PLOS One, examined the whole-body fat percentage and visceral adipose tissue mass of a group of 81 men and women. The British authors discovered that 36.5% more adults would be classified as obese using whole-body fat data (one in two participants) rather than BMI (around one in seven participants, or 13.5%). To conduct their study, they gathered accurate whole-body and abdominal fat data using a total body dual energy X-ray absorptiometry (DXA) scanner — a highly accurate way of measuring body composition and fat content. They then calculated five predictors of whole-body fat and visceral adipose tissue that could be easily replicated in a GP’s office, and compared the results with those of the DXA scan to determine which simple predictor of obesity was the most accurate. The five predictors tested were: BMI, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and waist-to-height ratio0.5 (WHtR0.5). Lead researcher Dr Michelle Swainson, senior lecturer in exercise physiology at Leeds Beckett University, says although there are benefits to the conventional BMI method, there is concern that it is a misleading measurement. “This is most definitely the case when people have a 'normal’ BMI but high abdominal fat that is often dismissed,” Dr Swainson says. The results from the study show the best predictor of whole-body fat percentage and visceral adipose tissue in both men and women is WHtR. This simple method of waist circumference divided by height measurement is not a new obesity classification but, despite evidence supporting its use, it is still not routinely measured in clinical settings, the authors note. Cut-points for predicting whole body obesity were 0.53 in men and 0.54 in women. The cut-point for predicting abdominal obesity was 0.59 in both sexes ive indication of obesity, it appears that height/waist circumference is a better measure.
  7. denzel

    Accountability

    Hi @rumplebear - sorry I didn't see the last part of your post. I had my arms lifted, an abdominoplasty and a 1/2 body lift December 2015, the same year I had my gastric sleeve. Documented in my blog . *Contains graphic images*.
  8. denzel

    Intro from new member

    Welcome @DeeCee! You may be interested in this section, and starting something off: http://www.bandingtogether.com.au/community/forum/75-endoscopic-sleeve-gastroplasty/ I've just done a search under "Endoscopic" and came up with quite a few comments: http://www.bandingtogether.com.au/community/search/?q=endoscopic All the best!
  9. denzel

    Could this be silent reflux??

    How are you going @kikiyep?
  10. denzel

    Accountability

    Hi @rumplebear Pre-op my dietitians long term weight goal for me was 53 kg (+/-3 kg) - She arrived at this by using the formula: your height in cm - 100 +/- 3 kg e.g. for me height 153.5 cm - 100 = 53.5 kg +/- 3 kg. She asked me what I would like to be, and I hesitantly said 50 kg - never imagining that I'd reach that magical number! I actually got down a lot lower - BMI 17.5, weight 41.3 kg - my GP was very concerned - in the first year (due to sickness). Then I slowly regained weight, and got up to 50 and wasn't happy when I saw some photos taken of me at that weight. So slowly lost, aimed on 46 kg (didn't get back to there). I found my "happy" weight around 47 kg, so that is my goal long term weight, hence it's a personal goal weight. Following 7 months of hideousness - Cymbalta withdrawal and POTS I put on 8 kg, bringing me up to 54.8 kg and an increase in 2 clothes sizes! Most of which I had earlier ditched lol! I simply could not stop eating. I think that my body was screaming out for energy. So, once I started feeling better - back on Cymbalta for Fibromyalgia + it has the wonderful side effect for me of decreasing my appetite - I have been slowly losing weight - nearly back at my original goal of 50 kg, but then of course, my next goal is to get back to 47 kg.
  11. denzel

    Introduction

    Welcome, and well done @George65!
  12. denzel

    Accountability

    My last weigh in was a fortnight ago, and I've lost 1 kg since then *dances happy dance*. Down to 50.98 kg, BMI 21.6, body fat % 25.5. Onwards and downwards!
  13. denzel

    Weigh In Wednesday

    Well done @Millymollymandy and @Boganlicious! Boganlicious, you have done outstandingly well! My last weigh in was a fortnight ago, and I've lost 1 kg since then *dances happy dance*. Down to 50.98 kg, BMI 21.6, body fat % 25.5. Onwards and downwards!
  14. denzel

    Goal Weight

    This has to be an individual decision. But for me - and others - it gives us something to aim for in the initial weight loss stages, and in maintenance (for the rest of our lives!) - helps to stop complacency and being aware when we are regaining weight and therecore can put a curb on it.
  15. https://www.diabetesdaily.com/blog/very-low-carbohydrate-diets-for-diabetes-ada-2018-580309/ Very Low Carbohydrate Diets for Diabetes (ADA 2018) By Maria Muccioli Ph.D. June 26th, 2018 A crowd overfilled the ballroom this Sunday afternoon at the ADA 78th Scientific Sessions to hear two presentations about very low carbohydrate diets (VLCD) for diabetes. In the first presentation, Dr. Jeannie Tay from the University of Alabama at Birmingham summarized the current knowledge on VLCD for type 2 diabetes (T2D) patients and presented new clinical trial results. In the second presentation, Dr. Martin I. de Bock of Princess Margaret Hospital discussed the limited data on VLCD for children with type 1 diabetes (T1D), including the benefits, hypothetical concerns, and areas for additional follow-up. Study Demonstrates Health Benefits for Patients with T2D Dr. Tay began her presentation by summarizing the available data on very low carbohydrate diets (VLCD) for patients with T2D. She defined VLCD as that containing between 20-70 grams of carbohydrate per day. She evaluated results from randomized controlled trials (RCTs) that followed patients for at least six months and highlighted that some data showed greater A1c improvements with the approach. The researcher noted that patients also experience an increase in HDL-C levels, a reduction in triglyceride levels, and improved insulin resistance. Dr. Tay explained that while some studies showed an increase in LDL-C levels in patients following a VLCD, other studies did not find this. She addressed that LDL-C is becoming a controversial metric to assess cardiovascular disease risk and that context is important when discussing its relevance as a risk factor. Dr. Tay noted that it is generally believed that LDL-C increases may be a result of the higher saturated fat content of some VLCD. Dr. Tay and colleagues set out to determine how a VLCD that is also low in saturated fat (LCLSF) compares against a high carbohydrate (HC) diet for the metabolic management of patients with T2D. RCT of HC vs. LCLSF Diet for T2D The researcher enrolled 115 adults with T2D and obesity with a mean A1c level of 7.3 +/- 1.1% and excluded patients with pre-existing renal conditions. The patients used a variety of methods to control their diabetes, including oral agents and/or insulin. They assigned the participants to either follow a HC diet (53% carbohydrate) or a LCLSF diet (14% carbohydrate, <10% saturated fat). Importantly, the diets were identical in calorie content. All participants followed the same exercise program and their adherence to the diet was closely followed via food logs, regular meetings with a dietician, as well as urinalysis for ketones and urea/creatinine. The researchers compared numerous parameters between the groups, including weight, body composition, A1c and markers for cardiovascular disease risk. Furthermore, they also used CGM technology to evaluate post-prandial blood glucose control and glycemic variability. The patients were followed for two years. Main Study Outcomes The drop-out rate (~50%) was not significantly different between the two groups, and the researchers confirmed that the remaining participants adhered to the prescribed diets. While the data showed a comparable reduction in A1c (~1%), weight, and similar body composition, the participants in the LCLSF group: Lowered their medication use by more than two-fold compared to the HC group Experienced a greater than two-fold reduction in glycemic variability parameters compared to the HC group Experienced a greater reduction in triglycerides than the HC group Both groups experienced comparable decreases in blood pressure, insulin use, insulin resistance, and c-reactive protein levels (a marker of inflammation). Additional Assessments The researchers also performed a very comprehensive evaluation of renal function and cognitive performance in the subjects following the low carbohydrate approach. The researchers found no difference between the HC and LCLSF groups in any of the measured outcomes, demonstrating its safety with regard to renal function and cognitive performance. Also, the researchers did not observe a significant difference in the LDL-C levels between the groups. Notably, the HC group experienced a significant drop in HDL levels during the study, while the HDL levels remained unchanged in the LCLSF group. Summary Dr. Tay stated that a very low carbohydrate diet offers a considerable advantage over a high carbohydrate approach for patients with type 2 diabetes. She noted that reducing medication use is not only cost-effective but can also safeguard from the considerable side effects of some second-line medications. She also explained that achieving less glycemic variability, which may be an independent risk factor for the development of diabetes-associated complications, is “of great clinical importance.” “It is a good diet to have if you have diabetes, and the data support that,” she concluded. Endocrinologist Discusses Considerations for Children with T1D Dr. de Bock began his presentation by describing what he believes to be the current political climate in discussing very low carbohydrate (VLC) approaches for children with T1D. “[It is] thorny, polarizing, and controversial,” he remarked. The speaker went on to explain that while he is no way against VLC approaches for children, the main purpose of his presentation was to identify putative concerns and areas that require additional study. “I am not a denier. One can get exceptional glycemic control on a very low carbohydrate diet,” he stated, also remarking that frequent blood glucose monitoring and dosing adjustments were key to achieving the results. Dr. de Bock believes that it is also possible to get “good control” on a high carbohydrate diet. To support this, he presented very limited blood glucose records for one teenage patient who consumes more than 300 g of carbohydrate per day, and also showed some data on pediatric A1c levels. Notably, while the A1c levels were below the average for that age group with T1D, they were still above normal. Dr. de Bock identified five areas that he believes to be of relevance regarding the potential concerns regarding children eating a VLCD: 1) growth; 2) long-term metabolic profile; 3) bones; 4) exercise and 5) psychosocial impact and conflict. As published data specific to VLCD in children with T1D is limited, the speaker presented some data from animal studies, case studies, and children with epilepsy who followed a ketogenic diet. Dr. de Bock did not define the specific nutrient distribution of VLCD and the data that he presented on varied greatly in the carbohydrate content, from “ketogenic” to “30% carbohydrate” for one particular case. Since data on the exact diet composition or on glycemic control for the case study subjects that experienced adverse outcomes was not presented, it was impossible to gauge whether these could be attributed to suboptimal glycemic control or the specific macronutrient distribution. Growth Dr. de Bock stated that the available data on pediatric growth on a low-carb diet is contradicting and requires further investigation. His main theoretical concern is that those on a VLCD may use less insulin, and insulin is very important for numerous physiological processes, including growth. However, he did not discuss the administration of insulin to account for protein consumption, which is an important consideration. Dr. de Bock also addressed the importance of identifying any nutritional deficiencies, in particular, iron. Long-Term Metabolic Profile Dr. de Bock presented some data about elevated LDL-C levels in individuals on a VLCD, although the study results were variable. He stated that for those individuals who experience an uptick in LDL-C, it is unclear whether the improved glycemic control mitigates the LDL-C increase. Notably, the LDL-C metric is a controversial one and needs to be considered in the context of triglycerides, HDL, and other metabolic parameters. Bones Dr. de Bock pointed to some studies on children with epilepsy who followed the ketogenic diet and exhibited low bone density. He noted that individuals with T1D are prone to low bone density, so it is an important parameter to follow. Dr. de Bock did not mention the relevance of optimizing glycemic control, as chronic hyperglycemia is a relevant factor in low bone density in patients with T1D. Exercise The speaker stated that the exercise capacity of children following a VLCD appears to be variable. He noted that some individuals do not have any problems, while others may experience fatigue. He believes the data on the subject is “inconclusive.” Careful assessment of the specific nutrient distribution of the diet to ensure appropriate nutrient intake may be at the heart of the matter. Psychosocial Impact and Conflict The speaker focused heavily on the potential mental and emotional implications of following a “restrictive” diet. He suggested that children (unlike adults) do not yet have the “executive thought” to make a rational decision to eat a VLCD. As such, he believes that children on a VLCD may feel deprived or resentful. “We are a society that celebrates with food,” de Bock pointed out, as a photograph of excited children gathered around a birthday cake appeared on his presentation slide. He stated that eating cake “may or may not result in a postprandial blood glucose excursion,” depending on the management, and did not discuss that low-carbohydrate dessert recipes are widely available. He also attempted to draw parallels between the perfectionism and idealism associated with the pursuit of very tight glycemic control on a VLCD and how these qualities are common to individuals who are at an increased risk for developing eating disorders. However, while there is no evidence to support that children on a VLCD are specifically at an increased risk for anxiety and eating disorders, there is evidence to suggest that these issues are more common in people with type 1 diabetes, in general, suggesting that they are likely related to glycemic control. Dr. de Bock did not address the tangible concerns of suboptimal blood glucose management in pediatric patients, or the potential psychological impacts of increased anxiety, depression, and resentment that may arise from frequently abnormal blood glucose levels and the associated physiological consequences. Summary Dr. de Bock does not deny that a VLCD for children with type 1 diabetes can help to achieve exceptional glycemic control, as recently demonstrated in a study showing normal average A1c levels in a large cohort of patients. The speaker remarked that the patients in that study had very low glycemic variability. He believes that more research needs to be conducted to evaluate the relevance of the potential concerns that he outlined. Until then, he advises parents of children who follow a VLCD to work closely with their medical care providers to monitor growth, cardiac, nutritional, and mental/emotional parameters. Concluding Remarks Undoubtedly, very low carbohydrate diets for the management of diabetes have been gaining popularity and acceptance in recent years. It is difficult to deny that they constitute an effective and important tool for optimizing glycemic control for both type 1 and type 2 diabetes patients. This symposium received considerable attention at the meeting and in social media channels. As always, we welcome your comments on the topic and hope that this review has been useful in summarizing the key points and relevant considerations in the broader context of the discussion.
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