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--- In baltimorebariatrics@yahoogroups.com, "Ethel Lau" <mrs4paw2@...> wrote:
>
> hi Dawn ,i am so sorry that you have lost your father . i lost my dad along
ago ,but he is still in my heart , everyday , believe me when i say it will get
better ,not tomorrow ,or next month , or maybe even a year but it gets better
and you start to remember the good times you had with him , just know that i
will be thinking of you ,and yours , and will be praying that you get through
this very hard time
> God Bless
> Ethel
>
Thank you :)

Calcium and Iron - why do they need to be separate?
People are often told that they need to take their calcium and their iron
separately, but they may not know why.

The basic issue is this: when calcium and iron are taken together, the
absorption of iron can be decreased by up to 62%i. Calcium in both food and in
dietary supplements appears to have similar effects.

Some of the studies done on calcium and iron competition have shown the
following:

Hallberg at al found that giving 165mg of calcium in milk, cheese or as a
supplement of calcium chloride, reduced iron absorption by 50 to 60 percent. 
They also found iron absorption was reduced by 50 to 60% with 300-600mg of
calcium added to bread doughii.
Gleerup et al found that when they asked volunteers to consume a level of just
over 900mg of calcium either with their meals that contained the most iron
(lunch and dinner) versus in the morning and in the evening after dinner, they
absorbed 30 to 50 percent more iron when they did not have the calcium (from
milk and cheese) with the iron containing meals (lunch and dinner)iii. In other
words, eating their iron food separately for their calcium foods lead to much
better iron absorption.
Cook et al found that a 600mg dose calcium citrate and calcium phosphate reduced
the absorption of iron by 49 to 62 percent when given with 18mg of iron (the
RDA).  They did not find these results with a lower dose of 300mg.  They also
found 300mg calcium carbonate reduced iron absorption by up to 15%.
Dawson-Hughes et al, found that a 500mg dose of either calcium carbonate or
hydroxyapatite reduced iron absorption by 54 to 57%.
Why is this important with weight loss surgery?
After gastric bypass, patients are asked to take 1500 to 1800 mg/day of calcium
as calcium citrate per day (this is the level advised in the ASMBS Guidelines).
It seems clear that even in divided doses, these levels of calcium are likely to
reduce the amount of iron patients can absorb if they take the nutrients
together.  Because gastric bypass "bypasses" the area of the small intestine
where most iron absorption occurs, it is possible that this problem is much more
profound after this procedure.  We do not know because the studies have not been
done.  What we do know is that rates of iron deficiency are quite high, and
doing what we can to improve the opportunity for iron absorption is important.

What can be done to best support iron absorption after gastric bypass?
The guidelines from the ASMBS specifically advise "Do not combine calcium with
iron containing supplements."  It would also be advisable to take iron away from
calcium-rich meals, especially those containing dairy products such as milk,
cheese or yogurt.

How about band patients?
Because band patients have no malabsorption, their risk for iron deficiency
should not generally differ from the non-banded population.  They may have some
increased risk if they have challenges eating meat, but this can often be
managed with band adjustments.  The ASMBS guidelines do not call for any
additional iron in band patients for this reason.  That said, in a band patient
with anemia, it would likely still be wise to advise them to take their iron and
calcium separately.  In the patient with adequate iron status, there is not an
obvious reason to make this recommendation.


--------------------------------------------------------------------------------


iCook JD, Dassenko SA, Whitaker P. Calcium supplementation: effect on iron
absorption.  Am J Clin Nutr 1991; 54: 266-273S.
iiHallberg L, Rossander-Hulten L, Brune M, Gleerup A. Calcium and iron
absorption: mechanism of action and nutritional importance. Eur J Clin Nutr
1992;46:317-27.

iiiGleerup A, Rossander-Hulthén L, Gramatkovski E, Hallberg L. Iron absorption
from the whole diet: comparison of the effect of two different distributions of
daily calcium intake. Am J Clin Nutr. 1995 Jan;61(1):97-104.

ivAillis L, Blankenship J, Buffington C, Furtado M, Parrott J. ASMBS Allied
Health Nutritional Guidelines for the Surgical Weight Loss Patient. Surgery for
Obesity and Related Diseases. 2008 May: 4(5): S73-S108.

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Enjoy babe :)

hi guys old puter died and now have new one ,need you guys never throght i would
miss ya`ll used to be (mrs4paw2)

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Hello Everyone!

I haven't been around in a long time.

I had RNY with Dr Roe almost 7 years ago.  I had done well and now I've gained
back about 80 pounds.  I am in counseling and still not motivated to lose the
weight.  I know I need to do something.  I eat right and exercise for 3-4 weeks
and lose weight and then I go off track again.  I've been playing with this 80
pounds for about a year now.

Any ideas??

Beth

hi Dawn ,i am so sorry that you have lost your father . i lost my dad along ago
,but he is still in my heart , everyday , believe me when i say it will get
better ,not tomorrow ,or next month , or maybe even a year but it gets better
and you start to remember the good times you had with him , just know that i
will be thinking of you ,and yours , and will be praying that you get through
this very hard time
God Bless
Ethel

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It is with great sadness that I note the passing of Paul Smith, the father of Dawn Schueler, our Program Director, who passed away yesterday after a long illness.

The wake will be held at the Evans Funeral Chapel in Forest Hill on Friday, July 24, from 3 to 5 and 7 to 9 P.M. and Saturday, July 25, from 1 to 3 P.M. with a service beginning at 3 P.M. Interment to be private.( www.evansfuneralchapel.com )

The office will be open as usual on July 24, 2009, but will be closed for the week of July 27-August 2, 2009. We will reopen on August 3 as usual. I will be available through the week of July 27 for emergencies only, and can be reached though the office answering machine as usual.

Dawn has asked that, in lieu of flowers, donations be made to the Paul Smith Memorial Fund care of Baltimore Bariatrics.  Proceeds will benefit the onging treatment and research of diabetes and obesity .

Good Morning Crystal,

It was good to see you express some of the things that was on your mind.  I am
also gain for any type of dance class.  Send me the information amnd i will make
some schedule arrangements.  My email id harrellanderson@....


Hope to talk with you later.


Towanda Harrell-Anderson
--- In baltimorebariatrics@yahoogroups.com, Crystal Carrington
<crystal_carrington21230@...> wrote:
>
> Allâ€"
> I’ve just returned from a trip to San Antonio for my daughters’ Air Force
BMT Graduation (where I cried endless tears to see my baby all dressed up and in
step) with her squad; “Lead, Follow or Move Out Of The Way!” I traveled
alone enjoying the peace and solitude that I get so little of on
a very soothing plane ride which I don't normally enjoy and spent a lot of
time in my room at the Crowne Plaza Hotel-Riverwalk  (though I went there
thinking I would make a mini vacation of it since it was had a breathtaking view
of the Riverwalk and was close to all the tourist attractions; but didn't get to
do much sightseeing since my poor daughter had a terrible limp from the blisters
on her feet) thinking about my recent weight loss progress or well lack thereof
to be more accurate. Since you guys are my support; (which is why I don't allow
my family to come with me) I’m sharing with you hoping to get some feedback.
> This month’s topic, “Sabotage…” was enlightening. I’ve since
discovered I was guilty of throwing in my wooden shoe. I’ve basically lived to
please others in my life to the detriment of my own happiness. I've always
felt like I need to be there for my Mom, brothers and kids I seem to have lost
myself in this process. And now that my kids and I have grown up I still feel
responsible for my Mom who makes me feel guilty and succeeds at keeping me by
her side especially since my father’s passing 21 years ago and my maternal
grandmother’s passing 22 years ago. She’s been a wonderful Mom and now that
she’s getting older and I notice her slowing down and becoming forgetful I
feel as though I must be there for her now. Has anyone ever experienced
anything similar to this?
> I on the other hand have always encouraged my kids to follow their dreams and
to live their own lives. Now they’ve all left the nest, the youngest leaving
for college next month; but I’m still not free. In 1996 I moved my kids to
North Carolina and became a Correctional Officer. I lost all my excess weight
not being responsible for Mom and the rest of my family-and was very happy for
the first time in a very long time. (I’m a country girl at heart though I was
born and raised here in Baltimore. My father’s stories of his childhood
background always delighted me as I am a naturalist preferring the simple things
in life.) However after two years there Mom informed me she felt all alone in
the world so I gave two week’s notice and moved back to Baltimore.
> After many years of therapy I have concluded none can break through the
barrier of my fort of guilt until I am willing to allow it. Which being raised
as the “preacher’s daughter” I was taught family is always the number one
priority. My loyalty has left me feeling trapped and tied down.
> I know this has been a long drawn out story-but I just needed to vent. I find
it too difficult to talk in group not because I am shy or shamefaced, but
because I prefer the background and past experience has taught me in the words
of Abe Lincoln “It is better to be silent and thought a fool than to open your
mouth and remove all doubt.” Also because I cry easily and hate others to see
me cry for fear it will be viewed as a sign of weakness and vulnerability.
> So I am trying to make some changes because I am worth it and deserve it. I am
beginning although slowly to do more things on my own that I enjoyâ€"though some
things don’t work so well by oneself. I can’t see myself doing the lap,
chair or especially the pole dancing; not to mention my arthritis will have no
part in it. So I am forcing myself to open up and ask if anyone’s interested
in taking square dance classes, ballroom dancing, (I know a place that offers
this)hiking or nature walks-short distances at first of course, geocaching or
things similar?
> Crystal
>