“Protein First!” after Bariatric Surgery

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“Protein First!” This is the mantra drummed into my mind by my bariatric surgery team back in 2003 when I had my gastric bypass surgery. And with good reason — as you should know, everyone who has bariatric surgery is at risk for nutrient deficiencies. And the further out from surgery the greater the likelihood.

Anemia after Bariatric Surgery

Iron-deficiency anemia is among the most common ailments associated with nutrient deficiencies in people who’ve had bariatric surgery. And it boggles my mind when folks challenge me on this clinically-proven fact just because they’re 6-months out and their iron levels are normal. I have to wonder if these people paid attention when their bariatric nutritionists spoke during “class.

Here are the science-backed facts: They [nutrient deficiencies] can develop as a consequence of reduced intake and/or malabsorption of nutrients and are more commonly seen malabsorptive or mixed procedures in comparison to the restrictive procedures. Other causal factors include pre-operative deficiencies, postsurgery food intolerance, changes in taste and eating patterns and non-adherence to dietary and supplement recommendations.” Source: National Institutes of Health 

I’ve battled iron-deficiency anemia several times. And anemia was never a “thing” for me until I was 9-years out from my gastric bypass surgery. Statistically, the American Society of Hematology shows 33%-49% of patients presenting anemia within 2 years after bariatric surgery. My lab results showed my reserves were nearly depleted. And this is not something that happens overnight. Rather, it was depleting for a while, unbeknownst to me.

Eat “Protein First!” after Bariatric Surgery

So, circling back to “Protein First!” I was told when sitting down to a meal or snack, start with protein first. In part this was to ensure I consumed adequate iron lest I became full before finishing my meal. Other reasons our bodies need additional protein after bariatric surgery is to heal and rebuild the body; and during the period of rapid weight loss to maintain muscle mass; and because protein is also required to have a healthy metabolism says the ASMBS.

Iron is available from animal and plant foods but the form in animal foods, heme iron, is better absorbed says Livestrong, another respected consumer health website.

Proteins such as beef, pork, or lamb, especially organ meats such as liver, chicken, turkey, and duck, especially liver and dark meat, and fish, especially shellfish, sardines, and anchovies, contain some of our highest dietary sources of iron.

Plant sources of iron are leafy green members of the cabbage family including broccoli, kale, turnip greens, and collard greens, legumes, including lima beans, peas, pinto beans, and black-eyed peas, and Iron-enriched pastas, grains, rice, and cereals.

Note well that pairing vitamin C-rich foods or beverages with iron-rich foods enhances iron absorption from both animal and plant sources.

Protein Powder and Iron after Bariatric Surgery

Protein powder is a staple of the bariatric diet. And some, but not all, protein shakes are fortified with dietary iron. So it is important to read your labels. Let’s look at the iron content of various protein powders:

Whey protein is a highly digestible milk-derived protein that contains all nine essential amino acids our bodies can’t make on their own. But whey contain a negligible amount of iron. Hydrolysates of whey protein, however, have good iron-binding that helps our bodies absorb iron.

Collagen powders are hydrolyzed, meaning they are broken down into smaller pieces called peptides that our bodies can easily absorb. Collagen has a number of health benefits but scientists have not substantiated all of its alleged claims. And like hydrolyzed whey, collagen peptides have a negligible amount of iron but good ironbinding properties that aid absorption. However, collagen is not a complete protein source.

Beef protein powders are usually hydrolyzed and/or isolate. It is a complete protein with essential and nonessential amino acids and branched chain amino acids. One study showed it preserved muscle mass and iron levels while reducing body mass. It is important to understand that beef protein powder and lean meat are different sources of protein. And I have not found a beef protein powder that contains iron.

Egg white protein powder is a highly absorbable source of protein. It’s also low in carbohydrates and sugar. But the majority of an egg’s nutrients are in the yolk and the whites have no iron. Whole egg protein powder is newer to market. And whole egg protein powder does provide iron.

Hemp protein powder is an excellent plant-based source of protein. It’s packed with beneficial nutrients like iron, essential fatty acids, and minerals.

Brown rice protein powder is one of the most hypoallergenic types of protein on the market and is easy to digest. It’s also high in iron.

Pea protein is a high-quality protein and a great source of iron, according to Healthline a respected consumer health website. Pea protein powders are also rich in iron.

Mixing plant-based proteins together into one powder boosts its nutritional value and should provide all the amino acids.

I am a health writer and have sourced all claims to reputable online sources. But I am not a healthcare professional. So before making a switch, talk to your bariatric healthcare professional or doctor.

Improve Iron Absorption with Protein Powders

Try mixing an iron-rich protein powder in orange juice (being careful to avoid dumping syndrome). The natural vitamin C in OJ will help your body absorb the iron. Or, mix iron-rich protein powder with hydrolyzed whey or collagen peptides to aid absorption of iron.

And remember to eat your protein first!

Living larger than ever, My Bariatric Life www.mybariatriclife.org

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  • Cheryl Ann Borne

Cheryl Ann Borne

Cheryl Ann Borne writing as My Bariatric Life is publisher of two free inspirational and transformative resources: MyBariatricLife.org an online bariatric magazine and Your Daily Success e-newsletter.