Saturday, October 25, 2008

Weight loss surgery, vitamin D and bone loss

Note: The comments on this blog are for information only. Do not make any changes in sunlight exposure, tanning-bed exposure or nutritional habits without first consulting a medical professional.

The obesity pandemic, brought about by horrendous eating patterns, lack of exercise and (in my opinion) lack of sunlight and vitamin D has spawned millions of nutritionally bizarre diet programs and numerous strange medical procedures. One of the strangest is gastric bypass surgery, a procedure that cuts calorie absorptions by bypassing the intestinal area that absorbs nutrients. It is another case, similar to open-heart bypass surgery, of a surgery that “bypasses” the real problem: preposterous lifestyle habits.

Any thinking person realizes that a surgery that reduces the calorie absorption also reduces the absorption of calcium and vitamin D. It is a recipe for osteoporosis and hip fractures; these nutrients are essential for optimal bone health. A recent study Dr. J Fleischer and colleagues at Columbia University (J Clin Endocrinol Metab. 2008;93:3735-40) has shown that one year after gastric bypass, bone loss at the hip was 8%. Just how important is this finding? One assessment showed that the risk of fracture increases two to three times for every 10 percent drop in bone density, and another showed that for every loss of 0.12g (.043 oz) per square centimeter (.15 square inch) of bone mass, the risk of a fracture increased by 360% in women and 340% in men!

Remember that this bone loss was reported only one year after the bypass surgery. If this rate of bone loss continued for several years, it would weaken the skeleton to the point that the slightest movement would cause a fracture. The bypass procedure is a horror, and the bone loss brought on by lack of absorption of calcium and vitamin D, is even worse.

In the case of decreased absorption of vitamin D, increased dietary intake of vitamin D may or may not work to improve bone strength; it is likely that only a very small quantity of the increased intake would ever make it to the system. The only way to ensure adequate vitamin D levels in the blood is to expose the skin to sunlight or light from sunlamps such as those found in conventional tanning beds. Vast quantities of vitamin D are produced in this manner, and the entire quantity is delivered to the blood, where it can work to increase calcium absorption in both the intestine and in the bone. Calcium absorption in the intestine, for instance, is 65% higher in people whose vitamin D levels are at the low end of “normal” when compared with those who are at the high end of normal.

Osteoporosis is not inevitable, and is to a certain extent reversible (see my earlier blog on the subject). It is a problem caused by excessive animal protein consumption, smoking, lack of activity and vitamin D deficiency. Now we have added another revolting cause: the doctor’s scalpel. I wonder just how many doctors advise their patients about bone loss and vitamin D before performing this monstrosity.

(Documentation for the statements in this blog is available in my book.)


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