I talked with the NUT at the Clinic yesterday to clear up some facts on vitamins, supplements and eating plan.

Carbs: I told her that I was trying to set up a plan for life and would like to have some guide lines on fats, carbs and sugars for a meal or a day. I told her that I would like to be setting up more well-balanced meals, if that is possible. Said I have read a zillion numbers on how many carbs that we should be taking in a day. She told me that carb count was not important that if you get your protein in first and then a small amount of carbs, the carbs will not be a factor and they will burn off first and not be stored. "Don't worry about a set amount of carbs"?!?! I kind of wish the Clinic had a more structured "after" food plan and that they gave more guidelines on setting up a lifetime plan. My fats are to be no more than 27 to 30 something a day. Sugars: still wants us to concentrate on no more than 2 grams added sugars. Gave me the suggestion that if a sugar (not in natural form) was listed as one of the first five ingredients and stated more than 2 grams, than I should pass on it. I'm sorry but have yet to hardly find anything that falls in that category except meat. So I guess I'll still be loosely following the South Beach.

Vitamins and Supplements: She kind of danced around what I should be taking on a regular basis. I think that they give a basic regime, like one prenatal, B12 500 mcg, calcium with vitamin D and a vitamin C for iron absorption. She told me that most people they have seen have a vitamin D deficiency and I could up my vitamin D if I wanted. They want you to get most of your vit. D from you diet?!?!, but I'm not a great dairy person, because there just isn't room for all of that right now. I'm on the low side of iron and was before surgery, but she said that I should be covered with the prenatal?!?! I think that they base what you should be taking on your labs, but my then you probably already have a deficiency.

If anyone has any suggestion, I'm open to them. I'd like to head off deficiencies, but don't want to spend money on stuff that I'm going to send down the potty.

Hmmm... I am not sure about the carb debate (and I have not had surgery for weight loss, so I know very little as far as that goes). But I have read a lot about vitamins and in my experience: If you are taking a prenatal vitamin you are getting tons of iron (eat fiber and drink water! Iron causes constipation! I took a prenatal for a while and the first couple of days - things moved a little slowly - but then I adjusted and was back to normal.) I have read that iron prevents the absorption of calcium - so you should not take them both at the same time - i.e. take iron in the morning - calcium at night. And you can get Vitamin D from taking a walk outside in the sun for 20 mins.

That seems a little odd, since the vitamin D in most foods (like cow milk) has been added to it as a supplement. There are foods that have it naturally, and most of them are high fat.

Here is an interesting read : http://vitamind.ucr.edu/milk.html

I was told by my doctor it wasn't possible to get the recommended amount from diet and to supplement. BTW there is a blood test for a vitamin d defiency which she should have done instead of just guessing.

i am glad you said that about he vit calcium and iron. i have been taking them at the same time. i will change that. thanks!

Since moving to Wisconsin, I've become very prone toward vitamin D deficiency (haven't had WLS surgery), especially in the winter. I was having very bad muscle cramps mostly in my legs and feet, but also in my shoulder and while doctors suggested it was calcium, magnesium, potassium it turned out to be vitamin D. It was a endocrinologist who finally did the test BEFORE suggesting a supplement. Now I take a vitamin D supplements during the winter. I seem to do fine once spring comes and it's easier to spend some time in the sun unbundled.

I don't know how WLS affects your ability to absorb vitamin D through diet and supplement or through sunlight for that matter but luckily, D supplements, are one of the cheaper supplements. I don't remember what I paid for my last bottle, but it's lasting forever and I know it was way under $10. In fact, it was probably less than $5 or I probably would remember it (I'm a real tightwad for things like that).