Bariatric Surgery Success podcast

#72 Does Keto Breath Smell Like Nail Polish Remover?

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You know the smell of nail polish remover? That familiar smell is very similar to keto breath. Along with that smell might come a metallic taste in your mouth. Keto breath…yes, it’s a thing. Let’s talk about what keto breath is and what you can do about it if you have it.

Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 72. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.

In the newsletter this week is a link to my new holiday freebie, a festive meal plan complete with appetizer, entree, side and dessert plus the recipes and color photos of the recipes. It will be available now to the end of December. If you’re not receiving the weekly Breaking Down Nutrition newsletter, it’s a quick way to find out first what’s going on in bariatric nutrition from new freebies, upcoming courses, tips, product discounts and the latest podcast episode. Be sure and sign up at the bottom of my home page https://www.breakingdownnutrition.com 

  

Have you recently had bariatric surgery and now you have a terrible metallic taste in my mouth? Does brushing your teeth help for a little while and then the bad taste returns? Does your breath smell like nail polish remover? You may have keto breath.

The good news right up front is that it will go away.

Here’s what you need to know now about keto breath.

The most common causes of bad breath are dehydration, ketosis from rapid weight loss, dental issues, and food not emptying your pouch well. 

Let’s start with dehydration as it’s a big factor in bad breath. It's easy to cut back on fluids after surgery when you don’t mean to because you’re having to take smaller sips and there’s less fluid in your mouth keeping it fresh. So for many reasons, and bad breath being just one, take note of how much water and other fluids you drink each day. Just as a reminder, you’ll slowly be working your way up to 8-12 cups/day or two to almost three liters of water and other liquids. You’ll start with small sips every 15 minutes as tolerated and build from there. Did you know that dehydration is the main reason for re-hospitalization after bariatric surgery? That’s why fluids are so important to start your journey off right and keep it on the right track. Sometimes bad breath can be resolved just by making sure you drink enough.

If you think there’s any chance you might have tooth decay, gum disease, or any other dental issues, visit your dentist to rule it out. These types of issues can be an underlying cause of bad breath. Try to brush and even floss after each meal or snack whether it’s liquid or solid. Even brush your tongue as bacteria and food particles can build up on the surface and cause bad breath.

Now let’s get to keto breath as a cause of bad breath. What is keto breath?

Basically when you reduce carbohydrates to a very low level, the lack of carbs fueling your cell metabolism [meaning there’s a lack of energy to your cells], your body will turn to stored fat as an energy source and break it down it. When your body breaks down fat for energy instead of carbs, it converts the fatty acids into chemicals called ketones. The body has numerous self-regulating processes whose goal is to maintain a balance of it’s internal environment. With the increased production of ketones, the body gets rid of the them through both your breath/respiration and urine. One type of ketone, acetone, is an ingredient in some nail polish removers, which is why your breath may smell like it. So when you hear the words, keto breath, they refer to the release of ketones, which is the breakdown of stored fat in your body when there is a lack of carbohydrate for fuel. It also can give you a metallic taste in your mouth.

Keto breath can happen to anyone who loses weight, but is more noticeable after weight loss surgery because of how fast the weight comes off. How do you get rid of it? As you move along your journey and start to add more carbs back to your food intake, keto breath should go away. Speak to your bariatric dietitian about it. Sometimes adding back as few as 5 grams of carbs can make a difference. Eating foods that increase saliva production, like parsley, celery and lemon or grapefruit can help a little too with bad breath.

A less common problem but one I want to mention is that bad breath after lap band or gastric sleeve surgery can be caused by food that isn’t emptying the stomach pouch as it should. The result is likely a build-up of digestive fluids such as acid in the stomach pouch. This build up can put you at an increased risk for acid reflux, which often shows up as heartburn or regurgitation. The main reasons that food becomes stuck in the pouch is eating foods that are not recommended after weight loss surgery or eating too quickly. If you’re drinking plenty of fluids every day, have good oral hygiene and slowly adding carbs as allowed to diminish keto breath and you still have bad breath issues, talk to your health care team.

I hear you. Keto breath is not fun to deal with when you’re trying to make many other changes after surgery. But it will go away. Remember that it’s the very low carb diet that causes it so as you start to add even small amounts of carbs back to your diet, it should correct itself. Take care of yourself and be good to you…you’re worth it.

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If you’re lifting weights, that protein first concept works but what if you’re walking/running/biking/swimming instead or training for a 5K, 10K, half marathon or marathon? You may not get the carbs you need for these types of events and could bonk. What is bonk? You’ll know if it happens. It’s where you feel a sudden loss of energy and a sudden fatigue which is caused by the depletion of glycogen stores in the liver and muscles. You don’t want this to happen and it’s why circling back with your bariatric dietitian to personalize your needs with your specific types of training is so important. You’ll need more carbs and may need to eat them first so this is an important discussion to have as it goes against what you’re always told to do.Let’s call this one food for thought. Intensive exercise is probably smarter after one-two years when your caloric intake can be higher and the macros tweaked. That does’t mean you don’t exercise. Not at all. The first six months, you’re healing and you’re just trying to move around more. Then you move on to walking, swimming, etc but the intensive workouts might be better initiated one to two years after your surgical procedure. Have this discussion with your team if you want to work out harder and longer and it’s still early in your recovery.If you’re down the track and desire to increase your workout, what does a pre workout meal look like? A couple of minutes ago we just talked about the need to include both protein and whole food carbs with the amounts of each based more on the type of workouts you do.Some general examples would be:An egg with 1/2-1 slice of whole grain toastDeli meat wrapped around a low-fat cheese stick and fruitCottage cheese with fruit: berries, grapes or bananaRemember, the protein or carb amount may need to be changed based on the type of exercise you’re doing. If you’re 3-4 hours out from your workout, a meal fits in fine. As you get closer to the time you plan to workout, reduce the amount of food and if it’s only 30 minutes - 1 hours before you get started, continue to hydrate only. Since you should know your event or training days, aim to pre-hydrate a bit more and increase your fluid intake 2-4 cups in the 1-2 days before your hard training or event. Then as usual, sip on fluids all day as well as during your workout. Continue to keep food and fluids separate by 30 or more minutes unless your dietitian has told you differently depending on how far out from surgery you are now. To help you stay hydrated, you can eat foods with a higher fluid/water content such as Greek yogurt, a protein shake, even veggies and fruit which have high water contents. Use your urine color as a way to monitor your hydration. What color should it be? That’s right, pale or light yellow. When it’s darker, it’s sending you the message to consume fluids.Don’t forget about dumping syndrome. Remember that if you consume foods high in refined carbohydrates you may experience bloating, abdominal pain, nausea, diarrhea, even low blood pressure or a change in your heart rate. Symptoms vary depending on whether you experience early or late dumping syndrome. This means that using sports drinks and gels may be a problem due to the high carbohydrate content. Remember if you exercise longer than one hour, consuming carbohydrates and electrolytes can help prevent that sudden loss of energy and fatigue. Recommendations suggest to consume somewhere in the range of 30-60 grams of carbohydrate per hour, in about 10 gram increments. But you don’t have to use sports drinks or gels. They don’t have magical powers, just convenience. Did you know you can eat a few raisins or other fruit and get your carbs and calories easily? You don’t want low blood sugar or fainting as you’re trying to get stronger thru your workouts. Also, not getting enough quality calories can show its ugly face in muscle wasting, poor performance, or trouble with recovery.Speaking of recovery, try to eat or drink your meal within 30 minutes to one hour after you’ve finished your workout. Shoot for a ratio of 2:1 carb to protein for a post-workout meal. I know…this is not the typically bariatric way which is why which carbs you choose to eat is important along with how much. Your dietitian may have a certain level/strategy for you.Be sure and take your bariatric supplements daily and let your dietitian know how much you train. Increased workouts and increased calorie burn can increase the need for some supplements such as iron for example.Sports nutrition is just as important after your surgery as it is for anyone who trains or works out. Try these strategies, discuss with your health care team. Find what works for you. Take care of yourself and be good to you…you’re worth it.
  • Bariatric Surgery Success podcast

    #73 Bariatric Nutrition Q & A #5: Your Questions Answered

    21:49

    Procarenow.com for free samples. Use Code: Susan10 to save 10%Ahhh slider foods…so tasty and so easy to eat copious amounts without ever feeling full or uncomfortable.Bariatric dietitians Gayle Smith and Isabel Maples join me to talk about what slider foods are and how they can cause a weight plateau and weigh regain.Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 73. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.Do you need a festive meal plan for the holidays? Check out my new freebie, a festive meal plan complete with appetizer, entree, side and dessert plus the recipes and color photos of each recipe. It’s available now to the end of December.Also, do you have a question you want Gayle, Isabel and myself to answer? You can post it anytime if you’re in the Facebook Group Bariatric Surgery Success with Dietitian Dr. Susan Mitchell.Joining me via Skype are bariatric dietitians Isabel Maples and Gayle Smith. If you’re a regular listener, you know that both Isabel and Gayle join me on these bariatric nutrition Q & A episodes to answer your questions.They both have boots on the group every day in their clinics. Isabel is a registered dietitian and bariatric coordinator with Fauquier Health in Warrenton Virginia. Gayle is the bariatric dietitian at the Weight Loss and Bariatric Surgery Institute in Orlando, Florida.Bariatric Dietitian Isabel Maples, RDFauquier Health Weight Loss SurgeryEmail:  [email protected] Bariatric Dietitian Gayle Brazzi Smith:OrlandoHealth.com/Bariatrics  [email protected] we discuss today:What is a slider food and why do we love them so?Why are slider foods so popular and easy to reach for?What about the stress component to slider foods?How are slider foods tied to a weight loss plateau and weight regain?How can you be slider food savvy?Remember, if you’re looking for the latest freebie, ProCare supplements, portion control dinnerware, the newsletter and other resources, just go right my resource pageTake care of yourself. You’re worth it!

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