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Bariatric Surgery: Risks in the OR and Beyond

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The extent of risk from bariatric weight-loss surgery may depend on the skill of the surgeon. After sleeve gastrectomy and Roux-en-Y gastric bypass, the third most common bariatric procedure is a revision to fix a previous bariatric procedure, as you can see below and at 0:16 in my video The Complications of Bariatric Weight-Loss Surgery . Up to 25% of bariatric patients have to go back into the operating room for problems caused by their first bariatric surgery. Reoperations are even riskier, with up to 10 times the mortality rate, and there is “no guarantee of success.” Complications include leaks, fistulas, ulcers, strictures, erosions, obstructions, and severe acid reflux. The extent of risk may depend on the skill of the surgeon. In a study published in The New England Journal of Medicine , bariatric surgeons voluntarily submitted videos of themselves performing surgery to a panel of their peers for evaluation. Technical proficiency varied widely and was related to the ra...
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Bariatric Weight-Loss Surgery and Mortality

Today, death rates after weight-loss surgery are considered to be “very low,” occurring in perhaps 1 in 300 to 1 in 500 patients on average. The treatment of obesity has long been stained by the snake-oil swindling of profiteers, hustlers, and quacks. Even the modern field of bariatric medicine (derived from the Greek word baros , meaning “weight”) is pervaded by an “insidious image of sleaze.” Beguiled by advertising for fairy tale magic bullets of rapid, effortless weight loss, people blame themselves for failing to manifest the miracle or imagine themselves metabolically broken. On the other end of the spectrum are overly pessimistic practitioners of the opinion that “people who are fat are born fat, and nothing much can be done about it.” The truth lies somewhere in between. The difficulty of curing obesity has been compared to learning a foreign language. It’s an achievement virtually anyone can attain with a sufficient investment of energies, “but it always takes a consider...
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How Healthy Are Baruka Nuts?

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How do barukas, also known as baru almonds, compare with other nuts? There is a new nut on the market called baru almonds, branded as “barukas” or baru nuts. Technically, it isn’t a nut but a seed native to the Brazilian Savannah, known as the Cerrado, which is now among the most threatened ecosystems on the planet. Over the last 30 years, much of the Cerrado’s ecosystem has been destroyed by extensive cattle ranching and feed crop production to fatten said cattle. If it were profitable not to cut down the native trees and instead sell baru nuts, for example, that could be good for the ecosystem’s health. But what about our health? “Although baru nuts are popular and widely consumed, few studies report on their biological properties.” They do have a lot of polyphenol phytonutrients, presumably accounting for their high antioxidant activity. (About 90% of their phytonutrients are present in the peel.) Are they nutritious? Yes, but do they have any special health benefits—beyond t...
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Can Vegan Fecal Transplants Lower TMAO Levels?

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If the microbiome of those eating plant-based diets protects against the toxic effects of TMAO, what about swapping gut flora? “Almost 2,500 years ago, Hippocrates stated that ‘All disease begins in the gut.’” When we feed our gut bacteria right with whole plant foods, they feed us right back with beneficial compounds like butyrate, which our gut bugs make from fiber. On the other hand, if we feed them wrong, they can produce detrimental compounds like TMAO, which they make from cheese, eggs, seafood, and other meat. We used to think that TMAO only contributed to cardiovascular diseases, like heart disease and stroke, but, more recently, it has been linked to psoriatic arthritis, associated with polycystic ovary syndrome, and everything in between. I’m most concerned about our leading killers, though. Of the top ten causes of death in the United States, we’ve known about its association with increased risk of heart disease and stroke, killers number one and five, but recently, ...
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Is Aflatoxin a Concern?

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Is “toxic mold syndrome” a real thing? What do we do about toxic mold contamination of food? In recent years, mold has been blamed for all sorts of “vague and subjective” symptoms, but we have little scientific evidence that mold should be implicated. However, this “concept of toxic mold syndrome has permeated the public consciousness,” perpetuated by disreputable predatory practices of those making money testing homes for mold spores or testing people’s urine or blood. But all these tests are said to “further propagate misinformation and inflict unnecessary and often exorbitant costs on patients desperate for a clinical diagnosis, right or wrong, for their constellation of maladies…The continued belief in this myth is perpetuated by those charlatans who believe that measles vaccines cause autism, that homeopathy works, that fluoride in the water should be removed….” Mold toxin contamination of food, however, has emerged as a legitimate issue of serious concern, and mycotoxins are ...
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Are the Effects of Ochratoxin Concerning?

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The overall cost-benefit ratio for mycotoxins depends on which food is contaminated. Ochratoxin has been described as toxic to the immune system, developing fetus, kidneys, and nervous system, as well as being carcinogenic, but that is in animal studies. Ochratoxin “ causes kidney toxicity in certain animal species, but there is little documented evidence of adverse effects in humans.” That’s why it’s only considered a possible human carcinogen. Big Ag assures that current ochratoxin levels are safe, even among those who eat a lot of contaminated foods. The worst-case scenario may be young children eating a lot of oat-based cereals, but, even then, “their lifetime cancer risk is negligible.” Individuals arguing against regulatory standards suggest we can eat more than 42 cups of oatmeal a day and not worry about it. Where do they get these kinds of estimates? They determine the so-called benchmark dose in animals—the dose of the toxin that gives a 10% increase in pathology—the...
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Mold Toxins in Cereals, Herbs, Spices, and Wine

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Most crops are contaminated with fungal mycotoxins, but some foods are worse than others. Oats can be thought of as “uniquely nutritious.” One route by which they improve human health is by providing prebiotics that “increase the growth of beneficial gut microbiota.” There are all manner of oats, ranging from steel-cut oats to, even better, intact oat groats (their form before being cut), all the way down to highly processed cereals, like Honey Nut Cheerios. “Rolling crushes the grain, which may disrupt cell walls and damage starch granules, making them more available for digestion.” This is bad because we want the starch to make it all the way down to our colon to feed our good gut bacteria. Grinding oats into oat flour to make breakfast cereals is even worse. When you compare blood sugar and insulin responses, you can see significantly lower spikes with the more intact steel-cut oats, as shown below and at 0:54 in my video Ochratoxin in Certain Herbs, Spices, and Wine . What ab...
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