Pocket Protein. An innovative new food solution for the WLS patient population.

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1 Pocket Protein. An innovative new food solution for the WLS patient population. Will. More powerful than hope. Fueled by inner strength. The weight loss surgery population exemplify both. This article explains the WLS patient's greatest new ally in the maintenance of a health, well being and nutrition. Introducing...Pocket Protein. Lyttleton Stewart, PharmD 08/11/2014

2 Protein. It is the most abundant substance in the human body next to water.. The word "protein" is derived from the Greek word meaning "of first importance." This is literally true for the weight loss surgery ( WLS) or bariatric surgery patient. Protein is the most important nutrient in the bariatric/wls patient's diet. Protein is needed for virtually every cell function, including enzymes, muscle contraction and movement, cell messengers, metabolic function, hormone production, antibodies, transporters, body support and structure, ph and fluid balancers, vitamin and mineral storage, and energy. Protein is especially important after WLS to help with wound healing and the preservation of lean muscle mass. 1 A new solution for weight loss surgery patients...pocket Protein. It is the latest innovation in nutrition. Pocket Protein is a 15 or 20 grams of heart healthy liquid protein food that is fat free, sugar free, carb free, gluten free, caffeine free, stimulant free and lactose free- in a 2 oz foil pack- that never needs refrigeration. Our proprietary blend of hydrolyzed collagen and whey protein isolate is ideal for both post surgery recovery and helping weight loss surgery patients achieve and maintain their desired results It's very difficult to consume enough protein from foods alone during the first several months after weight loss surgery. Most surgery patients integrate liquid protein supplements such as shakes, cold drinks, hot drinks, soups and puddings into their diet after surgery and many continue to use them as a balanced, convenient source of protein and nutrition for the rest of their lives. Protein provides many important benefits to the WLS surgery patient: 2 " Protein aids in proper wound healing after WLS. " Protein helps keep your hair, skin, bones and nails healthy. " Protein helps form hormones, enzymes and immune system antibodies to help your body function properly. " Protein helps your body burn fat instead of muscle for a healthier weight loss. " Protein supports your natural metabolism so you lose weight quicker. " Protein curb's your hunger between meals. When protein intake is not adequate, the body will break down lean body mass to compensate for poor oral intake. 3 Loss of lean body mass is inevitable for WLS patients or individuals following a very low calorie diet. To minimize that loss, sufficient high-quality protein must be consumed 4 Protein is the KEY factor in wound healing and immunity- both of which are of upmost importance to a WLS patient. You must heal after surgery. Perhaps the most important function of protein in a patient with a wound/post surgical wound- is growth and repair. The body constantly deposits protein into new cells to replace protein that has been lost. New living tissue cannot be built without protein, so it follows that no 1 Importance of Protein with Bariatric Surgery patients, Kimberly Mahoney, MS, RD, LDN 2 Protein Supplements and Weight Loss Surgery, Kimberly Mahoney, MS,RD,LDN 3 Reported consumption of low-nutrient poor foods by adult Americans: nutritional health implications. The third national Health and Nutrition exam Survey, Am J Clin Nutr 2000; 72: Pournaras DJ, le Roux CW. After bariatric surgery, what vitamins should be measured and what supplements should be given

3 wound can heal without adequate protein from which to build new tissue. The amino acids in protein directly affect and contribute to the body's immune system...also imperative for post surgical patients. Problems with the selections of protein products are the same with any individual trying to get significant levels of protein on a daily basis. Everyone is on the run, traveling in airports, has families/kids, soccer practice, piano lessons, work projects and the list goes on. We are all rushed and live in a fast paced world. Especially in this weight loss surgery population, it is absolutely imperative that they achieve adequate protein intake. How do you do that? 5 You can't take a microwave with you everywhere. You don't have a fridge or a blender in all locations. Do you want to eat eggs, chicken and steak every day and spend the money to do that? Eggs have a lot of cholesterol and steak has a ton of fat, and chicken can get expensive...do you want to eat distasteful, sugar, fat and carb loaded protein bars every day? Most protein bars are essentially candy bars...and they melt!...pocket Protein solves ALL of these issues. It is just the protein, nothing else. A quick and tasty, low volume liquid protein food solution that can be a vital component of any and all weight loss and weight loss surgery patient regimens, everyday. Coupled with the fact that protein is the ONLY macronutrient that is NOT stored in the body and must be replenished EVERY DAY, components including digestibility and bioavailability remain among the most important when a WLS patient is considering viable/effective protein sources. Whey products are always at the top of the list. Just make sure that these are LACTOSE FREE. Many patients get protein from milk products...they have lactose, which for many, causes gastric dysfunction. REGULAR collagen may not be good choice. Why? Because many of those products are not pre-digested or hydrolyzed. In other words, it is very hard for the patient to digest these sources due to their new gastric physiology profile. Also most of those sources are missing 1 essential amino acid- tryptophan, which can be an issue within the scope of collective amino acid profile benefits. You want a "complete" protein...meaning a complete essential amino acid profile. Pocket Protein is exhibits the highest bioavailability, is pre-digested and "hydrolyzed" which allows advanced absorption. Pocket Protein is a "COMPLETE PROTEIN" food. It has whey isolate and is "tryptophan fortified" which contributes to the complete essential amino acid profile. A Perfect option. Many surgical weight-loss programs recommend from 55 to over 100 grams of protein per day for the adjustable gastric band (AGB), vertical sleeve gastrectomy (VSG) and the Roux-en-Y gastric bypass (RYGB). The biliopancreatic diversion with duodenal switch (BPD/DS) requires approximately grams of protein per-day to accommodate for the malabsorption associated with this procedure. Pocket Protein is the perfect solution for many WLS patients- given these requirements. 678 Finally, the right source and adequate amounts of protein intake after WLS remain important precursors to "sustainabilities in habits." You train your body to "love" protein and it will become a habit. When WLS 5 Nutritional Course of Patients Submitted to bariatric Surgery, Obese Surg Obese patients have adequate protein intake related to protein intolerance up to 1 year following Roux-en-Y gastric bypass. Obese Surg. 2003:13: Prospective evaluation of biliopancreatic diversion with Roux-en-Y gastric bypass in the super obese. J Gastrointest Surg Roux-en-Y gastric bypass versus a variant of biliopancreatic diversion in a non-superobese population: prospective comparison of the efficacy and incidence of metabolic deficiencies. Obese Surg. 2006

4 patients enter that second period following WLS, maintenance becomes the focus. Protein causes satiety. Foods high in protein are usually denser, which means it makes a person feel full longer. Protein also sends signals to the brain telling it "I'm Full!." 910 These are and become beneficial effects in the latter stages after surgery when the stomach pouch naturally enlarges. It is important to have balance at every meal, and is recommended to consume protein sources first. "Protein at every meal"...every day. Pocket Protein can do that... anytime, anywhere, for everyone. 8 A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin conc, Am J Clin Nutr The satiating power of protein- a key to obesity prevention, Am J Clin Nutr- 2005

5 References 1. The satiating power of protein- a key to obesity prevention, Am J Clin Nutr- 2005:82: A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations, Am J Clin Nutr 2005:82: Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients). Washington, DC: National Academy Press, Astrup A, Grunwald GK, Melanson EL, Saris WHM, Hill JO. The role of low-fat diets in body weight control: a meta-analysis of ad libitum intervention studies. Int J Obes Relat Metab Disord 2000;24: Weigle DS, Breen PA, Matthys CC, et al. A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations. Am J Clin Nutr 2005;82: Obese patients have adequate protein intake related to protein intolerance up to 1 year following Roux-en-Y gastric bypass. Obese Surg. 2003:13: Prospective evaluation of biliopancreatic diversion with Roux-en-Y gastric bypass in the super obese. J Gastrointest Surg Roux-en-Y gastric bypass versus a variant of biliopancreatic diversion in a non-superobese population: prospective comparison of the efficacy and incidence of metabolic deficiencies. Obese Surg Protein Supplements & Weight Loss Surgery, Kimberly Mahoney, MS, RD, LDN 10. The satiating power of protein- a key to obesity prevention, Am J Clin Nutr Reported consumption of low-nutrient poor foods by adult Americans: nutritional health implications. The third national Health and Nutrition exam Survey, Am J Clin Nutr 2000; 72: Pournaras DJ, le Roux CW. After bariatric surgery, what vitamins should be measured and what supplements should be given

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