Bariatric Times

JUN 2017

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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4 Bariatric Times • June 2017 p rocedure is, in my opinion, completely outdated. We should be able to create scores by adding to the BMI other very important v ariables, such as age, type, severity of associated comorbidities, and of course the procedure-related morbidity, which are missing i n the metabolic score. 2 In "Ask the Leadership," I interview American Society for M etabolic and Bariatric Surgery (ASMBS) President-Elect Samer G. Mattar, MD, FACS, FRCS (Edin.), FASMBS, on the ASMBS pathway for approval of new devices and procedures. We need to thank John Morton, MD FASMBS, who started us on this trail while he was the ASMBS President. This pathway was never intended to control or obstruct progress, rather it was born from patients and insurance companies that reached out to us q uestioning why patients are undergoing new treatment modalities without clear published evidence in the literature. A SMBS Weekend is taking place June 8 to 10, 2017, in San Diego, California, and I hope to see many of you there. I urge you t o not miss this outstanding gathering that was put together by Stacy Brethauer, MD, FASMBS, society president, and Natan Zundel, MD, FACS, FASMBS, program chair. The session topics and faculty were very well thought out and developed with you in mind. See you in San Diego! Sincerely, Raul J. Rosenthal, MD, FACS, FASMBS REFERENCES 1. Aminian A, Brethauer S, Andalib A, et al. Individualized Metabolic Surgery Score: Procedure Selection Based on Diabetes Severity. Presented at: 137th Annual Meeting of the American Surgical Association, Philadelphia, PA; April 20-22, 2017. 2. Kalra S, Gupta Y. The metabolic score: A decision making tool in diabetes care. J Pak Med Assoc. 2015;65(11):1237–1241. A Message from Dr. Raul Rosenthal continued... A Message from Dr. Christopher Still continued... t eenagers (largely because of the amount of caffeine that the beverages contain). M any school districts and sports organizations have actually taking steps to ban the use of energy drinks by student athletes. T he National Federation of State High School Associations, in its position statement on energy drinks reported that in 2006, "over s even million adolescents reported that they had consumed energy drinks." In late 2010, Virginia became the first state to ban energy drinks from public high school athletic functions. The Virginia High School League (VHSL) stated "there is no regulatory control over energy drinks, thus their content and purity cannot be ensured. This may lead to adverse side-effects, potentially harmful interactions with prescription medications (particularly stimulant m edications used to treat ADHD), or positive drug tests". I expect to see similar decisions made across the country as the negative e ffects of such products are better understood. The fact is that kids don't need caffeine at all, especially when t hey are in an environment where paying attention is critical to their success. Young people attending school with increased heart rates, elevated blood pressures, higher than normal levels of irritability, nervousness and anxiety is in my opinion, a recipe for disaster. There are much better and healthier ways to get calories and energy than chugging a sugar- and caffeine-laden energy drinks, such as adding a piece of fresh fruit My patients know that I have always recommended eliminating regular sodas and fruit juices from their diets (due to their high caloric/sugar content), but if you are a fruit juice lover, you could satisfy that urge by using a Crystal Light-type juice that simply mixes with water. There are also the Trop50 and other juices that offer 50 percent fewer calories than regular orange juice; the advantage is that the sugar is already taken out. As for caffeine, a simple cup of coffee can provide you that much needed "kick start" in the morning (again, avoid the heavily sugared flavored coffees, lattes, and specialty morning drinks). The difference between black coffee, at zero to three calories, and the energy drinks is the significantly higher sugar and calorie content, as well as the grossly increased caffeine ingredient. So don't fall for the hype. None of us—especially children/teens—need more caffeinated energy from a can. A balanced diet, exercise, and sufficient sleep should give you all the energy you need to get through the day. Sincerely, Christopher Still, DO, FACN, FACP REFERENCES 1. Fletcher EA, Lacey CS, Aaron M, et al. Randomized controlled trial of high-volume energy drink versus caffeine consumption on ECG and hemodynamic parameters. J Am Heart Assoc. 2017 Apr 26;6(5). pii: e004448. 2. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (January 10, 2013). The DAWN Report: Update on Emergency Department Visits Involving Energy Drinks: A Continuing Public Health Concern. Rockville, MD. sr126-energy-drinks-use.htm Accessed May 19, 2017. 3. U.S. Food and Drug Administration. Energy "Drinks" and Supplements: Investigations of Adverse Event Reports Accessed May 19, 2017. 4. Ferdman R. The American energy drink craze in two highly caffeinated charts. craze-in-two-highly-caffeinated-charts/. Accessed May 19, 2017 Bariatric Times welcomes letters for possible publication. Letters should be no more than 500 words and five references. Letters that comment on a Bariatric Times article will be considered if they are received within two months of the time the article was published. All letters are reviewed by the editors and are selected based upon interest, timeliness, and pertinence, as determined by the editors. Send letters to: Angela Saba at or mail to: Angela Saba, Bariatric Times, Matrix Medical Communications, 1595 Paoli Pike, Suite 201, West Chester, PA 19380. Include the following statement with the letter:"The undersigned author transfers all copyright ownership of the enclosed/attached letter to Matrix Medical Communications in the event the work is published. The undersigned author warrants that the letter is original, is not under consideration by another journal, and has not been previously published. I sign for and accept responsibility for releasing this material on behalf of any and all co-authors." Letter to the Editor Submissions

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