Laparoscopic Associates of San Francisco

New Year, New You

December 12th, 2014 Posted in Bariatric surgery, Diabetes, Duodenal switch, Eating healthy, gastroesophageal reflux disease, GERD, News, Nutrition, post weight loss surgery tips, Protein and calories, Stomaphyx, surgical weight loss, Vertical gastrectomy, weight loss plan, weight loss surgery, Weight loss surgery results | No Comments »

The Near Year is here and it is important to think about how you want to start the New Year and set some goals to help this year be better than last. Here is the best strategy to start your year on a good foot and achieve what you want this year in regards to fitness and nutrition. This can also be applied to personal goals as well.


 1. Think about your current accomplishments. What have you achieved this year?

Write them down. Did you start a  fitness program you loved? Did you focus on cutting out alcohol from your weekly routine? Think of all the accomplishments you made this year and use that positivity as your starting point.

2. Assess your current state and the things that you want to change differently this year.

When it comes to nutrition, start a weekly food diary on tools such as MyFinessPal or Lose It. Make notes of things to change. Has your fat intake gotten high? Are simple carbs at every meal? These notes will help you form your goals.

3. Based on #2, start setting your goals.

Think about your big broad goals. For example, “I want to start exercising weekly.” Use this as a starting point to form more specific, small goals to address the big issues. Set small goals every 2 weeks to a month that are specific, measurable, achievable, and time framed. For example, “Every week, I am going to start doing Dailey Method (insert favorite workout here), 5 days a week, including 1 interval class.” That took our big goal and made it into a more specific goal.

 4. Start a journal.

Start to journal your goals and accomplishments. Also, continue to use your food journal.  Those who track their intake are far more likely to lose weight and maintain it.

5. Reward yourself (without food). 

Use non-food related ways to reward yourself for meeting your goals. Dropped a size? Reward yourself with a new dress. Haven’t had refined sugar in 30 days? Buy concert tickets. Up to you, but this is a way to make it fun and rewarding. It also helps you form discipline and willpower.  

 Merry Christmas and Happy New Year from LapSF.

Your “One Pot” Dish: Roasted Chicken with Veggies

August 13th, 2014 Posted in Bariatric surgery, Diabetes, Duodenal switch, Eating healthy, Nutrition, post weight loss surgery tips, Post WLS tips, Protein and calories, Recipes, surgical weight loss, Vertical gastrectomy, weight loss surgery, Weight loss surgery results | No Comments »

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-Organic free range chicken (4 drumsticks, 2 breasts)

– 1 can organic stewed tomatoes (no sugar added)

-bell pepper slices (~1-2 whole bell peppers, julienned into 1 inch slices)

-Seasonings: smoked paprika, black pepper, cayenne pepper, salt

-2 Tbsp. drizzled olive oil


1.  Pre-heat oven to 350 degrees F.

2. In a large glass baking pan, clean the chicken and place in the pan.

3. Place the tomato sauce over the chicken and add the bell peppers between the chicken pieces.

4. Season the chicken with smoked paprika, black pepper, cayenne pepper and salt.

5. Cook in the oven for  35-40 minutes or until just opaque. (DO NOT OVER COOK!)

6. Portion out 2-3 ounces and eat with the cooked veggies or with a side salad.

*This dish provides 7 grams of protein per ounce.

Gabriella’s note: This dish is perfect for leftovers! The chicken stays moist from the stewed tomatoes and is great cold or hot. The key is to just not overcook the chicken.

In the News: Blood Sugar at the Time of Eating Affects Appetite

July 30th, 2014 Posted in Bariatric surgery, Diabetes, Duodenal switch, Eating healthy, Holidays, News, Nutrition, Research, Vertical gastrectomy | No Comments »

A research was performed on identical twins and their response to foods. The study was trying to show if genetics and upbringing influences patient’s response to foods and how much is consumed after seeing those foods. To perform the study, the twins were split into groups and shown images of low cal foods and high cal foods. Then they were asked what was their hunger level. It looks like the twins shared the same response after the meals as well as the amount consumed, and their hunger before and after the meals. One thing that did show to be different was the brain activation between the two based on their blood sugar level at the time. This shows that genetics and upbringing can play a role in our weight and food choices, but our appetite is highly influenced on how low our blood sugar level is at the time before eating.

Based on these findings, this may show how eating small meals frequently can prevent overeating at meals because it decreases hunger before meals. This most likely is dependent on what is being consumed at the meals before as well because this can influence the blood sugar and ghrelin production pre-meal. It  has been seen recently that eating 90 grams of protein and keeping sugar intake low decreases pre-meal ghrelin and steady blood sugar. It would be advised that those with the sleeve keep sugar intake low, and protein intake high to maintain the low amount of ghrelin after VSG surgery.

What We Are Loving Right Now: Cold Brewed Coffee

July 15th, 2014 Posted in Bariatric surgery, Duodenal switch, Eating healthy, EsophyX, gastroesophageal reflux disease, GERD, heartburn, LapBand, News, Nutrition, post weight loss surgery tips, Post WLS tips, Protein and calories | No Comments »

Those with chronic heartburn know that the acid in coffee can be a huge culprit for causing heartburn and it can be the reason why they do not drink coffee. Surprisingly enough it is the heating process that causes coffee to be acidic.

Well, I have great news for those sensitive to acid especially after weight loss surgery. “Cold brewed” coffee is your answer. Cold brewed coffee reduces the acidity of coffee by 70% and has a much more smooth and refreshing taste than regular iced coffee or lattes. The smooth taste makes it great black over ice or spruced up with a little almond milk and cinnamon.  Sweetness is not usually required, but if necessary, add Stevia drops.

You can most certainly cold brew coffee at home. (There are multiple YouTube videos on this online or blog posts.) Thankfully, you can now find cold brewed coffee at the store as well and are rapidly showing up at grocery stores and specialty food stores.


Here are some favorites:

  1. Grady’s Cold Brew: a strong coffee concentrate with the New Orlean’s “chickory taste”.
  2. Chameleon Cold Brew: a great product out of Austin, produce a “mocha” flavor for the chocolate fiends (no sugar added)
  3. La Colombe Pure Black Coffee: great for those who like a strong brew with smooth taste
  4. Stumptown Coffee Roasters: Portland’s favorite coffee bar is serving cold brew locally and starting to ship them out nationwide.

For those reading this week’s newsletter, you will see Erin Jone’s recipe for cold brewed coffee with almond milk.

Healthy Ways to Cleanse, Rejuvenate, and Lose More Weight

July 8th, 2014 Posted in Bariatric surgery, Eating healthy, Nutrition, post weight loss surgery tips, surgical weight loss, Vertical gastrectomy, weight loss plan, weight loss surgery, Weight loss surgery results | No Comments »

There are many different factors that can help with weight loss other than just monitoring calories, protein, and fat. There are other factors such as hormone balance and even toxin accumulation in fat cells that may be keeping you from losing those last ten pounds. Fat cells (which only get smaller and never go away) tend to accumulate toxins because they are storage locations for toxins in the body.

To help cleanse your body and release toxins from your fat cells and further your weight loss, it may good to incorporate the following into your diet when you are 3 month post-op and beyond.

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1.     Work in vinegars and citrus that help with release of toxins.

Have you ever heard your friend say that they wake up have a cup of hot water with lemon? Lemon is not only a natural diuretic that helps you release water, but it is also loaded with vitamin C which helps aid the liver release built up toxins. Lemon also helps to aid digestion and release toxins from the lymph glands, bladder, and colon. Vinegars such as apple cider vinegar have also been seen to help with detoxification. Try a small cup of apple cider vinegar, Meyer lemon, and water to help you start your day or add lemon juice and vinegar to your salad dressing.

2.     Drink half your body weight in fluids.

I cannot stress fluids enough! Think about it. You can live without food for a significant amount of time, but no water means you will be dead within a few days. Your body is mostly water and you need to give back for proper energy, metabolism, and overall health. Water is also essential for the release of toxins.

3.     Fiber is helpful in cleansing.

The liver is not the only organ responsible for detoxification. Our skin, kidneys and colon are also responsible for detoxification. Fiber rich foods help to detox by pulling in water and releasing toxins through feces. One example? Chia seeds! Chia seeds are high in fiber and also contain omega-3 fatty acids which help “hold onto toxins” which then are excreted when you go #2.

These are just a few helpful tips to help you detox, rejuvenate, and lose more weight.

Tips for the 4th of July

July 2nd, 2014 Posted in Uncategorized | No Comments »
Exercise + Relaxation

Go on a hike this 4th!

1.       Stay hydrated.

Whether you are going on a hike, or going to a party, there are multiple reasons why you should stay hydrated this 4th of July. If you are going outdoors, bring water with you because thirst is not your first sign of dehydration and do not allow yourself to get behind in this hot weather. If many of you are going to a party, make sure you drink 2 glasses of water for every alcoholic beverage you decide to consume. Also, keeping to a cup of water will help prevent you from grazing throughout the party.

2.       Protein first.

To help prevent snacking, search out your nearest protein option first when entering a party. If you are hosting a party of dinner, make sure that you consume a high protein breakfast to help prevent frequent snacking. The protein will help curb carbohydrate cravings and keep you full longer throughout the party.

3.       Bring your own food options.

One of the biggest complaints I get from patients is that when they go to a party they do not provide food options that fit their diet. Be a good host and be prepared by bringing a couple options that you know you can eat. Others will also be happy that you provided a healthy, wholesome option.

4.       Start the day with a workout.

Starting the day with a little sweat session would be a perfect way to start the day. If you are in maintenance and typically do not indulge, give yourself one food that is usually off limits and practice the “3 bite rule”. Give yourself three bites of the food you wouldn’t typically eat such as chocolate mousse, blueberry crumble, or spinach dip.

What to do with all those recipes.

June 30th, 2014 Posted in Bariatric surgery, Diabetes, Duodenal switch, Eating healthy, gastroesophageal reflux disease, News, Nutrition, post weight loss surgery tips, Post WLS tips, Protein and calories, Recipes, Research, Resources, San Francisco weight loss center, surgical weight loss, Vertical gastrectomy, weight loss plan, weight loss surgery, Weight loss surgery results | No Comments »


Ever find numerous recipes online that you would like to try, but get too overwhelmed with bookmarks, addresses, and websites? There is a solution for this! I recently had a patient contact me asking for help with this exact issue. She always needed recipes to help her come up with ideas for what to eat but she states she tends to lose all the websites names or has a hard time managing her bookmarks. Also, she stated she wanted a way to figure out how to track the food that she makes from these recipes.

One of the best ways to manage recipes online by category is using the virtual pin-board, Pinterest. Pinterest allows you to add a recipe to a virtual board that you want to save for later. Good idea? Make a board for each type of food you eat. “Vegetable dishes” or “Proteins” would be examples of boards you could pin to and use these for when you need inspiration for new recipes. Want to take this a little further? There are applications that have been created to help you pull in all the recipes from a certain board and condense them into the application for better use and display. These applications are called, Chef Tap (Web/Android) or Paprika (Web/Android/iOS). Both of these options makes those recipes from the web easier to navigate and can be edited for later use.

So what if you have an old recipe that dates back before computers or one that you heard by word of mouth? Big Oven (Web/iOS/Android/ Windows Phone) is your best bet! This application also has a tool where you can take  a picture of a recipe in a book or magazine and it can add it to your database.

So now how do you track your intake with these recipes?

For those who track their intake daily with MyFitnessPal, there is a way to build a recipe with the application and modify it by portion sizes. Many times an average portion size that has nutritional analysis done does not fit your new portion size after a sleeve. This tool will help you put in recipes by name, add the ingredients use, and then determine the nutritional analysis per serving by determining how many servings it will provide. Whenever you have a serving of that recipe, you can then add 1 serving of “Chicken Meatball with Zucchini Noodles” for example, versus adding in each item of food individually from that meal. This is the easiest way to determine the nutrition facts of the recipes you make.

There are other websites you can do this such as Spark People, Livestrong, and many others.

Hope this helps your frustration with recipe storing and food tracking!

New Favorite Products for June 2014

June 23rd, 2014 Posted in Uncategorized | No Comments »

More and more I am getting impressed with the innovation and quality of  the food products that are coming out lately. Particularly with the focus not just on innovation but also health. With the resurgence of the “clean eating” movement, there are new products coming out that contain whole foods that shine and are tailored to bring convenience and health to the public. Also, as we recognize that modern day grains and sugar are the root of many health issues for Americans there are products to help combat that. I have come up with a list of my new favorite products on the market.

1. GemWraps by NewGemFoods


One of our patients showed this to me and I thought it was genius. These wraps are replacements for tortillas, breads, lavash, etc. These wraps are gluten free, low carb, and all natural. These wraps are made with vegetable or purees which make them low glycemic and gluten free.

2. Chia Company Chia Pods: Coffee Bean Flavor


I am not a huge fan of promoting foods that might be considered a treat but this treat also has huge benefits to it. Chia Company came out with their own prepared chia seed pudding and one flavor that grabbed my attention is their coffee bean flavor. It is slightly sweetened with coconut sugar, but it does provide 7 grams of protein and only 5 grams of sugar. Most yogurts have more sugar than that so I thought it was a great option for a snack in maintenance.

3. San Franola “High Protein” Granola: Cinnamon Almond or Ginger Snap 

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Here is another option for those in maintenance. Granola tends to be anything but a health food, but this option totally rocks. Made with oat bran, whey protein, and chicory root-this granola is high in fiber and protein. It also does not contain any refined sugar and sweetened with stevia and molasses. It does contain a net 13 grams of carbohydrate so it is only recommended for those in maintenance.

Those are just a few of my new favorite products. What are yours?

Is This Cup The Future of Nutrition Trackers?

June 12th, 2014 Posted in Uncategorized | No Comments »


Have you ever made a protein shake concoction and wondered how many calories, protein, and fiber am I actually eating? Yes, you probably could go over to your MyFitnessPal application and enter all the ingredients and determine roughly what those numbers might be. This is time consuming and then also can be somewhat inaccurate if you do not measure out all the ingredients. What if you had a cup that would determine what calories, fiber, protein for your drink for you? Here comes the smartest cup EVER. After seven years of development there is a new product called Vessyl.

Vessyl is an exciting new device that is hoping to help make changes to the way you drink and inform you of what exactly your are drinking. Obviously, most of you choose drinks that do not have calories, but this might be a helpful device when making a protein drink or protein smoothie.

Seven years in the making, Vessyl is essentially a VERY smart cup, outfitted with a sensor capable of identifying any liquid you pour inside by analyzing its chemical composition and comparing that analysis with stored information. This means that Vessyl can not only tell you what brand of green juice or protein drink you’re sipping, but also its calorie, sugar, and protein content. Want to know how much fat is in your cappuccino? This device will tell you that

Vessyl displays this information automatically on an LED screen that appears as if by magic on one side of the cup when you pour in liquid and tilt it upward. That’s the whole process — about as user-friendly as it gets. Designed in collaboration with fuseproject and Yves Behar (the creative mind behind the Jawbone) the device holds 13 ounces of liquid and comes with a spill-proof lid and a “coaster” for wireless charging.

Pre-sale right now is $99.00 but prices will go up to $199.00 once pre-sale ends.

Would you buy this device? What does this mean for the future of food tracking? Will our plates be able to determine calorie counts in the future? Stay tuned and see what happens.

Alternatives to Your Favorite Starchy Carbohydrates

June 3rd, 2014 Posted in Uncategorized | No Comments »

collard green wrap

For every carb rich food you loved before surgery there is an alternative. Let’s discuss all the different options.

If you like rice…

Opt for cauliflower rice or miracle rice. These are great low carb options to pair with chicken, tofu, or even eggs.

Recipes: Cilantro Lime Cauliflower Rice 

Miracle Rice

If you like tortillas or wraps…

Collard greens leaves or tuscan kale leaves can be used a base for proteins and vegetables so that you can make a vehicle for a tortilla. If you like tacos, using a butter lettuce cup or red cabbage cup is great!

Recipes: Romaine Spear with Chicken Caesar Salad 

Tortilla-less Beef Tacos 

Collard Wraps & Satay Sauce

If you like pizza…

Meaty dense slices of vegetables such as eggplant, and mushrooms are great alternatives to pizza. They have the ability to hold the ingredients well and be baked. Cauliflower can also be used to make pizza crust.

Recipes: Eggplant Parmesan Pizza 

Cauliflower Crust Pizza

Portabello Pizza 

If you like pasta or other noodles…

Shirataki noodles have been on the market for years and are probably the most popular to noodles. They are made from glucomannan which is a soluble fiber and is undigestible carbohydrate. Another great alternative to noodles is zucchini noodles!

Recipes: Chicken Shiitake Skinny Noodles 

Pork Medallions with “Zoodles”

Here are just a few options to look into when trying to come up with alternatives to your favorite carbs. There is also ways to use protein powder to makes pancakes, waffles, and even breads made with almond flour. Branch out of your normal eating pattern and find new, healthy alternatives for your old favorites!