March 2006 - Column:
Ask the Pharmacist
By Robert J. Anderson, Pharm. D

Shake or Bake? That depends…

Recently I have been asked my opinion on the efficacy and safety of milk shake meal supplements which may be used to lose, maintain or even gain weight. Since I am not a nutritionist, you will need to take my comments with a grain of salt!

Nutrition is very important to our physical and psychological well-being. In fact, we need a minimum of 800 calories per day just to breathe, sleep and walk around, and drive to pick up the mail each day! All of us need a minimum of 1200 calories per day, and most of us require 1500-1800 calories depending on our activity level and general health. Most of us consume more calories than we need or can “burn off”, thus we gain weight.

To lose one pound per week you must reduce your daily caloric intake by 500 calories or increase your energy expenditure by 500 calories per day (like 5 miles on the treadmill!), or preferably some combination of each. On the other hand if we lose too much weight, our bodies will break down precious protein for calories. This causes a catabolic or negative nutrition state that can depress your immune system. Why is it when we are young we are trying to lose weight and when we get old many are trying to gain or maintain weight?

Medical Illnesses Impacting Appetite

Certain cancers and their therapies (like chemo, radiation and surgery) can cause anorexia or a loss of appetite. If the weight loss progresses, it can cause cachexia or a muscle wasting syndrome. Inflammatory bowel diseases like Crohn’s disease and Ulcerative Colitis can interfere with the absorption of nutrients and also cause severe weight loss. These disease-induced weight losses can produce a negative nutritional balance.

Parkinson’s disease can adversely affect swallowing. Severe depression and pain can also cause weight loss. Some heart medications—like Lisinopril and other “prils”—can cause taste disturbances which can reduce our food intake.

Choice of Meal Supplements

In such cases supplementing the diet with supplemental nutrition like the Ensure series of milk shakes will help maintain body composition and a positive nutritional status. The Ensure line of supplements comes in many different flavors and provides needed calories in a balanced formulation of protein and carbohydrate which is generally low in saturated fat and cholesterol. There are specific shakes for more calories, more protein, more calcium and more fiber.

Prosure is a meal supplement (shake) that has been specially formulated for cancer patients. It provides 300 calories per eight ounces and contains balanced nutrition, many vitamins and minerals and omega-3 fatty acids. Two shakes a day has been shown to promote weight gain, build muscle, increase activity levels and strength. Maintaining a positive nutrition balance is thought to improve response to cancer chemotherapy and radiation.

The Glucerna line of meal replacements is formulated for Type II diabetics trying to lose weight. Their product line consists of slowly digested carbohydrates (allowing slow release of insulin), protein, heart healthy fats, low sugar, fiber and a generous supply of vitamins and minerals.

Safety Considerations

These shakes should supplement and not completely replace food intake. Most of these supplements do have some salt and sugar, so if you are on a low salt diet or have diabetes check with your doctor or nutritionist. If you have kidney disease, check with your doctor because he/she may want to restrict your protein or potassium intake. Most of the supplements are low in fiber, so if used often be sure to take lots of fruits and vegetables or a fiber supplement like Metamucil or Fibercon.

Also try to take your medicine—especially antibiotics—an hour before or two hours after your milk shake. Otherwise the supplement may slow the absorption of your medicine. Here is to your health!

Dr. Anderson is an Adjunct Professor at Mercer University, President of RJA Consultants, a sometime pharmacist at Ball Ground Pharmacy and a full-time resident of Big Canoe.

 


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