What is Dumping Syndrome?

Dumping syndrome is a disorder characterized by the passage of food from the stomach to the small intestine in a short time. It is a complication of surgery in which foods containing high sugar are rapidly and uncontrollably released or dumped into the bypassed small intestine. Although it is known that it is generally seen after obesity surgery, it can also be seen after an operation on the stomach and esophagus. In addition, individuals with dumping syndrome may be present even if no operation has been performed.

What Are the Symptoms of Dumping Syndrome?

Dumping syndrome is a syndrome in which the following symptoms are seen as a result of high carbohydrate consumption, which is likely to be seen after bariatric operations:

• Feeling of fullness in the stomach
• Bloating after eating, feeling full
• Cold sweating
• Weakness
• Nausea
• Vomiting
• Fast heartbeat
• It can be sorted like dizziness.

Dumping syndrome is divided into two according to the duration of symptoms after eating:

Early Dumping Syndrome:

Symptoms appear within 10-30 minutes after ingestion of food. 75% of the dumping syndromes observed in the clinic are the early type. 

Symptoms:

• Diarrhea
• Sudden heartburn
• Sweating
• Dizziness
• Nausea
• It can be listed as heartburn.

Late Dumping Syndrome:

Symptoms are observed within 1-3 hours after taking food. Unlike the early type, it is the insulin secretion that the body secretes quickly in response to the sudden increased blood sugar in the blood. As a result, hypoglycemia (low blood sugar) may occur in some patients.

Nutritional Treatment of Dumping Syndrome:

In the treatment, it is recommended to change the lifestyle as a priority. If all the recommendations of the dietitian and doctor are followed but there are symptoms that do not go away, medical and surgical methods are applied.

Foods should be consumed little and often during the day.

• The portions of meals should be small, small plates should be used if necessary.

There should be a minimum of 30 minutes between meals and liquid consumption.

• While consuming the meal, the protein-based group should be preferred first.
• Foods with high carbohydrate content such as simple sugar, white bread, carbonated drinks, cakes and pastries should be avoided and this should become a lifestyle.
• Food should be chewed well and should not be consumed too hot or too cold.
• Eating should not be continued after feeling full.

1-Cardiovascular Diseases

Cardiovascular diseases (CVD) are diseases of the heart and blood vessels. Many people die from CVD each year. It is even the number one cause of death for men and women in the United States. In our country, when we look at the Turkish Statistical Institute-2017 Cause of Death Statistics, it is seen that circulatory system diseases take the first place. Cigarette-alcohol use unbalanced, and malnutrition increase the risk of CVD. Looking at the basis of cardiovascular diseases, it has been observed that there is a very close relationship between nutrition and CVD. Nutrition is important in terms of improving mortality and morbidity in these patient groups. Adequate and balanced nutrition and medical nutrition therapy play a major role in the prevention and treatment of CVD.

Cardiovascular diseases:

-Hypertension

-Ischemic Heart Diseases

-Atherosclerosis

-Cerebrovascular Diseases

-Dyslipidemias

-Heart failure

-Transplantation

2-Risk Factors in Cardiovascular Diseases

Nutrition:

Inadequate and unbalanced nutrition

Atherosclerosis is a risk factor for CVD, especially coronary heart disease. A healthy diet is important for maintaining blood lipid profile, blood pressure and ideal body weight.

Consuming high amounts of saturated fatty acids increases the LDL cholesterol level and the total Cholesterol/HDL cholesterol ratio. Choosing fats containing polyunsaturated fatty acids instead of saturated fatty acids also reduces the risk of cardiovascular disease.

Omega-3 fatty acids docosahexaenoic acid (DHA) and eicosatetraenoic acid (EPA) reduce the risk of CVD. Mackerel, trout, herring are rich in EPA and DHA.

A high-fiber diet has been associated with a lower risk of CVD. Fiber reduces the absorption of cholesterol from the small intestine, thus reducing the levels of Total cholesterol and LDL cholesterol.

High salt consumption poses a threat to CVD, especially hypertension (HT). WHO has determined salt consumption as 5 g per day. Vegetable and fruit consumption should be consumed due to their antioxidant, functional components and high fiber content. In addition, according to studies, consumption of vegetables and fruits are foods that help reduce the risk of CVD.

Family history:

It is observed that individuals with a family history of CVD are more likely to encounter CVD risk in the future. In addition, studies argue that diseases such as hypertension, diabetes, and dyslipidemia may also be genetically based.

Smoking:

Studies have shown that approximately 10% of CVDs are smokers. Not only smoking, but also exposure to cigarettes increases the risk of disease. Many substances in cigarette smoke increase oxidation by damaging lipoproteins and reduce blood oxygen carrying capacity.

Diabetes:

Cardiovascular risk is directly proportional to the increase in blood glucose level. In addition, abnormal glucose levels in the blood can cause high blood pressure, low HDL cholesterol and high triglyceride (TG) levels. The fact that the blood glucose level was in the ideal range indicated that these risks were reduced.

3-Recommendations for Preventing Cardiovascular Diseases:

 *First, a healthy lifestyle should be adopted. 

* Tobacco use must be stopped.

* At least 150 minutes of moderate-intensity exercise per week should be done.

*Overweight individuals should consult a nutritionist to ensure body weight loss.

* Vegetable, fruit, vegetable or animal protein and fish consumption must be included in the nutrition program.

*Consumption of processed meat, trans fat, refined carbohydrates, packaged foods with added sugar should be avoided.

* Nutritional diversity should be given importance in the nutrition program. *Extra salt intake into the consumed food should be reduced and kept below 5 grams per day.

The blood pumped into the body by the left ventricle of the heart exerts a pressure on the blood vessels through which it passes. The blood vessels respond to this pressure with a resistance. The highest point when the heart contracts is called the systolic pressure, and the lowest point when the heart relaxes is called the diastolic pressure.

Hypertension is a condition in which the pressure in the blood vessels increases. The heart works harder to provide circulation in the face of increased blood pressure. In order for blood pressure to be normal, the systolic blood pressure should be below 120 mmHg and the diastolic blood pressure should be below 80 mmHg.

The prevalence of blood pressure in the population is between 30-45% and this rate increases with age. According to studies, hypertension is seen in one out of three adults.

Evaluation of Blood Pressure

The number of individuals diagnosed with hypertension is increasing due to reasons such as insufficient physical activity, alcohol use, excess body weight, and poor stress management. In addition, blood pressure is affected by the intake of nutrients. Therefore, adequate and balanced nutrition should be provided. The factors to be considered in the lifestyle and nutrition of the individual are as follows.

• Regular exercise is important in the prevention and treatment of hypertension. Therefore, it is recommended to exercise at least 3 days a week.

• Consumption of saturated fatty acids is increasing worldwide. Reducing consumption of saturated fatty acids leads to a decrease in plasma LDL cholesterol and total cholesterol levels. In international dietary guidelines, it has been reported that saturated fatty acid intake should be reduced, and unsaturated fatty acids should be consumed instead.

• Due to the potassium (K) content, green leafy vegetables should be included in the nutrition program.

• Grain-containing foods should be preferred for adequate mineral and fiber intake.

• Body mass index (BMI) should be kept within the ideal range.

• Alcohol intake should be limited. Women should not exceed 1 glass, men 2 glasses.

• Consuming fish 2 days a week or using fish oil supplements is important in blood pressure control.

• Avoid foods containing refined sugar.

• High salt consumption (such as canned foods, pickles, pickled foods) increases the risk of cardiovascular disease by increasing hypertension. The World Health Organization (WHO) recommends salt consumption to be less than 5 g/day.

• Adequate consumption of vegetables and fruits containing potassium helps to reduce the risk of hypertension.

• The nutrition plan should be created by considering cultural habits.

• It is known that high-fiber diets are associated with CVD risk. According to the Nutrition Scientific Advisory Board (SACN) 2015 report, it was reported that each 7 grams of fiber intake reduces the risk of CVD by 9%.

• Insufficient consumption of calcium increases the risk of hypertension. Therefore, attention should be paid to daily consumption of low-salt milk, yoghurt and cheese.

• Regular health checks should be done.