Download Protein, Carbohydrates, Fats

Nutrition Class #3
•Eating after Surgery
•Protein First, Forever
•Vitamins and Water
•Special Considerations
Protein
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The importance of Protein:
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Important nutrient pre- surgery to ensure proper nutrition and get you from one
meal to the next
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Needed for building lean muscle tissue
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Needed for healthy blood, skin, hair, nails
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Essential for growth and maintenance of cells and chemical processes for
body functioning
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The most important nutrient after surgery
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Must be the main focus of your meals: eat all protein first
–
Eating lean protein will help you feel fuller longer
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Drink your protein supplement beginning the day after surgery
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Lean protein is found in lean meat, poultry without the skin, fish, egg whites or
egg substitute, low-fat/non-fat dairy, low-fat soy based products and beans
(kidney, garbanzo, lentil, black, etc.)( refer to Lean Sources )
–
Remember that about 1 ounce of meat or its equivalent equals 7 grams
of protein
Protein Supplementation:
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At least 120 calories,15 grams of protein and less than 3 grams of fat and
less than 10 grams of carbohydrate
–
In the beginning while on liquids, the protein supplement will be your main
source of protein
–
As your diet progresses to solid food, lean protein sources + some protein
supplement will be your main source of protein (see sample meal plans)
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Initially, work toward an intake of 40 grams Protein
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By 1 month after surgery, your goal is to obtain 60 grams of protein daily.
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By 2mos after surgery ,your goal is a minimum of 72 grams of protein and your
maximum goal is 80 grams
–
Mix protein powders with water to keep calories lower. Right after surgery skim
milk is acceptable to add calories and protein.
–
Some products such as Proteinex can be added to a calorie free drink or full
liquid items like oatmeal, cream of wheat and applesauce
Purpose of the Bariatric Diet
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•
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This diet specifies what type and how much food you can eat at each
meal. Closely following your bariatric diet can help you lose weight
safely.
To allow the staple line in your stomach to heal without being stretched
by the food you eat
To get you accustomed to eating the smaller amounts of food that can
be digested comfortably and safely in your smaller stomach
To help you lose weight and avoid gaining excess weight
To avoid side effects and complications
Diet Details
•
•
•
Diet recommendations after weight loss surgery vary depending on the
type of surgery, where the surgery is performed and your individual
situation.
There are five phases to help you ease back into eating solid foods.
How quickly you move from one step to the next depends on how fast
your body heals and adjusts to the change in eating patterns. You can
usually start eating regular foods with a firmer texture about three
months after surgery.
After surgery, you must pay extra attention to signs that you feel
hungry or full. You may develop some food intolerances or
aversions.
Notes:_________________________________________________
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Post-Bariatric Surgery
Meal Progression
________________: Phase 1 Clear Liquid Diet + Protein supplement. This
is for breakfast, lunch and dinner. No soda, no creamer, no sugar. Drink 2
to 3 oz at a time, SLOWLY!
Allowed foods:
Broth
Unsweetened juice
Sugar free gelatin
Caffeine free coffee or tea (sugar substitutes may be used)
Skim milk (mix with protein supplement)
Crystal Light
Sugar free popsicles
** Avoid fruit nectars, juices with pulp and sports drinks
________________: Phase 2 Full Liquid Diet + Protein supplement. All
food chosen should be non fat, sugar free, and non carbonated. Your
protein consumption should be close to 60 grams per day. Drink/eat
meals slowly over 20 minutes. Use a kitchen timer.
Allowed foods:
All foods on clear liquid diet
Strained/pureed/low fat soups (no pieces or chunks) soups should
be broth based or a low fat cream soup
Sugar-free and low fat or fat free yogurt, unsweetened applesauce
and fat free or low fat whipped cottage cheese.
Scrambled EggBeaters are permitted and may also be added to
boiling broth for a higher protein soup
For at least the first 4 weeks after surgery, it is very important to
drink at least 1 high protein supplement over the course of the
day until you are getting in enough protein
**Avoid milkshakes, 2% or whole milk, cream, half and half, alcohol
______________: Phase 3 Pureed Foods (Daily protein goal = 60
grams)
After liquids are well tolerated, it is time to progress to your more solid
meals. Pureed: Most foods(low in sugar and fat) can be eaten as long
as they are put into a blender and the final consistency is puree, similar
to prepared baby food. Be sure there are no pieces of food in the
mixture.
To puree your foods, choose solid foods that will blend well, such as:
Lean ground meats
Beans
Fish
Egg whites
Yogurt
Soft fruits and vegetables
Cottage cheese
Blend the solid food with a liquid, such as:
Water
Fat- free milk
Juice with no added sugar
Broth
Fat-free gravy
Keep in mind that your digestive system might still be sensitive to spicy
foods or dairy products. If you’d like to eat these foods during this
phase, add them into your diet slowly and in small amounts.
* Refer to Food Choices and Sample Menu Handouts
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______________: Phase 4 Soft, solid foods (Daily protein goal =60-80
grams)
With your surgeon’s OK, after a few weeks of pureed foods, you can add
soft, solid foods to your diet. If you can mash your food with a fork, it’s
soft enough to include in this phase of your diet. These soft food may
have small, soft chunks, so be sure to chew very well before
swallowing.
Foods Allowed:
Ground or finely diced meats
Canned or soft, fresh fruit
Cooked vegetables
You usually eat soft foods for eight weeks before eating foods of
regular consistency with a firmer texture, as recommended by your
dietician or surgeon.
_________________: Phase 5 Solid foods ( Daily protein goal = 80
grams)
After approximately 2 months (8 weeks) on the soft phase, you can
gradually return to eating firmer foods. You may find that you still have
difficulty eating spicier foods or foods with crunchy textures. Start slowly
with regular foods to see what foods you can tolerate. If you have
difficulty with any stage, your stomach may not be ready to progress and
you can always go back to the previous stage.
** Foods to avoid:
Nuts and seeds,
Popcorn
Dried fruits
Sodas and carbonated beverages
Granola
Stringy or fibrous vegetables, such as, celery, broccoli, corn or
cabbage
Tough meats or meats with gristle
Breads
These foods are discouraged because they typically aren’t well tolerated
in the weeks after surgery and may cause gastrointestinal upset. Over
time, you may be able to try some of these foods again, with the
guidance of your surgeon.
Returning to Normal Living
Three to four months after weight loss surgery, you may be able to start
returning to a normal healthy diet, depending on your individual situation and
any foods you may not be able to tolerate. It’s possible that foods that initially
irritated your stomach after surgery may become more tolerable as your
stomach continues to heal.
Throughout all phases of the Bariatric Diet
• Keep meals small. During your diet progression, your should eat several
small meals a day and sip liquids slowly throughout the day (not with meals).
You may first start with six small meals a day, then move to four meals and two
to three snacks per day and finally, when following a regular diet, decrease to
three meals and two to three snacks per day. Each meal should include
approximately a half cup to 1 cup of food. Make sure you eat only the
recommended amounts and STOP eating BEFORE you feel full.
• Take recommended vitamin and mineral supplements. After surgery, your
stomach is much smaller and your body won’t be able to absorb enough
nutrients from your food. You’ll need to take a multivitamin supplement every
day for the rest of your life. Start your multivitamin and calcium supplements
within the first week after surgery.
•

Multivitamin with iron(Flinestones Complete) – 2 tablets daily taken
separately at least 3 hours from each other

Calcium Citrate with Vitamin D- 1500mg calcium citrate with vitamin D
daily. Take 500mg separately 3x day

For the first month after surgery, use only liquid or chewable forms of
calcium citrate with vitamin D supplements

Vitamin B12 it recommended at 3 months post surgery sublingual for
gastric bypass patients. Check with your surgeon on exact dosage.
Drink liquids between meals, NEVER with meals. Drinking liquids with
your meals can cause pain, nausea and vomiting as well as dumping
syndrome. Also, drinking too much liquid at or around mealtime can leave
you feeling overly full and prevent you from eating enough nutrient rich
foods. Expect to drink at least 6 to 8 cups of fluids a day to prevent
dehydration. Always wait at least 30 min before a meal and 30 min after a
meal to drink fluids. Drinking with meals will flush foods out of your
stomach too soon.
Throughout all phases continued
• Eat and drink slowly. Eating or drinking too quickly may cause dumping
syndrome – when foods and liquids enter your small intestine rapidly and in
larger amounts than normal, causing nausea, vomiting, dizziness, sweating
and eventually diarrhea. To prevent dumping syndrome, choose foods and
liquids that are low in fat and sugar, eat and drink slowly and wait 30 to 45
minutes before or after each meal to drink liquids. Take at least 30 minutes
to eat your meals and 30 to 60 minutes to drink 1 cup of liquid. Avoid foods
high in fat and sugar, such as non diet soda, candy, candy bars and ice
cream.
• Chew food thoroughly. The new opening that leads from your stomach
into your intestine is very small and larger pieces of food can block the
opening. Blockages prevent food from leaving your stomach and can cause
vomiting, nausea and abdominal pain. Take small bites of food and chew to
a pureed consistency before swallowing. If you can’t chew the food
thoroughly, don’t swallow it.
• Try new foods one at a time. After surgery, certain foods may cause
nausea, pain or vomiting or may block the opening of the stomach. The
ability to tolerate different foods varies from person to person. Try one new
food at a time and chew thoroughly before swallowing. If a food causes
discomfort, don’t eat it. As time passes, you may be able to eat this food, so
you may try it again in the future. Foods and liquids that commonly cause
discomfort include, meat, bread, pasta, rice, raw vegetables, milk and
carbonated beverages. Food textures not tolerated well include dry, sticky or
stringy foods.
• Focus on high protein foods. Immediately after your surgery, eating
high protein foods can help heal your wounds, re grow muscle and skin, and
prevent hair loss. High protein, low fat choices remain a good long-term diet
option after your surgery, as well. Try adding lean cuts of beef, chicken,
pork, fish or beans to your diet. Low fat cheese, cottage cheese and yogurts
also are good protein sources.
• Avoid foods that are high in fat and sugar. After your surgery, it may
be difficult for your digestive system to tolerate foods that are high in fat or
added sugars. Avoid foods that are fried and look for sugar free options of
soft drinks and dairy products.
Results
Bariatric surgery can result in long term weight loss. The amount of weight
you lose depends on the changes you make in your lifestyle habits. It may
be possible to lose half, or even more, of your excess weight within two
years.
Following your bariatric diet phases can help you recover from surgery and
return to enjoying many of the healthy foods you enjoyed before surgery. If
you find unhealthy eating habits creeping into your life, you may regain any
weight that you have lost.
Risks
• Dumping Syndrome. This complication occurs most often after eating
foods high in sugar or fat. These foods travel quickly through your stomach
pouch and ‘dump’ into your intestine. Dumping syndrome can cause
nausea, vomiting, dizziness, sweating and eventually diarrhea.
• Dehydration. Because you’re not supposed to drink fluids with your
meals, some people may become dehydrated. You can prevent dehydration
by sipping 64 ounces of water or other low calorie, decaffeinated beverage
throughout the day.
• Nausea and vomiting. If you eat too much, eat too fast or don’t chew
your food adequately, you may become nauseated or vomit after meals.
• Blocked opening of your stomach pouch. It’s possible for food to
become lodged at the opening of your stomach pouch, even if you carefully
follow the diet. Signs and symptoms of a blocked stomach opening include
ongoing nausea, vomiting and abdominal pain. Call your doctor if you
experience these symptoms for more than two days.
• Weight gain or failure to lose weight. It is possible to gain weight or fail
to lose weight after weight loss surgery. There are many reasons why
people may gain weight after weight loss surgery. If you experience any
weight re-gain, see your surgeon and/or dietitian as soon as possible.
Pre Op Liquid Diet
Low Fat, Low Carb, High Protein
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When: Start this diet two weeks before your surgery date.
Why: To shrink your liver for a safer surgery and to mobilize fat stores for
optimal weight loss after surgery.
Protein goal: 80 grams per day
Fluid goal: 64 ounces per day (8 cups)
Permitted Beverages:
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Water, ice
Nonfat skim milk, soy milk, lactaid
High protein supplements
Sugar free beverages
Decaf coffee or tea
Broth (chicken, beef, shrimp or vegetable)
Sugar free gelatin
Sugar free popsicles
Sugar free water ices
Permitted Extras:
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Low fat or non fat yogurt
Cottage cheese
Fresh fruit
Vegetable soup
Sample Pre Op Liquid Diet Menu
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Breakfast
– 8 oz protein supplement
•
– Decaf coffee with skim milk
and artificial sweetener
•
AM Snack
– Sugar-free gelatin
– 1 small piece of fruit
•
Lunch
– 1 cup vegetable soup
– ½ cup cottage cheese
– 1 cup sugar free or diet juice
PM Snack
– 8 oz protein supplement
Dinner
– 1 cup beef broth
– 8 oz protein supplement
Bedtime Snack
– Sugar-free popsicle
– 6 oz Greek low fat yogurt
Bariatric Meal Progression
Calorie, Carbohydrate, Fat and Protein Recommendations
Time
Diet
Calories
Fat
Carbs
Day 2 to Day Clear
6
Liquids
Protein
Min 20g
Day 7 to Day Full
20
Liquids
200-400
Less
than 8g
Min 40g
Day 21 to
Day 35
Pureed
300-400
Less
than 11g
Min 60g
Day 36 to
Day 49
Soft
400
Less
than 11g
Min 72g
2 to 4
Months
Regular
500
15g
50g
Min 72g
5 Months
Regular
600
16g
60g
Min 72g
6 Months
Regular
700
19g
70g
Min 72g
7 Months
Regular
800
22g
80g
Min 72g
8 Months
Regular
900
25g
90g
Min 78g
9 Months
Regular
1000
28g
100g
Min 88g
Lifelong
Regular
10001200
33g
120g
105g
Individual calorie, fat and protein needs may vary. Please schedule
a post-op visit with your registered dietitian to determine individual
needs.
Full Liquid Sample Menu Days 7-20
Breakfast 8am
Breakfast 8am
Breakfast 8am
¼ cup unsweetened
cooked or cold cereal
with ¼ cup skim milk
¼ cup unsweetened
applesauce and
¼ cup non-fat cottage
cheese
¼ cup unsweetened
cooked or cold cereal
with ¼ cup skim milk
Snack 10am
Snack 10am
Snack 10am
Protein supplement
Protein supplement
Protein supplement
Lunch 12pm
Lunch 12pm
Lunch 12pm
1 Tbsp Polaner All Fruit® ½ cup non-fat and low
¼ cup non-fat cottage
sugar yogurt
cheese
½ cup pureed low-fat
soup
Snack 2pm
Snack 2pm
Snack 2pm
¼ cup non-fat and low
sugar yogurt
¼ cup non-fat ricotta
cheese with cinnamon
and/or nutmeg
¼ cup pureed skinless
fresh fruit
Dinner 6pm
Dinner 6pm
Dinner 6pm
¼ cup Eggbeaters®, 1/8
cup unsweetened
applesauce
½ cup low-fat cream
soup
½ cup non-fat low sugar
yogurt
Daily Totals:
Calories – 353
Fat – 3.5 grams
Protein – 38 grams
Daily Totals:
Calories – 383
Fat – 5 grams
Protein – 37.5 grams
Daily Totals:
Calories – 373
Fat – 4 grams
Protein – 35.5 grams
Pureed Sample Menu Days 21-35
Breakfast 8am
Breakfast 8am
Breakfast 8am
½ cup Cheerios with ½
cup skim milk
½ cup Eggbeaters®
1 oz fat free cheddar
½ cup unsweetened
oatmeal with ¼ cup skim
milk
Snack 10am
Snack 10am
Snack 10am
Protein supplement
Protein supplement
Lunch 12pm
Lunch 12pm
Lunch 12pm
½ cup fat free/low fat
cottage cheese
4 oz pureed Progresso®
Light Soup
½ cup nonfat Greek
yogurt and ¼ small
banana mashed
Snack 2pm
Snack 2pm
Snack 2pm
Protein supplement
½ Protein supplement
Dinner 6pm
Dinner 6pm
Dinner 6pm
3 oz pureed chicken, 1 oz 3 oz pureed turkey, 1 oz
pureed carrots, 1 oz
green beans, 1 oz
mashed potatoes
mashed potatoes
Daily Totals:
Calories – 410
Fat – 11 grams
Protein – 60 grams
Daily Totals:
Calories – 380
Fat – 8 grams
Protein – 60 grams
3 oz pureed fish, 1 oz
pureed zucchini, 1 oz
mashed acorn squash
Daily Totals:
Calories – 420
Fat – 4.5grams
Protein – 64 grams
Pureed Food Choices
Food Group
Food Choice
Bread, cereal,
pasta, starchy
vegetables and
rice
Unsweetened cold cereals soaked in milk to soften,
Unsweetened hot cereals- oatmeal, cream of wheat, farina,
grits
Mashed potatoes, mashed sweet potatoes
Fruit
Mashed bananas, unsweetened applesauce, pureed canned
fruit packed in water or natural juices, pureed skinless soft
fresh fruit
(Avoid fruits in syrup or added sugar!)
Vegetable
Pureed carrots, green beans, beets, acorn squash, zucchini,
broccoli, cauliflower, tomatoes, tomato sauce, 2 oz low
sodium vegetable juice
Meat, Poultry,
Fish, Beans
and Eggs
Pureed skinless chicken, turkey and fish, soft scrambled egg
whites, Eggbeaters®, finely mashed beans- kidney, chick
peas, cannelloni
Milk, Cheese
and Yogurt
Fat free, 1% milk, Lactaid®, or low fat soy milk, Fat free or low
fat sugar free yogurt- no pieces of fruit, Greek style fat free
sugar free yogurt, whipped or small curd fat free/low fat
cottage cheese, fat free/low fat ricotta cheese
Fats and Oils
Pam® coating spray, 1 teaspoon olive/canola oil or low fat
mayonnaise, fat free ot low fat salad dressing
Miscellaneous
Sugar free popsicles, smooth consistency baby foods are
acceptable – choose high protein and low sugar varieties
(meats)
Liquids
Non carbonated, Sugar Free, Fat Free beverages only- Water,
Crystal Light®, regular and decaf coffee/tea, fat free milk
Soft Sample Menu
Days 36-49
Breakfast 8am
Breakfast 8am
Breakfast 8am
4 hard boiled egg whites
1 Morning Star Farms®
sausage patty and ½ cup
Greek yogurt
½ cup unsweetened
oatmeal with 1/8 cup
mixed berries
Snack 10am
Snack 10am
Snack 10am
Protein supplement
Lunch 12pm
Lunch 12pm
Lunch 12pm
½ cup minestrone soup
and 2 oz canned chicken
½ cup Health Valley®
turkey and bean chili
3 oz turkey breast and 1/8
cup sweet potato
Snack 2pm
Snack 2pm
Snack 2pm
Dinner 6pm
Dinner 6pm
Dinner 6pm
3 oz broiled tilapia, 1/8
cup soft vegetable, 1/8
cup soft boiled potatoes
3 oz fat free ricotta
cheese, 2 oz tomato
sauce, 1 oz Polly-O® fat
free mozzarella cheese
½ cup Eggbeaters®, 1 oz
fat free cheddar, 1/8 cup
diced well cooked
vegetables (peppers,
onions, mushrooms)
Protein supplement
Daily Totals:
Calories – 425
Fat – 8 grams
Protein – 70 grams
Daily Totals:
Calories – 485
Fat – 11.5 grams
Protein – 58 grams
Daily Totals:
Calories – 430
Fat – 6.5 grams
Protein – 61 grams
Soft Food Choices
Food Group
Food Choice
Bread, cereal,
pasta, starchy
vegetables and
rice
Unsweetened cold cereals soaked in milk to soften,
Unsweetened hot cereals- oatmeal, cream of wheat, farina,
grits
TOASTED only 100% whole wheat or rye bread, reduced
calorie, soft cooked potatoes, sweet potatoes or yams
Fruit
Soft banana, unsweetened applesauce, pureed canned fruit
packed in water or natural juices, skinless soft fresh fruit
Vegetable
Soft cooked carrots, green beans, beets, acorn squash,
zucchini (no seeds), tomato sauce, 2 oz low sodium vegetable
juice
NO CORN, ASPARAGUS, CELERY
Meat, Poultry,
Fish, Beans
and Eggs
Canned chicken breast, turkey breast, tuna packed in water,
soft cooked fish, crab, lobster, shrimp, scallops, ground
chicken or turkey breast, scrambled egg whites, Eggbeaters®,
mashed beans,- kidney, chick peas, cannellini beans, low fat
tofu
Milk, Cheese
and Yogurt
Fat free, 1% milk, Lactaid®, or low fat soy milk, Fat free or low
fat sugar free yogurt- no pieces of fruit, Greek style fat free
sugar free yogurt, whipped or small curd fat free/low fat
cottage cheese, fat free/low fat ricotta cheese
Fats and Oils
Pam® coating spray, 1 teaspoon olive/canola oil or low fat
mayonnaise, fat free or low fat salad dressing
Miscellaneous
Sugar free popsicles, smooth consistency baby foods are
acceptable – choose high protein and low sugar varieties
(meats)
Liquids
Non carbonated, Sugar Free, Fat Free beverages only- Water,
Crystal Light®, regular and decaf coffee/tea, fat free milk
Regular Diet Sample Menu for 800-1000 calories/day
Breakfast 8am
Breakfast 8am
Breakfast 8am
½ cup Eggbeaters®, 1 slice
fat free cheese, 1 slice light
whole wheat toast with
ICBINB spray
¾ cup Kashi Go Lean
Crunch® with ¼ cup skim or
1% milk
½ cup fat free cottage cheese
with ¼ cup fruit
Snack 10am
Snack 10am
Snack 10am
1 Light Cheese Stick with ¼
cup fruit
6 Almonds
½ cup fat free and low sugar
yogurt
Lunch 12pm
Lunch 12pm
Lunch 12pm
1 slice light whole wheat toast, Crab melt: 4 oz imitation crab,
4 oz canned chicken breast, 1 1 slice fat free cheese, 1 tbsp
tbsp light mayo, ¼ cup fruit
light mayo
1 lettuce leaf, 2 hard boiled
egg whites, 1 tbsp light or fat
free dressing, 1/3 cup tuna in
water
Snack 2pm
Snack 2pm
Snack 2pm
2 wedges Laughing Cow Light
Cheese®, 8 reduced fat
Wheat Thins®
2 oz low sodium ham made
into rolls with 8 reduced fat
Wheat Thins®
1 light cheese stick
Dinner 6pm
Dinner 6pm
Dinner 6pm
4 oz fish (halibut, flounder,
shrimp, etc), ¼ cup cooked
veggies, 1/8 cup banana
5 oz chicken breast or turkey
breast, ¼ cup cooked
veggies, ¼ cup fruit
4 oz extra lean pork
tenderloin, ½ cup brown rice,
1/8 cup cooked veggies
Snack 8:30pm
Snack 8:30pm
Snack 8:30pm
½ tbsp peanut butter and ½
cup fruit
Light cheese stick
1 tbsp peanut butter and 1
small skinless apple
Daily Totals:
Calories – 905
Fat – 17 grams
Protein – 92 grams
Daily Totals:
Calories – 823
Fat – 18 grams
Protein – 95 grams
Daily Totals:
Calories – 828
Fat – 20.5 grams
Protein – 82 grams
Regular Diet Sample Menu for 1000-1200 calories/day
Breakfast 8am
Breakfast 8am
Breakfast 8am
½ cup Eggbeaters®, small
whole wheat tortilla baked in
toaster, 1/8 cup salsa
1 egg & 3 egg whites, 2 oz
canadian bacon, ½ toasted
whole wheat english muffin
Protein shake and light
cheese stick
Snack 10am
Snack 10am
Snack 10am
1 slice light whole wheat toast
and 1 slice fat free cheese
½ cup fat free and low sugar
yogurt, ¼ cup Kashi® Go
Lean Crunch cereal
3 hard boiled egg whites and
8 reduced fat Wheat Thins®
Lunch 12pm
Lunch 12pm
Lunch 12pm
4 oz canned chicken breast, 1
tbsp light mayo, 4 pieces of
melba toast, ¼ cup skinless
apple
Tuna melt: 4 oz tuna in water,
1 slice low fat cheese, 1 slice
whole wheat toast
5 oz ground turkey breast or
veggie ground round with ¼
cup beans and 1/8 cup
banana
Snack 2pm
Snack 2pm
Snack 2pm
½ cup fat free ricotta cheese
with cinnamon
1 oz 50% reduced fat cheese
and 8 reduced fat Wheat
Thins®
½ cup fruit and ¼ cup low fat
(1%) cottage cheese
Dinner 6pm
Dinner 6pm
Dinner 6pm
4 oz 95% lean ground beef
hamburger patty with 1 slice
fat free cheese, ½ toatsed
english muffin and ¼ cup
cooked green beans
4 oz ground turkey breast
fajita or taco seasoning, 1
taco shell, ¼ cup 2% milk
shredded cheddar cheese,
chopped lettuce and tomato
5 oz cooked shrimp with garlic
and 1 tsp olive oil, ¼ cup
cooked brown rice, 1/8 cup
steamed spinach
Snack 8:30pm
Snack 8:30pm
Snack 8:30pm
2 tbsp reduced fat peanut
butter
4 oz sugar free, fat free
pudding
¼ cup chopped walnutsCAUTION and chew well!
Daily Totals:
Calories – 1042
Fat – 25 grams
Protein –102 grams
Daily Totals:
Calories – 1144
Fat – 31 grams
Protein – 113 grams
Daily Totals:
Calories – 1207
Fat – 36 grams
Protein – 122grams
Regular Diet Food Choices
Food Group
Food Choice
Bread, cereal,
pasta, starchy
vegetables and
rice
Limit to 1 seving/meal or snack (15 grams of carbohydrates)
100% light whole wheat or light whole grain breads, pastas, cereals.
Keep sugar less than 6g/serving for food and cereal. Unsweetened cold
cereals- Cheerios®, Crispix®, Rice Krispies®, etc. Brown rice (well
cooked). All bread should be toasted. No soft bread until 18 months after
surgery.
Fruit
Avoid the stringy membrane of oranges and grapefruits. Avoid other
stringy fruits. Otherwise all fruits are acceptable, no skins or seeds
(unless you chew well). Avoid fruit juices with a limit of 2 oz 100%
juice/day
Vegetable
All vegetables are acceptable. If having difficulty with any vegetables,
cook them well to help with digestion. Avoid skins or seeds. Be careful of
gas producing vegetables such as broccoli and cauliflower.
Meat, Poultry,
Fish, Beans and
Eggs
Make sure all meats are moist. Extra lean white meat chicken breast or
turkey breast (no skins), egg beaters or egg whites. Cooked fish, crab,
lobster, shrimp, scallops, ground chicken or turkey breast. For the first 2
months avoid nuts, skins and seeds. When you try them, start with a
small amount and chew well. Beef, pork, or lamb 1-2x/month. Choose
leaner cuts (round, sirloin, flank and pork tenderloin) with no visible fat
and cook off the bone.
Milk, Cheese and
Yogurt
Skim, 1% or Skim Plus milk, low fat or fat free and low sugar or sugar
free yogurt with less than 110cal/serving. Choose low fat cheeses with
less than or equal to 3g fat/serving. i.e. Laughing Cow Light® or reduced
fat Cabot® cheese
Fats and Oils
Nuts, peanut butter and olive oil are to be used sparingly. i.e. 1 tsp daily
of oil or peanut butter OR 6 almonds, 4-5 walnut halves or 10 peanuts
Miscellaneous
Alcohol should be limited to 1x/month if okay with surgeon or eliminated
as it has a high caloric content and is quickly digested. Keep empty
calories to about 25 per day. These are foods that have NO nutritional
value and take the place of healthy more filling foods.
Liquids
Water, water, water. Get in at least 64-96 oz per day. Keep to no more
than 8-16 oz of caffeinated beverages/day, non caloric sweeteners, fat
free or low fat milk only and no creamer unless fat free. No carbonation,
sugar free beverages only. Keep drinks to no more than 5 calories per 8
oz serving.
Bariatric
Problem Foods and Beverages
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Sugar: Sugar can cause ‘Dumping Syndrome’ which results in
dizziness, shaking, rapid heart rate, nausea, stomach cramping and
diarrhea. Dumping syndrome occurs when the undigested stomach
contents are released or ‘dumped’ into the small intestine too quickly.
Most people experience symptoms several hours after eating problem
foods and may also experience symptoms of low blood pressure
(feeling faint) and low blood sugar. Avoid products that list any of the
following in the first 5 ingredients: sugar, sucrose, honey, corn syrup,
corn sweetener, glucose, maltose, and dextrose. Sorbitol is a sugar
alcohol. It is sugar free but may cause diarrhea. Avoid excess. Read
labels carefully to avoid all sweeteners except Splenda®, Equal ®,
Stevia ® and Sweet’N Low ®.
Fat: Fat may be difficult to digest after surgery. Eating too much fat will
delay gastric emptying and may cause heartburn, nausea, diarrhea, or
stomach discomfort. Excess fat above recommendations will also slow
weight loss.
Alcohol: Consumption should be discussed with your physician. Intake
should be limtied!
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Some alcoholic beverages contain carbonation which causes gas, bloating
and discomfort. All carbonated beverages are prohibited.
Alcohol provides empty calories which are limited to 25 per day.
Alcohol will affect you differently after surgery causing intoxication much
quicker. Your risk for alcohol dependence increases post surgery. Seek
assistance if you are consuming alcohol on a consistent basis.
Empty calories: Any food with no or little nutritional value must be
limited to 25 calories per day. These foods will quickly increase your
calorie intake and slow or STOP weight loss. Some examples includepretzels, sugar free/fat free pudding, sugar free ice pops, fat/free sugar
free ice cream, etc.
Constipation- A Common Complaint
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Constipation after bariatric surgery is a common complaint. It may be
caused by decreased food and water intake, and in some people,
supplemental iron, narcotic pain killers, tranquilizers and antidepressants.
You should not expect your bowel pattern after surgery to be exactly the
same as it was before surgery. Many patients experience less frequent
bowel movements.
If infrequency and discomfort are present, we recommend the following:
– Drink plenty of fluids: a minimum of 64 ounces per day. In hot
weather or times of increased physical activity/sweating, fluid needs
increase.
– Consider increasing your fiber intake. Unprocessed bran can be
added to meat mixtures such as turkey meatloaf. It can be sprinkled
over food, too. Dried beans and peas are high fiber foods that can be
used as a portion of a meal (if problems with gas occur try adding a
drop of Beano® to your first bite of food.) Include a small portion of
vegetables with meals. Fiber supplements such as Benefiber® or
Citrucel® powder can be added to foods or liquids. These powders
can best be used by mixing with water.
– Increase physical activity once cleared by your physician to do so.
– Check your calcium supplement. Calcium citrate is recommended.
Calcium carbonate is not well absorbed and often contributes to
constipation. Choosing a calcium/magnesium combination with a ratio
of 2:1 works well and promotes softer more frequent bowel
movements.
– If you take iron supplements, choose ferrous fumerate or ferrous
gluconate since they are less constipating and better absorbed.
– Try avoiding ‘binding’ foods such as applesauce, banana, rice,
cheeses, peanut butter and potatoes.
– You may need a stool softener. Ask your physician for
recommendations to meet your specific needs.