Download Lap Band Nutrition Guidelinesx

Geoffrey Wilcox, MD, FACS
Michael Felix, MD, FACS
Tunc Aksehirli, MD
Nutrition Guidelines for the Gastric Adjustable Band
Purpose: To develop appropriate eating habits to maintain health and desired weight loss.
Main Focus: Drink adequate fluids, focus on lean protein and nutritionally sound foods and take
vitamin and mineral supplements to meet Recommended Daily Intake.
Principles: Drink 64 ounces daily, between meals, no liquids 30 minutes prior, during and one
hour after meals for LIFE.
Eat adequate protein daily and omit high calorie food and drinks.
Take adult complete multi vitamin, 1500 mg of calcium daily and 1000 IU vitamin D-3 daily.
The diet will gradually advance from liquids to solids to allow proper healing and tolerance
Post operative guidelines:
Phase 1 -Liquids Only - NO Meals, Clear liquids for first 3 days, then thin liquids.
Continuous slow sipping all day long that may include sugar free Jell-o, sugar free popsicles, low
calorie non- carbonated drinks such as crystal Light, decaf tea or coffee (no cream), water or
flavored waters, broth (low sodium if high blood pressure). Diluted low acid fruit juices such as
apple, grape, cherry and cranberry. (Fruit juices are to only be consumed in Phase 1 as they are full
of sugar). Day four begin with one serving of a protein supplement (whey protein isolate is
preferred) to be mixed with skim or 1% milk. You may also include low fat milk daily if you
choose to do so. This becomes thin liquids. Goal is to include 48-64 ounces of liquids daily from
one protein supplement and clear liquids. Milk consumed is included in this total. Includes slow
sipping of liquids, no meals on phase 1. This phase continues until your first post-op visit with your
physician. He will advance you to Phase 2.
Phase 2- Pureed foods- (begins after your first post- operative office visit with your doctor)
Baby food consistency foods. (Nothing you have to chew) Eat small amounts of food as your
capacity is very small (about ¼ cup maximum) protein foods first, pureed chicken, flaked fish,
scrambled eggs, mashed low fat cottage cheese, smooth low calorie yogurt (Dannon lite and fit
Greek Vanilla) plain Greek yogurt with sugar free flavorings (available from Davincigourmet.com
or torino.com) or sugar free Jell-o sprinkled in it, or sugar free, fat free puddings. You may continue
with a liquid protein supplement or drink skim, 1% milk for adequate protein intake. Try mild
pureed vegetables such as pureed carrots, green beans (avoid gassy vegetables such as cauliflower
and broccoli for now) and pureed fruits. Eat 3- 4 small meals per day- no less than 3 and no more
than 4 meals per day. Avoid snacking. Eat only good quality foods (avoid empty high calorie
sugars and fats). Eat slowly and chew thoroughly. Stop eating at first sign of fullness. Do not over
eat. Do not eat and drink together. No fluids half an hour prior to meals, with meals and 1
hour after your last bite to allow fullness and proper digestion. Drink adequate low calorie,
non- carbonated beverages, limit caffeine to 2 cups per day. Begin exercising when medically
appropriate and physician recommended.
Supplemental multi-vitamins and minerals after the Lap Band Surgery are necessary for LIFE to
prevent deficiencies. You cannot take in enough to maintain good health from the small amount
of food you will be able to eat. Phase 2 is when you begin taking supplements for LIFE. The
following are the ASMBS guidelines for Band patients:
1- Chewable adult strength Multi-vitamin daily. Always try to take vitamins with food or
meals.
2- 1500 mg daily of calcium in divided doses of 600 mg or less
3- 1000 IU of D-3 daily to maintain good bone health.
(If you take medication for a thyroid condition, wait four hours after taking it, before taking
a Multi-vitamin, iron or calcium as these decrease the thyroid medication’s effectiveness).
Continue Phase 2 for 1 week.
Phase 3- Soft/ Bland foods
Gradually advance to soft / bland foods such as tender moist cooked foods like fish and ground
turkey. Chew foods well in small pieces and advance to soft pieces of moist poultry or meat. No
raw or gassy vegetables or fresh fruit skins, no seeds or nuts. Avoid spicy foods. Eat in the order
food is most important, protein first, vegetables, fruits and then whole grain carbohydrates. Stop
eating at first sign of fullness. Do not overeat. No eating or drinking together, follow recommended
guidelines as stated above.
Continue Phase 3 for 1 week.
Phase 4 - Regular consistency foods.
Make healthy choices to include lean good quality protein, vegetables, fruit and complex (whole
grain) carbohydrates as tolerated. Continue to eat in the order of importance, protein, vegetables,
fruits and then whole grains. Avoid any high calorie foods and liquids such as syrups, sweets,
desserts, biscuits, chips, jellies and high calorie drinks such as alcohol, carbonated beverages and
excessive caffeine. Limited fat, no fried foods, sauces, gravies and use light salad dressing and light
mayonnaise in moderation. No eating and drinking together. No fluids ½ hr prior to meals, with
meals and 1 hr after last bite for LIFE.
General food guidelines: Avoid fibrous – stringy foods such as asparagus, celery, corn or dry
meat. Common problem foods may include shrimp, untoasted or doughy bread, pasta, rice, peanut
butter, dried fruit, nuts , popcorn seeds, skins of fruits and vegetables, membrane of citrus fruits.
Introduce these foods gradually to see if they are tolerated. Follow the rules for eating, drinking and
exercising to get the best results: Eat 3-4 small meals daily, avoid snacking, avoid high calorie
foods and drinks, eat and drink separately for life, eat slowly and chew well, avoid fibrous tough
foods, drink adequate appropriate fluids, exercise at least 30 minutes a day.
Continue with daily vitamin regime as recommended (one adult strength Multi–vitamin and
1500 mg calcium daily (in divided doses of 600 mg or less), 1000 IU vitamin D-3), drink plenty
of good fluids, and exercise regularly. If you take medication for a thyroid condition, wait four
hours after taking it, before taking a Multi-vitamin, iron or calcium as these decrease the thyroid
medication’s effectiveness.
Adjustments are suggested if you experience hunger between meals, not losing weight, or
experiencing discomfort. After a Band adjustment, continue on clear liquids for 48 hours and then
gradually advance from liquids to solids over a few days.
Denise Stuart, RD, LDN
Bariatric Dietitian, Hope Bariatrics
[email protected]
Cindy Nolfi, RN, CBN
Metabolic and Bariatric Coordinator, Hope Bariatrics
[email protected]
Revised: 2014