Download NUTRITION PLAN DR. THIEN NGUYEN

NUTRITION PLAN
DR. THIEN NGUYEN
The nutrition plan is one of the most important parts of this journey.
Specific instructions are for your safety and help to:
• Reduce the risk of major complications.
• Make the operation safer.
• Reduce the risk of dehydration, leaks, infection, the need for readmission to the hospital or the need for
re-operation.
Please make sure to read this part carefully and follow these instructions.
There are two parts to the weight loss surgery diet plan:
• The first is the liquid diet right BEFORE surgery.
• The second is the diet AFTER surgery which takes you slowly from liquids to solid food over about four
to five weeks
SHOULD I PURCHASE ANYTHING FOR AFTER THE SURGERY?
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Bullet blender
Small dishes and utensils
Ice cube trays
Crock pot
Measuring cups, measuring spoons and a food scale
 These items are necessary to determine the exact portion sizes of the food you eat and drink.
Food diary
 This will help the dietician better analyze your diet. Use a small tablet or journal to write down when
you ate, what you ate and the amount consumed
 You may also consider a Mobile App such as MyFitnessPal to record your intake
High Protein, low sugar drinks. Recommended drinks will consist of the following
 150-200 calories, 20 grams of protein or more, less than 5 grams of sugar
 Examples include: Muscle Milk Light Shake, Atkins Advantage, EAS Advant Edge, Low Carb Slim Fast
A few bottles of water or sugar-free, non-carbonated, non-caffeinated beverages
 Examples include: Crystal Light (not lemonade flavor), Propel G-2, Fruit2O, Diet Snapple
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PRE-OPERATIVE DIET
The pre-operative diet consists of 3 high protein shakes per day and one low calorie frozen meal such as Lean Cuisine or
Weight Watchers with one cup of raw or steamed vegetables.
You will be required to begin this diet two weeks prior to your surgical date unless directed otherwise by your surgeon.
MY PRE-OPERATIVE DIET BEGINS ON:
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The pre-operative diet is designed to:
• Shrink the liver and make the procedure easier for your surgeon. The liver sits on top of your stomach. When
you gain weight, the liver gets larger. The pre-operative weight loss diet helps to shrink the liver and gives the
surgeon greater visibility and more space to work in.
• Transition to the post-op phase more easily. Some individuals feel they need to “detox” from their current
eating habits. By following the pre-operative liquid diet, you will not need to focus constantly on food and
eating as you will have a specific meal plan. You can start to focus on positive behaviors related to eating and
using other coping methods.
• Prevent the “last meal syndrome” and weight gain. Most people think that having weight loss surgery is the
end of eating as they know it. Don’t worry, food won’t go away forever, you will just eat differently. Your eating
will change dramatically and you will likely prefer foods that are healthier as you are losing weight. You will
focus on quality rather than quantity and you may still have some of the same foods but in different portions
and different preparation methods.
PLAN:
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3 High Protein Drinks spread throughout the day. May try 8 am, 11 am and 3 pm.
 Examples: Slim Fast High Protein, Muscle Milk Light Shake, Atkins Advantage Shake
1 Meal + 1 cup of raw or steamed vegetables
 Examples: Lean Cuisine or similar low calorie frozen meal
Fluids should be non-caloric, non-carbonated and non-caffeinated
 Examples: Water, Diet Snapple, Crystal Light, Fruit2O, Propel; any other artificially sweetened beverage
(NutraSweet, Sweet & Lo and Splenda are acceptable)
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DIET PROGRESSION AFTER SURGERY
Weight loss surgery is only part of the treatment. The diet you follow after surgery and for the rest of your life will
affect your ability to control your weight.
The weight loss surgery diet is different than any other diet you may have followed in the past.
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It moves forward through a series of stages
You will eat smaller portions sizes than you may be used to
You must eat on a regular schedule
If you overeat, you may become sick to your stomach and/or vomit. After the surgery, many people
feel full after eating small portions of food. You will learn to stop eating sooner over time
For the first few months, your total food and liquid intake will increase to about 1,200calories per day. By 6-9 months
after surgery, the goal will be 3 meals per day. Snacking and drinking excess calories as part of your daily routine, should
be avoided.
Your dietician will design a meal plan for you that has enough protein and calories to maintain a healthy weight.
You may find other diet progressions on the Internet or from others who have had surgery. Please remember that
everyone is different and your dietician has recommended the diet that is most fitting for you.
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NEW EATING HABITS
Learning new eating habits is one of the most important parts of
successful weight loss surgery.
Your dietician will review your diet, weight history and exercise habits with you. She will show you how to keep a food
diary to identify problems. Together, you will develop a plan for successful weight loss surgery.
Weight loss surgery helps control calories by making it hard for you to eat large portions of food at one time. One can
still gain weight by eating and/or drinking high-calorie foods throughout the day. Try some of these eating tips to stay
on track:
 Don’t nibble. Constant snacking on high calorie foods and drinks
can make you gain weight.
 Be aware of why you are eating. Eating when you are bored,
depressed, anxious or unhappy can result in weight gain. Talk to
your dietician about things you can do instead of eating. Some
people find it helps to talk to a therapist about emotional
dependence on food.
 Keep a positive outlook. Permanent weight loss requires a
change in how you look at food. Stay positive about making
healthy food choices before, during and after your surgery.
 Plan for special occasions. Holidays, vacations and social events
can be tough when you are trying to lose weight. Your dietician
can help you through these times by putting a plan in place.
 Stay active. Exercise burns calories. It can also help control
hunger and relieve stress. Weight loss surgery patients who exercise regularly are most successful at weight
control.
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TIPS FOR SUCCESSFUL
WEIGHT LOSS
Try some of these ideas to help boost your long term success after weight loss surgery.
Make food less visible in your home
• Store all food out of sight. Try to keep food off of the counters
• Put your favorite foods in hard to reach places
• When serving meals, keep pots or serving platters on the stove – not on the table
• Store leftovers immediately after meals or immediately throw them in the trash
Change your food shopping habits
• Avoid grocery shopping on an empty stomach
• Make a shopping list and stick to it
• Shop the supermarket “walls”. Avoid temptation by avoiding the aisles. Most whole foods are found along the
perimeter of the store
• Buy only the items that are necessary for you and your family
• Avoid buying food items for other people that you may eat
Slow down
• Eating slowly and mindfully is very important after you have surgery. If you eat too quickly, you may vomit.
Start to become aware of eating patterns before surgery and modify the pace of eating. Try some of these tips
to help slow down:
 When eating a meal, start with protein first and then vegetables.
 Stop eating after 30 minutes. Do not try to “finish” a meal.
 Take small bites and chew food to a liquid texture before swallowing.
 Savor each bite. Pay attention to flavors, textures and consistency.
 Set your utensils down in between bites.
 Make a sign that says “EAT SLOWLY” to remind you to do so.
Avoid drinking while eating
• This may wash food through too quickly and take away the feeling of being full. This can then lead to
overeating. For others, drinking may fill them up and prevent them from getting enough protein or cause pain
and vomiting
• Choose sugar-free, non-carbonated (flat) beverages
Portions are important
• Carefully weigh and measure your food before eating. Start this before surgery to get used to what a healthy
portion looks like
• Put all extra food away before eating
• Use small dishes and glasses. This will make your portions look bigger
• Cook just enough
• Practice leaving something on your plate even before you have surgery
Make eating an isolated activity
• Choose a spot at home just for eating. The best bets are the dining room or kitchen table
• Make a rule to sit whenever you put something in your mouth
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VITAMINS AND MINERALS
To make sure your body has proper levels of vitamins and minerals begin supplements a week before surgery. We
recommend you get chewable, as they are easier to swallow after surgery. Continue to take daily after surgery.
VITAMINS/
MINERALS
GASTRIC
BYPASS
SLEEVE
GASTRECTOMY
GASTRIC
BANDS
Multivitamins
Two doses
daily.
One dose
daily.
One dose
daily.
1000 -1500 mg
daily
1000 –1500 mg
daily
1000 mg
daily
Vitamin B12
Sublingual
Place it under your tongue to dissolve
500
micrograms
daily
500
micrograms
daily
x
Iron Chewable
Sometimes, patients after gastric bypass may
develop anemia due to low iron. Women having
regular menstrual periods and those whose blood
work after surgery show anemia and low iron,
would need to take an iron supplement
Talk with your surgeon if you require Iron
Example:
Bariatric Advantage Chewable Iron
Ask your
surgeon
x
x
Examples of adult chewable multivitamins:
Bariatric Advantage Complete Chewable
Centrum Adult Chewable
CVS Spectravite Adult Chewable
Walgreens Adult Chewable
Nature Made Multi Chewable for Adults (Costco)
Spring Valley Adult Chewable (Wal-Mart)
Kirkland Adult Chewable (Costco)
Centrum Liquid
Calcium Citrate with
Vitamin D Chewable
Start one month after surgery
Look for a calcium supplement with Vitamin D.
It will help the calcium to be better absorbed.
Calcium Citrate is preferred due to better
absorption. Avoid Calcium Carbonate
Examples:
Citrical Creamy Bites
Twinlab Chewable Calcium Citrate
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FAQ Frequently Asked Questions
How will I know when I am full?
As you try new foods after surgery, you may have trouble knowing when you are comfortably full. Nausea may be your
first indication of fullness. Don’t’ let this alarm you. It will take time for your body to adjust to the stomach’s smaller
size and return to a normal “full” feeling. You may feel pressure in the center of your stomach or pain in the shoulder
area or upper chest when you are full. Initially you may only be able to tolerate 2-3 teaspoons of food at one time.
What will I eat when I go to a restaurant?
Restaurant eating will be a very different experience for you after the surgery. Ask the server to prepare your food in a
low-fat manner. Be prepared to bring much of your meal home in a “doggie bag”. Try some of these dining out tips:
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Call the restaurant in advance for preview of the menu. Don’t be afraid to ask for special orders.
Try ordering 1 dinner and splitting it with your friend or spouse.
Try ordering 2 appetizers instead of a full meal.
Ask that your food be broiled or baked with no added butter or fat.
Ask that bread and rolls be removed from the table.
Concentrate on talking and listening to conversation.
Be cautious with alcohol; you will feel its effects much sooner
Remember, the children’s menu is not always the answer for smaller portions. Children’s menu foods are often
laden with fat calories
How can I have fun at parties or weddings if I can’t eat a lot?
 Try to focus on the social aspect of the event. Position yourself away from the food table and catch up with
friends or get on the dance floor. Scan the buffet in advance and make a plan as to what you will eat. If it is a
served meal, call the facility ahead of time and ask what they will be serving. You may allow yourself 1 or 2
healthy appetizers and a smaller portion of the meal. Your dietitian will provide you with tips to make parties
and events more enjoyable and healthful.
If I get upset and want to eat, what will I do?
 Managing stress is important to your overall health and well being. Try different ways to handle your stress by
talking with someone or through exercise, reading or other activities. You may consider talking with a mental
health professional if you feel you need additional assistance in dealing with stress.
I have heard I might get “dumping” syndrome. What is this?
 Gastric bypass and sleeve patients can experience cramping, sweating, pounding heart, feeling lightheaded, feel
the need to lie down, or even pass out. This is part of a condition called “dumping” which can happen when
food empties too quickly from your stomach pouch into your small intestine. The most common cause of
dumping is excessive intake of foods and fluids containing a high amount of sugars. Dumping can also be caused
by drinking any liquid too soon after a meal.
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DIET PROGRESSION AFTER SURGERY
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STAGE 1
Bariatric Clear Liquid Diet (In Hospital)
You will begin on your bariatric clear liquid diet the day after surgery while still in hospital. This diet is usually limited to
1-2 days. You will begin with clear liquids such as water, broth, sugar-free jello and crystal light.
You will be instructed to sip slowly, 1oz every 15 minutes as tolerated
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STAGE 2
Bariatric Full Liquid Diet
You will begin your bariatric full liquid diet upon discharge home.
Duration: 14 days.
You will be instructed to sip protein shakes, soups, non-carbonated, decaffeinated drinks and zero-calorie liquids every
1-2 hours. Stop if feeling full or nauseated. Alternate soups and protein shakes for variety.
Fluid goal: 56 oz (7 cups)/day
Protein goal: 30-40 grams/day.
Milk-Based, High-Protein, Low-Sugar Beverages
• ½ cup low fat cream based soup (any flavor), no chunks, with unflavored whey protein powder such as
Beneprotein (nestlenutritionstore.com)
• Carnation Instant Breakfast – No Sugar Added (blue box)
• HMR 500, 800, chicken soup (no ice) (www.hmrprogram.com)
• Low Carb Diet Slim Fast
• DiabetiTrim (CVS)
• EAS Advant Edge Carb Control (Target)
• Worldwide Pure Protein Shake (Trader Joe’s)
• Atkins Advantage Shake (Walgreens, Walmart, GNC)
• Designer Whey (CVS, Target, Walmart, Walgreens)
• Smartforme shakes/drinks (www.smartforme.com)
Lactose-Free, High-Protein, Low-Sugar Beverages
• HMR 70+ (www.hmrprogram.com)
• Lactaid (drops, chewable tablets or milk)
• Choice DM (CVS, Walgreens)
• Unjury (www.unjury.com)
• Optisource (www.walgreens.com)
• Isopure (Vitamin Shoppe)
• Glucerna, Hunger Smart (Target, Walgreens)
Soups:
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Avoid very thick and high fat cream-based soups
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STAGE 2: Tips and important information
Vitamins:
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Bypass and Sleeve: Multivitamin twice daily, B12 once a day.
Band: Multivitamin once a day
Getting all your liquids:
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Sip all liquids slowly, sip 2 oz every 15 minutes to stay on track.
Avoid gulping; it introduces air into your system and may cause gas pains.
Do not force yourself to finish fluids if you feel full
It is VERY important to stay hydrated; sip fluids throughout the day. Keep an eye on your urine, if you are well
hydrated, it should be light yellow
Avoid drinking too fast
Protein drinks:
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Some protein drinks contain aspartame sweetener or Sucralose. Some people cannot tolerate these sweeteners
Plan ahead and have the protein drinks ready to drink
Use a thermos or chill your glasses in the freezer to keep your protein drinks cool while you are drinking them
If you are lactose intolerant, try Lactaid drops (available at your pharmacy), Lactaid milk or lactose-free protein
drinks
Your food diary
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Write down the amount of fluid you drink in your food diary
STAGE 2: SAMPLE MEAL PLAN
TIME
8 am
9 am
10 am
Noon
2 pm
3 pm
4 pm
5 pm
8 pm
LIQUID
Protein drink or soup
Water/fluid
Protein drink or soup
Protein drink or soup
Water/fluid
Protein drink or soup
Water/fluid
Protein drink or soup
Water/fluid
AMOUNT
4-8 oz
4-8 oz
4-8 oz
4-8 oz
4-8 oz
4-8 oz
4-8 oz
4-8 oz
4-8 oz
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STAGE 3
Diced Protein and Soft Foods
You will begin this diet about 2 weeks after surgery.
Duration:
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FOR GASTRIC BYPASS AND SLEEVE GASTRECTOMY: Three weeks (21 days)
FOR GASTRIC BANDING: Two weeks
You will be instructed to take 4 2-oz protein servings, 1 dairy serving, 3 fruit/vegetable/starch servings, and 1 fat serving.
At first you may be unable to achieve this goal. Stop if you feel full or experience any nausea or vomiting.
Fluid goal: 56 oz (7 cups)/day
Protein goal: 60-70 grams/day.
Protein: Choose 4 servings
• 2 oz chicken, diced or ground (dark meat)
• 2 oz turkey, diced or ground
• 2 oz fish (canned tuna, sole, haddock, halibut, salmon)
• 2 oz cheese or soy cheese
• 2 oz eggs or 4 egg whites or ½ cup Egg Beaters
• 2 oz deli meat (no roast beef)
• 2 tbsp cottage cheese
• 1 cup tofu
Dairy: Choose 1 serving
• 8 oz smooth light yogurt or 6 oz plain, non-fat Greek yogurt
• 8 oz fat-free milk
• ½ cup sugar-free pudding
• 1 cup sugar-free hot chocolate
• 8 oz light yogurt drink
Fruits/Vegetables/Starch: Choose 3 servings
• ½ cup applesauce (unsweetened)
• ½ cup mashed pears (no juice)
• 4” banana, mashed
• ½ cup mashed potatoes or sweet potatoes
• ½ cup pureed butternut squash
• 1 cup low-fat creamed soup made with 1% or skim milk
• ½ cup cooked cream of wheat or farina
Fat: Choose 1 serving
• 1 tsp butter, margarine or mayonnaise
• 1 tbsp (3 tsp) light margarine, light salad dressing, fat-free gravy or light mayonnaise
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STAGE 3: Tips and important information
Vitamins:
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Bypass and Sleeve: Multivitamin twice day, B12 once a daily, calcium citrate 2-3 times a day.
Band: Multivitamin once a day, calcium 1-2 times a day.
Getting your liquids:
• It is VERY important to stay hydrated; sip fluids throughout the day. Keep an eye on your urine; it should be a
light yellow.
• AVOID HIGH CALORIE BEVERAGES - Like juice, soda and sweetened beverages.
• Do not force yourself to finish fluids if you feel full.
• Do NOT drink while eating. Wait 30 minutes after eating before drinking.
Protein:
• Your body must get the protein it needs from your diet. It is important for you to eat the recommended dietary
protein.
• The diced protein and soft foods stage gradually re-introduces solid food to your system. You may want to
consider having one protein shake per day in the beginning of stage 3 to help increase protein intake.
• Increase the protein content of your fruits/vegetables by adding protein powder or dry skim milk powder. Whey
Protein Isolate is an excellent source of protein and well tolerated by people who are lactose intolerant.
• Weigh food on a scale after it has been cooked to be sure you are getting adequate protein. If you do not own a
food scale, cook a piece of protein the size of a deck of cards.
• Hair loss is inevitable due to the effects of major surgery and decreased calorie intake. You should see
improvement after six months.
Meats:
• Meat should be tender and moist. Marinated meats, boiled meats and the dark meat of chicken tend to be well
tolerated. Fibrous meats such as dry turkey, dry chicken breast or hamburger can be difficult to digest.
• Microwaving and grilling dries out meats, making them difficult to tolerate. Try adding broth before
microwaving to make the meat juicier. Crock pots can be very useful.
• Avoid ground beef, shrimp, scallops and lobster. They are very difficult to digest. Wait until at least 4 months
after surgery to try them.
• Do not fry your meats. Frying adds calories and can make foods hard to digest. Some people may experience
dumping with fatty foods.
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Tips for success:
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2-3 bites of food may be all that you can have initially; try again about 2 hours later.
AVOID overeating or drinking too fast! This may lead to staple line disruption.
DO NOT DRINK WITH MEALS. Drink fluids about 30 minutes before or 30 minutes after your meal.
If you are feeling constipated, try Miralax, a stool softener or add some Benefiber to your foods.
It is important to get on an eating schedule. If you are not hungry, take a few bites just to stay on schedule. You
may need to have more than 5 meals per day in the beginning. See the sample meal program that follows.
Avoid raw vegetables.
Some condiments are okay in moderation (1-2 tbsp): ketchup, light or fat-free mayonnaise, mustard, fat-free
gravy, herbs and spices.
Eat slowly; use 10 minutes per ounce as a guideline. Take VERY small bites of food and chew the food well until
it is liquid/paste in your mouth. Stop eating if you are full. Take maximum 30 minutes per meal.
AVOID PICKING OR GRAZING. This will lead to weight gain.
Avoid very hot or very cold foods as they may cause dumping syndrome.
Continue with your chewable vitamin supplements.
Do not chew gum or suck on hard candy. If swallowed, it can obstruct your outlet.
Continue your food diary. Write down the amount of fluid you drink. The food diary at this stage is critical to
ensure that you are eating enough protein.
STAGE 3 SAMPLE MEAL PLAN
TIME
8 am
9 am
10 am
Noon
1 pm
2 pm
3 pm
5 pm
6 pm
7 pm
8 pm
10 pm
FOOD
1 scrambled egg, ½ cup applesauce
LIQUID
PROTEIN
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8 oz decaf tea
½ cottage cheese
2 oz tuna, 4” banana, 1 tsp mayonnaise
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14
8 oz crystal light
8 oz propel
6 oz plain, non-fat Greek yogurt
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8 oz chicken broth
2 oz diced chicken, ½ cup mashed potatoes,
1 tsp light margarine, 1 tsp fat free gravy
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8 oz water
2 oz string cheese
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8 oz decaf tea
56 ounces (7 cups)
63 grams
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STAGE 4
Reduced Calorie Solids
You will begin this diet about 5 weeks after surgery. This will be your long term meal plan. You will continue to maintain
a daily intake of 1000-1500 calories.
Vitamins
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Bypass and Sleeve: Multivitamin twice day, B12 once a daily, calcium citrate 2-3 times a day.
Band: Multivitamin once a day, calcium 1-2 times a day.
Fluid goal: 56 oz (7 cups)/day
Protein goal: 60-70 grams/day
Stage 4: Tips and important information
About this stage
• The Reduced Calorie Solids stage gradually re-introduces solid food to your system.
• Start to move away from soft, mushy foods and liquid protein.
• Solid foods will be more filling.
Protein
• Your body must get the protein it needs from your diet. It is important for you to EAT the recommended dietary
protein. Not everyone will be able to eat all of the recommended foods, especially at first. Listen to your body
and do not overstuff your pouch. Only when you are unable to eat enough of the protein requirements should
you supplement with liquid protein.
• Hair loss is inevitable due to the effects of major surgery and decreased calorie intake. You should see
improvement after six months.
Meats
• Meats should be tender and moist. Marinated meats, boiled meats and the dark meat of chicken tend to be well
tolerated. Fibrous meats such as dry turkey or chicken breast can be difficult to digest.
• Microwaving and grilling dries out meats, making them difficult to tolerate. Try adding broth before
microwaving to make the meat juicier. A crock pot may be useful.
• Do not fry your meats. Frying adds calories and can make foods hard to digest.
• Weigh food on a scale after it has been cooked to be sure you are getting adequate protein. If you do not own a
food scale, cook a piece of protein the size of a deck of cards.
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Foods to avoid
• Membranes of oranges, tangerines and grapefruit (they can obstruct your outlet)
• Cores, skins and seeds of fruits and vegetables
• Fibrous vegetables such as celery
• Popcorn, nuts, rice, grapes, pea pods
• Avoid spongy, starchy foods such as breads, cakes and bagels. They expand in your stomach and may cause pain
or blockage. They can also be easy to overeat. Bread is better tolerated when toasted.
• Be careful with chewing gum or hard candy. If swallowed, it can obstruct your outlet.
Fruits and vegetables
• Start with canned fruits (packed in their own juice) and then advance to fruit with the skin peeled off. Watch out
for seeds. Start with well-cooked vegetables and cook for less time as you progress. Corn and peas count as
starches rather than vegetables
Tips for success
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2-3 bites of food may be all that you can have initially; try again about 2 hours later.
It is important to get on an eating schedule. If you are not hungry, make protein your priority; take a few bites
just to stay on schedule. As you are able to eat more at meal time, you will be eating fewer meals.
AVOID PICKING OR GRAZING! This will lead to weight gain.
Some condiments are okay in moderation (1-2 tbsp): ketchup, light or fat-free mayonnaise, mustard, fat-free
gravy.
Some people may experience dumping with fatty foods.
Baby warmer trays or warming plates can be used to keep food warm while you are (slowly) eating your meal.
Try using a smaller plate and utensils.
Stop eating if you are full; you can go back to your meal later.
If eating out and the entrée is the typical portion, plan on bringing most of the meal home in a “doggie bag.”
Continue with your chewable vitamin supplements.
DO NOT DRINK WITH MEALS. Wait 30 minutes after a meal to drink.
Continue your food diary. Write down all of the food you eat and the fluid you drink. The food diary at this stage
is critical to ensure that you are eating enough protein
Please feel free to contact your dietitian if you have any questions. Your dietitian wants you to SUCCEED!
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STAGE 4 SAMPLE MEAL PLAN
1,000 CALORIE
7 meat servings
1 milk serving
3 starch servings
2 fruit servings
2 vegetable servings
2 fat servings
Time
8 am
9 am
10 am
11 am
Noon
1 pm
2 pm
3 pm
5 pm
6 pm
7 pm
8 pm
10 pm
TOTAL
Food
1 egg
1 oz low fat cheese
½ cup cooked, chopped vegetables
Liquid
Food Group
1 meat
1 meat
1 vegetable
8 oz decaffeinated tea
3 oz Greek yogurt
½ milk
8 oz Crystal light
2 oz tuna
1 tbsp light mayonnaise
½ whole grain toasted english muffin
½ cup pears
2 meat
1 fat
1 starch
1 fruit
8 oz water
½ cup peaches
4 oz skim milk
8 oz Fruit2O
2 oz diced chicken
½ cup green beans
½ cup mashed potatoes
1 tsp margarine or 1 tsp oil
1 fruit
½ milk
2 meat
1 vegetable
1 starch
1 fat
8 oz Crystal light
6 whole grain crackers
1 oz low-fat cheese
1 starch
1 meat
8 oz water
56 OZ (7 CUPS)
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STAGE 4 SAMPLE MEAL PLAN
1,200 CALORIE
8 meat servings
2 milk serving
4 starch servings
2 fruit servings
2 vegetable servings
3 fat servings
Time
8 am
9 am
10 am
11 am
Noon
2 pm
3 pm
4 pm
5 pm
6 pm
7 pm
8 pm
9 pm
Food
1 oz low fat string cheese
½ cup cooked cereal
6 chopped almonds
Liquid
Food Group
1 meat
1 starch
1 fat
8 oz decaffeinated tea
6 oz Greek yogurt
1 milk
8 oz Crystal light
2 oz turkey
1 oz low fat cheese
2 slices toasted wheat bread
Small lunch salad
2 tbsp light salad dressing
1 cup skim milk
1 apple
2 meat
1 meat
2 starch
1 vegetable
1 fat
1 milk
1 fruit
8 oz Crystal light
8 oz water
3 oz baked fish
½ cup cooked spinach
½ cup mashed potatoes
1 tsp olive oil
3 meat
1 vegetable
1 starch
1 fat
8 oz Fruit2O
2 pear halves
¼ cup cottage cheese
1 fruit
1 meat
8 oz water
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STAGE 4 SAMPLE MEAL PLAN
1,500 CALORIE
9 meat servings
2 milk serving
5 starch servings
3 fruit servings
3 vegetable servings
4 fat servings
Time
8 am
9 am
10 am
11 am
Noon
1 pm
2 pm
3 pm
4 pm
5 pm
6 pm
7 pm
8 pm
9 pm
Food
Liquid
2 eggs
½ English muffin, whole grain
1 tsp margarine or 1 tsp oil
½ banana
Food Group
2 meat
1 starch
1 fat
1 fruit
8 oz decaffeinated tea
1 apple
1 tbsp peanut butter
1 fruit
1 meat
8 oz Crystal light
2 oz tuna
1 tbsp reduced fat mayonnaise
2 slices toasted wheat bread
½ cup carrot sticks
2 meat
1 fat
2 starch
1 vegetable
8 oz water
8 oz water
6 oz Greek yogurt
1 ¼ cup strawberries
1 milk
1 fruit
8 oz Crystal light
8 oz water
3 oz pork loin
½ cup cooked broccoli
3 oz baked potato
1 tsp margarine or 1 tsp oil
dinner salad
2 tbsp light salad dressing
3 meat
1 vegetable
1 starch
1 fat
1 vegetable
1 fat
8 oz Fruit2O
3 cups air popped popcorn
1 oz low fat string cheese
1 cup skim milk
1 starch
1 meat
1 milk
19
20