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Transcript
CHI St Vincent- Hot Springs
Gastric Sleeve Nutrition Guide
Jennifer Felgate, MS, RD, LD
[email protected]
501-622-1752
1
Dietitian Visits
The following is what you will be expected to bring with you at each dietitian visit.
Initial visit
Please bring the following:




Completed nutritional assessment
Detailed plan for your exercise regimen
Method that you will be using to track your diet and exercise
List of any questions that you have
First follow-up visit
Please bring the following:





Your completed diet log that includes your daily food intake and caloric intake
Your completed exercise log demonstrating progressive increase in physical activity
List of protein supplements you have tried and decision on which one you prefer
Three examples of dietary changes that you have made to reduce your overall intake of calories
Your copy of the gastric sleeve diet manual
Second follow-up visit
Please bring the following:
 Your completed diet log that includes your daily food intake and caloric intake
 Your completed exercise log demonstrating an increase in physical activity from the previous month
and approaching 30 minutes of physical activity most days of the week
 Your copy of the gastric sleeve diet manual
Third follow-up visit
Please bring the following:
 Your completed diet log that includes your daily food intake and caloric intake
 Your completed exercise log demonstrating you are completing 30 minutes of moderate intensity
physical activity most days of the week
 Your copy of the gastric sleeve diet manual
 List of any questions that you have regarding the 10 day pre-op diet
Consultation with the dietitian is a vital part of the program and requires you to provide detailed information
regarding your food and exercise habits. It is important that you are adequately prepared for your monthly
meetings so that appropriate consultation can be provided by the dietitian. If you are not prepared for your
visit, it will be rescheduled.
2
Advantages of Gastric Sleeve Weight Loss Surgery
The Sleeve Gastrectomy surgery is a restrictive type of weight loss surgery that permanently reduces the size
of the stomach. It promotes weight loss and reduces medical problems (related to obesity) by limiting food
intake and lessening the sensation of hunger. Permanent removal of 70-85% of the stomach along the greater
curvature is removed, leaving only a small tube, or “sleeve” for the stomach pouch that extends from the
natural stomach opening to the natural stomach outlet (pyloric valve). It is important for you to make healthy
food choices after your surgery to help with weight loss and to maintain nutritional health.

Promotes weight loss by restricting the amount of food that can be eaten at any one time

Reduces hunger since it removes the part of the stomach that produces the hunger stimulating
hormone ghrelin

Digestion occurs normally as the digestive system is not altered

Does not cause malabsorption or nutritional deficiencies as it does not involve rerouting or bypassing
the small intestine

Less chance of developing ulcers than with other gastric surgeries

Dumping syndrome is not likely to occur as the stomach outlet (pyloric valve) remains intact

Less complicated procedure than other gastric surgeries

Can usually be preformed laparoscopically

Does not require a gastric band being implanted into the body

Does not require adjustments or fills as with other surgeries

Expected excess weight loss is 60-70% at two years
3
Gastric Sleeve Basics

Eat slowly and chew thoroughly- at least 25 times- should take up to 20 minutes to eat

Avoid concentrated sugars, especially those in liquid form. They are filled with non-nutrient calories
and slow down weight loss

Limit fats and fried foods; they are a concentrated source of calories

Remember the stomach can only hold 4-6 oz after surgery. You will probably feel satisfied after 2-3
tablespoons of food. Do Not Overeat! Over time your stomach will stretch if you over fill it.

Stop eating when you feel comfortably satisfied- if ignored, vomiting will follow and you can stretch
the size of the stomach. If you are unable to keep anything down and are having extreme difficulty
staying hydrated, sip on Gatorade which also has electrolytes necessary for normal cell function. Once
you feel better, return to non calorie beverages such as water and diet drinks.

Drink at least 6 - 8 cups (8oz) of fluid per day to prevent dehydration. (Monitor for the following signs:
headache, dizziness, nausea, lethargy, a white-ish coating on the tongue and dark urine.) Do not drink
alcohol- it is dehydrating and has no nutrients. Carbonated beverages may give you gas.

Stop drinking liquids 15-30 minutes before meals and resume minutes after meals

Eat 3 small nutrient dense meals + 2-3 high protein snacks a day

Meals should include: protein first, then fruits and vegetables, and then whole grains

Set up a schedule for supplements (vitamins, minerals and protein shakes; refer to supplement page)
and medications; remember to take Calcium with meals and separate from iron supplements

Introduce new foods one at a time in order to rule out intolerance. If a food is not tolerated,
reintroduce it in 1 week

If you cannot tolerate dairy, substitute Lactaid for milk. You may need to take lactase pills with dairy to
help digest the lactose. You can also try soy milk fortified with calcium and vitamin D, Almond milk, or
other milk substitutes.

Exercise! This is the key to long term weight loss and maintenance. Walking should be the main
exercise for the first 6 weeks. Between 6-8 weeks, more strenuous exercises can be added.
4
Pre-Operative Preparation
Start doing this NOW- do not wait or else it will be difficult to follow guidelines for pre and post-op surgery.
Preparation for bariatric surgery includes several steps to optimize a patient’s health in anticipation of an
operation.
• Stop all carbonated beverages
• Limit all beverages which contain caffeine
• Begin a routine exercise program (consult your physician first)
• Begin cutting food into small pieces and practice chewing very well
• Join a monthly support group
Begin the practice of not drinking with your meals. Stop drinking 30 minutes before you eat and do not drink
again until 30 minutes after your eat. This will be a requirement following your surgical procedure and needs
to become a lifetime habit.
Gastric Sleeve Pre-Op Surgery Diet
10 days before surgery. Start ______ Surgery Date_____
The pre-op operative diet is desirable to decrease the risk of complications for our patients scheduled for the
gastric sleeve surgery. The pre-operative diet also reduces the severity of co-morbidities, reduces operating
room and recovery time. The following overview describes the general requirements of a pre-op surgery diet.
It is not meant to take the place of the specific instructions given to you by your surgeon, but provides
information on the basic dietary and nutritional guidelines that are common to most gastric sleeve patients.
To be specific, pre-op diet:






Reduces liver size and intra-abdominal fat
Improves visual field
Reduces co-morbidities
Increases patient’s understanding of post-op requirements
Reduces operating time
Reduces post-operative risks
Do NOT Splurge!
This is not the time to splurge on your diet. It is the time to show that you are serious about improving your
health and committed to making the changes necessary to do so. Your mindset and behaviors should be
focused on preparing for the upcoming surgery. It is very important that you adhere to the pre-op diet that
your surgeon is recommending for you. Situations can occur where a patient’s surgery is cancelled due to noncompliance with the pre-op diet. Please understand this can occur to you if you do not follow the guidelines. If
you find yourself struggling with the guidelines, please call the office for support and guidance. 501-622-1750
5
Diet and Nutrition Guidelines
 10 days before surgery, patients will begin a full liquid diet (this differs from the full liquid diet after
surgery)
 Diet will consist of high-protein supplements that are low-carbohydrate and low-fat (see page 15)
 To prevent dehydration, drink six to eight glasses (48 - 64 oz) of water each day; and/or other lowcalorie, sugar-free, caffeine-free, and non-carbonated liquids (such as Crystal Light)
 Solid foods are not allowed unless you are eating raw vegetables or raw fruit.
 Low Fat creamed soups
 Low fat cottage cheese
 Natural applesauce

Non-fat Yogurt, Greek Yogurt
 Skim milk, lactose free skim milk, or milk alternative
 V-8 juice (low sodium), V8 Fusion, tomato juice and all other no added sugar fruit juices. Try light
versions sweetened with sweetener
 Hot cereal- grits, oatmeal, cream of wheat, etc.
Protein Supplement Guidelines
Protein is necessary to preserve and protect muscle tissue and to help the body heal and recover after
surgery. The recommended protein intake ranges from 60 to 80 grams each day. Protein supplements are
available as ready-to-drink or powders. Generally, supplements with whey protein isolate are better absorbed
by the body than those with whey protein concentrate, which contain lactose/milk sugar.
If you are making protein shakes, consider these tips:
Mix with non-fat plain yogurt to increase protein and creaminess
Freeze skim milk into "ice cubes" and blend into shake to make it cold and slushy
Add 1 teaspoon of decaffeinated instant coffee to create a protein shake latte
If you cannot tolerate dairy, try fat free Lactaid milk, plain soy milk, almond milk or other milk
substitutes.




Liquids to Avoid
 High-sugar liquids (such as fruit juices, sports drinks, and alcoholic beverages)
 Whole or 2% milk
 Carbonated beverages (including regular and diet soda)
 Caffeinated beverages (including coffee and tea)
Diabetic Patients
Diabetic patients must be aware to monitor their blood glucose levels carefully once they begin the pre-op
surgery diet. Low-carbohydrate diets can alter insulin production and affect medication dosages. If you have
diabetes, make sure you talk to your doctor about any questions or concerns you have during this time.
Sample meal plan:
7:00 AM- protein shake with oatmeal
10:00 AM- light yogurt cup
1:00 PM- low fat cream soup, protein shake
4:00 PM- cottage cheese and 1 piece raw fruit
6:00 PM- low fat cream soup, protein shake
8:30 PM- raw vegetables to munch on if needed
6
Your diet progression during and after your hospital stay:
 Gastric Sleeve Clear Liquid Diet – day 1-3
In the hospital you will receive meals of clear, sugar free liquids. It is begun immediately after surgery or after
the results of your “swallow test” are back. Exercise is important in recovery of surgery- walk during your
hospital stay.
Recommended Clear Liquids:
• Clear Broth or Bouillon – Chicken, Beef, or Vegetable, can add protein powder
• Crystal Light or sugar-free Kool-Aid
• Decaf tea and coffee (artificial sweeteners allowed, non-dairy creamer is ok)
• Fruit juice sweetened with artificial sweetener.
• Herbal Tea or un-sweet tea – Caffeine Free
• Propel Water by Gatorade, or PowerAde Zero, or Gatorade
• Sugar Free drinks – no carbonated drinks
• Sugar-free popsicles, Sugar Free Italian Ice, Sugar Free Sherbet
• Try to sip fluids at the rate of ½ to 1 oz every hour; do not drink too fast.
• To prevent nausea and vomiting, do not drink too much or overfill your stomach
Start children’s chewable multiple vitamins with iron on the first day home
 Gastric Sleeve Full Liquid Diet – day 4-7
On day 4, you will begin a full liquid diet. Thicker liquids must be taken slower than thin liquids. Sip on liquids
at a rate of 1-3 ounces per hour. Vitamin and mineral supplementation should begin at this time. Iron should
be taken at bedtime and not consumed with Calcium. All items from the clear liquid diet can be consumed in
addition to the full liquids.
RECOMMENDED FOODS:

All food from previous stages
 Protein powder of choice with non-fat milk or milk alternative.

Low Fat creamed soups – thinned (no chunks). Add protein powder
 Low fat cottage cheese- add protein powder
 Natural applesauce (no chunks)

dairy Yogurt, Greek Yogurt (no chunks)
 Skim milk, lactose free skim milk, or milk alternative
 Sugar-free Fudgesicles
 pudding- make with skim milk or milk alternative and add protein power

Unsweetened 100% Fruit Juice diluted with water without pulp (no orange juice, grapefruit or tomato
juice). Limit to 4 ounces per day.
 V-8 juice (low sodium), V8 Fusion, tomato juice and all other no added sugar fruit juices. Try light
versions sweetened with sweetener.
Sample meal plan for Full Liquid diet:
Breakfast:
Mid morning:
Lunch:
Dinner:
Snack:
7
2-3 oz. light yogurt
3 oz. low fat cottage cheese
½ serving of protein drink
2-3 oz. low fat cream soup
½ serving of protein drink
 Gastric Sleeve Pureed/ Blended Soft Diet – day 8- week 6
You will progress to a diet composed of pureed/ blended foods low in fat and with no sugar. You will be on a
pureed diet for approximately 3-4 weeks. Aim for about 4-6 small meals per day.
 Start with baby food consistency and work towards very soft textured foods (ones you can mash
with a fork). Eating solid foods too soon will put pressure on the staple line and may cause breakage
or leaking.
 You will need 6-8 cups of fluid per day between meals.
 Continue to take the vitamin/ mineral supplements.
 You will only be able to eat a few tablespoons of food at each meal
(Approximately 4-8 Tbsp. or 2-4 ounces)

It is up to you to control how much you eat
Pureed Diet to Soft Diet

Add one new food at a time

Aim for 48 to 64 ounces of fluid per day to prevent dehydration. Avoid drinking 30 minutes before and
after meals.
 Avoid starch foods like white rice, pasta, breads
 Chew completely and slowly
 Continue full liquids to pureed adding one new food at a time, as tolerated.

Eat three (3) meals a day and (2) two snacks.
 Limit fats and avoid sugars.
 Protein is the priority (60-80 grams per day).
RECOMMENDED FOODS:
 All foods from previous stages.
 Baked potatoes (no butter), sweet potato
 Blended protein shakes with non-fat, sugar-free frozen yogurt, pureed fruit

Box mashed potatoes
 Canned peaches, apricots, mandarin oranges or pears (sweetened with non-caloric sweetener)
 Cream of Wheat, Oatmeal, Grits or Cream of Rice cereal. Start with 1-2 Tbsp at a meal.

Dried beans and peas-navy beans, kidney beans, low fat refried pinto beans, lima beans, lentils, split
peas cooked without added fat until very tender (remember that these foods may cause abdominal
discomfort and/or gas).
 Eggs, scrambled or egg whites
 Hummus
 Lean meats (fish, tuna fish, chicken, turkey) make sure the meats are moist and very chewed up before
swallowing. Pureed and blend them.
 Low fat cheese containing less than 6 grams of fat per ounce (most 2% cheese), Low fat or nonfat
cottage cheese (¼ cup), ricotta cheese

Smoothies, watch sugar content! (Best to make with protein powder at home)

Soft canned fruits (pears or peaches) sweetened with non-caloric sweetener

Soft cooked vegetables and mashed with a fork

Tuna fish made with low fat mayo or avocado
 Tuna, canned salmon without skin, ground white meat turkey, ground chicken
8
Sample meal plan:
Breakfast:
Mid morning:
Lunch:
Dinner:
Snack:
cottage cheese and pureed peaches
½ protein supplement
Pureed tuna made with avocado
pureed beef with diced tomatoes
½ serving of protein drink
Instructions for pureeing foods:
1. Cut food into small pieces about the size of your thumbnail.
2. Place food in the blender.
3. Add enough liquid (fat free chicken broth or fat free gravy) to cover the blades.
4. Blend until smooth like applesauce and enjoy!
 Strain out the lumps, seeds, or pieces of food.
 Use spices (avoid spicy ones) to flavor food.
Sample Menus for pureed/ blended soft diet
Breakfast 8 am
Breakfast 8 am
Breakfast 8 am
¼ cup unsweet applesauce
¼- ½ cup fat free cottage cheese
½ -1 soft poached egg
¼ cup unsweet applesauce
Supplement/ Snack 10 am
Supplement/ Snack 10 am
Supplement/ Snack 10 am
½ cup skim milk with
1 scoop protein powder
½ cup skim milk with
1 scoop protein powder
½ cup skim milk with
1 scoop protein powder
Lunch 12 pm
Lunch 12 pm
¼- ½ cup cooked cereal
¼- ½ cup skim milk
Lunch 12 pm
¼ - ½ cup light yogurt
¼ cup pureed peaches
¼ - ½ cup blended soup
¼ cup egg salad w/ low fat mayo
¼ - ½ cup blended soup
¼ cup tuna w/ low fat mayo
Supplement/ Snack 2 pm
Supplement/ Snack 2 pm
Supplement/ Snack 2 pm
¼ - ½ cup unsweet applesauce
1 sugar free popsicle
½ cup fat free cottage cheese
1 sugar free popsicle
¼ - ½ cup low fat ricotta cheese
with cinnamon
Dinner 6 pm
¼ - ½ cup blended soup
(add protein powder)
¼ cup pureed fruit
Dinner 6 pm
¼ - ½ cup blended soufflé
¼ cup mashed potato
9
Dinner 6 pm
1-2 oz. flaked fish
¼ cup puree vegetable
 Gastric Sleeve Solids/ Regular – week 7
If you can tolerate the items in the blended soft diet after 3-4 weeks, you will gradually advance the food
choices in your diet. This is a diet which emphasizes lean protein, fruits/vegetables, whole grains, and fiber. It
is important to keep a food record of your tolerance for texture, volume, and intake.










Remember:
Add one new food at a time
Chew completely and slowly
Food intake will be limited to 4-6 ounces per meal. (Approximately 8-12 Tbsp.)
Continue your fluid intake of 6-8 cups per day.
Limit foods high in carbohydrates: (Pasta, Rice, breads, Crackers, Potatoes)
Limit Foods high in saturated fats and avoid trans fats
Avoid Sugar beverages such as juice and soda.
Avoid fried foods
Continue to take your vitamin/ mineral supplements.
Continue supplemental protein if needed (70-80 grams of protein is the daily goal)
This diet is very individualized. It is normal to experience food intolerances. Try to reintroduce that food a
week later while focusing on eating slowly, chewing thoroughly, and not overeating. You will eventually be
able to tolerate a variety of foods from each of the food groups.
While surgery will trigger significant weight loss, you must also do your part to maintain the weight loss by
making lifelong changes in your eating habits. It is counterproductive to eat high calorie and high fat foods
after surgery. You need to be committed to making healthy choices and eat high protein and low fat
nutritional foods that will provide you with essential vitamins, minerals, and nutrients to keep you well
nourished and feeling healthy.
Exercise is also important. Regular exercise during the first year after surgery will result in more weight loss
(twenty pounds or more) from surgery than if you do not exercise.
10
Foods not recommended while healing from surgery
“Sticky” Foods
• Soft bread
• Sticky or sweet rice
• Spaghetti and other pasta
• Macaroni and cheese
• High-fat cheese, melted cheese
• Raisins, prunes, and other dried fruits
Crunchy Foods
• Granola and other cereals with nuts
• Raw vegetables, salad
• Nuts, seeds, and popcorn
• Chips
Tough Foods
• Tough or chewy meat
• Whole pieces of corn or whole peas
(puree these foods)
High-Fat Foods
• Butter, margarine, and oil
• Whole milk and half-and-half
• Ice cream, cakes, cookies, pies,
and other desserts
• Bacon
• Sausage
• Luncheon meats
• Gravy
Regular mayonnaise, sour cream, cream cheese, salad dressing
Foods with Seeds, Peels, or Husks
• Strawberries and other berries
• Corn (unless pureed)
• Peas (unless pureed)
11
Concentrated Sweets
Most of the foods and beverages that contain concentrated sweets are filled with “empty” calories in the form
of sugar. These products provide mainly calories with limited nutritional value. After surgery, every bite
counts. Filling up on these “concentrated sweets” can prevent weight loss and can replace healthier foods in
your diet with high calorie, high sugary foods.
Note: Artificial sweeteners such as nutrasweet/Equal ®, saccharine/ Sweet & Low ®, and sucralose/Splenda ®,
Truvia, etc. are OK to use.
Ice cream
Regular soft drinks
Chocolate milk
Lemonade
Pudding
Kool Aid
Sweetened, fruited or
frozen yogurt
Sugared ice tea
Dried fruits
Snapple or fruit drinks
Canned or frozen fruits in syrup
Table sugar
Fruit juice
Honey
Sugar coated cereal
Candy
Doughnut
Regular Jell-O
Popsicles
12
Sugar gum
Cakes
Molasses
Pies
Syrups
Cookies
Sherbet / Sorbet
Jellies
Jams
Supplement List
It is important that you take vitamin supplements every day. The key vitamins that are necessary include
vitamin B12, iron, and calcium. We recommend that you take multivitamin, plus extra calcium, iron. These
Vitamins need to be started before the surgery. Please consult your physician for the start date.
Multivitamin/mineral supplement: Chewable supplements are necessary for the first two to three months
after surgery because you cannot swallow large pills (bigger than an aspirin) and they are easier to digest and
absorb. Choose one of the following:
o
Flintstone’s Complete
o
Centrum Chewable
A few months after surgery, or when you feel you are able to swallow large pills (bigger than an
aspirin), you may switch to non-chewable supplements if you would like to. Choose one of the
following:





One-A-Day Maximum
One-A-Day Today
Centrum Performance
Centrum with lycopene
Centrum Carb Assist
Calcium with vitamin D, twice daily with food for at least 1000mg per day. Again, chewable supplements
must be taken for the first two to three months after surgery because you cannot swallow large pills (bigger
than an aspirin) and they are easier to digest and absorb. Because calcium is such a large mineral, many
patients prefer to stay on chewable calcium supplements because the non-chewables are just too big. Choose
one of the following:
o Caltrate with Vitamin D- Chewable
Citracal Creamy Bites
Solgar Calcium
Please remember not to take your calcium with your iron supplement as the two interfere with one another.
Calcium and iron should be taken at least two hours apart.
o
o
Iron, once daily with food. If you become constipated after surgery and believe your iron supplement is the
cause, please call the office for suggestions on how to alleviate this problem. Check you multivitamin to see if
it continues iron. Choose from the following:
o
o
Ferro-Sequels
Fergon
o
o
13
GNC Iron 18
Slow-Fe
Protein shakes:
Tips When Choosing a Protein Shake:




Approximately 15-20 grams of protein per serving
Less than 200 calories per serving
Less than 10 grams of sugar per serving
No added sugars or oils
You must read product labels to determine the nutritional value. The bests are the ones that have a protein
source/main ingredient such as: milk, soy, egg, whey protein isolate or soy protein isolate. You can find
protein shakes at a vitamin or health food store such as Vitamin Shoppe, GNC, a local health market, or online.
Everyone has different taste buds, so find the shake that tastes the best to you.
There are 2 types of protein shakes: Pre-mixed and Powders mixed with milk


Pre-mixed (Ready to Drink)
o Atkins
o Myoplex Low Carb
o Perfect Zero Carb
o Isopure
o Slimfast Low Carb
Powders mixed with milk*
o Juice Plus
o Unjury
o No Added Sugar Carnation
Instant Breakfast
o Revival Soy
*Directions for powders: Add protein powder by the scoop/tablespoon to 8 oz Skim plus Milk, Skim Milk, or
Fat Free Lactaid daily. You may choose to drink your shake in 2- 4 oz servings.
After surgery you will need between 50-80 grams of protein a day. In order to meet your protein needs,
protein shakes such as the ones listed above, will supplement your meal plans. Once you are able to get
enough protein from your food, you will not need to continue using protein shakes on a daily basis.
14
Protein Supplements
Liquid Premade Shakes
Worldwide Pure
Protein
Myoplex
Original
Myoplex Lite
Achiev One
Amount
Protein
Sugar
Flavors include
11 oz
35 grams
1 gram
Strawberry cream
17 oz
42 grams
2 grams
Strawberry cream
11 oz
9.5 oz
25 grams
20 grams
1 grams
3.5 grams
AdvantEdge
Carb Control *
11oz.
17 grams
0 grams
Choc Fudge
Coffee flavors (all contain
caffeine, OK after 1 month)
Café caramel, choc Fudge, French
Vanilla, choc., strawberry cream
Brand Name
Powder
Designer Whey
Protein
Vitamin Shoppe
100% Soy
Protein
Revival Soy*
(unsweetened
or made with
Splenda)
Isopure –
Perfect Zero
Carb
Myoplex
Original
Atkins
Unjury **
Amount
Protein
Sugar
Flavors include
1 scoop
18 grams
2 grams
2 scoops
26 grams
0 grams
Chocolate, Strawberry, French
Vanilla
No flavor
1 packet
20 grams
1 grams
Chocolate, Vanilla, Strawberry,
Blueberry, Cappuccino
2 scoops
50 grams
0 grams
Vanilla, Apple Melon, PineappleOrange Banana
1 packet
42 grams
2 grams
2 scoops
1/3 cup
15 grams
22 grams
2 grams
3 grams
Matrix
ProCel
1 packet
0.23 oz/6.6
grams/1 env
20 grams
5 grams
2 grams
<1 gram
Chocolate, Strawberry
Vanilla, unflavored, choc,
strawberry
Unflavored, Vanilla
Unflavored
Water/juicy
consistency
Isopure –
Perfect Zero
Carb
Nectar (best
mixed w/water)
Amount
Protein
Sugar
Flavors include
2 scoops
50 grams
0 grams
Apple Melon, Pineapple-Orange
Banana
1 scoop
23 grams
0 grams
Fuzzy Navel, Cherry Apple,
Lemonade
*Call 1-800-Revival or www.revivalsoy.com
**Call 1-800-517-5111 or www.unjury.com
15
RecipesPlease use these recipes as suggestions. The consistency of the shakes will depend on the fluid/ ice added. You
may want to increase or decrease fluids, depending on your likes and dislikes. You may be creative and make
recipes of your own. Remember, the key is to adhere to the guidelines and again, please do not forget to call the
office, should you need additional information and support.
Pineapple Blast
Mocha Shake
4 ice cubes
1 tbsp. milk
2 scoops protein powder
4 ice cubes
6 oz. water
2 scoops vanilla protein powder
1/3 cup pineapple chunks
Frozen Chocolate Banana
Pina Colada
8 oz. water
4 to 5 ice cubes
1/2 medium banana
2 scoops chocolate protein powder
6 oz. water
4 ice cubes
2 scoops vanilla protein powder
1/3 cup pineapple chunks
1 tsp. sugar free coconut extract
Chocolate Strawberry Shake
Orange Creamsicle
2 scoops of chocolate protein powder
6 ounces of water
4 to 6 ice cubes
6 small strawberries
2 scoops of vanilla protein powder
6 ounces of water
4 to 6 ice cubes
1 small orange (size of tennis ball)
Raspberry Chocolate
Blueberry Blaster
2 scoops of chocolate protein powder
6 ounces water
6 ice cubes
3/4 cup fresh raspberries
2 scoops of vanilla protein powder
6 ounces water
6 ice cubes
3/4 cup blueberries
16
Protein Content of Selected Foods
FOOD NAME
Beans, Cnd
Beef eye of round
Beef top loin
Cheese, American, fat free
Cheese, cottage, 1% fat
Cheese cottage creamed
Cheese, parmesan, grated
Cheese, mozzarella, part-skim
Cheese, ricotta, part skim
Chicken, white breast meat, no skin
Chicken, leg no skin
Cod, white, baked
Crab, steamed
Egg, hard cooked
Flounder
Halibut
Ham, lean
Hamburger (lean ground beef)
Lobster, steamed
Milk, skim
Milk, skim plus
Peas, chick, cnd
Pork tenderloin
Pork loin chop
Salmon, baked
Shrimp, steamed
Soybeans (edemante)
Soy flour, defatted
Soymilk, plain
Soynuts
Steak, sirloin, trimmed
Swordfish, baked
Tempeh
Texturized soy protein
Tofu
Tuna, cnd, water packed
Turkey, white meat
Veal loin
Veal leg (top round)
Yogurt, frozen, sugar free
Yogurt, fat free, low sugar
PORTION
½ cup
3 oz.
3 oz.
1 oz.
½ cup
½ cup
¼ cup
1 oz.
½ cup
3 oz.
3 oz.
3 oz.
3 oz.
1
3 oz.
3 oz.
3 oz.
3 oz.
3 oz.
1 cup
1 cup
½ cup
3 oz.
3 oz.
3 oz.
3 oz. (15 large)
½ cup
¼ cup
1 cup
¼ cup
3 oz.
3 oz.
½ cup
½ cup
½ cup
3 oz.
3 oz.
3 oz.
3 oz.
½ cup
1 cup
17
PROTEIN (grams)
7
21
21
6
14
13
12
8
14
26
21
21
17
6
21
21
21
21
16
8
11
7
21
21
16
21
18
14.3
12.8
6.6
15
26
21
11
10
25
21
21
21
5
8
How to Fit New Diet to Family Lifestyle:
Clear Liquid & Full Liquid Diet:
At this time you may find it difficult to find foods that fit both you and your family’s diet. Phase 1 and 2 of the
diet are very short. Convenience items, such as fat free broth, sugar free popsicles, and sugar free gelatin, are
easy items to fit into your diet.
Other ideas:
 Vegetable/ chicken noodle soup for the family. You will need to strain soup so that you are only
eating the broth
 Enjoy a sugar free gelatin or pudding snack with your children
Pureed Diet:
Two weeks after surgery, you will begin Phase 3 of your diet. This will include food that is blended to a pureed
consistency. During this phase it will be easier to cook for you and your family. Remember that you set the
example for your family. You will be able to share your new healthy eating habits with your family. Foods
should be prepared in the healthiest possible way. We want to limit margarines, butter, and other fat. During
each diet progression it is important to try one new item at a time.
 At this point in the diet you will be able to use the same foods that you cook for your family.
You will need a blender to puree your foods. Portions sizes are still limited to 2-4 oz.
 If meats are dry, you can add fat free broth to help make it moist.
 Include a balance meal for your family. Include a vegetable, meat, fruit, carbohydrate and dairy.
This way you will be able to choice a variety of food to puree.
Soft Diet:
A month after your surgery you will progress to the soft diet. During this phase you will be able to eat well
cooked vegetables and fruit. Also you will be able to eat fish and other tender meats without pureeing them.
Even though you are still drinking the protein shake, it is still important to eat protein items.
 Eat a variety of fruit and vegetables. Try to challenge your family to
see how many different fruit and vegetables they can consume.
 Breakfast is the most important meal of the day, not only for you but your whole family. Set
your family up on a regimen of toast and eggs or oatmeal.
Regular Diet:
Congratulations! You are now at the regular diet. At this time you can eat foods without any special
preparations. It is important to remember that your stomach holds 4-6 oz in capacity. Eat slowly and stop
eating once you start to feel satisfied. It is important to make the healthiest choicest possible.
You are recommended to avoid the following food for the long term.
 Foods high in carbohydrates: allowed to eat once per month (Pasta, Rice, breads, Crackers,
Potatoes)
 Foods high in saturated fats and avoid trans fats
 Fried foods
 Sugar beverages such as juice and soda.
18
FOOD LOG
Date:
Name:
Time
Amount
(tsp, oz, Tbs,
cups)
Time
Is this a good source
of Protein?
Amount
Food/Condiment/Supplement
(be as detailed possible- brands, method of
cooking, etc.)
Breakfast
Yes or No?
Time
Amount
Lunch
Yes or No?
Time
Amount
Dinner
Yes or No?
Time
Amount
Snack(s)
Yes or No?
Time
Amount
Beverages
19
FOOD LOG
Date:
Time
Name:
Amount
(tsp, oz, Tbs, Food/Condiment/Supplement
(be as detailed possible- brands, method of
cups)
cooking, etc.)
Amount
Breakfast
Yes or No?
Time
Amount
Lunch
Yes or No?
Time
Amount
Dinner
Yes or No?
Time
Amount
Snack(s)
Yes or No?
Time
Amount
Beverages
Time
20
Is this a good source
of Protein?