Eating for "The New You!" Baptist Hospital Bariatric Center of Excellence
Eating For “The New You”!Experience & Passion........Hope & Health
Baptist Hospital Bariatric Center of Excellence
Surgical Weight Loss Program
(850) 469-5810 Amy Hughes, RD, LD/N (850) 469-5810 Office Amy.Hughes@BHCPNS.org
Roux-en-Y Gastric Bypass Diet
The gastric bypass diet will be essential in promoting and maintaining weight loss after your surgery and preventing complications. The diet is intentionally low in calories, and will require lifetime vitamin and mineral supplementation.
Post-surgery dietary guidelines will vary by surgeon. You may hear of other patients who are given different guidelines following their weight loss surgery.
It is important to remember that every surgeon does not perform the exact same weight loss procedure and dietary guidelines may be different depending on the procedure and surgeon. What is most important is that you adhere to your surgeon's recommended guidelines.
Immediately after your gastric bypass surgery, you will be maintained on intravenous fluids and kept NPO (nothing by mouth). Some physicians allow a few ice chips at this stage.
When your surgeon feels you are ready, he will order “The Grape Juice Test.” This will help determine your tolerance to liquids, and, if well tolerated, your diet will be advanced.
Below is the progression of the gastric bypass diet at Baptist Hospital:
Phase Diet Type Total meal size Meals per day
Phase 1 Clear liquid 1-2 oz. (or 2-4 Tbsp) 3-5
Phase 2 Full liquid 1-2 oz. (or 2-4 Tbsp) 3-5
Phase 3 Puree 1-2 oz. (or 2-4 Tbsp) 3-5
Phase 4 Soft 1-2 oz. (or 2-4 Tbsp) 3-5
Phase 5 Regular 1-2 oz. (or 2-4 Tbsp) 3-5
With time .... Regular diet 3-4 oz. (or ~1/2 cup) 3 meals
The length of time you will be on each phase will vary by surgeon and your tolerance. You will most likely go home on Phase 1 and be advanced through the phases week by week.
*Remember: Advance to the next phase only when your surgeon advises.
Daily Supplements
Prior to surgery, If you have not been taking a multivitamin/mineral supplement regularly, begin a daily regimen now to ensure your nutrition status is at its best.
After the surgery, your surgeon will start you on the following as soon as you can tolerate:
1. 2 children’s chewable vitamins with iron (will advance to adult multivitamins later)
2. B-12 shots monthly Once you are referred to the Bariatric Center, your vitamin/mineral regimen will be reviewed. You can expect to be changed to a
3X/day supplement regimen including a high potency vitamin/mineral supplement, calcium citrate, and an iron supplement. Supplements are to continue for life. Follow-up care throughout your lifetime will help identify if any further changes in your supplements are necessary.
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Fluids
1. In the hospital, you will be maintained on IV fluids to prevent dehydration. Use this time to practice taking small amounts and sipping slowly.
2. Sip all fluids slowly. Take at least 5 minutes to consume 1 oz (30cc) of fluid. You will be given small 1 oz. medicine cups to help train you to take small amounts. Consider using a cocktail straw.
3. Drink between meals, not with meals. Wait at least 15 minutes before and 15-30 minutes after a meal before starting to drink your beverages.
4. Always be aware of your fluid intake! You should drink at least 48-64 oz of liquids each day between meals. Water is the best choice, but other choices include: iced or hot tea, coffee, herbal teas, Crystal Light or equivalent, Propel, or sugar-free flavored water. Sugar-free fluids are recommended. You may use sweeteners such as Splenda, Equal, Sweet/Low or other as preferred. Cold or hot beverages may be used.
5. You may drink 4 to 8 oz. of fruit juice, Gatorade or Powerade daily, but these are a source of simple sugars that may cause dumping syndrome, and, in excess, may increase caloric intake limiting weight loss. Dilute these beverages 50/50 with water to help decrease the chances of dumping syndrome.
6. Avoid carbonated beverages the first 2 weeks after surgery (or per surgeons recommendations). Moderate amounts of sugar-free carbonated beverages may be consumed thereafter, but water or other non-carbonated beverage is preferred.
7. Consume caffeinated beverages in moderation. Caffeinated beverages can have a dehydrating effect. Tea and coffee (even caffeine-free) can also interfere with iron absorption. Prior to surgery, you may want to wean yourself from caffeine to help prevent withdrawal and headaches post-op, as your consumption will be limited right after surgery.
8. Milk provides essential nutrients like protein, calcium and other vitamins and minerals and should be included daily after advancing to the phase 2 diet and beyond. It does however, contain calories, and could limit weight loss if consumed in excess. 2 cups of fat-free (skim) or 1% milk daily is recommended.
If you do not tolerate milk after surgery, try soy milk or lactaid milk or you may need to increase protein supplements to provide an additional 16 grams of protein.
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Eating Tips
1. Think slow: Take at least 5 minutes to consume 1 oz. of food. Never eat on the run. Relax, sit down and enjoy your meal. Avoid nibbling while preparing your meals. A two ounce meal should take at least 10 minutes to eat; a three ounce meal at least 15 minutes; and a four ounce meal at least 20 minutes.
2. Think small: Measure all your foods. See table below for measuring tips. Use smaller plates such as salad plate or coffee saucer to help ensure smaller portions and make food more appealing. Small bites are necessary–consider using baby silverware to help ensure small bites. Practice putting your fork or spoon down between bites to avoid putting too much in your mouth at one time.
3. Concentrate on what you put in your mouth: Chew thoroughly. Swallowing foods that are not chewed thoroughly may cause food to block the opening from your new pouch to the intestine. It may cause vomiting.
4. Learn to listen to your body: With your smaller stomach pouch, you will probably be able to identify signals of fullness that you may not have experienced before. Learn to stop eating at the first signs of fullness. If left shoulder or esophageal pain develop, stop eating immediately–this is a sign you have overeaten. “Listening to your body” will also help you identify foods that are not well tolerated.
5. Introduce one new food at a time: This may help identify foods that are not well tolerated.
6. Aim for 60 grams of protein daily initially after surgery: Always include a good protein source with each meal. Eat your protein foods first to ensure these are eaten before you become to full. Choose 2 cups of milk daily. Use a protein supplement in the initial stages, or if you are not tolerating protein foods.
7. No solid red meat for 6 months: Beef, pork, lamb, venison, etc, are difficult to chew adequately. On phase 3, puree red meat is allowed if it is pureed smooth, and on phase 4 (soft) and phase 5 (regular) lean finely ground meats are allowed.
Measuring Tips:
1 oz. = 30cc = 2 Tablespoons = 1/8 cup
2 oz. = 60cc = 4 Tablespoons = 1/4 cup
3 oz. = 6 Tablespoons
4 oz. = 8 Tablespoons = ½ cup
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Phase 1 – Clear Liquid Diet 2 oz meals; 3-5 times per day
Food Group Amount Food Choices Juice Limit 4-8 oz. per day Clear juices: grape, apple, cranberry, Powerade, Gatorade Fluids (calorie-free) At least 48-64 oz. Water, sugar-free flavored water, coffee, sugar-free tea, Propel, Crystal-Lite, sugar free popsicles, chicken, beef or vegetable broth Gelatin 1-2 oz. portion sugar-free Other Use in moderation sugar-free sweetener (Equal, Splenda, Sweet/Low) Mild seasonings and spices.
Sample Clear Liquid Menu:
Breakfast--1-2 oz sugar-free red gelatin Beverage between meals
4 oz apple juice diluted with 4 oz water and 8 oz water, sipped through morning
Lunch1-2 oz sugar-free green gelatin Beverage between meals
8 oz. sugar-free koolaid
Snack 1—1/2 sugar-free popscicle Beverage between meals
12 oz Crystal Lite and 8 oz. water, sipped through afternoon
Dinner--1-2 oz sugar-free yellow gelatin Beverage between meals
12 oz black cherry Propel and 8 oz hot chicken broth sipped through evening
(Total fluids for day = about 64 fluid oz.) *Take at least 5 minutes to consume 1 oz food or drink. *Wait 15 minutes before or after meals to begin drinking.
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Phase 2 – Full Liquid Diet 1-2 oz meals; 3-5 times per day
Food Group How Much Foods Choices Juice Limit 4-8 oz. per day grape, apple, cranberry, pineapple, orange, or grapefruit juice, Powerade, Gatorade Fluids (low-calorie) At least 48-64 oz. water, sugar-free flavored water, coffee, sugar-free tea, Propel, Crystal-Lite, SFKoolaid, SFpopsicles, chicken, beef or vegetable broth Refined cooked cereals 1-2 oz portions Cream of rice, cream of wheat, thin grits (cook with lots of water or milk) Strained soup 1-2 oz portions Strained soups, strained cream soups (avoid tomato or bean based soups) Other 1-2 oz. portions Sugar-free pudding or egg custard, Sugar-free gelatin Milk or yogurt 2 cups Fat-free (skim), 1% milk, buttermilk, soy, lactaid; Plain or sugar-free vanilla or other flavored smooth yogurt Protein supplement To equal ~35-40 grams See supplement list on page 14
Morning Sample Full Liquid Menu:Afternoon Evening Breakfast Lunch Dinner 1-2 oz. thin grits w/1/4 tsp 1-2 oz strained 1-2 oz sugar-free margarine & sprinkle salt cream of mushroom soup vanilla yogurt
Snack 1 Snack 2
1-2 oz sugar-free 1-2 oz sugar-free pudding egg custard
Bevarages 1 cup (8oz) fat free milk Beverages Beverages
8 oz water 16 oz Crystal Lite 1 cup (8 oz.) fat-free milk Protein drink (20 grams) Protein drink (20 grams) 8 oz water
*Take at least 5 minutes to consume 1 oz food or drink. (Total protein = 61 grams) *Wait 15 minutes before and 15-30 minutes after meals to begin drinking.
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Phase 3 – Pureed Diet 1-2 oz meals; 3-5 times per day
The pureed diet consists of low residue foods requiring minimal chewing. It is designed to avoid obstruction or blockage of the gastric bypass channel opening and to allow sufficient time for healing. Choose 1oz. high protein foods with each meal. Use a blender, food processor, and/or strainer to make foods a smooth consistency like applesauce. Add a little broth, cream soup, milk or other liquid to cooked foods to make pureeing easier. Baby foods (stage 1) are convenient on this phase of the diet.
Food Group Foods Allowed Foods to Avoid Juice Limit 4-8 oz. per day grape, apple, cranberry, pineapple, orange, or grapefruit juice, Tang, Powerade, Gatorade Apricot, peach or pear nectars Alcoholic beverages Fluids (low-calorie) At least 48-64 oz. water, sugar-free flavored water, coffee, sugar-free hot or cold tea, Propel, Crystal-Lite, SF Koolaid, SF popsicles, chicken, beef or vegetable broth, diet soda (2-3 weeks after surgery) Regular sodas, beverages sweetened with sugar, sweet tea, fruit punch, lemonade, etc. Meat HIGH PROTEIN All meats must be pureed, trim fat, remove poultry skin. May use beef, pork or ham, poultry, or fish. Bake, broil, boil or steam meats before pureeing. Fried meats, spiced meats, fatty meats (duck, goose, deviled ham, bacon, sausage, salami, pickled herring, smoked lunch meats) Eggs HIGH PROTEIN Pureed cooked eggs (scrambled, poached or boiled) Fried Eggs Cheese HIGH PROTEI N Melted cheese, smooth cheese dips, cottage or ricotta cheese Spicy cheese containing onions or peppers or those containing nuts. Milk & Yogurt HIGH PROTEIN 2 cups (16 oz) daily Fat-free or skim, 1% milk or buttermilk; Soy or lactaid milk; Sugar-free flavored low-fat or non-fat smooth yogurt Whole or 2% milk; whole milk yogurt Protein supplement HIGH PROTEI N To equal ~10-20 grams See supplement list on page 14 Nuts and Seeds Smooth peanut butter all nuts and seeds; crunchy peanut butter Soups and Sauces Strained soups only, cream soups, bisques and chowders tomato based soups, bean based soups or chili, french onion soup Cereals Cream of rice, cream of wheat, strained oatmeal, thin grits High fiber cooked or dry cereals
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Bread None Breads and bread products, crackers, popcorn, snack chips and pretzels Potatoes, Pasta and Rice Pureed or mashed potatoes (sweet or white), pasta and noodles, white rice, couscous Cornmeal, Chow mein noodles (wheat noodles), brown or wild rice Vegetable All vegetables pureed, low fiber except on the restricted list green beans, carrots, squash, greens, spinach, beets, peas, canned asparagus High fiber, gassy vegetables such as broccoli, beans, brussel sprouts, cabbage, corn, cauliflower, cucumber, onions, parsnips, green peppers Fruits All fruits must be pureed, low fiber and non citrus Applesauce, baby jar food fruits Avocado, all berries, cantaloupe, all dried fruits, fresh dates, fresh figs, pears, tangerines, citrus (grapefruit, orange,) Other Use in Moderation Sugar-free or pudding, sugar-free gelatin, sugar-free or low sugar fruit whips, sugar-free ice cream or yogurt Ice cream, cakes, pies, candy, cookies, doughnuts, sweet rolls; desserts made with coconut, raisins, nuts Condiments Use in Moderation Salt, mayo, vegetable oils, butter, margarine, cream, sour cream butter or pan sprays All herbs & spices, vinegar Pepper, BBQ sauce, chili sauce, catsup, cocktail sauce, tabasco, hot sauce, horseradish, mustard
Sample Pureed Menu: Morning Afternoon Evening Breakfast Lunch Dinner 2 Tbsp (1 oz.) pureed egg 2 Tbsp (1 oz) puree chicken 2 Tbsp (1 oz) puree turkey 2 Tbsp (1 oz.) crm of wheat 2 Tbsp (1 oz.) sweet potato 2 Tbsp (1 oz) puree peaches
Snack 1 Snack 2
1-2 oz cheesy grits 1-2 oz puree chicken salad
Bevarages Beverages Beverages
1 cup (8oz) fat free milk 16 oz Crystal Lite 1 cup (8 oz.) fat-free milk 16 oz water Protein drink (10 grams) 8 oz water
(Total fluids for day = about 64 fluid oz.) (Total protein = 61 grams) *Take at least 5 minutes to consume 1 oz food or drink. *Wait 15 minutes before or after meals to begin drinking.
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Phase 4 – Soft Diet1-2 oz meals; 3-5 times per day
The soft diet consists non-irritating low residue foods. All foods must be thoroughly chewed to avoid obstruction or blockage of the gastric bypass channel opening. Include a variety of foods and a good source of protein with all meals.
Food Group Foods Allowed Foods to Avoid Juice Limit 12 oz. per day grape, apple, cranberry, pineapple, orange, or grapefruit juice, Tang, Powerade, Gatorade Apricot, peach or pear nectars vwith your doctor about alcoholic beverages Fluids (low-calorie) At least 48-64 oz. Water, sugar-free flavored water, coffee, sugar-free hot or cold tea, Propel, Crystal-Lite, SF Koolaid, SF popsicles, chicken, beef or vegetable broth, diet soda (in moderation) Regular sodas, beverages sweetened with sugar, sweet tea, fruit punch, lemonade, etc.
Meat HIGH PROTEIN (prepare meats with a moist cooking method to avoid dry/tough meats) Trim visible fat from meat; remove skin from poultry; bake, broil, boil or steam meats; flakey fish, dark meat chicken, lean ground red meat, thin deli meat Fried meats, spiced meats, fatty meats (duck, goose, deviled ham, bacon, sausage, salami, pickled herring, smoked lunch meats) Eggs HIGH PROTEIN Eggs; scrambled, poached, over easy Fried Eggs Cheese HIGH PROTEIN Most cheeses and cheese dips, cottage or ricotta cheese Spicy cheese containing onions or peppers or those containing nuts. Milk & Yogurt HIGH PRTOEIN 2 cups (16 oz) daily Skim, 1% milk or buttermilk; Soy or lactaid; Plain or sugar-free flavored low-fat or non-fat yogurt Whole or 2% milk; whole milk yogurt Protein supplement HIGH PROTEI N To equal ~10-20 grams See supplement list on page 14 Nuts and Seeds Smooth peanut butter All nuts and seeds; crunchy peanut butter Soups and Sauces Chicken, beef, turkey noodle or rice soup, broth, consomme, vegetable based soups; cream based soups Tomato based soups, bean based soups, chili, or french onion soup Cereal Low fiber cereals such as Cheerios, Corn Flakes, Special K, Rice Krispies, Rice Chex, Corn Chex, Cream of Wheat, puffed rice, puffed wheat Cooked cereals High fiber cereals such as Bran Flakes, Bran Buds, Granola, Grapenuts, Product 19, Wheaties, Shredded Wheat, Shredded Bran, Raisin Bran, Ralston, Total, Wheat or Bran Chex, Wheat Germ
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Bread ½ slice = 1 oz 3 small crackers = 1 oz (Toasted bread is usually better tolerated.) Low fiber breads, bagels, English muffins, corn bread, dinner rolls, hamburger & hot dog buns, matzo, Melba toast, saltine crackers, plain bread sticks (with out sesame seeds) plain croutons High fiber breads such as whole wheat, rye, boston brown & those with nuts or seeds; high fiber muffins; high fiber whole grain crackers; popcorn, snack chips and pretzels Potatoes, Pasta and Rice Baked or boiled potatoes (sweet or white, without the skin); barley, noodles & pasta, chow mein; white or brown rice, grits, cornmeal, hominy, tapioca, cornstarch, arrowroot Whole grain flours: “whole wheat” or “whole rye”, wild rice Potato with skin Vegetable Low fiber vegetable (preferably cooked or canned) asparagus, green beans, wax beans, beets, carrots, collards, eggplant, mushrooms, okra, spinach, yellow squash, zucchini High fiber, grassy vegetables such as broccoli, beans, brussel sprouts, cabbage, corn, cauliflower, cucumber, onions, parsnips, green peppers, rutabaga, sauerkraut, scallions, onions, radishes, tomatoes, turnips, celery, lettuce Fruits Low fiber fruits; non citrus fruits (see restricted list); peel edible skins off fruits, soft bananas, applesauce, caned fruits (citrus fruits are okay 30 days after surgery) Avocado, all berries, cantaloupe, all dried fruits, fresh dates, fresh figs, pears, tangerines, citrus (grapefruit, orange) Desserts All in moderation except those on restricted list Desserts containing coconut, nuts, raisins, or seeds; fig bars, fruit cake Condiments Use in moderation mild salad dressing (french, 1000 island), oil & vinegar, mayo, vegetable oils, butter, butter sprays, margarine, cream, sour cream All herbs & spices, vinegar, pickles, relishes, A-1 sauce, soy sauce, teriyaki sauce, Worcestershire sauce spicy salad dressing (blue cheese, Cesar, Garlic, Italian, Roquefort, Russian) BBQ sauce, chili sauce, catsup, cocktail sauce, tabasco, hot sauce, horseradish, mustard
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Sample Soft Menu: *Remember to chew foods thoroughly
Breakfast
2 Tbsp (1 oz) scrambled eggs 2 Tbsp (1 oz) oatmeal with ¼ tsp margarine and Splenda
Beverage
1 cup fat-free milk and 12 oz water, sipped through morning
Mid morning snack
1 oz cheddar cheese 2-3 saltine crackers
Lunch
1 oz sliced deli turkey meat ½ slice bread (toast) with small amount mayonnaise
Beverage
12 oz orange Propel and protein drink (10 grams), sipped through afternoon
Midafternoon snack
2 Tbsp (1 oz.) cottage cheese 2 Tbsp (1 oz.) sliced peach
Dinner
2 Tbsp (1 oz) dark meat chicken 2 Tbsp (1 oz) vegetable medley with ¼ tsp margarine
Beverage
8 oz fat-free milk and 8 oz water sipped through evening
(Total fluids for day = about 60 fluid oz.) (Total protein = 61 grams)
*Take at least 5 minutes to consume 1 oz food or drink *Wait 15 minutes before or after meals to begin drinking
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Phase 5 – Regular Diet--Initially 1-2 oz. meals; 3-5 times per day
Once on the Regular diet, all foods may be eaten except those which cannot be thoroughly chewed or which cause discomfort or irritation. You can begin to try some of the foods that were in the restricted/avoid list like the vegetables or fruits you enjoy, or whole grain foods.
Remember to try one new food at a time so you will be able to identify which foods you may not be tolerating. Also, if you do not tolerate a specific food initially, try again later.
Eat a variety of foods daily (fruits, vegetables and whole grains) and be sure to include a good source of protein with each meal. Continue to choose 2 cups of milk or yogurt daily, and a protein supplement providing about 10-20 grams of protein (see page 14).
Sweets/desserts, fried foods and beverages containing calories should be limited/avoided (except 4-8 oz of juice or Gatorade or Powerade, if desired)
Sample Regular Menu
Morning Afternoon Evening
Breakfast Lunch Dinner
2 Tbsp (1 oz.) egg 2 Tbsp (1 oz) chicken thigh 2 Tbsp (1 oz) spaghetti/meat 2 Tbsp (1 oz.) oatmeal 1 tomato slice 2 Tbsp (1 oz) noodles
Snack 2
Snack 1 1 oz chicken salad 1 oz cheese 1-2 whole grain crackers 1-2 slices apple
BeveragesBevarages 16 oz Crystal Lite Beverages
1 cup (8oz) fat free milk 1 cup (8 oz.) fat-free milk
16 oz water Protein drink (10 grams) 8 oz waterSee page 14
(Total fluids for day = about 64 fluid oz.) (Total protein = 61 grams) *Take at least 5 minutes to consume 1 oz food or drink. *Wait 15 minutes before or after meals to begin drinking.
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Phase 5 – Regular Diet--Eventually 3-4 oz meals; 3 times per day
Once you are tolerating slightly larger meals, the regular diet should consist of three meals per day restricted in volume to 3-4 oz (6-8 Tbsp, or ½ cup total) per meal. However, do not try to force yourself to eat 3-4 oz. if you are not ready–Listen to your body and stop at the first signs of fullness.
With the larger meals, you should have 2 oz. of high protein foods with each meal, and include a variety of other foods including fruits, vegetables, and whole grains. Continue to consume 1-2 cups of milk daily, however, you will no longer need the protein supplement, unless you are unable to tolerate protein foods or milk.
A between meal snack may be needed if there is a long time between meals—limit in size to 1-2 oz and include a high protein food.
Sample Regular Menu (3-4 oz. meals):
Breakfast 1 egg w/cheese ½ slice whole wheat toast
Beverage 8 oz fat-free milk, and 12 oz water, sipped through morning
Lunch 1 oz. deli sliced turkey 1 oz. cottage cheese 1oz. macaroni salad 1 oz. tomato slices
Beverage 12 oz Iced tea with Splenda and 8 oz. water, sipped through afternoon
Dinner 2 oz. ham sliced thin 1 oz broccoli with ¼ tsp margarine 1 oz. fruit
cocktail
Beverage 8 oz fat-free milk and 12 oz black cherry Propel sipped through evening (Total fluids for day = 60 fluid oz.) (Total protein = 58 grams)
*Chew foods thoroughly*Take at least 5 minutes to consume 1 oz food or drink
*Wait 15 minutes before or after meals to begin drinking
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Protein
After gastric bypass surgery, your protein needs are increased because you are healing, however you can’t eat as much, and you may not be absorbing protein as well.
To aid in healing, keep the immune system running well, and minimize the loss of lean body mass (muscles, organs, etc.) as you are losing weight, a good source of protein should be included with every meal.
After surgery, aim for at least 60 grams of protein daily. To meet this, you will need a combination of food and protein supplements. Once you are healed, 45-60 grams of protein is a good goal and can be met through food alone. Taking more protein supplements than you need may result in added calories that can slow weight loss.
Food sources of protein are the best choice as they contain not only protein, but many other vitamins and minerals that are important for good health. Whenever possible, use food sources of protein. Vary your choices of protein foods for the best nutrition value.
Food Sources
Item Serving Size Calories Protein (grams) Carbs (grams) Fat (gram) Beef/ Pork,lean 1oz 55-75 7 0 3-7 Fish, Tuna 1oz 35-55 7 0 <3 Chicken/Turkey 1oz 55-75 7 0 3-5 Egg 1 75 7 0 5 Egg substitute ¼ cup 55 7 0 <3 Cottage cheese ¼ cup 55 7 0 <3 Cheese 1oz 100 7 0 9 Cheese, lowfat 1oz 55-75 7-9 0 3-5 Cheese, fatfree 1oz 55 7-9 0 0 Cream cheese Regular 1 oz (2 T) 100 2 1 9 Light 1 oz (2 T) 62 3 2 5 Fat-free 1 oz (2 T) 30 4 2 0 Fat-free milk 8 oz 90 8 12 0 Whole milk 8 oz 150 8 12 5 Sugar-free yogurt 8 oz 90 8 12 0-3 Powdered milk 1/3 cup 90 8 12 0 Peanut butter 2 Tbsp 190 8 6 17 Nuts 1 oz (1 T) 190 2-5 5 20 Beans ½ cup 80 7 15 0 Tofu 1 slice 55 5 3 3 Bacon 1 slice 35 1-2 0 3-4 Sausage 1 oz 100 7 0 5
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Protein (cont)
Protein supplements are needed in the first phases after surgery to meet your protein needs. Choose wisely—choose the ones that give the most protein for the least amount of calories. A protein supplement with 20 grams of protein should have 120 or less calories. You can choose ready mixed beverages, or flavored or unflavored powders to mix with your own beverage.
If you mix a protein powder with milk, make sure to count that as your milk and protein intake, so your calorie intake will not be too high.
Decrease and then discontinue protein supplements as the size of your meals increase, unless you are not tolerating other protein foods.
Supplements
Product Available at Amount Calories Protei n (gms) Carbs (gms) Fat (gms) Directions Beneprotein powder, unflavored Walgreens.co m 1 scoop 25 6 0 0 Mix 2 scoops with 16 oz crystal lite (12 gms protein 50 calories) Unjury powder, choc, van, or unflavored Unjury.com 1 scoop 80-90 20 0 0 Mix with favorite beverage 100% Whey protein GNC, Walmart 1 scoop ~100 21 0 0 Mix with favorite beverage ProComplex Powder GNC 1 scoop 130 27 4 2 Mix with favorite beverage Wheyfruity powder 1-888-8288008 molecularnutr ition.net 1 pkg 87 22 0 0 Mix as directed Carb Solutions Shake Powder Mix Walmart Prepared as indicated 120 21 3 2.5 Mix with favorite beverage EAS Whey protein shake mix Walmart 1 scoop 115 20 4 2 Mix with favorite beverage Optisource High Protein Drink Walgreens.co m 4 oz 100 12 6 3 Ready to drink Caramel strawberry EAS Advant-Edge Carb Control Shake Walmart 1 can 110 15 5 4 Ready to drink Carb Solutions Shake Canned Walmart 1 can 110 21 5 1 Ready to drink
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Gastric Bypass Diet Tips
• Contact your doctor if you have a medical concern such as vomiting, pain when eating meals, lasting pain, fever, etc. • Dumping Syndrome: Symptoms may include: nausea, weakness, sweating, faintness, cramping, rapid heart rate, and diarrhea. Often related to intake of concentrated sweets so you may find yourself eating fewer sweets or choosing sugar-free items more often to avoid this feeling. • Adequate fluid intake (48-64 oz per day) is necessary to prevent dehydration and constipation and to decrease risk of kidney stones. Use containers that help you reach this goal, such as 20 oz water bottles–drink 3 per day and you’ve had 60 oz of fluid. Once the bottle is empty you can fill with any calorie-free fluid. • Freeze water bottles–the water will stay cold as you sip it slowly through the day. • An increase in appetite or hunger may be noticed by some individuals about 10 to 14 days after surgery. During this time most patients feel water intake is improved and easier to consume. • Never eat on the run. Avoid eating while standing or in the kitchen. Set a place setting and sit down to eat your meals–you’re worth it! • Avoid distractions when eating such as TV or reading. This will help you concentrate on your meal to chew thoroughly and identify the “full” signal. • Measure foods in the beginning and learn what your meal size should look like on your plate. Then periodically afterward measure your foods to “check yourself” and avoid gradually increasing portions. • Attend support groups! • Exercise daily! Walking is a wonderful exercise that’s easy and inexpensive. Once your surgeon approves, weights or other muscle-toning exercises will be helpful to maintain lean body mass and help with long-term weight loss and maintenance. • Remember: Weight loss surgery is a tool to lose the weight that has been so difficult in the past for you to lose. To maintain the weight loss, behavior and dietary changes are necessary. Ask for help when you need it!
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Steps you can take while waiting for surgery:
1. Read “Eating for the New You” several times and share it with others who will be helping in your care after surgery.
2. Switch to calorie-free beverages and practice drinking slowly–1 oz in 5 minutes.
3. Practice eating meals without drinking.
4. Eat protein foods with each meal; smaller portions; variety of foods
5. Sample different protein supplements (see page 14) to determine which ones you would use.
6. Enjoy your meals free from distractions.
7. Practice concentrating on the food you eat and chewing thoroughly
8. Time yourself--Take at least 20 minutes to eat your meal (1 plate of food).
9. Grocery shop before you have surgery so that you will already have the food/drinks/equipment you need when you return home from the hospital.
10. Eliminate caffeine for the week before surgery to avoid the “withdrawal” headache after surgery.
11. Begin taking a daily multivitamin to ensure your body is ready for surgery. 12. Walk or engage in other exercise activity if able to prepare your body for surgery.
13. Attend a support group.
14. Call to register for Pre-Op Education and Nutrition Class after you have been approved for surgery.
15. Call if you have questions!
posted by Ann Marie @ 1/10/2008 11:09:00 AM
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