Helpfull info for those thinking about surgery

  • I got this info from my doctor and found it very helpful, it gives you a better understanding of the diet after surgery I thought. I even practiced sipping 1 oz. of water for 5 minutes and tried to make it last. Do some measurements at home to really bring all the info to life. Hope I help someone.





    Eating For “The New You”!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 epending on theprocedure 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.

    2. 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 ameal 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 daybetween meals. Water is the best choice, but other choices include: iced or hot tea, coffee, herbalteas, Crystal Light or equivalent, Propel, or sugar-free flavored water. Sugar-free fluids arerecommended. 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 ofsimple 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 dehydratingeffect. 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 beincluded daily after advancing to the phase 2 diet and beyond. It does however, contain calories, andcould 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 needto increase protein supplements to provide an additional 16 grams of protein.

    3.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 identifysignals 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

    4
    Phase 1 – Clear Liquid Diet
    2 oz meals; 3-5 times per day

    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.

    6
    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
    Sample Full Liquid Menu:
    Morning Afternoon Evening
    Breakfast
    1-2 oz. thin grits w/1/4 tsp
    margarine & sprinkle salt
    Lunch
    1-2 oz strained
    cream of mushroom soup
    Dinner
    1-2 oz sugar-free
    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
    8 oz water
    Protein drink (20 grams)
    Beverages
    16 oz Crystal Lite
    Protein drink (20 grams)
    Beverages
    1 cup (8 oz.) fat-free milk
    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.

    7
    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.

    Foods Allowed

    Juice
    Limit 4-8 oz. per day
    grape, apple, cranberry,
    pineapple, orange, or grapefruit
    juice, Tang, Powerade, Gatorade
    AVOID 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)
    AVOID 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.
    AVOID 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)
    AVOID Fried Eggs

    Cheese
    HIGH PROTEI N
    Melted cheese, smooth cheese
    dips, cottage or ricotta cheese
    AVOIDSpicy 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
    AVOIDWhole or 2% milk; whole milk
    yogurt

    Protein supplement
    HIGH PROTEI N
    To equal ~10-20 grams

    Nuts and Seeds
    Smooth peanut butter
    AVOIDall nuts and seeds; crunchy
    peanut butter
    Soups and Sauces
    Strained soups only, cream
    soups, bisques and chowders
    AVOIDtomato based soups, bean based
    soups or chili, french onion soup

    Cereals
    Cream of rice, cream of wheat,
    strained oatmeal, thin grits
    AVOIDHigh fiber cooked or dry cereals

    Bread-None
    AVOIDBreads 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
    AVOIDHigh 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
    AVOIDAvocado, 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
    AVOIDIce 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
    AVOIDPepper, BBQ sauce, chili sauce,
    catsup, cocktail sauce, tabasco,
    hot sauce, horseradish, mustard

    Sample Pureed Menu:
    Morning Afternoon Evening
    Breakfast
    2 Tbsp (1 oz.) pureed egg
    2 Tbsp (1 oz.) crm of wheat
    Lunch
    2 Tbsp (1 oz) puree chicken
    2 Tbsp (1 oz.) sweet potato
    Dinner
    2 Tbsp (1 oz) puree turkey
    2 Tbsp (1 oz) puree peaches
    Snack 1
    1-2 oz cheesy grits
    Snack 2
    1-2 oz puree chicken salad
    Bevarages
    1 cup (8oz) fat free milk
    16 oz water
    Beverages
    16 oz Crystal Lite
    Protein drink (10 grams)
    Beverages
    1 cup (8 oz.) fat-free milk
    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.

    Phase 4 – Soft Diet
    1-2 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



    Juice
    Limit 12 oz. per day
    grape, apple, cranberry,
    pineapple, orange, or grapefruit
    juice, Tang, Powerade, Gatorade
    AVOIDApricot, peach or pear nectars
    √with 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)
    AVOIDRegular 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
    AVOIDFried 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
    AVOIDFried Eggs

    Cheese
    HIGH PROTEIN
    Most cheeses and cheese dips,
    cottage or ricotta cheese
    AVOIDSpicy 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
    AVOIDWhole or 2% milk; whole milk

    Protein supplement
    HIGH PROTEI N
    To equal ~10-20 grams
    See supplement list on page 14

    Nuts and Seeds
    Smooth peanut butter
    AVOIDAll nuts and seeds; crunchy
    peanut butter

    Soups and Sauces
    Chicken, beef, turkey noodle or
    rice soup, broth, consomme,
    vegetable based soups; cream
    based soups
    AVOIDTomato 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
    AVOIDHigh 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

    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
    AVOIDHigh 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
    AVOIDWhole 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
    AVOIDHigh 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)
    AVOIDAvocado, all berries, cantaloupe,
    all dried fruits, fresh dates, fresh
    figs, pears, tangerines, citrus
    (grapefruit, orange)

    Desserts
    All in moderation except those
    on restricted list
    AVOIDDesserts 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
    AVOIDspicy salad dressing (blue
    cheese, Cesar, Garlic, Italian,
    Roquefort, Russian)
    BBQ sauce, chili sauce, catsup,
    cocktail sauce, tabasco, hot
    sauce, horseradish, mustard

    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

    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

    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
    2 Tbsp (1 oz.) egg
    2 Tbsp (1 oz.) oatmeal
    Lunch
    2 Tbsp (1 oz) chicken thigh
    1 tomato slice
    Dinner
    2 Tbsp (1 oz) spaghetti/meat
    2 Tbsp (1 oz) noodles
    Snack 1
    1 oz cheese
    1-2 slices apple
    Snack 2
    1 oz chicken salad
    1-2 whole grain crackers
    Bevarages
    1 cup (8oz) fat free milk
    16 oz water
    Beverages
    16 oz Crystal Lite
    Protein drink (10 grams)
    See page 14
    Beverages
    1 cup (8 oz.) fat-free milk
    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.

    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

    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.

    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.

    • 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!

    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.
    Good luck