Initial Weight Loss Surgery Nutrition Education

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1 Initial Weight Loss Surgery Nutrition Education

2 The primary nutrition goals before and after surgery are: Learn proper eating habits that will promote weight loss while maintaining health at a reduced weight. Consume adequate amounts of protein to minimize loss of lean body mass, and facilitate healing. Take adequate amounts of fluid to maintain hydration. Obtain adequate nutrients for optimal health through healthy food choices and vitamin and mineral supplementation.

3 For most individuals Bariatric Surgery meal planning requires a significant change in how and what you eat and drink. We recommend that you begin adapting your current diet pattern and health behaviors now to prepare for this change!

4 Band RNY Sleeve DS 1-2 oz ml. 1/8-1/4 cup 1-2 oz ml. 1/8-1/4 cup 2-4 oz ml. ¼-1/2 cup 4-6 oz ml.1/2-3/4 cup

5

6 How Your Diet Will Advance: Weeks 1&2: Week Three: Week four: Liquids Only Liquids and Semi-solids Liquids and Soft Foods

7 Weeks 1&2: Hydration Decaf coffee or tea Splenda, Equal, Truvia, and Stevia are allowed Clear fruit juice, (Diet or Sugar Free) Apple, grape, cranberry Sugar-free gelatin Sugar free Popsicles Chicken beef or vegetable broth Water Sugar-free non-carbonated beverages Liquids Only such as (crystal light, sugar free Kool-Aid, or lemonade) Vitamin water zero Fruit 2o Mio Dasani flavored water Dasani Drops Ayala y Herbal Water (whole foods) Metro Mint Water Hint Water (Whole Foods & Fresh Market) Volvic flavored water Skinny water (Harris Teeter, Target) G2 Propel Protein Clear Liquid Protein (1 st 48hrs after surgery) Nectar Protein Powder Nectar Protein Powder Health Wise high protein fruit drink (bottle) Healthwise high protein fruit drink (packets) Cytomax Healthwise Bouillon Isopure Liquid New Whey 42 Healthwise Sugar-free Protein jello Full Liquid Protein (Start Post-op Day 3) Muscle Milk Lite ChocoRite Matrix 2.0 Met Rx Meal Replacement Nectar Protein Powder Nectar Medical Protein Powder Healthwise High Protein Hot Chocolate Health Wise high protein fruit drink Bariatric Advantage meal replacement Muscle Milk Lite Pure Protein (RTD) Fit Freeze Oh Yeah Chike Protein Powder Other Full Liquids (Start Post-op Day 3) Low fat skim or 1% milk, soy milk, Almond milk, Lactaid. Stained low fat cream soups Low sugar low carb protein supplements No Bubbles, Sugar, or Caffeine Ability to see light coming through Milky or creamy consistency

8 Weeks 1&2: Hydrating Fluids Liquids Only Clear Liquid Protein (1 st 48 hrs after surgery) Full Liquid Protein (Start Post-op Day 3) No Bubbles No Sugar No Caffeine

9 Choosing a Protein Supplement Choose a liquid protein supplement with at least 15 grams of protein in an 8-12oz serving. Choose a liquid protein supplement with 20gm or less of carbohydrate and 10gm or less of sugar.

10 Understanding The Nutrition Facts Label < 10 g total fat 15 g protein < 20 g Carbs < 10 g Sugar

11 Drink fluids in no more than 2 ounce or ¼ cup portions every 15 minutes 1-2 oz About 1 cup or 8 oz. total each hour. Protein drink 1-2 ounces every 15 minutes 1-2 oz Fluid for hydration 1-2 oz Fluid for hydration SIP on this fluid over minutes 1-2 oz Fluid for hydration ***Drinking to quickly or drinking too much at one time may cause pain or discomfort***

12 Liquids Diet GOALS, Weeks 1&2 Preventing dehydration hours of fluid intake 64 oz fluid per day / grams protein Controlled fluid volume Preventing discomfort FULLNESS Pressure Tightness Heaviness

13 Semi-solids and Liquids, Week 3 Allowed Semi-Solids Strained soups broth and low fat cream base soups- (try stirring jar baby food meats into your soup to increase protein) Lite-low fat strained yogurt or plain Greek yogurt Protein fortified strained hot cereals like cream of wheat or cream of rice Low fat 1% cottage cheese or ricotta cheese Protein fortified cooked and mashed or pureed potatoes and non-gas forming veggie like: carrots, squash, green beans, or peas. *** see blending tips below*** Mashed black, pinto or navy beans low fat, fat free or vegetarian refried beans or hummus Protein fortified Sugar free and low fat or fat free pudding ***see how to increase protein below*** Semi-solids to Avoid Any soup with meat, veggie, rice or noodles; cream of potato or tomato Full fat yogurt or yogurt with fruit or seeds Oatmeal Full fat dairy and cheese All other mashed fruits and veggies Regular refried beans or cook beans and lentils Full fat, sugar containing puddings

14 Semi-solids and Liquids, Week 3 Allowed Semi-Solids Semi-Solids to Avoid

15 Semi-solids and Liquids GOALS, Week 3 Begin separating fluids from foods DO NOT DRINK WITH MEALS Measure out no more than ⅓ cup food Applesauce consistency foods

16 Soft Foods, Weeks 4-8 Group Soft Diet Class, 3-4 weeks after surgery Fork Tender Foods Foods to avoid on the soft diet: Carbonated drinks (avoid) Sugar sweetened, caffeinated beverages (use diet or sugar free) Simple carbohydrates like chips, crackers, rice, pasta, and noodles Shredded coconut (use coconut extract) Tough dry meats (steak, pork chops) (use moist heat preparation, stew, boil, roast) Rubbery meats like ham and hotdogs Skins, membranes and seeds of fruits and veggies (peel and or section prior to eating) Fibrous veggies (i.e. corn, celery, sweet potatoes) Fresh doughy bread like yeast rolls and biscuits (use toast, or crackers) Fried or high fat foods (bake, broil, grill, use added fats conservatively) Whole milk products (use skim or 1% milk products)

17 Meal Planning Plan to eat ⅓ cup protein every 3-4 hours Breakfast will be within 1 hour of waking Last mini-meal at least 2 hours before sleep

18 Soft Foods GOALS, Weeks grams protein per day 64oz fluid Start with ⅓ cup protein **Plan to eat ⅓ protein every 3-4 hours Thumbnail size bites Chew foods to applesauce consistency minutes to eat No Drinking with Meals.

19 Stop here Second. ½ cup green veggies This volume by 3-6 months post op. Stop here last. ¼ cup whole grain or starchy veggie This volume between 6 mo. and 1 year Start Here 1/3 cup or 3-4 oz. Protein

20 Dumping Syndrome only a side effect of RNY Gastric Bypass Limit FAT and SUGAR Single digits <10 grams/serving Avoid fried greasy and sugary foods. Alcohol?

21

22 Vitamin and Mineral Supplements in Chewable or Liquid ONLY A chewable or liquid B-Complex is the only vitamin needed 1 month after surgery!

23 Things to Do Before Surgery Choose and purchase a chewable or liquid B-Complex Vitamin Choose and purchase a variety of protein fortified fluids for the first two weeks after surgery Begin planning a small meal every 3-4 hours Practice eating without drinking Practice sipping on fluid between meals 64oz daily. Practice chewing foods to an applesauce consistency Practice eating with smaller utensils Practice eating with your non-dominant hand Practice mindful eating, try to eliminate distractions during meals, TV, Phone, tablet

24 Things to Do Before Surgery Begin decreasing high fat/fried and high sugar foods. Begin or continue an exercise program. Try starting with a pedometer and strive for 10K steps per day. Attend Gastric Bypass Support Groups, both before and after surgery. Begin or continue food journaling to increase mindfulness to food/fluid choices and diet pattern Begin or continue reading and self-education prior to surgery Maintain weight within 2-3 pounds of your current weight or initiate weight loss

25 Liver Reduction Diet, 2-4 Weeks Prior to Surgery 2-4 Weeks Before Surgery Liquids only the week before surgery 5 shakes per day

26 Download our patient app BSNC in the app store or google play!

27 NUTRITION FOLLOW UP? Do I need to see the dietitian again before surgery? Case Managers: Barbara Satterfield Michelle Harvey Maggie Pope Kevin Edinger Michael Parker Jamie Sandy

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