POST BARIATRIC SURGERY DIET

Transcription

1 POST BARIATRIC SURGERY DIET STAGE 1: Water Trial STAGE 2: Clear Liquids STAGE 3: Full Liquids STAGE 4: Pureed Diet STAGE 5: Soft Diet Maintenance Diet

2 STAGE 1: Water Trial Post-Operative - Day 1 ( in the hospital ) Start with water and sip: 1 medicine cup (30mLs) of water - the first hour 2 medicine cups (60 mls) of water - the second hour 3 medicine cups (90 mls) of water - the third hour When you have completed the water trial and DO NOT have any nausea, then you will progress to Stage 2: Clear Liquids. STAGE 2: Clear Liquids Post-Operative - Day 1 & Day 2 ( in the hospital ) You will receive 3 or 4 medicine cups of broth, sugar free Jell-O and/or diluted juice Take one bite or one sip at a time Wait 10 minutes between each bite/sip If you are full, STOP and DO NOT take another bite/sip YOUR GOAL IS TO LEARN TO STOP WHEN FULL and not take one more bite or sip even though you think you can. Note : If you are drinking juice, remember it needs to be diluted (½ juice, ½ water) to limit the amount of sugar you get. Eating or drinking foods/drinks high in sugar after surgery (such as puddings, ice cream, cakes, pies, cookies and soda) may cause a condition known as dumping syndrome. Dumping syndrome occurs when high sugar foods/drinks pass too quickly from the stomach to the small intestine. Symptoms may include a combination of nausea, uncomfortable fullness, cramping, diarrhea, weakness, sweating and/or fast heart rate. If this happens, reduce your intake of sweets and notify your surgeon. High sugar foods and drinks are also often high in calories but contain few nutrients, and thus, may affect the nutritional adequacy of your diet and your ability to lose weight. TAKE THE MEDICINE CUPS HOME TO USE FOR MEASURING!!! Sometimes you may need to come back to this Clear Liquid Stage for a short time. REMEMBER : NO STRAWS or CARBONATED DRINKS - this can cause air to get into the stomach which can make the size of the stomach larger. It can also cause bloating and discomfort.

3 Surgical Weight Loss Program STAGE 3: Full Liquids (Refer to Sample Diet Sheet; up to 400 calories per day) Post-Operative - Days 3-9 Protein Shakes ( the same as those used before surgery ) Skim Milk Fat Free / Sugar Free Yogurt ( NO FRUIT ) Fat Free / Sugar Free Pudding Sodium (salt) Free Broth V-8 Juice ( Low Sodium ) Add unflavored protein powder (using a salt shaker to prevent lumps of powder) to each item throughout the day - the equivalent of one extra scoop. Use a protein powder that adds at least grams of protein PER DAY and no carbohydrates. Take 2-3 sips/bites at a time (Your stomach is the size of an egg or ¼ cup. Decreased volume or space in your stomach = restriction) Wait 10 minutes between sips/bites Drink one cup (8 ounces) of non-caloric drink between meals at all times. BEGIN TAKING VITAMINS NOW - Liquid or Chewable ONLY! STAGE 4: Pureed Diet (Refer to sample diet sheet; up to 500 calories per day) Post-Operative - Days Protein Shakes ( the same as those used before surgery ) Pre-Surgical and Post-Surgical Diet Items Pureed Baby Foods - chicken, meat, fish Poached or Over Easy Eggs Creamed/Strained Soups ( made with Skim Milk) Applesauce Mashed Potatoes ( made with Skim Milk ) Pureed Baby Foods - Fruits & Vegetables Cream of Wheat Cereal ( thinned with Skim Milk) Avoid chunks/solid foods

4 STAGE 5: Soft Diet (Refer to sample diet sheet; up to 700 calories per day) Post-Operative - Days Protein Shakes ( the same as those used prior to surgery ) Pre-Surgical and Post-Surgical Diet Items Pureed Items Soft, Moist, Diced and Ground Protein Items Separate your fluids from your meals: 30 minutes before meals 30 minutes after meals 4-6 small meals per day 2 Liters of fluid or more ( no liquids with calories except milk ) Grits Over Easy or Poached Eggs NO Fruits with seeds MAINTENANCE DIET (Refer to sample diet sheet; up to 1000 calories per day) Post-Operative - Day 36 and thereafter 2 Liters of Fluid or more ( no liquids with calories except milk ) 3 meals with 2 snacks ( no fats added ) Closely monitor calorie count Return to journaling to assure accuracy of nutrition intake Include more daily activity - once cleared with your surgeon - incorporate more variety into your activities DO NOT need Protein Shakes ( unless using for convenience ) Increase variety - Foods, Fluids and Exercise CHEW, CHEW and CHEW - 30 times per bite May add Peanut Butter to diet Follow serving size Best to start with creamy style Other Reminders: NO straws / carbonated drinks NO bread / tortillas / pasta / rice or popcorn NO raw / dried fruit NO nuts / seeds NO breading / frying NO celery / broccoli / corn or cabbage NO stringy foods NO meat with gristle

5 VITAMINS Pre-Op: Integrate vitamins into your daily regime no later than your second month with the dietician. It is important to maximize your nutrients prior to surgery. The addition of vitamins and supplements to your daily diet will help assist with enhancing your nutritional health. We will monitor these components post-operatively as well. At a minimum you will need to take a Multi-Vitamin with 1,000mg of Vitamin D. See separate sheet for dosages. Post-Op: Since your food intake is greatly reduced, it is recommended that you take the necessary vitamins so that you will not develop a vitamin and/or mineral deficiencies. The most important supplements are the Calcium Citrate and Vitamin D. Take liquid, chewable or gel type vitamins for approximately 6 months post-op, then you may resume your preferred choice of vitamins, such as soft chew vitamins. Please discuss with your physician or dietician. You must continue taking the Calcium Citrate. Multivitamins - the multivitamin you choose should include: 18mg Iron, 400mcg Folic Acid, 140mcg Selenium, 3mg Copper and 30mg Zinc. Companies that market vitamins specifically for bariatric patients include, but are not limited to: Bariatric Advantage and Celebrate. Over the counter options include, but are not limited to: Centrum Adult Chewable - take two a day for 3 months after surgery, then reduce dose to one a day. Chewable Flintstones Complete Chewable Mega Teen Multivitamin (available at GNC) Calcium Citrate (MUST BE CITRATE) - take 1,2000 to 1,500 mg per day to prevent calcium deficiencies that cause bone disease. Take one tablet twice a day (once in the morning and once in the evening). Vitamin D3 - take 3,000 International Units (IU s) per day (total amount in 24 hours). Check to see if your calcium supplement has any Vitamin D in it, if it does not have Vitamin D, then take one tablet twice a day (one in the morning and one in the evening). B12 - take 500mcg per day sublingual ( under the tongue for better absorption ). The B12 you choose should include: Methylcobalamin and Cyanocobalamin DO NOT MIX Multivitamins containing Iron with your Calcium supplement - take these 2 hours apart

6 VITAMINS VITAMIN RECOMMENDED DOSE VITAMINS PER DAY Gastric Sleeve VITAMINS PER DAY Gastric Bypass Multivitamin w/ Minerals 100% RDA of Zinc and Iron One One in the AM One in the PM ( at different times ) B mcg One ( after the 3 month visit with your surgeon ) One ( after the 3 month visit with your surgeon ) Calcium Citrate / Vitamin D 1,200 to 1,500 mg/day 3,000 iu/day 2-3 chews 500mg / V-D ( best to contain magnesium ) 2-3 chews 500mg / V-D ( best to contain magnesium ) Biotin Optional One One Elemental Iron 18-27mg per day To be determined To be determined Protein 70 grams per day 70 grams per day 70 grams per day