Page 12 Patient Education Questions? Your questions are important. Call your doctor or health care provider if you have questions or concerns. UWMC clinic staff are also available to help. Dietitian/Diet Technician: Follow These Guidelines 1. Eat 5 to 6 meals a day. At first, you may be only able to eat a half a cup at a time. 2. Cut your food in small pieces and chew it well. 3. Eat and drink slowly. 4. 8 to 10 cups of liquid each day (1 cup = ). 5. You need enough calories, protein, and nutrients for wound healing and to maintain your weight. 6. After discharge, if you lose weight for longer than 1 week, call the dietitian or diet technician. Esophageal Diet After Surgery Nutrition guidelines Since you had an operation that involved your esophagus (the tube that carries food and drink from your mouth to your stomach), you will not be able to eat and drink your normal foods for the first 4 to 6 weeks after surgery. Swelling in your lower esophagus and the narrowing created to stop your reflux makes it harder for food to go down. This booklet tells you what foods and drinks you may eat and which ones you should avoid after surgery. Box 356057 1959 N.E. Pacific St. Seattle, WA 98195 University of Washington Medical Center 11/2007 Rev. 02/2010 Reprints on Health Online: http://healthonline.washington.edu
Page 2 Page 11 Meeting Your Protein and Calorie Needs Your body may need more protein and calories for wound healing after surgery. This time of healing is not the time to try to lose weight. Protein needs are based on your ideal body weight. You will need extra protein right after your surgery to promote wound healing and to help rebuild muscle. Your Protein Needs You will need servings of protein each day until your healing is complete. Below is a list of common foods rich in high-quality protein. Each food listed is equal to 1 protein serving of 7 grams. 1 ounce cooked fish, poultry, or lean ground meat 1 egg or ½ cup liquid egg substitute 1 ounce cheese (melted) 1 cup milk (skim, 1%, 2%, or whole) 1 cup yogurt ¼ cup canned tuna or salmon 1 cup pudding 3 ounces tofu Supplement Additives These products may be added to drinks or foods to add extra nutrition (calories or protein). Protein Powders A variety of protein powder supplements are available. Mix with foods or drinks. Benecalorie 330 calories 7 grams protein 1 serving Polycose Liquid (Ross) 1 tablespoon 30 calories Add to juice, milk, soup, gravy, drinks, or blended foods. Polycose Powder (Ross) 1 tablespoon 23 calories
Page 10 Page 3 Two Cal HN 475 calories 20 grams protein 3 servings Instant Breakfast (Ready-to-drink) 200 calories 12 grams protein Instant Breakfast VHC (Nestlé) 560 calories 22 grams 3 servings Slimfast 11 ounces 220 calories 10 grams protein Slimfast High Protein 11 ounces 190 calories 15 grams protein Boosting Protein Here are some more tips for adding protein to your diet: Add 1 cup skim milk powder to a quart of whole milk. Blend and chill. Use this milk mixture for cooking as well as drinking. Use milk, milk mixture, evaporated milk, or cream instead of water for cooking hot cereal. Also, use these liquids instead of water to make instant cocoa, canned soups, custards, and pudding. Add extra pureed or chopped meat to scrambled eggs, omelets, or soups. For example, add chicken to cream soups or tomato soup. Add mashed, hard-cooked eggs to sauces, soups, casseroles, and chicken or tuna salad mixtures. Blend egg substitute into fruit juice, eggnog, or milkshakes. Eat desserts such as custard that are made with eggs. Try supplements or special drinks. Add grated cheese to vegetables, sauces, soups, and casseroles. Cottage cheese and canned fruit is a good between-meal snack.
Page 4 Page 9 Boosting Calories You need calories per day. Here are ways to add calories to your diet: Eat smaller meals more often, or divide your regular meals in half. For example, have an egg for breakfast and then have some canned fruit and cooked cereal for a midmorning snack. Add butter, margarine, or cream cheese to hot cereal, eggs, cooked vegetables, mashed potatoes, pasta, and soups. Use gravies and sauces on meats and vegetables. Use sour cream on top of fruits, meats, cream soups, and baked potatoes (without the skin). You can also add sour cream to sauces or scrambled eggs and omelets. Pour cream or evaporated milk over cereals, puddings, Jell-O, and fruit. Make puddings and custard with cream or evaporated milk instead of milk. Use whipped cream or ice cream on top of pies, Jell-O, pudding, fruit, or cocoa. Eat soft, mashed avocado or mild guacamole with meat or egg dishes. Make large casseroles and freeze extra servings for quick snacks later. Keep a cooler or a thermos filled with a favorite shake or soup next to your bed or chair. Eat cheesecake without the crust. Boost Diabetic (Novartis) 250 calories 14 grams protein Boost High Protein (Novartis) 240 calories 15 grams protein Ensure (Ross) 250 calories 9 grams protein Ensure Plus (Ross) 355 calories 13 grams protein Ensure Enlive (Ross) 300 calories 10 grams protein Resource Fruit Beverage (Novartis) 250 calories 9 grams protein Instant Breakfast (Carnation) 280 calories 12 grams protein
Page 8 Page 5 High-Protein, High-Calorie Supplements If you are having a hard time eating enough solid foods, try adding a liquid protein supplement to your diet. Supplements are found at most drugstores and grocery stores. Your pharmacist can order supplements that are not usually stocked. Most supplements come in a variety of flavors and do not contain lactose. You can add syrups, allowed fruit, instant coffee, or other flavorings to ones that are not flavored. Here are some supplements you may want to try: Boost (Novartis) 240 calories 10 grams protein Boost Pudding (Novartis) 5 ounces 240 calories 7 grams protein 1 serving Boost Plus (Novartis) 360 calories 14 grams protein Food Type Meats and Other Protein Sources Vegetables OK to Eat and Tender, moist fish, shellfish, and poultry; canned chicken; ground meat with gravy or sauces; moist casseroles with allowed ingredients; cottage cheese; soft eggs; tuna or egg salad without chunky ingredients; moist macaroni and cheese; plain or flavored yogurt (no fruit chunks) Vegetable juices; soft, wellcooked vegetables (should be able to mash with a fork) Do NOT Eat or Other red meats; lunch meats, hot dogs, sausage; bacon; casseroles with rice; dry casseroles; cheese slices or cubes (OK if melted in casserole); sandwiches; peanut butter; yogurt with nuts or dried fruits; pizza; or hard-boiled eggs Anything raw or fried; whole kernel corn; peas; dried beans; gasforming vegetables (such as Brussels sprouts, broccoli, or cabbage) Eating enough calories and protein helps with wound healing.
Page 6 Page 7 Food Type s Breads and Cereals Starches Fats OK to Eat and All except carbonated drinks Soft pancakes with syrup; moist cooked and dry cereal Well-cooked, moist potatoes; potatoes in sauces; wellcooked pasta in sauces Butter, margarine, salad dressing, mayonnaise, gravy, sour cream, whipped toppings, oils Do NOT Eat or Carbonated drinks: beer, soda, sparkling water All breads, rolls, crackers; whole-grain, coarse, dry, or cooked cereals; all cereals with dried fruits, nuts, or seeds Potato chips, potato skins, fried potatoes, rice All fats with chunks added Food Type Desserts Fruits Soups Sweets OK to Eat and Pudding, custard, ice cream, sherbet, frozen yogurt, and gelatin made with allowed foods; fruit ice, frozen pops; milkshakes; soft cake Fruit juices; cooked or canned fruits without seeds or skin; ripe bananas Soups made with allowed ingredients that are easy to chew and swallow Sugar, syrup, honey, jelly, plain chocolate Do NOT Eat or Cookies, pies; all sweets and desserts containing nuts, coconut, or dried fruit; bread pudding, rice pudding All other fresh and frozen fruits; cooked or canned fruits with skin or seeds; dried fruits; pineapple Soups made with rice or large chunks Nuts, coconut; chewy candy such as caramels and licorice; hard candies Eat a variety of foods from each food type. Other Mild spices, ketchup, mustard, sauces such as barbecue Pickles, popcorn, sticky foods, very spicy foods