Nutrition for Bariatric Surgery

Surgical Clinic of Louisiana POB Suite South 860

1111 Medical Center Blvd. Marrero, LA 70072

Phone: (504) 349-6860 Fax: (504) 349-6865

Marian Vigo, MSPH, RDN, LDN, CSOWM Email: Marian.Vigo@LCMChealth.org

Phone: (504) 349-1402 Fax: (504) 349-6076

Dietitian

Pre-op Liquid Protein Diet Two weeks prior to surgery, you will start a liquid protein diet. This will help you lose

a modest amount of weight before surgery, as well as reduce risks of complications

during surgery. The first 12 days should consist of: 2-3 protein shakes, and

one meal of lean protein and vegetables. The last two days should consist of

3-4 protein shakes (if using protein powders, mixed with water only) and clear liquids.

Your goal should be to get at least 60 grams (g) of protein per day,

Ready-to-Drink Protein Shakes Grams (g) of

Sugar per

Serving

Grams (g) of

Protein per

Serving

Grams (g) of

Carbs per

Serving

Pure Protein 35g Shakes: Cookies ’n Crème, Vanilla Cream, Frosty

Chocolate, Banana Cream, Strawberry Cream

1

35

4

Pure Protein 23g Shakes: Cookies ’n Crème, Frosty Chocolate, Rich

Chocolate, Vanilla Cream 1 23 4

Atkins Shakes: Cookies and Crème, French Vanilla, Strawberry, Ca-

fé Caramel (contains caffeine), Mocha Latte (contains caffeine), Dark

Chocolate Royale, Milk Chocolate Delight

1 15 3-5

Atkins Lift Protein Drink: Berry, Lemon, Orange 0 20 1-2

Muscle Milk 100 Calorie: Chocolate, Vanilla Crème 0 20 4

Muscle Milk PRO Series: Crushing Cookies ‘N Crème,

Go Bananas, Intense Vanilla, Knockout Chocolate 1 40 8-10

Muscle Milk Genuine/Coffee House: Banana Crème, Chocolate,

Strawberries ‘N Crème, Chocolate Caramel Kick, Cookies ’N Crème,

Vanilla Crème, Vanilla Latte (contains caffeine), Mocha Latte

(contains caffeine), Café Latte (contains caffeine)

0 20-25 5-11

EAS AdvantEDGE: Strawberry Cream, Milk Chocolate,

Creamy Vanilla, Deluxe Dark Chocolate 0 15-17 3-5

EAS 100% Whey: Chocolate, Vanilla, Strawberry 1 30 5-7

ICONIC: Chocolate Truffle, Vanilla Bean,

Café au Lait (contains caffeine) 3 20 8

Smoothie King “The Gladiator” (20oz) *without fruit*:

Vanilla, Chocolate, Strawberry 3 45 1

Premier Protein: Chocolate, Strawberries & Cream, Bananas &

Cream, Vanilla, Caramel, and Clear (Orange Mango, Raspberry, and

Tropical Punch)

0-1 20-30 1-2

Isopure Zero Carb: Grape Frost, Apple Melon, Lemonade, Coco-

nut, Blue Raspberry, Pineapple Orange Banana, Peach Mango, Pas-

sion Fruit, Icy Orange

0 40 0

GNC Total Lean Shake: Vanilla Bean, Banana Cream,

Strawberries & Cream, Swiss Chocolate, Snickerdoodle 2-3 25 6

Mix protein powder according to package directions with skim milk or water. Protein powders can easily be found at the West Jeff Fitness Center, GNC, Vitamin Shoppe, Target, Wal-Mart, Sam’s Club, Winn-Dixie, Rouses, and on many

websites. Make sure to always read the nutrition labels before purchasing. Also, try all your new protein foods and powders in small quantities first.

Protein Powders

Protein Powders Grams (g) of

Sugar per

Serving

Grams (g) of

Protein per

Serving

Grams (g) of

Carbs per

Serving

Pure Protein: French Vanilla, Chocolate, Mixed Berry, Rich

Chocolate 5 15-25 3-8

EAS 100% Whey Protein: Vanilla, Chocolate, Strawberry 2 23-30 7

Muscle Milk 100 Calorie: chocolate, vanilla crème 0 15 9

Isopure Zero/Low Carb: Alpine Punch, Apple Melon, Bana-

na Cream, Cookies & Cream, Creamy Vanilla, Dutch Choco-

late, Mango Peach, Mint Chocolate Chip, Pineapple Orange

Banana, Strawberry & Cream, Toasted Coconut

0 42-50 0-10

Whey Gourmet: Chocolate, Strawberry Banana, Vanilla, Pea-

nut Butter Chocolate 3.5 20-21 3-4

Unjury: chocolate splendor, classic chocolate, vanilla,

strawberry sorbet, chicken soup, unflavored 2 20-21 0-4

Syntrax Nectar (Whey Protein Isolate): chocolate truffle,

strawberry kiwi, roadside lemonade, lemon tea, fuzzy navel 0 23-25 0

Cytosport 100% Whey: cocoa bean, cookies ‘n crème, straw-

berry banana, vanilla bean 3 18-27 1-3

Musclegen Genepro: Unflavored 1 30 1

New Whey Liquid Protein: Grape, Watermelon, Fruit Punch,

Acai Berry 0 42 0

Chike: chocolate bliss, strawberry burst, orange crème, banana

magic, very vanilla, Original Iced Coffee (contains caffeine),

Mocha Iced Coffee (contains caffeine)

3 20-28 9-12

Bariatric Advantage High Protein Meal Replacement: un-

flavored, banana, vanilla, orange cream, chocolate, strawberry,

iced latte

1 27 8

Body Fortress: Strawberry, Chocolate, Vanilla, Chocolate

Peanut Butter, Mocha Cappuccino (contains caffeine), Banana

Crème, Cinnamon Swirl, Cookies n’ Crème

3 20-30 7-9

Step 1: Check the serving size of the product,

this tells you the amount of food that the rest

of the label describes

Step 2: Notice the amount of calories in one

serving. After surgery calorie intake is very

low. Please note that food labels are made

based on a 2,000 calorie per day diet.

Step 3: The % Daily Value shows what

percentage of your daily needs this food

provides for a 2,000 calorie per day diet.

Step 4: Total Fat, Saturated Fat, Cholesterol

and Sodium are all nutrients that should be

limited each day. Choose foods that have less

than 20% Daily Value for these nutrients.

After surgery, total fat should be limited to

30-45g per day. Trans Fats should be com-

pletely avoided.

Step 5: Dietary Fiber, Protein, Vitamins and

Minerals are nutrients that are important to

get every day. Protein requirements for bari-

atric patients are a minimum of 60g per day.

Nutrition label: MUSCLE MILK® LIGHT

Reading the Food Label

Food Labels W E S T J E F F E R S O N F I T N E S S C E N T E R

S P E C I A L P O I N T S

O F I N T E R E S T

F O R B A R I A T R I C

P A T I E N T S :

• Carbohydrates

should be less

than 15g

(grams) per

serving*

• Total sugars

should be

restricted to

0-5g per

serving

• Protein should

be at least 15g

of protein per

serving

Protein is a

must!

5 0 4 - 3 4 9 - 6 1 6 4

Clear Liquids For the first week after surgery you will be on a clear liquid diet. * Day 3 after surgery, may start drinking watered down protein drink. Examples of acceptable clear liquids: • Sugar free Crystal Light, sugar free Kool Aid, and other sugar

free drink mixes • Herbal tea, caffeine free tea (no added sugar) • Sugar free popsicles • Sugar free Jell-O • Water • Broth • Clear liquid protein supplements

Full Liquids By week 2 you should be able to progress to a full liquid diet (follow your doctor’s orders!). Your full liquid diet should be high protein, sugar free, and low fat. Remember to sip liquids; do not gulp! The following are examples of full liquids: • Skim or 1%, no sugar added: cow’s milk, Fairlife, Lactaid milk, soy milk, etc. • Low-fat, strained or pureed creamy soups (smooth, no pieces of food) • Liquid protein supplements • Low carbohydrate yogurt, NO fruit pieces • Sugar free pudding • Cottage cheese • Sugar free applesauce • V-8 juice or V-8 Splash Lite • Thinned cream of wheat or rice cereal

Clear and Full Liquid Diet After Surgery

Additional Information • During the clear and full liquid diet phases you need to consume at least 60g of protein and

48 oz. (6 cups) of fluids per day (this includes the liquids from your protein drinks).

• Start with 1/4 cup and give yourself 15 minutes to sip it. If you want

more, give yourself another 15 minutes to sip another 1/4 cup.

• Sip on protein drinks or sugar free beverages all day.

• Avoid caffeinated, carbonated, and alcoholic drinks .

• Be cautious with milk: try 1/4 cup at a time. If you experience

intolerance (gas, cramping, bloating, diarrhea) make sure you are drinking

low fat (1% or skim) milk. If you continue to have problems, try

lactose-free milk, such as Lactaid or soymilk.

• Make sure to take your multivitamins every day!

High Protein Soft Diet

Week 3 post-surgery you should be able to follow a soft diet. This diet stage will last anywhere from a couple weeks to a couple months. Foods should be the con-sistency of soft baby food. Always eat protein-rich foods first to: help maintain muscle mass, increase healing, and increase weight loss. Protein-rich foods in-clude: milk, yogurt, cheese, eggs, soft meats, seafood, and beans. Eat 3-5 “meals” per day (2-4 Tbsps. each) with a protein drink in between meals to meet protein needs. Signs of inadequate protein intake are: hair loss, delayed wound healing, and muscle breakdown.

Your goal should be at least 60 grams of protein and 64 ounces of fluid every day.

Remember no liquids with meals. Do not drink within 30 minutes before or after

eating. Chew foods slowly and stop eating when you feel full. Avoid any foods

that are high in sugar, high in fat, high in starch, and are crunchy. Additionally,

avoid fruits canned in syrup and vegetables cooked with oil, butter, or bacon.

Examples of acceptable soft foods:

• Soft cooked vegetables (no corn)

• Ripe fruits (no peel)

• Fish

• Lean meats cooked tender and cut into small pieces

• Canned tuna or chicken (packed in water) • Strained baby food meats or homemade pureed lean meats and shrimp • Beans (red, white, black, lima, pinto, fat free refried) and lentils • Low fat/fat free cottage, mozzarella, or ricotta cheese • Boiled eggs, scrambled eggs, or egg beaters • Strained soups • Sugar-free pudding • Mashed tofu • Low fat yogurt or pudding • Non-fat dry milk powder (add to low fat soups or sugar

free pudding)

Soft Diet After Surgery

AVOID

• Caffeine (at least for the first 2 months) because it can dehydrate you

• Alcohol: alcohol is just empty calories that will impede weight loss efforts

• Carbonated beverages: causes gas, bloating, and can possibly stretch the stomach pouch

Your goal should be at least 60 grams of protein and 64 ounces of fluid per day. Aim for 3-4 small meals and 2-3 protein drinks per day, with liquids in between. Sip fluids continuously between meals. Drink at least 1/4 cup every 15 minutes.

1/4 cup fluids = 2 oz. = 4 Tbsp.

Sample Soft Meal Plan

8am 1 egg or 1/4 cup egg beaters or egg whites

9am 1 cup water, decaf coffee, or decaf unsweetened tea

10am Protein drink, 20g protein

11am 2 Tbsp. low-fat cottage cheese, 1 Tbsp. pureed peaches

12pm 1 cup water or crystal light

1pm 2 Tbsp. pureed chicken breast, 1 Tbsp. pureed carrots

2pm 1 cup water or sugar free lemonade

3pm Protein drink, 20g protein

4pm 1 cup water, decaf coffee, or decaf unsweetened tea

5pm 1 cup high protein creamy chicken soup, 14g protein (recipe below)

6pm 1 cup of water or sugar free Kool aid

7pm Protein drink, 20g protein

8pm 1 cup of water

Pureed Recipe Ideas*

High Protein Creamy Chicken Soup (Provides 14g protein per 1 cup serving)

Mix 1/3 cup nonfat dry milk powder, 1tsp chicken bouillon, and 1/2 scoop unfla-

vored protein powder

Add enough warm water to equal 2 cups

Note: soup may clump if water is too hot

High Protein Pudding (Provides 14g protein per 1/2 cup serving)

Add 2 scoops protein powder to 2 cups cold skim milk and mix well.

Stir in dry Jell-O sugar free instant pudding mix. Chill and enjoy!

Cottage Cheese and Fruit (Provides 12g protein per 1/2 cup serving)

Blend 1 cup non-fat or 1% cottage cheese, 1/2 cup canned

fruit (in own juice/low-sugar), and 1/2 cup 100% fruit

juice in a blender. Makes 2 servings.

* ask dietitian for more pureed recipes

Vitamin and mineral supplements are a mandatory part of bariatric

surgery. You will take these for the rest of your life! Make sure to talk to your

doctor, surgeon, or dietitian if you have questions about proper vitamin/mineral

supplementation, types, and amounts.

Vitamins are only appropriate in: chewable (not gummy), liquid, or capsule.

Vitamin Supplementation

Vitamins needed Post-Surgery (Daily)

• Adult Strength Multivitamin: must provide at least 200% RDA (DV%) for

Iron (16mg Men & 36mg Women), Folic Acid (800mcg), and Thiamine (3mg).

It is best if multivitamin also contains selenium, copper, and zinc.

• Vitamin B12: 350 micrograms (mcg) per day.

You can also get a monthly B12 injection from your primary care physician.

• Calcium Citrate with Vitamin D: 1200-1500mg per day

*take at least 2 hours apart from your multivitamin to maximize absorption.

Breakfast Lunch Dinner Bedtime

B-50 Complex and

Calcium Citrate:

500-600mg

Calcium Citrate:

500-600mg

Adult Strength

Multivitamin

Calcium Citrate:

500-600mg

Physical activity is essential to achieving and maintaining your weight loss.

Being active and exercising right after surgery will help you feel better, recover

faster, and minimize the likelihood of post-surgical complications. You should

choose an exercise program that is appropriate for your fitness level. A personal

trainer or physical therapist can assist you in setting exercise goals and adjusting

them as needed.

Physical Activity

Things to consider

• Choose a form of exercise that you enjoy and know you want to

participate in

• Find a friend or family member to exercise with

• Join an exercise club and/or group fitness classes

• Listen to your favorite music while you exercise

• Park in the farthest location from your destination and walk

• Always use stairs instead of elevators, whenever possible

• Prioritize exercise in your daily schedule

• Keep a journal of your activities

West Jefferson Fitness Centers • 2 locations

• 2 registered dietitians on staff

• Marrero has a swimming pool

• Oakwood has childcare

• 14 excellent personal trainers

• Dozens of group fitness classes

• Bootcamp classes available

• Updated equipment

Locations

Marrero

1121 Medical Center Blvd.

Marrero, LA 70072

(504) 349-6164

Terrytown

(next to Oakwood Mall)

175 Hector Avenue

Terrytown, LA 70056

(504) 349-6908

Bariatric weight loss surgery is designed to help people lose weight after previous attempts at weight loss have failed. Safe and successful weight loss requires a

permanent commitment: you must be committed to changing your current eating habits and behaviors in order to develop and maintain substantial weight loss.

Why should I follow these diet guidelines? If you do not adhere to your diet and supplement regimens, you may develop nutrient deficiencies which may have negative consequences to your health. Additionally, you may not achieve maximal weight loss, or your rate of weight loss may slow down.

The following guidelines should be followed immediately after surgery, as well as for the rest of your life. • Eat slowly: eating too quickly can over fill your stomach and cause discomfort • Eat and drink small amounts at a time: learn to sip. Do not fill your entire

mouth with food or fluids. Use a baby spoon or a 2oz medicine cup to assist with this • Stop eating or drinking when you feel full: Do not overeat. Listen to your body.

If you are not able to recognize fullness, then eat only the quantity of food recom-mended. Overeating can stretch your stomach and prevent optimal weight loss.

• Chew food thoroughly before swallowing: Large chucks of foods can get caught and cause discomfort. Try to chew each bite 30 times before swallowing.

• Drink adequate fluids between meals: drink at least 64oz (8 cups) a day to avoid dehydration. NO drinking with meals.

• Eat protein rich foods first: aim for more than 60g of protein a day to promote healing, and help you maintain lean body mass while losing weight

• Keep your food choices sugar-free and low-fat: foods high in sugar and fat can cause dumping syndrome, and can inhibit maximum weight loss

Nutrition Guidelines and Foods to Avoid

Foods to Avoid

High in Fat/Sugar Tough/Crunchy May add to diet 3 months

after surgery

High fat milk (whole, 2%) Tough or dry meats Raw veggies

Butter, margarine, oil, mayo Corn Plain, unsalted nuts

Ice cream, candy Granola/cereal with nuts Light or air-popped popcorn

Cakes, cookies, pies, desserts Shredded coconut Lettuce

Sour cream, cream cheese, salad

dressing Starchy Foods Foods to ALWAYS Avoid

Fried foods Bread, rice, pasta, cereal Sugary drinks

Luncheon meats Cooked cereals (grits, oatmeal) Carbonated beverages

Sausage, bacon Crackers, pretzels, chips Alcohol

Gravy Corn, peas, potatoes Straws

The resources listed on this page may be helpful for patients who wish to have

weight loss surgery, or who have already undergone weight loss surgery.

West Jefferson Fitness Center offers a free support group on the 4th Monday of every

month, at 6:30 pm, for all interested in the surgery. *3rd Monday in December.

Helpful Resources

• Gastric Sleeve Support Group on Facebook

• Bariatric Recipes on Pinterest

• CheatClean Cookbook: QuestNutrition.com/Cookbook

• The World According to Eggface:

TheWorldAccordingToEggface.blogspot.com

• Unjury Protein Recipes: www.Unjury.com/blog/recipes/

• Bariatric Advantage: BariatricAdvantage.com/Catalog

• West Jeff Medical Center Surgical Weight Loss:

WJMC.org/WeightLoss

• Bariatric Eating: BariatricEating.com

• Obesity Action Coalition: ObesityAction.org

• “Eating Well After Weight Loss Surgery” by Patt Levine and Michele

Bontempo-Saray. Marlowe & Co. Press, 2004

• “Exodus from Obesity: The Guide to Long-Term Success After Weight Loss

Surgery” by Paula Peck. BP Press, 2004

• “The Don’t Diet, Live-It Workbook” by Andrea LaBue and Marsea Marcus

• Online Food Databases:

• MyFitnessPal.com

• CalorieKing.com

• Baritastic App

• ndb.nal.usda.gov