What eating habits should I begin to practice prior to surgery?
It is helpful to start practicing good eating habits and adjusting to certain guidelines prior to surgery to ensure an easy transition and
- Practice eating meals without consuming liquids. This can be a difficult habit to break so it is best to start this now.
- Stop using a straw when drinking. This is important after surgery to avoid introducing air into the stomach, which can cause discomfort.
- Practice drinking at least 64oz (2 liters) of fluid each day. Be sure all beverages are sugar-free, and contain less than 5grams of carbohydrates and less than 5 calories per serving.
- Reduce/avoid consumption of caffeine and carbonated beverages.The acid from caffeine can erode the lining of the stomach, causing ulcers. Caffeine is also a natural diuretic and can cause dehydration after surgery. Carbonated beverages introduce air into the stomach, causing gas.
- Eat 3 meals per day. It is important not to skip meals. Eating consistent meals helps maintain a good metabolism and will prevent you from overeating at the next meal. Be sure to include protein with every meal.
- Eat slowly. Eating slowly can increase your awareness for when you become full and can prevent overeating. You will need to eat slowly after surgery to avoid vomiting. It should take you at least 30 minutes to eat a meal. Stop eating when you feel full. Practice chewing each bite 25+ times; you will need to do this after surgery.
Why does my diet have to be starch free 3 weeks before surgery? What foods are permitted/not permitted?
A diet high in carbohydrates can cause inflammation or enlargement of the liver. Since the liver overlays the stomach, it must be lifted in order for the surgeon to preform surgery on the stomach. The larger the liver, the more difficult it is to maneuver it. By following a low carbohydrate diet is followed prior to surgery, the liver can “shrink” in size, allowing for an easier and safer procedure. Limit carbohydrates to =50 grams/day.
Starchy foods include corn, potatoes, peas, cereal, bread, grains (rice, oats, quinoa, etc.), pasta, popcorn, and tortillas. Fruit and dairy are permitted during the 3 week period before surgery.
What beverages are acceptable on the clear liquid diet?
(Clear liquid diet should be followed 48 hours before surgery.)
Any liquid that you can see through is permitted in the clear liquid diet, including water, sugar-free drinks (PowerAde Zero, Propel Zero, Vitamin Water Zero, Crystal Light, etc.), Isopure Zero Carb Protein drink, Designer Whey 2Go Protein Water, Special K Protein Water, herbal tea, broth, sugar-free popsicles (red is acceptable), and sugar-free gelatin (red is acceptable).
What is the diet progression after surgery?
|Week 1 after surgery||Full Liquids
Pourable liquids (protein shakes, skim milk, unsweetened almond milk, water, yogurt smoothies, soups)
|Week 2 after surgery||Pureed Diet (baby food consistency)
Full liquids, pureed cottage cheese, blended meats, blended soups and beans.
|Weeks 3 & 4 after surgery||Soft Diet
Moist soft foods exclude tough meats, hard cereals, raw veggies or tough fruits with skins
|1 Month after surgery||Regular Diet
Reintroduce tougher, drier meats. (Wait six weeks after surgery to consume raw vegetables.)
Why can’t I drink with my meals after surgery?
Since your stomach will be significantly smaller after surgery, it is important to utilize the small space as best as possible, to consume your daily protein recommendations. Adding fluid to a stomach full of food following surgery, is similar to pouring water into a clogged drain; vomiting will occur. Fluid causes food to expand in the stomach, which can cause discomfort, nausea, and vomiting. Drinking with meals can also cause the food to empty from the stomach faster. The faster the food we consume leaves our stomach, the longer it takes us to feel full, which often leads to overconsumption. It is recommended to wait 30 minutes after the last sip to begin eating, and 30 minutes after the last bite to start drinking.
How much fluid should I be drinking every day? Why is fluid so important after surgery?
After surgery, you should consume at least 64oz. of fluid every day. You will not be able to "guzzle"? or chug fluids with your new stomach. It is best to sip constantly throughout the day at a rate of 4-8oz. per hour. Initially after surgery, you will be given 1 oz medicine cups full of water every 10 mins. It will take about 11 hours to consume 64 oz of fluid 1 oz every 10 mins = 3 oz every 30 minutes = 6 oz every hour.
Nearly all body processes depend on water for proper functioning. Drinking plenty of fluids can help prevent constipation. Consuming plenty of fluids helps flush waste from the body. Many waste products are expelled in the urine as a result of weight loss. Proper hydration helps prevent these substances from forming crystals, which can cause the formation of kidney stones.
Dehydration is the number one cause for post surgical complications/ER . Symptoms of dehydration include constipation, sluggishness, light-headedness, muscle weakness, and increased heart rate.
How much protein should I be consuming after surgery?
Your protein requirements after surgery are based on your height.
|If your height is between:||Your protein needs:|
|4’10 and 5’2||70 grams|
|5’3 and 5’7||80 grams|
|5’8 and 5’11||90 grams|
|6’0 and 6’4||100 grams|
It is very important to meet your daily protein requirements. It is okay to consume more than the daily required amount.
Why is protein so important after surgery?
Protein is crucial for the healing process after surgery. The body uses protein to repair and rebuild tissue. Protein is also important to maintain lean muscle mass. Lean muscle mass helps increase metabolism, which helps our bodies utilize calories more efficiently. Meeting your daily protein requirements can also help reduce hair loss after surgery and help with regrowth. High protein foods such as lean meats and fish, eggs, and low-fat dairy products are the best source. Protein powders can be used to supplement your diet and help you reach your daily protein requirements.
What should I look for when shopping for protein products?
Be sure to choose a product with “Whey isolate” or “whey protein isolate” as the first ingredient. Whey isolate is a “complete” form of protein, which means it contains all 9 essential amino acids. These amino acids are considered essential since they cannot be made by the body, therefore; we must obtain them through our diet. Soy protein and pea protein isolate are considered “incomplete” proteins, meaning they are missing one or more essential amino acid. One way to think of this rule is whey protein is derived from milk, which is an animal product. Animal products contain all essential amino acids, while plant sources do not.
- <200 calories/serving
- 15-30gm protein
- <4gm of saturated fat
- <5mg of sugar
Where can I find protein products?
You can find whey protein isolate powder at GNC, Wal-Mart, Walgreens, CVS pharmacy, and Amazon. It is highly recommended to sample different products, when possible, before committing to one product. Check out VITALADY.com to order samples of different brands. Also, check out the GMBC Walgreens for samples!
Will I have to take vitamins after surgery? Will insurance pay for these?
You will need to take a multivitamin for the rest of your life to prevent deficiencies. For the first 12 weeks after surgery, supplements need to be chewable, liquid, or crushed. You will be required to take 2 multivitamins each day, in addition to 1500mg total of calcium citrate and 1000 IU total of vitamin D. Be sure that the multivitamin you select contains thiamin, 400mcg folic acid, and 18mg iron.
Many patients require a vitamin B12 supplement at some point.
Risk of iron deficiency is most common in pre-menopausal women but others can be at risk as well due to poor intake and impaired absorption. Make sure to get a total of 36mg of iron daily from your multivitamin or a separate iron supplement.
Vitamin D can be a common deficiency after surgery. Make sure you are getting at least 1000 IU of vitamin D from your calcium supplement. If not, take an additional vitamin D supplement to total 1000 IUs.
Thiamin (also known as B1) stores in your body deplete in 2-3 weeks. Severe deficiency can cause nausea and vomiting. Check your multivitamin to make sure it has thiamine.
You will also need to have at least yearly lab checks. Insurance almost never pays for vitamin and mineral supplements but usually does pay for labs.
Why can’t I take all my vitamin/mineral supplements at the same time after surgery?
Our bodies can only absorb a certain amount of nutrients at one time. It is important to take 1 multivitamin 2 separate times each day to ensure maximum micronutrient absorption. Calcium citrate must be taken at three separate times during the day for this same reason. Only 500-600mg of calcium can be absorbed at one time. It is best to separate calcium doses by at least two hours. Many patients find it easiest to take their calcium supplements with meals. Setting alarms on your phone can help remind you when it is time to take each supplement.
If I am currently taking a vitamin D supplement, can I stop taking it once I start taking my Calcium Citrate + D supplement?
No. There is only enough vitamin D in the Calcium+D supplement to facilitate the absorption of calcium. This supplement cannot be used to replace the vitamin D supplement you are prescribed.
Are gummy vitamin/mineral supplements acceptable after surgery?
No. The sticky texture is not desirable after surgery. Gummy vitamins typically contain 2-3 grams of sugar and 15-20 calories per serving. Also, many gummy vitamins are not complete, meaning they are missing one or more necessary vitamins/minerals. Finally, many types of gummy vitamins require you to take 2 gummies for 1 serving, which will double the 2 servings/day you are required to take already.
What can I do nutritionally to help reduce hair loss after surgery?
Hair loss may occur a few months after surgery. It usually improves after a few months. To help reduce hair loss and facilitate regrowth:
- Eat enough protein
- Take your supplements
- Add 2-5mg of biotin or take a specialty hair supplement like Biosil
- Add fish oil supplements
For information regarding special shampoos, please visit www.nicehair.org.
Will I be able to eat the same types of food I ate prior to surgery?
After surgery, some food can be uncomfortable to eat (particularly those that are dry, sticky, gummy, or stringy). Each individual responds differently to particular foods and most people discover which foods are best tolerated by trial and error.
Some patients may develop food intolerances after surgery. Although some intolerances are permanent, most resolve with time. If you have a bad reaction, try that food again in a few weeks. Possible intolerances include:
Try moist cooking methods such as boiling, pressure cooking, or using a slow cooker.
- Red meat
- Poultry (if dry)
- Raw vegetables
- Cooked vegetables with tough skins
- Stringy vegetables (celery, asparagus)
- Gaseous vegetables (broccoli, cauliflower, cabbage, Brussels sprouts).
If you become lactose intolerant, try:
- Sweet acidophilus milk
- Lactaid milk
- Dairy Ease
- Calcium-fortified soymilk
- Fruit with tough skin
- Dried fruit
- Hard fruit
- Citrus fruit
- Dense bread
- All nuts and seeds
- Legumes or beans
- Chunky peanut butter
- Chili or spicy food
- Fried or high fat food
- Sweets or sugary food
Dumping syndrome occurs when foods containing sugar or excessive amounts of salt are consumed. Sugary or salty foods draw excess water into the intestines. Symptoms include:
- Increased heart rate
- Low blood pressure
- Low blood sugar
How much food will I be able to eat following surgery? How often will I be able to eat?
Most patients are instructed to eat 1/4 cup, or 2 ounces, of food at each meal. As time goes on, you can eat more as tolerated (as instructed by your medical team). Most people can eat approximately 1 cup of food after a year or more following surgery.
What could happen if I don't follow one or more of the dietary guidelines?
The guidelines are designed to improve the chance of long-term success in weight loss. You may also experience complications such as vomiting, diarrhea, dehydration, malnutrition or deficiencies after surgery. Furthermore, you will not see the weight loss progress you desire.