Gastric Bypass Surgery Nutrition Handbook

Gastric Bypass Surgery Nutrition Handbook

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Table of Contents

Introduction to Gastric Bypass Diet ..................................... 1 Hydration/Beverages............................................................ 2 Stage I Diet .......................................................................... 3 Stage II Diet ......................................................................... 4 Stage III Diet ........................................................................ 6 Stage IV Diet........................................................................ 8 How to Measure Foods ........................................................ 9 Vitamin & Mineral Supplementation ................................. 10 Protein Power ..................................................................... 14 Food Intolerances ............................................................... 16 Dumping Syndrome ........................................................... 18 Interpreting Food Labels .................................................... 20 Frequently Asked Questions .............................................. 23 Tips for Success ................................................................. 24 Helpful Resources .............................................................. 27 Contact Information ........................................................... 29

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Diet After Gastric Bypass Surgery

Gastric bypass surgery is not a magical procedure for losing weight. It is not a "quick fix." You will only be successful if you change the way you eat for the rest of your life. This handbook gives an overview of what you need to know.

The surgery works in two different ways:

First, the surgery reduces the amount your stomach will hold from 1000 ml (4 cups) to 30 ml (2 Tbsp). 1000 ml is about the size of a football, and 30 ml is about the size of a hardboiled egg. This reduces the amount of food you can eat at any one time (which is called restriction). You will feel full after eating very small meals and will therefore eat less overall.

Second, food bypasses part of your intestine, which reduces how much is absorbed from the foods you eat (which is called malabsorption). Some people cannot tolerate sugary and fatty foods after surgery because of the new changes, which helps them to avoid these high-calorie foods.

Combined with regular exercise, the gastric bypass diet will help you lose weight and keep it off. Most patients will lose up to 50-70% of their excess body weight within two years. However, if you do not follow the nutritional guidelines, you can develop health problems and can even gain the weight back. Besides developing good eating and exercise habits, ongoing counseling can help to create new attitudes towards food and prevent bad habits from returning. The information provided in this booklet will help you develop new eating patterns and ensure a healthy weight loss.

Ask a member of our program staff if you have specific questions or concerns related to this surgery.

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Hydration/Beverages

? Drink at least 48 oz (ounces) hydrating fluid daily with a goal of 64 oz. You need extra hydrating fluid when you exercise or spend time in the sun, as you lose water with perspiration.

? Avoid drinking with meals, or 30 minutes before/after meals. Drinking around meals can make you too full to eat the nutritious foods you need, or cause you to become sick.

? Avoid caffeine for 1-2 months after surgery, as caffeine can be irritating to the stomach as well as dehydrating. If you are drinking >64 oz hydrating fluid per day, you can have an 8 oz caffeinated beverage. If drinking more caffeinated beverages, you need additional hydrating fluid. (Note: Decaf coffee can also be irritating to your stomach after surgery and should be avoided during Stage II diet.)

Meeting your daily fluid needs helps to:

9 Prevent dehydration 9 Prevent constipation 9 Get rid of your body's waste products 9 Keep you full between meals

What counts as hydrating fluid:

* water * decaf coffee * lowfat milk

* sugar-free drinks * sugar-free jello * sugar-free popsicles

* decaf tea * protein drinks * broth

Beverages to limit (use occasionally only):

* whole milk * sports drinks

* juice

* coffee (caffeinated) * soda

* tea (caffeinated)

* alcohol

* carbonated beverages

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Stage I Diet ? Clear Liquids

For immediately after surgery

The first stage is a clear liquid diet and usually lasts for 1-2 days after surgery. You will receive a tray with appropriate food items while you are in the hospital. During this stage of the diet, you should sip fluids very slowly. Your meals should be about 1/2 cup in size. All liquids should be non-carbonated, since liquids with carbonation (fizz) can put pressure on your small stomach pouch. Fluids should be decaffeinated as caffeine is an irritant to the digestive tract.

Your diet will be advanced to Stage II after you are tolerating Stage I foods well. You should be on Stage II diet before you are discharged from the hospital.

Sample Menu (T = tablespoon)

Breakfast 2 T apple juice 3 T chicken broth 3 T diet gelatin

Lunch 2 T cranberry juice 3 T beef broth 3 T diet gelatin

Dinner 2 T grape juice 3 T chicken broth 3 T diet gelatin

Between Meals Water, Crystal Light, Fruit2O, Sugar-Free Kool-Aid, or Herbal Tea

(DHMC provides water and Crystal Light during your hospital stay. You can bring in other types of sugar-free beverages if you prefer.)

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Stage II Diet ? Lowfat Full Liquids

For 1-2 weeks before surgery & 3 weeks after surgery

You will be on the Stage II diet for 1-2 weeks before surgery to help prepare your body for the procedure. Then, you will follow this diet for 3 weeks after surgery to allow your stomach to heal.

Your stomach will be swollen for several weeks after surgery, and you may find it difficult to eat the appropriate quantities of food, meet fluid and protein goals and follow the vitamin/mineral supplement guidelines. This should get easier over time as the swelling decreases. A list of appropriate foods is provided on page 5, and a sample menu is printed below. Throughout the 3 weeks after surgery, your meal size should be about ? cup (8 T) in size.

Sample Menu (c = cup)

Breakfast ? c. Cream of Wheat ? c. plain or smooth reduced-calorie ("light") yogurt

Lunch ? c. strained soup ? c. sugar-free pudding

Dinner ? c. strained soup ? c. reduced-calorie ("light") yogurt

Between Meals (space out over the day ? for a total of 2 cups) Two ? c. servings of lowfat milk with Reduced Sugar/Carb CIB Two ? c. servings of lowfat milk with protein powder Low/No calorie fluids

Note: Avoid pepper, herbs and spices during this Stage, to prevent small particles from getting stuck.

Pre-Op: When instructed to follow this diet before surgery, you should not limit the quantity to ? cup. Eat a normal-sized meal.

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Stage II Grocery List

Nonfat or 1% milk Plain soy milk of Lactaid milk, if preferred Reduced-calorie ("Light") smooth yogurt (no chunks)* Plain yogurt Sugar-free custard mix Sugar-free pudding mix Reduced Sugar/Carb Carnation Instant Breakfast (CIB) Nonfat dry milk powder Soy or Whey protein powder Lowfat cream or tomato soup (strained)* Cream of Rice cereal (unsweetened) Cream of Wheat cereal (unsweetened) Unsweetened, pulp-free juice (limit to 4-8 oz per day) Unsweetened applesauce Infant strained fruits Herbal tea Crystal Light Sugar-Free Kool Aid Fruit2O water Bottled water, if desired (tap water is also okay) Artificial Sweeteners, if desired (Examples: Splenda, or

Sweet-n-Low, Equal, Stevia)

*Use a strainer to make sure foods/liquids are smooth (chunk-free).

Note: It is okay to use low-calorie flavorings for cream of rice/ wheat cereals or plain yogurts. Some examples are: cinnamon, unsweetened applesauce, infant strained fruit, sugar-free syrup, protein powder, No-Sugar-Added Carnation Instant Breakfast powder, sugar-free Jell-o or pudding powder, flavored extracts (vanilla, almond, orange, root beer, etc). Be creative!

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