Weight Loss Surgery – Post 0p Diet Guidelines

It is very important to follow the post-operative nutrition plan as noted in these guidelines. These guidelines were designed by our healthcare team to enable you to safely reach your weight loss goals while achieving adequate nutritional intake to prevent deficiencies.

You will progress slowly through 4 dietary stages over the course of the next 4 to 6 weeks.

These stages are not recommendations, but are rather necessary for the safe consumption of food while you are still healing from surgery.

Please refer to the list of foods that are suitable in each stage of your diet which you can find on the following pages.

Protein

Adequate protein intake is essential to prevent a nutritional deficiency and keep muscle mass. Protein also plays an important role in the postoperative healing process. Inadequate protein intake over time may also contribute to hair loss.
You must consume a liquid protein supplement at least 2 times per day to meet your protein requirements for healing and muscle mass preservation.

The daily goal for protein intake is at least 64 grams.

Keep track of your daily intake to make sure you get enough protein.

Protein supplements should be high protein and low carbohydrate. Choose a supplement that provides 25-30 grams protein and <5 grams carbohydrate per serving and 0 grams of added sugar.

Liquids

Consumption of an adequate amount of liquid, such as water o sugar free beverages is crucial. You should consume a minimum of 64 Oz quarts of liquid per day to prevent dehydration.

f you are drinking a total of 64 Oz of liquid per day, but your mouth is dry, your urine is dark or you feel dizzy when you get up, you could be dehydrated and should increase your liquid intake.
We recommend you keep track of your daily liquid intake to make sure you get enough liquids. If it is hot or humid outside and you are perspiring, you will need to increase the amount by 10%-20%.

Avoid caffeinated beverages on the first month of surgery and limit to <8 oz after the first month as these may lead to dehydration. Caffein may also irritate your stomach and esophagus.

Some patients report that regular water is harder to drink. Turning water acidic with lemon or lime juice or adding Crystal Light tames the problem.

Recommended Sports Drinks

Post-Op multivitamin and mineral supplementation

Lifelong supplementation is necessary as you will not be able to get all the necessary micronutrients in sufficient quantities to prevent deficiencies.
Begin with the supplements of vitamins and minerals must be in a chewable, liquid or dissolved form for the first month.

• Complete multivitamin – Make sure it has zinc (minimum of 12 milligrams) and copper (up to 2 milligrams), it can be liquid or chewable (not tablets or capsules). From the day of discharge.
• Biotin – 5.000 micrograms. After the first week.
• B12 (sublingual) 350 micrograms per day. After the first month.

• Calcium citrate – 1200 mg per day divided in 2 doses. Avoid taking your calcium and iron supple- ment at the same time as absorption of both will be affected. After the first month.
• Vitamin D – 2000 IU per day. After the first month.
• Probiotics – 1 daily on an empty stomach. Choose one that contains more than 1 billion bacteria and more than 3 strains of different bacteria. From the day of discharge. You can start with a chewa- ble presentation and then switch to capsules.

• Collagen – 10 grams dissolved in water daily on an empty stomach. Choose a supplement which only ingredient is hydrolyzed collagen. From the day of discharge.

We recommend you switch to a tablet or capsule form of supplements after the first month of surgery since chewable and liquid forms usually contain up to 5 grams of added sugar.

Meal structure

Eat meals and snacks at regularly scheduled times.

Eating tips

• Drink all fluids slowly, do not gulp, chug, or use straws. If you drink too fast or through a straw you may over fill your new stomach with liquid and/or air causing gas, pain, hiccups, nausea, and/or vomit.

• You must eat all meals slowly and always stop eating when you feel satiated even if you have not finished your appropriate portioned meal. Eating until you over fill your new stomach or eat too fast may cause pain, acid reflux, food intolerance, nausea or vomit.

• Introduce small bites of food and consciously chew all foods 25-30 times before swallowing.

• Do not eat your meals and drink fluids at the same time. Stop drinking 30 minutes before a meal and wait 30 minutes after a meal before drinking again. Eating and drinking too closely together may cause bloating, nausea, and vomit.

• Once you reach the soft diet it is still of most importance to avoid foods high in fat and sugar as this will affect your weight loss outcomes.

• Avoid alcohol for the first 3-6 months after surgery. Alcohol is known as empty calories which will affect your weight loss outcomes.

• Avoid drinking alcohol and sugar both can lead to vitamin and mineral deficiencies.

Stage 1: Clear liquid diet

Follow for 7 days from you discharge day
Goal: Staying hydrated and healing surgical injuries by ingesting 64 ounces of liquid and 64 grams of protein.

• A clear liquid diet is a diet consisting of foods or beverages made from see-through liquids.
• These foods should be sugar free, contain no added sugars, noncarbonated and caffeine free.
• Introduce new foods, one at a time and write down any problem of intolerance in your food journal, some foods that you could eat before surgery may not be tolerated after surgery.

Instructions:

• 1-2 ounces of fluid every 10-15 minutes should be taken as tolerated.
• Drink slow and take small sips, one at a time. If you drink too quickly you may experience pain and/or nausea.
• Do not drink fluids that are too hot or too cold for the first six weeks to avoid potential muscle spasms or pain.
• Avoid using straws as they may cause excess gas.
• Your daily goal for fluid intake is 64 ounces per day.

Permitted foods:

• Sugar free gelatin.
• Fruit or vegetable juice with no added sugar. Avoid the pulp. • Calorie free beverages.
• Low fat strained Soups & Broths.
• Electrolyte beverages.
• Caffeine free tea.
• Sugar free ice pops.

Stage 2: Full liquid diet

Follow for 7 days
Goal: 64 ounces of liquid and 70 grams of protein. Slowly increase your intake of fluids to 4 oz (120

ml) each hour.

A full liquid diet is a diet that includes all clear liquids with the addition of milk-based liquids and other foods which are listed below.

• These foods should be sugar free, contain no added sugars, noncarbonated and caffeine free.
• Introduce new foods, one at a time and write down any problem of intolerance in your food jour- nal, some foods that you could eat before surgery may not be tolerated after surgery.
• These foods should be sugar free, contain no added sugars, noncarbonated and caffeine free.
• Introduce new foods, one at a time and write down any problem of intolerance in your food jour- nal, some foods that you could eat before surgery may not be tolerated after surgery.

Instructions:

• Continue to consume 64 ounces of total fluid each day in between your meals.
• Consume at least 3 liquid meals per day plus 2 protein supplements in between each meal.
• Meals should not exceed 4 ounces or 1⁄2 cup in size. Start with 1-2 ounce meals and work up to 3-4 ounce meals.
• Remember to sip slowly to avoid nausea, vomiting, and discomfort.
• If you begin stage 2 and you are having trouble with full liquids, we suggest to go back to clear liquids for another day.
• Once you have tolerated Phase 2 for 7 days, you can advance to phase 3.

Permitted foods:

• All the permitted foods from the previous stage. • Protein supplement.
• Lactose free and low-fat milk
• Fruit free and sugar free plain Greek yogurt.

• Sugar free soy or almond milk. • Creamy vegetable soup.
• Sugar free fruit smoothies.
• Sugar free pudding.

*Slowly sip your protein supplementation in between meals. You should consume at least 50 grams of protein daily from supplementation as you are only consuming ~15-20 grams protein from foods during this full liquid stage. It is important to also focus on meeting the minimum requirement of 64 ounces fluid each day.

Stage 3: Puree diet

Follow for 7 days
Goal: 64 ounces of liquid and 75 grams of protein

Puree diet provides a complete diet and is based on food with a puree-based preparation. No chunks or solid material.

• Introduce new foods, one at a time and write down any problem of intolerance in your food jour- nal, some foods that you could eat before surgery may not be tolerated after surgery.

Instructions:

• Continue to consume 64 ounces of total fluid each day in between your meals.
• Consume at least 3 puree meals per day plus 2 protein supplements in between each meal.
• Meals should not exceed 4-6 ounces.
• Chew all food items 25-30 times.
• Focus on eating protein first.
• If you are having trouble finishing your food during each meal, it is perfectly fine to take a 30 minute or longer break and then continue eating. Try to finish your food for the day but never if it means pushing your stomach to eat more than you feel it can hold. If eating some foods cause discomfort, then stop eating it and wait until stage 4.

Permitted foods:

• All the permitted food from previous stages.
• Chicken, turkey, fish, tuna and vegetable purée. • Panela or cottage cheese.
• Eggs.
• Noodle soup.
• Cooked oatmeal.
• Wheat cream.
• Fruit purée.

Stage 4: Soft diet Follow for 7 days

Goal: 64 ounces of liquid and 80 grams of protein.

A soft diet is a diet that includes all clear and full liquids with the addition of soft, moist foods which are listed below. This stage consists of a healthy balanced diet, incorporating adequate amount of protein, vegetables, fruits, and whole grains.

Instructions:

• Continue to consume 64 ounces of total fluid each day in between your meals.
• Consume at least 3 soft meals per day plus 2 protein supplements in between each meal.
• Meals should not exceed 8 ounces.
• Focus on the protein food items first and stop eating when you feel full even if you have not finished your meal.
• Chew all food items 25-30 times.
• Introduce new food items one at a time and note any issues of intolerance in your food journal.

Permitted foods:

PROTEIN FOOD CHOICES:

• Soft cooked eggs or egg whites; limit yolks to 3 times per week. • Non-fat or low-fat cottage cheese or ricotta.
• Low fat soft cheeses.
• Greek yogurt.

• Canned chicken or fishes moistened with low-fat mayo, mustard, salsa; no raw vegetables.
• Boiled or stewed soft cooked white meat poultry.
• Baked or poached fish filet.

• Tofu.
• Cooked beans, lentils, legumes.

FRUITS AND VEGETABLES (1/4 CUP MAXIMUM SERVING):

• Avoid fibrous vegetables and fruit such as celery, cabbage, corn, asparagus, grapes and citrus membranes.
• Canned fruits (drained).
• Mashed ripe banana.

• Unsweetened applesauce.
• Canned vegetables (drained).
• Soft cooked zucchini, squash, broccoli, cauliflower, carrots, green beans.

GRAINS/STARCHES (1/4 CUP MAXIMUM SERVING):

• Oatmeal or cream of wheat thinned with skim, soy or almond milk (unsweetened). • Mashed potato thinned with skim milk.

OTHER:

• Herbs and spices.
You may not tolerate:

VEGETABLES: artichokes, alfalfa, celery, raw broccoli, raw onion, raw chayote, cabbage, cauliflow- er, lettuce, cucumber. Raw vegetables (add after 1 month of your surgery).

FRUITS: apricots, dates, pomegranate, guava seed, fig, watermelon. Membranes of orange and grapefruit, fruit and vegetable peels.

PROTEINS: octopus, squid, shrimp, crab, roast beef, pork ribs, yellow cheese. FAT: peanuts, fried foods, high fat foods/ sauces.

OTHER:

• Alcohol, carbonated beverages, high sugar foods, spicy herbs, condiments, or sauce.