You have already gone through life-changing weight loss surgery and have started making many adjustments, including behavior/lifestyle change, diet and nutrition changes. Following the guidelines of the post-op diet set by Mexico Bariatric Center’s surgeons and dietitians is a crucial part of the bariatric process aftercare. After gastric sleeve surgery, your stomach capacity is only 3 to 4 ounces, down from 60 ounces of capacity. To have a successful gastric sleeve procedure patients must follow the bariatric guidelines to facilitate weight loss and to reduce complications and side effects.
Guide to Bariatric Surgery Vitamins – The following must be taken every day for the rest of your life. Each surgical procedure has different requirements, so look for the list of your particular process.
Diet Smooth Recipes Guide – During your first four weeks following surgery, you will need to adhere to a diet beginning with liquids only and progressing to soft foods.
There are four primary nutrition goals to follow after surgery. They include consuming the right amount of protein that will help minimize the loss of muscle and help to heal. Patients should also learn how to eat properly, which will assist them with their long-term weight loss goals. Weight loss should occur in a safe and healthy way. Next, always consume enough fluids to maintain hydration. Lastly, consume the proper nutrients through vitamins and mineral supplements throughout the day.
Most patients will take an acid-blocking medication for at least 12 weeks following surgery, which helps reduce the risk of ulcers. A multivitamin, calcium citrate tablets, Vitamin B12 and other vitamins may also be recommended. BariatricSurgeryVitamins.com – Buy Bariatric Vitamins
Stages of Post-Operative Gastric Sleeve Diet
- Phase 1 – Clear Liquid Diet
- Phase 2 – Full Liquids Diet
- Phase 3 – Soft Foods Diet
- Phase 4 – Regular Foods Diet
Phase 1 – Clear Liquid Diet – (Typically occurs during the first 5-7 Days after surgery, but may vary)
(Typically occurs during the first 5 -7 Days after surgery, but may vary)
A clear liquid diet allows for healing time and to make sure that your body can tolerate anything by mouth. This phase takes a minimum of two days after your operation. At first, take in liquids every half hour – about two ounces at a time. Then gradually increase your intake of liquids to six to eight ounces every hour. Drink very slowly and refrain from gulping.
The Goal in Phase one is to stay hydrated- you want to consume a minimum of 48 ounces of fluids, optimal goal 64 ounces.
Things to Note:
- Sugary Drinks, Caffeinated Drinks or Carbonated Beverages can cause complications and side effects.
- Always consume beverages in small
- Patients must get enough liquids to prevent dehydration. It’s important to both calculate and record your intake daily.
- If urine is dark in color or your mouth is dry, you are not consuming enough liquids.
Approved Clear Liquids:
- Ice chips
- Flavored Water (Vitamin/Life water)
- Broth (Chicken or Beef)
- Sugar-free Jell-O
- Sugar-free Popsicles
- Herbal teas
- Light or diluted (60/40) juices (apple, white grape, cranberry)
CLEAR LIQUID DIET SAMPLE MENU
- Important: You do not weigh your fluids; you measure by volume. You can have as many fluids as your body wants. The minimum goal is 48 ounces to prevent dehydration.
- 6 ounces’ warm herbal tea (no milk/cream) or broth (warm fluids help in relaxing the stomach muscles)
- 8:00 am – 6 ounces JUICE – Apple or cranberry, white grape, Gatorade, vitamin water (fifty percent water, fifty percent juice)
- Sugar-free Jell-o
- 10:00 am- 6 ounces’ warm tea (no milk/cream) or broth
- 12:00 – 6 ounces Vitamin water
- Sugar-free Jell-O
- 3:00 pm – 6 ounces’ herbal tea or broth
- 5:00 pm 6 ounces’ white grape juice ((50% water, 50% juice)
- Sugar-free Jell-O or Sugar-free Popsicle
- 6 ounces’ herbal tea or broth
Phase 2 Diet – Full Liquids Diet – 5 through 14 Days After Gastric Sleeve
Goal is to stay hydrated and consume between 60 – 90 grams of protein
This diet allows a broad range of liquids and protein supplements. This will give your new pouch and digestive system time to heal properly and allow you time to adjust to your new stomach/pouch. A good rule of thumb for what is allowed on this diet is anything that has the consistency of what can easily be strained through a straw. Remember, however; at this stage you should not be sipping anything though a straw!!!!
Start taking your multi-vitamins, calcium and iron daily as directed two to three days into phase two. If you need guidance in this area or require vitamins, please contact us to purchase our recommended vitamins designed for your particular bariatric needs.
Approved Full Liquids:
- Start high protein full liquid diet
- All foods from the previous stage.
- Protein powders
- Greek Yogurt (remember it needs to have more protein than sugar- Fage/Chobani plain Greek yogurt; or Dannon’s Triple Zero – http://www.oikosyogurt.com/greek-yogurt/triple-zero/
- Almond, cashew or Coconut Milk – Unsweetened
- Natural Apple Sauce
- Vegetable juice (V8)
- Hot cereals like oatmeal/ cream of wheat/Kashi hot cereal
- Sugar-Free Pudding
- Soups (chose higher protein soups like bean soup, can take chunky soups and blend before eating)
- Avoid all carbonated beverages (fills the stomach with gas), sugar (extra calories that fight against weight loss) and coffee (it is acidic and may have problems with acid reflux after surgery. It is also a diuretic, causing you to be dehydrated)
- Drink a minimum of 48 oz. of fluids and a goal of 64 ounces of liquids per day to prevent dehydration. Sport drink bottles with measurements on the side will help ensure you are drinking enough fluid. Remember, you will not be able to gulp liquids so you will want to drink small amounts throughout the day.
During this phase, it is important to drink a high quality, protein supplement. Your goal is 60 to 90 grams per day. To determine your protein requirements, take your ideal healthy weight and divide by 2.2. This will provide you the amount of protein you need to reach a healthy weight and maintain your lean body mass.
Recommended Protein Supplements:
Please be sure it contains at least 20 grams of protein per serving. Sugar should be half the grams or less than protein- if you have 20 grams of protein, it should have less than 10 grams of sugar
- Jay Robbs: https://www.jayrobb.com/default.asp
- NO Artificial Sweeteners, NO Artificial Flavors, NO Artificial Colors, NO Soy
- NO Lactose, NO Sugar, no after-taste, rBGH-Free, Non-GMO, made with a Whey Isolate, From Grass-Fed Cows, flavored choices, sweetened with Stevia, unflavored has no after-taste. Provides 26 grams of protein.
- Unjury Unflavored: http://www.unjury.com/catalog/category/view/id/17
- Whey bases protein isolate, rBGH-Free, kosher, no after-taste, no sugar, no artificial colors, provides 20 grams of protein.
- Inspire: http://www.bariatriceating.com/product/inspire-pure-unflavored-protein-powder/
- Whey bases, no lactose, no sugar, no artificial sweeteners, no after-taste, provides 20 grams of protein.
- BQuick Performance Protein Blend: http://www.bquicknutrition.com/
- Add-ins like fiber, flaxseed, and digestive enzymes, along with antioxidant-rich maca root, beet, and acai powders make BQuick FUEL stand out. All-natural, zero artificial sweeteners, colors, or flavors (sweetened with stevia), provides 25 grams of protein.
- Aloha: https://aloha.com/home
- Plant based, organic, gluten-free, dairy-free, non-GMO,100% free of harsh chemicals, fillers, artificial sweeteners, provides 18 grams of protein.
- Sun Warrior: http://www.sunwarrior.com/store/classic-plus-500g
- Raw plant-based protein, Complete and balanced protein for muscle, building, repair, and maintenance, Rich in Lysine, often missing in plant-based proteins, Hypoallergenic (free of major allergens), provides 18 grams of protein.
Suggested Pre-made Protein Shakes:
It is recommended to use protein shakes that are hormone free and sweetened with stevia versus artificial sugars.
- Iconic: http://drinkiconic.com/ Whey based protein from grass fed cows, rBGH-free, no artificial sweeteners, sweetened with stevia.
- Orgain Organic Protein Shakes: www.orgain.com 25 grams of protein, sweetened with stevia, hormone free
- Coco Protein: www.musclepharm.com/store/all-products/coco-protein/
Thick LIQUID Sample Menu
- 1-ounce packet high protein oatmeal made with almond milk
- ½ – 1 scoop unflavored protein isolate added in
- Protein shake (minimum of 20 grams of protein)- clear or thick shake
- 4-ounce Greek style yogurt blended with almond milk (chose a yogurt that has more protein than sugar)
- Clear or thick liquid protein shake
- Pureed soup
- Sugar-free pudding with one scoop protein powder blended with coconut milk
Phase 3 – Soft Foods Diet – 15 – 21 Days After Surgery
Goal: start weighing food – 4 – 6 ounces total per meal, getting 20 grams of protein per meal (3 oz. will always be protein)- Protein first!
Chew all your food well to applesauce consistency. If you don’t follow these precautions, you may experience vomiting, stomach irritation, and swelling. You could also have obstruction of the small gastric pouch. If solid foods cause nausea and vomiting, go back to the liquid diet you had earlier. Then you can slowly add soft foods and eventually transition to solid foods. Vomiting may increase the incidence of band slippage, stomach slippage or stretching of the small stomach pouch above the band. IF VOMITING AND NAUSEA PERSIST, CALL YOUR DOCTOR IMMEDIATELY.
Think of your new pouch as shaped like a funnel. You can pour any liquid into this funnel, and it will run through and out the bottom. The same thing happens with your pouch when you only consume liquids. So you do not want to drink your calories or overeat.
As a part of your new life, you will want to STOP drinking 30 minutes before a meal and 30 minutes after a meal.
Approved Soft Foods include:
- You begin to weigh your food at this stage- Goal is no more than 6 ounces of food- 3 ounces of protein, one ounce of healthy fat and two ounces to play with adding vegetables, fruits or carbohydrates
- Your goal is to work towards getting 20 grams of protein at each meal
- Add only ONE food at a time
- Scrambled eggs (soft, boiled, poached)
- Egg salad
- Tuna fish moistened well with mayo
- Chicken salad, salmon, moistened with mayo
- Cottage cheese
- Fruit (mashed, can – anything soft)
- Veggies (mashed, can, and slow cooked to tenderize)
- Refried beans with cheese
- Meats pressure cooked to tenderize
- Sweet potatoes, and potatoes (mashed – only)
- Greek Yogurt
SOFT FOODS SAMPLE MENU:
- 2 scrambled eggs & 1 oz. string cheese (3 ounces)
- Protein shake
- 3 ounces can chicken
- 1 ounce blended avocado
- 4 ounces’ cottage cheese
- 1-ounce fruit blended in
- Protein shake or pudding with protein blended in
Things to Keep in Mind With Phase 3
Ideally three meals per day should be consumed, however some patients may have five or six meals per day. Also, you will include a shake to the 3 daily meals. It is important to only eat until you feel satisfied and no more!
Your goal in this phase:
- to eat a high protein, low sugar, diet.
- Never eat and drink at the same time.
- Never eat more than 4 ounces of food at once.
- Chew your food thoroughly.
- Aim for 800 calories daily.
- Never eat before bed and avoid any spicy food.
- Always check your labels before consumption for high fat, sugar or carbohydrates levels.
Phase 4 – Solid Foods Diet – 21 Days and Beyond
By this stage, your stomach should be in better shape to handle solid foods. From now on, these foods are the foods you’re going to be eating for the rest of your life. Ultimately, you can consume a healthy, well-balanced diet in small portions. Each meal you consume should have at least three ounces of protein.
At this phase, you start back on solid foods. Start with one to four ounces of solid food per meal and then slowly increase the amount of solid food per meal until you are eating at least four ounces per meal but no more than eight ounces.
At each meal, you want to have at least three ounces of protein. In the beginning, mentally identify your protein source. You may wish to get a digital pocket scale to weigh your food at the start, so you know what three ounces of protein look like as well as what four to six ounces of food are visual. You will find it is easier for non-protein foods to go down, so you may gravitate to choosing non-protein foods. You want to train yourself right at the beginning to eat protein. Eat three bites of protein to everyone bite of something else (three to one rule).
It is easy to get certain foods stuck, so from this phase forward, it will be imperative for you to slow down and chew your food thoroughly, pausing between bites.
Eat protein first. Make sure you have three ounces of protein at each meal. Add three ounces of healthy fats, fruits, vegetables or starches if you can tolerate them. Pay close attention to how you feel with the introduction of new foods.
- Meatless products
- Cottage cheese
- Low-sugar Greek yogurt
Hard to Tolerate:
- Red meat
Items like bacon, sausage, salami, bologna, pastrami, pepperoni and hot dogs are considered fats, not protein.
Remember that raw vegetables are harder to digest. In the beginning, they can easily irritate your pouch. Remember to take small bites and chew thoroughly. With gastric bypass surgery, you may want to wait approximately four months before trying raw vegetables. It is recommended to try one new food at a time and to try them while at home.
- Fresh or frozen cooked vegetables, like green beans, carrots, sweet potatoes and squash
Difficult to Tolerate:
- Raw vegetables
- vegetables with tough skin or seeds, like celery or tomatoes
- Vegetables like cabbage, cauliflower or broccoli may cause gas distress.
With all fruits, eat as part of your meal after you have had at least three bites of protein. Remember that the acid in citrus fruits can irritate your pouch. Remember to avoid the membrane portion (skin) of the fruit.
- Fresh fruit, peeled with no skin
- Canned fruit in water or natural juice that has been drained and rinsed
Difficult to Tolerate:
- Fruits with skin or seeds
There are two types of starches: whole grains and simple sugars. Focus on eating whole grains, such as:
- Ezekiel bread
- Whole grain tortilla
- Sweet potatoes
Minimize simple, refined grains, like candy, white rice, pasta, cereals and processed sugars, including cookies, cakes, and pastries.
You want to limit the amount of starch you have at each meal to one or two ounces. Be sure that you only eat a starch with your protein. Starches can act like a sponge in your pouch, leaving you little to no room for healthy proteins and essential fats.
Oils and Essential Fats:
It is important to include essential fats in your daily meal plan to prevent deficiencies. Examples of healthy fats are:
- A variety of nuts
- Oils, like olive, grape seed or coconut
Fats to Minimize:
- Fried foods
- Saturated fats, like bacon, sausage, pepperoni, salami and bologna
- Mayonnaise/Miracle Whip
- Salad dressings
- Sour cream
Successful Eating Behaviors: When you have endured gastric sleeve, you may become nausea or violently ill if you overeat.
- Only add ONE new food at a time!
- Avoid starchy food like white rice, pasta, bread.
- Chew thoroughly and slowly.
- Protein Supplements: 60-90 grams
- In between meals, drink at least six to eight cups of water and any other non-calorie, non-carbonated beverages.
- Stop drinking thirty minutes before eating and DO NOT drink until thirty minutes after a meal.
- EAT six small liquids and blended meals each day, but add one solid food item at one meal the first day. Add one more solid food item each day.
- ALL NEW FOODS NEED TO BE SOFT, COOKED OR CANNED.
- AVOID all raw fruit and vegetables, nuts, popcorn, pickles, olives or relishes.
- RECORD all new foods and any problems you have with them in a food diary and let your doctor know of any problems or questions you may have.
- CHEW your food very well before swallowing. The consistency of the food should be liked mashed potatoes. Make sure that each bite is very small (as if you were feeding a baby) and continue to eat small amounts slowly. Eat about two tablespoons over ten to fifteen minutes.
- CONTINUE to take your multiple vitamins, calcium supplements, iron and B12 supplement as directed.
- AVOID beverages that have alcohol or caffeine and those that are carbonated.
- REMEMBER, do NOT use a straw or chew gum!
Guide to Gastric Sleeve Surgery: