DIETARY GUIDELINES

It is vital in a long run for you to make healthy food choices after your weight loss surgery. It will help you achieve the maximum weight loss goals at the same time maintaining your nutritional needs.

A 4 stage diet plan is recommended to patients after the gastric bypass and sleeve gastrectomy operation.

Stage 1 – Liquids
The first stage will long up to 14 days after your surgery. In the first 3-4 days you have to drink water / diluted, non sugar juice by small sips all day long. After the first 4-5 days you can add non fat broth, semi skim milk, sugar free jelly, skim yogurt without bits, clear cream soup, tea, coffee.

Remember the necessary amount of liquids for your body is 1.5 – 2 l a day!

Aim to establish your eating schedule and have 3 main meals per day – breakfast (protein rich drink), lunch (1 small cup of soup & 1 small cup of thin yogurt), and dinner (a protein rich drink and or fruit squash), and 3 small meals (for ex. a cup of milk,) between 3 main meals. You also have to drink water between all meals.

Avoid sparkling drinks, alcohol, any liquid with bits, fluids with excess sugar and fats – those can make you feel sick or cause rejecting.

Supplements and medications – for the first period all vitamins and minerals should be used in chewable or liquid form. If you need to have some other medicines, mash them and space out the pills at least 5-10 minutes apart.

Stage 2 – Pureed food
After 2 weeks or earlier after the surgery you can move to the next stage of your diet which you should expect to follow up to 2 weeks, depending on your feelings. Listen to your body! All foods in this stage should be of a consistency of thinned mashed potatoes.

Foods to have on this stage – skim milk, blended soups (with skim milk instead of water), blended fruit shakes with or without milk or fat-free yogurt, blended meat in blended cream soups or mashed potatoes, cooked cereal thinned with skim milk, blended beans, mashed potatoes or other vegetables made with skim milk, sugar-free yogurt, blended cottage cheese (fat-free/low fat), pureed fruits.

Foods to avoid – all solid foods, raw vegetables, tough skin on vegetables and fruits (tomatoes, potatoes, also sausages), sweet corn, tomato seeds, red meets, non pureed meet, hard cheese, toast, bread, rusks, nuts.

Beware of high intake of legumes such as chickpeas, lentils, split peas – they absorb lots of fluid in the bowel and can cause discomfort at this stage of diet.

Tips –

  • Use blender or potato masher to puree your food.
  • Aim to have 3 main meals and 2-3 small snack meals per day. Each meal should not exceed the volume of a measuring cup – 168g (6oz).
  • Chew food well, even though it is mashed already.
  • Eat very slowly – plan at least 30 minutes for a meal.
  • If you are very hungry, try to ensure you have the protein part of your meal first.
  • Do not drink while eating and at least 30 minutes before and after your meals.
  • Supplements – follow your doctor’s instructions.
  • You need to ensure your diet contains sufficient nutrients, vitamins and minerals for you to live healthy. A balanced diet will also ensure that the weight you lose is mainly fat, not a muscle mass. Muscle helps you lose weight by boosting your metabolism when you do even the smallest amount of exercise.
Stage 3 – Semi-solid diet
You should expect to be on this stage of diet for up to 2 weeks (usually 5-6 weeks after the operation). But again – listen to your body and your stomach! Some people can have this stage earlier, some later.

Foods to have: Boiled eggs any type except fried, several types of casseroles, soups, chopped lean meat (except the red one), low-fat cottage cheese, boiled & peeled vegetables, sugar-free low-fat yogurt, fish in a sauce, well-cooked rice, pasta in sauce, mashed beans, chick peas, kidney beans, soft fruit.

Avoid: Any food with tough skin, stringy or fibrous vegetables such as celery, asparagus, sweet corn; fizzy drinks; alcohol – it can irritate the stomach and is high in calories.

Tips:

  • Add one new food at a time and observe your reaction to it.
  • Eat very slowly and stop eating as soon as you feel full so you don’t stretch the pouch.
  • You can start to introduce more foods and different textures. But still most of foods should still have a soft or mashed texture.
  • Aim to have 3 main meals a day and one of the suggested snacks, if you feel hungry between meals.
  • Use spices to make your meals more interesting and delicious. Avoid hot chilli, Cayenne pepper and similar.
  • Serve your meals on a small plate.
  • The size of portion can increase slightly but you should continue stop eating as soon as you feel full. Eating to quickly may be painful and can make you sick.
  • Remember – 1,5-2 l of fluids daily.
Stage 4 – Solid foods
People come to the 4th stage after 2-3 months after the surgery.

Tips:

  • Add one new food at a time and observe your reaction to it.
  • Read labels when shopping for food!
  • Add breads to your diet last. Bread tends to form a ball, which may be hard to get through the new pouch.
  • You can add red meat, raw vegetables, and raw fruits with skins back into your diet as well.
  • Remember to chew all food very well and sip only limited amounts of liquids with meals, if necessary.
  • Take the recommended by your surgeon supplements daily.

Avoid: sugars, deep fried, high calorie, fast foods, carbonated drinks.

The consequences of having a poor diet vary. In the short term it may lead to dry or cracked skin or nails or hair loss. In the long term a lack of nutrients can increase the risk of developing several health conditions. It is important to have a balanced diet including all types of foods!

Reduce risk of dumping syndrome and digestive upset

Concentrated sugars and alcohol can cause a dumping syndrome – vomiting and/or diarrheas, so try to avoid: candies, chocolate, sweetened & carbonated sodas, honey, cakes, ice cream, any alcohol.

It may happen you do not tolerate some of foods. Try to add this food to you diet later again.

Balanced diet

You will have to learn nutritional values of products to be sure you treat your body with love and responsibility.

There are five main food groups (many products like milk, beans etc. fit into more than one group), you should have in a balanced diet plan. Here you can find products and approximate amounts of each group products you should include in your daily diet plan.

  • Protein foods – about 15% of non diary protein foods should be included in your daily diet plan.
  • Fruit and vegetable foods – 30% of your daily amount of food.
  • Dairy foods (milk products) – 15% of your daily amount of food.
  • Breads, cereals and starchy foods (breads, pastas, potatoes, cereals, oatmeal, wheat flour, corn flour, brown rise, also beans, chick peas and lentils) – 30% of your daily amount of food.
  • Fats and sugars (margarine, oils, sugars, honey) – less than 10% of your daily amount of food.

You will be provided a more detailed dietary plan and product descriptions before discharging from the hospital.

 

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