GASTRIC BYPASS NUTRITIONAL GUIDELINES

Gastric reduction surgery was developed to induce weight loss.  However, some behavior patterns must be modified simultaneously in order to achieve and maintain desired weight loss. The following information has been helpful to those people who have made their operations successful.

***You may have a light breakfast prior to going to hospital (no bacon or sausage)***

Diet in the hospital:

Admission Day- Clear liquids

Next Day - Surgery

• 1st       day post-op- ice chips
• 2nd      day post-op- sugar free clear liquids
• 3rd       day post-op- mechanical soft

Start when discharged from hospital:

Vitamins: The following supplements are required to be taken daily:

1. A multi-vitamin and mineral supplement, e.g. One A Day, Centrum, Theragram
   Try children's chewable multi-vitamins (please read label for adult dose), if there is any difficulty with a large vitamin tablet.
2. Calcium Citrate (1200 mg.) such as Citracal.
3. Iron (250-300% daily value) after you have been discharged from hospital and having normal bowel movements.
4. B-12 supplement (500mcg, daily)

***Iron and Calcium Citrate may not be taken at the same time***

Eating Methods After Surgery-Progressing The Diet At Home

First thru Third Week After Surgery: continue to eat soft foods. (Protein, fruits and vegetables).  You should take 30 minutes for meals-3 meals per day.

Suggestions are:

1. fat free cottage cheese
2. fat free cheese (cheese made from skim milk only)
3. well scrambled egg
4. hard boiled egg
5. broiled fish
6. canned tuna fish, chicken or salmon (in water)
7. canned fruits (they must be packed in water or in their own juice. NO SYRUP).
8. canned vegetables (all canned products must be rinsed)
9. chopped chicken or turkey

Third Week After Surgery:

The following can also be added at this point, however they are starches and should be limited to twice a week.

1. baked Potato  do not eat the skin)
2. rice
3. pasta
4. crackers
5. crisp toast
6. peas
7. corn
8. all beans

Fourth week After Surgery: You can begin to experiment more with food. Meats as well as raw fruits and vegetables may be tried. Remember to slowly add these fiber rich foods back into your diet.  Also remember that you must chew your food well.

Sugars: You most likely will not tolerate sugar in any shape or form. You must look at food labels for ingredients. Some examples of words that mean sugar are:

1. anything with an -ose ending, i.e. dextrose, maltose, sucrose
2. corn syrup, maple syrup
3. molasses
4. honey

Beverages: Drink adequate liquids between meals. Liquids are needed to replace normal body water losses and thus prevent dehydration. Your beverages must be something that has no calories. Some examples are:

1. crystal light
2. sugar free Kool-Aid
3. water
4. coffee
5. tea
6. diet soda*
7. club soda*

* Not recommended for two weeks after surgery unless you allow the beverage to go flat.

You may also drink Skim Milk or up to two glasses per day (8 ounces each-16 ounces total) of V-8, tomato or vegetable juice.

Hints for drinking beverages include:

1. DO  NOT drink beverages 30 minutes before or after meals. (There is not enough room in your stomach for both food and liquids).
2. Sip beverages slowly. One way to begin this is by taking sips of a beverage from a straw instead of from a regular glass.
3. Eliminate high calorie drinks such as milkshakes, soda pop, whole milk, and fruit juice. By sipping on high calorie liquids throughout the day, many calories can be consumed without the effect of fullness. This will result in a poor weight loss record. Ice cream, sherbet, and frozen yogurt all count as liquids and should be avoided.
4. All alcoholic beverages must be avoided.
5. Alcohol can have anywhere from 100-150 calories, not including the mixers. In addition alcohol will digest to sugar. (See sugars above).
6. Soups are liquids with calories and should be avoided.

You may or may not tolerate skim milk or milk products after surgery. If you do not tolerate skim milk, switch to Lactaid milk. If you do not tolerate dairy products you may take a Lactaid tablet before eating such a food.

CERTAIN FOODS MAY BE DIFFICULT TO TOLERATE: Since toleration for these foods varies from individual to individual, use your own discretion as to whether to include them in your diet. Through trial and error you may find that you are able to tolerate some of these food items, but there may be others, which your digestive system cannot handle as well. Below are the most typical ones that are not tolerated:

1. tough meats
2. membranes of oranges and grapefruits
3. core, seeds or skins of fruits or vegetables
4. fibrous vegetables such as corn, celery or sweet potatoes
5. bread
6. fried foods

If you do not tolerate a certain food avoid it for a short period of time and try it again. What foods you do not do well with in the beginning you should do fine with later.

Green vegetables should be cooked until soft, if you have any difficulty with raw or hard vegetables.

Eating Methods After Surgery To Aid You In Achieving Success

After surgery, you will find you need to make changes in your eating patterns, not only to prevent pain, but also to produce the desired weight loss. Changes considered to be important (but not limited to) are:

Eat slowly and chew your food well.

The following are hints to help you eat more slowly.

1. Set aside 30-45 minutes to eat each meal
2. Chew well. Actually count the number of times you chew each bite. Aim for 30.
3. Make an  EAT SLOWLY sign and place it on the table in front of you.
4. Explain to family members why you must eat slowly so they will not urge you to eat faster.
5. Take small bites of food. You may try eating with a baby fork and spoon or a salad fork and teaspoon.
6. Pay attention to taste. Learn to savor each bite noticing its flavor, texture and consistency.

Stop eating as soon as you are comfortable.

Extra food over time may stretch your stomach. Indications of fullness may be:

1. A feeling of pressure or fullness in the center of your abdomen just below the rib cage.
2. Feelings of nausea
3. Pain in your shoulder area or upper chest, or into your back.

Set aside three meal times per day and eat solid foods only at these times. The emphasis should be placed on eating protein. Eat protein (see lean meat and substitutes) with each meal and eat it first. It is important to eat nourishing foods and to avoid the habit of snacking. Eating often and throughout the day may keep you from losing weight because you will be able to eat enough calories to maintain your weight. Individuals who continually munch on crackers, potato chips or other non-nutritious foods have not only failed to lose weight but have even gained weight. 

Eat a balanced diet.

Because the quantity of food you can now consume at a meal is greatly reduced, it is important that what you do eat be of good nutritional value.

Cooking Techniques:

1. Bake, broil, roast, grill or boil foods rather than fry them.
2. Use a non-stick pan spray or a non stick pan to brown meats.
3. Trim off visible fat before and after cooking.
4. Do not add flour, breadcrumbs, coating mixes or fats to foods when preparing them.
5. Do not buy pre-prepared frozen meals.
6. Do not add sugar. You may use artificial sweeteners, e.g. Sweet 'N Low or Equal.

LEAN  MEAT AND SUBSTITUTES

BEEF:	USDA Select or Choice grades of lean beef such as round, sirloin, and flank steak, tenderloin, and chipped beef
PORK:	Lean pork such as fresh ham, canned cured or boiled ham, Canadian bacon and tenderloin
VEAL:	All cuts are lean except for veal cutlets (ground or cubed). Examples of lean veal are chops and roasts
POULTRY:	Chicken, turkey, Cornish hen (without skin)
FISH:	All fresh and frozen fish, crab, lobster, scallops, shrimp, clams (fresh or canned in water), oysters, tuna, salmon (canned in water), herring (uncreamed or smoked), sardines (canned)
WILD GAME:	Venison
CHEESE:	Fat free cheese, Fat free cottage cheese
OTHER:	95% fat free luncheon meat, egg whites, egg substitutes, egg yolks (should be limited to no more than 3 per week)

 

Sun.	Mon.	Tues.	Wed.	Thurs.	Fri.	Sat.
Cantaloupe Scrambled Egg	Strawberries Lean Ham	Peaches Scrambled Egg	Pears FF Cottage Cheese	Honeydew Egg White	Applesauce Lean Ham	Pineapple Scrambled Egg
WP Tuna   Asparagus Fruit	Baked Turkey Breast Green Beans Fruit	Lean Broiled Beef Pattie Carrots Fruit	WP Salmon WP Beets Fruit	Baked Chicken Asparagus Fruit	95% FF Luncheon Meat Stewed Tomatoes 1 slice of bread	FF Cottage Cheese Fruit
Baked Chicken Squash Fruit	Broiled Fish Broccoli Fruit	Lean Baked Pork Roast Baked Potato Mixed Italian Vegetables	Center Cut Lamb Chops Green Beans Fruit	Baked Turkey Breast Brussel Sprouts Fruit	Lean Broiled Beef Pattie Cauliflower Fruit	Broiled Fish Zucchini Fruit

WP= Water Packed   -   FF= Fat Free