YOUR DIET AFTERWEIGHT-LOSSSURGERY

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Your Diet After Weight-Loss SurgeryNow that you have completed your weight-loss surgery, it is important for you to follow a healthy diet plan. As a general rule, adequate fluid and protein intake are essential to successful recovery. The information in this packet will serve as general guidelines to help you to determine what foods are best for you at the different stages of your recovery process.Your outpatient registered dietitian will help you customize a successful diet according toyour specific tolerances and taste preferences. This nutrition expert will also provide youwith other nutritional materials to help you with your diet.

In the Hospital The day after surgery, when you have received approval from the surgeon, you will be ableto drink 30 mL (one fluid ounce) of clear liquids. Liquids must be sipped over 30 minutesduring waking hours. If this is tolerated, then on day two you will be able to drink 30 mLsipped over 15 minutes.You may choose from the following:

• Water

• Crystal Light®

• Unsweetened decaffeinated iced tea

• Decaffeinated tea or coffee (Do not add cream.)

• Sugar-free ice pops (Popsicle®)

• Sugar-free, diet gelatin (Jell-O®) (Do not have red gelatin.)

• Clear broth

Before you are discharged, you will advance to a stage 1 diet.(See PAge 3.)When you are ready to leave the hospital, a dietitian will brieflyreview the dietary guidelines in this packet with you. Once youare discharged from the hospital, your surgeon or dietitian willcontinue to assist you with your dietary needs.

How Weight-Loss Diet Planning WorksYou will progress through four stages of dietary guidelines throughoutyour recovery process. If you are having difficulty with your current stage, please contactyour surgeon and DO NOT advance to the next stage.

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The following chart describes each dietary stage you will experience based on the food type and the general period of time you are to follow the prescribed diet.

Important TipsIt is important that you remember the following tips throughout each stage of your dietary process:• Do not use straws.• Do not chew gum (may cause blockage).• Do not drink at least 30 minutes before and after meals.• Do not drink caffeine.• Do not drink beverages with carbonation.• Do not drink alcohol.• Do not drink fruit juice.• Do not eat citrus foods.• Do not eat food high in fat and/or sugar.• each meal should last 30 minutes. Always drink and eat slowly.

Stage Recommended Diet Description

Stage 1

Full Liquid

Diet

You are able to add

smooth, minimal texture foods and protein supple-ments to your diet. Continue on this diet for approx-imately the first two weeks (14 days). (See PAge 3.)

Stage 2

Pureed DietYou are able to addblenderized protein

food sources to your diet in addition to blenderized fruits,vegetables and starches. Continue on this diet forapproximately one week (7 days). (See PAge 5.)

Stage 3

Soft Texture

Diet

Approximately three

weeks after your procedure you will regain the abil-ity to eat non-blenderized foods. Continue on thisdiet for approximately one week (7 days). (See PAge8.)

Stage 4

Healthy

Weight for Life DietPlan

The general dietary recommendations in this stagewill help you maintain a healthy weight for life. (See PAge 10.)

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Stage 1: Full Liquid Diet

The Full Liquid Diet is generally recom-mended the second day after your procedure.You will now add a protein supplement toyour diet. Use the recommendations belowas guidelines for healthy eating during thisdiet stage. The foods in this section are grouped according to their food type. It is importantthat you choose foods from all three groupson a daily basis. To help you determine howto plan meals, a sample one-day meal planis included at the end of this section.

Fluids GroupSlowly sip sugar-free, non-carbonated, caffeine-free fluids throughout the day. Remember to avoid using a straw. Drink 64 ounces of fluids per day to maintain hydration. (Do not drink within 30 minutesbefore and after meals.)Options:

• Water• Fruit-flavored water• Sugar-free Kool-Aid®• Crystal Light®• Unsweetened decaffeinated Iced Tea• Decaffeinated tea or coffee (You may

add fat-free and sugar-free creamer)• Sugar-free ice pops (Popsicle®)• Sugar-free gelatin (Jell-O®)• Clear broth• Strained cream soup (no chunks, 98%

fat free and made with 1% or skim milk)

• Broth with one scoop of protein powder

• Milk or Lactaid® (skim or 1%)

• Soymilk (plain or unsweetened vanilla)

Soft Foods GroupConsume ¼ to ½ cup of appropriate softfoods three times per day.Choose from the following:

• Sugar-free pudding made with 1% orskim milk

• Light, low-fat smooth (no chunks, plainor vanilla only) yogurt made withartificial sweetener (greek yogurt is anexcellent choice.)

• Cream of Wheat® made with water orskim milk

Protein Supplements GroupYour goal is to consume 60 grams of pro-tein each day. You will need to graduallywork up to this goal. Work with your dieti-tian to determine how you will meet thisgoal. You will need a protein supplement toreach this goal.

Guidelines for Choosing a Protein SupplementUse a protein supplement that is:

• 3 grams of fat or less• 3 grams of sugar or less• 150 calories or less• At least 15 grams of protein

examples of ready-to-drink, commercial,high-protein, supplement drinks:

• eAS® AdvanteDge Carb Control ™Ready-to-Drink

• gNC® Total Lean™ Lean Shake™• Isopure®• Premier Protein • 100% whey protein powder (Choose

any brand; can be mixed with fat-freemilk; typically has 20 grams of proteinper scoop.)

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You may make your own supplements withprotein powder. examples of protein powder include Designer Whey®, ZeroCarb Isopure®, gNC® 100% Whey Protein,UNJURY® and Syntrax® Nectar®.

examples of homemade high-proteinshakes:

Yogurt ShakeINgReDIeNTS

4 ounces of allowed smooth yogurt4 ounces of 1% or skim milk or

Lactaid®

1 scoop protein powder1 tablespoon Crystal Light®

DIReCTIONS

Use a blender to blend all ingredientsuntil smooth.

Vanilla ShakeINgReDIeNTS

8 ounces of 1% or skim milk orLactaid®

1 scoop protein powder½ teaspoon vanilla extract

DIReCTIONS

Use a blender to blend all ingredientsuntil smooth.

Stage 2:

Sample Meal Plan for Stage 1: Full Liquid Diet

Breakfast ¼ cup light yogurt

Lunch ¼ cup strained cream soup

Dinner ¼ cup skim milk

Fluids

Slowly sip

allowed fluids throughoutthe day. Drink 64 ouncesper day.

BetweenMeals

Drink high-protein supple-ment to help reach yourgoal of 60 grams of proteinper day.

examples of other high-protein foods:

High-Protein Pudding You will need the Jell-O® sugar-free instant pudding mix (4 servings).

• Measure 2 cups of cold skim milk (as indicated in package directions).

• Add two scoops of protein powder to thetwo cups of cold milk.

• Thoroughly mix the protein powder withthe milk by shaking or stirring.

• Put the Jell-O® sugar-free instant dry pud-ding mix into a bowl.

• Add the protein powder and milk mixture.

Cream of Chicken Soup• Pour 8 ounces of skim milk into a

microwave-safe container. • Microwave milk about one minute, then

microwave 10 seconds at a time, checkingthe temperature each time – until 130degees. Do not heat above 130 degrees.(It is a good idea to use a meat thermo-meter for the first time. This will allow youto know how long your microwave takes.)

• Stir in one scoop (or one packet) ofUNJURY® Chicken Soup flavor proteinpowder or the unflavored style of proteinpowder.

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Pureed DietThe Pureed Diet stage requires you to add pureed foods to your diet. Continue touse a high-protein supplement. Use therecommendations below as guidelines forhealthy eating during this diet stage. The foods in this section are grouped according to their food type. Although thefoods will be blenderized, do not mix foodfrom different food groups. You may mixfoods from the SAME food group.

Steps to Preparing Pureed Foods1. Select food from one of the food

groups.2. Use a blender or food processor to

puree foods to an applesauce consistency.3. Add low-sodium broth, low-fatgravy or low-fat milk for moisture

when blenderizing meats. Whenpureeing foods, add only enough liq-uid to create an applesauce consis-tency. This helps maximize yourprotein intake in a limited amount.

You are also able to eat the condi-ments listed below:

• Light or fat-free mayonnaise

• Mustard

• Fat-free spray butter

• Spices/herbs

To help you determine how to plan meals,a sample one-day meal plan is included atthe end of this section.

Tips for Preparing Pureed Foods

• Be sure to use a blender or food

processor.• Meats need to be tender (stewed,

baked or boiled) before they can bepureed. Cook in crock pot until verytender.

• Use light mayonnaise when blendingtuna or egg.

• Add low-fat milk to hot cereal ormashed potatoes to increase proteincontent.

• Add 1 to 2 tablespoons of proteinpowder to foods to increase protein.

• You may add butter buds, butterspray and/or spices to season foodsas tolerated.

Important Tips to RememberFor STAGE 2: Pureed Diet

• Your goal is to consume at least 60grams of protein per day; however,you will need to gradually work upto this goal. Work with your dietitianto determine how you will meet thisgoal.

• Continue to consume two servingsof high-protein supplements daily.

• eat protein first.• Blend all foods to the consistency of

applesauce.• Add foods slowly and one at a time

to test tolerance.• Stop eating or drinking when full.

Overfilling may stretch the stomachpouch and hinder weight loss.

• eat slowly. • Sip fluid slowly.• Do not eat baby food.• Be sure to consume food items from

each of the following groups daily.

Fluids GroupSlowly sip sugar-free, non-carbonated, caffeine-free fluids throughout the day.

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Drink at least 64 ounces of the followingfluids throughout the day. (Do not drinkwithin 30 minutes before and after meals.)Options:

• Water• Fruit-flavored water• Sugar-free Kool-Aid®• Crystal Light®• Unsweetened decaffeinated iced tea• Decaffeinated tea or coffee• Sugar-free ice pops (Popsicle®)• Sugar-free gelatin (Jell-O®)• Broth

Protein Foods Groupeat serving sizes between ¼ to ½ cup ofpureed protein foods.Choose from the following:

• Pureed chicken or turkey with no skin• Pureed fish (water-packed tuna)• These soft fish should be mashed very

fine with a fork: haddock, tilapia, codand salmon

• Pureed tofu• 2 scrambled egg whites or ¼ cup egg

substitute• Pureed fat-free refried beans• Cream soups made with fat-free or

1% milk• 1% cottage cheese• Part-skim ricotta cheese• Pudding (low fat, sugar free, no sugar

added)• Milk or Lactaid® (skim, fat-free or 1%)• Soymilk (plain or vanilla)• Blended light low-fat yogurt

(no chunks) made with artificialsweetener

Fruits, Vegetables and Starches Group eat ¼ cup of pureed fruits, vegetables andstarches once daily. Note that these foodsare not rich sources of protein.

• Applesauce (natural, no sugar added) • Mashed banana• Mashed potato• Canned vegetables

� Pureed peas� Pureed carrots� Pureed green beans� Pureed beets

• Pureed acorn or butternut squash• Pureed sweet potato• Cream of Wheat® (make with skim or

1% milk)• Oatmeal (make with skim or 1% milk)

Protein Supplements GroupDrink 8 ounces of protein supplementstwo times per day. Use liquid, high-protein supplement drinksas previously listed in the Protein Supple-ments Groups of Stage 1: Full Liquids. You may also use alternative high-proteinsupplements. See list of examples (servingsize included).

examples of alternative high-protein supplements:

High-Protein Oatmeal

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• ½ cup oatmeal – Make oatmealas directed but make with low-fatmilk instead of water.

• After oatmeal is cooked, stir in onescoop of protein powder (plain orflavored), until well blended.

• Optional: Add 2 ounces of additionalmilk, cinnamon and nutmeg.

High-Protein Cottage Cheese• Add a small amount of cold water to

a scoop of protein powder (plain orflavored). Stir to make paste.

• Add protein-paste to ½ cup low-fatcottage or ricotta cheese. Stir untilwell blended.

High-Protein Hot Chocolate• Add a small amount of cold water to

a scoop of protein powder, stir tomake a paste.

• Add paste and one packet of sugar-free hot cocoa mixture to bottomof mug.

• Heat 8 ounces of skim milk. Pour hotmilk into mug and stir well.

• Optional: Add cinnamon, nutmeg, any flavor of sugar-free syrup or1 teaspoon of fat-free whipped topping.

High-Protein Cream Soup• Combine one can of 98% fat-free

cream condensed soup and 8 ouncesof skim milk. Bring to a simmer.

• Add two scoops of plain proteinpowder and stir well.

• Take off heat and carefully strain anychunks of food.

• Pour 1 cup soup in bowl (makes twoservings).

Stage 3: Soft

Sample Meal Plan for Stage 2: Pureed Diet

Breakfast

¼ cup egg

substitute or 2 egg whites and ¼ to ½ cup light yogurt

Lunch ¼ to ½ cup pureed chicken

Dinner ¼ to ½ cup mashed tunawith light mayonnaise and ¼ cup pureed cookedvegetables

Fluids

Slowly sip

allowed fluids throughoutthe day. Drink 64 ouncesper day.

BetweenMeals

Drink high-

protein supplement to helpreach your goal of 60 gramsof protein per day.

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Texture DietWith the appropriate approval you haveentered the Soft Texture Diet. At thisstage, you will need to add non-blender-ized foods to your diet. Use the recom-mendations below as guidelines forhealthy eating during this diet stage. The foods in this group do not need tobe blenderized. Be sure to follow theseimportant tips:

• Continue to aim to consume at least60 grams of protein per day. Workwith your dietitian to determine howyou will meet this goal.

• Wean yourself off protein supplementswhen you reach your protein goalthrough meals.

• eat protein foods first.• Avoid mixed dishes, such as casseroles.• After protein foods, eat vegetables

and fruit.• eat only cooked vegetables and

skinless fruit.• Add foods slowly and one at a time to

test tolerance.• Stop eating or drinking when full.

Overfilling may stretch the stomachand hinder weight loss.

• Chew thoroughly.

Foods to Avoid• Soft breads, doughnuts, pastries

(These may form a dough ball andblock the stomach outlet.)

• Salads or other raw vegetables• Sugar and sweets (table sugar, cakes,

cookies, pies, pastries)• High-fat meat (bacon, sausage,

bologna, pepperoni, salami)• Steak, roast beef, pork, lamb, veal,

venison

• High-fat foods (butter, high-fat saladdressing, mayonnaise, sour cream,cream cheese, whole milk, whole-milkcheese, ice cream, cake, cookies, pies)

• Fibrous vegetables (broccoli, cauli-flower, Brussels sprouts, corn, cabbage, salad greens, asparagus)

• Fresh fruit except bananas• Nuts, seeds, coconut, raisins, popcorn,

dried fruit• Rice and pasta

The foods in the following sections aregrouped according to their food type. It isimportant that you choose foods from allthree groups on a daily basis. To help you determine how to plan meals, a sample one-day meal plan is included at the endof this section.

Fluids GroupSlowly sip sugar-free, non-carbonated, caffeine-free fluids throughout the day.Drink at least 64 ounces of the followingfluids throughout the day. (Do not drinkwithin 30 minutes before and after meals.)Options:

• Water• Fruit-flavored water• Sugar-free Kool-Aid®• Crystal Light®• Unsweetened decaffeinated iced tea• Decaffeinated tea or coffee• Sugar-free ice pops (Popsicle®)• Sugar-free gelatin (Jell-O®)• Broth

Protein Group½ 8

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Consume serving sizes between ¼ to ½ cupof protein foods at meals.

Choose from:• Cooked chicken or turkey with no skin;

thinly sliced and moist• Lean ground beef (at least 90% lean)• Fish, water-packed tuna• Tofu• 2 egg whites• Canned beans (kidney, lentils)• Reduced-fat cheese• Cream soups (98% fat free) made with

low-fat milk• 1% cottage cheese• Part-skim ricotta cheese• Smucker’s® Natural Peanut Butter –

Reduced Fat• Jif® Whipped Creamy Peanut Butter• Milk or Lactaid® (skim, fat-free or 1%)• Soy milk (plain or unsweetened vanilla)• Blended light low-fat yogurt

(no chunks)• Hummus (no chunks)

Fruit, Vegetables and StarchesGroup

Consume serving sizes between ¼ to ½ cupof the non-protein foods, one to two timesper day. Note that these foods are not richsources of protein.Choose from:

• Cooked cereal (Cream of Wheat®, oatmeal)

• Ripe bananas• Canned fruit (packed in natural juice)• Vegetables cooked tender without

seeds or skin—boiled or well steamed• Tomato sauce pureed, no seeds or

skins (Do not eat pasta.)

Stage 4:Healthy Weight

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Sample Meal Plan for Stage 3: Soft Texture Diet

Breakfast¼ cup egg

substitute or 2 egg whites

Lunch ¼ cup to ½ cup chicken

Dinner

¼ cup to ½

cup tuna fish with light may-onnaise and 1 to 2 table-spoons soft cooked vegetables

Fluids

Slowly sip

allowed fluids throughout theday. Drink 64 ounces per day.

BetweenMeals

Drink

high-protein supplement tohelp reach your goal of 60 grams of proteinper day.

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for Life Diet PlanYour dietitian or doctor has determinedthat you are ready for the Healthy Weightfor Life Diet Plan. At this stage you shouldhave general goals in place that will helpyou maintain the best nutrition and weightfor the rest of your life.Healthy eating for long-term weight control will be reviewed with you by yourdietitian when appropriate.

GoalsAs you plan meals, remember to keep thefollowing goals in mind:

• Keep meals low in fat.

• Keep meals low in sugar.

• eat foods adequate in protein.

• Drink adequate amount of fluid.

Tips for Healthy Weight for Life Diet Plan

• Always eat protein foods first. Your

new protein goals are 60-80 gramsper day.

• Drink 64 ounces of fluids each day tomaintain hydration.

• eat fresh fruits for added fiber. Startwith softer fruits like bananas,peaches, pears, etc.

• You may introduce crunchy, fibrousvegetables and salads four to sixmonths after surgery.

• While not recommended, whole-grainbread and pasta products may be tolerated four to six months aftersurgery.

• Items may be subject to your individualtolerance.

Protein Food Sources Include:Choose the leanest and/or lowest fat options. Remember to prepare with no

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added fats.Meat

Chicken (1 oz) 7 gramsTurkey (1 oz) 7 gramsSeafood (1 oz) 7 gramsBeef (1 oz) 7 gramsPork (1 oz) 7 gramsegg (1) 7 gramsVenison (1 oz) 7 grams

Dairygreek yogurt (6oz) 17 gramsYogurt (8 oz) 8 gramsMilk (8 oz) 8 gramsCottage cheese

(½ cup) 6 gramsCheese (1 oz) 6 grams

VegetableBlack beans (½ cup) 7 gramsChick peas (½ cup) 7 gramsHummus (½ cup) 10 gramsLima beans (½ cup) 7 gramsPinto beans (½ cup) 7 gramsSoymilk (8 oz) 6 gramsSoy yogurt (8 oz) 8 gramsMiso (½ cup) 18 gramsTempeh (½ cup) 17 gramsTofu (½ cup) 22 gramsAlmonds (1 oz) 6 gramsCashews (1 oz) 5 gramsPeanut butter (2 tbsp) 8 gramsPistachios (1 oz) 6 gramsSesame or sunflower seeds

(1 oz) 6 grams

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Sample Meal Plan for Stage 4: Healthy Diet for Life

Breakfast 6 ounces greek yogurt

Lunch ½ cup chicken salad and 2 tablespoons cooked carrots

Dinner

3 ounces

cooked salmon and 2 tablespoons cookedgreen beans

Fluids

Slowly sip

allowed fluids throughout theday. Drink 64 ounces per day.

BetweenMeals

Drink

high-protein supplement ifneeded to help reach yourgoal of 60 grams of protein per day.

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Bariatric Surgery Vitamin And Mineral Supplements For the first month after bariatric surgery, you need to have chewable or liquid vitaminsand minerals. After 1 month, you can switch to pills. Most other medications are designedto dissolve easily, but vitamins and minerals do not. So while you are healing, it is best to take chewable supplements. The types of vitamins and minerals you will need are listed below.

• Multivitamin with iron� Buy only from the following list of “Complete with Iron” vitamins.

� Pokemon CompleteÔ with Iron� FlintstonesÔ Complete� CentrumÒ Children’s Complete with iron� CentrumÒ Adult Chewable Vitamins or Centrum Liquid� CVS SpectraviteÒ Chewable or Liquid� Walgreen’s Complete MultivitaminÒ Multimineral Supplement Liquid

� Since you will be taking 2 multivitamins a day, you will need at least 60 chewabletablets for the first month.

• Vitamin B-12� Buy sublingual (melts under your tongue) vitamin B-12.� You need 350 to 500 micrograms (mcg) of vitamin B-12 per day oral/sublingual

or nasal or 1,000 micrograms per month intramuscularly.� Do not buy time release.� You can take vitamin B-12 once a day. You do not need to spread out the doses.

• Vitamin D-3� The amount of vitamin D recommended is 3,000 IU a day. Vitamin D can

be found in liquid or in gel caps.� You can take vitamin D-3 once a day. You do not need to spread out the doses.

• Calcium citrate with vitamin D� Purchase a calcium supplement that contains vitamin D.� The amount of calcium you need:

� Men and premenopausal women: 1,200 milligrams (mg) a day.� Postmenopausal women: 1,500 milligrams a day.

Do not take your other vitamins at the same time as your calcium citrate supplements.Calcium and iron (in the multivitamin) compete for absorption. It is best to take your vitamins a couple of hours apart from your calcium.It is also important that you spread out your doses when you take your calcium supplements. For better absorption, the doses should be taken at least 2 hours apart. It is best to take your calcium supplements with meals,

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Notes

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315 South Manning BoulevardAlbany, New York 12208

Rev. 3/2017

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