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Nutrition After Bariatric Surgery

Nutrition After Bariatric Surgery

It is vital to follow the recommended dietary guidelines after undergoing bariatric surgery. These guidelines were carefully designed, with the goal of limiting the amount of calories you consume, while providing balanced meals that help prevent nutrient deficiencies and preserve muscle tissue.

This new way of eating may seem overwhelming at first, but over time, most patients find the guidelines become an unconscious part of their daily routine.

At our registered dietitians will provide with dietary rules following your surgery. Here are some guidelines that can be helpful:

Nutrition Guidelines

1. Protein is your new number one food. Always eat your lean protein food first to meet your minimum 60g of lean protein intake a day. Lean protein can be: 1 oz. of meat (chicken, turkey, fish, beef, or pork), 1 oz. of low-fat cheese, 2 Tbsp. peanut butter, 1 egg, ¼ cup of low-fat cottage cheese.

2. You should not skip meals. Eat at least three meals a day. Having 1-2 small high-protein snacks may be beneficial if you are going more than 4 hours in between your meals. Small, frequent meals will help to prevent you from filling your pouch up too fast and will keep your metabolism burning.

3. You should eat at your table. Use a plate or dish and sit down. Take 30 minutes to eat your meals. Avoid eating at the counter or cupboards, in front of the refrigerator, in other areas of the home, or in front of the TV or computer.

4. Make portion control a priority. Serve smaller portions. Cut up chicken in smaller pieces. Use a salad plate as your dinner plate or baby spoons to prevent overeating. Slow down with eating, chew foods thoroughly, and stop when you feel full. Keep serving dishes off the table.

5. Liquids need to continually consumed throughout the day. Drinking 6-8 cups of caffeine-free, calorie-free, and non-carbonated beverages a day is a must. You don’t want to drink with your meals; stop drinking 30 minutes before your meal, eat, and then wait 30 minutes after your meal to drink again. This will prevent nausea and vomiting. Sip on fluids in between your meals.

6. Take your vitamin/mineral supplements daily. When your doctor gives you permission, take your multivitamin and calcium citrate supplements daily. Additional vitamin B12, vitamin D, and iron may be required.

7. Remember, this is a new way of life. Not just a diet. Try not to think of this weight loss surgery as a diet, but as a new way of life not only for you but also for your family and friends. These healthy habits are a lifestyle change for now and forever.

Vitamins and Minerals

You will not be able to meet certain vitamin and mineral needs without supplementation. Vitamin and mineral deficiencies have been observed in patients after weight loss surgery. Iron, folate, vitamin B12, calcium, and zinc are most affected after gastric bypass surgery.

If you are having gastric banding surgery you will not need to take all the above supplements. Gastric banding does not cause malabsoprtion of nutrients from your foods. A daily multi-vitamin and calcium supplement is usually sufficient.

Mandatory Supplements:

1. Multi-vitamin and Mineral
Dosage: 1-2 daily with meals
Type: 2 children’s chewable multi-vitamin OR 2 chewable or liquid adult multi-vitamin.
*Once on a regular diet can begin an over the counter prenatal vitamin OR 1 adult multivitamin (does not have to be chewable or liquid)
Function: Multi-vitamins will help ensure that you are getting enough of all the micronutrients that you need.
Interactions: None

2. Vitamin B12
Dosage: 1000 micrograms tablet or sublingual daily or 1000 micrograms monthly of injectable B12
Type: Any sublingual (dissolves under tongue), tablet, or monthly injection (prescribed by your surgeon)
Function: Helps with blood cell and nerve function, digestion and absorption of food, and protein synthesis. Deficiency may cause certain types of anemia.
Interactions: None

3. Iron
Dosage: 45-60 mg of elemental iron daily. Take with vitamin C.
Type: Any tablet of ferrous sulfate, gluconate, or fumarate that is equivalent to 27-28 mg
of elemental iron. Prenatal vitamins may already have enough iron in each tablet. Read the label first to see if additional supplementation is required.
Function: Vital to the formation of red blood cells that provide oxygen to the entire body.
Interactions: Take 1-2 hours before or after taking calcium. Do not take with milk, cheese, eggs, whole-grain breads and cereals. May cause diarrhea or constipation.

4. Calcium citrate with Vitamin D

Dosage: 1200-1500 mg daily. Calcium citrate is best absorbed in doses of 500-600 mg at a time. Take with meals.
Type: Tums® initially, once tolerating regular diet switch to Citracal® +D or any equivalent brand with calcium citrate. The citrate form of calcium is better absorbed since it doesn’t require the acid from your stomach to be absorbed.
Function: Maintains bone strength; also helps heart pump correctly and repairs soft tissue.
Interactions: Caffeinated products, spinach, and whole grain products may decrease absorption. Take at least 1-2 hours before or after taking iron, since calcium will decrease iron absorption.

All of the required vitamin supplements are listed above. They are available over the counter at your local pharmacy.

If you have difficulty locating or tolerating any of the supplements, call Anakaren Vargas, RD or Dr. Lopez for suggestions.

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