February 07, 2014

Dietary Guidelines After Bariatric Surgery

The term “Bariatric” refers to the field of medicine that addresses the causes, prevention and treatment of obesity. Bariatric surgery refers to a number of different surgical interventions designed as a tool to assist in obesity management. Each procedure assists with obesity management by restricting food intake through creation of a small pouch in the stomach. Some procedures may also produce malabsorption by altering the gastrointestinal tract.

Dietary recommendations post bariatric surgery:
It is very important to follow the recommended dietary guidelines after undergoing bariatric surgery. These guidelines were carefully designed by your health care providers, with the goal of limiting the amount of calories you consume, while providing balanced meals that help prevent nutrient deficiencies and preserve muscle tissue.

General Guidelines
  • Eat balanced meals with small portions.
  • Follow a diet low in calories, fats and sweets.
  • Keep a daily record of your food portions and of your calorie and protein intake.
  • Eat slowly and chew small bites of food thoroughly.
  • Avoid rice, bread, raw vegetables and fresh fruits, as well as meats that are not easily chewed, such as pork and steak. Ground meats are usually better tolerated.
  • Do not use straws, drink carbonated beverages or chew ice. They can introduce air into your pouch and cause discomfort.
  • Avoid sugar, sugar-containing foods and beverages, concentrated sweets and fruit juices.
  • For the first two months following surgery, your calorie intake should be between 300 and 600 calories a day, with a focus on thin and thicker liquids.
  • Daily caloric intake should not exceed 1,000 calories.
Fluids
  • Drink extra water and low-calorie or calorie-free fluids between meals to avoid dehydration. All liquids should be caffeine-free.
  • Sip about 1 cup of fluid between each small meal, six to eight times a day.
  • It is recommended to drink at least 2 liters (64 ounces or 8 cups) of fluids a day. You will gradually be able to meet this target.
  • You should strongly warn against drinking any alcoholic beverages. After surgery, alcohol is absorbed into your system much more quickly than before, making its sedative and mood-altering effects more difficult to predict and control.





Multivitamins

Calcium Supplement

Vitamin D Supplement

Vitamin B12 Supplement

Other Supplements
Diet Progression After Bariatric Surgery


Preserve muscle tissue by eating foods rich in protein. High-protein foods include eggs, meats, fish, seafood, tuna, poultry, soy milk, tofu, cottage cheese, yogurt and other milk products. Your goal should be a minimum of 65 to 75 grams of protein a day. Don't worry if you can't reach this goal in the first few months after surgery.


Supplements
You must take the following supplements on a daily basis to prevent nutrient deficiencies. Please remember that all pills must be crushed or cut into six to eight small pieces. You are not able to absorb whole pills as well as before surgery, and it can be difficult for the pills to pass through your new anatomy.
Take a high-potency daily chewable multivitamin and mineral supplement that contains a minimum of 18 mg of iron, 400 mcg of folic acid, selenium, copper and zinc. Brands that contain this formula include Trader Joe’s and Centrum Adult chewable multivitamins. Take two tablets daily for at least three months after your surgery, and then one tablet daily for life.
Take 1,200 to 2,000 mg of calcium daily to prevent calcium deficiency and bone disease. To enhance absorption, take the calcium in two to three divided doses throughout the day - for example, a 500 to 600 mg supplement taken three times a day. Calcium citrate is the preferred form of calcium.
Take a total of 800 to 1,000 International Units (IUs) of vitamin D each day. This total amount should be taken in divided doses of 400 to 500 IUs twice a day. Vitamin D should be taken with your calcium supplement. If you prefer, you can take a combination calcium-vitamin D supplement to avoid taking multiple pills, so long as it contains the proper dosages.
Take 500 mcg of vitamin B daily. It can be taken as a tablet, or in sublingual forms placed under the tongue.
Some patients need additional folic acid or iron supplements, particularly women who are still menstruating. Your dietitian will discuss this with you.
Immediately following surgery, you will begin with a clear liquid diet. You may gradually start adding thicker liquids to your diet after you are discharged from the hospital.
Two weeks following surgery, you may progress to blended and puréed foods. You may use high-protein (more than 20 grams protein), low-calorie (less than 200 calories) liquid supplement drinks or powders to meet your protein requirements during this period.


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