Nutritional Guidelines After Roux-en-Y Gastric Bypass Surgery
The purpose of your diet after gastric bypass surgery is designed to restrict caloric intake to produce desired weight loss, to help develop appropriate eating habits and to prevent disruption or obstruction of your pouch. In addition, it is strongly recommended to pursue weight loss in preparation for surgery. Even a small amount of weight loss may contribute to a decreased surgical risk during bariatric treatment. Main Focus: Diet Principles:
2. All foods, beverages and snacks that are high in calories are omitted. 3. When your doctor gives you permission, vitamin/mineral and calcium supplements are required daily. Additionally, vitamin B12, iron and zinc also may be recommended. 4. Eat very slowly. Foods need to be thoroughly chewed to prevent blockage. 5. Stop eating as soon as you are full. Indications of fullness are: a) a feeling of pressure in the center just below your rib cage, b) a feeling of nausea, c) a pain in your shoulder area or upper chest. Contact your doctor if the above symptoms persist or worsen. 6. Include protein first at each meal to help maximize protein intake. As your pouch expands, you may only need to eat 3 meals and 1-2 high-protein snacks each day. 7. The diet will be advanced gradually, depending on tolerance: Phase I: Clear liquid diet (in hospital only) Foods That May be Difficult to Tolerate After Surgery
* Sweets should NOT be part of your diet if you want to reach your weight-loss goal followed by weight maintenance. Phase I: Clear Liquid Diet 2. Once approved, you will receive water, clear broth, unsweetened apple juice or decaffeinated* tea (no red fluids)**. You will only be able to drink 30mL (1 oz) every hour. If you tolerate 1 oz of liquid each hour, on day 2 you may advance to 60mL (2 oz) of liquid every hour. 3. Remember to drink liquids SLOWLY. Do not use a straw***. 4. There may be large quantities of liquids brought to you on your tray. You do not have to finish everything. When you feel full, stop! 5. It is not unusual to experience nausea and/or vomiting during the first few days following surgery. Make sure that you drink slowly. If nausea or vomiting persists, contact your nurse. *Caffeine should be avoided after surgery because it is a diuretic. This will cause you to lose fluids and make it more difficult for you to keep yourself hydrated. **If ?red foods? are consumed after surgery and you vomit, it may be mistaken for blood. ?Red foods? include foods on the clear liquid diet such as sugar-free gelatin, sugar-free popsicles or any ?red? sugar-free beverages. ***If you drink from a straw after surgery you will cause air to enter into your new pouch. This will create a full feeling and you will have less room for liquids needed to keep hydrated as well as nutritious foods when you advance to those stages. Phase II: Full Liquid Diet 2. You will stay on the full liquid diet for 1-2 weeks unless directed otherwise by your surgeon and dietitian. 3. To prevent nausea and vomiting, drink liquids slowly. Sip ¼ cup (2 oz) of liquid over 30 minutes. You do not have to finish everything. When you feel full, stop! 4. Drink at least 6-8 cups of water or low-calorie drinks between high-protein beverages. Remember to avoid carbonation, caffeine and citrus. 5. Take your prescribed multi-vitamin/mineral supplements and calcium as instructed. 6. Make sure you keep track of the kind and amount of high-protein beverages you drink. Remember, you need a minimum of 60 grams of protein each day. The following are examples of protein sources that should be included on the Full Liquid Diet: Phase III: Puree Diet 2. You can continue to include foods on the full liquid diet throughout this stage. 3. It is very important to chew foods thoroughly to avoid blockage or nausea. Try 1-2 Tbsp of food at a time to see if tolerated. Each meal should consist of only 2-4 Tbsp (1/8 ? ¼ cup of food). 4. Remember to always include protein first at each meal. You need a minimum of 60 grams of protein each day. 5. Keep yourself hydrated! Drink 6-8 cups of water and low-calorie beverages between meals. Fat free or 1% milk can be included as part of your total fluid intake. 6. Continue to keep track of the kind and amount of protein you eat every day. Milk Group (8 grams protein per serving) Starch Group (3 grams protein per serving) Fruit Group (0 grams protein per serving) Vegetable Group (2 grams protein per serving) 2. Add non-fat powdered milk or acceptable protein powders to your foods to boost protein amount. 3. Try one new food at a time. If you feel nauseated or experience gas or bloating after eating, then you are not ready for this food. Wait a few days before trying this food again. 4. Portions may need to be adjusted depending on your individual tolerance. Listen to your body. Stop when you feel full. Phase IV: Soft Diet 2. You will remain on the Soft Diet for 2 weeks. Remember to try one new food at a time. 3. For better portion control, use smaller plates and baby spoons and forks. Stop eating when you feel full. 4. Keep yourself hydrated! Drink 6-8 cups of water and low-calorie beverages between your meals. Don?t drink with your meals. Don?t drink 30 minutes before and 30 minutes after meals. 5. Continue to take your supplements as prescribed. 6. Continue to keep track of the kind and amount of protein you eat every day. Remember, your goal is a minimum of 60 grams of protein each day. The following are examples of foods from each food group that can be included on the Soft Diet. Meat Group (7 grams protein per serving) Milk Group (8 grams protein per serving) Starch Group (3 grams protein per serving) Fruit Group (0 grams protein per serving) Vegetable Group (2 grams protein per serving) 2. Moist meats are tolerated better at this phase. Add chicken or beef broths, fat free gravies and low-fat cream soups to moisten meats. Finely dice meats and chew well. 3. Add 1-2 Tbsp of a new food at a time; if you feel nauseated or bloating after eating then you are not ready for this food. Wait a few days before trying this food again. Everyone progresses differently. Listen to your body. 2. This is the last stage of the diet progression. Continue to add new foods in slowly. Raw fruits and vegetables can be added in as tolerated. You may want to avoid the skin and membranes on fruit. 3. Follow a low-fat diet and avoid simple sugars for life. Your protein goal remains at a minimum of 60 grams each day. For successful weight loss, caloric intake may range between 800-1200 calories each day. Ask your registered dietitian how many calories are appropriate for you. 4. Continue to eat 5-6 small meals each day. As your pouch expands, 3 small meals and 1-2 high protein snacks may be more appropriate. 5. Continue to take your prescribed supplements for life. 6. Keep yourself hydrated! Always drink 6-8 cups of water and low-calorie beverages daily. 7. Continue to track your daily intake and activities. Include calories, protein, fluids, supplements and exercise. Meat Group (7 grams protein per serving) Milk Group (8 grams protein per serving) Starch Group (3 grams protein per serving) Fruit Group (0 grams protein per serving) Vegetable Group (2 grams protein per serving) Fat Group This information has been provided courtesy of the Cleveland Clinic Bariatric and Metabolic Institute. Please visit the Cleveland Clinic Bariatric and Metabolic Institute. |