carb counts in post ops

Hi everyone!  I am a littel over two years out and wondering where my carb count for the day should fall?  My nutritionist was hard pressed to give me a number but I am sure that there is one out there!  Any ideas? thanks! Anjanette

Are you looking for a carb count that fits in with your total calories for the day? To just give you a number would almost be irresponsible. In general, if a patient was maintaining a 1800 calorie per day diet, then I would use 15 servings per day (that is 50% of calories from carbs, 4 kcals/g, 15 carbs per serving).  Many people adjust their carbs up or down depending on goals, calorie levels, etc.  I use 15 as a guideline for a serving but teach that anything from 12 to18 g carb counts as that serving.  It requires label reading and measuring - but no one here is unfamiliar with those concepts. Hope that helps - if not, let me know.

Danielle~ Thank you so much for taking the time to answer my question.  I am looking for maintenance numbers.  So, I guess a carb number based on my caloric intake.  I eat about 1200-1300 calories per day.  I actually should be eating 1427 according to my nutritionist, but I am hard pressed to get them all in.  I just don't want to be overdoing the carbs....that is what got me into trouble in the first place. I do recognize that good carbs play an important role in our bodies and our health.  I just want to do the best with my pouch that I can, without gaining weight. Have a great day! Anjanette

If you are doing okay on 12-1300 calories a day, that's probably fine.  If I based your carbs on 1200, I would calculate 10 servings.  Using your nutritionist's (dietitian??) it would be 12. If you are calculating that in grams of carbohydrate that would be a minimum of 120 g per day to about 215 g.  That's a pretty big range.  To be on the safe side, I would recommend not going over about 180 g per day.  In food terms that is 15 cups of milk or 12 small apples or 6 cups of pasta (I am not recommending that you eat these - but just illustrating my point) About good carbs - good is relative and it doesn't just mean 'taste good'.  "Good Carbs" contain vitamins and minerals - think carbs from milk (12 g per cup) or from servings of fresh fruit (12-18 g).  Milk has calcium, phosphorus, zinc, and magnesium - all nutrients that you need after GBS.  Fruit has loads of the B vitamins, potassium, vitamin C, fiber and phytochemicals (these are chemicals that are related to the color of foods and have great health promoting benefits).  Your carbs should come with more than just calories, they should also have nutrients. I hope this helps! Danielle

WOW~ Can I hire you? Thanks again for all of your great advice!! Anjanette

I'm one of the dietitians at eNutritioncare.com - so yes, I'm for hire! I'm also here on the nutrition board. Looking at the postings, there is a need for information.  It's also unfortunate, not all of the dietitians working in bariatrics have the same amount of expertise.  It's a big country and dieitians are in short supply just like most other healthcare professionals. I'm happy to help when I can! Danielle

Well Danielle, I can tell you that I feel very lucky to have posted where I did!  As a nurse, I agree with you in terms of the need for information.  Being a nurse can be a disadvantage because I want to know specifics....what, when, how much, over how much time and that makes other professionals nervous.  My bariatric surgeon wouldn't even tell me in what range my counts should be.  If she doesn't know, who is going to?  There needs to be so much for education around bariatrics.  Well, if I have more questions, I will know who to find whether at OH or enutrition.com or maybe I will hire you!! Anjanette

Danielle, Can you clarify this, please?  When you say 15 servings per day, where is 15 coming from?  Or should I say, what does 15 represent?    Further down, you said, "If I based your carbs on 1200, I would calculate 10 servings."  What??  10 servings of what?  Marie

Absolutely - let me clarify. The carb levels I was talking about are based on a carbohydrate controlled diet which is a typical "diabetic diet".  Now, without leading anyone into a conversation about diabetes - the purpose here is to find a way to control carbs. So without reinventing the wheel, it is easiest to use an established eating plan like "Carb Counting". OK here are the basics - one carb serving is equal to 15 g of carbohydrate.  This equals one slice of bread, 1/2 c of pasta, 1 small banana, 1/2 cup of corn, etc.  15 g of carbs is considered one serving, so it is also a way to determine a recommended serving of a starch, fruit, starchy vegetable, or grain. For those who have used diabetic meal planning, weigh****chers, or another diet plan this is a pretty standard amount. Now, when I teach this, I tell people that 12-18g equals one serving because some foods don't fit nicely into the 15 g guideline.  A 8 oz. serving of milk has 12 g of carbs, that counts as a serving. So that explains servings. For the calorie level and number of portions.  I take the recommended amount of calories and allow 50% to be used for carbs.  So if you eat a 1200 calorie diet, 600 calories can come from carbs.  A carbohydrate has 4 calories per gram and we are allowing 15 g per serving. 600 calories divided by 4 calories per gram = 150 grams 150 grams divided by 15 g per serving = 10 servings That explains the number of servings. To get a list of carbs you can look up diabetic meal plans, exchange lists, or carb counting and find just about any food you can think of. Did that help? Danielle Halewijn RD eNutritioncare.com