Nutritional Guidelines

I know there are some RD's lurking out there - so if you are, please feel free to help!  I left the hospital on June 11th with a list of what I can eat and when. Basically I was told eat 2 oz of food 3 times a day, take my vitamins and drink 64 oz of water.  I am trying to put together a tracker that breaks down exactly what I am eating, and was wondering if someone could help me with defining targets for the following. Calories (I think this should be 600-800 for being 10 weeks out) Fat Saturated Fat Protein Carbs Sugar Fiber Cholesterol Sodium  Any help is appreciated. I just need a guideline - I have found that 2 oz of one food is very different than another. Kyla

 

Hi Kyla! Sure enough, you caught me -- I'm a dietitian cruising the message boards. :) I've been working with WLS (mostly RNY) for 5 years. So, I'm going to give you some RNY guidelines. If you've had a different surgery, let me know. I have experience in the other WLS, but RNY is my speciality. In any event, good news -- YOU DON"T NEED TO COUNT CALORIES!! OR FAT for that matter. :) Every surgeon has different guildelines -- if my guidelines differ from your surgeons, you may want to run it by him or her -- I don't want to step on anyone's toes out there. With that being said, here are my recommendations: 1. At 10 weeks out, you can now eat regular foods. No need to puree or mash your foods. You are also free to eat fresh fruit and vegetables (prior to this they were probably restricted). 2. You should be eating 3 meals per day, approximately 1/3 cup of food at each meal. I also recommend a bedtime snack. 3. You don't need to count calories, but your right, the average intake for 10 weeks out is 500-750 per day. Protein, however, you DO want to count. Try to consume at least 65 g per day. This is very, very difficult to do, but try your best. If you aren't taking a protein shake already, you may considering doing so. Buy a small amount of the shake to check the taste. Some are really awful. :) If you find one you like -- great! 4. Other good sources are protein are: nuts, legumes, meat, soy, dairy products. 5. Regarding fats -- you don't need to count fat --- your days of fat grams are (for the most part) over. Basically, avoid any fried foods and high fat/sugar foods (like donuts, fried chicken, french fries, fast-food burgers, almost all fast food). But fat found in cooking oils, the tab of butter you may put on your veggies, meats .... no big deal. :) Although, it's best to get your fat from unsaturated fat and consume as little saturated fat as possible (in general that's just a good idea -- WLS or not) 6. Avoid sugar like a disease. It can cause dumping syndrome (rapid passage of food to colon -- makes for nasty bathroom time). By sugar, I mean, cookies, candy, sweets, sugar drinks, sugar soda 7. Since you're 10 weeks out, the more fiber the better. General goal is 25g per day; however, with my WLS patients, sometimes we shoot for 10 g at first, then work our way up through the years. 8. Basically, eat a variety of foods. WLS is suppose to help you get portion control back. Avoid junk foods and fast foods -- pretty much all "healthy" food is game - just in smaller portions. Concentrate on protein - this helps you heal faster and maintain your muscles and your hair and nails ... at this point, for you, protien is key. Let me know if that helps - or send me your food intake for past 3 days or so and I can review it and give you more detailed advise on how you're doing. Good Luck!! :) Sara Nejat-Bina, RD www.enutritioncare.com

Sara, Thank you sooooooooooooo much. I did have RNY & your response meant so much to me. I have really been struggling to find some structure to what I am doing and I feel like I have that now.  I also realized based upon your response that I am doing pretty well!  I haven't had any "sugar" since surgery and I don't plan on it.  I do avoid fats, but every now and then have had "1" potato chip - to satisfy my craving so I don't binge. So far that has worked.  I drink 64 ounces of water a day at a minimum. I never have consumed soda so that is a plus.  I have had trouble with meat and veggies (getting stuck) so I've mainly stuck to cheese and soft foods. I did start salad and I love it - but I have to add cheese to get any protein or calories. :) I started adding a protein shake to my diet about a week ago. I found one that has 23G protein and only 2.5 carbs per scoop (Elite Whey Protein Dymatize). I do 2 scoops a day to get 46G and then supplement with food for the rest. Thank you again for all your help.  Kyla

Wow, so you are golden on the protein. Fantastic! What about vitamins? Are you taking them? You should at least be taking: 1. A multivitamin 2. Calcuim 3. Iron 4. B-complex (must include B12 -- usually under the tongue) Let me know if you have other questions or need assistance with vitamins. :) Sara

I'm supposed to be taking vitamins??? Just kidding! Yes, I take a children's chewable - 2 of them daily I also take Tums for calcium (just until I'm at 3 months then I'll switch to something else) I don't take iron - and ironically I had a GI bleed (8 weeks ago) so my blood counts are still really low. Maybe I should address this with my doc. Finally - I get Vitamin B shots - once a month I also take Potassium, because my level fell to 2.8 - that wasn't fun. It's up to 4.2 now and I feel much better. I do have another question - abou****er retention. I limit my sodium intake but have still had retention problems for the last few weeks. Is there anything diet-wise I can eat to help with this? Thanks Again! Kyla

I gasped at your first sentence! Funny. Glad you got the vitamins on board. :) You'll definately want to take Iron - review it with your doc, but I always recommend Iron Citrate. It's better absorbed & has less constipation side effects. I know you can find Iron Citrate on-line, in CA, my patients can find it at Costco, I'm not sure what your shopping options are in Utah. You did ask abou****er retention, so here's my two cents: -- Yup, avoid salt - when looking at sodium, keep it below 2000 mg per day (which will be easy considering your food intake is very low). -- other than avoiding salt, you can also walk (or any exercise) to reduce water retention. Work your way up to 30 minutes per day (if you have not already) -- Some doctors may give you a diuretic to help reduce the water - but really, with weight loss, the water will come off too. You're totally on the right track. Congratulations! You're doing great! Keep it up!

Thanks again. I only started walking this past Monday, but I've gone 3 days in a row. It helps that we have a gym here at work and it's only $15/month to join. Since I don't eat during lunch hour, I figured I would do that instead! I'm starting slow. I only do a 20 minute mile, but I increased to 2 miles and excercised 40 minutes today. I'm pretty proud of that since it's been 5 years since I stepped foot in a gym! I have set my sodium target at 1000 and tried to stay within it - so knowing I can go up to 2000 is great.

Thanks again, you have been fantastic!

kyla

Exercise will help with the water! I'm glad you've joined the gym - it will also help your weight loss goals and keeping the weight off in the future. Congratulations - you're totally on the right track. Let me know if I can be of further help to you. :) Sara

Please send me the CLOUD recipe. I am new in here,haveing lap band Sept. 14,07 Any other info. or recipes would be great!  [email protected]

A free source that will calculate that for you is TheDinnerPlate.com  I use it everyday and it is amazing! If you want to keep track after reading the RD's reply,  Take care! ~Tomi