Ask a Dietician - I need a refresher on nutrition.

Hello, I'm glad you are here to answer our questions. I had wls (rny) back in December 03. I lost 135 in the next 2 years (it came off fairly slowly but steadily). At Christmas of 2006, I gained about 5 pounds but I wasn't terribly worried about, I could get rid of it fairly easily. But I couldn't keep it off. I kept gaining and losing that same 5 pounds. Now, over Christmas 2007, I gained another 6 pounds. Well now, that is totally unacceptable! Anyway, I am going back to basics but I want to make sure I have it right. I've started exercising aerobically for 30 minutes (haven't had a formal exercise plan up to now. We had a pool and in the summer I'd swim but we got rid of it back in September). I plan to work my way up to 45 minutes 3 times a week. Nutitionally, I am weeding out the bad carb from my diet (pretzels, 1/2 bagel + lite cream cheese, pasta) and eating more protein. For example, this was a typical day back in December: breakfast: 1/2 bagel with 1 oz lite or regular cream cheese coffee with 2 of the little tubs of half & half (2 oz?) lunch: 6 oz bowl of chili with beef and kidney beans (from the cafeteria) one Fuji apple snack: 4 or 5 saltines with about 1/2 tbsp peanut butter on each dinner: 3/4 of a grilled chicken breast (can't usually eat a whole one) Kroger's lite sugar free yogurt with about 1/2 cup of fresh (frozen) fruit, usually blueberries or mandarin orange segments snack: 1/3-1/2 bag of microwave popcorn or 10-12 Doritos or 5 or 6 chocolate covered raisins (bad, I know) Unfortunately, throughout the whole month of December, there was a "goodie" list and people brought in something every day. And guess where it all was?? Yep, right outside my office. Couldn't go to the printer, cafeteria, or even the bathroom without passing a pile of cookies, pies, cakes, muffins, chocolates, did I mention cookies?? I did indulge in some of them but not too much as I dump on more than about 25 g of sugar at a time. I didn't keep track of how many times I strayed (can I say denial? yes... I can *sigh*). But before December I actually thought I was doing pretty good! But, apparantly not. I have stopped eating bagels, popcorn, Doritos, and I gave away my stache of chocolate covered raisins.. I still eat the yogurt, apples, and peanut butter. I think I have a handle on this but wanted to get a second opinion. Today I had: Breakfast: One packet of Eat Well Sugar Free oatmeal with 1/3 cup soy milk and a packet of Splenda hot tea (still have coffee/cream some days but not today) with Splenda Lunch: one Fuji apple fresh spinach with a little shredded carrot, chopped boiled egg (looked like maybe 1/2 an egg), and 1/2 cup cottage cheese. No dressing. Mid afternoon: 1/2 of a ham sandwich ( 1 slice whole wheat bread, 1 slice cooked deli ham, 1 slice baby swiss, brown mustard) Dinner: (last nights dinner) 1 slice of home made pizza (Kroger's thin pizza crust, green pepper, fresh tomato, mushroom, little bit of LaRosa pizza sauce, 2 thin slices of pepperoni, fat free cheese). My hubby made it for us. He is trying to lower his fat/cholesterol intake. There were 10 slices of pepperoni on the whole thing and I got two of them. Snack: (last night) Blue Bunny sugar free yogurt + 1/2 cup of blueberries 6 or 7 Triscuits I take my vitamins, and I am trying to increase my water intake (not a fan of water but I do like tea). I would consult the post-wls manual that I got from my surgeon but I lent it to someone who was considering wls. Your help is appreciated. Marcia

hi Marcia, I'm not a nutritionist, but see on often and also have a trainer who gives me nutritional advice.   Your new "menu" sounds  great, you're eating protein with every meal is not only what I was told to do as a post-op but it is beneficial for your body. Sticking to complex carbohydrates like oatmeal, whole wheat bread, wheat pasta, brown rice is also helpful as they burn slower than refined carbohydrates (white bread, pasta, potatoes, rice, foods with sugar like snack foods, etc) Being around different foods for the holiday season is tough for everyone, the holidays are gone now so put the past behind you and move on.  You can do it :) If the snacks start appearing at the office again, try chewing a piece of sugar free gum, if you have gum in your mouth it will give you an excuse not to stop at the table and grab something bad for you :) As far as water goes, a lot of people don't "like" it, but it refuels your body and honestly helps you lose weight!   Theres a great product out there called "Stevia" that is sold at vitamin shoppe and wholefoods.  They have different flavors that can be added to waters like fruit 2O (but better for you, stevia is a natural sweetener).  heres a link if you want to check it out.. http://sweetleaf.com/category.php?subcat=products&subpage=st eviaflavors Tea isn't bad, but even decaf has caffeine in it so it can dehydrate you if you're not drinking water.  I was always told every cup of caffeine you drink you should have 2 glasses of water to counteract it.  Some post-ops have problems with ice water or cold water, try room temp if thats the case of vice-versa if room temp bothers you.  Throw a slice of lemon, lime, orange, even cucumber your glass for a different taste (a lot of spas offer cucumber water, its very good :) ) good luck with everything!  

I'll agree with the other writer on just about everything - except... Contrary to popular opinion, caffeinated beverages don't dehydrate you.  I have posted on this topic before (if you want to check it out in the archives).  It's very important to get enough total fluids.  The presence of caffeine is not as big an issue as previously believed - and there are good clinical studies on this. Yeah - the holidays are tough.  Get back on track with your daily calorie goals.  Adding exercise is the single best thing that you can do to maintain your losses and counter the slowing metabolism that happens to all of us as we grow older.  Even WLS people need to remember that!  Maintenance is tough, but you look like you are on the right track. Good luck!

Danielle and Stylz, Thank you for the reply and support. I appreciate it! I am very motivated to continue on the right track. I am looking for a local post-op support group to attend to stay on the straight & narrow. Marcie

Danielle, I always suspected that the caffeine exclusion was exaggerated. Coffee is something like 99.98% water. Your body can absorb the water just as it would if you were drinking Crystal Lite. I will check the archives for more info, as you suggested. Thanks for the post.