Sample Gastric Bypass Diet
This is just a sample diet that my surgeon gave me. I thought Id offer it to pre-ops as a sample of what to expect post-op. Always follow your surgeons advice for post-op diet.
STAGE 1: NON-CALORIC CLEAR LIQUIDS
Start: 3 days post-operatively, some surgeons require Stage 1 be started in-hospital so adequate fluid consumption can be monitored.
Diet: Three fluid ounces (90 cc) of sugar-free clear liquids three times daily.
Between these meals you should take three ounces of clear liquids per hour. See page 4 for lists of recommended fluid for Stage 1.
Instructions: Stop sipping as soon as you feel full. Drink slowly; use a 1-oz. medicine cup to measure your fluid intake.
STAGE 2: SUGAR-FREE LOW-FAT FULL LIQUIDS
Start: Usually 48 hours after Stage 1.
Diet: Six small meals per day each consisting of 4 fluid ounces of Sugar-Free Carnation Instant Breakfast (CIB) mixed with skim milk. Drink slowly (sip) over a 1-hour period.
Instructions: 1. Continue to record fluid intake at home. Bring this record to your follow-up clinic visits
2. Other high-protein liquids can be substituted for Carnation Instant Breakfast.
See page 4 for suggestions.
3. Sip high-protein liquids slowly over 1 hour.
4. Between-meal fluids should be non-caloric clear liquids and should not exceed 6 oz. per hour.
5. Goal fluid intake is 48 oz. fluid daily.
6. Take liquid or chewable multivitamin supplements daily.
STAGE 3: PUREED FOODS
Start: Usually 2-3 weeks after discharge.
Diet: Three fluid ounces (6 Tbsp) of high-protein pureed food consumed three times per day. One of these ounces may be pureed vegetable or fruit. Eight fluid ounces of skim milk or Sugar-Free Carnation Instant Breakfast should be taken three times daily between meals. No more than 8 oz of fluid should be taken per hour.
(See Suggested Meal Plan for Stage 3 on the next page)
SUGGESTED MEAL PLAN FOR STAGE 3
Meal Serving Size Food Calories Protein (gm)
Breakfast 2 Tbsp Pureed Pudding or Yogurt 30 3 1 Tbsp Pureed Fruit 20 --
Snack 8 oz Sugar-Free CIB 150 15
Lunch 2 Tbsp Pureed Meat 30 3
1 Tbsp Pureed Vegetable 20 trace
Snack 8 oz Sugar-Free CIB 150 15
Dinner 2 Tbsp Pureed Meat 30 3
1 Tbsp Pureed Vegetable 20 trace
Snack 8 oz Sugar-Free CIB 150 15
TOTAL 600 kcal 54 gms
STAGE 4: SOFT AND SOLID FOOD
Start: 5-6 weeks after surgery.
Diet: Two-three fluid oz (4-6 Tbsp) of high-protein solid food consumed three or four times a day. Eight fluid oz skim milk or Sugar-Free CIB daily between meals (no more than 6 oz/hr).
Goal: At least 48 oz liquid daily, 600 grams protein daily.
Instructions: As with Stage 3.
1. Certain solid foods may not be well tolerated. Many patients have difficulty with meat despite chewing well.
2. Other foods to avoid include nuts, potato skin, fruit peel, and high-fat, high-calorie foods (including alcohol).
SUGGESTED MEAL PLAN FOR STAGE 4
Meal Serving Size Food Calories Protein (gm)
Breakfast 1 Egg, Scrambled 73 7
½ Slice Bread, Toasted 34 1
1 tsp Margarine for Toast 45 trace
¼ Banana 20 trace
Snack 8 oz Sugar-Free CIB 150 15
Lunch ¼ cup Plain Chicken Salad 73 7
1 tsp Mayo 45 trace
3 Crackers 34 1
¼ cup Applesauce 20 trace
Snack ½ cup Yogurt, Plain or Skim 90 8
Dinner 1 oz Fish, Baked with Lemon 73 7
¼ cup Noodles 34 1
¼ cup Carrots, cooked soft 12 1
Snack ½ cup Custard or Sugar-Free CIB 150 8
TOTAL 853 kcal 56 gms
Note: See page 4 for additional high protein foods that may be substituted into Stage 4.
RECOMMENDED FLUIDS FOR STAGE 1
AND
FOR BETWEEN MEALS (ALL STAGES)
RECOMMENDED HIGH-PROTEIN FLUIDS FOR STAGES 3 AND 4
Type Serving Size Calories Protein (gm)
Sugar-free CIB (skim milk) 8 fl oz 150 15
Plain Yogurt (nonfat, 1% fat) 8 fl oz 110-144 11-13
Skim Milk or Buttermilk 8 fl oz 90 8
Sugar free, Low-fat Yogurt 6 fl oz 90 7
Cream Soup (skim milk) 8 fl oz 131 6
Sugar-free Pudding 4 fl oz 76 5
Sugar-free Cocoa 1 pkt in 6 fl oz 50 4
RECOMMENDED HIGH-PROTEIN FOODS FOR STAGE 4
Type Serving Size Calories Protein (gm)
Tuna, canned in water 3 oz 95 22
Scallops, bay and sea 4 oz raw 100 19
Part skim hard cheeses 3 oz 150-240 21-24
Cottage cheese, 1% fat 3 oz 62 10
Eggs, whole 2 (large) 158 12
Egg substitute, liquid ¼ cup 45-90 9-10
Lean chicken or turkey pureed 2 oz 100 16
Baby food meats, all types 3 oz 105 12
Peanut butter 2 Tbsp 200 14
GUIDE FOR PROGRESSION OF DIET
Some foods may be difficult to tolerate. They may cause discomfort and/or vomiting. It is important to remember while progressing the diet that there are other reasons why vomiting may occur. A specific food should not be avoided because vomiting occurred once after eating. The food should be tried again after waiting several days. The following is a list of foods that may be used as a guide for diet progression.
TYPE OF FOOD |
FOODS ALLOWED |
|
FOODS TO LIMIT IN ORDER TO PROMOTE WEIGHT LOSS |
Beverages |
Coffee, tea, club soda, diet soda, water, milk
*Decarbonated soda |
Milk may not be tolerated. Alternate dairy products may be substituted. |
High calorie drinks: whole milk, milk shakes, beer, alcohol, sweetened beverages |
Breads |
Dry, crisp, or toasted breads, crackers, or chips |
Soft, doughy breads that become gummy, breads with nuts, seeds, or dried fruit |
Sweet breads, doughnuts or pastries |
Cereal |
All cooked and dried cereal except those listed under difficult to tolerate |
Cereals containing nuts and dried fruit, and very high-fiber cereals |
Sugar-sweetened cereals |
Dessert |
Yogurt, custard, pudding, gelatin, sherbet, ice cream, and crisp cookies |
Any dessert containing nuts, dried fruit, seeds or coconut |
All |
Fats |
All |
Fried foods with a hard, crusty coating |
All |
Fruits |
Soft, fresh, canned, frozen or cooked fruit |
Fruits with a core, seeds or skin: whole citrus fruit |
Fruit juices |
Meat, Eggs, Cheese |
Beef, lamb, veal, lean pork, ham, fish, chicken, turkey, cottage cheese, cheddar type or processed cheese, eggs, smooth peanut butter |
Tough meats or those containing gristle. In some cases, beef may not be tolerated |
Fried and high fat cuts of meat |
Starch |
Boiled, mashed or bakes potatoes (without the skin), noodles, and pasta |
Potato skins and rice |
None |
Soups |
Cream soups or clear soups |
Those with large pieces of meats or vegetables |
High fat, cream soups |
Vegetables |
Soft-cooked, steamed, or canned vegetables |
Those with tough, stringy texture, or small seeds |
None |
Miscellaneous |
Nutrasweet products |
Popcorn, nuts |
|
EXTRA TIPS
- Consume meals very slowly (about 10 minutes per ounce). If you feel full, stop at that point until the next meal.
- Do not drink fluids with meals; wait 30 minutes before and after to prevent stretching your pouch. Avoid carbonated liquids unless they are flat. Avoid drinking with a straw. Both of these precautions are to prevent gas from getting trapped beyond the outlet of the pouch.
- Milk intolerance may be due to temporary lactose intolerance. Try Lactaid milk or add 10 drops of Lactaid to a quart of milk.
- Adequate protein intake is essential to avoid losses of lean body mass and promote healing of your incision. Consider protein supplement drinks.
- Never, never, never chew gum!!! If you accidentally swallow it, an endoscopy may be necessary to remove the gum from your pouch. Consider sugar-free breath mints as an alternative to chewing gum.
- Take one chewable multivitamin/mineral supplement daily. Later, you may want to add other supplements such as calcium, B12, and Iron. Have your nutritional levels checked often.
- Do not swallow any pills whole until your surgeon says its ok (usually 4-6 weeks post-op). You can crush the pill and mix it with applesauce. You may also use liquid forms of medications if available.
- Ice cube trays are handy for storing pureed food (each cube section is about 1 fluid ounce).
- Baby warmer trays may be helpful for keeping pureed food warm while it is slowly being eaten.
- Food may be blenderized or you may choose baby food.
- Take small bites and chew well. Chew each bite at least 20 times before swallowing once you transition to solid food.
- A baby spoon or toddler spoon helps you control your bite size.
- Eat a balanced diet as much as possible. Because the amounts of food eaten at each meal will be small, it is important they be of high nutritional value.
- Exercise is important. Make it a part of your daily regimen once your physician consents. Walking in a great form of exercise for new post-op patients.
- When advancing from liquid to pureed or later on to soft food, you may experience problems with vomiting. This occurs with overeating, not chewing well, or mixing liquid and solid food. If you vomit, make sure you are not eating too much at one time and that you are chewing well. Some patients will vomit with certain foods the first time they try them, but may tolerate them at a later date.
- Avoid sugary foods and drinks. If you had Roux-en-Y bypass surgery, eating sugary foods and drinks may lead to dumping syndrome, a condition characterized by abdominal cramps, diarrhea, sweating, rapid heartbeat and a dizzy sensation.