GASTRIC BYPASS DIET

 

 

This diet is designed for use after gastric bypass surgery.  The stomach pouch created by surgery is the size of a large walnut.  You will be on a liquid or semi-liquid diet for about three to four weeks to allow healing of the stomach pouch.  This diet will help keep you healthy while losing weight.  Advances in your diet should be made only with the approval of your physician.

 

Diet Stages:

Stage 1

Clear liquids – start about 1 day after surgery.

Stage 2

Gastric bypass liquids (semi-liquids) – start about 2 days after surgery.

Stage 3

Semi-solid diet – start when directed by your physician (usually 3-4 weeks after surgery).

Stage 4

Low-fat solid diet – start when directed by your physician.

 

1.                  Stage 1- Clear Liquids

About one day after your surgery, you will be started on sips of clear liquids

(apple juice, orange juice, water, flat diet sodas, sugar-free jello, broth, etc.).  Take small sips and be aware of feelings of fullness.  If you tolerate clear liquids, the next day you will be advanced to the “Stage2- gastric bypass liquids/semi-liquids” as described below.

 

2.                  Stage 2- Gastric Bypass Liquids/Semi-liquids

All foods must be of a consistency of thinned mashed potatoes.

 

Protein Goal =                        grams/day

 

Examples:

·         Skim or 1% milk

·         “No Sugar Added” Carnation Instant Breakfast made with skim milk

·         Blenderized soups (make with skim milk instead of water)

·         Blenderized fruit added to shakes made with skim milk and light/nonfat yogurt

·         Blenderized meat added to blenderized cream soups or mashed potatoes

·         Cooked cereal thinned with skim milk (oatmeal, grits, Cream of Wheat)

·         Thin blenderized casseroles

·         Blenderized beans (black, pintos, lima, kidney, lima, northern, butter, lentils)

·         Unsweetened applesauce with non-fat dry milk powder

·         Fat-free refried beans with melted fat-free/reduced fat cheese

·         Mashed potatoes made with skim milk

·         Blended sugar-free yogurt

·         Cottage cheese (fat-free/low fat)

·         Add non-fat dry milk powder to all foods and beverages to increase the protein

 

You will start with small amounts of these liquids because you will feel full quickly.  At first you will have to drink small amounts frequently (2-4 ounces at a time).  After a few days your daily intake of the liquids listed above should be at least 24 ounces (3 cups).  Eventually you will be able to take 3 liquid meals of 4-6 ounces each.  Drink slowly.  It should take 30 minutes or more to drink 4-6 ounces (1/2 to 3/4 cup).

 

AT LEAST 6-8 cups of low calorie liquids should be consumed gradually throughout the day to prevent dehydration.

 

Examples:

·         Water or flavored water

·         Crystal Light

·         Diet sodas (flat)

·         Diet Snapple

·         Decaf tea and decaf coffee

·         Diluted juices (1/2 water, ½ juice- limit)

·         Skim milk

·         Sugar-free Kool-Aid

·        Sugar- Free Tang

 

A multivitamin with minerals, which includes iron and zinc, should be taken daily FOR THE REST OF YOUR LIFE to prevent hair loss and to improve overall nutrition.  During the first few weeks after surgery use a children’s chewable vitamin/mineral supplement and then advance to pill form  of a multivitamin with minerals if you desire.

 

Medications may be taken in liquid or chewable form, but most pills are easily swallowed.

 

Concentrated sugars and alcohol can cause vomiting and/or diarrhea (dumping syndrome) so avoid: 

 

·         Candy-including chocolate

·         Sweets

·         Regular sodas

·         Honey

·         Kool-Aid

·         Molasses

·         Cakes

·         Preserves

·         Sherbet

·         Ice cream

·         Alcohol (including beer)

·         Doughnuts

 

Different people have different foods they can and cannot tolerate.  Do not be disturbed if you find some foods do not agree with you at first.  You may be able to tolerate those foods later.

 

If you are having trouble tolerating pureéd food:

1)                 Try slowing the speed of your eating.

2)                 Decrease your portion size.

 

How to blenderize food:

1)                 Put food in a blender.

2)                 Add liquid such as skim milk, broth, fat-free gravy or juice.

3)                 Blend until pureéd.

 

Pureéd baby food can be used instead of blenderized foods. Only meat (pureed beef, pork, chicken) baby foods contains protein. 

 

 

 

 

 

 

 

SAMPLE GASTRIC BYPASS LIQUID/SEMI-LIQUID MENU

(Consistency of thinned mashed potatoes)

 

 

Breakfast:    1 cup “No Sugar-Added” Carnation Instant Breakfast mixed with skim milk

 

Snack #1:     ½ cup cottage cheese

 

Lunch:          Blenderize-    ½ cup fat-free refried

                                                1 ounce of melted fat-free/reduced fat cheese

                                               

 

Snack #2:     Blended sugar-free yogurt

 

Supper:         Blenderize-    ¼ cup meat

                                                ½ cup cream soup

                                                ¼ nonfat skim milk powder

                                               

 

You may have to eat more frequent meals and consume smaller amounts at each meal at first.  But try to take in at least 24 ounces (3 cups) of nutritious liquids every day.

 

Between meals:  at least 4 cups low calorie liquids, sipped slowly during the day.

 

3.                  Stage 3- Semi-solid diet (to begin the 3rd-4th week after surgery)

Remember to add one new food at a time and observe your reaction to it.

 

·         Cooked eggs any type except fried

·         Casseroles – such as macaroni & cheese or tuna w/ light mayo (limited)

·         Chopped lean meat (except red meat)

·         Lowfat cottage cheese

·         Cooked vegetables (peeled)

·         Canned fruits (in their own juices or water)

·         Crackers, rolls, bread

·         Skim milk, unsweetened instant breakfast, sugar-free lowfat yogurt

·         Canned chicken

 

Specific Information:

·         The diet consists of 4-6 small meals per day.

·         Each meal should not exceed the volume of a measuring cup (6 oz.)

·         Eat and drink slowly.  Take at least ½ hour to eat a meal.

·         Take small bites and chew very well.  Sip on liquids during meals if needed, but don’t drink large amounts during meals. (limit to 1 oz fluid/ meal)

·         Avoid red meats

·         Continue to take the vitamin/mineral supplement everyday.

·         Continue to drink low calorie liquids between meals – at least 6-8 cups per day.

·         Avoid raw vegetables and raw fruits with skins at this stage in your diet progression.

·         Keep in mind that you are “re-educating” your stomach.  When you eat too fast, too much, or don’t chew enough, you will feel discomfort.

 

 

 

 

SAMPLE SEMI-SOLID MENU

 

 

Breakfast:    1 egg

                        ¼ cup skim milk

 

Lunch:          3 oz of lean meat (such as turkey, low fat ham)

                        1 slice of reduced-fat/fat-free cheese

                        ¼ cup skim milk

                        (optional:  nonfat skim milk powder can be mixed in

                         skim milk to increase protein)

 

Supper:         ½  cup tuna

                        ¼  cup cooked vegetables

 

Snacks:                                            sugar-free lowfat yogurt

(between meals or after supper)     lowfat cottage cheese,

                                                            sugar-free Jello or popsicles

 

Between meals:      Drink at least 1 quart (4 cups) of liquids slowly during the day.

 

4.         Stage 4- Solid Foods (start when directed by your physician and dietitian)

Again add one new food at a time and observe your reaction to it.  Add breads last because they tend to form a ball, which will not go through the pouch easily. You can add red meat, raw vegetables, and raw fruits with skins back into your diet as well.  Remember to chew all food very well and sips limited amounts of liquids with meals, if necessary.

 

 

NUTRITION INFORMATION

 

A well-balanced diet is very important.  Eat foods from all food groups:

 

·         Dairy products

·         Fruit and vegetables

·         Breads and other starches, such as rice, pasta, cereal

·        Meat, eggs

 

PROTEIN:

Protein is important, especially to heal after surgery and to help prevent hair loss.  Many patients experience some hair loss two to four months after surgery.  Hair loss is related to poor protein, iron, and zinc intake as well as some medications, rapid weight loss within the first few months, experiencing shock, and having a long surgery.  To avoid hair loss and to improve nutrition eat more protein foods including:

 

 

 

 

·         Skim or 1% milk

·         Lowfat cottage cheese

·         Lowfat or nonfat yogurt with artificial sweeteners

·         Egg whites

·         Lowfat cheese

·         Oatmeal and cream of wheat made with skim milk

·         Fish

·         Chicken and turkey (poultry)

·         Other lean meats (pork tenderloin, extra lean ground beef)

·         Legumes (dried beans)

·         Nonfat dry milk powder (added to casseroles, soups, hot cereals, etc.)

 

 

NOTE:  You may not be able to tolerate meat or poultry after your surgery.  Until you are able to eat meat and poultry, you must get protein from the other protein sources listed above.

 

Also remember to take a vitamin/mineral supplement with iron and zinc daily!

 

FAT:

To help with weight loss and then to maintain your weight loss, remember to limit your fat and calorie intake.

 

 

 

Avoid these high fat foods and beverages except in small amounts:

·         Olives

·         Nuts

·         Avocados

·         Regular mayonnaise

·         Sour cream

·         Cream cheese

·         Pie crust

·         Whole milk

·         Butter, margarine

·         Peanut butter

·         Granola

·         Muffins

·         Cole slaw

·         Potato salad

·         Whole milk cheese

·         Snack crackers

·         Ice cream

·         Shortening, lard

·         Regular salad dressings

·         Sauces

·         Fried foods

·         Bacon, sausage, bologna

·         Potato chips

·         Doughnuts

·         All oils

·         Gravy

·         Regular sodas, Kool-Aid, etc

 

Learn to read labels on food for fat content.  Aim for no more than 35 grams of fat/day.

 

 

 

 

LOWFAT COOKING TIPS (for semi-solid diet and beyond)

 

MEAT AND POULTRY:

·        Use the leanest meat

Beef, top round

Chicken and turkey breast, no skin (white meat is lower in fat than dark meat)

·        Trim fat off meat

·        Use lowfat cooking methods

Bake, broil, grill, roast, sauté, stir fry (use vegetable spray, broth, water or small amounts of oil)

·        Drain off excess fat after cooking

 

 

VEGETABLES:

·        Avoid high fat sauces made with cream, cheese, oil, or butter.

·        Use cooking methods that require little or no added fat: steam, microwave, bake, grill.

·        Carefully choose and use low-fat/ fat-free salad dressings.

·        Try baked potato with fat-free sour cream or lowfat cottage cheese.  Then add chives or dill.

·        Add balsamic vinegar, fat-free salad dressing, or lemon juice and herbs.

·        Add vegetables such as green pepper, grated carrots, and fresh tomatoes to spaghetti sauces.

 

 

SOUPS:

·        Let cool, then skim fat off the top.

 

 

 

MODIFYING RECIPES

 

Look at the ingredients and find the ones high in fat.

·        Is the ingredient necessary?  If not, eliminate it.

Examples:  olives, nuts, meat, cheese, oil, salt

·        Can the ingredient amount be reduced?  Try using half the amount called for.

Examples:  meat, cheese, oil, shortening

·        Can a substitute lowfat ingredients be used?

Examples:  Fat-free sour cream, yogurt, cottage cheese, and buttermilk

                    Molly McButter or Butter Buds

 

 

 

 

  Lowfat Substitutions:

Ingredient

Calories

Grams of Fat

Mayonnaise (1 Tbsp.)

-use nonfat yogurt

99

8

11

0

Ground beef (4 oz.)

-use ground turkey breast

325

150

24

0.8

Whole egg (1)

-use egg whites (2)

80

30

5.5

0

Oil (1 Tbsp.)

-use fat-free chicken broth

126

3

14

0

Whole milk (1 cup)

-use skim milk

150

85

8

0

 

 

 

 

 

 

 

 

 

STOCKING YOUR KITCHEN

 

CUPBOARD

REFRIGERATOR

FREEZER

·         Pasta

·         Rice

·         Potatoes

·         Lowfat crackers

·         Lowfat spaghetti sauce

·         Tuna in water

·         Canned beans

·         Dry cereal

·         Oatmeal

·         Canola or olive oil

·         Ginger snaps, vanilla wafers, fig bars, or fat-free cookies

·         Herb or balsamic vinegar

·         Fat-free tortilla chips

·         Fat-free chicken broth

·         Lemon juice

·         Fat-free mayonnaise

·         Onions

·         Garlic

·         “Light” cheese

·         Parmesan cheese

·         Lowfat cottage cheese

·         Nonfat yogurt

·         Skim milk

·         Eggs (for the whites)

·         Fresh fruit

·         Fresh vegetables

·         V-8 juice

·         Slices turkey or lean roast beef or ham

·         Salsa

·         Mustard

 

 

·         English muffins

·         Bagels

·         Bread

·         Frozen juice

·         Vegetables

·         Cut-up chicken

·         Lean ground turkey

·         Lowfat frozen yogurt

 

 

GOALS

 

1.                                                                                                                                                        

 

2.                                                                                                                                                        

 

3.                                                                                                                                                        

 

 

Þ    Tell your local family doctor to check your Vitamin B12, iron, transferrin, and albumin levels at least 3-6 months.

 

Þ    You will visit with the dietitian during all of your follow-up appointments.

 

Þ    Call or email with any questions!

 

Dietitian:   Mary Beth Whelan, MS, RD

 

Phone Number:   (434) 982-3293   or   email: mew9d@virginia.edu          

 

 

 

Department of Nutrition Services

UVA Health System

Box 800673

Charlottesville, VA  22908-0673

(434) 924-2286