LONG TERM POST BARIATRIC SURGERY DIET: THE FUTURE/FOOD FOR LIFE
Only when you are able to tolerate a good variety of foods from Stage 2, should you then move tentatively onto Stage 3…eating FOOD FOR LIFE. Typically this occurs between 8-16 weeks post-op but everyone is different and always follow the advice of your own bariatric team (and, just because your dietician says you can eat sliced chicken, doesn’t mean that you may be able to do it straightaway, it sometimes takes a few times and retry occasions before you are able to tolerate a certain food forever). This is really the stage at which you should be able to try and eat a variety of solid food, in small amounts. Try using a side plate or child’s plate as a guideline for serving size.
Foods to begin with should have a soft and moist texture so may have to be served with a little sauce, salsa, dressing or gravy so they chew into a moist mouthful, although as time goes on a drier texture is encouraged for constriction and an ideal transition through the newly altered digestive system. These so-called ‘slider’ foods help in the early days but can mean that you are able to digest more at a later stage just when you are looking for ‘satiety’ and don’t want foods to pass through the stomach or pouch too quickly. Gradually cut down on them as you progress from week to week.
This is not a diet with a beginning and an end, nor is there need for a rush to the tape to get to your ‘goal weight’, take it slowly, learn to recognise when you are full and satisfied and don’t eat beyond that point of satisfaction. As time goes on gastric bypass and sleeve patients will learn to recognise this point and gastric band patients will certainly, in time, find their ‘sweet spot’.
It makes good sense to cook meals for everyone in the family rather than separate ones for all at this point. Why be a slave to a new regime that will happily suit all? Everyone can benefit from the foods suitable here, high protein, low fat and low sugar. Add an extra accompaniment for those growing members of the family or a sweet treat from time to time to get an ideal balance.
THE REGIME AND SOME RULES
HIGH PROTEIN, LOW FAT AND LOW SUGAR IS THE MANTRA
- Always eat your PROTEIN FIRST (the meat, poultry, eggs, fish etc) on your plate, then move onto the vegetables and fruit and finally the carbohydrate element – potatoes, rice, pasta etc.
- Choose LEAN PROTEIN with any visible fat removed (e.g. chicken skin); aim for LOW FAT (you won’t always manage it but again aim for less than 3 g fat per 100g); and always opt for a LOW SUGAR version of a meal or foodstuff (the syndrome known as ‘dumping’ – see page 00, is thought to occur when you eat between 7 and 15 g sugar in one hit).
- Eat 3 meals per day with a couple of small snacks if necessary. These should satisfy you. However beware of developing a ‘grazing’ eating pattern of small snacks throughout the day.
- Eat healthy, solid food. Soft food undoubtedly slips down more easily but you can end up eating more over the course of the day. If your food is drier and more solid you will generally eat less overall and stay fuller for longer.
- EAT SLOWLY and stop as soon as you feel full. Take tiny bites and chew each piece 10-25 times. CHEW, CHEW, CHEW AND CHEW some more! Once you feel full STOP! Gone are the days when you need to clear your plate.
- Keep your fluid intake up. It is also a good idea not to drink immediately before, during or after a meal so that your stomach isn’t full from fluids. Get into this habit as soon as you can of not taking food and fluids together.
- Take your multi-vitamin, calcium and any other supplement everyday religiously… they will ensure that you have the best chance of getting all the additional nutrition you require that may not be supplied from the reduced amount of food you are eating.
- The hardest nutrient to keep on track with is undoubtedly protein. Aim for 70 g per day. Quite difficult to begin with and do consider a protein whey isolate powder if you consistently fall short. A scoop of this powder in food or as a drink can quickly and efficiently provide 25 g or a third of your requirements in one fell swoop!
There are some cautionary solid foods, which may not be tolerated in the short and long term. Proceed with caution when eating them:
- non-toasted bread, especially soft and white
- over-cooked pasta and boiled rice
- red meat with a fibrous texture like steak and chops
- stringy vegetables like green beans
- sweetcorn, pineapple and mushrooms with a toughened texture
- pips, seeds and skins from fruit and vegetables
- dried fruits
- no caution, just a straight no to fizzy drinks and chewing gum (for life)