Diet ADvAncement

After BAriAtric Surgery

StageS of Diet

Stage 1: Clear liquiDS: Follow for 2 nights while in hospital

Stage 2: full liquiDS: Follow for 2 weeks, starting day of hospital discharge

Stage 3: PureeD fooDS: Follow for 1 week, after 2 weeks of full liquids

Stage 4: Soft fooDS: Follow for 1 week, after 1 week of pureed foods

Stage 5: aDvanCeD Diet: Follow indefinitely, after 1 week of soft foods

Stage 1: Clear liquiD Diet

You will most likely be instructed to advance to Stage 2: Full liquids upon hospital discharge.

If your surgeon discharges you home on a clear liquid diet, you can try additional clear liquids

like light apple juice and no-sugar-added popsicles.

All liquids should be non-carbonated, since carbonated drinks can put pressure on your

small stomach pouch. Avoid chewing gum- even sugar-free- because accidentally

swallowing it could cause a blockage.

Sip liquids slowly. Aim to drink 64 – 80 oz per day.

Clear liquiDS ShoPPing liSt

• Unsweetened light juices: light apple juice, light white grape juice, or Light Cranberry Juice

Cocktail, Must be <10 grams of sugar per serving

• Sugar-free Jell-O

• No added sugar popsicles without fruit pieces: Dole, Welch's, or Tropicana No Sugar

Added Fruit Juice Bars

• Fat-free chicken or beef broth, like College Inn Fat-free Broth

• Decaffeinated tea, or herb tea

• Non-carbonated no-cal flavored drink like Crystal Light or Fruit-2-O

• Non-carbonated bottled water

• Isopure Protein Zero Carb

• Premier Protein Clear protein drink

• Proti liquid protein concentrate (Sold at FCB Norwalk and Shelton locations)

Stage 2: full liquiD Diet

Upon discharge from the hospital you will start the Stage 2 Full Liquid Diet unless otherwise

directed by your surgeon. You will stay on the full liquid diet for 2 weeks from the date of

hospital discharge.

To prevent nausea and vomiting, DRINK LIQUIDS SLOWLY.

At each meal, sip liquid protein source. You do not have to finish everything. Stop

drinking your protein when you feel full. Aim for 60-80 grams of protein daily.

Aim for at least 64 – 80 ounces of water or a calorie free drink between high protein

beverages. Remember to avoid carbonation, sugar, carbonated drinks, caffeine, citrus,

and chewing gum.

Protein-riCh full liquiDS inCluDe:

Pre-mixeD BranD Protein CalorieS Sugar net CarBS Serving

Pure Protein Can 35g 170 1g 3g 11oz

Premier Protein 30g 160 1g 2g 11oz

Muscle Milk 25g 160 0g 3g 11oz

Atkins 15g 160 1g 1g 11oz

Protein PowDer BranD Protein CalorieS Sugar net CarBS Serving

Vega Sport Performance 30g 150 1g 2g 1

scoop

Bariatric Advantage 27g 150 1g 5g 2

scoop

Isoure Whey Unflavored 25g 100 0g 0g 1

scoop

Pure Protein Powder 23g 130 3g 4g 1

scoop

Garden of Life Organic 21g 120 2g 4g 2

scoop

Designer Whey 20g 110 2g 3g 1

scoop

Whey To Go 20g 90 1g 2g 1

scoop

Proti Shakes 17g 1 1g 4g 1.2oz

Garden of Life Plant Based 15g 90 0g 3g 1

scoop

Protein water Protein CalorieS Sugar net CarBS Serving

Isopure 20g 100 5g 5g 16 fl oz

Isopure 20g 100 5g 5g 16 fl oz

Premier 20g 90 0g 1g 16.9 fl oz

Proti 15 15g 76 2g 2g 1 packet

what Size iS my StomaCh now?

gaStriC ByPaSS anD Sleeve gaStreCtomy

Your new stomach holds only 1.5- 2 oz (3-4 measuring tablespoonfuls), so when

planning your prepare a maximum of:

2 to 3 tablespoonfuls of protein-rich food, plus

1/2- 1 tablespoonful of vegetable

laP BanD

Your new stomach holds only 3oz-4oz (6-8 measuring tablespoonfuls), so when planning

your prepare a maximum of :

3 to 4 tablespoonfuls of protein –rich food

1 to 2 tablespoonfuls of fruits & vegetables

Initially you may manage only a few teaspoonfuls per meal. Stop eating when you

begin to feel full, even if there is food left on your plate.

meaSurement ComPariSon liSt aBout the Size of

½ oz = 1tbsp = 1/16 cup = a poker chip

1oz = 2tbsp = 1/8 cup = a golf ball

2oz = 4tbsp = 1/4 cup = 4 dice

3oz = 6tbsp = 3/8 cup = a deck of cards

4oz = 8tbsp = 1/2 cup = a tennis ball

Stage 3: PureeD Diet

You will start your pureed diet after two weeks of full liquid diet. You will stay on pureed diet

for one week.

Now that your diet has progressed to pureed, you can start eating three meals a day- with

a spoon! Eating chunks of food could block the exit from your stomach.

Start with small portions of pureed foods, and stop before you feel full. Remember to eat

slowly - each meal should take 15- 30 minutes.

Because protein is so important to help you maintain muscle while you are losing weight,

eat your protein-rich foods first at meals. Then move on to vegetables.

It is still important to drink enough fluids- aim for at least 64 - 80 oz per day. Drink fluids

between meals, so you don’t overfill your stomach: wait 30 - 45 minutes after meals before

drinking, and stop drinking 30 minutes before a meal.

To puree foods, use a blender or food processor to a smooth consistency. If necessary, add

water, broth, tomato juice, milk or low fat mayo to make a smooth puree. To save time, you

can use stage 1 strained baby food like strained chicken and no-added sugar strained fruit.

Toddler foods are not suitable because they are lumpy.

Most patients still have at least one protein shake during the pureed stage, to ensure that

enough protein in being consumed daily.

PureeD fooD guiDe

ProteinS:

yeS - Pureed skinless chicken and turkey, pureed fish (like water-packed tuna), pureed

scrambled eggs, pureed tofu, low fat ricotta cheese, light greek yogurt, stage 1 baby

food strained chicken or turkey

no - Pureed beef, pork, lamb, pate, liverwurst, hot dogs, fried fish, canned fish in oil, fried

eggs, boiled eggs, sliced cheese, cream cheese, yogurt with fruit chunks, yogurt with

added sugars, ice cream

vegetaBleS:

yeS - Pureed cooked vegetables (Carrots, spinach, tomatoes, squash, beets, very small

amounts of sweet potato)

no - Raw vegetables, gassy vegetables (broccoli, cauliflower, onions, cabbage), fries,

chips, gravy, mashed potatoes

SamPle menu Stage 3: PureeD fooDS

BreakfaSt: 1 large egg, pureed with 1 ounce part skim mozzarella cheese (15 g protein).

Wait 30 minute after breakfast to begin sipping water. Sip water slowly.

Stop 30 minutes before lunch

lunCh: Premier protein shake (30 grams protein)

Wait 30 minute s after lunch to being sipping water. Sip water slowly.

Stop 30 minutes before dinner

Dinner: 2 ounces pureed turkey with 1-2 ounces pureed squash (15 g protein)

Wait 30 mins after dinner to begin sipping water

aim to Drink 64 – 80 oz liquids daily (calorie-free, non-carbonated beverages)

aim to eat 60g – 80g protein daily (your dietitian will instruct you on your specific

protein needs)

requireD vitamin anD mineral SuPPlementS after weight

loSS Surgery

Once you feel comfortable with your pureed foods, you should start your daily vitamins and

fiber supplement. See vitamin section of this packet for specifics.

You will not be able to meet certain vitamin and mineral needs without supplementation.

Vitamin and mineral deficiencies have been observed in patients after weight loss surgery.

Iron, Folate, vitamin B12, calcium and zinc are common deficiencies after gastric bypass

and gastric sleeve surgery.

If you are having gastric banding surgery you will not need to take all the above supplements.

Gastric banding does not cause malabsorption of nutrients from your foods. A daily chew-

able multi-vitamin and calcium supplement is usually sufficient.

We strongly advise Bariatric Fusion vitamins, sold at FCB locations in Shelton or Norwalk.

These vitamins have been found to sufficiently cover bariatric patients. These should be

taken as instructed on packaging.

We also advise starting a fiber supplement at this time.

Please note that we will send you for lab work to have your vitamin levels checked 6 weeks

post-operatively, and one year post-operatively. Should any of your vitamin levels appear low

on your blood work, we will advise extra supplementation.

STAGE 4: SOFT FOODSYou will start your soft food diet after one week of pureed foods. You will stay on soft food

diet for one week.

Your meals can now include tender cooked foods like fish, ground turkey, and cooked vegetables.

To avoid dumping and to maximize your weight loss, continue to choose low fat foods without added

sugar.

Now that your foods are more solid, make it a habit to chew foods well- aim for 20 to 30 chews before

swallowing.

To remind you of your new, smaller meal size, choose smaller plates for your meals.

Protein-rich foods remain the most important part of your diet. Aim to eat these foods first.

Drink liquids between meals. Wait 30 minutes after meals before drinking, and stop drinking 30

minutes before a meal. Your fluid goal for the day is now 64-80 oz.

SOFT FOODS GuiDE

PrOTEinS:

YES - lean ground chicken or turkey, tender skinless poached or boiled chicken, baked or grilled fish,

canned fish in water, eggs (scrambled, boiled, poached, or in an omelette), low fat cottage

cheese, low fat ricotta, tofu

nO - ground beef, pork, lamb, hamburger, sausage, hot dogs, fried or breaded fish, canned fish in

oil, eggs fried in butter, full-fat dairy, gassy foods like hummus

VEGETAblES:

YES - Peeled, well-cooked non-gassy vegetables (green beans, carrots, zucchini, asparagus tips),

small amounts of mashed sweet potato

nO - Raw vegetables, gassy vegetables, starchy vegetables like potatoes

bEVErAGES;

YES - water, non-carbonated drinks like Crystal Light or Diet Snapple, decaf coffee or tea without

sugar

nO - carbonated water, seltzer, soda, diet soda, fruit juice, alcohol, wine, beer

SAmPlE mEnu STAGE 4: SOFT FOODS

brEAkFAST: Premier protein shake, 160 calories, 30 grams of protein

Wait 30 mins, then drink water. Try to get in 16 ounces

miD-mOrninG SnAck: Dannon Oikos Triple Zero Yogurt, 120 calories, 15 grams of protein

Wait 30 mins, then drink water. Try to get in 16 ounces

lunch: 3 ounces Chicken salad with light mayo, 200 calories, 25 grams of protein

Wait 30 mins, then drink water. Try to get in 16 ounces

DinnEr: 3 ounces Turkey Meatballs, 1-2 ounces cooked vegetables, 230 calories, 17 grams

of protein

Wait 30 mins, then drink water. Try to get in 16 ounces

STAGE 5: ADVAncED DiETAfter one week of soft foods, you are ready to advance your diet! You may introduce foods like lean

red meat, small amounts of fresh fruits, and raw vegetables over the next few weeks. To avoid dump-

ing and to maximize your weight loss, continue to choose low fat foods without added sugar.

Make time to chew foods well- your meal should take 20 to 30 minutes. Continue to choose small

portions. Large bites of food could cause an intestinal blockage, as could swallowing chewing gum.

Protein-rich foods remain the most important part of your diet. Your protein goal is now 60 – 80 g per

day. Don’t forget that you may still drink a protein shake daily in addition to eating protein-rich foods.

Drink liquids between meals: wait 30minutes after meals before drinking, and stop drinking 30 minutes

before a meal. Aim for the day is 64 – 80 oz daily.

You will now be working up to 800 calories day, with 60-80 grams of protein and 64 ounces of water.

FullY ADVAncED bAriATric DiET GuiDE

mEATS:

YES - Lean chicken, turkey, eggs, beef, pork, natural turkey bacon/sausage (all skinless)

nO - Bacon, sausage, chicken nuggets/patties, hotdogs, all processed meats

FiSh:

YES - Salmon, tuna in water, haddock, cod, crab, shrimp, shellfish, lobster

nO - Fish sticks, breaded fish, fried fish/seafood

VEGETAblES:

YES - Asparagus, zucchini, yellow squash, garlic, cauliflower, broccoli, spinach, carrots, lettuce, peppers,

onions, mushrooms, eggplant, cucumber, kale, collard greens, limited amounts of sweet potato

nO - White potatoes, corn, peas

FruiT: (sparingly)

YES - Avocado, blueberries, blackberries, strawberries, raspberries, lemon, lime, tomatoes

Many other fruits are high in sugar and should be eaten only occasionally as to not slow weight loss

DAirY:

YES - Fat free/skim milk, unsweetened soy/almond/cashew/coconut milk, *Greek* yogurt zero sugar, low fat

Skim/low fat cheeses, string cheese, cottage cheese, sugar free pudding

nO - Regular(non-Greek) yogurts, kefir, whole milk, ice cream

cArbS: (Use sparingly!)

YES - Black beans, chickpeas, kidney beans, lentils, low carb wraps, hummus

nO - Cereals, “protein” cereal, oatmeal, grits, farina, bread of any kind, breading, breadcrumbs, rice, brown

rice, pasta, baked beans, wheat pasta, pretzels, crackers, chips

cOnDimEnTS: (Use sparingly or correct serving size!)

YES - Sugar free ketchup, mustard, sugar free BBQ sauce, vinegar, olive/avocado oil, lemon juice, horseradish,

garlic powder, onion powder, pepper, Mrs. Dash sodium free spices, herbs, salsa, hot sauce(very light,

may cause reflux!)

nO - Ketchup with sugar, mayonnaise, honey mustard, creamy dressing, jelly/jam, salt, adobo, butter

DrinkS:

YES - water, sugar free flavored water, crystal light, sugar free cranberry juice, Powerade Zero, Gatorade G2,

decaf tea, decaf herbal tea

nO - seltzer water, soda, carbonated drinks, coffee, alcohol, fruit juices (including Naked brand), V8, regular

Gatorade/Powerade

OThEr:

YES - Natural peanut butter/peanut butter powder, natural/roasted nuts, Premier protein shakes, Atkins protein

shakes, Bariatric Fusion shakes, Isopure protein water, Genepro flavorless protein powder, Quest protein

bars, tempeh

nO - “weight gainer/workout” protein powders, sugary peanut butters, trail mix, honey roasted nuts, granola

bars, cereal bars

SAmPlE bAriATric ADVAncED mEnu wiTh PrOTEin cOunT

brEAkFAST: Premier protein shake, 160 calories, 30 grams of protein

Wait 30 mins, then drink water. Try to get in 16 ounces

miD-mOrninG SnAck: Dannon Oikos Triple Zero Yogurt, 120 calories, 15 grams of protein

Wait 30 mins, then drink water. Try to get in 16 ounces

lunch: 3 ounces Tuna (packed in water) mixed with light mayo, over lettuce and cucumbers, 120 calories,

16 grams of protein

Wait 30 mins, then drink water. Try to get in 16 ounces

DinnEr: 3 ounces of grilled chicken breast tossed with ½ cup of zucchini noodles and one half tablespoon olive

oil, 250 calories, 25 grams of protein

Wait 30 mins, then drink water. Try to get in 16 ounces

Stop eating at least 3 hours before bedtime in order to avoid reflux

DAilY inTAkECalories: 650

Protein: 86 grams

QuESTiOnS AbOuT YOur PrOTEin inTAkE? Your dietitian can help you calculate your daily protein grams, and supply the checklist “Where’s the Protein?”

for you to use at home.

brAnD ExAmPlES

TrY ThESE: