Bellevue Hospital Center. Bariatric Surgery Nutrition and Exercise Guide

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1 Bellevue Hospital Center Bariatric Surgery Nutrition and Exercise Guide

2 Nutrition and Exercise Guide Table of Contents Pre-Op Liquid Diet 2 Post-Op Liquid Diet 3 Pureed Diet 4 Regular Diet 5 General Diet Guidelines 6 Physical Activity and Exercise 7 Manish Parikh, MD Medical Director of Bariatric Surgery (212) Indra Samaroo, RD, CDE Bariatric Dietitian (212) V

3 2 Pre-Op Liquid Diet (Before Surgery) For Weeks This diet will shrink your liver. This helps make your surgery easier and safer to perform. YES Protein Drinks 3 servings per day of ONE of the following: Glucerna Shake or Glucerna Hunger Smart Boost High Protein or Boost Glucose Control Ensure Muscle Health Slim Fast Optima Carnation Instant Breakfast Essentials No Sugar Added Homemade shakes with 1 scoop protein powder (whey or rice) & fat free/skim milk Other Liquids: 4 to 6 cups per day Water Crystal Light or other sugar/ calorie free drink mix Diet Snapple or other calorie free non-carbonated beverages Low Sodium Soup broth Herbal Teas NO No solid foods (other than vegetables listed in the YES column) Allowed vegetables: Broccoli, asparagus, Brussels sprouts, cabbage, raw carrots, cucumbers, tomatoes, lettuce, mushrooms, onions, okra, peppers, spinach, string beans, zucchini and watercress. No juice or other sweetened beverages No soda or carbonated drinks No alcohol No Jell-O or pudding No whole milk No yogurt or yogurt drinks No oil, butter or margarine No added sugar, honey or sugary foods No beans, peas, corn or potatoes (STARCHY vegetables) No ice cream, smoothies or frozen yogurt No creamy or instant soups

4 Post-Op Liquid Diet (After Surgery) For Weeks YES Protein Drinks 3 servings per day of ONE of the following: Glucerna Shake or Glucerna Hunger Smart Boost High Protein or Boost Glucose Control Ensure Muscle Health Slim Fast Optima Carnation Instant Breakfast Essentials No Sugar Added Homemade shakes with 1 scoop protein powder (whey or rice) & fat free/skim milk Other Liquids: 4 to 6 cups per day Water Crystal Light or other sugar/calorie free drink mix Diet Snapple or other calorie free noncarbonated beverages Low sodium soup broth Herbal teas Sugar-free popsicles (limit 1 per day) It is very important to remain on a liquid diet after surgery to allow the swelling to go down. Irritations from food on the NO list can cause complications. No solid foods NO No juice or other sweetened beverages No more than 2 cups of caffeinated drinks (coffee, tea, etc.) per day No soda or carbonated drinks No alcohol No Jell-O or pudding No whole milk No yogurt or yogurt drinks No oil, butter or margarine No added sugar, honey or sugary foods No beans, peas, corn or potatoes (STARCHY vegetables) 3

5 Pureed Diet For Weeks As your stomach continues to heal, you must progress your diet slowly before solids can be attempted. YES Remember to eat protein foods first. Protein Foods: Pureed chicken or turkey Moist ground turkey or chicken (chili) Flaky fish Scrambled eggs Egg salad or tuna salad made with light mayo Low fat and low sugar yogurt (Greek yogurt) Low-fat cottage cheese You may have 1 protein shake per day as a meal replacement Mashed beans Other Foods: Pureed non-starchy vegetables Pureed fruit (1 piece per day) Plain hot cereal (without sugar) Liquids: Water Crystal Light or other sugar/calorie free drink mix Diet Snapple or other calorie free noncarbonated beverages Low sodium soup broth Herbal teas Sugar-free popsicles (limit 1 per day) NO No solid foods No eating and drinking at the same time No juice or other sweetened beverages No more than 2 cups of caffeinated drinks (coffee, tea, etc.) per day No soda or carbonated drinks No Jell-O or pudding No whole milk No jarred baby food No oil, butter or margarine No added sugar, honey or sugary foods No ice cream, frozen yogurt or smoothies No mashed potatoes, corn or peas No creamy or instant soups 4

6 Regular Diet Please remember to eat healthfully and slowly. Avoid dry foods, and keep in mind that in order to maintain your healthy weight, you must continue with these lifestyle changes permanently. YES Remember to eat protein foods first. Protein Foods: Fish Chicken or turkey leg/thigh (dark meat) Ground chicken or turkey Eggs Lean, low sodium deli meats Low-fat cheeses Low-fat cottage cheese Low-fat and low-sugar yogurt (Greek yogurt) Beans Other Foods: Cooked Vegetables Salads/raw vegetables allowed 4 months after surgery 1 slice of light 100% whole wheat bread per day 1 Tbsp. of light salad dressing, or olive oil with lemon juice/vinegar Soft fruits (limit 2 pieces per day) Plain hot cereal (without sugar) Liquids: Water Crystal Light or other sugar/calorie free drink mix Diet Snapple or other calorie free non-carbonated beverages Low sodium soup broth Herbal teas y) Sugar-free popsicles (limit 1 per day) NO No eating and drinking at the same time No protein shakes (unless instructed by your bariatric provider or dietitian) No juice or other sweetened beverages No more than 2 cups of caffeinated drinks (coffee, tea, etc.) per day No soda or carbonated drinks No fried or greasy food No rice No red meat No pasta No pizza No chicken breast No Jell-O or pudding No whole milk No butter or margarine No added sugar, honey or sugary foods No cakes, cookies, ice cream, frozen yogurt or smoothies No corn No creamy or instant soups Limit alcohol intake 5

7

8 Bariatric Surgery Nutrition Guidelines Eat 3 small meals with 1 to 2 snacks per day! Each meal should take at least 45 minutes to complete Always eat protein rich foods first Avoid rice, red meat, chicken breast and pasta Anything dry will get stuck! No more than 1 slice of whole wheat toast per day Drink 6-8 glasses of water per day! No eating and drinking at the same time, wait 30 minutes between eating and drinking Make sure that liquids you drink contain zero calories and zero sugar! Avoid juice and sodas (liquid calories) Limit caffeinated beverages to 2 cups per day Limit alcohol intake (liquid calories) Read nutrition labels! check calories, fat and sugar content

9 Physical Activity and Exercise Although nutrition is important, healthy eating by itself is not enough to maximize your weight loss and keep your body healthy. Exercise plays an important role as well. Benefits of Exercise: Burn fat instead of muscle Lose weight faster Increase your level of energy Increase motivation to make healthy choices Reduce obesity-related complications (diabetes mellitus, heart disease, and sleep apnea) Improve self-esteem Reduce depression Simple ways to increase your active lifestyle: Walk or ride a bike instead of taking the bus, subway, or a cab Get off the bus or subway before your actual stop and walk the rest of the way Take the stairs instead of the elevator If you drive, park farther than usual from your destination for extra walking Use your lunch break at work as a chance to go on a speed walk To keep track of how much you walk, use a pedometer (a device that counts your steps) or estimate the distance. Try to work up to walking about 5 miles a day or about 10,000 steps a day. 20 blocks = about one mile Seven avenues = about one mile 7

10 Make an Exercise Schedule: Find a fitness center or gym: Other work-out options include public buildings (malls, supermarkets, and parks) Set a GOAL: Pick 3-5 days a week to exercise Be SPECIFIC: what type of exercise, time, and location PLAN in advance and mark your calendar Ask a friend to join you to motivate each other! Write down everything you do to keep track of your progress Sample Activity Log How Much Should You Exercise? Exercise at least minutes - moderate* or medium intensity days per week Examples of moderate/medium intensity exercises: speed walking water aerobics bicycling weight lifting tennis gardening *To check if you are exercising at a moderate/medium intensity do the talk test if you can talk but are unable to sing, then you are exercising at a moderate or medium intensity.

11 Strengthening Exercises (Stop exercising should you have any pain or shortness of breath) 1. Roll your ankles in circles for 1 minute then switch directions and continue for one minute 2. Raise your right knee and then your left to march. Continue marching for 1 minute 3. With arms out to your sides, raise and lower your arms for one minute 4. With your arms pointing forward, raise and lower your arms for one minute 5. With one knee bent and one knee straight, elevate your straight leg off the floor. Repeat 20 times then switch to the other leg. 6. With your knees bent, lift your hips off the floor, hold for 2 seconds and repeat 20 times 7. While lying on your side, lift your leg up to the side 8. Lying on your side with legs crossed, lift your bottom leg off the floor 9. While holding onto a steady surface or the back of a chair, raise your heels off the ground. Repeat 20 times. 10. Place feet 1 foot away from the wall. With your hips, shoulders, and head against the wall slowly bend your knees and then straighten them. Repeat 20 times. 9

12 Bellevue Hospital Center, America s first public hospital, was established in 1736 as a six bed infirmary in the New York Alms House on the current site of New York City Hall. Today Bellevue is a national leader in primary, specialty and tertiary services. Bellevue is the official hospital to the United Nations and any visiting dignitaries from around the world (including the President of the United States). A member of the New York City Health and Hospitals Corporation, the nation s largest public hospital system, Bellevue is a leader in public health. Its many contributions to medical science and education make it an enduring presence as a place for quality health care for all.

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