Celebrate Nutritional Supplements Vendor

Before Surgery

Test-drive the diet.

• Start by taking smaller bites (try using a baby spoon) to prepare yourself for eating after your procedure.
• Set down your utensil between bites. This will help to ensure that you have chewed your food completely. If you don't put your utensil down, you will go into "auto pilot" and be ready with the next spoonful before your food is thoroughly chewed. If you have to, put your utensil down and go in another room until you are done chewing. Then come back for the next bite.
• Learn to drink smaller mouthfuls, so as not to overfill your pouch. Use a cup with a float device that will only allow you to drink 15 cc or ½ oz of liquid at one time.

Vitamins

Remember to take your vitamins!
Remembering is often half the battle. Set your cell phone or watch alarm, put a reminder in Outlook (for you windows users). Leave a bottle where you are sure to see it-on the counter or on your nightstand as a reminder.

Don't like capsules, tablets or chewables?
Most capsules (including ours) can be opened up and mixed with food. Try it with a teaspoon of yogurt or applesauce.

Chalky chewables. 
We work hard to prevent the chalky taste that some chewables can have but sometimes, it is impossible to do away with this completely. Try taking a small sip of water or at least rinsing your mouth just prior to chewing your supplements. It will make all the difference in the world!

Want to mix up your supplements? 
There is nothing wrong with taking your multivitamin in a capsule form and your calcium in a chewable form or vice versa. 
Watch out for vitamin waters and drinks. They are not all they are cracked up to be and many are loaded with unnecessary calories. The label of one leading brand, for example, reports that it supplies half the daily requirement for some nutrients. But to get that amount, you have to drink the whole bottle, which contains 125 calories. And for that you get just 6 of the 40-plus essential nutrients provided by most supplements. An entire bottle may supply no more vitamin C than you'd get from eating two strawberries. When it comes to vitamins, more is not always better. You would do well to drink regular water and take your bariatric specific vitamins instead.

Protein

Getting in 60-80 grams of protein can be a full time job in itself, but there are ways to mix things up.

1. Try mixing up your favorite protein and putting it the freezer for a ½ hour. A protein slush on a hot summer day is as good as any cold treat around. Try it-you will be surprised.
2. Use a cup with a lid! Many patients will swear that they can smell the protein in a shake or drink no matter what the flavor. Putting a lid on will block the protein smell and allow you to enjoy the drink (and the protein)!

Shopping & Cooking

Food Labels. While you are making your grocery list, take a minute and read the labels of the products in your kitchen, especially the ones you are going to replace. Eliminate any product that contains high fructose corn syrup (which is not digested by the body and goes directly to fat), hydrogenated or partially hydrogenated fat (saturated fat), trans fat, or bleached white flour. Just getting rid of products that contain these ingredients will make a big difference. There are lots of excellent substitutes out there that don't contain these ingredients that taste just as good.

Whole grain. Look for products that contain whole grain. If the first ingredient in the list says whole grain, and it is not followed by ingredients such as bleached white flour, partially processed grains, or other qualifiers, you can be reasonably assured that you have a whole grain, and therefore a much healthier product with a good fiber content. Finding whole grain products is easier now that manufacturers who are supplying at least 16 g of whole grains per serving (considered an excellent source) are stamping their packaging with the Whole Grains Council's logo.

Go Green. Pesticides and other toxins may not only make you sick, but they can significantly contribute to weight gain as well. Buying organic fruits and vegetables 
helps a lot, but organic produce can get expensive. Some fruits and veggies aren't grown using pesticides; for example, buying organic bananas would be pointless. The following are your best bets for buying organic and drastically reducing the toxins you eat and feed your family: beef, milk, coffee, peaches, apples, strawberries, sweet bell peppers, celery, lettuce, grapes, potatoes, and tomatoes. If you can start buying these in organic form you'll do yourself a world of good. If not, be sure to wash and cook these items well. Don't eliminate them from your diet just because they may not be organic. Simply be smart about what you're eating and be aware. 

Don't Be a Frequent Fryer. Choose cooking methods that don't add fat to your foods: baking, broiling, grilling, roasting, poaching and steaming. Use nonstick cooking spray in place of oil and save 14 grams of fat. 
Plan Menus in Advance. When you know what you're going to eat ahead of time, you avoid impulsive high-fat, high-calorie food selections. Try to plan weekly menus on the weekend and shop for the ingredients you'll need. This will make weekday mealtimes a lot less hectic.

Give Your Spuds Some New Duds. Forget the butter when mashing potatoes. Every tablespoon has 11 grams of fat. Instead, use low-fat sour cream or buttermilk to get the creamy taste and texture you're after. Try salsa on baked potatoes-it's fat-free.

Carbs! Instead of swearing off rice and pasta altogether, nutritionists say you should choose unprocessed whole grains. Identical portions of whole-wheat pasta, bread, and brown rice usually pack more fiber than their refined, white counterparts, which helps prevent heart disease and diabetes and keeps you fuller longer. And don't cut out dairy entirely--it's a good source of calcium, and giving in to the occasional need for a double-dip will prevent you from feeling too deprived.

General Guidelines

1. Store tempting foods on the highest shelves of cabinets or on the lowest shelves of the refrigerator so they will be less noticeable and harder to reach. 
2. Don't talk on the phone, read, or watch TV in the kitchen (or any other place that food is stored). 
3. Serve reasonable portions of food in the kitchen and bring the plates to the dinner table. Don't put serving bowls or platters on the table. If you or someone else really wants seconds, they can go into the kitchen to get them. 
4. Laugh More Often! Did you know that 100 hearty, good laughs burn the same amount of calories as ten minutes of rowing?

5. Eat and don't be afraid of food. It may sound crazy to those trying to lose weight by severely restricting their daily caloric intake, but the problem with this old school of thought is that not eating actually slows metabolism. Every cell of the body is like a flashlight bulb. When our bodies don't get enough food, or fuel, every cell burns less brightly. Recent studies show that eating smaller meals every three to four hours aids metabolism and weight loss.
6. Beating cravings. People give in to cravings because they think they'll build in intensity until they become overwhelming, but that's not true. Cravings behave like waves: they build, crest, and then disappear. If you can "surf the urge," you have a better chance of beating it altogether. Studies also show that music helps in beating back the craving wave. Upbeat music seems to work the best, so break out the IPOD or crank up the stereo.

Eating Out

Fast food survival - stick to salads. A big problem with fast food is that many innocent-looking nuggets and patties are loaded with added fats, flavorful chemicals, and high-fructose corn syrup, which wreak havoc on your blood sugar levels. Salads are a good way to eat ingredients where you can easily observe whether they've been adulterated with bad-for-you additives. Not to be deterred, the fast food companies will try to get you with the dressings. Ask for oil and vinegar, if possible. If not, check the ingredients and calorie counts of the dressings. You're better off with a vinaigrette or vinegar-based dressing like Italian. Also, most places give you enough dressing to dress several salads. Either use only half the packet of dressing or ask for a side cup you can squirt it into, and then dip your fork in the dressing before you get a bite of salad. Another way to avoid the dressing trap is to forgo it completely, and scam some fresh lemons from the condiment or beverage counter and squeeze them over your salad.

Learn to dismantle your food. Ask if you can substitute the grilled chicken breast for the breaded chicken breast, wheat buns for white buns, lettuce cups for buns, or ask for extra veggies. And hold the cheez (cheese), especially if it's spelled with a "z." When you order the "healthy" grilled-chicken or fish sandwiches, make sure they're not loaded with mayo, ketchup, or special sauces. Ask for salsa or mustard instead. Don't be afraid to ask for what you need. If anyone gives you any grief, claim a severe food allergy. They'll usually get over the attitude and become very helpful.

Nausea & Vomiting

Possible Causes

• Not chewing well 
• Eating too fast 
• Eating too much
• Food intolerance 
• Low fluid intake 
• Stenosis or stricture
• Inappropriate intake of NSAIDS
• Band too tight

Possible Side Effects

• Band erosion
• Esophageal irritation
• Dehydration
• Thiamin deficiency
• Protein-calorie deficiency

Helpful Tips

• Anti-emetic medications prescribed by your surgeon
• Drink warm fluids (peppermint or chamomile tea, chicken bouillon) 15-30 minutes prior to a meal
• Make sure you are getting at least 64oz of water to help with nausea. Up to 100oz water per day may help with nausea
• Ginger root (drops or tea), chamomile, peppermint can help with nausea
• Chew food well and swallow before putting more food on your fork or spoon.
• Add one new food at a time. If it makes you sick, try the food again in another month.
• If eating too fast, try eating in front of a mirror, utilizing baby utensils, or taking dime-sized bites.
• If food feels "stuck," stand up and walk around or put your arms straight up in the air.
• Pour protein drinks in 1oz shot glass. Sip 1-2 oz every 15 minutes for 1 hour 3-4 times per day (depending on amount of protein in product and stage of diet after surgery).
• Marinate meats or use something acidic (like marinara or taco sauce) to cook with your meat. 

Exercise

• Get a pedometer and start tracking your steps. Average your steps over one week and then make small increases. Try increasing your average by 500 steps per day for the next week to increase your activity. Work towards 10,000 steps per day. For example, if your average is 3,000 steps per day, then aim for 3,500 steps per day next week and then 4,000 steps per day the week after that. 
• Do you find walking boring? Drag someone along with you or get a dog. If your lifestyle does not allow for you to keep a dog, borrow a neighbor's dog or visit a humane society once a week and offer to walk some dogs. They are great walking companions and always willing to go!
• If your joints will not tolerate walking, try a recumbent bike (like you are sitting in a row boat) or get in a pool. Many people are concerned with their appearance in a bathing suit but many YMCAs will allow you to wear shorts & T-shirt. If you don't have a local YMCA, then check with your local hotel. Many have indoor swimming pools and you may be able to work something out with hotel management where they may let you swim/water walk, for a small fee. The hotel has to keep the pool ready for guests, so they would rather see someone use it since they are paying for chemicals and filtration. And remember, if you see anyone at the pool, they are just traveling through and you will probably never see that person again.

 

Special thanks to the bariatric professionals providing the above tips: Cathleen Burke, RN, BSN; Kim Knopp, MS, RD, LD, CDE; Julie Lovisa, RD, CD; and our fantastic advisory board.