How To Read a Nutrition Label for Bariatric Surgery & Weight LossJanuary 27, 2021
Nutrition labels can be tricky and confusing! So many numbers and percentages—it can be daunting to know what is actually important. Well, if you follow these simple steps, you can be a pro on how to read a nutrition label and making choices to optimize your health.
Why All Those Numbers?
The United States Food and Drug Administration (FDA) created food labels to help compare different food items using standard measurements and serving sizes that the “average” consumer typically eats or drinks.
The numbers on the nutrition label are typically in grams and are converted into a percentage based on a daily value (DV). The DV is based on a daily dietary intake of 2,000 calories, which is given as general nutrition advice. The goal of a nutrition label is to compare food items on a standardized scale.
You are not the average person, and you will require different nutrition recommendations, especially if you have had bariatric surgery. Another caveat, before we get started, is that the FDA permits a discrepancy of up to 20% in product labels. Your “10 grams” of sugar could just as easily be 12!
7 Steps On How To Read a Nutrition Label
First, you actually have to look at the label and the ingredient list. I know many people shy away from reading labels because they are intimidating, or they just don’t really want to know, but knowledge is power! I assure you!
Do not trust the health claims on the front of the box. Simply because the box says vegan, gluten-free, or organic, light, natural, low-fat, or low-carb does not make it automatically healthy. Did you know that Oreos are technically vegan? Exactly, my point.
You should always read the ingredient list. The ingredients are listed in order of predominance, with the ingredients used in the greatest amount first, followed in descending order by those used in smaller amounts. You should try to choose products with a short ingredient list.
As a rule of thumb, the first three ingredients largely comprise what the product is made from. The longer the list, the more likely the food is highly processed.
Look at servings per container. If this number is more than one, and you plan on eating the entire package, you must multiply all the information (calories, protein, carbohydrates, fats, etc) by that number.
Determine the serving size. The most accurate way to do this is with a food scale. By guessing you will never know how much food you are actually consuming. This can lead to a calorie surplus, and ultimately weight gain. You can also use volumetric measurements, but this may also lead to inaccurate measurements.
Determine the calories that are provided by that one serving. If you plan on eating more than one serving, then the calories will be greater than the label, and you will need to multiply all the information by the number of servings you are actually consuming.
Your total number of calories per day will vary. Please ask a dietician or your program what the appropriate number is for you.
Look at protein in grams. This will tell you the amount of protein in one serving. As a bariatric patient, you should aim to consume about 20-30 g per meal, and 10-15 g per snack from all food sources combined. The recommendation for most bariatric patients is to consume between 60 and 80 grams per day of protein. This will vary, of course, please speak with your bariatric program for your specific goals.
Look at carbohydrates in grams. The amount of carbohydrates needed as a bariatric patient will differ based on how far out you are from your surgery.
Initially, most patients are under 50 grams of total carbohydrates per day during the first 3-6 months. This then slowly increases and will vary based on activity level. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), most bariatric patients should consume about 130 grams of total carbohydrates per day to maintain their weight. You will find fiber and sugar as subcategories under carbohydrates.
I, personally, do not count net carbohydrates and do not recommend this for my patients. Net carbohydrates is the total carbohydrate content less the amount of fiber in grams. This is why many products can claim to be “zero net carbs” if they are high in fiber. I find this to be confusing and inaccurate.
Fiber still provides some calories as our gut bacteria can extract energy from this to make short-chain fatty acids, and cannot be counted as zero calories. Aiming for a good amount of fiber every meal will keep you satiated and control your blood sugars in between meals. This can keep you at a healthy weight by preventing you from overeating or over-snacking, and can even prevent low blood sugars in between meals. It can also prevent dreaded constipation, which many patients suffer from in the first year. The daily goal for fiber should be between 25-35g per day.
Look at fat in grams. First and foremost AVOID trans-fats, as they can increase your risk of heart disease. They can be found in some microwave popcorn, margarine, fried fast foods, pastries, non-dairy coffee creamers and junk foods. The sneaky thing is that if a label has less than 0.5 g of trans fats it can be labeled as zero! When reading your ingredients avoid foods that contain hydrogenated oil or partially hydrogenated oil.
Saturated fat should also be limited as this can also increase your risk for heart disease and elevated cholesterol. Aim for less than 3 g of saturated fats per serving. Saturated fats are found in things like butter, animal protein, coconut oil, etc. Choosing lean sources of protein and reducing red meat consumption can help keep these numbers low. Also, please don’t add butter to your coffee!!!
As a bariatric patient, your total fat should not really exceed around 50 g per day, but should also not fall below 20 g per day, especially in women, as this is the minimum amount needed for optimal hormone function.
Lastly, SUGAR. This is a big one for weight loss surgery patients, as this can cause the much-feared dumping syndrome. The amount of sugar tolerated will vary based on the individual. As a general rule, you do not want to consume more than 10 g of added sugar in one sitting.
The American Heart Association recommends 25 grams of added sugar per day for women, and 35 grams of added sugar per day for men. This does not include sugar in whole pieces of fruit. When you start reading your labels you will find sugar in everything—condiments, bread, yogurt, sauces et cetera.
The more sugar we consume, the more we will crave. This is why keeping your added sugar low is so important. Another tip is to look at the ingredient list; if sugar or some form of it is at the top of the ingredients list, this means that it exists in a higher proportion in that product.
A word of caution: there are many names for sugar. These include corn syrup, cane sugar, invert sugar, molasses, malt syrup, dextran, maltose, etc. The list is far too long.
I know many people want to know about sodium. Generally speaking, the less processed foods you eat the less sodium you will consume. Most Americans get their excess sodium from fast foods, restaurants and highly-processed foods.
If you are concerned about sodium, make sure the majority of your intake comes from fresh fruits and vegetables, legumes, and minimally-processed animal proteins. The more unprocessed your diet is, the fewer labels you have to read! Hooray! The American Heart Association recommends no more than 2300 mg per day, and ideally closer to 1500 mg per day to improve heart health and blood pressure.
I hope this article makes reading labels slightly less intimidating and empowers you to be a more informed consumer!
ABOUT THE AUTHORLorraine Rojas, PA-C started her professional career in a Bariatric Center of Excellence in Syracuse, NY. Subsequently, she joined another Center of Excellence at her present position in Torrance, CA. As a result, she has learned the highest standards of care in Bariatric Surgery and non-surgical weight loss. Read more articles by Lorraine Rojas, PA-C