Nutritionist preop class

Okay so I went to my first Nutrionist class yesterday.  Everything went well but I was surpized about one thing.  My nutritionist was recommending complex carbs and protein both.  Not protein and veggies alone but whole grains and fruit too.  I was surprized she was recommend these.  (however I think it makes more sense for a balance diet to have these included in the diet)  But this contridicts my research that ppl with Bariatric surgery should have the main part of out diet being Protien first than veggies.  Most of our conversation in the class was talking out preop prior to liquid diet but I looked at things she had listed post op in a book we were given before awhile back after the liquid phase and on the list and example there were many good carbs listed.  Any thoughts?

From my book Example meals once starts solid foods this is appoximately 3 weeks post op:

Breakfast:
1 egg
1/4 cherrios
1/4 milk
1/4 C canned pears

Snack: protien supplement

Lunch:
2 oz low fat cheese
3-4 whole wheat  crackers
1/4 C cook carrots
1/4 C yogurt

Afternoon snack: protein supplement

Dinner:
2 oz fish
1/4 cup baked potatoes (no skin)
1/4 cup cooked green beans
1/4 cup sugar free pudding.

My first thought is how would someone 3 weeks post op even fit this much.  Second thought why are they recommending Cherrios and whole wheat crackers and potato.  I could see maybe 1 years out but I thought is' all about Protein Protein Protein and a little bit of veggies when room for them.

Interesting post, as this goes against what I've seen here also. I'm looking forward to hearing the answers on this one!

Ideally yes if our stomachs would be large enough complex carbs would be an important part of our diet.  I could see incorparating them in after the sleeve is matured but not 3 or 4 weeks post op.  I visited another nut. (nothing to do with bariatric surgery) in years past to try to loose weight on my own and she stressed that a balance of both protein, produce, and complex carbs will stabilize the blood sugar.  I went on her diet for about 1 month I did loose weight and felt good.  Only trouble is had a hard time stinking to it since it involved a lot of cooking which I didn't have time to do.  But my blood sugar didn't seem to dip while I was on that diet.  So I agree her diet is great but I don't see how it would work for a bariatric patient that wouldn't have the capacity to fit all the food.  I'd worry we'd be short protein. 

What you will probably find in time is that you can often fit more of combinations of foods thru your system than the basic firm proteins by themselves. Many here complain about the evils of the so-called "slider" foods that slide on thru your stomach, and they are partially correct in that most of the junk that we should avoid do tend to be sliders - chips, crackers, twinkies, etc. - but a lot of the good non-meat foods that we should be having can also be sliders. So, while my nominal capacity for firm meats is about 3 oz, I can easily have 5-6 oz of chili, chicken cacciatore with chicken stewed with tomatoes, onions, peppers, celery, etc., or other meat/veg stews, stir frys, or salads. I would typically have mostly meat for dinner, something originally prepared for that meal - steak or beef roast, chicken, pork tenderloin, etc. and then use smaller amounts of the leftovers for other meals in combination with veg and other foods; a couple ounces of meat with a little roasted potato and broccoli for breakfast, chop up some leftover meat and add some veg for a quick teriyaki stir fry, etc.

Your observations from before is consistent with most of nutrition science, in that higher glycemic index foods like breads and fruits are averaged out in a meal with lower glycemic index foods like meats.

I was fortunate that protein wasn't a big issue for me (my doc was adding veg to my diet by day ten,) With 4-6 meal/snacks that each have only 2 oz of meat, or high protein snack foods like greek yogurt or a protein shake, there is room for some of the other things to balance things out. The challenge sometimes, as you found, is that it often involves more cooking time than just grabbing a single food item out of the fridge (or worse, out of a package!) But given the small volume that we have at any one meal, there is always leftovers, so I can get several meals out of one particular cooking effort.

I tend to agree with everything you are saying.  It makes sense.  I see that this may not be a diet I want to do 3 weeks out but after weight loss it would be a good balanced diet for mantience.

Also side note in meeting with the doctor he said the sleeve would have the capabilty to hold 3 to 4 oz not 1 full cup.  At least not until it matures.

Initially, that does look like quite a bit of volume, but is something that will be workable in time,
It does look like they are trying to get you into the habit of eating a healthy balanced diet for the long term, which is not at all a bad thing.

While there is rather more evangelism about the low carb diet fad here on OH than on other boards, it is far from being the only way to successfully work the sleeve, or WLS in general. In the nine years or so that I have been going to the support groups and seminars (my wife had WLS around seven years ago,) low carb was never a big emphasis beyond the basic avoidance of simple carbs/sugars during the prime loss phase and the avoidance of junk or empty calories in general (and contrary to Atkins marketing, both fats and carbs can be junk, just as they both can be healthy). As with any high deficiency diet, low carb does have specific therapeutic value for some people, particularly those with diabetic related issues or those whose weight problem stems specifically from OD'ing on junk carbs and may need a period of detox. Some got into trouble from excessive fats, though that is less common today after the fat moderating effects of the last low-fat end of the diet fad cycle (the pendulum of the weight loss industry has swung between the low fat and low carb extremes several times over the past century, and we just happen to currently be near the peak of low carb phase of that cycle; if these diets were listed in the stock market, I would definitely be shorting LOCRB.)

The grains and potatoes do have a place in a healthy balanced diet, though it is not unreasonable for them, along with some of the more sugary fruits, to be later additions given their somewhat lower nutritional density. We do occasionally see people here reporting thamine deficiencies, which come mostly from the grain complex, and potatoes are one of the calorically most efficient sources of potassium, which isn't supplemented well in our normal supplements.

Overall, the balanced approach is as viable as any other for sleeve success, and better than most for long term maintenance success. Given the limited intake that we have along with the protein emphasis, there often isn't a lot left over for much else, so even the balanced approach is a defacto low carb diet, even if it isn't quite to the Atkins extreme. However, one recurring theme that seems to keep popping in nutrition science, and physiology in general, is that the body doesn't like extremes and tries to maintain balance, so this isn't a bad thing to practice to the extent possible, even during the times when our priorities may dictate some temporary imbalance is appropriate (as in protein over everything else during out initial loss phase.)

I havent been to NUT classes yet but Ive been to 2 of my 3 required weight management classes and though they are supposedly for patients of WLS, the info seems to be generalized for any patient trying to lose weight... that is NOT a good thing because WLS patients need specialized diets...
nowhere in my classes so far has there been a mention of focusing on proteins and such...
Im basically going only because insurance requires it... I REALLY hope the NUT classes are better suited.