Confused

I'm new to this site.  I VSG surgery 11-28-12.  I'm confused on the amount of food to eat daily.  My dr told me 800-1000 calories per day and 70 grams of protein.  I see on this site where most eat 600-800.  Also I have never been told to eat fruit and vegetables.  In fact, someone in our support group told me we don't have to worry about eating them since we're taking vitamins. 

That is a high number for the loss phase and to be honest, unless I was eating rubbish food all day, I still couldn't actually eat enough to get that amount in. Most people do work between 600-800 per day during the losing phase.

Fruit is high in sugar and calories, so I personally only have it occasionally, but veggies are important in my diet. I don't eat a huge amount of them, but I don't think it's healthy, or sustainable long term, to just eat meat.

For me, it's about total calories, protein and balance of food types and this is pretty much my NUTs plan too (although her food volumes are more than I can actually eat, it she's fine with that).

You don't have a ticker, so what are your stats so far?

I  have lost 68 Pounds. 

I know that you didn't really ask for specifics but I think that the plan I was given might be helpful.  That being said my nutritionist started me out on the 600 to 800 calories per day with 75 - 90 grams of protein ... I choose 80 as my minimum based on that.

 I was given a huge book that entailed my plan and it is very specific and very drawn out and definitely errs on the side of being cautious the whole way.  I am also a perfectionist which is why I lost 95 pounds in a little over 5 months and was basically at goal.   I didn't eat any vegetables to speak of for the weight loss phase.  In the last 6 months I have added back in the vegetables to a small degree.  

First the Tips for Post-Op Patients ... G D E s (Gotta Do Ems) - adapted from EAT IT UP by Connie Stapleton, PhD

- Make consistently healthy food choices (protein first)

- Maintain portion control

- Chew your food thoroughly (at least 20 times a bite)

- Take your time when eating (at least 20 minutes per meal)

- Drink plenty of water throughout the day, but not with meals

- Eat Breakfast

- Plan your meals and follow your plan 

- Exercise on a regular basis

- Keep food and exercise journals (myfitnesspal.com)

- Get good rest

- Utilize healthy support system (support group meetings and online support, individual counseling if needed

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Phase 1 - Post Operative Thin Liquid Diet

- Days 1 - 10 after surgery

- Calories 600 - 800

- Protein 75 - 90 grams

- Fluid: Aim for at least 64 oz. (8 cups).  Continue to stay hydrated with plenty of fluids.  No straws, no carbonation.

- No Chewing Gum at all this phase.

- After surgey, during the Phase 1 post op liquid diet, you have the option of continuing the Optifast 800s Ready to Drink shakes OR purchasing alternative protein supplements of your choice.

- No protein bars, including the Optifast 800 bars, are permitted until Phase 4, the soft diet.

Examples of acceptable sugar free, low calorie fluids:

   = Water or flavored water

   = Crystal Light or equivalent sugar free drink mixes

   = Sugar free popsicles

   = Sugar free gelatin

   = Broth - strained broth based soups acceptable (beef, chicken, vegetable)

   = Coffee/Tea (decaf, no cream)

   = Protein Supplement (Optifast or supplement of choice)

   = Skim or 1% milk, soy milk, almond milk (unsweetened)

Examples of fluids not allowed during Phase 1 post op diet

   = Milkshakes and smoothies

   = Yogurt, pudding, applesauce

   = Fruit Juice

   = Carbonated Beverages

   = Cream Based Soups

PROTEIN SUPPLEMENT GUIDELINES

   = Whey Protein Isolate (not blends or concentrates as they are not as quickly used and therefore some of the protein passes right through.

   = Approx. 24 grams of protein per serving.  

   = Less than 5 grams of sugar per 8 oz serving

   = Less than 5 grams of fat per 8 oz serving

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Phase 2 - Post Op Full Liquid Diet

Days 11-14 after surgery

Calories: 600 to 800

Protein: 75-90 grams of Protein

Fluid: Aim for at least 64 oz. (8 cups).  Continue to stay hydrated with plenty of fluids.  No Straws, No Carbonation.

Continue taking your chewable multivitamins and calcium daily.

Continue to consume the thin liquids from Phase 1.  Gradually work in small amounts of full liquids through the day.

Most of your calories and protein will still come from your protein supplements and/or low fat milk.

Examples of full liquids:

   = Strained, fat free cream soups without chunks.  Look for 98% fat free varieties that are made with 1% or less milk fat.

   = Sugar free pudding made with 1% or skim milk (or unsweetened almond milk, soy milk)

   = Light Low fat blended yogurt without chunks made with artificial sweetener

   = Unsweetened Applesauce

   & Portion Size: approximately 1/4 to 1/2 cup ... SMALL BITES

Keep track of your protein, calorie, and fluid intake.

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Phase 3 - Post Op Pureed Diet

Weeks 3-4 after surgery

Calories: 800 to 1000 (SIDE NOTE >>> I DID NOT INCREASE CALORIES AND KEPT BETWEEN 600 and 800)

Protein: 75 - 90 grams of protein

Fluid: 64 oz.    No Straws, No Carbonation

During this phase you may start having slightly textured foods.  Your food must be soft enough and moist enough that it can be very easily mashed up with a fork.  This will help you transition to more solid foods later.  Even though these foods are pureed or mashed, chew very well before swallowing.

- Continue taking your multivitamins and calcium dailies.

- Continue to STAY HYDRATED

- DO NOT drink any fluids 30 minutes before your meal, during your meal, or 30 minutes after your meal.

- Protein is important to help you maintain muscle while you are loosing weight so always consume your protein foods first, then move on to fruits and vegetables, and then whole grains.

- Portion size per meal ... 1/4 to 1/2 cup.  It should take you 20-30 minutes to consume this amount of food.

- You may need to have 5 or 6 small meals daily.  Do not Graze.

- Keep track of your protein, calories, and fluid intake.

- Continue to use your protein supplements (shakes) between meals to help meet your protein and calorie needs.

- Boost the protein content of lower protein foods by adding unflavored whey protein isolate powderor dried milk powder.

- Add foods one at a time to test tolerance.

- If you feel full, nauseated, or pressure in the upper stomach, then STOP!!!  Do not eat or drink anything for 2 hours.  Let the food pass.

FOODS in the pureed phase may include:

   = Scrambled Eggs, egg whites, or egg substitute (good source of protein)

   = Low fat cottage or ricotta cheese  (good source of protein)

   = Sugar free / low fat pudding

   = Fruits such as no sugar added applesauce, mashed bananas, or small homemade fruit smoothies made with a yogurt base.

   = Cream of Wheat/Rice. grits, oatmeal (thin and soupy consistency)  (SIDE NOTE ........... I didn't do this until maintenance phase)

   = Mashed sweet or white potatoes

   = Pureed acorn or butternut squash

   = Canned vegetables - coo****il very soft and mash with a fork.  Examples include puree peas, carrots, green beans, beets

   = Pureed chicken or turkey (no skin) or mashed canned chicken (white meat)  (good source of protein)

   = Soft fish - haddock, tilapia, cod, salmon, and water packed tuna can be mashed with a fork.  (good source of protein)

   = Fat free refried beans  (good source of protein)

   = Cream Soups (98% fat free)

   = Blended light, low fat yogurt or Greek yogurt (higher protein content)

   = Condiments:  low fat or fat free mayo, mustard, fat free spray butter, spices and herbs, hot sauce, and vinegar.

SAMPLE PUREED MEAL PLAN

Breakfast:  1/4 cup egg substitute or 2 egg whites and 1/4 cup light yogurt

Snack:  Protein supplement (shake)

Lunch:  1/4 to 1/2 cup pureed chicken

Snack:  Protein supplement (shake)

Dinner: 1/4 to 1/2 cup mashed tuna fish with light mayo and 1/4 cup puree cooked vegetables

Snack:  Protein supplement (shake)

 

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Phase 4 - Post Op Soft Diet

Weeks 5-8 after surgery

Calories: 800 to 1000 (SIDE NOTE >>> I DID NOT INCREASE CALORIES AND KEPT BETWEEN 600 and 800)

Protein: 75 - 90 grams of protein

Fluid: 64 oz.    No Straws, No Carbonation

Portion size: 1/2 to 3/4 cup.

- Choose soft foods that are low in fat and sugar but high in protein.

- Chew well !!!  Your food should be liquid in your mouth before swallowing.  If you have dentures, be sure to cut your food into small pieces.

- Slow Down !  Take 20 to 30 minutes to consume meals.

- Wean off protein shakes when you reach your calorie and protein goals through meals.  One shake a day for the rest of your life is fine.  (I PERSONALLY AT ONE YEAR POST OP STILL DO A SHAKE FOR BREAKFAST EVERY DAY)

- Eat protein foods first then move on to vegetables, fruits, and whole grains.

- Eat only cooked vegetables and avoid high fiber vegetables.

- Add foods slowly and one at a time to test tolerance.

- Stop eating or drinking when full.  Overeating may stretch the stomach pouch and hinder weight loss.

- You may need to have 5 to 6 small meals daily.  DO NOT GRAZE.

- If you do not follow these precautions, you may experience vomitting, stomach irritation, and swelling.  You could also have a stoma obstruction.

- If solid foods cause nausea and vomitting, go back to the clear and full liquid diet.

FOODS IN THE PHASE 4 SOFT DIET:

   = Fruits:  Soft fruits such as a ripe banana or soft melon or canned fruit packed in natural juices, not syrup

   = Vegetables:  Soft cooked vegetables without seeds or skins.  Tomato sauce puree with no seeds.

   = Potatoes:  Sweet potatoes, baked potatoes

   = Cereals:  Cooked oatmeal, grits, Cream of Wheat or Rice, Unsweetened dry cereal without nuts with added milk for soaking.

   = Bread and Crackers:  Dry or toasted bread.  Melba toast, whole wheat crackers.

   = Protein:  Baked or broiled flakey white fish, eggs, low fat soups, chicken or turkey without skin, tender roast beef, pork tenderloin, lean ground beef (at least 90% lean), water packed tuna, tofu, canned beans

   = Dairy:  Low fat cottage cheese, part skim ricotta cheese, low fat cheeses, sugar free low fat puddings or yogirt, Greek yogurt (higher protein content), 1% or skim milk

CAUTION FOODS INCLUDE:

   = Soft breads, doughnuts, pastries.  These may form a dough ball and block the stomach outlet.

   = Salads or other raw vegetables

   = Sugar and sweets such as table sugar, cakes, cookies, pies, pastries, and granola

   = High fat meat (bacon, sausage, salami, bologna, hot dogs)

   = Tough or gristly meat such as steak, roast beef, pork, lamb, veal, and venison

   = High fat foods such as butters, regular salad dressings, full fat mayo, sour cream, and cream cheese, whole milk, whole milk cheese, full fat ice creams

  = Fibrous vegetables such as broccoli, cauliflower, Brussels sprouts, corn, cabbage, salad greens, asparagus, and celery.  Some of these may be tolerated well if cooked very well.

   = Fresh fruit except bananas and soft melon

   = Rice and pasta.  These may also form a dough ball and block the stomach outlet.

   = Nuts, seeds, coconut, raisins, popcorn, dried fruit.

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PHASE 5 Post Op Regular Diet

Weeks 9 - a lifetime!  Once you are about 9 weeks out from surgery, you may start introducing fully solid foods into your diet.

For the rest of your life you should enjoy a low calorie, heart healthy diet that emphasizes lean protein, vegetables, fruits, and whole grains.

Portion size: 3/4 to 1 cup

Keep track of your protein, calorie, and fluid intake.  You need approximately 800 to 1000 calories and 75 to 90 grams of protein per day.  Your individual protein and calorie needs will be set by your dietician but these general guidelines usually apply.  The patients who keep track of their calorie and protein intake have better weight loss success after weight loss surgery.

- Continue to stay hydrated with plenty of fluids.  Drink at least 8 cups of fluid each day.  Remember to sip, not gulp.  Limit your caffeine intake and avoid carbonation.

- Set your meal and times and only eat at the designated times.  No grazing.  You can sneak in a lot of calories by nibbling between meals or sipping on fluids with calories, including alcohol.

- Get your protein in first.  Prioritize how you fill your stomach.  When you feel full ... STOP !!!

- Separate your food and drink.  Drinking with meals will wash food out of your stomach and make you hungry faster.  Liquids may also fill you up and leave no room for nutritional food.

- Enjoy and savor your food.  Eat slowly.  Try putting your fork down between bites.  Do no****ch television or play on the computer while eating.  (I AM SO GUILTY OF THAT >>> LOL)

- Exercise is critical when trying to lose weight.  Patients who exercise lose more weight than those who don't.

- Attend support group.

PROTEIN POINTERS

- Protein is required to build, repair, and preserve tissue to keep you healthy as you lose weight.

- Protein helps maintain fluid balance between blood and body tissues.

- If you do not get enough protein, you may develop flaky skin, hair loss, and or color change, swelling in your legs or abdomen.  You will also likely begin to feel weak, especially if you aren't taking in much of anything else.

- Cut chicken, beef, and pork into small, thin bites to increase tolerance.

- Double check your chewing (20-30 chews per bite) and check the clock.  Is it taking you 20-30 minutes to consume your meal?

- Protein foods help you feel fuller for longer so it's important to eat them at every meal, most meals of the week.

- Soft proteins like eggs, dairy, fish, and lean deli meats may be easier to digest, especially at first.

- Use low fat condiments to moisten foods when eating such as mustard, low fat mayo, ketchup, bbq sauce, tomato sauce, broth, low fat gravies.

- If you feel that your protein food was too dry and feels stuck in your throat, you may sip on appropriate fluids to help ease it down or wait 5 - 10 minutes until the feeling goes away.  But, make sure you avoid doing this repeatedly by eating slowly, taking small bites, and preparing your foods appropriately.

EASY PROTEIN IDEAS:

- Healthy Request bean soups

- Fat free refried beans and salsa

- Steamed white fish with lemon juice / olive oil

- Well blended crab salad on a whole wheat cracker

- Egg drop soup

- Frozen mini shrimp with ****tail sauce

- 2 slices of deli turkey rolled up with low fat cheese and Dijon mustard (I DID THIS A LOT WITHOUT MUSTARD ... USED WALDEN FARMS BACON RANCH 0 CALORIE DRESSING INSTEAD)

- 1/4 cup low fat cottage cheese with cinnamon and Splenda (or Stevia)

- Peanut Butter on reduced fat Triscuits

- Turkey meatballs with marinara sauce (CURRENT FAVORITE)

- Boca Burger with reduced fat melted cheese

- Leftover meat wrapped in a spinach leaf

- 1/4 cup low fat ricotta cheese or Greek Yogurt ... add Splenda, cinnamon, or soft fruit

- 1 oz. soy protein chips

   

 

Thank you so much  this really helps.  I have not seen a Nut.  

I am only 12 days post op and found your post so helpful!!!   I was given a basic diet to follow, but nothing like the details you listed.

What was the title/author of the book you were given?  I would love to read it.  Thanks for sharing this great information!!!