The Protein Shake Up

Protein’s importance is widely recognized in bariatric surgery because requirements are at least as high after surgery as before, yet stomachs are so much smaller.

Emerging research is suggesting that the distribution of our protein intake throughout the day can be just as important for maintaining muscle mass as the total quantity. One study found that consuming more than 30g of protein at a time provided no additional benefit, with the maximum benefit achieved at 30g.

Eating enough protein is essential for building and maintaining muscle mass and function. The older we get the faster our body breaks down our muscle after building it, to the point where we can almost pump ourselves up at the gym and slowly start deflating as we walk out the door. Muscle has an important impact on our metabolic rate, or how many calories our body burns in the day. Our calorie burning ability influences how easy it is to gain, lose or maintain weight.

So how much protein do we need and can we get enough at each meal without only eating meat?

There are varying recommendations for protein intake following bariatric surgery ( gastric bypass, sleeve gastrectomy and gastric band ) . The recommendations fall within the range of 50 – 80g of protein per day for most people. Taller individuals with higher muscle mass fall towards the top of this range and may even have needs that exceed 80g per day.

If this protein intake is spaced out between three periods in the day, then this would suggest that 16 – 26g would be ideal within each period, with a maximum of 30g in any period. If a period includes a meal and a snack, then we can divide the day into Breakfast plus morning snack, Lunch plus afternoon snack and dinner plus supper snack.

My assessment of the usual intakes down the track after surgery is that dinner would usually provide an easy opportunity to consume sufficient protein via intake of meat, poultry, fish, egg dishes or legumes such as black beans or lentils. Breakfast and lunch are the riskier times, where haste and convenience can influence intake.

Let’s review the protein content of some common breakfast meals that equate to approx. 200 Cals:

So, it seems it is not so easy to achieve the maximum of 30g or even 1/3 of the total requirement at breakfast after bariatric surgery, being 16-26g.

This means that what we eat at the morning snack is going to make or break a well-proportioned daily protein intake.

Let’s look at some options that can make up the difference and equate to approx. 100 Cals:

Morning snack options of approx 100 Cals that would not have contributed to achieving the protein target would be:

You can see that it would take a little planning but it is achievable. I think the take home message is that mid morning is the time to incorporate a protein based snack such as a half serve of a protein shake or bar and that cottage cheese is your friend.

A similar assessment of lunches reveals:

This places less reliance on the protein content of the snack as the amount of meat consumed at lunch approaches a 100g serve.

Evening meals planned around the bariatric plate model will result in greater than 20g protein where half the plate is filled with meat, poultry or fish.

Problems arise where meat is not well tolerated, such as commonly reported in gastric banding and also in other surgeries due to reduced stomach acid from the smaller stomach size or from long-term use of anti reflux medications.