DIET - I found a great document on the internet.

[TStew 25]

LAPAROSCOPIC GASTRIC SLEEVE DIET

Joseph E. Chebli MD FACS

Introduction

The following information provides guidelines for you to follow before and after Gastric Sleeve Surgery and for the rest of your life. Gastric Sleeve Surgery is a weight loss tool.

After surgery, you will be required to make lifelong changes in your eating habits and to exercise on a regular basis in order to achieve and maintain your weight loss goals.

Gastric Sleeve Surgery reduces the size of the stomach which restricts the volume of food that you can consume at one time. This means that you will feel full after eating a small amount. The surgery also induces hormonal changes which help prevent you from feeling excessively hungry.

You should avoid drinking liquids with meals. This is to prevent overfilling of the stomach.

Frequent snacking or grazing must also be avoided as this contributes to excess calorie intake and can slow weight loss or cause you to gain weight.

Exercise is an important component of weight loss success. Exercise is recommended before and after surgery in order to maximize the amount of weight that you lose and keep off. If you have not been an active exerciser, always consult with your physician for clearance and recommendations before beginning any exercise program.

It is important to follow the lifetime Gastric Sleeve diet rules, supplement guidelines, and exercise recommendations in order to achieve and maintain optimum weight loss success.

In order to begin preparing for surgery, start implementing the pre-surgery diet goals listed on the next page.

Pre-Surgery Diet

Practice Tips

1. Choose low-fat foods, and avoid fried foods.

2. Stop using sugar. Use healthy sugar substitutes. (T)

3. Decrease intake of Desserts and candy.< /span>

4. Stop drinking sugar-sweetened beverages such as regular soda and sweetened Kool-Aid.

5. Start weaning off of caffeine and carbonated beverages.

6. Start cutting back on fast food and eating out. Begin making healthy meal choices when eating out and at home.

7. Eat 3 meals a day. Do not skip Breakfast.< /span>

8. Start decreasing portion sizes.

9. Eat more fruits and vegetables.

10. Practice drinking Water and other fluids between meals, not with meals.

11. Drink 64 ounces Water a day.

12. Practice sipping liquids.

13. Avoid alcohol.

14. Begin some form of exercise.

15. Review the following information on the gastric sleeve diet.

16. Practice chewing foods thoroughly, 20 - 40 times or to paste consistency.

17. Purchase your Protein drinks or supplements.< /span>

18. Purchase your Vitamin and mineral supplements.

19. Begin planning a schedule for mealtime, fluids and Vitamin and mineral supplements.

Post Gastric Sleeve Surgery Diet

Important Diet Guidelines:

1. Eat 3 meals per day. Avoid snacking and grazing.

2. Eat small amounts. Initial portion size should be no more than 1 - 2 ounces - approximately 2 - 4 Tablespoons - of food per meal for the first month. At first you may not be able to tolerate this amount. Over time, you will slowly tolerate more

volume at each meal. Long term, the stomach will eventually hold about 4 - 8 ounces (1/2 - 1 cup) of food per meal.

3. Eat Protein foods first.

4. Do not try to eat food and drink liquid together. • Consume liquid 30 to 60 minutes before and/or 30 to 60 minutes after eating meals but not during meals.

5. You are required to take a Multi-Vitamin with minerals for the rest of your life.

6. Eat slowly!

• Each meal should last 30minutes or longer.

• Avoid gulping foods and drinks.

• All foods must be well-chewed to a paste consistency.

• Using a small fork or spoon (i.e. baby utensils) can help control portion sizes.

• Have one place to eat (such as at the table) and avoid reading or watching TV while you eat. This helps you to enjoy your food, concentrate on eating slower and to realize when your stomach is full.

7. Drink plenty of calorie-free, non-carbonated, caffeine- free fluids between meals.

• Drink slowly-sip fluids, never gulp.

• Calorie-containing beverages should be limited to skim milk and Protein Drinks.< /span>

• Limit juice to no more than 4oz. per day.

• Consume zero-calorie beverages throughout the day.

Diet Progression After Surgery

The diet after gastric sleeve surgery progresses through several stages. Your surgeon will let you know when it is okay to progress to the next stage.

Day 1 - 2 after surgery:

Clear liquid diet

The clear liquid diet means fluids or foods that are liquid at body temperature and can almost be seen through. You will be on a clear liquid diet while you’re in the hospital.

Examples of Clear Liquid Diet (No Added Sugar/ Sugar Free):

• Clear (diluted) fruit juices without added sugar: apple, grape or white grape or diet cranberry

• sugar-free Crystal Light drink mix or popsicles, sugar-free Kool-Aid. (T - careful, usually sweetened w/Aspartame)

• Herbal tea, caffeine-free tea

• flat soda

• Sugar-free Popsicles

• Sugar-free Gelatin

• Clear broth

• Water

�� It is best to dilute juices by 50% with water.

�� Avoid citrus juices (orange/grapefruit) and Tomato juice for the first three weeks.

�� coffee and de-caffeinated coffee contain acids which are irritating to the stomach lining and should be avoided for the first few weeks for healing.

Day 3 through Week 2:

Full Liquid Diet

The next stage is the full liquid diet which consists of sugar-free, low-fat milk products and the Clear Liquids listed above. You will need to supplement with protein (drinks or powder) after surgery. Remember to sip liquids, do not gulp.

Examples of Full Liquid Diet (No Added Sugar/Sugar-Free, Low Fat):

• Skim Milk or Lactaid milk

• Soy Milk (non-fat)

• Low fat, thin, strained cream Soup (smooth, no pieces of food)

• Sugar-free instant breakfast

• Protein drinks – Start daily when you get home from the hospital. (See section on protein and protein drinks)

• Plain or “light” (no sugar added) yogurt with no fruit pieces

• Sugar-free pudding or custard

• Thinned cream of wheat or rice Cereal

Week 3 through Week 8:

pureed Diet

You may now begin a pureed diet. This includes all items listed for clear and full liquids, and the items listed for the pureed (blenderized) diet.

• Eat PROTEIN foods first

• Make sure foods are well blended.

• Start slowly. If you do not tolerate pureed foods go back to the liquid diet and try again in a few days.

• Remember to drink liquids between meals, not with meals.

• Continue protein drinks or protein supplements every day.

Examples for the Pureed Diet (Sugar-Free/No Sugar Added, Low Fat):

eggs

cheese

Pureed or blenderized scrambled eggs or egg substitute or cheese omelet; melted low-fat cheese, low-fat or non-fat cream cheese, ricotta cheese, very smooth/mashed soft cheese such as mozzarella, string cheese, low-fat or non-fat smooth or small curd cottage cheese

meat, Fish, Poultry,

Baby food meat or pureed meat or poultry moistened with broth or low-fat gravy

Blenderized shrimp, scallops or fish

Pureed tuna or salmon (canned in water) or pureed egg salad with low-fat or non-fat mayonnaise

Potted meats thinned with broth; smooth deviled ham

Starches Unsweetened instant oatmeal (strained), cream of wheat or rice Cereal, mashed potatoes or sweet potatoes, smooth polenta, hummus, refried beans; low-fat or baked crackers or chips

Vegetables Baby food vegetables or pureed cooked vegetables (no corn or peas)

Mashed winter squash, tomato juice or sauce, pureed salsa, marinara

Soup Strained, low-fat cream soup made with skim milk; fat-free broth

Blenderized lentil or split pea soup or chili

Fruit Baby food fruits (bananas, pears, applesauce, peaches, mango, etc)

Unsweetened applesauce (smooth)

Unsweetened canned fruit – blenderized

Unsweetened fruit juice (diluted, no sugar added)

Remember: IF YOU CAN CHEW IT, DON’T DO IT!

Tips to Get Started

Everything that you eat on the pureed diet should be sugar-free or no sugar added, low fat and blended to the consistency of baby food or smooth applesauce.

• You will need a blender or food processor or you can purchase baby food.

• Start with 1 ounce (2 Tablespoon) portions - no more than 4 Tablespoons at the most. Listen to your body and stop eating as soon as you feel full.

• Eat protein foods first. Then if you are not too full, try vegetables or fruits.

• Continue protein supplements (80 g protein per day from supplement).

Helpful Hints for Blenderizing

• Cut foods into small pieces before putting into the blender or food processor.

• Remove seeds, skins and fat.

• Add liquid for ease of blending. Add enough liquid to cover the blades. Options include skim milk, broth, strained low-fat cream soup, low-fat gravy, low-fat or non-fat sour cream or fat-free half & half.

• Blend the item to a smooth, applesauce consistency.

• Make sure there are no particles, seeds or lumps remaining. If so put through a sieve or strainer.

• If you have leftover blenderized foods, try freezing in single serving portions in ice cube trays and put the frozen cubes into plastic freezer bags.

Meats – Very lean and dry meats puree better by adding a small amount of fat (margarine, oil, light Mayonnaise, gravy, etc.) Fish also tends to be dry. Improve the texture by adding small amount of lemon juice, light mayonnaise or strained low-fat tartar sauce.

Starches – Try pureed peas, canned Beans, sweet potatoes. Starches puree better when hot. Rice and potatoes tend to puree into a Gummy paste and are not recommended.

Substitute cream of rice cereal prepared with a flavorful broth and seasoned with margarine. Pasta or noodles are not recommended as they are not well-tolerated.

Vegetables – Cook vegetables until soft. If using canned vegetables, drain first. Add melted margarine and puree. Add a small amount of liquid until it reaches the smooth applesauce consistency.

Fruit – If using canned fruit, drain first. Add a few drops of lemon juice to help prevent them from discoloring.

Begin to take advantage of your favorite leftovers before surgery. Process these foods, and freeze them in an ice cube tray. (Each cube is approximately 1/2 to 1 ounce). When frozen, pop out into Zip-lock bag; label and date, and freeze cubes until needed.

Meal Guidelines for the Pureed Diet

(See Sample Pureed Meals listed in the Appendix)

Once you begin to eat pureed foods (which are considered solids) you will want to start differentiating between liquids and solids – meals should include pureed foods, and so liquids (including protein drinks) should be taken separately from your meals.

• You should eat 3 meals a day with protein drinks between meals.

• Protein drinks containing at least 20 grams of protein per serving should be consumed as needed to meet 80 g/day goal.

• Start with a portion size of 1 to 2 tablespoons of pureed food for the first month. At first you may not be able to tolerate this amount. Eat your protein source first, and then if you have room a small amount of fruit, vegetables or other foods may be consumed.

Hints for Measuring Foods: Liquids or soft/pureed foods are best measured in measuring cups or spoons; they can be measured in ounces, Tablespoons or mls.

1 cup 8 Fluid ounces 240 ml 16 tablespoons

3/4 cup 6 fluid ounces 180 ml 12 tablespoons

1/2 cup 4 fluid ounces 120 ml 8 tablespoons

1/4 cup 2 fluid ounces 60 ml 4 tablespoons

1/8 cup 1 fluid ounce 30 ml 2 tablespoons

1 Tablespoon = 3 teaspoons

1/2 Tablespoon = 1-1/2 teaspoons

Week 9-12 After Surgery:

Soft solid food Diet

If you have been tolerating pureed foods, you may now begin a soft diet. This includes all items listed for clear and full liquids and pureed diets plus items listed for the soft diet.

Try 1 to 2 new foods a day. This will help you to learn what foods you tolerate.

• Remember your stomach pouch empties more slowly with more solid or dense foods than with liquids, so you will be able to tolerate a smaller quantity of food than you could with liquids.

• Go slowly. If you do not tolerate the trial of soft foods, resume pureed foods and try again in a week.

• Eat protein foods first

• Avoid foods high in sugar and fat.

• Space meals 4-5 hours apart

• Continue your protein drinks between meals

• Drink other fluids constantly between meals

Examples of Soft Diet (No Added Sugar/Sugar-Free, Low Fat):

• Baked fish (no bones)

• Imitation crab meat, baby shrimp

• Bananas

• Canned peaches or pears in water or juice

• Well-cooked vegetables without seeds or skin (no corn or peas)

• Scrambled, poached or hard boiled eggs

• Tuna or egg salad (no onions, celery, pimientos, etc.)

• Finely shaved deli meat

• Baked, grilled or rotisserie chicken

o Moist foods will be better tolerated. Moisten meats with broth, low fat mayonnaise, or low-fat gravy or sauce.

o Fish and seafood Proteins are softer and easier to break down than poultry or red meat proteins.

o Reheating foods tends to make them dry out and hard to tolerate.

Common Problem Foods

(Avoid for 3 months after surgery)

• Red meat such as steak, roast beef, pork. Red meat is high in muscle Fiber, which is difficult to separate even with a great deal of chewing. Avoid hamburger for one month after surgery.

• Un-toasted bread; rolls, biscuits. (Toasted bread may be better-tolerated.)

• Pasta

• Rice

• Membrane of citrus fruits

• Dried fruits, nuts, popcorn, coconut

• Salads, fresh fruits (except banana) and fresh uncooked vegetables, potato skins.

Month 4 After Surgery:

Regular Diet

• Problem foods as listed above can now be tried.

• Rice, pasta and doughy bread may not be tolerated for 6 months or more.

• Try fresh fruits without the skin first. If tolerated, the skin can be tried the next time. Salads are generally well-tolerated if chewed well.

• Go slowly. Try a small amount to see how you feel.

• Avoid high sugar and high fat foods to avoid a high calorie intake.

Foods to Avoid: Hard/crunchy foods may always be poorly tolerated. Nuts and seeds are difficult to break down. Fried foods/greasy foods are hard to digest and are very high in calories.

• Corn chips, potato chips, tortilla chips, hard taco shells

• Nuts and seeds

• Fried foods and greasy foods

Points to Remember:

• Solid foods will fill your stomach pouch more than liquids so you will be eating smaller quantities of foods versus liquids.

• If you don’t tolerate a food the first time, wait a week and try again.

• You may find that you tolerate a certain food one day and not the next. It is normal for this to happen.

• If you don’t tolerate certain foods or notice nausea, vomiting or diarrhea during or after eating, ask yourself the following questions:

o Did I chew to a paste consistency?

o Did I eat too fast?

o Did I eat too much volume?

o Did I drink fluid with my real meal or too close to my meal?

o Did I eat something high in sugar or fat?

o Was the food moist or was it too dry?

Steps for adding solid foods:

• Try only 1 small bite of the new food and chew well. Wait awhile and if there are no problems, take another bite.

• If at any time you feel too full, nauseated or vomit, stop eating and rest. Take only clear liquids at the next meal and add blended foods and liquids at the following meal. Try one solid food again the next day.

PROTEIN

Protein is the most important nutrient to concentrate on when resuming your diet.

Because the volume of your meals will be limited, you should aim for a minimum of 80 grams of protein per day – this needs to come from your protein supplement.

Why is protein important?

• Wound healing

• Sparing loss of muscle

• Minimizing hair loss

• Preventing protein malnutrition

Remember to eat protein foods first at each meal, followed by vegetables and fruit.

These are some good sources of protein:

Protein Sources Serving size Protein (g)

Skim or 1% milk 1 cup 8

Evaporated skim milk (canned) 1 cup 19

Soy milk beverage 1 cup (8 ounces) 7

Non fat dry milk powder 1/3 cup powder 8

Nonfat, sugar free yogurt 1 cup (8 ounces) 8

Nonfat or low fat cottage cheese ½ cup (4 ounces) 14

Nonfat or low fat cheese slices

String cheese

*1 ounce/ 1 slice 6

LEAN meats – skinless chicken or turkey

breast, fish, beef, ham, Deli meats

*1 ounce 7

Egg or Egg substitute 1 egg or ¼ cup subst. 7

Peanut Butter (creamy) 1 Tablespoon 5

Tofu ¼ cup 5

Legumes; dried beans peas or lentils

Chili, bean soup

½ cup cooked

½ cup

7-9

6-7

Soy/vegetable patty (like Gardenburger) 1 patty 8 - 10

Hummus ½ cup 6

Measuring Hints:

*1 ounce of meat is equal to about 3 – 4 Tablespoons of chopped or ground meat.

1 ounce of grated or cottage cheese, tuna or egg salad is ~ 1/4th cup (4 Tablespoons).

A 3-ounce portion size of chicken or meat is about the size of a deck of cards.

High Protein Ideas

Chicken or Turkey

Pureed – Use baby food or make your own. Try mixing it into strained low-fat cream soup.

Breast – baked or grilled

Thin-sliced/shaved deli slices

Ground – meatballs, meatloaf

Canned – works great for chicken salad

• 2

ATLGirl and Filosophia Scandinavia reacted to this

[TStew 25]

I have a pdf version saved if anyone wants it. Just send me an email address and I'll be happy to share.

[feedyoureye 3,087]

I have a pdf version saved if anyone wants it. Just send me an email address and I'll be happy to share.

great comprehensive information!

[mp8btpc 33]

Great info....for sure.

[Was a humpty dumpty 35]

I will keep a copy, thanks for sharing.

[AMLP 4]

I have a pdf version saved if anyone wants it. Just send me an email address and I'll be happy to share.

HI,

I would love a pdf version if not too much trouble for you! Amazing (scary) diet guide I'm in my researching phase and love this forum! Thanks ever so much

amypep@comcast.net

[sleevemethin 0]

Thanksfor the document on preop and post op plans I needed that!!

[Queengamez 19]

Thanks so much for the info... Can you please email ctdgamez@yahoo

LAPAROSCOPIC GASTRIC SLEEVE DIET

Joseph E. Chebli MD FACS

Introduction

The following information provides guidelines for you to follow before and after Gastric Sleeve Surgery and for the rest of your life. Gastric Sleeve Surgery is a weight loss tool.

After surgery, you will be required to make lifelong changes in your eating habits and to exercise on a regular basis in order to achieve and maintain your weight loss goals.

Gastric Sleeve Surgery reduces the size of the stomach which restricts the volume of food that you can consume at one time. This means that you will feel full after eating a small amount. The surgery also induces hormonal changes which help prevent you from feeling excessively hungry.

You should avoid drinking liquids with meals. This is to prevent overfilling of the stomach.

Frequent snacking or grazing must also be avoided as this contributes to excess calorie intake and can slow weight loss or cause you to gain weight.

Exercise is an important component of weight loss success. Exercise is recommended before and after surgery in order to maximize the amount of weight that you lose and keep off. If you have not been an active exerciser, always consult with your physician for clearance and recommendations before beginning any exercise program.

It is important to follow the lifetime Gastric Sleeve diet rules, supplement guidelines, and exercise recommendations in order to achieve and maintain optimum weight loss success.

In order to begin preparing for surgery, start implementing the pre-surgery diet goals listed on the next page.

Pre-Surgery Diet

Practice Tips

1. Choose low-fat foods, and avoid fried foods.

2. Stop using sugar. Use healthy sugar substitutes. (T)

3. Decrease intake of desserts and candy.< /span>

4. Stop drinking sugar-sweetened beverages such as regular soda and sweetened Kool-Aid.

5. Start weaning off of caffeine and carbonated beverages.< /span>

6. Start cutting back on fast food and eating out. Begin making healthy meal choices when eating out and at home.

7. Eat 3 meals a day. Do not skip breakfast.

8. Start decreasing portion sizes.

9. Eat more fruits and vegetables.

10. Practice drinking Water and other fluids between meals, not with meals.

11. Drink 64 ounces Water a day.

12. Practice sipping liquids.

13. Avoid alcohol.

14. Begin some form of exercise.

15. Review the following information on the gastric sleeve diet.

16. Practice chewing foods thoroughly, 20 - 40 times or to paste consistency.

17. Purchase your Protein drinks or supplements.

18. Purchase your Vitamin and mineral supplements.

19. Begin planning a schedule for mealtime, fluids and Vitamin and mineral supplements.< /span>

Post Gastric Sleeve Surgery Diet

Important Diet Guidelines:

1. Eat 3 meals per day. Avoid snacking and grazing.

2. Eat small amounts. Initial portion size should be no more than 1 - 2 ounces - approximately 2 - 4 Tablespoons - of food per meal for the first month. At first you may not be able to tolerate this amount. Over time, you will slowly tolerate more

volume at each meal. Long term, the stomach will eventually hold about 4 - 8 ounces (1/2 - 1 cup) of food per meal.

3. Eat Protein foods first.

4. Do not try to eat food and drink liquid together. • Consume liquid 30 to 60 minutes before and/or 30 to 60 minutes after eating meals but not during meals.

5. You are required to take a Multi-Vitamin with minerals for the rest of your life.

6. Eat slowly!

• Each meal should last 30minutes or longer.

• Avoid gulping foods and drinks.< /span>

• All foods must be well-chewed to a paste consistency.

• Using a small fork or spoon (i.e. baby utensils) can help control portion sizes.

• Have one place to eat (such as at the table) and avoid reading or watching TV while you eat. This helps you to enjoy your food, concentrate on eating slower and to realize when your stomach is full.

7. Drink plenty of calorie-free, non-carbonated, caffeine- free fluids between meals.

• Drink slowly-sip fluids, never gulp.

• Calorie-containing beverages should be limited to skim milk and protein drinks.

• Limit juice to no more than 4oz. per day.

• Consume zero-calorie beverages throughout the day.

Diet Progression After Surgery

The diet after gastric sleeve surgery progresses through several stages. Your surgeon will let you know when it is okay to progress to the next stage.

Day 1 - 2 after surgery:

Clear liquid diet

The clear liquid diet means fluids or foods that are liquid at body temperature and can almost be seen through. You will be on a clear liquid diet while you’re in the hospital.

Examples of Clear Liquid Diet (No Added Sugar/ Sugar Free):

• Clear (diluted) fruit juices without added sugar: apple, grape or white grape or diet cranberry

• sugar-free Crystal Light drink mix or popsicles, sugar-free Kool-Aid. (T - careful, usually sweetened w/Aspartame)

• Herbal tea, caffeine-free tea

• flat soda

• Sugar-free Popsicles

• Sugar-free Gelatin

• Clear broth

• Water

�� It is best to dilute juices by 50% with water.

�� Avoid citrus juices (orange/grapefruit) and Tomato juice for the first three weeks.

�� coffee and de-caffeinated coffee contain acids which are irritating to the stomach lining and should be avoided for the first few weeks for healing.

Day 3 through Week 2:

Full Liquid Diet

The next stage is the full liquid diet which consists of sugar-free, low-fat milk products and the clear liquids listed above. You will need to supplement with protein (drinks or powder) after surgery. Remember to sip liquids, do not gulp.

Examples of Full Liquid Diet (No Added Sugar/Sugar-Free, Low Fat):

• Skim Milk or Lactaid milk

• Soy Milk (non-fat)

• Low fat, thin, strained cream Soup (smooth, no pieces of food)

• Sugar-free instant breakfast

• Protein drinks – Start daily when you get home from the hospital. (See section on protein and protein drinks)

• Plain or “light” (no sugar added) yogurt with no fruit pieces

• Sugar-free pudding or custard

• Thinned cream of wheat or rice cereal

Week 3 through Week 8:

pureed Diet

You may now begin a pureed diet. This includes all items listed for clear and full liquids, and the items listed for the pureed (blenderized) diet.

• Eat PROTEIN foods first

• Make sure foods are well blended.

• Start slowly. If you do not tolerate pureed foods go back to the liquid diet and try again in a few days.

• Remember to drink liquids between meals, not with meals.

• Continue protein drinks or protein supplements every day.

Examples for the Pureed Diet (Sugar-Free/No Sugar Added, Low Fat):

eggs

cheese

Pureed or blenderized scrambled eggs or egg substitute or cheese omelet; melted low-fat cheese, low-fat or non-fat cream cheese, ricotta cheese, very smooth/mashed soft cheese such as mozzarella, string cheese, low-fat or non-fat smooth or small curd cottage cheese

meat, Fish, Poultry,

Baby food meat or pureed meat or poultry moistened with broth or low-fat gravy

Blenderized shrimp, scallops or fish

Pureed tuna or salmon (canned in water) or pureed egg salad with low-fat or non-fat mayonnaise

Potted meats thinned with broth; smooth deviled ham

Starches Unsweetened instant oatmeal (strained), cream of wheat or rice cereal, mashed potatoes or sweet potatoes, smooth polenta, hummus, refried beans; low-fat or baked crackers or chips

Vegetables Baby food vegetables or pureed cooked vegetables (no corn or peas)

Mashed winter squash, tomato juice or sauce, pureed salsa, marinara

Soup Strained, low-fat cream soup made with skim milk; fat-free broth

Blenderized lentil or split pea soup or chili

Fruit Baby food fruits (bananas, pears, applesauce, peaches, mango, etc)

Unsweetened applesauce (smooth)

Unsweetened canned fruit – blenderized

Unsweetened fruit juice (diluted, no sugar added)

Remember: IF YOU CAN CHEW IT, DON’T DO IT!

Tips to Get Started

Everything that you eat on the pureed diet should be sugar-free or no sugar added, low fat and blended to the consistency of baby food or smooth applesauce.

• You will need a blender or food processor or you can purchase baby food.

• Start with 1 ounce (2 Tablespoon) portions - no more than 4 Tablespoons at the most. Listen to your body and stop eating as soon as you feel full.

• Eat protein foods first. Then if you are not too full, try vegetables or fruits.

• Continue protein supplements (80 g protein per day from supplement).

Helpful Hints for Blenderizing

• Cut foods into small pieces before putting into the blender or food processor.

• Remove seeds, skins and fat.

• Add liquid for ease of blending. Add enough liquid to cover the blades. Options include skim milk, broth, strained low-fat cream soup, low-fat gravy, low-fat or non-fat sour cream or fat-free half & half.

• Blend the item to a smooth, applesauce consistency.

• Make sure there are no particles, seeds or lumps remaining. If so put through a sieve or strainer.

• If you have leftover blenderized foods, try freezing in single serving portions in ice cube trays and put the frozen cubes into plastic freezer bags.

Meats – Very lean and dry meats puree better by adding a small amount of fat (margarine, oil, light Mayonnaise, gravy, etc.) Fish also tends to be dry. Improve the texture by adding small amount of lemon juice, light mayonnaise or strained low-fat tartar sauce.

Starches – Try pureed peas, canned Beans, sweet potatoes. Starches puree better when hot. Rice and potatoes tend to puree into a Gummy paste and are not recommended.

Substitute cream of rice cereal prepared with a flavorful broth and seasoned with margarine. Pasta or noodles are not recommended as they are not well-tolerated.

Vegetables – Cook vegetables until soft. If using canned vegetables, drain first. Add melted margarine and puree. Add a small amount of liquid until it reaches the smooth applesauce consistency.

Fruit – If using canned fruit, drain first. Add a few drops of lemon juice to help prevent them from discoloring.

Begin to take advantage of your favorite leftovers before surgery. Process these foods, and freeze them in an ice cube tray. (Each cube is approximately 1/2 to 1 ounce). When frozen, pop out into Zip-lock bag; label and date, and freeze cubes until needed.

Meal Guidelines for the Pureed Diet

(See Sample Pureed Meals listed in the Appendix)

Once you begin to eat pureed foods (which are considered solids) you will want to start differentiating between liquids and solids – meals should include pureed foods, and so liquids (including protein drinks) should be taken separately from your meals.

• You should eat 3 meals a day with protein drinks between meals.

• Protein drinks containing at least 20 grams of protein per serving should be consumed as needed to meet 80 g/day goal.

• Start with a portion size of 1 to 2 tablespoons of pureed food for the first month. At first you may not be able to tolerate this amount. Eat your protein source first, and then if you have room a small amount of fruit, vegetables or other foods may be consumed.

Hints for Measuring Foods: Liquids or soft/pureed foods are best measured in measuring cups or spoons; they can be measured in ounces, Tablespoons or mls.

1 cup 8 Fluid ounces 240 ml 16 tablespoons

3/4 cup 6 Fluid ounces 180 ml 12 tablespoons

1/2 cup 4 fluid ounces 120 ml 8 tablespoons

1/4 cup 2 fluid ounces 60 ml 4 tablespoons

1/8 cup 1 fluid ounce 30 ml 2 tablespoons

1 Tablespoon = 3 teaspoons

1/2 Tablespoon = 1-1/2 teaspoons

Week 9-12 After Surgery:

Soft solid food Diet

If you have been tolerating pureed foods, you may now begin a soft diet. This includes all items listed for clear and full liquids and pureed diets plus items listed for the soft diet.

Try 1 to 2 new foods a day. This will help you to learn what foods you tolerate.

• Remember your stomach pouch empties more slowly with more solid or dense foods than with liquids, so you will be able to tolerate a smaller quantity of food than you could with liquids.

• Go slowly. If you do not tolerate the trial of soft foods, resume pureed foods and try again in a week.

• Eat protein foods first

• Avoid foods high in sugar and fat.

• Space meals 4-5 hours apart

• Continue your protein drinks between meals

• Drink other fluids constantly between meals

Examples of Soft Diet (No Added Sugar/Sugar-Free, Low Fat):

• Baked fish (no bones)

• Imitation crab meat, baby shrimp

• Bananas

• Canned peaches or pears in water or juice

• Well-cooked vegetables without seeds or skin (no corn or peas)

• Scrambled, poached or hard boiled eggs

• Tuna or egg salad (no onions, celery, pimientos, etc.)

• Finely shaved deli meat

• Baked, grilled or rotisserie chicken

o Moist foods will be better tolerated. Moisten meats with broth, low fat mayonnaise, or low-fat gravy or sauce.

o Fish and seafood Proteins are softer and easier to break down than poultry or red meat Proteins.< /span>

o Reheating foods tends to make them dry out and hard to tolerate.

Common Problem Foods

(Avoid for 3 months after surgery)

• Red meat such as steak, roast beef, pork. Red meat is high in muscle fiber, which is difficult to separate even with a great deal of chewing. Avoid hamburger for one month after surgery.

• Un-toasted bread; rolls, biscuits. (Toasted bread may be better-tolerated.)

• Pasta

• Rice

• Membrane of citrus fruits

• Dried fruits, nuts, popcorn, coconut

• Salads, fresh fruits (except banana) and fresh uncooked vegetables, potato skins.

Month 4 After Surgery:

Regular Diet

• Problem foods as listed above can now be tried.

• Rice, Pasta and doughy bread may not be tolerated for 6 months or more.

• Try fresh fruits without the skin first. If tolerated, the skin can be tried the next time. Salads are generally well-tolerated if chewed well.

• Go slowly. Try a small amount to see how you feel.

• Avoid high sugar and high fat foods to avoid a high calorie intake.

Foods to Avoid: Hard/crunchy foods may always be poorly tolerated. Nuts and seeds are difficult to break down. Fried foods/greasy foods are hard to digest and are very high in calories.

• Corn chips, potato chips, tortilla chips, hard taco shells

• Nuts and seeds

• Fried foods and greasy foods

Points to Remember:

• Solid foods will fill your stomach pouch more than liquids so you will be eating smaller quantities of foods versus liquids.

• If you don’t tolerate a food the first time, wait a week and try again.

• You may find that you tolerate a certain food one day and not the next. It is normal for this to happen.

• If you don’t tolerate certain foods or notice nausea, vomiting or diarrhea during or after eating, ask yourself the following questions:

o Did I chew to a paste consistency?

o Did I eat too fast?

o Did I eat too much volume?

o Did I drink fluid with my real meal or too close to my meal?

o Did I eat something high in sugar or fat?

o Was the food moist or was it too dry?

Steps for adding solid foods:

• Try only 1 small bite of the new food and chew well. Wait awhile and if there are no problems, take another bite.

• If at any time you feel too full, nauseated or vomit, stop eating and rest. Take only clear liquids at the next meal and add blended foods and liquids at the following meal. Try one solid food again the next day.

PROTEIN

Protein is the most important nutrient to concentrate on when resuming your diet.

Because the volume of your meals will be limited, you should aim for a minimum of 80 grams of protein per day – this needs to come from your protein supplement.

Why is protein important?

• Wound healing

• Sparing loss of muscle

• Minimizing hair loss

• Preventing protein malnutrition

Remember to eat protein foods first at each meal, followed by vegetables and fruit.

These are some good sources of protein:

Protein Sources Serving size Protein (g)

Skim or 1% milk 1 cup 8

Evaporated skim milk (canned) 1 cup 19

Soy milk beverage 1 cup (8 ounces) 7

Non fat dry milk powder 1/3 cup powder 8

Nonfat, sugar free yogurt 1 cup (8 ounces) 8

Nonfat or low fat cottage cheese ½ cup (4 ounces) 14

Nonfat or low fat cheese slices

String cheese

*1 ounce/ 1 slice 6

LEAN meats – skinless chicken or turkey

breast, fish, beef, ham, Deli meats

*1 ounce 7

Egg or Egg substitute 1 egg or ¼ cup subst. 7

Peanut Butter (creamy) 1 Tablespoon 5

Tofu ¼ cup 5

Legumes; dried Beans peas or lentils

Chili, bean soup

½ cup cooked

½ cup

7-9

6-7

Soy/vegetable patty (like Gardenburger) 1 patty 8 - 10

Hummus ½ cup 6

Measuring Hints:

*1 ounce of meat is equal to about 3 – 4 Tablespoons of chopped or ground meat.

1 ounce of grated or cottage cheese, tuna or egg salad is ~ 1/4th cup (4 Tablespoons).

A 3-ounce portion size of chicken or meat is about the size of a deck of cards.

High Protein Ideas

Chicken or Turkey

Pureed – Use baby food or make your own. Try mixing it into strained low-fat cream soup.

Breast – baked or grilled

Thin-sliced/shaved deli slices

Ground – meatballs, meatloaf

Canned – works great for chicken salad

Strained out of canned soup – tends to be very moist

Fish (avoid bones)

Baked, broiled, poached, or grilled fish

Shrimp

Imitation or regular crab meat

Fresh or canned

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[Becca 108]

Wow! This is so great- Thanks for sharing!

[disappearingme 0]

Wonderful information, thank you!! Will you send me the pdf? lisa@momproject.org

[armstrong1003 0]

here's the direct link...enjoy! very informative!

http://www.northwestobesitysurgery.com/pdf/sleeve-gastrectomy-diet.pdf

[vicki s 146]

I have a pdf version saved if anyone wants it. Just send me an email address and I'll be happy to share.

I would love a copy of this if its not too much trouble...thanx so much, it was very informative...vicki

vslawich@gmail.com thanks again

[disappearingme 0]

I got it, thank you so much!

[Sherry77 166]

This is very helpful. Thanks

[Dropdeadkim 12]

This is so helpful