Diabetes entails a ton of rules that must be strictly followed, especially when it comes to diet. If you have huge appetite and love food more than your smartphone, you’d almost feel doomed after diagnosis as food choices become very restricted and eating habits change drastically. Someone whose normal routines include running to fast food chains for breakfast get to spend extra minutes in the morning to prepare a healthy meal; you’re lucky if you work at home. You just learn to make your life easier while keeping your menu healthier in the long run.
Now, imagine someone with Diabetes getting a gastric bypass surgery. Imagine what his plate looks like morning, noon, and night. Sorry, but eating after this just got harder. Talk about less palatable eats that may make your world less exciting compared to pre-RNY procedure or even pre-Diabetes days.
On the brighter side, the sacrifices you make, the little steps you take to improve your health would mean the world. It happens. Eat happens (pun intended). This one may look pretty off-putting at first but you’ll get used to it. It’s better to be safe than sorry.
Four phases of gastric bypass diet after surgery
Food restrictions aim to limit the calorie intake and prevent possible obstructions in your brand new stomach or pouch for ‘gastric bypassers.’ You would also want to let your staple wounds heal, therefore limiting your food intake would prevent stretching your pouch. Brace yourself….
Phase 0 (or so I call it): Clear Liquids Only (In-hospital after surgery)
Keep in mind that you are not allowed to eat or drink anything unless approved by your surgeon after the surgery. More or less you are allowed to drink water in cups and in sips, and some broth if possible. You might also need to inform your surgeon how much water you can imbibe for the rest of the day or the next.
Allowed:
- 30 ml of water every hour (first day, may increase to 60 ml per hour on the succeeding days)
- Sugar-free fruit juices
- Decaffeinated tea
- Jell-O
Not allowed:
- Red liquids and solids
- Caffeine
DOs:
- Drink slowly, better yet, take liquid in sips. Imbibing large quantities may offend your pouch
- You don’t have to eat up everything served to you on a tray. Once you feel full, wrap it up
DON’Ts:
- Don’t drink through a straw. Air might seep into your pouch and cause you to feel full immediately. This may then lead to dehydration
- Don’t eat or drink anything red yet. Just in case you vomit, doctors might mistake it for blood
- Don’t drink coffee or anything with caffeine. Since this is a diuretic, you might be at risk of dehydration
Phase I: Full Liquids (1 to 2 weeks after discharge)
Allowed:
- Water taken in sips at least 2 ounces every 30 minutes
- Drinks low in calories and high in protein
- Fat-free milk
- Soy milk
- Pure cream soup (no added ingredients)
- Powdered milk, non-fat
Not allowed:
- Carbonated drinks
- Caffeine
- Citrus
Note: It would help to keep track of your liquid intake. Log details such as amount, intervals, etc. Do not forget to take vitamins and supplements prescribed by your doctor. At least 65 grams of protein is the recommended daily intake.
Phase III: Soft (Pureed) Diet (1-2 weeks)
After 1-2 weeks on full liquid, you can either continue with it or slowly introduce viscous mixes or thicker foods to your diet. Certain solids can be pureed or blended and consumed one or two tablespoons at a time and up to four tablespoons per meal. For example, lean ground meats combined with fat-free gravy or fish with broth.
Protein is still your top priority, with a minimum of 65 grams per day. At the same time, drink liquids that are low in calories, non-fat milk, and at least six cups of water every day. Meat and milk are your major protein choices as these have essential amino acids. These are ‘complete protein’ compared to veggies, starches, and fruits. You can boost the amount of protein in your meals by pairing pureed veggies with non-fat milk, broth, or low-fat gravies.
If you feel stomach irritation, nausea or any sensation, you may want to wait a few more days before trying out pureed foods since this means you are not ready to switch. It is also advisable to stop eating as soon as you feel full. You can refrigerate your left-over and eat it later anyway. Also take note, you don’t need to prepare a plateful. Use a small plate and a teaspoon instead.
Choices of meats
- Lean meats
- Fish
- Turkey
- Chicken
Milk
- Blended low-fat cottage
- Blended low-fat ricotta cheese
- Low-fat and unsweetened plain yogurt
- Soy milk
- Pudding
- Cream soup with milk (without added ingredients)
Starch
- Cream of wheat
- Broth soup
- Oatmeal
- Mashed/sweet potatoes
- Rice
- Winter squash
Fruit (blended no calories)
- Unsweetened applesauce
- Unsweetened fruit juices (very minimal serving only)
- Peaches
- Apricots
- Pears
- Melon
- Banana
Vegetables (blended)
- Carrots
- Green beans (skinless and seedless)
Note: You may also eat tofu, egg whites, canned tuna, or canned fruits. Take it easy on bread or meats that can hardly be chewed. Actually, stay away from any of them!
Phase IV: Soft Solid Diet (2 weeks)
Surviving the puree diet after two weeks indicates you are ready to take your diet to the next level. You can give your blender a rest because you can eat soft foods now, particularly those you can easily cut through with a spoon or fork.
Drinking at least six cups of water and beverages with low calorie is still recommended but don’t drink during meals. Give yourself at least 30 minutes of rest after eating before drinking. This is to avoid filling up your stomach quickly, which would lead to feeling full and not getting enough nutrients.
Recommended foods:
- Meat (braised or slow-cooked)
- Skinless chicken
- Fish (preferably tuna)
- Turkey
- Ground beef (allowed but should be taken in moderation)
- Egg
- Low-fat cottage cheese
- Peanut butter (choose one that’s creamier)
Milk
- Fat-free milk
- Sugar-free, low-fat plain yogurt
- Sugar-free pudding
- Sugar-free, low-fat instant breakfast
- Plain cream soup with milk
Fruits
- Canned fruits
- Raw soft fruits
Things you should remember throughout these diet phases
You know you are on the right track if you are making noticeable progress. As much as possible, log your eating habit, food serving sizes, amount of water taken, grams of protein consumed, your weight, even mood changes.
- Keep your meals small. Eat in small plates.
- Never forget your vitamins and supplements to prevent malnutrition. After gastric bypass, the amount of nutrients your body can absorb is limited and there’s risk of developing various complications. Since this will be a lifetime habit, better start getting used to the daily regimen. Make it a point to consult your doctor each time you decide to switch brands, add, or give up supplements.
- Too much liquid intake may upset your stomach so drink only eight cups or 1.9 liters of water a day for hydration. Most notably, you should not drink during meals. Wait about 30 minutes or so before downing a cup of water in sips.
- Do not hurry with your meals and chew your food thoroughly.
- A gastric bypass patient’s diet looks sooo boring, mostly if you’re not creative enough to mix and match the only food items available to you. Once in a while, you can try an alternative to what is often recommended to find out if it’s safe. The first sign of discomfort means you should not eat it again.
- Stay away from fatty, sugary food and beverages. Go for steamed or grilled menus and say no to fries.
- As much as possible, keep your hands off alcoholic beverages. One, it is high in calories but has zero nutrients. Two, it stimulates appetite. Three, it hits you in the head faster than before the surgery, especially hard liquors.
- During the first two months after surgery, the recommended daily calorie intake is 300-600 per day.
Still, there’s no one-size-fits-all diet so go ahead and design your own meals, just remember to stick to the plan. You’re depriving yourself for a reason, for a good reason. To spice up your plate, there’s a wide range of diet resources especially designed for Diabetics and/or for gastric bypass patients. You can always come back to this site for more nutrition topics. See you on the next post.