A well-balanced, nutritional diet is vital in the months following the surgery. Subsequent to surgery strict liquid diet is mandatory to increase the efficacy of the procedure and reduce certain medical conditions post-op, which can get in the way of recuperation.
Sleeve Gastrectomy alters the stomach size to hold nearly 1-4 ounces of liquid. Vertical sleeve gastrectomy (VSG) is not an instant solution for obesity. Instead it requires enormous changes in your lifestyle and diet.
You must commit to eating healthy food choices, controlled portion sizes and exercise. There are 4 stages of the post-op diet. The first being clear liquids stage.
Stage 1: Clear Liquids ONLY
(Begins a day after surgery)
In Stage 1, you are limited to clear liquids only. The hunger producing hormone ghrelin is non-existent after surgery therefore; the urge to eat is less.
Your choice of liquids may include:
- Clear broth of chicken or veggies
- Sugar-free liquids, thinned juices (of apple, cranberry or grapes) without pulp or added sugar
- Sugar-free popsicles and Jell-O
- Tea/coffee (decaf and unsweetened)
- Soluble whey protein powder
- Keep yourself hydrated by sipping fluids regularly (one ounce per hour or 2-3 sips per minute)
- Refrain gulping down the fluid instead try to sip
- Avoid using a straw as it can cause bloating/gas build-up
- Do not consume any carbonated beverages or soft drinks
A Sample Clear Liquid Menu
|3-4 ounces thinned, sugar-free juice –Apple/CranberryORVegetable broth in same quantity||5-6 ounces Broth,Sugar free Jell-O||3-4 ounces thinned fruit juice – Apple/Grapes/Cranberry, Sugar free popsicles||Unsweetened Tea, flavored water or chicken/veggie broth|
Stage 2: Liquid Only Diet
Your transition to Stage 2 becomes easy if there is no nausea or vomiting. The liquids in this phase are thicker than stage 1. You may begin with high protein thicker drinks diet including:
- Stage 1 Clear Liquids
- Whey Protein shake or other protein powders
- Unsweetened soya milk or skimmed milk of almond or coconut
- Greek Yogurt
- Sugar-free egg custard or pudding
- Soups void of any vegetable pieces or chunks
- Diluted cereals of wheat and rice
- Avoid carbonated/fizzy drinks as they fill the stomach with gas and may cause acid reflux.
- Drink enough fluids (recommended 64 ounces of liquids per day) to prevent dehydration. Remember, to drink small amount throughout the day.
- A high quality, protein supplement (60-90 gms or as suggested by doctor) daily is suggested.
A Sample Thick Drinks Menu
|Whey protein isolate and oatmeal cereal with skim milk||3-4 ounces of Greek Yogurt with almond milk||Strained soup and sugar-free pudding||Vegetable/chicken broth, thinned juices and Jell-O|
Stage 3: Pureed Food Diet
Begins 3-4 Weeks Post-op
By the end of Stage 2, if you are tolerating liquid diet well, you may progress to Stage 3 (Pureed Diet). All foods at this stage must be blended to a soft consistency, should be low in fat and sugar. Start with high protein rich foods first, followed by veggies and lastly seedless fruits. This stage may include the following:
- Plain or sugar-free yogurt without fruit chunks
- Sieved cream soups of potato or chicken made with skim milk
- Skim milk with whey protein powder
- Non-fat cottage cheese
- Mashed potatoes/sweet potatoes
- Mashed bananas, apple, peaches, apricots, pears and other canned fruits in their own juices
- Pureed spinach, carrots, green beans
- Preferred Cooking Methods: baked, boiled, grilled or slow cooker
- Avoid fibrous vegetables such as broccoli and cauliflower
- Do not consume saturated fats, butter, margarine
- Do not have chicken/turkey with skin
A Sample Pureed Food Menu
|Mashed ripe banana, Protein shakeORScrambled egg with skim milk||Mashes, pureed chickenORboiled and blended potatoes/veggies||Pureed turkey with boiled carrots and non fat cheese||Pureed avocado with skim milk, sweet potato|
Stage 4: Soft Food Diet
During the Stage 4 – Soft Diet – Try to consume 4-6 small meals each day instead of 3 big ones and stop eating when you feel full.
- Lean meats, poultry, fish and eggs
- Sugar-free Lemonade and Tea/Coffee (preferably, decaffeinated)
- Wheat/rice porridge with skimmed milk
- Softly cooked chicken, fish or turkey in gravy/thin sauce
- Small pieces of potato, carrot in thin gravy
- Preferably you must drink one protein shake to meet your daily protein requirements.
- Chew thoroughly before swallowing in and take small bites.
- Drink slowly! Sip on liquids throughout the day but stop drinking 30 minutes before meal time.
- Prefer having whole grain bread which is well-toasted.
- Certain food items such as pasta, rice and corn tend to give trouble therefore, avoid them during the first 7 to 8 weeks post-surgery.
- Avoid skins and seeds on fruits and vegetables.
Tips for Successful Surgery
- Once your digestive tract is able to tolerate soft foods well, you may slowly progress to a “regular” diet.
- Introduce new textures cautiously. Skin, nuts, seeds and hard to chew meats should not be consumed until you are stomach is able to take it.
- Eventually you will be able to tolerate a variety of food groups but to you may need to supplement meals with a high protein shake or tablets.
Vitamins and Minerals
Vitamin and mineral supplements is essential for bariatric surgery patients to avert weak bones and fractures. They are important to build body tissues and muscles and provide you with energy. The way you eat after surgery must be permanently changed. Initially, the volume of food to be consumed will be restricted to aid healing and at the same time provide essential nutrients. Below are some of the multivitamins which may be required:
- The recommended protein intake is: Women: 50–60 grams of protein. For men: 60–70 grams of protein
- Fish/turkey/chicken, egg and cheese are good sources of proteins.
John Hopkins Medical Center recommends taking chewable mineral supplements containing iron (36mg), folic acid (800mcg) and thiamine (3mg) and 2 mg of copper along with selenium and zinc.
- Taking chewable calcium tabs of 500-600 mg, thrice a day
- Do not combine calcium with iron or multivitamins for good results
- It is required for calcium absorption and maintaining healthy bones
- Taking 3,000 International Units of Vitamin D3 per day is advised
- Initially, low impact exercises like walking, arm and shoulder rotations are recommended.
- You can also engage in some low cardio exercises later on.
Remember, sleeve gastrectomy is not a magical wand to reduce weight. In order to maintain a healthy weight long-term, establishing healthy eating habits is crucial.
In general, consuming 3-6 planned limited portion meals every day consisting of healthy, lean proteins, veggies, whole grains, fruits and low fat dairy is recommended. Processed carbs, high-cal liquids and foods with high sugar/fat should be avoided.