Phase III – Bariatric Diet

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  Soft or Pureed, Protein Rich Foods

Start Vitamin and Mineral Supplements

Phase III bariatric diet may begin approximately 2 weeks after surgery once it is determined that you are tolerating a Phase II Bariatric Diet.  You should stay on the Phase III Bariatric Diet for at least 6 – 8 weeks to ensure proper tolerance of soft protein and ensure nutritional status.

Types of foods/liquids permitted: Soft or pureed proteins (Proteins should be moist and lean)

 

Seafood (canned or fresh) – soft flaky fish

Tuna

Tilapia

Grouper

Salmon

White fish

Orange roughly

Flounder

Sole

Snapper

Catfish

Perch

Swordfish

Halibut

Cod

Haddock

Sea bass

Shellfish (canned or fresh)

Scallops

Lobster

Shrimp

Crab

Low fat Dairy Products

Low fat, sugar free or carb-controlled, Greek yogurt without visible fruit pieces

Low fat cottage cheese

Low fat farmer cheese

Low fat ricotta cheese

Low fat soft cheeses

Eggs

Eggbeaters®

Egg whites

          Whole egg

Boiled

Scrambled

Poached

Baked

Avoid fried or undercooked eggs

Poultry (canned or fresh, skin removed)

Turkey

Chicken

Game hen

Duck breast

Deli meats such as roast turkey breast or chicken breast

Meat (canned or fresh)

Low sodium, rind-less, no sugar added cold cuts and deli meats

Ham, red meat and pork may be difficult to digest; always check your tolerance level

Legumes

Black beans

Kidney beans

Garbanzo beans

White beans

Lentils

        Hummus and pureed beans may be well tolerated

Soy and Tofu

Tofu burgers

Boca-burgers®

Morningstar ® brand soy products

           Soy beans (edamame unshelled)

*** All burgers must be without the bun or lettuce, tomato etc.

Nuts and Nut butters (May consume ~1 month out from surgery)

Soft nuts such as walnuts and pistachios                    Natural whipped, low sugar peanut butter

Proteins should be moist and lean and low in fat.  Trim visible fat from meats.

You may add low sodium broth or low fat, low sugar dressings to prepare proteins and add moisture

Place food in a blender or food processor to create a soft/pureed consistency if desired.  Otherwise it is imperative that all foods are chewed thoroughly.

Types of foods/liquids NOT permitted:    No starchy carbohydrates, no high fiber fruits or vegetables

 

 

Bread

Cereals

Crackers

Noodles

Pasta

Rice

Potatoes

Corn

Peas

Fruits

Vegetables

 

  • No juices with >5g of sugar
  • Avoid dried out, over-cooked meats
  • No red meat for 6 months
  • No carbonated beverages
  • Do not fry or put “breading” on the protein
  • No caffeinated beverages
  • Monitor tolerance to spicy foods
  • No alcoholic beverages for 6 months
  • Avoid soups that are cream based. If high protein soups are consumed drain off the broth to ensure adequate protein intake.

 

Important Nutritional Considerations

  • Try to consume 3 – 4 ounces of protein 3 times per day (breakfast, lunch and dinner – do not skip these meals)
  • The goal is to consume at least 60-80 grams of protein per day (soft or pureed high protein foods)
    • As an estimate, 1 ounce of protein is approximately 7 grams of protein
    • For example, 3 ounces of protein is approximately 21 grams of protein
    • All meals and snacks should include protein
  • You may continue to use protein shakes as a meal replacement if you find that you cannot consume enough solid proteins.
  • Try to consume a total of 64 ounces (8 cups) of fluid per day (this includes any sugar-free, non-carbonated, decaffeinated clear liquids and protein shakes)
  • Use moist cooking methods such as boiled, baked, sautéed, poached, stewed or braised
  • Choose low fat proteins and choose other healthy fats such as avocado, oils, olive oil

Start vitamin and mineral supplementation (see Vitamin and Mineral Supplementation page)

Important Reminders

  • “30-Minute Rule”:  Do not drink any liquids 30 minutes before or after consuming “solid” proteins
  • “30-Second Rule”:  chew each bite 30 times or for 30 seconds before swallowing
    • Even though food is soft and pureed, take small bites and chew well
    • Start with a bite the size of a pencil eraser
  • Introduce one “new” food item at a time
  • Always check your tolerance level and stop drinking or eating when full
  • Do not use milk as a substitute for protein shakes (it does not provide enough protein per serving)
  • Monitor tolerance to extreme temperatures (extreme cold or hot)
  • Remember to sip slowly, do not gulp, do not use a straw
  • Do not skip meals, have 3 meals per day (breakfast, lunch and dinner)
    • Give yourself 30-45 minutes for each of your main meals
    • Avoid returning to your meal after a few hours
  • Always remember to keep increasing physical activity as tolerated
  • Eat from smaller plates (salad plates) and use smaller utensils to assist with portion control
    • You will only be able to eat a few tablespoons at a time

 

Remember

Inadequate protein intake can lead to:
– fatigue
– loss of lean body mass and
– increase your risk of infection and other illnesses

 

Sample of a Phase III Bariatric Diet Menu

Morning Decaffeinated coffee with Splenda® (without cream /sugar)
Breakfast 4 ounces of scrambled egg
Mid-morning 8 oz Crystal Light®
Lunch 3-4 ounces of pureed tuna fish made with 1 tablespoon of low fat mayonnaise
Mid-afternoon 8 oz Crystal Light®
Dinner 3-4 ounces of low fat, low sodium turkey deli slice
Evening 8 oz Crystal Light®

Remember: do not consume any liquids 30 minutes before or after consuming “solid” proteins

Phase III Breakfast Ideas

  • Protein shakes are a great way of getting some of your daily protein intake, they maybe a more convenient way to consume your breakfast. 
  • Remember to follow the guidelines for choosing the appropriate protein shake.
  • Low fat, carbohydrate controlled or sugar free yogurt
  • Low fat cottage cheese, farmer’s cheese or ricotta cheese
  • Low fat string cheese
  • Eggs:  whole, egg whites or EggBeaters® scrambled, baked, pouched or made into an omelet
  • You may add cheese or ham, but no vegetables
  • Low fat turkey or tofu breakfast sausage; baked or microwaved, do NOT fry
  • Low fat tofu hotdogs

Phase III Lunch and Dinner Ideas

  • Homemade chili made with ground turkey, chicken or ground tofu crumbles
  • Grilled, baked, poached seafood or shellfish, do NOT fry or bread the seafood or shellfish
  • Egg salad, Tuna salad, Crab salad, Chicken salad
  • You may use light or fat free mayo or salad dressing
  • Do NOT use celery, relish, onion
  • Grilled, baked, poached, braised, sautéed poultry (chicken, game hen, turkey, duck)
  • Legumes (black beans, navy beans, pinto beans, white beans) made into dip or hummus or can be added to chili
  • Grilled tofu burgers
  • Deli meats (turkey, chicken, ham etc.) make roll-ups with a piece of cheese
  • Baked, crust less cheese quiche (Do not add any vegetables)
  • Turkey or tofu meat balls
  • Plain turkey or tofu meatloaf (use eggs or milk to bind it together)
  • Egg and cheese frittata

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