Phase IV – Bariatric Diet

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  5. Phase IV – Bariatric Diet

High Protein Foods and Vegetables

Vitamin and Mineral Supplements

Start approximately 2-3 months after surgery once the Phase III bariatric diet is well tolerated.

You will continue the Phase IV bariatric diet until you have reached your goal of 75% excess body weight loss or via conversation with the registered dietitians or your medical doctor based on your nutritional status and food tolerance.

Types of foods/liquids permitted:  Soft 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

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

Vegetables are permitted

FACTS about VEGETABLES

Start with soft, cooked vegetables first
Avoid vegetables that do not become soft when cooked
Avoid fibrous stalks like those found in asparagus, broccoli, celery, stalks of romaine lettuce, kale, etc.
Avoid seeds and peels
You may introduce raw vegetables only after you can tolerate a variety of cooked vegetables
When eating raw vegetables try softer vegetables like broccoli florets, bibb lettuce, red-leaf lettuce or boston lettuce.  Remember to chew vegetables thoroughly (“30 second rule”- chew 30 times) and swallow only when it has been made into a mushy consistency
If you have trouble with gas avoid eating gas-producing vegetables like onions, cauliflower, garlic, scallions, leeks, brussel sprouts, cabbage

 

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

Bread

Cereals

Crackers

Noodles

Pasta

Rice

Potatoes

Corn

Peas

Fruits

 

  • 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

  • The goal is to consume at least 60-80 grams of protein per day with the addition of vegetables
  • Consume 3 – 4 ounces of protein 3 times per day (breakfast, lunch and dinner – do not skip these meals)
  • Always eat your PROTEIN foods first before eating the vegetables
    • Vegetables contain ~2g of protein per ½ cup serving
  • Continue to consume sugar-free, non-carbonated, decaffeinated clear liquids in between the high protein meals for a total of 64 ounces (8 cups) of liquids per day
  • 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

***  Continue vitamin and mineral supplementation with adjustments per the registered dietitians, or your medical doctor.

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
  • Take small bites and chew well
  • Introduce one “new” food item at a time
  • Always check your tolerance level and stop drinking or eating when full
  • 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

Sample of a Phase IV Bariatric Diet Menu

Morning Decaffeinated coffee with Splenda® (without cream/sugar)
Breakfast 4 ounces of Eggbeater® omelet with sautéed mushrooms, scallions and cheese
Mid-morning 8 oz Crystal Light®
Lunch 1 Boca burger without the bun, steamed broccoli
Mid-afternoon 8 oz Crystal Light®
Dinner 3-4 ounces baked tilapia fish, green beans
Evening 8 oz Crystal Light®

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

 

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