Phase V – Bariatric Diet

High Protein Foods and Complex Carbohydrates

Whole Grains, Starchy Vegetables and Fruit

Vitamin and Mineral Supplements

Phase V begins after you have reached 75% of your excess body weight loss or via conversation with the registered dietitians or your medical doctor based on your nutritional status and food tolerances.  This may be anywhere from 6 to 12 months after surgery.

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

You may add Complex Carbohydrates

FACTS about COMPLEX CARBOHYDRATES

Complex carbohydrates are found in whole grains, fruits, legumes and vegetables
It is recommended that you begin with peeled fruit (raw or cooked)

You can have canned fruits that are without syrup and have “no-added sugar”

Fruit juice is not recommended
Avoid white flours, rice, pastas or bread that are “gummy” or “doughy” they are hard to tolerate
Choose 100% whole wheat, 100% multigrain when selecting whole grains.

These are rich in fiber, vitamins and minerals

***  For more information on COMPLEX CARBOHYDRATES see page 123

Starchy vegetables are permitted

FACTS about STARCHY VEGETABLES

Limit portion sizes of starchy vegetables (peas, potatoes, corn)
Protein powder can be added to mashed potatoes to increase their protein content
Choose starchy vegetables without added salt and butter

 

Types of foods/liquids NOT permitted:

  • 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, fruit and complex carbohydrates
  • 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, fruits or complex carbohydrates
    • Vegetables contain ~2g of protein per ½ cup serving
    • Do not begin by eating your complex carbohydrates first.  They contain little to no protein and protein is essential
  • Add a variety of complex carbohydrates into your meal plan including vegetables, fruit and whole grain to ensure nutritional adequacy
  • 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 dietitian

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
  • Do not use milk as a substitute for protein shakes (it does not provide enough protein per serving)
  • Monitor tolerance 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

For long term success and nutritional health it is important to….

  • Consume a healthy balanced diet that is adequate in protein and includes fruit, vegetables, and whole grains. 
  • Monitor your nutritional status with yearly nutrition labs performed by your bariatric surgeon or primary care physician.  Nutritional supplements may be needed long term to prevent nutritional deficiencies due to malabsorption and decreased intake from the surgery.
  • Stay adequately hydrated with water and other healthy forms of hydration.
  • Consume protein throughout the day at all meals and snacks versus attempting to obtain all your protein at one time.  This will ensure that you are promoting your metabolism and fueling your body appropriately.
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