How will I achieve the best results?
What will my diet be like once I am home?
What will my diet be like in the following months?
How should I regulate my eating?
What's so important about protein, anyway?
With so many supplements to choose from is there really a difference between products?
Top selling protein supplements
What about the exercise?

How will I achieve the best results?

Exercise: Walk at least 20-30 minutes every day.

Follow-up: For optimal weight loss and best surgical outcome, it is vital for you to keep all your follow-up appointments.

Four Rules for Successful Weight Loss:
          1. Eat protein at every meal, 3 to 4 meals per day
          2. Never snack between meals.
          3. Drink plenty of water.
          4. Exercise 20-30 minutes every day.

What will my diet be like once I am home?

First month:
During the first month after surgery, your stomach and the opening into your intestines are swollen and very small. You will be able to eat only very limited amounts of food. It is important that you concentrate on eating the most important foods for healing: PROTEINS. All proteins must be very soft, moist, and well chewed in order to pass through your new little stomach successfully. If you eat too fast or too much, it will feel like heartburn and may cause you to become sick, so be careful.

Grocery list of Protein Foods:
1. Cottage Cheese (low-fat or non-fat).
2. Yogurt (low-fat, non-fat, plain, or artificially sweetened).
3. String cheese
4. Eggs (any style, limit yolks).
5. Tofu
6. Refried beans
7. Lentil or black bean soup
8. Fish (soft and moist).
9. Small amounts of cooking spray
10. Small amounts of non-fat mayonnaise or mustard.

How to eat:
1. Eat one to two meals a day (you must eat at least one meal each day).
2. Do not force yourself to eat just because it is mealtime.
3. Eat only when hungry, and stop when satisfied.
4. Do not take any longer than 20 minutes to eat a meal.
5. Chew food very well and eat slowly.
6. Do not drink water or liquids 30 minutes before or 30 minutes after eating your meals. Do not drink liquids while eating a meal.
7. Season as you wish, but use caution.

Water:
Build up to eight 8-oz glasses every day, drinking small amounts frequently. Avoid all other beverages, especially alcohol, coffee, tea, and sodas.

Vitamins:
Multivitamin with iron is to be taken twice daily and vitamin b-12 in a sublingual form should be taken 3x per week. Take vitamins as chewable or swallow one at a time with water or yogurt. You may cut the vitamins in half if swallowing it in pill form.

What will my diet be like in the following months?

Second through fourth month
What to eat: Eat mostly protein. You may begin to add very small amounts of soft cooked fresh, frozen, or canned vegetables, and fresh non-citrus or unsweetened canned fruits (packed in water or natural juices).

Grocery List
1. Eggs any style.
2. Fish (soft, moist, fresh, or canned, and shellfish).
3. Chicken (canned or fresh, moist, thinly-sliced deli).
4. Turkey (soft, moist, fresh, canned, thinly-sliced deli).
5. Liver
6. Tofu
7. Refried beans
8. Peanut butter (natural style, pour off the oil).
9. Cottage cheese, yogurt (non-fat, low-fat, plain, or artificially sweetened).
10. Cheese (non-fat, low-fat).
11. String-cheese (non-fat, low-fat).
12. Lentil or black bean soup.

Vegetables:
1. Vegetables must be boiled or very well steamed and soft
2. Carrots (soft cooked, fresh, canned, or frozen).
3. Beets (soft cooked, fresh, canned, or frozen).
4. Mushrooms (soft cooked, fresh, canned, or frozen).
5. Spinach (soft cooked, fresh, canned, or frozen).
6. Squash (soft cooked, fresh, canned, or frozen).
7. Green beans (soft cooked, fresh, canned, or frozen).
8. Asparagus (soft cooked, fresh, canned, or frozen).
9. Broccoli (very-well steamed, fresh, or frozen).
10. Cauliflower (very-well steamed, fresh, or frozen).

Fruits:
1. Fresh fruits, peeled and cored (non-citrus).
2. Bananas

Fats:
1. Small amounts of margarine, oil, or cooking sprays (preferably olive oil).
2. Small amount of non-fat or low-fat mayonnaise, salad dressing, or mustard to moisten food.

Beverages:
1. Water, eight 8-oz glasses daily.
2. Decaffeinated coffee or tea.
3. Avoid alcohol or sodas.

Vitamins:
Multivitamin with iron is to be taken twice daily and vitamin b-12 as a sublingual form should be taken 3x per week. Take all vitamins as prescribed by your physician. You may change from chewable to tablet form as tolerated.

How should I regulate my eating?

1. Eat protein at every meal, 3 to 4 meals per day.
2. Do not force yourself to eat just because it is mealtime
3. Eat only when hungry, and stop when satisfied (don't try to finish eating everything on your plate).
4. Do not take any longer than 20 minutes to eat a meal.
5. Chew, Chew, Chew all foods very well and eat slowly
6. Do not drink water or liquids 30 minutes before, or within 30 minutes following a meal (1 cup of decaffeinated coffee or tea following a meal is okay).
7. Season as you wish, but use caution.
8. Always follow the four rules.

The later months.
Advancing your Diet after surgery fifth month and beyond

What to eat: eat any proteins, vegetables, or starches as tolerated.

Remember:
1. Eat protein first.
2. Make it at least half of your meal.
3. Then eat vegetables and fruits.
4. And starches last if there is any room left.

What's so important about protein, anyway?

The nutrient protein plays a vital role in providing the body with essential amino acids necessary to sustain all living things. Next to water, protein makes up the greatest portion of our body. If the body does not get enough protein from our diet, it cannot properly build new cells and tissues. Such a condition is called protein energy malnutrition and restricts growth, impairs the healing of wounds and increases our susceptibility to infection. Initial signs of protein deficiencies may appear as general weakness, loss of muscle, brittle nails and most common hair loss. While dietary protein will not directly increase muscle size, it will help avoid further loss of muscle tissue that occurs during periods of bed rest, stress, injury, or illness. Bariatric surgery is an example of such trauma increasing protein needs that can often cause the "catabolism" or muscle wasting to supply the body with its increased energy needs.

The effect of surgery on our body and the need for increased protein intake, which can only be accomplished through liquids due to the new small-restricted pouch, should now be clear. But how much protein should we consume? The Recommended Dietary Allowance (RDA) is 44 grams a day for the average woman and 56 grams for the average man. However, this recommendation is for individuals in a non-trauma state. Confusing the issue further is the conflicting recommended number of protein grams needed to be consumed daily for the bariatric surgery patient.

With so many supplements to choose from is there really a difference between products?

Company products researchers and marketing professionals want you to believe there is a difference, but generally to the surgical patient there is not. The exception to this assertion is supplement manufacturers that use cheap proteins listed as gelatin or collagen as its major source of protein. Such proteins hold a very low bioavailability. Biological value or bioavailability is the most common measure of a protein supplement's quality. Such a value is based on four principles:

1. Amino acid pattern of the protein supplement
2. Digestibility for the specific protein type to convert into a form for assimilation
3. Assimilation or absorption of specific proteins.
4. How the body uses such protein or utilization units.

Lean body by Labrada
One packet mixed with 12 ounces water, milk, or juice provides 30 grams of whey protein, 200 calories with water and only 1 gram of sugar. Lean body Protein is available in a twenty-pack box with an average cost of $35.00 and offers the following flavors: Chocolate and Vanilla Ice Cream.

Met-rx Original Drink Mix
One packet mixed with 16 ounces of water, milk, or juice provides 37 grams of caseinate and whey proteins, 250 calories with water and only 3 grams of sugar. Met-rx is available in a twenty-packaged box with a cost of $45.00 and offers the following flavors: Chocolate and Vanilla.

Myoplex Lite by EAS
One packet mixed with 10 to 12 ounces of water, milk, or juice provides 25 grams of whey, soy, and casein proteins, 190 calories with water and only 2 grams of sugar. Myoplex Lite is available in a box of 20 individual packets with an average cost of $40.00 and offers the following flavors: Chocolate Cream, Vanilla Cream, Cappuccino Ice, and Tropical Variety pack.

90% Plus Protein by Weider
Three tablespoons mixed with 8 ounces of water, milk, or juice provides 24 grams of soy, whey, and egg proteins, 120 calories with water and 0 grams of sugar. Weider 90% Plus Protein is available in a 16-ounce container with an average cost of $10.00 and offers the following flavors: Chocolate and Vanilla Malt.

Pro Blend 55 by MD Labs
Two scoops mixed with 8 to 12 ounces of water, juice, or milk provides 55 grams of whey, egg, and casein proteins, 240 calories and only 4 grams of sugar (when mixed with water). Pro Blend 55 is available in a 2lb canister with an average cost of $34.00 and offers the following flavors: Swiss Chocolate, Alpine Vanilla, Strawberry Twist, and Mocha Cappuccino.

Simply Protein Complete Whey by EAS
Two scoops mixed with 4 to 6 ounces of water, juice, or milk provides 20 grams of whey protein, 115 calories, and only 3 grams of sugar (when mixed with water). Simply Whey is available in a 5lb canister with an average cost of $24.00 and offers the following flavors: Chocolate and Vanilla.

What about the exercise?

Begin exercise program at 6 weeks after your operation. Perform exercises 5 days per week and resting 2 days every week.

1st thru 3rd week: Brisk walk for 15 minutes on first day. Increase by 2 minutes per exercise day until after 2 weeks you are walking for 35 minutes.

4th thru 6th week: Continue brisk walking 5 days per week for 35-40 minutes per session.

7th thru 10th week: Begin resistance training using bands. Perform upper body training for 15 minutes 3 days per week and lower body resistance training for 15 minutes 2 days per week. Follow resistance training with 15 minutes of brisk walking (or some form of cardiovascular exercise).

11th week and Beyond: Alternate 2 weeks of cardiovascular exercise (brisk walking, jogging, or biking) for 35 to 40 minutes (exercise 5 days, rest for 2 days) with 2 weeks of combination training (15 minutes resistance training and 15 minutes cardiovascular training).

Remember…this is a lifelong process and the operation is designed to get you to a position where, with continued compliance and healthy eating habits, you will remain at a healthy weight. Surgery is a ‘tool’ not a ‘cure’.