Fundamentals of Success:
Nutrition
Eating is an essential part of life and plays a role in our social, physical and mental well-being. Yet many people pay little attention to nutrition and don't understand the basic building blocks of food. All food is comprised of calories from protein, carbohydrates, fats, or a combination of these elements. Water doesn't supply energy in the form of calories, but it is absolutely vital to the human body. Food also supplies essential vitamins and minerals in varying amounts.
To understand how what you eat affects your body, you need to become familiar with the basic fundamentals of nutrition:
Calories
A calorie is a unit of energy present in all food, including fats, proteins and carbohydrates. Fats contain nine calories per gram, while carbohydrates and proteins contain four calories per gram.
Protein
Proteins are the essential building blocks of life – every cell in the body contains protein! These cells make up your skin, bones, muscle, organ issue, blood, and hormones. Protein is essential to prevent malnutrition, and the consumption of protein results in very little insulin release. (Insulin regulates blood sugar and excess insulin has been known to lead to diabetes.)
Adequate protein intake following your surgery is key to preventing malnutrition. Lean sources of protein include low-fat cheeses, low-fat yogurt, eggs, poultry, fish, tofu, and beans/lentils.
Fats
Fats are also essential for optimal nutrition. Omega-3 fatty acids are excellent sources of 'good fat.' Sources of Omega-3s include fish, walnuts, canola oil, and flaxseed. Monounsatured fats are also 'good' fats, and sources include olive oil, canola oil and peanut oil. Polyunsatured fats are not as beneficial, and come from most vegetable oils. 'Bad' saturated fats come from butter, lards, meat fats, dairy products, and coconut oil.
Carbohydrates
Carbohydrates are actually a group of sugars attached together as a chain. Carbohydrates supply energy to the body but when consumed in excess, they are stored as fat. Carbohydrates also cause a sharp rise in insulin production. This can lead to insulin resistance, which has been shown to contribute to diabetes.
Complex carbohydrates lead to less insulin production and contain fiber, an essential part of a healthy diet. They are also harder for the body to break down, causing a longer-lasting feeling of fullness. Examples of complex carbohydrates include high-fiber grain products, legumes and vegetables.
Simple carbohydrates include milk, fruit and processed foods. They are easily digested, causing food to empty from the stomach quickly and an earlier feeling of hunger.
Water
Water is key to all of your body's functions. Your body weight is 55-75% water – including 70% of your brain, 82% of your blood and 90% of your lungs. However, you lose water daily from perspiration, exhalation, urine, and feces. That's why it's essential to consume a minimum of 64 ounces of water daily to prevent dehydration. You need even more than this amount during hot summer months and during physical activity.
While preparing for surgery, we recommend that you start carrying a water bottle with you wherever you go. Do not use a straw with your water bottle; this will cause you to swallow air, which will prove uncomfortable and contribute to stretching of your pouch. Slow, consistent sips of water are best, equaling about eight ounces per hour. However, with weight loss surgery, it is important that you follow the following rules so your water consumption does not hinder your protein intake at mealtimes.
- Stop drinking 30 minutes before a meal
- Give yourself 20 minutes to finish your meal
- For Gastric Bypass Patients: do not start drinking water again until 30 minutes after a meal
- For Lap Band Patients: do not start drinking fluids until 2 hours after a meal
Vitamins
Vitamins are present in many different types of food but should be supplemented during any period of weight loss, since food intake is reduced. Essential vitamins include:
- Multi-vitamins
- Calcium
- Vitamin B-12 for Gastric Bypass patients
- Iron, if recommended by your surgeon or primary physician
Our program has specific vitamin recommendations for our Roux-en-Y patients and for our LapBand patients. These will be discussed with you in-depth at your dietician consultation. We also have recommendations for liquid protein supplements.
The Four Rules for Post-Operative Success
Although these rules are essential to your post-operative success, you can start applying each and every one of these principles even before surgery. You don't have to wait to change your life through following these simple guidelines.
Thanks to these four easy steps, you don't need to worry about counting calories, fat or carbohydrates ever again. It's important not to follow any other program, whether it is off the Internet or from another surgical office. Your surgery is a tool to be used with these 'Four Rules' and experience shows that unless you follow them, we cannot predict any weight loss results.
1. Protein First Every Meal
Eat the protein portion of your meal first – every meal – one to three meals per day. Eating protein helps the body feel full and sends a signal to stop eating. Protein should constitute approximately ½ half of each meal.
Protein is also very important to building tissue in the body. Muscle, your organs, your brain – everything is built with proteins. The body does not necessarily need three meals a day, so listen to your hunger cues and don't worry about the clock. At the beginning, after they can tolerate solid food, most patients only eat one or two meals a day.
2. No Snacking Between Meals
Eating anything flavorful or containing calories in between meals is considered snacking. Do not eat between meals at all! If you absolutely have to snack, the only snack that is acceptable is protein.
The main problem with snacking on flavorful food is that it contains glucose or some other sugar. You feel good when eating sugar and when that sugar is gone, one to three hours later, your brain sends a message to snack again. Snacking, especially carbohydrates, actually makes you hungrier and it will slow down or even stop your weight loss. And depending on how much or how often you snack, you can actually gain weight!
Remember that surgery has only changed your digestive system and not your eating habits. Your commitment to a change in lifestyle is the key to making the surgery work for you for the rest of your life.
3. Drink Water - 48 to 64 oz. Per Day Minimum
The importance of water can't be emphasized enough. Especially in the beginning, when you can only tolerate a mouthful at a time, it is so important to continually sip water all day. Make sure you drink 48 to 64 oz. a day minimum – that's 2 to 3 quarts per day. 4. Exercise
Exercise every day for at least 30 minutes. Walking is fantastic exercise and is probably the easiest way to get started exercising. We understand that in the beginning you may struggle with a simple walk down the hall and that your energy level can be very low. Your job is to move your body a little more every day. Eventually, incorporating both aerobic and resistance training into your daily exercise routine will help you remain healthy, at a healthy weight, for the rest of your life. | 
