Southern Maryland Dietitian - FAQ

Southern Maryland Dietitian

Do I Need Protein Shakes After Bariatric Surgery?

9/20/2020

Getting enough protein after surgery is absolutely necessary and protein shakes are almost always needed.

Here's an overview of what you need to know about protein supplements.

Protein supplements come in several forms:

Ready-To-Drink Protein shakes. These usually come in 8 oz containers and don't have to be refrigerated, although they usually taste better cold.
Protein Powders.
Protein Bars.
Liquid Protein. These products usually resemble cough syrup and may not be complete proteins. They can help you reach your protein goals but are not intended to meet all of your protein needs. These are usually not a first-choice.

Dietary instruction will vary, but most patients need protein supplements AT LEAST starting 2 weeks before surgery and up to 6 weeks after surgery.

Many patients start drinking protein shakes well before this and use shakes longer than 6 weeks post op.
Be sure to follow your heath care provider's instruction because excess protein supplements may add excess calories or get in the way of eating other foods you need.

Choosing A Protein Supplement

A Serving is One Scoop of protein powder or 8 oz of protein shake.
Each serving should be:

15-30 grams of protein
200 calories or less
5 grams of sugar or less
10 grams of fat or less

Ingredients

It is important to consume complete protein isolates: Whey, Soy, Egg, Milk, Casein.

List of Recommended Protein Powders

Bariatric Advantage
Celebrate
Unjury
Optimum Nutrition
IsoPure Whey Protein Powder Isolate
Soy Protein Isolate
Whey Protein Isolate
Jay Robb Whey Protein Isolate

List of Ready-To-Drink Protein Shakes

Premier Protein
Bariatric Advantage
Celebrate
ProSource
Muscle Milk Light
EAS AdvantED GE Carb Control
EAS Myoplex Light
Syntrax Nectar Protein
Isopure Zero Carb
SlimFast Low Carb
Sugar Free Carnation Instant Breakfast

How Can I Be Successful With Bariatric Surgery?

9/20/2020

There are 9 main behavior changes that will help you be successful with Bariatric Surgery.

These changes should be started before surgery and will continue life-long.

1. Meal Timing & Frequency

Do not skip meals.
Eat 3 meals every day.
Eat at schedule times.
Eat breakfast within 2 hours of waking up.
Meals should be 4-6 hours apart.
Snacks should be minimized. Have a snack if needed for blood sugar control, if needed for exercise, and if needed to meet your protein needs.

2. Meal Size & How To Eat

Take small bites.
Eat slowly and mindfully.
Stop eating and drinking when you feel full.
Eating past fullness can cause weight gain, stretching of the stomach, nausea and vomiting.
Avoid distractions when eating.
Before surgery the stomach can hold about 48 ounces. After surgery the stomach will hold between 1-8 ounces.
After surgery you will start off eating 1-2 oz per meal. This will increase to about 8 oz (1 cup).
Use the "20-30 Rule": Chew food 20-30 times before swallowing. Meals should last 20-30 minutes.
Don't graze.
Drink water in between meals.

3. Drink Enough Water / Fluids

Dehydration is dangerous.
Dehydration can cause constipation, poor nutrient absorption, headaches, weakness, electrolyte imbalance and stress on the kidneys.
Most people will need between 48-80 oz of water daily.
You may not feel thirsty.
Keep water with you. Keep sipping.
Water is the best option.
Artificial sweeteners are acceptable but may cause sweets cravings, constipation and decreased nutrient absorption.
Beverages must be low calorie, non carbonated, caffeine free.
After surgery, do not drink liquids within 30-60 minutes after eating. Don't drink at meals.

4. Consume Enough Protein

Protein is needed by every cell and tissue in the body.
Protein is needed for healing, hair, skin, bones, nails, muscles, strength and fat loss.
Protein keeps you full and reduces hunger.
Protein is a top priority after surgery. Eat protein first at meals. If you fill up on other foods you won't be able to eat enough protein.
Most people will need 60-80 grams of protein.

5. Vitamins and Minerals

Vitamin and Mineral Supplements are needed post surgery.
Weight loss surgeries make you consume less food, less calories and less vitamins and minerals.
Weight loss surgeries put you at risk for developing nutrient deficiencies. These can be life threatening if not managed well.
Some weight loss procedures also decrease your nutrient absorption.
Labs should be checked at least yearly to monitor your nutrition status.
Routine supplements are needed.
You may need different supplements based on your labs and other clinical needs.
Make sure you keep going to your doctors appointments and let all health care providers know that you have had a weight loss surgery.

6. Fruit, Vegetables, Whole Grains

These foods keep you alive, healthy, and full.
Before surgery, try to have balanced meals that include protein, whole grains / complex carbohydrate foods along with fruits and vegetables.
The volume of foods will be limited after surgery.

7. Avoid Sweets and High Fat Foods

After surgery, sweets and high fat foods can cause dumping syndrome and can limit your weight loss.
Avoid sugar, honey, brown sugar, cake, ice cream, baked goods, candy, soda, juice, sports drinks, ginger ale.
Avoid high fat foods: salami, pepperoni, bacon, sausage, chips, pork rinds, mayo, sour cream, cream cheese. Very small amounts of healthy fats may be included.

8. Exercise

Exercise helps with weight loss, strength, health and mood.
Follow your doctors instructions for when and how to exercise.
Try for 30 minutes of cardio / aerobic activity most days.
Try for strength training 2/week. This helps you build and maintain muscle mass and may help improve your metabolism.
Don't forget to stretch. I recommend yoga once a week.

Here are some ways to increase your activity:

Take a 5 minute walk break when you feel stressed, bored or distracted.
Park you car far from work and stores.
Take a family walk.
Walk to work if possible
Walk your children to school if possible.
Do chores at home.
Take an after dinner walk.
Do online exercise programs.
Find a walking partner.
Look in to gym memberships.
Consider a pool membership. You might like lap swimming, pool exercises or water aerobics.
Use a smart watch to track your steps.

9. Get Support

Changing your lifestyle is tough. You need help, and help is available.
There are local support groups that meet regularly.
There are many online support groups available through social media.
You are not required to continue in support groups post surgery, but this is highly recommended.
Look in to your healthcare team: Surgeon, Primary Care, Therapist, Dietitian. There are specific requirements before surgery and less after surgery. However, you are highly encouraged to maintain regular and as-needed appointments after surgery.
Do you have friends, family, and co-workers who can support you?

Final Thoughts

Losing weight with bariatric surgery requires a total lifestyle change.

You'll incorporate all of these things:

Diet change.
Exercise.
Increased nutrition knowledge.
Positive motivation.
Focusing on overall health.
Self esteem and loving yourself.
Realistic goals.
Behavior change.
A helpful support system.

Do You Treat Eating Disorders?

9/20/2020

Treatment for eating disorders is an area that requires providers who specialize in this clinical area. This is not our area of focus and expertise and we want you to have the best care you possibly can.

We recommend that you utilize these resources to locate a provider who is best suited to help you.

HealthProfs
Academy Of Nutrition And Dietetics

If you have questions or a unique circumstance, please send an email to Info@SouthernMarylandDietitian.com

What Labs Do I Need With Bariatric Surgery?

9/19/2020

After weight loss surgery you should have some nutrition labs done every year.
I recommend: CBC, Albumin, Pre-albumin, Vitamin B12, Vitamin B1 (whole blood), Folic Acid, Vitamin D, Copper, Zinc, Serum Iron, Total Iron Binding Capacity, % Saturation, and Ferritin.
Your doctor can order these through your insurance - please ask for them specifically.
Labs can also be self-ordered through a discount lab service (not covered by insurance).

What Supplements Do You Recommend?

9/19/2020

Access Professional Quality Supplements at a Discount

Supplements can be a great help to your health.

I partner with a few select companies to give you access to quality supplements.

These companies tend to offer discounts and sales as well.

Can You Order Labs For Me?

9/19/2020

Southern Maryland Dietitian offers advanced nutrition testing to help you reach your health goals.

The following lab tests can be ordered at Southern Maryland Dietitian.
Discount programs are utilized and these are out of pocket costs.
Our team can also make recommendations for labs that your doctor can order utilizing your health insurance.

Through Ulta Lab Tests you have access to over 1000 lab tests & many health panels.
Significant discounts are available.

Through Precision Analytical we can test for sex hormone, cortisol, adrenal levels.

By partnering with Vibrant America, we have access to many specialized tests to help address chronic disease, auto-immune conditions, and nutrition status.

Vibrant America offers the Wheat Zoomer test as well as a Micronutrient test that measures nutrients inside your cells as well as in blood/serum circulation.

If you are eating healthy and exercising regularly and still are having a hard time losing 10-50 pounds, GxSlim may help - it is a genetic test that helps focus your diet and exercise.

Other tests from Genetic Direction can be used to better understand your genetic risks relate to nutrient levels, skin health, healthy aging, and sports abilities.

Is Food Making You Sick??

If you suspect food may be causing unexplained symptoms or you have inflammation that is not getting better with conventional treatment - food sensitivity testing and treatment may be an option.

Using this test requires a very specific diet therapy.

Results are not guaranteed but my patients usually see an 80% reduction in symptoms.

There are many food sensitivity tests on the market, and many are outdated or limited in their usefulness.

I only work with food sensitivity testing through Oxford Biomedical Technologies.

Southern Maryland Dietitian works closely with Diagnostic Solutions Laboratory to offer you the GI Microbial Assay Plus (GI-MAP).

The GI-MAP includes the first comprehensive pathogens assay that is FDA approved, the GPP assay by Luminex Corp.

The pathogen targets include bacteria, parasites and another first for the market, viruses!

My Child Is A Picky Eater. What Can I Do?

9/19/2020

Picky Eating can have more than one cause and may take a team to really help your child.

Besides a Nutrition visit, I recommend:

Work With Your Child's Pediatrician
Consult with an Occupational Therapist (OT).
Consult with a Speech Language Therapist (SLP).

I also recommend two books that are super helpful.

Helping Your Child With Extreme Picky Eating

Secrets Of Feeding A Healthy Family: How To Eat, How To Raise Good Eaters, How To Cook

Can Nutrition Help My Period?

9/19/2020

Yes!

There is a lot we can work on from a nutrition perspective to help your cycle.

In fact, your cycle gives a lot of clues about your overall health and nutrition status.

This book, The Period Repair Manual is a great resource on this topic.

Should I Track What I'm Eating?

9/19/2020

Most people think about tracking their intake to "keep them on track."
In other words, as a behavior modification.
Sometimes this can be a great practice.
Sometimes it is really annoying though.

However, tracking your intake for even a really short time can be excellent as a data collection practice.

I recommend the free version of MyFitnessPal.
You can download it from the App Store or GooglePlay.

This simple Health Journal is great also.
Sometimes putting pen to paper is a bit more therapeutic.
Also, I really like that this journal lets you track a lot of data in a really streamlined way.

This journal tracks:

Foods Consumed
Macros and Calories
Exercise
Blood Sugar
Weight
Blood Pressure
Sleep
Water
How You Feel
Pain Level
Goals For The Next Day
Vitamin and Supplement Log (This can be used for medication also.)

What is the LEAP Protocol for Food Sensitivities?

2/2/2017

What is the LEAP Protocol for Food Sensitivities? Learn more from Susan Linke in this great video.

Author

Lisa Hugh, Registered Dietitian.

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