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Gastric Bypass Meal Plan**

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Nutritional guidelines of Dr. Alfredo Fernandez
Florida Bariatric & Weight Loss Center Town & Country Hospital
to follow after Roux-en-Y Gastric Bypass surgery

**Consult your surgeon/nutritionist before following this specific plan

STAGE 1  STAGE 2  STAGE 3   STAGE 4 SAMPLE MEAL
Clear Liquid Full Liquid Puree Permanent Plan  

Why do we use protein supplements?

BIO-AVAILABILITY OF PROTEIN SOURCES

STAGE 1

Description:
The stage 1 Bariatric diet is used for the first week after bypass surgery. This diet consists of liquids that are clear, sugar-free fluids and or become liquid at room temperature.
Guidelines:
1. It is normal to have reduced appetite this soon after surgery, so before you feel full, stop drinking the fluids.
2. Sip fluids slowly.
Amounts:
One to two ounces (30-60 ml) every 30 minutes.


Food Groups Items to Include Items to Avoid
100% Fruit juice cranberry, apple, grape (sugar content in this is okay since it is natural sugars) All other juices
Soup fat-free bouillon or broth All other soups
Unsweetened beverages Water, Crystal Light, Sugar-free Kool Aid, decaffeinated tea or coffee All others: Carbonated beverages may cause some discomfort so soon after surgery

Other Items to Include:
Sugar-free Jell-O
Fluids:
Try to consume at least 48 oz. of fluid of each day.
Whey protein powder supplement:
Use Whey protein powder supplement mixed in liquids, add 1 scoop in 6-8 oz liquid or as indicated on label to equal 30 grams of whey protein. Begin this on your third day post-op.
Vitamins:
chewable or liquid multi-vitamin with Iron (i.e. Flintstones, Centrum, etc), chewable or liquid calcium citrate (2,000 mg daily) - Tums/Rolaids or other forms of calcium carbonate ARE NOT acceptable as it is not as readily absorbed. Take the multi-vitamin and calcium at separate times at least a half hour to hour apart.

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STAGE 2

Description:
Diet consists of a variety of sugar-free fluid and very soft food. This liquid diet is used as a transition from clear liquids to Pureed foods. Follow this diet plan for one week (second week post-op).
Guidelines:
1. Again, eat slowly and stop eating before you feel full.
2. Sip fluids slowly.
3. Some people become lactose intolerant after WLS and cannot tolerate most dairy except cultured diary products such as cheese or yogurt.
Amounts:
Limit to one to two ounces (30-60 ml) every 30 minutes.


Food Groups Items to Include Items to Avoid
100% Juice 100% fruit or 100% vegetable juices fruit drinks, all juices that are not pure juices, try acidic juices carefully
Milk 1%, skim or low fat buttermilk, sugar-free low fat yogurt no-fruit pieces), sugar-free low fat pudding Whole or 2% milk, milkshakes or eggnog, ice cream, regular yogurt, regular pudding
Soups Low-fat broth, strained or blended vegetable, or cream soups soups containing whole pieces of food
Cereal strained, refined, cooked cereal thinned with milk, water or juice Sugar sweetened/flavored hot cereals, all cold cereals
Fats None with except of light spray of canola or olive oil No butter, cream, bacon, or gravies
Miscellaneous Sugar-free jello & popsicles. spices as tolerated, unsweetened decaffeinated beverages Sugar, honey, regular jello, ice cream, sherbet, puddings, liquid nutritional supplements (Ensure/Boost)
Unsweetened beverages Water, Gatorade, Crystal Light, Sugar-free Kool Aid, decaffeinated tea or coffee All others: Carbonated beverages may cause some discomfort so soon after surgery

Other Items to Include:

Fluids:
Try to consume at least 48 oz. of fluid of each day.
Whey protein powder supplement:
Use Whey protein powder supplement mixed in liquids, add 1 scoop in 6-8 oz liquid or as indicated on label to equal 30 grams of whey protein. Begin this on your third day post-op.
Vitamins:
chewable or liquid multi-vitamin with Iron (i.e. Flintstones, Centrum, etc), chewable or liquid calcium citrate (2,000 mg daily) - Tums/Rolaids or other forms of calcium carbonate ARE NOT acceptable as it is not as readily absorbed. Take the multi-vitamin and calcium at separate times at least a half hour to hour apart.

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STAGE 3

Description:
The stage 3 diet provides for provision of small quantities of pureed foods as a transition between full liquids and your new permanent meal pattern. Follow this meal pattern for a full month. (Weeks 3-7)
Guidelines:
Liquids are consumed separately from meals. All meals must be consumed between 8am and 8pm. Expect to fill up with only a few bites.
Amounts:
1. Consume 6 Mini Meals per day, with one to two ounces of 1 type of food at a time.
2. You may consume two to four (2-4) ounces of food over 30-60 minutes.


Food Groups Items to Include Items to Avoid
100% Juice 100% fruit or 100% vegetable juices fruit drinks, all juices that are not pure juices, try acidic juices carefully
Milk 1%, skim or low fat buttermilk, sugar-free low fat pudding Whole or 2% milk, milkshakes or eggnog, ice cream, regular pudding
Dairy Items Sugar-free yogurt (no fruit pieces), soft-cheese, cottage cheese, sugar-free low fat pudding Regular yogurt, regular pudding
Soups Low-fat broth, strained or blended vegetable, or cream soups soups containing whole pieces of food
Eggs, Meat, Poultry, Fish Pureed: tuna, poultry, ham, casseroles, fish, beans; soft scrambled eggs, peanut butter, plain or cheese omelets, pureed meat if tolerated, tofu Raw eggs, nuts, all others not listed under foods allowed
Vegetables All pureed vegetables, mashed potatoes Whole vegetables
Fruits All pureed fruit, smooth applesauce, ripe bananas Whole fruit raw or cooked
Bread, Cereal, Rice & Pasta Pureed breads, pureed rice, pasta and cooked cereal Whole bread, dry cereals, whole rice and pasta
Fats and oils Very small amounts; low fat margarine, low fat mayonnaise, Canola or olive oil spray, low fat gravy No butter, cream, bacon, or high fat gravies
Miscellaneous Spices as tolerated, catsup, salt, sugar-free Jello Sugar, honey, candy, gum, items containing nuts, seeds or coconut, regular Jello, sherbet, desserts
Unsweetened beverages Water, Gatorade, Crystal Light, Sugar-free Kool Aid, decaffeinated tea or coffee All others: Carbonated beverages may cause some discomfort so soon after surgery

Other Items to Include:

Fluids:
Try to consume at least 48 oz. of fluid of each day.
Whey protein powder supplement:
Use Whey protein powder supplement mixed in liquids, add 1 scoop in 6-8 oz liquid or as indicated on label to equal 30 grams of whey protein. Begin this on your third day post-op.
Vitamins:
chewable or liquid multi-vitamin with Iron (i.e. Flintstones, Centrum, etc), chewable or liquid calcium citrate (2,000 mg daily) - Tums/Rolaids or other forms of calcium carbonate ARE NOT acceptable as it is not as readily absorbed. Take the multi-vitamin and calcium at separate times at least a half hour to hour apart.

Be sure to include protein source at each mini meal
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STAGE 4

Description:
This meal plan is not really considered a "diet" but represents the changes that need to be made on a permanent basis. It is used at the eighth week after Gastric bypass surgery and continues permanently.
Guidelines:
1. Diet will be low in fat, have a moderate amount of fiber and contain no sugar.
2. Avoid seeds and nuts. Fiber intake is based on individual tolerance.
3. Consume foods only between 8am and 8pm.
4. All liquids should be taken apart from meals.
Amounts:
6 mini meals per day, with one to two ounces of 1 type of food at a time. Consume 4-6 oz at one time over 30-60 minutes. Be sure to drink at least 48oz water or sugar free beverage each day.


Food Groups Items to Include Items to Avoid
100% Juice 100% fruit or 100% vegetable juices fruit drinks, all juices that are not pure juices, try acidic juices carefully
Milk 1%, skim or low fat,buttermilk, sugar-free low fat pudding Whole or 2% milk, milkshakes or eggnog, ice cream, regular pudding
Dairy Items Sugar-free yogurt (no fruit pieces), soft-cheese, cottage cheese, sugar-free low fat pudding Regular yogurt, regular pudding
Soups As tolerated None, except the more highly seasoned soups may not be tolerated well.
Eggs, Meat, Poultry, Fish Poultry should be ground at first, then advance to soft pieces of chicken, turkey. Baked fish is usally well tolerated. Many individuals will not tolerate meat (beef, pork, lamb), even if ground. Raw eggs, fattly, highly spiced meat, fish, and poultry. Meats only as tolerated.
Vegetables All canned, well-cooked vegetables, potatoes Fresh vegetables may added with care as tolerated
Fruits All canned fruits, smooth applesauce, ripe bananas Add fresh fruits with care as tolerated
Bread, Cereal, Rice & Pasta Pasta, rice, simple cold and hot cereals, toasted breads, crackers Breads are sometimes difficult to tolerate unless toasted. Seasoned party crackers may not be tolerated.
Fats and oils Small amounts; margarine, mayonnaise, Canola or olive oil spray, low fat gravy, salad dressings Keep portions small, rember fats are concentrated source of calories. Avoid spicy or highly seasoned dressings unless well tolerated.
Miscellaneous Spices as tolerated, catsup, salt, sugar-free Jello Sugar, honey, candy, gum, items containing nuts, seeds or coconut, regular Jello, sherbert, desserts
Unsweetened beverages Water, Gatorade, Crystal Light, Sugar-free Kool Aid, decaffeinated tea or coffee All others: Carbonated beverages may cause some discomfort so soon after surgery

Other Items to Include:
Fluids:
Try to consume at least 48 oz. of fluid of each day.
Whey protein powder supplement:
Use Whey protein powder supplement mixed in liquids, add 1 scoop in 6-8 oz liquid or as indicated on label to equal 30 grams of whey protein. Begin this on your third day post-op.
Vitamins:
chewable or liquid multi-vitamin with Iron (i.e. Flintstones, Centrum, etc), chewable or liquid calcium citrate (2,000 mg daily) - Tums/Rolaids or other forms of calcium carbonate ARE NOT acceptable as it is not as readily absorbed. Take the multi-vitamin and calcium at separate times at least a half hour to hour apart.

Be sure to include protein source at each mini meal

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Sample Meal Plan

Breakfast Lunch Dinner
8:00am:
2-4oz Skim Milk
1 oz Oatmeal
1 oz scrambled egg
12:00 noon:
2-4oz natural peanut butter, tuna, egg, chicken salad
1 slice toasted bread or 4 crackers
1 oz canned fruit or vegetable
5:00pm:
2-4oz soft chicken, fish, tofou, meat
2-4oz cooked vegetable
AM Snack PM Snack HS Snack
10:00am:
2 oz sugar-free low fat pudding
2 oz water with protein supplement
3:00pm:
2 oz sugar free low fat pudding
1 oz low fat cheese
7:00pm:
2-4 oz water with protein supplement

Tips:

  1. Try one solid food daily.

  2. You may start with canned, cooked and soft foods and gradually increase.
  3. Ground poultry at first then advance to small soft pieces.
  4. Many people do not tolerate meats at first, chewing properly will help with digestion.
  5. Always include a protein source at each meal.
  6. Choose only toasted bread and crackers, because some individuals have difficulty tolerating breads.
  7. Drink at least 8 cups (64oz) of water or sugar free fluids each day.
  8. Continue to use whey protein powder in liquids as tolerated.
  9. Over time, you may progress your diet slowly, adding raw food items as tolerated.
  10. Once you have achieved your weight loss goal you may change your meal plan to 3 main meals per day.

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