Hope Dietary Guidelines for the Gastric Bypass
Phase I Liquids
The goals of this Phase
- Stay well hydrated—that means you should include about 48- 64 ounces of liquid (non-calorie) each day. You will be drinking small amounts (“sips”) every hour through the day since you will not be able to drink a large amount all at once.
- Tip: Fill four 16 ounce bottles with your favorite non-calorie beverage (like Crystal Light Orange and carry a bottle with you.
- On Day Four after your surgery, begin adding liquid protein during this Phase (20 to 30 grams per day). That means you should buy a protein powder suggested by your dietitian, doctor or nurse. We recommend:
- Unjury (20grams of whey protein isolate per packet) once a day (available at our office or www.UNJURY.com or 800-517-5111
- Sugar-free Carnation Instant Breakfast with low fat milk twice a day, available at most grocery stores.
- NO straws (they fill you with air)
- Suggested liquids include clear broth (use low sodium, low fat), sugar free drinks (non carbonated) diluted 100% juice in limited quantities Apple, Cranberry, Grape, SF gelatin, decaf tea or coffee.
- Watch for signs of dehydration!
Phase II Pureed or Blended Foods
The goals of this Phase:
- Continue getting enough fluids (ideally 48-64 ounces) and when thirsty
- Include protein sources daily (40 gms per day)
- Take the recommended vitamins each day
- Chew slowly / take small bites/ serving size 2 tbsp to ¼ cup
- Don’t drink with meals
- Plan your meals to include protein; vegetables/fruit (soft), starches (eat these last and least). Always eat in order of Protein first, and then vegetables, fruits – stop eating at first sign of fullness.
- Incorporate 2 cups of skim milk into liquid intake.
- Review protein sources: meats, chicken, turkey, eggs, cheese, low fat milk, yogurt, tofu, soy beans, other legumes (beans)
- Look for products that come in “high protein” forms (like fortified hot cereals) read labels on food for protein information or buy a protein-count book.
- Choose mild pureed vegetables such as carrots, green beans, squash-nothing strong!
- You may use baby food without added sugar or starch such as baby food chicken, no blends such as chicken and rice.
- Try foods like mashed scramble eggs, low fat pureed cottage cheese, flaked fish, pureed low chicken or turkey.
- You can eat fruits without sugar or syrup.
- You may use a blender or food processor to keep foods soft.
- Introduce new foods slowly and one at a time.
- Avoid sugar drinks / avoid fatty or high sugar foods.
- For extra protein add powdered milk (1/4 c) to your 1 cup of skim milk (this give about 18 grams of protein)
- Taking vitamins will become a daily part of your life after gastric bypass surgery. We recommend:
- Multi Vitamins, 2 per day: 1 at breakfast and 1 at dinner
- Iron 36 mg per day, always 2 hours separate from Calcium
- Calcium Citrate, 1500 mg in 3 divided doses with Vitamin D 3 (2000 IU per day)
- Sublingual B12, 500 mcg daily or 1000 mcg 3 times per week or a monthly injection
Chewable or liquid vitamins recommended for first year.
Phase III Soft Foods/ Adaptive
The goals of this Phase:
- Continue to drink enough fluid (ideally 48-64 ounces/per day)
- Continue to eat a high protein food at each meal such as lean meat or chicken
(50 grams of protein for women/ 60 grams for men), lean ground turkey is good choice for this phase
- Choose mild vegetables such as green beans, carrots, squash
- Bananas and hard boiled eggs are also good choices
- No raw or gassy vegetables
- Use skim milk as a protein source (2 cups per day)
- Avoid carbonation
- No nuts
- Use a protein supplement (powder) to get enough protein
- Eat and drink separately, no liquids 30 minutes prior, with or 45 minutes after meals
- Try increasing portions from ¼ cup to 1/3 cup or as tolerated
- Remember to chew well and eat slowly
- Stop eating when you feel full
- Take your vitamins
- Keep appointments with your surgeon
Phase IV Stabilization
The goals of this Phase:
- Drink enough fluid each day
- Eat 3-4 well balanced meals each day
(protein—vegetable/fruit – starch)
- Eat and drink separately
- Take your vitamins each day
- Stop eating when you feel full
- Eat 60-70 grams (women) – 80 grams (men) of protein daily
- Eat a balanced diet (protein, veg./fruit, starches, fats)
- Keep appointments
- Avoid carbonation
- Avoid alcohol
- Avoid caffeine
- Avoid concentrated sweets or high fat foods
- Exercise
- Come to support groups
- See your surgeon for regular check-ups and lab work
- Don’t smoke
DURING ANY PHASE
Call or e-mail the nurse or dietitian if you have questions 412-741-8862
