Diet after Lap Band

 

1.     THE SURGERY
 
The Adjustable Lap Band is a silicone band that is placed around the stomach just below the gastro-esophageal junction. Tubing connects the inner shell of the band to a port where saline is injected to restrict the stoma opening. The band is adjusted based on symptoms that you feel as a patient.
Weight loss is slower with this procedure than other bariatric surgery procedures. The average weight loss is about 1-2 pounds per week.
  
REQUIRED SUPPLEMENTS
 
Protein
 
            Protein is a very important part of your diet.   It is used to repair and replace damaged tissues.   A protein supplement will be required for at least one month after surgery. They can be purchased at drug stores, health food stores or on the Internet.   Your goal is between 60-70 grams per day. As your diet progresses you will be able to reduce your use of a supplement, as the foods you will eat will contain protein.
 
POWDERS- There is a variety of protein powders on the market. These powders are added to your food or made into a “shake”. 
 
LIQUIDS-Protein drinks/shakes seem to be better tolerated. Some of the brands that have been tried are as follows:
 
1.    All the Whey protein powder- (www.allthewhey.com)
2.    Pure protein shake-35 grams/can (Body Source-473-3830 or 1-800-854-5019)
3.     New-Whey- (test tube) 25 grams or 42 grams (www.idssports.com)
 
VITAMINS- Should be taken for the rest of your life. Start taking them as soon as you get home form the hospital.
 
            Multivitamin
 
One multivitamin per day (chewable with iron such as Flintstones complete, any adult chewable or bariatric advantage vitamins (www.bariatricadvantage.com)).
 
          Folic Acid- Take 400 milligrams per day.
 
MINERALS
 
Calcium- Chewable- 1,000-1,200 milligrams per day
 
 
 
GENERAL NUTRITION GUIDELINES
 
Alcohol
          Alcohol is problematic for several reasons. It is packed with “empty” calories, which will only contribute to total calorie intake, it dehydrates the body, which impacts kidney function and waste removal. We do not recommend alcohol immediately after surgery.
 
Low Fat
          Fat may be difficult to tolerate after surgery. You may experience nausea and bloating after a high fat meal. NO FRIED FOODS. Sometimes the symptoms are similar to those of “dumping syndrome”. Also a high fat food can cause acid reflux or heartburn. Most importantly high fat foods are high in calories, which could slow down your weight loss rate. You do need some fat in your diet (minimum of 20 grams per day). It is better to choose oils (olive, canola), nuts (when you are allowed to eat them), and avoid saturated fats. Ask your dietitian for further details.
 
Liquids
          It can be easy to become dehydrated after Lap-Band surgery because you are only able to sip small amounts of liquid at one time (1-2 ounces at a time). It will be important for you to carry fluid with you throughout your day. The following are guidelines for drinking fluids.
 
          *All fluids should be low calorie and non-carbonated
*Drink fluids between meals NOT with meals. Drinking with meals allows your food to slide down past the band without giving you the sense of fullness.
          *Stop drinking 30 minutes before and after you plan to eat a meal.
*Begin by drinking 4-6 ounces slowly between meals and then increase to 8 ounces six times per day.
          *Avoid caffeine-containing beverages, as they are appetite stimulants
          *If you would like to drink fruit juice, it must be diluted.
 
Fiber: If you feel hungry soon after a meal or notice your portion sizes have increased, then it is time to add more fiber to your diet.
 
 
 
TIPS FOR OPTIMAL WEIGHT LOSS
 
YOU MUST LEARN THE GUIDELINES OF YOUR DIET BEFORE SURGERY IS PERFORMED.
 
1.     Take your time while eating or drinking. Allow plenty of time to eat your meal (20-45 minutes).
2.     Stop eating at the FIRST sign of fullness. A feeling or pressure or fullness in the center of your abdomen just below your rib cage.
3.     Sip at least 48-64oz. of calorie free non-carbonated beverages
4.     Wait at between 45 minutes to one hour between eating and drinking
5.     Take small bites and CHEW YOUR FOOD WELL. Chew 30 times.
6.     Take your vitamins and minerals daily
7.     Do not lie down immediately after eating
 
PORTION SIZES
 
**If you eat more than you should, you are risking injury to your surgery site, stretching your pouch, and physical discomfort such as bloating and vomiting.**
 
ADJUSTMENTS
 
As you know your Lap-Band will need to be adjusted. Some people may need their band adjusted as early as six weeks, others wait longer. If you notice that you have not lost weight, or you no longer have to restrict your meals, you may need an adjustment. Call your surgeon.
 
DIET PROGRESSION
 
 AT HOME (Day 1-2)
 
          Clear liquids- when you get home you should follow a clear liquid diet. Drink about 2ounces of clear liquids every 20 minutes. Foods that you can have for the first two days include apple, cranberry or grape juice, diet gelatin, clear broth, sugar free water ice and decaffeinated tea. It is good idea to drink out of a medicine cup to help control your portions. A sample meal plan follows:
 

Breakfast
Every 20 minutes
Lunch
Every 20 minutes
Dinner
2 ounces Apple juice
              
2 ounces Diet gelatin
 
 
2 ounces of clear liquid
2 ounces. Broth
 
2 ounces Sugar free water ice
 
 
 
2 ounces of clear liquid
2 ounces Grape juice
 
2 ounces Broth
 
 
 

 
 
*Try to sip 2oz over a 10-15 minute time period. If you feel full, pain, or nausea stop sipping until the feeling passes.
 
 
Examples of clear liquids: Crystal light (sugar free), diet lemonade, Propel, Broth, sugar free Popsicles, sugar free Jell-O, apple juice, water
 
 
 
POST-OPERATIVE DIET (Day 3-5)
 
          Full liquids- Once you are able to tolerate clear liquids you will progress to a full liquid diet. These foods contain protein and vitamins your body needs for healing. Your food is still in liquid form because your stomach is swollen and tender. Continue to drink clear liquids, but now add the following high protein drinks:
 
Full liquids: skimmed or 1% milk, Lactaid milk, sugar free fudgesicles, strained cream soup, low carbohydrate protein drinks
 
Sample Meal Plan

Breakfast
Snack
Lunch
    Snack
 Dinner
Snack
1/4 cup milk
1/2 sugar free fudgesicle
1/4 cup strained cream soup
1/4 cup of low carbohydrate protein drink
1/4 cup of milk
1/4 cup sugar free hot chocolate

 
Between each “feeding” drink water and your protein drink. Remember your protein goal is 60-70 grams of protein per day and 36-48ounces of fluid per day.
 
 
  POST OPERATIVE DIET (Day 5-21)
 
Blended diet- Foods in this stage should be SMOOTH (no lumps or seeds).     Your protein supplement is crucial at this point. During this stage you may have a small frequent meals (i.e. 1/4 cup of low fat milk). Space your meals about three hours apart. A guideline and sample meal plan follows: If you eat solid foods you could create a blockage and be forced to vomit.
 

Breakfast
Snack
Lunch
Snack
Dinner
Snack
4-6 oz Cream of Wheat
 
4-6 oz. skim or 1% cup milk
4-6oz cup sugar free strained yogurt
 
4-6oz Carnation Instant Breakfast no added sugar
4-6oz cup low fat strained soup
 
 
4-6oz cup sugar free pudding

 
GUIDELINE FOR DAYS 5-21

Category
Choose
Avoid
 
Beverages
Crystal Light, vegetable juice, skim or low fat milk, diluted unsweetened fruit juice, decaffeinated tea
Soda, fruit drinks, sugar iced tea, alcohol, coffee, tea, and carbonated beverage
Soups
Reduced fat cream soup, pureed meat and vegetable soups, broth. All soups must be pureed and lumps strained
All others
Starches
Crackers in soup, oatmeal, cream of wheat, mashed potatoes
 No pasta, rice, French fries, chips, dry cereals, bread, donuts, croissants, biscuits, muffins, popcorn, waffles
Vegetables
Pureed vegetables, vegetable juices
Raw vegetables, lettuce, celery, asparagus
Fruits
Unsweetened applesauce, pureed fruit without seeds or skins, mashed banana, unsweetened baby food fruits
Fresh fruits excluding bananas, dried fruit
Meat, Protein
Pureed skinless turkey/chicken breast, white fish (baked or grilled), tuna fish (light mayo), extra lean ground beef, scrambled eggs, refried beans, pureed bean soup
Fried meats, tough meat, lamb, veal, pork, bacon, breaded meat, sausage, nuts, seeds
Milk and Milk products
Low fat milk, plain or sugar free yogurt, Carb control smoothie, low fat cheese or cottage cheese
Chocolate milk, regular cheese, whole milk
Others
Sugar free pudding, custard
All others

 
 
GROCERY LIST FOR POST OPERATIVE DIET (Day 5-21)
 
 
__1% milk                  
__Plain soymilk                      
__Plain yogurt
__Sugar free yogurt (smooth consistency-Colombo raspberry, Dannon Key Lime Pie)
__Sugar-free hot chocolate    
__Sugar free Popsicles
__Liquid protein supplements
__Low fat cream soup                       
__Cream of Rice                    
__Cream of Wheat
__Oatmeal
__Infant strained fruits and vegetables         
__Herbal Tea                          
__Water
__ Carnation Instant Breakfast (No sugar added)
__Crystal Light                      
__Nonfat dry milk
__Low fat cottage cheese
__Low fat cheese
__Potato (to make mashed potato)
__Eggs
__Saltine crackers
__Tuna Fish (in water)
__Low fat mayonnaise
__Smooth peanut butter
__Plain white fish (flounder)
__Fruit H2O
__Tomato juice/ V-8 juice
__Orange juice (diluted)
__Apple Juice (diluted)
__Pureed soups such as bean, lentil (thin consistency)
__Dannon Carb control smoothie
 
 
POST-OPERATIVE DIET (Day 22-35)
 
Soft Food- After three weeks you can slowly introduce soft foods to your diet, and as soon as you can tolerate soft foods you can introduce solid food. Add solid foods gradually. There will be some foods of which even at 2-3 months after the surgery may still cause some difficulty. (i.e. Red meat, rice, bread)
 
 

Breakfast
Snack
Lunch
Snack
Dinner
Snack
1 egg
1oz of cheese
½ slice toast
 
 
 
4-6oz sugar free yogurt
4 Tbsp. Tuna salad
3 saltines
 
4-6oz sugar free pudding
3 Tbsp meatloaf
2 Tbsp. Cooked carrots
1 cube of cantaloupe
1/3-1/2 cup of Cottage cheese
2Tbsp. Blueberries

 
 
GUIDELINES FOR DAY 22-35
 

Category
Choose
Avoid
Beverages
Crystal Light, coffee, tea, vegetable juice, skim or 1% milk, diluted fruit juice, water,
Soda, alcohol, fruit drinks, sweetened tea/lemonade, whole milk, milkshake
Soups
Reduced fat cream soup, vegetable soups
Full fat cream soups
Starches
Cold (no bran) or hot cereal, saltines, toast, potato, rice
White bread, bagels, chips, pasta in sauce, fried potatoes, popcorn, high fat crackers
Vegetables
Soft cooked vegetables
Raw vegetables, celery, peas, corn
Fruits
Canned fruit (unsweetened), bananas, diluted fruit juice, fresh fruit
Fresh fruit with tough skins
Meat, protein
Soft flaky fish, eggs, low fat cheese, low fat cottage cheese, ricotta cheese, hummus, fat free refried beans, skinless chicken, pork chops, smooth peanut butter, lean ground beef, Tuna fish salad
High fat cuts of meat, fried meats, ground veal, lamb chops, Canadian bacon, sausage, goose
Milk and milk products
Skim or 1% milk, “lite” or plain yogurt, soft cheese, low fat cottage or ricotta cheese
Chocolate milk, condensed milk, whole milk
Others
 
 

 
GROCERY LIST FOR DAY 22-35 
__Non fat or 1% milk
__Plain soymilk
__Reduced calorie smooth yogurt
__Plain yogurt
__Sugar-free pudding
__Sugar-free custard
__Protein supplements
__Low fat cream soup
__Soup- including “chunky” and bean 
__Cream of Rice
__Cream of Wheat
__Unflavored oatmeal
__Rice (whole grain, brown, wild rice)
__Unsweetened pulp-free juice
__Fresh fruits and vegetables (soft, well cooked)
__Unsweetened applesauce
__ Tuna Salad made with mayonnaise (no celery or onions)
__Minced clams
__Fresh fish (soft and cooked moist)
__Low fat cottage cheese or ricotta cheese
__Eggs (poached, boiled or egg salad)
__Egg Beaters
__Low fat mayonnaise
__Herbal Tea
__Water
__Crystal Light
__Skinless chicken
__Smooth peanut butter
__ Cold cereal (Cheerios)-avoid dried fruit and nuts
__ Whole Wheat toast
__ Lean ground beef (to make meatloaf, meatballs)
__ Cheese (American, Muenster, Feta)
__ Deli meat-Turkey, Ham, Chicken (Avoid Salami, Pepperoni, Pastrami, Bologna, Corned Beef)
 
SEVEN WEEKS AFTER SURGERY
 
            At this time there are no texture restrictions for your food choices. However, it is recommended that you follow a well-balanced low fat diet with a focus on protein. You can try to introduce raw vegetables, high fiber cereals nuts and seeds into your diet at this time. At this point you should have only three meals with one snack. (Consuming 6 meals per day may slow down your rate of weight loss)
 
 

Breakfast
Lunch
Dinner
Snack
1-2scrambled eggs
1 slice toast
1tsp. butter
¼ cup low fat yogurt
 
3 ounces of Turkey salad
4 Saltines
¼ cup of tomato juice
3 ounces of Flounder
4 Tbsp. of Rice
¼ cup of soft carrots
1slice of American cheese
1oz. f whole wheat pretzels

 
REMINDERS
 
1.      Eat all your meals. Skipping meals can slow down your metabolism.
2.      Plan to eat your meals 5-6 hours apart.
3.      Chew your food WELL.
4.      Drink liquids throughout the day
5.      Choose high quality nutrient rich foods, which will prolong your feeling of fullness.
 
6.      Begin an exercise program
 
 
ALWAYS EAT THE PROTEIN IN YOUR MEAL FIRST
 
 
 

Seven weeks post op

 
Note: This is just a guide. Never force yourself to eat if you are full.
 

Meal
Food
Calories
Gram of Protein
 
Breakfast
8:00am
1 egg or egg substitute made with 2 Tbsp. Cottage Cheese
1 slice Whole Wheat toast
1 tsp. Butter/Margarine
75
30
80
45
7
3
2
 
 
                                               Total
230
12
 
 
 
 
 
 
Lunch
1:00pm
3 ounces Sliced turkey
1 Tbsp. Light Mayo
½ slice of Whole Wheat Bread
¼ cup of yogurt (plain)
 
105
50
40
28
21
 
 1
 2
 
 
                                              Total
223
24
 
 
 
 
 
 
Dinner
5pm
3 oz. Salmon broiled with lemon
½ cup of cooked vegetables
2 Tbsp of rice
232
 25
 40
21
 1
 1
 
 
                                             Total
297
23
 
 
 
 
 
 
Snack 8pm
1/3 of a peeled apple
2 ounces of low fat cheese
 30
150
 
14
 
 
                                              Total
180
14
 
 
                                                      Daily total
930
73
 
 
 
 
 
 
 
 
 
 
 

  
Sample Meals after 3 months
 
REMEMBER>>>>>>Always eat the protein first, vegetable/fruit second and the starch last. Stop when you are satisfied NOT stuffed.
 
 
Breakfast ideas:
 
1.      Scrambled egg or eggbeaters with a 1 slice of low-fat cheese and soft cooked vegetables.
2.      ½ cup of oatmeal made with skim milk
3.      ½ cup whole grain cereal (Kashi, wheaties) with skim milk
4.      1 slice of whole-wheat toast with 1 slice of low-fat cheese or 2 tsp. Smooth peanut butter or 1-2 Tbsp. Low fat ricotta or cottage cheese.
 
Lunch ideas:
 
1.      ¼ cup tuna/egg/chicken salad with 3-4 crackers
2.      2-3 oz. chicken or fish with ½ cup mixed greens/cooked vegetables an oil/vinegar
3.      2-3 slices of low fat deli meat rolled up with lettuce
4.      ¼ cup shrimp/seafood salad on bed of lettuce with 2 tomato slices and 2 whole wheat crackers
5.      ¼ cup of turkey chili with 2-3 whole grain crackers
 
Dinner ideas:
 
1.      2-3oz. chicken stewed with tomatoes, onion, and peppers. Served with ¼ cup brown rice.
2.      2-3oz. Broiled fish with ¼ cup steamed broccoli and ¼ cup sweet potato
3.      2 small meatballs with tomato sauce, ¼ cup zucchini, ¼ cup pasta
4.      2-3oz. meatloaf served with ¼ cup green beans
 
Snack ideas:
 
1.      ½ cup sugar free yogurt with ½ cup sliced strawberries/blueberries
2.      ½ protein bar (Atkins, pure protein)
3.      1 ounce of low cheese with 2 apple slices
4.      2 tsp smooth peanut butter and 1/3 banana
5.      3 baby carrots with onion dip made with nonfat sour cream.