So you’ve had your weight loss surgery and you’re ready to tackle your new journey ahead, lose the excess weight and make your way towards a healthier and happier life. At Upper GI Surgery we want to make this as easy for you as possible (because we know it can be tough) and like to provide useful information for our patients to help them along the way.
One of the major downfalls we see is that people aren’t actually aware of the essential nutrients in food. As a result they end up eating the wrong types of food and struggle to lose weight, or end up gaining weight further down the track. We have put together an easy guide of the essential nutrients that exist in food, to help you understand and make it easier for you to plan your meals.
MACRO NUTRIENTS
Water
About 50 per cent of the food we consume is made up of liquid. We need a minimum of one litre of water every day, but a lot of this will come from our food. People who are losing weight, people who have problems with constipation and those who are exercising will need to drink more. You need to avoid sweet and milky fluids. Most people who drink these things are not really thirsty – they are just filling in time.
Protein
Most of the protein we eat we get from meats, fish, eggs and dairy products. We absorb plant protein less efficiently than we absorb animal protein, and many supposedly high-protein plant foods contain less protein than we think. We need a minimum of 40 grams of protein per day, but it’s better to aim for 60 grams. The following calories and protein are provided by 100 grams of these foods:
Eggs: 150 calories; 13 grams protein
Chicken: 220 calories; 25 grams protein
Beef: 330 calories; 14 grams protein
Fish: 90 calories; 19 grams protein
Canned tuna in water: 110 calories; 25 grams protein
Cheese: 400 calories; 25 grams protein
Sugar: 390 calories; no protein
Cottage cheese: 100 calories; 11 grams protein
Yoghurt (Greek): 60 calories per 100 ml; 10 grams protein
Tofu: 75 calories; 8 grams protein
Baked beans: 150 calories; 6 grams protein
Bread: 290 calories (two-and-a-half slices of toast); 12 grams protein
Fibre
Deficiency in fibre is very common in patients after weight loss surgery. Unless you can get your bowels moving at least every two days you will develop debilitating and permanent constipation. Good sources of fibre include fresh fruits, vegetables and salads. Breakfast cereals with bran can be high in fibre. We recommend unprocessed bran (with breakfast cereal), or using supplements containing soluble fibre (Benefibre) or psyllium (which creates less gas) that you can put into water, such as Metamucil.
Carbohydrates
Carbohydrates are crucial for our day-to-day functioning, but they are the food group most commonly associated with the development of obesity and the recurrence of obesity after weight loss. Carbohydrates are the key ingredient in breads, snacks, potatoes, fruit juice, alcohol and sweets. Eating high GI carbohydrates or simple sugars promotes hunger, which promotes more carbohydrate eating – this includes foods like white bread, raw sugar, honey and rice malt ‘Low-carb’ versions of these foods are still just carbs. Our minimum requirement is about 50 grams of high fibre low GI carbohydrate per day which includes foods such as grainy bread, cereals and legumes. Most people should try to limit their intake to 60–100 grams per day, unless they are doing a lot of exercise. Carbohydrates are converted into sugar and eating sugar makes us produce the hormone insulin. For people needing to lose weight, their body needs to switch from using sugar as a fuel to using fat, this will occur if they limit their carbohydrate intake and start using stored fat for energy.
MICRO NUTRIENTS
Calcium
We get calcium from dairy products, meat and fish. We recommend that weight loss surgical patients eat foods that are high in calcium (except cheese).
Vitamin D
We create vitamin D in our own bodies when we are exposed to sunlight. It also exists in small amounts in many foods. Vitamin D helps us use calcium effectively to maintain bone strength, and has a role in immunity. It is probably more important than dietary calcium. Vitamin D deficiency is Australia’s most common vitamin deficiency. While many people can have low vitamin D levels without harm, it is likely to be a very important vitamin in patients losing weight. Daily supplements, monthly tablets and injections are available. The stronger tablets are probably more effective.
Folate
Folate is a vitamin found in fresh fruit, vegetables and salad. Patients who don’t get enough folate usually look and feel sickly. A daily multivitamin will provide sufficient folate for patients after surgery.
Thiamine
While present in many foods and all multivitamins, thiamine is a very important vitamin. Postoperative patients who experience vomiting and don’t take a multivitamin to supplement their thiamine levels are at very high risk of developing irreversible neurological injury and possibly dementia.
Vitamin B12
Vitamin B12 is the second most frequently deficient vitamin in Australia. It is only found in animal protein. If someone is developing a deficiency in B12, the only effective way to supplement it is via injections from your GP (every three to six months). All gastric bypass patients, many sleeve gastrectomy patients, and some lap band patients need these injections.
Iron
We get iron from meat proteins. There are small amounts in vegetable protein. Iron deficiency is quite common, and it is significant for two reasons:
- Iron deficiency can lead to a drop in blood production, which will lead to fatigue and reduced exercise capacity.
- Iron deficiency is the first sign of many bowel and stomach cancers.
Patients having gastric bypass often need iron supplements.
Other minerals: iodine, zinc, selenium, copper
In Australia our soils are deficient in iodine, so a multivitamin with iodine is advised. The other minerals are also important and a daily multivitamin will be sufficient for most patients. Patients who have diarrhoea, vomiting, poor diet, or who are considering pregnancy should probably take a multivitamin twice daily. Zinc, iron and silica may help reduce the risk of early hair loss after surgery.
At Upper GI Surgery we provide consultations with our dietician, both before and following your weight loss surgery. We believe this gives you the best chance of having the information you need in order to create a healthy balanced diet geared for weight loss. Our Weight Loss Education section of our blog is a great resource to refer back to for dietary advice and guidance.
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