Lap Band Dietary Recommendations

Lap Band Dietary Recommendations

Who is eligible?

1. Presence of morbid obesity persisted for at least 5 years, defined as either:
A. Body Mass index (BMI) exceeding 40 or;
B. More than 100 lbs over one’s ideal body weight.
C. BMI greater than 35 in conjunction with one of the following:
1. Severe cardiovascular Disease.
2. Diabetes Mellitus uncontrolled.
3. Obstructive Sleep Apnea.
4. Severe Pulmonary Disease.
5. Three or more of the following risk factors:
a. Hypertension (BP > 140 mmHg systolic and /or 90 mmHg diastolic).
b. Low high-density lipoprotein cholesterol (HDL < 40 mg/dL).
c. Elevated low –density lipoprotein cholesterol (LDL > 100 mg/dL).
d. Family history of early cardiovascular disease in a first degree relative (myocardial).
(infarction at age < 50 years in a male relative or at age < 65 years in a female relative).
5. Patient has completed growth (18 years of age or documentation of completion of bone growth).

NUTRITION GUIDELINES FOR LAP-BAND PATIENTS

Lap- band surgery was developed to induce weight loss. However, some patterns must be modified simultaneously in order to achieve and maintain the desire weight loss.

1. EATING METHODS
Eat slowly and chew foods until they reach a mushy consistency!
1. Set aside 30 to 45 minutes to eat each meal.
2. Actually count the number of times you chew each bite. Aim for 30.
3. Make an EAT SLOWLY sign and place it on the table in front of you.
4. Explain to family members the reasons why you need to eat slowly so they will not urge you to eat
faster.
5. Take small bites of food. You may want to try eating with a baby spoon or chop sticks.
6. Pay attention to taste. Learn to savor each bite, noticing its flavor, texture.
7. Chew well. Ground or very soft foods may be necessary if you have dentures.

2. STOP EATING AS SOON AS YOU ARE “SATISFIED”!
Try to recognize the feeling of fullness then stop eating at once.
Indication of fullness may be:
- A feeling of pressure or fullness in the center of your abdomen just below the rib cage, feeling of nausea, pain in your shoulder area, upper chest or jaw.
• If you start vomiting, stop eating solid foods and just sip clear liquids.
If intermittent vomiting continues for more than 24 hours, contact your doctor.

The causes of vomiting are:
- Eating too fast and not chewing properly.
- Eating too much at meal.
- Drinking liquids right after eating.
- Eating foods that do not agree with you.

3. SET ASIDE THREE MEALTIMES PER DAY AND EAT SOLID FOOD AT THESE TIMES!
- The LAP-BAND system creates a small pouch that can hold about half a cup (3-4oz) of food.
- You need to learn how much your stomach pouch can hold comfortably.
4. DRINK FOUR TO SIX CUPS OF LIQUIDS PER DAY BETWEEN MEALS!
- In order to replace normal body water losses and thus prevent dehydration.
5. DO NOT DRINK WHILE YOU ARE EATING!
- You should not drink anything for at least one hour after a meal.
6. SIP BEVERAGES SLOWLY!
- Sip from a medicine cup or shot glass instead of drinking from a regular glass.
7. ELIMINATE HIGH CALORIE DRINKS!
- Avoid carbonated liquids because they could increase the size of the pouch creating discomfort.
8. DO NOT EAT BETWEEN MEALS!
9. EAT A BALANCED DIET!
- Eating foods from each of the four food groups will provide adequate amounts of protein, vitamins and minerals for your needs.
10. EXERCISE AT LEAST 30 MINUTES A DAY!
- Start with simple activities such as walking and swimming.
- Gradually increase your activity level in the course of daily living.

PROGRESSION OF THE DIET DURING HOSPITALIZATION
- After surgery, in addition to water you will first be offered clear liquids.
- In time, your diet will include blended and pureed foods.

PROGRESSION OF THE DIET AT HOME

First week after surgery
• You’ll be on a clear liquid diet.
• Clear liquids include clear broth or soup (with no vegetables no meat and not creamy),jello, fruit juice(no nectars, no pulp), water, tea, coffee, non carbonated beverages.

Second week after surgery
• You’ll continue on liquids but adding liquids that have thicker consistency such as skim milk, low-fat yogurt, cream of wheat, oatmeal, creamy soups, fruit smoothies (nothing that you will have to chew), and tomato juice.
• Begin taking protein supplements such as Soyamax, Isopure.

Third week after surgery
• In addition to pureed food such as blended meat, meat paste, liverwurst, yogurt (no berries or other types containing seeds), you may begin to add cottage cheese, sliced cheese, cheese dishes (low fat), tofu, scrambled and hardboiled egg and fish.
• You may slowly add soft canned fruits and vegetables, baked potatoes (with no skin), rice, grits, macaroni, noodles, rice cereals, etc..

Fourth to sixth week after surgery
• You may begin to add meats that are ground after cooking, such as pork, veal, chicken, turkey and beef.
• After your checkup you can begin to experiment more with food.
• Sliced meats as well as raw fruits and vegetables may be tried (chew them well).
• If you fell hungry between meals, you may sip on low-calorie drinks and flat water.
• You may substitute one meal for a protein shake.

Something to remember!!!!
- It is important that you eat food high in protein at each of your three meals and drink 1-2 cups of milk between meals.
- Protein is needed to renew of body cells.
- The recommended daily dietary allowances (RDA) for protein is:
56g/day for men
46g/day for women
You should try to eat 50-70g of protein each day.
• Recommendation for protein intake:
- Lifeway organic brand low fat kefir drink.
- Energizer shake

ENERGIZER SHAKE!

Ingredients:
6 ounces of tofu (organic, soft or “silken” packed in water, rinse and drain) or ¼ cup nonfat dry milk powder or powdered egg whites (available at Whole Foods, in the baking section, Bob’s Red Mill brand)
6 ounces organic plain low fat yogurt (Fage 0% Greek Yogurt is best for lower carbohydrates to fit in the fruit carbs.)
1 small banana
½ cup strawberries
1 cup frozen blueberries
½ cup fruit of your choice (e.g. frozen peaches, mixed berries, or cherries)
4 cups of organic unsweetened soy milk (try “Silk” or Trader Joe’s brand)
Optional –for added fiber and omega-3 essential fatty acids, stir in a Tablespoon of ground flaxseed (try Organic Bob’s Red Mill whole ground flaxseed meal) to the cup you drink, so it doesn’t get rancid, you need to drink it right away.
Directions: In a blender, put all ingredients together. If you like a thinner shake, add water and use less milk. Put the top on the blender, chop, blend, and whip. You’re all set for an energizing breakfast or snack. Add a piece of whole wheat/grain toast or a small bowl of >5 grams dietary fiber cereal with the shake for even more sustainable energy. Make this shake the night before, keep it in the blender and store it in the refrigerator. The next morning, just press whip, and you’ve got a quick and easy “on-the-go” energizer.
Serving size: 1.5 cups
Total servings: ~4
Nutrition Analysis per serving:
239 Calories, 31 grams Carbohydrates, 16 grams Protein, 6 grams Fat.


CERTAIN FOODS MAY BE DIFFICULT TO TOLERATE!
-Through trial and error you will be able to recognize your tolerance to some food items.
Some of the food items that the digestive system cannot handle as well are:
• Tough meats, especially hamburger.
• Members of oranges or grapefruit.
• Core, seeds or skins of fruits or vegetables.
• Fibrous vegetables such as corn, celery or sweet potatoes.
• Bread.
• Chili or other highly spiced foods.
• Fried food.
• Milk.

CERTAIN FOODS MUST BE AVOIDED!
Concentrated sweets- filling up on these can prevent weight loss and can replace healthier foods in your diet with high calorie, high sugary foods.
Examples to high sugar foods:
• regular soft drinks,syrops,cakes,biscuits,sweets,jams,jellies,marmalade,honey,kool aid, sugared ice tea, dried fruits, fruit drinks, canned or frozen fruits in syrup, table sugar, sugar coated cereal, candy, doughnuts, regular jell-o, sugar gum, molasses, cookies, sherbet /sorbet, regular pudding, sweetened, fruited or frozen yogurt.
Examples to high fat foods:
• Whole milk, chocolate, chocolate milk, chips, pies, pastries, ice cream.
- Alcoholic drinks such as beer, wine, liquors, port, sherry, cocktails, and champagne should also be avoided as much as possible.

!! Some goals to achieve:
• Protein:70 grams per day
• Fluids: 64 ounces per day.
• Carbohydrate<100
• Fats<25

!!!! For successful weight loss after Adjustable Gastric Banding Surgery, a change in your habits is necessary. You will not be able to lose as much weight as you like if you eat continuously or if you stretch your stomach by eating large amounts of foods at one time. You will achieve your desired weight loss only if you are willing to control what you eat and the way in which you eat it.

Hungarian Paprika-Potato soup

Simply satisfying!
This vegetarian soup is low in calories and fat and still provides satiety on a chilly evening. The advantage to preparing a homemade soup is that you are able to use nutritious ingredients that add flavor. Using a low sodium chicken broth and fresh herbs and spices, replaces monosodium glutamate, excess sodium, and other additives that are used in canned soups. Potato is the main ingredient in this particular recipe. Potatoes are loaded with potassium. One medium potato provides 926 mg about 1/4 of the recommended daily intake. Potassium is an essential mineral for nerve impulse transmission, muscle contraction, and heart function.

Ingredients:
2 lbs russet or other starchy potato (about 4 large)peeled and cut into 3" cubes
1 Tbsp olive oil
1 med white onion, finely chopped (about 1 cup)
4 cups low-sodium vegetable or chicken broth
2 Tbsp. finely chopped fresh dill
1 Tbsp. smoky paprika
1 tsp. hot paprika
1 tsp. whole celery seeds
1/2 tsp. salt
1/8 tsp ground nutmeg
1 c. fat free milk

Directions:
1. BOIL potatoes in stock-pot of water until just soft, about 20 mins. Drain and mash roughly. Set aside.
2. HEAT oil in stockpot over medium heat. Add onion and saute until translucent, about 5 mins.
3. STIR in broth and then add potatoes back to pot. Stir and break up potatoes into broth to reach a slightly chunky consistency.
4. ADD dill, paprikas, celery seeds, salt,nutmeg and freshly ground black pepper to taste.
5. Pour in milk and combine to just heat through, 2-5 mins. Do not boil.
Per 2 cup serving this soup provides 267 cal. 6g protein, 52g. carbs, 6g fiber,4g fat,0.5g sat fat, 1mg chol, 470 mg sodium

Thanksgiving Recipes

Thanksgiving is around the corner. Here's a couple recipes that are de-licious!

PUMPKIN SURPRISE PIE!

Ingredients:
1 can (16 ounces) pureed pumpkin
¾ cup sugar
½ teaspoon salt
1 teaspoon ground cinnamon
½ teaspoon ground ginger
¼ teaspoon ground cloves
1 package (10.5 ounces) organic Silken tofu,* packed in water, rinsed, processed in blender until smooth
1 (9-inch) unbaked pie shell
*choose tofu made with soy beans rather than soy protein concentrate

Directions: Preheat oven to 425° F. In a blender (**Vitamix), blend the pumpkin and sugar. Add salt, spices, and tofu into the pumpkin mixture and blend again thoroughly. Pour the mixture into a pie shell and bake for 15 minutes. Lower the heat to 350° F and bake for an additional 40 minutes. Chill before serving.

Total servings: 9
Nutrition Analysis per serving:
216 calories, 37 grams Carbohydrates, 3 grams Protein, 7 grams Fat

**To purchase a Vitamix, the power blender for making smoothies and soups, etc. go to www.livitician.com and select the products tab.

TANTALIZING TURKEY LOAF! - great way to use the left over turkey breast.

Ingredients:

1 Tablespoon canola oil
2 teaspoons minced garlic (2 large cloves)
1 cup finely chopped celery (2 large stalks)
½ cup chopped onion
1½ cups diced red bell pepper (2 medium)
2½ cups thinly sliced mushrooms
1¼ pounds ground turkey breast
2 egg whites, lightly beaten
½ teaspoon freshly ground black pepper
Dash nutmeg
½ cup fresh whole wheat bread crumbs (1 slice)
½ cup minced fresh parsley

Directions: In a large nonstick skillet heat oil briefly and sauté garlic, celery, onions, and bell pepper, stirring until slightly softened, about 3 to 5 minutes. Meanwhile, boil a kettle of water and preheat oven to 375°F. Stir mushrooms into vegetable mixture, cover pan for a few minutes, then remove cover and sauté vegetables, stirring until all liquid has evaporated. Remove from heat and set aside. In a large bowl, combine turkey, egg whites, pepper, nutmeg, bread crumbs, and parsley. Add the sautéed vegetables and combine ingredients well. Transfer mixture to a lightly greased 8x4 loaf pan and set pan in a large shallow baking dish. Place in oven and pour boiling water into the outer pan to a depth of one inch. Bake loaf for 1 hour 15 minutes. Let loaf sit for 15 minutes before removing from pan and serving.

Total servings: 6
Nutrition Analysis per serving:
193 calories, 8 grams Carbohydrates, 32 grams Protein, 4 grams Fat

More recipes and holiday tips coming up soon.

LIVIT and LOVE IT!

Your Livitician,

Deborah A. Klein, MS, RD