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Avoiding Common Nutritional Pitfalls

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Avoiding Common Nutritional Pitfalls


  1. Liquid Calories

Liquid calories often lack the fiber, vitamins, minerals and satisfaction of a meal. They are digested rapidly while whole food calories take longer to digest. Thus, if you have a milk shake, the calories will be absorbed but you will be hungry sooner since the beverage goes straight through your body like water down a drain.

NOTE: Liquid calories also include ice cream

Examples (12 oz.)

Mocha made with skim milk 210 Calories

Sports drinks 85-115 Calories

Coke 145 Calories

Fresh orange juice 170 Calories

Snapple 175 Calories

Nestea lemon iced tea 135Calories

Water 0 Calories!


  1. High Fructose Corn Syrup

High-fructose corn syrup is a sweetener and preservative used in many processed foods. It is made by changing the sugar in cornstarch to fructose — another form of sugar. High-fructose corn syrup extends the shelf life of foods and is sweeter and cheaper than sugar. For these reasons, it has become a popular ingredient in many sodas, fruit-flavored drinks and other processed foods. Check your food labels. You may be surprised by how many foods contain high-fructose corn syrup. These types of foods are often high in calories and low in nutritional value. This fact alone is reason to be cautious about foods containing high-fructose corn syrup.

Suggestions:

• Try to purchase organic foods such as organic yogurt, jelly, cereals, etc

• Choose fresh fruit instead of fruit drink. Even 100 percent fruit juice has a high concentration of sugar

• Choose fruit canned in its own juices instead of heavy syrup



  1. Carbonated Drinks

Since you will have a smaller pouch with the Lap Band, carbonated drinks including champagne and beer can expand the pouch and cause discomfort. It may cause have the same effect as gas and bloating, thus avoiding these beverages is the best option.

  1. Protein Shakes

Manufacturers of protein shakes may claim that their products increase fat loss or weight loss, but there is no evidence that this is true. The truth is that many protein shakes use a dairy or egg base, which does provide the body with protein, but it also includes many unnecessary calories from fat. Some use a soy base which provides calories mostly from protein. Although protein shakes generally are not harmful, it is important for you to choose the brands that are lower in calories.


  1. Smoking/Alcohol

A common belief is that smoking causes the cessation of an appetite, which will in turn cause weight loss. Although it is true that smoking decreases ones’ appetite, it is not the healthy way of losing weight. Smoking has shown to have severe adverse effects on the body including respiratory (breathing) disorders and cancer. If you are a smoker, the Lap Band can be thought of as a replacement for suppressing your hunger, as you will get full quicker with smaller amounts of food.

There are no adverse effects to drinking small amounts of alcohol with weight loss surgery. Alcohol is a high calorie liquid, and as such, should be limited, especially during the weight loss period. Thus, occasional drinking is allowable. Keep in mind the added sugars in mixed drinks and avoid.


Important Dietary Information
How to Read a Nutrition Label (FDA.gov)

The Serving Size

The first place to start when you look at the Nutrition Facts label is the serving size and the number of servings in the package. Serving sizes are standardized to make it easier to compare similar foods; they are provided in familiar units, such as cups or pieces, followed by the metric amount, e.g., the number of grams. Pay attention to the serving size, especially how many servings there are in the food package. Then ask yourself, "How many servings am I consuming"? (e.g., 1/2 serving, 1 serving, or more)


Calories (and Calories from Fat)

In the example, there are 250 calories in one serving of this macaroni and cheese. How many calories from fat are there in ONE serving? Answer: 110 calories, which means almost half the calories in a single serving come from fat. What if you ate the whole package content? Then, you would consume two servings, or 500 calories, and 220 would come from fat.



The Nutrients: How Much?

Limit these nutrients: Eating too much fat, saturated fat, trans fat, cholesterol, or sodium may increase your risk of certain chronic diseases, like heart disease, some cancers, or high blood pressure.

Get enough of these: Eating enough of these nutrients can improve your health and help reduce the risk of some diseases and conditions.




Understanding the Footnote on the Bottom of the Nutrition Facts Label

Note the * used after the heading "%Daily Value" on the Nutrition Facts label. It refers to the Footnote in the lower part of the nutrition label, which tells you "%DVs are based on a 2,000 calorie diet". This statement must be on all food labels. But the remaining information in the full footnote may not be on the package if the size of the label is too small. When the full footnote does appear, it will always be the same. It doesn't change from product to product, because it shows recommended dietary advice for all Americans--it is not about a specific food product.

Look at the amounts circled in red in the footnote--these are the Daily Values (DV) for each nutrient listed and are based on public health experts' advice. DVs are recommended levels of intakes. DVs in the footnote are based on a 2,000 or 2,500 calorie diet. Note how the DVs for some nutrients change, while others (for cholesterol and sodium) remain the same for both calorie amounts.

The Percent Daily Value (%DV):

The % Daily Values (%DVs) are based on the Daily Value recommendations for key nutrients but only for a 2,000 calorie daily diet--not 2,500 calories. You, like most people, may not know how many calories you consume in a day. But you can still use the %DV as a frame of reference whether you consume more or less than 2,000 calories. The %DV helps you determine if a serving of food is high or low in a nutrient 5%DV or less is low and 20%DV or more is high. This guide tells you that 5%DV or less is low for all nutrients, those you want to limit (e.g., fat, saturated fat, cholesterol, and sodium), or for those that you want to consume in greater amounts (fiber, calcium, etc.). As the Quick Guide shows, 20%DV or more is high for all nutrients.

Nutrient Protein (g) Fat (g) Calories

Lean fish (sole, catfish, halibut) 3oz. 21-23 1-2 95-120

Fatty fish (salmon, blue fish) 3oz. 21-23 6 160

Cooked shrimp, scallops 3oz. 14-18 1-3 85-90

Tuna 3 oz. 20-22 1-2 109

Crabmeat 3 oz. 10 1 87

Chicken (packed in water) 3 oz. 16 1.5 80

Chicken or turkey (white, no skin) 3 oz. 25-26 2.7-3.4 135-148

Fat free cheese 3 oz. 20 0 120

Fat free cottage cheese ½ cup 15 0 80

Scrambled egg 1 large 6.3 5.3 78

Egg substitute ½ cup 10-12 0-1 46-60

Veggie burger 1 patty 7 3 120

Turkey burger 3 oz. 11 2 105

Kidney beans ½ cup 7.5 0.4 103

Fat free refried beans ½ cup 7.5 0.4 100

Lentils ½ cup 9 0.4 115


Additional Nutrition Facts for Week 4 and Beyond
Nutrient values may vary depending on product and preparation methods. Prepare your food by baking, broiling, roasting, poaching or steaming. Use fat free, low fat and sugar free condiments to keep foods moist.

Nutritional References

Vitamin Supplementation

• Gentle Chewable Multivitamin

Begin taking a chewable multivitamin one week after your surgery. We recommend taking a multivitamin that is formulated for bariatric patients to ensure that it will be gentle on the stomach and provide optimal absorption.

You may not get enough vitamins and minerals from your three-six small meals that you are eating every day. At your regular check-up, your surgeon will evaluate whether you are getting enough vitamin B12, folic acid, iron and calcium. If Dr. Marvin deems necessary, he will advise you to take supplements.



Vitamins and Minerals Reference Sheet

Vitamins and Minerals: Benefits, Food Sources, Deficiency Symptoms, Amount Needed per day

(IU= international units, mg= milligrams, mcg= micrograms)

Vitamins

Name: Vitamin A (Retinol)

Benefits: healthy skin and hair, sight and growth

Food Sources: fortified cereals, green vegetables and carrots

Deficiency Symptoms: Night blindness

Men: 3000 IU Women: 2700 IU

Name: Vitamin B1 (Thiamin)

Benefits: keeps nervous system healthy and is needed for energy metabolism

Food Sources: fortified cereals, whole grain breads, enriched grain products, rice, beans and nuts Deficiency Symptoms: Beriberi, anorexia

Men: 0.8-1.3 mg Women: 0.8 mg

Name: Vitamin B2 (Riboflavin)

Benefits: gives energy and helps body tissues grow

Food Sources: almonds, dairy products, avocados, dark green vegetables and fortified grain products

Deficiency Symptoms: Cheilosis, Dermatitis

Men: 1.3-1.6 mg Women: 1.1 mg
Name: Vitamin B3 (Niacin)

Benefits: breaks down food for energy

Food Sources: fortified cereals, meat, fish, peanuts, peanut butter and whole grain products Deficiency Symptoms: Pellagra, Dermatitis

Men: 16-23 mg Women: 14-16 mg


Name: Vitamin B6 (Pyridoxine)

Benefits: helps the brain function and body to build proteins for growth and development

Food Sources: poultry, fish, pork, beef, nuts, beans, eggs, vegetables, bananas, avocados & fortified cereals

Deficiency Symptoms: Convulsions

Men: 1.8 mg Women: 1.5 mg
Name: Vitamin B12

Benefits: promotes growth and development and helps make red blood cells

Food Sources: animal sources, like meat, fish, chicken, milk, cheese eggs and fortified cereals Deficiency Symptoms: Megaloblastic anemia

Men: 2 mcg Women: 2 mcg


Name: Folate (folic acid)

Benefits: prevents birth defects when take before and during Food Sources: cooked dry beans, peas, peanuts, oranges, dark green vegetables, enriched grain products and fortified cereals

Deficiency Symptoms: Macrocytic anemia

Men: 180-200 mg Women: 160-190 mg

Name: Pantothenic Acid

Benefits: energy metabolism

Food Sources: peas, pinto, black, and navy beans, lean meat, poultry and fish Deficiency Symptoms: no known deficiencies

Men: 2.5 mg Women: 2.5 mg

Name: Biotin

Benefits: energy metabolism

Food Sources: egg yolk and liver, kidney beans, soy beans

Deficiency Symptoms: Anorexia, vomiting, dermatitis

Men: 60 mcg Women: 60 mcg
Name: Vitamin C

Benefits: healthy gums and teeth, helps body absorb iron

Food Sources: sweet potatoes, pumpkin, liver, dairy products, mango, cantaloupe, apricots and other fruits and vegetables

Deficiency Symptoms: Scurvy, swollen gums, cracked lips

Men: 40 mg Women: 30 mg

Name: Vitamin D

Benefits: strong bones, regulation of calcium and phosphorus metabolism

Food Sources: fortified cereal, fortified milk and fatty fish

Deficiency Symptoms: Rickets, Osteomalacia

Men: 100 IU Women: 100 IU
Name: Vitamin E

Benefits: protects cells

Food Sources: nuts and vegetable oils

Deficiency Symptoms: No known deficiencies Men: 9-10 mg Women: 6-7 mg


Name: Vitamin K

Benefits: clots blood, builds protein, regulates calcium levels

Food Sources: dark green vegetables, soybean and canola oils

Deficiency Symptoms: Hemorrhages

Amount needed: none established, estimated 0.03 mcg/kg
Minerals

Name: Calcium

Benefits: strong bones and teeth, helps to regulate heartbeat, blood clotting, muscle and nerve function

Food Sources: milk, yogurt, cottage cheese, sardines and calcium fortified foods such as cereals, juices and calcium fortified soy milk and tofu

Deficiency Symptoms: Bone deformities

Men: 800-1000 mg Women: 700-800 mg

Name: Iron

Benefits: helps red blood cells carry oxygen to different parts of the body

Food Sources: organ meats like liver, beef, pork, and most legumes like soy and lima beans Deficiency Symptoms: Anemia, fatigue

Deficiency Symptoms: Night blindness

Men: 5-10 mg Women: 8-13 mg

Name: Magnesium

Benefits: normal muscle function, steady heart rhythm, healthy immune system, strong bones

Food Sources: green vegetables, beans, peas, nuts and whole grain wheat bread

Deficiency Symptoms: Convulsions, behavioral problems

Men: 230-250 mg Women: 200-210 mg

Name: Potassium

Benefits: helps with muscle contraction and balances fluids in body's cells

Food Sources: fruits and vegetables, milk and yogurt

Deficiency Symptoms: No known deficiencies

Men: 1600-2000mg Women: 1600-2000 mg
Name: Phosphorus

Benefits: component with calcium in structural formation of bones and teeth

Food Sources: meats, milk, cheese, cereals, nuts, dried beans and peas

Deficiency Symptoms: No known deficiencies

Men: 1000 mg Women: 850 mg
Name: Zinc

Benefits: helps in normal growth and with eyes, bones, skin, hair and nails

Food Sources: beef, turkey, fish, pork, oysters, whole grain bread with yeast and soybeans

Men: 15 mg Women: 12


Examples of Supplements

Multivitamin:

The Bariatric Advantage® High-ADEK Multivitamin provides the same high quality, highly bioavailable nutrients that our regular Chewable Multi-Formula does, but with additional levels of the fat-soluble nutrients vitamins A, D, E, and K. It is especially made for bariatric patients thus the formula is gentle on the stomach.


Calcium: (1000-1500 mg daily)

The chewable lozenge was developed to conveniently meet multiple needs of the Bariatric patients. It provides the most bio-available form of calcium and other nutrients that have been shown to support bone health. Various flavors are available.



B12 Supplementation (Sublingual B-12 or Intramuscular shot)

• Sublingual Vitamin B12 2500 mcg tablets by Nature’s Bounty: Take 1 time per week. Available at most drug stores, GNC, vitamin stores

• B-Complex Sublingual, liquid by Nature’s Bounty. Available at most drug stores, GNC, vitamin stores

• You may also choose to get B12 shots


Exercise Regimen

Weeks 1-4 post-op:

Begin walking the day you get back from the hospital. It is essential for you move about to assist in your recovery. Begin walking 10-15 minutes 3-4 times a day for the first week. Gradually increase the walking time to 30-40 minutes, as you recover.

To lose weight and keep it off forever, you must eat healthy and exercise. The diet counts as 80% of the weight loss and the exercise counts as 20%.

The key to exercise is consistency. Whatever type of exercise you choose to incorporate into your life, you must follow it on a regular basis.

At its most basic, exercise is any type of physical exertion we perform to improve our health, shape our bodies and boost performance. To optimize your exertion, you must gradually increase the intensity of your exercise to ensure calorie burning.

This includes a broad range of activities like:

• Running/jogging

• Fast paced walking

• Elliptical machine

• Taking the stairs instead of the elevator

• Jumping rope

• Bicycling

• Dancing

• Aerobics

• Various sports

In addition, your cardio, you should begin resistance training. Use resistance bands and tubing for both your upper body and lower body.

Suggestion: Purchase resistance bands that include an easy to follow video that can be done in the privacy of your own home. We recommend seeking training from a certified specialist for best results.

Aside from bands and weights, you can very easily lift moderately heavy items in your home such as jars or a gallon of milk. For example, if you are watching television at home you can easily stand up and lift two small jars through the duration of the show.

REMEMBER: CONSISTENCY IS KEY!



Body Mass Index:

The BMI is the relationship between the height and weight of an individual, which correlates to the body fat and can be an indicator of health risks the person may face. There is a high correlation between a high BMI and health risks. This will be calculated at each follow up visit.






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