Dietary Guidelines

By Jane Sylvestre, RD - 2/27/2016

The new Dietary Guidelines for Americans came out last month.  They are released every 5 years with the new dietary recommendations based on all the current research.  I know people get very frustrated because one day we are telling you to avoid something and later change the recommendation.  Throughout my 24 years of teaching nutrition, I have had to change my recommendations numerous times.  This can be frustrating as a professional as well.  I remember when all fat was bad, then there were the high carb, low protein days and of course the Atkins high protein, low carb era.  We all just need to keep in mind that nutrition is a science and science is based on research which is forever evolving. 

The new dietary guidelines focus on variety, nutrient density and quantity.  Our patients have the definite benefit of having the quantity of the food they are able to eat controlled.  Your job is focus on nutrient density and variety.  This is especially true since your portions are much smaller than they were before surgery.  You want to make sure you are maximizing and getting all the nutritional benefit you can get from the small amount of food that you are able to eat.  You can do this by cutting out as much sugar, saturated fat and sodium out of your diet as you can.

Our goal for our patients is to focus on protein such as seafood, lean meats, poultry, eggs, legumes (beans and peas), nuts, seeds and soy because you are not getting these foods in a pill.  You certainly want to eat it first, because you may not have enough room for it if you started with another food group such as vegetables.  Initially, 1 ounce of protein may be all the food you are able to eat.  One year out, I am seeing patients being able to tolerate 2 ounces with some vegetables.  Of course, everyone is different.  The new guidelines are really shunning red meats which actually include:  beef, pork, lamb, veal, goat and wild game like venison and bison (even though they can be lean.)  The guidelines suggest you eat red meat no more than once per week and twice per month would be even better!  In these guidelines, poultry is described as neither good nor bad for you.  The suggestion is to include more seafood, eggs and plant based protein sources such as nuts, seeds, soy and dried beans and peas.  The good news is the eggs and seafood is no longer an issue.  They may be high in cholesterol, but now it is just the saturated fat that is the issue which eggs and shellfish do not have high levels.  Most importantly,   you want variety from your protein choices.  Mix it up!  I don’t like to see someone eating grilled chicken day after day after day.  You may be thinking you are doing the right thing, but in actuality, you would be better off with more variety.  How about making lentil stew with a side of spinach for dinner? 

Fruits and vegetables should still be a big part of your diet.  I know- no surprise there.  The vegetables are broken down into 5 subgroups including:  dark green, red & orange, legumes (beans and peas), starchy and “other”.  All veggies are considered beneficial for different nutrients.  In our office, we do tend to shy away from the starchier vegetables like potatoes, corn and green peas as they are higher in calories, but if you eat them last, your quantity won’t contribute much in calories and you could still benefit from the nutrients they provide.  The actual recommendation for vegetables is 2.5 cups per day and 2 cups of whole fruit (not juice) per day which is a definite challenge post surgery.  That is why a multivitamin meeting 100% your daily value for most nutrients is essential!    

The recommendation for dairy has not changed.  Your goal should be to choose fat free or 1% milk, yogurt and cheese.  Two percent and whole milk are too high in saturated fat.  The fat in dairy is saturated and that is what you are trying to limit in your diet as it is highly associated with disease. 

The guidelines have not changed in their recommendation for grains either.  It was and still is making half of your grain choices whole grains.  Unfortunately, grains are a “sticky” subject when it comes to sleeve or lab band surgery.  I mean that more ways than one.  Starch, such as rice, bread and pasta tend to stick together and get stuck.  Starch also adds significant calories.  For the above two reasons, we suggest eliminating starch from the diet.  Sometimes, it can be a challenge getting enough fiber and we can work with you on that in our office. 

Here’s some good news:  3-5 cups of coffee per day does not pose any health risk.  Coffee actually has the added benefit of antioxidants which help fight cancer.  Of course, you don’t want the added sugar and cream.  Remember, one of the main goals of the new guidelines is to cut sugar and saturated fat.  If you can’t drink it without the cream and sugar then I would consider switching to tea or doing without. 

I know there are not too many surprises here.  You still want to focus on protein, but now more plant based.  You still want to eats lots of fruits and vegetables.  You still want to choose low fat dairy.   Most importantly, mix it up to maximize your nutritional benefit!  Remember that variety is the spice of life!  

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