Food for February Thought

By Jane Sylvestre, RD - 1/27/2015

A Very New Challenge

Our patients are those who have struggled most of their lives with their relationship with food.  The issues vary, but the one commonality is an abundance of calories.  Many times this is a result of less than optimal nutritional choices, but just as often, the struggle has just been excessive quantities of food.

Both the Lap-Band and the Sleeve work by reducing the amount of food needed to feel satisfied.  Patients with the Lap-Band, who follow the basic guidelines, do very well.  They key is to make high quality food choices, eat slowly, chew well and separate liquids and solids. Of course, an active lifestyle is important as well.   After working with our Sleeve patients for quite some time now, I am finding a whole new challenge, at least initially. 

The greatest struggle with the Sleeve appears to be eating enough.  In addition to the obvious reduction to the quantity of food one is able to eat, there is a metabolic component going on as well.  The desire to eat is much, much less.  The appetite is just not there.  There are also changes in the types of food cravings.  This is why the vitamin and mineral supplements are so important.

Our primary focus, as it is with the Lap-Band, is to meet protein requirements.  On average, women need a minimum of 50 grams of protein and men need a minimum of 70 grams of protein.  This can vary by a person’s weight and height, so if I have not told you your specific protein requirements, feel free to contact me at anytime.  Of course, these requirements may decline slightly as one loses weight. 

We focus on protein because protein does not come in a pill.  Most patients are only able to eat one ounce at a time which on average has 7 grams of protein.  Some protein options to consider could be seafood (watch out for overcooked shrimp or scallops as they can get rubbery), poultry, beef or pork (meats should not be overcooked), eggs / egg whites, low fat cheese / cottage cheese, yogurt (especially Greek for higher protein contents), Soybeans such as edamame, soy nuts or tofu, dried beans and peas such chick peas, black beans, pinto beans…, nuts chewed very well or peanut butter. 

Some of our Sleeve patients find they may need to eat 4 or sometimes even 5 times per day to reach their protein needs.  Some even rely on a protein drink post their liquid phase diet to meet their requirements.  Of course our goal is to eventually get all patients back on to solid foods at some point. 

Sometimes patients find they are full after just eating an ounce of protein.  If possible, the next step would be to add some nutrient dense vegetables and fruits.  I often recommend trying to include dark green leafy vegetables such as baby kale or baby spinach.  These dark, leafy greens provide beta carotene (which helps form vitamin A) which protects from cancer and slows aging and vitamin C to help keep us healthy.  Other nutrients include:  folate, potassium, fiber and lutein (for good vision and protection from cataracts and macular degeneration.)  The darker the greens are the better.  Romaine lettuce is actually 7 times more nutrient dense than iceberg. 

I had a patient tell me last week that he really missed eating and enjoying his food. He was newly out from surgery.  My advice for him was to be patient.  The patients who are 8 months, 10 months or a year out from surgery are able to include a little more food variety and find they enjoy eating again.  I have seen protein portions increase from 1-3 ounces and other foods such as the vegetables and fruit being added to the diet without a struggle. 

So for our Sleeve patients, I acknowledge the restriction can be a challenge.  Meet your protein needs through solid protein options as noted above and protein supplements if you need them.  When able, start adding nutrient dense fruits and vegetables.  You will eventually enjoy eating again.  We are here to help you every step of the way.  In the end, you will be a healthier, happier person.

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