The 4 Phase Gastric Sleeve Diet – Making Post-Op Easy
Gastric Sleeve Surgery Post-Op Diet Overview
The gastric sleeve is transforming lives at an alarming rate. It’s popularity is due to being a relatively short procedure, having high success-rates, and minimal complications.
Following the gastric sleeve diet guidelines that are set by certified surgeons and nutritionists is critical for post-op.
After gastric sleeve surgery, your stomach capacity is only 3 to 4 ounces, down from 60 ounces of capacity – which makes every single piece of food important in fulfilling nutritional deficiencies that you will face after surgery. Find out how to choose a healthy goal weight after gastric sleeve surgery!
What is the Gastric Sleeve Diet?
The gastric sleeve diet is a high-protein, healthy fat, small-bite plan with four nutritional goals.
- High protein to promote healing and to minimize the loss of muscle.
- Adequate fluid intake to prevent dehydration
- Moderate healthy fats as well as carbohydrates coming from whole foods such as fruits, vegetables, and legumes.
- Low in sugar and processed foods to prevent stalls or re-gain.
Nutrition Goals of Gastric Sleeve Diet
There are four primary nutrition goals to follow after surgery. They include:
- Consuming the right amount of protein that will help minimize the loss of muscle and help to heal. Patients should also learn how to eat properly, which will assist them with their long-term weight loss goals.
- Weight loss should occur in a safe and healthy way.
- Next, always consume enough fluids to maintain hydration.
- Lastly, consume the proper nutrients through vitamins and mineral supplements throughout the day.
Phase 1 – Clear Liquid Diet – 5 to 7 Days
Phase 1 of the gastric sleeve diet utilizes only clear or translucent liquids to allow for proper healing and recovery. This phase takes a minimum of two days after your operation. At first, take in very small sips at a time, about one teaspoon every 60 seconds. Then gradually increase your intake of liquids to six to eight ounces every hour. Drink very slowly and refrain from gulping.
Goal of Phase 1 is to stay hydrated by consuming a minimum of 48 ounces of fluids, optimal goal 64 ounces.
Things to Note:
- Sugary Drinks, Caffeinated Drinks or Carbonated Beverages are not recommended.
- Patients must get enough liquids to prevent dehydration. It’s important to both calculate and record your intake daily.
- If urine is dark in color or your mouth is dry, you are not consuming enough liquids.
Approved Clear Liquids
- Ice chips
- Sugar-free Beverages or Flavored Water (VitaminZero/Propel, PoweradeZero, crystal light)
- Broth (Chicken or Beef)
- Sugar-free Jell-O
- Sugar-free Popsicles
- Herbal teas
- Light or diluted (60/40) juices (apple, white grape, cranberry)
Phase 2 – Full Liquids Diet – 5 to 14 Days
Goal of Phase 2 to stay hydrated and consume between 60 – 90 grams of protein
This diet allows a broad range of liquids and protein supplements. This will give your new pouch and digestive system time to heal properly and allow you time to adjust to your new stomach/pouch.
A good rule of thumb for what is allowed on this diet is anything that has the consistency of what can easily be strained through a straw. Remember, however; at this stage, you should not be sipping anything through a straw!!!!
Start taking your multi-vitamins, calcium, and iron daily as directed two to three days into phase two. If you need guidance in this area or require vitamins, please contact us to purchase our recommended vitamins designed for your particular bariatric needs.
Approved Full Liquids
- All foods from the previous stage.
- Protein Powders
- Greek Yogurt (remember it needs to have more protein than sugar- Fage/Chobani plain Greek yogurt; or Dannon’s Triple Zero https://www.oikosyogurt.com/greek-yogurt/triple-zero/
- Almond, cashew or Coconut Milk – Unsweetened
- Natural Apple Sauce
- Hot cereals like oatmeal/ cream of wheat/Kashi hot cereal
- Sugar-Free Pudding
- Soups (chose higher protein soups like bean soup, can take chunky soups and blend before eating)
- Avoid all carbonated beverages (fills the stomach with gas), sugar (extra calories that fight against weight loss) and coffee (it is acidic and may have problems with acid reflux after surgery. It is also a diuretic, causing you to be dehydrated)
- Drink a minimum of 48 oz. of fluids and a goal of 64 ounces of liquids per day to prevent dehydration. Sport drink bottles with measurements on the side will help ensure you are drinking enough fluid. Remember, you will not be able to gulp liquids so you will want to drink small amounts throughout the day.
During phase 2, it is important to drink a high quality, protein supplement. Your goal is 60 to 90 grams per day. To determine your protein requirements, take your ideal healthy weight and divide by 2.2. This will provide you the amount of protein you need to reach a healthy weight and maintain your lean body mass.
Phase 3 – Soft Foods Diet – 15 to 21 Days After Surgery
Goal of Phase 3 is to start weighing food: 4 – 6 ounces total per meal, getting 20 grams of protein per meal (3 oz. will always be protein)- Protein first!
Chew all your food well to applesauce consistency. If you don’t follow these precautions, you may experience vomiting, stomach irritation, and swelling. You could also have an obstruction of the small gastric pouch.
If solid foods cause nausea and vomiting, go back to the liquid diet you had earlier. Then you can slowly add soft foods and eventually transition to solid foods. IF VOMITING AND NAUSEA PERSIST, CALL YOUR DOCTOR IMMEDIATELY.
Think of your new pouch as shaped like a funnel. You can pour any liquid into this funnel, and it will run through and out the bottom. The same thing happens with your pouch when you only consume liquids. So you do not want to drink your calories or overeat.
As a part of your new life, you will want to STOP drinking 30 minutes before a meal and 30 minutes after a meal.
Approved Soft Foods include:
- You begin to weigh your food at this stage- Goal is no more than 6 ounces of food- 3 ounces of protein, one ounce of healthy fat and two ounces to play with adding vegetables, fruits or carbohydrates
- Your goal is to work towards getting 20 grams of protein at each meal
- Add only ONE food at a time
- Scrambled eggs (soft, boiled, poached)
- Egg salad
- Tuna fish moistened well with mayo
- Chicken salad, salmon, moistened with mayo
- Cottage cheese
- Fruit (mashed, can – anything soft)
- Veggies (mashed, can, and slow cooked to tenderize)
- Refried beans with cheese
- Meats pressure cooked to tenderize
- Sweet potatoes, and potatoes (mashed – only)
- Greek Yogurt
Things to Keep in Mind With Phase 3
- It is important to only eat until you feel satisfied and no more!
- to eat a high protein, low sugar, diet.
- Never eat and drink at the same time.
- Never eat more than 4 ounces of food at once.
- Chew your food thoroughly.
- Aim for 800 calories daily.
- Never eat before bed and avoid any spicy food.
- Always check your labels before consumption of high fat, sugar or carbohydrates levels.
Phase 4 – Solid Foods Diet – 21 Days and Beyond
By this stage, your stomach should be in better shape to handle solid foods. From now on, these foods are the foods you’re going to be eating for the rest of your life. Ultimately, you can consume a healthy, well-balanced diet in small portions.
At each meal, you want to have at least three ounces of protein. You may wish to get a digital pocket scale to weigh your food at the start so you know what three ounces of protein looks like you will find it is easier for non-protein foods to go down, so you may gravitate to choosing non-protein foods. You want to train yourself right at the beginning to eat protein. Eat three bites of protein to everyone bite of something else (three to one rule).
It is easy to get certain foods stuck, so from this phase forward, it will be imperative for you to slow down and chew your food thoroughly, pausing between bites.
Remember to eat at protein first. Make sure you have three ounces of protein at each meal. Add three ounces of healthy fats, fruits, vegetables or starches if you can tolerate them. Pay close attention to how you feel with the introduction of new foods.
- Meatless products
- Cottage cheese
- Low-sugar Greek yogurt
Successful Eating Behaviors
Gastric Sleeve Surgery Diet: When you have endured gastric sleeve, you may become nausea or violently ill if you overeat.
- Only add ONE new food at a time!
- Avoid starchy food like white rice, pasta, bread.
- Chew thoroughly and slowly.
- Protein Supplements: 60-90 grams
- In between meals, drink at least six to eight cups of water and any other non-calorie, non-carbonated beverages.
- Stop drinking thirty minutes before eating and DO NOT drink until thirty minutes after a meal.
- EAT six small liquids and blended meals each day, but add one solid food item at one meal the first day. Add one more solid food item each day.
- ALL NEW FOODS NEED TO BE SOFT, COOKED OR CANNED.
- AVOID all raw fruit and vegetables, nuts, popcorn, pickles, olives or relishes.
- RECORD all new foods and any problems you have with them in a food diary and let your doctor know of any problems or questions you may have.
- CHEW your food very well before swallowing. The consistency of the food should be liked mashed potatoes. Make sure that each bite is very small (as if you were feeding a baby) and continue to eat small amounts slowly. Eat about two tablespoons over ten to fifteen minutes.
- CONTINUE to take your multiple vitamins, calcium supplements, iron and B12 supplement as directed.
- AVOID beverages that have alcohol or caffeine and those that are carbonated.
- REMEMBER, do NOT use a straw or chew gum!
Gastric Sleeve Diet – Sample Menu
Phase 1: Clear Liquid Sample Menu
- Important: You do not weigh your fluids; you measure by volume. You can have as many fluids as your body wants. The minimum goal is 48 ounces to prevent dehydration.
- 6 ounces’ warm herbal tea (no milk/cream) or broth (warm fluids help in relaxing the stomach muscles)
- 8:00 am – 6 ounces JUICE – Apple or cranberry, white grape, Gatorade, vitamin water (fifty percent water, fifty percent juice)
- Sugar-free Jell-O
- 10:00 am- 6 ounces’ warm tea (no milk/cream) or broth
- 12:00 – 6 ounces Vitamin water
- Sugar-free Jell-O
- 3:00 pm – 6 ounces’ herbal tea or broth
- 5:00 pm 6 ounces’ white grape juice (50% water, 50% juice)
- Sugar-free Jell-O or Sugar-free Popsicle
- 6 ounces’ herbal tea or broth
Phase 2: Thick Liquid Sample Menu
- 1-ounce packet high protein oatmeal made with almond milk
- ½ – 1 scoop unflavored protein isolate added in
- Protein shake (minimum of 20 grams of protein)- clear or thick shake
- 4-ounce Greek-style yogurt blended with almond milk (chose a yogurt that has more protein than sugar)
- Clear or thick liquid protein shake
- Pureed soup
- Sugar-free pudding with one scoop protein powder blended with coconut milk
Phase 3: Soft Foods Sample Menu
- 2 scrambled eggs & 1 oz. string cheese (3 ounces)
- Protein shake
- 3 ounces can chicken
- 1 ounce blended avocado
- 4 ounces’ cottage cheese
- 1-ounce fruit blended in
- Protein shake or pudding with protein blended in
Phase 4: Solid Foods Sample Menu
- Protein shake
- Cheese stick
- 2 ounces chicken
- 1/4 avocado
- 2 ounces black beans
- 15 almonds
- 3 ounces salmon
- 2 ounces green beans
- 1 TB olive oil
- Triple zero greek yogurt, up to 1/4 cup raspberries
Weight Loss Plateaus
Most times patients who are in weight loss plateaus can quickly adjust their lifestyle to jump off the plateaus. Patients consuming too many carbohydrates can easily be stuck on a plateau. Minimizing carbohydrates will typically break the weight loss plateaus – try exchanging carbohydrates with protein and fiber, which will keep you feeling fuller longer.
If you’re undergoing a weight training program/exercise regime, you could be stuck on a weight plateau. However your plateau could be specious or not legitimate, muscle weighs more than fat and patients can easily mislead into believing they are not losing fat when they are. It’s important to look at your body to see how you’re improving.
For the first 30 days, patients should not engage in strenuous activities including weight-lifting, running, or ab-crunches. We recommend that patients start by walking for 20 minutes for the first fourteen days after the surgery. After 15 days, patients can work up to 30-40 minutes of exercise per day.
- Swimming – Wait at least 15 days before using the tub or the pool. Wounds can easily be infected if the wound has not fully healed. Overall, swimming is an excellent exercise that can include resistance training.
- Weight Lifting – Wait at least 30 days after surgery to include lite resistance training. Use weights you can manage, and still incorporate cardiovascular exercise.
Vitamins and Supplements
After gastric sleeve surgery, patients will need to start a vitamin and supplement regimen for life. Common in restrictive bariatric surgeries are deficiencies in essential vitamins and minerals. Patients will need to take the following supplements:
- Vitamin B12
Mexico Bariatric Center has developed multi-vitamins specifically for Gastric Sleeve patients according to ASMBS guidelines. MBC highly recommends the patients to take these multivitamins for the first year after surgery and beyond for successful weight loss. Here are the highlights:
- Make sure the vitamin includes folate (at least 400 mcg daily required) and iron.
- Menstruating women or patients with anemia should take a multivitamin with supplemental iron.
- Approved Multivitamins: Centrum Performance, Flinstones, Costco vitamins, and various other brands available at stores internationally.
- Patients will need to supplement B12 in their diet, a deficiency is somewhat common and can lead to serious neurological problems.
- Patients will need to take a supplement of calcium/vitamin D complex. Supplements can help prevent osteoporosis.
Guide to Gastric Sleeve Surgery: