NUTRITION AND DIETARY TRANSITION - FOR - Mercy Bariatrics Perth
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NUTRITION AND DIETARY TRANSITION
FOR
POST - SLEEVE GASTRECTOMY SURGERY
DIETITIAN: ____________________________
CONTACT NUMBER: 9272 0408
Suite 1A, Level 2, SJOG Medical Centre, Ellesmere Road, Mount Lawley WA 6050
Telephone: (08) 9272 0400 Fax (08) 9272 0450 Email: info@mercybariatrics.com.au
Website: www.mercybariatrics.com.auPOST SURGERY TRANSITION DIET
To commence day 14 post bariatric surgery
During the first two weeks after your surgery for sleeve gastrectomy you have been
following a liquid diet.
You are now ready to commence the transition diet. This will slowly progress you back to
normal food textures.
The purpose of the transition diet is to allow you to slowly adjust to the restrictions of the
sleeve gastrectomy procedure and to develop healthy eating and drinking habits.
Key Habits to Learn During the Transition Phase
• Eat slowly
• Cut food into small pieces
• Chew each small portion of food thoroughly until it reaches a mushy consistency in
the mouth
• Avoid drinking 30 minutes BEFORE and AFTER eating
• Sip liquids slowly and regularly between meals
• Aim for nutritionally balanced meals
• Include lean protein and vegetables at each meal
Transition stages
• Commence the diet at Stage 1 and remain on this stage for a week or two.
• If you are not experiencing any adverse symptoms, progress to Stage 2.
• Repeat this process through each stage until you reach stage 4, at which time you
will be tolerating small amounts of normal textured food.
• If you experience adverse symptoms during the transition process, return to food
texture that you were previously tolerating. Maintain this texture stage for another
week before attempting to progress to the next stage again.
Adverse Symptoms may include
• vomiting or regurgitation of food
• pain or discomfort after eating
• reflux or indigestion
• nausea
If you are having any problems during the Transition Phase of your diet, please
contact your Dietitian for advice on 9272 0408Transition Stages (spend 1-2 weeks on each transition stage)
Stage 1 Soft + mashed texture
HIGH PROTEIN HIGH FIBRE
Eggs (scrambled, poached) Cooked cereals (quick oats)
White Fish (steamed/ poached) Soft cereals (weetbix)
Canned salmon/ tuna
Legumes (lentils/ fork mashed Cooked mashed soft vegetables
baked beans/ chickpeas) (carrot, pumpkin, zucchini, cauliflower,
broccoli, sweet potato)
Milk, smoothies, yoghurt Hommus/ avocado
Cottage cheese, ricotta cheese Tinned/ stewed fruit
Stage 2 Soft + minced texture
HIGH PROTEIN HIGH FIBRE
Minced meats (include sauce) High fibre cereals without dried fruit or
Boiled eggs (mash with low fat nuts (allbran, branflakes, oatflakes,
mayo or avocado) traditional porridge)
Soft seafood Steamed vegetables
(prawns, crab, crayfish)
Chicken/ tuna/ fish mornay Soft fresh fruit (banana, melon,
strawberries, kiwifruit, stone fruit)
Legumes (lentils, baked beans, Legumes
kidney beans, 4 bean mix)
Milk, smoothies, yoghurt,
grated cheese
Stage 3 Variable texture
HIGH PROTEIN HIGH FIBRE
Casseroles/ slow cooked meat Bircher muesli
Lean finely shaved meats Stir-fry vegetables
(ham, beef, chicken, turkey)
Soft fish, chicken, legumes Most fruit and tomatoes (may need to
peel apples and pears)
Milk, smoothies, yoghurt, Wholegrain crackers (rye cruskit/ ryvita/
cheese slices vitawheat) + peanut butter/ avocado/
hommus/ cottage cheese/ ricotta
Stage 4 Normal solid texture
HIGH PROTEIN HIGH FIBRE
Grilled/ barbaqued/ roasted Untoasted muesli
Meat/ chicken/ fish Salad and raw vegetables
Legumes Legumes
Nuts/ seeds All fruit (including dried fruit)
Milk, smoothies, yoghurt, Wholegrain flat bread/ mountain bread/
cheese brown rice/ couscous/ quinoaThe meal and fluid guide below provides a minimum of 60 g protein + 1.5 L fluid per day. Stage 1 of the transition diet: very soft, mashed foods: week 3 + 4 post surgery • 7 am: 1 cup tea with reduced fat milk • 8 am: 1 very soft poached/scrambled egg or 1 weetbix + reduced fat milk • 10 am: 1 cup protein smoothie (reduced fat milk, yoghurt, fruit, ½ scoop whey protein powder) • 12 pm: 1 cup water (add a slice of fruit or a dash or cordial to flavour) • 1 pm: ½ cup canned tuna + mashed avocado or ½ cup canned salmon + cottage cheese • 3 pm: 1 cup herbal tea or 1 cup water • 4 pm: ½ cup stewed pear + ricotta or ½ cup canned peaches + natural yoghurt • 5 pm: 1 cup water • 6.30: ½ cup fish pie (white fish, cheese sauce, mashed pumpkin) or ½ cup baked beans • 8 pm: 1 cup water Stage 2 of the transition diet: soft and minced texture: week 5+ 6 post surgery • 7 am: 1 cup tea with reduced fat milk • 8 am: 1 soft boiled egg or ½ cup porridge made with reduced fat milk • 10 am: 1 cup protein smoothie (reduced fat milk, yoghurt, fruit, ½ scoop whey protein powder) • 12 pm: 1 cup water (add a slice of fruit or a dash or cordial to flavour) • 1 pm: ½ cup canned tuna + mashed avocado or ½ cup prawns + mashed avocado • 3 pm: 1 cup herbal tea or 1 cup water • 4 pm: ½ cup diced watermelon or ½ cup berries or ½ banana • 5 pm: 1 cup water • 6.30: ½ cup mince + vegies or ½ cup chicken mornay (shredded chicken + cheese sauce) • 8 pm: 1 cup herbal tea
Stage 3 of the transition diet: variable texture: week 7+ 8 post surgery • 7 am 1 cup tea with reduced fat milk • 8 am 1 egg omelette or ½ cup Bircher muesli • 10 am: 1 milky coffee (skinny latte/flat white) • 12 pm: 1 cup water (add a slice of fruit or a dash or cordial to flavour) • 1 pm: 1 wholegrain cracker +1 slice cheese +1 slice ham/chicken/turkey + tomato chutney • 3 pm: ½ cup high protein yoghurt • 4 pm 1 cup water • 5 pm 1 cup tea with reduced fat milk • 6.30: ½ cup casserole (slow cooked meat + veg) or 60 g salmon + ¼ cup stir-fry vegetables • 8 pm: 1 cup reduced fat milk Stage 4 of the transition diet: normal texture: week 9 onwards post surgery • 7 am 1 cup tea with reduced fat milk • 8 am 1 egg omelette or ½ cup muesli + reduced fat milk/natural yoghurt • 10 am: 1 milky coffee (skinny latte/flat white) • 12 pm: 1 cup water (add a slice of fruit to flavour) • 1 pm: 2 wholegrain crackers + hommus + 1 sliced hard-boiled egg + cucumber • 3 pm: ¾ cup high protein yoghurt • 4 pm 1 cup water • 5 pm 1 cup tea with reduced fat milk or herbal tea • 6.30: 2 chicken tenderloins + ¼ cup salad or 60 g fillet steak + ¼ cup salad • 8 pm: 1 cup reduced fat milk Portion are a guide only. You may only manage ¼ of a cup of solid food initially. Eat slowly; stop when you feel satisfied; avoid fluid 30 minutes either side of solid food. Include 3 serves of dairy products or a protein smoothie each day to ensure adequate protein
Multivitamin
• It is essential that you continue to take multivitamin and mineral supplements in the long
term, to help you achieve your recommended dietary intake of micronutrients.
• Take 2 bariatric chewable multivitamins every day (BN Chews or Nutrichew).
• At 4 weeks post-surgery you can continue taking your bariatric chewable multivitamins or
you can swap to Centrum for women/men (2 per day) or BN Caps (2 per day).
• You may need a calcium and iron supplement, in addition to your multivitamins
• Your dietitian recommends you take: ______________________________
Tips for managing nausea
In the early stages of the texture progression, you may experience some nausea. The following may
help to prevent or reduce the severity:
• Spread medications over the day, rather than all at once, if possible
• Small, frequent meals are usually better tolerated than infrequent larger meals
• Even if you don’t feel hungry, it is important to have at least three small meals each day, as an
empty stomach for prolonged periods can cause nausea
• Avoid becoming overfull by eating slowly and chewing your food well
• Avoid spicy or foods with an intense aroma
• Avoid citrus fruit and citrus juice
• Drink beverages very cold with ice
• Suck on ice cubes/ hydralyte icy-poles
Tips for managing constipation
After surgery, changes in eating habits and food choices can cause constipation. A reduction in the
amount of food means there is less ‘bulk’ and this can reduce the number of bowel movements you
have. The following may help:
• Aim for one piece of fruit and two serves of vegetables per day
• Choose wholegrain carbohydrates (bread, crackers, rice, pasta, quinoa)
• Aim for at least 1.5 litres of water per day
• Take a fibre supplement such as Benefibre. This will add moisture to your stool, making it softer
and therefore easier to pass
• It is important to remember that Benefibre will only work if you are drinking enough fluids, at
least 1.5 L/ day
• Exercise on most days of the week
Tips for managing diarrhoea
Diarrhoea can occur due to the lack of solids or inadequate fibre in the diet. Benefibre can help to
form stools, so there is less urgency and loose bowel movements. The recommended dose is 2 tsp
per day. You will need to drink at least 1.5L of fluid/ day for Benefibre to work.
Diarrohea can be a result of dumping syndrome. To avoid dumping avoid drinking fluid with meals;
avoid high sugar foods; include protein with each meal and snack; include a source of fibre with
each meal and snack. If dumping persists, switch to decaffeinated coffee and lactose free milk.You can also read
