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Copyright © 2014 Dr. Jose T. Luna

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Preoperative Nutritional

Guidelines

For Bariatric Surgery


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INTRODUCTION

The success of bariatric surgery involves unconditional adherence to the nutritional guidelines that your doctor or dietitian will recommend. These rules gradually culminate in an objective to change your life. Your caloric needs will depend on the stage which you are at and your energy balance during the day; even so the patient must focus primarily on foods high in protein.

It is essential to meet your daily protein needs. Protein must be selected in the most tolerable and absorbable form in order to prevent serious nutritional deficiencies often mistakenly attributed to the deficiencies of other nutrients.

Finally, the change of lifestyle has to be incorporated into the treatment, thus preventing the regain of weight and the implications that this entails.

The main purpose of fatty liver as well as abdominal fat, in order to possibly decrease surgic a l operating time and promote a healthier weight loss. The diet will be composed of low glycemic index complex carbohydrates, low in fats, and high in protein. Protein is the most important nutrient for the bariatric patient; any kind of impairment (negligence, medical issue, self purpose) to achieve the adequate intake of protein will cause malnutrition and will increase the risk of diseases. Committing to a bariatric surgery requires that you prepare yourself ahead of time by following a healthy diet and ensuring adequate levels of physical activity. Pre-surgery diet changes are needed to help you lose a percentage of your excess body weight prior to surgery and have better eating habits to help you lose weight after surgery and keep it off. Following the pre-op nutritional recommendations may


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help you demonstrate that you are able to make a commitment to the changes you will need to continue to follow lifelong.

What are you going to eat?

In order to eat right you need to have healthy foods available at your fingertips. To help with this you need to stock your pantry with the right food s . Eating correctly really starts with shopping properly .

The following list should give you an idea of what to keep at hand on a regular basis. Also remember to read ALL food labels and avoid any foods that have more than 5g of fat per serving, and make sure that the sugar value is also under 10g of sugar per serving of 100g as listed on the nutritional label.

Suggested Protein Foods

Tuna (light, water canned)

Salmon

Cheese, low fat

Cottage cheese

Egg whites

Chicken (preferably moist parts)

Cooked Rotisserie Chicken

Scallops

Shrimp (fresh or frozen)


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Fish fillets (fresh or frozen)

Tofu

Deli sliced meat

Yogurt (GREEK ONLY)

Nuts (peanuts, cashews, almonds)

Physical Activity

Despite recognition that Physical Activity (PA) promotion is an important component of a comprehensive surgical weight loss program, there are currently no evidence-based preoperative or postoperative PA guidelines. However, several organizations have issued recommendations recently. The American Society for Metabolic and Bariatric Surgery (ASMBS) recommends mild exercise (including aerobic conditioning and light resistance training) 20 min a day 3 to 4 days a week before surgery to improve cardio-respiratory fitness, reduce risk of surgical complications, facilitate healing, and enhance postoperative recovery.

The American Heart Association recommends a similar ‘‘mild’’ preoperative exercise regimen of low- to moderate-intensity PA at least 20 min a day 3 to 4 days a week. The 2007 Expert Panel on Weight Loss Surgery recommends that patients be encouraged to increase preoperative to postoperative PA, in particular low- to moderate-intensity exercise. In addition, evidence points to a dose-response relationship between PA and both weight loss and long-term weight loss maintenance such that higher levels of PA translate to greater benefits.


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Begin Slowly

● It is important to begin your activity regimen at a slow pace. Start with light activity and work your way up.

● Begin your exercise with walking or water aerobics. Low impact activity is still beneficial. When your body is ready, increase the amount of time spent exercising or advance to a higher impact activity.

Stay Healthy

● A lways check with your doctor before starting a vigorous exercise program.● Be aware of how your body feels. If something doesn’t feel right, slow down or stop.


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● Choose well-respected facilities. When working with personal trainers or other staff, check to make sure they have the proper credentials.● Always use the proper exercise equipment and gear to help prevent injury.

Keep Yourself Hydrated

● It is important to stay hydrated before, during and after exercising. You will need to hydrate yourself to replenish the fluids you have lost while sweating.● Stay hydrated; don’t wait until you are thirsty. By the time you feel thirsty, you’re most likely already dehydrated.● Avoid carbonated beverages and fruit drinks. These take longer to absorb and can cause cramping, nausea and/or diarrhea.● Cool or chilled fluids may work best. Cooler liquids help to lower and normalize the body’s elevated core temperature.

Protein


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Make sure you are consistently maintaining your recommended protein requirements. Protein will help you build muscles as well as keep your energy at a high level. If you do not get a sufficient amount of protein, you will feel tired and sluggish.


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Pre-Operative Instructions

Preparation for bariatric surgery includes several steps to optimize a patient’s health in anticipation of an operation.

Stop all carbonated beverages Stop all beverages with caffeine Begin a routine exercise program approved

by your physician Start diet as guided Practice thorough chewing Stop smoking Drink at least 2l (64 oz.) of water a day Begin a practice of not drinking with your meals Stop drinking 30 minutes before you eat and do not

drink again until 30 minutes after a meal. This will be a requirement following your surgical procedure and needs to become a lifetime habit.

Drink protein supplements at least 40g per day.


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