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Patients

Nutrition

Dietary Progression

PRE AND POST OPERATIVE DIETARY PROGRESSION

BEFORE SURGERY - 2 Weeks prior to surgery date (14 days)
TIME DIET TYPE REASON
To be followed for 7 days A SOFT-LIGHT diet - consists of soft foods which as easy to mash with a fork – i.e. no skins/ pips and food must be cooked appropriately To start relaxing the digestive tract in preparation for surgery
7 Days prior to surgery date A FULL LIQUID diet – consists of smoothies, soups and protein supplements To relax the digestive tract and get rid of residue


DURING – In hospital
STAGE I - IN-HOSPITAL: IMMEDIATELY POST SURGERY
Stage 1 is brief and completed in the hospital
CLEAR LIQUIDS ONLY Very thin clear liquids with water sipped in-between to prevent dehydration – consists of water, consommé, iced tea lite, and diabetic jelly
MEAL PATTERN Slowly sip fluids throughout the day, aiming for 100ml clear liquids and 70 ml water per waking hour


AFTER SURGERY
The objectives of post-operative nutrition are to maintain adequate hydration and nutrition status; support homeostasis of bodily functions; promote wound healing; preserve lean muscle mass; facilitate safe and sustained weight loss; and nurture a healthier lifestyle. These goals are achieved through a multiphase dietary progression.

  STAGE II – WEEK 1 & 2 POST SURGERY
FULL LIQUIDS: Soups, Smoothies, Protein Supplements
  Minimum 80g protein/ day
  Total amount of fluid is 2.5L (supplements included)
  1 L of full liquids, plus 1.5 L fluids
  Stage II provides high quality protein, low-fat and low-sugar liquidized foods
  During stage II, the patient is dependent on liquid protein supplements or meal replacements as the primary source of nutrition eg Future Life High Protein
  In 2% of patients there is continuous nausea that may not be diet related. A physician must be consulted to assist with nausea resolution
  In some cases, approximately 15% (conservative estimate) of patients exhibit lactose intolerance. In this event, use lactose free milk and dairy products
MEAL PATTERN Slowly sip fluids throughout the day, aiming for 100ml of full liquids and 70 ml water per waking hour


STAGE III – WEEK 3 & 4 POST SURGERY
PUREE/SLOPPY DIET Protein requirements: 1.0-1.5 g protein /kg of adjusted body weight
Fluids 2 L per day
  Stage III consists of pureed and ground foods which are very moist and runny
  Diet must consist of 50 % protein (to be eaten first) and must be low in fat and sugar
MEAL PATTERN 6 small meals per day consisting of 60–90ml (4 – 6 tbsp) of pureed food


STAGE IV – WEEK 5 & 6 POST SURGERY
SOFT LIGHT DIET Stage IV consists of soft foods which as easy to mash with a fork – i.e. no skins/ pips and food must be cooked appropriately
  It gradually reintroduces the system to solid food
  Diet must consist of 50 % protein (to be eaten first) and must be low in fat and sugar
MEAL PATTERN 4 small meals per day consisting of ½ cup - ¾ cup of soft food


STAGE V – WEEK 7 onwards
SOLID FOODS All foods can now be included in the diet
  Diet must consist of 50 % protein (to be eaten first) and must be low in fat and sugar
MEAL PATTERN 4 meals per day consisting of 1 - 1½ cups of food of regular consistency and firmer texture as tolerated


The post-bariatric surgery diet progression should be followed carefully. The rate at which the patients progress from one food consistency to another will vary. Generally, patients should be able to tolerate foods of regular consistency with firmer texture 3 months after operation.