Nutrition After Tube Stomach Surgery
Nutrition After Sleeve Gastrectomy
The Way to a Healthy Life
These diet rules are arranged for post sleeve gastrectomy surgery. The new gastric sac created by surgery has the capacity to take approximately 150 ml of food. Juicy-soft and pureed foods should be taken for four weeks to allow the gastric sac to heal. The purpose of these rules is to keep you healthy while losing weight. Post-operative exercise is vital to maintain health while losing weight with healthy food selection and proper nutrition. Dietary habits and lifestyle change are essential for weight loss. However, it is important not to cause stomach discomfort, vitamin and mineral deficiencies while doing this.

Transitions in stages should be done with the approval of the doctor.




Stage 1
3-4 days after surgery; Clear watery foods

5-6 days after surgery. Day; +soup, yoghurt, white cheese, biscuits



Stage 2
1-4 weeks after surgery; Juicy soft and pureed foods (soup, yoghurt, vegetable dishes, soft-boiled eggs, fruit puree), grilled or baked fish.




Stage 3
1-3 months after surgery; +casseroles (vegetables+meat), kebab, boiled meat, chicken, cooked vegetables, beans and legumes.



Stage 4
3 months after the operation; All low-fat solid foods can be taken provided that they are chewed well. The restrictions have been lifted.

Stage 1: Clear Juicy Foods
Approximately 3 days after the operation, the consumption of clear watery foods (tea, water, compote, apple juice, broth, etc.) starts. When the patient tolerates these foods, soup, yogurt, biscuits + white cheese are added on the 5th-6th day. The patient should take these foods at frequent intervals, little by little.

Stage 2: Juicy Soft and Blended Foods
At this stage, in addition to the foods described in the Stage 1 above, watery, soft and blended foods can be taken. Blender is a device used to chop and mix dry food samples. The patient more easily tolerates meals made with foods that have been blended by a blender. Soft fruits (apricot, peach, strawberry, watermelon etc.) can be taken easily. Hard fruits should be blended by a blender.

The consumption of juicy, soft foods and those that are blended should be continued for 4 weeks after the surgery.

In order to avoid protein deficiency, the patient should take 70 grams of protein per day.

Examples

Fat-free or low-fat (light) milk, yoghurt and butter-milk
Vegetable dishes should be well cooked. Adding minced meat is recommended.
Blended Soups
Blended fruit + fat-free milk / fat-free yoghurt mix
Cream soup and mashed potatoes with added meat (minced meat) in a blender
Grilled or Baked Fish
Soft-boiled eggs (boiled for 3-4 minutes). 3-4 pcs per week is recommended.
Biscuits, breadcrumbs, meat
Fine-blended casserole
Dried beans and lentils etc. after using a blender
Juicy soft or blended fruit
Mashed potatoes made with skim milk
Blended unsweetened yogurt
White cheese, cottage cheese (non-fat).
Non-fat dry milk powder can be added to all foods

Initially, small amounts of watery-soft and pureed foods should be consumed. In the first days, you may feel full in a short time because in the first days, you can have a maximum of 60-80 ml of food at a time. Therefore, you should definitely eat six meals a day. At the end of a month, you will be able to eat 100-120 ml of food in one meal. Take care to eat your meals as slowly as possible (Eating a meal should take about 30 minutes.)


To prevent dehydration, at least eight glasses (1500 ml) of water or low-calorie fluids should be taken daily and consumed gradually. These liquids should be taken between meals. It takes at least 30-45 minutes to start drinking fluids after a meal.

Examples

Water or unsweetened or zero-calorie flavored water
Freshly squeezed juices
Tea (8 cups per day)
Skimmed milk, buttermilk
Unsweetened flavored mineral water/soda
A multivitamin that also contains minerals such as iron and zinc should be taken daily for the first year to prevent any nutrient deficiencies and hair loss. Vitamins and minerals can be chewed or taken in pill form four weeks after the surgery (1 Supradyn dragee per day). Vitamin and mineral supplementation is recommended for the first 12 months after sleeve gastrectomy. It is usually not needed after twelve months. However, after 12 months, 15-20% vitamin B12, iron and calcium supplements may be required for women.

It is necessary to measure vitamin B12, folic acid, iron and calcium values in your blood values, especially in women, in three-month periods. According to laboratory data, in case of any vitamin and mineral deficiency, additional vitamin and mineral supplements may be recommended by your doctor or dietitian.

You can also use pain relievers, antibiotics, etc., in the form of chewable or pills, four weeks after the operation.

Concentrated sugars, fried foods and alcohol prevent weight loss. The following must definitely be avoided.

Candy, wafer, chocolate Confectionery Jam, marmalade Honey, molasses Flavored drinks, instant juices Cake, pastry
Canned goods Sherbet (sweetened fruit juice) Ice cream (except light ones) Muffins - cakes - Donuts Fried foods Alcoholic beverages

Sometimes you may not be able to tolerate certain foods easily at first when consuming them. This is quite normal. Do not give up trying again later without being prejudiced against the foods consumed.

If you have trouble tolerating pureed foods:

1. Try slowing down your eating speed.

2. Reduce the portion.

How to puree food (using blender):

1. Slice the food into small pieces in the size of your pinky fingernail.

2. Strain out any lumps, seeds or pieces of food.

3. Use spices and seasonings (except hot sauce and chili peppers) to add flavor.

4. Use the blender and enjoy!

Pureed baby food can also be used instead of blended foods. At first, you need to have a small amount of food at each meal. Therefore, you should eat 5-6 meals. Try to take 600-700 ml-mg of nutritious liquid or pureed food every day.

Between meals: at least six glasses of water (6x250=1500ml=15 tea glasses) caffeine-free, low-calorie liquids should be taken throughout the day and consumed slowly.

Stage 3 Semi-Solid Foods
Four weeks after the operation, you can start consuming semi-solid foods. Your stomach pouch is now healed. You can easily tolerate soft and semi-solid foods. Focus primarily on protein-containing foods at meals, and avoid foods that are high in fat and sugar and are difficult to digest.

Three meals and two snacks per day

Scrambled eggs (except fried)
Casserole, vegetables + soft meat
Cooked vegetables (peeled)
Beans and legumes
Grain bread, bran bread
Cereals made with skim milk
Fruit
Crackers, bagels, hard rolls, bread (toast)
Low-fat milk, buttermilk, kefir
Unsweetened low-fat yogurt
Grilled or boiled meat, chicken
Grilled or Baked Fish
Shredded or soft low-fat/fat-free cheeses
Minced lean meat, kebab
Low-fat cheese
Special Information:

Eat three meals and two snacks a day.
Choose a balanced diet based on 'Healthy Eating'
Each meal should not exceed the level of 120 ml.
Eating and drinking should be slow. A meal should last at least 30 minutes.
Take small bites, and chew very well. Take care not to drink too much liquid during meals. Limit the amount of liquid to be taken per meal to half a tea glass.
Continue to drink at least six glasses of water or 15 tea glasses (1500 ml) per day.
You may need to take a daily vitamin and mineral supplement, including calcium and vitamin B12.
Avoid unminced red meat.
Avoid eating raw vegetables and raw fruit at this stage of the diet.
Avoid nuts, peanuts, almonds, etc., and popcorn.
Avoid all fibrous foods (which can cause congestion).
Avoid high-calorie drinks such as cola, juices, milkshakes.
Avoid all carbonated drinks
Do not fill your stomach up to the level at which you are fully satisfied. Overeating can disturb your stomach and cause vomiting.
Do not drink water or liquids with meals. Wait at least 30 minutes after a meal to drink water or liquids. Drink at least 1500-2000 ml of fluid per day
Remember that your stomach is in the adaptation period. If you eat too quickly, or if you eat without chewing enough, you may experience bloating and problems such as nausea or vomiting.



Breakfast
½ cup of skimmed milk or tea, a slice of white cheese + biscuit rusk


Appetiser
1 cup of skimmed milk


Lunch
Minced vegetables or fish, 1 scoop of nonfat yogurt


Appetiser
¼ cup canned low-fat cottage cheese


Dinner
Soup, 1/3 cup tuna, 1/2 cup cooked vegetables


Appetiser
2 tablespoons of nonfat yogurt (can be with fruit)


Between meals
Drink at least 1500 ml (6 glasses) of water or low-calorie liquids slowly throughout the day.

Stage 4: Low-Fat Solid Foods
About three months after the operation, the restrictions were removed. You can eat red meat, raw vegetables and raw fruits. You can eat all solid food, provided you chew it well. You can drink a glass of water during the meal. Avoid sugar and sweets, as well as high-fat foods such as cream soups, sauces, butter, fried foods, and fast food.

Nutritional Information

A good and balanced meal plan is very important. Eat foods from all food groups:
Dairy products (low-fat milk and light yogurt)
Beans and legumes
Fruit and vegetables
Lean meat and eggs
Whole grain products such as whole meal bread and cereals, brown rice, oatmeal,
Protein

Protein is essential for post-operative recovery. It is also important to help prevent hair loss and loss of muscle mass. You may experience hair loss three to six months after the surgery. Hair loss is related to insufficient protein, iron and zinc intake and some drugs. In order to have a balanced diet and prevent hair loss, the focus should be primarily on protein-containing meals.

Skimmed milk, yoghurt, buttermilk
Low-fat cheese
Low-fat or nonfat fruit yoghurt made with artificial sweeteners
Egg white
Oatmeal and wheat (made with creamy skimmed milk)
Fish
Chicken and turkey (poultry)
Other lean meats (tenderloin, lean ground beef)
Legumes (beans, chickpeas, lentils)
Nonfat dry milk powder (can be added to stews and soups)
Soy products
Do not forget to take daily zinc, iron, vitamin and mineral supplements.

Meat or chicken may not be tolerated after surgery. If it is not possible to eat meat and chicken, it is necessary to obtain protein from other protein sources.

Any additional vitamin and mineral supplements will be recommended by the doctor or dietitian as needed, based on food intake and laboratory values.

Obesity

Remember that in order to maintain your lifelong weight after weight loss, it is necessary to limit your fat and calorie intake.

Avoid the following high-fat foods and sugary drinks, except in small amounts:

Mayonnaise Sour cream Cream cheese Pastries, cakes, etc. Nuts (oil) Donut
Avocado (oil) Whole milk, yoghurt Butter, margarine Nuts, peanut butter (oil) Muffins All oils (olive oil, sunflower oil, etc. - use in moderation)
Full fat cheese Potato salad, rice pilaf Crackers, biscuits etc. Ice cream Tail fat, tallow Fizzy drinks, instant juices
Ready-made salad dressings Sauces Fried foods Bacon, sausage, salami, bologna sausage Crisps Alcohol
Learn to read food labels for fat content. Aim for no more than 35 grams of fat per day. If the fat content is not stated on the food labels, consult your dietitian.