1. “BASIC NUTRITION PRINCIPLES” TEXAS CENTER FOR MEDICAL & SURGICAL WEIGHT LOSS Nutrition After Weight Loss Surgery Gastric Bypass  Sleeve Gastrectomy  Gastric Banding

2. Overview Principles of Weight Loss Macronutrients Meal Compositions

3. Success after Weight Loss Surgery Weight loss surgeries help you lose weight by making it hard for you to eat as much and by making you less hungry. Making poor food choices and being inactive will make you less successful with your weight loss. Certain behaviors can promote weight regain  Eating frequently throughout the day  Drinking sodas, sweet teas and other calorie laden drinks  Drinking with meals  Repeatedly eating large serving sizes

4. Principles of Weight Loss To manage your weight your need to balance:  DEPOSITS (what your eat)  Which foods should be included more frequently  Which foods should be limited  Everyday foods versus once-in-awhile foods  WITHDRAWALS, or how we spend or “burn” calories Calorie=energy currency of our body  We need to balance our budget and spend as much as we are taking in!

5. Nutrition Basics Three types of macronutrients provide calories  Protein, 4 calories per gram  Carbohydrate, 4 calories per gram  Fat, 9 calories per gram  Alcohol does not provide nutrients but has 7 calories per gram Micronutrients (i.e. vitamins/minerals) do not provide any calories Theoretically, 3500 calories=1 pound

6. Protein Made up of amino acids or building block Animal proteins (meat, fish, dairy, eggs) Plant proteins (grains, legumes, nuts/seeds)  Do not always have all the amino acids so may need to be combined with other foods

7. Protein Most important macronutrient of bariatric diet (along with water)  Minimum 60g daily for women, 80g for men Needed for structure, regulating body functions, and to provide energy  If you do not eat enough protein after surgery  May not heal as well  Lower energy levels  Lose more muscle and less fat  May lose more hair Shoot for 50% of each meal from protein and eat your protein first!

8. Fats Needed for energy storage, cell signaling, membranes, transport and storage of fat-soluble vitamins, and hormone production Most calorically dense component of food

9. Fats Fats are higher in calories than protein and carbohydrates.  More than twice the calories per gram! They are habit forming/addictive. Our bodies are very efficient at storing fat.  A significant intake can dramatically decrease your rate of weight loss

10. Fats You do need some fat in your diet  Essential fatty acids omega-3 and omega-6  Fats also protect organs and bones and provide insulation Avoid added fats (saturated and trans fats)  Fried foods, dressings, butter, gravies, sauces, sour cream, cream cheese, mayo, etc. Healthy fats  (olive oil, canola oil, nuts/seeds, avocado) are acceptable in small amounts

11. Carbohydrates Main source of fuel for energy in cells Starches: breads, cereals, pasta, rice, crackers, tortillas Fruits Some dairy products

12. Carbohydrates Carbs/sugars give little satiety and cause you to become hungry again sooner. Foods like white bread, rice, potatoes, soft drinks, bagels, crackers, and fruit juices are especially bad choices. Choose whole grain carbohydrates in small amounts  May be problematic early in diet progression but should work for long term  Higher fiber (wheat, bran), barley, quinoa, brown rice

13. Meal Composition Remember that at least 50% of each meal needs to be a lean protein source Eat protein first

14. How Meals Should Look

16. Eat Vegetables Next

17. How Meals Should Look

18. Savvy Consumer Track your intakes  Manage portions  occasionally measure the foods to know how much you are eating  Read food labels or nutrition facts labels  Information is per serving so think about your portion size  Is the food a high-quality protein and how much protein does it have?  Is the food low calorie?  Is the food low in fat (especially saturated and trans fat)? Less than 3 grams per 100 calories  Is the food low in sugar? Keep to less than 12 grams per meal  Is the food a good source of fiber?

19. Savvy Consumer Track your intakes  Use a tool to give yourself accountability long term  Smartphone Apps  Myfitnesspal  Lose It  Computer  Sparkpeople  Supertracker

20. Spending Calories Basal Metabolic Rate  Over half the calories you burn are used for basic life  Breathing, heart beating, digestion, etc Day-to-day activities:  Sitting, standing, cooking, housework, walking into work  DO NOT MINIMIZE the effect of increasing the amount of PURPOSEFUL MOVEMENT in your day to day life Engaging in physical activity  Part of long term weight management to help us balance on energy budget  Find something you enjoy and work up to it

21. Spending Calories Basal Metabolic Rate  Over half the calories you burn are used for basic life  Breathing, heart beating, digestion, etc Day-to-day activities:  Sitting, standing, cooking, housework, walking into work  DO NOT MINIMIZE the effect of increasing the amount of PURPOSEFUL MOVEMENT in your day to day life Engaging in physical activity  Part of long term weight management to help us balance on energy budget  Find something you enjoy and work up to it

22. TEXAS CENTER FOR MEDICAL & SURGICAL WEIGHT LOSS Congratulations on starting the journey to a new you!