Nutrition

« Nutrition and weight loss surgery post operative monitoring»

  • Any surgical intervention requires an appropriate dietary follow-up. It intervenes in the good recovery of patients.
  • Obesity surgical operations require, in addition to preoperative monitoring, hygiene dietetics post procedure more rigorous.

ANY SURGERY FOR OBESITY NEED A PRE PROCEDURE PREPARATION.

  • Most obese patients have hypertrophy of the liver, due to the accumulation of glycogen and lipids. This hypertrophy is likely to cause difficulties of visualization of the upper part of the stomach during surgery.
  • All patients are therefore subject to a pre-operative plan whose goal is to reduce the size of the liver.

Bariatric Surgery is effective for weight loss and maintenance of weight targeted on the long term.

It represents a very effective therapy of diabetes, hypertension, sleep apnea and other health problems associated with overweight.

Any operation to be carried out, a post procedure diet will be prescribed, and will consist of different stages.

 ALWAYS PRIVILEGE QUALITY TO THE QUANTITY

Three weeks before surgery, it is important to follow those advices:

  • Eat slowly and chew well,
  • Drink 1.5 L to 2L of water / brew per day, without food
  • Split your food: make three small meals and 2 to 3 small snacks,
  • Stop all consumption of carbonated drinks,
  • Stop frying.

Five to seven days before surgery, it is important to follow a milk diet: take only light products will:

  • Skimmed milk,
  • Light yogurt,
  • Light cheese,
  • Water, tea, coffee without sugar or sweetened with sweetener (for people accustomed to the sweet taste)

 It is imperative to stop smoking at least 4 weeks before the surgery.

The day before surgery, all food must be stopped no later than 00:00.

For all surgeries of obesity, the feeding of the first month will be based on liquid and mixed.

From the 2nd month, feeding will be balanced: introduce into the diet a part of each food group, daily:

  • Animals proteins (fish, light dairy, egg, meat, chicken)
  • Vegetables
  • Legumes (peas, lentils…)
  • The carbohydrates (rice, potatoes, biscuit, cornmeal…)
  • Fruits
  • Dairy products without sugar (white cheese, fresh cheese)
  • FAT: ½ case of vegetable oil per meal.

CAS 1 : THE RING

CAS 2 : THE GASTRECTONIE SLEEVE

CAS 3 : BY-PASS

CASE 1: THE RING:

With the installation of a ring, the volume of the stomach is reduced.

First month post procedure:

General tips:

  • Split its food: make three small meals and 2 to 3 small snacks,
  • Take the time to drink in small sips with straw and/or spoon,
  • Drink 1.5 L to 2L per day: without gas and not ice water, teas, herbal teas without sugar or sweetened with the sweetener,
  • Do not drink more than 100 ml into each outlet.
  • D+1: Water, teas, infusions
  • D+2 et +3: Water, teas, infusions, vegetable broth, skim milk
  • From D+4 and for 1 week: the food will be mixed and liquid :
    • Water, teas, infusions
    • Soups
    • yoghurt lights
    • skimmed milk
    • Natur juice without sugar and filtered
  • • 2nd and 3rd week: food will be mixed but most thick:
    • Water, teas, infusions
    • Thick soups
    • Vegetable mash
    • Light yogurt
    • White cheese
    • Mixed Compotes
    • Natural juice without sugar
  • 4th week: food will be doughy texture:
    • water, teas, infusions
    • soups
    • vegetable mash
    • fine semolina pudding
    • cereals without sugar.
    • rice pudding
    • Compote
    • Natural juice without sugar or cooler
  • The food in soup or mashed should include meat chicken or fish, eggs or light cheese (mix them before introducing them to the soup or purée).
  • Avoid any stringy food and food that cause flatulence (spinach in branch, cabbage flower, broccoli, leeks, cabbage).
  • Meals will be taken slowly.
  • Also avoid bananas, avocado and grapes.

Second month post procedure :

  • Foods will be gradually reintroduced with a return to a normal and varied diet.
  • Raw vegetables (cucumbers…) only will be consumed only from the 6th week post procedure.
  • Certain foods (especially red meat) must be cut into small pieces otherwise, take eggs, fish, who pass more easily and also ensure protein intakes.
  • It is necessary to chew well each mouthful ingested.
  • Some times, some foods will have difficulty to pass. In principle, there is a degree of tolerance for each patient.
  • Avoid foods too sweet, too spicy, too acid, too rich in fat, too hot or too cold.

TO STOP IMMEDIATELY TO EAT WITH THE BEGINNING OF A FEELING OF SATIETY AND AVOID SNACKING BETWEEN MEALS

The gastric ring does not major imbalance, unless the patient unbalance their diet.

CASE 2: THE GASTRECTONIE SLEEVE:

The sleeve gastrectomy allows you to lose weight

  • By a decrease of your dietary intake due to the creation of a small stomach tube
  • By a decrease in the amount of food eaten

IT IS MANDATORY TO COMPLY WITH A STRICT DIET:

LIQUID, MIXES, FOR 1 MONTH

First month post procedure:

General advices :

  • Split its food: do five to six meals per day,
  • Take time to eat: chewing, drinking without food,
  • Foods will be cut into small pieces,
  • Take the time to drink in small sips with straw and/or spoon
  • Drink 1.5 L to 2L per day: without gas and not ice water, teas, herbal teas without sugar or sweetened with the sweetener.
  • Do not drink more than 100 ml into each outlet.

SPARKLING DRUGS ARE STRICTLY PROHIBITED

No food the first two days post operative (infusion)

  • D+3: A methylene blue test will be done to check the tightness of the stomach. If no abnormality is found, a drink will be allowed 2-3 hours after the test: verbena, water
  • D+4: Water, teas (not mint), infusion
  • D+5: Water, teas, infusions, vegetable broth, skim milk
  • D+6, D+7 et D+8 :
    • Water, teas, Infusions,
    • Vegetable broth,
    • Skimmed milk,
    • Nature juice, filtered except citrus and grapes.
  • • 2nd week: food will be hyper mixed to obtain a liquid texture:
    • Water, teas, infusions
    • Liquid soups,
    • Skimmed milk,
    • Nature juice, filtered except citrus and grape.
  • 3rd week: semi liquid diet :
    • Water, teas, infusions,
    • Thicker soups,
    • Skimmed milk,
    • Yoghurt lights,
    • Natural fruit juice,
    • Variegated,
  • 4th week: the food supply will have a thick mixed texture :
    • Water, teas, infusions,
    • Thick soups, puree vegetables: proteins: (meat, fish, eggs, chicken) will be mixed and mixed with the soups and purees.
    • Compotes,
    • Skimmed milk,
    • Yogurt lights, white cheese,
    • Natural fruit juice,
    • Cooler,

Second month post procedure:

  • • The power will be tender texture (cooked fruit compotes, cooked vegetables),
  • The food will be reintroduced gradually: fruit compotes cooked and diced,
  • The vegetables will be cooked into pieces (it is best to peel and remove the seeds),
  • Eggs (runny omelette) and fish steamed in foil or will be taken first. Follow the chicken and meat,
  • If discomfort and felt during the meal, return to the mixed.

TO STOP IMMEDIATELY TO EAT WITH THE BEGINNING OF A FEELING OF SATIETY AND AVOID SNACKING BETWEEN MEALS

The sleeve does create a major imbalance, (except vit B).

CASE 3: BY-PASS:

The by-pass is a short circuit between the stomach and the intestine so a food malabsorption: an intake of vitamins is therefore necessary for life.

Observed deficiencies are: iron, Zinc, Calcium, Vit D, Vit B1, lives B12

IT IS MANDATORY TO COMPLY WITH A STRICT DIET:

LIQUID, MIXES, FOR 1 MONTH

First month post procedure:

General advices:

  • Split your food: eating every 2 hours,
  • Take time to eat: chewing, drinking without food,
  • Foods will be cut into small pieces,
  • Take the time to drink in small sips with straw and/or spoon.
  • Drink 1.5 L to 2L per day: gas drinks and not ice water, teas, herbal teas without sugar or sweetened with the sweetener.
  • Do not drink more than 100 ml into each outlet.

SPARKLING DRUGS ARE STRICTLY PROHIBITED

No food the first three days post operative (infusion).

  • D+4: A methylene blue test will be done to check the tightness of the stomach. If no abnormality is found, a drink will be allowed 2-3 hours after the test: verbena, water
  • D+5 et D+6: Water, teas (not mint), infusion
  • D+7 et D+8: Water, teas, infusions, vegetable broth, skim milk
  • D+9 :
    • Water, teas, Infusions,
    • Vegetable broth,
    • Skimmed milk,
    • Nature juice, filtered except citrus and grapes.
  • From the 10th day and for 10 days: food will be hyper mixed to obtain a liquid texture
    • Water, teas, infusions
    • Liquid soups,
    • Skimmed milk,
    • Nature juice, filtered except citrus and grapes.
  • 3rd and 4th week: semi liquid diet:
    • Water, teas, infusions,
    • Thicker soups,
    • Skimmed milk,
    • Yoghurt lights,
    • Natural fruit juice,
    • Cooler
  • 5th week: food will have a thick mixed texture :
    • Water, teas, infusions,
    • Thick soups, puree vegetables: proteins: (meat, fish, eggs, chicken) will be mixed and mixed with the soups and purees
    • Compotes,
    • Skimmed milk,
    • Yogurt lights, white cheese,
    • Natural fruit juice,
    • Cooler,
  • 6th and 7th week: food will be more consistent:
    • water, teas, infusions,
    • Compotes,
    • skimmed milk,
    • yogurt lights, white cheese,
    • natural fruit juice,
    • cooler,
    • Eggs in slobbering omelette, boiled, fried, scrambled.
    • chicken and meat will be always hashed.
    • the fish will be cooked in broth.
    • fruits will be cooked
  • From the 8th week:
    • Raw fruits can be introduced (ripe and peeled) and crackers.

Troisième mois post opératoire :

  • The foods supply will be tender texture (fruit cooked in sauces, cooked vegetables),
  • Foods will be reintroduced gradually: fruit cooked compotes and then cut into small cubes,
  • Vegetables will be cut into pieces (it is best to peel and chop them),
  • Eggs (slobbering omelette) and fish cooked in steam or in foil will be taken first. Will follow the chicken and meat,
  • If you fell discomfort during the meal, return to the mixed

Starchy foods and legumes (bread, raw vegetables) will be introduced only from the 4th month.

The food will be strong, varied. Always need to chew.

Follow a rhythm of 6 meals per day at least (3 meals and 3 snacks).

Always avoid sweets and fatty foods.

In General, certain foods should be avoided: hard fibres (fennel, leek, celery, artichoke, asparagus, pineapple) and skins thick and with pepin

With a pass by, two forms of dumping syndrome can appear:

  • Gastro intestinal symptoms of bloating followed by diarrhea may occur after a large consumption of fat or sugar.

Dumping syndrome hypo Glycemic occurs two to three hours after a meal to high glycemic index.

  • Symptoms related to excess salt or spices: this is an osmotic dumpung
  • During one of these two symptoms, don’t eat anything, lie, do nothing and wait 15 min

It is advisable to do a review: 6 months, 12 months, 18 months and 24 months post procedure (prescribed not the attending physician)

TO STOP IMMEDIATELY TO EAT WITH THE BEGINNING OF A FEELING OF SATIETY AND AVOID SNACKING BETWEEN MEALS

Bariatric Surgery and sport:

We recommend that you don’t’ carry out physical efforts for a minimum period of 4 weeks.

On the other hand,walking is permitted even recommended the same evening of the intervention or at most the next day.

Avoid heavy lifting for 6 weeks.

As a general rule, the exercise must be adapted to each person according to his tastes and abilities.

Driving physiotherapy sessions will also help restore muscle capital.

Start smoothly.

The exercise must be moderate, reasonable, soft and with the extended time.

It is necessary to devote time to listen to his body.

The first two weeks:

Do 15 min walk, 2 times a day (morning and evening)

The first 6 months :

Do 30 min walk, 3 to 5 times per week.

Possibility to make also some sessions of yoga, aquagym, swimming and cycling.

From 6 months to 12 months:

The effort can be extended up to 45 min, 3-5 times per week.

From the second year, all sports are allowed.

NOTE:

  • Move walk, climb stairs, favour a soft and prolonged exercise.
  • Fats are used until 30 min of exercise.
  • The physical effort also has a « satiety » effect, that’s mean, it decreased appetite
  • Baths are possible after 21 days post operative (before, skin healing is not complete and the water can infect the wound)

THERE MUST BE REGULAR MONITORING AT YOUR DOCTOR.

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