Manual of Clinical Nutrition

Nutrition Management in Bariatric Surgery

Manual of Clinical Nutrition Management B- 26 Copyright © 2013 Compass Group, Inc.

Stage 4 (weeks 6 to 8)
Weeks 6 to 8: Bariatric Diet
 Provide four to six small feedings of regular-consistency food. Use high-quality protein foods such as
scrambled eggs, Egg Beaters, low-fat cheese or cottage cheese, or lean meats such as tuna fish, chicken, or
pork. (Refer to Table B- 3 (1,5).)
 Portion: 4 to 6 oz (8 to 12 tbsp) at a time of solid foods.
 Alternate fluid intake with food intake. Consume fluids at least 30 minutes before or after solid foods.
The combined volume of water, low-energy beverages, and milk should equal at least 6 cups/day, and at
least half of the beverages should be a good source of protein (1).
 Avoid rice, bread, and pasta until the patient is comfortably consuming 60 g/day of protein plus fruits
and vegetables (1).
 Consume protein food first, vegetables and fruit second, and starch foods last to help ensure adequate
protein consumption (5).
 Patients should avoid alcohol, as it may lead to dehydration and does not provide necessary nutrients (5).
 Avoid chewing gum; if gum is swallowed, it can block the stomach opening (5).
 Behavior techniques need to be applied and reinforced (eg, eating small amounts, eating slowly, chewing
food completely before swallowing, and eating from small plates).
 Avoid drinking from straws because the air swallowed can cause bloating and stretch the pouch (5).
 The patient should keep a food record to document food intake and eating behavior, including foods
tolerated or not tolerated, to discuss with the dietitian during follow-up visits and to assess adherence to
the multivitamin and mineral regimen.

Table B-2: Foods to Choose on a Pureed/Soft Diet Following Bariatric Surgery (5)
Food Choose Avoid
Beverages Crystal Light, decaffeinated coffee or tea,
carbonation-free beverages, and high-
quality nutrition drinks such as
GlucernaTM or no-sugar added diet
instant breakfast prepared with fat-free
milk

Fruit drinks, iced tea with sugar,

alcohol, soda and other carbonated

beverages with a high sugar content

(>15 g of sugar per serving) (1)

Soup Egg drop soup, reduced-fat cream soups,
broth, bouillon, low-fat soups with
added protein powder or strained meat

All others

Breads, cereals, rice,
and pasta

Cooked, refined/strained cereals (with no

added sugar)

Soft diet: Add pasta, rice, toasted breads,

Melba toast, and crackers.

Choose items with <2 g fiber per serving.

All others

Vegetables Pureed vegetables, vegetable juice
Soft diet: Add soft cooked vegetables and
mashed potatoes without skin.

All others

Soft diet: vegetables with tough hulls

or skins such as peas and corn

Fruits Unsweetened applesauce, pureed banana
or other fruit without seeds or hulls,
unsweetened fruit juice
Soft diet: Add soft unsweetened canned
fruits or fresh soft fruits without skin or
seeds.

All others