VSG - Eating Stages

PLEASE REFER TO YOUR DOCTOR AND DIETITIAN BEFORE FOLLOWING ANY DIET. THE MENUS INCLUDED ARE MORE TO ASIAN TASTE.

In this post, I'll share the eating stages plan that my dietitian gave me. This post will be the translated version of a Malay language leaflet about sleeve gastrectomy by Jabatan Dietetik & Sajian, HRPB, November 2014.

Eating Stages After Vertical Sleeve Gastrectomy

Eating Stages

Stage 1

Duration: Day one after surgery

In the hospital, the clear liquids allowed are only water and ice chips.

When do I need to start clear liquid diet?

• After your surgeon gave the permission.

Stage 2: Clear Liquid Diet

Duration: Week one after surgery

What kind of liquid can I drink?

• Water.
• Juice (strained, no sugar added).
• Clear soup.
• Decaffeinated coffee and tea.

Tips for Stage 1 and Stage 2:

• You must start the liquid diet in small quantities, 20 - 30 ml each time every 10 to 15 minutes.
• A 30 ml cup can be used.
• You are encouraged to drink at least 1.5 liters of water in a day.
• Measure your drinking liquid for a day in 1 liter or 1.5 liters water bottles.
• You need to drink in a very slow pace  because if you gulp or drink quickly, it may cause pain or making you nauseated.
• You are NOT encouraged to drink with a drinking straw.
• You can drink the clear liquids warm, cold or in room temperature.

Stage 3: Full Liquid Diet

Duration: 2 weeks (Week 2 and Week 3 after surgery)

Example of menu (600 kcal/day, 73 g protein)

Example of  a full liquid diet menu

These were the products that I used on my full liquid diet;

Supplement with fiber: Abbott's Glucerna Triple Care

Protein powder: Valens' Myotein

Glucerna tasted sweet with vanilla flavor which was a total life savior. The protein powder was nauseating at first but tolerable after few days drinking it.

So what other liquid can you have in this stage?

• Milk (low fat/ fat free/ skim)
• Unsweetened soy milk
• Yogurt (< 25 g sugar per serving)
• Thick tomato soup

Tips for Stage 3:

• Protein powder is important in this stage.
• The total liquid intake per day still the same, at least 1.5 liters (including plain water and other liquids).
• Plan your daily liquid intake from the morning to the night.

Stage 4: Blended/Pureed Diet

Duration: 3 weeks (Week 4 to Week 6 after surgery).

Example of menu (800 kcal/day, 70 g protein)

Example of a blended/pureed diet

What else can you eat in this stage?

• Mashed fruits and vegetables.
• Half boiled egg / steamed egg.
• Douhua (with no sugar syrup) / steam tofu.
• Shredded chicken.

Tips for Stage 4:

• Food quantity should be started with 1 - 2 tablespoon (15 - 30 g) each meal.
• Plain water should be drank 30 minutes before eating and 1 and a half hour after.
• Avoid water, juice and soup while eating.
• Plan your daily intake of liquids from morning (for example 30 ml every 10 minutes x 6 times in a  hour) x 5 hours = 900 ml water.

Stage 5: Soft Diet

Duration: 6 weeks (Week 7 to Week 12 after surgery).

Example of menu (1,000 kcal/day, 80 g protein)

Example of a soft diet.

* 1 piece of raw fish       = 100 - 120 g

* 1 piece of raw chicken = 150 - 180 g
* Oil usage in cooking should be reduced (only 3 teaspoons a day)
* Recommended types of oil: olive oil, sunflower oil, soybean oil and corn oil.
* Low fat cooking method highly encouraged.

Tips for Stage 5:

• Eat starting with protein (first), then vegetables and fruit (second) and lastly carbohydrate (third). 
• Finish your protein first before having other food.
• Eat and chew slowly (at least 25 times before you swallow).
• Eat in small portion but frequently (5 - 6 times a day).
• STOP eating when you feel full. Do not test your stomach ability by finishing up all the food on the plate.
• AVOID sweet drinks and foods.
• AVOID eating and drinking at the same time.
• Take your multivitamins daily.
• Avoid hard to digest food like oats, nuts, mushrooms, beef, lamb at the beginning.
• Continue the daily liquid intake of 1.5 liters a day.

Stage 6: Normal Diet

Week 13 (Month 4) after surgery onward.

Example of menu (1,000 kcals/day, 60 g protein)

Example of a normal diet.

Tips for Stage 6:

• Eat more solid food.
• Choose healthy food (satisfying but low in calories).
• Eat your protein first, then your carbohydrate.
• Avoid sweet food and drinks (that could cause abdominal pain, cramping and dumping syndrome).
• Avoid carbonated and alcoholic drinks.
• Avoid fried foods.
• Stop eating when you feel full to avoid your stomach pouch expanding.  

That is all for this post. Maybe I will share the pictures of my food by stages in the next post. Thank you for reading!

Reference:

Jabatan Dietetik & Sajian. (2014). Pembedahan Sleeve Gastrectomy: Apa yang Anda Perlu Tahu & Buat? Hospital Raja Permaisuri Bainun. Ipoh, Perak.