How to eat after bariatric surgery?Step by step

Are you planning on having weight loss surgery, or are you curious about the diet patients follow after surgery? There are some basic guidelines that patients must adhere to immediately after the operation and throughout the rest of their lives.

FIRST MONTH :

Liquid and Pureed Foods: During the first month post-bariatric surgery, patients typically start with clear liquids and then progress to full liquids and pureed foods. Here are some ideas for each stage:

Clear Liquids: Clear broth, sugar-free gelatin, sugar-free popsicles, diluted fruit juice, herbal tea, clear vegetable broth.

Full Liquids: Protein shakes (made with water or non-fat milk), low-fat yogurt smoothies, sugar-free pudding, cream of wheat or oatmeal (thin consistency), strained cream soups (like tomato or chicken).

Pureed Foods: Pureed Eggs, Pureed lean meats (chicken, turkey, fish), pureed cooked vegetables (carrots, peas, spinach), mashed potatoes (made with low-fat milk or broth), pureed fruits (applesauce, bananas).
Protein is Key: Focus on consuming protein-rich foods to support healing and muscle maintenance. Aim for around 60-80 grams of protein per day, divided into small, frequent meals. Prioritizing protein intake is crucial for bariatric patients due to several reasons, and neglecting adequate protein consumption can lead to various complications.

Here's why prioritizing protein is important after bariatric surgery and the potential consequences of neglecting this aspect:

Muscle Maintenance and Repair: Protein is essential for building and repairing tissues, including muscle tissue. After bariatric surgery, the body may be in a catabolic state, meaning it is breaking down muscle tissue for energy. Adequate protein intake helps preserve lean muscle mass and supports the body's recovery process.

Satiety and Weight Management: Protein is more satiating than carbohydrates or fats, meaning it helps you feel full and satisfied after meals. By prioritizing protein, bariatric patients can better control hunger and reduce the likelihood of overeating, which is essential for weight management and long-term success after surgery.

Wound Healing and Recovery: Protein plays a crucial role in wound healing and tissue repair. Bariatric surgery involves incisions and tissue manipulation, and adequate protein intake supports the healing process, reduces the risk of complications, and promotes faster recovery.

Prevention of Hair Loss: Hair loss is a common concern after bariatric surgery, often due to rapid weight loss and nutrient deficiencies. Protein is essential for healthy hair growth, and prioritizing protein intake can help minimize the risk of hair loss and support overall hair health.

Immune Function: Protein is necessary for the production of antibodies and immune cells, which are vital for a strong immune system. Adequate protein intake supports immune function and helps the body fight off infections and illnesses, particularly during the recovery period after surgery.

Consequences of Neglecting Protein Intake:

Muscle Loss: Inadequate protein intake can lead to muscle wasting and loss of lean body mass. This can slow down metabolism, decrease strength and mobility, and impair overall physical function.

Delayed Healing: Protein deficiency can impair the body's ability to repair tissues and wounds, leading to delayed healing, increased risk of infection, and complications after surgery.

Increased Hunger and Cravings: Protein helps regulate appetite and promote feelings of fullness. Without adequate protein intake, bariatric patients may experience increased hunger, cravings for unhealthy foods, and difficulty controlling food intake, which can hinder weight loss efforts.

Nutrient Deficiencies: Neglecting protein intake may result in nutrient deficiencies, as protein-rich foods are often good sources of essential vitamins and minerals. This can lead to a range of health problems, including fatigue, weakness, impaired immune function, and poor hair, skin, and nail health.

In summary, prioritizing protein intake is essential for bariatric patients to support muscle maintenance, promote satiety, facilitate wound healing, and ensure overall health and well-being.

Neglecting protein intake can lead to a range of complications and hinder the success of bariatric surgery in achieving long-term weight loss and improved health outcomes. Therefore, bariatric patients should prioritize protein-rich foods and consult with a healthcare provider or registered dietitian to ensure they meet their protein needs after surgery.

Stay Hydrated: Drink plenty of fluids throughout the day, aiming for at least 64 ounces (about 2 liters) of water per day, unless otherwise instructed by your healthcare provider.

Hydration is a critical aspect of post-bariatric surgery recovery and long-term health. Bariatric surgery can affect hydration levels due to several factors, including changes in stomach size, alterations in digestive anatomy, and rapid weight loss. Here's an explanation of hydration issues for bariatric patients, how to deal with them, and why hydration is so important:

Reduced Stomach Capacity: Many bariatric procedures involve reducing the size of the stomach, which limits the amount of fluid that can be consumed at one time. Patients may need to adjust their drinking habits to sip fluids slowly throughout the day rather than consuming large amounts at once.
Changes in Digestive Anatomy: Bariatric surgeries such as gastric bypass or sleeve gastrectomy alter the digestive anatomy, affecting the way nutrients and fluids are absorbed. This can impact fluid balance in the body and increase the risk of dehydration if adequate fluids are not consumed.
Increased Risk of Dehydration: Bariatric patients are at a higher risk of dehydration due to factors such as reduced fluid intake, vomiting (especially in the early post-operative period), and increased urine output resulting from rapid weight loss. Dehydration can lead to serious complications, including kidney stones, urinary tract infections, and electrolyte imbalances.
Importance of Hydration: Adequate hydration is essential for overall health and well-being, particularly after bariatric surgery. Hydration supports various bodily functions, including digestion, nutrient absorption, circulation, and temperature regulation. Proper hydration also helps prevent constipation, a common issue after surgery.
Toxin Release from Fat Cells: During rapid weight loss, fat cells release stored toxins into the bloodstream. Drinking water helps flush these toxins from the body, supporting the detoxification process and reducing the risk of complications associated with toxin buildup.
How to Deal with Hydration Issues:

Drink fluids regularly throughout the day, aiming for at least 64 ounces (about 2 liters) of water per day, unless otherwise instructed by your healthcare provider.
Sip fluids slowly and avoid drinking large amounts at once to prevent discomfort or vomiting.
Choose hydrating beverages such as water, herbal tea, and sugar-free electrolyte drinks.
Monitor urine color; pale yellow urine indicates adequate hydration, while dark yellow urine may indicate dehydration.
Seek medical attention if you experience symptoms of dehydration, such as excessive thirst, dry mouth, dizziness, fatigue, or decreased urine output.

In summary, hydration is crucial for bariatric patients to support recovery, prevent complications, and maintain overall health. By understanding the factors that contribute to hydration issues and adopting strategies to address them, bariatric patients can optimize their fluid intake and minimize the risk of dehydration-related complications.

Avoid Sugary and High-Calorie Foods: Steer clear of sugary beverages, high-fat foods, and foods with empty calories. These can hinder weight loss and may cause discomfort.

Portion Control: Even in the pureed stage, it's important to practice portion control and avoid overeating. Use small bowls or plates to help control portion sizes.

Gradually introducing solid foods after bariatric surgery is essential to allow the gastrointestinal tract time to heal and adapt to changes in anatomy and function. Here's a step-by-step guide to gradually introducing solid foods, starting with the first step:

Step 1: Clear Liquids and Full Liquids (Weeks 1-2 Post-Surgery)

During the first one to two weeks after bariatric surgery, the diet typically consists of clear liquids and full liquids. Clear liquids include fluids that are transparent and easily digestible, such as water, broth, sugar-free gelatin, and herbal tea. Full liquids include thicker liquids that provide more nutrients and calories, such as protein shakes, strained cream soups, and sugar-free pudding.
The amount of liquid consumed at each meal is usually small, starting with a few sips and gradually increasing as tolerated. It's essential to sip liquids slowly and avoid drinking large amounts at once to prevent discomfort or vomiting.
Avoid carbonated beverages, caffeine, and high-sugar liquids, as they can irritate the stomach and cause discomfort. Instead, choose clear or full liquids that are low in sugar and caffeine.
Preferably, opt for clear or full liquids that are high in protein to support healing and provide essential nutrients during the early stages of recovery.

Step 2: Pureed Foods (Weeks 3-4 Post-Surgery)

After the initial two weeks, patients can typically progress to pureed foods. Pureed foods have a smooth, creamy consistency that is easy to swallow and digest. Common pureed foods include lean proteins (such as chicken or fish), cooked vegetables, and soft fruits.
Portion sizes for pureed foods are small, typically starting with 1-2 tablespoons per meal and gradually increasing as tolerated. It's important to eat slowly and chew thoroughly to prevent discomfort and aid digestion.
Avoid foods with tough textures, seeds, or skins, as they can be difficult to digest and may cause discomfort. Instead, choose soft, easily pureed foods that are low in fat and sugar.
Preferably, prioritize protein-rich pureed foods to support muscle maintenance and promote satiety. Aim to include lean proteins, such as chicken, turkey, fish, or tofu, in each meal.

By gradually introducing solid foods in these steps, bariatric patients can allow their digestive system time to adapt to changes after surgery while ensuring adequate nutrition and promoting healing. It's important to follow the guidance of healthcare providers and registered dietitians regarding dietary progression and food choices to optimize outcomes and minimize the risk of complications.

Listen to Your Body: Pay attention to hunger and fullness cues. Stop eating as soon as you feel satisfied, and avoid eating until you feel uncomfortably full.

Nutritional Supplements: Follow your healthcare provider's recommendations regarding nutritional supplements, such as multivitamins and calcium supplements, to prevent nutrient deficiencies.

For bariatric patients, nutritional supplementation plays a crucial role in ensuring adequate nutrient intake, especially due to the changes in digestion and absorption that occur after surgery. Here are the main types of supplements commonly recommended for bariatric patients:

Multivitamins/Multimineral Supplements:

Bariatric multivitamins are specially formulated to provide a comprehensive blend of vitamins and minerals that may be deficient after surgery. These supplements typically contain higher levels of vitamins and minerals than standard multivitamins to meet the increased needs of bariatric patients. Key nutrients to look for include vitamin B12, vitamin D, calcium, iron, folate, and zinc.

Calcium Supplements:

Calcium is essential for bone health, and bariatric surgery can increase the risk of calcium deficiency due to changes in nutrient absorption. Calcium citrate is the preferred form of calcium supplement for bariatric patients because it is more easily absorbed than calcium carbonate. Calcium supplements should be taken separately from iron supplements to maximize absorption.

Vitamin B12 Supplements:

Vitamin B12 is important for nerve function, red blood cell production, and DNA synthesis. Bariatric surgery can impair the body's ability to absorb vitamin B12 from food, so supplementation is often necessary. Sublingual (under-the-tongue) or intramuscular injections are typically recommended for better absorption.

Iron Supplements:

Iron is essential for the production of red blood cells and the prevention of anemia. Bariatric surgery can lead to decreased absorption of iron, particularly in procedures that bypass or reduce the size of the stomach. Iron supplements may be needed to prevent or treat iron deficiency anemia. Iron supplements should be taken separately from calcium supplements, as calcium can inhibit iron absorption.

Vitamin D Supplements:

Vitamin D is important for bone health, immune function, and overall health. Bariatric surgery can affect vitamin D absorption, leading to deficiency. Vitamin D supplementation may be necessary to maintain adequate levels in the body.

Protein Supplements:

Protein is crucial for wound healing, muscle maintenance, and overall health after bariatric surgery. While it's ideal to obtain protein from food sources, protein supplements such as protein shakes or protein powders may be recommended to help meet protein needs, especially in the early stages of recovery when solid foods may be limited.

Other Supplements:

Depending on individual needs and specific deficiencies, bariatric patients may require additional supplements such as folate, zinc, magnesium, or omega-3 fatty acids. These supplements are typically prescribed based on blood tests and nutritional assessments conducted by healthcare providers.

It's important for bariatric patients to follow their healthcare provider's recommendations regarding supplementation and attend regular follow-up appointments to monitor nutrient levels and adjust supplementation as needed. Additionally, patients should choose supplements specifically designed for bariatric surgery patients to ensure they meet their unique nutritional needs.

SECOND MONTH:

Soft Foods: By the second month, patients can typically start incorporating soft foods into their diet. These foods should be easy to chew and digest.

Here are some examples:

Soft-cooked vegetables: steamed carrots, green beans, squash.
Soft fruits: ripe bananas, cooked apples or pears, canned peaches.
Lean protein sources: soft-cooked chicken, turkey, or fish.
Eggs: scrambled or soft-boiled.
Cottage cheese or ricotta cheese.
Soft grains: oatmeal, quinoa, couscous.

1. Continue to Prioritize Protein:

Protein remains essential for healing and maintaining muscle mass. Aim for 60-80 grams of protein per day, spread out over several small meals.

2. Gradually Introduce Solid Foods:

While you can start introducing soft solid foods, continue to focus on foods that are easy to chew and digest. Avoid tough meats, fibrous vegetables, and foods with seeds or skins.

3. Portion Control:

Stick to small, frequent meals and avoid overeating. Use portion control tools like measuring cups and food scales to help manage portion sizes.

Portion control is essential for bariatric patients to manage their weight, prevent overeating, and support their recovery after surgery. Here are some tips for managing portion control:

Use Smaller Plates and Bowls: Opt for smaller plates and bowls to visually reduce portion sizes. This can help trick your brain into feeling satisfied with smaller amounts of food.
Measure Portions: Use measuring cups, spoons, or a food scale to accurately measure serving sizes. This can be especially helpful when preparing meals at home.
Practice Mindful Eating: Pay attention to hunger and fullness cues. Eat slowly, savoring each bite, and stop eating when you feel satisfied, rather than waiting until you feel overly full.
Pre-Portion Snacks: Instead of eating directly from a large bag or container, portion snacks into small bags or containers ahead of time. This can prevent mindless snacking and help control portion sizes.
Fill Half Your Plate with Vegetables: Vegetables are low in calories and high in nutrients, making them an excellent choice for filling up your plate. Aim to fill half of your plate with non-starchy vegetables at meals.
Include Lean Proteins: Protein is important for bariatric patients to support muscle maintenance and promote satiety. Include lean protein sources such as poultry, fish, tofu, beans, and legumes in your meals.
Limit High-Calorie Foods: Be mindful of foods that are high in calories, fat, and sugar. While these foods can be enjoyed occasionally, they should be consumed in moderation to avoid excess calorie intake.
Plan Meals and Snacks: Plan your meals and snacks ahead of time to ensure balanced nutrition and appropriate portion sizes. This can help prevent impulse eating and unhealthy food choices. Here are some examples of small portion ideas for bariatric patients: Remember to consult with your healthcare provider or a registered dietitian for personalized portion control recommendations based on your individual needs and dietary goals.

Protein:
Grilled chicken breast (3-4 ounces)
Baked fish fillet (3-4 ounces)
Tofu or tempeh (1/2 cup)
Greek yogurt (6 ounces)
Cottage cheese (1/2 cup)
Vegetables:
Steamed broccoli (1/2 cup)
Mixed salad greens (1-2 cups)
Roasted Brussels sprouts (1/2 cup)
Sautéed spinach (1/2 cup)
Raw carrot sticks (1/2 cup)
Grains:
Cooked quinoa (1/2 cup)
Brown rice (1/2 cup)
Whole wheat pasta (1/2 cup cooked)
Oatmeal (1/2 cup cooked)
Whole grain bread (1 slice)
Fruits:
Sliced apple (1 small)
Mixed berries (1/2 cup)
Clementine or small orange (1)
Sliced mango (1/2 cup)
Grapes (1/2 cup)

Listen to Your Body: Pay attention to how your body responds to different foods and portion sizes. If you consistently feel uncomfortably full or experience discomfort after eating, adjust your portion sizes accordingly.

Check in with your body throughout the day to see what you need. Your body continually gives you signals of what it needs. Tune in, listen, and learn what the signals are telling you. • Do you need a stretch break? • Is it time for a trip to the restroom? • Are you thirsty? • Need to rest your eyes from the computerscreen? • Too cold? Too warm? • Need a hug? • Does a coworker leave you feeling drained or uplifted? • Are you hungry and ready for a meal? • Need to take a walk or be physically active? • Tired and ready for bed? • How do you feel? Take the time to honor your body’s needs in healthy and constructive ways.

4. Hydration:

Continue to drink plenty of fluids throughout the day, aiming for at least 64 ounces (about 2 liters) of water per day, unless otherwise directed by your healthcare provider.

6.Balanced Nutrition:

Strive for a balanced diet that includes a variety of nutrients from different food groups. Include fruits, vegetables, lean proteins, and whole grains in your meals.

Balanced nutrition refers to consuming a variety of foods in appropriate proportions to provide the body with the nutrients it needs for optimal health and well-being. A balanced diet typically includes foods from all the major food groups in the right amounts to meet the body's energy needs and support its functions.

Here are the key components of balanced nutrition:

Macronutrients:

Carbohydrates: Found in grains, fruits, vegetables, and legumes, carbohydrates provide the body's primary source of energy.
Proteins: Found in meats, poultry, fish, dairy, eggs, nuts, and seeds, proteins are essential for building and repairing tissues, as well as supporting immune function and hormone production.
Fats: Found in oils, butter, nuts, seeds, and fatty fish, fats are important for energy, hormone production, and nutrient absorption. Aim for healthy fats like monounsaturated and polyunsaturated fats, while limiting saturated and trans fats.

Micronutrients:

Vitamins: Essential for various bodily functions, vitamins are found in a wide range of foods. Fruits, vegetables, whole grains, and lean proteins are particularly rich sources of vitamins.
Minerals: Important for bone health, muscle function, and overall well-being, minerals can be found in foods like dairy products, leafy greens, nuts, seeds, and lean meats.

Fiber:

Found in fruits, vegetables, whole grains, legumes, and nuts, fiber is crucial for digestive health, regulating blood sugar levels, and maintaining a healthy weight.

Hydration:

Water is essential for numerous bodily functions, including regulating body temperature, transporting nutrients, and flushing out waste products. Aim to drink plenty of water throughout the day.

Variety:

Eating a variety of foods ensures that you get a wide range of nutrients. Include fruits, vegetables, whole grains, lean proteins, and healthy fats in your diet to maximize nutrient intake.

Portion Control:

Pay attention to portion sizes to avoid overeating. Eating appropriate portion sizes helps maintain a healthy weight and prevents overconsumption of calories.

Overall, balanced nutrition involves eating a variety of nutrient-rich foods in appropriate portions to support overall health and well-being. It's important to listen to your body's hunger and fullness cues, make mindful food choices, and seek guidance from a healthcare provider or registered dietitian if you have specific dietary needs or health concerns.

7.Monitor Tolerance:

Pay attention to how your body responds to different foods. If you experience any discomfort, such as nausea, vomiting, or abdominal pain, avoid the offending food and consult with your healthcare provider.

8.Nutritional Supplements:

Continue to take any recommended nutritional supplements, such as multivitamins and calcium, to prevent nutrient deficiencies.

Some of our bariatric patients have to go to school, while others have to go to work. Of course, when this is the case, is it difficult to eat every few hours? No, it's not. In fact, many of our bariatric patients say it's much more comfortable. So what should we do?

MEAL PLANING

Meal planning and preparation are essential for bariatric patients, especially when going to work or school. Here are some ideas for meal control and planning to take with you:

Protein-Rich Snacks:

Hard-boiled eggs: Pre-cook and peel hard-boiled eggs for a convenient protein-packed snack.
Greek yogurt: Portion out single servings of Greek yogurt and add fresh berries or nuts for added flavor and nutrients.
String cheese or cheese sticks: These are convenient and portable sources of protein.
Beef or turkey jerky: Look for low-sodium options to keep sodium intake in check.
Protein bars: Choose bars with at least 10 grams of protein and minimal added sugars.

Prepared Meals:

Bariatric-friendly casseroles: Prepare a batch of bariatric-friendly casseroles at home and portion them into individual containers for easy grab-and-go meals.
Mason jar salads: Layer chopped vegetables, lean protein (such as grilled chicken or tofu), and a small amount of dressing in a mason jar for a portable and customizable salad option.
Stir-fries: Cook up a batch of stir-fry with lean protein (chicken, shrimp, tofu) and plenty of vegetables. Portion into containers and pair with a small serving of brown rice or quinoa.

Leftovers:

Plan your dinners in advance and intentionally make extra portions to pack for lunch the next day.
Store leftovers in portion-controlled containers to avoid overeating.

Healthy Snack Packs:

Create snack packs with a combination of nuts, seeds, dried fruit, and whole grain crackers for a balanced and satisfying snack option.

Bento Boxes:

Use bento boxes or compartmentalized containers to pack a variety of foods, including lean protein, vegetables, fruits, and whole grains. This allows for easy portion control and ensures a balanced meal.

Homemade Protein Shakes:

Prepare homemade protein shakes using a portable blender or shaker bottle. Include ingredients such as protein powder, unsweetened almond milk, and frozen berries for a nutritious and filling meal replacement option.

Hydration:

Don't forget to pack water or other hydrating beverages to stay hydrated throughout the day. Consider investing in a reusable water bottle to carry with you.

Meal Prep Tips:

Dedicate time each week to meal prep and batch cooking to streamline the process and ensure you have healthy options readily available.
Invest in portion-controlled containers and utensils to help with portion control and avoid overeating.

By incorporating these meal control and planning ideas into your routine, you can ensure you have nutritious and satisfying options to take with you to work or school, helping you stay on track with your bariatric surgery goals.

Prep your home

With your family’s help, clean out the pantry, freezer, and refrigerator of food challenges. Stock with healthy options: fruits, vegetables, lean proteins and protein shakes.

• Place a bowl of fruit on the counter and cut up veggies in a clear container in the fridge.

• Keep the foods that tempt you out of the house.

• If family members want tempting foods in the house, designate a specific area for them, out of sight and accessibility.

• Use smaller plates for your meals.

• When serving meals, keep pots or serving platters on the stove – not on thetable.

• Store leftovers immediately after meals or immediately throw them in thetrash.

• Designate space on the kitchen counter and cupboard just for your things.

• Start collecting the protein shakes and powders, sugar free syrups, extracts, flavored waters and drops, herbs, spices and food journal needed after surgery.

• Once you’ve had surgery, keep the blender, protein shakes, scale, and other things youwill need, right on the counter, for you to see and useeasily.

• Make sure your home is your haven - free from tempting foods.

Change your food shopping habits

• Make a shopping list.

• Place lean proteins and fruits and vegetables at the top of the list.

• Avoid grocery shopping on an empty stomach; it will save your waistline and wallet.

• Shop the supermarket perimeter. Most whole foods are found along the walls of the store and it decreasestemptation.

• By avoiding the inner isles, you can avoid the highly processed and tempting foods.

• Buy only the items that are necessary for you and yourfamily.

• Avoid buying food items for other people that you may eat. If the thought, “But it’s for the kids” pops into your head, take a moment andask yourself if you would eat it too if it was in the house. If the answer is yes, put it back on the shelf.

• For vegetables and fruits, buy canned, fresh andfrozen.

While canned is not as nutritionally dense as fresh or frozen, it is easy to have on hand and better than fast foods choices.

• Buy canned or fresh packed its own juice, no added sugar or syrup.

Things to buy after bariatric surgery

Purchase the items you will need for the pre and post-surgery diets.

• Blender

• Ice cube tray – to freeze small portions of pureedfoods.

• Small dishes and utensils(child-sized).

• Measuring cups, measuring spoons and a food scale. Theseitems are needed to determine the exact portion sizes of the food you eat and drink.

• Crockpot – to prepare moist proteins, i.e. chicken or porkloin.

• Food journal or food record app – to track your protein, calories and all otherhabits needed to lose the weight and be healthy.

• The vitamins & supplements required for Bariatric surgery (see section 7 for more

information). Buy both solid/tablet form to take now and liquid or chewable form for the first 2 months postop.

• High Protein, low sugar beverages and powders. Be aware your taste preferences might change after surgery so you may not want to buy protein shakes a case at a time.

• Buy a variety of flavors and brands of protein shakes/powders to ensure you have options after surgery.

• Sugar-free syrups made with sucralose (i.e. DaVinci and Torani brands) will make your vanilla and chocolate protein shakes more appetizing (i.e. vanilla shake with SF raspberry, caramel, or coconut. The chocolate shake with SF mint, coffee, or amaretto). Cash & Carry have a wide selection for a lowerprice.

• A supply of sugar-free, non-carbonated, non-caffeinated beverages. Herbal tea, Propel water, Sweet Leaf stevia drops, etc.

• Herb and spice blends – these help to make your protein meals more flavorful and interesting during the post op diet progression. (i.e. Italian blend, Creole seasoning, curry powder, etc.). No hot sauces or cayenne pepper for the first two months after surgery. Your pouch needs time to heal.

Physical Activity

When planning for bariatric surgery, it’s easy to focus only on the diet and overlook exercise. In reality, exercise is just as important as your diet for your long term success. There are many benefits you will reap when you exercise regularly but the most important as you proceed with this surgery is you will lose more weight and have an easier time maintaining it.

For many, the thought of exercise conjures up images of the gym, every day for an hour, sweating and huffing and puffing; followed by soreness and fatigue caused by being too aggressive right away. Stop! It doesn’t have to be that way. Instead, start slow so you don’t get discouraged or injured. Think small, do-able steps.

10 minute rule

• Begin with 10+ minutes a day of some type of activity.

• Knowing you only have to do 10 minutes can make getting started mucheasier.

• If you want to continue after 10 minutes, go forit!

• If you are done at 10 minutes, congratulations, you met your goal.

• Walking is the easiest and most accessible form of activity for most people.

• Wear good shoes. Buy shoes that feel good right away, without need to“break them in.”

• Activate your lifestyle: park farther away, take the stairs, clean the house, mowthe lawn, and take stretch breaks at your desk. It all addsup.

• Joint pain is not healthy pain. If the exercise causes pain, modifythe exercise to alleviate the pain or stop.

• If you have physical limitations in your lower body, try performing your strength exercises from a seated position.

• Try “Sit and Be Fit” videos or a mini exercise bike petal system for upperbody.

IMPORTANT TIPS

• If foods feels ‘stuck” do not try to push it down by swallowing fluids as

drinking fluids will cause more discomfort and possibly regurgitation.

Instead get up and walk around.

• Eat slowly; use 10 minutes per ounce as a guideline & a full 20 minutes to

complete a meal. Practice mindful eating. Breathe after every bite.

• Puree meats/proteins with broth, milk or water in blender; pulse until the

consistency of applesauce isachieved.

• Add non-fat powdered milk or acceptable protein powders to your foods to boost protein

amount.

• Use herbs and spices to flavor the proteins/meats.

• Try one new food at a time.

• Eating or drinking too fast can cause nausea, vomiting, or pain.

• Stop eating if you experience any nausea or vomiting.

• If you feel nauseated or experience gas or bloating after eating, then you are notready for this food. Wait a few days before trying this foodagain.

• Listen to your body. Stop when you feelfull.

• Portions may need to be adjusted depending on your individual tolerance. 2-3 bites of food may be all that you can tolerate initially.

• Gradually increase quantity astolerated.

• Be very careful with soups available in the deli section at grocery stores; many arehigh fat and sugar. Be sure to read the label before buying to determine if it meets you needs.

• Eat animal proteins/meats as your main protein sources; and protein shakes and powders to supplement your daily intake.

• You will most likely only be able to eat 1-2 bites of fruits and vegetables since you are eating your protein first. You will be able to eat more in time.

• If you are feeling constipated, making sure you are drinking enough water andwalking helps. If you need more help, try Miralax, a stool softener or add some Benefiber to your foods. Section 8 has more information on constipation.