Nutrition is very important in bariatric surgery patients. Despite high energy consumption, micronutrient deficiencies can be seen in morbidly obese individuals. If there are deficiencies of macro or micronutrients in the preoperative period, this situation may double after the operation. Therefore, these deficiencies should be noticed before the operation and replaced with an adequate and balanced diet.
Adequate and balanced intake of energy and macro-micronutrients should be provided in order to facilitate tissue healing and support lean body mass after the surgical procedure. Minimizing the occurrence of side effects such as reflux and dumping syndrome seen after the surgical procedure is provided by proper nutrition recommendations. For this reason, attention should be paid to the implementation of preoperative and postoperative nutritional recommendations based on the type of surgery.
There are many different techniques of bariatric surgery, which has been on the agenda in recent years. The technique to be used varies according to the condition of the person.
Nutrıtıon Before And After The Surgery
Ensuring weight loss before the operation facilitates the process during and after the operation and reduces the occurrence of complications.
First of all, a detailed anamnesis should be taken from the patients. In general, healthy dietary recommendations should be given to patients before surgery. The diet program should be prepared individually, and it should contain sufficient energy, macro, and micronutrients.
The purpose of post-operative nutrition is to provide sufficient energy, macro, and micronutrients in the diet program to facilitate recovery and prevent muscle loss. In addition, providing an adequate and balanced diet will help reduce the risks of postoperative complications.
A gradual feeding process is applied after bariatric surgery. These; clear liquid, puree, soft and solid foods diet. The patient should take 60-80/g protein and 1500 ml liquid daily. The content of the selected food should be rich in protein. The number of meals should be 3-6. Fluids should be started thirty minutes after a meal and fluid consumption should be avoided during meals. Liquids should not be consumed with meals. In this process, solid-liquid separation is very important.
The solid foods diet is the addition of solid foods to the patient’s diet as tolerated. This diet starts when the patient is hungrier and can consume more food and lasts for life. The food consumed should be at room temperature. Since taking liquids with food can cause nausea and vomiting, they should not be consumed at the same time.
After bariatric surgery, the patient’s diet may be insufficient in terms of protein, vitamins, and minerals since the patient must eat very low calories and some procedures prevent the absorption of nutrients. In this process, muscle loss can be experienced if adequate protein is not taken, and a balanced and regular nutrition plan is not created. These losses should be replaced with nutrition and appropriate nutritional supplements.
After bariatric surgery, deficiencies in iron, B12, calcium and vitamin D values can often be seen. Multivitamins should be started in the early postoperative period. After the surgical procedure, patients should have blood tests after bariatric surgery at regular intervals. In the presence of deficiency, supplementation should be provided under the supervision of a physician.
Proteın Consumptıon In The Post-Surgery Perıod
Proteins are the basic building blocks of the body. Therefore, we need to get enough protein every day. The daily requirement varies according to the age, weight, and disease of the person. Protein requirement after bariatric surgery varies according to the patient and the type of surgery.
In order to prevent loss of muscle mass and to prevent protein malnutrition, protein needs must be completed in a short time. In the postoperative period, the daily energy intake of the patients decreases, while the protein requirement increases.
RYGB patients are recommended to use a minimum of 60 g of protein per day and a maximum of 120 g of protein or 1-1.5 g of protein per kilogram of formula weight per day. For sleeve gastrectomy patients, a minimum of 60 g and a maximum of 80 g of protein should be taken daily.
Post-Operatıonal Lıquıd Consumptıon
In the first weeks of the operation, attention should be paid to slow fluid consumption. After laparoscopic gastric bypass or sleeve gastrectomy, 30 ml of liquid can be consumed per hour on the first day. But this fluid consumption should be gradually. You should start with a daily consumption of at least 1 liter of water and gradually increase to 1.5-2 liters.
General Recommendatıons After Barıatrıc Surgery
The patient should consume the amount of food to be consumed by spreading over time. Eating time should last up to 20 minutes. Thus, complaints such as nausea and vomiting can be prevented.
When the food is consumed by reducing the volume, the congestion of the sensitive stomach can be prevented.
When consuming foods, the first choice should be proteins, then carbohydrates and fats should be consumed.
Caffeine consumption should be reduced gradually. Since excessive caffeine consumption can cause dehydration, its intake should be limited.
Dry and high-fiber foods can cause discomfort in the patient. Therefore, foods that are difficult to digest should be avoided. According to the tolerance, it should be added to the nutrition plan after a certain period.
Since sugar and sugar-containing foods can cause dumping syndrome, such foods should be avoided. Instead of these foods, fruits and vegetables containing natural sugar should be consumed.
Complex carbohydrates should be preferred over simple carbohydrates.
Consumption of protein-containing foods should be increased. Eating and drinking should be stopped as soon as satiety is felt
3 main and 3 snacks should be consumed daily.
Smoking and alcohol should not be consumed.
Solid foods and liquids should not be consumed at the same time.
Foods high in fat and sugar should be avoided.
Attention should be paid to portion control.
Exercise should be done regularly every day. For these patients, daily cardio exercises of at least 30-45 minutes will accelerate the weight loss process.