Protein…
the New Regime after Weight-Loss Surgery

Carol Bowen Ball, the UK's 1st Bariatric Cook offers some advice

We've all heard the advice from our bariatric team about taking our vitamin and mineral supplements; chewing slowly and thoroughly; not drinking while eating; eating 'mindfully' 3 main meals a day and no 'grazing'; hydrating well with at least 2 litres of water daily; opting for low-fat and low-sugar foods; and just eating to satiety…so the PROTEIN advice often gets forgotten or relegated to the back burner.

But protein is a key nutrient in the human body. Every cell within it contains protein and so the body needs a steady supply of it each and every day to help with repair and rebuild. Without adequate protein intake, individuals may see an increased loss in muscle mass, strength and stamina.

Although gastric bypass patients and those with more complex revisions are at most risk from protein deficiency (due to poor absorption), sleeve and band patients need also to be seriously aware of eating enough protein too.

Many weight-loss surgery patients seriously under estimate the importance of sufficient protein in their diets. Figures are quoted by dieticians and nutritionists, like 70g per day, but have little relevance when it's hard to know what 70g of protein looks like in 'real food'.

Protein Requirements

As a general rule of thumb most wls patients are asked to aim for 60-80g protein per day (but do follow the advice given to you by your own bariatric team since this varies with procedure and can be as high as 130g daily). Within a restricted number of calories per day this will inevitably mean a high protein regime needs to be implemented to ensure protein needs are met. This is why post-op patients are advised to eat protein at every meal and to focus on eating this element of the dish first. You've doubtless heard the mantra 'protein first, vegetables and fruit next, then finally eat the carbs' from your own dietician…and it makes sense.

Sources of Protein

Protein thankfully comes from a variety of sources, the main one, of course, being meat products. Most animal products contain at least 7g protein per 25g/1oz and that is how the majority of people meet their requirements for their day. Animal sources are not just limited to beef, lamb, pork and chicken but also include fish, eggs, seafood and all dairy products. Protein can also be found in non-animal sources too. Foods like beans, legumes, nuts, seeds, tofu and soy products can also be valuable sources of protein. By combining these different sources in a varied diet, an individual can usually achieve adequate protein intake pre-surgery.

However, after a bariatric procedure achieving this can be more of a challenge, especially if there is difficulty consuming and digesting certain sources of protein.

Like many other health professionals I agree that it is always better to eat your protein rather than drink it in the form of a protein powder supplement…but if you are continually under-scoring and coming up short on the daily tally then a little of this taken as a drink, as a protein bar or stirred into a food could be part of the answer. These items are usually easy to digest and provide a large quantity of protein without a lot of calories or bulk.

Achieving Protein Goals

So what does 70g protein look like in 'real food'?

A good shortcut for you to use is to know that most meat, fish, poultry or animal products have about 7g of protein per 25g/1 oz. On average, you would therefore need to eat about 275g/10 oz to achieve that bare minimum requirement of protein a day. Divide this over 3 meals and say a couple of light snacks and it can be anything but easy. My dietician suggests that I try to aim for:

• 100g/31/2 oz protein foods at breakfast
• 100g/31/2 oz protein foods at lunch
• 125g/4 oz protein foods at dinner

to ensure that all bases are covered, and then add 1-2 small snacks (chosen carefully) with perhaps 10-12g protein, so that I am well nourished protein-wise.

'But how do I know what 100g/31/2 oz protein food looks like'? you may well ask. Well if it's in a pack then look at the back and check the information on the nutrition label there. If it's a recipe then look at the amount for the portion size you are planning to eat. My own recipes give this information for a regular/normal portion and then give a guide for a wls portion.

For a generalised protein list giving guidelines for many protein sources like roast meat, cooked eggs, a portion of beans, a typical yogurt and a handful of nuts go to www.bariatriccookery.com and click on the food and nutrition category.