Stage 3 Blended/Pureed Nutrition diet

Follow this nutrition therapy, blending everything to the consistency of applesauce, until your dietitian gives you new instructions. This will usually happen at your first doctor's visit after surgery.


Goals
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To help you lose enough weight after gastric lap-band or Roux-en-Y surgery
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To provide enough protein, fluid, vitamins, and minerals to keep you healthy
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To decrease side effects of surgery


Beverage Guidelines
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Drink 48 ounces or more of low-fat, low-sugar liquids every day. To drink this much, try sipping 1 ounce (2 tablespoons) every 15 minutes.
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About half of what you drink (24 ounces per day) should be high-protein drinks or strained cream soups. These should have at least 15 grams protein, less than 20 grams carbohydrate, and less than 5 grams fat per cup (8 ounces).
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At least half of what you drink (24 ounces or more per day) should be sugar-free liquids.


Good choices include the following:
o Water
o Decaffeinated coffee or caffeine-free tea without sugar (you may use sugar substitute)
o Sugar-free, noncarbonated drinks, like Crystal Lite or sugar-free Kool-Aid,
or "flat" sugar-free soda pop
o Diet V-8 Splash
o Low-calorie cranberry juice
o Sugar-free Jell-O (¼ cup = 2 ounces)
o Sugar-free Popsicles
o Broth


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Do not drink liquids with a meal or for 30 minutes after a meal. This can cause the pouch
to stretch, and you will not lose all the weight that you can. You are also more likely to
regain weight later.
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Do not drink alcohol. It is dehydrating and has no nutrients.
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Do not drink carbonated (bubbly) drinks. The bubbles may give you gas, cause bloating,
and stretch the stomach pouch.


Meal Guidelines
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Stop eating when you first feel full.
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All foods must be blended or pureed.
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Take 15 minutes to eat each meal.
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If you had lap-band surgery, eat three meals per day.
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If you had Roux-en-Y surgery, eat six to eight meals per day.
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Eat foods in this order:
o Have protein foods first. Foods with protein include pureed or strained baby foods
(meat, fish, and poultry types) and eggs.
o Then eat vegetables and fruit.
o Have starchy mashed potatoes and strained cooked cereal last.


Vitamin and Mineral Supplements
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Take two chewable multiple vitamin/mineral supplements daily. You must do this
forever! Do not quit taking your vitamins, no matter how good you feel.
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Take other supplements, including calcium, vitamin B-12, and iron, if you need them.
Your doctor or dietitian will tell you what to do.


Dumping Syndrome
Dumping syndrome is a condition where food does not stay in the stomach for long enough.
Instead, it is "dumped" into the small intestine. This can make you feel weak or dizzy, get a
headache, turn red, or have diarrhea.
To avoid dumping:
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Do not drink liquids with a meal.
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Do not drink liquids within 30 minutes after a meal.
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Do not eat or drink foods made with sugar.
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Avoid high-fat and greasy foods.


Other Tips
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Do not chew gum. If you swallow it, gum can block the stomach opening.
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Do not drink from a straw. Straws make you swallow air. That causes bloating and can
stretch the pouch.


Sample 1-Day Menu
8:00 am 4 to 6 tablespoons cooked cream of wheat, with 2 tablespoons skim milk to thin cereal 1 chewable multiple vitamin tablet
9:00 am 1 cup skim milk—Sip slowly; have 2 ounces every 15 minutes.
10:00 am 1 cup low-calorie cranberry juice—Sip slowly; have 2 ounces every 15 minutes.
11:00 am 3 tablespoons cottage cheese and 1 tablespoon strained peaches
12:00 Noon 1 cup sugar-free lemonade—Sip slowly; have 2 ounces every 15 minutes.
1:00 pm 2 to 3 tablespoons strained beef, 2 tablespoons pureed green beans 2 tablespoons mashed potatoes 1 chewable calcium tablet (if prescribed)
2:00 pm 1 cup caffeine-free tea with sugar substitute—Sip slowly; have 2 ounces every 15 minutes.
3:00 pm 1 cup liquid protein supplement—Sip slowly; have 2 ounces every 15 minutes.
5:00 pm 6 tablespoons sugar-free instant pudding made with 1 scoop of protein powder
6:00 pm 2 to 3 tablespoons strained turkey, 2 tablespoons pureed carrots, 2 tablespoons mashed potato, 1 chewable multivitamin tablet
7:00 pm 1 cup skim milk—Sip slowly; have 2 ounces every 15 minutes
8:00 pm 3 tablespoons cottage cheese and 3 tablespoons applesauce with a sprinkle of cinnamon 1 chewable calcium tablet (if prescribed)
9:00 pm 1 cup high-protein cream of chicken soup
10:00 pm 1 cup decaffeinated coffee—Sip slowly; have 2 ounces every 15 minutes


Remember:
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Take 15 minutes to eat each meal.
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At meals, always eat protein (meat, eggs, fish, or poultry) first!
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Do not drink liquids at meals.
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Wait at least 30 minutes after a meal to start drinking fluids. Aim for 48 to 64 oz (6 to 8 cups) of fluids daily.
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Stop eating or drinking when you are full.
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Do not drink alcohol.
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Do not drink from a straw.
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Sip, don't gulp!