Let’s start with the serving size.
The serving size is the amount of the product that is being evaluated on the food label. It is important to understand how many servings are in a product prior to eating to help prevent eating excess calories. For Example, if you sit down and eat an entire family size bag of chips, you are consuming at least 5 times the number of calories, fat, carbohydrates (CHO), and protein that is on the food label. To avoid eating excess calories, measure out one serving prior to consuming when eating from multiple serving products.
Who knows what the percent daily value (DV) means?
This tricky number a lot of people look over. The percent daily value is the % of the nutrient found in the food product that contributes to your total daily intake of that item. For example, if a product has a DV of 16% then you have consumed 16% the recommendation for fat for the day. However, it is extremely important that you keep in mind; DVs are based on a 2,000 calorie diet. If you’ve had lap band, gastric sleeve, or gastric bypass surgery, this is not the normal calorie intake per day. You may be asking, well how will this apply to me? Let me tell you. One way you can use this value it to determine if it is high or low in a nutrient.
5% or less = low
20% or more = high
As you can see in the label above for Macaroni & Cheese, this item is high in sodium and pretty high in fat. It is also high in calcium, but low in vitamin A, C, and Iron, probably not the greatest snack to choose.
A lot of people have heard of and know what calories are.
Calories provide a measure of how much energy you are consuming from the product. Understanding this number is important because it helps you manage your weight. Calories IN (food consumed) must be less than calories OUT (calories burned) to lose weight. Calories also make up the total amount of macronutrients (CHO, fats, and protein) listed on the food label.
Fats, good or bad??
Fats are broken down into three types: saturated fat, unsaturated fat, and trans fats. Saturated fats may increase LDL (bad) cholesterol and are generally solid at room temperature. Sources of Saturated fat include: meat, dairy products (butter, ice cream, whole milk, cheeses made with whole milk, sour cream, and cream cheese), palm oil or coconut oil. Unsaturated fats are generally liquid at room temperature; they are separated into monounsaturated fatty acids and polyunsaturated fatty acids. Monounsaturated fats tend to lower your LDL cholesterol, and may increase your HDL (good) cholesterol. Monounsaturated fats include: olive oil, canola oil, peanut oil, almonds and avocado. Polyunsaturated fats (Omega-3 and Omega-6) tend to lower LDL cholesterol. Sources of Omega-6s include: corn oil, sunflower oil, safflower oil, sesame oil, and soybean oil. Sources of Omega-3s include: flax seeds, walnuts, sardines, salmon, soybeans, tofu, and shrimp.
Not as many people look at the cholesterol unless you have history of heart disease. Cholesterol is only in animal foods, and believe it or not, is actually made by the human liver. Cholesterol is important, because it is a building block for steroid hormones such as testosterone and estrogen. Even if you do not have a history of heart disease, you still need to watch the amount of cholesterol you consume each day. You should try to limit cholesterol to less than 300 mg daily.
Sodium is a nutrient that people struggling with hypertension may monitor. It is important to limit sodium intake to 2,000 mg daily (this is ONLY 1 teaspoon of salt). It is easy to reach this amount if you are consuming highly processed/convenient foods. You may want to especially watch out for soups, canned vegetables, prepared foods, soy sauce, pickled foods, and any items with visible salt. Eating fresh foods, making foods at home using herbs and spices instead of salt to season, and shopping the perimeter of the grocery store will help lower your intake of sodium daily.
Carbohydrates are made up of dietary fiber (soluble and insoluble) and sugar. When you subtract dietary fiber from the total amount of carbohydrates on the food label, this equals the NET carbs for the product. The left over carbohydrate number tells you how much starch and other non-sugary content is in the food.
Gastric bypass patients need to be especially careful with sugar. When it comes to sugar, it is important to understand the difference between natural sugars and added sugar. When you are looking at the food label and is says 19 g of sugar. If sugar is listed in the ingredient list, then the sugar has been added. If the sugar is NOT listed in the ingredient list, then the sugar is naturally occurring in the product. Some foods with naturally occurring sugars include: milk products (plain yogurts), fruit, grains, legumes, etc. For example:
Label 1 is plain yogurt – contains no added sugars
Ingredients include: cultured pasteurized grade A non-fat milk
Label 2 is a fruit (sugar sweetened) yogurt
Ingredients include: cultured grade A reduced fat milk, apples, high fructose corn syrup, cinnamon, nutmeg, natural flavors, and pectin.
You should also be aware the sugar can be disguised on the food label. It may be called one of the following: cane sugar, dextrose, cane juice, honey, barley malt, raw sugar, refiner’s syrup, high fructose corn syrup, molasses, maltose, fruit juice concentrate, dehydrated cane juice, agave nectar, beet sugar, buttered syrup, caramel, confectioner’s sugar, and more. For more names you can refer to this link. http://clinton.k12.wi.us/documents/sugar_names.pdf
Fiber, located under carbohydrates is broken down into two types, soluble and insoluble. Both types of fiber are extremely important following bariatric surgery. Sometimes patients my experience constipation, therefore getting enough fluid and fiber will help regulate the digestive system. Insoluble fiber functions to move bulk through the intestines and controls and balances the acidity in the intestines. The benefits include: promotion of regular bowel movements, removal of toxic waste through the intestines quickly, and it may help prevent colon cancer. Food sources include: vegetables (green beans, dark green leafy), fruit skins and root vegetable skins (potatoes), whole wheat products, corn bran, seeds, and nuts. Soluble fiber functions to bind fatty acids for excretion, prolongs stomach emptying (making you feel fuller longer and releases sugar more slowly). The benefits include: lowering total cholesterol and LDL cholesterol reducing the risk of heart disease, and regulating blood sugar. Food sources include: oats and oat bran, dried beans and peas, nuts, barley, and flax seed, fruits (oranges and apples) vegetables (such as carrots). It is important to aim for at least 25 g of fiber each day. If you are currently consuming a diet low in fiber, it is important to increase slowly and make sure you are drinking plenty of water throughout the day; this will prevent GI distress. To increase fiber intake, choose grains and breads with at least 5 g or more fiber in each serving.
Last, but definitely NOT least
Protein intake is the number ONE goal for bariatric surgery patients. Protein is essential to prevent hair loss, maintain immunity, and prevent a decrease in metabolism. It is extremely important to make sure you are meeting your protein goal daily. You can find your protein goal in the patient handbook on page 40; this number is based on your height and gender. Protein is easy to decipher on the food label, there are no tricks or gimmicks. The protein number is what it is. Good sources of protein include: egg whites, skim or 1% milk, low fat cheese/cottage cheese, light yogurt or Greek yogurt, lean-chopped meats, seafood, poultry, and bariatric approved protein supplements. Remember it is important to ALWAYS eat your protein FIRST at your meals to help you reach your protein goal.
Kelsey Shepperd, MS, RD/LD, CPT, Registered Licensed Dietitian with My Bariatric Solutions, works with weight loss surgery patients in Decatur, Fort Worth, and Dallas Texas on their nutrition requirements pre- and post-surgery. Not only does she educate, but also strives to motivate her patients while adjusting their lifestyle habits, making their bariatric experience even more successful. Kelsey has worked as a bariatric and clinical dietitian at various facilities in the Dallas Fort Worth area.