A macronutrient is something the body needs to consume in substantial quantities (as opposed to micronutrients, like vitamins and minerals, which are also essential but are needed in small quantities). There are four macronutrients: Water, plus the three energy (calorie) providing nutrients Protein, Fat, and Carbohydrate.
Water has many important functions in the body, including regulating body temperature, lubricating joints, carrying oxygen and nutrients to the cells, and flushing out toxins and waste products. Being well hydrated also keeps our skin feeling and looking its best. You need at least 64 ounces of fluid over the course of a day. (Drink more if you’re still thirsty!) You continue to need 64 ounces after Weight Loss Surgery (WLS), even if you do not feel like drinking much at the beginning, so please make this a priority. You can prevent a post-WLS dehydration hospitalization!
Do not count caffeinated or alcoholic beverages ounces in your daily fluid total, because both are diuretics which negatively impact hydration status. (And of course, follow your program’s guidelines regarding limiting or avoiding caffeine or alcohol after WLS.) If you don’t like the taste of plain water, flavor yours with mint leaves, cucumber slices, fresh fruit slices, or make herbal ice tea from your favorite tea bags. Try to cut back on your intake of beverages containing sugar or artificial sweeteners/colors….these are generally highly processed and contain very few redeeming nutritional qualities.
The word Protein comes from the Greek, Protos, which means “to come first.” This is exactly how we should think about protein consumption after WLS. The amino acids from the protein we eat are used as building blocks to make the body proteins of our skeletal and organ muscle as well as those responsible for immune function, blood clotting, fluid balance, hormone and enzyme production, and cell repair. Any leftover amino acids not needed for building body proteins can be broken down to provide energy to the body (4 calories/gram).
Unlike fat and carbohydrate, our body does not store protein away for a rainy day…so if we don’t consume adequate protein daily, we have to catabolize our own skeletal and organ muscle to get amino acids needed for the above tasks. Over time, this is harmful to our health, worsens our body composition, lowers our metabolic rate, and leaves us less strong and fit.
Please follow your program’s guidelines for the amount of protein to consume daily after weight loss surgery (most programs set the minimum intake around 50-60 grams of protein per day). If you don’t know how much protein you’re currently eating, log your consumption using an app or online calorie counter.
You should spread your protein consumption out between your three daily meals. Aim for whole foods that are good sources of protein like seafood, free-range eggs, organic poultry and beef, natural cheeses, no-sugar-added Greek yogurt, beans, and seeds/nuts (and their butters). After WLS some people find they need an additional protein supplement (like a low-sugar shake or bar) to meet their minimum protein needs. 100% whey protein is a great choice for most, but there are supplements made from egg white, soy, and even pea protein. Read labels and select brands with short ingredient lists. Be aware of any added sugars, artificial sweeteners/colors or preservatives added.
Fat has gotten a bad rap in the past, but new research is exonerating dietary fat in many ways. Fat has important roles in the body, including absorption of key vitamins, insulating the body, keeping our skin and hair soft, providing satiety from meals, and of course, storing energy for the future. Not all dietary fat is created equal however. Most of us should work to replace our consumption of trans fats (eliminate all together!), saturated fats (especially those from non-organic beef, pork and poultry) and omega-6 polyunsaturated fatty acids (found heavily in corn oil, soybean oil, sunflower oil and safflower oil and most processed foods) with consumption of heart healthy and anti-inflammatory omega 3 fatty acids (fatty fish, flaxseed, organic grass fed beef & dairy, and high omega-3 eggs) and monounsaturated fats (olives & olive oil, canola oil, avocado, nuts, nut oils and nut butters). Follow your program’s guidelines for total fat intake, and spread this out between your three meals. Fat provides 9 calories/gram.
The main role of carbohydrate in the body is to provide energy (4 calories per gram). For this reason, when we are watching our energy balance to manage our weight, we should bring the most scrutiny to our carbohydrate intake. Many carbohydrate foods contain lots of calories with very little nutrition; we should limit or avoid these for best weight management:
- Sugary beverages like fruit juice, sweetened coffee/tea, soda, energy drinks, cocktails, etc.
- Sweets like cookies, cakes, candy, etc
- Refined grains like white bread, white rice, regular pasta, crackers, cereals, etc
- Highly processed snacks like chips, popcorn, etc
However, other carbohydrate containing foods come packed with vitamins, minerals, phytonutrients, and fiber:
- Whole vegetables and fruits (deep color is often a clue that a plant food is particularly packed with phytonutrients)
- Whole grains
- Dried beans and peas (aka “legumes”)
- Organic milk and no-sugar-added yogurt
After WLS, we can include these foods in moderation if we have room after meeting our protein needs.
Author: Healthy Steps’ Dietitian Lindsay Pasdera