RE: Vegan after Weight Loss Surgery
Posted Friday, February 26, 2010 at 9:52 AM
All right. I've consulted another dietitian on staff who has a lot more professional experience in this area than I do. From Joseph Gonzalez, RD:
Congratulations on your successes and weight loss. This is a difficult question as we do not know your labs (pre and post op), and we are not your primary dietitian. Therefore, I do not want to persuade you from your current RD’s advice. Pretty much it depends on what you can handle as far as food goes. Everyone differs regarding what foods lead to diarrhea, constipation, reflux, etc. - I imagine you know your body very well by now. I think the beans are a great way to go for protein if the body agrees. Cook in a low sodium vegetable broth to add flavor…probably no spice (chilies) as that can be aggravating. As long as you are eating complex carbohydrates, dumping syndrome should not take effect. Tofu or tempeh could be a good friend as they are very high protein sources with minimal fat compared to meat products. Sauce it up with some braggs liquid amino acids or soy sauce (unless you are Hypertensive), garlic, and/or lemon juice.
Interestingly, meat aversion is common (more so with lap band surgery), but it does occur, hence why some are concerned with adequate iron intake. All Roux en-Y is different depending on where the attachment site has been placed; therefore it is very hard to determine mineral absorption.
Nutrients to be aware of regardless of vegan/vegetarian diet:
1) Iron is a key nutrient, as risk of low iron from gastric bypass related to low gastric acid, incomplete protein digestion, bypassed site of active absorption, and the above mentioned meat aversion (which is a non issue if you consume the beans and greens). Suggest consulting with physician/surgeon and taking MVI, or cooking in cast iron skillet, better yet cooking tomato sauce in cast iron skillet and pouring over buckwheat (whole grain) noodles. Pumpkin seeds although high in fat have substantial iron, I recommend eating 1-2 oz every other day if possible.
2) Calcium: Try to increase the greens, but more importantly maintain a healthy Vit D level as fat malabsorption may occur. Try to get 15 min of direct sunlight a day and drink fortified soy, rice, or almond milk for Vitamin D and B12. Once again, talk to your doctor about a vitamin D and B-12 supplement. You are bypassing the stomach which produces the B-12 carrier called intrinsic factor; therefore a B-12 supplement and B-12 fortified foods will be necessary, and I would consult your doctor about intravenous B-12 shots, if you are not currently on them.
I recommend eliminating lactose from the diet (which you have if you are eating a vegan diet), as this carbohydrate and other refined simple carbohydrates can lead to dumping syndrome as well.
Eat slowly, chew foods well, and drink water in between meals and 30 min after meals to support the high fiber containing foods in your new diet. Do not exersice after meals, but before and a few hrs after. 5-6 meals day, small portions of course.
Look at our recipes and re-arrange food items as necessary to meet your needs.
Susan Levin, MS, RD
PCRM Director of Nutrition Education