No doubt you have heard on the news that the Mediterranean diet is one of the healthier diets out there: less heart disease, less strokes, less memory loss. So how do we adopt this program for people who have the Lap-Band or Gastric Sleeve?
So here is a bit of that diet for people who have the Lap-Band , or sleeve, and recommendations to help you incorporate this pyramid into your life.
This is for our morning snack or breakfast. Remember, you can eat breakfast anytime of the day.
How to Eat
When people get in trouble with the food it is typically how they eat. So there is a simple rule to follow with any food. We call it nickel-twenty-twenty.
If you have the Lap-Band, before you eat any meal have a full glass of water or tea. If your band is just too tight- don’t think about eating. Gastric Sleeve patients shouldn’t do this because you have so much room, but your stomach will empty the liquid in 15 minutes or so, so a glass of water 15-30 minutes before you eat is great.
Never put anything in your mouth larger than a nickel. Eat something larger than a nickel and it can get stuck above the band, or in the case of the sleeve – at the curve. Where people get in trouble is when they eat with their hands- like eating an apple, or a carrot, or (sadly) pizza. When you take too big a bite it odes not matter how much you chew- it will clog the system. People who say they cannot eat lettuce is because they put a large piece on their fork and eat it. People who say they cannot eat apples often take a big bite – better to cut it into pieces and take a fork and eat small pieces at a time.
Twenty chews is good. It tells you to slow down -and chew well. If something is still “chewy” after twenty bites then it is overcooked (if it is meat) or way overcooked (if it is vegetables) will not go through the band. Better to quietly spit it out than to get it stuck and try to regurgitate it.
Wait twenty seconds before you have another bite. This encourages slow eating. Eating fast is the surest way to have a band slip or pouch dilation, and it is a way for gastric sleeve patients to NOT dilate their sleeve. So – after swallowing, wait at least twenty seconds before you have another bite.
Breakfast or Mid-Morning:
Lap-band patients are typically not breakfast eaters. The band is a bit tighter in the morning, and most people get up and head to work within a couple of hours. So we will change this to the mid-morning snack instead. Or, if you do get hungry – use this as a guide. Gastric sleeve patients may or may not like breakfast.
Even for people who do not have weight loss surgery, getting up and trying to eat something is just not always possible. Breakfast isn’t the most important meal of the day, it does not “jump start” your metabolism – so if your body isn’t ready to eat – don’t eat. But often you will feel ready about four hours after you wake up.
Options – consider this meal to have three components: a protein, a fruit, and a whole grain.
Proteins for mid morning snack
6 ounces of Greek yogurt (be careful, most yogurts – even labeled Greek have a lot of sugar – sometimes best to use plain and add fruit). with 1/2 cup of strawberries mixed in – sliced thinly. Mix together.
1 egg. If the egg is over cooked it won’t be good. So consider sous vide eggs, or a poached egg, or a soft boiled egg. If you hard boil and egg – cut it very thinly and eat with a bit of mustard.
1 egg that is scrambled – slowly and stir a lot, use olive oil. Add 1/2 ounce of crumbled feta cheese with it.
You can make a number of egg dishes like a scramble, but don’t overcook the eggs.
1 cup of granola – healthy style, not with added sugar or sugar roasted nuts.
Whole Grains for Mid morning or breakfast
One piece of Ezekiel bread with half mashed avocado or guacamole. Or 1 tablespoon of peanut butter
Steel cut oatmeal with 1 tablespoon of almonds and 1/2 cup of milk (fat free plus works). Also consider 1 tablespoon of raisons.
2 small oat muffins with 1 tablespoon of peanut butter – eat slowly
1/4 cup cup of granola with the protein being 6 ounces of Greek yogurt.
1 slice of cinnamon-raisin bread with 1 tablespoon of goat cheese or 1 slice of Norwegian goat cheese
Fruits for Mid Morning Snack
One cup of melon cubes. A good healthy fruit provides some substance. Remember, never eat anything larger than a nickel – because otherwise it can get stuck. So cut the cubes up – and eat them with a fork.
1 cup of berries – remember, don’t eat a mouthful at a time. Eat them slowly.
1 banana – again, this is easy to eat a big bite and get stuck. Take the banana and slice into nickel size pieces – eat with a fork.
Freshly squeezed grapefruit juice – we have them here- the pulp isn’t needed, but the juice is nice.
1 cup of sliced peaches. A refreshing snack for mid morning. Get a peach – slice it yourself – or keep some but watch for the added sugar.
1 small sliced tomato. Again, rule of nickel applies. A tomato is a nice fruit for breakfast.
4 small fresh figs – the nickel rule applies- eat them slowly and enjoy. Good snack for having at the desk.
1 cup of strawberries. Again, remember to slice and eat with a fork.
1 cup of blueberries – remember to eat these one at a time. A great snack.
Dr Terry Simpson
Dr. Terry Simpson is a Phoenix weight loss surgeon. He encourages his lap-band surgery patients to learn to cook and adopt healthier lifestyles. His goal is to use culinary medicine to keep patients out of his operating room. in 2017, Dr. Simpson became a Certified Culinary Medicine Specialist.