13 January 2021


Section 12: Dietary advice for weeks 1 & 2 – liquids only


A liquid diet must be followed for the first 2 weeks after surgery to ensure optimum healing occurs. During this time, you may feel hungry and “normal,” but you are likely to have internal swelling and there are stitches holding the band in place, which need time to settle. It is therefore crucial you stick to this regime.

 

What constitutes a ‘liquid’?

 

“Liquid” defines any fluids that can be poured in a steady stream/flow – this can range from water to a custard consistency.

 

Avoid any liquids with lumps – choose smooth varieties or use a blender where needed. Thin down any thicker fluids to ensure a pouring consistency.

 

 

How much should I drink?

 

Aim for a total fluid intake of at least 2 litres (around 4 pints) daily. This includes any meal replacement drinks, soups, milk, water, tea, coffee etc.

 

Everyone has different fluid requirements, so the best way to monitor your hydration is to keep checking the colour of your urine. It should be pale straw-coloured approximately 4-5 hours after waking onwards. If it is dark and concentrated, it is an indication you need to increase your fluid intake

 

 

How should I drink?

 

There are four very important things to remember in order to avoid discomfort and/or regurgitation:

 

  1. Don’t serveyourself too much in one sitting - the recommended portion size is around 200ml (⅓ pint).
  2. Take small sips/mouthfuls, not large gulps. Using a child’s spoon to take fluids, rather than drinking directly from a cup or glass, can be useful. It is best not to use a straw as it can mean you swallow air, which can be uncomfortable.
  3. Drink very slowly - after each mouthful, wait for 20 to 40 seconds before taking your next sip. This means that it is likely to take at least 20-30 minutes to drink 200ml (about ⅓ pint) of fluid, especially initially post-surgery.
  4. Don’t leave long gaps between drinks. Aim to sip continuously throughout the day. This will mean your digestive system is kept stimulated and so it will be easier to drink. It will also help to ensure you consume enough fluid.

 

It’s important to remember that everyone is different, and you may feel comfortable to drink at a faster pace than described. Do not worry if this is the case. The main thing is to avoid discomfort and/or regurgitation.

 

What should I drink?

 

The main focus at this stage is on liquids containing protein.

 

Your liquid diet will need to be high in protein to ensure optimum healing. The average requirement for an adult is around 50g per day. You will need to focus on fluids containing protein rather than just water/squash/tea/coffee. We recommend you aim for at least 5 x 200 ml (about ⅓ of a pint) of a variety of the following fluids, which will contain at least 10g of protein on average:

 

  • Semi-skimmed, 1% fat or skimmed milk (with 1 heaped tablespoon of skimmed milk

powder (most supermarkets do their own-branded version of this; another brand name is Marvel) – this is called fortified milk

 

  • Meal replacement shakes/soups / protein drinks, e.g. Slim Fast, Complan, Meritene, Tesco Ultraslim, Asda Meal Replacement, Celebrity Slim, Saints & Slimmers

 

  • Pouring yogurt / yogurt milk (e.g. Activia)

 

  • Lentil / pea & ham / bean soups – all blended and thinned down, if needed, with stock or milk to ensure they are the correct consistency

 

  • Any other type of soup (blended consistency) with 2 heaped tablespoons of skimmed milk powder added to increase the protein content

 

There are many protein drinks widely available in supermarkets and online, all of which are  suitable during this stage, too. They may contain more than 10g protein per 200ml serving, which is fine. Examples include U:Fit, Upbeat, Fuel, For Goodness Shakes, Arla Protein milkshake, Arla Protein flavoured milk, Arla Protein water, Arla Skyr yogurt drink, Asda Sports Nutrition protein water, Vieve protein water, Grenade Carb Killa, CocoPro protein water.

 

If you have found a protein drink not listed, just be careful to ensure it is not too high in sugar and that the consistency is thin and smooth.

 

You may consider that ice-cream is a suitable option during the liquid stage, but we advise against it due to its high calorie content.

 

Other liquids

 

The following fluids are allowed in the liquid diet to top up your total intake to 2 litres per day, but your primary focus should be on those with protein listed above:

  • Water
  • No added sugar squash/cordial
  • No added sugar, still, flavoured water
  • Regular/herbal/fruit tea
  • Coffee
  • Sugar-free ice lollies

 

Yoghurts, jelly and custard

 

Smooth low fat/fat-free yoghurts with no bits, sugar-free jelly and low-fat custard can be taken once you are comfortably tolerating pourable consistency liquids.

 

If you do attempt these, make sure that you follow the 20/20/20/20 rule. If you experience any discomfort or regurgitation with these, remove them from your diet and try them again 3-4 days later.

 

Drinks to avoid or limit during this phase

 

Completely avoid:

 

  • Fizzy drinks
  • Alcohol. As you are not consuming solid food, your tolerance levels will be greatly

reduced and its dehydrating effects will be magnified.

 

Avoid or limit high sugar/high fat drinks such as:

 

  • Flavoured water or squash/cordial, unless ‘no added sugar’ or ‘sugar free’ varieties
  • Still ready-mixed fruit drinks e.g. Oasis, Ribena, unless ‘no added sugar’ or

‘sugar free’ varieties

  • Whole (full fat) milk due its fat content
  • Milkshakes that are not designed as meal replacements e.g. Frijj, Nesquick
  • Fruit juice – limit to 100ml per day and dilute 50:50 with water
  • Smoothies
  • ‘Still’ energy drinks e.g. Lucozade.
  • Hot chocolate and malted drinks (e.g. Horlicks, Ovaltine) – choose “light” varieties but take care as they are still quite high in sugar

 

Vitamin and mineral supplement

 

Remember to take a chewable multivitamin and mineral supplement daily as advised earlier. (See Follow up and general guidelines on life with a band.)

 

 

Possible problems during this stage:

 

Nausea with milky drinks

 

Some people find that milky drinks/milkshakes can cause nausea (feeling sick). If this happens, switch to meal replacement soups.  If you still find these also cause nausea, choose hearty soups such as lentil, bean and pea & ham. Regular vegetable-based soups can have skimmed milk powder added to them to boost the protein content. If you still find you feel nauseous, try juice/smoothie-style drinks (e.g. Up Beat) or protein water (e.g. Asda Sports Nutrition, Vieve, Coco Pro).

 

Discomfort/pain when drinking and or regurgitation/vomiting

 

If drinking is uncomfortable / you are struggling to swallow and/or you are regurgitating fluid after drinking it, firstly think about whether you are taking small mouthfuls and resting between mouthfuls as described previously.

 

If you are still struggling, contact us immediately for advice, as we may need to inform your surgeon and/or arrange for your band to be loosened.

 

Constipation

 

Fibre and fluids help with constipation. Ensure your total fluid is enough overall – around 2 litres daily - and try options such as prune juice, blended fruit and vegetables, and meal replacement drinks (as these contain added fibre). If necessary, try a liquid fibre supplement, e.g. Fybogel, HyFiber (the latter available on prescription only).

 

Sample Meal Plan 1 (thin liquids only):

Breakfast: 200ml meal replacement shake – try a vanilla one and blend with a teaspoon of coffee powder and lots of ice

Mid-morning: 200ml glass of fortified milk

Lunch: 200ml lentil soup – blended until smooth

Mid-afternoon: 200ml pouring yoghurt

Evening meal: any tinned soup (blended until smooth), fortified with skimmed milk powder

Supper: homemade berry protein shake

 

Sample Meal Plan 2 (slightly thicker consistency once thin fluids are well-tolerated)

Breakfast: a handful of raspberries blended with 200ml fortified milk

Mid-morning: 200g natural low fat yoghurt (smooth consistency)

Lunch: 200ml homemade lentil and squash soup

Mid-afternoon: an individual pot of low fat custard or a sugar free jelly

Evening meal: 200ml meal replacement shake – try a vanilla one and blend with lots of ice

Supper: low calorie hot chocolate sachet made with 200ml of fortified milk

 

Remember: Although we have shown intake split into specific meals/snacks, you should aim to sip continuously throughout the day.  Don’t forget to have additional fluids (water, sugar-free squash, tea, coffee), so your total fluid intake is around 2 litres.

 

Liquid phase – check list

 

  • Aim to have around 2 litres of fluid daily
  • Smooth liquids only – no lumps
  • Sip slowly, and wait 20 seconds before the next sip
  • Avoid using a straw
  • Have around 5 protein-containing drinks daily – 200ml serving size
  • Avoid alcohol and fizzy drinks
  • Take a chewable multivitamin & mineral supplement daily
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