Bariatric Diet Guidelines:
Pre-testing
Tricia Mah MS,RD and Aisling Mc Ginty MS, RD.
Dietitian/Nutritionist
The Center for Bariatric Surgery and Metabolic Disease
Topic: Summary
 Stage 1 Diet: Clear Liquid Diet
 4 x 4 Rule
 Protein Supplement
 Daily Vitamin & Mineral Supplements
 Physical Activity
Stage 1 Diet: Clear Liquids
Gastric Bypass: 1 week of clear
liquids
Lap Band: 2 weeks of clear
liquids
Stage 1 Beverages: Clear
Liquids
 Crystal light®
 Herbal tea( decaf)
 Diet Gelatin
 DIET Twister
 DIET Snapple ®
 DIET Ocean Spray
Cranberry
 Sugar free Kool-Aid
 Broth/Consommé
 Diet V8 Splash ®
 Country Time Diet
Lemonade ®
 Wyler’s diet
lemonade
 Sugar free ice pops
Flavored Water Options







Water
Dasani Flavored Water
Hint Flavored Water
Fruit20
Aquafina Flavor Splash
Propel Water
Smart Water
READ the nutrition label!!!
*NO calories (<5-10kcal)
*NO sugar
*NO carbonation
What to Find on the Hospital
Tray
Clear Liquid Diet: Tray Contents
 Water
 Diet Jell-o
 Tea (non-caffeinated)
 Soup/Broth
 Juice
 Must dilute 1:1 with water
 Recommend: Avoid juices once discharged from hospital
4x4 Rule
4 x 4 Rule
Drink 1 oz per hour for the first 4 hours.
Remember to sip slowly!
= 1 oz
 Drink 2 oz per hour for the next 4 hrs.
=2 oz
4 x 4 Rule
Drink 3 oz per hour for the next 4 hrs.
= 3 oz
Drink 4 oz per hour for the next 4 hrs.
= 4 oz
4 x 4 Rule
 Start with 1 oz/ hr- sipped slowly.
 Increase in 1 oz increments every 4 hours
 Goal rate: 4 oz per hour
Fluids
 Drink 48 to 64 oz each day
 Avoid sweetened, caffeinated, carbonated
beverages
 Do NOT use a straw
 STOP drinking if you feel fullness, pain or
discomfort
Fluid Journal
 Record ALL liquids consumed
 4 oz EVERY hour for 12-16 hours per day.
 Record total ounces per day
Protein Shake
 Begin the day after you go
home from Hospital
 Minimum protein goal
70grams per day
 May be mixed with Skim milk,
Skim milk plus, 1% milk, Soy
milk, Water, Crystal Light.....
Nutrition Facts
Serving Size: 1 level scoop (~24g)
Amount per Serving
Calories 90
Calories from Fat 15
% Daily Value *
Total Fat 1.5g
Saturated Fat 1g
Cholesterol 30mg
2%
5%
10%
Sodium 80mg
3%
Potassium 160mg
5%
Total Carbohydrate 2g
1%
Dietary Fiber 0g
0%
Sugars 0g
Protein 18.0g
37%
Protein Supplement
Worksheet
Protein Powder Name:
Designer Whey Protein
Nutrition Label: Serving
Size: 1 scoop
Protein _____18____
Grams
Protein Content: Beverages
Beverage Type:
Skim Milk Plus
Protein Content in 4oz:
X
5.5 grams
Skim Milk
4.0 grams
Soy Milk
3.0 grams
Lactaid Milk
4.0 grams
Water
0.0 grams
Crystal Light
0.0 grams
Protein Supplement
Worksheet
5.5
_______Grams
of Protein in Beverage
+
18
_______Grams of Protein in 1 Scoop
23.5
_______Grams of Protein in ONE SHAKE!!!!
Protein Supplement
Worksheet
Circle One:
1 2 3 4 5 Shakes Needed Per Day to
get at least 70 grams of
Protein!!
Daily Multivitamin
and Mineral Schedule
Daily Vitamin and Mineral
Schedule
My schedule
Time
Sample
Schedule
Time:
Multivitamin
7:00am
Calcium:
500mg
12:00pm
Calcium:
500mg
5:30pm
Iron
9pm
Daily Vitamin and Mineral
Schedule
 Multivitamin  Chewable or Liquid form
 Calcium Citrate with vitamin D
 Do NOT take calcium with iron
 Take 2-4 hours apart!
 500mg of calcium at one time.
Multivitamin and Protein
 Begin your daily
vitamin/minerals and
protein shake the day
AFTER you get home!
 You will need to take
multivitamins for the rest of
your LIFE!
MOVE!
 Immediately following
surgery get up and move!
 Helps get rid of excess
gas
 Decrease potential health
risks- pulmonary embolus,
blood clots
MOVE!
At home: walk inside and outside. This is
your responsibility!
 Record exercise in journal and bring to visits.
As tolerated slowly incorporate treadmill,
stationary bike, elliptical, chair exercises.
 Swimming: incorporate once wounds heal.
Summary
 Only clear liquids are allowed
 Juices in hospital must be diluted 1:1 with water
 Do NOT use a straw
 Avoid caffeinated and carbonated beverages
 Start off with 1 oz of liquids sipped slowly over 1 hr.
Use the 1 oz cups provided.
 As tolerated, fluids will be gradually increased in 1
oz increments every 4 hrs to a goal rate of 4 oz/hr
while awake (4x 4 rule).
Important!
Bring to Hospital:

Booklet “Your
Guidelines for Food
Choices and Nutrition”

Pen or Pencil

4x4 Worksheet
(today’s handout).

Watch or clock
Bring to EVERY
office visit:


Booklet “Your
Guidelines for Food
Choices and Nutrition”
Food and Exercise
Journal