Guest Blog by: Lillian Craggs-Dino, DHA, RDN, LDN, CLT Embarking on the road to metabolic and bariatric surgery signifies a step toward a healthier and happier life. At the heart of this journey lies the bariatric diet, carefully crafted to support your body's needs through the transformative process. Focusing on protein, fluids, and essential nutrients through food and supplements, this dietary regimen is crucial in sustaining weight loss and promoting overall health post-surgery. In this blog, we'll explore the key role of protein in your bariatric diet, shedding light on its importance in preserving muscle mass during rapid weight loss and ensuring the health of your body's vital functions. From navigating the challenges of meeting protein requirements to understanding the quality of different sources of protein and how to monitor your intake, we'll provide you with the knowledge and tools to navigate your post-surgery nutrition journey confidently. Prioritizing Protein Intake The rapid weight loss experienced after bariatric surgery can lead to fat and lean muscle mass loss. To counteract this, patients are advised to prioritize protein consumption to preserve muscle mass and support healthy bodily functions. Adequate protein intake minimizes the side effects of weight loss, such as sarcopenia, and ensures long-term weight maintenance. Overcoming Challenges Patients may encounter challenges meeting their protein requirements post-surgery, such as: 1. Difficulty consuming adequate amounts of high-quality protein According to the American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines, consuming 1.2 grams of protein per kilogram of body weight during the rapid weight loss phase is recommended to maintain lean body mass. This translates to approximately 60-80 grams per day for women and 80-100 grams for men, depending on individual body weight. 2. Intolerance to specific protein sources due to textures and consistency Food tolerance typically improves over time, and strategies such as eating slowly, chewing thoroughly, and opting for moist and tender foods can facilitate easier consumption. Understanding Protein Quality Not all proteins are the same, and their quality is determined by the types of amino acids they contain. Amino acids are the building blocks of protein structures, with a total of 20 amino acids essential for human health. Among these, nine are considered essential because our bodies cannot produce them, so we must obtain them from our diet. However, with these nine essential amino acids, our bodies can synthesize the remaining 11. Complete proteins are those that contain all nine essential amino acids necessary for human health. Table 1 below gives the names of indispensable and essential amino acids that can be found in a high-protein diet. For those opting for plant-based protein in their diet, soy and quinoa provide complete protein alternatives. While other plant-based foods such as whole grains, legumes, pulses, and certain vegetables also contain amino acids, they may not offer all nine essential amino acids in one food item. Hence, it's important for individuals to understand how to combine different plant-based foods to ensure they obtain all essential amino acids in their diet. Self-Monitoring Protein Intake Self-monitoring is key to ensuring high-quality protein intake. Various methods, including mobile apps, food label reading, and portion weighing, can help patients track their protein consumption accurately. Table 2 shows some selected protein-rich foods and grams of protein in the serving indicated. Patients can also read food labels and weigh food on scales to calculate protein intake. As a general guide, every ounce of cooked protein would give approximately seven grams of protein. The goal would be for patients to consume three to four ounces of protein daily to give 21-28 grams of protein per meal. Drinking protein shakes is also an ideal way to ensure high-quality protein content and may be used as a meal replacement or as a snack in-between meals. Table 1. Amino Acid Chart Indispensable and Essential Amino Acids Dispensable Amino Acids Threonine Alanine Valine Arginine Tryptophan Asparagine Isoleucine Aspartic Acid Leucine Cysteine Lysine Glutamic Acid Phenyalanine Glutamine Methionine Glycine Histidine Proline Serine Tyrosine Table 2. Protein-Rich Foods Protein Foods Amount of Protein per Serving (grams) Large whole egg 6-7 Greek plain yogurt, 8 ounces 12-23 Cottage cheese, low-fat, 8 ounce 12-14 Swiss cheese, low-fat, 1 ounce 8 Nonfat milk, 1 cup 7-11 Pork chop, boneless, lean, 3 ounces 26 Turkey breast, skinless, 3 ounces 24 Chicken breast, skinless, 3 ounces 24 Ground beef, 95% lean 3 ounces 18 London broil red meat, 3 ounces 23 Yellow Fin Tuna, 3 ounces 25 Halibut, 3 ounces 23 Salmon, 3 ounces 23 Tilapia, 3 ounces 21 Sardines, 3 ounces 21 Navy beans, 1 cup 20 Lentils, ¼ cup 13 Canadian bacon, 3 ounces 15 Peanut butter, 2 Tablespoons 8 Tofu, 3 ounces 12 Edamame, ½ cup 8 Summary Metabolic and bariatric surgery is a valuable resource for individuals striving to reclaim their health and achieve their weight loss objectives, but it also requires a commitment from patients. Healthcare professionals, including registered dietitians, play a crucial role in supporting patients through education on the significance of daily protein intake, guidance on self-monitoring techniques, and assistance in overcoming nutritional hurdles. Patients can take charge of their journeys by participating in follow-up appointments, joining support groups, and adopting a diet rich in lean proteins and nutritious foods. By embracing these strategies, individuals can set themselves up for long-term success and wellness that extends throughout their lifetime. *These statements have not been evaluated by the Food & Drug Administration (FDA). These products are not intended to diagnose, treat, cure, or prevent any disease. This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your bariatric surgeon or another qualified healthcare provider with any questions in regard to a medical condition. A qualified healthcare professional can best assist you in deciding whether a dietary supplement is suitable based on your individual needs.