Guest blog by: Lillian Craggs-Dino, DHA, RDN, LDN, CLT Bariatric surgery is a powerful tool that helps people take control of their weight and health, but the journey doesn’t stop after surgery. It’s a lifelong commitment to staying healthy, which means your diet will need to adapt throughout your lifespan. Whether you’re pregnant, becoming more active, or simply getting older, your nutritional needs shift over time. In this blog, we guide you through these life cycle changes and explain the importance of protein, hydration, supplements, and staying in touch with your healthcare team to stay on track for long-term success. The Foundation of a Bariatric Diet After bariatric surgery, following a structured diet is key to long-term success. The foundation includes: 1. Protein: It is recommended that you consume at least 60 grams of lean protein daily.1 Opt for a high-quality protein supplement if you are struggling to reach your protein goals.2. Hydration: Aim to drink at least 64 ounces daily of sugar-free, carbonation-free, alcohol-free beverages.13. Dietary supplements: Take your recommended daily vitamin and mineral supplements.4. Physical activity: Don’t forget to stay active. After surgery, it's important to exercise for at least 30 minutes each day. This helps you reach a healthy body weight and improve your body composition.25. Eating habits: Eat slowly and chew properly. It’s okay to take 30 minutes to eat a meal. Adjusting Nutrient Needs for Pregnancy Post-Op Your nutritional needs will change based on your individual circumstances. For example, if you’re planning to get pregnant or become pregnant after waiting the recommended year post-op, you’ll need to adjust your nutrition to support your baby’s healthy development. After metabolic bariatric surgery, it’s important for you to increase your protein intake as your baby grows throughout each trimester.It’s also essential for you to take prenatal vitamins that include 800-1,000mcg of folic acid to help prevent neural tube defects (such as brain and nerve damage) in your baby. Regular check-ins with both your bariatric team and OBGYN are important to ensure all your vitamin and mineral levels are healthy for both you and your baby.Another concern is managing weight gain during pregnancy or preventing weight regain after delivery. You should work closely with your OBGYN to ensure you are gaining the appropriate amount of weight for your baby's growth. Typically, a weight gain of 25-35 pounds is recommended if you were at a normal weight before pregnancy, while if you are overweight, you should aim for no more than 25 pounds.Consulting with a registered dietitian can help you make healthy eating choices and manage your weight effectively during pregnancy and after, including if you are breastfeeding. Nutrient Requirements for Increased Physical Activity: Bariatric Athletes If you’ve had metabolic bariatric surgery and have increased your activity levels to reach an athletic stage, it’s important for you to adjust your diet. In addition to consuming more protein, you should include healthy carbohydrates and fats to meet your body’s needs.If you enjoy endurance exercises like running, cycling, or swimming, increasing your intake of complex carbs (whole grains, legumes, starchy vegetables) is essential. Carbs provide the energy you need for these activities and help prevent the loss of lean body mass (LBM). Generally, you need 30-50 grams of carbs for healthy brain function, and as an athlete, you’ll require even more to support your exercise. Timing your carb intake is also crucial—aim to have a serving before and after your workouts.When it comes to protein, focus on lean sources that are rich in leucine, a branched-chain amino acid that helps build LBM. Good sources of leucine include eggs, dairy, chicken, and red meat. Nutritional Requirements for Healthy Aging Post-Op As you get older, your nutritional needs change. It’s important for you to adjust your intake of protein, fluids, vitamins, and minerals to meet both your age-related needs and the specific recommendations for metabolic and bariatric surgery patients. Regular lab tests through your bariatric program are a great way for you to monitor and adjust these levels over time. Vegetarian Bariatric Diet As you age, you might consider following a vegetarian diet. While vegetarian diets can be very healthy, they can become problematic for you as a metabolic and bariatric patient if you’re unsure where to find plant-based proteins or if your protein intake quality is insufficient.Some plant-based proteins to include in a healthy diet include: - Quinoa: A versatile grain that is high in protein and contains all nine essential amino acids. - Soy products: These could include tofu, tempeh, or edamame. These options are high in protein and fiber and versatile in dishes.- Chia seeds: High in protein and healthy fats and can be used in many dishes.- Plant-based protein supplements: Pea protein is a high-quality protein source that can be added to smoothies, baking, or even oatmeal.It’s important to be mindful of your protein sources to maintain proper nutrition. Conclusion It’s important to remember that metabolic and bariatric surgery is just a tool to help you achieve your health goals. What you get out of it largely depends on your knowledge, motivation, and active involvement in your health journey. Your nutritional needs will change based on your activity level and stage of life, so staying informed is essential for your well-being.To ensure long-term success, all patients should:- Stay in contact: Regularly connect with your bariatric program.- Meet with health professionals: Schedule regular check-ins with your surgeon and dietitian to discuss your progress and any concerns.- Maintain a lifelong commitment: Continue taking your recommended supplements and have regular lab tests to monitor your nutritional levels. References 1. Mechanick JI et al. Obesity (Silver Spring). 2020;28(4):O1-O58.2. King WC et al. Exerc Sport Sci Rev. 2013;41(1):26–35.