Guest blog by: Lillian Craggs-Dino, DHA, RDN, LDN, CLT Metabolic and bariatric surgery is an incredible tool when it comes to obesity to help patients reach their health and weight loss goals. However, the surgery alone cannot do everything. Post-surgery, patients must commit to making significant diet and lifestyle changes to ensure long-term success. These changes include prioritizing protein intake, drinking adequate fluids, and taking daily vitamin and mineral supplements. Additionally, patients work hard to incorporate exercise and physical activity into their routines.This blog explores the crucial role of diet and nutrition post-surgery, with a special focus on sugar consumption. Understanding how to manage sugar intake effectively can help to avoid complications and sustain a healthy weight loss journey. Discover the challenges and four strategies for sugar management after metabolic and bariatric surgery. Components of a Healthy Post-Surgery Diet After metabolic and bariatric surgery, a healthy diet includes more than just lean proteins. Patients should eat a variety of wholesome foods such as whole grains, vegetables, and fruits. The surgery provides a feeling of restriction and may result in reduced nutrient absorption, making it crucial to choose nutrient-dense foods.One nutrient that requires special attention is sugar. Excessive sugar intake can elevate the risk of heart disease, dumping syndrome, high blood pressure, tooth decay, reactive hypoglycemia, weight gain, fatty liver, and the return of health conditions like type 2 diabetes. Understanding Sugar: Challenges and Recommendations For metabolic and bariatric patients, navigating sugar consumption can be confusing. Here are some key points to consider. 1. Different names for sugar: Sugar can appear under various names, such as dextrose, fructose, and high-fructose corn syrup. There are about 60 different names for sugar, which can complicate reading food labels. 2. Reading food labels: When looking at the amount of sugar in a product, patients often wonder whether to focus on "total sugar" or "added sugar." Added sugar refers to sugar that is not naturally part of the product and is added during processing. 3. Sweeteners and alternatives: There are numerous sweeteners, sugar replacers, and sugar substitutes available. So, is there an acceptable amount of these sweeteners to consume? It's unrealistic to expect patients to eliminate sugar entirely, especially since natural sugars are present in fruits. Sugar, also known as sucrose, is a substance produced by all plants. Sucrose is composed of fructose and glucose molecules. Different plant products contain varying amounts of sucrose.The World Health Organization recommends that less than 5-10% of calories come from free sugars, which is a suitable dietary guideline for bariatric patients.1,2 Typically, it's recommended that bariatric patients limit intake to approximately 15-20 grams of sugar per day.3 Strategies to Reduce Sugar Intake Sugar cravings are a normal occurrence. Patients can employ several strategies to manage and reduce their sugar intake: Sugar substitutes: Consider using sugar substitutes or artificial sweeteners such as sucralose. Natural alternatives like stevia and monk fruit are also acceptable. Sugar alcohols: Sugar alcohols, also known as sugar replacers, like sorbitol, xylitol, and maltitol, offer low-calorie alternatives but should be used with caution as they can cause sensitivity in some patients. Natural sugars: Opt for minimally processed natural sugars like blackstrap molasses, demerara sugar, honey, and maple syrup. These options provide more nutrients but should still be consumed in moderation. You should always measure, portion, and limit intake. Herbs and spices: Use flavorful herbs and spices such as vanilla, cardamom, cinnamon, anise, and unsweetened cocoa to enhance the taste of foods and beverages without adding sugar. If more recommendations are needed, it is important to speak with a registered dietitian regarding healthy eating. Summary Metabolic and bariatric surgery is a powerful tool, but its success depends on a patient's dedication to comprehensive lifestyle changes. Managing sugar intake post-surgery is crucial due to the potential complications from excessive consumption. Bariatric patients can consume sugar, but it's essential to do so cautiously.Understanding the different names for sugar, reading food labels accurately, and choosing appropriate sugar substitutes are essential skills for patients. By adopting strategies to reduce sugar intake and incorporating nutrient-dense foods, patients can effectively support their weight loss goals and reap the health benefits. References 1. World Health Organization. https://iris.who.int/handle/10665/42665. Accessed May 29, 2024. 2. World Health Organization. https://www.who.int/publications/i/item/97892415 49028. Accessed May 29, 2024. 3. Sherf Dagan S et al. Adv Nutr. 2017;8(2):382-394. *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.