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Gastric Sleeve Diet Discussion

I just read Ultimate Gastric Sleeve Success: A Practical Patient Guide to Help Maximize Your Weight Loss Results by Dr Duc Vuong. I’d recommend this book for all bariatric patients, because he embraces a whole foods approach to recovery and establishing new eating habits. It is totally worth the $8 Kindle version.

While I love his EAT REAL FOOD mantra, the book is biased towards an Asian diet. He never addresses anything dairy other than to say “only baby cows should drink milk”, which is in line with his Asian background. He also does not address taking medications – as in, when can you take pills again, etc.

The first chapters of the book are very informative about how the surgery is done, with diagrams, which I love. I think for any bariatric patient, this book is A MUST READ. It definitely goes against the crappy diets handed out by the “nutritionists” who work with bariatric surgeons. Every diet I’ve seen has been absolute CRAP. Geeze, no wonder everyone loses their hair if they only eat fruit smoothies and yogurt for eight weeks! The diet given to me was boring, fruit based and asked for WAY too much protein: 80 grams a day!! WHAT?! I don’t eat that now! That is a LOT of protein, and unless you can eat whey powder straight, it’s doubtful you’ll get that much down. I’m aiming for 40-50gm.

Another very important point that Dr Vuong addresses is “mushy food syndrome”. This is when a bariatric patient continues to eat mushy foods long past the time needed for the stomach to heal. By continuing to eat mushy foods, you not only are not helping your new stomach to work properly, but you are not getting satiety because these foods slide right through your pouch. You eat more and this can undo your weight loss. It’s important to start eating real protein as soon as possible after your sleeve surgery. Dr Vuong goes into rating foods on texture, which I think is an INVALUABLE thing for bariatric patients to learn.

I disagree with his hatred of chicken, however. He also hates on pork and beef and recommends never ever eating anything but fish. Again, his Asian bias is displayed. I think chicken is a staple for most Americans and there is nothing wrong with chicken as your protein. Pork and beef should not be eaten more than 1-2 times a week anyway, so restricting those makes sense.

I DO agree that fish is softer than chicken, so eating fish to start out with solid protein is a great idea.

Dr Vuong completely ignores dairy products in his recommendations. Again, Asian bias. I think that yogurt absolutely has a place in recovery to replenish gut flora. I don’t drink milk, so I probably won’t be using it myself, but I don’t think that using milk in smoothies is a bad thing at all. Milk has protein, which is a prime ingredient for recovering bariatric patients. I plan to use Silk, a soy milk that is fortified with calcium and protein. I also have soft cheese (SOFT cheese, not hard cheese in slices or blocks.) in my soft foods list, because I love cheese and I can make a soup, or eat some goat cheese or pimento cheese if I want it. I also love cottage cheese, so that is also on my soft foods list. Let’s not forget that cheese is also high in protein.

What I’ve found, overall, when reading about bariatric diets, is that there is about a million different ideas on what you should do. The typical diet handed out by so called dieticians is a generic, fruit based diet that really doesn’t address anyone’s dietary needs. I’ve seen the exact same diet given to diabetics (high carb for DIABETICS!!). I think that this generic diet is given with the assumption that you’ve been sitting around eating junk food and drinking sodas all your life and that is why you’re fat. I see lots of assumptions from Drs and dieticians, who tend to think that you must eat really shitty foods to be fat. Which is absolutely NOT true. I eat a great diet and I exercise regularly thankyouverymuch. I do get a little bent out of shape when I consistently see these biases towards bariatric patients.

Furthermore, I think it is a damn shame that fat shaming extends to the very industry that is supposed to be helping people lose the weight in the first place.

I think that bariatric patients need to eat nutrient dense vegetables and protein powder until they can manage solid proteins. Fruits contain lots of sugars and have little nutritional value, IMO. I am not a person who eats much fruit to begin with nor do I eat lots of sweet stuff in general. I simply cannot tolerate a diet that is sweet and fruity. Ick. It makes more sense to me to eat as low carb as possible from the get-go, since that is how you should eat to maintain your weight loss. It’s too bad that 90% of what I’ve seen on forums, sites and books is conflicting and biased towards bland, uninspired, high carb foods and omg no fats. Low fat is good, yes, but not at the expense of eating high carb fruit all day long. I actually feel that bariatric recovery patients should not worry about fats since they are calorie dense. When you can only eat a cup of food a day (in recovery), you need every calorie you can get. And NO, I do not subscribe to the idea that if you let one gram of fat pass your lips you’ll go back to eating like before. Why? Because your stomach is now about 1/6 of it’s original size, that’s why. It’s damned hard to overeat when you are recovering from sleeve surgery!

Again, I feel that pretty much every bit of “official” advice (Dr, Nurse, nutritionist) is based on the assumption that if you’re fat, you got that way because you have no idea how to eat. Perhaps that is so for some patients, but I doubt it’s true for the majority. If you learn one thing while you’re fat, it’s how to count calories and what foods are “bad”. Honey, I can tell you the calorie and fat counts of pretty much any food you name. WE GET IT. I resent being given these diet rules that have no basis in reality. They are given to “wean” you off of eating real food with the notion that if you have anything other than crappy smoothies you’ll immediately order Papa Johns and eat the whole thing. This bias that if you eat anything other than nonfat yogurt and berries you’ll “relapse” into being fat is really annoying.

I think anyone going on this journey should prep lots of different kinds of foods that YOU LIKE before you go under the knife. I am prepping about a dozen different veggie purees that can be made into soup or used as is. I’m freezing them in 1 cup portions for easy thawing. I’m assuming that I’ll only eat about 1/4 cup of anything at a time, hence the small portions. I am using lots of flavours in my purees, from Asian to Indian to Korean and beyond. Onions and garlic are in EVERYTHING. I see no reason to compromise on flavour just because I have to eat pureed foods. Hummus is also a smooth and tasty thing that’s on my list.

The base recipe for these purees and a Carrot Ginger soup recipe are here.

I hope this info helps someone else getting gastric sleeve or any bariatric surgery.

Coconut Confetti Rice

I’ve made this rice a couple of times for a side and I can tell you that it is AMAZING with the Gochujang Salmon! Don’t be afraid of the jalapeno, it is not noticeably hot. It just gives depth of flavour.
Coconut Confetti Rice

Coconut Confetti Rice

1 cup basmati rice, rinsed
1 cup chicken broth or water
1 cup coconut milk (sometimes called cream – NOT coconut water)
1 tsp curry powder (use two if you’re going for Indian/Asian flavour)
1/3 cup red onion, small dice
1 jalapeño, small dice
1 tsp butter
1 tsp EVOO
Juice of 1/2 lime

In a 2 quart sauce pan, melt butter and EVOO over med hi heat. Add in onion and jalapeño, cook for 3-4 minutes, until soft. Add curry powder and cook another minute. Add rinsed rice and stir to coat. Add coconut milk and stock. Turn up heat to high until you get to boil, then reduce to med to simmer. Simmer covered for about 12-15 minutes, until the rice is cooked through. If the liquid boils out, add a little more water. When rice is al dente, turn off heat add lime juice, and leave covered for another 8-10 minutes for perfectly fluffy rice.

Despite the curry powder, this rice is pretty neutral in taste and delicious with any protein – unless you double the curry to make it more Indian/Asian. I especially like it with my Gochujang Salmon, but it would be great with a teriyaki chicken or even a spicy pork. It is the best rice side I think I’ve ever had. I hope you enjoy it!

Base Recipe for Pureed Veg & Soups

I refuse to believe that you have to eat nothing but protein shakes and fruit smoothies for 2 months – as the diet plan from the nutritionist indicated. Just because you can’t eat much, does not mean that you have to eat flavourless goo. I don’t eat a lot of fruit in the first place, so I can’t see me being into it after surgery. I will be using Silk fortified soy milk since it has protein and calcium added. I have no idea what I’ll be able to eat after the gastric sleeve, but by the gods, I want to have delicious savoury options at the ready. I’m sure I’ll tire of sweet things since I don’t eat sweets much now.

These are recipes for bariatric diet weeks 3-4, which is pureed soups. You can use any root vegetable you like: carrot, potato, parsnip, celeriac. It will also work with tomatoes, spinach, broccoli, butternut squash, mushrooms and roasted red pepper. Actually, this same recipe will work for soft foods weeks 4-8, just reduce the liquid and you’ll have pureed veg. Weeks 1-2 are clear liquids, so I think anyone can figure out BROTH. I will suggest getting some beef bone broth from a Korean grocery if you have one. And miso soup would be good, too.

You’ll need flavourless whey protein to add to everything you eat. I’d make the puree/soup, then add the protein only to your serving to keep it from affecting the overall texture of the puree/soup. I am making purees and freezing them for quick and easy prep when I get back home. I’m also making lots and lots of homemade chicken stock to try to boost the protein content as much as possible.

The key to making any of these purees is the NutriBullet. GET ONE. If you are getting any sort of bariatric surgery and must follow a pureed diet, the NutriBullet will do everything you need. You can do smoothies, sure, but this thing makes veg into a beautiful smooth puree, which is perfect for soups or soft foods. Today I made Carrot & Ginger puree with coconut milk:


Carrot & Ginger Puree/Soup with Coconut Milk

1# carrots, scrubbed (no need to peel), sliced
1 medium white onion, med dice
1 Tbl garlic paste
2 Tbl ginger paste (These pastes are Indian items. I highly recommend them for these purees.)
2 cups +/- chicken stock
1/4 cup coconut milk (Sometimes called cream. NOT coconut water!)

In a 2 qt saucepan, add a bit of EVOO to the bottom and put over med hi heat. Toss in carrots and onions and cook for about 5 minutes – do not brown. Add in garlic and ginger, and enough stock to just cover the veg and cook at a fast simmer for about 15 minutes, until carrots and onions are soft. Take off the heat and check S/P. Puree the veg in the NutriBullet. Add coconut milk to the puree and stir in. Leave as is for puree or add more chicken stock to thin down to a soup.

The base for about 1 quart of puree is just this:
1# Veg, sliced or diced
1 Onion, diced
1 Tbl Garlic, minced or use paste
2 cups +/- chicken or beef stock

Cook until soft, check seasoning, puree. That’s it. If you’re freezing, do NOT add any dairy. You can add that when you make the soup. All these can be made with soy milk and veg stock or water if you’re vegan.

And don’t forget to add your plain whey protein when you eat. Assuming a 1/4 cup serving, one recipe should give you about 16 servings! The protein doesn’t add any significant flavour. I am using Vitacost whey protein which is really good: 18gm protein per scoop for plain; 22gm protein per scoop for flavoured. They have all the chewable vitamins you need, too.

Ideas (going from the base puree and adding flavours):
Potatoes with Mexican crema
Parsnips with pepper and cream
Celeriac with shallots
Tomatoes (use Italian crushed) add basil and cream if desired (could need some sugar if toms are acidic)
Spinach (use frozen chopped) add nutmeg and cream
Broccoli with balsamic vinegar OR Mexican crema
Butternut squash with coconut milk
Mushrooms with sherry, nutmeg and cream
Roasted red pepper with basil and cream

I hope these recipes will help others who have gotten bariatric surgery! Flavour forever! XO

Ways to Wealth: House vs Investments

HERE is a very VERY good article about buying a home vs investing for long term wealth. We have chosen investing with 401k and stocks. The comments are very good here, too, so read those. It’s an in-depth discussion about renting vs buying and there are several different viewpoints. My viewpoint is that I’d rather have savings and investments and a BUDGET rather than drain my savings and have large bills to pay at random times (repairs, etc.).

We had a home and I can tell you that the lure of “a smaller monthly payment” is completely undone by maintenance. Everything that breaks is $500-1000. Every time. Not to mention things that must be replaced periodically like roof, new paint, appliances. AND the fact that you’ve put all your cash into a down payment, so your savings are low. You’d also be amazed at how much shit you need to keep up a house. I’ll bet we spent $3000 at Home Depot in our first six months for lawn equipment, tools and parts for fixing crap.

We pay $1300/mo rent, which seems like a lot (compared to a $750 mortgage payment) BUT we never again have to worry when the fucking A/C stops or the deck needs work or the driveway is crumbling or the water line needs replacing or the basement leaks or the roof needs to be replaced. NEVER. And after dealing with that shit for 10 years, let me tell you IT IS NICE.

I still hear people preaching about how buying a house is the only way to wealth and I can tell you IT IS NOT TRUE. In the past, maybe, but in our current economy, not so much. Not only must you have a down payment (nope, no one can help with that), but you have to have this money in the bank for at least 6 months AND document how you got it. Because everyone is a drug dealer/terrorist now thanks to the Patriot Act and cash is frowned upon. And you’ll also be strapped into PMI (private mortgage insurance) which will add another coupla hundred to your mortgage payments – they don’t tell you THAT, either. Buying is a stressful, expensive process. Realtors are of the devil. House inspectors are untrained morons. I’ve covered this in another post. ;)

So for all of you who are being told over and over again that the ONLY way to live outside an apartment is to BUY, PLEASE for the love of all that is holy, READ THIS ARTICLE.

You can RENT a house. It’s not that much more than a good sized apt. Trust me on this: you do NOT have to be an indentured servant to the mortgage industry.

You can have your house and no worries, too. We do.

We lost our ass in the real estate crash, and YES, this colours our attitude about real estate, but now that we’ve done both: own and rent, renting is definitely the path for us. Owning is just too stressful and costs too much. We never had savings because it was always something with the house. Now we DO have savings and investments. We are in a much better place now than we were with Maplehurst, even paying almost twice as much.

I feel sorry for people who are talked into buying then realise that it is not all it’s cracked up to be. And now they are locked into a mortgage. You don’t make money selling unless you have equity. That takes a very long time to get. Equity, or lack thereof, is why we ditched Maplehurst. We lived there ten years and had $75k NEGATIVE equity, which is what “under water” means. It means that you’ll never get the benefits of having a mortgage because it’s not only worth nothing, it’s worth LESS THAN NOTHING. Negative equity. The market is far more stable now, but all the good deals are gone. You’ll pay a premium and it’ll take many years to get equity of any sort. So while the credit reporters just LOVE IT when you are strapped into a $200k loan, it is alllll a big fat LIE. No equity means you’re indentured to the mortgage company, plain and simple. Which leads me to my other post that addresses this.

The decision to buy a house is life changing. Don’t do it because your parents are pushing you to or your two-income-with-fulltime-jobs friends tell you it’s the best thing EVAR. For us, with an uncertain job outlook, the flexibility of renting is the best path. For ANYONE who has uncertain cash flow, buying a house is probably not for you. And there is absolutely nothing wrong with that. Just run the numbers and do what is best for YOU. Don’t forget to add at least 30% to your mortgage payment figure to cover PMI and repairs.

Bariatric Diet Recipes

I think I’m going to use my cooking skills to create some bariatric recipes. The crap given to me by the nutritionist is horrible. I don’t know what in the hell they teach nutritionists in school, but good eating isn’t it. I remember the dietician giving Dave his dialysis diet, which had to be low in potassium and fluids as well as diabetic safe. It was crap. She had him eating grapes as a snack – ALL SUGAR!! He was never once put on a low carb diet for diabetes. NEVER. Which is probably why he died at 48. He ate a horrible diet for as long as I knew him – about 20 years.

Anyway, I figure since I’m going to be making tons of soups and soft foods for myself, I may as well share them with everyone else. You know my food will taste great, no matter if it’s liquid or soft!!

I’m also going to do a vlog to document my experience. Why not? The best information I got was from a vlog, but the chick was 15 years younger than I am. I think if a 50 year old makes a vlog about bariatric surgery, perhaps it might appeal to older women.

In any case, I’m going to do the recipes as their own section and make the vlog as I go along. I hope it helps someone else with getting gastric sleeve.