The Bariatric Plate Method
One approach to bariatric eating
When it comes to diet recommendations after bariatric surgery, many things align and yet some thing do differ.
The biggest reason for this is individualization and clinical judgement. Dietitians take research and their experience working with patients plus information from the patient and they create specific goals or guidelines.
This is why one patient will hear something different from another.
The main things you’ll hear consistently about bariatric eating include:
Focus on hydrating fluids
Focus on protein first at your meals
Avoid drinking with meals and 30 (up to 60) minutes afterward
Take your vitamins as recommended by the ASMBS
Some of the things that might differ are the specifics of how those things play out.
For example, there will be differences in how much whole carbohydrate you should have and whether you should use whole grains for fiber or stick with vegetables.
(My personal take is to focus on two bites of protein to one bite of vegetable. For more on my approach, check out my video courses!)
The Bariatric Plate Model
Many dietitians will use the Bariatric Plate Model as a visual for post-op eating.
(More on my approach next but I do tend to go higher on the protein and veggies instead of the grains unless someone is doing high endurance exercises or in pregnancy.) Regardless, this is still a great visual to map out focusing on protein first and focusing on the quality of food you are eating and listen to your pouch for your natural stopping cues.
The Plate Model was initially created by dietitians as a visual method for teaching meal planning for patients with diabetes or high cholesterol. It was then modified into a plate method for bariatric surgery patients.
Those changes considered protein needs followed by vitamins and minerals and lastly whole carbohydrates.
Half the plate must contain proteins. One third of the plate should be vegetables and fruits. The rest of the plate should be whole carbohydrates.
The 2:1 Protein Method (My Approach)
In contrast to the bariatric plate method, I like to focus a little more on the protein and utilize vegetables for fiber. I coach patients to eat two bites of protein to one bite of vegetable and listen to their natural stopping point.
The main reason I approach things this way is for best hunger control. Carbohydrates can increase hunger for a lot of patients after surgery so by focusing on solid protein a bit more and using vegetables instead of fruit or grains, it tends to helps limit portion sizes and keep hunger controlled longer. It’s different for everyone but this is my common go to approach.
Fruit is also a great source of fiber so pairing it with protein at one meal a day is typically manageable for hunger. Every patient is different so it does mean finding out what works best for you!
For my approach, 70% of the plate has protein on it and 30% has vegetables (or fruit at one meal a day). This is different than the bariatric plate method of 50% protein, 30% fruits and vegetables and 20% whole carbohydrate.
What this means for macros
I get asked about macros a lot for bariatric surgery patients. Here is a more in depth blog post on macros.
It can get confusing to look at these pictures of plates because they may remind of you of the macro pie charts.
Macros including protein, carbohydrate, fat and water. The macro pie charts will graph of what you’re eating, how much was protein, carbs and fat. Someone can see what the ratio of those three nutrients are in their diet.
Diet plans may use macro percentages for their recommendations instead of calorie counting.
When the plate image shows 70% protein and 30% vegetables (or fruit) that IS different than the macros chart.
This approach to eating may average around 50% protein, 25% fat and 25% carbohydrate. It would all depend on how lean your meat was, which vegetables you had, what oils or dressing were included and so forth.
Keeping a food journal will allow you to look back over the macros and see if you want to make any adjustments. By the way, members can ask for food journal feedback from me anytime :)
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