Complex carbs okay? Milk or cream - lactose?

[mlleelise]

This question is probably really basic - but I recently talked to my NUT and now I'm a bit confused. She told me to eat mashed potatoes post-op (not the 1st week) but they would be fine afterward. AND that wholegrains bread and cereals could be included in my diet when I'm all healed. She also said stay with LOWFAT foods, and skim milk. Okay. This confuses me.
What exactly is it that causes the intestinal distress? I thought it was carbs any carbs (especially simple carbs) - even complex, whole grain carbs. Potatoes, brown rice, oats are complex carbs too, but I thought these would cause gas. I know that simple carbs are worst of all. I also thought, as DS'ers, we need fat, not lowfat. Would someone mind helping me understanding this? High fat or low fat? To carb or not to carb? Milk being full of natural sugar is bad, skim or not, right? Is cream okay - or is also bad, because of the sugar? Do we become lactose intolerant? HELP!!

[bldeck]

PUBLIC SERVICE ANNOUNCEMENT TO ALL NEWBIES......
NUTS are affectionately know as NUTS for this reason, they don't take the time to learn the difference between the DS and the RNY.

Yes carbs effect all DS'rs. The difference being that some people can tolerate some and other can not tolerate any at all. During your weight loss stage it is best to lower your carbs. I am one of the few who had to eat more then 50 (number set by carb conscious people) or I would not lose. Carbs can cause anything from gas to diarrhea as well as that full bloated feeling.

We as DS'rs need fat, we don't absorb near what we use to, I believe we absorb around 20% of what we eat. That being said to much fat can hurt you just like to little.

I could not drink milk for several months after the surgery but I drank my protein shake with 8oz of half-n-half, since about 2 months out.

With all things the one thing you need to remember is YMMV (your mileage may vary). What one DSer can do does not mean you will be able to do it.

Also there are some wonderful articles about protein and carbs on dsfacts. They are under the link "Life after DS".

Betty

[reinventingangela]

Im not a DSer (yet) or a Nutritionist but I will share this from reading literally hundreds of posts from the vets...

1. Your nutritionist probably doesnt really understand the DS so consider the source when following any advice

2. As a general rule DSers should consume food in this order of priority:
Proteins first until you have reached your daily goal (for most it seems to range between 100g-120g per day...except for post ops which are told to build up to it by consuming at least 30g by day 30, 60g by day 60 and 90g by day 90) then if you still have room...
Veggies/Dietary Fiber and usually prepared in Full Fats (because you will only absorb about 20% of the fat you consume and we need some fat so dont bother eating low fat because everything we eat is esentially made low fat through malabsorption....also lowfat products are typically higher in sugar to make them taste good and sugar is NOT the DSers friend), then if you still have room....
Complex carbs (should be limited but acceptable to consume)
Simple Carbs (if you must although these will tend to slow/stall your weight loss or in some cases cause weight gain, also some DSers can not tolerate simple carbs well)
Sugar (not the DSers friend although some have problems with any kind of artificial sweeteners so they do consume sugar in limited quantities)

3. When first out of surgery, getting your 64oz+ of fluids per day is far more important than getting your protein (see note under proteins). If you drink protein drinks, you can sort of "kill two birds with one stone" as you can count the liquids toward your daily intake requirement

In regards to using heavy cream vs. half and half or lowfat milk etc. I think its a matter of personal preference. Some DSers become lactose intolerant so this wont really be known until you try it.

Im sure one of the pros will come along and correct me if Im wrong but thats my understanding of it thus far....hope this helps

[inge]

Exactly, that's why they are called "NUTS".

Protein and Fat is your friend.
Right at first you may need to keep the fat a bit lower because your insides needs to get used to being rearranged.

But like others have said, right out from surgery, fluids are the most important.

[Gail R]

What everyone else said, plus- my surgeon suggested no milk for 3 months to possibly prevent lactose intolerance from developing. Yogurt and cheese is OK.

[shann_ds]

I have no problem with milk. I've had it every day since I was a few weeks out. But I know that's not true for a lot of people. Just try it cautiously.

[mlleelise]

All I can say is WOW! My NUT's advice was totally wrong - why should I be surprised??
Thank you for the good advice - I'm printing this thread out & keeping it handy. :-)

[sherbearmama]

I was suposed to go back to see my surgeon's NUT as part of the post op check ups. I respectfully declined (I actually posted about this a couple of weeks ago) and stated that the NUT from his office admitted to me while I was in the hospital that she knew NOTHING about DS nutrition. I stated that I would not waste my time driving 2 hours to see someone who will tell me to eat low-fat, 250 carbs a day (yikes!), and stay away from beef or any other high fat proteins and eat only white turkey or chicken. I've come to the conclusion that no one seems to know anything about DS nutrition except DSers.

I drink milk and use milk products without any problems--actually I was more lactose intolerant before surgery. I get a lot of protein from Greek yogurt (and I eat the one that has the most fat). But for the first 2-3 weeks I avoided dairy and then began to use is sparingly until I realized I could tolerate it well. I try to add fat to EVERYTHING I eat--low fat usually means higher in carbs because they add carbs to add flavor since fat makes things taste better and taking it away makes it less flavorful. Also, if I don't get enough fat, I end up having serious trouble pooping. In fact for the first month or so, I'd poop like once every week and then it was very little. It wasn't until I started eating fat that I began pooping a little easier. I still only go every few days but on the days where I get more fat, I poop the next day. Last night I ate 1/2 of an avocado and pooped this morning!

You'll get lots of nutritional advice here. OH, regarding the mashed potatoes--during recovery, a lot of DSers eat mashed potatoes cream of wheat (both with butter and cream if possible), apple sauce, and other things we might not use in a typical DS body. But I believe it's important to get some calories into your body if you feel you can tolerate it because you still need some energy to do all that walking you've got to do for the next few weeks. What's most important is hydration, then get something into your stomach you can tolerate. It'll all come together eventually.

Sheri

[California Poppy]

You've gotten great advice above, mlleelise. I did eat oatmeal within the first few weeks post-op (but it was put through a blender first) because it was one of the few things that didn't cause tummy distress, but I don't eat it now as I'm only four months out, and still in the "weight loss window". I've avoided breads, cereals, potatoes, and rice for the same reason.

I made the mistake of continuing with lowfat choices post-op until some generous souls here (EN and Shales) pointed me in the right direction. I wasn't trying for calorie restriction, I was just used to and liked the lowfat items. Unfortunately, the result was slowed weight loss, constipation, and super-dry skin, all of which are soooo much better now that I've increased my fat intake. You may need to re-educate your palate to adjust to added fat, but it's definitely do-able!

[reinventingangela]

California Im still freakin fascinated that youve lost over 130lbs

[mark540]

My personal experience is such that I can eat minor amounts of carbs and more than enough dairy products. 1 slice of white toast or 2 slices of whole wheat toast are fine- just a small amount of gas. 1/2 cup pasta won't kill me- a piece or two of fruit during the day. Much more than this and I will be in competition with major energy corporations as a supplier of natural gas.

It took a while to figure this out. It finally came to my attention it was bothering people around me when I went on vacation and my employer had 2 exhaust fans installed in my office. No joke there. They meant well.

Milk products in moderation are okay. A glass of milk is fine, yogurt is better. Asingle soop of ice cream posts no problem, more than a scoop and I will have diarhea the next morning.

A big YMMV.

ps. all of these items were added slowly over the course of year or so. The first six months it was all about protein, vitamins and water.

[pktwatch]

I only tell my NUT what she wants to hear. My daughter was up for a visit from Tennessee on my last visit. She saw what and how I ate (bacon, butter, cheese milk FAT etc) When we visited the NUT she went over my diet and I just kept nodding yes to what she thought were healthy choices and no to what I knew she thought I should not be eating. She told me that I was a "poster child" for the DS! I was right on track and doing perfect in my weight loss. On the way out I told my daughter I wonder how she would feel if she saw the bacon that I ate that morning!

[bb212]

Hi mlleelise,

Everyone has given you good advice, and yes your nutritionist is giving you bad guidance. She is obviously ignorant of the nutritional compliance for DSers if she's advocating high carb and low fat. DS nutrition and RNY nutrition are two different worlds, and if a DSer followed a diet for the RNY patients it would lead to severe malnutrition!

You're very early out, and as others have said: hydration first!!!

Carbs are something to add into your diet much much later and only AFTER you've eaten your protein.

While your stomach is healing you are going to be on mushy foods and protein shakes- as much as you can comfortably get down. At first it won't be much, but don't worry so much about that- in time things get easier. Right now you'll be on protein shakes, milk, cottage cheese, ricotta cheese, soft sugar free custards and puddings, soft poached eggs, and maybe some soft carbs like oatmeal or farina watered down with milk or cream. Baby banana food is also something to try during the fragile early weeks- it will help you get some electrolytes in.

As your stomach heals and you can take more solid foods, take everything your NUT said and throw it out the window! Eventually you may be able to handle chicken salad, ham salad, smoked salmon, harder cheeses like swiss, veggies like avocado (soft and fatty!) to get more protein in along with the shakes. As time goes by you can try different things and see how well your stomach handles it. If something makes your tummy upset, don't eat that food a while- wait a few weeks to try it again.

Do not eat any carbs until you've had enough protein for your meal. Your tummy is soooo small you need to make sure that every ounce of precious space is used to get water and protein!

As your stomach heals up and have a little extra room after your protein, then you can slowly-carefully try complex carbs (whole grains). But I would avoid anything with wheat flour in it for 3 months- wheat gluten is known to cause stomach problems until it has time to heal. My doc warned me about that but I unknowingly ate a "creamy" soup that had wheat flour as a thickener- oh the pain! IT SUCKED! Months later I was able to handle wheat gluten just fine, but it took time.

Happy eating!

[Sandra C.]

My Nut has given me good advice, agreed with all the D.S. guidelines everyone here is posting. She told me to up my fats and protein to break my stall, with bacon!!!