Month 5

Month 5 – Eat less meat and more beans

I try to never use the “V” word in my practice because I find that the idea of vegetarianism is unacceptable to most people.  I am not a practicing vegetarian and have no plans to become one and I fully understand people’s reluctance to not commit to a meat free life..  

However, you do not have to avoid meat altogether in order to gain most of the health benefits that vegetarianism offers.  Vegetarianism is usually thought of as a social movement to draw attention toward animal rights and the cruelty of raising animals just for food.  However, in recent years, vegetarianism as a health movement has gained traction after several important studies showed significantly lower rates of heart disease and cancer in vegetarians.  

If we look at the consumption of meat as a health decision, rather than a moral one, vegetarianism becomes a spectrum, rather than an absolute decision.  If the decision not to eat meat is made for social reasons, one single bite of meat is murder and cannot be tolerated.  However, if this decision is made for health reasons, then one single bite is insignificant.  It is the daily consumption of large amounts of meat that must be avoided and any decision to eat less meat is a step in the right direction.  Meat has been tightly linked to diabetes, heart disease and obesity and, contrary to what the Atkins or Paleo diet supporters will tell you, eating large amounts of meat will lead to weight gain.

I encourage men to limit their consumption of meat to three 3-4 ounce servings of meat per day and women to 2 of the same sized servings.  3-4 ounces of meat is approximately the size of a deck of cards, so, for most, this change will represent a reduction in the amount of meat you consume, but not a significant one.  Those who want to reduce their consumption further are encouraged to do so.   There are several good concepts out there that help you reduce your meat consumption significantly without becoming the one that always has special dietary concerns any time a group gets together for a meal.  The “vegan before five” movement encourages people to avoid eating any meat before 5pm and is a very easy way to limit your daily meat consumption significantly without difficulty.  “Weekday vegan” takes a similar approach and encourages people to avoid meat from Monday through Friday, but on the weekends when many people have gatherings that are centered around food and eating, you can feel free to indulge in meat.  Adopting either one of these strategies in an attempt to prevent weight regain after surgery is strongly encouraged.

Many people believe that the type of meat that you consume has significant effects on your health.  For instance, most people believe that eating beef is much less healthy than eating chicken.  In truth, in some situations, exactly the opposite is true.  The manner in which an animal is raised will greatly impact the health impact of the meat.  For instance, beef that comes from a cow that was raised organically, without hormones or antibiotics and allowed to roam freely and eat grass has much less of an impact on your health when compared to chicken that comes from animals that were genetically engineered to grow quickly, given large amounts of antibiotics and fed a highly processed diet.

When it comes to animal protein, purchasing small amounts of a higher quality, organically raised meat makes an excellent strategy.  The price is often twice what is paid for conventional products, but, organic meat may prevent weight gain when compared to non-organic products.  

After bariatric surgery, many patients lose their taste for meat and are not able to consume it comfortably for up to a year.  This puts patients in a difficult position as they put their effort into eating more of the food with the highest protein content (meat).  Even those patients who are able to keep animal protein down comfortably within a few weeks of surgery are only able to eat a few bites which contributes little to their total protein intake.  

Instead, I encourage patients to eat lots of vegetable protein after surgery, specifically, beans and nuts.  These foods much more comfortable to eat than animal sources of protein, so postoperative patients are able to consume more protein through beans and nuts since they can eat much more of them.  

Protein from yogurt lies somewhere in between animal and vegetable protein in terms of its health effects.  Yogurt contains a favorable mix of bacteria that has been linked to a lean body weight.  Other dairy proteins like those found in cheese or milk do not demonstrate the same linkage and are very similar to animal sources of protein. Yogurt can be easily consumed within a few days of surgery and contains reasonable amounts of protein, particularly greek yogurt.  However, I strongly encourage patients purchase plain yogurt and mix it with fruit in a blender, rather than purchasing pre-packaged flavored yogurts since they almost always contain added sugar or artificial sweeteners.

Most practices encourage the prolonged use of protein shakes after surgery, while I do not.  I find that many patients cannot tolerate the artificially sweetened and flavored protein shakes after surgery.  When patients complain that they can’t tolerate their postoperative shakes, I quickly move them onto yogurt smoothies which contain almost equivalent amounts of protein without the artificial additives.  Often times, these smoothies are well tolerated, while the shakes cause nausea.

Many patients find the changes in Month 5 are not particularly difficult to make and flow with the other decisions that you are making as you change your diet over the months preceding your surgery.  Moving to smaller amounts of higher quality animal protein is an important step toward success after surgery.

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