So far we have learned that: You have to be accountable for what you eat; you have to measure it so you can manage it; and you have to know the foodstuffs that don’t work well with Lap-band surgery. Now you have to know the ones that work well.
The simplicity is that these are choices that you can make — and none of them will leave you feel deprived. They are the basics of most meals: produce and meat (unless you are a vegetarian in which case it is produce and produce).
Food is something we celebrate in our practice. We love it, we enjoy it, and we do not want people to feel deprived in the slightest. We also don’t talk about diets in our practice — except for that early post operative period when our patients are allowing their body to get use to this piece of plastic called a Lap-band. We instead talk a lot about choices — because when it comes to eating there are a lot of choices (ok, I am writing this part on an airplane and the pilot will give me the lame speech about how we have choices in airlines and glad we chose this airline with its crowded seats, no meals, water that grows E. coli, and hope your luggage really does reach its destination sometime before you have to leave).
The basics of determining foods that are “healthy” for Lap-band surgery patients are:
- Less processed ones are better than more processed ones
- Low fat foods are preferred to high fat
- Low glycemic index carbohydrates are preferred
What does not determine choices are:
High protein vs. carbohydrates. This is a distinction of a dietary program that, while working in the short run by limiting calories, is neither healthy nor sustainable in the long-run for most people. For a more complete discussion of “low carb” diets and lifestyles please check out “Losing the last 30 lbs.: Fundamentals of weight loss.” This is not a choice you have to make, or a lifestyle you need to adopt with Lap-band surgery.
Indiscriminate classification of food groups with specified percentages of those groups. It is not the group, but the food that is important. While being in a zone is a wonderful concept, the real issue is eating healthy, not the per cent of which particular group you eat. Nevertheless, the food pyramid — which is less exciting than real pyramids — has sound principles that all would be wise would adhere to.
Processed foods – the sure way for Lap-band surgery patients to gain weight
Processed Foods have been the salvation of the human race. It allows massive stores to be preserved, allowing a stable food source. Grains can be milled — where large machines break the grains down into flour and preservatives added allowing them to be stored for years at a time. Oats are rolled, instead of cut, allowing a longer shelf-life.
The good news about processed foods is that they can be preserved for long periods of time. The bad news is that they digest much faster than the less processed ones — meaning that they are absorbed into the blood stream faster, causing a rapid rise in blood sugar — resulting in a rise in insulin that forces the blood sugar into cells where it becomes fat.
But, it is difficult to talk about processed foods without talking about the rather strange ways that we preserve some of them. One of the most benign preservation methods — cheese — which is essentially milk that is allowed to curdle and store in blocks — and even the mold that grows within them. The “blue” in blue cheese, is simply a mold that is quite flavorful. Preservation methods of milk (from cows, goats, sheep and whatever other mammals we can hold still long enough) has resulted in many types of cheese.
Historic food preservation methods from around the world:
Kimchi, vegetables that are pickled. The first known reference of Kimchi came from the 7th Century in what is modern day Korea. Vegetables were abundant during the summer and early fall months, but when winter months came the ability to pickle vegetables, and thus preserve them became critical to survival. So, imagine the first fellow who did this. When he opened the jar, thinking about the fresh cabbage of the summer and smelling the sweet aroma of … But, if you are starving, some pickled cabbage tastes like heaven. If your ancestors lives depended on pickled cabbage then it becomes a delicacy.
Lutefisk, a famous Norwegian dish that is essentially a preservation of white fish. The fish, of various types — generally cod, was initially preserved by drying. We Norwegians feel that if the fish cannot be used as housing material then it is not dried enough. From here the stories vary as to how it was discovered that lye could be used to reconstitute the fish. Some involve racks of dried fish that caught fire, and the ash and water formed the lye. Others that the Irish were trying to poison their Viking conquerors. They took the dried fish that was a staple, and attempted to poison the Vikings with lye. Instead, the hearty Vikings not only ate the dried out-lye soak fish, but enjoyed it much more than the dried fish that the poisoned fish became a staple, or another delicacy.
Haggis is another great dish in preservation. When the great hunters would get their game, they would eat the good stuff (also known as the Prosser back straps) and then salt the remainder for preservation purposes. The innards would then be mixed with cereal and cooked in the beast’s stomach. Most believe that Haggis comes from Scotland, however the origin of the term clearly implies it is Norwegian. Perhaps the Vikings were not conquering other lands to plunder, but to find some new recipes. Perhaps the reason the Vikings were able to conquer was because the locals would rather submit than be forced to eat Haggis and Lutefisk. But for the Norwegians who found themselves stuck in Scotland, having a stomach full of cereal and other parts proved a delicacy that revolted those who tried to conquer them.
But enough about history. Each culture found unique ways to preserve food to survive. On a mass scale, humans have developed more palatable, less nutritious methods of preservation — and it is the processing and preserving that led to a lack of famines. Between an increased in processed foods and the lack of famines, we have obesity, ultimately giving rise to procedures such as Lap-band surgery.
Processed foods – what’s the point?
Processed foods are examples like pastries, flour, fried rice, cakes, cookies, as well as sugars. Non-processed carbohydrates like grains, oats, lentils, and beans are preferred.
The point of the processing of foods is to preserve them, and by breaking them down into more elemental forms it is easier to preserve them for longer periods of time. Wheat, for example, when ground can be preserved for years. When in its original form, storage becomes a problem as the whole wheat can become infested with molds and weevils. Often times, on the great masted sail ships of old, they would have races with the weevils. These races became popular sport on those ships (not much to do, they had not invented slot machines or buffets) and great bets were placed on which weevil would win a race. So which weevil would you chose? The larger one, that is more powerful — or the smaller — well, of course, when faced with a challenge always choose the lesser of two weevils.
The difficulty with processed food is that it is essentially a form of digestion in itself, allowing more calories to be released early in the digestive tract. Processing allows more calories to escape early.
Low Fat Foods
There was a popular diet whose premise was that you could not become fat by eating fat. Perhaps one of the silliest dietary principles. Fat is the highest concentration of calories known. Per gram fat has twice as many calories as any carbohydrate or protein, and is only slightly more than alcohol.
Fat adds great texture, and the combination of fat and sugar provide a deadly, but delicious combination for obesity. For the reference of this check out any donut shop and over time you will see the police who visit develop rather large midsections.
Fats are a series of complex chemicals, all of which are high in calories, but some are more deadly than others. Fats found in fish, olives, and canola oils are today considered healthier than fats from animals or fats from “hydrogenated vegetable oil.” Nevertheless, all fats are high in calories — and lead to obesity.
While talking about fats is easy — here are a few examples of items that are fats and are not:
- Peanut butter is a fat, not a protein, not a complex carbohydrate. Two tablespoons of peanut butter has 190 calories and 16 grams of fat (responsible for 144 of the 190 calories or 75% of the calories come from fat). That is the same amount of fat as a Burger King hamburger. The amount of protein in those two tablespoons is 8 grams. Consider that 1 oz. of roast turkey has 50 calories and the same amount of protein. Peanut butter is a fat, full of calories. It is not a healthy snack.
- Cheese is not protein. Cheese is fat. The majority of calories from cheese comes from fat, not protein. Cheese tastes great, adds a lot of flavor — but consider a one ounce portion of cheese adds about 100 calories, most of which are from fat.
Best foods for Lap-band surgery patients – meat and produce
Foods that work for weight loss fall into two simple categories — we can follow carbs, proteins, fats, and alcohols — but lets go to the grocery store instead. What works to keep you full is meat and produce.
Meats are solid foods: seafood, shellfish, beef, pork, turkey, duck, chicken, elk, and many other solid meats. Seafood has the advantage of being better for a person, in general, and far healthier than some fatty meats.
The produce section it is hard to find things that will not stick with you. Be careful of potatoes, or other starches such as corn. Starches, like potatoes and corn, contribute to obesity. But in terms of broccoli, cauliflower, peas, beans, it is easy to fill up with these items and very difficult to get too many calories. Consider, for example that one half cup of broccoli is about 12 calories where a small order of French fries from Burger King is 400 calories. The produce section is where you will find a lot of things to eat that will stick with you, keep you satisfied for a long time, and yet not provide you with a lot of calories. Beware of the things you add to the vegetables — sauces, creams, butter are all items that add high calories.
So the key foods that work for lap-band surgery patients and for weight loss in general are the ones that stick with you. Since famine is not a problem, fresh produce, fresh fish, and other lean meats provide the staple of what works with lap-band surgery.