Protein and Bariatric Surgery
Proteins are long strings of amino acids obtained when our bodies break down food during digestion and resultant absorption. Every single cell in the human body contains proteins. The over 10,000 proteins in the body help with oxygen distribution, hair growth, and even developing antibodies to fight disease. Protein is also crucial for developing and maintaining muscle tissue. While protein can be used as energy, our bodies prefer to use carbohydrates and fat as energy since protein serves so many other important functions.
There are 20 amino acids we need, but our bodies only produce 11. This means we need to get the other nine from our food. These are essential amino acids. The foods we eat contain different amounts and types of amino acids. Complete proteins come from foods that contain all the amino acids our bodies can’t make. These foods include animal products (chicken, beef, fish, dairy), soy, and quinoa. Other foods contain incomplete proteins but can be combined to provide all nine essential amino acids – an example of this is rice and beans.
How Much Protein Do You Need?
A person’s protein needs depend on many different factors. The baseline recommendation is to consume .36 grams of protein per pound of body weight. This means a 150lb person would need a minimum of 55 grams of protein daily. This may seem like a lot but too little protein can contribute to lower muscle mass, brittle hair and nails, and a weakened immune system. Some medical conditions can increase our protein needs, such as cancer, liver disease, burns, or bodily injuries. High activity levels will also warrant higher protein intake since protein is crucial for building and maintaining lean muscle tissue. Active individuals (working out several days per week) should aim to get about 20-30% of their calories from protein.
Protein and the Bariatric Patient
Bariatric surgery will also change a person’s protein needs as well as the way they get it. After weight loss surgery, a person’s ability to eat large portions is decreased. This means they are at a higher risk of missing out on essential nutrients since they are not eating as much or as frequently. Protein is also vital to healing, which is important after undergoing surgery. Adequate protein intake after surgery can also ensure hair, skin, and nail health while keeping patients full and reducing sugar spikes.
Another key factor in protein intake is preserving muscle tissue (muscle mass is often compromised during times of rapid weight loss and caloric restriction) to help with weight loss, as muscle is metabolically active tissue. This means the more muscle someone has, the more calories they burn daily, even at rest – great for a bariatric patient! Finally, protein helps with weight loss when eaten with meals and snacks because protein keeps us fuller longer.
Protein shakes are often at least part of the solution after surgery, especially within the first few months, as a person’s appetite returns. A drink or shake of at least 20 grams of protein can help meet protein needs. Protein drinks can replace a meal or act as a supplement to a regular solid food eating schedule. In general, solid proteins (eggs, chicken, etc.) will be more filling than liquid forms but refer to your postoperative packet to ensure you are following proper protein consumption guidelines.
Below is a list of foods with their respective protein content in grams:
- Chicken breast, 3 oz cooked 21
- Egg, 1 7
- Soy milk, 1 cup 7
- Cow’s milk, skim, 1 cup 8
- Cottage cheese, ½ cup 13
- Tofu, extra firm, ½ cup 10
- Black beans (canned), ½ cup 8
- Greek yogurt, plain, 5oz 14
- Peanut butter, 2 tbsp 8
- Salmon, 3 oz cooked 17
- Edamame, 1 cup cooked 17
The Healthy Plate Method
Eating a variety of these foods throughout the day is helpful to ensure you are getting lots of protein. One of the best ways to make sure you’re meeting your protein needs is by using the healthy plate method, as shown to the right.
Ideally, protein foods make up ¼ of each meal, and this is a helpful tool to use when meal planning. Protein should also be incorporated into snacks to support fullness between meals. Ideally, a snack should consist of about 10 to 15 grams of protein. Examples include a low-sugar protein bar, cottage cheese with fruit, an English muffin with tuna salad and hummus, two hard-boiled eggs, roasted edamame, or low-fat Greek yogurt. Combining protein with fat sources (avocado, nuts, seeds) and fiber (fruits, veggies, whole grains) is a great and tasty way to maintain adequate nutritional intake every day.
Though there is no direct blood test to determine whether you are eating enough protein every day, many signs and symptoms can pop up. A common early sign of deficiency is hair, skin, or nail problems. Thinning hair is prevalent, especially after bariatric surgery. Excessive hunger throughout the day is another sign of low protein intake since this nutrient helps with satiety. Some also experience slow-healing wounds and injuries – cuts and scrapes that take longer than usual to get better. This is a result of low collagen production. A surefire way to determine that you are not consuming enough protein is a loss of muscle mass, as the body cannot maintain muscle tissue without adequate protein intake.
Protein is a crucial nutrient in everyone’s diet, especially after weight loss surgery. Most Americans get enough protein though it can be difficult if a person isn’t eating a well-balanced diet. Meeting with a dietitian or other health care professional can help ensure you are meeting all of your nutrient needs and can fill the gaps in your overall diet after surgery.
- Angrisani L, Santonicola A, Iovino P, Formisano G, Buchwald H, Scopinaro N. Bariatric surgery worldwide 2013. Obes Surg 2015;25:1822–32.
- Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database Syst Rev 2014;8:CD003641.
- Endevelt R, Ben-Assuli O, Klain E, Zelber-Sagi S: . The role of dietician follow-up in the success of bariatric surgery. Surg Obes Relat Dis 2013;9(6):963–8.
- Faria SL, de Oliveira Kelly E, Lins RD, Faria OP. Nutritional management of weight regain after bariatric surgery. Obes Surg 2010;20:135–9. [
- Shen R, Dugay G, Rajaram K, Cabrera I, Siegel N, Ren CJ. Impact of patient follow-up on weight loss after bariatric surgery. Obes Surg 2004;14:514–9.
- Shankar P, Boylan M, Sriram K. Micronutrient deficiencies after bariatric surgery. Nutrition 2010;26:1031–7.
- Faria SL, Faria OP, Buffington C, de Almeida Cardeal M, Ito MK. Dietary protein intake and bariatric surgery patients: a review. Obes Surg 2011;21:1798–805.
- Andreu A, Moize V, Rodriguez L, Flores L, Vidal J. Protein intake, body composition, and protein status following bariatric surgery. Obes Surg 2010;20:1509–15.
- Jastrzebska-Mierzyńska M, Ostrowska L, Wasiluk D, Konarzewska-Duchnowska E. Dietetic recommendations after bariatric procedures in the light of the new guidelines regarding metabolic and bariatric surgery. Rocz Panstw Zakl Hig 2015;66:13–9.