Content:

• Types of Carbohydrates

• How many grams of carbs do gastric sleeve patients need?

• Best sources of carbs

• Are vegetables carbs?

Carbohydrates are the body’s main source of energy and they play a crucial role in our brain, muscle and nervous system functions, among many other roles. It is important to choose healthy carbohydrate sources that will deliver adequate amounts of fiber and nutrients to maintain optimal health. 

Types of Carbohydrates

1. Sugar

• Sugars are known as “simple carbs” because they are used as a quick source of energy for our bodies.

• Sugar coming from whole foods is healthy in our diets. Examples of whole foods with naturally occurring sugars include: grapes, berries, apples, pear, mango, banana, melon, and more. These whole foods not only deliver an energy source for our bodies, but also provide vitamins, minerals and fiber (1).

• Added sugars such as table sugar and artificial sweeteners such as Splenda and high fructose corn syrup should always be avoided. Instead, use more natural sweeteners instead such as agave syrup or pure maple syrup. However, always use in moderate amounts due to their high calorie content.

• Unhealthy sources of sugar include: sweets (candies, chocolate, doughnuts, cakes, pies and cookies), high sugar energy and sports drinks, fruit juices with added sugars (unnatural juices) and sweetened or flavored yogurt. These tend to be low in nutrients and high in calories, with many having high amounts of sodium and saturated fats, which can lead to diabetes, high blood pressure and cancer over the long term.

2. Fiber

• Fiber is the part of plant-based foods that cannot be digested by your body, and it is only found in plant-based foods (1,2).

• Fiber has four main functions: 1) helps move food during digestion, allowing us to have more regular bowel movements; 2) helps promote healthy gut bacteria to keep our immune system strong; 3) lowers cholesterol levels; and 4) slows down the absorption of sugar and helps improve blood sugar levels.

• Fully recovered gastric sleeve patients should aim for at least 20 grams of fiber per day. Consuming less than the recommended amount can result in constipation, poor digestion, risk of cardiovascular diseases and a slowdown of your metabolism.

• The best sources of fiber include: Lentils, chickpeas, black beans, oats, almonds, quinoa, berries, among other foods (2,3).

3. Starch

• Starches are known as “complex carbs” because they take longer to digest due to their higher fiber content.

• Starches provide important calories to maintain optimal levels of energy. Most starches also provide antioxidants, iron, calcium, B vitamins, among other nutrients (3).

• The best sources of starches include starchy vegetables such as potatoes, corn, peas and whole grains such as brown rice, quinoa, and bulgur (3).

• Note, although white bread, white pasta, and white rice are considered carbohydrates, they should be limited as much as possible. These foods are classified as refined carbohydrates, meaning they are generally lower in fiber and nutrients. Opt instead for the whole grain versions, such as whole wheat pasta and brown rice.

How many grams of carbs do gastric sleeve patients need?

The short answer is 100 to 130 grams per day for fully recovered patients. For those that are still in recovery mode, the actual intake will be much less. Let us explain why. Early on in your recovery, the primary energy source that is limited are carbs. Protein is needed to help heal your stomach’s tissue, while fat is used as an energy source given that it contains more calories per gram than both carbs and protein. Since the stomach is still healing and has decreased in size considerably, we reduce carbohydrate intake. As your recovery progresses and you are able to eat more, you will be able to add more carbs into your diet. Carbs should be the new source of calories as you continue to recover, given that protein is needed at constant levels and should not change much while fat will likely only increase slightly. It is important that we focus on healthy carbs and not processed or high-fat carbs such as pizza, cookies, doughnuts or chips. To read about the reality of low-carb diets for gastric sleeve patients click on the button below.

The best sources of carbs are:

• Legumes such as black beans, chickpeas, and lentils

• Fruits such as grapes, apple, banana, mango, clementine, and melon

• Starchy vegetables such as potatoes, sweet potatoes, yams, corn and peas

• Whole grains such as oats, brown rice, quinoa, farro, and bulgur (1)

Another good source is buckwheat, which is technically a seed, although it is very similar to grains. One final healthy source is whole-wheat pasta. You might be wondering, “But everyone says pasta is a big no!” We have 2 responses for this common concern. 

1. The reason why pasta is viewed as an unhealthy item to eat is not because of the pasta itself in most cases, but rather what comes with it, especially the sauces. Most sauces are cream and butter based which make them extremely fatty and high in calories. It transforms the dish from a carb-loaded dish to a fat loaded dish. When eating pasta, either stick to tomato-based sauces like marinara (just check for added sugars) or make your own sauces. Almost all of our recipes use homemade sauces that are both delicious and very easy to make. 

2. Secondly, most dishes use regular white pasta. White pasta should be avoided at all times because it is made from refined wheat flour that has been processed and stripped from its nutrients, including vitamins, minerals, and fiber. Although some vitamins and minerals are added back, the fiber content remains low. What you should choose instead is whole-wheat pasta. To make sure the pasta you are buying is whole-wheat, read the nutrition label and check that it has at least 5 grams of fiber per serving of 2 ounces of dry pasta. The word “whole” should be listed in the ingredients as well, so you should look for the word “whole wheat” or “whole grain” to ensure it is not refined flour. It should also be dark brown colored rather than light brown or white. For our most recommended brand click here. 

Apart from being a good source of carbs, whole-wheat pasta is also very high in fiber, iron, and other minerals (4). It is even high in protein for being a predominantly carbohydrate rich food. So, do not be afraid of pastas, simply stick to tomato and very low-fat sauces, eat the right portions, and make sure to add a protein source. For example, you can add chicken, beans, or perhaps seeds, to boost the nutrient content and make it more appropriate for your diet. For an easy tomato based pasta recipe you can click here.

IMPORTANT NOTE: Many patients become intolerant to pasta and rice after surgery, so add them to your diet when appropriate and in small amounts to see how your body reacts to them. Patients should avoid them if they cause an upset stomach or any type of discomfort. A good alternative to wheat pasta is chickpea or lentil pasta, which is actually slightly higher in protein and fiber. Some patients may be intolerant to pasta and rice several months after surgery but then be ok with them after a year or two. Remember that everyone’s journey is slightly different so simply choose for the carbs that work best for you.

Are vegetables carbs?

Most vegetables are actually very low in carbohydrates, mainly because they are low in starch and have a high-water content. Some examples include broccoli, cucumber, tomatoes, zucchini, and leafy greens. These are very important vegetables to have in your diet given their high micronutrient content. Micronutrients are nutrients we need in lower amounts such as iron, potassium, calcium, and vitamins (3,4).

Higher starch vegetables such as potatoes and peas are also an important part of a gastric sleeve patients diet because they provide more calories per gram and can therefore help boost caloric intake to appropriate levels (3). A gastric sleeve diet that contains too many low-carb vegetables can result in a diet that is too low in calories, which can lead to decreased energy levels and a slowdown in your metabolism. A balanced intake of low-carb and high-carb vegetables is the best approach for gastric sleeve patients. 

We hope this article helped clear up some confusion around carbs and that you enjoyed reading it.

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References:

1. Mahan LK, Escott-Stump S, Raymond JL. Krause’s food and the nutrition care process. 13thed. St. Louis, MO: Elsevier; 2012.

2. Magee E. Why Carbs Matter To You. WebMD Website. https://www.webmd.com/food-recipes/features/carbohydrates. Accessed August 5, 2018.

3. Gunnars K. Good Carbs, Bad Carbs-How To Make The Right Choices. Healthline. https://www.healthline.com/nutrition/good-carbs-bad-carbs. Published August 18, 2016. Accessed August 5, 2018

4. Magee E. Why Carbs Matter To You. WebMD Website. https://www.webmd.com/food-recipes/features/carbohydrates. Accessed August 5, 2018.