Bariatric Nutrition and Exercise

 

Engaging in physical activity is one of the keys to success after bariatric surgery. Once cleared by your medical team to start exercise after surgery, you should have a regular routine in place that includes both cardiovascular and resistance training. It plays an extremely important role in building muscle, improving metabolism, keeping excess weight off, and of course, it is good for your mental and physical health! We encourage you to experiment with different types of exercise to find something that you truly enjoy and will continue to do long-term.

You have likely heard the saying, “You can’t out-exercise a poor diet.” The same is true after bariatric surgery. The majority of fat loss is still achieved from a low-calorie intake and healthy diet. Make sure that you do not make the error of thinking that exercise is a free pass to eat whatever you want.

Exercise recommendations from the American College of Sport Medicine (ACSM) Physical Activity Guidelines for Americans are 150-300 minutes per week of moderate intensity aerobic activity or 75-150 minutes per week of high intensity aerobic activity, and at least 2 days of strength training exercises that work all muscle groups. If you are curious about how to monitor your exercise intensity, you can review this infographic from the ACSM for more information here.

Plan Meals and Snacks Around Your Exercise Schedule for Optimal Benefit

For most, eating 3 consistent meals with 1-2 snacks daily and following the dietary guidelines as recommended should be sufficient to fuel you through exercise 60 minutes or less in duration. The goal of your post-workout meal or snack is to help you recover and maximize your workout’s benefits, which means repairing and building muscle, as well as replenishing glycogen (i.e. energy) stores. Rather than adding extra foods to your meal plan, schedule a meal or a snack within 1-2 hours after exercise. For example, hit the gym after work, then plan to have dinner when you get home.

If you are working out at a high intensity for longer than 60 minutes (long distance running or cycling, playing a sport, body building, training for a competition or race, etc.), the energy and/or protein needs and timing of intake required to fuel these types of activities become increased and more specific. There are currently no set nutrition guidelines as research is emerging on bariatric athletes. You should remember that there will be some trial and error involved as everyone is unique.

Decreased energy intake and lower carbohydrate tolerance after weight loss surgery can lead to earlier fatigue, poor recovery, and decreased performance. Those engaging in endurance exercise will likely benefit from meeting with a dietician to discuss specific goals and needs to create an individualized plan that will allow optimal performance while continuing to maintain weight loss goals.

What You Eat Matters: Protein and Healthy Carbohydrates

As with the bariatric diet, protein is a central piece of exercise nutrition as well. Exercise triggers muscle protein breakdown, and it is important that you follow a workout with a high protein meal or snack that will help repair and build your muscle mass. The minimum recommendation for protein intake is 1 gram or protein per kilogram of body weight, and more than this if you are seriously strength training. Protein needs vary based on several factors such as type and frequency of exercise, and the size of an individual, among other potential factors.

If you have reached weight maintenance and it is appropriate for you, consuming a small amount of complex, high fiber carbohydrate along with protein at a meal or snack following exercise helps both with replenishing glycogen stores and with protein synthesis. Make sure that you do not count exercise as a free pass to eat any carbohydrates you want or replace your protein intake with carbohydrates as these habits contribute to weight regain.

Here are some quick and easy ideas to help you with your post-workout meals and snack planning:

Post-Workout Meals	Post-Workout Snacks
·         Tuna salad on ½ slice whole grain bread with carrot sticks ·         Baked pork chop with green beans and roasted sweet potato ·         Salmon with potato/cauliflower mash ·         Turkey deli meat, cheese, and vegetables on small low carb tortilla  ·         Egg and vegetable scramble with oatmeal ·         Power bowl with grilled chicken, roasted vegetables, and brown rice	·         Greek yogurt with berries ·         String cheese and a few whole grain crackers ·         Apple slices with peanut butter ·         Mini cheese and bean quesadilla on small corn or whole grain tortilla ·         Hardboiled egg and melon cubes ·         Cottage cheese and pineapple ·         Snaps peas and carrots with Greek yogurt ranch dip or hummus

Don’t Forget About Hydration

Both water and electrolytes are lost through sweat during exercise. Drinking plenty of water both before, during, and after your workout will help optimize your recovery and performance and prevent dehydration. Staying hydrated allows your muscles to contract properly and to regulate your core temperature. Electrolyte drinks can be beneficial, however; Be aware that many sports nutrition products have a lot of added sugar which can cause dumping syndrome, hypoglycemia, or diarrhea. Look for low sugar options such as Gatorade Zero or Nuun Sport Hydration electrolyte tablets or powder packets. Signs you may benefit from electrolyte supplementation include intense exercise, sweating heavily, muscle cramping/spasms, persistent fatigue, or headaches.

Each Person is Unique

When it comes to nutrition, each person has different needs, health and lifestyle factors, and preferences that must be considered. Your nutritional intake should reflect the level of activity in which you are engaging. These recommendations are generalized and what works well for one person may not work well for you. Please contact your team at RMAP is you would like more information or assistance with creating a plan as we are here to support you and your goals.

About the Author:
Juliana Betker, MS, RDN, CD, is a registered dietitian nutritionist who joined Rocky Mountain Associated Physicians (RMAP) in 2023 as a Registered Dietitian Nutritionist specializing in weight management and bariatrics. She graduated with her BS in Food Science and Human Nutrition from Clemson University and her MS in Kinesiology from the University of North Carolina Charlotte. She supports patients both before and after surgery by providing nutrition education, helping to manage food-related issues, and encouraging a balanced and positive relationship with food as they navigate their new lifestyle.

Links to related articles:
Committing to Exercise and Fitness
Exercise
Tips for a Lifestyle of Healthy Nutrition

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Rocky Mountain Associated Physicians
801-268-3800
1521 East 3900 South, Suite 100
SLC, UT 84124