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Center for Obesity and MetabolicHealth (COMET)2
Meet the DietitiansChristine Goukasian, MS RDNcgoukasian@mednet.ucla.eduAllison Barbera, MS RDNabarbera@mednet.ucla.edu3
Healthy Eating and NutritionPrior to surgery&Long term weight maintenance4
Importance of Pre-surgical Weight Reduction Weight loss goal is set by surgeon The liver is front of the stomach Weight loss shrinks liver, allowingeasier access to stomach Surgery is only a tool Lifestyle & behavior modificationsarethe key to success5
Goals to Achieve Weight Loss Cook at home more often Eat within the first hour of waking up,then every 3 hours Aim for 64 oz. water daily Spend 20-30 minutes at each meal andenjoy every bite Start an exercise routine
Night Shift Workers andWeight GainNight shift workers lose lessweight than day shift workers: Irregular sleep cycle (disruptsCircadian rhythm) Irregular eating patterns Chronic fatigue, difficultyestablishing an exercise ormeal planning routine
How to Prevent Weight Gainat Night Pack healthy meals and snacks Set 12 hour fasting window, 12 houreating window Stay active at work Get plenty of rest (8-9 hours of sleep)
Wake up at 4:00 pmNight Shift MealTimingBreakfast 5:00 pmSnack 8:00 pmLunch 11:00 pmSnack 2:00 amDinner 5:00 amBed at 7:30 am
Macronutrients Carbohydrates Protein Fat Water10
Carbohydrates Sourceof energy the brainand body prefers NOT“bad” Choosecomplexcarbohydrates over simplecarbohydrates11
Simple Carbohydrates Digest quickly Spike blood sugar and insulin Don’t have fiber Usually from unhealthy sources: Icecream, cookies, pastries, cake Whiterice, white bread, pancakes,biscuits Processedand refined sugar: candy,soda, syrups, sugary coffee drinks Juice-doesn’t have fiber and high insugar12
Complex Carbohydrates Digest slowly Don’t spike blood sugar and insulin Have fiber Usually from healthy sources: Fruit Breads, Pasta,whole grainwhole grain Brownrice, quinoa, millet, amaranth,buckwheat Corn,peas, beans, potatoes Seemeal plan for more healthycarbohydrate ideas13
Portion Sizes½ cup cooked cereal½ banana1 slice bread1 cup berries1/3 cup rice½ cup beans14
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How Many Carbohydrate Servings are Recommended for Weight Loss? Can lose weight AND eat carbs Eat carbs with protein to stay energizedthroughout the day Choose complex carbohydratesFor example: Add 1 slice whole grain toast to breakfast Have a side of fruit at your snack Portion ½ sweet potato at lunch Snack on 3/4 cup yogurt Add 1/3 cup brown rice to dinner16
Protein Amino acids are the buildingblocks of protein These building blocks areresponsible for buildingmuscle, hair, skin, nails, andother tissues Weight loss results in muscleloss, can reduce loss withprotein17
ProteinFor weight loss, aim for at least 60 g protein daily*1 serving protein 7 grams protein, 60-80 calories1 serving 1 oz. lean meat1 oz. poultry, skinless1 egg3 oz. tofu1 oz. low-fat cheese1 cup non-fat milk1 oz. tempeh(For example: 3 servings chicken 21 g protein)*After surgery aim for 80-100 g protein daily18
ProteinLentils, beans, milk and yogurt areboth a protein and a carbohydrateNuts are both a protein and fat andare higher in calories than otherprotein sources1 oz. nuts 160-200 calories2 tbsp. nut butters 200 calories19
Protein Choices Poultry: Choose white, skinless breast. Fish: Bake, broil, or steam. Avoid pan-friedor breaded fish sticks. Beef: Limit intake. Choose lean cuts such assirloin, flank steak or tenderloin Pork: Choose lean sources such as porktenderloin. Dairy Products: Choose plain, (low-fat)yogurt and milk products. Be sure to checksugar content.20
FatsHealthy fats are protective while unhealthyfats increase risk for heart disease1 serving of fat 45 caloriesHealthy FatsUnhealthy FatsAvocadoCoconut oilOlivesFatty cuts of red meatNuts and seedsBaconOlive, avocado, canola,walnut, hemp oilFull-fat cheeseSalmon, mackerel,anchovies, sardinesButterEgg yolkMargarineLard21
Typesof FatsUnsaturated (more): heart healthy,liquid at room temperatureGood for dressings: olive oilGood for cooking: avocado,grapeseed, canolaSaturated (less): solid at roomtemperatureButter, lard, Crisco, coconut oilTrans Fats (avoid): highly processed,aka partially hydrogenated oilsFound in baked goods, chips,candy, some microwave popcorn,doughnuts, fried foods, pastries,cakes, non-dairy creamers, somefrozen pizzas, canned frosting22
Look at servingsize and howmany servingsper containerLow insaturated fatLook for 10 gsugarNot a highsource ofprotein15 gcarbohydrate 1 servingThis has 2servings ofcarbohydrates
Non-starchy VegetablesNon starchy Vegetables: artichoke,asparagus, green beans, bean sprouts,beets, broccoli, Brussels sprouts,cabbage, cauliflower, celery,cucumber, eggplant, onions, leeks,mushrooms, okra, pea pods, peppers,radishes, green leafy vegetables,summer squash, tomato, turnips, waterchestnuts, zucchiniThey include all vegetables except forcorn, green peas, potatoes, yucca,yams, beans and plantains25
Water Aim for at least 64 oz. of water daily Thirst can be confused with hunger,sometimes you’re just thirsty Lack of water can cause headaches andirritability Constipated? Drink water.26
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Snack Ideas 1/4 cup Trader Joe's Thai Lime & Chili Cashews Bada Bean Bada Boom fava bean snacks 3 oz. deli meat and 1 slice low-fat cheese Think Thin Protein & Fiber Hot Oatmeal Edamame, shelled and cooked, 1 cup Eggs, hard boiled, 2 Cottage cheese, 1%, 1/2 cup 1 Cheese stick with 1 orange Turkey or salmon jerky, 2 oz. Turkey pepperoni, 20 slices Morning Star Vegan Veggie BurgerChobani "Simply 100", "Less Sugar" or BlendedYogurt Danon Light and Fit Oikos Triple Zero Honey roasted almonds Small apple with 1 tbsp. peanut butter Icelandic yogurt (Skyr) Morning Star Grilled Chicken Patty
Foods to LimitFried FoodsFried fish, fried chicken, French fries,chipsAlcoholAll varietiesFull fat meatsRibeye, 80% ground beef, bacon, etc.Creamy salad dressingsRanch, blue cheese, Thousand IslanddressingTry Greek yogurt dressing instead(refrigerated section)Added sugarCereals, muffins, cakes, cookies,croissants, doughnuts, soda, coffeedrinksLook at the label for “added sugar”Sugary marinades, sauces, juicesTeriyaki sauce, barbeque sauce, andmarinara saucesFruit juice- natural but high in sugar andlacking fiber
Cooking at HomeDon’t know where to start? Pick one new recipe a week Choose a simple recipe Websites to visit: Skinnytaste.com Budgetbytes.com theworldaccordingtoeggface.blogspot.com/ Foodnetwork.com/healthy
Dining Out Choose restaurants withhealthy options Look up nutrition facts(restaurants with over 10 storeslegally must be able to providethis information) Plan what you will getahead of time Use nutrition calculatorswhen possible
Nutrition Calculator, Chipotle1850 calories71 g fatAn entire dayworth of caloriesand fat in onemeal.
Nutrition Calculator, Chipotle470 calories17.5 g fat
Emotional vs Physical Hunger Sudden and urgent Gradual Do not stop when full Stop when full Crave a specific food item Choose a variety of foods Mindless eating Physical grumbling in stomach Feeling of guilt, regret orshame Not satisfied when full Involved with a feeling(happy, sad, lonely, bored)
Emotional Hunger Checklist“I’m not hungry but I want ” Eat every 3 hours to prevent overeating. Before eating, check in with you howyou feel. Do you want to eat becauseyou’re stressed? Bored? Be present. Eat without distractions(television, phone, etc.) Focus on protein to help keep you full. Don’t keep trigger foods at home (foodsthat are easy to binge).
Thank you!Christine Goukasian, MS RDNcgoukasian@mednet.ucla.eduAllison Barbera, MS RDNabarbera@mednet.ucla.edu
cgoukasian@mednet.ucla.edu Allison Barbera, MS RDN abarbera@mednet.ucla.edu. 4 Healthy Eating and Nutrition Prior to surgery & Long term weight maintenance . . *After surgery aim for 80-100 g protein daily . Lentils, beans, milk and yogurt are both a protein and a carbohydrate
