All About Carbs After Bariatric Surgery

After bariatric surgery, the body undergoes tremendous transformation, and the same old eating rules may no longer apply. Carbohydrates, while often villainized, are an essential aspect of our diet, providing energy and supporting numerous bodily functions. However, how and when you consume these nutrients can significantly impact your health and weight-loss progress post-surgery. Let's take a few minutes to talk about the role of carbs after bariatric surgery.

Carbohydrates

Carbohydrates are the number one form of fuel for your body and brain. Carbohydrates are broken down into glucose (i.e., sugar) and then stored in the liver and muscle. When too many carbs are consumed, they are stored as fat. Carbohydrates contain 4 calories per gram. Carbohydrates come in two types: simple and complex. Simple carbs are quick-burning fuels that break down into sugar fast. Complex carbohydrates are a slower burning fuel source.

Simple Carbohydrates

Simple carbohydrates occur naturally (fruit sugars, honey, and milk sugar) or are processed (table sugar, corn sweeteners used in soft drinks). Generally, the foods that contain naturally occurring sugars are more nutrient-dense than foods that are high in processed sugars. Adding processed sugars to foods reduces their nutrient density, since the extra sugar adds nothing but calories.

Nutrient-dense describes food that provides a large amount of one or more nutrients for a relatively small number of calories. As you get older, your body requires less energy. During weight loss and maintenance, it is especially important to maximize your nutrient intake by choosing nutrient-dense foods, because these foods will give you the most nutritional “bang” for your caloric “buck”. 

Ingredients ending in “-ose” listed on the label will offer an easy way to spot added sugar. The name for table sugar is sucrose. Other names you might see include fructose, dextrose, and maltose. The higher up they appear in the ingredients list, the more added sugar the food contains. For a healthy diet, limit the amount of added sugar and choose whole grains (complex).

Complex Carbohydrates

Complex carbohydrates are absorbed much slower than simple carbohydrates. You may know them as starches and fibers. Foods high in these types of carbohydrates provide significant amounts of energy, as well as other important nutrients. Complex carbohydrates include: fruits, whole grains, legumes, and vegetables.

Complex carbohydrates come in two forms: whole (unrefined) and refined. The whole (unrefined) sources have not been processed and are high in fiber. The refined sources have lost most of their fiber. White flour is an example of a refined carbohydrate.

Why choose complex carbohydrates?

• Source of fiber, which provides bulk, vitamins and minerals
• Increased fullness

Fiber

Fiber is an important part of a healthy eating plan. Fiber takes longer to digest, which helps you feel full longer. It also slows the release of sugar into the bloodstream, which in turn slows the insulin response. The general recommendation for fiber intake is ~25-35 g per day as part of your total carb intake.

Fiber is primarily found in plants. It’s described as the indigestible husks, seeds, stems, skin and cell walls which hold plants together. There are two types of dietary fiber, soluble and insoluble.

Insoluble Fiber

Insoluble fiber speeds passage of food through the intestines and is essential for proper bowel function. The type of fiber is found in wheat bran, whole grain cereals and breads, and fruits and vegetables with edible skins.

The functions of insoluble fiber are:

• Speeds up the passage of food
• Increases stool bulk
• Helps protect against colon cancer
• Decreases risk of developing hemorrhoids and diverticulosis

The functions of insoluble fiber are:

• Increases intestinal gas formation
• Binds with calcium, zinc, iron, magnesium, phosphorus, and copper, thereby decreasing their absorption when excessive quantities are consumed

Soluble Fiber

Soluble fiber slows the emptying of food from the stomach, which may help to decrease hunger. In addition, it may be useful in lowering high blood cholesterol levels. This type of fiber is found in dried beans and peas, lentils, barley, oatmeal, oat bran and some fruits and vegetables such as apples, oranges and carrots.

The functions of soluble fiber are:

• Decreases hunger by slowing the movement of food through the body and promoting satiety (feeling of fullness)
• Slows down the absorption of carbohydrates which helps keep blood sugar levels down
• Decreases in “bad” cholesterol

How to Increase Fiber in Your Diet

Eat a variety of high fiber foods in moderation daily.

• Eat whole grain or whole wheat breads and cereals daily. When shopping, review the food label and look for “whole” grain or “whole” wheat as the first ingredient.
• Consume fresh fruits instead of fruit juices.
• Keep the skin on both fruits and vegetables whenever possible.

How Many Carbohydrates Are Needed?

The general population should consume about half of their calories from carbohydrates. It has been reported that individuals need a minimum of 100-130 grams of carbs per day for optimal brain function. A lower carbohydrate intake is safe since stored carbs (glycogen) can be used for energy and fuel as needed. Our body can also produce fuel from alternative sources such as fat. During weight loss, the body will turn to fat for fuel once you’ve used all your stored carbohydrates. Ketones are made when the body uses fat for fuel. This process is called ketosis. In addition to helping burn fat, ketosis can also curb hunger.

Summary

Adjusting to a new dietary lifestyle after bariatric weight loss surgery can seem daunting, especially when it comes to managing your carbohydrate intake. Remember, though, it's not about eliminating carbs altogether but rather about embracing a mindful approach. Whole, nutrient-dense, and low-glycemic carbs should be the backbone of your carbohydrate consumption, as they promote sustained energy and overall health without jeopardizing your weight loss efforts. It's also crucial to maintain an ongoing dialogue with your dietitian or healthcare provider as you adjust to your new eating patterns. With time, patience, and the right information, you can successfully navigate this journey towards a healthier you, avoiding weight gain, and reaping the full benefits of your bariatric surgery.

1. United States Department of Health and Human Services / United States Department of Agriculture. Dietary Guidelines for Americans 2005. Chapter 7: Carbohydrates. Available online at: http://health.gov/dietaryguidelines/dga2005/document/html/chapter7.htm. Accessed September 8, 2015.
2. United States Department of Agriculture: National Agriculture Library. Food and Nutrition Information Center: DRI Tables and Application Reports. Available online at: http://www.nal.usda.gov/fnic/DRI/DRI_Tables/DRI_RDAs_Adequate_Intakes_Total_Water_Macronutrient s.pdf. Accessed September 8, 2015.
3. https://www.perfectketo.com/keto-healthy-ketosis-vs-ketoacidosis/

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