Day 3: Soft Proteins
The next three days you get to eat as much as you want as often as you want! Ahhh, but there's a catch: it has to be solid protein and you only get 15 minutes each time you sit down to eat. No drinking 30 minutes before or after meals and no drinking with your food. A dry pouch will hold your soft protein longer helping your to feel full and fed longer.Protein Recommendations: canned fish (tuna or salmon) mixed with lemon and seasoned with salt and pepper, eggs cooked as desired seasoned with salt pepper and/or salsa, fresh soft fish (tilapia, sole, orange roughy), baked or grilled, and lightly seasoned.
This starts your program with "soft" protein. Measure your portion (1 cup volume or 4-6 ounces weight) and eat only until you feel full, not overfull. Remember, no water for 30 minutes before or after you meal, and no fluids with your meal. We are going back to the beginning and fluids will prevent you from feeling the pouch. If you need to add a moist condiment ( Miracle Whip or mayonnaise) to the canned fish I understand, but keep it to a minimum so the meat is not too moist. One reason we lose the sense of tightness in our pouch is that we eat "slider foods" - foods that are too moist and do not stay in the pouch very long, they slide right through the stoma.
From Amy: On day 3, is cottage cheese o.k. for soft protein? When I was first starting my wls diet, it included cottage cheese, but that wasn't on your list. Also, when you are doing the liquid part of the diet, can you drink chicken boullion with protein added to it?
Kaye Answers: Amy - Cottage cheese is a good protein and you can include it on Day 3. I didn't have it on the list because it is considered by some to be a slider food. To firm it up a bit you could add a chopped hard cooked egg to your cottage cheese. And yes, during the liquid phase chicken boullion with added protein is great.
I don't like canned fish. What can I have in place of the canned tuna or salmon?
Try canned turkey or chicken. We have some great recipes for Turkey and Chicken Salad that work well for Day 3 and as part of your regular diet after the 5 Day Pouch Test.
Question: What are slider foods?
Kaye's Answer: In a malabsorptive procedure the pouch is made and the stoma or outlet is attached to the lower part of the middle intestine called the jejunum. The majority of caloric absorption takes place in the jejunum, so depending upon where your surgeon created the outlet the level of absorption can vary. Skilled surgeons will adjust the length of intestine bypassed according to their patient's projected needs based on dieting history and pre-op psychological screening.
Slider foods slide right through the stoma into the jejunum. My first test of the slider foods was graham crackers and coffee for my after work snack. Now imagine, I could eat a stack of graham crackers and wash it right through the pouch with the coffee and never feel any satiation. What resulted was an easily absorbed slurry that my jejunum sucked up like a sponge - it didn't have to do any work to absorb this simple carbohydrate slurry. Of course, weight gain resulted and I had to give up this little indulgence. Another popular slider food is pretzels. I speak with post-ops all the time who are addicted to pretzels - again, this is a simple carb that your jejunum is very happy to receive and convert to fat. Traditionally dieters are encouraged to eat pretzels or popcorn - fat free and fiber, right? But that doesn't work so well for us. Giving our re-routed bodies these simple carbs is dangerous because our bodies have spent years perfect the art of fat storage - slider foods are to the body a great big lottery win.
By the way, in my example I spoke of a slurry from graham crackers and coffee. Simple carbs, however, will slide right through without the added benefit of a liquid. And several others can talk about cheese nip crackers, popcorn, mashed potatoes, ice cream/yogurt etc.
Lots of times I hear, "But I don't like that uncomfortable tight feeling of solid protein in my pouch." But the very purpose of the pouch is to signal fullness, which often comes by way of slight discomfort when we are eating in compliance with our bariatric owner's manual. The slider foods will never ever signal fullness. They are dangerous and in most cases non-nutritional. When I feel that full-pouch discomfort I try to mentally psych myself up, "YEAH-BABY! The pouch is on the job!!" Silly, but whatever works.