Jennifer is a registered dietitian, and has been a member of the Clarian Bariatrics team since November 2008. She will work with both pre and post-op patients. Prior to working at Clarian Bariatrics, she worked at Clarian North Medical Center as a clinical dietitian and Columbus Regional Hospital, where she worked with weight loss surgery patients. A graduate of Purdue University, Jennifer holds a degree in Dietetics and Nutrition, Fitness and Health. While there, she met her husband of five years and is currently expecting her first child in March. Outside of working and spending time with her husband, she enjoys playing with her dog, Wrigley, and two cats, Smokey and Petunia, gardening, reading and watching Purdue athletics. Jennifer is a registered dietitian, and has been a member of the Clarian Bariatrics team since November 2008. She will work with both pre and post-op patients. Prior to working at Clarian Bariatrics, she worked at Clarian North Medical Center as a clinical dietitian and Columbus Regional Hospital, where she worked with weight loss surgery patients. A graduate of Purdue University, Jennifer holds a degree in Dietetics and Nutrition, Fitness and Health. While there, she met her husband of five years and is currently expecting her first child in March. Outside of working and spending time with her husband, she enjoys playing with her dog, Wrigley, and two cats, Smokey and Petunia, gardening, reading and watching Purdue athletics. This delicious recipe was adapted from Hungry Girl: 200 under 200 by Lisa Lillien.
2 cups roughly chopped orange cauliflower (if you can’t find orange cauliflower, use regular but add a drop of yellow food coloring if you want your Devilish Eggs to look like the real thing)
¼ cup fat free mayonnaise
3 wedges The Laughing Cow Light Original Swiss cheese, room temperature
1 Tbs relish, patted dry to remove moisture
2 tsp minced shallots
1 ½ tsp yellow mustard
Salt and black pepper, to taste
10 hard boiled eggs, chilled
Optional topping: paprika
2 cups roughly chopped orange cauliflower (if you can’t find orange cauliflower, use regular but add a drop of yellow food coloring if you want your Devilish Eggs to look like the real thing)
¼ cup fat free mayonnaise
3 wedges The Laughing Cow Light Original Swiss cheese, room temperature
1 Tbs relish, patted dry to remove moisture
2 tsp minced shallots
1 ½ tsp yellow mustard
Salt and black pepper, to taste
10 hard boiled eggs, chilled
Optional topping: paprika
- Place cauliflower in a large microwave safe bowl with 1/3 cup water. Cover and microwave for 6-8 minutes, until cauliflower is soft
- Once bowl is cool enough to handle, drain any excess water from cauliflower. Lightly mash cauliflower, and then place in a blender. Add mayo and puree until just blended, not smooth. Do not over-blend.
- In a mixing bowl, combine cauliflower mixture with cheese wedges, relish, shallots, and mustard. Stir until smooth. Season mixture to taste with salt and pepper. Refrigerate for at least 1 hour.
- When ready to serve, halve eggs lengthwise and remove yolks. Evenly distribute cauliflower mixture among egg white halves and, if you like, top with paprika.
The following recipe is appropriate for liver reduction diet and soft diet and beyond following surgery.
2 large portabella mushrooms
1 summer squash (yellow or green), ends removed, finely diced
2 wedges The Laughing Cow Light Original Swiss cheese room temperature
1/2 tbsp. reduced-fat Parmesan-style grated topping
1/2 tsp. minced garlic
1/2 tsp. dried minced onion
1/8 tsp. salt, or more to taste
Dash ground thyme, or more to taste
Olive oil nonstick spray
MAKES 2 SERVINGS (1 large stuffed mushroom = 92 kcal, 6.5 g protein)
GRILL Instructions! Preheat grill to medium heat. Assemble foil pack according to above directions. Place on grill and cook for 10 - 13 minutes. Follow regular cooling instructions
Adapted from Hungry Girl
2 large portabella mushrooms
1 summer squash (yellow or green), ends removed, finely diced
2 wedges The Laughing Cow Light Original Swiss cheese room temperature
1/2 tbsp. reduced-fat Parmesan-style grated topping
1/2 tsp. minced garlic
1/2 tsp. dried minced onion
1/8 tsp. salt, or more to taste
Dash ground thyme, or more to taste
Olive oil nonstick spray
- Preheat oven to 375 degrees.
- In a bowl, combine cheese wedges, garlic, onion, salt, and thyme. Mix until smooth. Set aside.
- Remove mushroom stems and finely chop. Add chopped stems to the bowl, and set mushroom caps aside.
- Add squash to the bowl and stir well, until veggies are coated in the cheese mixture. Lay a large piece of heavy-duty foil on a baking sheet. Lightly mist mushroom caps with olive oil nonstick spray, and place next to each other on the foil with the rounded sides down. Spoon veggie-cheese mixture into the mushroom caps -- there will be a lot, so pack it in! Sprinkle with Parmesan cheese.
- Place another large piece of foil over the caps. Fold together and seal all four edges of the two foil pieces, forming a well-sealed packet.
- Place baking sheet in the oven and bake for 23 - 25 minutes, until mushrooms are soft and tender.
- Allow packet to cool for a few minutes, and then cut to release steam before opening it entirely. (Careful -- steam will be hot.) If you like, season to taste with additional salt and thyme. Enjoy!
MAKES 2 SERVINGS (1 large stuffed mushroom = 92 kcal, 6.5 g protein)
GRILL Instructions! Preheat grill to medium heat. Assemble foil pack according to above directions. Place on grill and cook for 10 - 13 minutes. Follow regular cooling instructions
Adapted from Hungry Girl
The following recipe is appropriate for liver reduction diet and post-surgery once on soft foods stage.
4 cups cubed butternut squash
2 wedges The Laughing Cow Light Original Swiss cheese, room temperature
¾ cup diced onion
¼ cup fat free liquid egg substitute
½ tsp salt
¼ tsp chili powder
1/8 tsp black pepper
4 cups cubed butternut squash
2 wedges The Laughing Cow Light Original Swiss cheese, room temperature
¾ cup diced onion
¼ cup fat free liquid egg substitute
½ tsp salt
¼ tsp chili powder
1/8 tsp black pepper
- Preheat oven to 350 degrees.
- Place squash in a large microwave safe bowl with ¼ cup water. Cover and microwave for 6 minutes. Once bowl is cool enough to handle, uncover and drain any excess water. Set aside.
- Place onion in a small microwave-safe dish with 2 Tbs of water. Cover and microwave for 3 minutes. Let cool slightly, uncover and drain any excess water. Set aside.
- Place squash in a blender. Add all of the other ingredients except for the onion. Pulse until thoroughly mixed but not liquefied.
- Remove blender from base and stir in onion. Transfer mixture to a small casserole dish sprayed with nonstick spray.
- Bake in the oven for 35-40 minutes, until edges of the squash casserole begin to brown. Serve with a spoon.
A patient should be concerned of a nutritional problem after bariatric surgery if any of the following occurred:
Zinc: Zinc deficiency has been tied to hair loss in both animal studies and human cases. Based on studies done and their results, it can not be definitely said that zinc would prevent hair loss after weight loss surgery and further studies would be needed to make this connection. A note on zinc: The tolerable upper intake level for zinc is 40 mg in adults. These levels can cause gastrointestinal distress. Chronic toxicity can start at intakes of 60 mg/day. Some patients have heard on chat rooms and list serv forums that “high dose zinc will prevent hair loss after weight loss surgery.” Patients should be advised that high dose zinc therapy is unproven and should only be done under supervision due to the risks associated with toxicity. A lab test to check for zinc deficiency would be best before giving a high dose such as this.
Protein: Low protein intake is associated with hair loss. Limited studies suggest that patients with the most rapid or greatest amounts of weight loss are at greatest risk. Pancreatic enzymes that would help aid in protein digestion are redirected to a lower part of the small intestine. Based on this, it is likely that maldigestion, rather than malabsorption, is responsible for many hair loss cases.
Biotin: To date, there is no science that would support supplementing with, or topically applying biotin will prevent hair loss or improve hair regrowth. While biotin deficiency can cause dermatitis, hair loss is only known to occur in experimentally induced states in animal models or in extreme cases of prolonged diets composed exclusively of egg whites.
Hair loss can be distressing to bariatric surgery patients and many will try to nutrition themselves to see if they can prevent it. Unfortunately, there is little evidence that early hair loss is preventable because it is most likely caused by surgery and rapid weight loss. However, later hair loss can be indicative of a nutritional problem.
Reference: Bariatric Times. “The Latest on Nutrition and Hair Loss in the Bariatric Patient” by Jacqueline Jacques, ND. 9/08
- Hair loss continued more than one year after surgery
- Hair loss started more than six months after surgery
- Patient has had difficulty eating and/or has not complied with supplementation
- Patient has shown low values of ferritin, zinc or protein on lab results
- Patient has had more rapid then expected weight loss
Zinc: Zinc deficiency has been tied to hair loss in both animal studies and human cases. Based on studies done and their results, it can not be definitely said that zinc would prevent hair loss after weight loss surgery and further studies would be needed to make this connection. A note on zinc: The tolerable upper intake level for zinc is 40 mg in adults. These levels can cause gastrointestinal distress. Chronic toxicity can start at intakes of 60 mg/day. Some patients have heard on chat rooms and list serv forums that “high dose zinc will prevent hair loss after weight loss surgery.” Patients should be advised that high dose zinc therapy is unproven and should only be done under supervision due to the risks associated with toxicity. A lab test to check for zinc deficiency would be best before giving a high dose such as this.
Protein: Low protein intake is associated with hair loss. Limited studies suggest that patients with the most rapid or greatest amounts of weight loss are at greatest risk. Pancreatic enzymes that would help aid in protein digestion are redirected to a lower part of the small intestine. Based on this, it is likely that maldigestion, rather than malabsorption, is responsible for many hair loss cases.
Biotin: To date, there is no science that would support supplementing with, or topically applying biotin will prevent hair loss or improve hair regrowth. While biotin deficiency can cause dermatitis, hair loss is only known to occur in experimentally induced states in animal models or in extreme cases of prolonged diets composed exclusively of egg whites.
Hair loss can be distressing to bariatric surgery patients and many will try to nutrition themselves to see if they can prevent it. Unfortunately, there is little evidence that early hair loss is preventable because it is most likely caused by surgery and rapid weight loss. However, later hair loss can be indicative of a nutritional problem.
Reference: Bariatric Times. “The Latest on Nutrition and Hair Loss in the Bariatric Patient” by Jacqueline Jacques, ND. 9/08
A common fear for patient’s who have undergone bariatric surgery is hair loss. For most of us, our hair is important as part of our self-image but is not very important to our bodies. After surgery, the body is forced to make a choice on where to send the nutrition that is going into the body. After surgery, the body will shift nutritional stores to vital organs like the brain and heart and away from hair thus resulting in hair loss.
Hair loss has many causes. The most common type of hair loss after weight loss surgery is a loss known medically as telogen effluvium, which can have both nutritional and non-nutritional causes.
For most of our life, we are always in the process of growing and losing hair. Human hair follicles have two states: a growth state and a dormant state. All hairs begin in the growth state and then shift to the dormant state, which lasts 100-120 days. After this many days, the hair will fall out. At any given time, about 90 percent of hairs are in growth state and 10 percent are in a dormant state.
Specific types of stress can result in a shift of a higher percentage to the dormant state. These stresses include: high fever, severe infection, major surgery, acute physical trauma, chronic debilitating illness (such as cancer or end stage liver disease), acute weight loss, crash dieting, hormonal disruption, anorexia, low protein intake, iron or zinc deficiency, heavy metal toxicity and some medications.
Bariatric surgery patients have two major risks for hair loss: major surgery and rapid weight loss. These two are likely to account for much of the hair loss after surgery. In the absence of a nutritional issue, hair loss will continue until all hairs that shifted into the dormant phase have fallen out. Hair loss will rarely last for more than 6 months in the absence of a dietary cause. Patients can be reassured that with time, patience and keeping up good nutritional intake, hair will grow back.
Hair loss has many causes. The most common type of hair loss after weight loss surgery is a loss known medically as telogen effluvium, which can have both nutritional and non-nutritional causes.
For most of our life, we are always in the process of growing and losing hair. Human hair follicles have two states: a growth state and a dormant state. All hairs begin in the growth state and then shift to the dormant state, which lasts 100-120 days. After this many days, the hair will fall out. At any given time, about 90 percent of hairs are in growth state and 10 percent are in a dormant state.
Specific types of stress can result in a shift of a higher percentage to the dormant state. These stresses include: high fever, severe infection, major surgery, acute physical trauma, chronic debilitating illness (such as cancer or end stage liver disease), acute weight loss, crash dieting, hormonal disruption, anorexia, low protein intake, iron or zinc deficiency, heavy metal toxicity and some medications.
Bariatric surgery patients have two major risks for hair loss: major surgery and rapid weight loss. These two are likely to account for much of the hair loss after surgery. In the absence of a nutritional issue, hair loss will continue until all hairs that shifted into the dormant phase have fallen out. Hair loss will rarely last for more than 6 months in the absence of a dietary cause. Patients can be reassured that with time, patience and keeping up good nutritional intake, hair will grow back.
After you drink milk, eat yogurt or have other dairy containing foods do you feel really bloated, gassy or have diarrhea? If so, then you are more than lactose intolerant. It is not uncommon for post-op bariatric surgery patients
to develop this intolerance.
How does this occur? The enzyme lactase, which is normally produced by cells lining the small intestine, breaks down lactose into substances that can be absorbed into the bloodstream. When there is a shortage of lactase, the body is not able to break down lactose, and it travels through the intestines unchanged.
In the intestines, undigested lactose has a laxative effect and stimulates the growth of bacteria that produce significant amounts of gas. Common symptoms, which range from mild to severe, include nausea, cramps, bloating, gas and diarrhea. Symptoms begin about 30 minutes to two hours after eating or drinking foods containing lactose. The severity of symptoms depends on many factors, including the amount of lactose a person can tolerate and a person’s age, ethnicity, and digestion rate.
If you have become lactose intolerant, does that mean that you cannot drink milk anymore? No, there are a few options. You can choose to use soy milk, lactose free milk or use dairy digestive enzymes. Dairy digestive enzymes are taken with the first sip or bite of a dairy containing product. If you drink a cup of milk later in the day then you need to take another enzyme pill. If one pill doesn’t work for you, try taking two pills the next time you have a dairy containing product.
Have an additional question about nutrition pre or post-op? Then feel free to leave me a comment below!
to develop this intolerance. How does this occur? The enzyme lactase, which is normally produced by cells lining the small intestine, breaks down lactose into substances that can be absorbed into the bloodstream. When there is a shortage of lactase, the body is not able to break down lactose, and it travels through the intestines unchanged.
In the intestines, undigested lactose has a laxative effect and stimulates the growth of bacteria that produce significant amounts of gas. Common symptoms, which range from mild to severe, include nausea, cramps, bloating, gas and diarrhea. Symptoms begin about 30 minutes to two hours after eating or drinking foods containing lactose. The severity of symptoms depends on many factors, including the amount of lactose a person can tolerate and a person’s age, ethnicity, and digestion rate.
If you have become lactose intolerant, does that mean that you cannot drink milk anymore? No, there are a few options. You can choose to use soy milk, lactose free milk or use dairy digestive enzymes. Dairy digestive enzymes are taken with the first sip or bite of a dairy containing product. If you drink a cup of milk later in the day then you need to take another enzyme pill. If one pill doesn’t work for you, try taking two pills the next time you have a dairy containing product.
Have an additional question about nutrition pre or post-op? Then feel free to leave me a comment below!
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