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Kierra Brown
Kierra Brown RD, earned her Master’s of Science degree in Food and Nutrition from Indiana University of Pennsylvania, a Bachelor’s of Science from Rutgers University, and a Certificate in Pediatric and Adult Weight Management. Kierra provides pre- and post-operative nutrition counseling to promote and sustain weight loss. Experienced in counseling and educating patients across the lifespan with varying conditions and health goals, Kierra is passionate about improving health and wellbeing.
Meeting With The Dietitian?
The dietitian is responsible for the nutrition care for all weight loss patients. The dietitian’s role is to educate patients on the appropriate dietary and lifestyle changes before and after surgery to promote and sustain weight loss. The dietitian also provides support and guidance throughout the weight loss process.
The goal of the dietitian is to provide the patients with the necessary tools and evidence-based knowledge to promote weight loss, healthy lifestyle changes, and positive health outcomes. These tools may include handouts, recipes, interactive discussions and support throughout the weight loss process.
In first meeting with patients, I review their weight history, diet history, eating behaviors, meal and snack patterns and exercise behaviors. During the session, I review with the patient the behavioral goals and preoperative meal plan that will help them establish healthy lifestyle and eating habits.
- To promote weight loss and lifestyle change, patient should follow a high protein diet. Additional dietary changes patients should follow are making half their plate non-starchy vegetables, limiting snacking and excluding any caffeinated, sugary or carbonated beverages.
- Changes in behavior are equally as important as diet changes. Some of the behavior changes patients are encouraged to implement prior to surgery are eating protein first, chewing food at least 20 times before swallowing, using smaller plates and bowls, waiting 30 minutes between meals and beverages, not multitasking when eating and tracking both food intake and exercise.
In the two weeks before surgery, patients should start a meal plan of 800 – 1000 calories per day to facilitate the breakdown of fat without causing muscle loss. Protein supplements are important to ensure the patient is still getting adequate protein.
Clear liquids are transparent or you can see through it. Full liquids are opaque or you cannot see through it.
- Examples of clear liquids include water, clear protein supplements, sugar-free gelatin and popsicles, and clear broths.
- Examples of full liquids include non-fat or 1% milk, soymilk, protein supplements, sugar-free yogurt and pudding, and low-fat strained cream soups.
The diet after surgery progresses through five stages:
- Day before, day of, and day after surgery: clear liquids
- Day 3 through day 9: full liquids
- Day 10 through day 20: pureed diet
- Day 21 through day 29: soft diet
- Day 30 and forward: regular diet
It is imperative to take the recommended chewable or liquid vitamins and minerals after surgery. Patients will need to take the recommended vitamins and minerals for life or until otherwise instructed by their doctor.
- Patients undergoing the Sleeve Gastrectomy: take a chewable or liquid high-potency multi-vitamin with iron, calcium with vitamin D and B12 are recommended. These can be found over the counter or ordered online.
- Patients undergoing Roux-En-Y Gastric Bypass or the Duodenal Switch (DS): a bariatric formulated multi-vitamin, calcium, iron, vitamin B12, fat soluble vitamins (A, D, E, K), and zinc are recommended. These must be ordered online.
Consuming enough calories is essential for meeting the body’s energy needs while promoting weight loss and muscle retention. Once advanced to regular diet after surgery, women will resume a 1200-calorie diet and men will resume 1500-calorie diet. Regular exercise is important for muscle retention and weight management.
Protein is essential for wound healing after surgery. Continuing adequate protein intake is essential well after surgery to prevent and maintain muscle mass. The continuation of protein supplementation is encouraged in post-op patients. Patients should consume about 65 grams protein per day. High protein foods include egg whites, lean meats, fish, tuna, soymilk, tofu, and low fat dairy products.
- Protein supplements should be made from whey, pea, hemp or soy proteins and contain a minimum of 15-20g protein per serving. Nondairy, lactose-free, gluten-free and vegetarian protein supplements are available. Protein supplements can be used in place of meals both pre- and post-surgery.
- For liquid shakes: 225 calories or less, 5g total fat or less, 10g total carbohydrates or less and 20 - 35g protein. Examples include Premier Protein, GNC Total Lean, Ensure Max Protein, Muscle Milk Genuine, and Orgain Clean Protein.
- For protein powders: 120 calories or less, 5g total fat or less, 10g total carbohydrates or less and 15 - 25g protein. Examples include Optimum Nutrition Whey Protein Powder, Quest Peanut Butter Protein Powder and Muscle Milk Genuine Protein Powder.