5DPT Bulletin
Rule #1: Protein First 
Why protein and how much?
February 2013
In This Issue
February Theme
Are you getting enough protein?
Food for Thought: Tight Pouch = Loose Pants
Recipe: Famous Senate Bean Soup
Protein & Fruit WLS Perfect Meal
Eggs & Turkey Breast with kiwi and berries for a high protein antioxidant-rich meal.

Long-term weight management with WLS requires a life-long commitment to a high protein diet.
Rule #1 Protein First:
It works.

"After any bariatric surgery our nutritional focus must be following Rule #1: Protein First. That is how we can lose weight after a surgical gastric procedure and that is how we can maintain a healthy weight. Most of us need 100 grams or more of protein a day. By the time we eat that before anything else there is little pouch real estate to surrender to simple carbs and empty calories. Protein First: it works immediately after surgery and it sustains us for life." ~ Kaye Bailey

WLS Four Rules

her: Definitions
Complex Carbohydrates: noun. Foods that contain a lot of starch --vegetables, fruits, beans, legumes, and whole grains. They are rich in vitamins, minerals, and fiber. Foods on your plate that most closely resemble the way they come from nature, unaffected by processing, are in the complex carbohydrate group..

Simple Carbohydrates: noun. Foods that contain a lot of sugar --syrups, jelly, honey, soda, molasses-- and have few, if any, vitamins and minerals and are void of fiber. Processed food including chips, crackers, cookies, cakes, pastries, and white bread are in this category.

Reprinted with permission from Cooking with Kaye: Methods to Meals page 55.

Cooking with Kaye


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Updates from LivingAfterWLS  


The Neighborhood is still offline as we continue to work on upgrading features and improving security. It is taking longer than we had hoped, but we want to get it right. Please keep an eye on your inbox for notice when we have our Safe Haven back online. Concurrently we are upgrading the LivingAfterWLS and 5DPT websites and blogs to provide a better user experience. I think you will appreciate the new LivingAfterWLS experience (and we will appreciate being done with this huge project!)


Diet Journal: We were crestfallen to learn last month that our favorite journaling tool "Ultimate Pocket Diet Journal" was taken out of print by the publisher. We no longer have it in stock. The good news is Kaye is putting the finishing touches on the LivingAfterWLS Meal Planner and Diet Journal to be published in the second quarter this year. This will be a great tool for us as it is specific to WLS.



LivingAfterWLS is your premier destination for life-long support for your health and weight management with all bariatric surgery procedures. Kaye Bailey founded LivingAfterWLS in 2004 and has served the WLS community since then, all-the-while learning to manage her own health with gastric bypass sugery in 1999.

Read the words we live by:
LAWLS Empowerment Statement


Quick List: Dietary Protein
Reprinted with permission from Cooking with Kaye, page 20.

Meat: beef, bison, lamb, game. The term meat is a broadly used term that includes beef, bison, lamb, and game meat. Beef is the most commonly consumed meat in the United States while lamb is the top in meat consumption worldwide. Bison or buffalo is becoming more readily available with the increase of agricultural bison ranches. Bison and game may be substituted for beef in most recipes. People following a high protein diet should select lean cuts of meat to reduce their intake of saturated fat.
Try This Day 5 Recipe:

22 grams protein per serving

Poultry. Chicken, turkey and other poultry are popular sources of lean protein for their ease in preparation and affordability. White meat poultry contains less fat than dark meat, but dark meat protein is a better source of nutrients including B vitamins.
Enjoy This Day 5 Recipe:
Papaya-Glazed Chicken.
28 grams protein per serving.

Pork. There is much talk about today's leaner pork thanks to improved agriculture practices. Lean cuts such as tenderloin, top loin, rib chops, and sirloin steak are 31 percent leaner than the same cuts two decades ago. Pork cooks quickly and is affordable, priced similar to chicken.
Love This Day 6 Recipe:
Pork Chops with
Onions and Apples
Cooking with Kaye page 133.
38 grams protein per serving.

Fish and shellfish. Perhaps the best source of lean protein combined with healthy fats, fish and shellfish support a well-planned high protein diet. Most fish contain the heart-healthy fat known as omega 3 which is shown to improve cardiovascular health and prevent the risk of stroke and heart disease.
All-time favorite 5DPT Recipe Day 3: Parmesan Tuna Patties. 16 grams protein per tuna patty
Recipe on 5DPT website and in print on page 142 of the new 2012 5DPT Owner's Manual 2nd Edition and page 76 Owner's Manual 1st Edition (out of print).

Soy. Plant based soy protein, the base ingredient for tofu, is a low-fat protein option with the added benefit of cholesterol lowering properties.
Days 1 and 2 Recipe:
Ham & Cheese Soup (with secret ingredient tofu)
Recipe on the Web or on page 125 5DPT Owner's Manual 2nd Edition and page 68 Owner's Manual 1st Edition (out of print).

Beans and legumes. High protein diets tend to be low in dietary fiber. Including beans and legumes in meals provides the benefits of plant protein and dietary fiber in one healthy ingredient. A half cup serving of beans contains nearly the same protein as 3 ounces of broiled steak.

Famous Senate Bean Soup: Featured Recipe
Works for Days 1 and 2: simple, warm and comforting on all other days of Living!
In print: Cooking with Kaye page 59


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Perfect Prime Rib of Beef
Perfect Prime Rib of Beef
Happy heart health month to you! I hope this newsletter finds you well and Living after WLS!  This February bulletin addresses dietary protein as it fits in our "Protein First" post-WLS diet.  An abundance of proof exists that shows when our protein intake drops weight loss stalls and weight gain may occur. The "Protein First" rule must be followed with some rigor well beyond the so-called honeymoon period of weight loss. In order to sustain a healthy weight we must eat a high protein diet. I don't know of anyone with WLS who has not, at some point, struggled to follow a high protein diet. I've gone through spells where animal protein was repulsive to me so I had to supplement my nutritional intake with protein bars and shakes. If you struggle now and again with the high protein diet take a look at the articles in this newsletter to learn why protein is so important and how to increase your intake of protein.

Learn More:
High Protein Diet Promotes Weight Loss for Bariatric Patients

A protein-rich diet can lead to increased satiety, enhanced weight loss, and improved body composition.

Protein First:
A really big deal in our long-term WLS success
Reprinted with permission from Cooking with Kaye. Methods to Meals: Protein First Recipes You Will Love,  page 21.

"Prior to most bariatric procedures patients are taught Four Rules that we agree to follow for the rest of our life. The Four Rules  are misleading in their simplicity: Protein First; Lots of Water; No Snacking; Daily Exercise. Fewer than ten words! I remember being so overwhelmed by the transition that surgery puts in motion that I was grateful for the simplicity of these four little guidelines. But as time marched forward and weight loss became more difficult and later weight maintenance was confusing and illusive I became desperate for more information. I needed details so I could intelligently sustain a healthy weight and manage my WLS tool. Leaving my weight management to chance had never worked before surgery and I was fearful that after surgery leaving things to chance would take me right back up the scale to morbid obesity.

So, it turns out, Protein First is highly critical in our weight management efforts. Not just in the early days and weeks following surgery, but for as long as we live. And Protein First sounds simple and easy but we quickly discover the information about protein can be confusing and complicated. A weight loss surgery Protein First diet is a high protein diet. This indicates that of the three major nutrients (protein, fat, and carbohydrate) protein contributes 50 percent or more of our food intake, followed by fat and carbohydrates in near-equal percentages."

LivingAfterWLS Newsletter Archive And if you missed our two special edition bulletins in January you can check them out in our newsletter archive:
5 Day Pouch Test FAQ's Part 1
5 Day Pouch Test FAQ's Part 2

I wish you the very best of health this New Year! You have the power to make this your healthiest year ever - Let's do it together!


"I believe in you.
You deserve to be healthy.
 You deserve to be kind to yourself.
You deserve to achieve your greatest level of success with weight loss surgery when you harness your inner resources."
--Kaye Bailey
5 Day Pouch Test Owner's Manual

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How much protein have you had today?
Protein shortfall puts our health at risk   Kettle-Grilled Chicken

"As a group, we are not eating enough protein and this shortfall is putting our health at risk."

We know that after weight loss surgery we should follow a high protein diet. We call this "Protein First" - the first of the Four Rules of WLS. Mainstream studies of people managing their weight without bariatric surgery continue to indicate a diet high in protein supports weight loss and weight management in addition to promoting health.

WebMD recently reported, "Diets higher in protein and moderate in carbs, along with a lifestyle of regular exercise are often purported by experts to reduce blood fats and maintain lean tissue while burning fat for fuel without constant hunger sidetracking dieters." Researchers don't understand exactly how protein works to turn down appetite. They surmise that it may be because a high-protein diet causes the brain to receive lower levels of appetite-stimulating hormones. It may be due to eating fewer carbs and/or the specific protein effect on hunger hormones and brain chemistry.

How Much Protein Do You Need?
The experts are now suggesting dieters eat 120 grams of protein a day to get the potential weight loss benefit. They advise advancing protein intake gradually, "If you want to increase your protein intake, do it slowly over the course of a week.  To be on the safe side, check with your doctor before adding large amounts of protein to your diet."

120 grams = 20 ounces or 1.25 pounds protein/day

Bariatric centers are less precise in their protein recommendations. In fact, a 2008 study reveals nutritionists recommend anywhere from 60 to 105 grams of protein a day for patients following a 1,200-calorie diet. The recommendations vary so much that there is confusion in the WLS population about how much protein we need. What we do know is that as a group, we are not eating enough protein and this shortfall is putting our health at risk.

In 2011 a leading researcher and bariatric specialist reported, "We found that there have been few studies on protein intake recommendations for bariatric patients. Dietary protein ingestion among this population tends to be inadequate, potentially leading to a loss of lean body mass, reduced metabolic rates, and physiological damage. Conversely, a protein-rich diet can lead to increased satiety, enhanced weight loss, and improved body composition. The quality and composition of protein sources are also very important."

We need to turn this trend around. Today's 5 Day Pouch Test Bulletin takes a look at how we can use our 5DPT experience as a catalyst to following and enjoying a high protein diet and the health benefits and weight loss that accompany it.  As we turn the page on summer stepping into autumn let's use the enthusiasm of "back to learning" to make a new commitment to the goals and health objectives that we valued so much when we underwent surgery in the first place.:.

Please consider this if you are using the 5 Day Pouch Test to get back on track. Take your knowledge and let it empower you because you are a good and worthy person. You are not your disease. I have met enough of you, my WLS Neighbors ,  to say this with complete conviction. You deserve to be your very best - obesity be damned for getting in the way!

You Can Do This!

5 Day Pouch Test Featured Articles

5 Day Pouch Test Owner's Manual
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The complete 5 Day Pouch Test plan including inspiration, instructions, and recipes in Kay  e Bailey's classic empowering style. 180-page easy to read paperback with hints, tips and encouragement that enables you to take charge of your weight loss surgery tool. 2nd Edition includes new guidelines from the FDA, USDA, and the ASMBS. 16 new 5DPT recipes; more FAQ's; more inspiration from Kaye. Improved format. Same great plan shared with Kaye's encouragement and enthusiasm. Same low first edition price $22.95. Get back on track with Kaye! You Can Do This!

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buffetFood for Thought:
Tight Pouch =  Loose Pants 

Eating lean protein will create a tight feeling in the surgical stomach pouch:  this feeling is the signal to stop eating. Many patients report discomfort when eating lean protein, yet this discomfort is the very reason the stomach pouch is effective in reducing food and caloric intake. Animal products are the most nutrient rich source of protein and include fish, shellfish, poultry, and meat. Dairy protein, including eggs, yogurt, and cheese, is another excellent source of protein. (page 33, 5DPT Owner's Manual 2nd Ed.)

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cookieFeatured Recipe:
Famous Senate Bean Soup
Country Road Chef, guilt-free comfort food, crowd friendly  
Cooking with Kaye: Methods to Meals 
This famous soup, which is served daily by decree of law in the United States Senate lunchroom, is hearty and comforting. It fits our  Country Road Chef criteria because preparing the beans by soaking is an overnight process. The actual cooking method is uncomplicated as is the soup.

Navy beans are small white legumes, also called Yankee beans. Because of their nutritional value and long storage life, the United States Navy has served these healthy beans regularly since the mid-1800's, and from there comes the name. Affordable dried navy beans are delicious in soups, salads, and baked bean dishes. ~ Kaye

Reprinted with permission from
Cooking with Kaye: Methods to Meals.
Page 59.

featuredRecipeFamous Senate Bean Soup
1 pound dried navy beans
3 quarts cold water
1 tablespoon canola oil
1 tablespoon butter
3 medium onions, diced
4 stalks celery, finely chopped
3 cloves garlic, minced
1 (1-2 pound) ham bone with meat
2 (48-ounce) cans chicken broth, reduced-sodium
1/4 cup fresh parsley, finely chopped

Directions: Place beans in a large Dutch oven and cover with the 3 quarts cold water: let sit overnight. Drain and rinse beans. Set aside. In the same Dutch oven heat the canola oil and butter over medium high heat. Add the onion and celery and cook until soft and translucent, about 10 minutes. Add the garlic and cook 3 minutes. Place the ham bone in the pot. Return the soaked beans to the pot and add the chicken broth. Bring soup to a low boil, reduce heat to a low simmer; cover and cook 90 minutes, stirring occasionally. Test beans for doneness: they should be tender to bite but still hold their shape. Remove ham bone and allow to cool: pull meat from ham bone and return meat to pot. Discard bone. Season the soup with salt and pepper. Stir in chopped parsley just before serving.

Nutrition: Serves 10. Each 1-cup serving provides 283 calories, 27 grams protein, 11 grams fat, 19 grams carbohydrate, 4 grams dietary fiber.

Page 59, Cooking with Kaye: Methods to Meals

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