Welcome to the 5 Day Pouch Test Special edition featuring our semi-annual questions and answers. Today we've gathered some of the hottest 5DPT topics and presented them to you in question and answer format. Have you struggled with afternoon hunger or trying to get the 5DPT done perfectly? Looking to include vegetables in your 5DPT menu? And what do you do for breakfast on Days 4 & 5? We give you the answers in Trending Questions. And for a matter of more sensitive nature we answer the question about gas and bloating and how to manage it during the 5DPT and beyond. Read More.

One of our most requested recipes is for Fennel and Celery Soup that is recommended as a soothing preparation prior to beginning the 5 Day Pouch Test. We share the recipe in today's bulletin. Make this soup when your tummy needs a soothing tonic.

Today's Bulletin includes FAQ's people are asking. And, as always, the bulletin is loaded with links to further information and resources. Thanks for joining me, I value the time you give to our publications. If you enjoy the 5 Day Pouch Test be sure to participate in our LivingAfterWLS Project 2014: "Uniting like minded people through education, support, and community while promoting health sustainability and weight management with weight loss surgery." Learn more here: Project 2014.
 
Sincerely,

 
Question: I'm starting Day 1 today, tried last week and kept making it until around 3pm and then would eat off the plan. How can I prevent afternoon hunger or cravings that take me off the plan?

Answer: One of the mistakes I see made during the 5 Day Pouch Test, and in our daily routines, is we try to muscle through afternoon hunger with will power or difficult attempts to ignore it.  If we truly have afternoon hunger, as opposed to an afternoon snacking habit, a better strategy is to acknowledge it, plan for it, and make sensible choices. Rather than respond with a bag of chips or a soft cookie plan for the hunger and be ready with a cup of yogurt, a protein bar or shake, slices of deli meat and cheese, or even a cup of soup. During the 5 Day Pouch Test, always select your snack choices from the approved menu to keep you on track for day 6.  As you enjoy your allowed afternoon food think about how rewarding it is to acknowledge your afternoon hunger as a biological need and then respond to that need in a mindful and healthy way.

Question: I cannot seem to get past Day 1 without messing up and have to start over the next day. How can I get Day 1 perfect so I can move on to Day 2?

Answer: Remember - the 5DPT is never about perfection. Who among us can possibly live up to the lofty standards we set for ourselves? The 5DPT is about learning, re-learning, growth, understanding, kindness, and self-nurturing. Each meal is a new opportunity independent of anything that has come before. Do your best, learn, and march forward with the same gritty determination you had going into WLS. With that said, there are ways to increase your performance on the 5DPt. Here are a few quick hints:

• Schedule the 5DPT when it fits into your life and there are the fewest days where you are not in control of your schedule or diet.
• Plan your 5 days and write down meal plans, exercise schedules, and strategies for moments that will present challenges.
• Shop ahead of schedule and do your cooking in advance, if possible. Many of the recipes are family friendly and can be shared to avoid cooking tempting things for other people.
• Ask for support. Get with your family, friends, online support groups, or others who will empower your efforts. Avoid people who are spoilers and avoid becoming your own spoiler.
• Journal your effort. You are going to the effort to use the 5DPT as a catalyst for change. Use the 5DPT journal to record the event and lessons learned. This becomes a useful resource any time we feel slightly off track. Download the Journal 

Question: I'm having a hard time finding something for breakfast on Days 4 and 5. What can you recommend?

Answer: Traditional breakfast usually means whole grains, dairy and fruit or juice. The focus on a high protein breakfast presents a challenge to our traditional practices. The 5DPT is a good time to look outside of the cereal box for high protein choices. Protein first thing in the morning is a great way to raise our metabolic thermostat because it takes a lot of energy to metabolize protein. More importantly, a breakfast of 70% protein or more will stabilize our blood sugar and prevent hunger cravings. Here are some ideas:

Eggs, leftover tuna patties from Day 3, measured portions of cottage cheese or yogurt, peel-and-eat shrimp, ground beef, chicken, or turkey patties grilled or broiled, each provide ample protein to start the day. And of course, in a pinch, we can always count on protein drinks or meal replacement bars for the first meal of the day.  Day 4 Recipes

Question: Can I have a salad or vegetables with meals during the 5DPT?

Answer: Vegetables are to be used only as ingredients in meal preparation, such as salsa on grilled fish or the Carb Monster Soups. By restricting vegetables and fruit (complex carbohydrates) during the five days your body is forced to go into high metabolic burn to digest the protein. This should result in weight loss. In addition, restricting complex carbohydrates and eliminating processed carbohydrates helps regulate your blood sugar (glucose) preventing cravings and energy swings. 

On Days 1 and 2 the soup recipes are made with vegetables and legumes to help counter carb cravings or carb withdrawal associated with the change in diet when beginning the 5 Day Pouch Test.  Soup Recipes

Vegetables and low-glycemic fruit should be gradually introduced back to the diet on Day 6 and beyond. The focus must always remain on Protein First. A portion-controlled high-protein diet is how we lose weight after a surgical gastric procedure, and that is how we can maintain a healthy weight for the rest of our life.

5 Day Pouch Test Website

Question: HELP! the 5 Day Pouch Test always gives me gas an uncomfortable bloating. What can be done about that?

Answer: shared with permission, from pages 78-79 of the 5 Day Pouch Test Owner's Manual.

"It is quite common for patients of gastric bypass, gastric banding and gastric sleeve weight loss surgery to report an increase in uncomfortable intestinal bloating and the frequent release of foul and offensive gas. Some patients report the problem of gas to be so offensive they suffer chronic embarrassment leading them to isolation. By its nature gastric surgery changes the human digestive process and increases the occurrence of gas. In addition, weight loss surgery patients follow a high protein, low carbohydrate diet which is also known to cause gas. Understanding what causes excessive flatulence is the first step to implementing therapies to reduce the occurrence and offensiveness of this natural body function.

High Protein Diet: Weight loss surgery patients who follow a strict high protein diet frequently report excessive flatulence beyond the 14 releases per day experienced by adults with a healthy digestive tract. In digestion proteins are broken down with the secretion of hydrocholoric acid which allows the activation of pepsin, a protein digesting enzyme. Weight loss surgery patients become deficient in hydrocholoric acid or pancreatin when their intestines are shortened or bypassed with surgery. Therefore the gastric enzymes and acids to facilitate complete digestion are deficient and excessive gas can be produced. A high protein diet, by nature, is a diet low in fiber intake. The absence of adequate fibrous carbohydrates leads to waste material moving too slowly through the large bowel and constipation and flatulence results.

To reduce the occurrence of flatulence associated with a high protein diet stay hydrated by drinking at least 64 ounces of water daily. The water will help to move food along the digestive and intestinal tract preventing the build-up of gas. Eliminate processed meat, cured meat, beans, tofu and soy products from the diet for several days until symptoms of chronic flatulence are reduced.

Sugar Replacers: Weight loss surgery patients are strongly encouraged to eliminate sugar and sweets from their diet. Many people include products labeled "sugar-free" in their diet to satisfy sweet cravings. Sugar-free products use sugar replacers, a term to describe the sugar alcohols such as mannitol, sorbitol, xylitol, maltitol, isomalt, and lactitol, which provide bulk and sweetness to cookies, hard candies, sugarless gums, jams, and jellies. Sugar alcohols evoke a low glycemic response because the body absorbs them slowly making them slow to enter the bloodstream. However, side effects such as gas, abdominal discomfort, and diarrhea, are so extreme that regulations require food labels to state that "excess consumption may have a laxative effect."

To decrease the gas associated with sugar alcohols eliminate or reduce the intake of food containing sugar alcohol. Do not exceed package serving size of sweets made from sugar alcohol.

Therapies to Reduce Offensive Flatulence: The following therapies may be effective in reducing embarrassing and uncomfortable gas and bloating associated with the diet after gastric weight loss surgery

Beano: A few drops help prevent gas formation. Not effective in preventing bloating and gas pain however will prevent gas-passing or flatulence.

Chamomile, ginger and papaya teas: good digestive aides, nerve tonics, and cramp and pain relievers.

Peppermint oil: relieves flatulence and related pain."
Answer by Kaye Bailey pages 78-79 of the 5 Day Pouch Test Owner's Manual.

 

Question: What is the best way to get the eBooks from LivingAfterWLS?

Fennel Root: Nutritional Super-Star

Question: What is fennel root and where do I get it for the fennel Celery Soup?

Answer: Fennel is a key ingredient in a soup suggested for enjoyment and healing prior to the starting the 5DPT.  (Recipe provided below). Fennel has long been considered an natural digestive aid and soother of intestinal discomfort. The fennel plant is often considered a culinary herb with a fragrance similar to licorice. The leaves and seeds are often dried and available with quality herbs in most supermarkets. For the soup we use the fresh bulb, similar in form to onions, cleaned and chopped. You will find fennel bulbs in most supermarkets located with the onions. For a garnish chop the feathery fronds to sprinkle on each serving.


Below: excerpted with permission from the 5 Day Pouch Test Owner's Manual, page 36.
Do you have a grumpy pouch? Here is a healing soup to ease your pouchy woes. Many times when we turn to the 5 Day Pouch Test we have been eating all the wrong things and we have an inflamed digestive system; sometimes we call this a grumpy pouch. If you are feeling particularly poorly going into the 5DPT consider making this soup the day before and enjoy the healing benefits of the ingredients that are natural digestive aids. This recipe is a great remedy any time you experience a grumpy pouch, use it even when you are not following the 5 Day Pouch Test.

Fennel and celery are both good digestive healers. Fennel is known to soothe an inflamed digestive lining and celery helps to support liver function. Raw vegetables can irritate an inflamed digestive system so this well-cooked soup soothes the digestive system and helps cleanse your body of toxins. Feel free to enjoy a 1-cup serving as a snack on any day of the 5DPT. Remember to observe the liquid restrictions, especially when eating soup. You want to make sure your body has time to absorb and digest the wholesome nutrients that come from a carefully made soup.

Fennel and Celery Soup
Ingredients:
1 large white or yellow onion, chopped (about 1 cup)
2 bulbs of root fennel, peeled and chopped
8 ribs of celery, chopped
4 cups vegetable stock, reduced-sodium
2 bay leaves
1 tablespoon fresh parsley, finely chopped
Parsley sprigs for garnish

Place all of the ingredients in a large saucepan and bring to a boil. Reduce to a low boil and cook for 10 minutes. Further reduce temperature to a slow simmer and cook an additional 30 minutes. Remove from heat and allow cooling. Remove and discard the bay leaves. Using a blender or immersion blender puree the soup until smooth. Return to saucepan and gently reheat. Thin the soup to desired consistency with additional vegetable broth. Enjoy a 1-cup serving of soup garnished with parsley sprigs. This soup keeps well refrigerated for three to four days. Serve gently reheated on the stove top or in the microwave oven.

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