A Conversation With My Nutritionist

Next month marks the sixth month anniversary of my having a sleeve gastrectomy and with that anniversary comes a couple of very important follow up visits for me.  One of them is my follow up with my surgeon, in which blood work will be done, along with certain measurements taken.  The other follow up happened today.  That follow up was with the nutritionist who works with the surgeons at the hospital I was sleeved at, Forrest Park Medical Center in Dallas, TX.

I had several questions for her that I needed answered.  Questions such as:

1. Do I need to count net carbohydrates or gross?
2. Am I eating too much?
3. What should my ideal weight be; what should I be aiming for?
4. How should I nutritionally balance my meals?
5. How should I nutritionally prepare for race days?
6. Is it okay to use fuel gels during an endurance race?
7. How should I eat to recover after a race is finished?

After going over my weight loss so far and my exercise habits, Sarah (the nutritionist) was very complimentary over what I had accomplished so far.  She told me that it normally took most sleeved patients a year or more to lose 130 pounds and that I was doing quite well for the time I had been sleeved.  She was also complementary on my running and circuit training that I do.

But onto the questions and her answers.

Q:  Do I count net calories or gross calories?  (For those who may not know the difference, Net calories are calories burned during exercise (not BMR/Sedentary burn), minus calories eaten)
A:  I need to count net calories, especially when I am on my exercise or run days.  My net calories need to be between 950 and 1200, which could put my gross calories for those days at anywhere from 1800 to 2500.

Q:  Am I eating too much?  (Please understand that my current caloric intake right now averages about 1000 to 1100 calories, and there are times when the calorie count can reach upwards of 1800 or more, even though my daily goal is 950.)
A:  No I am not.  Right now my caloric intake should be between 950 to 1200 calories on the days in which I don't run or exercise, and up to double that on the days I do run and/or exercise.

Q:  What should my ideal weight be; what weight should I actually be aiming for?
A:  According to the nutritionist, the ideal body weight for my height and body structure should be 178.  However, because I am old and decrepit, well, old enough that my skin really no longer has the elasticity it used to have, the body weight I need to shoot for would be 210.  That would also be with approximately 20 pounds of excess skin hanging on my body.
(It will be nice when I am able to have plastic surgery to have that excess skin removed, but that surgery will not happen for at least another year.)

Q:  How should I nutritionally balance my meals?
A:  Right now my nutritional balance for my meals should be be as follows:
      On days that I do not exercise:

• 80 to 100 grams of protein

• 80 to 100 grams of carbohydrates

• 30% of calories dedicated to be fat grams

      On days that I do exercise:

• 160 to 200 grams of protein

• 160 to 200 grams of protein

• 30% of calories dedicated to fat grams

Q:  How should I nutritionally prepare for race days?
A:  To nutritionally prepare for the days in which I race, whether it is a 5K, 10K, 8M, Half Marathon or Marathon, the nutritionist informed me that I need to start fueling up about three days before the race.  To fuel up properly I will need to start eating as if I had run or completed my circuit training that day, doubling up on both carbohydrates and protein and increasing my caloric intake as well, to 1800 to 2000 calories for those three days.  She also told me that it didn't matter what foods I ate for the carbohydrate count as long as it had carbohydrates.  (So I don't just have to eat pasta.)

Q:  Is it okay to use to use fuel gels during an endurance race?
A:  Absolutely.  If I am going to do endurance races longer than 10K I was encouraged by the nutritionist to make sure I use them to ensure I have the fuel to complete the race.

Q:  How should I eat to recover after a race is finished?
A:  The nutritionist told me that I needed to eat a balanced carbohydrate/protein "meal" as soon after the race as possible.  This could be anything from a peanut butter and jelly sandwich to a commercially prepared protein shake.  Usually the meal needs to be eaten within 30 minutes after the finish of the race.

So after my talk with the nutritionist, I feel confident that I have been doing and eating the right things and the right way.  I was concerned that I might have stretched out my sleeved stomach, but that is not the case.  As I continue on this journey of weight loss and healthy living, I can honestly say, so far, so good.

Thanks for reading.  Have a great rest of the day!