Diet after bypass surgery

I recently had coronary bypass surgery. My doctors are recommending "The Sugarbusters Diet" and "The Zone Diet" in preference to AHA's low fat diet. What diet does Cleveland Clinic recommend for their coronary bypass patients?

At the Cleveland Clinic's Preventive Cardiology and Rehabilitation we focus on individualizing a patient's dietary needs based on a number of factors, such as presence or absence of coronary heart disease, weight status, lipid profile, blood pressure, etc. However, we do stem the majority of our recommendations from the American Heart Association's dietary guidelines, which are as follows:

• Less than 7% of calories coming from saturated fat.
• Less than 1% of calories from trans fat
• Less than 300 mg of dietary cholesterol per day.
• Consume fish, especially oily fish, twice a week
• Choose whole-grain, high fiber foods
• Consume a diet rich in fruits and vegetables
• Select all fat free, 1 percent, or low fat dairy products
• Cut back on foods and beverages with added sugar
• Choose and prepare foods with little or no added salt. Aim to eat 1,500 mg – no greater than 2,300 mg of sodium per day.
• If you consume alcohol do so in moderation
• Balance calorie intake and physical activity to maintain a healthy body weight

If followed adequately, these very important dietary factors can have significant positive affects on blood lipids and coronary heart disease risk:

High-protein diets have been around for years as a quick-fix weight loss plan. The problem is, what's mostly lost is water weight and lean body mass. And once you get off of the high protein diet the weight comes right back.

There are a variety of reasons why the Cleveland Clinic does not condone dietary practices similar to "Adkins" and "South Beach" however I will just point out a few. For one, these diets recommend foods that are the exact cause of elevated cholesterol levels: high-fat meats, eggs, dairy products and unlimited supplies of added fats, which contribute to a truckload of saturated fat, trans fat and dietary cholesterol. If the diet does not push high-fat meats, they still condone unhealthy low levels of carbohydrates. These diets, in turn, eliminate whole food groups like breads and other starches, fruits and certain quantities of vegetables. If followed, this results in a limited intake of dietary fiber and a variety of vitamins and minerals essential to good health.

There are a lot of physiologic reasons why one should not adopt a high-protein, low-carbohydrate diet plan. One reason is because of the potential for kidney stones and bone loss, which can lead to a variety of other problems in the long run. Another is the development of ketones, a process in which the body uses fatty acids for energy in the absence of adequate carbohydrates from the diet. Some ketone production is normal in the human body, but excessive ketone production as a result of these diets is not a normal physiologic process, and can have a number of negative side effects on the body, especially in those with diabetes.

While many diets claim the root of obesity and disease lies in carbohydrate-containing foods, I must say that there is some truth to this. However, the problem lies not in carbohydrate-containing foods per se, rather it is the quantity of these foods and the food choices one makes that lead to obesity and disease progression. What we recommend at the Cleveland Clinic is a healthy balance of carbohydrate-rich foods high in fiber, such as unrefined whole grain breads, crackers and cereals and a variety of other whole grains like brown or wild rice, wheat berries or bulgur. These foods, along with a variety of fruits, vegetables, legumes, low-fat dairy products and lean meats, eaten in moderate portions, will help one both lose weight and reap heart-protective benefits such as cholesterol reduction.

Protein is very important for wound healing and tissue development, especially after surgery. The recommended amount of protein after surgery is 0.8 – 1.0 gram of protein per kilogram of body weight. Therefore a 150 pound female requires about 52 – 66 grams of protein per day 150 lbs and 73 – 91 grams of protein is recommended for a 200 pound male. Dietary protein can be found in animal products such as meat, fish, eggs, and dairy and non-animal sources such as beans, nuts, seeds and vegetables. Ideally, meat sources of protein should not exceed 6 ounces per day which would provide 42 grams of protein – the remainder is to be met from fat free or low fat dairy, beans, nuts, seeds and vegetarian textured protein.

Nothing takes the place of whole foods, so limit your intake of refined foods such as convenience foods, desserts and frozen treats, fast foods and other snack-like foods. Couple these dietary practices with regular aerobic exercise and you are well on your way towards good heart health.

For more information on a heart-healthy diet plan, please contact the Preventive Cardiology and Rehabilitation Program at 216.444.9353 (or toll-free at 800.223.2273, extension 49353) and we can schedule a nutrition consultation - or - use our Remote Cardiac Nutrition Counseling Services.

This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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