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Are you a bariatric athlete? Working out to feel good now and to keep moving forward with your fitness level? Try theses seven strategies to get the most from your workouts.

Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 74. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.

Have you signed up for the weekly Breaking Down Nutrition newsletter? It’s a quick way to find out first what’s going on in bariatric nutrition from new freebies, upcoming courses, tips, product discounts and the latest podcast episode. It’s super easy to sign up at the bottom of my home page https://www.breakingdownnutrition.com 

Let’s talk sports nutrition and specifically bariatric sports nutrition which is a very new field of research. I want you to know this up front because there aren’t a lot of sports nutrition guidelines if you’ve had bariatric surgery and are involved in sports and workout. The guidelines currently available can vary a lot between different types of workouts such as endurance/distance running for half marathons and marathons for example, as compared to weight lifting. 

Since dietitians often specialize in an area of nutrition just like physicians in medicine, bariatric dietitians may or may not be up-to-date on sports nutrition and dietitians who specialize in sports nutrition might not know a lot about bariatric nutrition. Bottom line: Ask your dietitian specific questions about your workouts or sports. They may need to check with their contacts and resources. Read on your own and then ask more questions, and then add in some trial and error. Each of you is different and each of your surgeries and outcomes are too. The type of surgical procedure matters in how you tweak the diet for workouts. For example, a sleeve gastrectomy tends to be easier to adapt to than a Roux-en-Y procedure because it’s less invasive which typically means a smaller incision and less tissue trauma during surgery. 

I’m the kind of person that wants direct, specific answers. Are you? And often, it just doesn’t work that way in medicine or nutrition. It does’t mean there aren’t strategies that work, there are for sure. But it may take you some trials and tweaking to find what works for you. So let’s look deeper into what we know now.

If you exercise for less than one hour, most likely you can continue with your daily bariatric diet or you may need a few more calories. Where the calories come from, meaning which macros, depends on what your workout is like. If you’re an athlete who exercises at higher intensity for longer than one hour at time, there are several things to think about. Remember, you’re unique and special so trial and error is the answer to find what foods and fluids you tolerate the best as you work out. 

Let’s look at seven things to consider:

Have you heard the term ‘nutrition periodization’? It means that your diet or how much you eat should match the level of your activity. In a less intense workout, typically under an hour, your body will need less total carbs and calories than if you’re training longer and at a higher intensity. Your workouts that are lower intensity and less time (again, typically under an hour) usually work well with your normal daily intake or a few more additional calories as I mentioned just a minute ago. If you workout longer (one hour or more) and at a higher intensity, you may need to eat 5-6 smaller meals or snacks rather than 3 meals. These 5-6 smaller meals include both pre and post exercise meals and snacks. The volume of your meals and snacks will depend on your surgery type and personal tolerance as well as your training demand. Keep an eye on your weight so you prevent weight regain from eating more calories than you are burning in your activity. 

These pre and post workout meals and snacks should include both protein and whole food carbs such as fruit, whole grains or starchy veggie just like you eat when you’re not working out. What do you eat first? Your answer has always been protein, right? But here’s a potential conflict to think about. If you’re lifting weights, that protein first concept works but what if you’re walking/running/biking/swimming instead or training for a 5K, 10K, half marathon or marathon? You may not get the carbs you need for these types of events and could bonk. What is bonk? You’ll know if it happens. It’s where you feel a sudden loss of energy and a sudden fatigue which is caused by the depletion of glycogen stores in the liver and muscles. You don’t want this to happen and it’s why circling back with your bariatric dietitian to personalize your needs with your specific types of training is so important. You’ll need more carbs and may need to eat them first so this is an important discussion to have as it goes against what you’re always told to do.

Let’s call this one food for thought. Intensive exercise is probably smarter after one-two years when your caloric intake can be higher and the macros tweaked. That does’t mean you don’t exercise. Not at all. The first six months, you’re healing and you’re just trying to move around more. Then you move on to walking, swimming, etc but the intensive workouts might be better initiated one to two years after your surgical procedure. Have this discussion with your team if you want to work out harder and longer and it’s still early in your recovery.

If you’re down the track and desire to increase your workout, what does a pre workout meal look like? A couple of minutes ago we just talked about the need to include both protein and whole food carbs with the amounts of each based more on the type of workouts you do.

Some general examples would be:

An egg with 1/2-1 slice of whole grain toast

Deli meat wrapped around a low-fat cheese stick and fruit

Cottage cheese with fruit: berries, grapes or banana

Remember, the protein or carb amount may need to be changed based on the type of exercise you’re doing. If you’re 3-4 hours out from your workout, a meal fits in fine. As you get closer to the time you plan to workout, reduce the amount of food and if it’s only 30 minutes - 1 hours before you get started, continue to hydrate only. 

Since you should know your event or training days, aim to pre-hydrate a bit more and increase your fluid intake 2-4 cups in the 1-2 days before your hard training or event. Then as usual, sip on fluids all day as well as during your workout. Continue to keep food and fluids separate by 30 or more minutes unless your dietitian has told you differently depending on how far out from surgery you are now. To help you stay hydrated, you can eat foods with a higher fluid/water content such as Greek yogurt, a protein shake, even veggies and fruit which have high water contents. 

Use your urine color as a way to monitor your hydration. What color should it be? That’s right, pale or light yellow. When it’s darker, it’s sending you the message to consume fluids.

Don’t forget about dumping syndrome. Remember that if you consume foods high in refined carbohydrates you may experience bloating, abdominal pain, nausea, diarrhea, even low blood pressure or a change in your heart rate. Symptoms vary depending on whether you experience early or late dumping syndrome. This means that using sports drinks and gels may be a problem due to the high carbohydrate content. Remember if you exercise longer than one hour, consuming carbohydrates and electrolytes can help prevent that sudden loss of energy and fatigue. Recommendations suggest to consume somewhere in the range of 30-60 grams of carbohydrate per hour, in about 10 gram increments. But you don’t have to use sports drinks or gels. They don’t have magical powers, just convenience. Did you know you can eat a few raisins or other fruit and get your carbs and calories easily? You don’t want low blood sugar or fainting as you’re trying to get stronger thru your workouts. Also, not getting enough quality calories can show its ugly face in muscle wasting, poor performance, or trouble with recovery.

Speaking of recovery, 

try to eat or drink your meal within 30 minutes to one hour after you’ve finished your workout. Shoot for a ratio of 2:1 carb to protein for a post-workout meal. I know…this is not the typically bariatric way which is why which carbs you choose to eat is important along with how much. Your dietitian may have a certain level/strategy for you.

Be sure and take your bariatric supplements daily and let your dietitian know how much you train. Increased workouts and increased calorie burn can increase the need for some supplements such as iron for example.

Sports nutrition is just as important after your surgery as it is for anyone who trains or works out. Try these strategies, discuss with your health care team. Find what works for you. Take care of yourself and be good to you…you’re worth it.