Guest Blog By: Dr. Lillian Craggs-Dino, DHA, RDN, LDN, CLT The obesity epidemic continues to contribute to health problems and cardiovascular risk factors, such as type 2 diabetes, high blood pressure (hypertension), and sleep disorders (sleep apnea).1 Thankfully, metabolic and bariatric surgery (MBS), such as gastric bypass (Roux-en-Y) and sleeve gastrectomy, is a durable and long-term weight management option for obesity. The significant reduction in body weight and lifestyle change resulting from MBS supports cardiovascular health, healthy blood sugars within a normal range, and other weight-related comorbidities. 2 After MBS, the responsibility lies in following a healthy lifestyle to reap the long-term benefits of surgery and maintain sufficient weight loss. While there are specific bariatric nutrition and diet guidelines to follow due to the nature of the surgery, heart-healthy foods, and lifestyle behaviors can be incorporated to support cardiovascular outcomes. This blog discusses the prevalence of cardiovascular events in obese patients and how lifestyle intervention resulting from MBS supports a healthier quality of life. We also list heart-healthy foods to include in your bariatric diet. Lifestyle Intervention for Cardiovascular Health Unfortunately, heart disease is still the leading cause of death in the United States.3 According to the CDC, one in every five deaths is due to heart disease.4 The good news is that metabolic and bariatric surgery is shown to aid cardiovascular function by supporting healthy blood pressure, cholesterol and triglyceride levels, blood flow to the heart muscle, and combating metabolic syndrome and systemic inflammation.5 These supportive changes result from lifestyle interventions, including diet modifications, physical activity, and behavioral changes. A bariatric diet and heart-healthy practices go hand in hand. Heart-Healthy Foods Heart-healthy foods include those nutritionally dense with vitamins and minerals found in whole grains, fruits, and vegetables. Other essential food choices include those high in fiber, low in total and saturated fat, and low in calories. Aim to consume foods that provide “good” fats, such as omega-3 fatty acids and monosaturated fats. These healthy fats include fatty fish, olive oil, and nuts. Plant sterols and stanols can also impact heart health. These naturally occurring compounds are found in plants, including whole grains, vegetables, fruits, legumes, and nuts. Since these compounds have a similar structure to cholesterol, they play a role in the digestive system to help absorb cholesterol in the body. In turn, this process supports healthy cholesterol levels. Knowing what foods are heart-healthy, you should consider adding them to your bariatric diet to support your weight management efforts and cardiovascular wellness. Check out some of these bariatric-friendly, heart-healthy foods. Whey Protein After undergoing metabolic and bariatric surgery, protein becomes a priority to support lean body mass (LBM), satiety, and healing. Whey protein is also a heart-healthy option that supports blood flow, insulin secretion, and healthy blood pressure.6* Fatty Fish Examples of fatty fish are salmon, mackerel, herring, sardines, and tuna, which contain omega-3 fatty acids shown to confer heart health by helping to reduce triglycerides.7 Reducing triglyceride levels helps to reduce atherosclerosis, a fatty plaque that can build up in your blood vessels and cause blockages and heart attacks. Fatty fish also contains high-quality protein needed to preserve lean body mass. Nuts Various nuts, including almonds and walnuts, are heart-healthy because they contain fatty acids that can help lower the “bad” LDL cholesterol and total cholesterol. Nuts also contain plant stanols that we mentioned above. Green Leafy and Brightly Colored Vegetables While all vegetables are healthy, brightly colored and green veggies contain heart-healthy pigments. They also contain vitamins and minerals like folate, vitamin C, vitamin A, beta carotene, B-complex vitamins, calcium, magnesium, and potassium that help support healthy blood pressure. Berries All fruits contain heart-healthy vitamins and minerals. However, berries are unique due to their high-fiber and low sugar ratio, making them a nutrient-dense food without too much sugar. After metabolic and bariatric surgery, especially gastric bypass surgery, you must be mindful of high sugar since it can result in dumping syndrome. Whole Grains Whole grains contain the entire grain, including bran, germ, fiber, and starch. Fiber supports healthy blood sugar, blood pressure, and gut function. Those with MBS can consume fiber, but be mindful to eat foods slowly and chew well to prevent digestive obstructions. Summary Those who have undergone metabolic and bariatric surgery (MBS) have made the mindful decision to take control of not just weight and body mass index (BMI) but also gain control of health and quality of life. Be smart with food choices, especially since your portions are small after surgery. Include more nutrient-dense foods that are heart-healthy while enjoying a long and healthful life. The American Heart Association has excellent resources for heart-healthy recipes if you need help figuring out where to start. You can also follow up with a dietitian if you need help with weight loss and diet. References Circulation. 2022; 143(21):e984-e1010 [PMID: 33882682] Cureus. 2022; 14(3):e23340 [PMID: 35371868] Centers for Disease Control and Prevention, National Center for Health Statistics. CDC WONDER Online Database website. 2022 Circulation. 2022; 145(8):e153-e639 [PMID: 35078371] Ann Transl Med. 2020; 8(Suppl1):S12 [PMID: 32309416] AM J Clin Nutr. 2016; 104(6):1534-1544 [PMID: 27797709] Circulation. 2019; 140(12):e673-e691 [PMID: 31422671] *These statements have not been evaluated by the Food & Drug Administration (FDA). These products are not intended to diagnose, treat, cure, or prevent any disease. This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your bariatric surgeon or another qualified healthcare provider with any questions in regards to a medical condition. A qualified healthcare professional can best assist you in deciding whether a dietary supplement is suitable based on your individual needs. Dr. Lillian Craggs-Dino is a retained consultant for Bariatric Fusion.