Guest blog by: Lillian Craggs-Dino, DHA, RDN, LDN, CLT\nUndergoing the transformative journey of metabolic and bariatric surgery is a big step toward reaching weight loss goals. However, the process isn't without its challenges, and one of the key concerns is the loss of lean body mass, commonly known as muscle mass. Weight loss, through surgery or other means, doesn't only target body fat; it can break down muscle mass. This blog explains the connection among exercise, nutrition, and the maintenance of muscle mass after metabolic and bariatric surgery. Contrary to what you may think, that higher protein intake alone guarantees lean muscle, we explore the role of calories, macronutrients, and even specific vitamins in maintaining and building muscle mass post-surgery.\n\nThe Impact of Metabolic and Bariatric Surgery on Muscle Mass\n\nMetabolic and bariatric surgery is a valuable tool for weight loss, but it often leads to the loss of lean body mass, also known as muscle mass. This is a concern, especially considering the natural decline in muscle mass with age and other factors such as illness, surgery, medications, and restrictive diets. Post-surgery exercise becomes crucial in this context, but it’s essential to understand that exercise alone may not be sufficient for building muscle. \n\nThe Role of Nutrition in Building Muscle\n\nTo effectively build and preserve muscle post-surgery, a combination of strength, weight lifting, and resistance exercises is essential. You must also pair exercise with proper nutrition. Simply eating higher amounts of protein is not a guaranteed strategy for building lean muscle. \nThe right balance of calories, macronutrients (carbohydrates and protein), and essential vitamins like vitamin D are crucial for achieving a sculpted look.1 If you lack the appropriate nutrition or carbohydrates to "preserve" muscle during your workout, the time spent lifting weights and exercising may provide no positive outcome.\n\nBalancing Caloric Intake and Macronutrients\n\nAfter metabolic and bariatric surgery, calorie intake is often restricted. Therefore, it becomes important to find a balance in caloric intake with macronutrients like proteins, carbohydrates, and fats. \nAnimal-based proteins such as eggs, poultry, seafood, dairy, and red meat are recommended for their complete essential amino acids, with an emphasis on the branched-chain amino acid leucine.1 Good sources of these amino acids include grass-fed beef, whey protein powder, poultry, seafood, and low-fat cheese. \nEstimating Protein Content in Foods\nProtein guidelines following metabolic and bariatric surgery recommend 60 to 120 grams of protein, depending on factors such as the type of surgery, gender, current weight, type of exercise, and individual goals.2 \nA helpful chart is included below, showcasing the protein content in various foods. This serves as a reference for individuals looking to meet their dietary protein goals post-surgery. Examples range from vegetarian sources such as tofu and edamame to animal-based sources such as chicken breast and filet mignon. \n\n\n\n\n\nFood (3 ounces)\n\n\nAmount of protein (grams)\n\n\n\n\nTofu\n\n\n7\n\n\n\n\nCottage cheese\n\n\n9\n\n\n\n\nTurkey breast\n\n\n15\n\n\n\n\nShrimp\n\n\n17\n\n\n\n\nSalmon\n\n\n18\n\n\n\n\nChicken thigh\n\n\n21\n\n\n\n\nFilet mignon\n\n\n25\n\n\n\n\nChicken breast\n\n\n28\n\n\n\n\n\n \n\nImportance of Carbohydrates and Fats\n\nApart from proteins, carbohydrates and fats also play essential roles in health and muscle building. Recommendations for complex carbs (50 grams per day) and “good” fats (30-40 grams per day) are provided in the chart below.2 These examples can also “spare” muscles and provide energy for a workout.\n\n\n\n\nHealthy fats (may often include protein)\n\n\nComplex carbs\n\n\n\n\nSalmon\n\n\nLow-sugar fruits\n\n\n\n\nTuna\n\n\nSweet potato\n\n\n\n\nSardines\n\n\nPlantain\n\n\n\n\nNuts\n\n\nBrown rice\n\n\n\n\nSeeds\n\n\nQuinoa\n\n\n\n\nAvocado\n\n\nFarro\n\n\n\n\n \nTiming and Recovery Strategies\nAnother tip for building muscle includes the timing of your meals or snacks. A recovery snack or post-workout meal is encouraged to prevent muscle loss. A guide to follow is to eat at least 1-2 servings of carbs for workout recovery.3\nA sample meal plan is outlined below. You may also consider incorporating a whey protein shake as a meal replacement and don’t forget to take your essential vitamins and minerals as recommended by your bariatric program. \n\n\n\n\nBreakfast\n\n\nLunch\n\n\n\n\n\n2-egg white vegetable omelet with 1 slice low-fat cheddar cheese \n1 cup cooked oatmeal\nCoffee, black\n\n\n\n\n\n3 oz. lean, grass-fed ground beef\n1 whole-grain hamburger bun\n1 cup mixed greens with 1 Tbsp. oil and vinegar dressing\n\n\n\n\n\n\nMidmorning snack\n\n\nAfternoon snack\n\n\n\n\n\n1 cup Greek yogurt\n½ cup blueberries\n\n\n\n\n\n½ cup low-fat cottage cheese\n2 whole grain crackers\n\n\n\n\n\n\nDinner\n\n\n\n\n\n3 oz. broiled salmon\n1 cup steamed broccoli, chopped\n1 cup brown rice\n\n\n\n\n\nSummary\nEnjoy your weight loss journey beyond the numbers on the scale. Evaluate your body composition and muscle-building progress and, most importantly, gauge how you feel throughout the process. Don’t forget to utilize your support system and resources surrounding you.\nReferences\n1. Aggarwal R et al. Crit Rev Food Sci Nutr. 2022;62(9):2548-2559.2. Sherf Dagan S et al. Adv Nutr. 2017;8(2):382-394.3. Kerksick CM et al. J Int Soc Sports Nutr. 2017;14:33.\n\n*These statements have not been evaluated by the Food \u0026amp; Drug Administration (FDA). These products are not intended to diagnose, treat, cure, or prevent any disease.\nThis 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 regard 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.\nDr. Lillian Craggs-Dino is a retained consultant for Bariatric Fusion.