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Stage 4 Diet

Duration: 5 weeks

Goals

  • 64 ounces of fluid/day (clear liquids + full liquids)
  • 60 grams of protein/day (Women)
  • 70 grams of protein/day (Men & Women 5’8” or taller) 

Guidelines

  • You may now add soft, moist protein foods. No fruits, vegetables or starchy carbohydrates yet. This means no potato, rice, pasta, bread, crackers, desserts.
  • Cut or chop all food into small pieces and be sure to chew thoroughly. Remember a bite should be the size of a dime. 
  • Make sure your food is very moist. Try adding low fat/low sugar condiments such as: broth, gravies, mayonnaise, marinades, sauces and salad dressings. Use moist cooking methods such as baking, roasting, steaming or poaching.
  • Use a food scale to make sure that you are getting the right amount of protein. Goal is 1-2 oz per meal to start, increasing to 3 oz as tolerated.
  • Eat SLOW.  Mindful eating is very important to make sure you are taking the time to chew your food.
  • Learn to recognize when you are full. Indications of fullness may be a pressure, tightness, or heaviness in the center of your abdomen just below the breast bone. Feelings of nausea, regurgitation, or heartburn are indications that too much has been eaten or the meal was eaten too quickly.
  • Stop eating if full. If you cannot eat the entire portion within 30 minutes, STOP.  Never force the food or beverage.
  • Do not drink any beverages during meals to prevent over-filling the stomach pouch.  Fluids should be separate from meals by about 30 minutes. Drinking while eating can push food through your pouch too quickly, leading to discomfort and possibly vomiting.  Drinking while eating may also cause early fullness, which could limit protein intake. 
  • Continue to food log, noting grams of protein and ounces of fluid.
  • You should now be taking your vitamins (MVIs, calcium citrates, and vitamin B12).  See Vitamin and Mineral Supplementation Guide for recommended schedule 

Soft Protein List 

Food

Serving Size

Grams of Protein/Serving

Greek yogurt (< 15 gm sugar per serving)

5.3 oz

12 - 18

Light yogurts (< 15 gm sugar per serving)

6-8 oz

5-8

Egg (large)

I egg

6

Egg White

3 Tbsp or 2 whites

5-7

Egg Substitute

3 Tbsp

5

Low Fat Cottage Cheese

1/3 cup

8 - 9

Low Fat Ricotta Cheese

1/3 cup

8 - 9

Low Fat Cheese

2 oz

14 - 16

Beef (lean)

2 oz

14 - 17

Chicken and turkey (skinless)

2 oz

14

Fish (tuna, haddock, salmon, etc)

2 oz

14

Shellfish

2 oz

7 - 9

Beans (kidney, black, refried, etc)

½ cup

7-10

Tofu

3 oz

8-12

Veggie burger (Garden Burgers, Boca, Morningstar Farms)

2 – 3 oz

varies

Tempeh

3 oz

15

Lentils

½ cup

9

* For products that have a nutrition facts label, refer to the label for the most accurate information regarding grams of protein.  Remember, the nutrition facts label is for “one serving”, so make sure you read what a serving is for a particular product, and adjust the grams of protein accordingly based on a 2 -3 oz portion.                                                                            

A quick way to count protein:

1 oz of meat, fish, poultry, and cheese = ~ 7 grams of protein

2 oz = ~ 14 grams of protein

3 oz = ~ 21 grams of protein

Stage 4:  Sample Meal/Fluid Plan to Meet Nutrition Goals

 

Time

 

Food or Beverage

Grams of Protein

Ounces of Fluid

7:00 am

8 ounces water

 

8

8:00 am (Meal 1)

1 scrambled egg

6

 

9:00 am

8 ounces decaf tea/coffee or water

 

8

10:30 am (Snack 1)

1 slice turkey breast + 1 slice Swiss cheese

14

 

11:30 am

8 ounces water

 

8

12:30 pm (Meal 2)

2 oz tuna with light mayo

14

 

1:30 pm

12 ounces water

 

12

3:30 pm (Snack 2)

5.3 oz Plain nonfat Greek yogurt

15

 

5:00 pm

8 ounces water

 

8

6:00 pm (Meal 3)

2 oz canned chicken with light mayo

14

 

7:00 pm

8 ounces Crystal light

 

8

8:00 pm (Snack 3)

1/4 cup low fat cottage cheese

7

 

9:00 pm

4 ounces sugar free jello

 

4

10:00 pm

8 ounces water

 

8

 

Totals

70 grams

64 ounces

 

 

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