Eat right to regain health after your bypass surgery

Good nutrition is important for us to be healthy, prevent many diseases and feel good, and is especially important for our hearts as heart disease is the number one killer disease today. Quite often we manage our ailments through lifestyle changes, medications or non-surgical procedures, but there are some medical conditions that need to be surgically managed and cardiac conditions are no exception to this.

A surgical procedure that is performed to resolve a problem in the heart is called a cardiac surgery or a heart operation. The most commonly performed type of cardiac surgery is Coronary Artery Bypass Graft also known as bypass surgery. A bypass surgery may be done via an open heart procedure where the rib cage is cut open to access the heart or a minimally invasive procedure where the heart is accessed through key holes without opening the rib cage. Bypass surgery has been used for the treatment of heart attack or coronary artery disease for more than 50 years, and has been performed for millions of people worldwide. The recovery process after a cardiac surgery can differ depending on varying procedures performed as part of the patient’s operative treatment. Caring for wounds and keeping up good health is mandatory after the surgery.

Dietary management after cardiac surgery

In the immediate post-operative period, nutrition is provided through an intravenous line in order to rest your gut and to allow your anaesthesia to wean off completely. This is known as parenteral nutrition and is planned by your surgical team and the hospital’s in-house dietician. Once your surgical team certifies you fit for oral food intake, you will be initiated on a healthy liquid-based diet that is easy to digest like soups, stews, protein-based drinks followed by semi-solid foods like porridge, smoothies etc. and then slowly progressed to a solid diet. You may notice that your appetite is poor and that the food has lost its flavour in the early post operative period. Your sense of smell may change and you may also experience a strange metallic taste in your mouth. This can be caused by the operation or your medications and can take some time to fully recover. Eating small amounts of food at frequent intervals is a good way to gradually build your digestive abilities.

Common dietary questions of individuals undergoing bypass surgery

There are some common questions that I face as a dietician from individuals who have undergone bypass surgery recently and would like to share them here for the benefit of the readers.

  1. What is the best diet after bypass surgery?

Our bodies get stressed when we are ill or have surgeries and it is very important to have good nutrition before your surgery (if it is a planned surgery) to help you heal faster after your surgery. Many studies have shown that a diet rich in fruits, vegetables, whole grains, nuts and seeds can reduce your risk of heart disease and help you heal better post surgery. A healthy balanced diet (2 serves of fruit, 5 serves of vegetables and 4 or more serves of whole grains per day, lean proteins and legumes, nuts and oil seeds, low fat dairy products) will help the body to heal, reduce the risk of complications and enable speedy recovery. Maintaining a well-balanced diet plays an integral part in reducing surgical complications and promoting heart disease reversal

2. How much protein should I consume on a daily basis?

You need a good proportion of protein and enough calories to heal after a cardiac surgery. The normal protein intake for a healthy individual is 1 gram per kilogram body weight whereas 1.2-1.5 grams per kilogram body weight are required per day if you have undergone a bypass surgery. It can be hard to meet your daily requirements because you may be on medications that affect your appetite. Taking small frequent protein-rich foods like lean meats soups, sprouts or ‘sundal’, low fat milk products, ‘dhals’ or legumes, mixed unsalted nuts and seeds can help you meet the protein requirements

3. What are the recommended levels of sugar and salt intake?

Sugar – sugary foods are often consumed instead of healthy foods and can contribute to poor blood sugar control and weight gain. Keep your blood sugars under control; high blood sugar also makes it hard for your body to heal. Added sugar in any form like white sugar, brown sugar, jaggery or honey is harmful and is best avoided or kept to a minimum.

Salt – reducing your salt intake or limiting your sodium intake to less than 1,500 mg per day helps by reducing fluid accumulation and preventing excessive stress on the heart. Cardiac patients are regularly advised to consume less than 5 g of salt per day (less than 1 tablespoon per day) which means that you need to follow low-salt cooking and avoid packaged foods, pickles, ‘papads’, crisps and other snacks which are high in hidden salt.

4. What foods should I avoid after my bypass surgery?

Foods with a high saturated fat content like liver and organ meats, egg yolk, whole milk, ghee, butter, cream and whole-milk cheese should be limited to once or twice a week. Fried foods, packaged and processed foods and pastries should be avoided completely as they are high in trans fat that is extremely unhealthy for the recovering body tissues.

5. How can I eat better to improve my good cholesterol or HDL (High Density Lipoproteins)?

High-density lipoprotein (HDL) is the good kind of cholesterol that will keep your arteries healthy. Mixed nuts and seeds, lean meat, fish and beans are the dietary sources to increase HDL level. Several medical and environmental factors such as sedentary lifestyle, uncontrolled blood sugar, inflammation, smoking and obesity are also responsible for low HDL cholesterol and should be aggressively modified.

6. How much of dietary fiber do I need?

Fiber is an important component of a healthy balanced meal. It acts as a natural laxative by increasing stool bulk, which allows stools to pass more readily through the colon. Most of the fiber is found in the husk and skin of fruits, vegetables, greens and whole grains. The normal requirement of fiber for an individual is 25-30 grams per day. Constipation is the biggest enemy for heart health and should be completely avoided in heart patients. Post surgery, you may have constipation due to improper food intake, less fruits, vegetables and whole grains in your diet, less fluid intake, medications and physical inactivity. Consuming adequate fiber will help to prevent constipation and keep your heart as well as gut healthy.

These are the most frequent and common questions asked by cardiac patients and their caregivers. Eating right is an art. Eating right after a surgery is extremely important to the healing process. Therefore, it is vital that you stick to the diet chart prescribed by your dietitian. Do not hesitate to ask questions or raise your concerns to your doctor or dietitian. Be sure to get the physical activity and exercise your physiotherapist recommends, stay away from smoking, keep your blood sugar and blood pressure under control, and do things that make you happy and help you relax.


Watch your Micro-Nutrient intake

Micronutrients play a crucial role in human nutrition, particularly in the prevention and treatment of various diseases. Though they are needed only in small amounts, these substances are essential to produce enzymes and hormones and regulate all body functions. Micronutrient deficiencies if left untreated can lead to symptoms and ailments of many organs including the heart and blood vessels. In other words, sufficient micronutrient intake in our daily diet helps to maintain cardiac function and to prevent many common health problems faced by people today.
Now let us take a detailed look at of some of the micronutrients known to impact heart health and also learn how to include them in our everyday cooking.

Magnesium is essential for the proper functioning of heart, muscles, kidneys, and other organs in the body. Magnesium deficiency is associated with higher blood pressure and cardiovascular disease. You should include varieties of nuts and legumes in your diet to avoid magnesium deficiency. The Recommended Dietary Allowance (RDA) of Magnesium is 340 mg/day for men and 310 mg/day for women.

Vitamin D is a fat-soluble vitamin that is naturally present in few foods. It is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Low levels of Vitamin D increases the risk of hypertension and diabetes, both known to cause cardiovascular disease. Intake of vitamin D-rich foods will help lower your risk of coronary heart disease. The RDA of Vitamin D is 400 IU/day.

Calcium is the key micronutrient for healthy bone and teeth. It also helps our heart, muscles, and nerves to work well. Calcium deficiency is associated with abnormal heart rhythm, also known as arrhythmia. Higher intake of calcium from food sources is known to lower the risk of atherosclerosis and maintain normal beating and pumping actions of the heart. RDA of Calcium is 600 mg/day.

Potassium helps the heart muscle to pump blood effectively throughout the body. Taking a good amount of potassium-rich foods will improve your blood pressure, lower your cholesterol and regulate your heartbeat. Low levels of potassium could cause heart rhythm disturbances and muscle weakness. RDA of potassium is 3750 mg/day for men and 3225 mg/day for women.

B vitamins like vitamin B9, B6, B12 have been linked to a healthy heart rhythm and lack of these can cause palpitation. Sources of folate (B9) include vegetables, fruits, whole or enriched grains, beans, and legumes. Pyridoxine (B6) sources include fish, vegetables, liver, meats and whole grain. RDA of Folic acid-vitamin Bis 200 mg/day, Cobalamin-vitamin B12 is 1 mg/day and Pyridoxine-vitamin B6 is 2 mg/day.

Vitamin C is a powerful antioxidant; it has the ability to block the damage caused by free radicals. Free radicals may accelerate ageing and contribute to the development of atherosclerosis. It’s through this antioxidant effect that vitamin C has an influence on heart health. RDA of Vitamin C is 40 mg/day.

This table gives the Recommended Dietary Allowance (RDA) for 100 grams of edible portion of these food substances. 

Note: We recommend adequate intake of natural foods containing the above micronutrients. We do not advise the use of commercially available supplements. If you have any health concerns, please follow the dietary advise of your healthcare provider or contact us for assistance.



A colourful plate for a healthy heart

Fruits and vegetables are high in vitamins, minerals and fiber – and they’re low in calories. Eating a variety of fruits and vegetables may help you control your weight and blood pressure. Fresh, filling and heart-healthy, fruits and vegetables are an important part of your overall healthy eating plan. The American Heart Association recommends eating five or more fruit and vegetable servings every day. Also variety matters, so try a wide range of fruits and veggies.

Keep it colorful

Challenge yourself to try fruits and vegetables of different colors. Make it a red/green/orange day (apple, green leafy vegetables, carrot), or see if you can consume a rainbow of fruits and vegetables during the week.


Fruit and vegetables

Antioxidants in fruit and vegetables offer protection against heart disease. Fruit and vegetables are also important sources of folate, which helps lower the blood levels of the amino acid homocysteine, which appears to be linked to an increased risk of heart disease.

Foods containing vitamin E 

Some studies indicate that vitamin E acts as an antioxidant, helping to protect against ‘bad’ cholesterol. Good sources of vitamin E include almonds, dark green vegetables, vegetable oils and wholegrain products. It is better to eat foods containing vitamin E rather than take supplements, which do not have the same protective nature.

Fruits containing Iron

Fruits and vegetables are rich sources of iron. Watermelon is a fruit that contains 1.5g of iron in 1/8 of a medium sized fruit. Watermelon is also rich in vitamin C which helps your body to absorb iron efficiently. Raisins are a good addition to oat meal or Payasam (Indian milk-based dessert) which can increase your iron intake. Mushrooms, dark green leafy vegetables, beans, peas are also good sources of iron.

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Citrus Fruits

Women who consume high amounts of the flavonoids found in oranges and grapefruits have a 19% lower risk of ischemic stroke(caused by a clot) than women who don’t get as much of these compounds, a recent study found. Citrus fruits are also high in vitamin C, which has been linked with a lower risk of heart disease. Oranges are an excellent source of vitamin C. They are also a very good source of dietary fibre. In addition, oranges are a good source of B vitamins including vitamin B1, pantothenic acid and folate as well as vitamin A, calcium, copper and potassium. An orange has over 170 different phytonutrients and more than 60 flavonoids, many of which have been shown to have anti-inflammatory, anti-tumour and blood clot inhibiting properties, as well as strong antioxidant effects.


Papaya may be beneficial to your heart health as it contains lycopene and vitamin C. The antioxidants in papaya may protect your heart and enhance the protective effects of HDL, the good cholesterol.


Pomegranates contain numerous antioxidants, including heart-promoting polyphenols and anthocyanins which may help stave off hardening of the arteries.


Creamy, rich and sweet bananas are a favourite food for everyone from infants to elders. Bananas are a good source of potassium an essential nutrient in maintaining blood pressure. Since one medium sized banana contains whopping 400mg of potassium the inclusion of bananas in your routine meal plan may help to prevent high blood pressure and protect again atherosclerosis. While bananas are a very low-fat food, one type of fat that they do contain is small amounts of sterols like sitosterol.  As these sterols look structurally similar to cholesterol, they can block the absorption of dietary cholesterol. By blocking absorption, they help us keep our blood cholesterol levels in check. They are good sources of vitamins, minerals and fibre.

Green leafy vegetables

A generous portion of green veggies in your daily diet can benefit your body .Greens make up a significant source vitamins A, C, E and K as well as several B vitamins. They are rich sources of minerals such as calcium, magnesium, iron and potassium. They are rich in fiber, extremely low in fat and carbohydrates and provide an excellent source of protein. Winter is the best time to enjoy leafy, green vegetables as they are fresh and can be consumed in a variety of ways. Add them to salads, have a green soup, make gravy or simply stuff  them in your sandwich. Whatever you choose, make sure you eat them.