Reading Nutrition Labels After Bariatric Surgery

Standing in the supermarket aisle after bariatric surgery, a quick shop can soon turn into a long one. You pick up a yoghurt labelled "high protein", put it back for one that says "no added sugar", then wonder whether either is the better choice. The front of the packs are full of claims that compete for your attention, but how do you know which one is best for you?

If this sounds familiar, you’re in the right place. This article explores how to read nutrition labels after bariatric surgery, from the Nutrition Information Panel to the ingredients list, so that choosing packaged foods becomes quicker and easier.

What Is the Nutrition Information Panel?

In New Zealand, most packaged foods carry a Nutrition Information Panel (NIP), usually on the back or side of the pack. It must list energy, protein, total fat, saturated fat, carbohydrate, sugars and sodium, shown both per serve and per 100g (or per 100ml for drinks). Fibre only has to appear if the product makes a claim about fibre, sugar or carbohydrates, for example “good source of fibre” or “low sugar.”

Energy is listed in kilojoules (kJ), sometimes alongside calories (Cal). To convert, divide kilojoules by about 4.2. A snack with 840kJ provides around 200 calories.

The ingredients list sits nearby and is always listed from the largest ingredient by weight to the smallest.

Per Serve or Per 100g?

The per 100g column is best for comparing products. Because every product is measured against the same amount, it quickly shows you which of two yoghurts or crackers is higher in sugar, fat or protein.

The per serve column shows what is in the manufacturer's serving size. After surgery, your portion is often smaller than the stated serve, so the figures may need adjusting. They can also vary greatly from product to product, so the per serve column isn’t a great benchmark for comparison. 

A Simple Guide for Sugar and Fat

After bariatric surgery, foods high in sugar or fat are often less well tolerated, and for some people they may contribute to symptoms known as dumping. A guide commonly used in bariatric nutrition care is:

• Packaged foods: less than 10g sugar and less than 10g total fat per 100g
• Drinks: less than 10g sugar and less than 10g total fat per serve

This is a starting point for comparing packaged products rather than a strict rule. Some whole foods, such as certain cheeses or nuts, may have a higher fat content and can still fit into a balanced post-surgery diet in suitable portions. Your nutritionist or dietitian can give you more guidance with this. 

What About "Sugar-Free" Products?

Many sugar-free and low-sugar products, particularly protein bars, are sweetened with sugar alcohols (polyols) such as sorbitol, maltitol, xylitol, erythritol and isomalt. These are not counted in the sugars line, but they appear in the ingredients list.

Sugar alcohols are generally well tolerated in small amounts, but larger amounts may cause bloating, wind or loose bowel motions. Products containing significant amounts must carry a statement that excess consumption may have a laxative effect. If you see that statement, start with a small amount and see how you go. 

Is the Health Star Rating Useful?

The Health Star Rating can help compare similar products in the same category, such as two breakfast cereals. It’s not designed to compare products between categories, for example breakfast cereal with peanut butter. 

Because the rating is calculated per 100g, energy-dense foods such as olive oil can score lower than expected, while some highly processed foods score well. It is also designed for the general population and does not account for bariatric nutrition needs. It can be helpful at a glance, but treat it as a starting point and look at the nutrition panel and ingredients list for the fuller picture.

Quick Label Checklist

• Look past front-of-pack claims and go straight to the Nutrition Information Panel
• Compare similar products using the per 100g column
• Check sugar and total fat against the <10g guide
• Read the first few ingredients to get a sense of what makes up the majority
• Check the protein per serve as this is typically a priority after surgery 
• Adjust per serve figures to the portion you actually eat

Less Label Reading, More Simple Recipes 

Cooking more meals at home is one of the simplest ways to rely less on packaged-food labels. Our Bariatric Recipe E-book Collection brings together breakfast, lunch and dinner recipes created for everyday life after bariatric surgery. Every recipe includes its nutrition information, so the hard work is already done for you.

References

• Food Standards Australia New Zealand. (n.d.). Nutrition information panels. https://www.foodstandards.gov.au/consumer/labelling/panels

Disclaimer: This article is general information and is not a substitute for individual advice. Your bariatric team, nutritionist or dietitian can help tailor these guides to your surgery type and stage of recovery.