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how registered dietician angie asche helped jake diekman after j-pouch surgery

During the final stages of Jake’s J-Pouch surgery, he and his wife Amanda reached out to me and hired me on as their dietitian. I own a private practice and have been working with athletes for the past several years, guiding them towards their nutrition and health goals (Jake was actually my first client to have the J-Pouch surgery). Jake had lost a significant amount of weight, and was hardly eating anything besides bread, potatoes, and bland chicken when we first started. Watching Jake’s progression over the course of his recovery has truly been one of the most rewarding experiences of my career.

It's important to know that everyone's body is different and what worked for Jake might not work for you. I'd like to share a few approaches I took with Jake that you or your loved one can consider:

1. Introduce one new food at a time

Once the off season began, I started meal prepping every meal for him. Our focus was to introduce one new food at a time. Every two days I added in something new, making sure he tolerated it well before introducing the next. Some of the first vegetables I had him try were cauliflower, zucchini, and carrots – all with skin and seeds removed and fully cooked. These were served in small portions, such as zucchini in noodle form mixed in with spaghetti noodles, or cauliflower in rice form blended into mac & cheese. As for meat, we kept red meat to a minimum and instead stuck with poultry and tofu to start (one of his favorites actually being tofu scramble!) This method really helped Jake feel confident eating more foods and branching out from the few he had felt so comfortable with post-op.

2. Increase calories each week

As for promoting weight gain, I calculated his calorie and macronutrient needs and spread this out into several meals and snacks throughout the day. Rather than making a large jump in both calories and volume from what he was currently eating, I increased his calories each week until he was up to the recommended range. This way, the portions of the meals never seemed to overwhelm him or cause discomfort.

3. Pay close attention to ingredients to find out what causes you discomfort

It’s very common for athletes to drink sports drinks as a quick and easy way to replenish carbohydrates and electrolytes. However, we learned very quickly that citric acid caused him pain and discomfort…and that it was in just about every type of sports drink (and in a lot more foods than you would imagine!) This made replenishing his electrolytes mid-game a little more challenging, but I was able to find a few different electrolyte products without citric acid that he tolerated well. If there’s an additive that causes you irritation, it’s so important to examine the ingredient list – even on foods you assume may not have it!

4. Keep a journal to track your food

The more I reviewed the post-op nutrition therapy protocols, the more I realized just how individualized each case is – a food one person may struggle with may not be an issue for someone else. Because each case can be so different, I think it’s important to keep a journal and to work alongside a dietitian to help find what works best for you.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your condition.

About Angie Asche

Angie Asche is a nationally recognized registered dietitian, sports nutritionist, and personal trainer. She works with high school, collegiate, and professional athletes in the MLB and NFL. Angie is the dietitian for the Nebraska volleyball team, as well as the owner of Eleat Sports Nutrition™, a virtual nutrition practice. Her expertise and recipes have been featured in numerous publications, including Men’s Fitness, Food Network, Shape, Self, Runner’s World, Fox News, and more. Angie also works with her favorite brands as a media spokesperson, consultant, and recipe developer. You can follow Angie on Instagram @eleatnutrition.


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