Changes in nutrient composition and diet quality in the first 6 months following bariatric surgery: An observational cohort study.

bariatric surgery diet quality food groups macronutrients nutrient composition obesity

Journal

Journal of human nutrition and dietetics : the official journal of the British Dietetic Association
ISSN: 1365-277X
Titre abrégé: J Hum Nutr Diet
Pays: England
ID NLM: 8904840

Informations de publication

Date de publication:
14 Nov 2023
Historique:
received: 22 05 2023
accepted: 26 10 2023
medline: 15 11 2023
pubmed: 15 11 2023
entrez: 15 11 2023
Statut: aheadofprint

Résumé

Bariatric surgery (BS) may result in inadequate nutrient intake and poor diet quality, which can lead to nutritional complications. The present study aimed to evaluate changes in macro- and micronutrient composition and diet quality in the first 6 months following BS. One hundred seven participants undergoing BS (Roux-en-Y gastric bypass: n = 87, sleeve gastrectomy: n = 20) completed 3-day food records before and 6 months after surgery. Changes in energy, macronutrient (carbohydrates, protein, fat, dietary fibre) and micronutrient intake (folate, vitamin B12, vitamin D, calcium, iron) were evaluated. Diet quality was assessed by adherence to the Dutch food-based dietary guidelines. After BS, we observed a significant decrease in intake of energy and all macro- and micronutrients (p < 0.01 for all), except for calcium (-39.0 ± 404.6 mg; p = 0.32). Overall, nutrient composition slightly changed with an increase in the relative intake of protein (+1.1 ± 4.3 energy percentage [en%]; p = 0.01) and mono- and disaccharides (+4.2 ± 6.4 en%; p < 0.001) post-surgery. Consumption (median [Q1, Q3]) of vegetables (-50 [-120, 6] g day Our results demonstrate both favourable and unfavourable changes in macro- and micronutrient composition and diet quality in the first 6 months following BS. Insight into these changes can improve dietary counselling in this population. Future research into underlying causes, consequences and long-term changes in dietary intake is needed.

Sections du résumé

BACKGROUND BACKGROUND
Bariatric surgery (BS) may result in inadequate nutrient intake and poor diet quality, which can lead to nutritional complications. The present study aimed to evaluate changes in macro- and micronutrient composition and diet quality in the first 6 months following BS.
METHODS METHODS
One hundred seven participants undergoing BS (Roux-en-Y gastric bypass: n = 87, sleeve gastrectomy: n = 20) completed 3-day food records before and 6 months after surgery. Changes in energy, macronutrient (carbohydrates, protein, fat, dietary fibre) and micronutrient intake (folate, vitamin B12, vitamin D, calcium, iron) were evaluated. Diet quality was assessed by adherence to the Dutch food-based dietary guidelines.
RESULTS RESULTS
After BS, we observed a significant decrease in intake of energy and all macro- and micronutrients (p < 0.01 for all), except for calcium (-39.0 ± 404.6 mg; p = 0.32). Overall, nutrient composition slightly changed with an increase in the relative intake of protein (+1.1 ± 4.3 energy percentage [en%]; p = 0.01) and mono- and disaccharides (+4.2 ± 6.4 en%; p < 0.001) post-surgery. Consumption (median [Q1, Q3]) of vegetables (-50 [-120, 6] g day
CONCLUSIONS CONCLUSIONS
Our results demonstrate both favourable and unfavourable changes in macro- and micronutrient composition and diet quality in the first 6 months following BS. Insight into these changes can improve dietary counselling in this population. Future research into underlying causes, consequences and long-term changes in dietary intake is needed.

Identifiants

pubmed: 37964680
doi: 10.1111/jhn.13258
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Nutrition and Healthcare Alliance

Informations de copyright

© 2023 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.

Références

Gloy VL, Briel M, Bhatt DL, Kashyap SR, Schauer PR, Mingrone G, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f5934.
O'Brien PE, Hindle A, Brennan L, Skinner S, Burton P, Smith A, et al. Long-term outcomes after bariatric surgery: a systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-year outcomes after adjustable gastric banding. Obes Surg. 2019;29(1):3-14.
Sjöström L, Peltonen M, Jacobson P, Sjöström CD, Karason K, Wedel H, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307(1):56-65.
Brown WA, Shikora S, Liem R, Holland J, Campbell AB, Sprinkhuizen SM, et al. Seventh IFSO Global Registry Report. 2022.
Lupoli R, Lembo E, Saldalamacchia G, Avola CK, Angrisani L, Capaldo B. Bariatric surgery and long-term nutritional issues. World J Diabetes. 2017;8(11):464-474.
Steenackers N, Vanuytsel T, Augustijns P, Tack J, Mertens A, Lannoo M, et al. Adaptations in gastrointestinal physiology after sleeve gastrectomy and Roux-en-Y gastric bypass. Lancet Gastroenterol Hepatol. 2021;6(3):225-237.
Osland E, Powlesland H, Guthrie T, Lewis CA, Memon MA. Micronutrient management following bariatric surgery: the role of the dietitian in the postoperative period. Ann Transl Med. 2020;8(Suppl 1):S9.
Gasmi A, Bjørklund G, Mujawdiya PK, Semenova Y, Peana M, Dosa A, et al. Micronutrients deficiences in patients after bariatric surgery. Eur J Nutr. 2022;61(1):55-67.
Zarshenas N, Tapsell LC, Neale EP, Batterham M, Talbot ML. The relationship between bariatric surgery and diet quality: a systematic review. Obes Surg. 2020;30(5):1768-1792.
Moizé VL, Pi-Sunyer X, Mochari H, Vidal J. Nutritional pyramid for post-gastric bypass patients. Obes Surg. 2010;20(8):1133-1141.
Sherf Dagan S, Goldenshluger A, Globus I, Schweiger C, Kessler Y, Kowen Sandbank G, et al. Nutritional recommendations for adult bariatric surgery patients: clinical practice. Adv Nutr. 2017;8(2):382-394.
Janssen-Burg W, van der Kaaden I, den Otter J, Punt M, Slabbekoorn A, Smelt M, et al. Dieetbehandelingsrichtlijn Bariatrische chirurgie bij obesitas II en III. 2017.
Kromhout D, Spaaij CJK, de Goede J, Weggemans RM. The 2015 Dutch food-based dietary guidelines. Eur J Clin Nutr. 2016;70(8):869-878.
Farias G, Silva RMO, da Silva PPP, Vilela RM, Bettini SC, Dâmaso AR, et al. Impact of dietary patterns according to NOVA food groups: 2 y after Roux-en-Y gastric bypass surgery. Nutrition. 2020;74:110746.
Kanerva N, Larsson I, Peltonen M, Lindroos AK, Carlsson LM. Changes in total energy intake and macronutrient composition after bariatric surgery predict long-term weight outcome: findings from the Swedish Obese Subjects (SOS) study. Am J Clin Nutr. 2017;106(1):136-145.
Raatz SK, Johnson LK, Caliquary A, King WC, Kalarchian MA, Devlin MJ, et al. Reported nutrient intake over 7 years after Roux-en-Y gastric bypass in the Longitudinal Assessment of Bariatric Surgery-3 (LABS-3) psychosocial study. Surg Obes Relat Dis. 2020;16(8):1022-1029.
Sherf Dagan S, Keidar A, Raziel A, Sakran N, Goitein D, Shibolet O, et al. Do bariatric patients follow dietary and lifestyle recommendations during the first postoperative year? Obes Surg. 2017;27(9):2258-2271.
Redpath TL, Livingstone MBE, Dunne AA, Boyd A, le Roux CW, Spector AC, et al. Methodological issues in assessing change in dietary intake and appetite following gastric bypass surgery: a systematic review. Obes Rev. 2021;22(6):e13202.
Nielsen MS, Christensen BJ, Ritz C, Holm L, Lunn S, Taekker L, et al. Factors associated with favorable changes in food preferences after bariatric surgery. Obes Surg. 2021;31(8):3514-3524.
Da Silva FBL, Gomes DL, De Carvalho KMB. Poor diet quality and postoperative time are independent risk factors for weight regain after Roux-en-Y gastric bypass. Nutrition. 2016;32(11-12):1250-1253.
Nymo S, Lundanes J, Aukan M, Sandvik J, Johnsen G, Graeslie H, et al. Diet and physical activity are associated with suboptimal weight loss and weight regain 10-15 years after Roux-en-Y gastric bypass: a cross-sectional study. Obes Res Clin Pract. 2022;16:163-169.
Freire RH, Borges MC, Alvarez-Leite JI, Correia MITD. Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass. Nutrition. 2012;28(1):53-58.
Harbury C, Collins CE, Callister R. Diet quality is lower among adults with a BMI >/=40kgm(-2) or a history of weight loss surgery. Obes Res Clin Pract. 2019;13(2):197-204.
Harbury CM, Verbruggen EE, Callister R, Collins CE. What do individuals with morbid obesity report as a usual dietary intake? A narrative review of available evidence. Clin Nutr ESPEN. 2016;13:e15-e22.
Hong YR, Yadav S, Suk R, Lee AM, Newsome FA, Johnson-Mann CN, et al. Assessment of physical activity and healthy eating behaviors among US adults receiving bariatric surgery. JAMA Netw Open. 2022;5(6):e2217380.
Marques da Silva M, Waitzberg DL, Sala P, Barcelos S, Santo MA, Martinez AC, et al. Nutritional guidance, monitoring, and supplementation before and after bariatric surgery-are we doing this correctly? Nutrición Hospitalaria. 2021;38(3):478-487.
Schiavo L, Di Rosa M, Tramontano S, Rossetti G, Iannelli A, Pilone V. Long-term results of the Mediterranean diet after sleeve gastrectomy. Obes Surg. 2020;30(10):3792-3802.
Soares FL, Bissoni de Sousa L, Corradi-Perini C, Ramos da Cruz MR, Nunes MGJ, Branco-Filho AJ. Food quality in the late postoperative period of bariatric surgery: an evaluation using the bariatric food pyramid. Obes Surg. 2014;24(9):1481-1486.
Ziadlou M, Hosseini-Esfahani F, Mozaffari Khosravi H, Hosseinpanah F, Barzin M, Khalaj A, et al. Dietary macro- and micro-nutrients intake adequacy at 6th and 12th month post-bariatric surgery. BMC Surg. 2020;20(1):232.
Ullrich J, Ernst B, Wilms B, Thurnheer M, Schultes B. Roux-en Y gastric bypass surgery reduces hedonic hunger and improves dietary habits in severely obese subjects. Obes Surg. 2013;23(1):50-55.
Miller GD, Norris A, Fernandez A. Changes in nutrients and food groups intake following laparoscopic Roux-en-Y gastric bypass (RYGB). Obes Surg. 2014;24(11):1926-1932.
Heusschen L, Berendsen AA, Balvers MG, Deden LN, de Vries JH, Hazebroek EJ. Relative validity of a short screener to assess diet quality in patients with severe obesity before and after bariatric surgery. Public Health Nutr. 2022;25:1-11.
Commission E, Eurostat, Co-operation OfE, Development. ISCED 2011 operational manual-guidelines for classifying national education programmes and related qualifications: Unesco; 2015.
NEVO-online versie 2016/5.0 Bilthoven, Nederland: RIVM.
Looman M, Feskens EJ, de Rijk M, Meijboom S, Biesbroek S, Temme EH, et al. Development and evaluation of the Dutch Healthy Diet Index 2015. Public Health Nutr. 2017;20(13):2289-2299.
Brink E, van Rossum C, Postma-Smeets A, Stafleu A, Wolvers D, van Dooren C, et al. Development of healthy and sustainable food-based dietary guidelines for the Netherlands. Public Health Nutr. 2019;22(13):2419-2435.
de Rijk MG, Slotegraaf AI, Brouwer-Brolsma EM, Perenboom CW, Feskens EJ, de Vries JH. Development and evaluation of a diet quality screener to assess adherence to the Dutch food-based dietary guidelines. Br J Nutr. 2021;128:1-11.
Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures-2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic amp; Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists. Off J Am Soc Bariatric Surg. 2020;16(2):175-247.
Ito MK, Gonçalves VSS, Faria SLCM, Moizé V, Porporatti AL, Guerra ENS, et al. Effect of protein intake on the protein status and lean mass of post-bariatric surgery patients: a systematic review. Obes Surg. 2017;27(2):502-512.
Steenackers N, Gesquiere I, Matthys C. The relevance of dietary protein after bariatric surgery: what do we know? Curr Opin Clin Nutr Metab Care. 2018;21(1):58-63.
Van Rossum CTM, Buurma-Rethans EJM, Dinnissen CS, Beukers MH, Brants HAM, Dekkers ALM, et al. The diet of the Dutch. Results of the Dutch National Food Consumption Survey 2012-2016. Bilthoven: National Institute for Public Health and the Environment; 2020.
van der Krieken SE, van Dooren C, Mensink F, Velema E, van der Vossen-Wijmenga WP, Stafleu A. Vegetables. Fact sheet: Netherlands Nutrition Centre; 2018.
Boerlage TCC, van de Laar AWJM, Westerlaken S, Gerdes VEA, Brandjes DPM. Gastrointestinal symptoms and food intolerance 2 years after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Br J Surg. 2017;104(4):393-400.
Freeman RA, Overs SE, Zarshenas N, Walton KL, Jorgensen JO. Food tolerance and diet quality following adjustable gastric banding, sleeve gastrectomy and Roux-en-Y gastric bypass. Obes Res Clin Pract. 2014;8(2):e183-e191.
Grosse CS, Cope VC. Dietary fibre intake and bowel habits after bariatric surgery: a structured literature review. Obes Surg. 2019;29(7):2247-2254.
Afshar S, Kelly SB, Seymour K, Woodcock S, Werner AD, Mathers JC. The effects of bariatric procedures on bowel habit. Obes Surg. 2016;26(10):2348-2354.
Ostad AN, Barghchi H, Jangjoo A, Ranjbar G, Rezvani R, Bahrami LS, et al. Macro- and micro-nutrient intake adequacy in gastric bypass patients after 24 months: a cross-sectional study. Clin Nutr Res. 2021;10(4):341-352.
Reichmann MTF, Todeschini S, Setter N, Vilela RM, Radominski RB. Comparison of the dietary intake amongst women in the late postoperative period after Roux-en-Y gastric bypass with the bariatric food pyramid. Nutr Hosp. 2019;36(3):599-603.
Ahmed K, Penney N, Darzi A, Purkayastha S. Taste changes after bariatric surgery: a systematic review. Obes Surg. 2018;28(10):3321-3332.
Molin Netto BD, Earthman CP, Farias G, Landi Masquio DC, Grotti Clemente AP, Peixoto P, et al. Eating patterns and food choice as determinant of weight loss and improvement of metabolic profile after RYGB. Nutrition. 2017;33:125-131.
Kapoor N, Al Najim W, Menezes C, Price RK, O'Boyle C, Bodnar Z, et al. A comparison of total food intake at a personalised buffet in people with obesity, before and 24 months after Roux-en-Y-gastric bypass surgery. Nutrients. 2021;13(11):3873.
Livingstone MBE, Redpath T, Naseer F, Boyd A, Martin M, Finlayson G, et al. Food intake following gastric bypass surgery: patients eat less but do not eat differently. J Nutr. 2022;152(11):2319-2332.
Søndergaard Nielsen M, Rasmussen S, Just Christensen B, Ritz C, le Roux CW, Berg Schmidt J, et al. Bariatric surgery does not affect food preferences, but individual changes in food preferences may predict weight loss. Obesity. 2018;26(12):1879-1887.
Aguas-Ayesa M, Yárnoz-Esquíroz P, Olazarán L, Gómez-Ambrosi J, Frühbeck G. Precision nutrition in the context of bariatric surgery. Rev Endocr Metab Disord. 2023;24:979-991.
Baboumian S, Pantazatos SP, Kothari S, McGinty J, Holst J, Geliebter A. Functional Magnetic Resonance Imaging (fMRI) of neural responses to visual and auditory food stimuli pre and post Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG). Neuroscience. 2019;409:290-298.
Ochner CN, Kwok Y, Conceição E, Pantazatos SP, Puma LM, Carnell S, et al. Selective reduction in neural responses to high calorie foods following gastric bypass surgery. Ann Surg. 2011;253(3):502-507.
Masood A, Alsheddi L, Alfayadh L, Bukhari B, Elawad R, Alfadda AA. Dietary and lifestyle factors serve as predictors of successful weight loss maintenance postbariatric surgery. J Obes. 2019;2019:1-6.
Gesquiere I, Foulon V, Augustijns P, Gils A, Lannoo M, Van der Schueren B, et al. Micronutrient intake, from diet and supplements, and association with status markers in pre- and post-RYGB patients. Clin Nutr. 2017;36(4):1175-1181.
DICA. DATO Bariatrische chirurgie-Jaarrapportage 2018. 2018.
Poslusna K, Ruprich J, de Vries JHM, Jakubikova M, van't Veer P. Misreporting of energy and micronutrient intake estimated by food records and 24 hour recalls, control and adjustment methods in practice. Br J Nutr. 2009;101(Suppl 2):S73-S85.
Trijsburg L, Geelen A, Hollman PC, Hulshof PJ, Feskens EJ, Van't Veer P, et al. BMI was found to be a consistent determinant related to misreporting of energy, protein and potassium intake using self-report and duplicate portion methods. Public Health Nutr. 2017;20(4):598-607.

Auteurs

Laura Heusschen (L)

Vitalys Obesity Clinic, Rijnstate Hospital, Arnhem, The Netherlands.
Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands.

Agnes A M Berendsen (AAM)

Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands.

Michiel G J Balvers (MGJ)

Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands.

Laura N Deden (LN)

Vitalys Obesity Clinic, Rijnstate Hospital, Arnhem, The Netherlands.

Jeanne H M de Vries (JHM)

Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands.

Eric J Hazebroek (EJ)

Vitalys Obesity Clinic, Rijnstate Hospital, Arnhem, The Netherlands.
Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands.

Classifications MeSH