Changes in total energy intake and macronutrient composition after bariatric surgery predict long-term weight outcome: findings from the Swedish Obese Subjects (SOS) study

Kanerva, Noora; Larsson, Ingrid; Peltonen, Markku; Lindroos, Anna‐Karin; Carlsson, Lena

doi:10.3945/ajcn.116.149112

Cited by 73 publications

(80 citation statements)

References 33 publications

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“…However, it was reported that the strength of association between maximum weight loss and %EBWL in the immediate postoperative period and the first 3-months after LSG is twice as strong as in RYGB 8 . Moreover, Kanerva et al 11 demonstrated that in the short-term, considered 3 months after bariatric surgery, changing dietary macronutrient composition was associated with 10-year weight change. Better weight loss at 10 years was seen with diets higher in the proportion of protein than fat, higher in carbohydrate than fat, and higher in protein than carbohydrates.…”

Section: Discussionmentioning

confidence: 99%

“…Early postoperative weight loss is reported to be an important predictive factor for overall weight loss 1- and 3-years after bariatric surgery non-Asian 5 , 8 , 9 and Asian populations 10 . Kanerva et al 11 demonstrated that in the short-term, considered to be 6-months after bariatric surgery, changing dietary macronutrient composition affects 10-year postoperative weight. Therefore, early postoperative detection of poor weight loss is key to clinical decision-making regarding treatment interventions.…”

Section: Introductionmentioning

confidence: 99%

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Check point to get adequate weight loss within 6-months after laparoscopic sleeve gastrectomy for morbid obesity in Asian population

Chen

Lee

et al. 2020

Sci Rep

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Purpose of this study is to develope a scoring system to predict the likelihood of excess body weight loss (EBWL) ≥ 50% 6-months after laparoscopic sleeve gastrectomy (LSG). From April 2016 to September 2018, data was collected from 160 patients (BMI ≥ 32) who underwent primary LSG with at least 6-months follow-up. They were separated into score generation (operated by one surgeon, n = 122) and validation groups (operated by 3 different surgeons, n = 38). EBWL at 6-months ≥ 50% was considered adequate weight loss. Independent variables including age, gender, initial body mass index (BMI), comorbidities, life-style habits, percentage of EBWL and percentage of total body weight loss at 1-week, 1-month, and 3-months were analyzed with mutivariate logistic regression to generate the scoring system. The system was applied to internal and external validation groups to determine efficacy. As results, between the score generation and internal validation groups, the only significant difference in patient characteristics was in exercise participation. EBWL at 1-month > 19.5% (1 point) and EBWL at 3-months > 37.7% (2 points) were identified as independent factors to predict EBWL at 6-months ≥ 50%. When scores were > 1, the system had 94.03% positive predictive value (PPV) and 81.82% negative predictive value (NPV) (AUC: 0.923). Internal validation scores > 1 had a 95.83% PPV and 85.71% NPV (AUC: 0.975). External validation results showed 88.59% PPV and 72.00% NPV (AUC: 0.802). We concluded that this scoring system provides a reliable, objective prediction of EBWL at 6-months ≥ 50%. Patients requiring more aggressive clinical follow-up and intervention can be detected as early as 1- to 3-months after LSG.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Check point to get adequate weight loss within 6-months after laparoscopic sleeve gastrectomy for morbid obesity in Asian population

Chen

Lee

et al. 2020

Sci Rep

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“…In terms of eating behavior, it has been reported that bariatric surgery could benefit in improving eating behavior such as binge eating disorder, uncontrolled eating, night eating syndrome, grazing, reduced meal size, increased meal frequency, meal taste and smell, accelerated gastric emptying half-life, decreased T-lag phase duration [ 110 , 111 , 112 , 113 ]. However, deficiencies in protein, iron, zinc, copper, calcium, selenium, magnesium, folate, and vitamin B12, B1, D, ascorbic acid, and carotene have been reported in post-surgery cases [ 114 , 115 , 116 , 117 , 118 ]. For example, fat-soluble vitamin deficiencies are reported in malabsorptive procedures and thiamine deficiency was reported in cases with frequent nausea and vomiting [ 114 , 119 ].…”

Section: Metabolic Surgery Outcomes and Functional Foods In T2dm Mmentioning

confidence: 99%

Functional Foods and Lifestyle Approaches for Diabetes Prevention and Management

et al. 2017

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Functional foods contain biologically active ingredients associated with physiological health benefits for preventing and managing chronic diseases, such as type 2 diabetes mellitus (T2DM). A regular consumption of functional foods may be associated with enhanced anti-oxidant, anti-inflammatory, insulin sensitivity, and anti-cholesterol functions, which are considered integral to prevent and manage T2DM. Components of the Mediterranean diet (MD)—such as fruits, vegetables, oily fish, olive oil, and tree nuts—serve as a model for functional foods based on their natural contents of nutraceuticals, including polyphenols, terpenoids, flavonoids, alkaloids, sterols, pigments, and unsaturated fatty acids. Polyphenols within MD and polyphenol-rich herbs—such as coffee, green tea, black tea, and yerba maté—have shown clinically-meaningful benefits on metabolic and microvascular activities, cholesterol and fasting glucose lowering, and anti-inflammation and anti-oxidation in high-risk and T2DM patients. However, combining exercise with functional food consumption can trigger and augment several metabolic and cardiovascular protective benefits, but it is under-investigated in people with T2DM and bariatric surgery patients. Detecting functional food benefits can now rely on an “omics” biological profiling of individuals’ molecular, genetics, transcriptomics, proteomics, and metabolomics, but is under-investigated in multi-component interventions. A personalized approach for preventing and managing T2DM should consider biological and behavioral models, and embed nutrition education as part of lifestyle diabetes prevention studies. Functional foods may provide additional benefits in such an approach.

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“…Surgical procedures are effective for successful weight loss, but nutrient intake after surgery also plays a key role in achieving the long-term goals [ 2 , 4 ]. The recommended percentage of energy intake from carbohydrates after bariatric surgery is 35–48%, with an intake of at least 60–80 g protein/day [ 8 , 9 , 10 ]. There have been a number of studies on calorie intake and nutrient deficiency, but the results in relation to weight loss vary [ 3 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…The recommended percentage of energy intake from carbohydrates after bariatric surgery is 35–48%, with an intake of at least 60–80 g protein/day [ 8 , 9 , 10 ]. There have been a number of studies on calorie intake and nutrient deficiency, but the results in relation to weight loss vary [ 3 , 8 ]. In addition, the specific criteria guidelines for proper nutrient intake according to the surgical overtime point are insufficient.…”

Section: Introductionmentioning

confidence: 99%

Establishment of Adequate Nutrient Intake Criteria to Achieve Target Weight Loss in Patients Undergoing Bariatric Surgery

Lim

Kim²,

Lee³

et al. 2020

Nutrients

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Although bariatric surgery is the best treatment modality for morbidly obese patients, a 10–30% rate of weight recidivism has been reported in various specialized centers. We examined changes in energy and macronutrients after bariatric surgery and performed analysis to establish appropriate nutritional guidelines for reaching the target percentage of weight loss after surgery. A total of 189 subjects who underwent bariatric surgery were classified into success and failure groups depending on whether or not they reached 50% loss of excess weight at 12 months after bariatric surgery. Physical examinations and dietary surveys were completed before and 1, 6, and 12 months after surgery. Using receiver operating characteristic (ROC) analysis, the optimal cutoff points for nutrient intakes for determining success after bariatric surgery were computed based on maximal Youden’s index. At 6 and 12 months after surgery, the success group had significantly lower carbohydrate and fat intakes than the failure group. The cutoff calorie intake for success in weight loss was <835.0, <1132.5, and <1523.0 kcal/day at 1, 6, and 12 months post operation, respectively. With regard to protein, the cutoff intakes were >44.5, >41.5, and >86.5 g/day at 1, 6, and 12 months post operation, respectively. At 12 months, the cutoff ratio for energy obtained from carbohydrates, protein, and fat was <49.0, >24.5, and <28.0%, respectively. Our findings confirm that the level of diet control and nutrition restriction affect the achievement of target weight loss, emphasizing that long-term weight loss is related to compliance with nutrient recommendations.

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Changes in total energy intake and macronutrient composition after bariatric surgery predict long-term weight outcome: findings from the Swedish Obese Subjects (SOS) study

Cited by 73 publications

References 33 publications

Check point to get adequate weight loss within 6-months after laparoscopic sleeve gastrectomy for morbid obesity in Asian population

Check point to get adequate weight loss within 6-months after laparoscopic sleeve gastrectomy for morbid obesity in Asian population

Functional Foods and Lifestyle Approaches for Diabetes Prevention and Management

Establishment of Adequate Nutrient Intake Criteria to Achieve Target Weight Loss in Patients Undergoing Bariatric Surgery

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