Sociodemographic and lifestyle factors as determinants of energy intake and macronutrient composition: a 10-year follow-up after bariatric surgery

Abstract

Background Early identification of the potential to adopt an unhealthy diet, long-term, could improve weight outcomes for patients having undergone bariatric surgery. Objectives We explored whether pre-surgical sociodemographic and lifestyle characteristics, together with the type of surgery, could predict 10-year changes in dietary intake following bariatric surgery. Setting Surgical departments and primary health care centers, nationwide. Methods Participants were from the Swedish Obese Subjects study, a matched (nonrandomized) prospective trial comparing bariatric surgery to standard care for obese patients. This study included the 1695 surgery patients with complete information on pre-surgery diet. Questionnaires were completed before and 0.5, 1–4, 6, 8, and 10 years after surgery. Analyses were conducted with linear mixed model. Results Dietary changes were observed in 1561, 1298, and 1243 participants, at the 2-, 6-, and 10-year follow-ups, respectively. Sex and treatment type predicted changes in energy, carbohydrate, protein, and fiber intake over the follow-up (P <.05). Furthermore, male sex, younger age, a sedentary behavior, and gastric bypass predicted increased alcohol consumption (P <.001). Two important phases for intervening bariatric patients’ diet were identified. The first was six months after surgery, when the maximal changes in diet were achieved. The second, stretched from the six-month until the 4-year after surgery, during which earlier commitments to dietary changes were largely abandoned. Conclusions Male sex and banding surgery in particular predicted unfavorable post-surgery changes in energy and macronutrient intake. Furthermore, gastric bypass, a younger age, and an unhealthy lifestyle pre-surgery, may predispose individuals to increased alcohol intake following surgery.

Sex and Gender Differences in Prevention of Type 2 Diabetes

“…A recent French retrospective study, including 16,620 patients who underwent bariatric surgery since 2009, found in a multivariable analysis that male sex, young age, no diagnosis of T2DM and poor 1 year follow-up was a predictor of poor 5-year follow-up ( 70 ). In studies with follow-up until 10 years after bariatric surgery, male sex was associated with an unfavorable energy and macronutrient intake and higher alcohol intake, which was also shown for younger age and sedentary behavior before surgery ( 71 ). Furthermore, male sex was associated with higher weight regain after RYGB procedure, next to other factors as white ethnicity and higher socioeconomic status ( 72 ).…”

Is There Any Change in Phenotypic Characteristics Comparing 5 to 10 Years of Follow-Up in Obese Patients Undergoing Roux-en-Y Gastric Bypass?

“…Obesity is a chronic disease that affects millions of individuals and its incidence has been increased in pandemic proportions 27 . Bariatric surgery is considered the most effective treatment, resulting in significant weight loss, as well as improvement of associated comorbidities 18 , 19 . Considering surgical techniques, Roux-en-Y gastric bypass (RYGB) is the most commonly performed surgical procedure 18 , 19 .…”

Evaluation of Dietary Assessment Tools Used in Bariatric Population

“…It is important to mention that little information was available about the form of questionnaires used. Five studies [ 66 , 69 , 71 , 93 , 120 ] used the Swedish Obese Subjects (SOS) study questionnaire [ 132 ] ( Table 3 ), which was adapted from a simplified dietary history interview and was previously validated using a 4-day FR, nitrogen urinary excretion and 24 h energy expenditure measured by indirect calorimetry in obese and non-obese population, but not in bariatric population.…”