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饮食质量、身体活动和营养随访对 Roux-en-Y 胃旁路手术后体重反弹的决定作用。

Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass.

机构信息

Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

出版信息

Nutrition. 2012 Jan;28(1):53-8. doi: 10.1016/j.nut.2011.01.011. Epub 2011 Aug 31.

Abstract

OBJECTIVE

Assess the lifestyle habits, including food patterns, of patients who underwent Roux-en-Y gastric bypass (RYGB) and to identify predictive factors in weight loss and regain.

METHODS

Obese patients (100) who underwent RYGB from 1998 to 2008 were included. Dietary habits were assessed by using 24 h dietary recall and the Food Frequency Questionnaire. Rates of weight regain and the percentage of excess weight loss (EWL) were calculated. Patients were also asked whether they attended nutritional follow-up visits after the operation and about the type and regularity of physical activities.

RESULTS

The mean age was 45.1 ± 9.9 y, and the majority of the patients were women (84%). Mean EWL was 59.1 ± 20.3%. Weight regain was seen in 56% of the patients with 29% of the patients having regained over 10.1% of the minimum weight reached after RYGB. Weight regain increased significantly with time after surgery (up to 2 y: 14.7%; from 2 to 5 y: 69.7%; over 5 y: 84.8%). Poor diet quality characterized by excessive intake of calories, snacks, sweets, and fatty foods was statistically higher among those who regained weight. Sedentary lifestyle and lack of nutritional counseling follow-up were also significantly associated with regaining weight.

CONCLUSION

Despite satisfactory results of EWL, the patients did not properly maintain the lost weight, mainly after 5 y postsurgery. Major factors that influenced this weight gain were poor diet quality, sedentary lifestyle, and lack of nutritional counseling follow-up.

摘要

目的

评估接受 Roux-en-Y 胃旁路手术(RYGB)患者的生活方式习惯,包括饮食模式,并确定与减重和体重反弹相关的预测因素。

方法

纳入了 1998 年至 2008 年间接受 RYGB 的肥胖患者(100 例)。通过 24 小时膳食回忆和食物频率问卷评估饮食习惯。计算体重反弹率和体重减轻超过 10.1%的比例(EWL)。还询问了患者手术后是否接受营养随访以及体育活动的类型和规律。

结果

患者的平均年龄为 45.1 ± 9.9 岁,大多数为女性(84%)。平均 EWL 为 59.1 ± 20.3%。56%的患者出现了体重反弹,其中 29%的患者体重反弹超过了 RYGB 后达到的最低体重的 10.1%。体重反弹随着术后时间的增加而显著增加(术后 2 年:14.7%;2 至 5 年:69.7%;5 年以上:84.8%)。体重反弹患者的饮食质量较差,表现为摄入过多的卡路里、零食、甜食和高脂肪食物,这在统计学上更为明显。久坐的生活方式和缺乏营养咨询随访也与体重反弹显著相关。

结论

尽管 EWL 结果令人满意,但患者并没有很好地维持减轻的体重,主要是在手术后 5 年以后。影响体重增加的主要因素是饮食质量差、久坐的生活方式和缺乏营养咨询随访。

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