Remedios Carlyne, Bhasker Aparna Govil, Dhulla Neha, Dhar Shilpa, Lakdawala Muffazal
Centre for Obesity and Digestive Surgery, CODS, ground floor, Shiv Tapi building, H. Goregaonkar Road, Opp. Motor House, Opera House, 400007, Mumbai, India.
Department of Minimal Access and Bariatric Surgery, Saifee Hospital, Mumbai, India.
Obes Surg. 2016 May;26(5):1057-68. doi: 10.1007/s11695-015-1836-y.
Bariatric surgery numbers have seen a sharp rise in India in the last decade. A country known for its undernourished population has seen economic growth and with it, greater influence of western culture and foods. The obesity epidemic is on the rise here and India is one of the 10 most obese nations of the world being second only to China in the number of type 2 diabetes. Nutritionists in India often rely on recommendations and guidelines meant for the Caucasian population. Religious and cultural practices influence the dietary habits and patterns of the Indian population to a great extent; because of which the nutritional requirements are very different. This document was put together with an aim to provide nutritionists with recommendations on how to manage the Indian bariatric patient.
A bariatric nutrition round table meeting was initiated by the Centre for Obesity and Digestive Surgery (CODS) to bring together experts in the field of bariatric nutrition to review current data on nutritional deficiencies in the morbid obese and existing post-operative deficiencies and to formulate nutritional recommendations for bariatric/metabolic surgery specific to patients from India.
Percentage of nutritional deficiencies and reasons for the same were identified among the Indian population and recommendations were made to suit this particular population.
It is recommended that all patients undergo compulsory pre-operative nutritional counseling and nutritional investigations and that nutritional follow-up be continued lifelong. In addition, long-term implications like hypoglycemia, dumping syndrome, sugar cravings, and weight regain, need to be picked up and managed efficiently. Most importantly, post-operative supplementation is a must irrespective of type of surgery.
在过去十年中,印度的减肥手术数量急剧上升。这个以营养不良人口众多而闻名的国家实现了经济增长,随之而来的是西方文化和食物的更大影响。肥胖症在这里呈上升趋势,印度是世界上最肥胖的10个国家之一,在2型糖尿病患者数量上仅次于中国。印度的营养学家常常依赖针对白种人群体的建议和指南。宗教和文化习俗在很大程度上影响着印度人口的饮食习惯和模式;因此,营养需求差异很大。编写本文件的目的是为营养学家提供关于如何管理印度减肥患者的建议。
肥胖与消化外科中心(CODS)发起了一次减肥营养圆桌会议,召集减肥营养领域的专家,回顾病态肥胖患者营养缺乏的现有数据以及术后现存的营养缺乏情况,并为来自印度的患者制定减肥/代谢手术的营养建议。
确定了印度人群中营养缺乏的百分比及其原因,并提出了适合这一特定人群的建议。
建议所有患者接受强制性术前营养咨询和营养检查,并终身持续进行营养随访。此外,需要有效识别和管理低血糖、倾倒综合征、嗜糖和体重反弹等长期影响。最重要的是,无论手术类型如何,术后补充营养都是必须的。