The Department of Health, National Institute for Health and Welfare, Helsinki, Finland; The Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
The Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Department of Gastroenterology and Hepatology, Unit of Clinical Nutrition, Sahlgrenska University Hospital, Gothenburg, Sweden.
Surg Obes Relat Dis. 2017 Sep;13(9):1572-1583. doi: 10.1016/j.soard.2017.05.025. Epub 2017 Jun 1.
Early identification of the potential to adopt a long-term unhealthy diet, could improve weight outcomes for patients having undergone bariatric surgery.
We explored whether presurgical sociodemographic and lifestyle characteristics, together with the type of surgery, could predict 10-year changes in dietary intake after bariatric surgery.
Surgical departments and primary healthcare centers, nationwide.
Participants were from the Swedish Obese Subjects study, a matched (nonrandomized) prospective trial comparing bariatric surgery with standard care for obese patients. This study included the 1695 surgery patients with complete information on presurgery diet. Questionnaires were completed before and 6 months, 1-4, 6, 8, and 10 years after surgery. Analyses were conducted with linear mixed-model.
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 6 months after surgery, when the maximal changes in diet were achieved. The second, stretched from 6 months until 4 years after surgery, during which earlier commitments to dietary changes were largely abandoned.
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 presurgery, may predispose individuals to increased alcohol intake after surgery.
早期识别长期不健康饮食的倾向，可能改善接受减重手术患者的体重结局。
我们探讨了术前社会人口学和生活方式特征，以及手术类型，是否可以预测减重手术后 10 年内饮食摄入的变化。
全国范围内的外科部门和初级保健中心。
参与者来自瑞典肥胖受试者研究，这是一项比较减重手术与肥胖患者标准护理的配对（非随机）前瞻性试验。该研究包括了 1695 名手术患者，他们有完整的术前饮食信息。在手术前、手术后 6 个月、1-4 个月、6 个月、8 个月和 10 年时完成了问卷调查。分析采用线性混合模型进行。
在 2 年、6 年和 10 年的随访中，分别有 1561、1298 和 1243 名参与者观察到饮食变化。性别和治疗类型预测了随访期间能量、碳水化合物、蛋白质和纤维摄入的变化（P<.05）。此外，男性、年龄较小、久坐不动的行为和胃旁路手术预测了饮酒量的增加（P<.001）。确定了两个干预减重患者饮食的重要阶段。第一个阶段是手术后 6 个月，此时饮食变化最大。第二个阶段从手术后 6 个月持续到 4 年，在此期间，早期对饮食变化的承诺大部分被放弃。
男性和特别的带手术预测了术后能量和宏量营养素摄入的不利变化。此外，胃旁路手术、年龄较小和术前不健康的生活方式可能使个体在手术后更容易增加饮酒量。
