Bariatric Surgery Laboratory, Hospital Universitário Onofre Lopes HUOL, Av. Nilo Peçanha 620, Petrópolis, Natal, RN, CEP 59012-300, Brazil.
Instituto Vida, R. Ver. João Alves da Silva Filho 733, Tirol, Natal, RN, CEP 59014-530, Brazil.
Obes Surg. 2018 Jun;28(6):1540-1545. doi: 10.1007/s11695-017-2850-z.
Roux-en-Y gastric bypass (RYGB) surgery often leads to food intolerance, especially protein intake.
This is to investigate the association of food intolerance with protein intake and chewing parameters in patients who underwent RYGB surgery 2 years prior.
An observational study was carried out in 30 patients aged between 18 and 60 years old with at least a 2-year postoperative period since undergoing RYGB surgery. A specific questionnaire was applied to obtain a food tolerance score; a masticatory efficiency, chewing cycles, and time were evaluated with a standard test based on the size of the fragmentation of almonds and of meat after a certain chewing time. Protein intake was evaluated by 24-h dietary recall.
Mean age was 42.3 ± 11.2 years; mean body mass index was 33 ± 6 kg/m; and mean time since surgery was 4.9 years. The food tolerance score was 23.4 ± 3.3 points. There was no evidence of an association between food tolerance and chewing efficiency for meat (p = 0.28) nor between food tolerance and protein intake (Spearman correlation coefficient 0.03, p = 0.86). Regarding chewing efficiency with almonds, tolerance was higher in patients with optimal efficiency than among those with good and acceptable efficiency (p = 0.01).
In the evaluation of mastication using almonds, food tolerance increased with the number of chewing cycles and with greater chewing efficiency; the same association was not found in the evaluation using red meat.
Roux-en-Y 胃旁路（RYGB）手术常导致食物不耐受，尤其是蛋白质摄入。
本研究旨在调查 RYGB 术后 2 年患者的食物不耐受与蛋白质摄入和咀嚼参数的关系。
对 30 名年龄在 18 至 60 岁之间的患者进行了一项观察性研究，这些患者在接受 RYGB 手术后至少有 2 年的术后期。应用特定问卷获得食物耐受评分；通过基于杏仁和肉在一定咀嚼时间后碎裂大小的标准测试评估咀嚼效率、咀嚼周期和时间。通过 24 小时膳食回顾评估蛋白质摄入。
平均年龄为 42.3±11.2 岁；平均体重指数为 33±6kg/m2；术后时间平均为 4.9 年。食物耐受评分平均为 23.4±3.3 分。食物耐受与肉类咀嚼效率之间（p=0.28）或食物耐受与蛋白质摄入之间（Spearman 相关系数 0.03，p=0.86）均无相关性。在杏仁咀嚼效率方面，最佳效率患者的耐受程度高于良好和可接受效率患者（p=0.01）。
在使用杏仁评估咀嚼时，随着咀嚼次数和咀嚼效率的增加，食物耐受度增加；而在使用红肉评估时，未发现这种关联。
